20120792 Ver 2_401 Application_20121112

Engineers
`� • Planners
Pjivers Surveyors
Landscape Architects
&Associates,lnc.
sincelms
November 27, 2012
Thomas Brown
Raleigh Regulatory Field Office
US Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
Subject: Sheetz — Smithfield Business Park
SAW-2012-01604 (NWP 39)
Permit Modification Request
Rivers File - 2011103
Mr. Brown,
As discussed, we are requesting a modification to the NWP 39 (SAW - 2012 -01604 and DWQ #
12 -0792) previously issued for the subject project. The modification is being requested for
temporary impacts to wetlands associated with the installation of a flinch electrical conduit.
The temporarily impacted area is calculated to be approximately 0.01 acres (4' x 120'). The
proposed conduit will be installed by excavating a trench with a small backhoe and backfilled
with excavated material. The disturbed area will be returned to pre - construction grade and
allowed to re- vegetate. Page 5 of the enclosed Pre- Construction Notification form has revised to
include the proposed temporary wetland impact. Also enclosed is the revised wetland impact
exhibit map illustrating the location of the proposed flinch electrical conduit.
The previously issued permit was issued for 0.29 acres of permanent impacts (fill) to 404
wetlands. This request is for 0.01 acres of temporary impacts, bringing the total wetland impacts
(permanent and temporary) to 0.30 acres.
Thank you for your assistance. Should you require any additional information, please do not
hesitate to contact me.
Respectfully,
E. EWiMIham--s-.,`AICP EP
Project Planner
Enclosures
CC: Martin Richmond, DWQ (w/ enclosures)
107 Fast Second Street, Greenville,NC 27858 • Post Office Box 929 • Greenville, NO 27535 • (252) 7524135 • FAX [phone]
NOBELS IAA. No. F -0334 ti www.riversandassociates.com NCBOLA Uc. No. 0-312

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2, - D i 9 a. U a.
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre - Construction Notification Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the
Corps:
®Section 404 Permit ❑ Section 10 Permit
1b. Specify Nationwide Permit (NWP) number. 39 or General Permit (GP) number.
1c. Has the NWP or GP number been verified by the Corps?
® Yes
❑ No
Id. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
le. Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
❑ Yes ❑ No
For the record only for Corps Permit:
❑ Yes ❑ No
1f. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in -lieu
fee program.
®Yes
[I No
19. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yes
® No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2. Project lnfbrmatton
2a. Name of project:
Sheet
2b. County:
Johnston
2c. Nearest municipality / town:
Smithfield
2d. Subdivision name:
Smithfield Business Park
2e. NCDOT only, T.I.P. or state
project no:
N/A
3. Owner Information
3a. Name(s) on Recorded Deed:
Motoparthy Properdes, LLC
3b. Deed Book and Page No.
DB 2444, Pg 534
3c. Responsible Party (for LLC if
applicable):
Dr. V. C. Motoparthy
3d. Street address:
105 Cashwell Drive
3e. City, state, zip:
Goldsboro, NC 27534
3f. Telephone no.:
919 -731 -2528
3g. Fax no.:
3h. Email address:
[e-mail]
Page 1 of 11
PCN Form — Version 1.3 December 10, 2008 Version

AL Applicant Information (if different from owner)
4a. Applicant is:
❑ Agent Other, specify. Purchaser
4b. Name:
Sheetz, Inc.
4c. Business name
Of applicable):
Sheetz, Inc.
4d. Street address:
5700 Sixth Avenue
4e. City, state, zip:
Altoona, PA 16602
4f. Telephone no.:
919- 437 -9859
4g. Fax no.:
4h. Email address:
[e-mail]
5. AgentfConsultent Information (If applicable)
5a. Name:
Dwight Vemelson, P. E.
5b. Business name
(i applicable):
Rivers and Associates, Inc.
5c. Street address:
107 E. 2n° Street
5d. City, state, zip:
Greenville, NC 27834
5e. Telephone no.:
252 - 752.4135
5f. Fax no.:
252- 752 -3974
5g. Email address:
dvemerison @dversandassodates.ccm
Page 2 of 11
PCN Form — Version 1.3 December 10, 2008 Version

S. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
260305 -09 -7276 and 260305 -09 -5299
1b. Site coordinates (in decimal degrees):
Latitude: 35.5044 Longitude: - 78.3256
(DD.DDDDDD) ( -DD.DDDDDD)
1c. Property size:
2.419 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
Neuse River
proposed project:
2b. Water Quality Classification of nearest receiving water.
WS V - NSW
2c. River basin:
Neuse
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
Site is currently vacant with small trees and underbrush coveing the property. Burger King restaurant is located to the
east, vacant lots to the south, Golden Coral restaurant
3b. List the total estimated acreage of all existing wetlands on the property:
Subject parcels 1 and 2 have an approximate total of 32,930 sf (0.75 acres). Entire Smithfied Business Park site has an
approximate total of 1.7 acres (0.185 have already been permitted/filled during earlier phase of development).
3a. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
WA
3d. Explain the purpose of the proposed project:
Sheetz is a convenience store with gasoline sales and a restaurant.
3e. Describe the overall project in detail, including the type of equipment to be used:
Construction of a Sheetz gas station. Typical commercial development construction equipment will be utilized. Grading
and excavation equipment will be used during installation of on -site utilities. Paving equipment will be used during
parking lot constriction. Mobile cranes may be utilized during building constriction.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
®Yes [I No ❑Unknown
project (including all prior phases) in the past?
Comments: Preliminary JD for development of business park.
4b. If the Corps made the jurisdictional determination, what type
19 Preliminary ❑Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas?
Agency /Consultant Company: Soil and Environmental
Name (if known): Bob Zarzecki
Consultants
Other.
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Action ID: 2010 -00735 (May 19, 2010)
6. Project History
5a. Have permits or certifications been requested or obtained for
❑Yes ®No ❑Unknown
this project (including all prior phases) in the past?
5b. if yes, explain in detail according to °help file' instructions.
Page 3 of 11
PCN Form — Version 1.3 December 10, 2008 Version

S. Future Project Plans
6a. Is this a phased project? ❑ Yes ® No
6b. If yes, explain.
Page 4 of 11
PCN Form — Version 1.3 December 10, 2008 Version

C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
® Wetlands ❑ Streams - tributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
2b.
2c.
2d.
2e.
2f.
Wetland impact
Type of jurisdiction
number —
Type of Impact
Type of wetland
Forested
(Corps - 404,10
Area of Impact
Permanent (P) or
(if known)
DWQ — non -404, other)
(saes)
Temporary
W1 ® P ❑ T
Fill
Non - Riparian
❑ Yes
® No
® Corps
❑ DWQ
0.28
W2 ❑ POT
Excavation
Non - Riparian
❑ Yes
® No
® Corps
❑ DWQ
0.01
W3 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W4 ❑ P [IT
❑ Yes
❑ Corps
❑ No
❑ DWQ
W5 ❑ P [IT
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 ❑ P ❑ T
❑Yes
❑ Corps
❑ No
❑ DWQ
2g. Total wetland Impacts
0.30
2h. Comments: W2 will be a temporary impact (4'x 120) to install a 44nch electric utility conduit/line below grade. Area will
be returned to preclisturbed grade.
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
3b.
3c.
3d.
3e.
3f.
3g.
Stream Impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number -
(PER) or
(Corps - 404,10
stream
length
Permanent (P) or
intermittent
DWO — non -404,
width
(linear
Temporary m
(INT)?
other)
(feet)
fW)
S1 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S2 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S3 ❑ POT
❑ PER
❑ Corps
❑ INT
❑ DWQ
S4 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S5 ❑ P [IT
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 [] P ❑ T
❑ PER
❑ Corps
❑ INT
❑DWQ
3h. Total stream and
tributary impacts
n/a
3i. Comments:
Page 5 of 11
PCN Form —Version 1.3 December 10, 2008 Version

4. Open Water Impacts
If there are proposed Impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then Individually list all open water Impacts below.
4a.
4b.
4c.
4d.
4e.
Open water
Name of waterbody
impact number —
(if applicable)
Type of impact
Waterbody type
Area of Impact (acres)
Permanent (P) or
Temporary
01 ❑P [IT
02 ❑P [IT
03 ❑P ❑T
04 ❑P ❑T
4L Total open water Impacts
n/a
4g. Comments:
5. Pond or Lake Construction
ff Pond or lake construction proposed, then complete the chart below.
5a.
5b.
5c.
5d.
5e.
Pond ID
proposed use or purpose
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
(acres)
number
of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5E Total
n/a
n/a
n/a
n/a
n/a
n/a
n/a
59. Comments: n/a
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
51. Expected pond surface area (acres):
5j. Size of pond watershed (awes):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will Impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any Impacts require miligation, then you MUST fill out Section D of this form.
68.
Tar-Pamlico ❑ Other
Project is in which protected basin?
❑ Catawba
atawba ❑ Randleman
6b.
6c.
6d.
Be.
Of.
69.
Buffer Impact
number —
Reason
Buffer
Zone 1 Impact
Zone 2 impact
Pemnanent (P) or
for
Stream name
mitigation
(square feet)
(square feet)
Temporary
impact
uired?
B1 ❑ PC] T
❑Yes
❑ No
B2 ❑P [IT
❑Yes
❑ No
B3 ❑P ❑T
[I Yes
❑ No
6h. Total buffer impacts
n/a
n/a
61. Comments:
Page 6 of 11
PCN Form — Version 1.3 December 10, 2008 Version

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Configuration was done in a manner to locate proposed improvements outside of regulated wetlands to the extent possible
while maintaing a functionable site. Unavoidable impacts have been limited to an amount below the requested NWP 39
threshold.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
A retaining wall will be installed to minimize the amount of fill necessary for proposed site Improvements.
2 Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State?
® Yes ❑ No
2b. If yes, mitigation Is required by (check all that apply):
® DWQ ® Corps
2c. If yes, which mitigation option will be used for this
project?
❑ Mitigation bank
®Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete If Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter)
Type
Quantity
3c. Comments:
4. Complete If Making a Payment to In -Ileu Fee Program
4a. Approval letter from in -lieu fee program is attached.
® Yes
4b. Stream mitigation requested:
n/a linear feet
4c. If using stream mitigation, stream temperature:
❑ warm ❑ cool []cold
4d. Buffer mitigation requested (DWQ only):
n/a square feet
4e. Riparian wetland mitigation requested:
n/a acres
4f. Non - riparian wetland mitigation requested:
0.58 acres
4g. Coastal (tidal) wetland mitigation requested:
n/a acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
En/a ng a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 7 of 11
PCN Form — Version 1.3 December 10, 2008 Version

S. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation
❑ Yes ® No
6b. If yes, then Identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
Zone
6c.
Reason for impact
6d.
Total impact
(square feet)
Multiplier
6e.
Required mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund).
6h. Comments:
Page 8 of 11
PCN Form — Version 1.3 December 10, 2008 Version

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. DNfuse Flow Plan
1a. Does the project include or Is it adjacent to protected riparian buffers identified
❑Yes No
within one of the NC Riparian Buffer Protection Rules?
1b. If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes ❑ No
Comments:
2 Stormwater Management Plan
2a. What is the overall percent imperviousness of this project?
61.7%
2b. Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: SW Plan for Smithfield Business Paris
previously approved bj Town of Smithfield (reference attached Johnston County Register of Deeds Map Book 75 Page
157 recorded June 11 , 2010)
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
® Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan?
❑ DWQ Stonnwater Program
❑ DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. in which local governments jurisdiction is this project?
Town of Smithfield
❑ Phase 11
3b. Which of the following locally4mplemented stormwater management programs
® NSW
❑ USMP
apply (check all that apply):
❑ Water Supply Watershed
❑ Other.
3c. Has the approved Stormwater Management Plan with proof of approval been
® Yes ❑ No
attached?
4. DWQ Stormwater Program Review
❑ Coastal counties
4a. Which of the following state- implemented stormwater management programs apply
❑ HQW
❑ 0RW
(check all that apply):
❑ Session Law 2006 -246
❑ Other.
4b. Has the approved Stormwater Management Plan with proof of approval been
attached?
❑ Yes ❑ No
6. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b. Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 9 of 11
PCN Form — Version 1.3 December 10, 2008 Version

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal/state/local) funds or the
❑ Yes ® No
use of public (federal/state) land?
1b. If you answered "yes' to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes ❑ No
(North Carolina) Environmental Policy Act (NEPAISEPA)?
1 c. If you answered "yes° to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.)
❑ Yes ❑ No
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Welland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
❑ Yes ® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after - the -fact permit application?
❑ Yes ® No
2c. N you answered "yes° to one or both of the above questions, provide an explanation of the Volation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in
yes No
additional development, which could impact nearby downstream water quality?
3b. If you answered 'yes° to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered 'no,' provide a short narrative description.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non - discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
The proposed project will conned to existing municipal wastewater collection and treatment infrastructure current
available at property line.
Page 10 of 11
PCN Form — Version 1.3 December 10, 2008 Version

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
❑ Yes ® No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
❑ Yes No
®
Impacts?
Raleigh
❑
5c. If yes, indicate the USFWS Field Office you have contacted.
❑ Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
On -site visit and NC Natural Heritage Program
G. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
On -site visit
T. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
❑Yes No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
On -site visit
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA -designated 100 -year floodplain?
❑ Yes ® No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? FEMA Floodmap 3720260200J
Originally
J. Dwight Vernelson, P.E.
Submitted
8-20-12
Applicant/Agenrs Printed Name
p nt/Agenrs Signature
Rev. 11 -27 -12
(Ag a nature is only if an authorization letter from the applicant
Date
Is
Page 11 of 11
PCN Form — Version 1.3 December 10, 2008 Version

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U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. RE: SAW- 2012 -01604 County: Johnston U.S.G.S. Quad: NC -SELMA
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Property Owner: Sheetz
Tom Anastasi
Address: 5700 Sixth Avenue
Altoona, PA. 16602
ent: Rivers and Associates
Ben Williams
Address: 107 East Second Street
Greenville, NC, 27834
Size and location of property (water body, road name /number, town, etc.): The project site is located on the south side of
US Hwy 70 Business, just west of its intersection with Industrial park Drive, Smithfield, Johnston County, NC. Latitude
35.5048 Loneitude - 78.3256
Description of projects area and activity: This permit authorizes 0.29 acre of wetland fill associated with a commercial
development. This permit also authorizes 0.01 acres of temporary impacts associated with a utility line.
Applicable Law: ® Section 404 (Clean Water Act, 33 USC 1344)
❑ Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: Regional General Permit Number or Nationwide Permit Number: NWP 39 Commercial and Institutional
Developments.
SEE ATTACHED NATIONWIDE AND SPECIAL CONDITIONS, AND COMPENSATORY MITIGATION
RESPONSIBILITY TRANSFER FORM
Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with the attached
conditions and your submitted application and attached information dated 8/20/2012. Any violation of the attached conditions
or deviation from your submitted plans may subject the permittee to a stop work order, a restoration order and/or
appropriate legal action.
This verification will remain valid until the expiration date identified below unless the nationwide authorization is modified,
suspended or revoked. If, prior to the expiration date identified below, the nationwide permit authorization is reissued and/or
modified, this verification will remain valid until the expiration date identified below, provided it complies with all requirements of
the modified nationwide permit. If the nationwide permit authorization expires or is suspended, revoked, or is modified, such that the
activity would no longer comply with the terms and conditions of the nationwide permit, activities which have commenced (i.e., are
under construction) or are under contract to commence in reliance upon the nationwide permit, will remain authorized provided the
activity is completed within twelve months of the date of the nationwide permit's expiration, modification or revocation, unless
discretionary authority has been exercised on a case -by -case basis to modify, suspend or revoke the authorization.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality Certification. You
should contact the NC Division of Water Quality (telephone [phone]) to determine Section 401 requirements.
For activities occurring within the twenty coastal counties subject to regulation under the Coastal Area Management Act (CAMA),
prior to beginning work you must contact the N.C. Division of Coastal Management .
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other required Federal,
State or local approvals/permits.
If there are any questions regarding this verification, any of the conditions of the Permit, or the Corps of Engineers regulatory
program, please contact Thomas Brown at 919 -554- 4884 x22.
BROWN.THOMAS.L.1282'
Corps Regulatory Official 125397 °.-WA MOMA MI" Date: November 27.2012
w,emiain .sew mm
Expiration Date of Verification: November 27, 2014
The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we continue to do so,
please complete the attached customer Satisfaction Survey or visit http:// per2 .nyM.usace.army.mil /survey.htmi to complete the survey
online.
Copy Furnished:
Motoparthy Propeties, LLC
105 Cashwell Drive
Goldsboro, NC 27534

Determination of Jurisdiction:
A. ❑ Based on preliminary information, there appear to be waters of the US including wetlands within the above described project
area. This preliminary determination is not an appealable action under the Regulatory Program Administrative Appeal Process
( Reference 33 CFR Part 331).
B. ❑ There are Navigable Waters of the United States within the above described project area subject to the permit requirements of
Section 10 of the Rivers and Harbors Act and Section 404 of the Clean Water Act. Unless there is a change in the law or our
published regulations, this determination may be relied upon for a period not to exceed five years from the date of this
notification.
C. ❑ There are waters of the US and/or wetlands within the above described project area subject to the permit requirements of
Section 404 of the Clean Water Act (CWA)(33 USC § 1344). Unless there is a change in the law or our published regulations,
this determination may be relied upon for a period not to exceed five years from the date of this notification.
D. ® The jurisdictional areas within the above described project area have been identified under a previous action. Please reference
jurisdictional determination issued 5/19/2010. Action ID 2010- 00735.
Basis For Determination
The site exhibits wetland criteria as defined in the 1987 Corps Wetland Delineation Manual and appropriate Regional
Supplement.
Remarks
Attention USDA Program Participants
This delineation/determination has been conducted to identify the limits of Corps' Clean Water Act jurisdiction for the particular site
identified in this request. The delineation/determination may not be valid for the wetland conservation provisions of the Food Security
Act of 1985. If you or your tenant are USDA Program participants, or anticipate participation in USDA programs, you should request
a certified wetland determination from the local office of the Natural Resources Conservation Service, prior to starting work.
F. Appeals Information (This information applies only to approved jurisdictional determinations as indicated in B and C
above).
This correspondence constitutes an approved jurisdictional determination for the above described site. If you object to this
determination, you may request an administrative appeal under Corps regulations at 33 CFR Part 331. Enclosed you will find a
Notification of Appeal Process (NAP) fact sheet and request for appeal (RFA) form. If you request to appeal this determination you
must submit a completed RFA form to the following address:
US Army Corps of Engineers
South Atlantic Division
Attn: Jason Steele, Review Officer
60 Forsyth Street SW, Room 10M15
Atlanta, Georgia 30303 -8801
Phone: [phone]
In order for an RFA to be accepted by the Corps, the Corps must determine that it is complete, that it meets the criteria for appeal
under 33 CFR part 331.5, and that it has been received by the Division Office within 60 days of the date of the NAP. Should you
decide to submit an RFA form, it must be received at the above address by
* *It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this correspondence. **
BR0WN.TH0MAS.L. 128212539 02ftRU&d= � „ "u”'
Corps Regulatory Official: 7 SROM'"°"�"U2125M
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30,7.11.271.30.57-0=
Date: November 27.2012 Expiration Date: November 27, 2014
Copy furnished:

Attached
is:
See Section below
INITIAL PROFFERED PERMIT Standard Permit or Letter of ermission
A
PROFFERED PERMIT Standard Permit or Letter of permission)
B
PERMIT DENIAL
C
APPROVED JURISDICTIONAL DETERMINATION
D
PRELIMINARY JURISDICTIONAL DETERMINATION
E
A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
OBJECT: If you object to the permit (Standard or LOP) because of certain terms and conditions therein, you may request
that the permit be modified accordingly. You must complete Section II of this form and return the form to the district
engineer. Your objections must be received by the district engineer within 60 days of the date of this notice, or you will
forfeit your right to appeal the permit in the future. Upon receipt of your letter, the district engineer will evaluate your
objections and may: (a) modify the permit to address all of your concerns, (b) modify the permit to address some of your
objections, or (c) not modify the permit having determined that the permit should be issued as previously written. After
evaluating your objections, the district engineer will send you a proffered permit for your reconsideration, as indicated in
Section B below.
B: PROFFERED PERMIT: You may accept or appeal the permit
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• APPEAL: If you choose to decline the proffered permit (Standard or LOP) because of certain terms and conditions therein,
you may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of
this form and sending the form to the division engineer. This form must be received by the division engineer within 60 days
of the date of this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process by
completing Section II of this form and sending the form to the division engineer. This form must be received by the division
engineer within 60 days of the date of this notice.
D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or provide new
information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the
date of this notice, means that you accept the approved JD in its entirety, and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD, you may appeal the approved JD under the Corps of Engineers
Administrative Appeal Process by completing Section II of this form and sending the form to the district engineer. This form
must be received by the division engineer within 60 days of the date of this notice.

E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps regarding the
preliminary JD. The Preliminary JD is not appealable. If you wish, you may request an approved JD (which may be appealed),
by contacting the Corps district for further instruction. Also you may provide new information for further consideration by the
Corps to reevaluate the JD.
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your objections to an initial
proffered permit in clear concise statements. You may attach additional information to this form to clarify where your reasons or
objections are addressed in the administrative record.)
ADDITIONAL INFORMATION: The appeal is limited to a review of the administrative record, the Corps memorandum for the
record of the appeal conference or meeting, and any supplemental information that the review officer has determined is needed to
clarify the administrative record. Neither the appellant nor the Corps may add new information or analyses to the record.
However, you may provide additional information to clarify the location of information that is already in the administrative
record.
If you have questions regarding this decision and/or the If you only have questions regarding the appeal process you may
appeal process you may contact: also contact:
District Engineer, Wilmington Regulatory Division, Mr. Jason Steele, Administrative Appeal Review Officer
Attn: Thomas Brown CESAD -PDO
Raleigh Regulltory Field Office U.S. Army Corps of Engineers, South Atlantic Division
3331 Heritage Trade Dr, Suite 105 60 Forsyth Street, Room 1OM15
Wake Forest, NC 27587 Atlanta, Georgia 30303 -8801
Phone: [phone]
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel, and any government
consultants, to conduct investigations of the project site during the course of the appeal process. You will be provided a 15 day
notice of any site investigation, and will have the opportunity to participate in all site investi ations.
Date: Telephone number:
Signature of appellant or agent.
For appeals on Initial Proffered Permits send this form to:
District Engineer, Wilmington Regulatory Division, Attn: Thomas Brown, 69 Darlington Avenue, Wilmington, North
Carolina 28403
For Permit denials, Proffered Permits and approved Jurisdictional Determinations send this form to:
Division Engineer, Commander, U.S. Army Engineer Division, South Atlantic, Attn: Mr. Jason Steele, Administrative
Appeal Officer, CESAD -PDO, 60 Forsyth Street, Room 1OM15, Atlanta, Georgia 30303 -8801
Phone: [phone]

SAW - 2012 -01604
Special conditions:
November 27, 2012
In order to compensate for impacts associated with this permit, mitigation shall be provided in
accordance with the provisions outlined on the most recent version of the attached Compensatory Mitigation
Responsibility Transfer Form. The requirements of this form, including any special conditions listed on this
form, are hereby incorporated as special conditions of this permit authorization."

Action ID Number: SAW -2012 -01604 County: Johnston
Permittee• Sheetz
Date Permit Issued: November 27, 2012
Project Manager: Thomas Brown
Upon completion of the activity authorized by this permit and any mitigation required by the permit,
sign this certification and return it to the following address:
US ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Attn: Thomas Brown
Raleigh Regualtory Field Office
3331 Heritage Trade Dr, Suite 105
Wake Forest, NC 27587
Please note that your permitted activity is subject to a compliance inspection by a U. S. Army Corps of
Engineers representative. If you fail to comply with this permit you are subject to permit suspension,
modification, or revocation.
I hereby certify that the work authorized by the above referenced permit has been completed in
accordance with the terms and condition of the said permit, and required mitigation was completed in
accordance with the permit conditions.
Signature of Permittee Date