20130361 Ver 1_401 Application_20130413

I
2013036 1
Jackson Square
Lexington, Davidson County, NC
Nationwide Permit PCN Submittal
Prepared For
Tom Honeycutt
Jackson Square Housing, LLC
P.O. Box 504
Troy, NC 27371
Prepared By:
Leonard S. Rindner, PLLC
Wetlands and Environmental Planning Group
3714 Spokeshave Lane
Matthews, NC 28105
(704) 904 -2277
April 4, 2013
APR - 5 2013

ot wArF19
vi r
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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre - Construction Notification (PCN) Form
A. Appkant Information
1. Processing
1a. Type(s) of approval sought from the
Corps:
®Section 404 Permit ❑Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 29 or General Permit (GP) number.
1c. Has the NWP or GP number been verified by the Corps?
® Yes
❑ No
1d. 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
1e. 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
® No
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yes
® No
1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
[:]Yes
® No
2. Project Information
2a. Name of project:
Jackson Square
2b. County:
Davidson County
2c. Nearest municipality / town:
Lexington
2d. Subdivision name:
Jackson Square
2e. NCDOT only, T.I.P. or state
project no:
3. Owner Information
3a. Name(s) on Recorded Deed:
Jackson Square Housing LLC
3b. Deed Book and Page No.
Same, bk 2089 pg 363 - 367
3c. Responsible Party (for LLC if
applicable):
Attn: Tom Honeycutt; Southern Property & Development, LLC
3d. Street address:
PO Box 504
3e. City, state, zip:
Troy, NC 27371
p
3f. Telephone no.:
704 9981189
3g. Fax no.:
APP _
3h. Email address:
tom @spropllc.com
DENR - _wATEft UALIITTY
Page 1 of 11
PCN Form — Version 1.3 December 10, 2008 Version

4. Applicant Information (if different from owner)
4a. Applicant is:
❑ Agent ® Other, specify: Owners Representative
4b. Name:
Mr.Tom Honeycutt
4c. Business name
(if applicable):
Southern Property & Development, LLC
4d. Street address:
PO Box 504
4e. City, state, zip:
Troy, NC 27371
4f. Telephone no.:
704 9981189
4g. Fax no.:
4h. Email address:
tom @sproplic.com
5. Agent/Consultant Information (if applicable)
5a. Name:
Leonard S. Rindner
5b. Business name
(if applicable):
Leonard S. Rindner, PLLC
5c. Street address:
3714 Spokeshave Lane
5d. City, state, zip:
Matthews, NC 28105
5e. Telephone no.:
704 - 904 -2277
51'. Fax no.:
5g. Email address:
Len.Rindner.PWS @gmail.com
Page 2 of 11
PCN Form — Version 1.3 December 10, 2008 Version

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
6726 -03 -00 -5831
1b. Site coordinates (in decimal degrees):
Latitude: 35.8330 Longitude: - 80.2802
(DD.DDDDDD) (- DD.DDDDDD)
1c. Property size:
+/- 4.67 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
UT of Swearing Creek 03040103
proposed project:
2b. Water Quality Classification of nearest receiving water:
Water Classification - C
2c. River basin:
Lower Yadkin
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:
The site consist mature woodland area in mid succession; previously disturbed areas. The site is adjacent to existing
commercial development and near NC Hwy 52/NC Hwy 64 interchange.
3b. List the total estimated acreage of all existing wetlands on the property:
Approximately 0.08 acres of wetlands and streams
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
approximately 80 linear feet
3d. Explain the purpose of the proposed project:
Fill minor stream channel and small wetland areas for prepare site for construction of multi - family development including
buildings, roads, parking, gradings; and stormwater management facility.
3e. Describe the overall project in detail, including the type of equipment to be used:
The project is a multi - family residential development consisting of buildings, roads, parking, gradings; and stormwater
management facility. Impacts are limited to 80 linear feet of stream for road crossings and +/-.07 acres of wetland
impacts.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
® Yes ❑ No ❑ Unknown
project (including all prior phases) in the past?
Comments:
4b. If the Corps made the jurisdictional determination, what type
❑ Preliminary ® Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas?
Agency /Consultant Company: Leonard S. Rindner, PLLC
Name (if known): Leonard S. Rindner /Pat Kealy
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
The delineation was field verified by John Thomas (USACE) and Sue Homewood (NCDENR) on 12/15/12.
5. 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

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)
(acres)
Temporary T
W1 ®P ❑ T
Fill - NWP 29
PSSlAIPFO1A
® Yes
❑ No
®
® DWQ WQ
.062 acres
❑ Yes
❑ Corps
W2 ❑ PDT
❑ No
❑ DWQ
W3 ❑ P [IT
❑ Yes
❑ No
❑ Corps
❑ DWQ
W4 ❑ P ❑ T
® Yes
❑ No
❑ Corps
❑ DWQ
W5 ❑ P ❑ T
❑ Yes
❑ No
❑ Corps
❑ DWQ
W6 ❑ P ❑ T
❑ Yes
❑ No
❑ Corps
❑ DWQ
2g. Total wetland impacts
0.062
2h. Comments: Approximately 0.03 acres of the wetlands are associated with a former sediment basin that has naturalized
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
DWQ — non -404,
width
(linear feet)
Temporary (T)
(INT)?
other)
(feet)
S1 ®P ❑ T
Fill - NWP #29
UT of Swearing
Creek
❑ PER
® INT
® Corps
® DWQ
3
80.3 LF
(unimportant
per USACE)
S2 ❑ P ❑ T
❑ PER
❑ INT
❑ Corps
❑ DWQ
S3 ❑ P ❑ T
❑ PER
❑ INT
❑ Corps
❑ DWQ
S4 ❑ P FIT
❑ PER
❑ Corps
❑ INT
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
3h. Total stream and tributary impacts
80.3 linear
feet
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.
Open water
impact number —
Permanent (P)
or Temporary
4b.
Name of
waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody type
4e.
Area of impact (acres)
01 ❑P ❑T
02 ❑P ❑T
03 ❑P ❑T
04 ❑ PC] T
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a.
Pond ID
number
5b.
Proposed use or purpose
of pond
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f. Total
5g. Comments:
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
Page 6 of 11
PCN Form — Version 1.3 December 10, 2008 Version

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 mitigation, then you MUST fill out Section D of this form.
6a.
❑ Neuse ❑Tar- Pamlico El Other:
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b.
6c.
6d.
6e.
6f.
6g.
Buffer impact
number—
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P)
for
Stream name
mitigation
(square feet)
(square feet)
or Temporary
impact
required?
B1 ❑P❑T
❑Yes
❑ No
B2 ❑P
El Yes
❑ No
B3 ❑P
El Yes
❑ No
6h. Total buffer impacts
61. Comments:
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Impacts are limited to a minor wetland impact and unavoidable fill due to grading requirements.Proposed impacts are less
than 150 linear feet of stream and less than 1/10"' acre of wetlands. Avoidance would require over 20' retaining retaining
walls.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Project is subject to strict enforcement of erosion control plan.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
❑ Yes ® No
impacts to Waters of the U.S. or Waters of the State?
2b. If yes, mitigation is required by (check all that apply):
❑ DWQ ❑ Corps
❑ Mitigation bank
2c. If yes, which mitigation option will be used for this
❑ payment to in -lieu fee program
project?
❑ Permittee Responsible Mitigation
3. Complete N Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter)
[Type
Quantity
Page 7 of 11
PCN Form — Version 1.3 December 10, 2008 Version

3c. Comments: NA
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
❑ Yes
4b. Stream mitigation requested:
linear feet
4c. If using stream mitigation, stream temperature:
❑ warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested:
acres
4f. Non - riparian wetland mitigation requested:
acres
4g. Coastal (tidal) wetland mitigation requested:
acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
6. 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. Diffuse 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?
approximatelty 40 %
2b. Does this project require a Stormwater Management Plan?
® Yes ❑ No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
A stormwater management plan has been prepared by the civil engineer per NCDENR 2007 BMP Manual in accordance
with 401 WQC conditions. As required, the final stormwater plans and /or approvals will be submitted to NCDENR for
approval prior to any impacts to streams and wetlands.
The plans were prepared by and submitted under a separate cover by:
Tim Clinkscales PE, PLS
PARAMOUNTE ENGINEERING, INC
5911 Oleander Drive, Suite 201
Wilmington, NC 28403
OFFICE: (910) 791 -6707
CELL: (910) 520 -1991
FAX: [phone]
www.paramounte - eng.com
❑ Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan?
❑ DWQ Stormwater Program
® DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project?
® Phase II
3b. Which of the following locally - implemented 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
4a. Which of the following state- implemented stormwater management programs apply
❑ Coastal counties
❑ HQW
(check all that apply):
❑ ORW
Page 9 of 11
PCN Form — Version 1.3 December 10, 2008 Version

F.
Supplementary Information
1.
Environmental Documentation (DWQ Requirement)
la.
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 (NEPA/SEPA)?
1c.
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
❑ Yes
❑ No
letter.)
Comments:
2.
Violations (DWQ Requirement)
2a.
Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland 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.
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(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.
The project connects to an existing municipal road and utility infrastructure.
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.
Will connect with existing municipal sewer system
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?
E] 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?
Site was evaluated during the wetland delineation process for the presence of Schweinitz's Sunflower. The existing
vegetation along road sides is maintained lawn. Ecotonal edges along roads and clearings were inspected to determine
if Schweinitz's sunflower was present. Project site is not in a watershed that has been identified as habitat for the Carolina
heelsplitter. Based on a field evaluation Schweinitz's sunflower or it's habitat was determined not to be present.
6. 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?
http: //www. nmfs. noaa. gov /habitaVhabitatprotection/efh/G I S_inve n. htm
7. 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?
According to the latest published version of the National Register of Historic Places for the presence or absence of
registered properties, or properties listed as being eligible for inclusion therein, this site is not registered property or
property listed as being eligible for inclusion in the Register. There are no known existing historical structures on the site.
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 determinatio er /engineer provided information
Leonard S. Rindner, PLLC
4/4/13
Applicant/Agent's Printed Name
cant/Agent's Signature
Date
(Agent's sig atu �is valid only if an authorization letter from the applicant
is provided.)
Page 11 of 11
PCN Form — Version 1.3 December 10, 2008 Version

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Pat McCrory Charles Wakild, P. E. John E. Skvarla, III
Governor Director Secretary
February 19, 2013
Mr. Len Rindner
Wetlands & Environmental Planning Group
3714 Spokeshave Lane
Matthews, NC 28105
Subject Property: Hwy 52 -Hwy 64 Development Site, Lexington NC, Davidson County
On -Site Determination for Applicability to the Mitigation Rules (15A NCAC 2H .0506(h))
Dear Mr. Ridner:
On December 15, 2012, at your request and in your attendance, Sue Homewood conducted an on -site
determination to review features located on the subject property for intermittent /perennial determinations
with regards to the above noted state regulations. John Thomas with the US Army Corps of Engineers
(USACE) was also present at the site visit. The features that were reviewed are identified on the attached
map.
The Division acknowledges the areas and boundaries identified as jurisdictional wetlands by the USACE. The
channel identified as C1 -4 on the attached map was determined to be an intermittent stream from the
wetland boundary to the property line.
Please note that at the time of this letter, all intermittent and perennial stream channels and jurisdictional
wetlands found on the property are subject to the mitigation rules cited above. These regulations are subject
to change in the future.
The owner (or future owners) should notify the DWQ (and other relevant agencies) of this decision in any
future correspondences concerning this property. This on -site determination shall expire five (5) years from
the date of this letter.
North Carolina Division of Water Quality, Winston -Salem Regional Office
Location 585 Waughtown St. Winston - Salem, North Carolina 27107
Phone 336 - 771 -50001 FAX 336 - 771 -46301Customer Service 1- 877.623 -6748
Internet www ncwaterqualdy org
An Equal Opportunity 1 Affirmative Action Employer
NofthCarolina
Naturally

Len Rindner
Hwy 52 -Hwy 64 Development Site Stream Determination
February 19, 2013
Page 2 of 2
Landowners or affected parties that dispute a determination made by the DWQ or Delegated Local Authority
that a surface water exists and that it is subject to the buffer rule may request a determination by the
Director. A request for a determination by the Director shall be referred to the Director in writing c/o Cyndi
Karoly, DWQ 401 Oversight /Express Review Permitting Unit, 2321 Crabtree Blvd., Suite 250, Raleigh, NC
27604 -2260. Individuals that dispute a determination by the DWQ or Delegated Local Authority that
"exempts" surface water from the buffer rule may ask for an adjudicatory hearing. You must act within 60
days of the date that you receive this letter. Applicants are hereby notified that the 60 -day statutory appeal
time does not start until the affected party (including downstream and adjacent landowners) is notified of
this decision. DWQ recommends that the applicant conduct this notification in order to be certain that third
party appeals are made in a timely manner. To ask for a hearing, send a written petition, which conforms to
Chapter 150B of the North Carolina General Statutes to the Office of Administrative Hearings, 6714 Mail
Service Center, Raleigh, N.C. 27699 -6714. This determination is final and binding unless you ask for a hearing
within 60 days.
This letter only addresses the applicability to the mitigation rules and the buffer rules and does not approve
any activity within Waters of the United States or Waters of the State or their associated buffers. If you have
any additional questions or require additional information please contact me at 336 - 771 -4964 or
sue.homewood @ncdenr.gov
Sincerely,
Sue Homewood
DWQ Winston -Salem Regional Office
Enclosures: USGS Topo Map
Wetlands & Environmental Planning Group Map
cc: Tom Honeycutt, Southern Properties & Development LLC (via email)
RBC Lexington LLC, 311 Odell Myers Rd, Advance NC 27006
John Thomas, USACE Raleigh Regulatory Office (via email)
DWQ Winston -Salem Regional Office

LEONARD S. RINDNER PLLC
Environmental Planning Consultant 3714 Spokeshave Lane
Professional Wetland Scientist Matthews, NC 28105
Land Planning Tele: (704) 904 -2277
March 28, 2013
Mr. Tom I loneycutt
Re: Jackson Square, Lexington, Davidson County, NC
Dear Mr. Honeycutt:
In order to interface with the United States Army Corps of Engineers and the North
Carolina Department of Natural Resources I will need your authorization. Please sign the
following statement:
This letter authorizes Leonard S. Rindner, PLLC as our firm's agent in matters related
to Waters of the U.S and Waters of North Carolina for the referenced project site. This
includes interfacing with the United States Army Corps of Engineers and the North
Cs.
tB' t3
Signatu a Date
Please contact me if you have any questions or require additional explanation. Thank
you.
Sincere
Leonard S. Rindner, PWS
Environmental Planning Consultant
Profession Wetland Scientist

World - Unded States • NC • Davidson Co • Lexhgton
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FIGURE NO. LEONARD S. RINDNER PLLC JACKSON SQUARE SHEET
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BY 3714 Spokeshave Lane
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(704) 904 - 2277 VICINITY MAP
[e-mail] APPROXIMATE LOCATION 030113

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LATITUDE LONGITUDE
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LOWER YADKIN
FIGURE NO. LEONARD S. RINDNER PLLC JACKSON SQUARE SHEET
Wetlands & Environmental Planning Group DRAWN REVIEWED
Lexington, NC BY PJK BY LSR
3714 Spokeshave Lane
Matthews, NC 28105 USGS LOCATION MAP DATE PACE
(704) 904 - 2277 APPROXIMATE LOCATION
[e-mail] LEXINGTON WEST (NC) QUADRANGLE 03129113
1950 Revised 1994

JACKSON SQUARE: LEXINGTON, NC
SITE ~ ��
` WETLAND B1 - 4(w)
LOCATE CL & WIDTH �o
"Verified by USACE/NCDENR
SEASONAL RPW on 11/15112
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'Verified by USACE/NCDENR on WETLAND Al — 7
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FIGURE NO. LEONARD S. RINDNER PLLC JACKSON SQUARE SHM
Wetlands & Environmental Planning Group Lexington, NC DRAWN e PJK �Y"ED LSR
3714 Spokeshave Lane
Matthews, NC 28105 DATE PAGE
(704) 9D4 — 2277 APPROXIMATE MAP FOR SURVEY 10123112
LEN.RINDNER.PWS @gmail.com WATERS THE U. S. •Revised
FOR STUDY PURPOSES ONLY
SUIUECFTO USACE /NCDENR VERIFICATION 1111542

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SITE
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FIGURE NO. LEONARD S. RINDNER PLLC
Wetlands & Environmental Planning Group
3714 Spokeshave Lane
Matthews, NC 28105
\ (704) 9D4 - 2277
[e-mail]
JACKSON SQUARE
SHEET
Lexington, NC
DRAWN PJK
REVIEWED LSR
DATE
PAGE
APPROXIMATE MAP FOR SURVEY
10123112
WATERS OF THE U. S.
- Revised
FOR STUDY PURPOSES ONLY
11115112
SUBIECTTO USACE/NCDENR VERIFICATION

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"71PG94

Jackson Square
NC DENR Retention Requirements
Objective, design a wet detention basin with the following charactenstics: a permanent water pool depth between 3- and
6 -feet, a surface area that meets TSS removal requirements (values set by NC DENR and included here), a fombay that
is approximately 20% of the total pond volume, a temporary water pool sized to detain the initial 1.0 inch of rainfall runoff, an
outlet device that drains the temporary water pool within 2 -5 days
Step 1: Determine the surface area required for 85% TSS removal
Post - Development Conditions
Total Drainage Area 466 ACRE Value from CAD
Impervious Drainage Area 187 ACRE Value from CAD
Impervious Cover 40.1% Impervious Covem(Imperv/ous Drainage
AreaffTotal Drainage Ama)•100%
Elevation of Permanent Pool Surface
755.0
FT
Value selected by designer
Depth of Permanent Pool
5.0
FT
Value selected by designer
Elevation of Wet Detention Pond Bottom
750.0
FT
(Bottom Elevetion) =(Permanent Pool Surface
Volume Below Permanent Pool
6,554
CF
Elevation)- (Depth of Permanent Pool)
Approximate Pond Length
85
FT
Value from CAD
Approximate Pond Width
38
FT
Value from CAD
Len h:Width Ratio
2:1
Ratio= Len th 1 Wdth .1
Required SAIDA Ratio for 85% TSS Removal 125 Value from chart. Reference: 85% TSS Removal
Required Permanent Pool Surface Area 2,637 SF Required Surface Area= (Required SA/)A
Ratio) *(Total Drainage Area)
Provided Permanent Pool Surface Area 2,576 SF Interpolated value Irom stage - storage calculations
Step 2: Determine the 1 -inch runoff elevation within the wet detention pond
Runoff Coefficient, Rv
0 411
IN/IN
Rv=O 05 +0.009 -(% Impervious)
Required 1.0" Runoff Volume (Volume of
6955
CF
f.0" Runoff Vo1ume =1.5 inch'Rv'1 foot/12
Temporary Pool)
,
inch'(Total Drainage Area)
Volume Below Permanent Pool
6,554
CF
Value from stage - storage calculations (cumulative
pond volume at permanent pool elevation)
Total Volume to be Controlled
13,509
'
CF
Total Volume to be Controlled = (Volume Below
Permanent Poo)+(1.5" Runoff Volume)
Storage Elevation at Required Volume
756.86
FT
Value is interpolation based upon stage - storage
values. See stage-storaaa calcutatinnR
4�{ : y
r L •

Step 3: Calculate the required forebay volume (18 -22% of total pond volume) and compare to the forebay volume provideo
Total Pond Volume 6,554 CF Value from stage - storage calculations
Required Total Forebay Volume 1,311 CF Forebey Volume= Total Pond Volume '2030
Provided Total Forebay Volume 1,213 CF Value from stage-storage calculations
Provided Forebay Volume:Total Pond Volume 19% (Provided Forebay Volume) /(Total Pond
Volume)'10030
Step 4: Verify that time required to drawdown the 1 -inch runoff volume is within 2 to 5 days
Diameter of Proposed Low -flow Orifice
100
IN
Value chosen by designer
Elevation of Outlet Structure
75500
FT
Value chosen by designer
Total Elevation Head Above Orifice
2.40
FT
(Total Elevation Head Above Orifice) =(Weir
Elevation) - (Elevation of Permanent Pool Surface)
(Average Elevation Head Above Oriffce)= ((Storage
Average Elevation Head Above Orifice
080
FT
Elevation at Required Volume) +(Elevedon of
Permanent Pool Sufface))/3-(Storage Elevation at
Required Volume)
Cd, Coefficient of Discharge
060
Value chosen by designer
Q, Flowrate Through Low -flow Onfice
0.02
CFS
Q= Cd'(Pi)'((Diameter of Orifice) *(1 R112
in) ^2/4' '32.? (Avers a Head) "12
Drawdown Time for 1 -inch Runoff
3.43
DAYS
( Drawdown Trme) =(i.5" Runoll Volume�Q'(1

HWY 52 - HWY 64: LEXINGTON, NC
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3583303 N 8028024W
HUC 03040103
LOWER VADKIN
FIGURE NO.
LEONARD S. RINDNER PLLC
HWY S2 - HWY 64
SHEET
Wetlands & Environmental Planning Group
Lexington, NC
D AWN PJK
!
3714 Spokeshave Large
LISGS LOCATION MAP
DATE
PAGE
I ilk'
1 •�
_'� ' '1 ' '; ''C� ? • _ • ° - - - � = ' -
UP
0 � I _ „- _
/ %f .
LOCATION:
SCALE
LATITUDE LONGITUDE
18W 900 0 1800(Feet)
3583303 N 8028024W
HUC 03040103
LOWER VADKIN
FIGURE NO.
LEONARD S. RINDNER PLLC
HWY S2 - HWY 64
SHEET
Wetlands & Environmental Planning Group
Lexington, NC
D AWN PJK
��D LSR
3714 Spokeshave Large
LISGS LOCATION MAP
DATE
PAGE
Matthews, NC 28105
(704) 904 — 2277
[e-mail]
APPROXIMATE LOCATION
10112112
LEXINGTON WEST (NC) QUADRANGLE
2950 Revised 1994
_t

HWY 52 -HWY 64: LEXINGTON, NC
f } SITE
.n I fib' ,,! � 1 rr�' � • / . , _. _ - - ,
792
• r
WETLAND B1— 4(w)
POTENTIAL RPW �, LOCATE CL & WIDTH 'a y
\ - Subject to USACE NCDENR C�
C1 —4 i e verfication } ~�
LOCATE CL 8 WIDTH
' 'Subject to USACE/NCDENR
verification `6'p WETLAND Al -7
1i � , - ti` Naturalized Detention Basin
1 >�
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•dry. O
(8.09A) - 4 -67A 7722 � .6
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Scale fin =1501t f
FIGURE NO. LEONARD S. RINDNER PLLC HWY 52 — HWY 64 SHEET
Wetlands & Environmental Planning Group Lexington, NC DRAWN JAL REVIEWED 3714 3714 Spokeshave Lane BY BY
Matthews, NC 28105 DATE PAGE
(704)904 - 2277 APPROXIMATE MAP FOR SURVEY
WATERS OF THE U. S.
[e-mail] FOR STUDY PURPOSES ONLY 10123 /12
SUBJECT TO USACE/NCDENR VERIFICATION

JACKSON SQUARE
Soil Map — Davidson County, North Carolina
0 5$900 30 564960 %0990 565020 50 565080 565110 n
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FIGURE NO. LEONARD S. RINDNER PLLC
Wetlands & Environmental Planning Group
3714 Spokeshave Lane
Matthews, NC 28105
\ (704) 904 — 2277
[e-mail]
JACKSON SQUARE
Lexington, NC
NRCS SOIL MAP
APPROXIMATE LOCATION
MEET 1
DRAWN PJK REVIEWED LSR
BY BY
DATE PAGE
03129113

JACKSON SQUARE

WETLAND DETERMINATION DATA FORM — Eastern Mountains and Piedmont Region
Projedlsite: -�atVywn '-)q - City(County h nglo 1 u -idiw2 Sampling Data:
Appficant0wrher. State: A!L Sanpft Paint: QP1 W1 jd A.
Investigator(s): Pj' K , L S lliL Section. Township, Range:
Landlorm (hidslope. terrace, air.): 5 !ey" Local relief (concave. convex, none): 40#1C LW- Slope M. d -/ 16
Subregion (LRR or MLRAy M L V A Lat. S. 8 3,3161 Long- -10-A1031 Datum NfiD 83
Sob Map Unit Name: S, h.J J ocrw, NWI classification:
Are climatic / hydrologic conditions on the site typical for 9b time of yoor? Yes X No Of no, explain In Remarits.)
Are Vegetation N , Safi /J , or Hydrology P_ significantly disturbed? Are "Nonnel Circumstances" presart? Yes X No
Are Vegetation _b_, Sol Al or Hydrology 1-j _ naturally problematic? pf needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytia Vegetation Present? Yoe X No Is the Sampled Area
Hydric Goff Resent? Yes �_ No within a Welland? Yes _2�, No
Wetland Hydrology Resent? Yes �� No
Remarks: '
/fi w --4/aJ A,
ltit.e�l� H tS 5- cpcia4wA 4y 4 ovvNq A - m e,kr.. &,,wh .
HYDROLOGY
Welland Hydrology tndleators:
Serendary Indimlors (m iinknurn of two rmmkiti t
Primary IndieaMro (m inlmum of one is required:
dtedt ell that aootvt
_ Surface Sob Credos (8M
.� Surface Water (At)
_ True Aquatic Plants (814)
_ Sparsely Vegetated Concave Surface (88)
1L, High Wator Table (A2)
_ Hydrogen SuNWe Odor (Cl)
_ Drainage Patterns (810)
X Saturation (A3)
_ Oxidized Rhlsospheres on Living Roots (0)
_ Moss Trim Lines (816)
Water Mart (81)
_ Presenoa of Reduced Iron (04)
_ Dry - Season Water Table (CZ)
_ Sediment Deposits (82)
_ Recent Iron Reduction In Tilled Sob (C8)
Crayfish Burrows (Ca)
_ Drift Deposits (83)
_ Thin Muds SuAeco (C7)
_ Saturation Visible on Aerial Imagery (C9)
_ Algal Mat or Crust (84)
Other (Explain in Remarks)
_ Stunted or Stressed Plants (DI)
_ Iron Doposits (85)
_ Geomorphic Position (D2)
_ Inundation Vlsibto on Aerial lmagary (87)
_ Shallow Aquitard (D3)
,_V_ Water- Stained Leaves (88)
_ Mirrotopographic Relic( (D4)
_ Aquatic Fauna (813)
FAC- Noulral Test (DS)
Field Observations:
Surface Water Present? Yes K
No Depth (litires):
Water Table Resent? Yes
No Depth ("as):
Saturation Resent? Yes X
No Depth (inches). 0'
Wetland Hydrology Present? Yes X No
Includes capillary
Describe Recorded Data (stream gaugo, monitoring wall, aerial photos, previous inspections), if available -
Romnks: 1
rrt -ClUet•,"Wd by -" yv+<>7- vtidk
eke— be,•
US Army Corps of Engineers Eastern Mountains and Pledmart - Version 2 0

VEGETATION (Four Strata) - Use sclentft names of plants.
�
Tree Stratum (Plot sin; )
rviw,wv . .�.
L ?
1. Cwl1]L,
x 1 a
2.
x 2 a
3.
x 3 a
4.
x 4 a
S.
X5-
6.
(A) (B)
7.
8.
7 • Total Cover
SaolinatshnA Stratum (Plot size:
)
1. Seirx mare+,
�_ _ 013L-
2. L ALl A^"J" ur ti�yrwc. {ILIA
t17 FAQ+
3..<inv'� t7�wn rvwr+�cs
S FitiyJ
4.
5
6
7.
e.
9.
10.
3 S . Told Cover
Herb a (Plot site: )
1 GYp4&r4rnu4;
2. _T4A c �'JPL.4
3. Loh '.4- era
v1. A% FA(e.-
4.
5.
6.
7.
8.
A.
10.
11.
12.
a Total Cover
Woody Virg Stmtum (Plot size: )
1
DP 1
Sampling Point w20 A
Number of Dominant Species
That Am OBL, FACW, or FAC: 's _ (A)
Total Number of Dominant
Species Across An Strata: (B)
Parcont of Dominant Species Ldp
That Are OBL. FACW, or FAC: (A18)
Total %Cover of
Muhioly by:
OBL species
x 1 a
FACW spades
x 2 a
FAC species
x 3 a
FACU species
x 4 a
UPL spades
X5-
Colmar Totals:
(A) (B)
Prevalence Index a B!A a
1 • Rapid Test for Hydrophytie Vegetation
2 - Dominence Test is ),50%
_ 3 • Prevalence Index is S3.0'
_ 4 • Morphological Adaptations' (Provide supporting
data in Remarks or on a separate shoat)
_ Problematic Hydrophytic Vegetation' (Explain)
'Indicators of hydric soil and watlend hydrology must
bo proaant. unless disturbed or problematic.
Tree - Weedy plants, excluding vines. 3 in. (7.8 cm) or
more in diameter at breast height (06H). regardless of
helght.
Sopling/Shrub -Woody plants. excluding vines, loss
than 3 in. DBH and greater than or equal to 3.28 ft (1
m) tan.
Herb - An herbaceous (non - woody) plants, regardless
of size, and woody plants less than 3.28 ft tail.
Woody vine - A I woody vines greater than 3.28 it in
2.
3
4.
Hydtophytic
S. Vegetation
6. Present? Yes X No
Total Cover
photo numbers hero or on a separate
; .- ..q+.r- �t So 90 of +kc gipee_jGS wr.e--
F' -A C✓ a r- w- -,44e. r-
US Army Corps of Engineers
Eastern Mountains and Piedmont - Version 2 0

SOIL
DPI -
Sarrom Po6nt w+' 1 A A .
Profile Description: (Describe to the depth needed to document the Indicator or confirm the absence of indicators.)
Depth Matron Redox Features
Onthos) Cal �_ Color (molstl % Tvoo+ Lao! Te)dure RamaAn
b-4 goo
Hydric Soil indicators:
Indicators for Problematic Hydric Soils':
_ Hislosol (At)
_ Dark Surface (S7)
_ 2 an Muck (A 10) (MLRA 147)
_ Hbtic Eplpedon (A2)
_ Poyvatue Below Surface (S8) (MLRA 147,148)
_ Coast Ptairie Redox (A1G)
_ Black Histic (A3)
_ TAM Dark Surface (SO) (MLRA 147,148)
(MLRA 147,148)
_ Hydrogen Sulfide (A4)
_ Loamy Guyed Matra (F2)
_ Piedmont Floodptain Soils (Fig)
_ StralTed Layers (A5)
Depleted Mater (F3)
(MLRA 136,147)
_ 2 an Muds (A10) (LRR N)
_ Rodox Dark Surface (F6)
_ Very Shallow Dark Surface (TF12)
_ Depleted Below Dark Surface (At 1)
_ Depleted Dark Surface (F7)
_ OThor (Expisin in Remarks)
_ Thick Dark Surface (Al2)
_ Redox Depressions (F8)
_ Sandy Mucky Mineral (S1) (LRR N.
_ Iron- Mangonese Masses (F12) (LRR N,
MLRA 147,148)
MLRA 136)
_ Sandy Guyed Matra (S4)
_ Umbric Surface (F13) (MLRA 136,122)
31ndicalom of hydrophytic vegetation and
_ Sandy Redox (S5)
Piednwrd Floodplain Soils (F16) (MLRA 148)
wetland hydrology must be present,
_ Stripped Matra (S6)
Red Parent-Material (F21) (MLRA 127,147)
unless disturbed or problematic.
Type:
Depth (inches): Hydric Soil Present? Yes No
marks:
�•i���Ls7 /S Of t'-pg !L �v1 vVrie- tJrl4c�v:���-
US Amry Corps of Engineers Eastern Mountoins and Piodmont - Version 2.0

WETLAND DETERMINATION DATA FORM — Eastern Mountains and Piedmont Region
Pro)owska: _ INc,i 4+o r% f Oh City/County: L ex k5jVK - NW;j14?N Sampling Date:
ApplicantlOwner. State: N L- Sampling Point: DP2 ! 4 Q (A
Imostator(s): 9,Tk , L5 ►Z Section, Township, Range:
Landfomn (hdkbpe. tenaea. etc.): Local rodof (concave. convex. none): Nen-C- Slope (%):
Subregion (LRR or MLRA): Lot: -1 15 , 00 "A I Long: ` � • 71`11530 Datum: NNA 3 3
Sod Map UnIt Name: lP o D P• 01Lt Sa. V 16-1 NWl classification:
Are dimetk ( hydrologic conditions on the site typical for this time of year? Yes k_ No IN no, explain In Remarks.)
Are Vegotation fJ , Sod L , or Hydrology t'') signiffeantly disturbod? Aro'Normal Circumstances- present? Yes �(_ No
Aro Vogolation N • Sod 0 , or Hydrology N naturally problematic? (If needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present?
Yes
No 7<
Primary indiwtons (mkumum of ene k required:
Is the Sampled Area
Hydrir: Sod Present?
Yes
No X
_ Sparsely vegetated Cori cave Surface (SM
�/
within a Wetland? Yes No /�
Wettand Hydrobgy Present!
Yes
No X
_ Oxidmed Rhb mpheres on Living
Roota (C3) _ Moss Trim Linea (816)
Remarks:
_ Presence of Reduced Iron (C4)
_ Orly- Season Water Table (C2)
_ Sediment Deposits (82)
Ares /s iLQrcSu,1�7rV
-C K
/1nA �u�rSo�►�,'>�vp+.q� x���cL.CY .
HYDROLOGY
Welland Hydrology indicators:
Secondary indicators (minimum of two required)
Primary indiwtons (mkumum of ene k required:
chock ad that anoM
I'll
Surface Soil Craulxs (86)
_ Surface Wator (At)
_ True Aquatic Plants (B14)
_ Sparsely vegetated Cori cave Surface (SM
_ High Water Table (A2)
_ Hydrogen Sulfide Odor (CI)
_ Drainage Patterns (B10)
_ Saburation (A3)
_ Oxidmed Rhb mpheres on Living
Roota (C3) _ Moss Trim Linea (816)
_ Water Marks (81)
_ Presence of Reduced Iron (C4)
_ Orly- Season Water Table (C2)
_ Sediment Deposits (82)
_ Recent Iron Reduction in Tilled Sods (C6) _ Crayfish Burrows (Ca)
Drift Deposts (83)
_ Thin Muck Surface (C7)
_ Saturation Visible on Aerial Imagery (C8)
Algal Met or Crust (B4)
_ Other (Explain in Remarks)
_ Stunted or Stressed Plants (01)
_ Iron Deposits (B5)
_ Goomorphic Position (02)
_ Inundation Visible on Aerial imagery (87)
_ Shadow Aqu48rd (03)
_ Water-Stained Leaves (89)
_ Miaotopograpt,ic Relief (D4)
_ Aquatic Fauna (813)
_ FAC- Neutral Test (DS)
Field Observations:
Surface Water Present? Yes
No _ Y Depth (inches)-
Water Table Present? Yes
No _ e Depth (inches):
Saturation Present? Yes
No a Depth (inches):
Wetland Hydrology Present? Yes No X
includes cafirings)
Describe Recorded Data (stream gauge, monitoring wad, aerial photos, previous inspections), d available.
Remarks•
vie-W a
US Army Corps of Engineers Eastern Mountains and Pkdmont - Ventbn 2.0

VEGETATION (Four Strata) — Use scientific names of plants.
Tree ShaNm (plot stto: )
% Cover Species? status
Multiply by,
x 1 •
.0_ ._ F9( ._
2. 6vL
15
-'
3. _ Ac�i ra„6ruw%
FAC species
4. 1-.ca'�T �►vi,�Rr /o -
ib N.
D.-r LA t. V 1 )'A MA.
T
S Al roe /i
6.
UPL species
7.
x 5 ■
a.
y i
(A)
64 • Total Cover
S001inpl3Arub Stratum (Plot size: 1
2.
MCJA
3. A e V Q
�-
4.
S.
8.
7.
8.
e.
10.
'S'� • Total Cover
(Plot stro: )
1. 1>40 0%, I v ...
35 F-Ar-
2. a.A a- C44 S 4t fir- c
/O
3.
4.
5.
6.
7.
8.
9.
10.
It
12.
4• S • Total Cover
Wbodv Vine Stratum (Plot size• )
t.
2
3
4
5.
6.
Total Cover
or on a soparsto shoot.)
Sampling Point: DP, :L - U P U
Number of Dominant Species
That Are OBL, FACW. or FAC: r (A)
Total Number of Dontlunt
Species Across All Strata: _7_ (�
Percent of Domnard Species 4
That Are OBL, FACW, or FAC: ° (AA3)
Total % Cover
or
Multiply by,
x 1 •
OBL species
-
FACW species
-'
x 2 •
FAC species
7 D
x 3= ;L10
FACU species
-75_
x 4 •
UPL species
x 5 ■
Columm Totals.
y i
(A)
Prevalence Index • BIA • 3..S
_ 1 . Rapid Test for Hydrophyfic Vegetation
_ 2 - Dominance Test is *50%
_ 3 . Provatence Index B S3.0'
_ 4 - Morphotogi al Adaptations' (Provide supporting
data in Remarks or on a separate shoot)
_ Probiomabc Hydrophybc Vegetation' (Explain)
'Indicators of hydric sell and watland hydrology must
be present, unless disturbed or problematic.
Tree - Woody plants, excluding vines, 3 in. (7 6 cm) or
tame in diametor at breast height (DBH), regardless of
height
SaplinglShrub -Woody plants, excluding vines, less
than 3 in. DBH and greater than or equal to 3.28 It (1
M) tall.
Herb - AD herbaceous (non-woody) plants, regardless
of sire, and woody plants less than 3.28 ft tall
Woody vine - All woody vines greater than 3 28 It in
Hydrophytic
Vegetation
Present? Yes No
Lest J-1 „>1 60A, s� +d e. elo^viwtm4' ,����,� 5p0- c1-5 ,^& )O�014 C., oi,
Lkj < - -' '
US Army Corps of Engiroors Eastern Mountains and Piodmontt - Vors;on 2 0

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8
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NC Division of Water Quality - Methodology for Identification of Intermittent and
Perennial Streams and Their Oristins v. 4.1
rC' DWO Streatn Identification Forth Version 4.1
Date: October' 17, 2012
Pro ecUSlte Jackson Seasonal RPW C - Lexington, NC
Latitude: 35.83383 N
Evaluator: LSR, PJK
County: Davidson County, NC
Longitude: - 80.28069 W
Total Points: Stream Determl n circle one) I Other Lexington West (NC) Quad
Stream is at least rrrtermittent 21 Ephemeral termitten erennlal e g Ouad Name: HUC: 03040103
if a 19 or oerennral if a 30'
A. Geomorphology (Subtotal = 12.5
Absent
Weak
Moderate
Strong
1a Continuity of channel bed and bank
0
1
2
C3J
2. Sinuosity of channel along thalweg
0
1
2
3
3. In- channel structure: ex. riffle -pool, step -pool.
ripple-pool sequence
0
1O
2
3
4. Particle size of stream substrate
0
1
2
3
5. Active /relict floodplain
0
C13
2
3
6. Depositional bars or benches
0
1
2
3
7. Recent alluvial deposits
0
1
2
3
8. Headcuts
0
1
2
3
9. Grade control
0
G).53
1
1.5
10. Natural valley
0
0.5
1
1.5
11. Second or greater order channel
N) "o
Yes = 3
artificial ditches are not rated, see discussions in manual
B. Hydrology (Subtotal = 3.5 )
12. Presence of Baseflow
0
1
2
3
13. Iron oxidizing bacteria
0
co
2
3
14. Leaf litter
1.5
1
QL5
0
15. Sediment on plants or debris
0
.5
1
1.5
16. Organic debris lines or piles
0
0.5
1
1.5
17. Soil -based evidence of high water table?
No 0
Yes = 3
C. Biology (Subtotal = 5
18. Fibrous roots in streambed
3
co
1
0
19. Rooted upland plants in streambed
co
2
1
1
2
0
3
20. Macrobenthos (note diversity and abundance)
CO-)
21. Aquatic Mollusks
0
1
2
3
22. Fish
co
0.5
1
1.5
23. Crayfish
0
0.5
0.5
1
1
1.5
1.5
24. Amphibians
0
25. AI ae
0
0.5
1
1.5
26. Wetland plants in streambed
FACW = 0.75: OBL = 1.5 Othe = 0
'perennial streams may also be identified using other methods See p 35 of manual
Notes: Rain +/- 48 hrs., Sand, gravel.
2'- 3' wide channel.
Sketch:

APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
RALEIGH REGULATORY FIELD OFFICE
US Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
General Number: [phone]
Fax Number: [phone]
Applicant:
C. PROJECT LOCATION AND BACKGROUND INFORMATION: Jackson Square: Hwy 52, Hwy 64, on Forest Hill Rd
State:NC County /parish/borough: Davidson County City: Lexington
Center coordinates of site (lat/long in degree decimal format): Lat. 35.83303° N, Long. 80.28024° WY.
Universal Transverse Mercator: 17
Name of nearest waterbody: Swearing Creek.
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: Yadkin River
Name of watershed or Hydrologic Unit Code (HUC): 03040103: Lower Yadkin
® Check if map /diagram of review area and/or potential jurisdictional areas is /are available upon request.
❑ Check if other sites (e.g., offsite mitigation sites, disposal sites, etc...) are associated with this action and are recorded on a
different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
© Office (Desk) Determination. Date:
® Field Determination. Date(s): 11/15/12
SECTION II: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
There Are no "navigable waters of the U.S" within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the
review area [Required]
❑ Waters subject to the ebb and flow of the tide.
❑ Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce.
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There Are "waters of the US." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply):
❑ TNWs, including territorial seas
❑ Wetlands adjacent to TNWs
Relatively permanent wated (RPWs) that flow directly or indirectly into TNWs
Non -RPWs that flow directly or indirectly into TNWs
Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to non -RPWs that flow directly or indirectly into TNWs
Impoundments of jurisdictional waters
❑ Isolated (interstate or intrastate) waters, including isolated wetlands
Identify (estimate) size of waters of the U.S. in the review area:
Non- wetland waters: ( + / -) 80.3 linear feet: 3 - 6 width (ft) and/or acres.
1 Boxes checked below shall be supported by completing the appropriate sections in Section III below.
Z For purposes of this form, an RPW is defined as a tributary that is not a TN W and that typically flows year -round or has continuous flow at least "seasonally"
(e.g., typically 3 months).

Wetlands: ( + / -) 0.054 acres.
c. Limits (boundaries) of jurisdiction based on: O871?eli4e�04 M_q�a1
Elevation of established OHWM (if known):
2. Non - regulated waters/wetlands (check if applicable):
❑ Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional.
Explain:
3 Supporting documentation is presented in Section III.F

SECTION III: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section III.A.1 and Section III.D.1. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.1 and 2
and Section III.D.1.; otherwise, see Section III.B below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent ":
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non - navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i.e. tributaries that typically flow year -round or have continuous flow at least seasonally (e.g, typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year -round
(perennial) flow, skip to Section III.D.2. if the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III.D.4.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbody° is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section III.B.1 for
the tributary, Section III.B.2 for any onsite wetlands, and Section III.B3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section III.0 below.
1. Characteristics of non -TNWs that flow directly or indirectly into TNW
(1) General Area Conditions:
Watershed size: (HUC: 03040103 entire watershed) 1190 square miles
Drainage area: +/- 10 -11 (acres
Average annual rainfall: inches
Average annual snowfall: inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
❑ Tributary flows directly into TNW.
® Tributary flows through 2 tributaries before entering TNW.
Project waters are 15.20 river miles from TNW.
Project waters are (or less) river miles from RPW.
Project waters are -10-15 aerial (straight) miles from TNW.
Project waters are i (or lessj aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain: No.
Identify flow route to TNW5: Seasonal RPW C, which originates onsite, flows offsite before flowing into Swearing
Creek, which flows directly into the Yadkin River (TNW) at High Rock Lake.
4 Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the and
West.
' Flow route can be described by identifying, e.g, tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW.

(iv) Biological Characteristics. Channel supports (check all that apply):
® Riparian corridor. Characteristics (type, average width): Forested, +/ -35'.
® Wetland fringe. Characteristics: Channel has abutting headwater wetlands.
® Habitat for:
❑ Federally Listed species. Explain findings:
❑ Fish/spawn areas. Explain findings:
❑ Other environmentally - sensitive species. Explain findings:
® Aquatic /wildlife diversity. Explain findings: May provide habitat for amphibians..
Z. Characteristics of wetlands adjacent to non -TNW that flow directly or indirectly into TNW
(I) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: + /- 0.054acres
Wetland type. ExplainTorested.
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain: No.
season.
(b) General Flow_ Relationship with Non -TNW:
Flow is: �phemeraI flow. Explain: Wetlands will discharge into the offsite RPW s periodically during the growing
Surface flow is: KTOtreseat
Characteristics:
Subsurface flow: U own. Explain findings:
❑ Dye (or other) test performed:
(c) Wetland Adjacency Determination with Non -TNW:
® Directly abutting
❑ Not directly abutting
❑ Discrete wetland hydrologic connection. Explain:
❑ Ecological connection. Explain:
❑ Separated by berm/barrier. Explain:
(d) Proximity (Relationship) to TNW
Project wetlands are X5-20 river miles from TNW.
Project waters are 10-15 aerial (straight) miles from TNW.
Flow is from:,Wetland to navigable waters.
Estimate approximate location of wetland as within the 100 - 500 -year floodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface; water quality, general watershed
characteristics; etc.). Explain: No water at time of survey. Wetland contained water stained leaves..
Identify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
® Riparian buffer. Characteristics (type, average width):Forested, +/- 35'.
® Vegetation type /percent cover. Explain:Alluvial /Riparian +/- 90%.
® Habitat for:
❑ Federally Listed species. Explain findings:
❑ Fish/spawn areas. Explain findings:
❑ Other environmentally - sensitive species. Explain findings:
® Aquatic/wildlife diversity. Explain findingsTrovides habitat for amphibians.
3. Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis: 2
Approximately ( +/- 0.054 ) acres in total are being considered in the cumulative analysis.

For each wetland, specify the following:
Directly abuts? (Y/N) Size (in acres) Directly abuts? (Y/N) Size (in acres)
Wtld A/B (Y) ( + / -) 0.034
Wtld D/E (Y) ( + / -) 0.020
Summarize overall biological, chemical and physical functions being performed: Onsite wetlands provide habitat for
herpetofauna and macroinvertebrates. The wetlands provide flood storage and ground water recharge. The wetlands also trap and
filter pollutants before reaching RPWs and the TNW (Yadkin River).
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW.
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNW). Similarly, the fact an adjacent wetland lies within or
outside of a floodplain Is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Dens the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Dens the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Dens the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Dens the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
Significant nexus findings for non -RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III. D:
Significant nexus findings for non -RPW and its adjacent wetlands, where the non -RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section III.D:
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section I1I.D:
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERS/WETLANDS ARE (CHECK ALL
THAT APPLY):
1. TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
❑ TNWs: linear feet width (ft), Or, acres.
❑ Wetlands adjacent to TNWs: acres.
2. RPWs that flow directly or indirectly into TNWs.
❑ Tributaries of TNWs where tributaries typically flow year -round are jurisdictional. Provide data and rationale indicating that
tributary is perennial:
® Tributaries of TNW where tributaries have continuous flow "seasonally" (e.g., typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section III. B. Provide rationale indicating that tributary flows
seasonally: Seasonal RPW C has the geomorphology, hydrology, and biology consistent with intermittent streams. The

channels has clear bed and banks, scour, and substrate sorting. See Jackson Square_Lexington_NCDWQ_Strm data
form_SeaRPW_C.
Provide estimates for jurisdictional waters in the review area (check all that apply):
MTributary waters: ( + / -) 80.03 linear feet( + / -) 3-6 width (ft).
Other non - wetland waters: acres.
Identify type(s) of waters:
3. Non -RPWss that flow directly or indirectly into TNWs.
❑ Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section II1.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
❑ Tributary waters: linear feet width (ft).
[] Other non - wetland waters: acres.
Identify type(s) of waters:
Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
® Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
❑ Wetlands directly abutting an RPW where tributaries typically flow year -round. Provide data and rationale
indicating that tributary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
® Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section III.B and rationale in Section III.D.2, above. Provide rationale indicating that wetland is directly
abutting an RPW: Jurisdictional wetlands A/B and D/E empty directly into and are not separated from seasonal RPW C.
Provide acreage estimates for jurisdictional wetlands in the review area: ( + / -) 0.054 acres.
5. Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
❑ Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
Wetlands adjacent to non -RPWs that flow directly or indirectly into TNWs.
❑ Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this
conclusion is provided at Section I11.C.
Provide estimates for jurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters 9
As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional.
❑ Demonstrate that impoundment was created from "waters of the U.S.," or
❑ Demonstrate that water meets the criteria for one of the categories presented above (1-6), or
❑ Demonstrate that water is isolated with a nexus to commerce (see E below).
E. ISOLATED [INTERSTATE OR INTRA- STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY):10
which are or could be used by interstate or foreign travelers for recreational or other purposes.
from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
sSee Footnote # 3.
To complete the analysis refer to the key in Section III.D.6 of the Instructional Guidebook.
t0 Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiction Following Rapanos.

which are or could be used for industrial purposes by industries in interstate commerce.
Interstate isolated waters. Explain:
Other factors. Explain:
Identify water body and summarize rationale supporting determination:
Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: linear feet width (ft).
❑ Other non - wetland waters: acres.
Identify type(s) of waters:
❑ Wetlands: acres.
F. NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
❑ If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements.
Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
❑ Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction. Explain:
[j Other: (explain, if not covered above):
Provide acreage estimates for non jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the MBR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check all that apply):
[� Non- wetland waters (i.e., rivers, streams): linear feet width (ft).
N Lakes /ponds: acres.
Other non - wetland waters: acres. List type of aquatic resource:
Wetlands: acres.
Provide acreage estimates for non jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required for jurisdiction (check all that apply):
❑ Non - wetland waters (i.e., rivers, streams): linear feet, width (ft).
❑ Lakes /ponds: acres.
BOther non - wetland waters: acres. List type of aquatic resource:
Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall be included in case file and, where checked
and requested, appropriately reference sources below):
® Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant:
® Data sheets prepared/submitted by or on behalf of the applicant/consultant.
❑ Office concurs with data sheets/delineation report.
❑ Office does not concur with data sheets/delineation report.
❑ Data sheets prepared by the Corps:
❑ Corps navigable waters' study:
❑ U.S. Geological Survey Hydrologic Atlas:
❑ USGS NHD data.
❑ USGS 8 and 12 digit HUC maps.
® U.S. Geological Survey map(s). Cite scale & quad name: 1:24K - Lexington West (NC) quad
USDA Natural Resources Conservation Service Soil Survey. Citation:Natural Resources Conservation Service
Web Soil Survey URL: http : / /websoilsurvey.nres.usda.gov.
National wetlands inventory map(s). Cite name:
State/Local wetland inventory map(s):
FEMA/FIRM maps:
100 -year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
Photographs: ® Aerial (Name & Date):
or ❑ Other (Name & Date):
Previous determination(s). File no. and date of response letter:
Applicable /supporting case law:
Applicable /supporting scientific literature:
❑ Other information (please specify):