20210824 Ver 1_401 Application_20210524

Staff Review Form
Updated September 4, 2020
Staff Review
Does this application have all the attachments needed to accept it into the review process?*
6* Yes r No
ID#* Version* 1
20210824
Is this project a public transportation project?*
r Yes
r No
Reviewer List:* Andrew Moore:eads\awmoore3
Select Reviewing Office:*
Asheville Regional Office - [phone]
Does this project require a request for payment to be sent?*
Yes
r
No
How much is
owed?*
r $240.00
r $570.00

Project Submittal Form
Please note: fields marked with a red asterisk * below are required. You will not be able to submit the form until all
mandatory questions are answered.
Project Type:*
✓ For the Record Only (Courtesy Copy)
✓ New Project
✓ Modification/New Project with Existing ID
✓ More Information Response
✓ Other Agency Comments
✓ Pre -Application Submittal
✓ Re-Issuance\Renewal Request
✓ Stream or Buffer Appeal
Pre -Filing Meeting Information
Before submitting this form please ensure you have submitted the Pre -Filing Meeting Request Form as we will not
be able to accept your application without this important first step. The Pre -Filing Meeting Request Form is used in
accordance with 40 C.F.R. Section 121.4(a) "At least 30 days prior to submitting a certification request, the project
proponent shall request a pre -filing meeting with the certifying agency" and in accordance with 40 C.F.R. Section
121.5(b)(7), and (c)(5) all certification requests shall include documentation that a pre -filing meeting request was
submitted to the certifying authority at least 30 days prior to submitting the certification request. Click here to read
more information on when this form is needed prior to application submission or here to view the form.
Attach documentation of Pre -Filing Meeting Request here:
Gravelly Branch 30 Day clock met.pdf
Date for Meeting Request 5/4/2021
ID# 20210824 Version 1
Project Contact Information
Name: Tyson Kurtz
who is submitting the inforrration?
Email Address: [e-mail]
Project Information
Existing ID #:
20210824
20170001 (no dashes)
Project Name: Gravelly Branch Road Tract
Is this a public transportation project?
r Yes
a No
81.19KB
Existing Version:
1
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
r Yes r No r Unknown
County (ies)

Buncombe
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach docurrent
Gravelly Branch Rd NWP 29 and 401 Application
6.24MB
5.24.21 - Signed.pdf
Only pdf or krre files are accepted.
Describe the attachments
or comments:
Individual 401 WQC Certification Application. PCN was already submitted to the USACE during the 30-day
prefilling window (Action ID: SAW-2021-00986).
Sign and Submit
rJ By checking the box and signing box below, I certify that:
• I, the project proponent, hereby certifies that all information contained herein is true, accurate, and complete to
the best of my knowledge and belief.
• I, the project proponent, hereby requests that the certifying authority review and take action on this CWA 401
certification request within the applicable reasonable period of time.
• I agree that submission of this online form is a "transaction" subject to Chapter 66, Article 40 of the NC General
Statutes (the "Uniform Electronic Transactions Act");
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General
Statutes (the "Uniform Electronic Transactions Act");
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a
written signature; AND
• I intend to electronically sign and submit the online form.
Signature:
Submittal Date: Is filled in automatically.

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Lear a Pr
ClearWater Environmental Consultants, Inc.
www.cwenv.com
May 24, 2021
Mr. Paul Wojoski
NC DWR, 401 Permitting & Buffer Unit
512 N. Salisbury Street, 9th Floor
Raleigh, North Carolina 27604
RE: Gravelly Branch Rd Tract (+/- 20 Ac)
NC DWR Project No. 20210824 vl and Action ID: SAW-2021-00986
NWP 29 Application & Individual Water Quality Certification Request
Buncombe County, North Carolina
Dear Mr. Wojoski,
The attached Pre -Construction Notification (PCN) is being submitted on behalf of MVBMCG,
LLC, represented by Steven Greer. The project site is defined by Buncombe County parcel
967552402800000, off of Gravelly Branch Road in Fairview, North Carolina. The applicant is
pursuing a Nationwide Permit 29 and Individual 401 Water Quality Certification to authorize
wetland and stream impacts associated with an access road for a residential development.
Please do not hesitate to contact me at 828-698-9800 if you have any questions regarding the
attached application and supplemental information. A copy of this application was sent to Amanda
Jones Fuemmeler, USACE Asheville Regulatory Office, Ms. Andrea Leslie, NC Wildlife
Resources Commission, and Mr. Byron Hamstead, US Fish and Wildlife Service on April 28,
2021.
Sincerely,
—Docu Signed by: g y
1-750ti 2- C2. C-AcAAt.4 2iaik
0A79F7DC85EE4F7
DocuSi ned by:
—8BE1DDE05B634F5...
Tyson Kurtz R. Clement Riddle, P.W.S.
Biologist Principal
145 7th Avenue West, Suite B
Hendersonville, NC 28792
828-698-9800 Tel

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Preliminary ORM Data Entry Fields for New Actions
ACTION ID #: SAW -
Prepare file folder n
Begin Date (Date Received):
Assign Action ID Number in ORM
1. Project Name [PCN Form A2a]: Gravelly Branch Rd Tract
2. Work Type: Private InstitutionalFl Government [1 Commercial
3. Project Description / Purpose [PCN Form B3d and B3e]:
NWP 29 application on behalf of MVBMCG, LLC for a residential development of a +/- 20 acre tract in Fairview, Buncombe County,
NC. The purpose of the project is to authorize wetland and stream impacts associated with an access road.
4. Property Owner / Applicant [PCN Form A3 or A4]: MVBMCG, LLC / Steven Greer
5. Agent / Consultant [PNC Form A5 — or ORM Consultant ID Number]:
ClearWater Environmental Consultants, Inc.
6. Related Action ID Number(s) [PCN Form B5b]: n/a
7. Project Location — Coordinates, Street Address, and/or Location Description [PCN Form Bib]:
The project site is located at the intersection of Gravelly Branch Rd and Robey Dr, in Fairview, NC.
(35.493001, -82.442694).
8. Project Location — Tax Parcel ID [PCN Form B 1 a] : 967552402800000
9. Project Location — County [PCN Form A2b]: Buncombe
10. Project Location — Nearest Municipality or Town [PCN Form A2c]: Fairview
11. Project Information — Nearest Waterbody [PCN Form B2a]: Moore Lake
12. Watershed / 8-Digit Hydrologic Unit Code [PCN Form B2c]: French Broad / 06010105
Authorization: Section 10 fl Section 404 fl Section 10 and 404 pi
Regulatory Action Type:
Standard Permit
Nationwide Permit # 29
Regional General Permit #
Jurisdictional Determination Request
RPre -Application Request
Unauthorized Activity
RCompliance
No Permit Required
Revised 20150602

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
CLea rWaLe r
Department of the Army
Wilmington District, Corps of Engineers
Attn: Scott McLendon, Chief Regulatory Division
PO Box 1890
Wilmington, NC 28402-1890
-and-
NC DWR, Webscape Unit
Attn: Paul Wojoski
512 North Salisbury Street
Raleigh, North Carolina 27604
I, the current landowner/managing partner of the property identified below, hereby authorize
ClearWater Environmental Consultants, Inc. (CEC) to act on my behalf as my agent during the
processing of jurisdictional determination requests and permits to impact Wetlands and Water of
the US subject to Federal jurisdiction under Section 404 of the Clean Water Act and/or Section 10
of the Rivers and Harbors Act of 1899. CEC is authorized to provide supplemental information as
needed at the request of the USACE or DWR.
Additionally, I authorize representatives of the Wilmington District, US Army Corps of Engineers
to enter upon the property herein described for the purposes of conducting onsite investigations and
issuing a determination associated with Wetlands and Waters of the US subject to Federal
jurisdiction under Section 404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors
Act of 1899.
Property Owner of Record:
Property Owner Address:
11� II3.4cc, LL C
3`s PCW t,4r CreekR!.
r-c7 7 z/Li?
Phone Number: - 3 51 - )- 7 ?b
Email address: J, Ste.-g6p ;p2(.r.e. Co►✓�
Property Location:
Owner/Managing partner Signature: _ rcj•.•c._
Owner/Managing printed name: 544.444-L 6-rater—
Date: B V—o S .2 r
145 7th Avenue West, Suite B
Hendersonville, NC 28792
Phone: [phone]
www.cwenv.com

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
sr —
Buncombe County Assessment
Property Record Search
BUNCOMBE COUNTY ASSESSMENT PROPERTY RECORD SEARCH
967552402800000 MVBMCG LLC
99999 GRAVELY BRANCH RD PO BOX 1285, SEARCY, AR, 72145
Key Information
Total Appraised Value
$491,100
Zoning
Neighborhood
Land Use Code UNDEVELOPED TRACT Municipality
Fire District
Present Use
Exemption
FFA
Special District
EGVH
Appraisal Area Greg Green [phone]
[e-mail]
Legal Description Deed Date:11/05/2020 Deed:5974-1577 Lot:PARCEL 1 Plat:0213-0044
Plat Reference 213-44
Assessment Details
Land Value
Building Value
Features
$491,100
$0
$0
Total Appraised Value
Deferred Value
Exempt Value
Total Taxable Value
$491,100
$0
L
$0
$491,100
LAND INFORMATION
ZONING
OPEN USE
LAND USE CODE
UNDEVELOPED TRACT
SIZE
NEIGHBORHOOD ASSESSED VALUE
20.11 acres
EGVH l $491,100
FLOODPLAIN
NO
VALUE CHANGE HISTORY
DATE OF VALUE
CHANGE
2021-02-01
EFFECTIVE TAX LAND BUILDING FEATURES NEW
YEAR REASON FOR CHANGE VALUE VALUE VALUE VALUE
2021 RAPP REAPPRAISAL $491,100 $0 $0 $491,100
NOTICE
RECENT PERMIT ACTIVITY
No data to display
Developed for Buncombe County Assessment Property Record Search by
Spatialest
Data last updated: 04/08/2021

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
Pre -Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the Corps:
❑ Section 10 Permit
X Section 404 Permit
1 b. Specify Nationwide Permit (NWP) number: 29 or General Permit (GP) number:
1 c. Has the NWP or GP number been verified by the Corps?
❑ Yes X No
1 d. Type(s) of approval sought from
the DWQ (check all that apply):
— Regular ❑ Non-404 Jurisdictional General Permit
— Express ❑ Riparian Buffer Authorization
X 401 Water Quality Certification
❑ 401 Water Quality Certification
1 e. Is this notification solely for the record
because written approval is not required?
For the record only for DWQ
401 Certification:
For the record only for Corps Permit:
❑ Yes X No
❑ Yes X 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 X No
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yes X No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes X No
2. Project Information
2a. Name of project:
Gravelly Branch Rd Tract
2b. County:
Buncombe
2c. Nearest municipality / town:
Fairview
2d. Subdivision name:
n/a
2e. NCDOT only, T.I.P. or state project no:
n/a
3. Owner Information
3a. Name(s) on Recorded Deed:
MVBMCG, LLC
3b. Deed Book and Page No.
5974-1577
3c. Responsible Party (for LLC if
applicable):
Steven Greer
3d. Street address:
365 Panther Creek Rd
3e. City, state, zip:
Searcy, AR 72143
3f. Telephone no.:
870-351-2770
3g. Fax no.:
n/a
3h. Email address:
[e-mail]
Page 1 of 10
PCN Form — Version 1.4 January 2009

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
4. Applicant Information (if different from owner)
4a. Applicant is:
X Agent ❑ Other, specify:
4b. Name:
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name:
R. Clement Riddle
5b. Business name
(if applicable):
ClearWater Environmental Consultants, Inc.
5c. Street address:
145 7th Avenue W; Suite B
5d. City, state, zip:
Hendersonville, NC 28792
5e. Telephone no.:
828-698-9800
5f. Fax no.:
5g. Email address:
[e-mail]
Page 2 of 10

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
B. Project Information and Prior Project History
1. Property Identification
la. Property identification no. (tax PIN or parcel ID):
967552402800000
1b. Site coordinates (in decimal degrees): Latitude: 35.493001 Longitude: -82.442694
lc. Property size:
20 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project:
Moore Lake
2b. Water Quality Classification of nearest receiving water:
C; Tr
2c. River basin:
French Broad / 06010105
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 project parcel is an active cattle pasture. The adjacent land use is a mixture of undeveloped forest, pasture, and sparse residential. In the greater
vicinity, the land use is primarily residential with a mixture of sparse commercial and institutional properties.
3b. List the total estimated acreage of all existing wetlands on the property: 0.427
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 1,221
3d. Explain the purpose of the proposed project:
To provide an access road to an upload residential development.
3e. Describe the overall project in detail, including the type of equipment to be used:
See Additional Information following the PCN form.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
(includingall priorphases)in the past?
project �
❑ Yes X No ❑ Unknown
Comments: A PJD request is included in Appendix A.
4b. If the Corps made the jurisdictional determination, what type
of determination was made?
Preliminary Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
Yes X No Unknown
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project?
❑ Yes X No
6b. If yes, explain.
Page 3 of 10
PCN Form — Version 1.4 January 2009

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below
for your project (check all that apply):
❑ Buffers ❑ Open Waters ❑ Pond Construction
X Wetlands X Streams — tributaries
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
Wetland impact
number
Permanent (P) or
Temporary (T)
2b.
Type of impact
2c.
Type of wetland
2d.
Forested
2e.
Type of jurisdiction
Corps (404,10) or
DWQ (401, other)
2f.
Area of
impact
(acres)
W1 P
Fill
Non -Tidal Freshwater Marsh
Yes/No
Corps
0.079
W2 P
Fill
Non -Tidal Freshwater Marsh
Yes/No
Corps
0.004
W3 -
Choose one
Choose one
Yes/No
-
W4 -
Choose one
Choose one
Yes/No
-
W5 -
Choose one
Choose one
Yes/No
-
W6 -
Choose one
Choose one
Yes/No
-
2g. Total Wetland Impacts:
0.082
2h. Comments:
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.
Stream impact
number
Permanent (P) or
Temporary (T)
3b.
Type of impact
3c.
Stream name
3d.
Perennial (PER) or
intermittent (INT)?
3e.
Type of
jurisdiction
3f.
Average
stream
width
(feet)
3g.
Impact
length
(linear
feet)
S1 P
Culvert
SA - Moore Lake
PER
Corps
8.7
45
S2 -
Choose one
-
-
S3 -
Choose one
-
-
S4 -
Choose one
-
-
S5 -
Choose one
-
-
S6 -
Choose one
-
-
3h. Total stream and tributary impacts
45
3i. Comments:
S1 would result in 0.009 acres of stream bed impact.
Page 4 of 10
PCN Form — Version 1.4 January 2009

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
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 (T)
4b.
Name of waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody
type
4e.
Area of impact (acres)
01 -
Choose one
Choose
O2 -
Choose one
Choose
03 -
Choose one
Choose
04 -
Choose one
Choose
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
P1
Choose one
P2
Choose one
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:
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. Project is in which protected basin?
❑ Neuse ❑ Tar -Pamlico ❑ Catawba ❑ Randleman ❑ Other:
6b.
Buffer Impact
number —
Permanent (P) or
Temporary (T)
6c.
Reason for impact
6d.
Stream name
6e.
Buffer
mitigation
required?
6f.
Zone 1
impact
(square
feet)
6g.
Zone 2
impact
(square
feet)
B1 -
Yes/No
B2 -
Yes/No
B3 -
Yes/No
B4 -
Yes/No
B5 -
Yes/No
B6 -
Yes/No
6h. Total Buffer Impacts:
6i. Comments:
Page 5 of 10

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
D. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The project design avoids impacts to 1176 linear feet of stream (96% of stream on site) and 0.345 acres of wetland (81 % of wetland on site). Access to
the site is currently limited to the western side of SA (UT to Gravelly Creek). To access the majority of the site, SA and the floodplain wetlands must be
crossed. The selected alignment for the two lane access road is the most direct path that provides a perpendicular crossing to SA. The steep grade on
the eastern side of SA requires grading to make an appropriate approach angle, impacting Wetland C.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Appropriate erosion and sediment control measure will be implemented to avoid unintended impacts to waters on site. The proposed culvert
installation on SA will by done in the dry by use of coffer dams and a pump around system (details on Figure 6.2).
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?
No
❑ Yes X
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: Choose one
Type: Choose one
Type: Choose one
Quantity:
Quantity:
Quantity:
3c. Comments:
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:
Choose one
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.
Page 6 of 10
PCN Form — Version 1.4 January 2009

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
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 X 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 7 of 10

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified
within one of the NC Riparian Buffer Protection Rules?
❑ Yes X No
lb. If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes ❑ No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project?
g
2b. Does this project require a Stormwater Management Plan?
X 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:
The proposed project is subject to review and approval by Buncombe County. Buncombe County is a delegated authority for the review and approval
of Stormwater Management Plans. Documentation of approval can be forwarded if requested.
2e. Who will be responsible for the review of the Stormwater Management Plan?
Buncombe Co.
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project?
Buncombe co.
3b. Which of the following locally -implemented stormwater management programs
apply (check all that apply):
X Phase II
NSW
MP
❑ ❑ Water Supply Watershed
❑ Other:
3c. Has the approved Stormwater Management Plan with proof of approval been
attached?
❑Yes X No
4. DWQ Stormwater Program Review
4a. Which of the following state -implemented stormwater management programs apply
(check all that apply):
❑Coastal counties
❑HQW
❑ORW
❑Session Law 2006-246
❑Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached?
❑ Yes ❑ No
5. 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 8 of 10
PCN Form — Version 1.4 January 2009

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal/state/local) funds or the
use of public (federal/state) land?
❑ Yes X No
1 b. 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
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
❑Yes ❑ No
lc. 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.)
Comments:
❑ Yes ❑ No
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,
or Riparian Buffer Rules (15A NCAC 2B .0200)?
❑Yes X No
2b. Is this an after -the -fact permit application?
❑Yes X 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
additional development, which could impact nearby downstream water quality?
Yes X No
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 only involves residential development of the subject parcel. This project will not result in additional development that could affect
downstream water quality.
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.
Wastewater from the residential houses will be treated by privately owned, septic systems.
Page 9 of 10
PCN Form — Version 1.4 January 2009

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
habitat?
❑ Yes
X No
5b. Have you checked with the USFWS concerning Endangered Species Act
impacts?
❑ Yes
X No
5c. If yes, indicate the USFWS Field Office you have contacted.
-
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
See Additional Information following the PCN form.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes
X No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
NOAA's Essential Fish Habitat (EFH) Mapper. Accessed 4/26/2021 at https://www.habitat.noaa.gov/protection/efh/efhmapper/.
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
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
❑ Yes
X No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
See Additional Information following the PCN form.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?
❑ Yes
X No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination?
FEMA's National Flood Hazard Layer Viewer; FIRM Panel: FIRM Panel 3700967500J (eff. 1/6/2021). See Figure 7.
R. Clement Riddle
Applicant/Agent's Printed Name
r DocuSigned by:
2• CAC;24At.
`-0A79F7DC85EE4F7...
5/21/2021
Date
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization
letter from the applicant is provided.)
Page 10 of 10

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
PCN Form Additional Information
Section 8.3e Project Description - Details
The project parcel is proposed for development of 15 residential lots. Approximately 18 acres (90% of the
site) are inaccessible to vehicles due to the alignment of SA (UT to Gravelly Branch), existing roads, and
parcel boundaries. Impacts to streams and wetlands are necessary to access the upland site. A 45-foot-
long culvert, to allow for a two-lane road, is proposed to cross the stream at the straightest location of
the reach within the site. There is an abrupt and steep grade change adjacent to the east side of the
stream where the access road is to be located. To create a suitable road grade and approach angle, a
relatively wide road fill footprint is required at the base of the hillside. Houses, driveways, and stormwater
basins (sediment basins during construction that will be dry detention basins post construction) will all be
located in uplands. Typical construction equipment will be used on site i.e. backhoe, etc.
Section F.5d Endangered Species and Designated Critical Habitat — Sources
CEC consulted the FWS's "Northern Long -Eared Bat Consultation Areas" map for Buncombe County.
Buncombe County is not listed as having known occurrences of hibernation or maternity sites. Therefore;
the project satisfies the 4(d) rule and consultation for effects on the northern long-eared bat is not
required. A review of the NC Natural Heritage Program database on April 26, 2021 indicates no
documented occurrences of federally protected species occurring within a one -mile radius of the project
boundary. See Appendix B.
Section F.7b. Historic or Prehistoric Cultural Resources — Sources
The three nearest potential historic sites are between 0.6 and 0.75 miles from the project site and are not
likely to be within the viewshed of project site. The nearest potential historic sites are Site ID: BN0323:
Clayton House (Status: SO); ID: BN0344: Auls Cox House (Status: SO); and Site ID: BN0691: Stroup House
(Status: SO). Data gathered from NCHPO's HPOWEB 2.0 for General Audience. Accessed 4/26/2021.

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Gravelly Branch Tract (+1- 20 AC)
Buncombe County,
North Carolina
CLearWaker
145 7th Avenue W; Suite B
Hendersonville, NC 28792
Vicinity Map
Figure 1

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Gravelly Branch Tract (+1- 20 AC)
Buncombe County,
North Carolina
CLearWaker
145 7th Avenue W; Suite B
Hendersonville, NC 28792
USGS Topographic Map
7.5 Minute Quad: Fruitland
Figure 2

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Gravelly Branch Tract (+1- 20 AC)
Drawn by: TJK 4.26.21; CEC Project# 1181
Buncombe County,
North Carolina
CLearWaker
145 7th Avenue W; Suite B
Hendersonville, NC 28792
Aerial Imagery Map
NCCGIA (2019)
Figure 3

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Gravelly Branch Tract (+1- 20 AC)
Project Boundary
Soil Unit
DrB: Dillard loam, 1-5% slopes, rarely flooded
JbB: Junaluska-Brasstown complex, 2-8% slopes
JbC: Junaluska-Brasstown complex, basin, 8-15% slopes
JbD: Junaluska-Brasstown complex, basin, 15-30% slopes
NkA: Nikwasi loam, 0-2% slopes, frequently flooded
TaB: Tate loam, basin, 2-8% slopes
TaC: Tate loam, basin, 8-15% slopes
Drawn by: TJK 4.26.21; CEC Project# 1181
Buncombe County,
North Carolina
CLearWaker
145 7th Avenue W; Suite B
Hendersonville, NC 28792
USDA Soils Map
NRCS Web Soil Survey
Figure 4

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Gravelly Branch Tract (+1- 20 AC)
Jurisdictional wetlands and waters identified on this map have been
located within sub -meter accuracy utilizing a Trimble mapping grade
Global Positioning System (GPS) and the subsequent differential
correction of that data. GPS points may demonstrate uncorrectable
errors due to topography, vegetative cover, and/or multipath signal
error.
Note: The illustrated wetland and stream locations are approximate.
These areas have been flagged in the field; however, they have not
been surveyed. Although ClearWater Environmental Consultants,
Inc. (CEC) is confident in our assessment, the US Army Corps of
Engineers (Corps) is the only agency that can make final decisions
regarding jurisdictional wetland and waters of the US delineations.
Therefore, all preliminary determinations are subject to change until
written verification is obtained. CEC strongly recommends that
written verification be obtained from the Corps prior to closing on the
property, beginning any site work, or making any legal reliance on this
determination.
This map was prepared by CEC using the best information available
to CEC at the time of production. This map is for informational
purposes only and should not be used to determine precise
boundaries, roadways, property boundary lines, nor legal
descriptions. This map shall not be construed to be an official survey
of any data depicted.
Source Data: Parcel Boundary - Buncombe County GIS; Contours -
NC OneMap
Potential Wetland
Waters of the US
WE-0.214Ac
Potential Non -Wetland
Waters of the US
SB - 825 LF / 0.071 Ac
Potential Wetland
Waters of the US
WF - 0.017 Ac
Potential Wetland
Waters of the US
WD - 0.003 Ac
Potential Wetland
Waters of the US
WB - 0.011 Ac
Potential Wetland
Waters of the US
WA-0.168Ac
j _ ! Project Boundary
Stream
Wetland
Culvert
Contours - 4ft
* Data Form
WE
jDP-WET
DP-UPL
WD
WC
Potential Wetland
Waters of the US
WC - 0.004 Ac
Potential Non -Wetland
Waters of the US
SA - 396 LF / 0.060 Ac
Drawn 0.by: TJK 4 27.21; CEC Projec # 1181
WF
Potential Wetland
Waters of the US
WG-0.010Ac
Potentially Jurisdictional Waters of the US
Stream
Wetland
Linear
Feet
Acres
(stream bed)
Acres
SA
396
0.06
WA
0.168
SB
825
0.071
WB
0.011
WC
0.004
WD
0.003
WE
0.214
WF
0.017
WG
0.01
Total
1,221
0.131
Total
0.427
J..
Buncombe County,
North Carolina
CLearWaker
145 7th Avenue W; Suite B
Hendersonville, NC 28792
Wetland and Stream Map
Delineated April 8, 2021
Figure 5

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
STREAM & WETLAND IMPACT LEGEND
ExI.:T. BOUNDARY
EXIST. WETLAND
EXIST. STREPIA
AIA BUFFER
SOTS S
- E EV % NEW PAVER NTDUR
- ST - NEW STORM PIPE
OUTLET PROTEcR,DN
w-DI
SWALE
PERMANENT WETLAND IMPACT
VO//////////////I PERIAANENT STREAM PAPA,
PERMANENT IMPACT SUMMARY
TOTAL 3,SES O.R&
STREAMS AREA (AC) LINEAR FEET
51 0.00S 95
PE NANENT STREAM IMPACT
PERM Mn 0,9 A.�,naiz F
DEVELOPMENT DATAPROPER, ADDRESS: ...GRAVELY ANci ROAD
PIN NUMBER: ss7ssaaFosa,ONvI ,/
PROPER, SIZE: 20.35 ACRES
INQ REVIEW: CONTROL EROSION
UNYOMBE COUNTY
REVIEW: BUNCOM. COUNTY
ZONING. CLASSIFMATION: OPEN USE
PROPOSED
PROPOSED NUMBER OF
E IJnl,a/acre
PROPOSED LINEAR FEET OF ROAD: 1803'
ADDRESS: PO BOX 12P5
[e-mail]
PHONE. 5001-30,1920
DEVELOPER: 1.k./BMC,
ADDRESS
LIA& IN4B' IPELINECOM
8-8801
ENGINEER: BROOKS ENGINEERING
CONTACT: NARK BROOKS
ADDRESS 2: czs(O
oKSQBRJOKSEA.COM
PHONE: [phone]
VICINITY MAP
SWALE PERMANENT OUTLET PROTECTION
PERMANENT DIVERSION ALE
BEE SALE CHART SHEET C.-5.6 m,
PROPOSEDE.EMIENT Irvr
EXISTING PROPERTYBDUNDARY;T P
SWALE PERMANENT OUTLET PROTECTIO
PRYPOSED SEE DETAIL SHEET S-5.3
V /
�INOLE I,PERN ANENT OUTLET PROTECTION ,TYP(
PROPOSED OPEN THROAT CATCHe IN
PROPOSED 35. RADIUS PAVED
ROOF LEADERS FOR LOT .8
DIVERSION 5,,,ALES
PERMANENT DIVERSION SWALE.
SEE SWALE CHART SHEET c ,,.8 TYPI
PROPOSED 35. R.I. PAVED
CUL-DE-SAC WITH 50..1
PERMANENT Wd Doo4AG 53 SAID IMPACT
PERMANENT OUTLET SEE PIPE CHART SHEET r PROTECTION.
LIGHTED COLLARS
MALE PERMANENT OUTLET PROTECTION
IIII'1`I`. �� 1
PROPOSER LOT LI TYP]
OPO ED HDPE IPE ITYP)
WITH oSORIVABLE SUURFA PRIVATE
OROS.Dac PRIVATEROHT-0E-P)AV ITYI
sSIBLE HOUSE
,SEE DETAIL SHEET ac.a( LOCAI ION, I YP/
PROPOSED. WIDE PARKING AREA (FYI,
MIN. 2 SPACES PER SIDE RP,
PERMANENT OUTLET PROTECTION (TY?,
/
WITH BINULE PARMNU OPACE /� /
PROPOSEDEASEMENTITY/
PROPOSEDPp3
(SEE DETAIL S-MET OO
JOINER PROPERTY LINE?
Figure
6.1

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
STREAM & WETLAND IMPACT LEGEND
EXIST. RIGHHTN,JRs„av
E,IST.,aETLAND
EXIST. ,TREANI
- EXIST. STREAM BUFFER
EXIST. STORM DRAIN
NEW RIGHT OEmAY
EOU R S
- NEWSTORM PIPE
Ea DIEwISAE ION
SW VONW
s RIPRAP-LINED
„aLE
PERMANENT WETLAND IMPART
PERMANENT STREAM IMPACT
LISP
POSSIBLE
SE LOCA I ION II,
LOCATION
POSSIBLE ENTRY SIONAMOE
'INE NE, F1I1
PROPOSED LF OF
—2206
P
EERMANENT OUTLET B PIPE CHART SHEET C..PROTECTION.
STREAM & WETLAND IMPACTS PLAN VIEW
DEVELOPMENT DATA
PROPERTY ADDRESS: YU. ,RAVELV BRANCH ROAD
PIN NUMBE PROPERTYs .75-32-4022
20NING REVIEV, BUNCOMBE COUNTY
EROSION CONTROL REVIEW: BUNCOMBE COUNTY
STORMWATER REVIEW: BUN,OMBE COUNTY
JONING CI ASSIFICATION: OPEN Lis,
PROPOSED NUf9IBER OF UNITS: 15
PROPOSED LINEAR FEET OF ROAD: ,808'
PROPERTY OWNER: NIVDMCG, LLG
CONTACT: VIBMCG, LEG
ADDRESS: PO BOX 128.,
ADDRESS 2: SEARCY, AR 72145
EMAIL: .1.SAMOLIN,QBGPIPELI,COM
PHONE: [phone]
ADDRESS: PO BOX 128r,
ENGINEER: BROOKS ENGINEERING
CONTACT: MARK ADDRESS: 17 ARLINGTON ST
ADDRESS 2: SS4BROOKSe0.C'
�OLn
PHONE. 828-22-a]00
2230
2220
2210
2200
PERMANENT WETLAND IMPACT
(PERMANENT STREAM IMPACT
I,�I
1_ vvT ,B•PAVED PRIVP,aTEROAD
PROPOSED
�,� z0DRIVABLESDREA� ITYP,
/ / i /
ZrZ,LEGHARTGHEEM.o,TYP,
PROPOSED PR VATE RIGHT -OF- YR)
PROPOSED GRADE B
22.
22122..88
CULVERT PROFILE VIEW
CULVERT
INSTALLATION
DETAIL NOTTO SCALE
1,50
oiav
EXISTING STREAM GRADE
PIPE EMBEDMENT ISEE DETAIL BELO,
E�
111111.-
RE MaBED
ELESATION
W
N
20 S <0 60
SCALE: 1"=
20'
CCONSI RUC LIOSEQUENCE:
GRMED M snoPER mTHE DRTUNESNRE'R'oMED
ONLY AFTER am,ma PERMIT HASaE'14Oamstarvt ,CORDANCE OE ALL CONDITIONS.
LN
1. INSTALL FILTREX FILTER RING
Z. INN:TALL NM AROUND AND DEMATERING PUMP, DO
INWAITAI
EEQUIR
INSTALL UPSTREAM AND DOVIN,TREAM DIKE, AND
BEGIN DEWATERING
ONLsENNT) AND INSTALLREMOVE
NE GVOENE%unrvG calve
RT JF
PRERE.STABILI2E BM< IF NECESSARY. USE
BIO-DEGPADABLE E%CELSOIR CURIE% III 100% SEED
REMOVEPANYCaE'ECTED SEDIMENT IN TRENCH OR
FIL8. ,OVVING'PUMPSANDPIPING EQu,P,ENI
MOVE DIKES
110. APPLY WETLAND SEED MIX TO ANY DISNRBED AREAS
3.
7.
PERMANENT IMPACT SUMMARY
AREA
wErLAtrnc SF AC
3,432 0.079
19 0.004
3,505 0.062
STREAMS AREA (AC) LINEAR FEET
SI ] 0.009
WI
w2.
TOTAL
LOBES TACT,. OE
mne:rc ENION imerO EATEN Boo
1
BECTON or
FILTREXX TRENCH WATER DE -WATERING BASIN DETAIL
eA 'r�Itp -moo
�a+oIaLII[ b.Ac
Gar
Gr
. awn. aultl discharge
mist a ,61E rekrll71
a%se:pxa. rnW. M.Ip Lys
ar uadMp
Merairks
N on
#r EE
,can wale. dr.a
4.1311, aroo
w1 titi are E. L�.arf
a . xl-Ld•,
ewTWYM r• ono do,
rrrm
pwws
w -'he.
h 10' drP
2010
5TI AM DE-AATEFuNG tETAIL
No Imola( SHALL OC PERFORMED Ix1RING ELEVATED STREAM BASE FLOWS
PROPOSED PUMP AROUND SYSTEM
9
BC STDRMWATER AND ESC SUBMITTAL
STREAM AND WETLAND IMPACTS
PRELIMINARY DRAWINGS
GRAVELY BRANCH ROAD
MAJOR SUBDIVISION
9
Figure
6.2

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Gravelly Branch Tract (+1- 20 AC)
Drawn by: TJK 4.26.21; CEC Project# 1181
Buncombe County,
North Carolina
CLearWaker
145 7th Avenue W; Suite B
Hendersonville, NC 28792
FEMA Flood Zone Map
FIRM Panel 3700967500J
(eff. 1/6/2021)
Figure 7

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Appendix A:
Preliminary Jurisdictional
Determination Request

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Jurisdictional Determination Request
US Army Corps
of Engineers
Wilmington Dstrict
This form is intended for use by anyone requesting a jurisdictional determination (JD) from the
U.S. Army Corps of Engineers, Wilmington District (Corps). Please include all supporting
information, as described within each category, with your request. You may submit your request
via mail, electronic mail, or facsimile. Requests should be sent to the appropriate project
manager of the county in which the property is located. A current list of project managers by
assigned counties can be found on-line at:
http: //www. saw. usace. army. mil/Missions/RegulatoryPermitProgram/Contact/CountyLocator. aspx,
by calling 910-251-4633, or by contacting any of the field offices listed below. Once your
request is received you will be contacted by a Corps project manager.
ASHEVILLE & CHARLOTTE REGULATORY
FIELD OFFICES
US Army Corps of Engineers
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
General Number: [phone]
Fax Number: [phone]
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]
WASHINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
2407 West Fifth Street
Washington, North Carolina 27889
General Number: [phone]
Fax Number: [phone]
WILMINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
69 Darlington Avenue
Wilmington, North Carolina 28403
General Number: 910-251-4633
Fax Number: [phone]
INSTRUCTIONS:
All requestors must complete Parts A, B, C, D, E, F and G.
NOTE TO CONSULTANTS AND AGENCIES: If you are requesting a JD on behalf of a
paying client or your agency, please note the specific submittal requirements in Part H.
NOTE ON PART D — PROPERTY OWNER AUTHORIZATION: Please be aware that
all JD requests must include the current property owner authorization for the Corps to
proceed with the determination, which may include inspection of the property when
necessary. This form must be signed by the current property owner(s) or the owner(s)
authorized agent to be considered a complete request.
NOTE ON PART D - NCDOT REQUESTS: Property owner authorization/notification for
JD requests associated with North Carolina Department of Transportation (NCDOT)
projects will be conducted according to the current NCDOT/USACE protocols.
NOTE TO USDA PROGRAM PARTICIPANTS: A Corps approved or preliminary JD
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 also request a certified wetland determination from the local
office of the Natural Resources Conservation Service, prior to starting work.
Version: May 2017 Page 1

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Jurisdictional Determination Request
A. PARCEL INFORMATION
Street Address: 99999 Gravelly Branch Rd
City, State: Fairview, North Carolina
County: Buncombe
Parcel Index Number(s) (PIN): 967552402800000
B. REQUESTOR INFORMATION
Name: ClearWater Environmental Consultants
Mailing Address: 145 7th Avenue W; Suite B
Telephone Number:
Electronic Mail Address:
Select one:
Hendersonville, NC 28792
828-698-9800
[e-mail]
I am the current property owner.
I am an Authorized Agent or Environmental Consultant'
Interested Buyer or Under Contract to Purchase
Other, please explain.
C. PROPERTY OWNER INFORMATION2
Name: See Attached Agent Authorization
Mailing Address:
Telephone Number:
Electronic Mail Address:
See Attached Agent Authorization
See Attached Agent Authorization
See Attached Agent Authorization
See Attached Agent Authorization
' Must provide completed Agent Authorization Form/Letter.
2 Documentation of ownership also needs to be provided with request (copy of Deed, County GIS/Parcel/Tax Record).
Version: May 2017 Page 2

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Jurisdictional Determination Request
D. PROPERTY ACCESS CERTIFICATION3,4
By signing below, I authorize representatives of the Wilmington District, U.S. Army Corps of
Engineers (Corps) to enter upon the property herein described for the purpose of conducting on -
site investigations, if necessary, and issuing a jurisdictional determination pursuant to Section
404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899. I, the
undersigned, am either a duly authorized owner of record of the property identified herein, or
acting as the duly authorized agent of the owner of record of the property.
See Attached Agent Authorization
Print Name
Capacity: ❑ Owner 2 Authorized Agents
Date
Signature
E. REASON FOR JD REQUEST: (Check as many as applicable)
El
I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all aquatic resources.
❑ I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all jurisdictional aquatic resources under Corps authority.
❑ I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps, and the JD would be used to avoid and minimize
impacts to jurisdictional aquatic resources and as an initial step in a future permitting
process.
❑✓ I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps; this request is accompanied by my peil lit application
and the JD is to be used in the peiiuitting process.
❑ I intend to construct/develop a project or perfoilu activities in a navigable water of the
U.S. which is included on the district Section 10 list and/or is subject to the ebb and flow of
the tide.
A Corps JD is required in order obtain my local/state authorization.
I intend to contest jurisdiction over a particular aquatic resource and request the Corps
confirm that jurisdiction does/does not exist over the aquatic resource on the parcel.
❑ I believe that the site may be comprised entirely of dry land.
❑ Other:
E
3 For NCDOT requests following the current NCDOT/USACE protocols, skip to Part E.
4 If there are multiple parcels owned by different parties, please provide the following for each additional parcel on a
continuation sheet.
5 Must provide agent authorization form/letter signed by owner(s).
Version: May 2017
Page 3

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Jurisdictional Determination Request
F. JURISDICTIONAL DETERMINATION (JD) TYPE (Select One)
❑
I am requesting that the Corps provide a preliminary JD for the property identified herein.
A Preliminary Jurisdictional Determination (PJD) provides an indication that there may
be "waters of the United States" or "navigable waters of the United States"on a property.
PJDs are sufficient as the basis for permit decisions. For the purposes of permitting, all
waters and wetlands on the property will be treated as if they are jurisdictional "waters of
the United States". PJDs cannot be appealed (33 C.F.R. 331.2); however, a PJD is
"preliminary" in the sense that an approved JD can be requested at any time. PJDs do
not expire.
I am requesting that the Corps provide an approved JD for the property identified herein.
An Approved Jurisdictional Determination (AJD) is a determination that
jurisdictional "waters of the United States" or "navigable waters of the United
States" are either present or absent on a site. An approved JD identifies the limits of
waters on a site determined to be jurisdictional under the Clean Water Act and/or
Rivers and Harbors Act. Approved JDs are sufficient as the basis for permit
decisions. AJDs are appealable (33 C.F.R. 331.2). The results of the AJD will be
posted on the Corps website. A landowner, permit applicant, or other "affected
party" (33 C.F.R. 331.2) who receives an AJD may rely upon the AJD for five years
(subject to certain limited exceptions explained in Regulatory Guidance Letter 05-
02).
I am unclear as to which JD I would like to request and require additional information
to inform my decision.
G. ALL REQUESTS
n
Map of Property or Project Area. This Map must clearly depict the boundaries of the
review area.
Size of Property or Review Area +/- 20 acres.
❑ The property boundary (or review area boundary) is clearly physically marked on the site.
Version: May 2017
Page 4

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Jurisdictional Determination Request
H. REQUESTS FROM CONSULTANTS
❑✓
❑✓
Project Coordinates (Decimal Degrees): Latitude: 35.493001
Longitude: -82.442694
A legible delineation map depicting the aquatic resources and the property/review area.
Delineation maps must be no larger than 11x17 and should contain the following: (Corps
signature of submitted survey plats will occur after the submitted delineation map has been
reviewed and approved).6
• North Arrow
• Graphical Scale
• Boundary of Review Area
• Date
• Location of data points for each Wetland Determination Data Form or tributary
assessment reach.
For Approved Jurisdictional Determinations:
• Jurisdictional wetland features should be labeled as Wetland Waters of the US, 404
wetlands, etc. Please include the acreage of these features.
• Jurisdictional non -wetland features (i.e. tidal/navigable waters, tributaries,
impoundments) should be labeled as Non -Wetland Waters of the US, stream, tributary,
open water, relatively permanent water, pond, etc. Please include the acreage or linear
length of each of these features as appropriate.
• Isolated waters, waters that lack a significant nexus to navigable waters, or non -
jurisdictional upland features should be identified as Non -Jurisdictional. Please
include a justification in the label regarding why the feature is non jurisdictional (i.e.
"Isolated", "No Significant Nexus", or "Upland Feature"). Please include the acreage
or linear length of these features as appropriate.
For Preliminary Jurisdictional Determinations:
• Wetland and non -wetland features should not be identified as Jurisdictional, 404,
Waters of the United States, or anything that implies jurisdiction. These features can be
identified as Potential Waters of the United States, Potential Non -wetland Waters of
the United States, wetland, stream, open water, etc. Please include the acreage and
linear length of these features as appropriate.
n
Completed Wetland Determination Data Forms for appropriate region
(at least one wetland and one upland form needs to be completed for each wetland type)
6 Please refer to the guidance document titled "Survey Standards for Jurisdictional Determinations" to ensure that the
supplied map meets the necessary mapping standards. http://www.saw.usace.army.mil/Missions/Regulatory-Permit-
P ro gram/Juri s dictio n/
Version: May 2017
Page 5

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Jurisdictional Determination Request
✓❑ Completed appropriate Jurisdictional Determination form
• PJDs, please complete a Preliminary Jurisdictional Determination Form' and include the
Aquatic Resource Table
• AJDs, please complete an Approved Jurisdictional Determination Form'
✓❑
❑
Vicinity Map
Aerial Photograph
USGS Topographic Map
Soil Survey Map
Other Maps, as appropriate (e.g. National Wetland Inventory Map, Proposed Site
Plan, previous delineation maps, LIDAR maps, FEMA floodplain maps)
Landscape Photos (if taken)
NCSAM and/or NCWAM Assessment Forms and Rating Sheets
NC Division of Water Resources Stream Identification Forms
Other Assessment Forms
www.saw.usace.army.mil/Portals/59/docs/regulatory/regdocs/JD/RGL 08-02 App A Prelim JD Form fillable.pdf
' Please see http://www.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Jurisdiction/
Principal Purpose: The information that you provide will be used in evaluating your request to determine
whether there are any aquatic resources within the project area subject to federal jurisdiction under the regulatory
authorities referenced above.
Routine Uses: This information may be shared with the Department of Justice and other federal, state, and local
government agencies, and the public, and may be made available as part of a public notice as required by federal
law. Your name and property location where federal jurisdiction is to be determined will be included in the
approved jurisdictional determination (AJD), which will be made available to the public on the District's website
and on the Headquarters USAGE website.
Disclosure: Submission of requested information is voluntary; however, if information is not provided, the
request for an AJD cannot be evaluated nor can an AJD be issued.
Version: May 2017 Page 6

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Appendix 2 - PRELIMINARY JURISDICTIONAL DETERMINATION (PJD) FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PJD: April 28, 2021
B. NAME AND ADDRESS OF PERSON REQUESTING PJD: See Agent Authorization Form
C. DISTRICT OFFICE, FILE NAME, AND NUMBER: CESAW-RG-A
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
(USE THE TABLE BELOW TO DOCUMENT MULTIPLE AQUATIC RESOURCES AND/OR
AQUATIC RESOURCES AT DIFFERENT SITES)
State: N C
County/parish/borough: Buncombe CO. City: Fairview
Center coordinates of site (lat/long in degree decimal format):
Lat.: 35.493001 Long.: -82.442694
Universal Transverse Mercator: NAD83
Name of nearest waterbody: Moore Lake
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
❑ Office (Desk) Determination. Date:
❑ Field Determination. Date(s):
TABLE OF AQUATIC RESOURCES IN REVIEW AREA WHICH "MAY BE" SUBJECT TO REGULATORY
JURISDICTION.
Site
number
Latitude
(decimal
degrees)
Longitude
(decimal
degrees)
Estimated amount
of aquatic resource
in review area
(acreage and linear
feet, if applicable)
Type of aquatic
resource (i.e., wetland
vs. non -wetland
waters)
Geographic authority
to which the aquatic
resource "may be"
subject (i.e., Section
404 or Section 10/404)
See Table 1.

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Table 1. Table of Aquatic Resources in Review Area which "May be" subject to Regulatory Jurisdiction
Site
Number
Latitude
(Decimal
Degrees)
Longitude
(Decimal
Degrees)
Estimated amount of
aquatic resources in
review area (Acreage and
linear feet, if applicable)
Type of aquatic
resource (i.e. wetland
vs. non -wetland
waters)
Geographic authority to
which the aquatic
resource "may be"
subject (i.e., Section 404
or Section 10/404)
SA
35.492264
-82.444484
396 LF / 0.060 Ac
non -wetland
Section 404
SB
35.494055
-82.443334
825 LF / 0.071 Ac
non -wetland
Section 404
WA
35.492240
-82.444700
0.168 Ac
wetland
Section 404
WB
35.492446
-82.444506
0.011 Ac
wetland
Section 404
WC
35.492509
-82.444312
0.004 Ac
wetland
Section 404
WD
35.492759
-82.444400
0.003 Ac
wetland
Section 404
WE
35.493569
-82.443699
0.214 Ac
wetland
Section 404
WF
35.494383
-82.443068
0.017 Ac
wetland
Section 404
WG
35.491755
-82.441808
0.010 Ac
wetland
Section 404

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
1) The Corps of Engineers believes that there may be jurisdictional aquatic resources in
the review area, and the requestor of this PJD is hereby advised of his or her option
to request and obtain an approved JD (AJD) for that review area based on an
informed decision after having discussed the various types of JDs and their
characteristics and circumstances when they may be appropriate.
2) In any circumstance where a permit applicant obtains an individual permit, or a
Nationwide General Permit (NWP) or other general permit verification requiring "pre -
construction notification" (PCN), or requests verification for a non -reporting NWP or
other general permit, and the permit applicant has not requested an AJD for the
activity, the permit applicant is hereby made aware that: (1) the permit applicant has
elected to seek a permit authorization based on a PJD, which does not make an
official determination of jurisdictional aquatic resources; (2) the applicant has the
option to request an AJD before accepting the terms and conditions of the permit
authorization, and that basing a permit authorization on an AJD could possibly result
in less compensatory mitigation being required or different special conditions; (3) the
applicant has the right to request an individual permit rather than accepting the terms
and conditions of the NWP or other general permit authorization; (4) the applicant can
accept a permit authorization and thereby agree to comply with all the terms and
conditions of that permit, including whatever mitigation requirements the Corps has
determined to be necessary; (5) undertaking any activity in reliance upon the subject
permit authorization without requesting an AJD constitutes the applicant's acceptance
of the use of the PJD; (6) accepting a permit authorization (e.g., signing a proffered
individual permit) or undertaking any activity in reliance on any form of Corps permit
authorization based on a PJD constitutes agreement that all aquatic resources in the
review area affected in any way by that activity will be treated as jurisdictional, and
waives any challenge to such jurisdiction in any administrative or judicial compliance
or enforcement action, or in any administrative appeal or in any Federal court; and (7)
whether the applicant elects to use either an AJD or a PJD, the JD will be processed
as soon as practicable. Further, an AJD, a proffered individual permit (and all terms
and conditions contained therein), or individual permit denial can be administratively
appealed pursuant to 33 C.F.R. Part 331. If, during an administrative appeal, it
becomes appropriate to make an official determination whether geographic
jurisdiction exists over aquatic resources in the review area, or to provide an official
delineation of jurisdictional aquatic resources in the review area, the Corps will
provide an AJD to accomplish that result, as soon as is practicable. This PJD finds
that there "may be"waters of the U.S. and/or that there "may be" navigable waters of
the U.S. on the subject review area, and identifies all aquatic features in the review
area that could be affected by the proposed activity, based on the following
information:

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
SUPPORTING DATA. Data reviewed for PJD (check all that apply)
Checked items should be included in subject file. Appropriately reference sources
below where indicated for all checked items:
• Maps, plans, plots or plat submitted by or on behalf of the PJD requestor:
Map:Vicinity, USGS Topo, Aerial, USDA Soil, Wetland/Stream Delineation, FEMA
O Data sheets prepared/submitted by or on behalf of the PJD requestor.
n Office concurs with data sheets/delineation report.
n Office does not concur with data sheets/delineation report. Rationale:
❑ 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: 1:24,000 Scale Topo Quad: Fruitland
❑ Natural Resources Conservation Service Soil Survey. Citation:
❑ National wetlands inventory map(s). Cite name:
❑ State/local wetland inventory map(s):
■❑ FEMA/FIRM maps: FIRM Panel: 3700967500J (eff. 1/6/2021)
❑ 100-year Floodplain Elevation is: .(National Geodetic Vertical Datum of 1929)
• Photographs: • Aerial (Name & Date): NCGGIA 2019
or • Other (Name & Date): Photolog (CEC 4/8/2021)
n Previous determination(s). File no. and date of response letter:
n Other information (please specify): Property Data
IMPORTANT NOTE: The information recorded on this form has not necessarily
been verified by the Corps and should not be relied upon for later jurisdictional
determinations.
Signature and date of
Regulatory staff member
completing PJD
DocuSigned by:
2. U 21MC.
L 0A79F7DC85EE4F7...
5/21/2021
Signature and date of
person requesting PJD
(REQUIRED, unless obtaining
the signature is impracticable)'
1 Districts may establish timeframes for requestor to return signed PJD forms. If the requestor does not respond
within the established time frame, the district may presume concurrence and no additional follow up is
necessary prior to finalizing an action.

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Cowardin_Code NWPR_Determine_Cod
SA NORTH CAROLINA Linear 396 FOOT PJD404 35.49226400 -82.44448400
SB NORTH CAROLINA Linear 825 FOOT PJD404 35.49405500 -82.44333400
WA NORTH CAROLINA Area 0.168 ACRE PJD404 35.49224000 -82.44470000
WB NORTH CAROLINA Area 0.011 ACRE PJD404 35.49244600 -82.44450600
WC NORTH CAROLINA Area 0.004 ACRE PJD404 35.49250900 -82.44431200
WD NORTH CAROLINA Area 0.003 ACRE PJD404 35.49275900 -82.44440000
WE NORTH CAROLINA Area 0.214 ACRE PJD404 35.49356900 -82.44369900
WF NORTH CAROLINA Area 0.017 ACRE PJD404 35.49438300 -82.44306800
WG NORTH CAROLINA Area 0.01 ACRE PJD404 35.49175500 -82.44180800

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
U.S. Army Corps of Engineers
WETLAND DETERMINATION DATA SHEET — Eastern Mountains and Piedmont Region
See ERDC/EL TR-07-24; the proponent agency is CECW-CO-R
OMB Control #: 0710-xxxx, Exp: Pending
Requirement Control Symbol EXEMPT:
(Authority: AR 335-15, paragraph 5-2a)
Project/Site: Gravelly Branch Rd
Applicant/Owner:
City/County: Fairview / Buncombe Co. Sampling Date: 04/08/2021
Investigator(s): T. Kurtz & B. Yant
Landform (hillside, terrace, etc.): Floodplain
Subregion (LRR or MLRA): LRR N, MLRA 130E Lat: 35.493138
Soil Map Unit Name: DrB: Dillard loam, 1-5% slopes, rarely flooded
Section, Township, Range:
State: NC Sampling Point: DP -Wet
Local relief (concave, convex, none):
Slope (%): 3
Long: -82.444143 Datum: NAD83
Are climatic / hydrologic conditions on the site typical for this time of year?
NWI classification: n/a
Yes X No (If no, explain in Remarks.)
Are Vegetation , Soil , or Hydrology significantly disturbed? Are "Normal Circumstances" present? Yes X No
Are Vegetation , Soil , or Hydrology 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?
Hydric Soil Present?
Wetland Hydrology Present?
Yes X No
Yes X No
Yes X No
Is the Sampled Area
within a Wetland? Yes X No
Remarks:
Wetland is located within the floodplain of SB. The Anticedent Precipitation Tool resulted in "normal" conditions during the date of delineation.
HYDROLOGY
Wetland Hydrology Indicators:
Primary Indicators (minimum of one is required; check all that apply)
Secondary Indicators (minimum of two required)
Surface Soil Cracks (B6)
Surface (B8)
(C2)
Imagery (C9)
(D1)
(D4)
_
Water (A1) Aquatic Plants (B14) Vegetated Concave
_Surface _True _Sparsely
High Water Table (A2) Hydrogen Sulfide Odor (C1) Drainage Patterns (B10)
_ _ _
X Saturation (A3) X Oxidized Rhizospheres on Living Roots (C3) Moss Trim Lines (B16)
_
Marks (B1) n/a Presence of Reduced Iron (C4) -Season Water Table
_Water _Dry
Deposits (B2) Iron Reduction in Tilled Soils (C6) Burrows (C8)
_Sediment _Recent _Crayfish
Drift Deposits (B3) Muck Surface (C7) X Saturation Visible on Aerial
_ _Thin
Mat or Crust (B4) (Explain in Remarks) or Stressed Plants
_Algal _Other _Stunted
X Iron Deposits (B5) X Geomorphic Position (D2)
Inundation Visible on Aerial Imagery (B7) Shallow Aquitard (D3)
_ _
Water -Stained Leaves (B9) Microtopographic Relief
_ _
Aquatic Fauna (B13) FAC-Neutral Test (D5)
Field Observations:
Surface Water Present? Yes No X Depth (inches):
Wetland Hydrology Present?
Yes
X
No
Water Table Present? Yes No X Depth (inches):
Saturation Present? Yes X No Depth (inches): 0
(includes capillary fringe)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:
ENG FORM 6116-4-SG, JUL 2018
Eastern Mountains and Piedmont — Version 2.0

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
VEGETATION (Four Strata) - Use scientific names of plants.
Sampling Point:
DP -Wet
Tree Stratum
1.
2.
3.
4.
5.
6.
7.
(Plot size:
30
50% of total cover:
Absolute Dominant Indicator
% Cover Species? Status
0
Sapling/Shrub Stratum (Plot size: 15
1.
2.
3.
4.
5.
6.
7.
8.
9.
50% of total cover:
Herb Stratum (Plot size: 5
0
=Total Cover
20% of total cover:
=Total Cover
20% of total cover:
1. Carex lurida 60 Yes OBL
2. Juncus effusus 20 Yes FACW
3. Viola sororia 5 No FAC
4. Andropogon virginicus 15 No FACU
5.
6.
7.
8.
9.
10.
11.
100 =Total Cover
50% of total cover: 50 20% of total cover: 20
Woody Vine Stratum (Plot size: 15
1.
2.
3.
4.
5.
0
=Total Cover
50% of total cover: 20% of total cover:
Dominance Test worksheet:
Number of Dominant Species
That Are OBL, FACW, or FAC: 2 (A)
Total Number of Dominant
Species Across All Strata: 2 (B)
Percent of Dominant Species
That Are OBL, FACW, or FAC: 100.0% (NB)
Prevalence Index worksheet:
Total % Cover of: Multiply by:
OBL species 60 x 1 = 60
FACW species 20 x 2 = 40
FAC species 5 x 3 = 15
FACU species 15 x 4 = 60
UPL species 0 x 5 = 0
Column Totals: 100 (A) 175 (B)
Prevalence Index = B/A = 1.75
Hydrophytic Vegetation Indicators:
1 - Rapid Test for Hydrophytic Vegetation
X 2 - Dominance Test is >50%
X 3 - Prevalence Index is <_3.01
4 - Morphological Adaptations' (Provide supporting
data in Remarks or on a separate sheet)
Problematic Hydrophytic Vegetation (Explain)
'Indicators of hydric soil and wetland hydrology must be
present, unless disturbed or problematic.
Definitions of Four Vegetation Strata:
Tree - Woody plants, excluding vines, 3 in. (7.6 cm) or
more in diameter at breast height (DBH), regardless of
height.
Sapling/Shrub - Woody plants, excluding vines, less
than 3 in. DBH and greater than or equal to 3.28 ft
(1 m) tall.
Herb - All herbaceous (non -woody) plants, regardless
of size, and woody plants less than 3.28 ft tall.
Woody Vine - All woody vines greater than 3.28 ft in
height.
Hydrophytic
Vegetation
Present? Yes X No
Remarks: (Include photo numbers here or on a separate sheet.)
ENG FORM 6116-4-SG, JUL 2018
Eastern Mountains and Piedmont - Version 2.0

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
SOIL
Sampling Point: DP -Wet
Depth
(inches)
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Matrix Redox Features
Color (moist) % Color (moist) % Typel Loc2 Texture
0-4 5Y 5/2 85
4-16
2.5Y 5/2 80
5YR 4/6 15 C PL
5YR 4/6 10 C PL
7.5YR 5/8 10 C M
Type: C=Concentration, D=Depletion, RM=Reduced Matrix, MS=Masked Sand Grains.
Remarks
Loamy/Clayey Prominent redox concentrations
Loamy/Clayey Prominent redox concentrations
Prominent redox concentrations
2Location: PL=Pore Lining, M=Matrix.
Hydric Soil Indicators:
Histosol (A1)
_ Histic Epipedon (A2)
Black Histic (A3)
_ Hydrogen Sulfide (A4)
Stratified Layers (A5)
2 cm Muck (A10) (LRR N)
Depleted Below Dark Surface (A11)
_Thick Dark Surface (Al2)
Sandy Mucky Mineral (S1)
_ Sandy Gleyed Matrix (S4)
_ Sandy Redox (S5)
_ Stripped Matrix (S6)
Dark Surface (S7)
Polyvalue Below Surface (S8) (MLRA 147, 148)
_Thin Dark Surface (S9) (MLRA 147, 148)
Loamy Mucky Mineral (F1) (MLRA 136)
_ Loamy Gleyed Matrix (F2)
X Depleted Matrix (F3)
_ Redox Dark Surface (F6)
_ Depleted Dark Surface (F7)
_ Redox Depressions (F8)
Iron -Manganese Masses (F12) (LRR N,
MLRA 136)
Umbric Surface (F13) (MLRA 122, 136)
Piedmont Floodplain Soils (F19) (MLRA 148)
Red Parent Material (F21) (MLRA 127, 147, 148)
Indicators for Problematic Hydric Soils3:
2 cm Muck (A10) (MLRA 147)
_ Coast Prairie Redox (A16)
(MLRA 147, 148)
Piedmont Floodplain Soils (F19)
(MLRA 136, 147)
_ Red Parent Material (F21)
(outside MLRA 127, 147, 148)
_Very Shallow Dark Surface (F22)
Other (Explain in Remarks)
3lndicators of hydrophytic vegetation and
wetland hydrology must be present,
unless disturbed or problematic.
Restrictive Layer (if observed):
Type:
Depth (inches):
Hydric Soil Present?
Yes X No
Remarks:
ENG FORM 6116-4-SG, JUL 2018
Eastern Mountains and Piedmont — Version 2.0

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
U.S. Army Corps of Engineers
WETLAND DETERMINATION DATA SHEET — Eastern Mountains and Piedmont Region
See ERDC/EL TR-07-24; the proponent agency is CECW-CO-R
OMB Control #: 0710-xxxx, Exp: Pending
Requirement Control Symbol EXEMPT:
(Authority: AR 335-15, paragraph 5-2a)
Project/Site: Gravelly Branch Rd
Applicant/Owner:
City/County: Fairview / Buncombe Co. Sampling Date: 04/08/2021
Investigator(s): T. Kurtz & B. Yant
Landform (hillside, terrace, etc.): Hillside
Subregion (LRR or MLRA): LRR N, MLRA 130E Lat: 35.493124
Soil Map Unit Name: DrB: Dillard loam, 1-5% slopes, rarely flooded
Section, Township, Range:
State: NC Sampling Point: DP-UPL
Local relief (concave, convex, none):
Slope (%): 10
Long: -82.444030 Datum: NAD83
Are climatic / hydrologic conditions on the site typical for this time of year?
NWI classification: n/a
Yes X No (If no, explain in Remarks.)
Are Vegetation , Soil , or Hydrology significantly disturbed? Are "Normal Circumstances" present? Yes X No
Are Vegetation , Soil , or Hydrology 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 X
Hydric Soil Present? Yes No X
Wetland Hydrology Present? Yes No X
Is the Sampled Area
within a Wetland?
Yes No X
Remarks:
Data point was taken on an upland hillside, adjacent to the floodplain. The Anticedent Precipitation Tool resulted in "normal" conditions during the date
of delineation.
HYDROLOGY
Wetland Hydrology Indicators:
Primary Indicators (minimum of one is required; check all that apply)
Secondary Indicators (minimum of two required)
Surface Soil Cracks (B6)
Surface (B8)
(C2)
Imagery (C9)
(D1)
(D4)
_
Water (A1) Aquatic Plants (B14) Vegetated Concave
_Surface _True _Sparsely
High Water Table (A2) Hydrogen Sulfide Odor (C1) Drainage Patterns (B10)
_ _ _
Saturation (A3) Oxidized Rhizospheres on Living Roots (C3) Moss Trim Lines (B16)
_ _ _
Marks (B1) n/a Presence of Reduced Iron (C4) -Season Water Table
_Water _Dry
Deposits (B2) Iron Reduction in Tilled Soils (C6) Burrows (C8)
_Sediment _Recent _Crayfish
Drift Deposits (B3) Muck Surface (C7) Saturation Visible on Aerial
_ _Thin _
Mat or Crust (B4) (Explain in Remarks) or Stressed Plants
_Algal _Other _Stunted
Iron Deposits (B5) Geomorphic Position (D2)
_ _
Inundation Visible on Aerial Imagery (B7) Shallow Aquitard (D3)
_ _
Water -Stained Leaves (B9) Microtopographic Relief
_ _
Aquatic Fauna (B13) FAC-Neutral Test (D5)
Field Observations:
Surface Water Present? Yes No X Depth (inches):
Wetland Hydrology Present?
Yes
No
X
Water Table Present? Yes No X Depth (inches):
Saturation Present? Yes No X Depth (inches):
(includes capillary fringe)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:
ENG FORM 6116-4-SG, JUL 2018
Eastern Mountains and Piedmont — Version 2.0

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
VEGETATION (Four Strata) - Use scientific names of plants.
Sampling Point:
DP-UPL
Tree Stratum
1.
2.
3.
4.
5.
6.
7.
(Plot size:
30
50% of total cover:
Absolute Dominant Indicator
% Cover Species? Status
0
Sapling/Shrub Stratum (Plot size: 15
1.
2.
3.
4.
5.
6.
7.
8.
9.
50% of total cover:
Herb Stratum (Plot size: 5
0
=Total Cover
20% of total cover:
=Total Cover
20% of total cover:
1. Plantago lanceolata 20 Yes UPL
2. Hypochaeris radicata 15 No UPL
3. Potentilla simplex 5 No FACU
4. Andropogon virginicus 60 Yes FACU
5.
6.
7.
8.
9.
10.
11.
100 =Total Cover
50% of total cover: 50 20% of total cover: 20
Woody Vine Stratum (Plot size: 15
1.
2.
3.
4.
5.
0
=Total Cover
50% of total cover: 20% of total cover:
Dominance Test worksheet:
Number of Dominant Species
That Are OBL, FACW, or FAC: 0 (A)
Total Number of Dominant
Species Across All Strata: 2 (B)
Percent of Dominant Species
That Are OBL, FACW, or FAC: 0.0% (NB)
Prevalence Index worksheet:
Total % Cover of: Multiply by:
OBL species 0 x 1 = 0
FACW species 0 x 2 = 0
FAC species 0 x 3 = 0
FACU species 65 x 4 = 260
UPL species 35 x 5 = 175
Column Totals: 100 (A) 435 (B)
Prevalence Index = B/A = 4.35
Hydrophytic Vegetation Indicators:
1 - Rapid Test for Hydrophytic Vegetation
2 - Dominance Test is >50%
3 - Prevalence Index is <_3.01
4 - Morphological Adaptations' (Provide supporting
data in Remarks or on a separate sheet)
Problematic Hydrophytic Vegetation (Explain)
'Indicators of hydric soil and wetland hydrology must be
present, unless disturbed or problematic.
Definitions of Four Vegetation Strata:
Tree - Woody plants, excluding vines, 3 in. (7.6 cm) or
more in diameter at breast height (DBH), regardless of
height.
Sapling/Shrub - Woody plants, excluding vines, less
than 3 in. DBH and greater than or equal to 3.28 ft
(1 m) tall.
Herb - All herbaceous (non -woody) plants, regardless
of size, and woody plants less than 3.28 ft tall.
Woody Vine - All woody vines greater than 3.28 ft in
height.
Hydrophytic
Vegetation
Present? Yes No X
Remarks: (Include photo numbers here or on a separate sheet.)
ENG FORM 6116-4-SG, JUL 2018
Eastern Mountains and Piedmont - Version 2.0

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
SOIL
Sampling Point: DP-UPL
Depth
(inches)
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Matrix Redox Features
Color (moist) % Color (moist) % Typel Loc2 Texture
0-2 10Y R 4/3 100
2-16 10YR 5/6 90
10YR 5/4
Loamy/Clayey
10 D M Loamy/Clayey
Type: C=Concentration, D=Depletion, RM=Reduced Matrix, MS=Masked Sand Grains.
Remarks
2Location: PL=Pore Lining, M=Matrix.
Hydric Soil Indicators:
Histosol (A1)
_ Histic Epipedon (A2)
Black Histic (A3)
_ Hydrogen Sulfide (A4)
Stratified Layers (A5)
2 cm Muck (A10) (LRR N)
Depleted Below Dark Surface (A11)
_Thick Dark Surface (Al2)
Sandy Mucky Mineral (S1)
_ Sandy Gleyed Matrix (S4)
_ Sandy Redox (S5)
_ Stripped Matrix (S6)
Dark Surface (S7)
Polyvalue Below Surface (S8) (MLRA 147, 148)
_Thin Dark Surface (S9) (MLRA 147, 148)
Loamy Mucky Mineral (F1) (MLRA 136)
_ Loamy Gleyed Matrix (F2)
_ Depleted Matrix (F3)
_ Redox Dark Surface (F6)
_ Depleted Dark Surface (F7)
_ Redox Depressions (F8)
Iron -Manganese Masses (F12) (LRR N,
MLRA 136)
Umbric Surface (F13) (MLRA 122, 136)
Piedmont Floodplain Soils (F19) (MLRA 148)
Red Parent Material (F21) (MLRA 127, 147, 148)
Indicators for Problematic Hydric Soils3:
2 cm Muck (A10) (MLRA 147)
_ Coast Prairie Redox (A16)
(MLRA 147, 148)
Piedmont Floodplain Soils (F19)
(MLRA 136, 147)
_ Red Parent Material (F21)
(outside MLRA 127, 147, 148)
_Very Shallow Dark Surface (F22)
Other (Explain in Remarks)
3lndicators of hydrophytic vegetation and
wetland hydrology must be present,
unless disturbed or problematic.
Restrictive Layer (if observed):
Type:
Depth (inches):
Hydric Soil Present?
Yes No X
Remarks:
ENG FORM 6116-4-SG, JUL 2018
Eastern Mountains and Piedmont — Version 2.0

DocuSignEnvelope ID: F599EOD99-D498-47-B-B1C5-ACOOFFDD233E pitatiOrl vs Normal Range based on NOAA's Daily Global Historical Climatology Network
10-
8-
.4-
2-
0
J1r
Sep
2020
Oct
2020
Nov
2020
fl
Dec
2020
Coordinates
35.493138, -82.444143
Observation Date
2021-04-08
Elevation (ft)
2213.19
Drought Index (PDSI)
Severe wetness (2021-03)
WebWIMP H2O Balance
Wet Season
Figure and tables made by the
Antecedent Precipitation Tool
Version 1.0
written by Jason Deters
U.S. Army Corps of Engineers
JI „ _f4aL�
Jan
2021
■ w—'w
021-02-07
Feb
2021
rti
Mar
2021
411
21-04-08
Apr
2021
May
2021
Jun
2021
— Daily Total
- 30-Day Rolling Total
30-Year Normal Range
Jul
2021
Aug
2021
30 Days Ending
30th %ile (in)
70th %ile (in)
Observed (in)
Wetness Condition
Condition Value
Month Weight
Product
2021-04-08
2.885039
4.446063
8.732284
Wet
3
3
9
2021-03-09
2.367717
4.697638
4.622047
Normal
2
2
4
2021-02-07
2.610236
4.997638
1.555118
Dry
1
1
1
Result
Normal Conditions - 14
Weather Station Name
Coordinates
Elevation (ft)
Distance (mi)
Elevation A
Weighted L
Days (Normal)
Days (Antecedent)
ASHEVILLE RGNL AP
35.4319, -82.5375
2117.126
6.746
96.064
3.684
11353
90

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Appendix B:
Federally Protected Species Information

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Endangered Species, Threatened Species,Federal Species of Concern, and Candidate Species,
Buncombe County, North Carolina
Updated: 07-17-2020
Common Name
Vertebrate:
Allegheny woodrat
Appalachian Bewick's wren
Bachman's sparrow
Bald eagle
Blotchside logperch
Bog turtle
Carolina northern flying squirrel
Cerulean warbler
Eastern small -footed bat
Gray bat
Hellbender
Longhead darter
Northern long-eared bat
Northern saw -whet owl (Southern Appalachian
population)
Paddlefish
Pygmy salamander
Rafinesque's big -eared bat
Red crossbill (Southern Appalachian)
Southern Appalachian black -capped chickadee
Southern water shrew
Spotfin chub (turquise shiner)
Yellow -bellied sapsucker (Southern Appalachian
population)
Invertebrate:
Appalachian elktoe
French Broad crayfish
Rusty -patched bumble bee
Southern Tawny Crescent butterfly
Spruce -fir moss spider
Tan riffleshell
Vascular Plant:
Blue Ridge Goldenrod
Blue Ridge Ragwort
Bunched arrowhead
Butternut
Cain's reedgrass
Fraser fir
Fraser's loosestrife
French Broad heartleaf
Gray's lily
Granite Dome Goldenrod
Mountain Sweet Pitcherplant
Piratebush
Spreading avens
Virginia spiraea
Nonvascular Plant:
a liverwort
a liverwort
Appalachian Pocket Moss
Lichen:
Rock gnome lichen
Scientific name
Neotoma magister
Thryomanes bewickii altus
Aimophila aestivalis
Haliaeetus leucocephalus
Percina burtoni
Glyptemys muhlenbergii
Glaucomys sabrinus coloratus
Dendroica cerulea
Myotis leibii
Myotis grisescens
Cryptobranchus alleganiensis
Percina macrocephala
Myotis septentrionalis
Aegolius acadicus pop. 1
Polyodon spathula
Desmognathus wrighti
Corynorhinus rafinesquii
Loxia curvirostra
Poecile atricapillus practicus
Sorex palustris punctulatus
Erimonax monachus
Sphyrapicus varius appalachiensis
Alasmidonta raveneliana
Cambarus reburrus
Bombus affinis
Phyciodes batesii maconensis
Microhexura montivaga
Epioblasma florentina walkeri (=E. walkeri)
Solidago spithamaea
Packera millefolium
Sagittaria fasciculata
Juglans cinerea
Calamagrostis cainii
Abies fraseri
Lysimachiafraseri
Hexastylis rhombiformis
Lilium grayi
Solidago simulans
Sarracenia rubra ssp. Jonesii
Buckleya distichophylla
Geum radiatum
Spiraea virginiana
Plagiochila sharpii
Plagiochila virginica var. caroliniana
Fissidens appalachiensis
Gymnoderma lineare
Federal Status Record Status
FSC
FSC
FSC
BGPA
FSC
T (S/A)
E
FSC
ARS
E
ARS
FSC
T
FSC
FSC
FSC
FSC
FSC
FSC
FSC
T
FSC
E
FSC
E
FSC
E
E
T
FSC
E
FSC
FSC
FSC
FSC
FSC
FSC
FSC
E
FSC
E
T
ARS
FSC
ARS
E
Current
Historical
Historical
Current
Historical
Current
Current
Current
Current
Current
Current
Historical
Current
Current
Historical
Current
Historical
Current
Historical
Current
Historical
Current
Current
Current
Historical
Historical
Current
Historicalal and Obscure
Current
Current
Historical
Historical
Current
Current
Historical
Current
Current
Current
Current
Current
Current
Historical
Current
Current
Historical
Current

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Definitions of Federal Status Codes:
E = endangered. A taxon "in danger of extinction throughout all or a significant portion of its range."
T = threatened. A taxon "likely to become endangered within the foreseeable future throughout all or a significant portion of its range."
C = candidate. A taxon under consideration for official listing for which there is sufficient information to support listing. (Formerly "Cl" candidate species.)
BGPA =Bald and Golden Eagle Protection Act. See below.
ARS = At Risk Species. Species that are Petitioned, Candidates or Proposed for Listing under the Endangered Species Act. Consultation under Section 7(a)(2) of the ESA is not
required for Candidate or Proposed species; although a Conference, as described under Section 7(a)(4) of the ESA is recommended for actions affecting species proposed for
listing.
FSC=Federal Species of Concern. FSC is an informal term. It is not defined in the federal Endangered Species Act. In North Carolina, the Asheville and Raleigh Field Offices of
the US Fish and Wildlife Service (Service) define Federal Species of Concern as those species that appear to be in decline or otherwise in need of conservation and are under
consideration for listing or for which there is insufficient information to support listing at this time.Subsumed under the term "FSC' are all species petitioned by outside parties
and other selected focal species identified in Service strategic plans, State Wildlife Action Plans, or Natural Heritage Program Lists.
T(S/A) = threatened due to similarity of appearance. A taxon that is threatened due to similarity of appearance with another listed species and is listed for its protection. Taxa
listed as T(S/A) are not biologically endangered or threatened and are not subject to Section 7 consultation. See below.
EXP = experimental population. A taxon listed as experimental (either essential or nonessential). Experimental, nonessential populations of endangered species (e.g., red wolf)
are treated as threatened species on public land, for consultation purposes, and as species proposed for listing on private land.
P = proposed. Taxa proposed for official listing as endangered or threatened will be noted as 'PE" or 'PT", respectively.
Bald and Golden Eagle Protection Act (BGPA):
In the July 9, 2007 Federal Register( 72:37346-37372), the bald eagle was declared recovered, and removed (de -listed) from the Federal List of Threatened and Endangered
wildlife. This delisting took effect August 8,2007. After delisting, the Bald and Golden Eagle Protection Act (Eagle Act) (16 U.S.C. 668-668d) becomes the primary law
protecting bald eagles. The Eagle Act prohibits take of bald and golden eagles and provides a statutory definition of "take" that includes "disturb". The USFWS has developed
National Bald Eagle Management Guidelines to provide guidance to land managers, landowners, and others as to how to avoid disturbing bald eagles. For mor information, visit
http://www.fws.gov/migratorybirds/baldeagle.htm
Threatened due to similarity of appearance(T(S/A)):
In the November 4, 1997 Federal Register (55822-55825), the northern population of the bog turtle (from New York south to Maryland) was listed as T (threatened), and the
southern population (from Virginia south to Georgia) was listed as T(S/A) (threatened due to similarity of appearance). The T(S/A) designation bans the collection and interstate
and international commercial trade of bog turtles from the southern population. The T(S/A) designation has no effect on land management activities by private landowners in
North Carolina, part of the southern population of the species. In addition to its official status as T(S/A), the U.S. Fish and Wildlife Service considers the southern population of
the bog turtle as a Federal species of concern due to habitat loss.
Definitions of Record Status:
Current - Based on NC Natural Heritage Program information, this taxon is considered to be extant in the county.
Historical - Based on NC Natural Heritage Program information, this taxon is considered to be historical in the county, meaning that all recorded occurrences are either
extirpated, have not been found in recent surveys, or have not been surveyed recently enough to be confident they are still present.
Obscure - the date and/or location of observation is uncertain.
Incidental/migrant - the species was observed outside of its normal range or habitat.
Probable/potential - the species is considered likely to occur in this county based on the proximity of known records (in adjacent counties), the presence of potentially suitable
habitat, or both.

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
■ ■■■
■E■ • NC DEPARTMENT OF
■ ■. ■a NATURAL AND CULTURAL RESOURCES
• ■D•
April 26, 2021
ClearWater Environmental Consultants, Inc.
ClearWater Environmental Consultants, Inc.
145 7th Avenue West
Hendersonville, NC 28792
RE: Gravelly Branch Rd; 1181
Dear ClearWater Environmental Consultants, Inc.:
Roy Cooper, Governor
D. Reid Wilson, Secretary
Walter Clark
Director, Division of land and Water Stewardship
NCNHDE-14550
The North Carolina Natural Heritage Program (NCNHP) appreciates the opportunity to provide
information about natural heritage resources for the project referenced above.
Based on the project area mapped with your request, a query of the NCNHP database indicates that
there are no records for rare species, important natural communities, natural areas, and/or
conservation/managed areas within the proposed project boundary. Please note that although there
may be no documentation of natural heritage elements within the project boundary, it does not
imply or confirm their absence; the area may not have been surveyed. The results of this query
should not be substituted for field surveys where suitable habitat exists. In the event that rare
species are found within the project area, please contact the NCNHP so that we may update our
records.
The attached `Potential Occurrences' table summarizes rare species and natural communities that
have been documented within a one -mile radius of the property boundary. The proximity of these
records suggests that these natural heritage elements may potentially be present in the project area
if suitable habitat exists. Tables of natural areas and conservation/managed areas within a one -mile
radius of the project area, if any, are also included in this report.
If a Federally -listed species is found within the project area or is indicated within a one -mile radius of
the project area, the NCNHP recommends contacting the US Fish and Wildlife Service (USFWS) for
guidance. Contact information for USFWS offices in North Carolina is found here:
https://www.fws.gov/offices/Directory/ListOffices.cfm?statecode=37.
Please note that natural heritage element data are maintained for the purposes of conservation
planning, project review, and scientific research, and are not intended for use as the primary criteria
for regulatory decisions. Information provided by the NCNHP database may not be published
without prior written notification to the NCNHP, and the NCNHP must be credited as an information
source in these publications. Maps of NCNHP data may not be redistributed without permission.
The NC Natural Heritage Program may follow this letter with additional correspondence if a
Dedicated Nature Preserve, Registered Heritage Area, Land and Water Fund easement, or Federally -
listed species are documented near the project area.
If you have questions regarding the information provided in this letter or need additional assistance,
please contact Rodney A. Butler at [e-mail] or 919-707-8603.
Sincerely,
NC Natural Heritage Program
DEPARTMENT OF NATURAL AND CULTURAL RESOURCES
4) 121 W. JONES STREET, RALEIGh 1_ NC 27603 • 1851 MAIL SERVICE CENTER. ALEIOH. NC 27699
OFC 919 707.9120 • FAX [phone]

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Natural Heritage Element Occurrences, Natural Areas, and Managed Areas Within a One -mile Radius of the Project Area
Gravelly Branch Rd
Project No. 1181
April 26, 2021
NCNHDE-14550
Element Occurrences Documented Within a One -mile Radius of the Project Area
Taxonomic EO ID cientific Name Common Name
Group Observation
Date
Amphibian 29361
Dragonfly or 33442
Damselfly
Freshwater Fish5893
Freshwater Fish15724
Cryptobranchus
alleganiensis
alleganiensis
Calopteryx amata
Erimystax insignis
Percina burtoni
Eastern Hellbender 2011-05-01
Superb Jewelwing
Blotched Chub
Blotchside Logperch
2004-Pre
2014-04-10
1900s
No Natural Areas are Documented Within a One -mile Radius of the Project Area
Managed Areas Documented Within a One -mile Radius of the Project Area
Managed Area Name
NC Agricultural Development and Farmland
Preservation Trust Fund Easement
owner
NC Department of Agriculture
Element Accuracy
Occurrence
Rank
Federal State Global State
Status Status Rank Rank
E 3-Medium
H? 5-Very
Low
E 3-Medium
X 3-Medium
Owner Type
State
Special
Concern
Significantly
Rare
Significantly
Rare
Endangered
G3T2 S3
G5 S1S2
G4 S2
G2G3 S1
Definitions and an explanation of status designations and codes can be found at https://ncnhde.natureserve.ora/help. Data query generated on April 26, 2021; source: NCNHP, Q4 January 2021. Please
resubmit your information request if more than one year elapses before project initiation as new information is continually added to the NCNHP database.
Page 2 of 3

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
April 26, 2021
❑ Project Boundary
❑ Buffered Project Boundary
f Managed Area (MAREA)
NCNHDE-14550: Gravelly Branch Rd
1:22,348
0 0.175 0.35
I
0.7 mi
0 0.3 0.6
1.2 km
Sources: Esn, HERE, Garmin. Inlarmap, increment P Corp., GERCO, USGS,
FAO, NPS. NRCAN, CieoEase. IGN, Kadaster NL, Ordnance Survey, Esri Japan.
METI_ Esri China {Hong Kong). (c). Open5lreelMap contributors, and the GIS
User Community
Page 3 of 3

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Appendix C:
Photolog

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Photo 1. Typical view of SA. Culvert to be installed at the upper end of shown reach.
Photo 2. Typical view of WA looking north. Area shown in foreground is to be impacted.

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Photo 3. Partial view of WC. WC appears to be a former stream meander. Wetland to be
impacted.
Photo 4. SB looking upstream from confluence with SA. SB is the property line.

DocuSign Envelope ID: F599E0D9-D498-470B-B1C5-ACOOFFDD233E
Photo 5. Typical view of WE.
Photo 6. WG in front of fence and off -site connection to tributaries in background.

Tyson Kurtz
From: [e-mail]
Sent: Sunday, May 23, 2021 12:00 AM
To: Tyson Kurtz
Cc: [e-mail]
Subject: Pre -Filing Meeting Review Completed for Gravelly Branch Road - 20210824 Ver 1
The North Carolina Division of Water Resources has received the Pre -Filing Meeting Request Form for Gravelly Branch
Road that you submitted on 4/22/2021 4:47 PM. The ID number for that project is 20210824, Version 1.
It has been decided that no meeting is needed for this project.
Review Comments (If provided):
Project file link: https://edocs.deq.nc.gov/WaterResources/Browse.aspx?dbid=0&startid=1741544
When you submit your application please upload a copy of the attached document in this email.
This email was automatically generated by Laserfiche workflow. Please do not respond to this email address, as
responses are not monitored.
1