CCK19020_CirckeK_rcvd_SAW-2019-00299 NWP 39 Verification

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW-2019-00299 County: WAYNE U.S.G.S. Quad:NC-NORTHEAST GOLDSBORO
GENERAL PERMIT (REGIONAL AND NATIONWIDE)VERIFICATION
Applicant: Circle K
Mr.Andy Priolo
Address: 1100 Situs Court,Suite 100
Raleigh,North Carolina 27606
Authorized Agent: The John R.McAdams Company,Inc.
Ms.Kelly Roth
Address: 2905 Meridian Parkway
Durham,North Carolina 27713
Size(miles) -4 miles Nearest Town Goldsboro
Nearest Waterway Howell Branch River Basin Neuse River
USGS HUC 03020202 Coordinates Latitude:35.421931
Longitude: -77.981012
Description of project location: The project area is identified as an approximate 4 acre tract of land located on Wayne County,
North Carolina parcels 3600395938 and 3601305359.These parcels are located at 2825 Carolina Commerce Drive,in
Goldsboro,Wayne County,North Carolina.Work in waters of the United States(U.S.)will occur in one wetland within the
Howell Branch watershed,an indirect tributary of the Neuse River(8-digit HUC: 03020202).
Description of projects area and activity: The applicant,Circle K,has requested a Department of the Army authorization to
discharge fill material into waters of the U.S.in conjunction with the construction of the Circle K-US 117 Project.Project
activity will involve the construction of a gas station/convenience store and associated infrastructure and attendant features.
Implementation of the proposed project will result in the permanent discharge of fill material into 0.47 acre of wetland.All
other impacts associated with the Circle K—US 117 Project will be constructed in uplands,outside of waters of the U.S.
Compensatory mitigation is required at a minimum of 1:1 mitigation to impact ratio for all wetland losses that exceed 1/10-
acre.The proposed wetland impact scored a low rating in accordance with the North Carolina Wetland Assessment Method.
Therefore,the applicant has proposed to purchase 0.47 acre of riparian wetland mitigation units(1:1 mitigation to impact
ratio)from the North Carolina Division of Mitigation Services(8-di2it HUC 03020202),in order to offset the unavoidable
impacts to waters of the U.S
Applicable Law: ® Section 404(Clean Water Act,33 USC 1344)
❑ Section 10(Rivers and Harbors Act,33 USC 403)
Authorization: Regional General Permit Number or Nationwide Permit Number:NWP 39(Commercial and Institutional
Developments)
SEE ATTACHED RGP or NWP GENERAL,REGIONAL AND SPECIAL CONDITIONS
Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with the attached
conditions and your submitted application and attached information dated November 1, 2019. Any violation of the attached
conditions or deviation from your submitted plans may subject the permittee to a stop work order,a restoration order,a Class
I administrative penalty,and/or appropriate legal action.
This verification will remain valid until the expiration date identified below unless the nationwide authorization is modified,
suspended or revoked. If, prior to the expiration date identified below, the nationwide permit authorization is reissued and/or
modified, this verification will remain valid until the expiration date identified below, provided it complies with all requirements of
the modified nationwide permit. If the nationwide permit authorization expires or is suspended,revoked,or is modified, such that the
activity would no longer comply with the terms and conditions of the nationwide permit, activities which have commenced (i.e., are
under construction) or are under contract to commence in reliance upon the nationwide permit, will remain authorized provided the

activity is completed within twelve months of the date of the nationwide permit's expiration, modification or revocation, unless
discretionary authority has been exercised on a case-by-case basis to modify,suspend or revoke the authorization.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality Certification. You
should contact the NC Division of Water Quality(telephone [phone])to determine Section 401 requirements.
For activities occurring within the twenty coastal counties subject to regulation under the Coastal Area Management Act(LAMA),
prior to beginning work you must contact the N.C.Division of Coastal Management in Morehead City,NC,at(252)808-2808.
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other required Federal,
State or local approvals/permits.
If there are any questions regarding this verification, any of the conditions of the Permit, or the Corps of Engineers regulatory
program,please contact Samantha Dailey at 919-554-4884 x22 or Samantha.J.DaileyAusace.army.mil.
DAILEY.SAMANT Digitally signed by
DAI LEY.SAMANTHA.J.1387567948
Corps Regulatory Official: HA.J.1387567948 Date:2019.11.22 08:48:10-05'00'
Date: November 22,2019
Expiration Date of Verification: March 18,2022

Action ID Number: SAW-2019-00299 County: WAYNE
Permittee: Circle K
Attn: Mr. Andy Priolo
Project Name: Circle K—US 117
Date Verification Issued: November 22, 2019
Project Manager: Samantha Dailey
Upon completion of the activity authorized by this permit and any mitigation required by the permit,
sign this certification and return it to the following address:
US ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Raleigh Regulatory Field Office
Attn: Samantha Dailey
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27857
Please note that your permitted activity is subject to a compliance inspection by a U. S. Army Corps of
Engineers representative. Failure to comply with any terms or conditions of this authorization may
result in the Corps suspending, modifying or revoking the authorization and/or issuing a Class I
administrative penalty, or initiating other appropriate legal action.
I hereby certify that the work authorized by the above referenced permit has been completed in
accordance with the terms and condition of the said permit, and required mitigation was completed in
accordance with the permit conditions.
Signature of Permittee Date

SPECIAL CONDITIONS
ACTION ID: SAW-2019-00299
CIRCLE K
CIRCLE K—US 117
MITIGATION
1. In order to compensate for impacts associated with this permit, mitigation shall be provided in
accordance with the provisions outlined on the most recent version of the attached
Compensatory Mitigation Responsibility Transfer Form. The requirements of this form,
including any special conditions listed on this form, are hereby incorporated as special
conditions of this permit authorization. Special condition regarding compensatory mitigation
was included to insure compliance with the 404(b)(1) guidelines.

U.S. ARMY CORPS OF ENGINEERS
Wilmington District
Compensatory Mitigation Responsibility Transfer Form
Permittee: Circle K Action ID:SAW-2019-00299
Project Name:Circle K—US 117 County:Wayne
Instructions to Permittee: The Permittee must provide a copy of this form to the Mitigation Sponsor, either an approved
Mitigation Bank or the North Carolina Division of Mitigation Services (NCDMS), who will then sign the form to verify the
transfer of the mitigation responsibility. Once the Sponsor has signed this form, it is the Permittee's responsibility to ensure
that to the U.S.Army Corps of Engineers(USACE) Project Manager identified on page two is in receipt of a signed copy of this
form before conducting authorized impacts, unless otherwise specified below. If more than one mitigation Sponsor will be
used to provide the mitigation associated with the permit,or if the impacts and/or the mitigation will occur in more than one
8-digit Hydrologic Unit Code (HUC), multiple forms will be attached to the permit, and the separate forms for each Sponsor
and/or HUC must be provided to the appropriate mitigation Sponsors.
Instructions to Sponsor:The Sponsor must verify that the mitigation requirements(credits)shown below are available at the
identified site. By signing below, the Sponsor is accepting full responsibility for the identified mitigation, regardless of
whether or not they have received payment from the Permittee. Once the form is signed,the Sponsor must update the bank
ledger and provide a copy of the signed form and the updated bank ledger to the Permittee,the USACE Project Manager,and
the Wilmington District Mitigation Office (see contact information on page 2). The Sponsor must also comply with all
reporting requirements established in their authorizing instrument.
Permitted Impacts and Compensatory Mitigation Requirements:
Permitted Impacts Requiring Mitigation* 8-digit HUC and Basin:03020202, Neuse River Basin
Stream Impacts(linear feet) Wetland Impacts(acres)
Warm Cool Cold Riparian Riverine Riparian Non-Riverine Non-Riparian Coastal
0.47
*If more than one mitigation sponsor will be used for the permit, only include impacts to be mitigated by this sponsor.
Compensatory Mitigation Requirements: 8-digit HUC and Basin:03020202, Neuse River Basin
Stream Mitigation (credits) Wetland Mitigation (credits)
Warm Cool Cold Riparian Riverine Riparian Non-Riverine Non-Riparian Coastal
0.47
Mitigation Site Debited: NCDMS
(List the name of the bank to be debited. For umbrella banks,also list the specific site. For NCDMS,list NCDMS. If the NCDMS
acceptance letter identifies a specific site,also list the specific site to be debited).
Section to be completed by the Mitigation Sponsor
Statement of Mitigation Liability Acceptance: I, the undersigned, verify that I am authorized to approve mitigation
transactions for the Mitigation Sponsor shown below, and I certify that the Sponsor agrees to accept full responsibility for
providing the mitigation identified in this document(see the table above), associated with the USACE Permittee and Action
ID number shown. I also verify that released credits (and/or advance credits for NCDMS), as approved by the USACE, are
currently available at the mitigation site identified above. Further, I understand that if the Sponsor fails to provide the
required compensatory mitigation, the USACE Wilmington District Engineer may pursue measures against the Sponsor to
ensure compliance associated with the mitigation requirements.
Mitigation Sponsor Name:
Name of Sponsor's Authorized Representative:
Signature of Sponsor's Authorized Representative Date of Signature
Page 1 of 2 Form Updated 23 November, 2015

USACE Wilmington District
Compensatory Mitigation Responsibility Transfer Form, Page 2
Conditions for Transfer of Compensatory Mitigation Credit:
• Once this document has been signed by the Mitigation Sponsor and the USACE is in receipt of the signed form, the
Permittee is no longer responsible for providing the mitigation identified in this form, though the Permittee remains
responsible for any other mitigation requirements stated in the permit conditions.
• Construction within jurisdictional areas authorized by the permit identified on page one of this form can begin only after
the USACE is in receipt of a copy of this document signed by the Sponsor, confirming that the Sponsor has accepted
responsibility for providing the mitigation requirements listed herein. For authorized impacts conducted by the North
Carolina Department of Transportation (NCDOT), construction within jurisdictional areas may proceed upon permit
issuance; however, a copy of this form signed by the Sponsor must be provided to the USACE within 30 days of permit
issuance. NCDOT remains fully responsible for the mitigation until the USACE has received this form,confirming that the
Sponsor has accepted responsibility for providing the mitigation requirements listed herein.
• Signed copies of this document must be retained by the Permittee, Mitigation Sponsor,and in the USACE administrative
records for both the permit and the Bank/ILF Instrument. It is the Permittee's responsibility to ensure that the USACE
Project Manager(address below) is provided with a signed copy of this form.
• If changes are proposed to the type, amount, or location of mitigation after this form has been signed and returned to
the USACE, the Sponsor must obtain case-by-case approval from the USACE Project Manager and/or North Carolina
Interagency Review Team (NCIRT). If approved, higher mitigation ratios may be applied,as per current District guidance
and a new version of this form must be completed and included in the USACE administrative records for both the permit
and the Bank/ILF Instrument.
Comments/Additional Conditions:
This form is not valid unless signed below by the USACE Project Manager and by the Mitigation Sponsor on Page 1. Once
signed,the Sponsor should provide copies of this form along with an updated bank ledger to:1)the Permittee,2)the USACE
Project Manager at the address below,and 3)the Wilmington District Mitigation Office,Attn:Todd Tugwell,3331 Heritage
Trade Drive, Suite 105, Wake Forest, NC 27587(email: [e-mail]). Questions regarding this form or
any of the permit conditions may be directed to the USACE Project Manager below.
USACE Project Manager: Samantha Dailey
USACE Field Office: Raleigh Regulatory Field Office
US Army Corps of Engineers
3331 Heritage Trade Drive,Suite 105
Wake Forest, North Carolina 27587
Email: [e-mail]
DAILEY.SAMANTHA.J.1 Digitally signed by
DAI LEY.SAMANTHA.J.1387567948
387567948 Date:2019.11.22 08:45:21 -05'00' November 22,2019
USACE Project Manager Signature Date of Signature
Current Wilmington District mitigation guidance, including information on mitigation ratios, functional assessments, and
mitigation bank location and availability, and credit classifications (including stream temperature and wetland groupings) is
available at http://ribits.usace.armV.mi1.
Page 2 of 2
The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we continue to do so,please complete the
Customer Satisfaction Survey located at our website at http://regulatorV.usacesurvey.com/to complete the survey online.

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LEGEND
I - - Stream
0 Wetland
0 Project area
—Roads
Note: USACE verification site visit conducted 9/19/2019 2-ft contours
0 50 100
J FIGURE 4. JURISDICTIONAL AND ISOLATED WATERS Feet
DELINEATION MAP 1 inch=100 feet
CIRCLE K - US 117 VERSION: 2
GOLDSBORO, WAYNE COUNTY, NC DATE: 10/28/2019
McADAMS JOB NO: CCK-19020
DRAWN BY: roth
X:\Projects\CCK\CCK-19020\Storm\Natural Resources\GIS\CCK19020_Figure 4 Delineation Map.mxd,10/28/2019 4:06:32 PM,roth

' II
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Proposed limits I
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sanitary sewer ;I ;
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(to be permitted by others)
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LEGEND
Proposed '
stormwater pond I I 0 Project area Proposed limits of disturbance
- -- Exising power line - -- Proposed underground power line
---- �� —Proposed Existing water line Proposed water line
stormwater -- Existing sanitary sewer -- Proposed sanitary sewer
outlet Existing 2-ft contours Proposed 1-ft contour
Existing wetland \ Proposed wetland impact
II —Existing edge of pavement Proposed NCDOT work
—Proposed pond Proposed storm drain
Proposed building —Proposed riprap
I — —Proposed canopy —Proposed gas pump
—Proposed concrete Proposed fuel tank
—Proposed utility
0 40 80
J FIGURE 5. OVERALL IMPACTS MAP Feet
CIRCLE K - US 117 1 inch=100 feet
GOLDSBORO, WAYNE COUNTY, NC VERSION: 1
DATE: 10/28/2019
McADAMS JOB NO: CCK-19020
DRAWN BY: roth
X:\Projects\CCK\CCK-19020\Storm\Natural Resources\GIS\CCK19020_Figure 5 Overall Impacts Map.mxd,10/28/2019 1:51:41 PM,roth