20211292 Ver 1_ePCN Application_20210824

DWR
Dlrlslon of Water Resources
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
June 1, 2021 Ver4.1
Initial Review
Has this project met the requirements for acceptance in to the review process?*
r Yes
r No
Is this project a public transportation project?*
r Yes r No
Change only if needed.
BIMS # Assigned
20211292
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Sue Homeowod:eadsWhomewood
'Information for Initial Review
la. Name of project:
CORTESY COPY Maple Grove Subdivision Lots 4 - 7
1a. Who is the Primary Contact?*
Walter Cole
1b. Primary Contact Email:*
v,[e-mail]
Date Submitted
8/24/2021
Nearest Body of Water
Leonard Creek
Basin
Yadkin -Pee Dee
Water Classification
C
Site Coordinates
Latitude: Longitude:
35.889699-80.562218
A. Processing Information
County (or Counties) where the project is located:
Davie
Is this a NCDMS Project
r Yes r No
Is this project a public transportation project?*
r Yes r No
Pre -Filing Meeting Information
Version#*
1
Reviewing Office*
Winston-Salem Regional Office - (336) 776-
9800
1c. Primary Contact Phone:*
[phone]
Is this a courtesy copy notification?*
r Yes r No

ID# Version
Pre -fling Meeting or Request Date
Attach documentation of Pre -Filing Meeting Request here:
dick the upload button or drag and drop files here to attach document
File type rust be FCF
1a. Type(s) of approval sought from the Corps:
W Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Has this PCN previously been submitted?*
r Yes
r No
1b. What type(s) of permit(s) do you wish to seek authorization?
fJ Nationwide Permit (NWP)
r Regional General Permit (RGP)
r Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
r Yes r No
Nationwide Permit (NWP) Number: 18 - Minor Discharges
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
W 401 Water Quality Certification - Regular r 401 Water Quality Certification - Express
r Non-404 Jurisdictional General Permit r Riparian Buffer Authorization
r Individual 401 Water Quality Certification
le. Is this notification solelyfor the record because written approval is not required?
For the record onlyfor DWR401 Certification: r Yes r No
For the record onlyfor Corps Permit: r Yes r No
1f. Is this an after -the -fact permit application?*
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
1h. Is the project located in any of NC's twenty coastal counties?
r Yes r No
1j. Is the project located in a designated trout watershed?
r Yes r No
B. Applicant Information
1d. Who is applying for the permit?
rJ Owner r Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
r Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
Chad Fuller
2b. Deed book and page no.:
DB 20 PG 375A
2c.Contact Person:
Chad Fuller
2d.Address

Street Address
1508 County Home Road
Address tine 2
City
Mocksville
Postal / Zip Code
27028
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Walter Cole
4b. Business Name:
S&ME
4c.Address
Street Address
3201 Spring Forest Road
Address Line 2
City
Raleigh
Postal / Zip Code
27616
4d. Telephone Number:
[phone]
4f. Email Address:*
[e-mail]
State / Province / Rion
North Carolina
Country
United States
2f. Fax Number:
Slate / Province / Region
North Carolina
Country
United States
4e. Fax Number:
C. Project Information and Prior Project History U
r
1. Project Information
1b. Subdivision name:
(if appropriate)
Maple Grove
1c. Nearest municipality/ town:
Mocksville
2. Project Identification
2a. Property Identification Number:
2b. Property size:
5738-72-1492
1.15
2c. Project Address
Street Address
401 South Main Street
Address tine 2
CKY
Slate / Province / legion
Mocksville
North Carolina
Postal / Zip Code
Country
27028
United States
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Leonard Creek
3b. Water Resources Classification of nearest receiving water:*
C
3c. What river basin(s) is your project located in?*
Yadkin-PeeDee
3d. Please provide the 12-digit HUC in which the project is located.

030401011404
4. Project Description and History
4a. 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 existing conditions on the site consist of graded lots ready for home construction. The disturbance was less than one -acre therefore a sedimentation and erosion control permit was
not required.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r Yes r No r Unknown
4f. List the total estimated acreage of all existing wetlands on the property:
0.06
4g. List the total estimated linear feet of all existing streams on the property:
0
4h. Explain the purpose of the proposed project:*
The project consists of four single-family residential lots that have road frontage along South Main Street.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
There was an existing wetland pocket on -site that the developer protected with silt fence however there was a narrowditch feature that connected the wetland feature and a stream
feature located off property that was filled erroneously because the client thought it was just a ditch and not jurisdictional. The regional Land Quality office brought into question the
filling of the ditch and indicated that it may have been a stream or wetland. After site evaluations by S&ME and Sue Homewood with NCDWR, it was determined that the wetland feature
was indeed a wetland and not a stream, however the status of the ditch that was filled with a culvert was unable to be determined so it was decided by all parties to assume that the filled
feature was a linear jurisdictional wetland and an after the fact NWP 18 would be applied for.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No r Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved r Not Verified r Unknown r N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Walter Cole
Agency/Consultant Company: S&ME
Other:
6. Future Project Plans
6a. Is this a phased project?*
r Yes r No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activity?
No
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
W Wetlands r Streams -tributaries F Buffers
r Open Waters r Pond Construction
2. Wetland Impacts
2at Reason (?) 2b. Impact type * (?) 2c. Type of W. 2d. W. name * 2e. Forested* �21`. Type of 2g. Impact
Jurisdicition*(?) area*
Rip -Rap
Inlet Protection
P
Seep
W1
No
Corps
0.002
(acres)
Culvert Fill
Culvert
P
Unknown
W1
No
Corps
0.010
(acres)
2g. Total Temporary Wetland Impact 2g. Total Permanent Wetland Impact
0.000 0.012

2g. Total Wetland Impact
0.012
21. Comments:
E. Impact Justification and Mitigation U
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The graded area has been minimized as much as practicable in the design of the project. Appropriate sediment and erosion control practices equaling
those outlined in the most recent version of the "North Carolina Sediment and Erosion Control Planning and Design Manual" will be used, although a
S&EC permit is not required for this project.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Specific attention will be paid to ensure grading is only performed to the e:dent needed for the proposed project and all grading not required will be
avoided. Additional impacts will be avoided through the use of appropriate sediment and erosion control devices although not required for this project.
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?
r Yes r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
The impacts are well below 1 /10th acre.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
r Yes r No
If no, explain why:
This project is not in a buffered basin.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes r No
2b. Does this project meet the requirements for low density projects as defined in 15ANCAC 02H .1003(2)?
r Yes r No
Comments:
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
C Yes r No
2. Violations (DWR Requirement)
V
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 21-1.0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)? *
r Yes r No
2b Provide an explanation of the violation(s):
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
r Yes r No
3b. If you answered "no," provide a short narrative description.
These is the one and only Phase of this subdivision

4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR forth is project?*
r Yes r Nor WA
4b. Describe, in detail, the treatment methods and dispositions (non -discharge or discharge) of wastewater generated from the proposed project. If the wastewater will be treated
at a treatment plant, list the capacity available at that plant.
Municipal Sewer System
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?*
r Yes IT No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No
5d. Is another Federal agency involved?*
r Yes r No r Unknown
5e. Is this a DOT project located within Division's 1-8?
r Yes IT No
5f. Will you cut anytrees in order to conduct the work in waters of the U.S.?
r Yes r No
5g. Does this project involve bridge maintenance or removal?
r Yes IT No
5h. Does this project involve the construction/installation of a wind turbine(s)?'
r Yes r No
51. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
r Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
The NC Natural Heritage Program online data explorer (hftps://wvm.ncnhp.org/data) and US Fish and Wildlife Service Information for Planning and
Consultation (IPaC) report. No critical habitat was identified vdthin the site and no element occurrences of protected species have been observed
within the site or within one mile of the site.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
The USFWS IPaC report and the National Marine Fisheries Service Essential Fish Habitat Mapper
(hftps://w,Aw.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?*
r Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
The North Carolina State Historic Preservation Office web mapping tool HPOWEB(https://www.ncdcr.gov/about/history/division-historical-
resou rces/g is -maps -and -data)
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-yearfloodplain?*
r Yes IT No
8c. What source(s) did you use to make the floodplain determination?*
The project engineer and the FEMA firm maps
Miscellaneous
Please use the space below to attach all required documentation or any additional information you feel is helpful for application review. Documents should be combined into one
file when possible, with a Cover Letter, Table of Contents, and a Cover Sheet for each Section preferred.

pick the upload button or drag and drop files here to attach docurrent
Agent Authorization Form (USACE).pdf
156.29KB
LiDAR.pdf
428.24KB
NWI.pdf
845.09KB
SOIL.pdf
543.6KB
Stream Assessment Report.pdf
3.2MB
TOPO.pdf
613.78KB
USGS.pdf
418.1 KB
DP-1.pdf
46.52KB
DP-2.pdf
46.56KB
IMPACT EXHIBIT.pdf
458.16KB
File rrust be FDF or IM
Comments
Signature
® By checking the box and signing below, I certify that:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete to the best of my knowledge and belief; and
• 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 have given true, accurate, and complete information on this form;
• I agree that submission of this PCN 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 PCN form.
Full Name:
Willard Walter Cole III
Signature
1114-1q l --t -- 1
Date
8/24/2021

AGENT AUTHORIZATION AND RIGHT -OF -ENTRY FORM
Date: August 16, 2021
Project Information
S&ME Project Name: Maple Grove Subdivision
Type of Project: Residential
Location: South Main Street, Mocksville, Davie County, North Carolina
Property Owner/Representative Information
Business Name: Fuller Contracting Company, LLC
Mailing Address: 1508 County Home Rd.
City, State, Zip Code: Mocksville, NC 27028
Telephone No. / Email 336-345-8943/[e-mail]
Contact: Chad Fuller
Agent Information
Business Name: S&ME, Inc.
Street Address: 3201 Spring Forest Road
City, State, Zip Code: Raleigh, NC 27616
Telephone No. 919-872-2660
Contact: Walter Cole
Authorization: I, Z�� ��� , on behalf of
Fuller Contracting Company, LLC
(Name of Landowner or Duly Authorized Agent)
a duly authorized owner of record of the property/ properties identified herein, hereby authorize S&ME to
act as agent with the USCAE in connection with the above -mentioned project. By signing above, I also
authorize representatives of the Wilmington District, U.S. Army Corps of Engineers (Corps) to enter upon
the property herein described for the purposes 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 River and Harbors Act of 1889. I, the above signed, 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.

U.S. Army Corps of Engineers OMB Control #: 0710-xxxx, Exp: Pending
WETLAND DETERMINATION DATA SHEET — Eastern Mountains and Piedmont Region Requirement Control Symbol EXEMPT.•
See ERDC/EL TR-07-24; the proponent agency is CECW-CO-R (Authority: AR 335-15, paragraph 5-2a)
Project/Site: Maple Grove Subdivision City/County: Mocksville/Davie Co Sampling Date:
Applicant/Owner: Fuller Contracting Company State: nc Sampling Point: DP-1
Investigator(s): Walter Cole Section, Township, Range:
Landform (hillside, terrace, etc.): Terrace Local relief (concave, convex, none): concave Slope (%): 8-15
Subregion (LRR or MLRA): LRR P, MLRA 136 Lat: 35.88997 Long:-80.56263 Datum: NAD83
Soil Map Unit Name: Pacolet sandy clay loam, 8 to 15 percent slopes NWI classification: N/A
Are climatic / hydrologic conditions on the site typical for this time of year? Yes X No (If no, explain in Remarks.)
Are Vegetation Soil or Hydrology significantly disturbed? Are "Normal Circumstances" present? Yes No X
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 X No Is the Sampled Area
Hydric Soil Present? Yes X No within a Wetland? Yes X No
Wetland Hydrology Present? Yes X No
Remarks:
HYDROLOGY
Wetland Hydrology Indicators:
Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required: check all that apply)
—Surface Soil Cracks (136)
_Surface Water (Al) _True
Aquatic Plants (1314)
_Sparsely Vegetated Concave Surface (138)
—High Water Table (A2) —Hydrogen
Sulfide Odor (Cl)
X Drainage Patterns (B10)
_Saturation (A3) _Oxidized
Rhizospheres on Living Roots (C3)
_Moss Trim Lines (B16)
—Water Marks (131) —Presence
of Reduced Iron (C4)
_ Dry -Season Water Table (C2)
_Sediment Deposits (132) _Recent
Iron Reduction in Tilled Soils (C6)
_Crayfish Burrows (C8)
_Drift Deposits (133) _Thin
Muck Surface (C7)
_Saturation Visible on Aerial Imagery (C9)
_Algal Mat or Crust (134) —Other
(Explain in Remarks)
—Stunted or Stressed Plants (D1)
_Iron Deposits (135)
_Geomorphic Position (D2)
—Inundation Visible on Aerial Imagery (137)
_Shallow Aquitard (D3)
X Water -Stained Leaves (139)
_ Microtopographic Relief (D4)
Aquatic Fauna (1313)
X FAC-Neutral Test (D5)
Field Observations:
Surface Water Present? Yes No
X Depth (inches):
Water Table Present? Yes No
Depth (inches):
Saturation Present? Yes No
Depth (inches):
Wetland Hydrology Present? Yes X No
(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

VEGETATION (Four Strata) - Use scientific names of plants.
Sampling Point: DP-1
Absolute Dominant
Indicator
Tree Stratum (Plot size: 20*20 )
% Cover Species?
Status
Dominance Test worksheet:
1
Number of Dominant Species
2.
That Are OBL, FACW, or FAC: 2 (A)
3.
Total Number of Dominant
4.
Species Across All Strata: 3 (B)
5.
Percent of Dominant Species
6.
That Are OBL, FACW, or FAC: 66.7% (A/B)
7.
Prevalence Index worksheet:
=Total Cover
Total % Cover of: Multiply by:
50% of total cover:
20% of total cover:
OBL species x 1 =
Sapling/Shrub Stratum (Plot size: 20*20
)
FACW species x 2 =
1.
FAC species x 3 =
2.
FACU species x 4 =
3.
UPL species x 5 =
4.
Column Totals: (A) (B)
5.
Prevalence Index = B/A =
6.
Hydrophytic Vegetation Indicators:
7.
_ 1 - Rapid Test for Hydrophytic Vegetation
8.
X 2 - Dominance Test is >50%
9.
3 - Prevalence Index is :53.0'
=Total Cover
4 - Morphological Adaptations' (Provide supporting
50% of total cover:
20% of total cover:
data in Remarks or on a separate sheet)
Herb Stratum (Plot size: 15*15 )
-Problematic Hydrophytic Vegetation' (Explain)
1. Saururus cernuus
30 Yes
OBL
'Indicators of hydric soil and wetland hydrology must be
2. Typha domingensis
10 No
OBL
present, unless disturbed or problematic.
Definitions of Four Vegetation Strata:
3. Carex lurida 20 Yes OBL
4. Persicaria pensylvanica
10 No
FACW
Tree - Woody plants, excluding vines, 3 in. (7.6 cm) or
5.
more in diameter at breast height (DBH), regardless of
6
height.
7.
Sapling/Shrub - Woody plants, excluding vines, less
8.
than 3 in. DBH and greater than or equal to 3.28 ft
9
(1 m) tall.
10.
Herb -All herbaceous (non -woody) plants, regardless
11.
of size, and woody plants less than 3.28 ft tall.
70 =Total Cover
Woody Vine - All woody vines greater than 3.28 ft in
50% of total cover:
35 20% of total cover:
14
height.
Woody Vine Stratum (Plot size: 15*15 )
1. Pueraria montana
30 Yes
UPL
2.
3.
4.
5.
Hydrophytic
30 =Total Cover
Vegetation
50% of total cover:
15 20% of total cover:
6
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

SOIL Sampling Point: DP-1
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
(inches) Color (moist) % Color (moist) % Type' Loc2 Texture Remarks
0-6 10YR 4/1 100 Loamy/Clayey Loam
6-18 10YR 5/1 90 10YR 5/8 10 C PL Loamy/Clayey Prominent redox concentrations
'Type: C=Concentration, D=Depletion, RM=Reduced Matrix, MS=Masked Sand Grains.
Hydric Soil Indicators:
Histosol (Al)
_ 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 (Al 2)
_Sandy Mucky Mineral (S1)
_Sandy Gleyed Matrix (S4)
_Sandy Redox (S5)
_Stripped Matrix (S6)
Dark Surface (S7)
Restrictive Layer (if observed):
Type:
Depth (inches):
Remarks:
_ 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)
2Location: PL=Pore Lining, M=Matrix
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)
3Indicators of hydrophytic vegetation and
wetland hydrology must be present,
unless disturbed or problematic.
Hydric Soil Present? Yes X No
ENG FORM 6116-4-SG, JUL 2018 Eastern Mountains and Piedmont — Version 2.0

U.S. Army Corps of Engineers OMB Control #: 0710-xxxx, Exp: Pending
WETLAND DETERMINATION DATA SHEET — Eastern Mountains and Piedmont Region Requirement Control Symbol EXEMPT.•
See ERDC/EL TR-07-24; the proponent agency is CECW-CO-R (Authority: AR 335-15, paragraph 5-2a)
Project/Site: Maple Grove Subdivision City/County: Mocksville/Davie Co Sampling Date:
Applicant/Owner: Fuller Contracting Company State: nc Sampling Point: DP-2
Investigator(s): Walter Cole Section, Township, Range:
Landform (hillside, terrace, etc.): hillside Local relief (concave, convex, none): none Slope (%): 15-40
Subregion (LRR or MLRA): LRR P, MLRA 136 Lat: 35.89009 Long:-80.56227 Datum: NAD83
Soil Map Unit Name: Pacolet sandy loam, 15 to 40 percent slopes NWI classification: N/A
Are climatic / hydrologic conditions on the site typical for this time of year? Yes X No (If no, explain in Remarks.)
Are Vegetation Soil or Hydrology significantly disturbed? Are "Normal Circumstances" present? Yes No X
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 Is the Sampled Area
Hydric Soil Present? Yes No X within a Wetland? Yes No X
Wetland Hydrology Present? Yes No X
Remarks:
HYDROLOGY
Wetland Hydrology Indicators:
Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required: check all that apply)
—Surface Soil Cracks (136)
_Surface Water (Al) _True
Aquatic Plants (1314)
_Sparsely Vegetated Concave Surface (138)
—High Water Table (A2) —Hydrogen
Sulfide Odor (Cl)
_ Drainage Patterns (B10)
_Saturation (A3) _Oxidized
Rhizospheres on Living Roots (C3)
_Moss Trim Lines (B16)
—Water Marks (131) —Presence
of Reduced Iron (C4)
_ Dry -Season Water Table (C2)
_Sediment Deposits (132) _Recent
Iron Reduction in Tilled Soils (C6)
_Crayfish Burrows (C8)
_Drift Deposits (133) _Thin
Muck Surface (C7)
_Saturation Visible on Aerial Imagery (C9)
_Algal Mat or Crust (134) —Other
(Explain in Remarks)
—Stunted or Stressed Plants (D1)
_Iron Deposits (135)
_Geomorphic Position (D2)
—Inundation Visible on Aerial Imagery (137)
_Shallow Aquitard (D3)
—Water-Stained Leaves (139)
_ Microtopographic Relief (D4)
Aquatic Fauna (1313)
FAC-Neutral Test (D5)
Field Observations:
Surface Water Present? Yes No
X Depth (inches):
Water Table Present? Yes No
X Depth (inches):
Saturation Present? Yes No
X Depth (inches):
Wetland Hydrology Present? Yes No X
(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

VEGETATION (Four Strata) - Use scientific names of plants.
Sampling Point: DP-2
Absolute Dominant
Indicator
Tree Stratum (Plot size: 20*20 )
% Cover Species?
Status
Dominance Test worksheet:
1
Number of Dominant Species
2.
That Are OBL, FACW, or FAC: 2 (A)
3.
Total Number of Dominant
4.
Species Across All Strata: 4 (B)
5.
Percent of Dominant Species
6.
That Are OBL, FACW, or FAC: 50.0% (A/B)
7.
Prevalence Index worksheet:
=Total Cover
Total % Cover of: Multiply by:
50% of total cover:
20% of total cover:
OBL species x 1 =
Sapling/Shrub Stratum (Plot size: 20*20
)
FACW species x 2 =
1.
Aronia prunifolia
10 Yes
FACW
FAC species x 3 =
2.
FACU species x 4 =
3.
UPL species x 5 =
4.
Column Totals: (A) (B)
5.
Prevalence Index = B/A =
6.
Hydrophytic Vegetation Indicators:
7.
_ 1 - Rapid Test for Hydrophytic Vegetation
8.
2 - Dominance Test is >50%
9.
3 - Prevalence Index is :53.0'
10 =Total Cover
4 - Morphological Adaptations' (Provide supporting
50% of total cover:
5 20% of total cover:
2
data in Remarks or on a separate sheet)
Herb Stratum (Plot size: 15*15 )
-Problematic Hydrophytic Vegetation' (Explain)
1.
Rhus copallinum
20 Yes
FACU
'Indicators of hydric soil and wetland hydrology must be
2.
Microstegium vimineum
20 Yes
FAC
present, unless disturbed or problematic.
Definitions of Four Vegetation Strata:
3. Lamium amplexicaule 10 No UPL
4.
Digitaria ciliaris
10 No
FAC
Tree - Woody plants, excluding vines, 3 in. (7.6 cm) or
5.
more in diameter at breast height (DBH), regardless of
6
height.
7.
Sapling/Shrub - Woody plants, excluding vines, less
8.
than 3 in. DBH and greater than or equal to 3.28 ft
9
(1 m) tall.
10.
Herb -All herbaceous (non -woody) plants, regardless
11.
of size, and woody plants less than 3.28 ft tall.
60 =Total Cover
Woody Vine - All woody vines greater than 3.28 ft in
50% of total cover:
30 20% of total cover:
12
height.
Woody Vine Stratum (Plot size: 15*15 )
1.
Pueraria montana
30 Yes
UPL
2.
3.
4.
5.
Hydrophytic
30 =Total Cover
Vegetation
50% of total cover:
15 20% of total cover:
6
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

SOIL
Sampling Point: DP-2
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
(inches) Color (moist) % Color (moist) % Type' Loc2 Texture
0-3 10YR 3/2 100 Loamy/Clayey Sandy clay
3-8 10YR 5/4
8-18 2.5YR 4/6
Remarks
100 Loamy/Clayey Clay loam
100 Loamy/Clayey Clay
'Type: C=Concentration, D=Depletion, RM=Reduced Matrix, MS=Masked Sand Grains.
Hydric Soil Indicators:
Histosol (Al)
_ 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 (Al 2)
_Sandy Mucky Mineral (S1)
_Sandy Gleyed Matrix (S4)
_Sandy Redox (S5)
_Stripped Matrix (S6)
Dark Surface (S7)
Restrictive Layer (if observed):
Type:
Depth (inches):
Remarks:
_ 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)
2Location: PL=Pore Lining, M=Matrix
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)
3Indicators of hydrophytic vegetation and
wetland hydrology must be present,
unless disturbed or problematic.
Hydric Soil Present? Yes No X
ENG FORM 6116-4-SG, JUL 2018 Eastern Mountains and Piedmont — Version 2.0

VNI1O'dVD H121ON 'h1NnOD 31AV(1 '3111AS)DOW N
I I 13ldiS NIVN H1f1OS lob oN T d
NOISVUOonS 3AO21`J 3ldVV4 w o N Cl
w
Q u? F z 1p l /�
III V
1IffIHX3 13ddWI S?I]iV/11 �VN❑IlSIQSI?Jf r- � N
a

SOIL MAP UNIT:
CeB2: Cecil sandy clay loam, 2 to 8 percent, eroded
PcC2: Pacolet sandy clay loam, 8 to 15 percent slopes, eroded f
N
O
N
N
O +
s
-2 A.
6
-O
E 4
v
z
N�
a
0
v
Ce-B
E
Q
2
rq
a
_ c
N
Ur
o
eB #
a
0 0 500 1,000 yyr.
(FEET) 'y
REFERENCE:
r�j GIS BASE LAYERS WERE OBTAINED FROM THE DAVIE COUNTY 1995 USDA-SCS SOIL SURVEY
SHEET NO. 3. THIS MAP IS FOR INFORMATIONAL PURPOSES ONLY. ALL FEATURE
a, LOCATIONS DISPLAYED ARE APPROXIMATED. THEY ARE NOT BASED ON CIVIL SURVEY
3 INFORMATION, UNLESS STATED OTHERWISE. LJ Earnhardt Property
0
SCALE: FIGURE NO.
USDA-SCS SOIL SURVEY EXHBIT 1 " = 500 '
DATE:
I I EARNHARDT PROPERTY 8-24-21 1
700 BOGER STREET PROJECT NUMBER
MOCKSVILLE, DAVIE COUNTY, NORTH CAROLINA 1 217443

=0
July 6, 2021
Fuller Contracting Company, LLC
1508 Country Home Road
Mocksville, North Carolina 27028
Attention: Mr. Chad Fuller via email: [e-mail]
Reference: Report for Preliminary Stream Assessment
Maple Grove Subdivision Site
Mocksville, Davie County, North Carolina
S&ME Project No. 216056
Dear Mr. Fuller:
S&ME, Inc. (S&ME) has conducted a preliminary jurisdictional wetland and stream assessment and Town
of Holly Springs riparian buffer assessment on the requested site. These services were performed in
general accordance with S&ME Proposal 216056 dated June 22, 2021.
Background Information
The subject property is located on the west side of South Main Street (Hwy 601 North) in Mocksville,
Davie County, North Carolina. The project consists of a residential subdivision containing four lots. The
subject property is depicted on the attached United States Department of Agriculture (USDA) Soil
Conservation Service (SCS) Davie County soil survey exhibit (Figure 1), United States Geologic Service
(USGS) Topographic exhibit (Figure 2), 2017 color aerial and topographic exhibit (Figure 3), and 2007
color aerial exhibit (Figure 4).
Methodology
Preliminary Stream Assessment
S&ME's preliminary stream assessment consisted of examining features on the site that are depicted on
the attached Figure 1 and Figure 2 using North Carolina Department of Environmental Quality (NCDEQ)
Division of Water Resources (DWR) stream evaluation techniques contained in the NCDEQ-DWR
publication, Identification Methods for the Origins of Intermittent and Perennial Streams, v 4.11. There is
one feature on -site depicted as the head of an intermittent stream on Figure 1 labeled as Feature A.
Using the NCDWR Stream Identification Form (Version 4.11), the drainage Feature A was rated at the
location depicted on the attached Figure 3 and labeled as Stream Form 1 (SF-1). The NCDWR Stream
Identification Form (SF-1) is included in Appendix I. Photographs of drainage Feature A are included as
Appendix II.
S&ME, Inc. 13201 Spring Forest Road I Raleigh, NC 276161 p 919.872.2660 1 f 919.876.39581 www.smeinc.com

Report for Preliminary Stream Assessment
Maple Grove Subdivision Site s
Mocksville, Davie County, North Carolina �f
S&ME Project No. 216056
Findings
On July 1, 2021, S&ME evaluated the Stream Feature depicted as Feature A on Figure 1, which is located
above a recently installed reinforced concrete culvert and rip -rap inlet protection. Feature A scored as an
ephemeral stream on the NCDWR Stream Rating Form (SF-1) on the day of evaluation. Feature A is
located within a topographic crenulation at the head of a drainage feature that flows into the culvert.
Based on historical aerial photographs, there did not appear to be a defined stream channel prior to the
recent construction activities including culvert installation and site grading. A 2007 color aerial exhibit
(Figure 4) is attached for reference.
Closing
S&ME appreciates the opportunity to provide natural resource services for this project. If you have any
questions please contact Walter Cole at 919-872-2660 or [e-mail].
Sincerely,
S&ME, Inc.
Walter Cole, LSS, REHS Thomas P. Raymond, PE
Senior Project Manager Environmental Area Manager
Enclosed: Figure 1: USDA-SCS Davie County Soil Survey Exhibit
Figure 2: USGS Topographic Quadrangle Exhibit
Figure 3: 2017 Color Aerial and Topographic Exhibit
Figure 4: 2007 Color Aerial Exhibit
Appendix I: NCDWR Stream Identification Form (SF-1)
Appendix II: Site Photographs (1 through 8)
July 6, 2021

Figures

SOIL MAP UNIT:
PaD: Pacolet sandy loam, 15 to 40 percent slopes
PcC2: Pacolet sandy clay loam, 8 to 15 percent slopes, eroded
locks UF
N .82 N
O
r
O
� II
Y
6 �.
x A..
E
Wei
z
a
> n
Q
Q
a
0
o
MrB
NPC
GeB
o
0 500 1,000
0
(FEET) ,
zjdw
REFERENCE: Y `'
GIS BASE LAYERS WERE OBTAINED FROM THE USDA-SCS 1995 DAVIE COUNTY SOIL SURVEY..
Y SHEET NO. 3. THIS MAP IS FOR INFORMATIONAL PURPOSES ONLY. ALL FEATURE
a LOCATIONS DISPLAYED ARE APPROXIMATED. THEY ARE NOT BASED ON CIVIL SURVEY
3 INFORMATION, UNLESS STATED OTHERWISE. 4 Mocksville Property Boundary
0
SCALE: FIGURE NO.
USDA-SCS SOIL SURVEY EXHIBIT 1 " = 500 '
DATE:
I I MAPLE GROVE SUBDIVISION 7-1-21 1
SOUTH MAIN STREET PROJECT NUMBER
MOCKSVILLE, DAVIE COUNTY, NORTH CAROLINA 216056

Appendix I

NC Division of Water Quality -Methodology for Identification of Intermittent and
Perennial Streams and Their Origins v. 4.11
NC DWQ Stream Identification Form Version 4.11
Date: July 1, 2021
Project/Site: Maple Grove Subdivision
Latitude: 35.889873
Evaluator: W. Cole
County: Davie
Longitude:-78.562593
Total Points:
Stream is at least intermittent 13.25
Stream Determination (circle one)
Other
SP
if>_ 19 or perennial if>_ 30"
Ephemeral
e.g. Quad Name:
A. Geomorphology (Subtotal = )
Absent
Weak
Moderate
Strong
1a. Continuity of channel bed and bank
0 •
10
2 0
30
2. Sinuosity of channel along thalweg
0 •
1 0
2 0
3
3. In -channel structure: ex. riffle -pool, step -pool,
ripple -pool sequence
0 0
10
2 0
30
4. Particle size of stream substrate
0 Q
10
2 0
30
5. Active/relict floodplain
00
10
20
30
6. Depositional bars or benches
0 .
1n
2 n
3
7. Recent alluvial deposits
0 •
1 0
2 0
3
8. Headcuts
0
1
2
30
9. Grade control
00
0.50
10
1.50
10. Natural valley
00
1 0.50
10
1.50
11. Second or greater order channel
No = 0 •
Yes = 3
a artificial ditches are not rated; see discussions in manual
B. Hydrology (Subtotal = 6.5 )
12. Presence of Baseflow
00
10
20
30
13. Iron oxidizing bacteria
00
1 •
20
30
14. Leaf litter
1.
10
0.50
0
15. Sediment on plants or debris
00
0.50
10
1.5
16. Organic debris lines or piles
0 0
1 0.5 U
10
1.50
17. Soil -based evidence of high water table?
No = 0
Yes = 3 .
C. Biology (Subtotal = 5.75 )
18. Fibrous roots in streambed
3
20
1 n.
0
19. Rooted upland plants in streambed
30,
20
1
0
20. Macrobenthos (note diversity and abundance)
0 •
in
20
3
21. Aquatic Mollusks
0 •
10
20
3
22. Fish
00,
0.50
in
1.5
23. Crayfish
0 .
0.50
10
1.5
24. Amphibians
00
0.50
10
1.5
25. Algae
00
0.5 &
1
1.5
26. Wetland plants in streambed
FACW = 0.75QOBL =
1.500ther = 0 O
'perennial streams may also be identified using other methods. See p. 35 of manual.
Notes:
Sketch:
41

Appendix II

CL
cu
cu
N
a
e �� Y' �i� � �� �� ��•, ,j.' �. Vie:- Q
•1 I�
z s.
N N
v
M
N
O
N
C
O Y
L
O
O
N N
(6
O
Z
U
N
2
a_
W
2E
06
O
U
a>
(6
H
R
.O
L
R
U
N
� L
a
O
tU
a .0)
>
C d
O -
N
� V
O
cn
> as
O L
cn
Q �
R
O
cn
Q
IN E