20130852 Ver 1_401 Application_20130813

Wetland and Natural Resource
Consultants
US ACE, Asheville Regulatory Field Office
151 Patton Avenue, Room 208
Asheville, North Carolina 28801 -5006
and
NC DWR, Webscape Unit
1650 Mail Service Center
Raleigh, NC 27699 -1650
Re: PCN - M/1 Homes, Blume Property (USACE AID: 2013- 01107)
Proposed Residential Subdivision
Harrisburg, Cabarrus County, North Carolina
To whom it may concern:
�L1.[
August 9, 2013
The purpose of this correspondence is to request written verification for the proposed impacts as detailed in the
attached PCN for the above referenced project. Nationwide Permits 14 and 29 have recently been issued by the
Army Corps. Additional temporary impacts are requested from the US Army Corps under NW 12 (located within
the 100 year flood plain) for temporary impacts to Reedy Creek associated with water and sewer utility line
installations (S3 and S4). These crossings were initially to be bored, but further investigation has determined that
additional costs are significant as opposed to temporary impacts associated with temporary open trenching
methods. Stabilization will be achieved through bioengineering techniques.
A 401 Water Quality Certification is requested for total impacts (both temporary and permanent) from the
Division of Water Resources.
Please contact me if you have any questions, comments, or require additional information.
Sincerely,
Tamp Bandy
Hickory Office
1646 Machine Shop Rood
Hickory, NC 28602
Phone: [phone]
AUG 1 2 2013

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action ID. 2013 -01107 County: Cabarrus USGS Quad: Harrisburg/Concord SE
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Property Owner / Authorized Agent: M/I Homes Charlotte, Attn: Marty Davis
Address: 5350 Seventy Seven Center Drive, Suite 100
Charlotte, NC 28217
Telephone No.: 704 -597 -4571
Size and location of property (water body, road name /number, town, etc.): The site is located on the east
side of Hickory Ridge Road, lust south of Rocky River Road, near Harrisburg, Cabarrus County.
North Carolina.
Description of projects area and activity: This permit authorizes impacts associated with a residential
development to include two road crossings and lot fill. See the table below for a more detailed
description of impacts. This permit replaces the previous authorization dated February 8, 2007
which has since expired. Also, please refer to special conditions listed below.
Sum ary of Authorized Im acts and Required Miti ation
Impact ID #
NWP /
GP #
Open Water ac
Wetland ac
Stream I
Temporary
Permanent
Temporary
Permanent
Temporary
Permanent
Stream 1
14
79
Stream 2
14
69
Wetland 1
29
0.01
Impact Totals
0.01
0
148
Total Loss of Waters of the U.S. (ac)
0.01
Total Loss of Waters of the U.S. (if)
148
Required Wetland
Mitigation ac
0
Required Stream Mitigation (If)
0
Special Conditions:
1) Storm water discharge pipes and associated outlet protection should be located outside of county
regulated stream buffer as shown on revised plans dated July 8, 2013.
2) Please be advised that if additional impacts to waters of the U.S., either on this property or
on/adjacent to this property and associated with this project/activity, are proposed at a later date,
those impacts will be combined with the current impacts to waters of the U.S. and will be
reviewed cumulatively. Generally, compensatory mitigation will be required if individual or
cumulative (i.e., past and present) losses or degradation of waters of the U.S. are greater than 150
linear feet of perennial or intermittent stream channel and/or 0.1 acre of wetland. Additionally,
cumulative impacts that result in the loss or degradation of greater than 300 linear feet of
perennial or intermittent stream channel, and/or 0.5 acre of wetland, will be processed under an
Individual Permit. This verification of the use of the Nationwide Permit Program for this project
does not imply that this office will necessarily approve any future proposal to impact waters of
the U.S. on this property and/or associated with this project/activity.
Applicable Law: N Section 404 (Clean Water Act, 33 USC 1344)
❑ Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: Regional General Permit Number:
Nationwide Permit Number: 14 & 29

Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with
the attached conditions and your submitted plans. Any violation of the attached conditions or deviation from
your submitted plans may subject the permittee to a stop work order, a restoration order and/or appropriate
legal action.
This verification will remain valid until the expiration date identified below unless the nationwide authorization
is modified, suspended or revoked. If, prior to the expiration date identified below, the nationwide permit
authorization is reissued and/or modified, this verification will remain valid until the expiration date identified
below, provided it complies with all requirements of the modified nationwide permit. If the nationwide permit
authorization expires or is suspended, revoked, or is modified, such that the activity would no longer comply with
the terms and conditions of the nationwide permit, activities which have commenced (i.e., are under construction) or
are under contract to commence in reliance upon the nationwide permit, will remain authorized provided the activity
is completed within twelve months of the date of the nationwide permit's expiration, modification or revocation,
unless discretionary authority has been exercised on a case -by -case basis to modify, suspend or revoke the
authorization.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality
Certification. You should contact the NC Division of Water Quality (telephone [phone]) to determine
Section 401 requirements. You may also visit their website at: http:// portal. ncdenr .ore/web/wq/swp/ws/webscape
For activities occurring within the twenty coastal counties subject to regulation under the Coastal Area
Management Act (CAMA), prior to beginning work you must contact the N.C. Division of Coastal Management.
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other
required Federal, State or local approvals/permits.
If there are any questions regarding this verification, any of the conditions of the Permit, or the Corps of
Engineers regulatory program, please contact Amanda Fuemmeler at 828 - 271 -7980.
Corps Regulatory Official Amanda Fuemmeler Date: July 12, 2013
Expiration Date of Verification: March 18 2017
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
hgp://per2.nyM.usace.ar7ny.mil/survey.htmi to complete the survey online.
Determination of Jurisdiction:
A. ® Based on preliminary information, there appear to be waters of the US including wetlands within the above
described project area. This preliminary determination is not an appealable action under the Regulatory
Program Administrative Appeal Process (Reference 33 CFR Part 331).
B. ❑ There are Navigable Waters of the United States within the above described project aiea subject to the
permit requirements of Section 10 of the Rivers and Harbors Act and Section 404 of the Clean Water Act.
Unless there is a change in the law or our published regulations, this detemrination may be relied upon for a
period not to exceed five years from the date of this notification.
C. ❑ There are waters of the US and/or wetlands within the above described project area subject to the permit
requirements of Section 404 of the Clean Water Act (CWA)(33 USC § 1344): Unless there is a change in the
law or our published regulations, this determination may be relied upon for a period not to exceed five years
from the date of this notification.
D. ❑ The jurisdictional areas within the above described project area have been identified under a previous action.
Please reference jurisdictional determination issued Action ID
Copy Furnished:
Wetland & Natural Resource Consultants, Attn: Tamp Bandy, 1646 Machine Shop Road, Hickory, NC
28602

Permit Number: 2013 -01107
Permit Type: NW29
Name of County: Cabarrus
Name of Permittee: MA Homes Charlotte, Attn: Marty Davis
Date of Issuance: July 12, 2013
Project Manager: Amanda Fuemmeler
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:
U.S. Anmy Corps of Engineers
Attention: CESAW -RG -A
151 Patton Avenue, Room 208
Asheville, North Carolina 28801 -5006
Please note that your permitted activity is subject to a compliance inspection by an U.S. Army
Corps of Engineers representative. If you fail to comply with this permit you are subject to
permit suspension, modification, or revocation.
I hereby certify that the work authorized by the above referenced permit has been completed in
accordance with the terms and conditions of the said permit, and required mitigation was
completed in accordance with the permit conditions.
Signature of Permittee
Date

ATTACHMENT
PRELIMINARY JURISDICTIONAL DETERMINATION FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PRELIMINARY JURISDICTIONAL DETERMINATION (JD):
B. NAME AND ADDRESS OF PERSON REQUESTING PRELIMINARY JD:
M11 Homes Charlotte, 5350 Seventy Seven Center Drive, Ste. 100, Charlotte, NC 28217
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION: Southeast of intersection of Rocky River Road and
Hickory Ridge Road, Harrisburg, NC. North and South of Reedy Creek
(USE THE ATTACHED TABLE TO DOCUMENT MULTIPLE WATERBODIES AT DIFFERENT SITES)
State:NC County /parish /borough: Cabarrus City: Harrisburg
Center coordinates of site (lat/long in degree decimal format): Lat..
Universal Transverse Mercator:
Name of nearest waterbody: Reedy Creek
Identify (estimate) amount of waters in the review area: -,Zt I W se_
Non- wetland waters: Cowardin Class: Stream Flow -
Wetlands: Cowardin Class:
Name of any water bodies on the site that have been identified as Section 10 waters:
Tidal:
Non - Tidal:
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
❑ Office (Desk) Determination. Date:
[Field Determination. Date(s):
1. a Corps of Engineers believes that there may be jurisdictional waters of the United States on the subject site, and
the permit applicant or other affected party who requested this preliminary JD is hereby advised of his or her option to
request and obtain an approved jurisdictional determination (JD) for that site. Nevertheless, the permit applicant or other
person who requested this preliminary JD has declined to exercise the option to obtain an approved JD in this instance
and at this time.
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 approved JD for the activity, the permit
applicant is hereby,made aware of the following: (1) the permit applicant has elected to seek a permit authorization based
on a preliminary JD, which does not make an official determination of jurisdictional waters; (2) that the applicant has the
option to request an approved JD before accepting the terms and conditions of the permit authorization, and that basing a
permit authorization on an approved JD could possibly result in less compensatory mitigation being required or different
special conditions; (3) that 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) that 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) that undertaking any activity in reliance upon the subject permit authorization
without requesting an approved JD constitutes the applicant's acceptance of the use of the preliminary JD, but that either
form of JD will be processed as soon as is practicable; (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 preliminary
JD constitutes agreement that all wetlands and other water bodies on the site affected in any way by that activity are
jurisdictional waters of the United States, and precludes 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 approved JD or a preliminary JD, that JD will be processed as soon as is practicable. Further, an
approved JD, 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, and that in any administrative appeal, jurisdictional issues
can be raised (see 33 C.F.R. 331.5(a)(2)). If, during that administrative appeal, it becomes necessary to make an official
determination whether CWA jurisdiction exists over a site, or to provide an official delineation of jurisdictional waters on
the site, the Corps will provide an approved JD to accomplish that result, as soon as is practicable.
This preliminary JD finds that there may be" waters of the United States on the subject project site, and identifies all
aquatic features on the site that could be affected by the proposed activity, based on the following information:
SUPPORTING DATA. Data reviewed for preliminary JD (check all that apply - checked items should be included in
case file and, where checked and requested, appropriately reference sources below):
® Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant: WNR.
® Data sheets prepared /submitted by or on behalf of the applicant/consultant.
❑ Office concurs with data sheets/delineation report.
❑ Office does not concur with data sheets/delineation report.
❑ Data sheets prepared by the Corps:
❑ Corps navigable waters' study:
❑ U S. Geological Survey Hydrologic Atlas:
❑ USGS NHD data.
❑ USGS 8 and 12 digit HUC maps.
❑ U.S. Geological Survey map(s). Cite scale & quad name:
❑ USDA Natural Resources Conservation Service Soil Survey. Citation*
❑ National wetlands inventory map(s). Cite name:
❑ State /Local wetland inventory map(s):
❑ FEMA/FIRM maps:
❑ 100 -year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
❑ Photographs: ❑ Aerial (Name & Date):
or ❑ Other (Name & Date):
❑ Previous determination(s). File no. and date of response letter.
❑ Other information (please specify):
IMPORTANT NOTE: The information recorded on this form has not necessarily been verged by the Corps and
should not be relied upon for later jurisdictional determinations.
s-
ignature and date of
Regulatory Project Manager
(REQUIRED)
Signature and date of
person requesting preliminary JD
(REQUIRED, unless obtaining the signature is impracticable)
N

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Estimated
Site #
Latitude
Longitude
Co
amount of
aquatic
Class aquatic
Class ss
resource
resource in
review area
WL -1
35.29601 ° N
- 80.615230 W
Palustrine
4 AC
non - section 10 —
forested
wetland
WL -2
35.291820 N
- 80.62186° W
Palustrine
0.1 AC
non - section 10 —
forested
wetland
WL -3
35.293140 N
- 80.623160 W
Palustrine
0 52 AC
non - section 10 —
forested
wetland
WLA
35.29161 ° N
-80.622910 W
Palustrine
0.15 AC
non - section 10 —
forested
wetland
WL -5
35.291650 N
- 80.61915° W
Palustrine
0.01 AG
non - section 10 —
forested
wetland
WL-6
35.291040 N
- 80.622200 W
Palustrine
0 06 AC
non - section 10 —
forested
wetland
WL -7
35.288270 N
- 80.620760 W
Palustrine
0.01 AC
non - section 10 —
forested
wetland
S -1
35.293020 N
- 80.619880 W
Perennial
3000 LF
non - section 10 — non -
Streambed
wetland
S -2
35.289270 N
- 80.619880 W
Perennial
1850 LF
non - section 10 — non -
Streambed
wetland
P -1
35.295840 N
- 80.61591 ° W
Freshwater
0.16 AC
non - section 10 — non-
Pond (imp)
wetland
P -2
35.29431 ° N
- 80.623230 W
Freshwater
0.23 AC
non - section 10 — non -
Pond (Imp)
wetland
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ti -
.. 1 if .f t,'� �•, ! 11 i _ WL -1
WL -3 AFL- 2 550 `l
I•f) �... , - i l
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WN;tti
Wetland and Natural Resource ••�-
Consultants'�
Department of the Army
Wilmington District, Corps of Engineers
PO Box 1890
Wilmington, North Carolina, 28402 -1890
-and-
NC Division of Water Quality, WBSCPE Unit
512 North Salisbury Street
Raleigh, North Carolina, 27604
Re: Agent Authorization
The undersigned, registered property owners of the noted property, do hereby authorize
Wetland and Natural Resource Consultants to act on my behalf and take all actions
necessary for the processing of this jurisdictional verification, permit or certification
request and any and all standard and special conditions attached. I/we reserve the right
to accept or appeal all final, proffered actions, jurisdictional determinations, permits or
certifications and any and all standard and special conditions attached.
Property Owner / PD M l PIC roe s RrR.�n'.
Contact Name:' KA&MA 04yi-5
Street Address / PO Box: 53,50 J:vir'"Iq 65voi C* jiAp-ov, sr. too
City, State, Zip Code: (milaftlor _ NL ?.6v
Phone / Fax Number: ?oa(- 517-7 - Ys77
Project Name: "'R1_,UJML
2tS�c. ��SSl6GG?�I�ooa�
Property Street Address: 'a,_ Azeaga S60670/05o 000
(street address, city, Sti_06Zand zip, or County and Tax PIN)
Owner / A MSignature: 01 (.�awoY
Date: W 17, • /3
Hickory OR1ce
1646 Machine Shop Rood
Hickory. NC 28602

Pre - Construction Notification PC Form
A. AppHcant Information
1. Processing
1 a. Type(s) of approval sought from the
Corps:
® Section 404 Permit ❑ Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number. 12, 14 and 29 or General Permit (GP) number.
1 c. Has the NWP or GP number been verified by the Corps?
❑ Yes
® No
Id. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e. Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
❑ Yes ® No
For the record only for Corps Permit:
❑ Yes ® No
1f. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in -lieu
fee program.
El Yes
® No
1 g. Is the project located in any of NC's twenty coastal counties. if yes, answer 1 h
below.
❑ Yes
® No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
Yes
® No
2. Project Information
2a. Name of project:
Blume
2b. County:
Cabarrus
2c. Nearest municipality / town:
Harrisburg
2d. Subdivision name:
2e. NCDOT only, T.I.P. or state
project no:
Owner Information
3a. Name(s) on Recorded Deed:
Blume Family Farm, LLC (per GIS /previous Permit Verification)
3b. Deed Book and Page No.
05531 0265 and 0503 0123
3c. Responsible Party (for LLC if
applicable):
3d. Street address:
1217 Crescent Ave.
3e. City, state, zip:
Gastonia, NC 28052
3f. Telephone no.:
704 - 87478
3g. Fax no.:
3h. Email address:

4. Applicant Information (if different from owner)
4a. Applicant is:
❑ Agent ® Other, specify: Potential Developer
4b. Name:
Marty Davis
4c. Business name
(if applicable):
M/I Homes Charlotte
4d. Street address:
5350 Seventy Seven Center Drive, Suite 100
4e. City, state, zip:
Charlotte, NC 28217
4f. Telephone no.:
7045974571
4g. Fax no.:
4h. Email address:
mdavis @mihomes.com
5. Agent/Consultant Information (if applicable)
5a. Name:
Tamp Bandy
5b. Business name
(if applicable):
Wetland and Natural Resource Consultants
5c. Street address:
1646 Machine Shop Road
5d. City, state, zip:
Hickory NC 28602
5e. Telephone no.:
828 - 302 -3437
5f. Fax no.:
5g. Email address:
tamp @wetland- consultants.com

B. Project Information and Prior Project History
1. Property Identification
1 a. Property identification no. (tax PIN or parcel ID):
55166624340000 and 55167403040000
1 b. Site coordinates (in decimal degrees):
Latitude: Longitude: -
35.29557°N (- 80.61956°W
1c. Property size:
225 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
proposed project
Rey Creek
2b. Water Quality Classification of nearest receiving water.
C
2c. River basin:
Yadkin - Pee Dee
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application: Site currently undeveloped. Residential and Institutional adjacent property uses. North of Reedy Creek
currently fenced and grazed - cattle production. South of Reedy Creek wooded.
3b. List the total estimated acreage of all existing wetlands on the property:
+/- 5 acres
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
+/- 5000 linear feet
3d. Explain the purpose of the proposed project:
Road crossings of jurisdictional channels within a proposed residential subdivision
3e. Describe the overall project in detail, including the type of equipment to be used:
The site is composed of 225.5 acres that is currently zoned as LDR and proposed to be zoned as RL- Conservation District.
There are 297 proposed lots, which are either 75' or 95' in width. Reedy Creek, a Class C stream, runs through the property creating
two distinct areas of development, as we are not creating a connection across Reedy Creek. On the southern portion of the site, there
is a perennial stream that runs south to north into Reedy Creek. There will be two road crossings developed on the perennial t stream,
one a residential collector with a 31' paved section (S 1) and the other a residential lane with a 20' paved section (S2). The required
sidewalk will be tapered in near the back of curb to reduce impacts in those areas. Additional request under NW 12 for temporary
impacts associated with crossings of Reedy Creek for l water line crossing (adjacent to bridge off Hickory Ridge Road) and 1 Sewer
line installation / crossing of Reedy Creek.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
® Yes ❑ No ❑ Unknown
Comments: Action ID: 2007492 -313
4b. If the Corps made the jurisdictional determination, what type
of determination was made?
❑ Preliminary® Final
4c. If yes, who delineated the jurisdictional areas?
Agency /Consultant Company: WNR
Name (if known): WNR
Other.
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
NW 14 / 29 (Action ID: 2013 - 01107)
5. Project History
5a. Have permits or certifications been requested or obtained for
this
Yes ❑ No ❑Unknown
project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions. Authorizations issued, but no impacts completed, yet. The proposed
site plan to generally resulting in the same, previously authorized impacts. Additional authorization requested for temporary sewer
and water line crossing of Reedy Creek.

6. Future Project Plans
6a. Is this a phased project? ❑ Yes ® No
6b. If yes, explain.
No additional or future development is planned at this time.

Proposed Impacts Inventory
Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
® Wetlands ® Streams - tributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction

2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
2b.
2c.
2d.
2e.
2f.
Wetland impact
Type of jurisdiction
number -
Type of impact
Type of wetland
Forested
(Corps - 404, 10
Area of impact
Permanent (P) or
(if known)
DWQ - non404, other)
(acres)
Temporary
W1 ® P ❑ T
NW29 - Lot fill
❑ Yes
❑ No
® Corps
® DWQ
0.01
W2 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W3 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W4 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W5 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
2g. Total wetland impacts
2h. Comments: (currently authorized by USACE AID: 2013 -01107)
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
3b.
3c.
3d.
3e.
3f.
3g.
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number -
(PER) or
(Corps - 404, 10
stream
length
Permanent (P) or
intermittent
DWQ - non404,
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 ®P ❑ T
Culvert - outlet
protection NW14
UT to Reedy Creek
® PER
❑ INT
® Corps
® DWQ
4
79
S2 ®P ❑ T
Culvert - outlet
protection NW14
UT to Reedy Creek
® PER
❑ INT
® Corps
® DWQ
3
69
S3 ❑ P ® T
Water Line
Installation NW12
Reedy Creek
® PER
❑ INT
® Corps
® DWQ
-y20
15
S4 [:]POT
Sewer Line
InstallationNW12
Reedy Creek
PER
❑ INT
®Corps
® DWQ
-25
15
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
❑ PER
❑ Corps
S6 ❑ P ❑ T
❑ INT
❑ DWQ
3h. Total stream and tributary impacts
178
31. Comments: Sl and S2 currently authorized by USACE AID: 2013 - 01107. S3 and S4 temporary impacts proposed for utility
line crossings under NW 12 (located within 100 year fp)

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 ❑P
02 ❑P
03 ❑P ❑T
04 ❑P ❑T
4E Total open water impacts
4g. Comments:
S. Pond or Lake Construction
If Pond or lake construction proposed, then complete the chart below.
5a.
Pond ID
number
5b.
Proposed use or purpose
of pond
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f. Total
5g. Comments:
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
51. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:

6. Buffer Impacts (for DWG)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a.
❑
Neuse
❑
Tar - Pamlico ❑ Other.
Project is in which protected basin? No
❑
Catawba
❑
Randleman
6b.
6c.
6d.
6e.
6f.
6g.
Buffer impact
number—
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
for
Stream name
mitigation
(square feet)
(square feet)
Temporary T
impact
required?
B1 ❑P ❑T
El Yes
❑ No
B2 ❑ P ❑ T
❑ Yes
❑ No
B3 ❑P ❑T
F] Yes
❑ No
6h. Total buffer impacts
6i. Comments:
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
Impacts for the total project are limited to 1/100 of an acre of wetlands and 148 linear feet of stream channel for two road crossings
for a 225 acre site. Utility crossings initially proposed as borings; however, further investigation and cost analysis has determined that
significant additional costs provide for only minimal environmental benefits vs. temporary open trench installation combined with
bioengineering stabilization.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
The proposed project has limited permanent impacts to less than 150 linear feet of stream channels utilizing construction methods
designed to reduce impacts such as headwalls and / or wingwalls. Proposed utility crossings to utilize bioengineering for stabilization
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
a. Does the project require Compensatory Mitigation for
❑ Yes ® No
impacts to Waters of the U.S. or Waters of the State?
2b. If yes, mitigation is required by (check all that apply):
FIDwo ❑ Corps
❑ Mitigation bank
c. If yes, which mitigation option will be used for this project?
El Payment to in -lieu fee program
Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
a. Name of Mitigation Bank:
b. Credits Purchased (attach receipt and letter)
Fyp
[Quantity

X Comments:
4. Complete If Making a Payment to In -lieu Fee Program
a. Approval letter from in -lieu fee program is attached.
0 Yes
b. Stream mitigation requested:
linear feet
c. If using stream mitigation, stream temperature:
1:1 warm ❑ cool Qcoid
d. Buffer mitigation requested (DWQ only):
square feet
e. Riparian wetland mitigation requested:
acres
f. Non - riparian wetland mitigation requested:
acres
g. Coastal (tidal) wetland mitigation requested:
acres
h. Comments:
Complete if Using a Permittee Responsible Mitigation Plan
a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
S. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation?
Yes ® No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
Zone
c.
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 in4isu fee fund).
h. Comments:

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
❑ Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan Included? If no, explain why.
Yes No
❑ ❑
Comments:
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project?
<24 %
2b. Does this project require a Stormwater Management Plan?
® Yes ❑ No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
Required and to be approved through Town of Harrisburg
® Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan?
❑ DWQ Stormwater Program
❑ DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local governments jurisdiction is this project?
Harrisburg
❑ Phase II
❑ NSW
3b. Which of the following locally- implemented stormwater management programs
❑ USMP
apply (check all that apply):
❑ Water Supply Watershed
® Other.
3c. Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ® No
attached?
4. DWG Stormwater Program Review
❑
Coastal counties
❑
HQW
4a. Which of the following state - implemented stormwater management programs apply
❑
ORW
(check all that apply):
❑
Session Law 2006 -246
❑
Other.
4b. Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ® No
attached?
S. 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

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal /state/local) funds or the
Yes ® No
use of public (federal /state) land?
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
❑ Yes ❑ No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c. If you answered "yes " -to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.)
❑ Yes ❑ No
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
❑ Yes ® No
or Riparian Buffer Rules (15A NCAC 213 .0200)?
21b. Is this an after - the -fact permit application?
❑ Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in
Yes ® No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
No future development associated with MI is planned at this time
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.
Tie into existing sanitary sewer utility running parallel to Reedy Creek

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
Sa. Will this project occur in or near an area with federally protected species or
❑Yes ®No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ® No
impacts?
❑ Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted.
❑ Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
previously authorized Nationwide Permit 29
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
none
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this projdct occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
Yes No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
previously reviewed maps from State archaeology office in Raleigh
8. Flood Zone Designation (Corps Requirement)
® Yes, Impact S1 (NW14) and temporary
8a. Will this project occur in a FEMA - designated 100 -year floodplain?
impacts S3 and S4 (NW12)
® No, Impact S1 and W1 - NW29
8b. If yes, explain how project meets FEMA requirements: The only impact areas within the 100 year flooplain are associated
with the residential collector road (S 1) as requested under NW 14 and proposed sewer and water utility line mstallations under NW 12.
Areas of the 100 -year floodplain will be impacted by filling above the floodplain elevation to allow lots to be developed above the
floodplain; however, there are no wetland fills within the 100 year floodplain. The plan assumes that FEMA approval of a CLOMR-
F will be obtained prior to fill being placed in the floodplain. If CLOMR -F is approved with a no-rise condition then a floodplain cut
balance will not be required. If a floodplain cut - balance is required, it will be completed without impacts to wetlands.
8c. What source(s) did you use to make the floodplain determination? project engineer / GIS
Tamp Bandy
8 -9 -13
Agent /Consultant's Printed Name
9
Date
Applicant/Agent's Signature
(Agents signature is valid only if an authorization letter from the applicant
is provided.)

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The National Map
NOTES: Data available from U.S. Geological Survey, National Geospatial Program.
Blume Wetlands Delineation Depicted on USGS
Harrisburg and Concord SE Topographic Quadrangles
Open in The National Map Viewer
(provided for Illustrative purposes only)
4/19/13 12:47 AM