20210825 Ver 1_401 Application_20210922

Staff Review
Does this application have all the attachments needed to accept it into the review process?*
r Yes r No
ID#*
20210825
Version* 1
Is this project a public transportation project?* r Yes
r No
Reviewer List:* Sue Homewood:eads\slhomewood
Select Reviewing Office:* Winston-Salem Regional Office - [phone]
Submittal Type:* 401 Application
Does this project require a request for payment to be sent?*
r
Yes
r
No
How much is r $240.00
owed?* 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: * r
For the Record Only (Courtesy Copy)
r
New Project
r
Modification/New Project with Existing ID
r
More Information Response
r
Other Agency Comments
r
Pre -Application Submittal
r
Re-Issuance\Renewal Request
r
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:
Prefile Submittal_04.23.21.pdf
Date for Meeting Request 4/23/2021
I D#
Project Contact Information
Name: Heather LaGamba
who is submitting the information?
Email Address: [e-mail]
Project Information
Project Name: 1613 West Lexington Ave
Is this a public transportation project?
r Yes
r No
Version
50.14KB
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
r Yes r No r Unknown
County (ies)
Guilford
Please upload all files that need to be submited.

Oickthe upload button or drag and drop files here to attach document
3576.3-West Le)angton Avenue_PCN 9.22.2021.pdf 8.54MB
Only pdf or Iv17 files are accepted.
Describe the attachments
or comments:
PCN for 401 WQC.
Sign and Submit
P 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');
■ 1 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:
��AW-4 :10.1��IIIWIOI
Submittal Date: Is filled in autorratically.

Preliminary ORM Data Entry Fields for New Actions
ACTION ID 9: SAW- 2020-02241
Prepare file folder ❑
Begin Date (Date Received): September 22, 2021
Assign Action ID Number in ORM ❑
1. Project Name [PCN Form A2a]: 1613 West Lexington Ave
2. Work Type: ❑✓ Private ❑Institutional ❑Government ❑ Commercial
3. Project Description / Purpose [PCN Form B3d and B3e]:
The site is proposed for residential development. The site currently contains wooded land.
4. Property Owner / Applicant [PCN Form A3 or A4]: Edgedale Partners, LLC
5. Agent / Consultant [PNC Form A5 — or ORM Consultant ID Number]:
Pilot Environmental, Inc.
6. Related Action ID Number(s) [PCN Form B5b]:
7. Project Location —Coordinates, Street Address, and/or Location Description [PCN Form Blb]:
1613 West Lexington Ave
35.9655920/-80.0494470
8. Project Location —Tax Parcel ID [PCN Form Bla]: See Attached
9. Project Location — County [PCN Form A2b]: Davidson
10. Project Location —Nearest Municipality or Town [PCN Form A2c]: High Point
11. Project Information — Nearest Waterbody [PCN Form 132a]: Payne Creek
12. Watershed / 8-Digit Hydrologic Unit Code [PCN Form 132c]: 03040103
Authorization: Section 10 ❑ Section 404 ✓❑
Regulatory Action Type:
❑ Standard Permit
✓ Nationwide Permit 9
Regional General Permit 9
Jurisdictional Determination Request
Section 10 and 404 ❑
❑ Pre -Application Request
::]Unauthorized Activity
❑ Compliance
❑ No Permit Required
Revised 20150602

Proposal far Environmental Services
Pilot Proposal 3576.1
April 15, 2021
AGENT AUTHORIZATION
This form authorizes Pilot to act as our agent in stream/wetland matters including U.S. Army
Corps of Engineers and North Carolina Division of Water Resources field verification and
permitting.
Property Address: 1613 W. Lexington Ave.
High Point, NC
Applicant Information:
Name:
Address:
Telephone Number:
Fax Number:
E-mail Address:
Land Acquisition & Development Services, LLC
PO Box 9147, Greensboro NC 27429
336-282-3535
RTT-
[e-mail]
Signature Date: 4/22/21
4

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5 Information:
LEXINGTON AVE
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1 Land Units:
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Railroads
Deed Book:
2498 Pg: 1392
a parch Text
.: rnme.0
Deed Date:
08/27/2021
Account
9255887
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9r9lN1�

NORTH CAROLINA
Environmental Quality
Water Resources
Office Use Only
Corps Action ID no. SAW-2020-02241 Date received: 9/22/2021
DWR project no. 20210825 Date received: 9/22/2021
Site Coordinates:
Latitude (DD.DDDDDD): 35.966009'
Longitude (DD.DDDDDD): 80.049598'
Form Version 1.5, September 2020
Pre -Construction Notification (PCN) Form
(Ver. 1.5, September 2020)
For Nationwide Permits and Regional General Permits and corresponding Water Quality Certifications
Please note: fields marked with a red asterisk are required. The form is not considered complete until all mandatory
questions are answered.
The online help file may be found at this link:
https:Hedocs.deg.nc.gov/WaterResources/0/edocl6247041PCN%2OHelp%2OFile%202018-1-30.pdf
The help document may be found at this link:
http://www.saw. usace.army. mil/Missions/Regulatory-Permit-Program/Permits/2017-Nationwide-Permits/Pre-
construction-Notification/
Before submitting this form, please ensure you have submitted the Pre -Filing Meeting Request Form as DWR will not be
able to accept your application without this important first step. The Pre -Filing Meeting Request Form is used to satisfy 40
C.F.R. Section 121.4(a) which states "At least 30 days prior to submitting a certification request, the project proponent shall
request a pre -filing meeting with the certifying agency." In accordance with 40 C.F.R. Section 121.5(b)(7), and (c)(5), all
certification requests must include documentation that a pre -filing meeting request was submitted to the certifying authority
at least 30 days prior to submitting the certification request.
Attach documentation of Pre -Filing Meeting Request to this Application.
Date of Pre -filing Meeting Request (MM/DD/YYYY) : 4/23/2021
DWR ID # 20210825 Version 1 (If applicable)
A. Processing Information
County (counties) where project is located:
Davidson Additional (if needed).
Is this a public transportation project?
(Publicly funded municipal, state, or federal road, rail,
❑ Yes ❑x No
or airport project)
Is this a NCDOT project?
❑ Yes ❑x No
If yes, NCDOT TIP or state project number:
Click to enter.
If yes, NCDOT WBS number:
Click to enter.
❑x Section 404 Permit (wetlands, streams, waters,
Clean Water Act)
la. Type(s) of approval sought from the Corps:
❑ Section 10 Permit (navigable waters, tidal
waters, Rivers and Harbors Act)
Pagel of 21 PCN Form - Version 1.5, September 2020

❑x Nationwide Permit (NWP)
1 b. Permit type(s)?
❑ Regional General Permit (RGP)
❑ Standard (IP)
This form may be used to initiate the standard/ individual permit process with the USACE. Please contact your Corps
representative concerning submittals for standard permits. All required items can be included as separate attachments
and submitted with this form.
1 c. Has the NWP or GP number been verified by the Corps?
❑ Yes ❑x No
NWP number(s):
NWP 29
RGP number(s):
Click to enter.
1d. Type(s) of approval sought from the DWR (check all that apply):
❑x 401 Water Quality Certification — Regular ❑ 401 Water Quality Certification— Express
❑ Non-404 Jurisdictional General Permit ❑ Riparian Buffer Authorization
❑ Individual 401 Water Quality Certification
1e. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification: *
❑ Yes ❑x No
For the record only for Corps Permit: *
❑ Yes ❑x No
1f. Is this an after -the -fact permit/certification application?
❑ Yes ❑x No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for
mitigation of impacts?
® Yes ❑ No
If yes, attach the acceptance letter from mitigation bank or in -lieu fee program.
1 h. Is the project located in any of NC's twenty coastal counties?
❑ Yes ❑x No
1 i. Is the project located within an NC DCM Area of Environmental
Concern (AEC)?
❑ Yes ❑x No ❑ Unknown
1j. Is the project located in a designated trout watershed?
❑ Yes ❑x No
If yes, you must attach a copy of the approval letter from the appropriate Wildlife Resource Commission Office.
Trout information may be found at this link: http://www.saw.usace.army.mil/Missions/Regulatory-Permit-
Program/Agency-Coordination/Trout.aspx
Page 2 of 21 PCN Form - Version 1.5, September 2020

B. Applicant Information
1 a.
Who is the primary contact?
David Michaels
1 b.
Primary Contact Email:
[e-mail]
1 c.
Primary Contact Phone: (###)###-####
[phone]
1 d.
Who is applying for the permit/certification? (check
all that apply)
® Owner ❑ Applicant (other than owner)
1 e.
Is there an agent/consultant for this project?
® Yes ❑ No
2.
Landowner Information
2a.
Name(s) on Recorded Deed:
Central Alamance Scenic Housing, LLC
2b.
Deed Book and Page No.:
2498/1392
2c.
Responsible Party (for corporations):
David Michaels
2d.
Address
Street Address:
PO Box 9147
Address line 2:
-;licktu IVI RIM.
City:
Greensboro
State/ Province/ Region:
North Carolina
Postal/ Zip Code:
27429
Country:
U.S.
2e.
Telephone Number: * (###)###-####
[phone]
2f.
Fax Number: (###)###-####
Click to eniei.
2g.
Email Address: *
[e-mail]
3.
Applicant Information (if different from owner)
3a.
Name:
David Michaels
3b.
Business Name (if applicable):
Land Acquisition & Development Services, LLC
3c.
Address:
Street Address:
PO Box 9147
Address line 2:
Clicktu UlRer.
City:
Greensboro
State/ Province/ Region:
NC
Postal/ Zip Code:
27429
Country
US
3d.
Telephone Number: (###)###-####
[phone]
3e
Fax Number: (###)###-####
UICK io enier.
Page 3 of 21 PCN Form - Version 1.5, September 2020

3f. Email Address: Dmichaels @windsorinvestments.com
4. Agent/ Consultant (if applicable)
4a. Name: *
Michael T. Brame
4b. Business Name:
Pilot Environmental, Inc.
4c. Address: *
Street Address:
743 Park Lawn Court
Address line 2:
Click to enter.
City:
Kernersville
State/ Province/ Region:
NC
Postal/ Zip Code:
27284
Country:
U.S.
4d. Telephone Number: * (###)###-####
[phone]
4e Fax Number: (###)###-####
Click to enter.
4f. Email Address: *
[e-mail]
Agent Authorization Letter:
Attach a completed/signed agent authorization form or letter. A sample form may be found at this link:
https://www.saw. usace.army. mil/Missions/Regulatory-Permit-Program/Permits/2017-Nationwide-Permits/Pre-
construction-Notification/
Page 4 of 21 PCN Form - Version 1.5, September 2020

C. Project Information and Prior Project History
1. Project Information
la. Name of project: *
Canter Creek Subdivision
1 b. Subdivision name (if appropriate):
Canter Creek
1c. Nearest municipality/town: *
High Point, NC
2.
Project Identification
2a.
Property identification number (tax PIN or parcel ID):
1630100000013
2b.
Property size (in acres):
44
2c.
Project Address:
Street Address:
1613 West Lexington Avenue
Address line 2:
Click to enter.
City:
High Point
State/ Province/ Region:
NC
Postal/ Zip Code:
27262
Country:
U.S.
2d.
Site coordinates in decimal degrees (using 4-6 digits
after the decimal point): *
Latitude (DD.DDDDDD): 35.966009'
Longitude (-DD.DDDDDD):-80.049598'
3. Surface Waters
3a. Name of nearest body of water to proposed project:
Payne Creek
3b. Water Resources Classification of nearest receiving
Class C
water:
The Surface Water Classification map may be found at this link:
https://ncdenr.maps.arcqis.com/apps/webappviewer/index.html?id=6e125ad7628f494694e259c80dd64265
Yadkin-PeeDee
3c. In what river basin(s) is your project located?
Choose additional (if needed)
3d. Please provide the 12-digit HUC in which the project is
030401030203
located:
The Find Your HUC map may be found at this link:
https://ncdenr.maps.arcgis.com/apps/Publiclnformation/index.html?appid=ad3a85aOc6d644aOb97cdO69db238ac3
Page 5 of 21 PCN Form - Version 1.5, September 2020

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 site contains undeveloped, wooded land. A high tension powerline and associated easement cross the
central portion of the site. The site is located in a residential area of High Point.
4b.
Have Corps permits or DWR certifications been obtained for this
❑ Yes ❑x No ❑ Unknown
project (including all prior phases) in the past?
4c.
If yes, please give the DWR Certification number and/or Corps
SAW-2020-02241
Action ID (ex. SAW-0000-00000):
jClick to enter.j
Attach any pertinent project history documentation
4d.
Attach an 8'h x 11" excerpt from the most recent version of the USGS topographic map indicating the location of
the project site.
4e.
Attach an 8'h x 11" excerpt from the most recent version of the published County NRCS Soil Survey map
depicting the project site.
4f.
List the total estimated acreage of all existing wetlands on the
2.42 acres
property:
4g.
List the total estimated linear feet of all existing streams (intermittent
3,692 linear feet
and perennial) on the property:
4g1.
List the total estimated acreage of all existing open waters on the
0 acres
property:
4h.
Explain the purpose of the proposed project:
The purpose of the proposed project is to construct a 98 lot single family residential subdivision.
4i.
Describe the overall project in detail, including the type of equipment to be used:
The overall project includes the construction of a 98 lot single family residential subdivision. In order to facilitate the
proposed development and access the central and southern portions of the site, it is necessary to impact a stream and
wetlands. To facilitate the development of the site, clearing and grading the site is necessary. Graders, haulers,
excavators and other heavy equipment will be used during grading and construction of the site.
4j.
Attach project drawings/site diagrams/depictions of impact areas for the proposed project.
5.
Jurisdictional Determinations
5a.
Have the wetlands or streams been delineated on the property or in
® Yes ❑ No ❑ Unknown
proposed impact areas?
Comments:
The site was delineated by Pilot Environmental on April 26, 2018. The site was verified in the field by Mr. Rhoden -
Reynolds with the USACE on February 3, 2021 (SAW-2020-02241, PJD Dated 4/15/2021).
Name (if known): Michael Brame
5b.
If 5a is yes, who delineated the jurisdictional
Agency/Consultant Company: Pilot Environmental
areas?
Other: Click to enter
5c.
If the Corps made a jurisdictional determination,
❑x Preliminary ❑ Approved ❑ Emailed Concurrence
what type of determination was made?
❑ Not Verified ❑ Unknown
Corps AID number (ex. SAW-0000-00000):
SAW — 2020-02241
Page 6 of 21 PCN Form - Version 1.5, September 2020

5d. List the dates of the Corps jurisdictional determination or State determination if a determination was made by
either agency.
The USACE issued a PJD dated 4/15/2021.
5d1. Attach jurisdictional determinations.
Page 7 of 21 PCN Form - Version 1.5, September 2020

6. Future Project Plans
6a. Is this a phased project?
® Yes ❑ No
6b. If yes, explain.
The project consists of two phases. This permit application includes impacts associated with both phases.
Are any other NWP(s), regional general permit(s), or individual permit(s) used, or intended to be used, to authorize
any part of the proposed project or related activity? This includes other separate and distant crossings for linear
projects that require Department of the Army authorization but don't require pre -construction notification.
No other permits are intended to be used.
Page 8 of 21 PCN Form - Version 1.5, September 2020

D. Proposed Impacts Inventory
Impacts Summary
❑x Wetlands
1 a. Where are the impacts associated with your project ❑ Buffers
(check all that apply):
❑ Pond Construction
❑x Streams - tributaries
❑ Open Waters
2.
Wetland Impacts
If there are wetland impacts proposed on the site, complete this table for each wetland area impacted.
2a.
2a1.
2b.
2c.
2d.
2e.
2f.
2g.
Site #
Impact
Impact
Wetland Name
Wetland Type*
Forested
Jurisdiction
Impact Area
Reason/Type
Duration
?
Type
(ac)
W1
Fill (Incl.
Permanent
Unnamed
Headwater
Yes
Both
0.1140
Riprap)
Forest
W2
Fill (Incl.
Permanent
Unnamed
Headwater
Yes
Both
0.0995
Riprap)
Forest
W3
Fill (Incl.
Permanent
Unnamed
Bottomland
Yes
Both
0.0780
Riprap)
Hardwood
Forest
W4
Fill (Incl.
Permanent
Unnamed
Headwater
Yes
Both
0.1478
Riprap)
Forest
W5
Fill (Incl.
Permanent
Unnamed
Headwater
Yes
Both
0.0208
Riprap)
Forest
W6
Choose one
Temp/
Click to enter
Choose one
Y/N
Choose one
Click to
Perm
enter
2g1.
Total temporary wetland impacts
Click to enter. ac
2g2.
Total permanent wetland impacts
0.46 ac
2g3.
Total wetland impacts
0.46 ac
2h.
Comments:
Wetland Impacts 1 and 2 are associated with road fill in order to access the site. Wetland Impact 3 is a associated with
a road crossing where a culvert is being installed across a stream and adjacent wetland. Wetland Impact 4 is
associated with road fill. A small area of wetland would be located up -gradient of the crossing that it is considered a
total loss and lot fill will be placed over the small area of wetland. Wetland Impact 5 is associated with lot fill. In order
to bring Lot 22 up to grade, it is necessary to impact 0.0208 acres of wetland.
The total wetland mpacts are 0.46 acres of wetland. The applicant proposes to mitigate for the impacts at a 2:1.
Mitigation is proposed through the Division of Mitigation Services.
Page 9 of 21 PCN Form - Version 1.5, September 2020

3.
Stream Impacts
If there are perennial or intermittent stream/ tributary impacts (including temporary impacts) proposed on the site,
complete this table for all stream/ tributary sites impacted.
** All Perennial or Intermittent streams must be verified by DWR or delegated local government
Site #
3a.
Impact Reason/
Type
3b.
Impact
Duration
3d.
Stream Name
3e.
Stream
Type
3f.
Jurisdiction
Type
3g.
Stream Width
(avg ft)
3h.
Impact length
(linear ft)
S1
Crossing/ Culvert
Permanent
Unnamed
Perennial
Both
3
122/18
S2
Dewatering
Temporary
Unnamed
Perennial
Both
3
10
S3
Choose one
Temp/ Perm
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S4
Choose one
Temp/ Perm
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S5
Choose one
Temp/ Perm
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S6
Choose one
Temp/ Perm
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S7
Choose one
Temp/ Perm
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S8
Choose one
Temp/ Perm
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S9
Choose one
Temp/ Perm
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S10
Choose one
Temp/ Perm
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S11
Choose one
Temp/ Perm
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S12
Choose one
Temp/ Perm
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S13
Choose one
Temp/ Perm
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S14
Choose one
Temp/ Perm
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S15
Choose one
Temp/ Perm
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
3i1.
Total jurisdictional ditch impact:
Click to enter. linear ft
3i2.
Total permanent stream impacts:
122/18 linear ft
36.
Total temporary stream impacts:
10 linear ft
3i4.
Total stream and ditch impacts:
150 linear ft
3j.
Comments:
122 linear feet (366 square feet or 0.0084 acres) of stream channel will be permanently impacted with a culvert,
walls and associated fill. 18 linear feet (54 square feet or 0.0012 acres) of stream channel will be permanently
impacted with rip rap that is to be keyed in. 10 linear feet (30 square feet or 0.0007 acres) of stream channel will
be temporarily impacted by a cofferdam and associated pump around.
The total permanent stream impacts (excluding keyed -in rip rap) is to 150 linear feet (0.0103 acres) of stream
impact. The stream impacts are below the mitigation threshold. Therefore, stream mitigation should not be
required and is not proposed.
Page 10 of 21 PCN Form - Version 1.5, September 2020

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., individually list all open water impacts in the table below.
4a.
4b.
4c.
4d.
4e.
4e1.
4f.
Site #
Impact Reason/
Impact
Waterbody Name
Waterbody
Jurisdiction
Impact area (ac)'
Type
Duration
Type*
Type
01
Choose one
Temp/
Click to enter.
Choose one
Choose one
Click to enter.
Perm
02
Choose one
Temp/
Click to enter.
Choose one
Choose one
Click to enter.
Perm
03
Choose one
Temp/
Click to enter.
Choose one
Choose one
Click to enter.
Perm
04
Choose one
Temp/
Click to enter.
Choose one
Choose one
Click to enter.
Perm
4g.
Total temporary open water impacts
Click to enter. ac
4g.
Total permanent open water impacts
Click to enter. ac
4g.
Total open water impacts
Click to enter. ac
4h.
Comments:
Open water impacts are not proposed.
5.
Pond or Lake Construction
If pond or lake construction is proposed, complete
the table
below. (*This
does NOT include ofFline stormwater
management ponds.)
5a.
5b.
5c.
5d.
5e.
Pond ID
Proposed use or
Wetland Impacts
(ac)
Stream
Impacts (ft)
Upland
#
purpose of pond
Impacts (ac)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
Click to
Click tL
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
enter.
P2
Choose one
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
enter.
5f.
Total
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
enter.
5g.
Comments:
Pond or lake construction is not proposed.
5h.
Is a dam high hazard permit required?
❑ Yes ❑ No
If yes, permit ID no.:
Click to enter.
5i.
Expected pond surface area (acres):
Click to enter.
5j.
Size of pond watershed (acres):
Click to enter.
5k.
Method of construction:
Click to enter.
Page 11 of 21 PCN Form - Version 1.5, September 2020

6. Buffer Impacts (DWR requirement)
If project will impact a protected riparian buffer, then complete the chart below. Individually list all buffer impacts.
6a. Project is in which protected basin(s)?
(Check all that apply.)
❑ Neuse ❑ Tar -Pamlico ❑ Catawba
❑ Jordan ❑ Goose Creek ❑ Randleman
❑ Other: Click to enter.
Site #*
6b.
Impact Type*
6c.
Impact Duration*
6d.
Stream Name*
6e.
Buffer
Mitigation
Required?*
6f.
Zone 1 Impact*
(sq ft)
6g.
Zone 2 Impact*
(sq ft)
B1
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B2
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B3
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B4
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B5
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B6
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B7
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B8
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B9
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B10
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
6h. Total temporary impacts:
Zone 1: Click to enter. sq ft
Zone 2: Click to enter. sq ft
6h. Total permanent impacts:
Zone 1: Click to enter. sq ft
Zone 2: Click to enter. sq ft
6h. Total combined buffer impacts:
Zone 1: Click to enter. sq ft
Zone 2: Click to enter. sq ft
6i. Comments:
Please attach supporting documentation (impact maps, plan sheets, etc.) for the proposed project.
Page 12 of 21 PCN Form - Version 1.5, September 2020

E. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts through project design:
The applicant has designed the proposed development to avoid impacts to other streams and wetlands. A headwall
and endwall are designed to minimize impacts to the stream. Rip rap is being keyed in to the existing bed to maintain
the current stream bed. The remaining roads, lots and utilities have been designed to avoid additional impacts to
jurisdictional areas. 3,524 linear feet of stream channel and 1.96 acres of wetland have been avoided.
1 b. Specifically describe measures taken to avoid or minimize proposed impacts through construction techniques:
The clearing limits will be surveyed, staked and silt fencing and clearing limit fencing will be used. Coffer dams will be
used to minimize sediment discharge during construction activities. Disturbed areas will be seeded and mulched to
limit sediment from entering downgradient waters. Slope matting will be used on steep slopes.
2. Compensatory Mitigation for Impacts to Waters of the U.S., Waters of the State, or Riparian Buffers
2a. If compensatory mitigation is required, by whom is it required? * ❑x DWR ❑x Corps
(check all that apply)
2b. If yes, which mitigation option(s) will be used for this ❑ Mitigation Bank
project? * (check all that apply) ❑x In Lieu Fee Program
❑ Permittee Responsible Mitigation
3. Complete if using a Mitigation Bank
(Must satisfy NC General Statute143-214.11 (d1).)
3a. Name of mitigation bank:
Click to enter.
3b. Credits purchased/requested:
Type: Choose one
Quantity Click to enter.
Type: Choose one
Quantity Click to enter.
Type: Choose one
Quantity Click to enter.
Attach receipt and/or approval letter.
3c. Comments:
Click to enter.
4.
Complete if Using an In Lieu Fee Program
4a.
Attach approval letter from in lieu fee program.
4b.
Stream mitigation requested:
Click to enter. linear feet
4c.
If using stream mitigation, what is the stream temperature:
Choose one
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington
District's RIBITS website: (Please use the filter and select Wilmington district)
https://ribits.usace.army.mil/ribits apex/f?p=107:27:2734709611497::NO: RP: P27 BUTTON KEY:O
4d.
Buffer mitigation requested (DWR only):
Click to enter. square feet
4e.
Riparian wetland mitigation requested:
0.46 (0.92 at 2:1) acres
4f.
Non -riparian wetland mitigation requested:
Click to enter. acres
4g.
Coastal (tidal) wetland mitigation requested:
Click to enter. acres
Page 13 of 21 PCN Form - Version 1.5, September 2020

4h. Comments:
Click to enter.
5. Complete if Providing a Permittee Responsible Mitigation Plan
5a. If proposing a permittee responsible mitigation plan, provide a description of the proposed mitigation plan,
including the amount of mitigation proposed.
Click to enter
5b. Attach mitigation plan/documentation.
6.
Buffer Mitigation (State Regulated Riparian Buffer Rules) — DWR requirement
6a.
Will the project result in an impact within a protected riparian buffer
❑ Yes ❑x No
that requires buffer mitigation?
If yes, please complete this entire section — please contact DWR for more information.
6b.
If yes, identify the square feet of impact to each zone of the riparian buffer that requires
mitigation. Calculate the
amount of mitigation required in the table below.
6c.
6d.
6e.
Zone
Reason for impact
Total impact (square
Multiplier
Required mitigation
feet)
(square feet)
Zone 1
Click to enter.
Click to enter.
:,hoose one
Click to enter.
Zone 2
;lick to enter.
Click fo enter
" hnnca nna
Click to enter.
6f. Total buffer mitigation required
Click to enter.
6g.
If buffer mitigation is required, is payment to a mitigation bank or
❑ Yes ❑ No
NC Division of Mitigation Services proposed?
6h.
If yes, attach the acceptance letter from the mitigation bank or NC Division of Mitigation Services.
6i.
Comments:
Buffer mitigation is not required or proposed.
Page 14 of 21 PCN Form - Version 1.5, September 2020

F. Stormwater Management and Diffuse Flow Plan (DWR requirement)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers
❑ Yes ❑x No
identified within one of the NC Riparian Buffer Protection Rules?
1 b. All buffer impacts and high ground impacts require diffuse flow or other forms of stormwater treatment. If the
project is subject to a state implemented riparian buffer protection program, include a plan that fully documents
how diffuse flow will be maintained.
All Stormwater Control Measures (SCM) must be designed in accordance with the NC Stormwater Design
Manual (https://deg.nc.gov/about/divisions/energv-mineral-land-resources/energv-mineral-land-permit-
guidance/stormwater-bmp-manual).
Associated supplement forms and other documentation must be provided.
❑ Level Spreader
What Type of SCM are you
❑ Vegetated Conveyance (lower seasonal high water table- SHWT)
providing?
❑ Wetland Swale (higher SHWT)
(Check all that apply)
❑ Other SCM that removes minimum 30% nitrogen
❑ Proposed project will not create concentrated stormwater flow through the
buffer
For a list of options to meet the diffuse flow requirements, click here:
Attach diffuse flow documentation.
2. Stormwater Management Plan
2a. Is this an NCDOT project subject to compliance with NCDOT's
Individual NPDES permit NCS000250?
El Yes ❑x No
2b. Does this project meet the requirements for low density projects as
defined in 15A NCAC 02H .1003(2)?
❑x Yes ❑ No
To look up low density requirements, click here:
http://reports.oah.state.nc.us/ncac/title%2015a%20-%20environmental%20guality/chapter%2002%20-
%20environmental%20management/subchapter%20h/15a%20ncac%2002h%20.1003.pdf
2c. IS the project over an acre?
❑x Yes ❑ No
2d. Does this project have a stormwater management plan (SMP)
reviewed and approved under a state stormwater program or state-
❑x Yes ❑ No
approved local government stormwater program?
Note: Projects that have vested rights, exemptions, or grandfathering from state or locally implemented
stormwater programs or projects that satisfy state or locally -implemented stormwater programs through use of
community in -lieu programs should answer "no" to this question.
2e. Which of the following stormwater management program(s) apply?
❑x Local Government
(Check all that apply)
❑ State
If you have local government approval, please include the SMP on their overall impact map.
Page 15 of 21 PCN Form - Version 1.5, September 2020

❑x Phase II
❑ USMP
Local Government Stormwater Programs
❑ NSW
❑ Water Supply
Please identify which local government stormwater program you are using.
High Point
❑ Phase II
❑ HQW or ORW
State Stormwater Programs
❑ Coastal Counties
❑x Other
Comments:
The impervious surfaces are less than 24%.
A SWMP was required under the low density provisions and is
currently being reviewed and will be approved by the City of High Point.
Page 16 of 21 PCN Form - Version 1.5, September 2020

G. Supplementary Information
1. Environmental Documentation
1 a. Does the project involve an expenditure of public (federal/state/local)
❑ Yes ❑x No
funds or the 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
❑ Yes ❑ No
requirements of the National or State (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
❑ Yes ❑ No
NEPA or SEPA final approval letter.)
Comments:
A NEPA or SEPA is not required.
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A
NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300),
DR Surface Water or Wetland Standards or Riparian Buffer Rules El Yes ❑x No
W
(15A NCAC 2B .0200)?
2b. If you answered "yes" to the above question, provide an explanation of the violation(s):
Click to enter.
3. Cumulative Impacts (DWR Requirement)
3a. Will this project (based on past and reasonably anticipated future
impacts) result in additional development, which could impact nearby
❑ Yes ❑x No
downstream water quality?
3b. If you answered "no", provide a short narrative description:
Additional development as a result of the proposed development is not anticipated.
3c. If yes, attach a qualitative or quantitative cumulative impact analysis (.pdo in accordance with the most recent
DWR policy.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project? I ® Yes ❑ No ❑ N/A
4b. If yes, 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.
Sewage will be discharged into an existing sewer line that crosses the site. Additional impacts associated with sewage
disposal are not proposed.
Page 17 of 21 PCN Form - Version 1.5, September 2020

5.
Endangered Species and Designated Critical Habitat (Corps Requirement)
5a.
Will this project occur in or near an area with federally protected
® Yes ❑ No
species or habitat? (IPAC weblink: https://www.fws.gov/ipac/ Ifws.govl)
5b.
Have you checked with the USFWS concerning Endangered Species
❑ Yes ❑x No
Act impacts?
5c.
If yes, indicate the USFWS Field Office you have contacted.
Choose one
5d.
Is another federal agency involved?
❑ Yes ❑x No ❑ Unknown
If yes, which federal agency?
Click to enter.
5e.
Is this a DOT project located within Divisions 1-8?
❑ Yes ❑x No
5f.
Will you cut any trees in order to conduct the work in waters of the
U.S.?
®Yes ElNo
5g.
Does this project involve bridge maintenance or removal? *
❑ Yes ❑x No
Link to NLEB SLOPES document: http://saw-reg.usace. army. mil/NLEB/1-30-17-signed NLEB-
SLOPES&apps.pdf
5h.
Does this project involve the construction/ installation of a wind
turbine(s)?
❑ Yes ❑x No
If yes, please show the location of the wind turbine(s) on the permit drawings/ project plans (attach .pdo
5i.
Does this project involve blasting and /or other percussive activities
that will be conducted by machines, such as jackhammers,
❑ Yes ❑x No
mechanized pile drivers, etc.?
If yes, please provide details to include type of percussive activity, purpose, duration, and specific location of this
activity on the property (attach .pdo
5j.
What data sources did you use to determine whether your site would impact Endangered Species or Designated
Critical Habitat?
US Department of the Interior — Fish and Wildlife Service Official Species List from IPaC
3 listed species are identified on the IPaC report (attached). Schweinitz's sunflower and northern long-eared bat are
listed as federally protected species.
Suitable habitat for Schweinitz's sunflower was not observed on the site. Wooded areas on the site could afford
suitable summer roosting habitat for northern long-eared bats. Similar habitat was observed on nearby properties.
Based on a review of the June 1_2016_NLEB —HUC12 NLEB shapefiles obtained from the Raleigh Ecological Services
Field Office website, the 12 digit HUC with the nearest confirmed hibernation and/or maternity sites is located more
than 90 miles from the site. Therefore, tree clearing outside of the pup season (June 1 to July 31) is not likely to
adversely affect the NLEB. If tree clearing activities cannot be conducted outside of the pup season, then the applicant
will rely on the final 4(d) rule and any take will be considered exempt from the ESA.
Attach consultation documentation.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as
an Essential Fish Habitat?
❑ Yes ❑x No
Page 18 of 21 PCN Form - Version 1.5, September 2020

Are there submerged aquatic vegetation (SAV) around
the project vicinity?
El Yes ❑x No El Unknown
Will this project affect submerged aquatic vegetation?
❑ Yes ❑x No ❑ Unknown
Explain: Dlick to enter.
6b. What data source(s) did you use to determine whether your site would impact Essential Fish Habitat?
Essential Fish Habitat Mapper— NOAA Fisheries
Page 19 of 21 PCN Form - Version 1.5, September 2020

7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data):
hftp://qis.ncdcr.gov/hpoweb/
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural
❑ Yes ❑x No
preservation status (e.g., National Historic Trust designation or
properties significant in North Carolina history and archaeology)?
7b. What data source(s) did you use to determine whether your site would impact historic or archeological
resources?
NC Historic Preservation Office's HPOWEB 2.0. Historic properties were not identified on the site. A surveyed
property (DV0385, A.M. Swaim House (Gone ?) is identified on adjacent property southeast of the site. Other
properties are located 800 feet and farther from the site. A copy of the SHPO Map is included as an attachment.
7c. Attach historic or prehistoric documentation.
8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https://msc.fema.gov/portal/search
8a. Will this project occur in a FEMA-designated 100-year floodplain? *
i] Yes ❑x No
8b. If yes, explain how the project meets FEMA requirements.
Click to enter.
8c. What source(s) did you use to make the floodplain determination?
National Flood Hazard Layer froom FEMA Web Map Service — Drawing 4 (Attached)
Page 20 of 21 PCN Form - Version 1.5, September 2020

H. Miscellaneous
Comments:
Please let Pilot know if you need additional information in order to issue the PCN.
Attach pertinent documentation or attachments not previously requested
I. Signature *
❑x By checking the box and signing below, I, as the project proponent, certify to the following:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete, to
the best of my knowledge and belief;
• 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;
• The project proponent hereby agrees 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");
• The project proponent hereby agrees to conduct this transaction by electronic means pursuant to Chapter 66,
Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• The project proponent hereby understands that an electronic signature has the same legal effect and can be
enforced in the same way as a written signature; AND
• As the project proponent, I intend to electronically sign and submit the PCN/online form.
Full Name: Michael T. Brame
Michael Digitzlly signed by Michael Brame
DN: cn-Michael Brame, -Pilot
Signature: mnmental,ln .,nn.
Brame e"zo1-22°4'geoa�00.-6s
9.22.2021
Page 21 of 21 PCN Form - Version 1.5, September 2020

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U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW-2020-02241 County: Davidson U.S.G.S. Quad: NC- High Point West
NOTIFICATION OF JURISDICTIONAL DETERMINATION
Requestor: Edgedale Partners, LLC
Maurice Hull
Address: 1560 N. Main Street, Suite 104
High Point, NC 27262
Telephone Number: 336-883-6800
E-mail: mh(&mpmanage.com
Size (acres) 44 Nearest Town High Point
Nearest Waterway Payne Creek River Basin Upper Pee Dee
USGS HUC 03040103 Coordinates Latitude: 35.965592
Longitude:-80.049447
Location description: The review area is located on the west side of Swaim Road; at the intersection of Swaim Road and W.
Lexington Avenue. Reference review area descrintion shown in Jurisdictional Determination Request nackage entitled
"Drawing 1, USGS Topographic Mau"
Indicate Which of the Following Apply:
A. Preliminary Determination
® There appear to be waters on the above described project area/property, that may be subject to Section 404 of the Clean Water
Act (CWA)(33 USC § 1344) and/or Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403). The waters have been
delineated, and the delineation has been verified by the Corps to be sufficiently accurate and reliable. The approximate boundaries
of these waters are shown on the enclosed delineation map dated 4/27/2018. Therefore this preliminary jurisdiction determination
may be used in the permit evaluation process, including determining compensatory mitigation. For purposes of computation of
impacts, compensatory mitigation requirements, and other resource protection measures, a permit decision made on the basis of a
preliminary JD will treat all waters and wetlands that would be affected in any way by the permitted activity on the site as if they
are jurisdictional waters of the U.S. This preliminary determination is not an appealable action under the Regulatory Program
Administrative Appeal Process (Reference 33 CFR Part 331). However, you may request an approved JD, which is an appealable
action, by contacting the Corps district for further instruction.
❑ There appear to be waters on the above described project area/property, that may be subject to Section 404 of the Clean Water
Act (CWA)(33 USC § 1344) and/or Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403). However, since the waters
have not been properly delineated, this preliminary jurisdiction determination may not be used in the permit evaluation process.
Without a verified wetland delineation, this preliminary determination is merely an effective presumption of CWA/RHA
jurisdiction over all of the waters at the project area, which is not sufficiently accurate and reliable to support an enforceable
permit decision. We recommend that you have the waters on your project area/property delineated. As the Corps may not be able
to accomplish this wetland delineation in a timely manner, you may wish to obtain a consultant to conduct a delineation that can
be verified by the Corps.
B. Approved Determination
❑ There are Navigable Waters of the United States within the above described project area/property subject to the permit
requirements of Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403) and Section 404 of the Clean Water Act
(CWA)(33 USC § 1344). Unless there is a change in 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.
❑ There are waterson the above described project area/property 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.
❑ We recommend you have the waters on your project area/property delineated. As the Corps may not be able to accomplish
this wetland delineation in a timely manner, you may wish to obtain a consultant to conduct a delineation that can be verified by
the Corps.
❑ The waters on your project area/property have been delineated and the delineation has been verified by the Corps. The
approximate boundaries of these waters are shown on the enclosed delineation map dated DATE. We strongly suggest you have

SAW-2020-02241
this delineation surveyed. Upon completion, this survey should be reviewed and verified by the Corps. Once verified, this survey
will provide an accurate depiction of all areas subject to CWA jurisdiction on your property which, provided there is no change in
the law or our published regulations, may be relied upon for a period not to exceed five years.
❑ The waters have been delineated and surveyed and are accurately depicted on the plat signed by the Corps Regulatory Official
identified below onDATE. 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.
❑ There are no waters of the U.S., to include wetlands, present on the above described project area/property which are subject to the
permit requirements of Section 404 of the Clean Water Act (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.
❑ The property is located in one of the 20 Coastal Counties subject to regulation under the Coastal Area Management Act (CAMA).
You should contact the Division of Coastal Management in Morehead City, NC, at [phone] to determine their
requirements.
Placement of dredged or fill material within waters of the US, including wetlands, without a Department of the Army permit may
constitute a violation of Section 301 of the Clean Water Act (33 USC § 1311). Placement of dredged or fill material, construction or
placement of structures, or work within navigable waters of the United States without a Department of the Army permit may
constitute a violation of Sections 9 and/or 10 of the Rivers and Harbors Act (33 USC § 401 and/or 403). If you have any questions
regarding this determination and/or the Corps regulatory program, please contact Bryan Roden -Reynolds at 704-510-1440 or
brvan.roden-reynolds(&u sace.army.mil.
C. Basis For Determination: Basis For Determination: See the preliminary jurisdictional determination
form dated 4/15/2021.
D. Remarks: None.
E. Attention USDA Program Participants
This delineation/deternimation has been conducted to identify the limits of Corps' Clean Water Act jurisdiction for the particular site
identified in this request. The delineation/deternimation 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 request
a certified wetland determination from the local office of the Natural Resources Conservation Service, prior to starting work.
F. Appeals Information (This information applies only to approved jurisdictional determinations as indicated in B.
above)
This correspondence constitutes an approved jurisdictional determination for the above described site. If you object to this
determination, you may request an administrative appeal under Corps regulations at 33 CFR Part 331. Enclosed you will find a
Notification of Appeal Process (NAP) fact sheet and request for appeal (RFA) form. If you request to appeal this determination you
must submit a completed RFA form to the following address:
US Army Corps of Engineers
South Atlantic Division
Attn: Phillip Shannin, Review Officer
60 Forsyth Street SW, Room 10M15
Atlanta, Georgia 30303-8801
In order for an RFA to be accepted by the Corps, the Corps must determine that it is complete, that it meets the criteria for appeal
under 33 CFR part 331.5, and that it has been received by the Division Office within 60 days of the date of the NAP. Should you
decide to submit an RFA form, it must be received at the above address by Not applicable.
**It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this correspondence.**
Bryan Roden -Reynolds
Corps Regulatory Official: 2021.04.15 15:46:09-04'00'
Date of JD: 4/15/2021 Expiration Date of JD: Not applicable

SAW-2020-02241
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
http://corpsmapu.usace.army.mil/cm_apex/f?p=136:4:0
Copy furnished:
Agent:
Pilot Environmental, Inc.
Michael Brame
Address:
P.O. Box 128
Kernersville, NC 27285
Telephone Number:
336-310-4527
E-mail:
mbramc(&j)ilotcnviro.com

NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
REQUEST FOR APPEAL
Applicant: Ed edale Partners LLC, Maurice Hull File Number: SAW-2020-02241
Date: 4/15/2021
Attached is:
See Section below
INITIAL PROFFERED PERMIT (Standard Permit or Letter of permission)
A
PROFFERED PERMIT (Standard Permit or Letter of permission)
B
PERMIT DENIAL
C
APPROVED JURISDICTIONAL DETERMINATION
D
❑X
PRELIMINARY JURISDICTIONAL DETERMINATION
E
SECTION I - The following identifies your rights and options regarding an administrative appeal of the above decision.
Additional information may be found at or http://www.usace.army.miUMissions/CivilWorks/ReaulatoryProgramandPenuits.asi)
OZI& Corps regulations at 33 CFR Part 331.
A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• OBJECT: If you object to the permit (Standard or LOP) because of certain terms and conditions therein, you may request
that the permit be modified accordingly. You must complete Section II of this form and return the form to the district
engineer. Your objections must be received by the district engineer within 60 days of the date of this notice, or you will
forfeit your right to appeal the permit in the future. Upon receipt of your letter, the district engineer will evaluate your
objections and may: (a) modify the permit to address all of your concerns, (b) modify the permit to address some of your
objections, or (c) not modify the permit having determined that the permit should be issued as previously written. After
evaluating your objections, the district engineer will send you a proffered permit for your reconsideration, as indicated in
Section B below.
B: PROFFERED PERMIT: You may accept or appeal the permit
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• APPEAL: If you choose to declinc the proffered permit (Standard or LOP) because of certain terms and conditions therein,
you may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of
this form and sending the form to the division engineer. This form must be received by the division engineer within 60 days
of the date of this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process by
completing Section II of this form and sending the form to the division engineer. This form must be received by the division
engineer within 60 days of the date of this notice.
D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or provide new
information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the
date of this notice, means that you accept the approved JD in its entirety, and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD, you may appeal the approved JD under the Corps of Engineers
Administrative Appeal Process by completing Section II of this form and sending the form to the district engineer. This form
must be received by the division engineer within 60 days of the date of this notice.

E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps regarding the
preliminary JD. The Preliminary JD is not appealable. If you wish, you may request an approved JD (which may be appealed),
by contacting the Corps district for further instruction. Also you may provide new information for further consideration by the
Corps to reevaluate the JD.
SECTION II - REQUEST FOR APPEAL or OBJECTIONS TO AN INITIAL PROFFERED PERMIT
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your objections to an initial
proffered permit in clear concise statements. You may attach additional information to this form to clarify where your reasons or
objections are addressed in the administrative record.)
ADDITIONAL INFORMATION: The appeal is limited to a review of the administrative record, the Corps memorandum for the
record of the appeal conference or meeting, and any supplemental information that the review officer has determined is needed to
clarify the administrative record. Neither the appellant nor the Corps may add new information or analyses to the record.
However, you may provide additional information to clarify the location of information that is already in the administrative
record.
POINT OF CONTACT FOR QUESTIONS OR INFORMATION:
If you have questions regarding this decision and/or the
If you only have questions regarding the appeal process you may
appeal process you may contact:
also contact:
District Engineer, Wilmington Regulatory Division
Mr. Phillip Shannin, Administrative Appeal Review Officer
Attn: Bryan Roden -Reynolds
CESAD-PDO
Charlotte Regulatory Office
U.S. Army Corps of Engineers, South Atlantic Division
U.S Army Corps of Engineers
60 Forsyth Street, Room 1 OM15
8430 University Executive Park Drive, Suite 615
Atlanta, Georgia 30303-8801
Charlotte, North Carolina 28262
Phone: [phone]
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel, and any government
consultants, to conduct investigations of the project site during the course of the appeal process. You will be provided a 15-day
notice of any site investigation, and will have the opportum to participate in all site investi ations.
Date:
Telephone number:
Signature of appellant or agent.
For appeals on Initial Proffered Permits send this form to:
District Engineer, Wilmington Regulatory Division, Attn: Bryan Roden -Reynolds, 69 Darlington Avenue, Wilmington, North
Carolina 28403
For Permit denials, Proffered Permits and Approved Jurisdictional Determinations send this form to:
Division Engineer, Commander, U.S. Army Engineer Division, South Atlantic, Attn: Mr. Phillip Shannin, Administrative
Appeal Officer, CESAD-PDO, 60 Forsyth Street, Room 1OM15, Atlanta, Georgia 30303-8801
Phone: [phone]

PRELIMINARY JURISDICTIONAL DETERMINATION (PJD) FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PJD: 01/31/2021
B. NAME AND ADDRESS OF PERSON REQUESTING PJD: Edgedale Partners, LLC, Maurice Hull,
1560 N. Main Street, Suite 104, High Point, NC 27262
C. DISTRICT OFFICE, FILE NAME, AND NUMBER: Wilmington District, W Lexington Ave, SAW-
2020-02241
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION: The review area is located on the
west side of Swaim Road; at the intersection of Swaim Road and W. Lexington Avenue. Reference review
area description shown in Jurisdictional Determination Request package entitled "Drawing 1, USGS
Topographic Map".
(USE THE TABLE BELOW TO DOCUMENT MULTIPLE AQUATIC RESOURCES
AND/OR AQUATIC RESOURCES AT DIFFERENT SITES)
State: NC County: Davidson City: High Point
Center coordinates of site (lat/long in degree decimal format): Latitude: 35.965592 Longitude:-80.049447
Universal Transverse Mercator:
Name of nearest waterbody: Payne Creek
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
®Office (Desk) Determination. Date: 12/18/20
® Field Determination. Date(s):02/03/21
TABLE OF AQUATIC RESOURCES INREVIEW AREA WHICH "MAY BE" SUBJECT TO
REGULATORY JURISDICTION
Feature
Latitude
Longitude
Estimated
Type of aquatic
Geographic authority to
(decimal
(decimal
amount of
resources (i.e.,
which the aquatic
degrees)
degrees)
aquatic
wetland vs.
resource "may be"
resources in
non -wetland
subject (i.e., Section 404
review area
waters)
or Section 10/404)
(acreage and
linear feet, if
applicable
SEE ATTACHED TABLE
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 AID 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 AID 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:

SUPPORTING DATA. Data reviewed for PJD (check all that apply) Checked items are included in the administrative
record and are appropriately cited:
® Maps, plans, plots or plat submitted by or on behalf of the PJD requestor:
Map: Drawings 1-5
® Data sheets prepared/submitted by or on behalf of the PJD requestor. Datasheets:
® Office concurs with data sheets/delineation report.
❑ 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: Drawing 1, USGS Topographic May (7.5-minute
quadrangle High Point West, NC)
®Natural Resources Conservation Service Soil Survey. Citation: Drawing 2, Web Soil May (Web Soil Survey of
Davidson County) and Drawing 2A, Published Soil May (Soil Survey of Davidson County, Sheet 3 Dated 1994)
® National wetlands inventory map(s). Cite name: Drawing 3, NWI May (USFWS NWI Mapper)
❑ State/local wetland inventory map(s):
®FEMA/FIRMmaps: Drawing 4, FEMA FIRM (National Flood Hazard Laver)
❑ 100-year Floodplain Elevation is: (National Geodetic Vertical Datum of 1929)
® Photographs: ® Aerial (Name & Date): Drawing 5, Wetland Map (Dated 04/27/18)
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 verified by the Corps
and should not be relied upon for later jurisdictional determinations.
Bryan Roden -Reynolds
2021.04.15 15:40:12
-04'00'
Signature and date of Regulatory
staff member completing PJD
4/ 15/2021
Signature and date of person requesting PJD
(REQUIRED, unless obtaining the signature is
impracticable)1
1 Districts may establish timeframes for requester to return signed PJD forms. If the requester does not respond within the established
time frame, the district may presume concurrence and no additional follow up is necessary prior to fmalizing an action.

rA
WA 1-28
sCA 1-8
A 9-11 /
42
or /
13-17 /
1-12
LEGEND
Site Boundary
Wetland
Perennial Stream
FLAG NUMBERS/INFO
WETLAND FLAGS
STREAM FLAGS =
Stream Flags = 11
Wetland Flags = 273
Total Flags = 284
SHOWN ON THIS MAP ARE PRELIMINARY. THEY HAVE NOT BEEN VERIFIED BY THE USACE AND/OR THE
BEEN SURVEYED OR GEOLOCATED. STREAMS WERE FLAGGED AT ORIGINS AND INTERSECTIONS WITH THE
--LL DEFINED AND SHALL BE LOCATED BY SURVEY.
Drawing 5 Wetland Map
Aerial Imagery from ESRI ` ` E' W. Lexington Ave.
and Pilot Field Data u i Approximate 44 Acre Tract
Scale: 1" = 400' ' High Point, Davidson County, NC
PI1.�7
Date:4.27.18 PLOT ENVIR0NMENTAE,INC Pilot Project3576

ID#* 20210825
Version* 1
Regional Office * Winston-Salem Regional Office - [phone]
Reviewer List* Sue Homewood
Pre -Filing Meeting Request submitted 4/23/2021
..............................................................................................................................................................................................................................................................
Contact Name* Heather LaGamba
Contact Email Address* [e-mail]
Project Name* 1613 West Lexington Ave
Project Owner* Land Acquisition & Development Services, LLC
Project County* Guilford
Owner Address: Street Address
PO Box 9147
Address Line 2
aty
State / Province / Pegion
Greensboro
NC
Postal / Zip axle
Country
27429
USA
Is this a transportation project?* r Yes r No
Type(s) of approval sought from the DWR:
W 401 Water Quality Certification - F- 401 Water Quality Certification
Regular Express
F- Individual Permit F- Modification
F- Shoreline Stabilization
Does this project have an existing project ID#?*
C Yes (-- No
Do you know the name of the staff member you would like to request a meeting with?
Sue Homewood
Please give a brief project description below and include location information.*
The applicant does not request a meeting. The applicant may submit
a
request for 401 WQC.
By digitally signing below, I certify that I have read and understood that per the Federal Clean Water Act Section
401 Certification Rule the following statements:

• This form completes the requirement of the Pre -Filing Meeting Request in the Clean Water Act Section 401 Certification
Rule.
• I understand by signing this form that Icannot submit myapplication until 30 calendar days after this pre -filing
meeting request.
• I also understand that DWR is not required to respond or grant the meeting request.
Your project's thirty -day clock started upon receipt of this application. You will receive notification regarding meeting location
and time if a meeting is necessary. You will receive notification when the thirty -day clock has expired, and you can submit an
application.
Signature
0. a6;6F.A,,
Submittal Date 4/23/2021

IF IPA
tz
Al
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• I ; T
I LEGEND
* , •- ,. - -ti -.x� _; 1 Site Boundary
USGS Topographic Map
Drawing 1
USGS Topographic Map W. Lexington Ave.
_ Approximate 44 Acre Tract
High Point West, NC Quadrangle P11.01
"Q7High Point, Davidson County, NC
Scale: 1" = 2,000' 1IL0—ENVI10NIENTAI INc Pilot Project3576

At
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....... ..�,
ti
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PnE
PnD
Pn B QC LEGEND
Site Boundary
PnD -,,-vcCfl
Drawing 2A Published Soil Map
USDA Soil Survey �', W. Lexington Ave.
of Davidson County, NC _ - Approximate 44 Acre Tract
Published 1994, Sheet 3 p11.01� High Point, Davidson County, NC
Not to Scale PILOT ENVIR0NMEN7AL.INC Pilot Project3576

i
Drawing 3
USFWS NWI
Wetlands Mapper PILOT ' -
Scale: 1" = 400' R I L 0 TEE N V I R 0 N M E N T A L I N C
0
LEGEND
Site Boundary
Freshwater Emergent
Freshwater Forested/Shrub
Estuarine and Marine Deepwater
Estuarine and Marine
Freshwater Pond
Lake
Riverine
Other
NWI Map
W. Lexington Ave.
Approximate 44 Acre Tract
High Point, Davidson County, NC
Pilot Project 3576

LEGEND
Site Boundary
1%Annu@1 Chance FlmodMaz@rd
Ruoul@tory F|oodway
Sped a|F|oodw@y
Are@ ofundetemn|red F|oouHaoard
0.2+6Annua|ChemcmFlood MazarU
Future Conditions 1 V.Annum|Cxmnm: F|oouHaoard
PF
,,Are@wuhnmuucmd Risk Due toLevee
FEMAF|RM
Drawing
' N/Lexington Ave.
National Flood Hazard Layer
' Appnoxirnate44 Acre Tract
fnornFEK�AVVebK�apService —
PILOHighPoint,DavidaonCounty,NC
Scale: 1"=400' 0 m' ~��-~~—= 0

WCA 43-145
ISCA 1-8
/
ISCA 9-11
WCA 18-42
SCA /
Surveyor
INA,
Locate
/
WCA 13-17
WCA 1-12
ISC —
Surveyor
` Locate
Y
DP-2 Q
DP-1
~i
/ 41
Y
i
Y
rF
WCA 15-145
SCB —
Yk F
Surveyor
Locate
\ Sc —
Surveyor
Locate
WCA 1-14
SB —
Surveyor
/ Locate
LEGEND
Site Boundary
Wetland
Perennial Stream
. _ _ _ _ _ Intermittent Stream
Culvert
SA 1-5 Flag Number
DP-1 0 Data Point
FLAG NUMBERS/INFO
WETLAND FLAGS =
STREAM FLAGS =
Stream Flags = 11
Wetland Flags = 273
Total Flags = 284
THE LOCATIONS OF FEATURES SHOWN ON THIS MAP ARE APPROXIMATE. THEY WERE VERIFIED BY MR. BRYAN RODEN REYNOLDS WITH
THE USACE ON FEBRUARY 3, 2021. THEY HAVE NOT BEEN SURVEYED OR GEOLOCATED. STREAMS WERE FLAGGED AT ORIGINS AND
INTERSECTIONS WITH THE SITE BOUNDARY. THEY ARE WELL DEFINED AND SHALL BE LOCATED BY SURVEY.
I
Drawing 5 Wetland Map
Aerial Imagery from ESRI W. Lexington Ave.
and Pilot Field Data - - Approximate 44 Acre Tract
Scale: 1" = 400' PIL01 High Point, Davidson County, NC
Date:2.9.21 PILOT ENVIPCNMENTAL,17NC Pilot Project3576

United States Department of the Interior
FISH AND WILDLIFE SERVICE
Asheville Ecological Services Field Office
160 Zillicoa Street
Asheville, NC 28801-1082
Phone: [phone] Fax: [phone]
http://www.fws.p,ov/nc-es/es/coupiyfr.html
In Reply Refer To: September 22, 2021
Consultation Code: 04EN1000-2021-SLI-1256
Event Code: 04EN1000-2021-E-02782
Project Name: Canter Creek Subdivision
Subject: List of threatened and endangered species that may occur in your proposed project
location or may be affected by your proposed project
To Whom It May Concern:
The attached species list identifies threatened, endangered, proposed and candidate species, as
well as proposed and final designated critical habitat, that may occur within the boundary of your
proposed project and/or may be affected by your proposed project. Although not required by
section 7, many agencies request species lists to start the informal consultation process and begin
their fulfillment of the requirements under section 7(c) of the Endangered Species Act (Act) of
1973, as amended (16 U.S.C. 1531 et seq.).
This list, along with other helpful resources, is also available on the U.S. Fish and Wildlife
Service (Service) —Asheville Field Office's (AFO) website: https://www.fws.gov/raleigh/species/
cntylist/nc counties.html. The AFO website list includes "species of concern" — species that
could potentially be placed on the federal list of threatened and endangered species in the future.
Also available are:
Design and Construction Recommendations
https://www.fws.gov/asheville/htmis/project review/Recommendations.html
Optimal Survey Times for Federally Listed Plants
https://www.fws.gov/nc-es/plant/plant survey.html
Northern long-eared bat Guidance
https://www.fws.gov/asheville/htmis/project review/NLEB in WNC.html
Predictive Habitat Model for Aquatic Species
https://www.fws.gov/asheville/htmls/Maxent/Maxent.html
New information based on updated surveys, changes in the abundance and distribution of
species, changed habitat conditions, or other factors could require modifications of these lists.

09/22/2021 Event Code: 04EN1000-2021-E-02782
Please note that under 50 CFR 402.12(e) of the regulations implementing section 7 of the Act,
the accuracy of the species lists should be verified after 90 days. This verification can be
completed formally or informally as desired. The Service recommends that verification be
completed by visiting the ECOS-IPaC website or the AFO website (the AFO website dates each
county list with the day of the most recent update/change) at regular intervals during project
planning and implementation for updates to species lists and information. An updated list may
be requested through the ECOS-IPaC system by completing the same process used to receive the
enclosed list or by going to the AFO website.
The purpose of the Act is to provide a means whereby threatened and endangered species and the
ecosystems upon which they depend may be conserved. Under sections 7(a)(1) and 7(a)(2) of
the Act and its implementing regulations (50 CFR 402 et seq.), Federal agencies are required to
utilize their authorities to carry out programs for the conservation of threatened and endangered
species and to determine whether projects may affect threatened and endangered species and/or
designated critical habitat.
A Biological Assessment is required for construction projects (or other undertakings having
similar physical impacts) that are major Federal actions significantly affecting the quality of the
human environment as defined in the National Environmental Policy Act (42 U.S.C. 4332(2)
(c)). For projects other than major construction activities, the Service suggests that a Biological
Evaluation similar to a Biological Assessment be prepared to determine whether the project may
affect listed or proposed species and/or designated or proposed critical habitat. Recommended
contents of a Biological Assessment are described at 50 CFR 402.12 and on our office's website
at https://www.fws.gov/asheville/htmis/project review/assessment guidance.html.
If a Federal agency (or their non-federal representative) determines, based on the Biological
Assessment or Biological Evaluation, that listed species and/or designated critical habitat may be
affected by the proposed project, the agency is required to consult with the Service pursuant to
50 CFR 402. In addition, the Service recommends that candidate species, proposed species, and
proposed critical habitat be addressed within the consultation. More information on the
regulations and procedures for section 7 consultation, including the role of permit or license
applicants, can be found in the "Endangered Species Consultation Handbook" at: http://
www.fws.gov/endangered/esa-library/pdf/TOC-GLOS.PDF.
Though the bald eagle is no longer protected under the Endangered Species Act, please be aware
that bald and golden eagles are protected under the Bald and Golden Eagle Protection Act (16
U.S.C. 668 et seq.), and projects affecting these species may require additional consultation (see
https://www.fws.gov/southeast/our-services/permits/eagles/). Wind energy projects should
follow the wind energy guidelines (http://www.fws.gov/windenerg_y/) for minimizing impacts to
migratory birds (including bald and golden eagles) and bats.
Guidance for minimizing impacts to migratory birds for projects including communications
towers (e.g., cellular, digital television, radio, and emergency broadcast) can be found at: http://
www. fws. gov/migratorybirds/CurrentBirdlssues/Hazards/towers/towers.htm;
http://www.towerkill.com; andhttp://www.fws.gov/migratoDbirds/CurrentBirdlssues/Hazards/
towers/comtow.html.

09/22/2021 Event Code: 04EN1000-2021-E-02782 3
We appreciate your concern for threatened and endangered species. The Service encourages
Federal agencies to include conservation of threatened and endangered species into their project
planning to further the purposes of the Act. Please include the Consultation Tracking Number in
the header of this letter with any request for consultation or correspondence about your project
that you submit to our office.
Attachment(s):
• Official Species List
• Migratory Birds
• Wetlands

09/22/2021 Event Code: 04EN1000-2021-E-02782
Official Species List
This list is provided pursuant to Section 7 of the Endangered Species Act, and fulfills the
requirement for Federal agencies to "request of the Secretary of the Interior information whether
any species which is listed or proposed to be listed may be present in the area of a proposed
action".
This species list is provided by:
Asheville Ecological Services Field Office
160 Zillicoa Street
Asheville, NC 28801-1082
[phone]

09/22/2021 Event Code: 04EN1000-2021-E-02782 2
Project Summary
Consultation Code: 04EN1000-2021-SLI-1256
Event Code: Some(04EN1000-2021-E-02782)
Project Name: Canter Creek Subdivision
Project Type: DEVELOPMENT
Project Description: 1613 West Lexington Avenue, 44 Acres, Residential Subdivision
Project Location:
Approximate location of the project can be viewed in Google Maps: https:
www. google.com/maps/(c►)35.96589255,-80,04939042678683,14z
Counties: Davidson County, North Carolina

09/22/2021 Event Code: 04EN1000-2021-E-02782 3
Endangered Species Act Species
There is a total of 3 threatened, endangered, or candidate species on this species list.
Species on this list should be considered in an effects analysis for your project and could include
species that exist in another geographic area. For example, certain fish may appear on the species
list because a project could affect downstream species.
IPaC does not display listed species or critical habitats under the sole jurisdiction of NOAA
Fisheriesi, as USFWS does not have the authority to speak on behalf of NOAA and the
Department of Commerce.
See the "Critical habitats" section below for those critical habitats that lie wholly or partially
within your project area under this office's jurisdiction. Please contact the designated FWS office
if you have questions.
1. NOAA Fisheries, also known as the National Marine Fisheries Service (NMFS), is an
office of the National Oceanic and Atmospheric Administration within the Department of
Commerce.
Mammals
NAME STATUS
Northern Long-eared Bat Myotis septentrionalis Threatened
No critical habitat has been designated for this species.
Species profile: https:Hecos.fws.gov/ecp/species/9045
Insects
NAME
STATUS
Monarch Butterfly Danaus plexippus
Candidate
No critical habitat has been designated for this species.
Species profile: https:Hecos.fws.gov/ecp/species/9743
Flowering Plants
NAME
STATUS
Schweinitz's Sunflower Helianthus schweinitzii
Endangered
No critical habitat has been designated for this species.
Species profile: https:Hecos.fws.gov/ecp/species/3849
Critical habitats
THERE ARE NO CRITICAL HABITATS WITHIN YOUR PROJECT AREA UNDER THIS OFFICE'S
JURISDICTION.

09/22/2021 Event Code: 04EN1000-2021-E-02782
Migratory Birds
Certain birds are protected under the Migratory Bird Treaty Act! and the Bald and Golden Eagle
Protection Act2.
Any person or organization who plans or conducts activities that may result in impacts to
migratory birds, eagles, and their habitats should follow appropriate regulations and consider
implementing appropriate conservation measures, as described below.
1. The Migratory Birds Treat. Act of 1918.
2. The Bald and Golden Eagle Protection Act of 1940.
3. 50 C.F.R. Sec. 10.12 and 16 U.S.C. Sec. 668(a)
The birds listed below are birds of particular concern either because they occur on the USFWS
Birds of Conservation Concern (BCC) list or warrant special attention in your project location.
To learn more about the levels of concern for birds on your list and how this list is generated, see
the FAQ below. This is not a list of every bird you may find in this location, nor a guarantee that
every bird on this list will be found in your project area. To see exact locations of where birders
and the general public have sighted birds in and around your project area, visit the E-bird data
mapping tool (Tip: enter your location, desired date range and a species on your list). For
projects that occur off the Atlantic Coast, additional maps and models detailing the relative
occurrence and abundance of bird species on your list are available. Links to additional
information about Atlantic Coast birds, and other important information about your migratory
bird list, including how to properly interpret and use your migratory bird report, can be found
below.
For guidance on when to schedule activities or implement avoidance and minimization measures
to reduce impacts to migratory birds on your list, click on the PROBABILITY OF PRESENCE
SUMMARY at the top of your list to see when these birds are most likely to be present and
breeding in your project area.
NAME BREEDING SEASON
Red-headed Woodpecker Melanerpes erythrocephalus Breeds May 10 to Sep 10
This is a Bird of Conservation Concern (BCC) throughout its range in the
continental USA and Alaska.
Probability Of Presence Summary
The graphs below provide our best understanding of when birds of concern are most likely to be
present in your project area. This information can be used to tailor and schedule your project
activities to avoid or minimize impacts to birds. Please make sure you read and understand the
FAQ "Proper Interpretation and Use of Your Migratory Bird Report" before using or attempting
to interpret this report.
Probability of Presence (■)

09/22/2021 Event Code: 04EN1000-2021-E-02782
Each green bar represents the bird's relative probability of presence in the 10km grid cell(s) your
project overlaps during a particular week of the year. (A year is represented as 12 4-week
months.) A taller bar indicates a higher probability of species presence. The survey effort (see
below) can be used to establish a level of confidence in the presence score. One can have higher
confidence in the presence score if the corresponding survey effort is also high.
How is the probability of presence score calculated? The calculation is done in three steps:
1. The probability of presence for each week is calculated as the number of survey events in
the week where the species was detected divided by the total number of survey events for
that week. For example, if in week 12 there were 20 survey events and the Spotted Towhee
was found in 5 of them, the probability of presence of the Spotted Towhee in week 12 is
0.25.
2. To properly present the pattern of presence across the year, the relative probability of
presence is calculated. This is the probability of presence divided by the maximum
probability of presence across all weeks. For example, imagine the probability of presence
in week 20 for the Spotted Towhee is 0.05, and that the probability of presence at week 12
(0.25) is the maximum of any week of the year. The relative probability of presence on
week 12 is 0.25/0.25 = 1; at week 20 it is 0.05/0.25 = 0.2.
3. The relative probability of presence calculated in the previous step undergoes a statistical
conversion so that all possible values fall between 0 and 10, inclusive. This is the
probability of presence score.
Breeding Season( )
Yellow bars denote a very liberal estimate of the time -frame inside which the bird breeds across
its entire range. If there are no yellow bars shown for a bird, it does not breed in your project
area.
Survey Effort (1)
Vertical black lines superimposed on probability of presence bars indicate the number of surveys
performed for that species in the 10km grid cell(s) your project area overlaps. The number of
surveys is expressed as a range, for example, 33 to 64 surveys.
No Data (—)
A week is marked as having no data if there were no survey events for that week.
Survey Timeframe
Surveys from only the last 10 years are used in order to ensure delivery of currently relevant
information. The exception to this is areas off the Atlantic coast, where bird returns are based on
all years of available data, since data in these areas is currently much more sparse.
■ probability of presence breeding season I survey effort — no data
SPECIES JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC

09/22/2021 Event Code: 04EN1000-2021-E-02782 3
Red-headed
Woodpecker ---- ---- ----—�--'--- ---- ---- ---- ---- ---- ---- ----
BCC Rangewide
(CON)
Additional information can be found using the following links:
• Birds of Conservation Concern http://www.fws.gov/birds/management/managed-species/
birds-of-conservation-concern.php
• Measures for avoiding and minimizing impacts to birds http://www.fws.gov/birds/
management/project-assessment-tools-and-guidance/
conservation-measures.php
• Nationwide conservation measures for birds http://www.fws.gov/migrato . b� irds/pdf/
management/nationwidestandardconservationmeasures. pdf
Migratory Birds FAQ
Tell me more about conservation measures I can implement to avoid or minimize impacts
to migratory birds.
Nationwide Conservation Measures describes measures that can help avoid and minimize
impacts to all birds at any location year round. Implementation of these measures is particularly
important when birds are most likely to occur in the project area. When birds may be breeding in
the area, identifying the locations of any active nests and avoiding their destruction is a very
helpful impact minimization measure. To see when birds are most likely to occur and be breeding
in your project area, view the Probability of Presence Summary. Additional measures or permits
may be advisable depending on the type of activity you are conducting and the type of
infrastructure or bird species present on your project site.
What does IPaC use to generate the migratory birds potentially occurring in my specified
location?
The Migratory Bird Resource List is comprised of USFWS Birds of Conservation Concern
(BCQ and other species that may warrant special attention in your project location.
The migratory bird list generated for your project is derived from data provided by the Avian
Knowledge Network (AKN). The AKN data is based on a growing collection of survey, banding-,
and citizen science datasets and is queried and filtered to return a list of those birds reported as
occurring in the 10km grid cell(s) which your project intersects, and that have been identified as
warranting special attention because they are a BCC species in that area, an eagle (Eagle Act
requirements may apply), or a species that has a particular vulnerability to offshore activities or
development.
Again, the Migratory Bird Resource list includes only a subset of birds that may occur in your
project area. It is not representative of all birds that may occur in your project area. To get a list
of all birds potentially present in your project area, please visit the AKN Phenology Tool.
What does IPaC use to generate the probability of presence graphs for the migratory birds
potentially occurring in my specified location?

09/22/2021 Event Code: 04EN1000-2021-E-02782
The probability of presence graphs associated with your migratory bird list are based on data
provided by the Avian Knowledge Network (AKN). This data is derived from a growing
collection of survey, banding, and citizen science datasets .
Probability of presence data is continuously being updated as new and better information
becomes available. To learn more about how the probability of presence graphs are produced and
how to interpret them, go the Probability of Presence Summary and then click on the "Tell me
about these graphs" link.
How do I know if a bird is breeding, wintering, migrating or present year-round in my
project area?
To see what part of a particular bird's range your project area falls within (i.e. breeding,
wintering, migrating or year-round), you may refer to the following resources: The Cornell Lab
of Ornithology All About Birds Bird Guide, or (if you are unsuccessful in locating the bird of
interest there), the Cornell Lab of Ornithology Neotropical Birds guide. If a bird on your
migratory bird species list has a breeding season associated with it, if that bird does occur in your
project area, there may be nests present at some point within the timeframe specified. If "Breeds
elsewhere" is indicated, then the bird likely does not breed in your project area.
What are the levels of concern for migratory birds?
Migratory birds delivered through IPaC fall into the following distinct categories of concern:
1. "BCC Rangewide" birds are Birds of Conservation Concern (BCC) that are of concern
throughout their range anywhere within the USA (including Hawaii, the Pacific Islands,
Puerto Rico, and the Virgin Islands);
2. "BCC - BCR" birds are BCCs that are of concern only in particular Bird Conservation
Regions (BCRs) in the continental USA; and
3. "Non -BCC - Vulnerable" birds are not BCC species in your project area, but appear on
your list either because of the Eagle Act requirements (for eagles) or (for non -eagles)
potential susceptibilities in offshore areas from certain types of development or activities
(e.g. offshore energy development or longline fishing).
Although it is important to try to avoid and minimize impacts to all birds, efforts should be made,
in particular, to avoid and minimize impacts to the birds on this list, especially eagles and BCC
species of rangewide concern. For more information on conservation measures you can
implement to help avoid and minimize migratory bird impacts and requirements for eagles,
please see the FAQs for these topics.
Details about birds that are potentially affected by offshore projects
For additional details about the relative occurrence and abundance of both individual bird species
and groups of bird species within your project area off the Atlantic Coast, please visit the
Northeast Ocean Data Portal. The Portal also offers data and information about other taxa besides
birds that may be helpful to you in your project review. Alternately, you may download the bird
model results files underlying the portal maps through the NOAA NCCOS Integrative Statistical
Modeling and Predictive Mapping of Marine Bird Distributions and Abundance on the Atlantic
Outer Continental Shelf project webpage.

09/22/2021 Event Code: 04EN1000-2021-E-02782 5
Bird tracking data can also provide additional details about occurrence and habitat use
throughout the year, including migration. Models relying on survey data may not include this
information. For additional information on marine bird tracking data, see the Diving Bird Study
and the nanotag studies or contact Caleb Spiegel or Pam Lorin.
What if I have eagles on my list?
If your project has the potential to disturb or kill eagles, you may need to obtain a permit to avoid
violating the Eagle Act should such impacts occur.
Proper Interpretation and Use of Your Migratory Bird Report
The migratory bird list generated is not a list of all birds in your project area, only a subset of
birds of priority concern. To learn more about how your list is generated, and see options for
identifying what other birds may be in your project area, please see the FAQ "What does IPaC
use to generate the migratory birds potentially occurring in my specified location". Please be
aware this report provides the "probability of presence" of birds within the 10 km grid cell(s) that
overlap your project; not your exact project footprint. On the graphs provided, please also look
carefully at the survey effort (indicated by the black vertical bar) and for the existence of the "no
data" indicator (a red horizontal bar). A high survey effort is the key component. If the survey
effort is high, then the probability of presence score can be viewed as more dependable. In
contrast, a low survey effort bar or no data bar means a lack of data and, therefore, a lack of
certainty about presence of the species. This list is not perfect; it is simply a starting point for
identifying what birds of concern have the potential to be in your project area, when they might
be there, and if they might be breeding (which means nests might be present). The list helps you
know what to look for to confirm presence, and helps guide you in knowing when to implement
conservation measures to avoid or minimize potential impacts from your project activities,
should presence be confirmed. To learn more about conservation measures, visit the FAQ "Tell
me about conservation measures I can implement to avoid or minimize impacts to migratory
birds" at the bottom of your migratory bird trust resources page.

09/22/2021 Event Code: 04EN1000-2021-E-02782
Wetlands
Impacts to NWI wetlands and other aquatic habitats may be subject to regulation under Section
404 of the Clean Water Act, or other State/Federal statutes.
For more information please contact the Regulatory Program of the local U.S. Army Corps of
Engineers District.
Please note that the NWI data being shown may be out of date. We are currently working to
update our NWI data set. We recommend you verify these results with a site visit to determine
the actual extent of wetlands on site.
WETLAND INFORMATION WAS NOT AVAILABLE WHEN THIS SPECIES LIST WAS GENERATED.
PLEASE VISIT HTTPS://WWW.FWS.GOV/WETLANDS/DATA/MAPPER.HTML OR CONTACT THE FIELD
OFFICE FOR FURTHER INFORMATION.

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Contact Name* Heather LaGamba
Contact Email Address* [e-mail]
Project Owner* Land Acquisition & Development Services, LLC
Project Name* 1613 West Lexington Ave
Project County* Guilford
Owner Address:* Street Address
PO Box 9147
Address Line 2
aty
State / Province / Pegion
Greensboro
NC
Postal / Zip axle
Country
27429
USA
Is this a transportation project?* (- Yes c: No
Type(s) of approval sought from the DWR:
W 401 Water Quality Certification - F- 401 Water Quality Certification -
Regular Express
F- Individual Permit F- Modification
F- Shoreline Stabilization
Does this project have an existing project ID#?*
(- Yes c: No
Do you know the name of the staff member you would like to request a meeting with?
Sue Homewood
Please give a brief project description below and include location information.*
The applicant does not request a meeting. The applicant may submit
a
request for 401 WQC.
Please give a couple of dates you are available for a meeting.
Please attach the documentation you would like to have the meeting about.
pdf only
By digitally signing below, I certify that I have read and understood that per the Federal Clean Water Act Section
401 Certification Rule the following statements:

• This form completes the requirement of the Pre -Filing Meeting Request in the Clean Water Act Section 401 Certification
Rule.
• I understand by signing this form that Icannot submit myapplication until 30 calendar days after this pre -filing
meeting request.
• I also understand that DWR is not required to respond or grant the meeting request.
Your project's thirty -day clock started upon receipt of this application. You will receive notification regarding meeting location
and time if a meeting is necessary. You will receive notification when the thirty -day clock has expired, and you can submit an
application.
Signature *
0. a6;6F.A,,
Submittal Date 4/23/2021

Strickland, Bev
From: [e-mail]
Sent: Monday, May 24, 2021 12:01 AM
To: [e-mail]
Cc: Homewood, Sue
Subject: Pre -Filing Time Clock has been reached for 1613 West Lexington Ave - 20210825 Ver
1
Attachments: DWR Pre -Filing Meeting Request Form.pdf
The North Carolina Division of Water Resources has received the Pre -Filing Meeting Request Form for 1613 West
Lexington Ave that you submitted on 4/23/2021. The ID number for that project is 20210825, Version 1.
Your Pre -Filing Meeting Request has now reached the 30 calendar days' requirement and your application can now be
accepted.
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.
Internal Use only: Non Transportation
i

DWR Pre -Filing Meeting Request Form
ID#*
Regional Office*
Reviewer List*
20210825
Version*
1
Winston-Salem Regional Office - [phone]
Sue Homewood
Pre -Filing Meeting Request submitted 4/23/2021
Contact Name *
Contact Email Address*
Project Name*
Project Owner*
Project County*
Owner Address:
Is this a transportation project?*
Heather LaGamba
[e-mail]
1613 West Lexington Ave
Land Acquisition & Development Services, LLC
Guilford
Street Address
PO Box 9147
Address Line 2
aty State / Ft -mince / Region
Greensboro NC
Ibstal / Zip Code Country
27429 USA
r Yes r No
Type(s) of approval sought from the DWR:
i7 401 Water Quality Certification - I— 401 Water Quality Certification -
Regular Express
I— Individual Permit I— Modification
F Shoreline Stabilization
Does this project have an existing project ID#?*
r Yes (' No
Do you know the name of the staff member you would like to request a meeting with?
Sue Homewood
Please give a brief project description below and include location information.*
The applicant does not request a meeting. The applicant may submit
a
request for 401 WQC.
By digitally signing below, I certify that I have read and understood that per the Federal Clean Water Act Section
401 Certification Rule the following statements:

• This form completes the requirement of the Pre -Filing Meeting Request in the Clean Water Act Section 401 Certification
Rule.
• I understand by signing this form that I cannot submit my application until 30 calendar days after this pre -filing
meeting request.
• I also understand that DWR is not required to respond or grant the meeting request.
Your project's thirty -day clock started upon receipt of this application. You will receive notification regarding meeting location
and time if a meeting is necessary. You will receive notification when the thirty -day clock has expired, and you can submit an
application.
Signature
�rY /� t rar�*rrfr?
Submittal Date 4/23/2021

DWR Pre -Filing Meeting Request Form
ID#*
Regional Office*
Reviewer List*
20210825
Version*
1
Winston-Salem Regional Office - [phone]
Sue Homewood
Pre -Filing Meeting Request submitted 4/23/2021
Contact Name *
Contact Email Address*
Project Name*
Project Owner*
Project County*
Owner Address:
Is this a transportation project?*
Heather LaGamba
[e-mail]
1613 West Lexington Ave
Land Acquisition & Development Services, LLC
Guilford
Street Address
PO Box 9147
Address Line 2
aty State / Ft -mince / Region
Greensboro NC
Ibstal / Zip Code Country
27429 USA
r Yes r No
Type(s) of approval sought from the DWR:
i7 401 Water Quality Certification - I— 401 Water Quality Certification -
Regular Express
I— Individual Permit I— Modification
F Shoreline Stabilization
Does this project have an existing project ID#?*
r Yes (' No
Do you know the name of the staff member you would like to request a meeting with?
Sue Homewood
Please give a brief project description below and include location information.*
The applicant does not request a meeting. The applicant may submit
a
request for 401 WQC.
By digitally signing below, I certify that I have read and understood that per the Federal Clean Water Act Section
401 Certification Rule the following statements:

• This form completes the requirement of the Pre -Filing Meeting Request in the Clean Water Act Section 401 Certification
Rule.
• I understand by signing this form that I cannot submit my application until 30 calendar days after this pre -filing
meeting request.
• I also understand that DWR is not required to respond or grant the meeting request.
Your project's thirty -day clock started upon receipt of this application. You will receive notification regarding meeting location
and time if a meeting is necessary. You will receive notification when the thirty -day clock has expired, and you can submit an
application.
Signature
�rY /� t rar�*rrfr?
Submittal Date 4/23/2021