20221094 Ver 1_ePCN Application_20220814

Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
April 13, 2022 Ver 4.3
Initial Review
Has this project met the requirements for acceptance in to the review process?*
OO Yes
O No
Is this project a public transportation project?*
OYes 0No
Change only if needed.
Pre -Filing Meeting Date Request was submitted on:
7/14/2022
BIMS # Assigned *
20221094
Is a payment required for this project?*
0 No payment required
O Fee received
O Fee needed - send electronic notification
Reviewing Office*
Raleigh Regional Office - [phone]
Information for Initial Review
Version#*
What amout is owed?*
® $240.00
0 $570.00
Select Project Reviewer*
Colleen Cohn:eads\cmcohn
la. Name of project:
Louisburg Falls
la. Who is the Primary Contact?*
Joseph S. Lassiter
lb. Primary Contact Email:*
[e-mail]
Date Submitted
8/14/2022
Nearest Body of Water
Wolfpen Branch
Basin
Tar -Pamlico
Water Classification
C:NSW
Site Coordinates
Latitude:
36.0874
A. Processing Information
Longitude:
78.3171
lc. Primary Contact Phone:*
[phone]
County (or Counties) where the project is located:
Franklin
Is this a NCDMS Project
0Yes ONo
Is this project a public transportation project?*
0Yes ONo

la. Type(s) of approval sought from the Corps:
EI Section 404 Permit (wetlands, streams and waters, Clean Water Act)
O Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Has this PCN previously been submitted?*
0 Yes
O No
1b. What type(s) of permit(s) do you wish to seek authorization?
E Nationwide Permit (NWP)
0 Regional General Permit (RGP)
0 Standard (IP)
lc. Has the NWP or GP number been verified by the Corps?
OO Yes 0 No
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
na
1d. Type(s) of approval sought from the DWR:
EO 401 Water Quality Certification - Regular
0 Non-404 Jurisdictional General Permit
0 Individual 401 Water Quality Certification
39 - Commercial/Institutional Developments
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
If. Is this an after -the -fact permit application?*
O Yes O No
O 401 Water Quality Certification - Express
0 Riparian Buffer Authorization
lg. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
O Yes O No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
O Yes O No
lh. Is the project located in any of NC's twenty coastal counties?
O Yes O No
1j. Is the project located in a designated trout watershed?
OYes 0No
B. Applicant Information
0Yes ONo
OYes 0No
Id. Who is applying for the permit?
0 Owner OO Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
OYes 0No
2. Owner Information
2a. Name(s) on recorded deed:
Umiva RDU, Inc.
2b. Deed book and page no.:
Deed Book 1941, Pgs. 797-808
2c. Contact Person:
Javantilal Patel
2d. Address
Street Address
217 Roebling Lane
Address Line 2
City
Cary
Postal / Zip Code
27513
State / Province / Region
North Carolina
Country
USA

2e. Telephone Number:
[phone]
2f. Fax Number:
2g. Email Address:*
kvanl iew@global restrategies.com
3. Applicant Information (if different from owner)
3a. Name:
Ken J. Van Liew, PE
3b. Business Name:
Global Real Estate Strategies, Inc
3c. Address
Street Address
777 Walnut Ave.
Address Line 2
City
Cranford
Postal / Zip Code
07016
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Joseph S. Lassiter
4b. Business Name:
Lassiter Environmental Consulting, LLC
4c. Address
Street Address
139 S. Dogwood Trail
Address Line 2
City
Southern Shores
Postal / Zip Code
27949
4d. Telephone Number:
[phone]
4f. Email Address: *
[e-mail]
C. Project Information and Prior Project History
State / Province / Region
New Jersey
Country
USA
3e. Fax Number:
State / Province / Region
North Carolina
Country
USA
4e. Fax Number:
1. Project Information
lb. Subdivision name:
(if appropriate)
na
lc. Nearest municipality / town:
Louisburg
2. Project Identification
2a. Property Identification Number:
2804-18-7206
2b. Property size:
45.40

2c. Project Address
Street Address
0 Fox Park Rd.
Address Line 2
City
Louisburg
Postal / Zip Code
27549
3. Surface Waters
3a. Name of the nearest body of water to proposed project: *
Wolfpen Branch
3b. Water Resources Classification of nearest receiving water: *
C:NSW
3c. What river basin(s) is your project located in?*
Tar -Pamlico
3d. Please provide the 12-digit HUC in which the project is located.
03020101
4. Project Description and History
State / Province / Region
North Carolina
Country
USA
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: *
Property is in general undeveloped with a variety of native shrubs and trees. General vicinity is best described as containing a mixed use of residential, commercial, and retail.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
0 Yes O No 0 Unknown
4f. List the total estimated acreage of all existing wetlands on the property:
0.345
4g. List the total estimated linear feet of all existing streams on the property:
1,910 linear feet
4h. Explain the purpose of the proposed project:*
The project will be a mixed use commercial/residential Planned Unit Development called Louisburg Falls (see attached master plan for additional details).
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
As indicated on the Master Plan/Wetlands Impact Exhibit (attached), the proposed planned unit development will involve a major site clearing and grading to facilitate the development
proposed. Project will require installation of roads, parking, water and sewer line extension and extension of power, etc. Project will require an approved and permitted Stormwater
Management system and Sedimentation and Erosion Control Plan. Site work will require the use of dump trucks, grading equipment, backhoes, paving equipment, etc.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas? *
o) Yes
Comments:
Confirmed Section 404 wetlands delineation
0 No 0 Unknown
5b. If the Corps made a jurisdictional determination, what type of determination was made? *
O Preliminary 0 Approved 0 Not Verified 0 Unknown 0 N/A
Corps AID Number:
SAW-2022-00428
Sc. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
Keller Environmental, LLC
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
May 5, 2022 by April Norton representing the US Army Corps of Engineers
6. Future Project Plans
6a. Is this a phased project?*
O Yes O No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activity?
No

D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
• Wetlands Streams -tributaries
Open Waters Pond Construction
2. Wetland Impacts
0 Buffers
2a. Site #* (?)
2a1 Reason (?)
2b. Impact type*(?)
2c. Type of W.*
2d. W. name
2e. Forested*
2f. Type of Jurisdicition*
(?)
2g. Impact
area*
0 fox park rd
facilitate road and
infrastructure installation
P
Headwater Forest
Section 404
Yes
Corps
0.345
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.345
21. Comments:
E. Impact Justification and Mitigation
2g. Total Permanent Wetland Impact
0.345
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Applicant has been able to avoid impacts within the 50' Tar -Pamlico buffer but requirements for interior road connection to US 401 and a requirement
pedestrian hiking trail made it impossible to avoid impacts to the Section 404 wetlands.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Project will have both a Sedimentation and Erosion Control Plan and a Stormwater Management Plan designed by a civil engineer and reviewed and
permitted by NC Department of Environmental Quality.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for impacts to Waters of the U.S. or Waters of the State?
• Yes No
2c. If yes, mitigation is required by (check all that apply):
• DWR Corps
2d. If yes, which mitigation option(s) will be used for this project?
Mitigation bank 0 Payment to in -lieu fee program Permittee Responsible Mitigation
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
• Yes No
4b. Stream mitigation requested:
(linear feet) 4c. If using stream mitigation, what is the stream temperature:
0
4d. Buffer mitigation requested (DWR only): 4e. Riparian wetland mitigation requested:
(square feet) (acres)
0 0.345
4f. Non -riparian wetland mitigation requested: 4g. Coastal (tidal) wetland mitigation requested:
(acres) (acres)
0 0
4h. Comments
6. Buffer mitigation (State Regulated Riparian Buffer Rules) - required by DWR
6a. Will the project result in an impact within a protected riparian buffer that requires buffer mitigation? If yes, you must fill out this entire form - please contact DWR for more information.
Yes • No

F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
la. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
O Yes 0 No
What type of SCM are you providing?
O Level Spreader
O Vegetated Conveyance (lower SHWT)
O Wetland Swale (higher SHWT)
0 Other SCM that removes minimum 30% nitrogen
Proposed project will not create concentrated stormwater flow through the buffer
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
0Yes ONo
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)7
OYes ONo
2c. Does this project have a stormwater management plan (SMP) reviewed and approved under a state stormwater program or state -approved local govemment stormwater program?
O Yes O No
O N/A - project disturbs < 1 acre
3. Stormwater Requirements
3a. Select whether a completed stormwater management plan (SMP) is included for review and approval or if calculations are provided to document the project will not cause degradation of
downstream surface waters. *
Stormwater Management Plan 0 Antidegradation Calculations
Comments:
Stormwater Management plan is being prepared by Global Real Estate Strategies, Inc. and will be submitted for review an approval by NC DEQ.
G. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
O Yes • No
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), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)7 *
0 Yes O No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
O Yes O No
3b. If you answered "no," provide a short narrative description.
Surrounding area is currently substantially developed and this project should not accelerate the development potential beyond what currently exits.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
OYes 0No0N/A
4b. Describe, in detail, the treatment methods and dispositions (non -discharge or discharge) of wastewater generated from the proposed project. If the wastewater will be treated at a
treatment plant, list the capacity available at that plant.
Wastewater will be delivered to and treated by the Town of Louisburg central wastewater treatment plant. Discussions with the operators of the system
advise that they have abundant excess capacity to serve the proposed development at Louisburg Falls.
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or habitat?*
O Yes J No

5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
O Yes O No
5d. Is another Federal agency involved?*
O Yes
What Federal Agency is involved?
US Army Corps of Engineers
5e. Is this a DOT project located within Division's 1-8?
0 Yes ® No
0 No 0 Unknown
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
OYes 0No
5g. Does this project involve bridge maintenance or removal?
0 Yes ® No
5h. Does this project involve the construction/installation of a wind turbine(s)?*
OYes 0No
5i. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
OYes 0No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
US FWS Endangered and Threatened Species by County in NC (online)
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
0 Yes J No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
NOAA Essential Fish Habitat Mapper
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal governments have designated as having historic or cultural preservation status?*
O Yes O No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
Historic Preservation Property Map.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
O Yes • No
8c. What source(s) did you use to make the floodplain determination?*
FEMA flood plain map online.
Miscellaneous
Please use the space below to attach all required documentation or any additional information you feel is helpful for application review. Documents should be combined into one file when
possible, with a Cover Letter, Table of Contents, and a Cover Sheet for each Section preferred.
Click the upload button or drag and drop files here to attach document
global Louisburg Falls DMS acceptance[4799].pdf
Global Commercial Agent Authorization 6.29.22[4612] executed.pdf
global 220722 Louisburg Falls - Wetland Impact Exhibit[4766].pdf
global SAW-2022-00428 (0 Fox Park Road ) Jurisdictional Determination (003)[4598].pdf
Global DWQ Fox Park Rd, Louisburg[4764].pdf
global UMIYA-BOUNDARY-8-9-22[4813].pdf
File must be PDF or KMZ
Comments
The following is a list of attachment provided in support of this application:
1. NC Division of Mitigation Services acceptance letter for providing in -lieu mitigation for wetlands impacts.
2. Agent authorization by Global Real Estate Strategies to Lassiter Environmental Consulting, LLC
3. Louisburg Falls Master Plan with detailed inset of impacts to Section 404 wetlands
4. USACE Preliminary Jurisdiction Determination for property SAW-2022-00428
5. Soils, Topographic and Location information provided the NC Division of Water Resources
6. Louisburg Falls property boundary survey with listing of adjacent property owners, etc.
Signature
234.78KB
983.9KB
652.53KB
692.42KB
639.26KB
394.86KB
O By checking the box and signing below, I certify that:

• The project proponent hereby certifies that all information contained herein is true, accurate, and complete to the best of my knowledge and belief'; and
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401 certification request within the applicable reasonable period of time.
• I have given true, accurate, and complete information on this form;
I agree that submission of this PCN form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
I intend to electronically sign and submit the PCN form.
Full Name:
Kenneth J. Van Liew, PE
Signature
Date
8/14/2022

ROY COOPER ¢- _:
Governor r`. '
't, erg::
ELIZABETH S.BISER ,=,0,b ,
Secretory .. ..,
MARC RECKTENWALD NORTH CAROLINA
Director Environmental Quality
July 28, 2022
Kenneth Van Liew, PE
Global Real Estate Strategies, Inc.
777 Walnut Avenue, Suite One
Cranford, NJ 07016 Expiration of Acceptance: 1/28/2023
Project: Louisburg Falls County: Franklin
The purpose of this letter is to notify you that the NCDEQ Division of Mitigation Services (DMS) is willing to
accept payment for compensatory mitigation for impacts associated with the above referenced project as
indicated in the table below. Please note that this decision does not assure that participation in the DMS in-
lieu fee mitigation program will be approved by the permit issuing agencies as mitigation for project impacts.
It is the responsibility of the applicant to contact permitting agencies to determine if payment to the DMS will
be approved. You must also comply with all other state, federal or local government permits, regulations or
authorizations associated with the proposed activity including G.S. § 143-214.11.
This acceptance is valid for six months from the date of this letter and is not transferable. If we have not
received a copy of the issued 404 Permit/401 Certification within this time frame, this acceptance will
expire. It is the applicant's responsibility to send copies of the permits to DMS. Once DMS receives a copy
of the permit(s) an invoice will be issued based on the required mitigation in that permit and payment must
be made prior to conducting the authorized work. The amount of the in-lieu fee to be paid by an applicant is
calculated based upon the Fee Schedule and policies listed on the DMS website.
Based on the information supplied by you in your request to use the DMS, the impacts for which you are
requesting compensatory mitigation credit are summarized in the following table. The amount of mitigation
required and assigned to DMS for this impact is determined by permitting agencies and may exceed the
impact amounts shown below.
River Basin Impact Location Impact Type Impact Quantity
(8-digit HUC)
Tar-Pamlico 03020101 Riparian Wetland 0.345
Upon receipt of payment, DMS will take responsibility for providing the compensatory mitigation. The
mitigation will be performed in accordance with the In-Lieu Fee Program instrument dated July 28, 2010.
Thank you for your interest in the DMS in-lieu fee mitigation program. If you have any questions or need
additional information, please contact [e-mail].
Sincerely,
A/L��tAryl�ao
FOR James. B Stanfill
Asset Management Supervisor
cc: Joseph Lassiter, agent
North Carolina Department of Environmental Quality I Division of Mitigation Services
��`` 217 West Jones Street 11652 Mail Service Center I Raleigh,North Carolina 27699-1652
De'Ja M1nic n c1 Ear I O N..131 Dual 919.707.8976

AGENT AUTHORIZATION FOR US ARMY CORPS OF ENGINEERS and
ASSOCIATED PERMITS AND APPROVALS
Global Real Estate Strategies, Inc.
777 Walnut Avenue, Suite One
Cranford, New Jersey 07016
Kenneth J. Van Liew, P.E. — Contract Purchaser
201.424.0961
[e-mail]
I certify that I have authorized:
Joseph S. Lassiter, Lassiter Environmental Consulting, LLC
139 S. Dogwood Trl.
Southern Shores, NC 27949
252.202.3800
[e-mail]
, Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all US Army Corps of
Engineers (USACE) permits and other associated approvals for the proposed development
located at 0 Fox Park Road, Louisburg, NC, 27549. I further certify that I am authorized to grant, and
do in fact grant permission to USACE staff, to enter on the aforementioned lands in
connection with evaluating information related to the various permits and approvals.
Authorized by:
Signature: / 9, /ad. f rAu-
Mr. Ken Van Liew
Global Real Estate Strategies, Inc.
Date: June 27, 2022
This certification is valid through December 31, 2022

IIIIU
Town of Louisburg Sanitary Sewer Outfall
FUTURE R.O.W. FOR
US HWY 401 NORTHBOUND
WIDENING
EAST OF EXISTING LANEAGE
J `
EXISTING R.O.W.
TRAIL REALIGNMENT
WITH US HWY 401
WIDENING
PUBLIC AC . S
WALKING TRAI
PROPOSED
PROPOSED PROPERTY ACCESS
MIN. INTERSECTION SEPARATION
APPLICABLE
INSET DETAIL
Louisburg Falls
Wetland Impact Exhibit
PROPOSED
DEVELOPMENT
J U LY 22, 2022
IN I
Wetland Surveyed
15,043.7 SF (0.345 AC)
NOTE: US HWY 401 ROADWAY IS ELEVATED
ABOVE SITE REQUIRING FILL FOR FUTURE
WIDENING, ACCESS AND TRAIL DEVELOPMENT.
/ Wolf Pen Branch
Top of Bank
Tar -Pam Zone-1 (30')
Tar -Pam Zone-2 (20')
\
7.22-ti• 7-11:1 • • • • •
aac.
.Normm NE
O
o Or
595
35' Perimeter Buffer Yard
9
\""
SEE INSET THIS PAGE FOR DETAIL OF AREA
0
100
20
300 FT

Louisburg Falls
0 Fox Park Rd, Louisburg
Franklin County
Legend:
- Approximate Site Boundary:
- Approximate Start/Stop Point
Map provided by NCDEQ
Division of Water Resources
:: Locations are approximate
and are provided for refer-
ence only ::

Louisburg Falls
0 Fox Park Rd, Louisburg
Franklin County
Legend:
- Approximate Site Boundary:
- Approximate Start/Stop Point
Map provided by NCDEQ
Division of Water Resources
:: Locations are approximate
and are provided for refer-
ence only ::

Louisburg Falls
0 Fox Park Rd, Louisburg
Franklin County
r-.
Legend:
- Approximate Site Boundary:
- Approximate Start/Stop Point
Map provided by NCDEQ
Division of Water Resources
:: Locations are approximate
and are provided for refer-
ence only ::

I, MICHAEL A. MOSS, CERTIFY THAT THIS PLAT
WAS DRAWN UNDER MY SUPERVISION FROM AN
ACTUAL SURVEY MADE UNDER MY SUPERVISION;
THAT THE SOURCE OF INFORMATION FOR THE
SURVEY IS SHOWN HEREON; THAT THE BOUNDARIES
NOT SURVEYED ARE CLEARLY INDICATED; THAT THE
RATIO OF PRECISION IS GREATER THAN 1:10,000;
THAT THIS PLAT WAS PREPARED IN ACCORDANCE
WITH G.S. 47-30 AS AMENDED: AND THAT THIS MAP
MEETS THE REQUIREMENTS OF THE STANDARDS OF
PRACTICE FOR LAND SURVEYING IN NORTH CAROLINA
(21 NCAC 56. 1600). WITNESS MY ORIGINAL SIGNATURE,
REGISTRATION NUMBER AND SEAL
THIS DAY OF
,2022.
PROFESSIONAL LAND SURVEYOR (L-3794)
CERTIFY THAT I AM
THE PROSPECTIVE OWNER OF THE PROPERTY
FOR WHICH THIS RECOMBINATION IS DRAWN
AND FURTHER CERTIFY THAT THIS INSTRUMENT
RECOMBINES THE LOTS AS SHOWN TO CREATE
TWO REMANING LOTS. I FURTHER CERTIFY
THAT TO THE BEST OF MY KNOWLEDGE, THIS
DOES NOT CREATE A NON -CONFORMING LOT
OR MAKE A NON -CONFORMING
LOT A GREATER NON-CONFORMANCY.
PROPERTY OWNER
THIS PLAT IS APPROVED FOR RECORDING
PER SECTION OF THE TOWN OF
LOUISBURG SUBDIVISION ORDINANCE.
TOWN PLANNER DATE
.C.G.S. MONUMENT
"MISSJESS"
N(y)=847,223.2576'
E(x)= 2, 200, 049.4644'
NAD '83
N /F
LOUISBURG PLAZA
SHOPPING CENTER
M'. 2008, PG. 153 i
\ \
\ \/ �1
\ OD\ / © II
)/\
\ �\ PROPERTY UNE AS PER PLAT BY
L M. KEITH WRENN, RLS DATED 12/1/85
'` ENTITLED "SURVEY FOR ADALAIDE JOHNSON,
\ /�� NkT\ AL" (UNRECORDED) /
N
\ QJ/ \ / X C)
\ /�� \
\ - \ O'\ /
\ \ 4 \ pc /
\ CIP / /�L\
\ \ �`�// \ ®mac/
/ n \ J/ Q
"Z/
PROPERTY LINE AS PER PLAT BY
M. KEITH WRENN, RLS DATED 12/1/85
ENTITLED "SURVEY FOR ADALAIDE JOHNSO
ET AL." (UNRECORDED)
PROPERTY UNE AS PER PLAT BY
HAROLD B. MULLEN, RLS DATED 4/13/73 41
ENTITLED "SURVEY FOR HERMAN KEMP"
CORDED IN M.B. 13, PG. 52)
C IAN/ %o\
/// HRMP AND WIFE CLARA KEMP �W ��
\ (RECOR) IN D.B. 320, PG. 601)
\ PROPERTY UNE AS PER PLAT BY
PHIL R. INSCOE, RLS DATED 7/6/82 \
ENTITLED "MAP OF THE A.F. JOHNSON LAND
SURVEYED FOR JAMES JOHNSON, ET AL"
\ .(RECORDED IN PRF 2, SLIDE 20)
25.0' NITARY
SEWER E MENT
M.B. 2008, PG. 48
PROPERTY UNE AS PER DEED FOR
H.C. KEMP AND WIFE CLARA KEMP
(RECORDED IN D.B. 320, PG. 601)
NEW R/W PER
M.B. 20008, PG. 156
PROPERTY UNE AS PER PLAT BY
HAROLD B. MULLEN, RLS DATED 4/13/73
ENTITLED "SURVEY FOR HERMAN KEMP"
(RECORDED IN M.B. 13, PG. 52)
CAWTHORN
9
NORTHEAST
CORNER OF
BOX CULVERT
. WF-32k
WF-1
\-S 1 \ 25.0' SANITARY
\\ \ \SEWER EASEMENT
\ M.B. 2008, PG 48
REFERENCE LINE
\ PER M.B.1999, P
CONTROL (1.366 AC.)
CORNER it
RIGHT-OF-WAY AS PER PLAT BY (/
WIWAM T. DEMENT, JR., PLS DATED
5/8/2007 ENTITLED "REVISED PLAT BOUNDARY
FOR JPG, INC." (RECORDED IN M.B. 2007, PG. 145)
PROPERTY LINE AS PER PLAT BY
M. KEITH WRENN, RLS DATED 12/1/85
/ P EN11TLED "SURVEY FOR ADALAIDE JOHNSON,
T AL." (UNRECORDED) & ON PLAT BY
WILLIAM T. DEMENT, JR., PLS DATED
5/8/ 07 ENTITLED "REVISED PLAT BOUNDARY
FOR JP , INC." (RECORDED IN M.B. 2007, PG. 145)
UNE FALL WITHIN LIMITS OF
APPARENT OLD US HWY 401 ROAD BED
EIP RIGHT-OF-WAY AS PER P T BY
WILUAM T. DEMENT, JR., PLS TED
5/8/2007 ENTITLED "REVISED PLAT BOUNDARY
FOR JPG, INC." (RECORDED IN M.B. 007, PG. 145)
DISPUTED AREA 0.108 AC.
AREA DEEDED TO JPG, INC
BY D.B. 1703, PG. 646
SEE NOTE BELOW
RIGHT-OF-WAY AS PER PLAT BY
WIWAM T. DEMENT, JR., PLS DATED
5/8/2007 ENTITLED "REVISED PLAT BOUNDARY
FOR JPG, INC." (RECORDED IN M.B. 2007, PG. 145)
RUN OF WOLF PIT
BRANCH IS
PROPERTY LINE
PROPERTY UNE AS PER PLAT BY
/ M. KEITH WRENN, RLS DATED 12/1/85
EN11TLED "SURVEY FOR ADALAIDE JOHNSON,
��. ET AL" (UNRECORDED)
WF 3 xW. F-4
WETLANDS
15,044 S.F.
0.345 AC.
REFERENCE LINE
N/F
GATEKEEPER STOR GE III, LLC
D.B. 2279, PG 1062
M.B. 1999, PG. 165
PIN # 2804--07-8173
FRANKLIN COUNTY, NORTH CAROLINA
I, VIEW OFFICER
KLIN COUNTY, CERTIF THAT THE
PLAT TO WHICH THIS CERTIFICATION
FFIXED MEETS ALL STATUTORY
TEMENTS FOR RECORDING.
DATE REVIEW OFFICER
CORDED IN MAP B•OK 2009, PAGE
MOSS
1
30
NON -JURISDICTIONAL
DRAINAGCWAY
100' TAR-PAMLICO
RIVER RIPARIAN
BUFFER
REFERE
I, MICHAEL A. MOSS, PROFESSIONAL LAND SURVEYOR NO. L-3794, CERTIFY
THAT THIS PLAT IS OF A SURVEY OF ANOTHER CATEGORY, SUCH AS THE
RECOMBINATION OF EXISTING PARCELS, A COURT ORDERED SURVEY,
OR OTHER EXCEPTION TO THE DEFINITION OF SUBDIVISION.
MICHAEL A. MOSS, PROFESSIONAL LAND SURVEYOR NO. L-3794
iC0s\\/PO4
\4 60
a
RIGHT-OF-WAY AS PER NCDOT PLANS
PROJECT NUMBER 8.1360701
D.B. 1148, PAGE 820
\\\ REFERENCE LINE
\ \ PER M.B.1999, PG. 165
CE LINE
RUN OF WOLF PIT
BRANCH IS
PROPERTY LINE
0) 5
EIP N
▪ ••••••,„.
_(0-
\
•yd
02 AC.)
N
25.0' SANITARY
SEWER EASEMENT
M.B. 2008, PG 48
REFERENCE LINE
100' TAR-PAMLICO
RIVER RIPARIAN
BUFFER
RUN OF WOLF PIT
BRANCH IS
PROPERTY LINE
N /F
MARTHA C. TIMBERLAKE ESTATE
NO DEED LISTED
PRF 3, SLIDE 92-165
PIN # 2804-15-5826
18j 0
L-15
16
rn
i RUN OF DITCH
IS PROPERTY LINE
A
co
NIP
,13
RUN OF DITCH
IS PROPERTY LINE
N /F
HENRY HAYES HEIRS \
D.B. 307, PG. 529
PIN # 2804-28-5990
N/F
SUSIE W. TANNER
& HENRY WILLIAMS JR.
D.B. 1040, PG. 134
0&D 9, PG. 399
PIN # 2804-28-4493
\
N
N/F
AUD Y M. WILLIAMSON
& GR .ORY WILLIAMSON
D.B. 1059, PG. 421
0&D 9, PG. 399
PIN # 2804-28-4371
N/F
THOMAS EARL PERRY
& FANNIE P. PERRY
B. 1147, PG. 468
&D 9, PG. 399
PIN # 2804-28-4251
PIN # 2804-28-4112
N/F
REOUSA, INC
D.B. 1963, PG. 525
0&D 9, PG. 399
PIN # 2804-28-3082
N/F
THOMAS EARL PERRY
& FANNIE P. PERRY
D.B. 1147, PG. 468
0&D 9, PG. 399
PIN # 2804-27-3972
N/F
HENRY HAYES HEIRS
NO DEED LISTED
0&D9, PG. 399
PIN # 2804-27-3843
N/F
THOMAS EARL PERRY
Sc FANNIE P. PERRY
D.B. 1147, PG. 470
0&D 9, PG. 399
PIN # 2804-27-2794
N/F
THOMAS EARL PERRY
& FANNIE P. PERRY
D.B. 735, PG. 343
M.B. 1997, PG. 72
PIN # 2804-27-4594
\
„MA
LINE TABLE
INE
LENGTH
BEARING
L 1
211.16'
S 37°21'38" W
L 28'
N 37°25'06" E
L-3
75.17'
N 37°25'06" E
L-4
33.57'
S 55°05'39" E
L-E,
232.95'
SN55°05'39" E
L-6
249.99' -
N 44 32'30" E
L-7
244.42'
N 54°53'23" W
L-8
4.5.75'
N 54°53'23" W
L-9
22.50'
N 80°57'34" E
L-10
31.65'
S 16°44'25" W
L-11
100.00'
S 16°48'13" W
L-12
48.69'
S 16°09'21" W
L-13
27.99'
N 75°45'04" E
L-14
27.51'
N 63°26'15" E
L-15
58.18'
S 79°52'18" E
L-16
23.68'
S 67°37'30" E
L-17
31.27'
S 79°25'04" E
L-18
19.41'
S 88°30'37" E
L-19
218.93'
S 14°21'44" W
L-20
60.87'
N 24°01'54" E
L-21
71.10'
N 14°28'51" E
L-22
145.42'
N 16°28'22" E
L-23
62.13'
N 10°42'00" E
L-24
125.83'
S 61 °41'42" E
L-25
174.90'
N 63°12'28" W
L-26
195.34'
N 32°10'48" W
L-27
317.42'
N 38°39'38" W
L-28
247.54'
S 69°34'26" W
L-29
47.25'
S 35°11'58" W
L-30
143.76'
N 63°32'10" W
L-31
31.60'
S 57°49'37" W
L-32
128.58'
N 75°42'02" W
L-33
187.98'
N 34°32'47" W
L-34
118.75'
N 25°00'27" W
L-35
54.06'
N 51 °50'04" W
L-36
20.80'
N 51 °50'04" W
L-37
170.00'
S 44°52'35" W
L-38
432.74'
S 35°28'31" W
L-39
513.45'
N 44°52'35" E
CURVE TABLE
CURVE
LENGTH
RADIUS
CHORD
BEARING
C- 1
266.02'
6960.43'
266.00'
N 43°47'55" E
C- 2
245.97'
5006.30'
245.94'
N 41 °13'13" E
C- 3
82.12'
6209.63'
82.12'
N 39°34'23" E
C- 4
301.89'
16713.64'
301.89'
N 38°16'23" E
WETLAND 3
125 sq. ft.
0.003 AC.
RIM
NOTES
- AREA COMPUTED BY COORDINATE METHOD.
- THIS PROPERTY MAY BE SUBJECT TO NEUSE RIVER RIPARIAN BUFFER RULES.
- APPARENT DISPUTED AREA WAS DEEDED
TO JPG, INC. BY D.B. 1703, PG. 646 (TRACT 3),
AS SHOWN ON SURVEY PREPARED BY WILLIAM T. DEMENT JR., PLS
DATED 5/8/2007, RECORDED IN M.B. 2007, PG. 145. THIS AREA
WAS ALSO PREVIOUSLY DEEDED TO UMIYA RDU, INC. RECORDED IN
D.B. 1594, PG. 867 AND RECORDED AGAIN IN D.B. 1727, PG. 814
- SEE MAP BOOK 2009, PAGE 37 FOR A DETAILED MAP OF THE
DISPUTED AREA.
- REVISED PLAT HAS UPDATED WETLANDS INFORMATION ADDED.
- ONLY WETLAND FLAGS WERE LOCATED ON MAY 17, 2022. ALL OTHER
SURVEY DATA IS FROM THE ORIGINAL SURVEY DATED OCTOBER 28, 2009
LINE TYPE LEGEND
PROPERTY LINE - LINE SURVEYED
RIGHT-OF-WAY
ADJOINING LINE - LINE NOT SURVEYED
- OVERHEAD LINE
- BUILDING SETBACK
EASEMENT
BUFFER
• - FLOOD HAZARD SOILS
ITY MAP
LEGEND:
EIP - EXISTING IRON PIPE
EPK - EXISTING PK NAIL
NIP - NEW IRON PIPE SET
R/W - RIGHT OF WAY
CATV - CABLE TV BOX
EB - ELECTRIC BOX
TEL - TELEPHONE PEDESTAL
PP - POWER POLE
OHL - OVERHEAD LINE
LP - LIGHT POLE
WM - WATER METER
WV - WATER VALVE
CO - SEWER CLEAN -OUT
CM - CONCRETE MONUMENT
TSP - TRAFFIC SIGNAL POLE
REFERENCES:
PRF 2, SLIDE 20
MAP BOOK 7, PAGE 34
MAP BOOK 2009, PAGE 37
MAP BOOK 2007, PAGE 132
MAP BOOK 13, PAGE 52
MAP BOOK 2008, PAGE 132
D.B. 320, PAGE 601
MAP BOOK 2007, PAGE 145
MAP BOOK 1, PAGE 31
MAP BOOK 1, PAGE 8
D.B. 1703, PAGE 646
D.B. 1727, PAGE 814
D.B. 1148, PAGE 820 (NCDOT R/W)
NCDOT PROJECT #8.1360701
UNRECORDED PLAT BY
KEITH M. WRENN, RLS FOR
ADALAIDE JOHNSON, et.al.
DATED 12-1-1985
SURVEY FOR
UMIYA RDU, INC.
OWNER: UMIYA RDU, INC.
REF: D.B. 1594, PAGE 861
REF: D.B. 1594, PAGE 867
REF: D.B. 1693, PAGE 765
REF: D.B. 1603, PAGE 258
LOUISBURG TOWNSHIP
FRANKLIN COUNTY, NORTH CAROLINA
200 100 0 200 400
SCALE 1"=200'
OCTOBER 28, 2009
REVISED MAY 17, 2022
ZONED
PIN # 2804-18-7828
PIN # 2804-18-8433
PIN # 2804-27-0570
8c PANCIERA, P.C. PROFESSIONAL LAND SURVEYORS, C-1525, 333 S. WHITE STREET, P.O. BOX 1253, WAKE FOREST N.C., 27588, [phone]
(UMIYA-BOUNDARY.DWG-MM)

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id.SAW-2022-00428 County:Franklin U.S.G.S.Quad:NC-Louisburg
NOTIFICATION OF JURISDICTIONAL DETERMINATION
Requestor: Umiva RDU,Inc.
Attn:Javantilal Patel
Address: 217 Roeblin2 Lane
Cary,North Carolina 27513
Telephone Number: 201.424.0961
E-mail: kvanliew(a,globalrestrate2ies.com
Size(acres) -49.29 Nearest Town Louisburg
Nearest Waterway Wolfpen Creek River Basin Pamlico
USGS HUC 03020101 Coordinates Latitude:36.0874
Longitude:-78.3171
Location description:The project area is located at 0 Fox Park Road in Louisburg,Franklin County,North Carolina.The
project review area is shown as the red polygon on the attached"Goo2le Earth"sketch.
Indicate Which of the Following Apply:
A. Preliminary Determination
0 There appear to be waters,including wetlands 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,including wetlands 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 5/3/2018.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,including wetlands 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,including wetlands 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,including wetlands at the project area,which
is not sufficiently accurate and reliable to support an enforceable permit decision.We recommend that you have the waters,
including wetlands 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 waters,including wetlandson 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,including wetlands 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.

SAW-2022-00428
❑The waters,including wetlands 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.We strongly suggest
you have 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,including wetlands have been delineated and surveyed and are accurately depicted on the plat signed by the
Corps Regulatory Official identified below on.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(252)808-2808 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 April Norton at 919-441-3637 or
Ap ri1.R.No rton(a,usace.army.mil.
C. Basis For Determination: See the preliminary jurisdictional determination form dated 05/03/2022.
D. Remarks:None.
E. Attention USDA Program Participants
This delineation/determination has been conducted to identify the limits of Corps'Clean Water Act jurisdiction for the particular site
identified in this request. The delineation/determination 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)
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: Mr.Philip A. Shannin
Administrative Appeal Review Officer
60 Forsyth Street SW,Floor M9
Atlanta,Georgia 30303-8803
AND
[e-mail]
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.**
Corps Regulatory Official: 4 / /1.96`4'AL
Date of JD: 05/03/2022 Expiration Date of JD:Not applicable

SAW-2022-00428
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/cmapex/f?p=136:4:0
Copy furnished:
Agent: Keller Environmental
Attn:Jay Keller
Address: 7921 Haymarket Lane
Raleigh,North Carolina 27615
Telephone Number: 919.749.8259
E-mail: i ay(a,kellerenvironmental.com

M* NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
REQUEST FOR APPEAL
Applicant: Umiva RDU,Inc.,Attn: Javantilal Patel 1 File Number: SAW-2022-00428 Date: 05/03/2022
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.mil/Missions/CivilWorks/RegulatoryProgramandPermits.aspx
oijig 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 fmal
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 decline 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 oLECTIONS 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.PHILIP A. SHANNIN
Attn:April Norton ADMINISTRATIVE APPEAL REVIEW OFFICER
Raleigh Regulatory Office CESAD-PDS-O
U.S Army Corps of Engineers 60 FORSYTH STREET SOUTHWEST,FLOOR M9
3331 Heritage Trade Drive,Suite 105 ATLANTA,GEORGIA 30303-8803
Wake Forest,North Carolina 27587
PHONE:[phone];FAX[phone]
EMAIL:[e-mail]
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 appeal process. You will be provided a 15-day notice of any
site investigation and will have the opportunity to participate in all site investigations.
Date: Telephone number:
Signature of appellant or agent.
For appeals on Initial Proffered Permits send this form to:
District Engineer,Wilmington Regulatory Division,Attn:April Norton,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.Philip Shannin,Administrative
Appeal Officer,CESAD-PDO,60 Forsyth Street,Room 10M15,Atlanta,Georgia 30303-8801
Phone:[phone]

Appendix 2 - PRELIMINARY JURISDICTIONAL DETERMINATION (PJD) FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PJD: 5/3/2022
B. NAME AND ADDRESS OF PERSON REQUESTING PJD: Jay Keller; 7921 Haymarket Lane, Raleigh NC 27615
C. DISTRICT OFFICE, FILE NAME, AND NUMBER: Raleigh, Fox Park, SAW-2022-00428
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
(USE THE TABLE BELOW TO DOCUMENT MULTIPLE AQUATIC RESOURCES AND/OR
AQUATIC RESOURCES AT DIFFERENT SITES)
State: NC County/parish/borough: Franklin City: Louisburg
Center coordinates of site (lat/long in degree decimal format):
Lat.: 36.087496 Long.: -78.317151
Universal Transverse Mercator: 17
Name of nearest waterbody: Wolfpen Creek
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
■❑ Office (Desk) Determination. Date: 5/3/2022
■❑ Field Determination. Date(s): 5/3/2022
TABLE OF AQUATIC RESOURCES IN REVIEW AREA WHICH "MAY BE" SUBJECT TO REGULATORY
JURISDICTION.
Site Latitude Longitude Estimated amount Type of aquatic Geographic authority
number (decimal (decimal of aquatic resource resource (i.e.,wetland to which the aquatic
degrees) degrees) in review area vs. non-wetland resource "may be"
(acreage and linear waters) subject(i.e., Section
feet, if applicable) 404 or Section 10/404)
1 36.07795 -78.31977 7,000 SF wetland 404/401
2 36.07682 -78.31834 1500 LF stream 404/401

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

SUPPORTING DATA. Data reviewed for PJD (check all that apply)
Checked items should be included in subject file. Appropriately reference sources
below where indicated for all checked items:
n Maps, plans, plots or plat submitted by or on behalf of the PJD requestor:
Map:Google Earth Fox Park Sketch
n Data sheets prepared/submitted by or on behalf of the PJD requestor.
n Office concurs with data sheets/delineation report.
n Office does not concur with data sheets/delineation report. Rationale:
n D• ata sheets prepared by the Corps:
n Corps navigable waters' study:
n U• .S. Geological Survey Hydrologic Atlas:
n USGS NHD data.
n USGS 8 and 12 digit HUC maps.
n U• .S. Geological Survey map(s). Cite scale & quad name: 2,000; Louisburg
n Natural Resources Conservation Service Soil Survey. Citation: Franklin County
n N• ational wetlands inventory map(s). Cite name:
n State/local wetland inventory map(s):
n F• EMA/FIRM maps:
n 1• 00-year Floodplain Elevation is: .(National Geodetic Vertical Datum of 1929)
n P• hotographs: n Aerial (Name & Date): Fox Park 5-3-18 Wetland Aerial
or n Other (Name & Date):
n Previous determination(s). File no. and date of response letter:
n 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.
Jay Keller Dateal 022.02ly 22 Y Jay Keller
15:14:42-05'00'
Signature and date of Signature and date of
Regulatory staff member person requesting PJD
completing PJD (REQUIRED, unless obtaining
the signature is impracticable)'
Districts may establish timeframes for requestor to return signed PJD forms. If the requestor does not respond
within the established time frame, the district may presume concurrence and no additional follow up is
necessary prior to finalizing an action.

•
' .-..
Fox Park
. .e / • .,, • ft- 1- • 4. Legend
,. . . ...
A '
/ I•I ? ?P c kh o u s e Coffee Company
May 3, 2018 aerial " a. •
Fox Park Rd
,..., „
. ,
'me.4 .1,
'... i
• . .
. . ... 4`.
.,. •
._. .
4-- . .- •., .
..'", • •
...f• ' .
. ,
i 11111%Nriiik
.-,
•:41 ----‹
8i 14. .10,...:z.: i
•
i
. .., Oi II lii2
\ Ilictip.
1
/
- • • . .
,... .. -
• . • . . . .. ...i
._ • • %
_ .
. ._ . .
. .
- • . .,.
,._ .
Google Earth . .
• . ., .. : • • -
-- - . •• • ,•
,. . goo ft N11,