20221135 Ver 1_401 Application_20220819

Staff Review Form
NORTH CAROLINA
Envlronm¢ntcl Qvofiry
Updated September 4, 2020
Staff Review
Does this application have all the attachments needed to accept it into the review process?*
Yes No
ID# *
20221135
Version* 1
Is this project a public transportation project?*
Reviewer List:*
Select Reviewing Office: *
Submittal Type:*
Yes
• No
Sue Homewood:eads\slhomewood
Winston-Salem Regional Office - [phone]
401 Application
Does this project require a request for payment to be sent?*
Yes
No
How much is owed?* $240.00
$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: *
For the Record Only (Courtesy Copy)
New Project
Modification/New Project with Existing ID
More Information Response
Other Agency Comments
Pre -Application Submittal
Re-Issuance\Renewal Request
Stream or Buffer Appeal
Pre -Filing Meeting Date Request was submitted on:
4/28/2022
Project Contact Information
Name:
Heather LaGmaba
Who is submitting the information?
Email Address: [e-mail]
Project Information
...................................
Project Name: Tri West Business Park
Is this a public transportation project?
Yes
No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
Yes No Unknown
County (ies)
Davie
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach document
5917.3 Tri-West Bus Park PCN
8.6MB
submittal_8.18.22.pdf
Only pdf or kmz files are accepted.
Describe the attachments or
comments:
PCN for 401 WQC
Sign and Submit
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");
• 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 online form.
Signature:
rif 00. �Zaf.
Submittal Date: Is filled in automatically.

Preliminary ORM Data Entry Fields for New Actions
ACTION ID #: SAW-2020-01262
Prepare file folder ❑
Begin Date (Date Received):
Assign Action ID Number in ORM
1. Project Name [PCN Form A2a]: Tri West Business Park
2. Work Type:
Private ❑ Institutional
Government
3. Project Description / Purpose [PCN Foitii B3d and B3e]:
The site is being developed with the Tri-West Business Park.
Commercial
4. Property Owner / Applicant [PCN Form A3 or A4]: Mocksville Development Partners
5. Agent / Consultant [PNC Form A5 — or ORM Consultant ID Number]:
David Brame/Pilot Environmental, Inc.
6. Related Action ID Number(s) [PCN Form B5b]:
o
7. Project Location — Coordinates, Street Address, and/or Location Description [PCN Folios B lb]:
US Highway 158, Mocksville, Davie County, NC
36.134614 ° /-79.891898 °
8. Project Location — Tax Parcel ID [PCN Form Bla]: 5840855939
9. Project Location — County [PCN Form A2b]: Davie
10. Project Location — Nearest Municipality or Town [PCN Form A2c]: Mocksville
11. Project Information — Nearest Waterbody [PCN Form B2a]: Ceadr Creek
12. Watershed / 8-Digit Hydrologic Unit Code [PCN Form B2c]: Upper Yadkln/03040101
Authorization: Section 10 ❑ Section 404 n Section 10 and 404 n
Regulatory Action Type:
F7Standard Permit ❑ Pre -Application Request
✓ Nationwide Permit # F7 Unauthorized Activity
Regional General Permit # n Compliance
Jurisdictional Determination Request ri No Permit Required
Revised 20150602

NORTH CAROLINA
Environmental Quality
Water Resources
Office Use Only
Corps Action ID no. [Click to enter.]
DWR project no. Click enter.]
Site Coordinates:
Latitude (DD.DDDDDD): 35.954668°
Longitude (DD.DDDDDD): 80.520644°
Form Version 1.5, September 2020
Date received: [Click to enter.]
Date received: [Click to enter.]
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://edocs.deq.nc.gov/WaterResources/0/edoc/624704/PCN%20Help%20File%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.
DWR Pre -File E-mail dated April 28, 2022 is attached.
DWR ID # Click to ente Version Click to enter. (If applicable)
A. Processing Information
County (counties) where project is located: *
Davie Additional (if needed).
Is this a public transportation project? *
(Publicly funded municipal, state, or federal road, rail,
or airport project)
❑ Yes ❑x No
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.
1 a.
Type(s) of approval sought from the Corps:
❑x Section 404 Permit (wetlands, streams, waters,
Clean Water Act)
❑ Section 10 Permit (navigable waters, tidal
waters, Rivers and Harbors Act)
Page 1 of 21
PCN Form - Version 1.5, September 2020

1b. Permit type(s)?
El Nationwide Permit (NWP)
❑ 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 0 No
NWP number(s):
NWP 39
RGP number(s):
Click to enter
1d. Type(s) of approval sought from the DWR (check all that apply):
0 401 Water Quality Certification — Regular ❑ 401 Water Quality Certification— Express
❑ Non-404 Jurisdictional General Permit ❑ Riparian Buffer Authorization
❑ Individual 401 Water Quality Certification
1 e. Is this notification solely for the record because written approval is not required? *
For the record only for DWR 401 Certification: *
❑ Yes 0 No
For the record only for Corps Permit:
❑ Yes 0 No
1f. Is this an after -the -fact permit/certification application?
❑ Yes 0 No
lg. Is payment into a mitigation bank or in -lieu fee program proposed for
mitigation of impacts?
0 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 0 No
1 i. Is the project located within an NC DCM Area of Environmental
Concern (AEC)?
Yes 0 No Unknown
1j. Is the project located in a designated trout watershed?
❑ Yes 0 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? *
Daniel Barnes
1 b.
Primary Contact Email: *
danielb©crown-companies.com
1 c.
Primary Contact Phone: ' (###)###-####
336-386-9790
1 d.
Who is applying for the permit/certification?
all that apply)
(check
@ Owner ❑Applicant (other than owner)
le.
Is there an agent/consultant for this project?
0 Yes ❑ No
2. Landowner Information
2a. Name(s) on Recorded Deed: *
Mocksville Development Partners, LLC
2b. Deed Book and Page No.:
011960344
2c. Responsible Party (for corporations):
Daniel Barnes
2d. Address
Street Address:
PO Box 341
Address line 2:
CliuN iu eiiier.
City:
Dobson
State/ Province/ Region:
NC
Postal/ Zip Code:
27017
Country:
United States
2e. Telephone Number: * (###)###-####
336-386-9790
2f. Fax Number: (###)###-####
Click to enter.
2g. Email Address: *
danielb©crown-companies.com
3.
Applicant Information (if different from owner)
3a.
Name:
Click to ent€
3b.
Business Name (if applicable):
Click to enter.
3c.
Address:
Street Address:
Click to enter.
Address line 2:
Click to enter.
City:
Click to enter.
State/ Province/ Region:
Click to enter.
Postal/ Zip Code:
Click to enter.
Country
Click to enter.
3d.
Telephone Number: (###)###-####
Click to enter.
3e
Fax Number: (###)###-####
Click to enter.
Page 3 of 21
PCN Form - Version 1.5, September 2020

3f. Email Address: *
Click to enter.
4. Agent/ Consultant (if applicable)
4a. Name: *
David S. Brame
4b. Business Name:
Pilot Environmental, Inc.
4c. Address: *
Street Address:
743 Park Lawn Court
Address line 2:
Click to entE
City:
Kernersville
State/ Province/ Region:
NC
Postal/ Zip Code:
27284
Country:
U.S.
4d. Telephone Number: - (###)###-####
[phone]
4e Fax Number: (###)###-####
Click to entE
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: *
Tri-West Business Park
1 b.
Subdivision name (if appropriate):
None
lc.
Nearest municipality/town: *
Mocksville, NC
2.
Project Identification
2a.
Property identification number (tax PIN or parcel ID):
5840855939
2b.
Property size (in acres):
201
2c.
Project Address:
Street Address:
US Hwy 158
Address line 2:
Click to enter.
City:
Mocksville
State/ Province/ Region:
NC
Postal/ Zip Code:
27028
Country:
U.S.
2d.
Site coordinates in decimal degrees (using 4-6 digits
after the decimal point):
Latitude (DD.DDDDDD):
35.954668°
Longitude (-DD.DDDDDD):
-80.520644°
3.
Surface Waters
3a.
Name of nearest body of water to proposed project: *
Cedar Creek
3b.
Water Resources Classification of nearest receiving
water:
C
The Surface Water Classification map may be found at this link:
https://ncdenr.maps.arcgis.com/apes/webappviewer/index.html?id=6e125ad7628f494694e259c80dd64265
3c.
In what river basin(s) is your project located?*
Yadkin-PeeDee
Choose additional (if needed)
3d.
Please provide the 12-digit HUC in which the project is
located:
030401011402
The Find Your HUC map may be found at this link:
https://ncdenr.maps.arcgis.com/apes/Publiclnformation/index.html?appid=ad3a85a0c6d644a0b97cd069db238ac3
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 northwestern portion of the site is developed with a residence, agricultural structures, and
outbuildings. The remainder of the site contains fields and wooded areas. Three ponds, Cedar
Creek and several streams are present on the site. Forested and emergent wetlands are
located throughout the property. The wetlands are separated from surrounding uplands by
topographic, vegetation and/or soil breaks. The nearby properites contain fields, wooded
areas and residences. The Davie County Health Department is located on adjoining property
to the west. Commerical/light industrial development is located along Farmington Road and
US 158.
4b. Have Corps permits or DWR certifications been obtained for thisEl
project (including all prior phases) in the past? *
Yes x❑ No El Unknown
4c. If yes, please give the DWR Certification number and/or Corps
Action ID (ex. SAW-0000-00000):
[Click to enter.]
.[Click to enter.]
Attach any pertinent project history documentation
4d. Attach an 8% x 11" excerpt from the most recent version of the USGS topographic map indicating the location of
the project site.
4e. Attach an 8'/z 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
property:
13.0 acres
4g. List the total estimated linear feet of all existing streams (intermittent
and perennial) on the property:
9,840 linear feet
4g1. List the total estimated acreage of all existing open waters on the
property:
1.475 acres
4h. Explain the purpose of the proposed project: *
The purpose of the proposed project is to construct an industrial facility.
4i. Describe the overall project in detail, including the type of equipment to be used:
The overall project includes the proposed construction of Tri-West Business Park on an approximate 201 acre tract.
The business park will consist of four buildings, parking lots and roadways. The project will result in 51 built -upon
acres. Four entrances from US 158 and one entrance from Farmington Road are required to satisfy safety and
development ordinances. When developed, the site will have five permanent stormwater ponds.
To facilitate the development, clearing and grading the site is necessary. Graders, haulers, excavators and other
heavy equipment will be used during grading of the site and construction of the business park. When developed, water
and sanitary sewer services will be provided by the municipality.
In order to develop the site with the business park, one stream and three wetland areas will be filled. Wetland and
stream impacts have minimized to the extent possible through the careful placement of buildings, parking lots and
roads and the use of retaining walls.
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
proposed impact areas?
❑ No
❑ Unknown
0 Yes
Page 6 of 21
PCN Form - Version 1.5, September 2020

Comments:
The site was delineated by Pilot Environmental in July 2020.
5b. If 5a is yes, who delineated the jurisdictional
areas?
Name (if known): David Brame
Agency/Consultant Company: Pilot Environmental
Other: ,,.ill, LU GI!LG.
5c. If the Corps made a jurisdictional determination,
what type of determination was made?
x❑ Preliminary ❑ Approved ❑ Emailed Concurrence
❑ Not Verified ❑ Unknown
Corps AID number (ex. SAW-0000-00000):
SAW-2020-01262
5d. List the dates of the Corps jurisdictional determination or State determination if a determination was made by
either agency.
September 22, 2020 — confirmed by Bryan Roden -Reynolds, USACE (field determination)
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?
0 Yes El No
6b. If yes, explain.
The site is a proposed single phase development. No additional phases are proposed.
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
1. Impacts Summary
la. Where are the impacts associated with your project
(check all that apply):
❑x Wetlands
❑ Buffers
❑ 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.
Site #*
2a1.
Impact
Reason/Type*
2b.
Impact
Duration*
2c.
Wetland Name*
2d.
Wetland Type*
2e.
Forested
?*
2f.
Jurisdiction
Type*
2g.
Impact Area
(ac)*
W1
Fill (Incl.
Riprap)
Permanent
WT
Seep
No
Both
0.2402
W2
Fill (Incl.
Riprap)
Permanent
WD
Bottomland
Hardwood
Forest
Yes
Both
0.1108
W3
Fill (Incl.
Riprap)
Permanent
WL
Bottomland
Hardwood
Forest
Yes
Both
0.0466
W4
Choose one
Temp/
Perm
Click to enter
Choose one
Y/N
Choose one
Click to
enter
W5
Choose one
Temp/
Perm
Click to enter
Choose one
Y/N
Choose one
Click to
enter
W6
Choose one
Temp/
Perm
Click to enter
Choose one
Y/N
Choose one
Click to
enter
2g1. Total temporary wetland impacts
0 ac
2g2. Total permanent wetland impacts
0.3976 ac
2g3. Total wetland impacts
0.3976 ac
2h. Comments:
Three wetland impacts are proposed. Wetland impact W1 is associated with building/parking lot construction. This
wetland will be filled. The wetland is emergent and has historically been farmed. Wetland impact W2 is associated with
parking lot/roadway construction. This wetland will be filled. Wetland impact W3 is associated with parking lot
construction. This wetland will be filled.
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)
Si
Fill (Incl. Riprap)
Permanent
SC2
Perennial
Both
4.4
275
S2
Choose one
Temp/ Perm
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
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:
0 linear ft
3i2. Total permanent stream impacts:
275 linear ft
3i3. Total temporary stream impacts:
0 linear ft
3i4. Total stream and ditch impacts:
275 linear ft
3j. Comments:
S1 — Stream location 1 will be impacted by permanent fill/riprap associated with the parking lot and roadway.
Page 10 of21 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.
Site #
4b.
Impact Reason/
Type
4c.
Impact
Duration
4d.
Waterbody Name
4e.
Waterbody
Type
4e1.
Jurisdiction
Type
4f.
Impact area (ac)
01
Choose one
Click to enter.
Choose one
Choose one
Click to enter
02
Choose one
amps
Perm
Click to enter.
Choose one
Choose one
Click to enter
03
Choose one
Temp/
Perm
Click to enter.
Choose one
Choose one
Click to enter
04
Choose one
Temp/
Perm
Click to enter.
Choose one
Choose one
Click to enter
4g. Total temporary open water impacts
0 ac
4g. Total permanent open water impacts
0 ac
4g. Total open water impacts
0 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.
Pond ID
#
5b.
Proposed use or
purpose of pond
5c.
Wetland Impacts (ac)
5d.
Stream Impacts (ft)
5e.
Upland
Impacts (ac)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
UIIcK to
enter.
P2
Choose one
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
5f. Total
Click to
en+cr
Click to
erifnr
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
Click to
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 of21 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: .6K to entE
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:
Click to enter.
Please attach supporting documentation (impact maps, plan sheets, etc.) for the proposed project.
Page 12 of21 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 the remaining streams and wetlands
located on the site. In order to develop the site and provide the necessary parking and the required access and to
construct the project, the proposed impacts could not be avoided. Civil design, such as minimizing the entranceway
widths, use of retaining walls were used to further reduce impacts to streams and wetlands.
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. Disturbed areas will
be promptly 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? *
(check all that apply)
❑x DWR x❑ Corps
2b. If yes, which mitigation option(s) will be used for this
project? * (check all that apply)
❑ Mitigation Bank
❑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:
Yadkin Valley Umbrella Mitigation Bank
3b.
Credits purchased/requested:
Type: Riparian Wetland
Quantity NA
Type: Stream
Quantity 550
Type: Choose one
Quantity Click to enter.
Attach receipt and/or approval letter.
3c.
Comments:
The applicant intends to purchase stream credits from the Yadkin Valley Umbrella Mitigation Bank. Wetland
credits are not available and will be satisfied through DMS. 550 LF of stream credits will be purchased to off -set
275 LF of impact at a 2:1 ratio. Wildlands Statement of Availability (SoA) is attached.
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:
0.555 acres
Page 13 of 21
PCN Form - Version 1.5, September 2020

4f. Non -riparian wetland mitigation requested:
Click to enter. acres
4g. Coastal (tidal) wetland mitigation requested:
Click to enter. acres
4h. Comments:
DMS has been contacted and will be used to secure wetland mitigation credits and stream credits should private
bank credits not be available at the time of purchase. DMS SoA is attached. Wetland credits will be purchased
at 1:1 ration for wetland impact W1 (see attached NCWAM Form) and 2:1 for wetland impacts W2 and W3.
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
that requires buffer mitigation?
® Yes x❑ No
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.
Zone
6c.
Reason for impact
6d.
Total impact (square
feet)
Multiplier
6e.
Required mitigation
(square feet)
Zone 1
Click to enter.
Click to enter.
Choose one
Click to enter.
Zone 2
Click to enter.
Click to enter
Choose one
Click to enter.
6f. Total buffer mitigation required
Click to enter.
6g. If buffer mitigation is required, is payment to a mitigation bank or
NC Division of Mitigation Services proposed?
® Yes ❑ No
6h. If yes, attach the acceptance letter from the mitigation bank or NC Division of Mitigation Services.
6i. Comments:
Buffer mitigation is not proposed.
Page 14 of21 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
identified within one of the NC Riparian Buffer Protection Rules?
� Yes ❑x No
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://deq.nc.gov/about/divisions/energy-mineral-land-resources/energy-mineral-land-permit-
guidance/stormwater-bmp-manual).
Associated supplement forms and other documentation must be provided.
What Type of SCM are you
providing?
(Check all that apply)
❑ Level Spreader
IIIVegetated Conveyance (lower seasonal high water table- SHWT)
❑ Wetland Swale (higher SHWT)
❑ 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?
❑Yes ❑x No
2b.
Does this project meet the requirements for low density projects as
defined in 15A NCAC 02H .1003(2)?*
El Yes ❑x No
To look up low density requirements, click here:
http://reports.oah.state.nc.us/ncac/title%2015a%20-%20environmental%20quality/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-
approved local government stormwater program?
❑x Yes ❑ No
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?
(Check all that apply) *
❑ Local Government
❑ State
If you have local government approval, please include the SMP on their overall impact map.
Page 15 of21
PCN Form - Version 1.5, September 2020

Local Government Stormwater Programs
El Phase II El USMP
❑ NSW ❑ Water Supply
Please identify which local government stormwater program you are using.
City of Winston-Salem
State Stormwater Programs
El Phase II El HOW or ORW
❑ Coastal Counties ❑ Other
Comments:
A SWMP has been submitted to Davie County/Town of Mocksville for review and approval.
Page 16 of21 PCN Form - Version 1.5, September 2020

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?
❑ Yes
x❑ No
1 b.
If you answered "yes" to the above, does the project require
preparation of an environmental document pursuant to the
requirements of the National or State (North Carolina) Environmental
Policy Act (NEPA/SEPA)?
❑ Yes
❑ No
lc.
If you answered "yes" to the above, has the document review been
finalized by the State Clearing House? (If so, attach a copy of the
NEPA or SEPA final approval letter.)
❑ Yes
❑ No
Comments:
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),
DWR Surface Water or Wetland Standards or Riparian Buffer Rules
(15A NCAC 2B .0200)?
❑ Yes x❑ No
2b. If you answered "yes" to the above question, provide an explanation of the violation(s):
;lick 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
downstream water quality? *
❑ Yes x❑ No
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 (.pdf) in accordance with the most recent
DWR policy.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project? *
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 is located on Framington Road. Additional impacts
associated with sewage disposal are not proposed.
Page 17 of21
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
species or habitat? (IPAC weblink: https://www.fws.gov/ipac/ [fws.govj)
►1 Yes ❑ No
5b.
Have you checked with the USFWS concerning Endangered Species
Act impacts? *
Yes x❑ No
5c.
If yes, indicate the USFWS Field Office you have contacted.
Choose G—
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 ❑ No
5g.
Does this project involve bridge maintenance or removal? *
❑ Yes x❑ No
Link to NLEB SLOPES document: http://saw-req.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)? *
El Yes El No
If yes, please show the location of the wind turbine(s) on the permit drawings/ project plans (attach .pdf)
5i.
Does this project involve blasting and /or other percussive activities
that will be conducted by machines, such as jackhammers,
mechanized pile drivers, etc.? *
❑ Yes x❑ No
If yes, please provide details to include type of percussive activity, purpose, duration, and specific location of this
activity on the property (attach .pdf)
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
Four listed species are identified on the IPaC report (attached). The Northern long-eared Bat, Monarch Butterfly,
Michaux's Sumac and Schweinitz's Sunflower are included by the IPaC as federally listed species identified within the
project area. Bat hibernacula is not located on the site. The majority of the site contains fields and, so, does not
include areas of suitable summer roosting habitat. Potentially higher quality suitable summer roosting habitat was
observed on surrounding properties. Percussive activities including blasting or driving piles are not anticipated as a
result of construction of the proposed project.
Based on a review of the June_1_2016_NLEB_HUC12 NLEB shapefiles obtained from the Asheville Ecological
Services Field Office website, the 12-digit HUC with the nearest confirmed hibernation and/or maternity sites is located
more than 65 miles from the site. Based on the distance from known hibernacula and roost trees and the availability of
similar suitable habitat on nearby properties, the proposed project is not likely to adversely affect the Northern long-
eared bat. Suitable habitat for Michaux's Sumac and Schweinitz's Sunflower is not present on the site and known
occurences of these species have not been identified within 2 miles of the site. The Monarch Butterfly is a candidate
species.
Attach consultation documentation.
6. Essential Fish Habitat (Corps Requirement)
Page 18 of 21
PCN Form - Version 1.5, September 2020

6a.
Will this project occur in or near an area designated as
an Essential Fish Habitat?
El Yes x❑ No
Are there submerged aquatic vegetation (SAV) around
the project vicinity? *
❑ Yes ❑x No ❑ Unknown
Will this project affect submerged aquatic vegetation?
*
❑ Yes x❑ No ❑ Unknown
Explain: Click 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):
http://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
preservation status (e.g., National Historic Trust designation or
properties significant in North Carolina history and archaeology)? *
0 Yes El No
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 that are listed or are eligible for listing on the
National Register for Historic Places were not identified on the site or proximate to stream and wetland impacts. 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? *
0 Yes
El 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 from FEMA Web Map Service — Drawing 4 (Attached)
Page 20 of 21 PCN Form - Version 1.5, September 2020

H. Miscellaneous
Comments:
Please let me know if you need additional information in order to process this application.
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:
L The project proponent hereby certifies that all information contained herein is true, accurate, and complete, to
the best of my knowledge and belief;
L 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;
L 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");
L 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");
L 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
i As the project proponent, I intend to electronically sign and submit the PCN/online form.
Full Name: * David S. Brame
Signature: * �"' g
8/18/22
Page 21 of 21 PCN Form - Version 1.5, September 2020

Proposal for Environmental Services
Pilot Proposal 5917.3
April26, 2022
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: UJ /4/4Vthl V /mac
Applicant Information:
Name:
Address:
Telephone Number:
Fax Number:
E-mail Address:
1`lac4-4...1/l d .JG
/`?cez5 v/LG aVVEcapi-1c---J7 P.44T,4&-As c L c
Po &2)C 3 L//
Doo-J f NC 270,7
36 356- 97 9 3
DAB/EL d3 eeo i4- et:WPA4' i . CON-(
Signature: na,CUIPILEcicvwLegJT P/ •n� pate
6y.7�� bJ C0 914J �Ec «<
.Z7 : Ar)*1,0 ei z -a A& J 7
z8 z
4

WETLAND IMPACT AREA #2
4,826 SF (0.1108) ACRES.
275 LF OF PERENNIAL
STREAM IMPACT (FILL)
1,219 SF (0.0280 ACRES)
11111111101111LCI 1011 01 10 _111111011111111�=
WETLAND IMPACT AREA #1
10,461 SF (0.2402) ACRES.
WETLAND IMPACT AREA #3
2,031 SF (0.0466) ACRES.
Now or Formerly
Blatr Gibson Younts
Geed Book 1102, Page 946
PIN 5850058252
Now of Formerly
Steve Wiliam Hungerford
Deed Bank 568 Page 798
PIN 5850171383
\\\
Now or Formerly
5te.en Dan Whitaker
Deed Book 828, Page 616
PIN 5850049820
Now or f edy
Helen 1. Jordan, Trustee
Deed Book 814. Page 307
PIN 5850140429
how or Formely •
°noel Baptist Church
d Book 111, Page 1 4
PIN 58501 65 I
Now or Formerly
Dorothy Norklin, tol •
Deed Book 1049, Page 1199
PIN 5850049292
Now arf Famed,
Shoran Smith Cox, td
Geed Boo( 1019, Page 912
PIN 5850257667
Now of Formerly
Gwendolyn C. Smith
Geed Book 44, Page 134
PIN 5850352382
Now or Formerly
Sharon Smith Cox. elal
Deed Book 1019, Page 912
PIN 5850234862

Requestor:
Address:
Telephone Number:
E-mail:
Size (acres)
Nearest Waterway
USGS HUC
U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW-2020-01262 County: Davie U.S.G.S. Quad: NC- Mocksville
NOTIFICATION OF JURISDICTIONAL DETERMINATION
Wells Fargo Bank
Lorraine Bulloch
150 Fayetteville Street
Raleigh, NC 27601
919-624-3971
Lorraine.bulloch(awellsfargo.co m
Nearest Town Mocksville
River Basin Upper Pee Dee
Coordinates Latitude: 35.954668
Longitude: -80.520644
Location description: The review area is located on the north side of US Highway 158; approximately 5.4 miles north of the
intersection of US Highway 158 and US Highway 64. PIN: 5840855939. Reference review area description shown in
Jurisdictional Determination Request package entitled "Drawing 1, USGS Topographic Map".
201
Cedar Creek
03040101
Indicate Which of the Following Apply:
A. Preliminary Determination
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 9/22/2020. 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.
❑ 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 DATE. We strongly

SAW-2020-01262
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 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-revnolds(a,u sace.armv.mil.
C. Basis For Determination: Basis For Determination: See the preliminary jurisdictional determination
form dated 9/22/2020.
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)
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.**
RODEN Digitally signed by RODEN
REYNOLDS.BRYAN.KENNETH.1263385574 REYNOLDS.BRYAN.KENNETH.1263385574
Corps Regulatory Official: Date: 2020.09.2215:47:38-04'00'
Date of JD: 9/22/2020 Expiration Date of JD: Not applicable

SAW-2020-01262
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: Pilot Environmental, Inc.
Seren Homer
Address: P.O. Box 128
Kernersville, NC 27285
Telephone Number: 336-310-4527
E-mail: shomer(apilotenviro.com

PROCESS AND
NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND
REQUEST FOR APPEAL
Applicant: Wells Fargo Bank Lorraine Bulloch File Number: SAW-2020-01262 Date: 9/22/2020
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
PRELIMINARY JURISDICTIONAL DETERMINATION
E
x
SECTION
Additional
grAg
I - The following identifies your rights and options regarding an administrative appeal
information may be found at or http://www.usace.army.mil/Missions/CivilWorks/RegulatoryProgramandPermits.aspx
of the above decision.
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
•
signature
rights
•
this
PERMIT: You may accept or appeal the permit
ACCEPT: If you received a Standard Permit, you may sign the permit document and return
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and
on the Standard Permit or acceptance of the LOP means that you accept the permit
to appeal the permit, including its terms and conditions, and approved jurisdictional
permit.
APPEAL: If you choose to decline the proffered permit (Standard or LOP) because of
you may appeal the declined permit under the Corps of Engineers Administrative Appeal
it to the district engineer for fmal
your work is authorized. Your
in its entirety, and waive all
determinations associated with the
certain terms and conditions therein,
Process by completing Section II of
the division engineer within 60 days
form and sending the form to the division engineer. This form must be received by
of the date of this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers
completing Section II of this form and sending the form to the division engineer. This form
engineer within 60 days of the date of this notice.
Administrative Appeal Process by
must be received by the division
D: APPROVED
information.
•
•
JURISDICTIONAL DETERMINATION: You may accept or appeal the
ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify
date of this notice, means that you accept the approved JD in its entirety, and waive all
APPEAL: If you disagree with the approved JD, you may appeal the approved JD under
Administrative Appeal Process by completing Section II of this form and sending the form
approved JD or provide new
the Corps within 60 days of the
rights to appeal the approved JD.
the Corps of Engineers
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
proffered permit in clear concise statements. You may attach
objections are addressed in the administrative record.)
reasons for appealing the decision or your objections to an initial
additional information to this form to clarify where your reasons or
ADDITIONAL INFORMATION: The appeal is limited to a
record of the appeal conference or meeting, and any supplemental
clarify the administrative record. Neither the appellant nor the
review of the administrative record,
information that the review
Corps may add new information
the location of information that
the Corps memorandum for the
officer has determined is needed to
or analyses to the record.
is already in the administrative
However, you may provide additional information to clarify
record.
POINT OF CONTACT FOR QUESTIONS OR INFORMATION:
If you have questions regarding this decision and/or the
appeal process you may contact:
District Engineer, Wilmington Regulatory Division
Attn: Bryan Roden -Reynolds
Charlotte Regulatory Office
U.S Army Corps of Engineers
8430 University Executive Park Drive, Suite 615
Charlotte, North Carolina 28262
If you only have questions regarding
also contact:
Mr. Phillip Shannin, Administrative
the appeal process you may
Appeal Review Officer
South Atlantic Division
CESAD-PDO
U.S. Army Corps of Engineers,
60 Forsyth Street, Room 10M15
Atlanta, Georgia 30303-8801
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 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: Bryan Roden -Reynolds, 69 Darlington Avenue, Wihnington, 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 10M15, Atlanta, Georgia 30303-8801
Phone: [phone]

PRELIMINARY JURISDICTIONAL DETERMINATION (PJD) FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PJD: 09/30/2020
B. NAME AND ADDRESS OF PERSON REQUESTING PJD: Wells Fargo Bank, Lorraine Bulloch, 150
Fayetteville Street, Raleigh, NC 27601
C. DISTRICT OFFICE, FILE NAME, AND NUMBER: Wilmington District, US Highway 158, SAW-
2020-01262
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION: The review area is located on the
north side of US Highway 158; approximately 5.4 miles north of the intersection of US Highway 158 and US
Highway 64. PIN: 5840855939. 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: Davie City: Mocksville
Center coordinates of site (lat/long in degree decimal format): Latitude: 35.954668 Longitude: -80.520644
Universal Transverse Mercator:
Name of nearest waterbody: Cedar Creek
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
Z Office (Desk) Determination. Date: 07/07/2020
® Field Determination. Date(s): 09/22/2020
TABLE OF AQUATIC RESOURCES INREVIEW AREA WHICH "MAY BE" SUBJECT TO
REGULATORY JURISDICTION
Feature
Latitude
Longitude
Estimated
Type of aquatic
Geographic authority to
(decimal
degrees)
(decimal
degrees)
amount of
aquatic
resources in
review area
resources (i.e.,
wetland vs. non-
wetland waters)
which the aquatic
resource "may be"
subject (i.e., Section 404
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 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 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 Map (1:24,000
Mocksville and Advance, NC)
▪ Natural Resources Conservation Service Soil Survey. Citation: and Drawing 2A, Published Soil Map (Soil
Survey of Davie County, Sheet 3 Dated 1995)
® National wetlands inventory map(s). Cite name- Drawing 2, Web Soil Map (Web Soil Survey of Davie
County) and Drawing 3, NWI Map (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 07/07/2020)
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.
RODEN Digitally signed by RODEN
REYNOLDS.RRYAN.KENNETH.1263385574
REYNOLDS.BRYAN.KENNETH.1263385574 Date: 2020.09.2215:48:09-04'00'
Signature and date of Regulatory Signature and date of person requesting PJD
staff member completing PJD (REQUIRED, unless obtaining the signature is
9/22/2020 impracticable)'
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.

Feature
Latitude
(decimal
degrees)
Longitude
(decimal
degrees)
Estimated
amount of
aquatic
resources in
review area
(acreage and
linear feet, if
applicable
Type of aquatic
resources (i.e.,
wetland vs. non-
wetland waters)
Geographic
authority to
which the
aquatic resource
"may be"
subject (i.e.,
Section 404 or
Section 10/404)
PA
35.959462
-80.524969
0.12
Non -wetland
404
PB
35.956093
-80.522955
0.24
Non -wetland
404
PC
35.955266
-80.520983
1.12
Non -wetland
404
Cedar Cr
35.948831
-80.513514
4850
Non -wetland
404
SA
35.959589
-80.524528
190
Non -wetland
404
SB
35.959676
-80.524329
30
Non -wetland
404
SC 1
35.95755
-80.524235
770
Non -wetland
404
SC 2
35.956401
-80.524931
350
Non -wetland
404
SD
35.955708
-80.520983
240
Non -wetland
404
SE
35.956023
-80.522571
580
Non -wetland
404
SF
35.955147
-80.521563
70
Non -wetland
404
SG
35.954035
-80.521595
330
Non -wetland
404
SH
35.955048
-80.512743
1650
Non -wetland
404
SI
35.948844
-80.513567
780
Non -wetland
404
WA
35.959268
-80.525937
0.884
Wetland
404
WB
35.959577
-80.524636
0.04
Wetland
404
WC
35.959668
-80.523972
0.025
Wetland
404
WD
35.957145
-80.524337
0.401
Wetland
404
WE
35.955951
-80.523189
0.066
Wetland
404
WF
35.956054
-80.52232
0.201
Wetland
404
WG
35.955978
-80.52138
0.115
Wetland
404
WH
35.955066
-80.52159
0.017
Wetland
404
WI
35.954382
-80.521242
0.227
Wetland
404
WI
35.955829
-80.520822
0.126
Wetland
404
WK
35.957391
-80.519917
5.597
Wetland
404
WL
35.95628
-80.518853
0.211
Wetland
404
WM
35.956136
-80.516595
1.283
Wetland
404
WO
35.95646
-80.516074
0.209
Wetland
404
WP
35.953014
-80.515836
0.071
Wetland
404
WQ
35.950667
-80.51297
0.43
Wetland
404
WR
35.952449
-80.513296
0.127
Wetland
404
WS
35.954148
-80.514695
2.715
Wetland
404
WT
35.954208
-80.527954
0.24
Wetland
404

WA I
0.884 ac.
WT
/0.24 ac.
WB
0.04 ac. NN
PA I
0.12 ac.
SB
/30 LF
5A1 WC
0.025 ac.
190 LF
SC 1
770 LF
WO
0.401 ac.
WE
0.066 ac,
FLAG NUMBERS/INFORMATION
WETLAND FLAGS =
STREAM FLAGS =
Wetland Flags = 337
Stream Flags = Flagged at origins
and intersections; surveyor locate
V///////1
V////////1
WK
5.597 ac.�
PB
0.24 ac.
WH
0.017 ac.�~
6+Li ..L•
•
5G
330 i.F
WV
❑.227 a
M
'ODP41.12ar.
oDP-3
b
Cedar Cr
' 1710 LF
WL
0.211 ac. WM
1.283 ac.
I°
Alb lir
I. •
•- R
WO
/0.205 ac.
d1f ak.r
0.071 ac.
c
•
WS
2.715 ac.
1650 LF
Cedar Cr
3140 LF
WR
0.127 ac,
51
WQ
Nplk
.f
LEGEND
DP-1 0
WA
Site Boundary
Pond
Perennial Stream
Wetland
Data Point
Feature ID
THE LOCATIONS OF FEATURES SHOWN ON THIS MAP WERE VERIFIED BY MR. BRYAN RODEN-REYNOLDS WITH THE USACE ON SEPTEMBER
22, 2020. THIS EXHIBIT INCLUDES GPS LOCATIONS OF DELINEATED FEATURES.
!ten
1
Drawing 5
2018 Satellite Imagery from ESRI
and Pilot GPS Data
Scale: 1" = 600'
Date: 7.7.20
Revised: 9.22.20
P I L❑ T E N Y I R O N M E N T A e• I N C
Wetland Map
US Highway 158
Approximate 201-Acre Tract
Mocksville, Davie County, NC
Pilot Project 5917

Drawing
USGSTopographic Map
MookaviUeand Advance,
NC Quadrangles
"``0` '"° i ^"""""`^` °`
USGS Topographic Map
USHighway 158
Approximate ZO1-AoreTract
Mooksvi||e, Davie County, NC
Pilot Project 5917

Drawing 2
USDA Web Soil Survey
of Davie County, NC
Scale: 1" = 600'
PILOT"'
PLT E t1 V I R❑ Y M E N T A L, I N C.
Web Soil Map
US Highway 158
Approximate 201-Acre Tract
Mocksville, Davie County, NC
Pilot Project 5917

Drawing 2A
USDA Soil Survey
of Davie County, NC
Published 1995, Sheet 3
Not to Scale
PILOT EtI V I R❑ Y M E N T AL, I N C
Published Soil Map
US Highway 158
Approximate 201-Acre Tract
Mocksville, Davie County, NC
Pilot Project 5917

•
- f'11'
Vtt4-'
•
•
•, •t-,,
11'14'
*V**,
tk.
LEGEND
Site Boundary
7" Freshwater Emergent
Mr Freshwater Forested/Shrub
Estuarine and Marine Deepwater
Estuarine and Marine
Freshwater Pond
Lake
Riverine
Other
Drawing 3
USFWS NWI
Wetlands Mapper
Scale: 1" = 600'
PILOT EliVIROYMENTAL.INC
NWI Map
US Highway 158
Approximate 201-Acre Tract
Mocksville, Davie County, NC
Pilot Project 5917

f 174
i
11,
.tip
ODOJ r F!t
'eff. 9117/2008.,: ,, ,'' ri.- Owe
r''*„ ,. ► ..4i,'F:i, k:AREi ❑F MI NIMAL'FLOO HAZARD46ri
r
•
ulT
w
• LEGEND
Site Boundary
;1 %Annual Chance Flood Hazard
it Regulatory Flood ray
fa Special Floodvay
Area of Undetermired Flood Hazard
0.2%Annual Chance Flood Hazard
FLture Conditions 1 %Annual Chance Flood Hazard
I4 Area with Reduced Risk Due to Levee
Drawing 4
National Flood Hazard Layer
From FEMA Web Map Service
Scale: 1" = 600'
PILOT "'
P I LOT E Y V I R❑ Y M E N T A L, I N C.
FEMA FIRM
US Highway 158
Approximate 201-Acre Tract
Mocksville, Davie County, NC
Pilot Project 5917

WB
0.04 ac.N
ISA
PA 190 LF
WA 0.12 ac.
0.884 ac,
WD
0.401 ac. N
SC 2
350 IF
FLAG NUMBERS/INFORMATION
WETLAND FLAGS =
STREAM FLAGS =
Wetland Flags = 337
Stream Flags = Flagged at origins
and intersections; surveyor locate
SB
30 LF
5C 1
770 LF
WF
0.201 ac.
WE /
0.066 ac.
V///////1
V ///////1
WK
5.597 ac.
PB
0.24 ac.
SE
580 IF SD
240 LF
DP-2
SF
70 IF
WH
0.017 ac.
WG
0.115 ar.
WJ
0.126 ac.
5G PC
330 LF \ DP-4 1.12 ac.
`lO DP-3
Cedar Cr
1710 LF
2,715 ac.
1650 LF
Cedar Cr
3140 Lf
WR
0.127 ac.
DP-1 0
WA
Site Boundary
Pond
Perennial Stream
Wetland
Data Point
Feature ID
THE LOCATIONS OF FEATURES SHOWN ON THIS MAP WERE VERIFIED BY MR. BRYAN RODEN-REYNOLDS WITH THE USACE ON SEPTEMBER
22, 2020. THIS EXHIBIT INCLUDES GPS LOCATIONS OF DELINEATED FEATURES.
Drawing 5
2018 Satellite Imagery from ESRI
and Pilot GPS Data
Scale: 1" = 600'
Date: 7.7.20
Revised: 9.22.20
PILOT ""
PILOT EtI V I RO - M EN T AL, I NC
Wetland Map
US Highway 158
Approximate 201-Acre Tract
Mocksville, Davie County, NC
Pilot Project 5917

NC WAM WETLAND ASSESSMENT FORM
Accompanies User Manual Version 5
USACE AID#: NCDWR #:
Project Name Tri-West Business Park Date of Evaluation 7/6/20
Applicant/Owner Name Mocksville Development Partners LLC Wetland Site Name WT
Wetland Type Non -Tidal Freshwater Marsh Assessor Name/Organization David Brame
Level III Ecoregion Piedmont Nearest Named Water Body Dutchmand Creek
River Basin Yadkin-PeeDee USGS 8-Digit Catalogue Unit 03040101
County Davie NCDWR Region Winston-Salem
r- Yes 3"- No Precipitation within 48 hrs? Latitude/Longitude (deci-degrees) 35.954248°/-80.527816°
Evidence of stressors affecting the assessment area (may not be within the assessment area)
Please circle and/or make note on last page if evidence of stressors is apparent. Consider departure from reference, if
appropriate, in recent past (for instance, approximately within 10 years). Noteworthy stressors include, but are not limited
to the following.
• Hydrological modifications (examples: ditches, dams, beaver dams, dikes, berms, ponds, etc.)
• Surface and sub -surface discharges into the wetland (examples: discharges containing obvious pollutants, presence of nearby
septic tanks, underground storage tanks (USTs), hog lagoons, etc.)
• Signs of vegetation stress (examples: vegetation mortality, insect damage, disease, storm damage, salt intrusion, etc.)
• Habitat/plant community alteration (examples: mowing, clear -cutting, exotics, etc.)
Is the assessment area intensively managed? r. Yes ' - No
Regulatory Considerations - Were regulatory considerations evaluated? Yes 3' - No If Yes, check all that apply to the assessment area.
I Anadromous fish
1 Federally protected species or State endangered or threatened species
I NCDWR riparian buffer rule in effect
I Abuts a Primary Nursery Area (PNA)
I Publicly owned property
I N.C. Division of Coastal Management Area of Environmental Concern (AEC) (including buffer)
I Abuts a stream with a NCDWQ classification of SA or supplemental classifications of HOW, ORW, or Trout
E Designated NCNHP reference community
I Abuts a 303(d)-listed stream or a tributary to a 303(d)-listed stream
What type of natural stream is associated with the wetland, if any? (check all that apply)
Blackwater
Brownwater
1 Tidal (if tidal, check one of the following boxes) 3' - Lunar 3' - Wind 3' - Both
Is the assessment area on a coastal island? 3-- Yes No
Is the assessment area's surface water storage capacity or duration substantially altered by beaver? 3' - Yes r No
Does the assessment area experience overbank flooding during normal rainfall conditions? 3' - Yes No
1. Ground Surface Condition/Vegetation Condition — assessment area condition metric
Check a box in each column. Consider alteration to the ground surface (GS) in the assessment area and vegetation structure
(VS) in the assessment area. Compare to reference wetland if applicable (see User Manual). If a reference is not applicable,
then rate the assessment area based on evidence of an effect.
GS VS
3' - A 3' - A Not severely altered
is B is B Severely altered over a majority of the assessment area (ground surface alteration examples: vehicle tracks, excessive
sedimentation, fire -plow lanes, skidder tracks, bedding, fill, soil compaction, obvious pollutants) (vegetation structure
alteration examples: mechanical disturbance, herbicides, salt intrusion [where appropriate], exotic species, grazing,
less diversity [if appropriate], hydrologic alteration)
2. Surface and Sub -Surface Storage Capacity and Duration — assessment area condition metric
Check a box in each column. Consider surface storage capacity and duration (Surf) and sub -surface storage capacity and
duration (Sub). Consider both increase and decrease in hydrology. A ditch <_ 1 foot deep is considered to affect surface water only,
while a ditch > 1 foot deep is expected to affect both surface and sub -surface water. Consider tidal flooding regime, if applicable.
Surf Sub
A 3' - A Water storage capacity and duration are not altered.
B B Water storage capacity or duration are altered, but not substantially (typically, not sufficient to change vegetation).
C 3' - C Water storage capacity or duration are substantially altered (typically, alteration sufficient to result in vegetation
change) (examples: draining, flooding, soil compaction, filling, excessive sedimentation, underground utility lines).
3. Water Storage/Surface Relief — assessment area/wetland type condition metric (skip for all marshes)
Check a box in each column for each group below. Select the appropriate storage for the assessment area (AA) and the wetland
type (WT).
AA WT
3a. 3' - A - A Majority of wetland with depressions able to pond water > 1 foot deep
C- B - B Majority of wetland with depressions able to pond water 6 inches to 1 foot deep
C - C Majority of wetland with depressions able to pond water 3 to 6 inches deep
D D Depressions able to pond water < 3 inches deep
3b. (' A Evidence that maximum depth of inundation is greater than 2 feet
C" B Evidence that maximum depth of inundation is between 1 and 2 feet
C Evidence that maximum depth of inundation is less than 1 foot

4. Soil Texture/Structure - assessment area condition metric (skip for all marshes)
Check a box from each of the three soil property groups below. Dig soil profile in the dominant assessment area landscape
feature. Make soil observations within the 12 inches. Use most recent National Technical Committee for Hydric Soils guidance for
regional indicators.
4a. A Sandy soil
B Loamy or clayey soils exhibiting redoximorphic features (concentrations, depletions, or rhizospheres)
C C Loamy or clayey soils not exhibiting redoximorphic features
( D Loamy or clayey gleyed soil
( E Histosol or histic epipedon
4b. C A Soil ribbon < 1 inch
B Soil ribbon >_ 1 inch
4c. ( A No peat or muck presence
(-` B A peat or muck presence
5. Discharge into Wetland - opportunity metric
Check a box in each column. Consider surface pollutants or discharges (Surf) and sub -surface pollutants or discharges (Sub).
Examples of sub -surface discharges include presence of nearby septic tank, underground storage tank (UST), etc.
Surf Sub
A A Little or no evidence of pollutants or discharges entering the assessment area
B - B Noticeable evidence of pollutants or discharges entering the wetland and stressing, but not overwhelming the
treatment capacity of the assessment area
C C Noticeable evidence of pollutants or discharges (pathogen, particulate, or soluble) entering the assessment area and
potentially overwhelming the treatment capacity of the wetland (water discoloration, dead vegetation, excessive
sedimentation, odor)
6. Land Use - opportunity metric (skip for non -riparian wetlands)
Check all that apply (at least one box in each column). Evaluation involves a GIS effort with field adjustment. Consider sources
draining to assessment area within entire upstream watershed (WS), within 5 miles and within the watershed draining to the
assessment area (5M), and within 2 miles and within the watershed draining to the assessment area (2M). Effective riparian buffers
are considered to be 50 feet wide in the Coastal Plain and Piedmont ecoregions and 30 feet wide in the Blue Ridge Mountains ecoregion.
WS 5M 2M
f- A IA I A >_ 10% impervious surfaces
✓ B r B F B Confined animal operations (or other local, concentrated source of pollutants)
✓ C r C E C >_ 20% coverage of pasture
▪ D F D F D >_ 20% coverage of agricultural land (regularly plowed land)
✓ E fl E fl E >_ 20% coverage of maintained grass/herb
▪ F F F f F >_ 20% coverage of clear-cut land
G F G PG Little or no opportunity to improve water quality. Lack of opportunity may result from little or no disturbance in
the watershed or hydrologic alterations that prevent dainage and/or overbank flow from affectio the
assessment area.
7. Wetland Acting as Vegetated Buffer - assessment area/wetland complex condition metric (skip for non -riparian wetlands)
7a. Is assessment area within 50 feet of a tributary or other open water?
Yes r. No If Yes, continue to 7b. If No, skip to Metric 8.
7b. How much of the first 50 feet from the bank is weltand? (Wetland buffer need only be present on one side of the water body. Make
buffer judgment based on the average width of wetland. Record a note if a portion of the buffer has been removed or disturbed.)
( A >_ 50 feet
( B From 30 to < 50 feet
C From 15 to < 30 feet
{- D From 5 to < 15 feet
{" E < 5 feet or buffer bypassed by ditches
7c. Tributary width. If the tributary is anastomosed, combine widths of channels/braids for a total width.
{` <_ 15-feet wide 3' - > 15-feet wide 3' - Other open water (no tributary present)
7d. Do roots of assessment area vegetation extend into the bank of the tributary/open water?
.-' Yes 3-' No
7e. Is tributary or other open water sheltered or exposed?
Sheltered - adjacent open water with width < 2500 feet and no regular boat traffic.
- Exposed - adjacent open water with width >_ 2500 feet or regular boat traffic.
8. Wetland Width at the Assessment Area - wetland type/wetland complex condition metric (evaluate WT for all marshes
and Estuarine Woody Wetland only; evaluate WC for Bottomland Hardwood Forest, Headwater Forest, and Riverine Swamp
Forest only)
Check a box in each column. Select the average width for the wetland type at the assessment area (WT) and the wetland complex at the
assessment area (WC). See User Manual for WT and WC boundaries.
WT WC
3'-A {`A >_ 100 feet
(B ('B From80to<100feet
( . C {" C From 50 to < 80 feet
D (i D From 40 to < 50 feet
( ' E (' E From 30to <40feet
{` F (' F From 15 to < 30 feet
{" G G From 5 to < 15 feet
{ H 3' H <5feet

9. Inundation Duration - assessment area condition metric (skip for non -riparian wetlands)
Answer for assessment area dominant landform.
3' - A Evidence of short -duration inundation (< 7 consecutive days)
B Evidence of saturation, without evidence of inundation
C Evidence of long -duration inundation or very long -duration inundation (7 to 30 consecutive days or more)
10. Indicators of Deposition - assessment area condition metric (skip for non -riparian wetlands and all marshes)
Consider recent deposition only (no plant growth since deposition).
3' - A Sediment deposition is not excessive, but at approximately natural levels.
is B Sediment deposition is excessive, but not overwhelming the wetland.
- C Sediment deposition is excessive and is overwhelming the wetland.
11. Wetland Size - wetland type/wetland complex condition metric
Check a box in each column. Involves a GIS effort with field adjustment. This metric evaluates three aspects of the wetland area: the
size of the wetland type (WT), the size of the wetland complex (WC), and the size of the forested wetland (FW) (if applicable, see User
Manual). See the User Manual for boundaries of these evaluation areas. If assessment area is clear-cut, select "K" for the FW column.
VVT WC FW (if applicable)
CA CA CA >_ 500 acres
(- B (' B C B From 100 to < 500 acres
('C ('C ('C From 50 to < 100 acres
C D (" D ('" D From 25 to < 50 acres
CE (` E (" E From 10 to < 25 acres
CF (` F (" F From 5 to < 10 acres
CG (`G CG From 1 to < 5 acres
("H (''H ('"H From 0.5 to < 1 acre
6."1 (:1 (`1 From 0.1 to < 0.5 acre
C J (` J is J From 0.01 to < 0.1 acre
C K r- K r K < 0.01 acre or assessment area is clear-cut
12. Wetland Intactness - wetland type condition metric (evaluate for Pocosins only)
/- A Pocosin is the full extent (>_ 90%) of its natural landscape size.
/`" B Pocosin is < 90% of the full extent of its natural landscape size.
13. Connectivity to Other Natural Areas - landscape condition metric
13a. Check appropriate box(es) (a box may be checked in each column). Involves a GIS effort with field adjustment. This
evaluates whether the wetland is well connected (Well) and/or loosely connected (Loosely) to the landscape patch, the contiguous
metric naturally vegetated area and open water (if appropriate). Boundaries are formed by four -lane roads, regularly maintained utility
line corridors the width of a four -lane road or wider, urban landscapes, fields (pasture open and agriculture), or water > 300 feet wide.
Well Loosely
CA !"A 500 acres
( B B From 100 to < 500 acres
( C C From 50 to < 100 acres
CD i- D From 10 to < 50 acres
(: E r: E < 10 acres
C" F f F Wetland type has a poor or no connection to other natural habitats
13b. Evaluate for marshes only.
kr: Yes f- No Wetland type has a surface hydrology connection to open waters/stream or tidal wetlands.
14. Edge Effect - wetland type condition metric (skip for all marshes and Estuarine Woody Wetland)
May involve a GIS effort with field adjustment. Estimate distance from wetland type boundary to artificial edges. Artificial edges include
non -forested areas >_ 40 feet wide such as fields, development, roads, regularly maintained utility line corridors and clear -cuts. Consider
the eight main points of the compass. Artificial edge occurs within 150 feet in how many directiions? If the assessment area is clear-cut,
select option "C."
�: A 0
/`"B 1to4
C 5 to 8
15. Vegetative Composition - assessment area condition metric (skip for all marshes and Pine Flat)
C A Vegetation is close to reference condition in species present and their proportions. Lower strata composed of appropriate
species, with exotic plants absent or sparse within the assessment area.
C B Vegetation is different from reference condition in species diversity or proportions, but still largely composed of native species
characteristic of the wetland type. This may include communities of weedy native species that develop after clearcutting or
clearing. It also includes communities with exotics present, but not dominant, over a large portion of the expected strata.
C C Vegetation severely altered from reference in composition, or expected species are unnaturally absent (planted stands of non -
characteristic species or at least one stratum inappropriately composed of a single species), or exotic species are dominant in
at least one stratum.
16. Vegetative Diversity - assessment area condition metric (evaluate for Non -tidal Freshwater Marsh only)
f A Vegetation diversity is high and is composed primarily of native species (<10% cover of exotics).
( B Vegetation diversity is low or has > 10% to 50% cover of exotics.
C Vegetation is dominated by exotic species (>50% cover of exotics).

17. Vegetative Structure — assessment area/wetland type condition metric
17a. Is vegetation present?
r: Yes r~ No If Yes, continue to 17b. If No, skip to Metric 18.
17b. Evaluate percent coverage of assessment area vegetation for all marshes only. Skip to 17c for non -marsh wetlands.
r: A >_ 25% coverage of vegetation
B < 25% coverage of vegetation
17c. Check a box in each column for each stratum. Evaluate this portion of the metric for non -marsh wetlands. Consider structure
in airspace above the assessment area (AA) and the wetland type (WT) separately.
AA WT
C A r~ A Canopy closed, or nearly closed, with natural gaps associated with natural processes
C B (--B Canopy present, but opened more than natural gaps
• C {: C Canopy sparse or absent
C A f A Dense mid-story/sapling layer
f ' B C B Moderate density mid-story/sapling layer
• C {i C Mid-story/sapling layer sparse or absent
C A C A Dense shrub layer
C B (' B Moderate density shrub layer
• C (;" C Shrub layer sparse or absent
• A {" A Dense herb layer
a. fi B ( B Moderate density herb layer
= i C C C Herb layer sparse or absent
Shrub Mid -Story Canopy
18. Snags — wetland type condition metric (skip for all marshes)
f A Large snags (more than one) are visible (> 12-inches DBH, or large relative to species present and landscape stability).
r: B NotA
19. Diameter Class Distribution — wetland type condition metric (skip for all marshes)
C A Majority of canopy trees have stems > 6 inches in diameter at breast height (DBH); many large trees (> 12 inches DBH) are
present.
[_. B Majority of canopy trees have stems between 6 and 12 inches DBH, few are > 12-inch DBH.
C Majority of canopy trees are < 6 inches DBH or no trees.
20. Large Woody Debris — wetland type condition metric (skip for all marshes)
Include both natural debris and man -placed natural debris.
C A Large logs (more than one) are visible (> 12 inches in diameter, or large relative to species present and landscape stability).
{: B NotA
21. Vegetation/Open Water Dispersion — wetland type/open water condition metric (evaluate for Non -Tidal Freshwater
Marsh only)
Select the figure that best describes the amount of interspersion between vegetation and open water in the growing season. Patterned
areas indicate vegetated areas, while solid white areas indicate open water.
( A
C
r: D
22. Hydrologic Connectivity — assessment area condition metric (evaluate for riparian wetlands and Salt/Brackish Marsh only)
Examples of activities that may severely alter hydrologic connectivity include intensive ditching, fill, sedimentation, channelization,
diversion, man-made berms, beaver dams, and stream incision. Documentation required if evaluated as B, C, or D.
A Overbank and overland flow are not severely altered in the assessment area.
B Overbank flow is severely altered in the assessment area.
C Overland flow is severely altered in the assessment area.
D Both overbank and overland flow are severely altered in the assessment area.
Notes

Wetland Site Name
Wetland Type
NC WAM Wetland Rating Sheet
Accompanies User Manual Version 5.0
WT
Non -Tidal Freshwater Marsh
Date
Assessor Name/Organization
Notes on Field Assessment Form (Y/N)
Presence of regulatory considerations (Y/N)
Wetland is intensively managed (Y/N)
Assessment area is located within 50 feet of a natural tributary or other open water (Y/N)
Assessment area is substantially altered by beaver (Y/N)
Assessment area experiences overbank flooding during normal rainfall conditions (Y/N)
Assessment area is on a coastal island (Y/N)
Sub -function Rating Summary
7/6/20
David Brame
NO
NO
YES
NO
NO
NO
NO
Function
Hydrology
Water Quality
Habitat
Sub -function
Surface Storage and Retention
Sub -Surface Storage and Retention
Pathogen Change
Particulate Change
Soluble Change
Physical Change
Pollution Change
Physical Structure
Landscape Patch Structure
Vegetation Composition
Metrics
Condition
Condition
Condition
Condition/Opportunity
Opportunity Presence? (Y/N)
Condition
Condition/Opportunity
Opportunity Presence? (Y/N)
Condition
Condition/Opportunity
Opportunity Presence? (Y/N)
Condition
Condition/Opportunity
Opportunity Presence? (Y/N)
Condition
Condition/Opportunity
Opportunity Presence? (Y/N)
Condition
Condition
Condition
Rating
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
LOW
LOW
MEDIUM
Function Rating Summary
Function
Metrics/Notes
Rating
Hydrology
Water Quality
Habitat
Condition
Condition
Condition/Opportunity
Opportunity Presence? (Y/N)
Condition
LOW
Overall Wetland Rating

x
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]
In Reply Refer To:
Project Code: 2022-0072440
Project Name: Tri-West
August 08, 2022
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 enclosed species list identifies threatened, endangered, proposed and candidate species, as
well as proposed and designated critical habitat, that may occur within the boundary of your
proposed project and/or may be affected by your proposed project. The enclosed species list
fulfills the requirements of the U.S. Fish and Wildlife Service (Service) under section 7(c) of the
Endangered Species Act (Act) of 1973, as amended (16 U.S.C. 1531 et seq.).
Please note that new species information can change your official species list. Under 50 CFR
402.12(e) of the regulations implementing section 7 of the Act, the accuracy of this species list
should be verified after 90 days. The Service recommends you visit the ECOS-IPaC website at
regular intervals during project planning and implementation to ensure your species list is
accurate or obtain an updated species list.
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 (BA) or biological evaluation (BE) should be completed for your
project. A BA is required for major construction activities (or other undertakings having similar
physical impacts) considered to be 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))
(NEPA). For projects other than major construction activities, the Service suggests that a BE be
prepared to determine effects of the action and whether those effects may affect listed species
and/or designated critical habitat. E?ects of the action are all consequences to listed species or
critical habitat that are caused by the proposed action, including the consequences of other

08/08/2022 2
activities that are caused by the proposed action. A consequence is caused by the proposed action
if it is reasonably certain to occur and would not occur "but for" the proposed action..
Recommended contents of a BA/BE are described at 50 CFR 402.12. More information and
resources about project review and preparing a BA/BE can be found at the following web link:
https://www.fws. gov/office/asheville-ecological-services/asheville-field-office-online-review-
process-overview.
If a Federal agency determines 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. The Service is not required to concur with "no effect" determinations from Federal action
agencies. If consultation is required, the Service recommends that candidate species, proposed
species, proposed critical habitat, and at -risk species be addressed within the consultation. More
information on the regulations and procedures for section 7 consultation, including the role of
permit or licensed applicants, can be found in the "Endangered Species Consultation Handbook"
at the following web link: https://www.fws.gov/media/endangered-species-consultation-
handbook.
Migratory Birds: In addition to responsibilities to protect threatened and endangered species
under the Act, there are additional responsibilities under the Migratory Bird Treaty Act (MBTA)
and the Bald and Golden Eagle Protection Act (BGEPA) to protect native birds from project -
related impacts. Any activity, intentional or unintentional, resulting in take of migratory birds,
including eagles, is prohibited unless otherwise permitted by the Service (50 C.F.R. Sec. 10.12
and 16 U.S.C. Sec. 668(a)). More information about MBTA and BGEPA can be found at the
following web link: hops://www.fws.gov/program/migratory-birds.
We appreciate your consideration of Federally listed species. The Service encourages Federal
agencies to include conservation of threatened and endangered species in their project planning
to further the purposes of the Act. Please contact our staff at 828-258-3939, if you have any
questions. In any future correspondence concerning this project, please reference the
Consultation Code which can be found in the header of this letter.
Attachment(s):
• Official Species List
• USFWS National Wildlife Refuges and Fish Hatcheries
• Migratory Birds
• Wetlands

08/08/2022 1
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]

08/08/2022 2
Project Summary
Project Code: 2022-0072440
Project Name: Tri-West
Project Type: Commercial Development
Project Description: The site is being considered for Industrial development.
Project Location:
Approximate location of the project can be viewed in Google Maps: https://
www.goog1e.com/maps/@35.95645245,-80.5212764211077,14z
Counties: Davie County, North Carolina

08/08/2022 3
Endangered Species Act Species
There is a total of 4 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
Fisheriesl, 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
Northern Long-eared Bat Myotis septentrionalis
No critical habitat has been designated for this species.
Species profile: https://ecos.fws.gov/ecp/species/9045
Insects
NAME
Monarch Butterfly Danaus plexippus
No critical habitat has been designated for this species.
Species profile: https://ecos.fws.gov/ecp/species/9743
Flowering Plants
NAME
STATUS
Threatened
STATUS
Candidate
STATUS
Michaux's Sumac Rhus michauxii
No critical habitat has been designated for this species.
Species profile: https://ecos.fws.gov/ecp/species/5217
Schweinitz's Sunflower Helianthus schweinitzii
No critical habitat has been designated for this species.
Species profile: https://ecos.fws.gov/ecp/species/3849
Endangered
Endangered
Critical habitats
THERE ARE NO CRITICAL HABITATS WITHIN YOUR PROJECT AREA UNDER THIS OFFICE'S
JURISDICTION.

08/08/2022 4

08/08/2022 1
USFWS National Wildlife Refuge Lands And Fish
Hatcheries
Any activity proposed on lands managed by the National Wildlife Refuge system must undergo a
'Compatibility Determination' conducted by the Refuge. Please contact the individual Refuges to
discuss any questions or concerns.
THERE ARE NO REFUGE LANDS OR FISH HATCHERIES WITHIN YOUR PROJECT AREA.

08/08/2022
Migratory Birds
Certain birds are protected under the Migratory Bird Treaty Act1 and the Bald and Golden Eagle
Protection Actz.
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 Treaty 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
Bald Eagle Haliaeetus leucocephalus
This is not a Bird of Conservation Concern (BCC) in this area, but warrants attention
because of the Eagle Act or for potential susceptibilities in offshore areas from certain types
of development or activities.
Prothonotary Warbler Protonotaria citrea
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA
and Alaska.
Rusty Blackbird Euphagus carolinus
This is a Bird of Conservation Concern (BCC) only in particular Bird Conservation Regions
(BCRs) in the continental USA
Breeds Sep 1 to
Jul 31
Breeds Apr 1 to
Jul 31
Breeds
elsewhere

08/08/2022 2
NAME
Wood Thrush Hylocichla mustelina
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA
and Alaska.
BREEDING
SEASON
Breeds May 10
to Aug 31
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 (■)
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 (I)
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.

08/08/2022 3
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.
SPECIES
Bald Eagle
Non -BCC
Vulnerable
Prothonotary
Warbler
BCC Rangewide
(CON)
Rusty Blackbird
BCC - BCR
Wood Thrush
BCC Rangewide
(CON)
• probability of presence breeding season I survey effort — no data
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
1111 H'�
-++ ; dill 1111 !!!! 1111 1111 1111 1111
+ —,-+ ++++ —+++
III■I
1111 1111
+ ---+ ++,+ —+++ -.--++ ---- ----
+ —�+ ++++ —+++ --11
1--
+--- ---- +,-- -+-- ----
+++ +--- ---- +_,_-- —I-- ----
Additional information can be found using the following links:
• Birds of Conservation Concern https://www.fws.gov/program/migratory-birds/species
• Measures for avoiding and minimizing impacts to birds https://www.fws.gov/library/
collections/avoiding-and-minimizing-incidental-take-migratory-birds
• Nationwide conservation measures for birds https://www.fws.gov/sites/default/files/
documents/nationwide-standard-conservation-measures.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.

08/08/2022 4
What does IPaC use to generate the list of migratory birds that potentially occur in my
specified location?
The Migratory Bird Resource List is comprised of USFWS Birds of Conservation Concern
(BCC) 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 Rapid Avian Information
Locator (RAIL) Tool.
What does IPaC use to generate the probability of presence graphs for the migratory birds
potentially occurring in my specified location?
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 or migrating in my 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 query your location using the RAIL Tool and look
at the range maps provided for birds in your area at the bottom of the profiles provided for each
bird in your results. 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

08/08/2022 5
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.
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 Loring.
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

08/08/2022 6
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.

08/08/2022
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.
FRESHWATER FORESTED/SHRUB WETLAND
• Palustrine
RIVERINE
• Riverine

08/08/2022 2
IPaC User Contact Information
Agency: Pilot Environmental, Inc
Name: David Brame
Address: 743 Park Lawn Court
City: Kernersville
State: NC
Zip: 27284
Email [e-mail]
Phone: [phone]

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EFH Mapper Report
EFH Data Notice
Essential Fish Habitat (EFH) is defined by textual descriptions contained in the fishery management plans developed by the
regional fishery management councils. In most cases mapping data can not fully represent the complexity of the habitats that make
up EFH. This report should be used for general interest queries only and should not be interpreted as a definitive evaluation of EFH
at this location. A location -specific evaluation of EFH for any official purposes must be performed by a regional expert. Please
refer to the following links for the appropriate regional resources.
Query Results
Degrees, Minutes, Seconds: Latitude = , Longitude =
Decimal Degrees: Latitude = , Longitude =
The query location intersects with spatial data representing EFH and/or HAPCs for the following species/management units.
EFH
No Essential Fish Habitats (EFH) were identified at the report location.
Salmon EFH
No Pacific Salmon Essential Fish Habitat (EFH) were identified at the report location.
HAPCs
No Habitat Areas of Particular Concern (HAPC) were identified at the report location.
EFH Areas Protected from Fishing
No EFH Areas Protected from Fishing (EFHA) were identified at the report location.

ROY COOPER.
Governor
ELIZABETH S. BISER
Secretory
MARC RECKTENWALD
Director
Daniel Barnes
Mocksville Development Partners, LLC
121 N. Crutchfield Street
Dobson, NC 27101
NORTH CAROLINA
Environmental Quality
August 10, 2022
Expiration of Acceptance: 2/10/2023
Project: Tri West Business Park County: Davie
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
(8-digit HUC)
Impact Type
Impact Quantity
Yadkin
03040101
Riparian Wetland
0.398
Yadkin
03040101
Warm Stream
275
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].
cc: David Brame, agent
41:0,E0-5A
Sincerely,
Atiirktlactvw0a
FOR James. B Stanfill
Deputy Director
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
919.70711976

WILDLANDS
HOLDINGS
Stream Credit Statement of Availability
August 10, 2022
THE CROWN COMPANIES, LLC
121 N. Crutchfield St., PO Box 341
Dobson, NC 27017
Attn: Mr. Daniel Barnes
RE: Availability of Stream Credits for the "Tri West Business Park" project
Bank Name: Yadkin Valley Umbrella Mitigation Bank
Bank Site: Dugger Creek Mitigation Site
Bank Sponsor: Wildlands Holdings IV, LLC
USACE Action ID No. SAW-2017-01918
Permittee: Mocksville Development Partners, LLC
Stream Credits Needed: 550.00 LF — Cool Stream
Stream Credits Available: 11,227.00 LF — Cold Stream
Yadkin 03040101 River Basin
Dear Mr. Barnes,
Wildlands Holdings IV, LLC currently has sufficient cold stream credits from the Yadkin Valley Umbrella
Mitigation Bank - Dugger Creek Mitigation Site to satisfy the mitigation requirements related to the
above -mentioned project. The project is located within the Yadkin (HUC 03040101) watershed.
This letter is simply a statement of availability of credits as of the date written. Although current
inventory is high, the letter is not a guarantee of availability as credits will be sold on a first come, first
serve basis. An invoice for this transaction will be sent upon your request and we will formally reserve
both the credits and price quoted for a period of 30 days from the invoice at no cost.
Final transfer of the credits will be made upon completion of the Mitigation Responsibility Transfer Form
within the 404-permit approving the mitigation purchase from the Bank and upon receipt of your
payment to Wildlands Holdings IV, LLC.
We appreciate the opportunity to assist you with your mitigation requirements. Please contact me at
[phone] x124 or [e-mail] if you have any questions or need any additional
information.
Wildlands Holdings IV, LLC • Wildlands Engineering, Inc • 1430 S. Mint Street, Suite 104, Charlotte, NC 28203

WILDLANDS
HOLDINGS
Sincerely,
Ashley N. Yarsinske
Wildlands Engineering, Inc.
Marketing & Credit Sales
[e-mail]
0: [phone] ext. 124
M: [phone]
Cc: Mr. David Brame, PWS I Pilot Environmental, Inc.
Wildlands Holdings IV, LLC • Wildlands Engineering, Inc • 1430 S. Mint Street, Suite 104, Charlotte, NC 28203

David Brame
From: 401 PreFile <401 [e-mail]>
Sent: Thursday, April 28, 2022 4:34 PM
To: Heather LaGamba
Subject: Automatic reply: [External] Pre -File Notice - Tri-West Business Park - US Highway 158
(5914.3)
This email confirms receipt of your pre -filing meeting request. Please retain this email for your records and
submit this documentation as part of your 401 application (PCN Application) as required by federal law. DWR
will not be able to accept your application without this federally required documentation. 401 applications
received without documentation that a pre -filing meeting request was submitted at least 30 days prior will be
returned as incomplete.
Responses to this email are not monitored.
Background
On April 6, 2022, the United States Supreme Court issued an order staying a lower court's vacatur of the
Trump Administration's 2020 "Clean Water Act Section 401 Certification Rule" ("Federal Rule"). As a result of
the United States Supreme Court order, the Trump Administration's Federal Rule has sprung back into effect.
The Trump Administration's Federal Rule imposes additional procedural requirements on applicants for 401
Certifications and on DWR's processing of those applications. One requirement is that 401 applicants must
request a pre -filing meeting request at least 30 days prior to submitting their 401 application. [40 C.F.R.
§121.4] In turn, the Federal Rule requires that applicants include documentation of their pre -filing meeting
request in their 401 Certification application. [40 C.F.R §121.1; 40 C.F.R. §121.5]. Please refer to the Federal
Rule for more information.
Per 40 CFR §121 and §121.5, a 401 Certification application that does not include the required pre -filing
meeting request documentation does not constitute a "certification request." As a result of the reinstatement
of the Trump Administration's Federal Rule, all 401 applications received after April 6, 2022 that do not have
documentation that a pre -filing meeting request was submitted at least 30 days prior to submittal of a 401
Certification application will be returned as incomplete.
If you need to contact 401/Buffer Permitting Staff, please use the following link(s) to access of staff contact
list(s).
For Non -Transportation Central Staff:
https://deq.nc.gov/about/divisions/water-resources/water-quality-permitting/401-buffer-permitting/401-
buffer-permitting-contacts
For Non -Transportation Regional
Staff: https://edocs.deq.nc.gov/WaterResources/DocView.aspx?dbid=0&id=2162034&cr=1
For all Transportation Projects Including NCDOT Projects:
https://deq.nc.gov/about/divisions/water-resources/water-resources-permits/transportation-
permitting/staff-contacts
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