20221260 Ver 1_ePCN Application_20220908

DWR
Division of Water Resources
Initial Review
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
April 13, 2022 Ver 4.3
Has this project met the requirements for acceptance in to the review process?*
Yes
No
Is this project a public transportation project?*
Yes No
Change only if needed.
Pre -Filing Meeting Date Request was submitted on:
6/1/2022
BIMS # Assigned* Version#*
20221260 1
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Select Project Reviewer*
Doug Perez:eads\djperez
Information for Initial Review
la. Name of project:
COURTESY COPY 1212 Union Road
la. Who is the Primary Contact?*
Sean Clark
Reviewing Office*
Mooresville Regional Office - [phone]
1 b. Primary Contact Email:* lc. Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
9/8/2022
Nearest Body of Water
Duck Creek
Basin
Yadkin-PeeDee
Water Classification
C
Site Coordinates
Latitude: Longitude:
35.1558 -80.6132
A. Processing Information
County (or Counties) where the project is located:
Union
Is this a NCDMS Project
Yes No
Is this project a public transportation project? *
Yes No

la. Type(s) of approval sought from the Corps:
Section 404 Permit (wetlands, streams and waters, Clean Water Act)
Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Has this PCN previously been submitted?*
Yes
No
1 b. What type(s) of permit(s) do you wish to seek authorization?
Nationwide Permit (NWP)
Regional General Permit (RGP)
Standard (IP)
lc. Has the NWP or GP number been verified by the Corps?
Yes No
Nationwide Permit (NWP) Number: 29 - Residential Developments
NWP Numbers (for multiple NWPS):
ld. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
1f. Is this an after -the -fact permit application?*
Yes No
lg. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
lg. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1 h. Is the project located in any of NC's twenty coastal counties?
Yes No
1j. Is the project located in a designated trout watershed?
Yes No
B. Applicant Information
ld. Who is applying for the permit?
Owner Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
Yes No
2. Owner Information
2a. Name(s) on recorded deed:
Alexander Melnichuk
2b. Deed book and page no.:
DB 8383/PG 696
2c. Contact Person:
2d. Address
Street Address
3633 Longpond Lane
Address Line 2
City
Monroe
Postal /Zip Code
28110
401 Water Quality Certification - Express
Riparian Buffer Authorization
State / Province / Region
NC
Country
USA
Yes No
Yes No

2e. Telephone Number:
[phone]
2f. Fax Number:
2g. Email Address: *
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Sean Clark
4b. Business Name:
Sage Ecological Services, Inc.
4c. Address
Street Address
3707 Swift Drive
Address Line 2
City State / Province / Region
Raleigh NC
Postal / Zip Code Country
27606 USA
4d. Telephone Number: 4e. Fax Number:
[phone]
4f. Email Address: *
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
lc. Nearest municipality / town:
Matthews
2. Project Identification
2a. Property Identification Number:
08321029
2c. Project Address
Street Address
1212 Union Road
Address Line 2
City
Matthews
Postal / Zip Code
28104
3. Surface Waters
3a. Name of the nearest body of water to proposed project: *
Duck Creek
3b. Water Resources Classification of nearest receiving water: *
C
3c. What river basin(s) is your project located in?*
Yadkin-PeeDee
3d. Please provide the 12-digit HUC in which the project is located.
030401050701
4. Project Description and History
2b. Property size:
10.6
State / Province / Region
NC
Country
USA
4a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application:*
The 10.6-acre Site consists of undeveloped, wooded land with moderate to thick understory vegetation. No structures were identified within the Site boundaries. The tree canopy is
dominated by hardwoods with small pockets of pines in the upland areas. The topography of the Site ranges from a low point of +/-630 feet above mean sea level (msl) along the southern
boundary where the drainage exits the Site, to a high point of +/-660 feet msl in the northwestern portion of the Site. The surrounding area is mostly undeveloped forest with scattered
residential areas.

4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past? *
Yes No Unknown
4f. List the total estimated acreage of all existing wetlands on the property:
0.26
4g. List the total estimated linear feet of all existing streams on the property:
535
4h. Explain the purpose of the proposed project:*
The purpose of the proposed project is to subdivide the single lot into three residences
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
The purpose of the project is to construct three (3) single family residences and a driveway to access the subdivided lots. One stream crossing is proposed to access usable upland
portions of the site. The remaining jurisdictional resources on the Site are avoided. Utilities for the proposed lots will connect to existing utility lines adjacent the Site. Individual septic will
be provided for each lot. Heavy equipment typically used for residential construction (e.g., backhoes, bulldozers, etc.) will be utilized.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made? *
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
SAW -2022-01523
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
6. Future Project Plans
6a. Is this a phased project?*
Sean Clark
Sage Ecological Services, Inc.
Yes No
Unknown
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activity?
No
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
Wetlands
Open Waters
3. Stream Impacts
Streams -tributaries
Pond Construction
Buffers
3a. Reason for impact (?)
3b.Impact type*
3c. Type of impact*
3d. S. name*
3e. Stream Type*
(?)
3f. Type of
Jurisdiction*
3g. S. width
3h. Impact
length*
St
Impact 1 Driveway
Permanent
Culvert
SA
Perennial
Both
15
Average (feet)
22
(linear feet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
22
3i. Total stream and ditch impacts:
22
3i. Total temporary stream impacts:
0
3j. Comments:
The driveway crossing has been narrowed to reduce the overall impact footprint. The temporary dewatering impacts will be conducted concurrently while
the culvert is installed.
6. Buffer Impacts (for DWR)

6a. Project is in which protect basin(s)?
Check all that apply.
Neuse
Catawba
Goose Creek
Other
Tar -Pamlico
Randleman
Jordan Lake
6b. Impact Type
6c. Per or Temp
6d. Stream name
6e. Buffer mitigation required?
6f. Zone 1 impact
6g. Zone 2 impact
Driveway Crossing
P
SA
No
1,258
1,509
6h. Total buffer impacts:
Total Temporary impacts:
Total Permanent impacts:
Total combined buffer impacts:
6i. Comments:
Zone 1
0.00
Zone 1
1,258.00
Zone 1
Zone 2
0.00
Zone 2
1,509.00
Zone 2
1,258.00 1,509.00
This project is in the Goose Creek watershed, therefore, 100-foot buffers apply. Per 15A NCAC 02B .0607 (i) (W) Table of Uses (Road, driveway or
railroad crossings), "impacts equal to or less than one -tenth of an acre of riparian buffer" are "deemed allowable". The proposed driveway crossing is
well below notification thresholds.
E. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
There are two wetlands and three streams on the Site. The proposed driveway crossing is the only proposed permanent impact. The driveway access
easement was narrowed from 25-feet to 20-feet within the buffer; the driveway crossing itself is only 12-feet wide within the buffer area and at the stream
crossing. All other jurisdictional features on the Site have been avoided. Construction fencing will be used to define the construction corridor and prevent
any accidental additional impacts. Silt fencing will be installed to provide additional protection from stormwater runoff.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
General techniques include the use of construction fencing to define the construction corridor and prevent any accidental additional impacts. Silt fencing
will also be used to prevent sediment runoff into stream and wetland areas.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for impacts to Waters of the U.S. or Waters of the State?
Yes No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Impacts are below mitigation thresholds.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
la. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
Yes No
What type of SCM are you providing?
Level Spreader
Vegetated Conveyance (lower SHWT)
Wetland Swale (higher SHWT)
Other SCM that removes minimum 30% nitrogen
Proposed project will not create concentrated stormwater flow through the buffer
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250? *
Yes No

2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?
Yes No
Comments:
The proposed project is to construct three residences on the Site. As the stream bisects the property, the proposed driveway crossing is necessary to access the useable upland portions
of the property. This project will not create discrete points of stormwater discharge and does not meet the criteria for a high -density project which would require stormwater management
devices.
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 No
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)?*
Yes No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
Yes No
3b. If you answered "no," provide a short narrative description.
Per the NC DWQ April 2004 Version 2.1 Cumulative Impacts policy, small scale residential development projects have a "low potential for cumulative
impact" since the project already in a developed landscape (i.e. existing residences and development in the vicinity) and the area already contains the
necessary infrastructure (i.e. water, electricity, etc.). The project drains to Duck Creek, which is Class C Waters, (i.e. not HQW or ORW). We anticipate
the NCDWR will advise us if a qualitative or quantitative analysis is needed.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
Yes No N/A
4b. Describe, in detail, the treatment methods and dispositions (non -discharge or discharge) of wastewater generated from the proposed project. If the wastewater will be treated at a
treatment plant, list the capacity available at that plant.
Each lot will have individual septic systems.
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?*
Yes No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
Yes No
5d. Is another Federal agency involved?*
Yes
5e. Is this a DOT project located within Division's 1-8?
Yes No
No Unknown
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 No
5h. Does this project involve the construction/installation of a wind turbine(s)?*
Yes No
5i. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
Yes No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
On June 17, 2022, we received correspondence from NC Natural Heritage Program (NCNHP). Based upon their review, no federally listed T&E species
are documented on the Site or within 1.0-mile of the Site.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
Yes No

6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
The proposed project is in Union County which is not near any coastal or tidal habitat which would support EFH (i.e., salt marshes, oyster reefs, etc.).
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal governments have designated as having historic or cultural preservation status?*
Yes No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
The Site is not listed as a historic property or within a historic district. No historic structures were found on the Site. Two historic properties are located
within 1-mile of the Site. Both properties are designated as "Surveyed Only (SO)." Figure 4 provides a graphical representation of these properties in
relation to the Site.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
Yes No
8c. What source(s) did you use to make the floodplain determination?*
FEMA online database; panel 3710551100L, effective on 02/19/2014
Miscellaneous
Please use the space below to attach all required documentation or any additional information you feel is helpful for application review. Documents should be combined into one file when
possible, with a Cover Letter, Table of Contents, and a Cover Sheet for each Section preferred.
Click the upload button or drag and drop files here to attach document
Union Road Project PCN Supplemental Information.pdf 7.4MB
File must be PDF or KMZ
Comments
Signature
By checking the box and signing below, I certify that:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete to the best of my knowledge and belief'; and
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401 certification request within the applicable reasonable period of time.
• I have given true, accurate, and complete information on this form;
I agree that submission of this PCN form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
I intend to electronically sign and submit the PCN form.
Full Name:
Nicole J. Thomson
Signature
Date
9/8/2022

ECOLOGICAL
SERVICES
EST., 2016
September 8, 2022
US Army Corps of Engineers
Asheville Regulatory Field Office
Attn: Mr. Steven Kichefski
151 Patton Ave., Rm. 208
Asheville, NC 28801
Re: 1212 Union Road
Request for NWP 29 Authorization
Sage Project #2021.141
NC Division of Water Resources
Mooresville Regional Office
Attn: Mr. Doug Perez
610 E. Center Ave., Ste. 301
Mooresville, NC 28115
On behalf of Alexander Melnichuk (applicant), please find attached a complete application and supplemental
information requesting written concurrence from the US Army Corps of Engineers (USACE) that the activities
associated with the proposed development of the 1212 Union Road Site (Project) may proceed under Nationwide
Permit (NWP) 29.
Project Purpose and Location
The Project purpose is to subdivide a single lot into three (3) single family residences. The +/-10.6-acre tract is
located at 1212 Union Road, Matthews, Union County. The coordinates of 35.1558°N, 80.6132°W generally
correspond to the center of the Site.
Project Detail
The proposed Project consists of the construction of a driveway access so that three (3) residences can be built
on the Site. Homes will be on individual septic systems and will tie into existing public water systems.
Access to the Site will be provided via Union Road to the south. Heavy equipment typically used for utility
installation projects (e.g., backhoes, bulldozers, etc.) will be utilized.
No federally threatened or endangered species are listed to occur on the Site according to the NC Natural
Heritage Program (NCNHP) Database. (see attached report dated June 17, 2022).
The Site itself is not listed as a historic property. There are two properties listed within 1.0 mile of the Site.
Project History
The 10.6-acre Site consists of undeveloped, wooded land with moderate to thick understory vegetation. No
structures were identified within the Site boundaries. The tree canopy is dominated by hardwoods with small
pockets of pines in the upland areas. The topography of the Site ranges from a low point of +/-630 feet above
mean sea level (msl) along the southern boundary where the drainage exits the Site, to a high point of +/-660
feet msl in the northwestern portion of the Site. The surrounding area is mostly undeveloped forest with scattered
residential areas. There are three (3) streams and two (2) riparian wetlands on the Site. Residential and
agricultural properties exist around the Site.
Avoidance and Minimization
This project has been designed to meet purpose and need while avoiding and minimizing impacts to onsite
natural resources to the greatest extent practicable. The proposed driveway crossing is the only proposed
permanent impact. The driveway access easement was narrowed from 25-feet to 20-feet within the buffer; the
driveway crossing itself is only 12-feet wide within the buffer area and at the stream crossing. All other
1212 Union Road Site Page 1 of 2

jurisdictional features on the Site have been avoided. Construction fencing will be used to define the construction
corridor and prevent any accidental additional impacts. Silt fencing will be installed to provide additional protection
from stormwater runoff.
Project Impacts
Impact 1 Culvert 1 is a proposed driveway crossing and will result in 22 linear feet of permanent stream impact.
Additionally, 2,767 square feet of permanent buffer impact are proposed as part of the driveway crossing.
Mitigation
Permanent stream impacts total 22 linear feet which are below compensatory mitigation thresholds. Per the
Goose Creek Watershed Buffer protection rules, 15A NCAC 02B .0607 (i)(W) Table of Uses, perpendicular
driveway crossings that impact less than 1/10 acre of riparian buffer are "deemed allowable," therefore, buffer
mitigation is not required.
If you have any questions, please call me at [phone].
Respectfully submitted:
Sage Ecological Services, Inc.
Attachments:
Pre -construction Notification (PCN) Application Form
Agent Authorization Form
Figure 1-USGS Site Vicinity Map
Figure 2-Soil Survey Site Vicinity Map
Figure 3 — Stream & Wetland Sketch Map
Figure 4 — NCSHPO Map
NCNHP Database Report
401 Prefiling Memo
USACE PJD Request email (SAW-2022-01523)
Impact Maps
ORM Upload Sheet
cole J.,Thomson, PWS
Sage Ecological Services, Inc.
1212 Union Road Site Page 2 of 2

Authentisign ID; 4963D8C1-ABBC-4CEA-0E4D-3D439BEBD33E
Name:
ECOLOGICAL
SERVICES
E ST.ill 201e
AGENT AUTHORIZATION FORM
All Blanks to Be Filled in By the Current Landowner or Legal Rcvresentativc
Alexander Melnichuk
Address:10.6 Acres Union RD Matthews NC 28104
Phone: [phone]
Email: valeriysoloCa?gmail.com
Project NamefDescriptionU n ion RD 10.6 Acres
Sage Project # 2021.141
Date:
The Department of the Anny
U.S. Army Corps of Engineers, Wilmington District
P.O. Box 1890
Wilmington, NC 28402
Attn:
Field Office:
Re: Wetlands and Streams Related Consulting and Permitting
To Whom It May Concern:
I, the undersigned, the owner or a duly authorized representative of record of the property/properties identified
herein, do authorize representatives of the U.S. Army Corps of Engineers (Corps) to enter upon the property herein
described for the purpose of conducting on -site investigations and issuing a determination associated with Waters
of the U.S. subject to Federal jurisdiction under Section 404 of the Clean Water Act and/or Section 10 of the Rivers
and Harbors Act of 1899. I also hereby designate and authorize Sage Ecological Services to act on my behalf as my
agent in the processing of permit applications, to furnish upon request supplemental information in support of
applications, etc. from this day forward.
This notification supersedes any previous correspondence concerning the agent for this project.
Notice: This authorization, for liability and professional courtesy reasons, is valid only for government
officials to enter the properly when accompanied by Sage staff. Please contact Sage to arrange a meeting
prior to visiting the site.
rAuthenti
BY: [ae&umdes Atetnichat
PriagNiiillY6PralTowner or
BY:
Signature of Landowner or
Legal Representative Legal Representative

IP
FXIS OR
Chf‘,
C,v
N
FAIR VIEw r,
buck ('reek
SA
Mi tch efts
Lake
C] Project Study Area
Map Location
USGS Topographic Map
Union Road Property
Sage Project # 2021.141
Midland, NC Quadrangle
2019 USGS Topography
October 13, 2021
0 1,000 2,000
Feet
Figure 1
Sage Ecological Services, Inc.
Office: 919-335-6757
Cell: 919-559-1537

Map Location
Ft A .---r
1 :111..;
NRCS Soil Survey Map
Union Road Property
Sage Project # 2021.141
Union County Soil Survey
Soil Sheet 5
October 13, 2021
0 650 1,300
Feet
—
LH
Project Study Area
Figure 2
ECOLOGICAL
SERVICES
Sage Ecological Services, Inc.
Office: 919-335-6757
Cell: 919-559-1537

Map
NCSHPO Data Updated Sep. 1, 2021.
House -
MK1203
r
Noljpti
� Yyoo
C o�n«Y
Project Study Area
1-Mile Project Buffer
NCSHPO Status
Surveyed Only
Alex IS Ur
T. Kissler
Harris House
- UN0154
tot,
1002hiieti'%''o-
A, ec'
446
I fyl es, Rd
4,10""1"°+I Creek 45
7,
7d
4.
Ca,
9`
�6
V
L1
Map Location
Cabarrus
Mecklenburg
Union
SOUTH
CA RO LI NA
Stanly
Anson
NCSHPO Map
Union Road Property
Sage Project # 2021.141
Map Prepared by: K. Hamlin
October 15, 2021
0 1,000 2,000
Feet
Figure 4
SAGE
ECOLOGICAL
SERVICES
t I.V
Sage Ecological Services, Inc.
Office: 919-335-6757
Cell: 919-559-1537

• ■■■
■■ • NC DEPARTMENT OF
■ ■•■E NATURAL AND CULTURAL RESOURCES
• ■■■
June 17, 2022
Kim Hamlin
Sage Ecological Services, Inc.
3707 Swift Drive
Raleigh, NC 27606
RE: Union Road Property; 2021.141
Dear Kim Hamlin:
Roy Cooper, Governor
D. Reid Wilson, Secretary
Misty Buchanan
Deputy Director, Natural Heritage Program
NCNHDE-18336
The North Carolina Natural Heritage Program (NCNHP) appreciates the opportunity to provide
information about natural heritage resources for the project referenced above.
A query of the NCNHP database, based on the project area mapped with your request, indicates
that there are no records for rare species, important natural communities, natural areas, and/or
conservation/managed areas within the proposed project boundary, or within a one -mile radius of
the project boundary.
Please note that although there may be no documentation of natural heritage elements within or
near the project boundary, it does not imply or confirm their absence; the area may not have been
surveyed. The results of this query should not be substituted for field surveys where suitable habitat
exists. In the event that rare species are found within the project area, please contact the NCNHP so
that we may update our records.
Please also note that natural heritage element data are maintained for the purposes of conservation
planning, project review, and scientific research, and are not intended for use as the primary criteria
for regulatory decisions. Information provided by the NCNHP database may not be published
without prior written notification to the NCNHP, and the NCNHP must be credited as an information
source in these publications. Maps of NCNHP data may also not be redistributed without
permission.
If you have questions regarding the information provided in this letter or need additional assistance,
please contact Rodney A. Butler at [e-mail] or 919.707.8603.
Sincerely,
NC Natural Heritage Program
DEPARTMENT OF NATURAL AND CULTURAL RESOVRCES
Q 121 W. JONES STREET. RALEIGH. NC 27603 • 16S1 MAIL SERVICE CENTER. RALEIGH. NC 27699
OFC 919.707.9120 • FAX [phone]

NCNHDE-18336: Union Road Property
0
o-
r
S
w
pa
c
a
Alexis Dr
Allen
9 R�
,,721 ft
o, Creek Dr
Perslre
/
qa
55
/ a
PLu55e\\ R
Ra
Emerald Lake
Golf
0
a
4,C
0.25 0.5 64oft 1 Miles
I I 1 i I I 1 i
-278,
0
L7
June 17, 2022
Buffered Project Boundary
❑ Project Boundary
Sources. Esri, Airbus DS. USGS. NGA. NASA, CGIAR. N Robinson. NCEAS.
NLS. OS, NMA. Geodatastyrelsen, Rijkswaterstaat GSA, Geoland FEMA,
Intermap and the GIS user community
Sources. Esri, HERE. Garmin. FAO. NOAA, USGS. © OpenStreetMap
contributors, and the GIS User Community
Page 2 of 2

From: Nikki Thomson
To: 401 PreFi le
Cc: Sean Clark
Subject: Union Road Property, Union County, Sage Project No. 2021.141
Date: Wednesday, June 1, 2022 11:17:00 PM
To whom this may concern:
This email serves to notify DWR of the intent of Sage Ecological to file a Permit Application for the
Union Road Property.
Thank you,
Nikki
Nicole Thomson, PWS
Sage Ecological Services, Inc.
[e-mail]
[phone]

From: Metcalf, Deborah G CIV USARMY CESAW (USA)
To: David Gainey; Roden Reynolds, Bryan K CIV USARMY CESAM (USA)
Cc: Nikki Thomson; Kim Hamlin
Subject: SAW-2022-01523 (Union Road property)
Date: Monday, July 11, 2022 2:19:06 PM
On July 6, 2022 we received your request for jurisdictional determination. We have assigned the
request the file number SAW-2022-01523 and forwarded it to Bryan Roden Reynolds for further
processing.
Sincerely,
Debbie Metcalf
From: David Gainey <[e-mail]>
Sent: Wednesday, July 6, 2022 4:57 PM
To: AshevilleNCREG <[e-mail]>
Cc: Nikki Thomson <[e-mail]>
Subject: [Non-DoD Source] Union County Project Preliminary Jurisdictional Determination Submittal
Please see the attached Preliminary Jurisdictional Determination submittal for The Union Road Site
located in Union County, NC. Please let me know if you need any additional information.
Thank, David Gainey
David Gainey
Sage Ecological Services, Inc.
Cell: 919.771.9136
DGainey©a SageEcological.com

WOOTEN SURVEYING & ASSOCIATES, PLLC
119 SMITH CIRCLE
MATTHEWS, NC 28104
TEL. [phone]
WWW.WOOTENSU RVEYING.COM
MAY 10, 2022: REVISED 6/24/22 20'AE
0
KENNETH ZIMMERMAN &
SHAWNTINA C SMITH
DEED 8176-2
TAX 08-309-001B
(UNION COUNTY)
RCP - REINFORCED CONCRETE PIPE
AE - ACCESS EASEMENT
100' BUFFER
PROPOSED
DRIVEWAY PIPE
(2) 20'X48" RCP
SEE INSET A
STREAM (BRANCH)
DAISY LEE WILLIAMS &
MARVIN WILLIAMS
DEED 819-560
TAX 08-321-033A
(UNION COUNTY)
PAUL JOHANNSSON &
SANDY RAMOS ESCAMILLA
DEED 36750-136
TAX 197-251-02
(MECKLENBURG COUNTY)
CARLOS E CONTRERAS
DEED 37133-973
TAX 197-251-04
(MECKLENBURG COUNTY)
TAX NO. 08-321-029
200
400
SCALE 1"=200'
OLGA WEISS GUIN
DEED 3060-910
TAX 08-309-001E
(UNION COUNTY)
' EXISTING
STREAM WETLANDS
(NOW OR FORMERLY)
TONY NIXON
DEED 126-339
TAX 08-321-027
(UNION COUNTY)
25' ACCESS EASEMENT
OVERALL IMPACT MAP
BLACK TREE HOLDINGS LLC PROPERTY
#1212 UNION ROAD
GOOSE CREEK TOWNSHIP, UNION COUNTY, NORTH CAROLINA
1212UNIONRD.DWG

8/31/22
BLACK TREE HOLDINGS LLC PROPERTY
#1212 UNION ROAD
GOOSE CREEK TOWNSHIP, UNION COUNTY, N.C.
WOOTEN SURVEYING & ASSOCIATES, PLLC
119 SMITH CIRCLE
MATTHEWS, NC 28104
TEL. [phone]
WWW.WOOTENSU RVEYING.COM
640
635
630
625
620
BUFFER IMPACT
1258 SQ.FT.
0.029 ACRES
TOTAL BUFFER IMPACT
2767 SQ.FT.
0.064 ACRES
C/L
0
100
0
OFFER
30
60
SCALE 1"=30'
INSET A
WETLANDS IMPACT MAP
22 LINEAR FEET IMPACT
ON WETLAND STREAM
6
_II
w
J
/
12' DRIVEWAY
i
STREAM
(X2)
20' OF 48"
RCP 0
1.20%
U
J
N
co
--to
to
Q
U
H
to
N
t0
II
Z
Z
ro
N
t0
II
1-
O
CC
W
>
Z
-0+20
-0+10
0+00 0+10
HORIZONTAL SCALE 1 "=10'
0+20
TOP OF BANK
(2X) 20' OF 48" RCP®1.20%
OUTER EDGE
PROPOSED DRIVE
BUFFER IMPACT
1509 SQ.FT.
0.035 ACRES
UFFi
LEGEND
RCP — REINFORCED CONCRETE PIPE
C/L — CENTER LINE
ESMT — EASEMENT
TAX NO. 08-321-029
1212UNIONRD.DWG

OMBIL Regulatory Module (ORM)
Project Upload Template
Version Date: 15-May-2022
The zip archive of upload template documents must first be downloaded and saved to
your local disk.
The template file(s) must then be extracted from the zip archive and also saved to your
local disk before using them.
If the template file is not first saved to your local disk, the data validation macros will
not function.
Please be aware: if older versions of Microsoft Office or Excel are utilized with this template, the user
may experience issues with the functionality and features of this template.
Reminder: when using copy/paste to transfer data from one template to another, you must not use the
regular paste functionality. This will cause formatting issues. Instead, use the "paste values"
functionality.
Change Log
15-May-2022 Current Version
• Took off Red warning fill on waters_name column on Impacts worksheet
• Added yellow fill warning to Name column on Impacts worksheet
25-Feb-22
• Added NWP 29 as a selectable NWP_ID
• Bypassed all 3rd Party Mitigation checks when Closure_Method = "Denied without Prejudice"
30-Jan-22
• At least one Mitigation-Permittee Responsible must exist when any PermitSheet.Mitigation_Permittee_Responsib = "All"
• At least one Mit-PermitteeResp row AND at least one MB_ILF row must exist WHEN a PermitSheet.Mitigation_Permittee_Responsib = "Some"
• At least one MitBank/ILF row must exist WHEN a PermitSheet.Compensatory_Mitigation_Regd = "YES"AND PermitSheet.Mitigation_Permittee_Responsib = "None"
• Mit-PermitteeResp.Waters_Name must NOT exist WHEN a PermitSheet.Compensatory_Mitigation_Regd = "YES" AND PermitSheet.Mitigation_Permittee_Responsib = "None"
• MitBank/ILF row must NOT exist when a PermitSheet.Compensatory_Mitigation_Regd = "YES" AND PermitSheet.Mitigation_Permittee_Responsib = "All"
• MitigationSheet.Waters_Name must NOT exist when a PermitSheet.Compensatory_Mitigation_Regd = "NO"
• When PermitSheet.Compensatory_Mitigation_Regd = "NO", PermitSheet.Mitigation_Permittee_Responsib MUST be "None"
• Removed "Not verified by the Corps - 401 process only" from Closure Method list
24-Nov-21
• Workbook contains digitally signed data validation macros
17-Oct-21
• Ensure that the value in the Worksheet column on the Validation worksheet displays "Request Details" instead of "RGP_PGP" when Impact and Mitigation data exists but there is no Permit data.
• Makes waters_name column header on the Rapanos_JD worksheet green.
• Change tooltip text on Waters_name on Rapanos_JD worksheet.
• Throw message, "Finalize Not Specified for RGP_PGP sheet," if Finalize <> YES.
• Do not throw message, "info required to finalize," if end_date is blank on the RGP_PGP worksheet.
• If Load = YES and Finalize <> YES on Request Details don't throw this message: "Finalize Not Specified for AgResources sheet."
• Throw message if Load = YES but no data exists on corresponding worksheet.
• Only compare waters_nam es between (among) worksheets if Load = YES for both of them.
• If Load = YES but Finalize = NO (or is null), then throw user-friendly warning message asking user if they need to finalize or not.
• If Finalize = NO (or is null), then there is no need to verify that finalize fields are populated (function VerifyFinalizeFieldsPopulated) or throw a validation message.
• Remove "Date Permit Expires" from RGP_PGP worksheet and any references to it in the VBA code.
• Throw message reminding user to validate if they make a change(s).
• Change (correct) closure method value in dropdown on Rapanos_JD worksheet.
• Remove Critical_Habitat_Impacted from NWP and RGP_PGP worksheets and references to it in VBA code.
• Fix logic that prompts user to enter in an action id.
12-Mar-21
• When Closure_Method is "Not verified by the Corps - 401 process only", bypass validating:
Compensatory Mitigation Required
Impact must exist
Mitigation Must Exist
Issued By (only for RGP_PGP)
Worktype_1
Date Permit Expires (only for RGP_PGP)
Mitigation Permittee Responsible
WRDA 214 Funded Corps
C D_Date_App_Fi rst_Received
C D_Rcpt_Fed_Com pl ete_Ap p
CD_Determ ined_Com plete_by_PM
Permit Name Number (for RGP_PGP)
NWP_ID (only for NWP)
Evaluation Checklist
All columns beginning with "EVALCKLST_"
• When Closure_Method is "Denied Without Prejudice", bypass validating:
Impact must exist
Mitigation Must Exist
Issued By (only for RGP_PGP)
Worktype_1

Date Permit Expires (only for RGP_PGP)
Mitigation Permittee Responsible
• Removed "Oil_Gas_Ind" column (from NWP)
November 9, 2020
• Rapanos_JD Worksheet - Added two new JD Closure Methods to the Closure_Method list of values
• NWP, RGP_PGP Worksheets - Removed "Provisional Verification" Closure Method from the list of values
23-Dec-2019 Version
• Removed TNWRPW from the Waters_Type list on the Ref_Help worksheet
28-Apr-2019 Version
• NWP and RGP_PGP Worksheets - Added validation: Begin_Date must be before CD_Rcpt_Fed_Complete_App, CD_Rcpt_Fed_Complete_App must be before End_Date
• AgResources Worksheet - If Aquatic Resources shapefle specified, Latitude / Longitude not required
• Request Details Worksheet - Added validation: If Impacts or Mit-PermitteResp and MitBank_IF Worksheets contain data, NWP data or RGP_PGP data or a Permit Action ID must be provided
• Request Details Worksheet - Added validation: a DA# must be provided
10-Dec-2018 Version
• NWP and RGP_PGP Worksheets - Replaced EVALCKLST_Historic_Properties column with EVALCKLST_S106_NHPA
• VBA Code - Added validation of new EVALCKLST_S106_NHPA list selections
• Finalize Worksheet - Replaced tab with new 'Request Details'. Made requisite VBA code changes to enforce entry of Load and Finalize columns
• Mitigation Worksheet - Added validation to ensure that the Proposed and Required amounts are entered.
19-Sep-2018 Current Version
• VBA Code - Corrected Validation VBA code throwing "Object variable or With block variable not set"
• AgResources worksheet - Removed Waters Type 'TNWRPW' from the Waters_Type dropdown menu.
22-May-18
• NWP worksheet - Added 'CD_Date_App_First_Received'
• PGP/RGP worksheet - Added' CD_Date_App_First_Received'
11-Jan-2018 Version
• NWP worksheet - Updated Closure_Method column values
• RGP_PGP worksheet - Updated Closure_Method column values and removed cascading dependency upon the Permit Type column
• Format worksheet - Consolidated the Closure_Method_NWP, Closure_Method_RGP, and Closure_Method_PGP columns into a single Closure_Method_GP column and updated the list of values
• Format worksheet - Updated the Closure_Method_JD column values
• VBA- Updated VerifyValues calls in ValidateNWP() and ValidateRGP_PGP(( to reference the new Closure_Method_GP list of values
30-OCT-2017 Version
• Mitigation worksheet -Added check to allow "0"s in Proposed_Amount and Required_Amount
20-APR-2017 Version
• AgResources worksheet - Limited list of Cowardin Code options to second and third tiers only
• Impacts worksheet - Added Length and Width columns for Initially Proposed, Proposed and Authorized
• Impacts worksheet - Removed Linear columns
• Impacts worksheet - Changed "Area" labels to "Amount"
• Impacts worksheet - Updated Amount_Type to include Fill Volume and Removal Volume
• Impacts worksheet - Updated Amount_Units to include Cubic Yards (volume)
• Impacts worksheet - Added check to ensure Amount_Units is specified if Amount is provided
• Impacts worksheet - Added check to ensure either Length/Width are provided OR Amount is provided but not both
• Impacts worksheet - Added check to ensure that if Length is provided, Width must also be provided (and vice versa)
• Impacts worksheet - Added check to ensure that if Amount_Type is Volume, then Amount must be entered, not Length and Width
• Impacts worksheet - Added check to ensure that if a value is provided for any Stage (IP/P/A), then a value must be provided for all Stages
• Mit-PermitteeResp worksheet - Added Length and Width columns for Proposed and Required
• Mit-PermitteeResp worksheet - Removed linear columns
• Mit-PermitteeResp worksheet - Changed "Area" labels to "Amount"
• Mit-PermitteeResp worksheet - Added check to ensure Amount_Units is specifed if Amount is provided
• Mit-PermitteeResp worksheet - Added check to ensure either Length/Width are provided OR Amount is provided but not both
• Mit-PermitteeResp worksheet - Added check to ensure that if Length is provided, Width must also be provided (and vice versa)
• Mit-PermitteeResp worksheet - Added check to ensure that if a value is provided for either Proposed or Required, then a value must be provided for both Stages
• NWP worksheet - Updated NWP_ID list and associated Permit_Authority list with the 2017 data
• NWP worksheet - Moved the Permit_Authority column to the left of the NWP_ID column
• NWP worksheet - The NWP_ID values displayed are now dependent upon the selected Permit_Authority value
02-JUN-2016 Version
• Mit-PermitteeResp worksheet - waters that exist on the Mit-PermitteeResp worksheet must also appear on either the NWP worksheet or on the PGP/RGP worksheet
• MitBank_ILF worksheet - waters that exist on the MitBank_ILF worksheet must also appear on either the NWP worksheet or on the PGP/RGP worksheet
• added a validation to check for garbage characters in the Waters Name column values of all worksheets
21-APR-2016 Version
• removed 100K blank rows of data from the Aquatic Resources worksheet of the Consolidated Rapanos template, reducing its size from 9M to 180K.
31-MAR-2016 Version
• added a Version worksheet
• General - removed the dropdowns from the header cells on all user input worksheets
• General - standardized user functionality across all user input worksheets
• AgResources worksheet - changed the format of columns I (Latitude) and J (Longitude) to be decimal formatted numers with 8 significant digits of precision
• AgResources worksheet - added a Validation check to ensure Amount > zero
• AgResources worksheet - add validation check requiring Water Type of Upland (Rapanos)/Dry Land (CWR) when Cowardin Code = U
• NWP worksheet - the Validation process will now verify whether Mitigations are present in the Mit-PermitteeResp or MitBank_ILF worksheets if cells in column S (Compensatory_Mitigation_Regd) of the NWP worksheet are
set to a value of YES
• RGP_PGP worksheet - the Validation process will now verify whether Mitigations are present in the Mit-PermitteeResp or MitBank_ILF worksheets if cells in columns U (Compensatory_Mitigation_Regd) of the RGP_PGP
worksheet are set to a value of YES

PROJECT UPLOAD REQUEST DETAILS
DA #
So that the ORM team may accurately understand the requirements for this project upload, please provide the details of how the included data is to be loaded.
Specify clearly which data needs to be uploaded to ORM, and which is to be finalized. Provide Required Additional Information as described in the explanation below.
Load
Finalize
Required Additional Information
Aquatic Resources
Loaded at District?
Impacts
Permit Action ID?
Mitigation-Permittee Responsible
Permit Action ID?
Mitigation Bank/ ILF
Permit Action ID?
NWP
JD ID? Reasons for Delay?
Rapanos_JD
RGP / PGP
JD ID? Reasons for Delay?
Required Additional Information explanation:
Loaded at District? For ARs, please indicate whether the data has been already loaded by the District Administrators.
Permit Action ID? When Impact and/or Mitigation are provided, but not loading a Permit, you must provide the ACTION ID of one unfinalized Permit to which the data is to be tied.
JD ID? For NVVP or RGP/PGP: if the permit is to be tied to a JD, but the JD information is not included for upload, please provide the ID of the JD to which the uploaded permits should be
associated.
(The id can be viewed by hovering over the specific JD in the JD lists.) Also consider including the Begin and End dates for the JD.
Reasons For Delay? For NVVP or RGP/PGP, if the Permit End Date is more than 60 days past the Date Received, then please specifiy the Delay Reason information. (Multiple Delay Reasons may
be provided.)
SHAPEFILE UPLOAD REQUEST DETAILS **
Specify the Filenames that contain geometry data for the ARs and/or Project Location to be loaded into ORM.
Filename(s)
Notes
Aquatic Resources
Project Boundary
* The zip archive of upload template documents must first be downloaded and saved to your local disk.
The template file(s) must then be extracted from the zip archive and also saved to your local disk before using them.
If the template file is not first saved to your local disk, the data validation macros will not function.
** Please be aware that the .shp, .shx, .dbf, and .prj files at a minimum must be received in order to be a complete submission.
For Aquatic Resources, ORM must receive both an AR worksheet and a shapefile in the submission.
- In the Shapefile, each geometry must include an attribute for WatersName and each WatersName MUST be unique within and across all files.
- Furthermore, there must be a one to one relationship between the WaterName in the AR Worksheet and the WatersName in the Shapefile.
- When uploading Aquatic Resources via shapefile, the Latitude / Longitude in the AciResources worksheet is not required.
For Project Boundary, the submitted file must contain only one Geometry.

Stream SA NORTH CAROLINA R2
Stream SB NORTH CAROLINA R4
Stream SAB NORTH CAROLINA R4
Wetland WA NORTH CAROLINA PFO
Wetland WB NORTH CAROLINA PFO
RIVERINE Linear 289 FOOT RPW 35.15550000 -80.61310000 Duck Creek
RIVERINE Linear 250 FOOT RPW 35.15580000 -80.61300000 Duck Creek
RIVERINE Linear 22 FOOT RPW 35.15550000 -80.61290000 Duck Creek
RIVERINE Area 0.15 ACRE RPWWD 35.15570000 -80.61310000 Duck Creek
RIVERINE Area 0.13 ACRE RPWWD 35.15570000 -80.61280000 Duck Creek

'Z'ITA"fgrld-1 "t:ed— 11=1 'e.ts
ITV Acres 22 15 0 008
Notes