20150551 Ver 1_401 Application_20150615

Planning
Mr William Elliott
U S Army Corps of Engineers
Asheville Regulatory Field Office
151 Patton Avenue, Room 208
Asheville, NC 28801
Mr Alan Johnson
NCDENR
Division of Water Resources
610 East Center Street, Suite 301
Mooresville, NC 28115
Ms Karen Higgins
NCDENR
Division of Water Resources
Wetlands & Storm Water Branch
512 North Salisbury Street
Raleigh, NC 27604
June 2, 2015
Dear Ms Higgins and Mr Messrs Elliott and Johnson,
Leonard S Rmdner, PLLC
20154551
Enclosed is a request for Nationwide Permit #29 associated with the proposed development of a
residential retirement community known as Adelaide Estates Proposed permanent impacts
associated with the project total 119 linear feet of stream channel for the installation of a culvert
for a road crossing to access the development A proposed sanitary sewer line will be installed
through directional bore methods under a stream channel therefore no additional impacts are
expected The storm water plan for the site has already been approved and the approval letter is
enclosed
The site plan was designed to avoid jurisdictional features to the maximum extent practicable
while still providing a viable access and development of the site Due to the location /extent of
jurisdictional features on the site, complete avoidance was not practicable All impacts for the
project are associated with the installation of culvert to access upland areas of the site No
mitigation is proposed due to the minor amount of stream channel being proposed and the
avoidance of the remainder of stream /wetland features on the site
We appreciate the opportunity to provide this information and please contact us if you have any
questions
Sincerely,
Charlotte Office www wetlands -epg com Asheville Office
10612 -D Providence Rd 1070 Tunnel Rd, Bldg I
PMB 550 Suite 10, PMB 283
Charlotte NC 28277 Asheville, NC 28805
(704) 904 -2277 (828) 708 -7059
ten rindner @wetlands -epg com 1 amanda tones g wetlands -epg com

Wetlands and
Amanda Jones, PWS
Regulatory Specialist
Leonard 5 Rindner, PLLC
Heath Caldwell, PWS
I
rnc""rw
Environmental Scientist
Charlotte Office www wetlands -epg com Asheville Office
10612 -D Providence Rd 1070 Tunnel Rd , Bldg I
PMB 550 Suite 10, PMB 283
Charlotte, NC 28277 Asheville, NC 28805
(704) 904 -2277 (828) 708 -7059
len rindner @wetlands -epg com 2 amanda cones @wetlands -epg com

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Permit Application

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Office Use Only
Corps action ID no
DWQ project no
Form Version 1 4 January 2009
Page 1 of 10
PCN Form — Version 1 4 January 2009
Pre - Construction Notification (PCN) Form
A
Applicant Information
1
Processing
1a
Type(s) of approval sought from the Corps
❑X Section 404 Permit
❑ Section 10 Permit
1 b Specify Nationwide Permit (NWP) number 29 or General Permit (GP) number
1c
Has the NWP or GP number been verified by the Corps?
❑ Yes ❑X No
1d
Type(s) of approval sought from the DWQ (check all that apply)
❑X 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
le
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ
401 Certification
❑X Yes ❑ No
For the record only for Corps Permit
❑ Yes NX No
1f
Is payment into a mitigation bank or in -lieu fee program proposed for
mitigation of impacts? If so, attach the acceptance letter from mitigation bank
or in -lieu fee program
❑ Yes ❑X No
1g
Is the project located in any of NC's twenty coastal counties If yes, answer 1h
below
❑ Yes ❑X No
1h
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes ❑X No
2
Project Information
2a
Name of project
Adelaide Estates
2b
County
Union County
2c
Nearest municipality / town
Wesley Chapel
2d
Subdivision name
2e
NCDOT only, T I P or state project no
3
Owner Information
10) 19 VV7
3a
Name(s) on Recorded Deed
Mike Kissel
3b
Deed Book and Page No
JUN
3c
Responsible Party (for LLC if
applicable)
Bonterra Builders, LLC
DENR .
3d
Street address
5615 Potter Road
8 BUFFER PE CES
3e
City, state, zip
Matthews, NC 28104
3f
Telephone no
980- 333 -1038
3g
Fax no
3h
Email address
I mkissel @bonterrabuilders com
Page 1 of 10
PCN Form — Version 1 4 January 2009

4
Applicant Information (if different from owner)
4a
Applicant is
❑ Agent ❑ Other, specify
4b
Name
4c
Business name
(if applicable)
4d
Street address
4e
City, state, zip
4f
Telephone no
4g
Fax no
4h
Email address
5
Agent/Consultant Information (if applicable)
5a
Name
Len Rindner
5b
Business name
(if applicable)
Leonard S Rindner, PLLC, Wetlands & Environmental Planning Group (WEPG)
5c
Street address
10612 -D Providence Road, PMB 550
5d
City, state, zip
Charlotte, NC 28277
5e
Telephone no
704 904 2277
5f
Fax no
5g
Email address
len nndner @wetlands -epg corn
Page 2 of 10

B
Project Information and Prior Project History
1
Property Identification
1a
Property identification no (tax PIN or parcel ID)
06006010
1 b
Site coordinates (in decimal degrees)
Latitude 34 9943 Longitude -80 6618
1c
Property size
6775 acres
2
Surface Waters
2a
Name of nearest body of water to proposed project
East Fork Twelvemile Creek
2b
Water Quality Classification of nearest receiving water
C
2c
River basin
Catawba
3
Project Description
3a Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application
The site is currently undeveloped and predominately wooded General land use in the vicinity consists of residential and commercial developments
3b
List the total estimated acreage of all existing wetlands on the property 0 428
3c
List the total estimated linear feet of all existing streams (intermittent and perennial) on the property 2,869
3d Explain the purpose of the proposed project
The purpose of the protect is for development of residential structures and access
3e Describe the overall project in detail, including the type of equipment to be used
Grading and installation of a 48" RCP culvert will impact approximately 119' of sRPW C which will be captured for construction of an access road The l:
4
Jurisdictional Determinations
4a
Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
❑ Yes X❑ No ❑ Unknown
Comments
4b
If the Corps made the jurisdictional determination, what type
of determination was made?
❑ Preliminary ❑ Final
4c
If yes, who delineated the jurisdictional areas?
Name (if known)
Agency /Consultant Company
Other
4d If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
A site visit was conducted by Mr William Elliott on 2/4/2014
5
Project History
5a
Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
El Yes ❑X No ❑ Unknown
5b
If yes, explain in detail according to "help file" instructions
6
Future Project Plans
6a
Is this a phased project?
❑ Yes ❑X No
6b
If yes, explain
Page 3 of 10
PCN Form — Version 1 4 January 2009

C. Proposed Impacts Inventory
1 Impacts Summary
la Which sections were completed below for your project (check all that apply)
❑ Wetlands X❑ Streams — tributaries ❑ Buffers ❑ Open Waters ❑ Pond Construction
2 Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted
2a
Wetland impact
number
Permanent (P) or
Temporary T
2b
Type of impact
2c
Type of wetland
2d
Forested
2e
Type of jurisdiction
Corps (404,10) or
DWQ (401, other)
2f
Area of
impact
(acres)
W1
Choose one
Choose one
Yes /No
-
W2
Choose one
Choose one
Yes /No
W3
Choose one
Choose one
Yes /No
W4
Choose one
Choose one
Yes /No
W5
Choose one
Choose one
Yes /No
W6
Choose one
Choose one
Yes /No
2g Total Wetland Impacts
2h Comments
3 Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted
3a
Stream impact
number
Permanent (P) or
Temporary (T)
3b
Type of impact
3c
Stream name
3d
Perennial (PER) or
intermittent (INT)?
3e
Type of
jurisdiction
3f
Average
stream
width
(feet)
3g
Impact
length
(linear
feet)
S1 P
Culvert
sRPW C
INT
Corps
4
119
S2
Choose one
S3
Choose one
S4
Choose one
S5
Choose one
S6
Choose one
3h Total stream and tributary impacts
119
31 Comments
Page 4 of 10
PCN Form —Version 1 4 January 2009

4 Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U S then indiv ually list all open water impacts below
4a
Open water
impact number
Permanent (P) or
Temporary T
4b
Name of waterbody
(if applicable)
4c
Type of impact
4d
Waterbody
type
4e
Area of impact (acres)
01
Choose one
Choose
O2
Choose one
Choose
03
Choose one
Choose
04
Choose one
Choose
4f Total open water impacts
4g Comments
5 Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below
5a
Pond ID number
5b
Proposed use or
purpose of pond
5c
Wetland Impacts (acres)
5d
Stream Impacts (feet)
5e
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
P2
Choose one
5f Total
5g Comments
5h Is a dam high hazard permit required
❑ Yes ❑ No If yes, permit ID no
51 Expected pond surface area (acres)
5j Size of pond watershed (acres)
5k Method of construction
6 Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below If yes, then individually list all buffer impacts
below If any impacts require mitigation, then you MUST fill out Section D of this form
6a Project is in which protected basin?
❑ Neuse ❑ Tar - Pamlico ❑ Catawba ❑ Randleman ❑ Other
6b
Buffer Impact
number —
Permanent (P) or
Temporary T
6c
Reason for impact
6d
Stream name
6e
Buffer
mitigation
required?
6f
Zone 1
impact
(square
feet )
6g
Zone 2
impact
(square
feet
B1
Yes /No
B2
Yes /No
B3
Yes /No
B4
Yes /No
B5
Yes /No
B6
Yes /No
6h Total Buffer Impacts
61 Comments
Page 5 of 10

D Impact Justification and Mitigation
1 Avoidance and Minimization
1a Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
The protect area is approximately 68 acres in size in which a portion is bisected by streams /wetlands therefore a road crossing is needed to access
uplands within the eastern portion of the site Total impacts proposed are to 1191f of stream The site contains over 2700 linear feet of stream channel
and 0 428 acres of wetlands which are being avoided No impacts will occur from lot fill or sewer lines which will be directional bored to avoid
additional impacts to streams
1 b Specifically describe measures taken to avoid or minimize the proposed Impacts through construction techniques
The culvert length and fill within the stream have been designed /sized to safely accommodate anticipated residential traffic but minimize the area of
impact to existing surface waters
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 X❑ No
2b If yes, mitigation is required by (check all that apply)
❑ DWQ ❑ Corps
2c If yes, which mitigation option will be used for this
project?
❑ Mitigation bank
❑ Payment to In -lieu fee program
❑ Permittee Responsible Mitigation
3 Complete if Using a Mitigation Bank
3a Name of Mitigation Bank
3b Credits Purchased (attach receipt and letter)
Type Choose one
Type Choose one
Type Choose one
Quantity
Quantity
Quantity
3c Comments
4 Complete if Making a Payment to In -lieu Fee Program
4a Approval letter from In -lieu fee program Is attached
❑ Yes
4b Stream mitigation requested
linear feet
4c If using stream mitigation, stream temperature
Choose one
4d Buffer mitigation requested (DWQ only)
square feet
4e Riparian wetland mitigation requested
acres
4f Non - riparian wetland mitigation requested
acres
4g Coastal (tidal) wetland mitigation requested
acres
4h Comments
5 Complete if Using a Permittee Responsible Mitigation Plan
5a If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan
Page 6 of 10
PCN Form —Version 1 4 January 2009

6 Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation?
El Yes X No
6b If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation Calculate the
amount of mitigation required
Zone
6c
Reason for impact
6d
Total impact
(square feet)
Multiplier
6e
Required mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1 5
6f Total buffer mitigation required
6g If buffer mitigation is required, discuss what type of mitigation is proposed (e g , payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund)
6h Comments
Page 7 of 10

E
Stormwater Management and Diffuse Flow Plan (required by DWQ)
1
Diffuse Flow Plan
1a
Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ❑X No
within one of the NC Riparian Buffer Protection Rules?
1 b
If yes, then Is a diffuse flow plan Included? If no, explain why
❑ Yes ❑ No
2
Stormwater Management Plan
2a
What Is the overall percent Imperviousness of this project?
24%
2b
Does this project require a Stormwater Management Plan?
❑X Yes ❑ No
2c
If this project DOES NOT require a Stormwater Management Plan, explain why
2d
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative
description of the plan
In order to meet the requirements of the local ordinance, one (1) dry detention basin is being proposed for
the site and is designed to attenuate
the
2yr and 10yr storms The proposed dry detention basins will be used as sediment control basins for the road and infrastructure improvements
during the erosion control phases Additionally, please see the attached preliminary stormwater management plan and the attached Stormwater Permit
No
SW33140801
2e
Who will be responsible for the review of the Stormwater Management Plan?
Union County
3
Certified Local Government Stormwater Review
3a
In which local government's jurisdiction Is this project?
Union County
0 Phase II
❑ NSW
3b
Which of the following locally - Implemented stormwater management programs
❑ USMP
apply (check all that apply)
❑ Water Supply Watershed
❑ Other
3c
Has the approved Stormwater Management Plan with proof of approval been
El Yes ❑X No
attached?
4
DWQ Stormwater Program Review
❑Coastal counties
❑HQW
4a
Which of the following state - Implemented stormwater management programs apply
❑ORW
(check all that apply)
❑Session Law 2006 -246
❑Other
4b
Has the approved Stormwater Management Plan with proof of approval been
❑X Yes ❑ No
attached?
5
DWQ 401 Unit Stormwater Review
5a
Does the Stormwater Management Plan meet the appropriate requirements?
❑X Yes ❑ No
5b
Have all of the 401 Unit submittal requirements been met?
❑X Yes ❑ No
Page 8 of 10
PCN Form —Version 1 4 January 2009

F
Supplementary Information
1
Environmental Documentation (DWQ Requirement)
la
Does the project involve an expenditure of public (federal /state /local) funds or the
❑ Yes
❑X No
use of public (federal /state) land?
lb
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
El Yes
❑ No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c
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
❑ Yes
❑ No
letter )
Comments
2
Violations (DWQ Requirement)
2a
Is the site in violation of DWQ Wetland Rules (15A NCAC 2H 0500), Isolated
Wetland Rules (15A NCAC 2H 1300), DWQ Surface Water or Wetland Standards,
❑Yes
❑X No
or Riparian Buffer Rules (15A NCAC 2B 0200)?
2b
Is this an after - the -fact permit application?
El Yes
❑X No
2c
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s)
3
Cumulative Impacts (DWQ Requirement)
3a
Will this project (based on past and reasonably anticipated future impacts) result in
❑Yes
❑X No
additional development, which could impact nearby downstream water quality?
3b
If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy If you answered "no," provide a short narrative description
No
cumulative effects are anticipated from the protect There are no additional properties to be developed that are associated with
this protect so all
the
impacts have been accounted for
4
Sewage Disposal (DWQ Requirement)
4a
Clearly detail the ultimate treatment methods and disposition (non - discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility
Wastewater
generated on the site will be transported to the nearest treatment facility via installation of sewer lines
Page 9 of 10
PCN Form — Version 1 4 January 2009

5 Endangered Species and Designated Critical Habitat (Corps Requirement)
5a Will this project occur In or near an area with federally protected species or
❑ Yes ❑X No
habitat?
5b Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ❑X No
Impacts?
5c If yes, Indicate the USFWS Field Office you have contacted
-
5d What data sources did you use to determine whether your site would Impact Endangered Species or Designated Critical
Habitat?
Professional knowledge of threatened /endangered resources in the area No habitat for potential species exists on site
6 Essential Fish Habitat (Corps Requirement)
6a WIII this project occur In or near an area designated as essential fish habitat?
❑ Yes ❑X No
6b What data sources did you use to determine whether your site would Impact Essential Fish Habitat?
No Essential Fish Habitat in this region
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
❑ Yes ❑X No
status (e g , National Historic Trust designation or properties significant In
North Carolina history and archaeology)?
7b What data sources did you use to determine whether your site would Impact historic or archeological resources?
http / /gis ncdcr gov /hpoweb/
8 Flood Zone Designation (Corps Requirement)
8a WIII this project occur In a FEMA - designated 100 -year floodplain?
❑ Yes ❑X No
8b If yes, explain how project meets FEMA requirements
8c What source(s) did you use to make the floodplain determination?
Information provided by Engineer and union county floodplain mapping system
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a—Appp�licMtlAgent's
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Applicant /Agent's Printed Name
Date
Signature
(Agent's signature is valid only if an authorization
letter from the applicant is provided
Page 10 of 10

LEONARD S. RINDNER PWS
Environmental Planning Consultant _ 3714 Spokeshave Lane
Professional Wetland Scientist Matthews, NC 28105
Land Planning (704) 904 -2277
Ap-ent Authorization Letter
The purpose of this form is to authorize our firm to act on your behalf in matters related to
aquatic resource (i a stream/wetlands) identification /mapping and regulatory permitting The
undersigned, who are either registered property owners or legally under authonzed to conduct
due diligence activities on the property as identified below, do hereby authorize associates of
Leonard S. Rindner, PLLC, Wetlands and Environmental Planning Group (WEPG) to act
on my behalf and take all actions necessary for the processing, issuance, and acceptance of
applicable permit(s) and/or certification(s)
Project/Site Name
Property Address South Potter Road
Parcel identification Number (PIN) 06006010
Select one I am an Interested Buyer with Contract to Purchase
Name: Mike Kissel
Company: Bonterra Builders
Mailing Address: 5615 Potter Road, Matthews, NC 28104
Telephone Number: 980- 333 -1038
Electronic Mail Address: mkissel @bonterrabuilders com
* The Interested Buyer /Other acknowledges that an agreement and /or formal contract to
purchase and /or conduct due diligence activities exists between the current property owner and
the signatory of this authorization to cases where the property is not owned by the signatory

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WitiENR
North Carolina Department of Environment and Natural Resources area III
John E. Skv
Pat McCrory Secretary
Governor August 14, 2014
Mr Darren Sutton, Manager
Bonterra Builders
5615 Potter Road
Matthews, North Carolina 28104
Subject. Stormwater Permit No. SW3140801
Adelaide Estates in Union County
Dear Mr. Sutton: complete Stormwater
The Division of Energy, Mineral, and Land Resources (DELMR), received a
Management Permit Application for the subject project ed August comply 2014.
ith he Stortmwat r Regulations ons set
specifications has determined that the project, as prop
n Title 15A NCAC 2H.1000 and Session Law 2006-246, d ain maintenance of hes subject P Je t and the 08 , permit No.
forth i operation
dated August 14, 2014, for the construction, op unit that maybe
stormwater system. This permit shall be effective ndrdoes not supersede any other agency permit to e
conditions and limitations as specified therein,
required. you have the right to
If any parts, requirements, or limitations contained en petition with the offcecoft Administrative
Statutes Per
request an adjudicatory hearing by filing days G receipt antis permit.
(OAH). The written petition must cone filed to Chapte with the OAH within thirty (30) d ys Genera and/or the
NCGS 143- 215(e) the petition must b
Mail Service Center, Raleigh, NC 27699 -6714, or via telephone at 919 -
You should contact the OAH with a�auestions regarding the filing fee (if a filing fee is required)
details of the filing process at 6714
or visit their website at www.NCOAH com Unless such demands are made this permit shall e
431-3000,
final and binding,
ro'ect will be kept on file at the Mooresville Regional Office If you have any questions, or need
This p lease contact Mike Randall at (9 19) 807 -6374; or
additional information concerning this matter, p
mike rndall @ncdenr gov.
sincerely,
1 2- 7 -
for Tracy E
SW3140801 File, Mooresville Regional Office
Mike Kissel, Bonterra Builders
Mattew Mobley, P.E , Design Resource Group
Davis, PE, CPM, Director
cc
ec•
Division of Energy, Mineral, and Land Resources
Energy Section � hl Survey Section Section
Service Center, Raleigh, North Carolina 276991612 919- 7 92001 F AX: 919 - 715 -8601
1612 Ma
512 North Salisbury Street, Raleigh, North Carolina 2604 o internet Action Employer ? 50% Recycled hit I/ Consumer Paper
An Equal opportunity \ Affirmative

State Stormwater Permit
Permit No.SW4130801
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
STATE STORMWATER MANAGEMENT PERMIT
In accordance with the provisions otherta Article cable Laws, and Regulations of
North Carolina as amended, p
PERMISSION IS HEREBY GRANTED TO
Bonterra Builders
Darren Sutton
Sandy Ridge Township, Union County
FOR THE
construction, operation and maintenance of a low density development in compliance
with the provisions of NCAC
approved stormwate?m0anage(hereafter
ent Gans and red to as
the stormwater rules') an pp roved
specifications, and other a supporting fg data a as attached and on file with and app y
the State and considered p
The Permit shall be effect ve m the
oe of d limitations-
1. u ncuntil rescinded and shall be
subject to the following specific conditions
DESIGN STANDARDS
or under 2 Dwe g
1 The overall tract built -upon
below 24 /o Ilin area peaAcre,raseequieed by Session Law
ned
2006 -246 of the stormwater rules
3 Approved plans anspecifications
f and are enforceable partseof the permit
permit are
incorporated by reference
4. The only runoff conveyance systems allowed will be
vegetated
such side n 1 (H.v) conveyances e
somwaterrules and approved by the Divisi
5 No piping is allowed except '
s s ace such as a road ortto provide to
ccessct runoff
beneath an impervious
6. All roof drains must terminate at least 30 foot from the mean high water mark.
7 The built -upon areas associated with his project
reams hall be located at least 30 feet
landward of all perennial a
8 All swales shall that discharge into a wetland shall do so at a non - erosive velocity
for the 10 year storm.
g Each builder and /or property hl approved,
knowing and understanding the BUA limit and the prohibition against excessive
piping, how to size the driveway esements are d the expectation to keeptexisting where the buffer is on
knowing where the drainage
swales open and
o thenmaximum roof gutters and extent technically feasible, a urFaces are
disconnect
Page 1 of 4

State Stormwater Permit
Permit No SW4130801
II. SCHEDULE OF COMPLIANCE
1, The permittee is responsible for verifying that the proposed built -upon area does
not exceed the allowable built -upon area
2, The Director may notify the permittee of the per m tmWi hinithe time fame et one
or more of the minimum requirements
specified in the notice, the permittee shall submit a written time schedule tot the
Director for modifying the site d o laps minimum n wee ing to the Director
shall provide copies of revs p
that the changes have been made.
3 This project may not be sold subdivided in whole or in part without first
receiving a permit modification
4. The following deed restrictions must be recorded with the Office of the Register
of Deeds:
a The following covenants ement Permit Number SW31408011..pliance with
State Stormwater Manag of these
b. The State of North Carolina acompbancei with the Sto mwate ants to
the extent necessary t
Management Permit.
c These covenants lnreu der them the land and be binding on all persons
and parties claim g
d The covenants pertaining t may not be altered or rescinded
without the express written consent of the
e Alteration of the drainage the State approved plans may not take
place without the concurrence o
f This project may not be sold or subdivided,
Dives onhole or n part, without firs
receiving a permit modification
h Construction of additional impervious ioilu areas e a permit modification prior to
requirements are n longer
An engineered l
the ru noff fr om all built u p on system
associated required with he project, including
that area permitted under the low density option.
i
associated a or with is any vegetative except conveyances
or average drriivewaylcrossings,
associated with this development, ersons
is strictly prohibited by any p
j, The built -upon areas shall be located
ce waters minimum of 30 feet landward of all
perennial and intermittent
5 A copy of the recorded restrictions must be received in this Office within 30 days
of the date of sale.
6. Filling in or piping of any vegetative d developmentaexceptfo h average ldSiveway
associated with the permitted persons.
crossings, is strictly prohibited by any p
royal for
7. The permittee shall submit at onso and Director
alculations prior t have received
ton approval
any
revised plans, spec
modification to the approved plans, including, but not limited to, those lis e
below'
a Any revision to the approved plans, regardless of size.
b. Project name change.
C. Transfer of ownership.
Page 2 of 4

State Stormwater Permit
Permit No SW4130801
d Redesign or addition to the approved amount of built -upon area
e. Further subdivision, acquisition, or sale of the project area in whole or in
part The project area is defined as all property owned by the permittee,
for which Sedimentation and Erosion Control Plan approval was sought.
f Filling in, altering or piping any vegetative conveyance shown on the
approved plan.
8. During construction, erosion shall be kept to a minimum and any eroded areas of
the swales or other vegetated conveyances will be repaired immediately.
9 The permittee shall at all times provide the operation and maintenance
necessary to operate the permitted stormwater management systems at
optimum efficiency to include:
a Inspections
b Sediment removal
c Mowing, and re- vegetating of the side slopes
d Immediate repair of eroded areas
e Maintenance of side slopes in accordance with approved plans and
specifications.
10. Within 30 days of completion of the project, the permittee shall certify in writing
that the project has been constructed in accordance with the approved plans.
11 The permittee shall submit all information requested by the Director or his
representative within the time frame specified in the written information request
III. GENERAL CONDITIONS
1. This permit is not transferable to any person or entity except after notice to and
approval by the Director The Director may require modification or revocation and
re- issuance of the permit to change the name and incorporate such other
requirements as may be necessary In the event of a name or ownership
change, a completed Name /Ownership Change form, signed by both parties,
must be submitted to the State accompanied by the supporting documentation
as listed on page 2 of the form The approval of this request will be considered
on its merits, and may or may not be approved
2 The permittee is responsible for compliance with all permit conditions until the
Director approves a transfer of ownership. Neither the sale of the project nor the
transfer of common areas to a third party, such as a homeowner's association,
constitutes an approved transfer of the stormwater permit
3 Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to an enforcement action in accordance with North
Carolina General Statutes 143- 215.6A to 143- 215.6C.
4. The issuance of this permit does not prohibit the Director from reopening and
modifying the permit, revoking and reissuing the permit, or terminating the permit
as allowed by the laws, rules, and regulations contained in Session Law 2006-
246, Title 15A of the North Carolina Administrative Code, Subchapter 2H 1000,
and North Carolina General Statute 143 -215.1 et. al.
5. In the event that the facilities fail to perform satisfactorily, including the creation
of nuisance conditions, the Permittee shall take immediate corrective action,
including those as may be required by the State, such as the construction of
additional or replacement stormwater management systems
Paoe 3 of 4

State Stormwater Permit
Permit No SW4130801
6 The permittee grants permission to DENR Staff to enter the property during
normal business hours, for the purpose of inspecting all components of the
stormwater management facility
7 The permit issued shall continue in force and effect until revoked or terminated.
The permit may be modified, revoked and reissued or terminated for cause The
filing of a request for a permit modification, revocation and re- issuance, or
termination does not stay any permit condition.
8 Unless specified elsewhere, permanent seeding requirements for the swales
must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual
9. Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
10. The issuance of this permit does not preclude the Permittee from complying with
any and all statutes, rules, regulations, or ordinances, which may be imposed by
other government agencies (local, state and federal), which have jurisdiction.
11 The permittee shall notify the Division in writing of any name, ownership or
mailing address changes at least 30 days prior to making such changes
Permit issued this the 14th day of August, 2014
_
for Tracy E. Davis, P. E., CPM
Director Division of Energy, Mineral, and Land Resources
Page 4 of 4

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IIErzAND rFRTlncAnGv
77M5 CER77F1£S MA1 THIS COPY OF THIS PLAT ACCURATELY DEPICTS THE BOUNDARY OF THE .AURISDICTION OF SECTION 404
OF INE CLEAN WA IER Ac AS DETERMINED BY THE UNDERSIGNED ON THIS DATE. UNLESS THERE IS A CHANGE IN THE LAW OR
OUR PUBLl9NED REGULATIONS TINIS DETERMINATION OF SECTION 404 AIRISDIC77ON MAY BE RELIED UPON FOR A PERIOD NOT
TO EXCEED FIVE /EARS FROM THIS DATE THIS DETERMINATION WAS MADE U77UZING THE 1987 CORPS OF ENGINEERS
WETLANDS DELINEATION MANUAL
REGULATORY OFFICIAL:
777LE: --------------- -- --
DATE:
USAGE AC770N ID:
415
4P0
N54-38'01 -E 2440.68 (TOTAL)
M]
67.725 ACRES
REBAR FOUND
NAIL SET
raft'1LW Ab Y^
CONTROL CORNER
IHwY It,
N. 456276. B7
lb'X p0
E. 150276.62
CF 0.99985848
CF 0.99985848
NA 8
Y 09 T
0.057 2,488 SF
PERV"4L RPW Y'
t3' WOE
OCINI rY MAP
a025 1,0169 sF
NOT TO SCALE
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IIErzAND rFRTlncAnGv
77M5 CER77F1£S MA1 THIS COPY OF THIS PLAT ACCURATELY DEPICTS THE BOUNDARY OF THE .AURISDICTION OF SECTION 404
OF INE CLEAN WA IER Ac AS DETERMINED BY THE UNDERSIGNED ON THIS DATE. UNLESS THERE IS A CHANGE IN THE LAW OR
OUR PUBLl9NED REGULATIONS TINIS DETERMINATION OF SECTION 404 AIRISDIC77ON MAY BE RELIED UPON FOR A PERIOD NOT
TO EXCEED FIVE /EARS FROM THIS DATE THIS DETERMINATION WAS MADE U77UZING THE 1987 CORPS OF ENGINEERS
WETLANDS DELINEATION MANUAL
REGULATORY OFFICIAL:
777LE: --------------- -- --
DATE:
USAGE AC770N ID:
415
4P0
N54-38'01 -E 2440.68 (TOTAL)
M]
67.725 ACRES
S53'16717-W 1064 -37 (TOTAL)
AAW5VOCTIOWAL RPW TABLE
REBAR FOUND
NAIL SET
CONTROL CORNER
CONTROL CORNER
N: 456973.30
N. 456276. B7
E 1502686.56
E. 150276.62
CF 0.99985848
CF 0.99985848
NA 8
(NAD83)
S53'16717-W 1064 -37 (TOTAL)
AAW5VOCTIOWAL RPW TABLE
1DONIFIR
AMMAGE WIDTH
LDAGIN (FT)
ACRES S1aFT.
SEASONAL RPW A'
t2' WO£
20'
0.001 40 9r
SEASONAL RPW 'C'
14' Il"
622'
0.057 2,488 SF
PERV"4L RPW Y'
t3' WOE
3630
a025 1,0169 sF
PEREAM6AL MW 'r
t9' WD£
749'
0.133 5,741 sF.
PER£ANMAL RPW -G'
15' WOE
1,114'
0.128 457o sF.
TOTALS
2666'
0. x6 (IA 928.W.
"CRISDICTIONAL WETLAND TABLE
V011TVIER
AVERAGE MOTH
ILDVGTH (ITil
ACRES SOFT.
WETLAND i4"
POCKET
I POCKET
I aw (539 ST)
WEAANO 7D'
POCKE -r
I PacKeT
ja4t5 (lao9.3 SF)
NOTES.
1. IRON PINS SET AT ALL CORNERS UNLESS OTHERWISE NOTED.
2. PROPERTY ZONED: R -40. SETBACKS ARE SUB.CCT 70 AN INTERPRETATION FROM THE ZCWING BOARD
J. TAX PARCEL NUMBER 06006010
4. DEED REFERENCE: DB 1723 PO 552.
5 BOUNDARY SURVEY ONLY THROUGH POINTS AS SHOWN.
6. A PORTION OF THIS PROPERTY IS LOCATED WININ AN AREA HAVING A ZONE DESIONA77ON AE BY THE
FEDERAL EMERGENCY MANAGEMENT AGENCY (FEMA), ON FLOOD INSURANCE RATE MAP (FIRM) NO
3710540500J, W IN A DATE OF IDENn£ICA770FW OF 10/16/06.
7 THIS PROPERTY MAY BE SU&ECT TO AM770VAL RECORDED OR UNRECORDED EASEMENTS
RIGHTS -OF -WAY, OR RESTRICTIVE COVENANTS, OTHER THAN SHOWN. SURVEY MADE WITHOUT THE
BENEFIT OF A TITLE EXAMINA77CIN
8. AREA COMPUTED BY COORDINATED METHOD.
9. NO NCGS MONUMENT FOUND IWTHIN 2000'.
10 UTILITY LOCH 17ONS SHOWN ARE LOCATED BASED ON SITE CONDITIONS AT THE TIME OF SURVEY.
CONTRACTORS ARE TO HAVE ALL UlIU77ES ACCURATELY MARKED PRIOR TO CONSTRUCTION.
I1. ANY CONSTRUCTION OR USE WIRBN ANY DELINEATED FLOOD AREA IS SUB..ECT TO THE R£S1RIC770NS
IMPOSED BY THE FLOODWAY REGULA77ON5
12. NOT ALL IMPROVEMENTS SHOWN
.31
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N8376'12 E 148.69
67•v - N547627 E
PERENNIAL RPW E"
% LEN7H:364'
4,o AVGWID TH. 3'
47 WETLAND D"
18,093 S0. FT.
(SEE INSET)
SEASONAL RPW A"
LENTH: 20'
AVG. WD TH: 2'
(SEE INSET)
WETLAND
559 S0. FT.
(SEE INSET)
9.70 61 \ Q�yo <aa
� �Ii6. fAiZ� 0"0 .4E.
PERENNIAL RPW "F'--
LENTH: 749'
AVG. WIDTH: 9'
PERENNIAL RPW "G"
� L£NTH: 1174' \
ISZNJAL RPW "C" AVG.WIDTH:S'
LEN TH.622' 615
AVG. WD 7H: 4'
2
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GRAPHIC SCALE
7110 0 150 700 600 1200
( IN FEET )
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CAROLINA SURVEYORS, INC
P.O. BOX 267
PINEVILLE, N.C. 26154
(704) 669 -7601
FAX: [phone]
CUnWICATI Or MNTIOIWZA7M
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INTERPRETATION FROM THE ZONING BOARD
3. TAX PARCEL NUMBER 06006010.
4. DEED REFERENCE: DB 172J PG 552.
5. BWNDARY SURVEY ONLY THROUGH POINTS AS SHOWN.
6. A PORTION OF TIMS PROPERTY IS LOCATED WHIR AN AREA HAVING A
ZONE DESIGNATION AE BY THE FEDERAL EMERGENCY MANAGEMENT
AGENCY (FEMA). ON FLOOD INSURANCE RATE MAP (FIRM) NO
3710540500J. WIN A DATE OF IDENTIFICATION OF 10/16/08.
7 THIS PROPERTY MAY BE SUe,.Ecr To ADDITIONAL RECORDED OR
UNRECORDED EASEMENTS. RIGHTS -OF -WAY, oR RESTRICTIVE COVENANTS
OTHER THAN SHOWN. SURVEY MADE WITHOUT THE BENEFIT OF A 77A£
EXAMINATION. `
B AREA COIPUTED BY COORDINATED METHOD.
'q NO NCGS MONUMENT FOUND WITHIN 2000'.
10 UTILITY LOCATIONS SHOWN ARE LOCATED BASED ON SITE CONDITIONS AT
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2. PROPERTY ZONED.- R -40. SETBACKS ARE SUBE'CT TO AN
INTERPRETATION FROM THE ZONING BOARD
3. TAX PARCEL NUMBER 06006010.
4. DEED REFERENCE. DB 1723 PG 552.
5, BOUNDARY SURVEY ONLY THROUGH POINTS AS 5HOMN.
6. A POR TON OF THIS PROPERTY IS LOCATED WTHIN AN AREA HA MNG A
ZONE DESIGNATION AE BY THE FEDERAL EMERGENCY MANAGEMENT
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7 THIS PROPERTY MAY BE SU&XCT TO ADDITONAL RECORDED OR
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OTHER THAN SHOWN. SURVEY MADE WTHOUT THE BENEnF OF A TITLE
EXAMINA nOV.
8. AREA COYPU TEO BY COORDINATED AlfTNOJ.
9. NO NCGS MONUMENT FOUND WTHIN 2000'.
10 UTILITY LOCATONS SHOWN ARE LOCATED BASED ON SITE CONDInONS A
THE TIME OF SUURI£Y CONTRACTORS ARE TO HAW ALL UTlUnES
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11. ANY CONSTRUCTON OR USE WTHIN ANY DELINEATED FLOOD AREA IS
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12 NOT ALL IMPROIEMENTS SHOWN
PERENNIAL RPW F"
LENTH: 749'
AVG. W10 TH: 9'
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TRIBUTARY 3
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(SEE SHEET 41
1
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STREAM REACH EVALUATION FORM
Date
3126114 Evaluator NRN /AJ
Easting
80 6618 W
Pro ect
Adelaide Estates Intermittent RPW A
Northing
34 9943_ N
Total Points:
2
Stream is at least intermittent if > 19 or perennial if > 30`
23 °5
(right -click the purple number and left -click Update Field to summarize points)
0
A. Geomorphology
Absent
Weak °
° Moderate
Strong
..SCORE
1a Continuity of channel bed and bank
0
1
2
3
2
2 Sinuosity of channel along thalweg
0
1
2
3
2
3 In- channel structure riffle- / step- pool sequence
0
1
2
3
1
4 Particle size of stream substrate
0
1
2
3
2
5 Active /relic flood lain
0
1
2
3
0
6 Depositional bars or benches
0
1
2
3
0
7 Recent alluvial deposits
0
1
2
3
0
8 Headcuts
0
1
2
3
2
9 Grade controls
0
05
1
1 5
1
10 Natural valley
0
05
1
1 5
1 5
11 Second or greater order channel
No = 0
Yes = 3
0
Geomor holo gy Subtotal
11 5
a Man -made ditches are not rated see discussion in NCDWQ Manual
B. Hydrology
12 Presence of Baseflow
0
1
2
3
2
13 Iron Oxidizing Bacteria
0
1
2
3
1
14 Leaf litter
1 5
1
05
0
1
15 Sediment on plants or debris
0
05
1
1 5
1
16 Oncianic debris lines or piles Wrack lines
0
05
1
1 5
1
17 Soil -based Evidence of high water table?
No = 0
Yes = 3
3
Hydrology Subtotal
90 °
C. Biology
18 Fibrous roots in streambed
3
2
1
0
2
19 Rooted upland plants in streambed
3
2
1
0
1
20 Macrobenthos note diversity and abundance
0
1
2
3
0
21 Aquatic Mollusks
0
1
2
3
0
22 Fish
0
05
1
1 5
0
23 Crayfish
0
05
1
1 5
0
24 Amphibians
0
05
1
1 5
0
25 Algae
0
05
1
1 5
0
26 Wetland plants in streambed
FACW= 0 75, OBL= 1 5, Other= 0
0
Biology Subtotal
3
perennial streams may also be identified using other methods See page 35 of NCDWQ manual
Notes
Adapted from NCDWQ Methodology for Identification of Intermittent and Perennial Streams and their
Ongins
(version 4 11)

STREAM REACH EVALUATION FORM
Date
3/26/14 1 Evaluator NRN /AJ
Easting
80 6618 W
Project
Adelaide Estates Intermittent RPW C
Northing
34 9943 N
Total Points:
2
Stream is at least intermittent if > 19 or perennial if > 30'
270
(right-click the purple number and left -click Update Field to summarize points)
0
A. Geomorphology
Absent,
Weak. q°
Moderate`
,Strong
SCORE.
1a Continuity of channel bed and bank
0
1
2
3
2
2 Sinuosity of channel along thalweg
0
1
2
3
3
3 In- channel structure riffle-/ step- pool sequence
0
1
2
3
1
4 Particle size of stream substrate
0
1
2
3
1
5 Active /relic flood lain
0
1
2
3
0
6 Depositional bars or benches
0
1
2
3
1
7 Recent alluvial deposits
0
1
2
3
0
8 Headcuts
0
1
2
3
1
9 Grade controls
0
05
1
1 5
05
10 Natural valley
0
05
1
1 5
1 5
11 Second or greater order channel
No = 0
Yes = 3
0
Geomorphology Subtotal
11 0
a Man -made ditches are not rated see discussion in NCDWQ Manual
B. Hydrology
12 Presence of Baseflow
0
1
2
3
2
13 Iron Oxidizing Bacteria
0
1
2
3
0
14 Leaf litter
1 5
1
05
0
1 5
15 Sediment on plants or debris
0
05
1
1 5
05
16 Organic debris lines or piles Wrack lines
0
05
1
1 5
1
17 Soil -based Evidence of high water table?
No = 0
Yes = 3
3
Hydrology Subtotal
80
C. Biology
18 Fibrous roots in streambed
3
2
1
0
2
19 Rooted upland plants in streambed
3
2
1
0
3
20 Macrobenthos (note diversity and abundance)
0
1
2
3
1
21 Aquatic Mollusks
0
1
2
3
0
22 Fish
0
05
1
1 5
0
23 Crayfish
0
05
1
1 5
0
24 Amphibians
0
1 05
1
1 5
05
25 Algae
0
1 05
1
1 5
1 5
26 Wetland plants in streambed
FACW=
0 75, OBL= 1 5, Other= 0
0
Biology Subtotal
80
perennial streams may also be identified usinq other methods See paqe 35 of NCDWQ manual
Notes
Adapted from NCDWQ Methodology for Identification of Intermittent and Perennial Streams and their
Ong►ns
(version 4 11)

STREAM REACH EVALUATION FORM
Date
3/26/14 1 Evaluator I NRN /AJ
Easting
80 6618 W
Project
Adelaide Estates Perennial RPW E
Northing
34 9943 N
Total Points:
2
Stream is at least intermittent if > 19 or perennial if > 30*
31 5
(right -click the purple number and left -click Update Field to summarize points)
0
A. Geornorphology Geomorphology
Absent
Weak° a
o Moderate°
;Strong° ;
„SCORE
1a Continuity of channel bed and bank
0
1
2
3
1
2 Sinuosity of channel along thalweg
0
1
2
3
3
3 In- channel structure riffle- / step- pool sequence
0
1
2
3
2
4 Particle size of stream substrate
0
1
2
3
3
5 Active /relic flood lain
0
1
2
3
1
6 Depositional bars or benches
0
1
2
3
1
7 Recent alluvial deposits
0
1
2
3
1
8 Headcuts
0
1
2
3
2
9 Grade controls
0
05
1
1 5
1 5
10 Natural valley
0
05
1 1
1 5
1 5
11 Second or greater order channel
No = 0
1 Yes = 3
0
Geomorphology Subtotal
170
a Man -made ditches are not rated see discussion in NCDWQ Manual
B. Hydrology
12 Presence of Baseflow
0
1
2
3
3
13 Iron Oxidizing Bacteria
0
1
2
3
1
14 Leaf litter
1 5
1
05
0
1 5
15 Sediment on plants or debris
0
05
1
1 5
1 5
16 Organic debris lines or piles Wrack lines
0
05
1
1 5
1
17 Soil -based Evidence of high water table?
No = 0
Yes = 3
0
Hydrology Subtotal
80 °
C. Biology
18 Fibrous roots in streambed
3
2
1
0
2
19 Rooted upland plants in streambed
3
2
1
0
3
20 Macrobenthos (note diversity and abundance)
0
1
2
3
0
21 Aquatic Mollusks
0
1
2
3
0
22 Fish
0
05
1
1 5
0
23 Crayfish
0
05
1
1 5
05
24 Amphibians
0
05
1
1 5
1
25 Algae
0
05
1
1 5
0
26 Wetland plants in streambed
FACW= 0 75, OBL= 1 5, Other= 0
0
Biology Subtotal
65
perennial streams may also be identified using other methods See page 35 of NCDWQ manual
Notes
Adapted from NCDWQ Methodolorav for Identification of Intermittent and Perennial Streams and their
Ongins
(version 4 11)

STREAM REACH EVALUATION FORM
Date
3/26/14 1 Evaluator NRN /AJ
E­asting
80 6618 W
Pro ect
Adelaide Estates Perennial RPW F
Northing
34 9943 N
Total Points:
2
Stream is at least intermittent if > 19 or perennial if > 30*
385
(right-click the purple number and left -click Update Field to summarize points)
0
A. Geomorphology
Absent
Weak
Moderate'
,Strong°
,°SCORE,
1a Continuity of channel bed and bank
0
1
2
3
3
2 Sinuosity of channel along thalweg
0
1
2
3
2
3 In- channel structure riffle- / step- pool sequence
0
1
2
3
3
4 Particle size of stream substrate
0
1
2
3
3
5 Active /relic flood lain
0
1
2
3
2
6 Depositional bars or benches
0
1
2
3
2
7 Recent alluvial deposits
0
1
2
3
1
8 Headcuts
0
1
2
3
1
9 Grade controls
0
05
1
1 5
1 5
10 Natural valley
0
05
1
1 5
1 5
11 Second or greater order channel
No = 0
Yes = 3
0
Geomorphology Subtotal
200
a Man -made ditches are not rated see discussion in NCDWQ Manual
B. Hydrology
12 Presence of Baseflow
0
1
2
3
3
13 Iron Oxidizing Bacteria
0
1
2
3
1
14 Leaf litter
1 5
1
05
0
1 5
15 Sediment on plants or debris
0
05
1
1 5
1 5
16 Organic debris lines or piles Wrack lines
0
05
1
1 5
1 5
17 Soil -based Evidence of high water table?
No = 0
Yes = 3
3
Hydrology Subtotal
11 5
C. Biology
18 Fibrous roots in streambed
3
2
1
0
2
19 Rooted upland plants in streambed
3
2
1
0
3
20 Macrobenthos (note diversity and abundance)
0
1
2
3
0
21 Aquatic Mollusks
0
1
2
3
0
22 Fish
0
05
1
1 5
0
23 Crayfish
0
05
1
1 5
1
24 Amphibians
0
05
1
1 5
1
25 Algae
0
05
1
1 5
0
26 Wetland plants in streambed
FACW= 0 75, OBL= 1 5, Other= 0
0
Biology Subtotal
70
perennial streams may also be identified using other methods See page 35 of NCDWQ manual
Notes
Adapted from NCDWQ Methodology for Identification of Intermittent and Perennial Streams and their
Ongins
(version 4 11)

STREAM REACH EVALUATION FORM
Date
3/26/14 Evaluator I NRN /AJ
Easting
80 6618 W
Project
Adelaide Estates Perennial RPW G
Northing
34 9943 N
Total Points:
2
Stream is at least intermittent if > 19 or perennial if > 30•
345
(right -click the purple number and left -click Update Field to summarize points)
0
A. Geomorphology
Absent-
Weak"::
Mod`erate
Strong:
. , SCOREp
1a Continuity of channel bed and bank
0
1
2
3
3
2 Sinuosity of channel along thalweg
0
1
2
3
2
3 In- channel structure riffle- / step- pool sequence
0
1
2
3
3
4 Particle size of stream substrate
0
1
2
3
3
5 Active /relic flood lain
0
1
2
3
1 1
6 Depositional bars or benches
0
1
2
3
2
7 Recent alluvial deposits
0
1
2
3
1
8 Headcuts
0
1
2
3
2
9 Grade controls
0
05
1
1 5
1 5
10 Natural valley
0
05
1
1 5
1 5
11 Second or greater order channel
No = 0
Yes = 3
0
Geomorphology Subtotal
200
a Man -made ditches are not rated see discussion in NCDWQ Manual
B. Hydrology
12 Presence of Baseflow
0
1
2
3
3
13 Iron Oxidizing Bacteria
0
1
2
3
0
14 Leaf litter
1 5
1
05
0
1 5
15 Sediment on plants or debris
0
05
1
1 5
1 5
16 Organic debris lines or piles Wrack lines
0
05
1
1 5
1 5
17 Soil -based Evidence of high water table?
No = 0
Yes = 3
0
Hydrology Subtotal
75
C. Biology
18 Fibrous roots in streambed
3
2
1
0
2
19 Rooted upland plants in streambed
3
2
1
0
3
20 Macrobenthos (note diversity and abundance )
0
1
2
3
0
21 Aquatic Mollusks
0
1
2
3
0
22 Fish
0
05
1
1 5
0
23 Crayfish
0
05
1
1 1 5
1
24 Amphibians
0
05
1
1 1 5
1
25 Algae
0
05
1
1 1 5
0
26 Wetland plants in streambed
FACW= 0 75, OBL= 1 5, Other= 0
0
Biology Subtotal
70
* perennial streams may also be identified usinq other methods See paqe 35 of NCDWQ manual
Notes
Adapted from NCDWQ Methodology for Identification of Intermittent and Perennial Streams and their
Ongms
(version 4 11)

WETLAND DETERMINATION DATA FORM - Eastern Mountains and Piedmont Region
Project/Site Adelaide Estates City /County Monroe /Union Co Sampling Date 03126114
Applicant /Owner Bonterra Builders, LLC State NC Sampling Point Mid B,D
Investigator(s) NRN,AJ Section, Township, Range
Landform (hit Islope, terrace etc) Floodplain Local relief (concave, convex, none) Concave Slope ( %) 8 -15%
Subregion (LRR or MLRA) MLRA 136 Lai 34 9943 N Long 80 6618 W Datum WGS84
Soil Map Unit Name BdC2 Bad in channery silty clay loam NWI classification
Are climatic / hydrologic conditions on the site typical for this time of year? Yes Y No (If no, explain in Remarks )
Are Vegetation N , Soil N or Hydrology N significantly disturbed? Are "Normal Circumstances" present? Yes X No
Are Vegetation N Sod N or Hydrology N naturally problematic? (if needed, explain any answers in Remarks )
SUMMARY OF FINDINGS - Attach site map showing sampling point locations, transects, Important features, etc,
Hydrophytic Vegetation Present? Yes X No Is the Sampled Area
Hydnc Soil Present? Yes X No within a Wetland? Yes X No
Wetland Hydrology Present? Yes X No
Remarks
HYDROLOGY
Wetland Hydrology Indicators
Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required, check all that apply)
_ Surface Sod Cracks (66)
X Surface Water (Al)
_ True Aquatic Plants (614)
_ Sparsely Vegetated Concave Surface (B8)
_ High Water Table (A2)
X Hydrogen Sulfide Odor (Cl)
X Drainage Patterns (1310)
_ Saturation (A3)
_ Oxidized Rhizospheres on Living Roots (C3)
_ Moss Trim Lines (B16)
X Water Marks (61)
_ Presence of Reduced Iron (C4)
_ Dry- Season Water Table (C2)
_ Sediment Deposits (132)
_ Recent Iron Reduction in Tilled Sods (C6)
_ Crayfish Burrows (C8)
_ Drift Deposits (63)
_ Thin Muck Surface (C7)
_ Saturation Visible on Aerial Imagery (C9)
_ Algal Mat or Crust (134)
_ Other (Explain in Remarks)
_ Stunted or Stressed Plants (D1)
_ Iron Deposits (65)
X Geomorphic Position (D2)
_ Inundation Visible on Aerial Imagery (137)
_ Shallow Aquuard (D3)
_ Water Stained Leaves (89)
_ Microtopographic Relief (D4)
Aquatic Fauna (613)
_ FAC Neutral Test (D5)
Field Observations
Surface Water Present? Yes X No
Depth (inches) 2
Water Table Present? Yes X No
Depth (inches)
Saturation Present? Yes X No
Depth (inches)
Wetland Hydrology Present? Yes X No
(includes capillary fringe)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available
Remarks
US Army Corps of Engineers Eastern Mountains and Piedmont — Version 2 0

VEGETATION (Five Strata) — Use scientific names of plants
Absolute Dominant Indicator
Tree Stratum (Plot size 30' ) % Cover Species? Status
1 Acer rubrum 25 Y FAC
2 Fraxinus pennsylvanlca 20 Y FACW
3 Salix nigrn 15 Y OBL
4
5
6
60 = Total Cover
50% of total cover 30 20% of total cover 12
Sapling Stratum (Plot size 30' 1
1 Acer rubrum 15 Y FAC
2 Fraxlnus pennsylvanlca 15 Y FACW
3 Sallx nlgra 10 Y OBL
4
5
6
40 = Total Cover
50% of total cover 20 20% of total cover 8
Shrub Stratum (Plot size 30' )
1 Alnus serrulata 15 Y OBL
2 Cornus amomum 5 Y FACW
3
4
5
6
20 = Total Cover
50% of total cover 10 20% of total cover 4
Herb Stratum (Plot size 30' )
1 Carex crinita 25 Y OBL
2 Microsteglum vimineum 15 Y FAC
3
4
5
6
7
8
9
10
11
35 = Total Cover
50% of total cover 175 20% of total cover 7
Woody Vine Stratum (Plot size 30' )
1
2
3
4
5
50% of total cover
or on a separate
= Total Cover
20% of total cover
Sampling Point Wtld B,D
Dominance Test worksheet
Number of Dominant Species
That Are OBL, FACW or FAC 10 (A)
Total Number of Dominant
Species Across All Strata 10 (B)
Percent of Dominant Species
That Are OBL, FACW, or FAC 100% (A /B)
Prevalence Index worksheet
Total % Cover of
Multiply by
OBL species
x 1 =
FACW species
x 2 =
FAC species
x 3 =
FACU species
x 4 =
UPL species
x 5 =
Column Totals
(A) (B)
Prevalence Index = B/A =
_ 1 - Rapid Test for Hydrophytic Vegetation
X 2 Dominance Test is >50%
_ 3 Prevalence Index is <_3 0'
_ 4 Morphological Adaptations' (Provide supporting
data in Remarks or on a separate sheet)
Problematic Hydrophytic Vegetation' (Explain)
'Indicators of hydric soil and wetland hydrology must
be present, unless disturbed or problematic
Definitions of Five Vegetation Strata
Tree - Woody plants, excluding woody vines
approximately 20 it (6 m) or more in height and 3 in
(7 6 cm) or larger in diameter at breast height (DBH)
Sapling - Woody plants, excluding woody vines,
approximately 20 ft (6 m) or more in height and less
than 3 in (7 6 cm) DBH
Shrub - Woody plants, excluding woody vines,
approximately 3 to 20 ft (1 to 6 m) in height
Herb - All herbaceous (non- woody) plants, including
herbaceous vines, regardless of size, and woody
plants, except woody vines, less than approximately 3
it (1 m) in height
Woody vine - All woody vines, regardless of height
Hydrophytic
Vegetation
Present*7 Yes X No
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2 0

SOIL
Profile Description (Describe to the depth needed to
Sampling Point Wtld B,D
or confirm the absence of indicators )
Depth Matrix Redox Features
(inches) Color (moist) % Color (moist) % Tvue oc Texture Remarks
RM= Reduced Matrix. MS= Masked Sand Grains
Hydnc Soil Indicators
Histosol (Al)
_ Histic Epipedon (A2)
Black Histic (A3)
Hydrogen Sulfide (A4)
Stratified Layers (A5)
2 cm Muck (A10) (LRR N)
Depleted Below Dark Surface (All)
_ Thick Dark Surface (Al 2)
_ Sandy Mucky Mineral (S1) (LRR N,
MLRA 147, 148)
_ Sandy Gleyed Matrix (S4)
_ Sandy Redox (S5)
Stripped Matrix (S6)
Type
Depth (inches)
2Location PL =Pore Lining, M =Matrix
Indicators for Problematic Hydric Sods
Dark Surface (S7)
_ 2 cm Muck (A10) (MLRA 147)
Polyvalue Below Surface (S8) (MLRA 147, 148)
_ Coast Prairie Redox (Al 6)
_ Thin Dark Surface (S9) (MLRA 147, 148)
(MLRA 147, 148)
_ Loamy Gleyed Matrix (F2)
_ Piedmont Floodplain Sods (F19)
Depleted Matrix (F3)
(MLRA 136, 147)
_ Redox Dark Surface (F6)
_ Very Shallow Dark Surface (TF12)
_ Depleted Dark Surface (F7)
_ Other (Explain in Remarks)
_ Redox Depressions (F8)
_ Iron - Manganese Masses (F12) (LRR N,
MLRA 136)
Umbric Surface (F13) (MLRA 136, 122) 3Indicators of hydrophytic vegetation and
_ Piedmont Floodplain Sods (F19) (MLRA 148) wetland hydrology must be present,
_ Red Parent Material (F21) (MLRA 127, 147) unless disturbed or problematic
Hydnc Soil Present? Yes X No
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2 0

WETLAND DETERMINATION DATA FORM - Eastern Mountains and Piedmont Region
Project/Site Adelaide Estates City /County Monroe /Union Co Sampling Date 03126114
Applicant /Owner Bonterra Builders, LLC State NC Sampling Point Upland DP
Investigator(s) NRN,AJ Section, Township, Range
Landform (hillslope, terrace etc ) Floodplain Local relief (concave, convex none) Concave Slope ( %) 8 -15%
Subregion (LRR or MLRA) MLRA 136 Lai 34 9943 N Long 80 6618 W Datum WGS84
Soil Map Unit Name BdC2 Badin channery silty clay loam NWI classification
Are climatic / hydrologic conditions on the site typical for this time of year? Yes Y No (If no, explain in Remarks)
Are Vegetation N , Soil N or Hydrology N significantly disturbed? Are "Normal Circumstances" present? Yes X No
Are Vegetation N Soil N or Hydrology N naturally problematic? (If needed, explain any answers in Remarks )
SUMMARY OF FINDINGS - Attach site map showing sampling point locations, transects, Important features, etc
Hydrophytic Vegetation Present? Yes No X Is the Sampled Area
Hydric Soil Present? Yes No X within a Wetland? Yes No X
Wetland Hydrology Present? Yes No X
Remarks Location Approximately 30' W of Wetland D
HYDROLOGY
Wetland Hydrology Indicators
Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required, check all that apply)
_ Surface Sod Cracks (66)
_ Surface Water (Al)
_ True Aquatic Plants (614)
_ Sparsely Vegetated Concave Surface (BB)
_ High Water Table (A2)
_ Hydrogen Sulfide Odor (Cl)
_ Drainage Patterns (610)
_ Saturation (A3)
_ Oxidized Rhizospheres on Living Roots (C3)
_ Moss Trim Lines (B16)
_ Water Marks (131)
_ Presence of Reduced Iron (C4)
_ Dry - Season Water Table (C2)
_ Sediment Deposits (132)
_ Recent Iron Reduction in Tilled Sods (C6)
_ Crayfish Burrows (C8)
_ Drift Deposits (133)
_ Thin Muck Surface (C7)
_ Saturation Visible on Aerial Imagery (C9)
_ Algal Mat or Crust (84)
_ Other (Explain in Remarks)
_ Stunted or Stressed Plants (D1)
_ Iron Deposits (85)
_ Geomorphic Position (D2)
_ Inundation Visible on Aerial Imagery (137)
_ Shallow Aquitard (D3)
_ Water Stained Leaves (69)
_ Microtopographic Relief (D4)
_ Aquatic Fauna (B13)
_ FAC Neutral Test (D5)
Field Observations
Surface Water Present? Yes No
X Depth (inches)
Water Table Present? Yes No
X Depth (inches)
Saturation Present? Yes No
X Depth (inches)
Wetland Hydrology Present? Yes No X
(includes ca ills fringe)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available
Remarks
US Army Corps of Engineers Eastern Mountains and Piedmont — Version 2 0

VEGETATION (Five Strata) - Use scientific names of plants
Sampling Point Upland DP
65 = Total Cover
50% of total cover 32 5 20% of total cover 13
Sapling Stratum (Plot size 30' )
1 Quercus alba 10 Y FACU
2 Quercus rubra 10 Y FACU
3 Carta glabra 10 Y FACU
4
5
6
30 = Total Cover
50% of total cover 15 20% of total cover 6
Shrub Stratum (Plot size 30' )
1 Elaeaqnus angustdolia 45 Y FACU
2
3
4
5
6
0 (A)
10 (B)
0% (A /B)
Prevalence Index worksheet
Absolute Dominant Indicator
Dominance Test worksheet
Tree Stratum (Plot size 30' )
% Cover Species? Status
Number of Dominant Species
1 Quercus alba
25 Y FACU
That Are OBL FACW, or FAC
2 Quercus rubra
20 FACU
x 4 =
UPL species
—L
Total Number of Dominant
3 S'�a glahra
_2_ Y FACU
Species Across All Strata
4
Percent of Dominant Species
5
That Are OBL, FACW, or FAC
6
65 = Total Cover
50% of total cover 32 5 20% of total cover 13
Sapling Stratum (Plot size 30' )
1 Quercus alba 10 Y FACU
2 Quercus rubra 10 Y FACU
3 Carta glabra 10 Y FACU
4
5
6
30 = Total Cover
50% of total cover 15 20% of total cover 6
Shrub Stratum (Plot size 30' )
1 Elaeaqnus angustdolia 45 Y FACU
2
3
4
5
6
0 (A)
10 (B)
0% (A /B)
Prevalence Index worksheet
45 = Total Cover
225 20% of total cover 9
35 Y UPL
Total % Cover of
Multiply by
OBL species
x 1 =
FACW species
x 2 =
FAC species
x 3 =
FACU species
x 4 =
UPL species
x 5 =
Column Totals
(A) (B)
Prevalence Index = B/A =
1 Rapid Test for Hydrophytic Vegetation
_ 2 Dominance Test is >50%
_ 3 Prevalence Index is :53 0'
4 - Morphological Adaptations' (Provide supporting
data in Remarks or on a separate sheet)
_ Problematic Hydrophytic Vegetation' (Explain)
'Indicators of hydric sod and wetland hydrology must
be present, unless disturbed or problematic
50% of total cover
Herb Stratum Plot size 30'
{ )
1 ErYthronium rostratum
45 = Total Cover
225 20% of total cover 9
35 Y UPL
Definitions of Five Vegetation Strata
Tree -Woody plants, excluding woody canes,
approximately 20 ft (6 m) or more in height and 3 in
(7 6 cm) or larger in diameter at breast height (DBH)
Sapling - Woody plants, excluding woody vines,
approximately 20 ft (6 m) or more in height and less
than 3 in (7 6 cm) DBH
Shrub - Woody plants, excluding woody vines,
approximately 3 to 20 ft (1 to 6 m) in height
Herb - All herbaceous (non - woody) plants, including
herbaceous vines, regardless of size, and woody
plants, except woody vines less than approximately 3
ft (1 m) in height
Woody vine - All woody vines, regardless of height
2 Polystichum acrostichoides 15 Y FACU
3
4
5
6
7
B
9
10
11
50 = Total Cover
50% of total cover 25 20% of total cover 10
Woody Vine Stratum (Plot size 30' )
1 Smilax glauca 10 Y FACU
2
3
4
5
10 Hydrophytic
= Total Cover Vegetation
50% of total cover 5 20% of total cover 2
Present) Yes No X
Remarks (Include photo numbers here or on a separate sheet )
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2 0

SOIL
Sampling Point Upland DP
Profile Description (Describe to the depth needed to document the indicator or confirm the absence of indicators)
Depth Matrix Redox Features
(inches) Color (moist) % Color (moist) % Tvoe Loc Texture Remarks
'Type C= Concentration, D= Depletion, RM
Hydric Soil Indicators
_ Histosol (Al)
_ Histic Epipedon (A2)
Black Histic (A3)
_ Hydrogen Sulfide (A4)
_ Stratified Layers (A5)
_ 2 cm Muck (A10) (LRR N)
Depleted Below Dark Surface (A11)
_ Thick Dark Surface (Al2)
Sandy Mucky Mineral (S1) (LRR N,
MLRA 147, 148)
_ Sandy Gleyed Matrix (S4)
_ Sandy Redox (S5)
_ Stripped Matrix (S6)
Type
Depth (inches)
Remarks
=duced Matrix, MS= Masked Sand Grains zLocation PL =Pore Lining, M =Matrix
Redox Depressions (F8)
_ Iron Manganese Masses (F12) (LRR N,
MLRA 136)
Umbrnc Surface (F13) (MLRA 136, 122) 3Indicators of hydrophytic vegetation and
_ Piedmont Floodplam Soils (F19) (MLRA 148) wetland hydrology must be present,
Red Parent Material (F21) (MLRA 127, 147) unless disturbed or problematic
Hydnc Soil Present? Yes No X
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2 0
Indicators for Problematic iHydric Sc
_ Dark Surface (S7)
_ 2 cm Muck (A10) (MLRA 147)
_ Polyvalue Below Surface (S8) (MLRA 147, 148)
_ Coast Prairie Redox (A16)
_ Thin Dark Surface (S9) (MLRA 147, 148)
(MLRA 147, 148)
Loamy Gleyed Matrix (F2)
_ Piedmont Floodplam Soils (F19)
Depleted Matrix (F3)
(MLRA 136, 147)
Redox Dark Surface (F6)
_ Very Shallow Dark Surface (TF12)
Depleted Dark Surface (F7)
_ Other (Explain in Remarks)
Redox Depressions (F8)
_ Iron Manganese Masses (F12) (LRR N,
MLRA 136)
Umbrnc Surface (F13) (MLRA 136, 122) 3Indicators of hydrophytic vegetation and
_ Piedmont Floodplam Soils (F19) (MLRA 148) wetland hydrology must be present,
Red Parent Material (F21) (MLRA 127, 147) unless disturbed or problematic
Hydnc Soil Present? Yes No X
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2 0

APPROVED JURISDICTIONAL DETERMINATION FORM
U S Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form instructional Guidebook
SECTION 1 BACKGROUND INFORMATION
A REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD)
B DISTRICT OFFICE, FILE NAME, AND NUMBER
Applicant Bonterra Builders, LLC
Site Adelaide Estaes
Form for Wetland B, Wetland D, Seasonal RPW A, Seasonal RPW C, Perennial RPW E, Perennial RPW F and Perennial RPW G
C PROJECT LOCATION AND BACKGROUND INFORMATION
State NC County /parish /borough Union City Wesley Chapel
Center coordinates of site (lat/long in degree decimal format) Lat 34 9943° N, Long -80 6618° LWW„I
Universal Transverse Mercator
Name of nearest waterbody East Fork Twelvemile Creek
Name of nearest Traditional Navigable Water (TNW) Into which the aquatic resource flows Twelvemile Creek
Name of watershed or Hydrologic Unit Code (HUC) 03050103
® Check if map /diagram of review area and /or potential Jurisdictional areas is /are available upon request
❑ Check if other sites (c g offsite mitigation sites, disposal sites, etc ) are associated with this action and are recorded on a
different JD form
D REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY)
❑ Office (Desk) Determination Date
® Field Determination Date(s) 2/4/2014
SECTION H SUMMARY OF FINDINGS
A RHA SECTION 10 DETERMINATION OF JURISDICTION
There re no "navigable haters of the US' within Rivers and Harbors Act (RHA) Jurisdiction (as defined by 33 CFR part 329) in the
review area [Required]
❑ Waters subject to the ebb and flow of the tide
❑ Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce
Explain
B CWA SECTION 404 DETERMINATION OF JURISDICTION
There Are "ivaters of the US' within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area [Requited]
1 Waters of the U S
a Indicate presence of waters of U S in review area (check all that apply) i
❑ TNWs, including territorial seas
❑ Wetlands adjacent to TNWs
® Relatively permanent waters2 (RPWs) that flow directly or indirectly into TNWs
❑ Non -RPWs that flow directly or indirectly into fN Ws
❑ Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
❑ Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
❑ Wetlands adjacent to non -RPWs that flow directly or indirectly into TNWs
❑ Impoundments of jurisdictional waters
❑ Isolated (interstate or intrastate) waters including isolated wetlands
b Identify (estimate) size of waters of the U S in the review area
Non - wetland waters 2869 linear feet 5 width (ft) and /or 0 366 acres
Wetlands 0 428 acres
c Limits (boundaries) of, jurisdiction based on Established by OHWM.
Elevation of established OHWM (if known)
2 Non - regulated waters /wetlands (check if applicable) s
Boxes checked below shall be supported by completing the appropriate sections in Section III below
For purposes of this form, an RPW is defined as a tributary that is not a TN W and that typically flows year -round or has continuous flow at least "seasonally"
(e g , typically 3 months)
' Supporting documentation is presented in Section iiI F

❑ Potentially jurisdictional waters and /or wetlands were assessed within the review area and determined to be not jurisdictional
Explain

SECTION 111 CWA ANALYSIS
A TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs If the aquatic resource is a TNW, complete
Section 111 A 1 and Section 111 D 1 only, if the aquatic resource is a wetland adjacent to a TNW, complete Sections III A 1 and 2
and Section Ill D 1 , otherwise, see Section Ill B below
1 TNW
Identify TNW
Summarize rationale supporting determination
2 Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is `adjacent'
B CHARACTERISTICS OF TRIBUTARY ('1 HAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY)
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met
The agencies will assert jurisdiction over non - navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i e tributaries that typically flow year -round or have continuous flow at least seasonally (e g, typically 3
months) A wetland that directly abuts an RPW is also jurisdictional If the aquatic resource is not a TNW, but has year -round
(perennial) flow, skip to Section III D 2 If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section 111 D 4
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law
If the waterbody° is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both If the JD covers a tributary with adjacent wetlands, complete Section 111 B 1 for
the tributary, Section III B 2 for any onsite wetlands, and Section III B 3 for all wetlands adjacent to that tributary, both onsite
and offsite The determination whether a significant nexus exists is determined in Section III C below
1 Characteristics of non -TNWs that flow directly or indirectly into TNW
(i) General Area Conditions
Watershed size 1374squar`— a miles'
Drainage area 198 acres
Average annual rainfall 44 inches
Average annual snowfall 0 inches
(n) Physical Characteristics
(a) Relationship with TNW
❑ Tributary flows directly into TNW
® Tributary flows through � tributaries before entering TN W
Project waters are 55 -10 river miles from TNW
Project waters are 1100 le ) river miles from RPW
Project waters are 5-10, l (straight) miles from TN W
Project waters are 1L(or less) aerial (straight) miles from RPW
Project waters cross or serve as state boundaries Explain
Identify flow route to 3`N WS On -site jurisdictional features flow to East Fork Twelvemile Creek then to Twelvemile
Creek (TN W)
° Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the and
West
s Flow route can be described by identifying, e g , tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW

Tributary stream order, if known 1
(b) General Tributary Characteristics (check all that apply)
Tributary is ® Natural
❑ Artificial (man -made) Explain
❑ Manipulated (man- altered) Explain
Tributary properties with respect to top of bank (estimate)
Average width 5 feet
Average depth +/ -3 feet
Average side slopes 0
Primary tributary substrate composition (check all that apply)
® Silts ® Sands
® Cobbles ® Gravel
❑ Bedrock ❑ Vegetation Type /% cover
❑ Other Explain
❑ Concrete
❑ Muck
Tributary condition /stability [e g , highly eroding sloughing banks] Explain
Presence of run/riffle/pool complexes Explain
Tributary geometry Relative ly strarg thth
Tributary gradient (approximate average slope) %
(c) Flow
Tributary provides for Seasonal fl w
Estimate average number of flow events in review area/year b 9
Describe flow regime Flow of RPWs A and C are seasonal Flow of RPW E, F and G are perennial See attached
stream evaluation forms
Other information on duration and volume
Surface flow is Discrete and confined! Characteristics
Subsurface Flow n, krnnown Explain findings
❑ Dye (or other) test performed
Tributary has (check all that apply)
® Bed and banks
® OHWM' (check all indicators that apply)
® clear natural line impressed on the bank
® changes in the character of soil
❑
® shelving
❑
❑ vegetation matted down, bent, or absent
® leaf litter disturbed or washed away
❑
❑ sediment deposition
❑
❑ water staining
❑
❑ other (list)
❑ Discontinuous OHWM' Explain
If factors other than the OHWM were used to determ
❑ High Tide Line indicated by ❑
❑ oil or scum line along shore objects
❑ fine shell or debris deposits (foreshore)
❑ physical markings /characteristics
❑ tidal gauges
❑ other (list)
the presence of litter and debris
destruction of terrestrial vegetation
the presence of wrack line
sediment sorting
scour
multiple observed or predicted flow events
abrupt change in plant community
me lateral extent of CWA jurisdiction (check all that apply)
Mean High Water Mark indicated by
❑ survey to available datum
❑ physical markings
❑ vegetation lines /changes in vegetation types
(w) Chemical Characteristics
Characterize tributary (e g , water color is clear, discolored, oily film, water quality, general watershed characteristics, etc )
Explain water color is clear - no signs of pollutants
Identify specific pollutants if known
'A natural or man -made discontinuity in the OHWM does not necessarily sever jurisdiction (e g , where the stream temporarily flows underground, or where
the OHWM has been removed by development or agricultural practices) Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime (e g , flow over a rock outcrop or through a culvert) the agencies will look for indicators of flow above and below the break
'Ibid

(iv) Biological Characteristics Channel supports (check all that apply)
® Riparian corridor Characteristics (type, average width) 25 -50
® Wetland fringe Characteristics Wetland B and D are located in the riparian corridor of sRPW A and pRPW E,
respectively
❑ Habitat for
❑ Federally Listed species Explain findings
❑ Fish /spawn areas Explain findings
❑ Other environmentally - sensitive species Explain findings
❑ Aquatic /wildlife diversity Explain findings likely amphibians present
2 Characteristics of wetlands adjacent to non -TNW that flow directly or indirectly into TNW
(i) Physical Characteristics
(a) General Wetland Characteristics
Properties
Wetland size acres
Wetland type Explain Forested/open water
Wetland quality Explain Fair to Good
Project wetlands cross or serve as state boundaries Explain
(b) General Flow Relationship with Non -TN W
Flow is Pick List Explain
Surface flow is Pick ListUst
Characteristics
Subsurface flow Pick LtstList Explain findings
❑ Dye (or other) test performed
(c) Wetland Adiacency Determination with Non -TN W
❑ Directly abutting
❑ Not directly abutting
❑ Discrete wetland hydrologic connection Explain
❑ Ecological connection Fxplam
❑ Separated by berm/barrier Explain
(d) Proximity (Relationship) to TN W
Project wetlands are ficik st river miles from I'NW
Project waters are F ick List aerial (straight) miles from TN W
Flow is from Pick Ltst
Estimate approximate location of wetland as within the'Pcek tstLlstL floodplain
(n) Chemical Characteristics
Characterize wetland system (e g , water color is clear, brown, oil film on surface, water quality, general watershed
characteristics, etc ) Explain
Identify specific pollutants, if known
(in) Biological Characteristics Wetland supports (check all that apply)
❑ Riparian buffer Characteristics (type, average width) 50 -100,
❑ Vegetation type /percent cover Explain 50% Forested riparian corridors and 50% maintamed/distrubed powerline
ROWS
❑ Habitat for
❑ Federally Listed species Explain findings
❑ Fish /spawn areas Explain findings
❑ Other environmentally - sensitive species Explain findings
❑ Aquatic /wildlife diversity Explain findings typical wetland species - amphibians, etc
3 Characteristics of all wetlands adjacent to the tributary (if any,,)
S
All wetland(s) being considered in the cumulative analysis � ckLtst
Approximately ( ) acres in total are being considered in the cumulative analysis

For each wetland specify the following
Directly abuts9 (Y/N) Size (in acres) Directly abuts9 (Y/N) Size (in acres)
Wetland B 0 013 Y
Wetland D 0 415 Y
Summarize overall biological, chemical and physical functions being performed Onsrte wetlands and jurisdictional rpw's
provide habitat for herpetofauna and macro invertebrates These wetlands have the capacity to provide nutrients and organic carbon
to downstream foodwebs Wetlands provide flood storage during rain events and ground water recharge during dry periods The
wetlands also trap and filter pollutants before reaching downstream Perennial RPWs and Twelvermle Creek (TNW)
C SIGNIFICANT NEXUS DE] ERM[NATION
A significant nexus analysis w dl assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and /or biological integrity of a TNW
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands it is not appropriate to determine significant nexus based solely on any specific threshold of distance (e g between a
tributary and its adjacent wetland or between a tributary and the 7 NW) Similarly, the fact an adjacent wetland lies within or
outside of a floodplam is not solely determinative of significant nexus
Draw connections between the features documented and the effects on the 7 NW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook Factors to consider include, for example
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs or to reduce the amount of pollutants or flood waters reaching a TN W9
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding nesting, spawning or rearing young for species that are present in the TNW9
• Does the tributary in combination with its adjacent wetlands (if any) have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs9
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TN W9
Note the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below
1 Significant nexus findings for non -RPW that has no adjacent wetlands and flows directly or indirectly into TNWs Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section iII D
2 Significant nexus findings for non -RPW and its adjacent wetlands, where the non -RPW flows directly or indirectly into
TNWs Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section 111 D
3 Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW Explain findings of
presence or absence of significant nexus below based on the tributary in combination with all of its adjacent wetlands then go to
Section III D
D DETERMINATIONS OF JURISDICTIONAL FINDINGS THE SUBJECT WATERS/V1'ETLANDS ARE (CHECK ALL
THAT APPLY)
1 TNWs and Adjacent Wetlands Check all that apply and provide size estimates in review area
Q TNWs linear feet width (ft), Or, acres
[] Wetlands adjacent to TNWs acres
2 RPWs that flow directly or indirectly into TNWs
® Tributaries of TNWs where tributaries typically flow year -round are, jurisdictional Provide data and rationale indicating that
tributary is perennial Perennial RPW's E, F and G exhibit geomorphology hydrology and biological indicators consistent
with perennail flowing streams in the piedmont ecoregion as documented by the attached NCDWQ Stream Identification
Assessment Forms

Tributaries of TNW where tributaries have continuous flow "seasonally" (e g , typically three months each year) are
® Tributaries of TNW where tributaries have continuous flow `seasonally' (e g , typically three months each year) are
jurisdictional Data supporting this conclusion is provided at Section III B Provide rationale indicating that tributary flows
seasonally Seasonal RPWs A and C exhibit geomorphology, hydrology, and biological indicators consistent with seasonal
flowing streams in the piedmont ecoregion as documented by the attached NCDWQ Stream Identification Assessment Forms
Provide estimates for jurisdictional waters in the review area (check all that apply)
® Tributary waters 2869 linear feet 5 width (ft)
❑ Other non - wetland waters acres
Identify type(s) of waters
3 Non -RPWss that flow directly or indirectly into TNWs
❑ Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional Data supporting this conclusion is provided at Section III C
Provide estimates for jurisdictional waters within the review area (check all that apply)
❑ Tributary waters linear feet width (ft)
El Other non - wetland waters acres
Identify type(s) of waters
4 Wetlands directly abutting an RPW that flow directly or indirectly into TNWs
Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands
® Wetlands directly abutting an RPW where tributaries typically flow year -round Provide data and rationale
indicating that tributary is perennial in Section III D 2, above Provide rationale indicating that wetland is
directly abutting an RPW Wetlands D directly abuts seasonal RPW E with no break in Jurisdiction
® Wetlands directly abutting an RPW where tributaries typically flow `seasonally' Provide data indicating that tributary is
seasonal in Section 111 B and rationale in Section 111 D 2 above Provide rationale indicating that wetland is directly
abutting an RPW Wetland B directly abuts seasonal RPW A with no break in jurisdiction
Provide acreage estimates for jurisdictional wetlands in the review area 0 428 acres
5 Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs
❑ Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands have a significant nexus with a TNW are jurisidictional Data supporting this
conclusion is provided at Section I Il C
Provide acreage estimates for jurisdictional wetlands in the review area acres
6 Wetlands adjacent to non -RPWs that flow directly or indirectly into i'NWs
❑_ Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional Data supporting this
conclusion is provided at Section III C
Provide estimates for jurisdictional wetlands in the review area acres
7 impoundments of jurisdictional waters 9
As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional
❑ Demonstrate that impoundment was created from "waters of the U S ," or
❑ Demonstrate that water meets the criteria for one of the categories presented above (1 -6), or
❑ Demonstrate that water is isolated with a nexus to commerce (see E below)
E ISOLATED I INTERSTATE OR INTRA- STATE1 WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANN'
SUCH WATERS (CHECK ALL THAT APPLY) 10
"See Footnote # 3
To complete the analysis refer to the key in Section I I I D 6 of the Instructional Guidebook
"' Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will ele,. ate the action to Corps and EPA HQ for
rei iew consistent with the process described in the Corps /EPA Memorandum Regarding CWA Act Jurisdiction Following Rapanos

❑ which are or could be used by interstate or foreign travelers for recreational or other purposes
❑ from which fish or shellfish are or could be taken and sold in interstate or foreign commerce
❑ which are or could be used for industrial purposes by industries in interstate commerce
Q Interstate isolated waters Explain
❑ Other factors Explain
Identify water body and summarize rationale supporting determination
Provide estimates for Jurisdictional waters in the review area (check all that apply)
❑ Tributary waters linear feet width (ft)
❑ Other non - wetland waters acres
identify type(s) of waters
❑ Wetlands acres
NON - JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY)
❑ If potential wetlands were assessed within the review area. these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements
❑ Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce
❑ Prior to the Jan 2001 Supreme Court decision in "SWANCC, 'the review area would have been regulated based solely on the
'Migratory Bird Rule' (MBR)
❑ Waters do not meet the "Significant Nexus" standard, where such a finding is required for Jurisdiction Explain
Other (explain, if not covered above)
Provide acreage estimates for non - jurisdictional waters in the review area, where the sole potential basis ofJurisdiction is the MBR
factors (i a presence of migratory birds presence of endangered species use of water for irrigated agriculture) using best professional
Judgment (check all that apply)
❑ Non - wetland waters (i e , rivers streams) linear feet width (ft)
❑ Lakes /ponds acres
Other non - wetland waters acres List type of aquatic resource
❑ Wetlands acres
Provide acreage estimates for non - Jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required for Jurisdiction (check all that apply)
❑ Non - wetland waters (i e , rivers streams) linear feet width (ft)
❑ Lakes /ponds acres
❑ Other non - wetland waters acres List type of aquatic resource
❑ Wetlands acres
SECTION IV DATA SOURCES
A SUPPORTING DATA Data reviewed for JD (check all that apply -checked items shall be included in case file and, where checked
and requested, appropriately reference sources below)
® Maps, plans, plots or plat submitted by or on behalf of the apphcanUc.onsultant
® Data sheets prepared/submitted by or on behalf of the applicant/consultant
❑ Office concurs with data sheets /delineation report
❑ Office does not concur with data sheets /delineation report
❑ Data sheets prepared by the Corps
❑ Corps navigable waters study
❑ U S Geological Survey Hydrologic Atlas
❑ USGS NHD data
❑ USGS 8 and 12 digit HUC maps
® U S Geological Survey map(s) Cite scale & quad name
® USDA Natural Resources Conservation Service Soil Survey Citation
❑ National wetlands inventory map(s) Cite name
❑ State /Local wetland inventory map(s)
® FEMA /FIRM maps
❑ 100 -year Floodplam Elevation is (National Geodectic Vertical Datum of 1929)
® Photographs ® Aerial (Name & Date)
or ❑ Other (Name & Date)
Previous determination(s) File no and date of response letter

Q Applicable /supporting case law
Q Applicable /supporting scientific literature
Q Other information (please specify)
B ADDITIONAL COMMENTS TO SUPPORT JD