20230925 Ver 1_7258.1 - Burlington Road_USACE PCN Request_6.23.23_20230626

Preliminary ORM Data Entry Fields for New Actions
ACTION ID #: SAW- 2021-02340 Begin Date (Date Received):
Prepare file folder ❑ Assign Action ID Number in ORM ❑
1. Project Name [PCN Form A2a]: Burlington Road Industrial
2. Work Type: ❑✓ Private ❑ Institutional ❑ Government ❑ Commercial
3. Project Description / Purpose [PCN Form 133d and 133e]:
The site contains residential structures, out -buildings and wooded land. The site is proposed for light industrial development.
4. Property Owner / Applicant [PCN Form A3 or A4]: Multiple Owners - Attached/Crown Companies
5. Agent / Consultant [PNC Form A5 — or ORM Consultant ID Number]:
David Brame, Pilot Environmental, Inc.
6. Related Action ID Number(s) [PCN Form B5b]: NA
7. Project Location— Coordinates, Street Address, and/or Location Description [PCN Form Blb]:
Burlington Road
36.09165 /-79.70392
8. Project Location— Tax Parcel ID [PCN Form Bla]: Multiple Parcels - See Attached
9. Project Location— County [PCN Form A2b]: Guilford
10. Project Location — Nearest Municipality or Town [PCN Form A2c]: Greensboro
11. Project Information — Nearest Waterbody [PCN Form 132a]: South Buffalo Creek
12. Watershed / 8-Digit Hydrologic Unit Code [PCN Form 132c]: 03030002
Authorization: Section 10 ❑ Section 404 ❑✓
Regulatory Action Type:
❑ Standard Permit
✓ Nationwide Permit #
Regional General Permit #
Jurisdictional Determination Request
Section 10 and 404 ❑
❑ Pre -Application Request
❑ Unauthorized Activity
❑ Compliance
❑ No Permit Required
Revised 20150602

FATr'
4.
N•:3-�1 H CARD-INA
EUArGnme �Qua4iy
WaiV REeEuJrLes
Office Use Only
Corps Action I D no. [Click to enter.] Date received: [Click to enter.]
DWR project no. Click enter.] Date received: [Click to enter.]
Site Coordinates:
Latitude (DD.DDDDDD): 36.091745'
Longitude (DD.DDDDDD): 79.703674'
Form Version 4.3, April 20, 2022
Pre -Construction Notification (PCN) Form
(Ver. 4.2, January31, 2022)J
For Nationwide Permits and Regional General Permits and corresponding Water Quality Certifications
Please note: fields marked with a red asterisk are required. The form is not considered complete until all
mandatory questions are answered.
The PCN help document may be found at this link:
httas://edocs.dea.nc.aov/WaterResources/DocView.asax?dbid=0&id=2196924&cr=1
Please ensure you have submitted a pre -filing meeting request at least 30 days prior to submitting this
form, as DWR will not be able to accept your application without documentation of this important first step.
The Division has developed a Pre -filing Meeting Request email address 401 PreFile(a)ncdenr.clov to accept
the federally required pre -filing meeting request and provide confirmation receipt of submittal . This receipt
or similar documentation will satisfy 40 C.F.R. Section 121.4(a) which states "At least 30 days prior to
submitting a certification request, the project proponent shall request a pre -filing meeting with the certifying
agency." In accordance with 40 C.F.R. Section 121.5(b)(7), and (c)(5), all certification requests must
include documentation that a pre -filing meeting request was submitted to the certifying authority at least 30
days prior to submitting the certification request.
Attach documentation of Pre -Filing Meeting Request to this Application.
Date of Pre -filing Meeting Request (MM/DD/YYYY) : 12/9/2022
Page 1 of 23 PCN Form Version 4.3- April 20, 2022

A. Processing Information
County (counties) where project is located: *
Guilford Additional (if needed).
Is this a NCDMS project? *
(Click yes only if NCDMS is the applicant or co-
❑ Yes 0 No
applicant)
Is this a public transportation project?
(Publicly funded municipal, state, or federal road, rail,
❑ Yes N No
or airport project)
Is this a NCDOT project?
❑ Yes N No
If yes, NCDOT TIP or state project number:
Click to enter.
If yes, NCDOT WBS number:
Click to ente
N Section 404 Permit (wetlands, streams, waters,
Clean Water Act)
la. Type(s) of approval sought from the Corps:
❑ Section 10 Permit (navigable waters, tidal
waters, Rivers and Harbors Act)
Has this PCN previously been submitted? *
❑ Yes N No
Please provide the date of the previous submission. *
Click to enter a date.
N Nationwide Permit (NWP)
1 b. What type(s) of permit(s) do you wish to seek
❑ Regional General Permit (RGP)
authorization?
❑ Standard (IP)
This form may be used to initiate the standard/ individual permit process with the USACE. Please contact your Corps
representative concerning submittals for standard permits. All required items can be included as attachments and
submitted with this form.
1 c. Has the NWP or GP number been verified by the Corps? *
❑ Yes N No
NWP number(s) (list all numbers ):
NWP 29
RGP number(s) (list all numbers ):
Click to enter.
Are you a federal applicant?
❑ Yes N No
If yes, please provide a statement concerning compliance with the Coastal Zone Management Act
Click to enter text
1d. Type(s) of approval sought from DWR (check all that apply):
N 401 Water Quality Certification — Regular
❑ 401 Water Quality Certification— Express
❑ Non-404 Jurisdictional General Permit
❑ Riparian Buffer Authorization
❑ Individual 401 Water Quality Certification
Is this a courtesy copy notification
❑ Yes 0 No
1e. Is this notification solely for the record because written approval is not required? *
For the record only for DWR 401 Certification:
❑ Yes N No
For the record only for Corps Permit:
❑ Yes N No
1f. Is this an after -the -fact permit/certification application?
❑ Yes N No
Page 2 of 23 PCN Form Version 4.3-April 20, 2022

1 g.
Is payment into a mitigation bank or in -lieu fee program proposed for
❑ Yes
0 No
mitigation of impacts?
If yes, attach the acceptance letter from mitigation bank or in -lieu fee program.
1 h.
Is the project located in any of NC's twenty coastal counties? *
❑ Yes
N No
1i.
Is the project located within an NC DCM Area of Environmental
❑ Yes
N No ❑ Unknown
Concern (AEC)? *
1j.
Is the project located in a designated trout watershed?
❑ Yes
N No
If yes, you must attach a copy of the approval letter from the appropriate
Wildlife Resource Commission Office.
Trout information may be found at this link: httr)://www.saw.usace.army.miI/Missions/Regulatory-Permit-
Program/Agency-Coordination/Trout.aspx
Page 3 of23 PCN Form Version 4.3-April 20, 2022

B. Applicant Information
1a.
Who is the primary contact? *
Daniel Barnes
1b.
Primary Contact Email: *
[e-mail]
1 c.
Primary Contact Phone: * (###)###-####
336-386-9790
1 d.
Who is applying for the permit/certification? (check
all that apply)
® Owner ❑ Applicant (other than owner)
1 e.
Is there an agent/consultant for this project?
® Yes ❑ No
2.
Landowner Information
2a.
Name(s) on Recorded Deed: *
Annacor Properties, LLC/ Donnell, John
2b.
Deed Book and Page No.:
Multiple — See attached
2c.
Contact Person (for corporations):
Kelly Wallace Baird
2d.
Address *
Street Address:
375 Coventry Park Lane
Address line 2:
Click to enter.
City:
Winston-Salem
State/ Province/ Region:
North Carolina
Postal/ Zip Code:
27104
Country:
United States
2e.
Telephone Number: * (###)###-####
336-580-0809
2f.
Fax Number: (###)###-####
Click to enter.
2g.
Email Address: *
[e-mail]
3.
Applicant Information (if different from owner)
3a.
Name:
Daniel Barnes
3b.
Business Name (if applicable):
Eight Forty Partners, LLC
3c.
Address:
Street Address:
PO Box 341
Address line 2:
Click to enter.
City:
Dobson
State/ Province/ Region:
NC
Postal/ Zip Code:
27017
Country
United States
3d.
Telephone Number: (###)###-####
336-386-9790
3e
Fax Number: (###)###-####
Click to ente
3f.
Email Address:
[e-mail]
Page 4 of 23 PCN Form Version 4.3-April 20, 2022

4. Agent/ Consultant (if applicable)
4a. Name:
David Brame
4b. Business Name:
Pilot Environmental, Inc.
4c. Address:
Street Address:
743 Park Lawn Court
Address line 2:
Click to entr
City:
Kernersville
State/ Province/ Region:
North Carolina
Postal/ Zip Code:
27284
Country:
United States
4d. Telephone Number: (###)###-####
336/708-4617
4e Fax Number: (###)###-####
Click to entr
4f. Email Address:
[e-mail]
Agent Authorization Letter:
Attach a completed/signed agent authorization form or letter. A sample form may be found at this link:
https://www.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Permits/2017-Nationwide-Permits/Pre-
construction-Notification/
Page 5 of23 PCN Form Version 4.3-April 20, 2022

C. Project Information and Prior Project History
1. Project Information
1a. Name of project: *
Burlington Road Industrial
1 b. Subdivision name (if appropriate):
Click to entp
1c. Nearest municipality/town: *
Greensboro
2.
Project Identification
2a.
Property identification number (tax PIN or parcel ID):
Multiple — see attached
2b.
Property size (in acres):
56
2c.
Project Address:
Street Address:
Burlington Road
Address line 2:
LU UJ I«1.
City:
Greensboro
State/ Province/ Region:
North Carolina
Postal/ Zip Code:
27405
Country:
United States
2d.
Site coordinates in decimal degrees (using 4-6 digits
after the decimal point):
Latitude (DD.DDDDDD): 36.091745'
Longitude (-DD.DDDDDD):-79.703674'
3. Surface Waters
3a. Name of nearest body of water to proposed project: *
South Buffalo Creek
3b. Water Resources Classification of nearest receiving
WS-V;NSW
water: *
The Surface Water Classification map may be found at this link:
https://ncdenr.maps.arcgis.com/apes/webappviewer/index.htmI?id=6e125ad7628f494694e259c80dd64265
Cape Fear
3c. In what river basin(s) is your project located? `
unoose aamuonal (if needed)
3d. Please provide the 12-digit HUC in which the project is
030300020104
located:
The Find Your HUC map may be found at this link:
https://ncdenr.maps.arcqis.com/apps/Pubiiclnformation/index.html?appid=ad3a85aOc6d644aOb97cdO69db238ac3
Page 6 of23 PCN Form Version 4.3-April 20, 2022

4.
Project Description and History
4a.
Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of
this application: *
Several single-family residences and out -buildings are located on the northeastern portion of the site.
Remnants of residential driveways and a small garage building are located on the southern portion of
the site. The remainder of the site contains wooded land. Ponds and streams are not located on the
site. Wetlands are located in drainage swales on the western and northern portions of the site. The
wetlands are separated from surrounding uplands by topographic, vegetation and/or soil breaks. The
surrounding properties contain residences, a gas station, roadways and wooded land.
4b.
Have Corps permits or DWR certifications been obtained for this
❑ Yes X No ❑ Unknown
project (including all prior phases) in the past? *
If yes, please give the DWR Certification number and/or Corps
[Click to enter.]
Action ID (ex. SAW-0000-00000):
IClick to enter.]
Attach any pertinent project history documentation
4b2.
Is any portion of the work already complete?
❑ Yes X No
If yes, describe the completed work.
Click to enter text.
4c.
List of other certifications or approvals/denials received from other federal, state or local agencies for work
described in this application not related to the 404 or 401.
NA
4d.
Attach an 8'Y2 x 11" excerpt from the most recent version of the USGS topographic map indicating the location of
the project site.
4e.
Attach an 8'Y2 x 11" excerpt from the most recent version of the published County NRCS Soil Survey map
depicting the project site.
4f.
List the total estimated acreage of all existing wetlands on the
1.7 acres
property:
4g.
List the total estimated linear feet of all existing streams (intermittent
0 linear feet
and perennial) on the property:
4g1.
List the total estimated acreage of all existing open waters on the
0 acres
property:
4h.
Explain the purpose of the proposed project:
The purpose of the proposed project is to construct an industrial facility.
4i.
Describe the overall project in detail, including the type of equipment to be used:
The overall project includes the proposed construction of the Burlington Road Industrial park on an approximate
56 acre tract. The business park will consist of three buildings, parking lots and driveways/roadways. Two
entrances, one from Burlington Road and one from Willow Lake Road are required to satisfy safety and
development ordinances. When developed, the site will have three permanent stormwater ponds.
To facilitate the development, clearing and grading the site is necessary. Graders, haulers, excavators and other
heavy equipment will be used during grading of the site and construction of the business park. When developed,
water and sanitary sewer services will be provided by the municipality.
In order to develop the site with the business park, two wetland areas will be filled. Impacts to streams are not
required. Wetland impacts have been minimized to the extent possible through the careful placement of
buildings, parking lots and roads. French drains are proposed to reduce secondary impacts to wetlands.
4j.
Attach project drawings/site diagrams/depictions of impact areas for the proposed project.
Page 7 of23 PCN Form Version 4.3-April 20, 2022

4k. Will this activity involve dredging in wetlands or waters? * ❑ Yes X No
If yes, describe the type of dredging, the composition of the dredged material, and the locations of disposal area.
UlICK to enter teh,
Page 8 of23 PCN Form Version 4.3-April 20, 2022

5.
Jurisdictional Determinations
5a.
Have the wetlands or streams been delineated on the property or in
® Yes ❑ No ❑ Unknown
proposed impact areas?
Comments:
,lick to enter text
5b.
If the Corps made a jurisdictional determination,
X❑ Preliminary ❑ Approved ❑ Emailed concurrence
what type of determination was made?
❑ Not Verified ❑ Unknown ❑ n/a
Corps AID number (ex. SAW-0000-00000):
SAW-2021-02340
Name (if known): Michael Brame
5c.
If 5a is yes, who delineated the jurisdictional
Agency/Consultant Company: Pilot Environmental
areas?
Other: Click to enter
5d.
List the dates of the Corps jurisdictional determination or State determination if a determination was made by
either agency.
USACE JD dated December 2, 2021 provided by Mr. James Lastinger with the USACE attached
5d1.
Attach jurisdictional determinations.
6. Future Project Plans
6a. Is this a phased project?
❑ Yes X❑ No
6b. If yes, explain.
Click to enter.
Are any other NWP(s), regional general permit(s), or individual permit(s) used, or intended to be used, to
authorize any part of the proposed project or related activity? This includes other separate and distant crossings
for linear projects that require Department of the Army authorization but don't require pre -construction
notification.
No additional permits are intended to be used for this project.
7. Addresses of adjoining property owners, lessees, etc. whose property adjoins the waterbody (if more than can be
entered here, please attach a supplemental list)
PIN 7895139771
Owner SANDERS, DONNA M;SANDERS, ROBERT A
Mail Address 6708 CARRIAGE CROSSING DR
Mail City PLEASANT GARDEN
Mail State NC
Mail Zip 27313
Property Address 229 WILLOWLAKE RD
8. Scheduling of activity:
To begin upon all necessary authorizations and to be completed within the next 1 to 5 years.
Page 9 of23 PCN Form Version 4.3-April 20, 2022

D. Proposed Impacts Inventory
Impacts Summary
0 Wetlands ❑ Streams - tributaries
1 a. Where are the impacts associated with your project ❑ Buffers ❑ Open Waters
(check all that apply):
❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, complete this table for each wetland area impacted.
2a.
Site # `
2a1.
Impact
Reason/Type
2b.
Impact
Duration
2c.
Wetland Type
2d.
Wetland Name
2e.
Forested
?
2f.
Jurisdiction
Type
2g.
Impact Area
(ac)
W1
Fill (Incl.
Riprap)
Permanent
Headwater
Forest
WD
Yes
Both
0.259
W2
Fill (Incl.
Riprap)
Permanent
Headwater
Forest
WD
Yes
Both
0.068
W3
Grading
Temporary
Headwater
Forest
WD
Yes
Both
0.007
W4
Grading
Temporary
Headwater
Forest
WD
Yes
Both
0.003
W5
Choosc one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W6
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W7
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W8
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W9
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W10
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W11
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W12
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W13
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W14
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W15
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
2g1. Total temporary wetland impacts
0.010 ac
2g2. Total permanent wetland impacts
0.327 ac
2g3. Total wetland impacts
0.337 ac
2h. Type(s) of material being discharged and the amount of each type in cubic yards:
Click to enter text.
Page 10 of23 PCN Form Version 4.3-April 20, 2022

2i. Comments:
Four wetland impacts are proposed. Wetland impact W1 and W2 are associated with building/parking lot
construction. These wetlands will be filled. The wetlands are forested. Wetland impact W3 and W4 are
temporary impacts associated with the installation of the permanent fill and grassed side slope and include
installation of silt fence, diversion swales and tree and wetland protection fencing. W3 and W4 will be returned to
their existing elevation and hydrological conditions and allowed to revegetate following construction.
Page 11 of23 PCN Form Version 4.3-April 20, 2022

3. Stream Impacts
If there are perennial or intermittent stream/ tributary impacts (including temporary impacts) proposed on the site,
complete this table for all stream/ tributary sites impacted.
** All Perennial or Intermittent streams must be verified by DWR or delegated local government
Site #X
3a
Impact
Reason*
3b.
Impact
Duration*
3c.
Impact Type
3d.
Stream Name
3e.
Stream
Type*
3f.
Jurisdiction
Type
3g.
Stream Width
(avg ft)
3h.
Impact length
(linear ft)
Si
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S2
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S3
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S4
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S5
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S6
dick to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S7
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S8
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S9
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S10
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S11
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S12
lick to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S13
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S14
lick to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S15
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S16
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S17
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S18
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S19
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S20
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
3i1. Total jurisdictional ditch
impact:
0 linear ft
3i2. Total permanent stream
impacts:
0 linear ft
M. Total temporary stream
impacts:
0 linear ft
34. Total stream and ditch
impacts:
0 linear ft
3j. Comments:
Stream impacts are not proposed.
Page 12 of23 PCN Form Version 4.3-April 20, 2022

4.
Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other
open water of the U.S., individually list all open water impacts in the table below.
4a.
Site #*
4a1.
Impact Reason
4b.
Impact
Duration*
4c.
Waterbody Name*
4d.
Activity Type*
4e.
Waterbody
Type*
4f.
Impact area
(ac)*
01
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
02
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
03
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
04
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
05
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
4g.
Total temporary open water impacts
Click to enter. ac
4g.
Total permanent open water impacts
Click to enter. ac
4g.
Total open water impacts
Click to enter. ac
4h.
Comments:
Open water impacts are not proposed.
5.
Pond or Lake Construction
If pond or lake construction is proposed, complete the table
below. (*This
does NOT include offline stormwater
management ponds.)
5a.
5b.
5c.
5d.
5e.
Pond ID
Proposed use or
Wetland Impacts
(ac)
Stream
Impacts (ft)
Upland
#
purpose of pond
Impacts (ac)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
enter.
P2
Choose one
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
enter.
P3
Choose one
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
enter.
5f.
Total
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
enter.
5g.
Comments:
Click to enter.
5h.
Is a dam high hazard permit required?
❑ Yes ❑ No
If yes, permit ID no.:
Click to enter.
5i.
Expected pond surface area (acres):
Click to enter.
5j.
Size of pond watershed (acres):
Click to enter.
5k.
Method of construction:
Pond or lake construction is not proposed.
Page 13 of 23 PCN Form Version 4.3- April 20, 2022

6. Buffer Impacts (DWR requirement)
If project will impact a protected riparian buffer, then complete the chart below. Individually list all buffer impacts.
6a. Project is in which protected basin(s)?
(Check all that apply.)
❑ Neuse ❑ Tar -Pamlico ❑ Catawba
❑ Jordan ❑ Goose Creek ❑ Randleman
❑ Other: Click to ente
Site #*
6b.
Impact Type*
6c.
Impact Duration*
6d.
Stream Name*
6e.
Buffer
Mitigation
Required?*
6f.
Zone 1 Impact*
(sq ft)
6g.
Zone 2 Impact*
(sq ft)
131
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B2
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
133
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
134
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B5
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
136
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
137
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
138
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B9
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B10
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
1311
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B12
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B13
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B14
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B15
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B16
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B17
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B18
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B19
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B20
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
6h. Total temporary impacts:
Zone 1: Click to enter sq ft
Zone 2: Click to enter. sq ft
6h. Total permanent impacts:
Zone 1: Click to enter sq ft
Zone 2: Click to enter. sq ft
6h. Total combined buffer impacts:
Zone 1: Click to enter. sq ft
Zone 2: Click to enter. sq ft
6i. Comments:
Protected buffers will not be impacted by the proposed.
Please attach supporting documentation (impact maps, plan sheets, etc.) for the proposed project.
Page 14 of23 PCN Form Version 4.3-April 20, 2022

E. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts through project design:
The applicant has designed the proposed development to avoid impacts to the remaining stream and wetlands
located on the site. In order to develop the site and provide access across the stream and permanent
maintenance of the community septic system, the proposed impacts could not be avoided. Civil design, such as
reducing the length of pipe by use of headwalls and endwalls were used to further reduce impacts to streams
and wetlands.
1 b. Specifically describe measures taken to avoid or minimize proposed impacts through construction techniques:
The applicant has designed the proposed development to avoid impacts to the remaining stream and wetlands
located on the site. In order to develop the site and provide access across the stream and permanent
maintenance of the community septic system, the proposed impacts could not be avoided. Civil design, such as
reducing the length of pipe by use of headwalls and endwalls were used to further reduce impacts to streams
and wetlands.
The applicant has designed the proposed development to avoid impacts to the remaining wetlands located on
the site. In order to develop the site and provide the necessary parking and the required access and to construct
the project, the proposed impacts could not be avoided. Civil design, such as minimizing the preferred number
of parking, use of 2:1 slopes, the sizes, orientation and locations of buildings and roadways were used to further
reduce impacts to streams and wetlands.
In order to avoid secondary impacts to wetlands by removing/redirecting hydrology, French drains have been
added above the fill locations for each of the wetlands, stormwater ponds have been placed adjacent to the
wetlands and will resupply hydrology back to the wetlands Providing the use of French drains at the heads of
wetlands and stormwater outlets as upgradient as possible, secondary impacts that cause a loss of hydrology to
wetlands on the site are not anticipated.
2. Compensatory Mitigation for Impacts to Waters of the U.S., Waters of the State, or Riparian Buffers
2a. If compensatory mitigation is required, by whom is it required? * 0 DWR 0 Corps
(check all that apply)
2b. If yes, which mitigation option(s) will be used for this ❑ Mitigation Bank
project? * (check all that apply) 0 In Lieu Fee Program
❑ Permittee Responsible Mitigation
3. Complete if using a Mitigation Bank
(Must satisfy NC General Statute143-214.11 (d1).)
3a. Name of mitigation bank:
Click to enter.
3b. Credits purchased/requested:
Type: Choose one
Quantity Click to enter.
Type: Choose one
Quantity Click to enter.
Type: Choose one
Quantity Click to enter.
Attach receipt and/or approval letter.
3c. Comments:
Local mitigation banks were contacted but anable to provide the necessary credits.
Page 15 of23 PCN Form Version 4.3-April 20, 2022

4.
Complete if Using an In Lieu Fee Program
4a.
Attach approval letter from in lieu fee program.
4b.
Stream mitigation requested:
Click to ente linear feet
4c.
If using stream mitigation, what is the stream temperature:
Choose one
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington
District's RIBITS website: (Please use the filter and select Wilmington district)
https://ribits. usace. army. mil/ribits apex/f?p=107:27:2734709611497::NO: RP:P27 BUTTON KEY:O
4d.
Buffer mitigation requested (DWR only):
Click to enter. square feet
4e.
Riparian wetland mitigation requested:
0.327 acres
4f.
Non -riparian wetland mitigation requested:
Click to enter. acres
4g.
Coastal (tidal) wetland mitigation requested:
Click to enter. acres
4h.
Comments:
DMS has been contacted and will be used to secure wetland mitigation credits. Wetland credits will be
purchased to off -set wetland impacts W1 and W2. 0.654 acres of wetland credits will be purchased to off -set
0.327 acres of impact at a 2:1 ratio. DMS Statement of Availability (SoA) is attached.
5. Complete if Providing a Permittee Responsible Mitigation Plan
5a. If proposing a permittee responsible mitigation plan, provide a description of the proposed mitigation plan,
including mitigation credits generated.
Click to enter.
5b. Attach mitigation plan/documentation.
6.
Buffer Mitigation (State Regulated Riparian Buffer Rules) - DWR requirement
6a.
Will the project result in an impact within a protected riparian buffer
❑ Yes X No
that requires buffer mitigation?
If yes, please complete this entire section - please contact DWR for more information.
6b.
If yes, identify the square feet of impact to each zone of the riparian buffer that requires
mitigation. Calculate the
amount of mitigation required in the table below.
6c.
6d.
6e.
Zone
Reason for impact
Total impact
Multiplier
Required mitigation
(square feet)
(square feet)
Zone 1
CIIGK Lu en Lei.
�_,JJLA Lu en Lei.
l muse one
-ucrc Lu en Lei.
Zone 2
Click to enter.
Click to enter.
Choose one
Click to enter.
6f. Total buffer mitigation required
Click to enter.
6g.
If buffer mitigation is required, is payment to a mitigation bank or
❑ Yes ❑ No
NC Division of Mitigation Services proposed?
6h.
If yes, attach the acceptance letter from the mitigation bank or NC Division of Mitigation
Services.
6i.
Comments:
Buffer mitigation is not proposed.
Page 16 of23 PCN Form Version 4.3-April 20, 2022

Page 17 of 23 PCN Form Version 4.3- April 20, 2022

F. Stormwater Management and Diffuse Flow Plan (DWR requirement)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers
❑ Yes 0 No
identified within one of the NC Riparian Buffer Protection Rules?
1 b. All buffer impacts and high ground impacts require diffuse flow or other form of stormwater treatment. If the
project is subject to a state implemented riparian buffer protection program, include a plan that fully documents
how diffuse/dispersed flow will be maintained.
All Stormwater Control Measures (SCM) must be designed in accordance with the NC Stormwater Design
Manual (https://deg.nc.,qov/about/divisions/energy-mineral-land-resources/energy-mineral-land-permit-
guidance/stormwater-bmp-manual).
Associated supplement forms and other documentation must be provided.
❑ Level Spreader
What Type of SCM are you
❑ Vegetated Conveyance (lower seasonal high water table- SHWT)
providing?
❑ Wetland Swale (higher SHWT)
(Check all that apply)
❑ Other SCM that removes minimum 30% nitrogen
❑ Proposed project will not create concentrated stormwater flow through the
buffer
For a list of options to meet the diffuse flow requirements, click here.
Attach diffuse flow documentation.
2.
Stormwater Management Plan
2a.
Is this an NCDOT project subject to compliance with NCDOT's
Individual NPDES permit NCS000250?
0 Yes ❑ No
2b.
Does this project meet the requirements for low density projects as
defined in 15A NCAC 02H .1003(2)? *
❑ Yes 0 No
To look up low density requirements, click here:
http://reports.oah.state. nc.us/ncac/title%2015a%20-%20environmental%20guaIity/chapter%2002%20-
%20environmental%20manage ment/subchapter%20h/15a%20ncac%2002h%20.1003.pdf
2c.
Does this project have a stormwater management plan (SMP)
0 Yes ❑ No
reviewed and approved under a state stormwater program or state -
approved local government stormwater program?
❑ n/a — project disturbs < 1 acre
Note: Projects that have vested rights, exemptions, or grandfathering from state or locally implemented
stormwater programs or projects that satisfy state or locally -implemented stormwater programs through use of
community in -lieu programs should answer "no" to this question.
2d.
Which of the following stormwater management program(s) apply?
0 Local Government
(Check all that apply.)
❑ State
If you have local government approval, please include the SMP on their overall impact map.
Local Government Stormwater Programs
0 Phase II ❑ USMP
0 NSW 0 Water Supply
Page 18 of23 PCN Form Version 4.3-April 20, 2022

Please identify which local government stormwater program you are using.
Guilford County
State Stormwater Programs ❑ Phase II ❑ HQW or ORW
❑ Coastal Counties ❑ Other
Comments:
Post construction stormwater management is a requirement for the project. A SWMP will be prepared for review
and approval by local planning prior to any grading activities at the site.
Page 19 of23 PCN Form Version 4.3-April 20, 2022

G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local)
❑ Yes X No
funds or the use of public (federal/state) land?
1 b. If you answered "yes" to the above, does the project require
preparation of an environmental document pursuant to the
requirements of the National or State (North Carolina) Environmental
❑Yes X No
Policy Act (NEPA/SEPA)?
1 c. If you answered "yes" to the above, has the document review been
finalized by the State Clearing House? (If so, attach a copy of the
❑ Yes X No
NEPA or SEPA final approval letter.)
Comments:
The project does not require a NEPA or SEPA.
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),
Federally Non -Jurisdictional Wetlands /Classified Surface Waters
❑ Yes X No
(15A NCAC 2H. 1400) DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. If you answered "yes" to the above question, provide an explanation of the violation(s):
AICK to enter.
3. Cumulative Impacts (DWR Requirement)
3a. Will this project (based on past and reasonably anticipated future
impacts) result in additional development, which could impact nearby
❑ Yes X No
downstream water quality?
3b. If you answered "no", provide a short narrative description:
Click to enter.
3c. If yes, provide a qualitative or quantitative cumulative impact analysis in accordance with the most recent DWR
policy. (Attach .pdf)
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project? I ® Yes ❑ No ❑ N/A
4b. If yes, describe in detail the treatment methods and dispositions (non -discharge or discharge) of wastewater
generated from the proposed project. If the wastewater will be treated at a treatment plant, list the capacity
available at that plant.
Wastewater will be discharged into existing infrastructure located proximate to the site. Additional impacts will
not be required by proposed sewer line installation.
Page 20 of23 PCN Form Version 4.3-April 20, 2022

5.
Endangered Species and Designated Critical Habitat (Corps Requirement)
5a.
Will this project occur in or near an area with federally protected
❑ Yes 0 No
species or habitat? (IPAC weblink: https://www.fws.gov/ipac/ [fws.govl)
5b.
Have you checked with the USFWS concerning Endangered Species
0 Yes 0 No
Act impacts? *
5c.
If yes, indicate the USFWS Field Office you have contacted.
Choose one
5d.
Is another federal agency involved? *
❑ Yes 0 No ❑ Unknown
If yes, which federal agency?
Click to enter.
5e.
Is this a DOT project located within Divisions 1-8?
❑ Yes 0 No
5f.
Will you cut any trees in order to conduct the work in waters of the
U.S.? *
®Yes El No
5g.
Does this project involve bridge maintenance or removal? *
❑ Yes 0 No
5g1.
If yes, have you inspected the bridge for signs of bat use such as
staining, guano, bats, etc.? Representative photos of signs of bat use
❑ Yes ❑ No
can be found in the NLEB SLOPES, Appendix F, pages 3-7.
Representative photos of signs of bat use can be found in the NLEB SLOPES, Appendix F, pages 3-7. Link to
NLEB SLOPES document: http://saw-reg.usace.army.mil/NLEB/1-30-17-signed
NLEB-SLOPES&apps.pdf
If you answered yes to 5g1, did you discover any signs of bat use? *
❑ Yes ❑ No ❑ Unknown
If yes, please show the location of the bridge on the permit drawings/ project plans
5h.
Does this project involve the construction/ installation of a wind
turbine(s)? *
❑ Yes 0 No
If yes, please show the location of the wind turbine(s) on the permit drawings/ project plans (attach .pdf)
5i.
Does this project involve blasting and /or other percussive activities
that will be conducted by machines, such as jackhammers,
❑ Yes 0 No
mechanized pile drivers, etc.?
If yes, please provide details to include type of percussive activity, purpose,
duration, and specific location of this
activity on the property (attach .pdf)
Page 21 of23 PCN Form Version 4.3-April 20, 2022

5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated
Critical Habitat? *
US Department of the Interior — Fish and Wildlife Service Official Species List from IPaC
The tri-colored bat (Proposed Endangered), small whorled pogonia (Threatened), Schweinitz's sunflower
(Endangered), and monarch butterfly (Candidate) are included by the IPaC as federally listed species that have
been identified within the vicinity of the site.
Bat hibernacula is not located on the site. Trees that could afford suitable summer roosting habitat are present
within the areas of impact. A small amount of clearing will be required to complete the impacts. Known
occurrences are not identified within 2 miles of the site. Additionally, the Tri-colored bat is currently listed as
proposed endangered. Based on the small amount of clearing and the low potential of impact, the project is
unlikely to impact TCB should it become uplisted.
The areas of proposed impacts and areas surrounding the proposed impacts contain dense wooded land.
Suitable habitat for the sunflower or small whorled pogonia are not located on the site. The proposed project is
not likely to adversely impact these species.
The Monarch butterfly is a candidate species that is not subject to provisions of the ESA or consultation with the
service. The proposed project is not likely to adversely impact this species.
Attach consultation documentation.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as
an Essential Fish Habitat? *
❑ Yes X No
Is there submerged aquatic vegetation (SAV) around
the project vicinity? *
❑Yes 0 No ❑Unknown
Will this project affect submerged aquatic vegetation?
❑ Yes X No ❑ Unknown
Explain: Click to erIL,
6b. What data source(s) did you use to determine whether your site would impact Essential Fish Habitat?
Essential Fish Habitat Mapper — NOAA Fisheries
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data):
http://gis. ncdcr.,qov/hpoweb/
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural
preservation status (e.g., National Historic Trust designation or
❑ Yes X No
properties significant in North Carolina history and archaeology)?
7b. What data source(s) did you use to determine whether your site would impact historic or archeological
resources? *
NC Historic Preservation Office's HPOWEB 2.0. Historic properties that are listed or are eligible for listing on the
National Register for Historic Places were not identified on or proximate to the wetland impacts or the site. A
copy of the SHPO Map is included as an attachment.
7c. Attach historic or prehistoric documentation.
Page 22 of23 PCN Form Version 4.3-April 20, 2022

8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https://msc.fema.,qov/portal/search
8a. Will this project occur in a FEMA-designated 100-year floodplain? *
❑ Yes X No
8b. If yes, explain how the project meets FEMA requirements.
Click to enter.
8c. What source(s) did you use to make the floodplain determination?
FEMA Firm Map (Drawing 4)
H. Miscellaneous
Comments:
Click to enter.
Attach pertinent documentation or attachments not previously requested
I. Signature *
X By checking the box and signing below, I, as the project proponent, certify to the following:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete, to
the best of my knowledge and belief;
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401
certification request within the applicable reasonable period of time;
• The project proponent hereby agrees that submission of this PCN form is a "transaction" subject to Chapter
66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act');
• The project proponent hereby agrees to conduct this transaction by electronic means pursuant to Chapter 66,
Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act');
• The project proponent hereby understands that an electronic signature has the same legal effect and can be
enforced in the same way as a written signature; AND
• As the project proponent, I intend to electronically sign and submit the PCN/online form.
Full Name: * David S. Brame
Signature: * �0;�-?-
612312023
Page 23 of 23 PCN Form Version 4.3- April 20, 2022

Proposal for Environmental Services
Pilot Proposal 7258.1
December 12, 2022
AGENT AUTHORIZATION
This form authorizes Pilot to act as our agent in stream/wetland matters including U.S. Army
Corps of Engineers and North Carolina Division of Water Resources field verification and
permitting.
Property Address: A],?e./.aW, —J RZ. :At
apewf.s
Applicant Information:
Name: % C,,MQJ C 01-tP4� /,C-,) -t C
Address: tip & Xc 3 Y/
Z)04330ra), /i L �TO!
Telephone Number:
Fax Number:
E-mail Address: DA.J145:7Z_Z e CRO1Lj1j _(fO1 lr 4^h_C .s. C&--(
Signature: ZY Date: 4 —zo ? 3
5

Jurisdictional Determination Request
I). 1'ROPERTY ACCESS CERT11111CATIONI,I
ltt .:iitnillp ki'low, I lnihorize representatives of the Wihningio►t District. US. Army Corps or
itI611i'vi., tl'(,rp!;) to cnler 11I►on llic property herein dcscribed for the ptirpose of conducting on-
!4i1. invr aiitnliom:. it' llem ity, ,Ill([ issuing a jurisdictional determination pursuant to Section
11I.1 lit t11c 1 •Irnl Willer Act and/or Section ill orthe Rivers and I larbors Act of 1899. 1, the
111111cr diawd. null cillwr 11 duly authorised owner or record of the property identified herein, or
;Ich"r m the duly authorized agent or the owner of record orihc property.
Kolly Wallam- aaird Manager of AnnCor Properties, LLC
I'I int Nnrn(•
ilY, Owner hl Authorized Anent'
I i:111• � �
IMl111 I /
I;. REASON FOR .11) REQUEST: (Check as many as applicable)
I intend to colvartict/dcVelop it project or perform activities on This parcel which would be
(rr;I wd 111 ,Amid n11 agonlic resources.
I i111cild to vollsirtid/develop it prnjccl or perform activities on this parcel which would be
I .ii n l I,, ;I\'6d;III jurisdictional rtcivatic resources tinder Corpsauthority.
E I I int"Ild III ('4111' trtid/develop 11 project m• IM-li,rlii activities on this parcel which mayt'.1116w :111111m i.;r(iml frotu Iile Corps, and the .11) would be used to avoid and minimize
iIIII I{I( r•, 141 jllri5d1C110II:It rt(ItititiC I•etiources acid its aii initial Step in a 1111n1'e I3e1'rilittirii;
I,IC..
illwml to t'11rm(I.11cl/develop t1 project or perlorm activities on this parcel which may
I.•Iluhc :1111111I►iralion From file Corps; this request is accompanied by my Permit application
mid (lit, 11) if, In he toted in the permilling process.
I-1 1 illictid It- coll';Irncl/develop 11 project or' perliirin activities in a navigable water of the
i I.S. wbi. 11 it hwhided oil the disirict Secliort 10 list ruld/or is subject to the ebb and flow of
t[Ie tide,
H A Corpri II) in w(luirecl in order oblaitt city local/Male authorization.
III Ielid I,- ronttrsl jIIrirulit, lioII 0VCI-:I Irrl'tic111.1r MllIitIic resource and regtiest itie Corps
I•Ilnfirlli Shirt !III i.,dictioll doer!/(Ines not exist over Hie aquatic resource on the Parcel.
HI I+4,1i"kc Ill:11 111c mite may be comprised entirely ofdry I:IIId.
1 )Ilt+•I,
I uI N1 IA I I rc'Ilur ,I , I,.11mvillp 111r i mfod N{'DO I A ISA(T. IrIr1111rok. skip In fart 1i,
r1 Ihrlr AW Inullihlr 1):ul ck owurd i)y 11111virm par*L, pluw prnvidr 11ty fidlowhili Ihr c:udh additional parcel tm a
1101141M I II)II 4111'1•1
Nh1•n 1nm 111+ :;J!d III m11111irinnl(n im mil nrl-,iltnrd I,y ownrw.).
V. I !roll Nlll1 '1111

Deed Book and Page — Owner - PIN
006041-03032
- ANNACOR PROPERTIES LLC - 7895139168
006099-03054
- ANNACOR PROPERTIES LLC - 114932
006933-02554
- DONNELL, JOHN W II;DONNELL, LILLIE H - 7895235311
002763-00180
- DONNELL, JOHN W II;DONNELL, LILLIE H - 7895234125
006293-00328
- ANNACOR PROPERTIES LLC - 7895235131
006064-02595 - ANNACOR PROPERTIES LLC - 7895226605
006068-02097 - ANNACOR PROPERTIES LLC - 7895226517
006041-03028 - ANNACOR PROPERTIES LLC - 7895226424
006429-02931 - ANNACOR PROPERTIES LLC - 7895128593
006429-02931 - ANNACOR PROPERTIES LLC - 7895222379
006429-02931 - ANNACOR PROPERTIES LLC - 7895221334
006444-00661 - ANNACOR PROPERTIES LLC - 7895220118
007243-02615 - ANNACOR PROPERTIES LLC - 7895128069
007243-02619 - ANNACOR PROPERTIES LLC - 7895127084

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U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW-2021-02340 County: Guilford U.S.G.S. Quad: NC-McLeansville
NOTIFICATION OF JURISDICTIONAL DETERMINATION
Requestor:
Pilot Environmental
Spencer Webster
Address:
PO Box 128
Kernersville, NC 27285
Telephone Number:
336-310-4527
E-mail:
swebster(dt)ilotenviro.com
Size (acres) 56 Nearest Town Greensboro
Nearest Waterway South Buffalo Creek River Basin Cape Fear
USGS HUC 03030002 Coordinates Latitude: 36.0916
Longitude:-79.7039
Location description: The proiect site is located at 7258 Burlington Road, near the citv of Greensboro, Guilford Countv, North
Carolina.
Indicate Which of the Following Apply:
A. Preliminary Determination
® There appear to be wetlands on the above described project area/property, that may be subject to Section 404 of the Clean Water
Act (CWA)(33 USC § 1344) and/or Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403). The wetlands have been
delineated, and the delineation has been verified by the Corps to be sufficiently accurate and reliable. The approximate boundaries
of these waters are shown on the enclosed delineation map dated 10/26/2021. Therefore this preliminary jurisdiction
determination may be used in the permit evaluation process, including determining compensatory mitigation. For purposes of
computation of impacts, compensatory mitigation requirements, and other resource protection measures, a permit decision made
on the basis of a preliminary JD will treat all waters and wetlands that would be affected in any way by the permitted activity on
the site as if they are jurisdictional waters of the U. S. This preliminary determination is not an appealable action under the
Regulatory Program Administrative Appeal Process (Reference 33 CFR Part 331). However, you may request an approved JD,
which is an appealable action, by contacting the Corps district for further instruction.
❑ There appear to be wetlands on the above described project area/property, that may be subject to Section 404 of the Clean Water
Act (CWA)(33 USC § 1344) and/or Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403). However, since the
wetlands have not been properly delineated, this preliminary jurisdiction determination may not be used in the permit evaluation
process. Without a verified wetland delineation, this preliminary determination is merely an effective presumption of CWA/RHA
jurisdiction over all of the wetlands at the project area, which is not sufficiently accurate and reliable to support an enforceable
permit decision. We recommend that you have the wetlands on your project area/property delineated. As the Corps may not be
able to accomplish this wetland delineation in a timely manner, you may wish to obtain a consultant to conduct a delineation that
can be verified by the Corps.
B. Approved Determination
❑ There are Navigable Waters of the United States within the above described project area/property subject to the permit
requirements of Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403) and Section 404 of the Clean Water Act
(CWA)(33 USC § 1344). Unless there is a change in law or our published regulations, this determination may be relied upon for
a period not to exceed five years from the date of this notification.
❑ There are wetlandson the above described project area/property subject to the permit requirements of Section 404 of the Clean
Water Act (CWA) (33 USC § 1344). Unless there is a change in the law or our published regulations, this determination may be
relied upon for a period not to exceed five years from the date of this notification.
❑ We recommend you have the wetlands on your project area/property delineated. As the Corps may not be able to accomplish
this wetland delineation in a timely manner, you may wish to obtain a consultant to conduct a delineation that can be verified by
the Corps.
❑ The wetlands on your project area/property have been delineated and the delineation has been verified by the Corps. The
approximate boundaries of these waters are shown on the enclosed delineation map dated DATE. We strongly suggest you have
this delineation surveyed. Upon completion, this survey should be reviewed and verified by the Corps. Once verified, this survey

SAW-2021-02340
will provide an accurate depiction of all areas subject to CWA jurisdiction on your property which, provided there is no change in
the law or our published regulations, may be relied upon for a period not to exceed five years.
❑ The wetlands have been delineated and surveyed and are accurately depicted on the plat signed by the Corps Regulatory
Official identified below onDATE. Unless there is a change in the law or our published regulations, this determination may be
relied upon for a period not to exceed five years from the date of this notification.
❑ There are no waters of the U.S., to include wetlands, present on the above described project area/property which are subject to the
permit requirements of Section 404 of the Clean Water Act (33 USC 1344). Unless there is a change in the law or our published
regulations, this determination may be relied upon for a period not to exceed five years from the date of this notification.
❑ The property is located in one of the 20 Coastal Counties subject to regulation under the Coastal Area Management Act (CAMA).
You should contact the Division of Coastal Management in Morehead City, NC, at [phone] to determine their
requirements.
Placement of dredged or fill material within waters of the US, including wetlands, without a Department of the Army permit may
constitute a violation of Section 301 of the Clean Water Act (33 USC § 1311). Placement of dredged or fill material, construction or
placement of structures, or work within navigable waters of the United States without a Department of the Army permit may
constitute a violation of Sections 9 and/or 10 of the Rivers and Harbors Act (33 USC § 401 and/or 403). If you have any questions
regarding this determination and/or the Corps regulatory program, please contact James Lastinger at 919-554-4884 ext 32 or
James. C.Lastinger(dusace.armv.mil.
C. Basis For Determination: Basis For Determination: See the preliminary jurisdictional determination
form dated 12/02/2021.
D. Remarks:
E. Attention USDA Program Participants
This delineation/determination has been conducted to identify the limits of Corps' Clean Water Act jurisdiction for the particular site
identified in this request. The delineation/determination may not be valid for the wetland conservation provisions of the Food Security
Act of 1985. If you or your tenant are USDA Program participants, or anticipate participation in USDA programs, you should request
a certified wetland determination from the local office of the Natural Resources Conservation Service, prior to starting work.
F. Appeals Information (This information applies only to approved jurisdictional determinations as indicated in B.
above)
If you object to this determination, you may request an administrative appeal under Corps regulations at 33 CFR Part 331. Enclosed
you will find a Notification of Appeal Process (NAP) fact sheet and Request for Appeal (RFA) form. If you request to appeal this
determination you must submit a completed RFA form to the following address:
US Army Corps of Engineers
South Atlantic Division
Attn: Mr. Philip A. Shannin
Administrative Appeal Review Officer
60 Forsyth Street SW, Floor M9
Atlanta, Georgia 30303-8803
AND
PHIL,IP.A. SHANNINAUSACE.ARMY.MIL,
In order for an RFA to be accepted by the Corps, the Corps must determine that it is complete, that it meets the criteria for appeal
under 33 CFR part 331.5, and that it has been received by the Division Office within 60 days of the date of the NAP. Should you
decide to submit an RFA form, it must be received at the above address by Not applicable.
**It is not necessary to submit an RFA rm to the Divisi Office if you do not object to the determination in this correspondence.**
Corps Regulatory Official:
Date of JD: 12/02/2021 Expiration Date of JD: Not applicable

SAW-2021-02340
The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we
continue to do so, please complete our Customer Satisfaction Survey, located online at
https:Hregulatoly.ops.usace.anny.mil/customer-service-survey/.
Copy Furnished:

NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
REQUEST FOR APPEAL
Applicant: Pilot Environmental, Spencer Webster File Number: SAW-2021-02340
Date: 12/02/2021
Attached is:
See Section below
INITIAL PROFFERED PERMIT (Standard Permit or Letter of permission)
A
PROFFERED PERMIT (Standard Permit or Letter of permission)
B
❑
PERMIT DENIAL
C
❑
APPROVED JURISDICTIONAL DETERMINATION
D
X❑
PRELIMINARY JURISDICTIONAL DETERMINATION
E
SECTION I - The following identifies your rights and options regarding an administrative appeal of the above decision.
Additional information may be found at or http://www.usace.annv.mil/Missions/CivilWorks/Res4ulatorvPros4ramandPennits.asbx
or the Corps regulations at 33 CFR Part 331.
A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• OBJECT: If you object to the permit (Standard or LOP) because of certain terms and conditions therein, you may request
that the permit be modified accordingly. You must complete Section II of this form and return the form to the district
engineer. Your objections must be received by the district engineer within 60 days of the date of this notice, or you will
forfeit your right to appeal the permit in the future. Upon receipt of your letter, the district engineer will evaluate your
objections and may: (a) modify the permit to address all of your concerns, (b) modify the permit to address some of your
objections, or (c) not modify the permit having determined that the permit should be issued as previously written. After
evaluating your objections, the district engineer will send you a proffered permit for your reconsideration, as indicated in
Section B below.
B: PROFFERED PERMIT: You may accept or appeal the permit
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• APPEAL: If you choose to decline the proffered permit (Standard or LOP) because of certain terms and conditions therein,
you may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of
this form and sending the form to the division engineer. This form must be received by the division engineer within 60 days
of the date of this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process by
completing Section 11 of this form and sending the form to the division engineer. This form must be received by the division
engineer within 60 days of the date of this notice.
D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or provide new
information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the
date of this notice, means that you accept the approved JD in its entirety, and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD, you may appeal the approved JD under the Corps of Engineers
Administrative Appeal Process by completing Section 11 of this form and sending the form to the district engineer. This form
must be received by the division engineer within 60 days of the date of this notice.

E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps regarding the
preliminary JD. The Preliminary JD is not appealable. If you wish, you may request an approved JD (which may be appealed),
by contacting the Corps district for further instruction. Also you may provide new information for further consideration by the
Corps to reevaluate the JD.
IF
SECTION II - REQt7WT FOR APP= CTIONS TO AN INITIAL PROFFERED PERMIT
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your objections to an initial
proffered permit in clear concise statements. You may attach additional information to this form to clarify where your reasons or
objections are addressed in the administrative record.)
ADDITIONAL INFORMATION: The appeal is limited to a review of the administrative record, the Corps memorandum for the
record of the appeal conference or meeting, and any supplemental information that the review officer has determined is needed to
clarify the administrative record. Neither the appellant nor the Corps may add new information or analyses to the record.
However, you may provide additional information to clarify the location of information that is already in the administrative
record.
POINT OF CONTACT FOR QUESTIONS OR INFORMATION:
If you have questions regarding this decision and/or the
If you only have questions regarding the appeal process you may
appeal process you may contact:
also contact:
District Engineer, Wilmington Regulatory Division
MR. PHILIP A. SHANNIN
Attn: James Lastinger
ADMINISTRATIVE APPEAL REVIEW OFFICER
Raleigh Regulatory Office
CESAD-PDS-O
U.S Army Corps of Engineers
60 FORSYTH STREET SOUTHWEST, FLOOR M9
3331 Heritage Trade Drive, Suite 105
ATLANTA, GEORGIA 30303-8803
Wake Forest, North Carolina 27587
PHONE: [phone]; FAX [phone]
EMAIL: PHILIP.A.SHANNIN(&USACE.ARMY.MIL,
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel, and any government
consultants, to conduct investigations of the project site during the course of the appeal process. You will be provided a 15-day
notice of any site investigation, and will have the opportuni to participate in all site investi ations.
Date:
Telephone number:
Signature of appellant or agent.
For appeals on Initial Proffered Permits send this form to:
District Engineer, Wilmington Regulatory Division, Attn: James Lastinger, , 69 Darlington Avenue, Wilmington, North
Carolina 28403
For Permit denials, Proffered Permits and Approved Jurisdictional Determinations send this form to:
Division Engineer, Commander, U.S. Army Engineer Division, South Atlantic, Attn: Mr. Philip Shannin, Administrative
Appeal Officer, CESAD-PDO, 60 Forsyth Street, Room 1OM15, Atlanta, Georgia 30303-8801
Phone: [phone]

PRELIMINARY JURISDICTIONAL DETERMINATION (PJD) FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PJD: 12/02/2021
B. NAME AND ADDRESS OF PERSON REQUESTING PJD: Pilot Environmental, Spencer Webster, PO
Box 128, Kernersville, NC 27285
C. DISTRICT OFFICE, FILE NAME, AND NUMBER: Wilmington District, 7258 Burlington Road site,
SAW-2021-02340
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION: The project site is located at 7258
Burlington Road, near the city of Greensboro, Guilford County, North Carolina.
(USE THE TABLE BELOW TO DOCUMENT MULTIPLE AQUATIC RESOURCES
AND/OR AQUATIC RESOURCES AT DIFFERENT SITES)
State: NC County: Guilford City: Greensboro
Center coordinates of site (lat/long in degree decimal format): Latitude: 36.0916 Longitude:-79.7039
Universal Transverse Mercator:
Name of nearest waterbody: South Buffalo Creek
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
© Office (Desk) Determination. Date: December 2, 2021
❑ Field Determination. Date(s):
TABLE OF AQUATIC RESOURCES INREVIEW AREA WHICH "MAY BE" SUBJECT TO
REGULATORY JURISDICTION
Site Number
Latitude
Longitude
Estimated
Type of aquatic
Geographic authority to
(decimal
(decimal
amount of
resources (i.e.,
which the aquatic
degrees)
degrees)
aquatic
wetland vs.
resource "may be"
resources in
non -wetland
subject (i.e., Section 404
review area
waters)
or Section 10/404)
(acreage and
linear feet, if
applicable
WA
36.08850000
-79.7064000
0.1 acre
wetland
Section 404
WB
36.09030000
-79.7064000
0.1 acre
wetland
Section 404
WC
36.09280000
-79.7064000
0.02 acre
wetland
Section 404
WD/WDE
36.09320000
-79.7051000
1 acre
wetland
Section 404
WE/WEA
36.09400000
-79.7036000
0.48 acre
wetland
Section 404

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

SUPPORTING DATA. Data reviewed for PJD (check all that apply) Checked items are included in the administrative
record and are appropriately cited:
0 Maps, plans, plots or plat submitted by or on behalf of the PJD requestor:
Map: attached
OData sheets prepared/submitted by or on behalf of the PJD requestor. Datasheets:
®Office concurs with data sheets/delineation report.
❑Officedoesnotconcurwithdata sheets/delineation report. Rationale:
❑ Data sheets prepared by the Corps:
❑Corps navigable waters' study:
®U.S. Geological Survey Hydrologic Atlas:
❑X USGS NHD data:
❑ USGS 8 and 12 digit HUC maps:
❑X U.S. Geological Survey map(s). Cite scale & quad name: McLeansville Quad
®Natural Resources Conservation Service Soil Survey. Citation: Guilford County, 1977, sheet 22 & 23
❑X National wetlands inventory map(s). Cite name: USFWS NWI mapper
❑ State/local wetland inventory map(s):
❑X FEMA/FIRM maps: NC FIRM
❑ 100-year Floodplain Elevation is: (National Geodetic Vertical Datum of 1929)
❑X Photographs: © Aerial (Name & Date): undated
or ❑ Other (Name & Date):
❑Previous determination(s). File no. and date of response letter:
❑Other information (please specify):
IMPORTANT NOTE: The information recorded on this form has not necessarily been verified by the Corps
and should not be relied upon for later jurisdictional determinations.
October 23, 2021
ignature and date of Regulatory Signature and date of person requesting PJD
staff member completing PJD (REQUTRED, unless obtaining the signature is
12/02/2021 impracticable) 1
r Districts may establish timeframes for requester to return signed PJD forms. If the requester does not respond within the established
time frame, the district may presume concurrence and no additional follow up is necessary prior to finalizing an action.

� J.
THE LOCATIONS OF FEATURES SHOWN ON THIS MAP ARE VERIFIED BY USACE JD SAW-2021-02340 DATED DECEMBER 2, 2021. THIS MAP
INCLUDES GPS LOCATIONS OF DELINEATED FEATRURES.
Drawing 5 Wetland Map
Satellite Imagery from ESRI s" `'' Burlington Road
and Pilot GPS Data
-'' 4 "'` ` ` Approximate 56-Acre Tract
- - =�-�;
Scale: 1" = 500' PIL131Greensboro, Guilford County, NC
Date:10.26.21 PIL0T 9NVIR0NMIN7AL.INC Pilot Project7258

• 1f Q p � �.. 1
Pfiscn �
v _-
w �/�■ r
•• � ,r �--� � 'des]
owl
VAL
1
o.
!!! mid' � y•. A7; �'
. =
"'.. .• �` LEGEND
` •J7 ' Site Boundary
Drawing 1 :1< ; ;ter;. USGS Topographic Map
USGS Topographic Map ' �.;. Burlington Road
McLeansville, '' =' Approximate 56-Acre Tract
NC Quadrangles PILOT Greensboro, Guilford County, NC
Scale: 1"=2,000' PIL0T ENV 1RO YENIAL,iN[ Pilot Project7258

Drawing 2
USDA Web Soil Survey
of Guilford County, NC PILOT wE,
Scale: 1" = 400' P I L 0 i E N V I R ON MEN 7 A L, INC
LEGEND
Site Boundary
Web Soil Map
Burlington Road
Approximate 56-Acre Tract
Greensboro, Guilford County, NC
Pilot Project 7258

Op
i
Frigram.
LEGEND
y
Site Boundary
Drawing 2A - Published Soil Map
USDA Soil Survey ``s I ..E. `:'{n` Burlington Road
of Guilford County, NC J - - Approximate 56-Acre Tract
Published 1977, Sheet 22 and 23 PIL 111� Greensboro, Guilford County, NC
Not to Scale PIL0T ENV IRO MENTAL,IX[ Pilot Project7258

Drawing 3
USFWS NWI
Wetlands Mapper PILOT .. /�
Scale: 1" = "00' P I L 0 i E N V 1 11 0 h Al E 14 7 A L I N[
NWI Map
Burlington Road
Approximate 56-Acre Tract
Greensboro, Guilford County, NC
Pilot Project 7258

y LEGEND
Site Boundary
a 1 %Annual Chance Flood Hazard
ORegulatory Floodvay
Sped al Floodvay
Area of Undetermined Flood Hazard
0.2%Annual Chance Flood Hazard
Future Conditions 1%Annual Chance Flood Hazard
�Area with Reduced Risk Due to Levee
FEMA FIRM
Drawing4
tr
Burlington Road
National Flood Hazard LayerApproximate 56-Acre Tract
From FEMA Web Map Service L01■ � Greensboro Guilford County, NC
Scale: 1" = 400' T RNVIR0NMIMTAL,INC Pilot Project7258

United States Department of the Interior
FISH AND WILDLIFE SERVICE
Raleigh Ecological Services Field Office
Post Office Box 33726
Raleigh, NC 27636-3726
Phone: [phone] Fax: [phone]
In Reply Refer To:
Project Code: 2023-0096385
Project Name: Brulington Road Industrial
June 22, 2023
Subject: List of threatened and endangered species that may occur in your proposed project
location or may be affected by your proposed project
To Whom It May Concern:
The enclosed species list identifies threatened, endangered, proposed and candidate species, as
well as proposed and final designated critical habitat, that may occur within the boundary of your
proposed project and/or may be affected by your proposed project. The species list fulfills the
requirements of the U.S. Fish and Wildlife Service (Service) under section 7(c) of the
Endangered Species Act (Act) of 1973, as amended (16 U.S.C. 1531 et seq.). If your project area
contains suitable habitat for any of the federally -listed species on this species list, the proposed
action has the potential to adversely affect those species. If suitable habitat is present, surveys
should be conducted to determine the species' presence or absence within the project area. The
use of this species list and/or North Carolina Natural Heritage program data should not be
substituted for actual field surveys.
New information based on updated surveys, changes in the abundance and distribution of
species, changed habitat conditions, or other factors could change this list. Please feel free to
contact us if you need more current information or assistance regarding the potential impacts to
federally proposed, listed, and candidate species and federally designated and proposed critical
habitat. Please note that under 50 CFR 402.12(e) of the regulations implementing section 7 of the
Act, the accuracy of this species list should be verified after 90 days. This verification can be
completed formally or informally as desired. The Service recommends that verification be
completed by visiting the ECOS-IPaC website at regular intervals during project planning and
implementation for updates to species lists and information. An updated list may be requested
through the ECOS-IPaC system by completing the same process used to receive the enclosed list.
The purpose of the Act is to provide a means whereby threatened and endangered species and the
ecosystems upon which they depend may be conserved. Under sections 7(a)(1) and 7(a)(2) of the
Act and its implementing regulations (50 CFR 402 et seq.), Federal agencies are required to
utilize their authorities to carry out programs for the conservation of threatened and endangered

06/22/2023
species and to determine whether projects may affect threatened and endangered species and/or
designated critical habitat.
A Biological Assessment is required for construction projects (or other undertakings having
similar physical impacts) that are major Federal actions significantly affecting the quality of the
human environment as defined in the National Environmental Policy Act (42 U.S.C. 4332(2)
(c)). For projects other than major construction activities, the Service suggests that a biological
evaluation similar to a Biological Assessment be prepared to determine whether the project may
affect listed or proposed species and/or designated or proposed critical habitat. Recommended
contents of a Biological Assessment are described at 50 CFR 402.12.
If a Federal agency determines, based on the Biological Assessment or biological evaluation, that
listed species and/or designated critical habitat may be affected by the proposed project, the
agency is required to consult with the Service pursuant to 50 CFR 402. In addition, the Service
recommends that candidate species, proposed species and proposed critical habitat be addressed
within the consultation. More information on the regulations and procedures for section 7
consultation, including the role of permit or license applicants, can be found in the "Endangered
Species Consultation Handbook" at:
http://www.fws.gov/endangered/esa-library/pdf/TOC-GLOS.PDF
Migratory Birds: In addition to responsibilities to protect threatened and endangered species
under the Endangered Species Act (ESA), there are additional responsibilities under the
Migratory Bird Treaty Act (MBTA) and the Bald and Golden Eagle Protection Act (BGEPA) to
protect native birds from project -related impacts. Any activity, intentional or unintentional,
resulting in take of migratory birds, including eagles, is prohibited unless otherwise permitted by
the U.S. Fish and Wildlife Service (50 C.F.R. Sec. 10.12 and 16 U.S.C. Sec. 668(a)). For more
information regarding these Acts see https://www.fws.gov/birds/policies-and-regulations.php.
The MBTA has no provision for allowing take of migratory birds that may be unintentionally
killed or injured by otherwise lawful activities. It is the responsibility of the project proponent to
comply with these Acts by identifying potential impacts to migratory birds and eagles within
applicable NEPA documents (when there is a federal nexus) or a Bird/Eagle Conservation Plan
(when there is no federal nexus). Proponents should implement conservation measures to avoid
or minimize the production of project -related stressors or minimize the exposure of birds and
their resources to the project -related stressors. For more information on avian stressors and
recommended conservation measures see https://www.fws.gov/birds/bird-enthusiasts/threats-to-
birds.php.
In addition to MBTA and BGEPA, Executive Order 13186: Responsibilities of Federal Agencies
to Protect Migratory Birds, obligates all Federal agencies that engage in or authorize activities
that might affect migratory birds, to minimize those effects and encourage conservation measures
that will improve bird populations. Executive Order 13186 provides for the protection of both
migratory birds and migratory bird habitat. For information regarding the implementation of
Executive Order 13186, please visit https://www.fws.gov/birds/policies-and-regulations/
executive-orders/e0-13186. php.

06/22/2023
3
We appreciate your concern for threatened and endangered species. The Service encourages
Federal agencies to include conservation of threatened and endangered species into their project
planning to further the purposes of the Act. Please include the Consultation Code in the header of
this letter with any request for consultation or correspondence about your project that you submit
to our office.
Attachment(s):
• Official Species List
• Migratory Birds

06/22/2023
OFFICIAL SPECIES LIST
This list is provided pursuant to Section 7 of the Endangered Species Act, and fulfills the
requirement for Federal agencies to "request of the Secretary of the Interior information whether
any species which is listed or proposed to be listed may be present in the area of a proposed
action".
This species list is provided by:
Raleigh Ecological Services Field Office
Post Office Box 33726
Raleigh, NC 27636-3726
[phone]

06/22/2023
KA
PROJECT SUMMARY
Project Code: 2023-0096385
Project Name: Brulington Road Industrial
Project Type: Commercial Development
Project Description: The site is an approximate 55 acre tract that is being considered for
industrial development. The development is anticipated to occur within
the next 1-5 years.
Project Location:
The approximate location of the project can be viewed in Google Maps: https://
www.google.com/maps/(a)36.0912701,-79.70412871216175,14z
Counties: Guilford County, North Carolina

06/22/2023 3
ENDANGERED SPECIES ACT SPECIES
There is a total of 4 threatened, endangered, or candidate species on this species list.
Species on this list should be considered in an effects analysis for your project and could include
species that exist in another geographic area. For example, certain fish may appear on the species
list because a project could affect downstream species.
IPaC does not display listed species or critical habitats under the sole jurisdiction of NOAA
Fisheriesi, as USFWS does not have the authority to speak on behalf of NOAA and the
Department of Commerce.
See the "Critical habitats" section below for those critical habitats that lie wholly or partially
within your project area under this office's jurisdiction. Please contact the designated FWS office
if you have questions.
1. NOAA Fisheries, also known as the National Marine Fisheries Service (NMFS), is an
office of the National Oceanic and Atmospheric Administration within the Department of
Commerce.
MAMMALS
NAME
Tricolored Bat Perimyotis subflavus
No critical habitat has been designated for this species.
Species profile: https:Hecos.fws.gov/ecp/species/10515
INSECTS
NAME
Monarch Butterfly Danaus plexippus
No critical habitat has been designated for this species.
Species profile: https:Hecos.fws.gov/ecp/species/9743
FLOWERING PLANTS
NAME
Schweinitz's Sunflower Helianthus schweinitzii
No critical habitat has been designated for this species.
Species profile: https:Hecos.fws.gov/ecp/species/3849
Small Whorled Pogonia Isotria medeoloides
Population:
No critical habitat has been designated for this species.
Species profile: https:Hecos.fws.gov/ecp/species/1890
STATUS
Proposed
Endangered
STATUS
Candidate
STATUS
Endangered
Threatened

06/22/2023
CRITICAL HABITATS
THERE ARE NO CRITICAL HABITATS WITHIN YOUR PROJECT AREA UNDER THIS OFFICE'S
JURISDICTION.
YOU ARE STILL REQUIRED TO DETERMINE IF YOUR PROJECT(S) MAY HAVE EFFECTS ON ALL
ABOVE LISTED SPECIES.

06/22/2023
MIGRATORY BIRDS
Certain birds are protected under the Migratory Bird Treaty Act! and the Bald and Golden Eagle
Protection Actz.
Any person or organization who plans or conducts activities that may result in impacts to
migratory birds, eagles, and their habitats should follow appropriate regulations and consider
implementing appropriate conservation measures, as described below.
1. The Migratory Birds Treat. Act of 1918.
2. The Bald and Golden Eagle Protection Act of 1940.
3. 50 C.F.R. Sec. 10.12 and 16 U.S.C. Sec. 668(a)
The birds listed below are birds of particular concern either because they occur on the
USFWS Birds of Conservation Concern (BCC) list or warrant special attention in your
project location. To learn more about the levels of concern for birds on your list and how this
list is generated, see the FAQ below. This is not a list of every bird you may find in this location,
nor a guarantee that every bird on this list will be found in your project area. To see exact
locations of where birders and the general public have sighted birds in and around your project
area, visit the E-bird data mapping tool (Tip: enter your location, desired date range and a species
on your list). For projects that occur off the Atlantic Coast, additional maps and models detailing
the relative occurrence and abundance of bird species on your list are available. Links to
additional information about Atlantic Coast birds, and other important information about your
migratory bird list, including how to properly interpret and use your migratory bird report, can be
found below.
For guidance on when to schedule activities or implement avoidance and minimization measures
to reduce impacts to migratory birds on your list, click on the PROBABILITY OF PRESENCE
SUMMARY at the top of your list to see when these birds are most likely to be present and
breeding in your project area.
BREEDING
NAME SEASON
Bald Eagle Haliaeetus leucocephalus Breeds Sep 1 to
This is not a Bird of Conservation Concern (BCC) in this area, but warrants attention Jul 31
because of the Eagle Act or for potential susceptibilities in offshore areas from certain types
of development or activities.
Chimney Swift Chaetura pelagica Breeds Mar 15
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA to Aug 25
and Alaska.
Red-headed Woodpecker Melanerpes erythrocephalus Breeds May 10
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA to Sep 10
and Alaska.

06/22/2023
NAME
Wood Thrush Hylocichla mustelina
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA
and Alaska.
PROBABILITY OF PRESENCE SUMMARY
BREEDING
SEASON
Breeds May 10
to Aug 31
The graphs below provide our best understanding of when birds of concern are most likely to be
present in your project area. This information can be used to tailor and schedule your project
activities to avoid or minimize impacts to birds. Please make sure you read and understand the
FAQ "Proper Interpretation and Use of Your Migratory Bird Report" before using or attempting
to interpret this report.
Probability of Presence (■)
Each green bar represents the bird's relative probability of presence in the 10km grid cell(s) your
project overlaps during a particular week of the year. (A year is represented as 12 4-week
months.) A taller bar indicates a higher probability of species presence. The survey effort (see
below) can be used to establish a level of confidence in the presence score. One can have higher
confidence in the presence score if the corresponding survey effort is also high.
How is the probability of presence score calculated? The calculation is done in three steps:
The probability of presence for each week is calculated as the number of survey events in
the week where the species was detected divided by the total number of survey events for
that week. For example, if in week 12 there were 20 survey events and the Spotted Towhee
was found in 5 of them, the probability of presence of the Spotted Towhee in week 12 is
0.25.
2. To properly present the pattern of presence across the year, the relative probability of
presence is calculated. This is the probability of presence divided by the maximum
probability of presence across all weeks. For example, imagine the probability of presence
in week 20 for the Spotted Towhee is 0.05, and that the probability of presence at week 12
(0.25) is the maximum of any week of the year. The relative probability of presence on
week 12 is 0.25/0.25 = 1; at week 20 it is 0.05/0.25 = 0.2.
3. The relative probability of presence calculated in the previous step undergoes a statistical
conversion so that all possible values fall between 0 and 10, inclusive. This is the
probability of presence score.
Breeding Season( )
Yellow bars denote a very liberal estimate of the time -frame inside which the bird breeds across
its entire range. If there are no yellow bars shown for a bird, it does not breed in your project
area.
Survey Effort (1)
Vertical black lines superimposed on probability of presence bars indicate the number of surveys
performed for that species in the 10km grid cell(s) your project area overlaps. The number of
surveys is expressed as a range, for example, 33 to 64 surveys.

06/22/2023
3
No Data (—)
A week is marked as having no data if there were no survey events for that week.
Survey Timeframe
Surveys from only the last 10 years are used in order to ensure delivery of currently relevant
information. The exception to this is areas off the Atlantic coast, where bird returns are based on
all years of available data, since data in these areas is currently much more sparse.
■ probability of presence breeding season I survey effort — no data
SPECIES JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
Ea
gle agle
BaldNonEa ++++ +4 —+ +� I 'I � � I I I I I I I I I �+ ++++ —+—+ +—+— —+++ ++—+ ++­+
Vulnerable
Chimney Swift
' „ Jill'' '''"
++++ ++—+ ++++ + +
' '
+—+ +� ++ ++�+ ++�+
BCC Rangewide
(CON)
— — — — — — —
--
Red-headed
Woodpecker
OMM0
+'+' ++—' ++++ l++' ++++ ++++
++
—+—+ +­+— —+++ ++—+ ++­+
BCC Rangewide
(CON)
Wood Thrush
++++ " + +—+ ++++ ++'+++ i77i
+
11
""
+—+' +++ ++—+ ++—+
BCC Rangewide
(CON)
Additional information can be found using the following links:
• Birds of Conservation Concern https://www.fws.gov/program/migratory-birds/species
• Measures for avoiding and minimizing impacts to birds https://www.fws.gov/library
collections/avoidins7-and-minimizinv--incidental-take-mis7ratorv-birds
• Nationwide conservation measures for birds https://www.fws.gov/sites/default/files/
documents/nationwide-standard-conservation-measures.pdf
MIGRATORY BIRDS FAQ
Tell me more about conservation measures I can implement to avoid or minimize impacts
to migratory birds.
Nationwide Conservation Measures describes measures that can help avoid and minimize
impacts to all birds at any location year round. Implementation of these measures is particularly
important when birds are most likely to occur in the project area. When birds may be breeding in
the area, identifying the locations of any active nests and avoiding their destruction is a very
helpful impact minimization measure. To see when birds are most likely to occur and be breeding
in your project area, view the Probability of Presence Summary. Additional measures or permits
may be advisable depending on the type of activity you are conducting and the type of
infrastructure or bird species present on your project site.

06/22/2023 4
What does IPaC use to generate the list of migratory birds that potentially occur in my
specified location?
The Migratory Bird Resource List is comprised of USFWS Birds of Conservation Concern
(BCQ and other species that may warrant special attention in your project location.
The migratory bird list generated for your project is derived from data provided by the Avian
Knowledge Network (AKN). The AKN data is based on a growing collection of survey, banding,
and citizen science datasets and is queried and filtered to return a list of those birds reported as
occurring in the 10km grid cell(s) which your project intersects, and that have been identified as
warranting special attention because they are a BCC species in that area, an eagle (Eagle Act
requirements may apply), or a species that has a particular vulnerability to offshore activities or
development.
Again, the Migratory Bird Resource list includes only a subset of birds that may occur in your
project area. It is not representative of all birds that may occur in your project area. To get a list
of all birds potentially present in your project area, please visit the Rapid Avian Information
Locator (RAIL)Tool.
What does IPaC use to generate the probability of presence graphs for the migratory birds
potentially occurring in my specified location?
The probability of presence graphs associated with your migratory bird list are based on data
provided by the Avian Knowledge Network (AKN). This data is derived from a growing
collection of survey, banding, and citizen science datasets.
Probability of presence data is continuously being updated as new and better information
becomes available. To learn more about how the probability of presence graphs are produced and
how to interpret them, go the Probability of Presence Summary and then click on the "Tell me
about these graphs" link.
How do I know if a bird is breeding, wintering or migrating in my area?
To see what part of a particular bird's range your project area falls within (i.e. breeding,
wintering, migrating or year-round), you may query your location using the RAIL Tool and look
at the range maps provided for birds in your area at the bottom of the profiles provided for each
bird in your results. If a bird on your migratory bird species list has a breeding season associated
with it, if that bird does occur in your project area, there may be nests present at some point
within the timeframe specified. If "Breeds elsewhere" is indicated, then the bird likely does not
breed in your project area.
What are the levels of concern for migratory birds?
Migratory birds delivered through IPaC fall into the following distinct categories of concern:
1. "BCC Rangewide" birds are Birds of Conservation Concern (BCC) that are of concern
throughout their range anywhere within the USA (including Hawaii, the Pacific Islands,
Puerto Rico, and the Virgin Islands);
2. "BCC - BCR" birds are BCCs that are of concern only in particular Bird Conservation
Regions (BCRs) in the continental USA; and

06/22/2023 5
3. "Non -BCC - Vulnerable" birds are not BCC species in your project area, but appear on
your list either because of the Eagle Act requirements (for eagles) or (for non -eagles)
potential susceptibilities in offshore areas from certain types of development or activities
(e.g. offshore energy development or longline fishing).
Although it is important to try to avoid and minimize impacts to all birds, efforts should be made,
in particular, to avoid and minimize impacts to the birds on this list, especially eagles and BCC
species of rangewide concern. For more information on conservation measures you can
implement to help avoid and minimize migratory bird impacts and requirements for eagles,
please see the FAQs for these topics.
Details about birds that are potentially affected by offshore projects
For additional details about the relative occurrence and abundance of both individual bird species
and groups of bird species within your project area off the Atlantic Coast, please visit the
Northeast Ocean Data Portal. The Portal also offers data and information about other taxa besides
birds that may be helpful to you in your project review. Alternately, you may download the bird
model results files underlying the portal maps through the NOAA NCCOS Integrative Statistical
Modeling and Predictive Mapping of Marine Bird Distributions and Abundance on the Atlantic
Outer Continental Shelf project webpage.
Bird tracking data can also provide additional details about occurrence and habitat use
throughout the year, including migration. Models relying on survey data may not include this
information. For additional information on marine bird tracking data, see the Diving Bird Study
and the nanotag studies or contact Caleb Spiegel or Pam Loring.
What if I have eagles on my list?
If your project has the potential to disturb or kill eagles, you may need to obtain a permit to avoid
violating the Eagle Act should such impacts occur.
Proper Interpretation and Use of Your Migratory Bird Report
The migratory bird list generated is not a list of all birds in your project area, only a subset of
birds of priority concern. To learn more about how your list is generated, and see options for
identifying what other birds may be in your project area, please see the FAQ "What does IPaC
use to generate the migratory birds potentially occurring in my specified location". Please be
aware this report provides the "probability of presence" of birds within the 10 km grid cell(s) that
overlap your project; not your exact project footprint. On the graphs provided, please also look
carefully at the survey effort (indicated by the black vertical bar) and for the existence of the "no
data" indicator (a red horizontal bar). A high survey effort is the key component. If the survey
effort is high, then the probability of presence score can be viewed as more dependable. In
contrast, a low survey effort bar or no data bar means a lack of data and, therefore, a lack of
certainty about presence of the species. This list is not perfect; it is simply a starting point for
identifying what birds of concern have the potential to be in your project area, when they might
be there, and if they might be breeding (which means nests might be present). The list helps you
know what to look for to confirm presence, and helps guide you in knowing when to implement
conservation measures to avoid or minimize potential impacts from your project activities,
should presence be confirmed. To learn more about conservation measures, visit the FAQ "Tell

06/22/2023
me about conservation measures I can implement to avoid or minimize impacts to migratory
birds" at the bottom of your migratory bird trust resources page.

06/22/2023
IPAC USER CONTACT INFORMATION
Agency: Pilot Environmental, Inc
Name: David Brame
Address: 743 Park Lawn Court
City:
Kernersville
State:
NC
Zip:
27284
Email
[e-mail]
Phone:
3363104527

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EFH Report
https://www.habitat.noaa.gov/apps/eflimapper/eflireport/
ireport/
EFH Mapper Report
EFH Data Notice
Essential Fish Habitat (EFH) is defined by textual descriptions contained in the fishery management plans developed by the
regional fishery management councils. In most cases mapping data can not fully represent the complexity of the habitats that
make up EFH. This report should be used for general interest queries only and should not be interpreted as a definitive
evaluation of EFH at this location. A location -specific evaluation of EFH for any official purposes must be performed by a
regional expert. Please refer to the following links for the appropriate regional resources.
Greater Atlantic Regional Office
Atlantic Highly Migratory Species Management Division
Query Results
Degrees, Minutes, Seconds: Latitude = 360 5' 27" N, Longitude = 800 17' 45" W
Decimal Degrees: Latitude = 36.091, Longitude =-79.704
The query location intersects with spatial data representing EFH and/or HAPCs for the following species/management units.
***WARNING***
Please note under "Life Stage(s) Found at Location" the category "ALL" indicates that all life stages of that species share the
same map and are designated at the queried location.
EFH
No Essential Fish Habitats (EFH) were identified at the report location.
Salmon EFH
No Pacific Salmon Essential Fish Habitat (EFH) were identified at the report location.
HAPCs
No Habitat Areas of Particular Concern (HAPC) were identified at the report location.
EFH Areas Protected from Fishing
No EFH Areas Protected from Fishing (EFHA) were identified at the report location.
Spatial data does not currently exist for all the managed species in this area. The following is a list of
species or management units for which there is no spatial data.
"For links to all EFH text descriptions see the complete data inventory: open data inventory -->
All spatial data is currently available for the Mid -Atlantic and New England councils,
Secretarial EFH,
Bigeye Sand Tiger Shark,
Bigeye Sixgill Shark,
1 of 2 6/22/2023, 10:47 AM

EFH Report
https://www.habitat.noaa.gov/apps/eflimapper/eflireport/
ireport/
Spatial data does not currently exist for all the managed species in this area. The following is a list of
species or management units for which there is no spatial data.
"For links to all EFH text descriptions see the complete data inventory: open data inventory -->
Caribbean Sharpnose Shark,
Galapagos Shark,
Narrowtooth Shark,
Sevengill Shark,
Sixgill Shark,
Smooth Hammerhead Shark,
Smalltail Shark
2 of 2 6/22/2023, 10:47 AM

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
MARC RECKTENWALD
Director
Daniel Barnes
Eight Forty Industrial Partners, LLC
121 North Crutchfield Street
Dobson, NC 27017
Project: Burlington Road Industrial
NORTH CAROLINA
Environmental Quality
June 23, 2023
Expiration of Acceptance: 12/23/2023
County: Guilford
The purpose of this letter is to notify you that the NCDEQ Division of Mitigation Services (DMS) is willing to
accept payment for compensatory mitigation for impacts associated with the above referenced project as
indicated in the table below. Please note that this decision does not assure that participation in the DMS in -
lieu fee mitigation program will be approved by the permit issuing agencies as mitigation for project impacts.
It is the responsibility of the applicant to contact permitting agencies to determine if payment to the DMS will
be approved. You must also comply with all other state, federal or local government permits, regulations or
authorizations associated with the proposed activity including G.S. § 143-214.11.
This acceptance is valid for six months from the date of this letter and is not transferable. If we have not
received a copy of the issued 404 Permit/401 Certification within this time frame, this acceptance will
expire. It is the applicant's responsibility to send copies of the permits to DMS. Once DMS receives a copy
of the permit(s) an invoice will be issued based on the required mitigation in that permit and payment must
be made prior to conducting the authorized work. The amount of the in -lieu fee to be paid by an applicant is
calculated based upon the Fee Schedule and policies listed on the DMS website.
Based on the information supplied by you in your request to use the DMS, the impacts for which you are
requesting compensatory mitigation credit are summarized in the following table. The amount of mitigation
required and assigned to DMS for this impact is determined by permitting agencies and may exceed the
impact amounts shown below.
River Basin
Impact Location
8-di it HUC
Impact Type
Impact Quantity
Cape Fear
03030002
Riparian Wetland
0.327
Upon receipt of payment, DMS will take responsibility for providing the compensatory mitigation. The
mitigation will be performed in accordance with the In -Lieu Fee Program instrument dated July 28, 2010.
Thank you for your interest in the DMS in -lieu fee mitigation program. If you have any questions or need
additional information, please contact [e-mail].
Sincerely,
FOR James B. Stanfill
Deputy Director
cc: David Brame, agent
North Carolina Department of Environmental Quality I Division of Mitigation Services
217 West Jones Street 1 1652 Mail Service Center I Raleigh, North Carolina 27699-1652
h(h�TH :.AROI iRA IV
o �nmmmenni w�a 919,707,8976

David Brame
From: Heather LaGamba
Sent: Friday, December 9, 2022 3:32 PM
To: 401 [e-mail]
Subject: Pre -File Notice - Burlington Rd (7258.1)
We would like to submit a Pre -filing Notice for the following project:
Project Name: Burlington Rd (7258.1)
Project Owner: The Crown Companies, LLC
Project Owner's Address: 121 North Crutchfield Street, North Carolina 27017
Project County: Guilford
Type of project/Approval Sought: 401 WQC, Pre -Application Request Meeting Declined
Thank you and have a wonderful day!
Sincerely,
Heather LaGamba
336.345.9536 (c)
336.310.4527 (o)
P.O. Box 128
Kernersville, NC 27285
www.pilotenviro.com
[e-mail]