20231169 Ver 1_6968.2_Suits Rd_PCN_8.18.23_20230818

Preliminary ORM Data Entry Fields for New Actions
ACTION ID #: SAW- 2022-02029 Begin Date (Date Received):
Prepare file folder ❑ Assign Action ID Number in ORM ❑
1. Project Name [PCN Form A2a]: Suits Road (Providence Pointe)
2. Work Type: ❑Private ❑Institutional ❑Government Commercial
3. Project Description / Purpose [PCN Form 133d and 133e]:
4. Property Owner / Applicant [PCN Form A3 or A4]:
5. Agent / Consultant [PNC Form A5 — or ORM Consultant ID Number]:
Brad Luckey, Pilot Environmental, Inc
6. Related Action ID Number(s) [PCN Form 135b]:
7. Project Location — Coordinates, Street Address, and/or Location Description [PCN Form B lb]:
35.89767, 79.91644
8. Project Location —Tax Parcel ID [PCN Form Bla]: 7728826865
9. Project Location — County [PCN Form A2b]: Randolph
10. Project Location — Nearest Municipality or Town [PCN Form A2c]: Archdale
11. Project Information — Nearest Waterbody [PCN Form 132a]: Muddy Creek
12. Watershed / 8-Digit Hydrologic Unit Code [PCN Form 132c]: Cape Fear/03030003
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

Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre -Construction Notification PCN Form
A. Applicant Information
1.
Processing
1 a.
Type(s) of approval sought from the
Corps:
®Section 404 Permit El Section 10 Permit
1 b.
Specify Nationwide Permit (NWP) number: NWP 29 or General Permit (GP) number:
1c.
Has the NWP or GP number been verified by the Corps?
❑ Yes
® No
1d.
Type(s) of approval sought from the DWQ (check all that apply):
N 401 Water Quality Certification — Regular ❑ Non-404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e.
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
❑ Yes N No
For the record only for Corps Permit:
❑ Yes N No
1f.
Is payment into a mitigation bank or in -lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in -lieu
fee program.
❑ Yes
® No
1g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yes
® No
1 h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2.
Project Information
2a.
Name of project:
Suits Rd
2b.
County:
Randolph
2c.
Nearest municipality / town:
Archdale
2d.
Subdivision name:
Providence Pointe
2e.
NCDOT only, T.I.P. or state
project no:
3.
Owner Information
3a.
Name(s) on Recorded Deed:
Frank Kepley Hardwood Co., Inc.
3b.
Deed Book and Page No.
002001/00362
3c.
Responsible Party (for LLC if
applicable):
Jim Kepley
3d.
Street address:
975 Conrad Hill Mine Road
3e.
City, state, zip:
Lexington, NC 27292
3f.
Telephone no.:
336-746-5419
3g.
Fax no.:
3h.
Email address:
[e-mail]
Page 1 of 14
PCN Form — Version 1.3 December 10, 2008 Version

4.
Applicant Information (if different from owner)
4a.
Applicant is:
❑ Agent ® Other, specify: Developer
4b.
Name:
James Floyd
4c.
Business name
(if applicable):
MG Suits, LLC
4d.
Street address:
PO Box 10794
4e.
City, state, zip:
Greensboro, NC 27404
4f.
Telephone no.:
336-451-6479
4g.
Fax no.:
4h.
Email address:
[e-mail]
5.
Agent/Consultant Information (if applicable)
5a.
Name:
Bradley Luckey
5b.
Business name
(if applicable):
Pilot Environmental, Inc.
5c.
Street address:
PO Box 128
5d.
City, state, zip:
Kernersville, NC 27285
5e.
Telephone no.:
336.708.4997
5f.
Fax no.:
5g.
Email address:
[e-mail]
Page 2 of 14
PCN Form — Version 1.3 December 10, 2008 Version

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
7728826865
1 b. Site coordinates (in decimal degrees):
Latitude: 35.89767 Longitude: - 79.91644
(DD.DDDDDD) (-DD.DDDDDD)
1c. Property size:
156 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
Muddy Creek
proposed project:
2b. Water Quality Classification of nearest receiving water:
WS-IV, NSW
2c. River basin:
Cape Fear
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
The site contains undeveloped wooded land and fields. The site is located within a rural residential area of Archdale,
North Carolina.
3b. List the total estimated acreage of all existing wetlands on the property:
Wetland=3.83 ac
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
Streams=8,730 LF
3d. Explain the purpose of the proposed project:
The purpose of the proposed project is to develop the site with Providence Pointe, a single family residential
neighborhood.
3e. Describe the overall project in detail, including the type of equipment to be used:
The overall project includes the construction of Providence Pointe, a single family residential neighborhood. The overall
project includes the construction of single family residences, amenity and landscaped areas and stormwater control
devices. In order to facilitate the proposed development and access lots, it is necessary to have three road crossings and
one aerial sewer line crossing that impact streams and/or wetlands. Clearing and grading the site is necessary. Graders,
haulers, excavators and other heavy equipment will be used during grading and construction of the site.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
®Yes ❑ No El Unknown
project (including all prior phases) in the past?
Comments: SAW-2022-02029
4b. If the Corps made the jurisdictional determination, what type
El Preliminary ❑Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas?
Agency/Consultant Company: Pilot Enviromental, Inc.
Name (if known): Bradley Luckey/David Brame
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
SAW-2022-02029
5. Project History
5a. Have permits or certifications been requested or obtained for
❑ Yes ® No ❑ Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
Page 3 of 14
PCN Form — Version 1.3 December 10, 2008 Version

6. Future Project Plans
6a. Is this a phased project? ❑ Yes ® No
6b. If yes, explain.
Impacts to streams/wetlands, outside of those proposed in this application, are not anticipated as a result of the proposed
project.
Page 4 of 14
PCN Form — Version 1.3 December 10, 2008 Version

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
® Wetlands ® Streams - tributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction
Page 5 of 14
PCN Form — Version 1.3 December 10, 2008 Version

2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
2b.
2c.
2d.
2e.
2f.
Wetland impact
Type of jurisdiction
number —
Type of impact
Type of wetland
Forested
(Corps - 404, 10
Area of impact
Permanent (P) or
(if known)
DWQ — non-404, other)
(acres)
Temporary T
W1 ®P ®T
Road Fill/Temp
Construction
Bottomland
® Yes
® Corps
0.071/0.004
Access
Hardwoods
❑ No
❑ DWQ
W2 ® P ❑ T
Road Fill
Bottomland
® Yes
® Corps
0.02
Hardwoods
❑ No
❑ DWQ
W3 ®P ®T
Road Fill/Temp
Construction
Bottomland
® Yes
® Corps
0.158/0.066
Acess
Hardwoods
❑ No
❑ DWQ
W4 ®P ®T
Sewer Fill/Sewer
Bottomland
® Yes
® Corps
0.001/0.024
Installation
Hardwoods
❑ No
❑ DWQ
W5 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
2g. Total wetland impacts
0.25/0.094
2h. Comments: Wetland Impact 1 will permanently impact 0.071 acres of wetlands with road crossing fill (culvert, wall and rip -
rap) and temporarily impact 0.004 acres of wetlands with temporary construction access.
Wetland Impact 2 will permanently impact 0.020 acres of wetlands with road crossing fill.
Wetland Impact 3 will permanently impact 0.158 acres of wetlands with road crossing fill and temporarily impact 0.066 acres of
wetlands with temporary construction access.
Wetland Impact 4 will permanently impact 0.001 acres of wetlands from sewer line pier footers and temporarily impact 0.024
acres of wetlands for sewer line installation.
Areas of temporary impacts will be restored to similar pre -construction grade and stabilized with native herbaceous seed mix.
Mitigation for the net loss impact to wetlands is proposed.
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
3b.
3c.
3d.
3e.
3f.
3g.
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number -
(PER) or
(Corps - 404, 10
stream
length
Permanent (P) or
intermittent
DWQ — non-404,
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
Road Fill/
® PER
® Corps
S1 ®P ®T
Keyed in Rip -Rap/
Unnamed
❑INT
❑ DWQ
3.09
88/30/42
Dewateringl
Road Fill/
® PER
® Corps
S2 ®P ®T
Keyed in Rip -Rap/
Unnamed
❑ INT
❑ DWQ
3.02
162/35/10
Dewateringl
S3 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S4 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
Page 6 of 14
PCN Form — Version 1.3 December 10, 2008 Version

S6 ❑ P ®T
❑ PER
❑ Corps
❑ INT
❑ DWQ
3h. Total stream and tributary impacts
112/65
3i. Comments: Stream Impact 1 will permanently impact 88 linear feet (272 SF) of stream with culvert, sideslope and wall fill,
permanently impact 30 linear feet (90 SF) of stream with keyed in rip -rap dissipaters and temporarily impact 42 linear feet
(125SF) of stream channel with associated de -watering and temporary construction access.
Stream Impact 2 will permanently impact 162 linear feet (489 SF) of stream with culvert, sideslope and wall fill, permanently
impact 35 linear feet (105 SF) of stream with keyed in rip -rap dissipaters and temporarily impact 10 linear feet (30 SF) of
stream channel with associated de -watering and temporary construction access.
Areas of temporary impact will be restored to similar pre -construction grades, stabilized with matting and native herbaceous
seed mix. Mitigation is not proposed for proposed for net loss stream impacts.
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a.
4b.
4c.
4d.
4e.
Open water
Name of waterbody
impact number —
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
Temporary T
01 ❑P❑T
02 ❑P❑T
03 ❑P❑T
04 ❑P❑T
4f. Total open water impacts
4g. Comments: Open water impacts are not proposed.
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a.
5b.
5c.
5d.
5e.
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose
(acres)
number
of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f. Total
5g. Comments:
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
Page 7 of 14
PCN Form — Version 1.3 December 10, 2008 Version

6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a.
❑ Neuse ❑ Tar -Pamlico ® Other: Randleman
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b.
6c.
6d.
6e.
6f.
6g.
Buffer impact
number —
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
for
Stream name
mitigation
(square feet)
(square feet)
Temporary T
impact
re uired?
B1 ❑P❑T
El Yes
❑ No
B2 ❑P❑T
El Yes
❑ No
B3 ❑P❑T
El Yes
❑ No
6h. Total buffer impacts
6i. Comments: A buffer authorization certificate from local municiality will be approved prior to impacts occuring.
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The applicant has designed the proposed residential sub -division to avoid other impact to streams, wetlands. The applicant
has selected the stream crossing locations in an area the stream is narrow and straight with few meanders. The applicant
designed the road crossing the utilize approximate 7-8-foot head/end walls thus reducing the permanent impacts to streams
and wetlands. Initial designs included an additional stream crossing of Muddy Creek. However, the applicant revised the
overall site plan to avoid and minimize impacts to streams and wetlands by removing this crossing from the proposed design.
The remaining 3.74 acres of wetlands and 8,553 linear feet of stream channel are being avoided.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
The clearing limits will be staked and silt fence or other BMPs will be used. Temporary coffer dams will be installed. During
construction, water will be bypassed around the construction footprints. Appropriate stream bank protection will be provided in
the channel during construction and all excess excavated material will be immediately removed from the crossing area and
stockpiled in upland locations. Upon completion of the culvert/sewer line installations, the temporary sand bag coffer dams will
be removed and flow will be diverted through the culvert or over the restored stream beds. Following installation of the culvert
and sewer lines, areas of temporary stream or wetland impacts will be restored to similar pre -construction grades. The stream
banks will be matted with biodegradable materials and seeded/live staked with native species. The wetlands will be stabilized
with native grass herbaceous seed mix.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
® Yes ❑ No
impacts to Waters of the U.S. or Waters of the State?
2b. If yes, mitigation is required by (check all that apply):
® DWQ ® Corps
❑ Mitigation bank
2c. If yes, which mitigation option will be used for this
®Payment to in -lieu fee program
project?
❑ Permittee Responsible Mitigation
Page 8 of 14
PCN Form — Version 1.3 December 10, 2008 Version

3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter)
Type
Quantity
3c. Comments: Credits necessary to satisfy the mitigation proposal are not available from private banks at this time.
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
® Yes
4b. Stream mitigation requested:
linear feet
4c. If using stream mitigation, stream temperature:
❑ warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested:
0.52 acres
4f. Non -riparian wetland mitigation requested:
acres
4g. Coastal (tidal) wetland mitigation requested:
acres
4h. Comments: The applicant proposes mitigation for the unavoidable impact to 0.249 acres of wetland impact from road fill at
a 2:1 ratio and impact to 0.024 acre of wetland impact from conversion of forested to emergent wetland for the sewer line's
permanent corridor. The applicant proposes to purchase 0.52 acres of wetland credits from NCDMS. According to NCDMS
letter dated 8.14.23 (attached) the NC DMS has the credits available to satisfy the mitigation proposal.
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation?
❑ Yes ® No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
Zone
6c.
Reason for impact
6d.
Total impact
(square feet)
Multiplier
6e.
Required mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund).
6h. Comments:
Page 9 of 14
PCN Form — Version 1.3 December 10, 2008 Version

E.
Stormwater Management and Diffuse Flow Plan (required by DWQ)
1.
Diffuse Flow Plan
1 a.
Does the project include or is it adjacent to protected riparian buffers identified
® Yes ❑ No
within one of the NC Riparian Buffer Protection Rules?
1 b.
If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes ❑ No
Comments: Archdale
2.
Stormwater Management Plan
2a.
What is the overall percent imperviousness of this project?
26 %
2b.
Does this project require a Stormwater Management Plan?
® Yes ❑ No
2c.
If this project DOES NOT require a Stormwater Management Plan, explain why: Stormwater management plan approval
from local delgated municipality will be obtained prior to impacts occuring.
2d.
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
® Certified Local Government
2e.
Who will be responsible for the review of the Stormwater Management Plan?
❑ DWQ Stormwater Program
❑ DWQ 401 Unit
3.
Certified Local Government Stormwater Review
3a.
In which local government's jurisdiction is this project?
Archdale
❑ Phase II
® NSW
3b.
Which of the following locally -implemented stormwater management programs
❑ USMP
apply (check all that apply):
® Water Supply Watershed
❑ Other:
3c.
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ® No
attached?
4.
DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a.
Which of the following state -implemented stormwater management programs apply
❑ ORW
(check all that apply):
❑ Session Law 2006-246
❑ Other:
4b.
Has the approved Stormwater Management Plan with proof of approval been
attached?
❑ Yes ❑ No
5.
DWQ 401 Unit Stormwater Review
5a.
Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b.
Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 10 of 14
PCN Form — Version 1.3 December 10, 2008 Version

F.
Supplementary Information
1.
Environmental Documentation (DWQ Requirement)
1a.
Does the project involve an expenditure of public (federal/state/local) funds or the
❑ Yes
® No
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
❑ Yes
® No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c.
If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
❑ Yes
® No
letter.)
Comments: A NEPA or SEPA is not required as part of this project.
2.
Violations (DWQ Requirement)
2a.
Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
❑ Yes
® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b.
Is this an after -the -fact permit application?
❑ Yes
® No
2c.
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3.
Cumulative Impacts (DWQ Requirement)
3a.
Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes
® No
additional development, which could impact nearby downstream water quality?
3b.
If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
We are not aware of additional development that will result which will impact nearby downstream water
quality.
4.
Sewage Disposal (DWQ Requirement)
4a.
Clearly detail the ultimate treatment methods and disposition (non -discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
Impacts from wastewater generation, outside of those in this application, are not proposed.
Page 11 of 14
PCN Form — Version 1.3 December 10, 2008 Version

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
❑ Yes ® No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ® No
impacts?
❑ Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted.
❑ Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
The IPaC report for the site identifies Schweinitz's sunflower as a federally protected species that could be proximate to
the project area.
The project area contains a mature hardwood forest estimated to be at least 40 years in age. Mid and understory
vegetation is densely vegetated. Suitable habitat for Schweinitz's sunflower is not located within the proposed project
area. Therefore, we have made a determination of no effect for this species.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
Based on our knowledge of the site, the site is not located in or near an area designated as essential fish habitat. Best
management practices and the construction of stormwater ponds will prevent sediment from entering down -gradient
waterbodies which may contain fish.
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
❑ Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
We reviewed the SHPO Map (http://gis.ncdcr.gov/hpoweb/) to identify cultural resources of the site. The map does not
identify listed or eligible for listing properties on or nearby the project area. A copy of the map is included as an
attachment.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?
❑ Yes ® No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? FEMA NHFL (Drawing 4, attached)
Digitally signed by Bradley Luckey
DIN: cn=Bradley Luckey, o=Pilot
Bradley
Enviromental, Inc., ou,
B
Bradley S. Luckey, PWS
email=[e-mail],
Luckey c=us
8.18.23
Date: 2023.08.18 16:14:27-04'00'
Applicant/Agent's Printed Name
Date
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization letter from the applicant
isprovided.)
Page 13 of 14
PCN Form — Version 1.3 December 10, 2008 Version

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: O Suits Rd.
Archdale, NC 27263
Owner Information:
Name: MG Suits, LLC
P.O. Box 10784
Address: Greensboro, NC 27404
Telephone Number: 336-451-6479
Fax Number:
E-mail Address: [e-mail]
Signature: Date: 6-23-23

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ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
MARC RECKTENWALD
Director
James Floyd
MG Suits, LLC
PO Box 10784
Greensboro, NC 27404
Project: Providence Pointe
NORTH CAROLINA
Environmental Quality
August 14, 2023
Expiration of Acceptance: 2/14/2024
County: Randolph
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
03030003
Riparian Wetland
0.52
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, `
AvdA�1�l �' /�
FOR James. B Stanfill
Deputy Director
cc: Bradley Luckey, agent
North Carolina Department of Environmental Quality I Division of Mitigation Services
217 West Jones Street [ 1652 Mail Service Center I Raleigh. North Carolina 27699-1652
OP9aIGnent of rnrnonmenldl a�al� �f 919,707,8976

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: 2023-0119042
Project Name: Suits Road
August 18, 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 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 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

08/18/2023
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:
https://www.fws.gov/sites/default/files/documents/endangered-species-consultation-
handbook.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/program/migratory-bird-permit/what-
we-do.
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/library/collections/threats-birds.
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/partner/council-conservation-
migratory-birds.

08/18/2023
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
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]

08/18/2023
4
PROJECT SUMMARY
Project Code: 2023-0119042
Project Name: Suits Road
Project Type: Residential Construction
Project Description: Residential
Project Location:
The approximate location of the project can be viewed in Google Maps: https:
www.google.com/maps/@35.89779345,-79,91624830135184,14z
T-A
�juJJ4 4f
'4
Counties: Randolph County, North Carolina

08/18/2023
ENDANGERED SPECIES ACT SPECIES
There is a total of 3 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 S TATU S
Tricolored Bat Perimyotis sub flavus Proposed
No critical habitat has been designated for this species. Endangered
Species profile: https://ecos.fws.gov/ecp/species/10515
INSECTS
NAME
S TATU S
Monarch Butterfly Danaus plexippus
Candidate
No critical habitat has been designated for this species.
Species profile: https://ecos.fws.gov/ecp/species/9743
FLOWERING PLANTS
NAME
S TATU S
Schweinitz's Sunflower Helianthus schweinitzii
Endangered
No critical habitat has been designated for this species.
Species profile: https://ecos.fws.gov/ecp/species/3849
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.

08/18/2023
MIGRATORY BIRDS
Certain birds are protected under the Migratory Bird Treaty Act! and the Bald and Golden Eagle
Protection Act2.
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 Treater of 1918.
2. The Bald and Golden Eagle Protection Act of 1940.
3. 50 C.F.R. Sec. 10.12 and 16 U.S.C. Sec. 668(a)
The birds listed below are birds of particular concern either because they occur on the
USFWS Birds of Conservation Concern (BCC) list or warrant special attention in your
project location. To learn more about the levels of concern for birds on your list and how this
list is generated, see the FAQ below. This is not a list of every bird you may find in this location,
nor a guarantee that every bird on this list will be found in your project area. To see exact
locations of where birders and the general public have sighted birds in and around your project
area, visit the E-bird data mapping tool (Tip: enter your location, desired date range and a species
on your list). For projects that occur off the Atlantic Coast, additional maps and models detailing
the relative occurrence and abundance of bird species on your list are available. Links to
additional information about Atlantic Coast birds, and other important information about your
migratory bird list, including how to properly interpret and use your migratory bird report, can be
found below.
For guidance on when to schedule activities or implement avoidance and minimization measures
to reduce impacts to migratory birds on your list, click on the PROBABILITY OF PRESENCE
SUMMARY at the top of your list to see when these birds are most likely to be present and
breeding in your project area.
NAME
BREEDING SEASON
Chimney Swift Chaetura pelagica Breeds Mar 15 to Aug 25
This is a Bird of Conservation Concern (BCC) throughout its range in the
continental USA and Alaska.
PROBABILITY OF PRESENCE SUMMARY
The graphs below provide our best understanding of when birds of concern are most likely to be
present in your project area. This information can be used to tailor and schedule your project
activities to avoid or minimize impacts to birds. Please make sure you read and understand the
FAQ "Proper Interpretation and Use of Your Migratory Bird Report" before using or attempting
to interpret this report.
Probability of Presence (■)

08/18/2023
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.
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

08/18/2023
Chimney Swift
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/librqu/
collections/avoidin g-and-minimizing-incidental-take-migratory-birds
• Nationwide conservation measures for birds https://www.fws.gov/sites/default/files/
documents/nationwide-standard-conservation-measures.Ddf
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.
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?

08/18/2023
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
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.

08/18/2023
10
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 Lorin.
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
me about conservation measures I can implement to avoid or minimize impacts to migratory
birds" at the bottom of your migratory bird trust resources page.

08/18/2023
IPAC USER CONTACT INFORMATION
Agency: Private Entity
Name: Bradley Luckey
Address: 743 Park Lawn Court
City:
Kernersville
State:
NC
Zip:
27285
Email
[e-mail]
Phone:
3367084997
LEAD AGENCY CONTACT INFORMATION
Lead Agency: Army Corps of Engineers

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LEGEND
WIB Site Boundary
Drawing 2A ' ` Published Soil Map
USDA Published Soil Survey Suits Road
of Randolph County, NC t. - Approximate 156-Acre Tract
Published 2006, Sheet 2 PILOT
� -- Archdale, Randolph County, NC
Scale: 1" = 800' PIL0TENYIRONMENTAL.INC Pilot Project6968

Drawing 3
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Scale: 1" = 600'
LEGEND
Z Site Boundary
Freshwater Emergent
Freshwater Forested/Shrub
Estuarine and Marine Deepwater
Estuarine and Marine
Freshwater Pond
4OW ■ Lake
Riverine
Other
PILOT
P I L O T E N V I R O N M E N T A L. I N C
N
NWI Map
Suits Road
Approximate 156-Acre Tract
Archdale, Randolph County, NC
Pilot Project 6968

Drawing 4
National Flood Hazard Layer
From FEMA Web Map Service
Scale: 1" = 600'
PILOT
P I L O T E N V I R O N M E N T A L. I N C
FEMA FIRM
Suits Road
Approximate 156-Acre Tract
Archdale, Randolph County, NC
Pilot Project 6968

HSC 1
540 LF\ 40
�HWH 1
0.092 a
HWD 1-9 ■
0.279 ac. \HWG 1-6
HWF 1 0.025 ac. A
C 0.039 ac.
IHSC 2
300 LF
HW C 1-3
0.605
HSA
2450 LF
H5B
320 LF
0P-2'_HWE 1-4
_ 0.015 ac.
HWB 1-44
0.653 ac.
HWA 1-20
0.295 ac.
W1-5
0.006 ac.'
WJ 1-77
0.871 ac.
JSF 1
1380 LF
W F 1-2
2 0.003 ac.�
50 LF _WE 1-10
SFA 0.167 ac.
} LF_�SF
150 LF
_Muddy Creek
2310 LF
W8 1-33
0.189 ac.
WH 1-6
0.256 ac.
SA 2
670 LF\
�5B
100 LF
SA 1
110 LF
� Rd
WA 1-5 Flag Number/Feature ID
Culvert
STREAM AND DELINEATION CONDUCTED BY PILOT PERSONNEL 7/20/21. THE DELINEATION WAS CONFIRMED BY MR. LYLE PHILLIPS WITH
THE USACE BY FIELD VERIFICATION ON 11.03.22. THIS EXHIBIT INCLUDES GPS LOCATIONS OF DELINEATED FEATURES.
Drawing 5
2020 Satellite Imagery from ESRI
and Pilot GPS Data
Scale: 1" = 550'
Date: 7.26.21, Revised 11.11.22
P I L O T E N V 1 R 0 N M E N T A L. 11 N C
Wetland Map
Suits Road
Approximate 156-Acre Tract
Archdale, Randolph County, NC
Pilot Project 6968

Brad Luckey
From: Heather LaGamba
Sent: Tuesday, June 20, 2023 6:11 PM
To: 401 [e-mail]
Subject: Pre -File Notice - Providence Pointe - Suits Road(6968.2)
We would like to submit a Pre -filing Notice for the following project:
Project Name: Providence Pointe - Suits Road(6968.2)
Project Owner: MagnaGray, LLC
Project Owner's Address: Post Office Box 10784, Greensboro, North Carolina 27404
Project County: Randolph
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.lilotenviro.com
[e-mail]