20230317 Ver 2_Receipt_20231012

DocuSign Envelope ID: 001667C5-ECC3-4649-AE91-FA884CB4423B
ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
NORTH CAROLINA
Environmental Quality
COMPENSATORY MITIGATION RESPONSIBILITY TRANSFER FORM
July 31, 2023
Permittee: HSREI, LLC DWR Project #20230317v2
Project Name: AMC Project
County: Cabarrus
The Division has received a Statement of Availability (SOA) from Water & Land Solutions LLC for the
Upper Rocky Umbrella Mitigation Bank (Mitigation Provider) to satisfy the mitigation requirements set
forth in the IWGP Certificate of Coverage issued to HSREI, LLC, dated July 31, 2023 as provided in the
table below.
Compensatory Mitigation River and 8-digit HUC Number
Non -Riparian Wetland 0.113 acres (credits) Yadkin / 03040105
The Permittee must provide a copy of this form to the Mitigation Provider specified above who will then
sign the form to verify receipt of payment and the transfer of the mitigation responsibility. Once the
Mitigation Provider has signed this form, it is the Permittee's responsibility to ensure that a signed copy
of this form is submitted to the Division before conducting any of the authorized impacts.
The Mitigation Provider verifies that the mitigation requirements (credits) shown above, have been
released and are available at the identified bank site(s). By signing below, the Mitigation Provider is
accepting full responsibility for the identified mitigation. As a reminder to the Mitigation Provider, no
more than 25 percent of the total mitigation required by Division can be met through preservation,
unless requested and approved by the Division Director (15A NCAC 02H. 1305(c)(6)).
Signature Authority Name (print):
Signature:
Riane Fisher
Date: 10/12/2023
D E Q�� North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
NORTH CAROLINA
919.707.9000