20231561 Ver 1_5914.4 _Pisgah Church_PCN_10.27.23_20231113

Preliminary ORM Data Entry Fields for New Actions
ACTION ID #: SAW- Begin Date (Date Received):
Prepare file folder Assign Action ID Number in ORM
1. Project Name [PCN Form A2a]:
2. Work Type: Private Institutional Government Commercial
3. Project Description / Purpose [PCN Form B3d and B3e]:
4. Property Owner / Applicant [PCN Form A3 or A4]:
5. Agent / Consultant [PNC Form A5 – or ORM Consultant ID Number]:
6. Related Action ID Number(s) [PCN Form B5b]:
7. Project Location – Coordinates, Street Address, and/or Location Description [PCN Form B1b]:
8. Project Location – Tax Parcel ID [PCN Form B1a]:
9. Project Location – County [PCN Form A2b]:
10. Project Location – Nearest Municipality or Town [PCN Form A2c]:
11. Project Information – Nearest Waterbody [PCN Form B2a]:
12. Watershed / 8-Digit Hydrologic Unit Code [PCN Form B2c]:
Authorization: Section 10 Section 404 Section 10 and 404
Regulatory Action Type:
Standard Permit Pre-Application Request
Nationwide Permit # Unauthorized Activity
Regional General Permit # Compliance
Jurisdictional Determination Request No Permit Required
Revised 20150602

Page 1 of 13
PCN Form – Version 1.3 December 10, 2008 Version
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
1a. Type(s) of approval sought from the
Corps: Section 404 Permit Section 10 Permit
1b. 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):
401 Water Quality Certification – Regular Non-404 Jurisdictional General Permit
401 Water Quality Certification – Express Riparian Buffer Authorization
1e. Is this notification solely for the record
because written approval is not required?

For the record only for DWQ 401
Certification:
Yes No
For the record only for Corps Permit:

Yes 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 1h
below.
Yes No

1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? Yes No
2. Project Information
2a. Name of project: Pisgah Church Road
2b. County: Guilford
2c. Nearest municipality / town: Greesboro
2d. Subdivision name:
2e. NCDOT only, T.I.P. or state
project no:
3. Owner Information
3a. Name(s) on Recorded Deed: RAK LLC
3b. Deed Book and Page No. multiple, see attached pacel cards in JD Request package
3c. Responsible Party (for LLC if
applicable): Mr. Phil Kleinman
3d. Street address: 1801 Carlisle Street
3e. City, state, zip: Greensboro, NC 27408
3f. Telephone no.: 336-580-6401
3g. Fax no.:
3h. Email address: [e-mail]

Page 2 of 13
PCN Form – Version 1.3 December 10, 2008 Version

4. Applicant Information (if different from owner)
4a. Applicant is: Agent Other, specify:
4b. Name:
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name: 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 3 of 13
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):
7866690508, 7866691720, 7866693634, 7866695656,
7866686730, 7866691367, 7866693483, 7866695486,
7866694209, 7866696301, 7866685917, 7866681947,
7866589877, 7866681737, and 7866589526
1b. Site coordinates (in decimal degrees): Latitude: 36.13571 Longitude: - 79.79171
(DD.DDDDDD) (-DD.DDDDDD)
1c. Property size: 25 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
proposed project: Lake Jeanette/Richland Lake
2b. Water Quality Classification of nearest receiving water: WS-III, 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 southwestern portion of the site is currently developed with a school. A gasoline station is located on the
southeastern portion of the site. Residences are located on the eastern portion of the site. The remainder of the site
contains fields and wooded land. The site is located in a commercial/residential portion of Greensboro, Guilford County,
North Carolina.
3b. List the total estimated acreage of all existing wetlands on the property:
Wetland=0.658 Ac
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
Stream=1,330
3d. Explain the purpose of the proposed project:
The purpose of the project is to develop the site with an apartment complex and commercial outparcel.
3e. Describe the overall project in detail, including the type of equipment to be used:
The purpose of the project is to develop the site with apartments and commercial outparcel as a storage unit facility. In
order to provide access and develop the site with an apartment complex, it is necessary to impact wetlands. Clearing and
grading the site is necessary. Graders, haulers, excavators and other heavy equipment will be used during site
construction.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
Comments: SAW-2020-01186
Yes No Unknown
4b. If the Corps made the jurisdictional determination, what type
of determination was made? Preliminary Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known): David Brame/MichaelBrame
Agency/Consultant Company: Pilot Enviromental, Inc.
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
JD pending

Page 4 of 13
PCN Form – Version 1.3 December 10, 2008 Version

5. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past? Yes No Unknown
5b. If yes, explain in detail according to “help file” instructions.

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 5 of 13
PCN Form – Version 1.3 December 10, 2008 Version

C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
Wetlands Streams - tributaries Buffers
Open Waters Pond Construction

Page 6 of 13
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.
Wetland impact
number –
Permanent (P) or
Temporary (T)
2b.

Type of impact
2c.

Type of wetland
(if known)
2d.

Forested

2e.
Type of jurisdiction
(Corps - 404, 10
DWQ – non-404, other)
2f.

Area of impact
(acres)
W1 P T Fill Bottomland
Hardwoods
Yes
No
Corps
DWQ 0.038
W2 P T Fill Bottomland
Hardwoods
Yes
No
Corps
DWQ 0.001
W3 P T Fill Bottomland
Hardwoods
Yes
No
Corps
DWQ 0.011
W4 P T Fill Bottomland
Hardwoods
Yes
No
Corps
DWQ 0.014
W5 P T Yes
No
Corps
DWQ
W6 P T Yes
No
Corps
DWQ
2g. Total wetland impacts 0.064
2h. Comments: Wetland Impact 1 will permanently impact 0.038 acres (1,670 SF) of wetlands with fill.

Wetland Impact 2 will permanently impact 0.001 acres (62SF) of wetlands with fill.

Wetland Impact 3 will permanently impact 0.011 acres (498 SF) of wetlands with fill.

Wetland Impact 4 will permanently impact 0.014 acres (621 SF) of wetlands with fill.

Temporary impacts to wetlands are not proposed. Mitigation for unavoidable net loss of wetlands is not 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.
Stream impact
number -
Permanent (P) or
Temporary (T)
3b.
Type of impact
3c.
Stream name
3d.
Perennial
(PER) or
intermittent
(INT)?
3e.
Type of jurisdiction
(Corps - 404, 10
DWQ – non-404,
other)
3f.
Average
stream
width
(feet)
3g.
Impact
length
(linear
feet)
S1 P T Road Fill/Rip-
Rap/Dewatering Unnamed PER
INT
Corps
DWQ 5 61/18/10
S2 P T PER
INT
Corps
DWQ
S3 P T PER
INT
Corps
DWQ
S4 P T PER
INT
Corps
DWQ
S5 P T PER
INT
Corps
DWQ
S6 P T PER
INT
Corps
DWQ
3h. Total stream and tributary impacts 61/18/10
3i. Comments: Stream Impact 1 will permanently impact 61 linear feet (305 SF) of stream from culvert/wall fill, permanently
impact 18 linear feet (90 SF) of stream from keyed in rip-rap fill and temporarily impact 10 linear feet (50 SF) of stream from
dewatering. Temporary impacts will be restored to similar pre-construction grade and stabilized with natural biodegradable
matting and herbaceous seed mix. Mitigation is not proposed for the net loss of stream from culvert or sideslope fill.

Page 7 of 13
PCN Form – Version 1.3 December 10, 2008 Version

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.
Open water
impact number –
Permanent (P)
or Temporary (T)
4b.
Name of waterbody
(if applicable)
4c.

Type of impact
4d.

Waterbody type
4e.

Area of impact (acres)
O1 P T
O2 P T
O3 P T
O4 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.

Pond ID
number
5b.

Proposed use or purpose
of pond

5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded Filled Excavated Flooded Filled Excavated 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:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a.
Project is in which protected basin?
Neuse Tar-Pamlico Other: Jordan
Catawba Randleman
6b.
Buffer impact
number –
Permanent (P)
or Temporary (T)
6c.

Reason
for
impact
6d.

Stream name
6e.

Buffer
mitigation
required?
6f.

Zone 1 impact
(square feet)
6g.

Zone 2 impact
(square feet)
B1 P T Yes
No
B2 P T Yes
No
B3 P T Yes
No
6h. Total buffer impacts
6i. Comments: City of GSO will issued buffer authorization certification prior to impacts occuring.

Page 8 of 13
PCN Form – Version 1.3 December 10, 2008 Version

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 site has been designed to avoid impacts to streams and wetlands. The proposed stream impact was selected in a
location that the stream is relatively straight with few meanders and does not contain significant amounts of wetlands. Stream
Crossing 1 has been designed to utilize rip-rap that will be keyed into existing stream grade, thus not resulting in a net loss of
aquatic function to the stream. The applicant has designed utilities to be located within the proposed road crossing footprint,
thus reducing temporary impacts to streams.

The remaining 1,241 linear feet of stream channel and 0.594 acres of wetlands are being avoided.
1b. 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. A temporary coffer dam will be installed. During
construction, water will be pumped around the construction footprint. 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 installation, the temporary sand bag coffer dams will be
removed and flow will be diverted through the culvert. Following installation of the culvert, areas of temporary stream impact
will be restored to similar pre-construction grade. The stream banks will be matted with biodegradable materials and
seeded/live staked with native species.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State?
Yes No

2b. If yes, mitigation is required by (check all that apply): DWQ Corps
2c. If yes, which mitigation option will be used for this
project?
Mitigation bank
Payment to in-lieu fee program
Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: warm cool cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.

Page 9 of 13
PCN Form – Version 1.3 December 10, 2008 Version

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 10 of 13
PCN Form – Version 1.3 December 10, 2008 Version

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified
within one of the NC Riparian Buffer Protection Rules? Yes No
1b. If yes, then is a diffuse flow plan included? If no, explain why.
Comments: Yes No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? 38.4 %
2b. Does this project require a Stormwater Management Plan? Yes No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:

2e. Who will be responsible for the review of the Stormwater Management Plan?
Certified Local Government
DWQ Stormwater Program
DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government’s jurisdiction is this project? Greensboro
3b. Which of the following locally-implemented stormwater management programs
apply (check all that apply):
Phase II
NSW
USMP
Water Supply Watershed
Other:
3c. Has the approved Stormwater Management Plan with proof of approval been
attached?
Yes No
4. DWQ Stormwater Program Review
4a. Which of the following state-implemented stormwater management programs apply
(check all that apply):
Coastal counties
HQW
ORW
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 11 of 13
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
use of public (federal/state) land? Yes No
1b. 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 Policy Act (NEPA/SEPA)?
Yes No
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
letter.)
Comments: A NEPA or SEPA is not required as part of this project.
Yes No
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,
or Riparian Buffer Rules (15A NCAC 2B .0200)?
Yes No
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
additional development, which could impact nearby downstream water quality? Yes No
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.

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 are not proposed.

Page 12 of 13
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
habitat? Yes No
5b. Have you checked with the USFWS concerning Endangered Species Act
impacts? Yes No
5c. If yes, indicate the USFWS Field Office you have contacted. Raleigh
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 and small whorled pogonia as federally protected species
that could be proximate to the project area.
The project area contains a mature hardwood/pine forest estimated to be at least 40 years in age. Mid and understory
vegetation is densely vegetated. Suitable habitat for Schweinitz's sunflower or small whorled pogonia are not located
within the proposed project area. Therefore, we have made a determination of no effect for these 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 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
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
Yes No
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 historic and/or archaeological resources of the site.
The map does not identify eligible for listing or listed properties on or near 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, Verification Package)

Bradley S. Luckey, PWS

Applicant/Agent's Printed Name

_______________________________
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization letter from the applicant
is provided.)

10.27.23

Date

WETLANDS IMPACT AREA
EXISTING WETLANDS
FLARED END SECTIONFES
CI CURB INLET
GRATE INLETGI
YARD INLETYI
STORM DRAINAGE PIPE
SANITARY MANHOLE
STORM MANHOLE
SSMH
SDMH
WATER MAIN
CB CATCH BASIN
SEAL
C
14984
H
ENGI
SEFO
E
N
A
RAO
LI
REEN
L
A
N
OIS
N
RO
P
A
H
C
T
R
R BURT
L
S P
Y JR.
,
.
2
PISGA
H

C
H
U
R
C
H

R
O
A
D
N
O
R
T
H

C
H
U
R
C
H

S
T
R
E
E
T
DIXON STREET
PAX

S
T
R
E
E
T
October 27, 2023
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: 2024-0010238
Project Name: Pisgah Church Road

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
10/27/2023   2

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.
10/27/2023   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
USFWS National Wildlife Refuges and Fish Hatcheries
Bald & Golden Eagles
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]
10/27/2023   4

PROJECT SUMMARY
Project Code:2024-0010238
Project Name:Pisgah Church Road
Project Type:Residential Construction
Project Description:Residential Development
Project Location:
The approximate location of the project can be viewed in Google Maps: https://
www.google.com/maps/@36.1353004,-79.79116810679766,14z
Counties:Guilford County, North Carolina
10/27/2023   5

1.
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
Fisheries , 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.
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 STATUS
Tricolored Bat Perimyotis subflavus
No critical habitat has been designated for this species.
Species profile: https://ecos.fws.gov/ecp/species/10515
Proposed
Endangered
INSECTS
NAME STATUS
Monarch Butterfly Danaus plexippus
No critical habitat has been designated for this species.
Species profile: https://ecos.fws.gov/ecp/species/9743
Candidate
FLOWERING PLANTS
NAME STATUS
Schweinitz's Sunflower Helianthus schweinitzii
No critical habitat has been designated for this species.
Species profile: https://ecos.fws.gov/ecp/species/3849
Endangered
Small Whorled Pogonia Isotria medeoloides
Population:
No critical habitat has been designated for this species.
Species profile: https://ecos.fws.gov/ecp/species/1890
Threatened
1
10/27/2023   6

1.
2.
3.
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.
USFWS NATIONAL WILDLIFE REFUGE LANDS
AND FISH HATCHERIES
Any activity proposed on lands managed by the National Wildlife Refuge system must undergo a
'Compatibility Determination' conducted by the Refuge. Please contact the individual Refuges to
discuss any questions or concerns.
THERE ARE NO REFUGE LANDS OR FISH HATCHERIES WITHIN YOUR PROJECT AREA.
BALD & GOLDEN EAGLES
Bald and golden eagles are protected under the Bald and Golden Eagle Protection Act and the
Migratory Bird Treaty Act .
Any person or organization who plans or conducts activities that may result in impacts to bald or
golden eagles, or their habitats , should follow appropriate regulations and consider
implementing appropriate conservation measures, as described below.
The Bald and Golden Eagle Protection Act of 1940.
The Migratory Birds Treaty Act of 1918.
50 C.F.R. Sec. 10.12 and 16 U.S.C. Sec. 668(a)
There are bald and/or golden eagles in your project area.
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
Bald Eagle Haliaeetus leucocephalus
This is not a Bird of Conservation Concern (BCC) in this area, but warrants attention
because of the Eagle Act or for potential susceptibilities in offshore areas from certain
types of development or activities.
https://ecos.fws.gov/ecp/species/1626
Breeds Sep 1 to
Jul 31
1
2
3
10/27/2023   7

▪
▪
▪
▪
 no data survey effort breeding season probability of presence
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 the supplemental
information and specifically the FAQ "Proper Interpretation and Use of Your Migratory Bird
Report" before using or attempting to interpret this report.
Probability of Presence ()
Green bars; the bird's relative probability of presence in the 10km grid cell(s) your project
overlaps during that week of the year.
Breeding Season ()
Yellow bars; liberal estimate of the timeframe inside which the bird breeds across its entire
range.
Survey Effort ()
Vertical black lines; the number of surveys performed for that species in the 10km grid cell(s)
your project area overlaps.
No Data ()
A week is marked as having no data if there were no survey events for that week.
SPECIES JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
Bald Eagle
Non-BCC
Vulnerable
Additional information can be found using the following links:
Eagle Managment https://www.fws.gov/program/eagle-management
Measures for avoiding and minimizing impacts to birds https://www.fws.gov/library/
collections/avoiding-and-minimizing-incidental-take-migratory-birds
Nationwide conservation measures for birds https://www.fws.gov/sites/default/files/
documents/nationwide-standard-conservation-measures.pdf
Supplemental Information for Migratory Birds and Eagles in IPaC https://www.fws.gov/
media/supplemental-information-migratory-birds-and-bald-and-golden-eagles-may-occur-
project-action
10/27/2023   8

1.
2.
3.
MIGRATORY BIRDS
Certain birds are protected under the Migratory Bird Treaty Act and the Bald and Golden Eagle
Protection Act .
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.
The Migratory Birds Treaty Act of 1918.
The Bald and Golden Eagle Protection Act of 1940.
50 C.F.R. Sec. 10.12 and 16 U.S.C. Sec. 668(a)
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
Bald Eagle Haliaeetus leucocephalus
This is not a Bird of Conservation Concern (BCC) in this area, but warrants attention
because of the Eagle Act or for potential susceptibilities in offshore areas from certain types
of development or activities.
https://ecos.fws.gov/ecp/species/1626
Breeds Sep 1 to
Jul 31
Black-billed Cuckoo Coccyzus erythropthalmus
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA
and Alaska.
https://ecos.fws.gov/ecp/species/9399
Breeds May 15
to Oct 10
Cerulean Warbler Dendroica cerulea
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA
and Alaska.
https://ecos.fws.gov/ecp/species/2974
Breeds Apr 28
to Jul 20
Chimney Swift Chaetura pelagica
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA
and Alaska.
https://ecos.fws.gov/ecp/species/9406
Breeds Mar 15
to Aug 25
Kentucky Warbler Oporornis formosus
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA
and Alaska.
https://ecos.fws.gov/ecp/species/9443
Breeds Apr 20
to Aug 20
1
2
3
10/27/2023   9

NAME
BREEDING
SEASON
Prairie Warbler Dendroica discolor
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA
and Alaska.
https://ecos.fws.gov/ecp/species/9513
Breeds May 1
to Jul 31
Prothonotary Warbler Protonotaria citrea
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA
and Alaska.
https://ecos.fws.gov/ecp/species/9439
Breeds Apr 1 to
Jul 31
Red-headed Woodpecker Melanerpes erythrocephalus
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA
and Alaska.
https://ecos.fws.gov/ecp/species/9398
Breeds May 10
to Sep 10
Rusty Blackbird Euphagus carolinus
This is a Bird of Conservation Concern (BCC) only in particular Bird Conservation Regions
(BCRs) in the continental USA
https://ecos.fws.gov/ecp/species/9478
Breeds
elsewhere
Wood Thrush Hylocichla mustelina
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA
and Alaska.
https://ecos.fws.gov/ecp/species/9431
Breeds May 10
to Aug 31
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 the supplemental
information and specifically the FAQ "Proper Interpretation and Use of Your Migratory Bird
Report" before using or attempting to interpret this report.
Probability of Presence ()
Green bars; the bird's relative probability of presence in the 10km grid cell(s) your project
overlaps during that week of the year.
Breeding Season ()
Yellow bars; liberal estimate of the timeframe inside which the bird breeds across its entire
range.
Survey Effort ()
Vertical black lines; the number of surveys performed for that species in the 10km grid cell(s)
your project area overlaps.
No Data ()
A week is marked as having no data if there were no survey events for that week.
10/27/2023   10

▪
▪
▪
 no data survey effort breeding season probability of presence
SPECIES JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
Bald Eagle
Non-BCC
Vulnerable
Black-billed
Cuckoo
BCC Rangewide
(CON)
Cerulean Warbler
BCC Rangewide
(CON)
Chimney Swift
BCC Rangewide
(CON)
Kentucky Warbler
BCC Rangewide
(CON)
Prairie Warbler
BCC Rangewide
(CON)
Prothonotary
Warbler
BCC Rangewide
(CON)
Red-headed
Woodpecker
BCC Rangewide
(CON)
Rusty Blackbird
BCC - BCR
Wood Thrush
BCC Rangewide
(CON)
Additional information can be found using the following links:
Eagle Management https://www.fws.gov/program/eagle-management
Measures for avoiding and minimizing impacts to birds https://www.fws.gov/library/
collections/avoiding-and-minimizing-incidental-take-migratory-birds
Nationwide conservation measures for birds https://www.fws.gov/sites/default/files/
documents/nationwide-standard-conservation-measures.pdf
10/27/2023   11

▪Supplemental Information for Migratory Birds and Eagles in IPaC https://www.fws.gov/
media/supplemental-information-migratory-birds-and-bald-and-golden-eagles-may-occur-
project-action
10/27/2023   12

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:[phone]
LEAD AGENCY CONTACT INFORMATION
Lead Agency:Army Corps of Engineers
LEGEND
Site Boundary
Drawing 1
USGS Topographic Map
Lake Brandt and Greensboro,
NC Quadrangles
Scale: 1” = 2,000’
USGS Topographic Map
Pisgah Church Road
Approximate 25-Acre Tract
Greensboro, Guilford County, NC
Pilot Project 5914.1
Drawing 2
USDA Web Soil Survey
of Guilford County, NC
Scale: 1” = 200'
LEGEND
Site Boundary
Web Soil Map
Pisgah Church Road
Approximate 25-Acre Tract
Greensboro, Guilford County, NC
Pilot Project 5914.1
Drawing 2A
USDA Published Soil Survey
of Guilford County, NC
Published 1977, Sheets 15 and 16
Not to Scale
Published Soil Map
Pisgah Church Road
Approximate 25-Acre Tract
Greensboro, Guilford County, NC
Pilot Project 5914.1
LEGEND
Site Boundary
Drawing 3
USFWS NWI
Wetlands Mapper
Scale: 1” = 400'
LEGEND
Site Boundary
Freshwater Emergent
Freshwater Forested/Shrub
Estuarine and Marine Deepwater
Estuarine and Marine
Freshwater Pond
Lake
Riverine
Other
NWI Map
Pisgah Church Road
Approximate 25-Acre Tract
Greensboro, Guilford County, NC
Pilot Project 5914.1
LEGEND Site Boundary
Drawing 4
National Flood Hazard Layer
From FEMA Web Map Service
Scale: 1” = 800'
FEMA FIRM
Pisgah Church Road
Approximate 25-Acre Tract
Greensboro, Guilford County, NC
Pilot Project 5914.1
WG DP-1
FLAG NUMBERS/INFORMATION
WETLAND FLAGS =
STREAM FLAGS =
Wetland Flags = 76
Stream Flags = Flagged at origins and
intersections; surveyor locate
Drawing 5
2020 Satellite Imagery from ESRI
and Pilot GPS Data
Scale: 1” = 200'
Date: 7.8.21
Wetland Map
Pisgah Church Road
Approximate 24.9-Acre Tract
Greensboro, Guilford County, NC
Pilot Project 5914.1
TRACT A: THE LOCATIONS OF FEATURES SHOWN WERE VERIFIED BY MR. DAVID BAILEY WITH THE USACE AND MS. SUE HOMEWOOD WITH THE NCDEQ-DWR ON AUGUST 5, 2020. DELINEATION CONDUCTED BY PILOT PERSONNEL 6/30/20.
TRACT B: THE FEATURES DEPICTED HAVE NOT BEEN VERIFIED BY THE USACE AND ARE SUBJECT TO CHANGE. DELINEATION CONDUCTED BY PILOT PERSONNEL 6/30/21.
THIS MAP INCLUDES GPS LOCATIONS OF DELINEATED FEATURES.
LEGEND
Site Boundary
Pond
Intermittent Stream
Perennial Stream
Wetland
Data Point
Flag Number/Feature ID
DP-1
WA 1-5
USACE PJD
Area
WG DP-2
USACE AJD
Area
WG DP-1
FLAG NUMBERS/INFORMATION
WETLAND FLAGS =
STREAM FLAGS =
Wetland Flags = 76
Stream Flags = Flagged at origins and
intersections; surveyor locate
Drawing 5
2020 Satellite Imagery from ESRI
and Pilot GPS Data
Scale: 1” = 200'
Date: 7.8.21
Wetland Map
Pisgah Church Road
Approximate 0.10-Acre Tract
Greensboro, Guilford County, NC
Pilot Project 5914.1
TRACT A: THE LOCATIONS OF FEATURES SHOWN WERE VERIFIED BY MR. DAVID BAILEY WITH THE USACE AND MS. SUE HOMEWOOD WITH THE NCDEQ-DWR ON AUGUST 5, 2020. DELINEATION CONDUCTED BY PILOT PERSONNEL 6/30/20.
TRACT B: THE FEATURES DEPICTED HAVE NOT BEEN VERIFIED BY THE USACE AND ARE SUBJECT TO CHANGE. DELINEATION CONDUCTED BY PILOT PERSONNEL 6/30/21.
THIS MAP INCLUDES GPS LOCATIONS OF DELINEATED FEATURES.
LEGEND
Site Boundary
Pond
Intermittent Stream
Perennial Stream
Wetland
Data Point
Flag Number/Feature ID
DP-1
WA 1-5
WG DP-2
USACE PJD
Area
USACE AJD
Area
From:Heather LaGamba
To:"[e-mail]"
Subject:Pre-File Notice - Pisgah Church Road (5914.4)
Date:Wednesday, October 11, 2023 4:18:26 PM
We would like to submit a Pre-filing Notice for the following project:
Project Name: Pisgah Church Road (5914.4)
Project Owner: Premier Stores, Inc.
Project Owner’s Address: 7609 Business Park Drive, Greensboro, North Carolina 27409
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]