20051117 Ver 3_401 Application_20150914

REEBOR & CARVER, PR.
CIVIL ENGINEERS LAND SURVEYORS
LAND PLANNING
September 10, 2015
Mr. John Thomas
Raleigh Regulatory Field Office
US Army Corps of Engineers
3331 Heritage Trade Drive - Suite 105
Wake Forest, NC 27587
Mr. Thomas —
I have enclosed the PCN and supporting documents for a stream crossing for a proposed
residential driveway. This PCN is a follow up to an email inquiry I sent you on 7/24/2015. The
lot was recently platted and is part of a larger development that has been through 404/401
permitting in 2008 for the construction of a dam and other environmental requirements. I have
attached a copy of that previous permit letter for you reference. There is a large amount of
additional documentation that is a part of that file that I have not included as it did not appear
pertinent to this request.
The request is for a basic culvert crossing in a perennial stream. The lot has a long flag pole to
access the buildable area. The stream was previously determined by the Corp and DENR —
DWR. That UT to the Yadkin River has deeded stream buffers and the deed documents and
covenants are included. I have provided pictures along the stream reach were this crossing is
proposed.
Enclosed is also a DVD disk with all of the documents in an electronic format. The pictures are
considerably more clear than the color prints. Please advise if any further documents are
required.
Thank you and kindest regards, ����� ``������������������ "���''�.
� CAROB/ 0. S/0 .9
Alex Carter, PE '• FNGINE�;�'Q
T CP�o```�
CC: Sue Homewood — DENR - DWR �•��'
Enclosures: PCN
Deed and Covenants
Recorded Plat of Lot
Aerial overview map of location of crossing
USGS map of location of crossing
Plan Sheets for crossing installation
503 High Street Winston Salem, NC 27101 336- 748 -0071

. -
BEESUR &CRRTER, PR.
CIVIL ENGINEERS LAND SURVEYORS
LAND PLANNING
503 High Street, Winston- Salem, NC 27101
Phone [phone] Fax [phone]
www.beesonengineering.com
TO: NCDENR - DWQ
WBSCP UNIT
RE: Wetlands Permitting
We are sending you: Attached
COPIES DATE DESCRIPTION
2 6/22/2015 Full Size Plan Set
3 6/22/2015 11x 17 Size Plan Set
5 6/22/2015 PCN And Agent Authorization
1 6/22/2015 Fee Check For $240
TRANSMITTAL
'20 50 9
56
ACTION
For Approval
For Approval
For Approval
As requested
Remarks:
Please find enclosed documents to request permitting for a stream crossing for proposed
residential home site (NWP 29) and Stabilization for same (NWP 13). This package has also been
submitted to John Thomas at USACE for permitting.
Thank you,
Alex Carter
CC T0:
Signed: '4�' Z?
Alex T. Carter, PE

A. Applicant Information
1. Processing
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
Pre - Construction Notification (PCN) Form
1a. Type(s) of approval sought from the Corps: ❑X Section 404 Permit ❑ Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 29 and 13 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? I ❑ Yes ❑X No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
❑X 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e.
Is this notification solely for the record For the record only for DWQ
For the record only for Corps Permit:
because written approval is not required? 401 Certification:
❑ Yes ❑X No
❑ Yes ❑X 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
❑ Yes ❑X No
or in -lieu fee program.
1 g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
❑ Yes ❑X No
below.
1h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes ❑X No
2.
Project Information
2a.
Name of project: The Estates at Lissara - Lot 21 Driveway Crossing for Proposed Residential Home
2b.
County: Forysth
2c.
Nearest municipality / town: Town of Lewisville
2d.
Subdivision name: The Estates at Lissara
2e.
NCDOT only, T.I.P. or state project no: N/A
3.
Owner Information
3a.
Name(s) on Recorded Deed: Estates at Lissara, LLC
3b.
Deed Book and Page No. PB63, Pg 182
3c.
Responsible Party (for LLC if Bruce Hubbard
applicable):
3d.
Street address: 1598 Westbrook Drive, Suite 200
3e.
City, state, zip: Winston - Salem, NC 27103
3f.
Telephone no.: 336- 723 -0303
3g.
Fax no.:
3h.
Email address: bhubbard @hubbardcommercial.com
Page 1 of 10
PCN Form — Version 1.4 January 2009

4. Applicant Information (if different from owner)
4a. Applicant is:
❑X Agent ❑ Other, specify:
4b. Name:
Alex T. Carter
4c. Business name
Beeson & Carter, P.A.
(if applicable):
4d. Street address:
503 High Street
4e. City, state, zip:
Winston - Salem, NC 27101
4f. Telephone no.:
336- 748 -0071
4g. Fax no.:
336- 748 -0470
4h. Email address:
acarter @beesonengineering.com
5. Agent /Consultant Information (if applicable)
5a. Name:
Alex T. Carter
5b. Business name
Beeson & Carter, P.A.
(if applicable):
5c. Street address:
503 High Street
5d. City, state, zip:
Winston - Salem, NC 27101
5e. Telephone no.:
336- 748 -0071
5f. Fax no.:
336- 748 -0470
5g. Email address:
acarter @beesonengineering.com
Page 2 of 10

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): 1 5876 -13- 5789.00 currently; lot 21 pin not assigned yet
1 b. Site coordinates (in decimal degrees): I Latitude: 36.11498 Longitude: - 80.44988
1 c. Property size: 6.57 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project: UT to Yadkin River
2b. Water Quality Classification of nearest receiving water: Class C
2c. River basin: Yadkin -Pee Dee
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 total site was developed for 27 residential home lots. The site is primarily in mature trees with rolling topography. Lot 21 is a flag lot with the
buildable area across the UT to the Yadkin River.
3b. List the total estimated acreage of all existing wetlands on the property: 0
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 145
3d. Explain the purpose of the proposed project:
The project is to provide a permanent crossing over the UT to access the proposed home site.
3e. Describe the overall project in detail, including the type of equipment to be used:
The project will include clearing of the driveway area and installation of a 48" double wall HDPE pipe with inlet and outlet scour protection in the form of
rock aprons. A nedui um s ze I oader and excavator W I I be used for cl eari ng and construction.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the ❑X Yes ❑ No ❑ Unknown
Corps or State been requested or obtained for this property /
project (includinq all prior phases) in the past? Comments: Action ID SAW - 200520968
4b. If the Corps made the jurisdictional determination, what type ❑ Preliminary 0 Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas? Agency /Consultant Company: USACE / NCDENR
Name (if known): John Thomas / Sue Homewood Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Nov 4, 2008 USACE and NCDENR Proj 2005 -1117 (Unable to locate 401 permit via Microfiche system) Relating to Construction of Dam, Mitigation
and Requirements for same
5. Project History
5a. Have permits or certifications been requested or obtained for I 0 Yes ❑ No ❑ Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
USACE Action ID #200520968 and DWR Proj #2005 -1117
6. Future Project Plans
6a. Is this a phased project? ❑ Yes 0 No
6b. If yes, explain.
Page 3 of 10
PCN Form — Version 1.4 January 2009

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
❑ Wetlands
Q Streams
—tributaries ❑ Buffers
❑ Open Waters
❑ Pond Construction
2. Wetland Impacts
Stream impact
Type of impact
Stream name Perennial (PER) or
Type of
Average
If there are wetland impacts proposed on
the site, then complete this question for each wetland
area impacted.
intermittent (INT)?
2a. 2b.
stream
2c.
2d.
2e.
2f.
Wetland impact
Type of impact
Type of wetland
Forested
Type of jurisdiction
Area of
number
(feet)
feet)
S1 P
Corps (404,10) or
impact
Permanent (P) or
4
58.1
S2 P
DWQ (401, other)
(acres)
Temporary (T)
4
16.8
S3
Choose one
W1
Choose one
Choose one
Yes /No
-
W2
Choose one
Choose one
Yes /No
Choose one
W3
Choose one
Choose one
Yes /No
Choose one
W4
Choose one
Choose one
Yes /No
W5
Choose one
Choose one
Yes /No
W6
Choose one
Choose one
Yes /No
2g. Total
Wetland Impacts:
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
3b.
3c. 3d.
3e.
3f.
3g.
Stream impact
Type of impact
Stream name Perennial (PER) or
Type of
Average
Impact
number
intermittent (INT)?
jurisdiction
stream
length
Permanent (P) or
width
(linear
Temporary (T)
(feet)
feet)
S1 P
Culvert
UT to Yadkin River PER
Corps
4
58.1
S2 P
Stabilization
UT to Yadkin River PER
Corps
4
16.8
S3
Choose one
S4
Choose one
S5
Choose one
S6
Choose one
3i. Comments:
See plan sheet C -4 and C -4.1 for details for S1 and S2
3h. Total stream and tributary impacts 74.9
Page 4 of 10
PCN Form — Version 1.4 January 2009

4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a. 4b.
4c.
4d. 4e.
Open water Name of waterbody
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer
impacts
impact number (if applicable)
Type of impact
Waterbody Area of impact (acres)
Permanent (P) or
❑ Neuse ❑ Tar - Pamlico ❑ Catawba ❑ Randleman
type
Temporary (T)
6b. 6c.
6d. 6e. 6f.
01
Choose one
Choose
02
Choose one
Choose
03
Choose one
Choose
04
Choose one
Choose
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, ther complete the chart below.
5a. 5b. 5c. 5d. 5e.
Pond ID number Proposed use or Wetland Impacts (acres) Stream Impacts (feet) Upland
purpose of pond (acres)
Flooded Filled Excavated Flooded Filled Excavated
P1 Choose one
P2 Choose one
5f. Total:
5g. Comments:
5h. Is a dam high hazard permit required? ❑ Yes ❑ No If yes, permit ID no:
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 ❑ Catawba ❑ Randleman
❑ Other:
6b. 6c.
6d. 6e. 6f.
6g.
Buffer Impact Reason for impact
Stream name Buffer
Zone 1
Zone 2
number—
mitigation
impact
impact
Permanent (P) or
required?
(square
(square
Temporary (T)
feet)
feet)
B1
Yes /No
B2
Yes /No
B3
Yes /No
B4
Yes /No
B5
Yes /No
B6 -
Yes /No
6h. Total Buffer Impacts:
6i. Comments:
Page 5 of 10

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The crossing site will be cleared only to the extent needed to install the culvert and place the fill. Stabilization is limited for the upstream approach to
minimize scour and culvert undermining. Stabilization is limited to the area need to dissipate velocity of water exiting the culvert.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
The overall site is left largely undisturbed. The clearing for the driveway is limited to 20' in width. The site is in the process of erosion control permitting
which will implement measures to prevent any sediments from leaving the construction area through the use of temporary silt fence and drainage
controls.
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 ❑X 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
project? El Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank: N/A
Type: Choose one Quantity:
3b. Credits Purchased (attach receipt and letter) Type: Choose one Quantity:
Type: Choose one Quantity:
N/A
3c. Comments:
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached. ❑ Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: Choose one
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non - riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments: N/A
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.
N/A
Page 6 of 10
PCN Form — Version 1.4 January 2009

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires I Yes X No
buffer mitigation?
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.
6c. 6d. 6e.
Zone Reason for impact Total impact Multiplier Required mitigation
(square feet) (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).
N/A
N/A
6h. Comments:
Page 7 of 10

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 ❑X No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
N/A
❑ Yes ❑ No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? 5.7%
2b. Does this project require a Stormwater Management Plan? ❑ Yes ❑X No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
Single Family Residential is excluded
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
N/A
2e. Who will be responsible for the review of the Stormwater Management Plan?
3. Certified Local Government Stormwater Review
3a. In which local qovernment's jurisdiction is this project?
3b. Which of the following locally - implemented stormwater management programs
apply (check all that apply):
3c. Has the approved Stormwater Management Plan with proof of approval been
attached?
4. DWQ Stormwater Program Review
4a. Which of the following state - implemented stormwater management programs apply
(check all that apply):
4b. Has the approved Stormwater Management Plan with proof of approval been
attached?
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements?
5b. Have all of the 401 Unit submittal requirements been met?
N/A
Town of Lewisville
❑X Phase II
❑ NSW
❑ USMP
❑ Water Supply Watershed
❑ Other:
❑ Yes ❑ No
❑Coastal counties
❑HQW
❑ ORW
❑Session Law 2006 -246
❑Other:
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Page 8 of 10
PCN Form — Version 1.4 January 2009

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal /state /local) funds or the ❑ Yes Q 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 Q No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.) N/A E] Yes E] No
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, El Yes ❑X No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after - the -fact permit application? ❑ Yes 0 No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
N/A
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ❑ Yes Q 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.
N/A
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.
The proposed home will have a connection to private sanitary sewer system
Page 9 of 10
PCN Form — Version 1.4 January 2009

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or ❑ Yes Q No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act ❑ Yes ❑X No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted. -
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
http: // criticalhabitat .fws.gov /crithab /; Bog Turtle
http://www.fws.gov/nc-es
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? I ❑ Yes ❑X No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
http: / /www. habitat. noaa .gov /protection /efh /index.htm]
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation ❑ Yes ❑X No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
http://www.hpo.ncdcr.gov/
http: / /www.archaeology. ncdcr. gov /ncarch /articles /articles.htm #piedmont
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA- designated 100 -year floodplain? I ❑ Yes ❑X No
8b. If yes, explain how project meets FEMA requirements:
N/A
8c. What source(s) did you use to make the floodplain determination?
http: / /www.ncfloodmaps.com/
Alex T. Carter 9/9/2015
Applicant /Agent's Printed Name Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization
letter from the applicant is provided.)
Page 10 of 10

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/
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E�j \ ( l / I ( l / / / / /j / lj % / / / / / / / IMPORTANT NOTES:
I
1. NOT A BOUNDARY SURVEY. The deeds and plats have been rotated to NC Grid.
2. Site is located in the Yadkin - Pee Dee Watershed
3. The site has future potential for additional development upstream and this has been
considered in the hydrology study.
\ / / Wa
4. Wildflower Woods / Limberlost Lane, Common Areas, 35' Private Access Easement
( y
and Public Utility Easement off Limberlost Lane all recorded in Plat Book 58, Pgs 1 -3 and
Plat Book 63, Page 182.
5. Stream Buffers shown recorded in Deed Book 2959, P g s 1904 -1907.
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2.60 ACRES /// / // / / / I \ \ - - - -�/ \ \ \\
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Drainage Area Cross Pi e
1063231 ±SQ FT
24.41 ±ACRES
/ / i // / / / 149395 SQ FT
/
3.43 ACRES
Hydrologic Soil Group- Summary by Map Unit- Forsyth County, North Carolina (NC067)
Acres in
/
Map unit symbol Map unit name Rating AOI
v / / / ) / CIB Clifford sandy loam, 2 to A 0.3
16 I / / / / / / / / / / / / CIC Clifford sandy loam, 6 to A 1.4
CID Clifford sandy loam, 10 to A 6.9
/ 87207 SQ FT \ / / - / /
/ / I I 1 I '' / / - -J _- 23 / / /// / / // / / %/ / - / / I / / / / / / / ( \ � _ \ \\ \\ HYDRO a 8.6
2.00 ACRES / % / / // / / / / \
CmC2 Clifford clay loam, 6 to 10 B 3.5
159428 SQ / / // / / / o - / / / / / / / / / \ \ \ \ \ \ \ \ FaD Fairview fine sandy B 0.5
/ / /// /// // // /
/ / / / /// (// / / / / / / // / / / / / / // // // 1 \ -
PcF2 Pacolet clay loam, 15 to B 7.5
3.66 ACRES '0
TmB Tomlin loam, 2to6 B 2.2
TmC Tomlin loam, 6to10 B 2.1
HYDRO B 15.8
- __
\ \ / / / /' - _� --' -� / / / ' �� l I' I l I I ! ) I I (I (/ // / / / / p/ \ - -_ � Totals for Area of Interest 24.4
COMBINED Cn
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Hydraflow Express Extension for AutoCAD® Civil 3D® 2010 by Autodesk, Inc.
\� - -
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/128440S FT / / / /// l/ l l I / / I i I I I \ \ 1 \ \ \\ \ \ \\ � \
'Stream and Buffers s sown \ \ \
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way -/ // / / / / / /// / \ \ \\ \\ \ \ /_ -- \
/15 Pj / / // / / / / recorded in Deed Book 2959, I \ \ \ \ _ \ _ - - - _ - _ _ - \ Hydrograph type = SCS
- \ - - - - Storm frequency (yrs) = 100
/ / Pgs 1904 -1907 as located. \ \ \ \ - - \ _ -
/ _
/ \-_- /
Drainage area ac = 24.500
I I I / / / / _ / / / _ \ p () _
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QFT I ( I �- - - -J /' // / / / PIPE CROSSING AREA \ \ \ o �____/\ / \ \___ Tcmethod = TR55
RES _ _ / / / \ \ \ \ \ Total precip. (in)
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\ _ 18 -_/ \/ 4.27 ACRES / / 60 / // // / / / / 1 I I \ \ \�-- - - - - -- \ \ \
/ I I \ _ -� \ \ �__ \ \ LISSARA LOT 21 Cross Pipe
_ 89885 SQ FT - / / / / / / / / / / \\ Invert Elev Dn (ft) = 749.00
// PIPE OUTLET PROTECTION: / \ - \
\ \ _ 2.06 ACRES - - _ - i \ / / // / / // 16.8'L x 2'D x 6'W / / / / / I I \ / \ \ \ Pipe Length (ft) = 58.10
19 / \ / / J // // / / // /I / Class 1 and B Stone over / / / / / / / / // / / _ - - - \ \ J / / \ ` \ \ \ \ Slope ( %) = 1.29
/ / _ Invert Elev U ft = 749.75
i - " � / / o medium weight filter fabric / / � / / / / / / \ / ' - - \ \ \ Rise In p O = 48.0
-106789 SQ //, -� �/ / / / // / / - / / / / / /- \ ( )
/ / / / oo ' / / / / / / / / \ / Shape =Cir
2.45 ACRES
Span (in) No. Barrels = 1 8.0
-
\ n -Value =0.012
Inlet Ede = 0
Coeff.K,M,c,Y,k = 0.0045, 2, 0.0317, 0.69, 0.5
D
// / / / // / // 1 \ \ \ \ \\ III I I I I I I I I \ \ \ /_ J/ / / / /� - - -- \\ // / \ \// ) / / / / ( I Embankment
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TopElevation() = 758.00
I l I I I Top Width (ft) = 20.00
Crest Width (ft) =60.00
\ \\l
LO
Peak discharge (cfs)
Time interval (min)
Curve number (CN)
Hydraulic length (ft)
Time of conc. (min)
Calculations
Qmin (cfs)
Qmax (cfs)
Tailwater Elev (ft)
Highlighted
Qtotal (cfs)
Qpipe (cfs)
Qovertop (cfs)
Veloc Dn (ft /s)
Veloc Up (ft/s)
HGL Dn (ft)
HGL Up (ft)
Hw Elev (ft)
Hw /D (ft)
Flow Regime
Cn
61
65
63.6 1
Friday, Jun 26 2015
= 117.80
=1
= 64
= See Worksheet
=16
Thursday, Sep 10 2015
= 53.00
= 120.00
= 0
= 118.00
= 118.00
= 0.00
= 9.83
= 10.70
= 752.64
= 753.03
= 755.28
= 1.38
= Inlet Control
Elev (ft) LIS SARA LOT 21 Cross Pipe I Iw Depth (ft)
75900 925
// / / / / -- \ \ \ \ \ \ \ \ \ \ \\ \ \ 1 / / /// / / //- / \\ \��1 \ \ \ \ \ \\ \ \\ \ 75T00 7,25
III ­V0
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/ '286217SQFT. / / / /�_�-/ / / J % \
/ / / / / / / / / / / �' - - - - - 753.00 3 25
6.57 ACRES
/ /X R�rdedin Forsyth Count y
\
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- - - 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80
Reach(ft)
Cir Culvert HGL Embank
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❑ Preliminary for Review Only; Not for Construction
X Final for Approval; Not for Construction
❑ Approved and Released for Construction on:
PROJECT:
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CLIENT/ PREPARED FOR:
ESTATES AT LISSSARA LLC
C/O Bruce Hubbard
1598 Westbrook Plaza Dr, Suite 200
Winston Salem, NC 27103
Ofc. No.: (336) 723 -0303
Fax No.: (336) 725 -6644
Email: bhubbard @hubbardcommercial.com
I
S
NC Grid - NAD83 (2011)
DATE: 09- 09.2015
DRAWN BY: ATC / CNK
JOB NO.: 09 -201
REVISIONS:
LD
SCALE: 1 " = 80'
40 0 20 40 80 160
SHEET TITLE:
© Beeson & Carter, P.A.
SHEET NO:
C -4

i
/
/
SF Pak
15.0'
/ SF—
/
1 1
Stream and Buffers shown
recorded in Deed Book 2959,
Pgs 1904 -1907 as located. I
SF
Armor area immediately
/ / /
around inlet
SF Class and B Stone over
SF medium weight filter fabric.
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x TLETP OTECTION:
\ / / / / // // / / / /1 / / Class 1 and B Stone over
medium weight filter fabric/
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Section A -A
760 760
756 I � 756
me
752 w 752
58.1' of 48" HDP @1.29%
Q
748 Pour 3000psi Fast Set Concrete fo ters; 748
2' D x 2'W x Stream bed width at 'tart
and End )f pipe to reduce undermining.
746 746
-1 +00 -0 +75 -0 +50 -0 +25 0 +00 0 +125 0 +50 0 +75 1+)0
VERTICAL SCALE: 1" = 4'
2 0 1 2 4 8
Section B -B
760
756
752
748
Pour 3000psi Fast S t Concrete looters;
2' D x 2'W x Stream Bed width at Start
and End of pipe to reduce undermining.
744
-1 +00 -0 +75 -0 +50 -0 +25
760
756
T
752
1' Or 48" HDPE @ 1.290
i EG
r
744
0 +00 0 +25 0 +50 0 +175 1 +jo
IMPORTANT NOTES:
1. Pipe shall be RCP or ADS double wall Storm pipe or equal.
2. Install per manufactures specifications.
3. ADS 48" HDPE has a minimum cover of 33" to prevent float.
4. Use impervious weir and pump around per details below during pipe installation.
5. A 2" semi trash pump rated at 8000 GPH or higher shall be the minimum used for pump around operations.
PUMP - AROUND DETAILS
TEMPORARY IN- STREAM CONSTRUCTION MEASURES
DESCRIPTION
The work should consist of installing a temporary pump around and supporting measures to divert flow around in- stream
construction sites.
CONSTRUCTION SEQUENCE
1. Construction activities including the installation of erosion and sediment control measures should not begin until a pre- construction
meeting is held with the erosion inspector. All existing utilities should be marked in the field prior to construction. The contractor is
responsible for any damage to existing utilities that may result from construction and should repair the damage at his /her own expense.
2. The contractor should notify the Division of Water Resources at least 5 days before beginning construction.
3. The contractor should conduct a pre- construction meeting on site with the erosion control inspector, the project manager, and the
engineer to review limits of disturbance, erosion and sediment control requirements, and the sequence of construction. The contractor
should stake out all limits of disturbance prior to the pre- construction meeting so they may be reviewed. The participants will also
designate the contractor's staging areas and flag all trees within the limit of disturbance which will be removed for construction access.
4. Construction should not begin until all sediment and erosion control measures have been installed and approved by the erosion control
inspector. The contractor should stay within the limits of the disturbance as shown on the plans and minimize disturbance within the
work area whenever possible.
5. Upon installation of all sediment control measures and approval by the erosion control inspector and the local DENR- DWR inspector,
the contractor should begin work at the upstream section and proceed downstream. The sequence of construction must be followed
unless the contractor gets written approval for deviations from the Engineer or DENR -DWR. The contractor should only begin work in
an area which can be completed by the end of the day including grading adjacent to the channel. At the end of each work day, the
work area must be stabilized and the pump around removed from the channel. Work should not be conducted in the channel during
rain events.
6. Sandbag dikes should be situated at the upstream and downstream ends of the work area as shown on the plans, and stream flow
should be pumped around the work area. The pump should discharge onto a stable velocity dissipater made of riprap or sandbags.
7. Water from the work area should be pumped to a sediment filtering measure such as a dewatering basin, sediment bag, or other
approved source. The measure should be located such that the water drains back into the channel below the downstream sandbag
dike.
8. Traversing a channel reach with equipment within the work area where no work is proposed should be avoided. If equipment has to
traverse such a reach for access to another area, then timber mats or similar measures should be used to minimize disturbance to the
channel. Temporary stream crossings should be used only when necessary and only where noted on the plans or specified.
9. The contractor is responsible for providing access to and maintaining all erosion and sediment control devices until the sediment
control inspector approves their removal.
10. After construction, all disturbed areas should be regraded and revegetated as per the erosion control plan details.
approved
dewatering device
PLAN VIEW
discharge hoses
flow
sediment dike
N uIII N,� J11NJUJd discharge
onto a stable velocity
dissipator made of rip rap
orsandbags
P dewatering pump
II _ A
intake hose
stream
diversion pumps
intake
hose
A I
flow
clean water dike
� sump —hole
OT pool
(12" to 18" deep
work area ► 2' dia.)
length not to exceed
that which can be
completed in one day
SECTION A —A
impervious sheeting
C�
n base flow + 1 foot
work area — (2 foot minimum)
cross section of sandbag dike
SEAL:
BEESOR & CARTER, PR.
CIVIL ENGINEERS LAND SURVEYORS
LAND PLANNING
503 HIGH STREET, WINSTON- SALEM, NC 27101
OFFICE:(336) 748 -0071 FAX:[phone]
WEB: www.beesonengineering.com
Corp #: C -4017

❑ Preliminary for Review Only; Not for Construction
X Final for Approval; Not for Construction
❑ Approved and Released for Construction on:
PROJECT:
CLIENT/ PREPARED FOR:
ESTATES AT LISSSARA LLC
C/O Bruce Hubbard
1598 Westbrook Plaza Dr, Suite 200
Winston Salem, NC 27103
Ofc. No.: (336) 723 -0303
Fax No.: (336) 725 -6644
Email: bhubbard @hubbardcommercial.com
I
S
NC Grid - NAD83 (2011)
DATE: 09- 09.2015
DRAWN BY: ATC / CNK
JOB NO.: 09 -201
REVISIONS:
LD
SCALE: 11, = 40'
20 0 10 20 40 80
SHEET TITLE:
© Beeson & Carter, P.A.
SHEET NO:
C -4.1
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CLIENT/ PREPARED FOR:
ESTATES AT LISSSARA LLC
C/O Bruce Hubbard
1598 Westbrook Plaza Dr, Suite 200
Winston Salem, NC 27103
Ofc. No.: (336) 723 -0303
Fax No.: (336) 725 -6644
Email: bhubbard @hubbardcommercial.com
I
S
NC Grid - NAD83 (2011)
DATE: 09- 09.2015
DRAWN BY: ATC / CNK
JOB NO.: 09 -201
REVISIONS:
LD
SCALE: 11, = 40'
20 0 10 20 40 80
SHEET TITLE:
© Beeson & Carter, P.A.
SHEET NO:
C -4.1

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO.: 21 BLOCK NO. 4609 PARCEL ID: 5876 -13- 5789.00 currentiv; lot 21 Din not
assigned vet
STREET ADDRESS: TBD Limberlost lane. Lewisville. NC 27023
Property Owner: Estates at Lissara. LLC
The undersigned, registered property owners of the above noted property, do hereby authorize
Alex Carter, PE , of Beeson & Carter. P.A.
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
1598 Westbrook Plaza. Suite 200, Winston Salem. NC 27103
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
�i^'r j0►�£ S r k L4 s S "-r- w L L-
i
Authorized Signature Authorized Signature
Date: 9'10 -15--
Date:

DEPARTMENT OF THE ARMY
WILMINGTON DISTRICT, CORPS OF ENGINEERS
F.O. SOX. 1890
WILMINGTON. NORTH CAROLINA 28402 -1890
REPLY TO November 4, 2008
ATTES+FT ON OP:
Regulatory Division
Action ID SAW-200520968
Mr. Lang Wilcox
Lissara, LLC
1210 Forrest Wood Drive
Lewisville, North Carolina 27023
Dear Mr. Wilcox:
Enclosed is a Department of the Army permit authorizing the proposed placement of fill
material into 433 linear feet of stream channel and the flooding of 4,674 linear feet of stream
channel including 0.042 acre of wetland flooding of the jurisdictional waters of an unnamed
tributary of the Yadkin Diver associated with the construction of the water ski lake included with
the development of the Lissara Lake Subdivision. The project, a residential subdivision, is
approximately 132 acres in size and is located north of Shallowford Road (SR 100 1) and west of
Conrad Road (SR 1305), approximately two miles west of Lewisville, in Forsyth County, North
Carolina. Coordinates (in decimal degrees) for the site are 36.10690 North, - 80.44910 West.
The site contains an unnamed tributary of the Yadkin River and adjacent wetlands in the Yadkin
River Basin (8 -Digit Cataloging Unit 03040101).
Any deviation in the authorized work will likely require modification of this permit. if a
change in the authorized work is necessary, you should promptly submit revised plans to the
Corps showing the proposed changes. You may not undertake the proposed changes until the
Corps notifies you that your permit has been modified.
Carefully read your permit. The general and special conditions are important. Your failure
to comply with these conditions could result in a violation of Federal law. Certain significant
conditions require that:
a. You must complete construction before December 31, 2013.
b. You must allow representatives from this office to make periodic visits to your worksite
as deemed necessary to assure compliance with permit plans and conditions.
You must notify this office in advance as to when you intend to commence and complete
work.

-2-
You should address all questions regarding this authorization to John Thomas, Raleigh
Regulatory Field Office at (919) 554 - 4884, extension 25.
Sincerely,
w,Jefferson M. Ryscavage
Colonel, U.S. Army
District Commander
Enclosures
Copy Furnished (with enclosures):
Chief, Source Data Unit
NOA,A/National Ocean Service
ATTN: Sharon Tear N /CS261
1315 Fast -West Hwy., Rm 7316
Silver Spring, Maryland 2.0910 -3282
Copies Furnished (with special conditions and plans):
Mr. Ronald J. Mikulak, Chief Mr. Doug Huggett
Wetlands Regulatory Section Division of Coastal Management
61 Forsyth Street N.C. Department of Environment
Atlanta, Georgia 30303 and Natural Resources
Mr. Pete Benjamin
U.S. Fish and Wildlife 'Service
Fish and Wildlife Enhancement
Post Office Box 33726
Raleigh, North Carolina 27636 -3726
Mr. Ron Sechler
National Marine Fisheries Service
Pivers Island
Beaufort, North Carolina 28516
400 Commerce Avenue
Morehead City, North Carolina 28557
Mr. David Rackley
National Marine Fisheries service
219 Fort Johnson Road
Charleston, South Carolina 29412 -9110

e, Damage claims associated with any future modification, suspension, or revocation of this permit.
4. Reliance on Applicant's Data: The determination of this office that issuance of this peanut is taut c011111u-y to the public interest was mad in reliance
on the information you provided.
5. Reevaluation of Permit Decision. This office may reevaluate its decision on this permit at any time the circumstances
warrant. Circumstances that could require a reevaluation include, but are not limited to, the following:
a. You fail to comply with the terms and conditions of this permit.
b. The information provided by you in support of your permit application proves to have been false, incomplete, or
inaccurate (see 4 above).
c. Significant new information surfaces which this office dirt not consider in reaching the original public interest
decision.
Such a reevaluation may result in a determination that it is appropriate to use the suspension, modification, and
revocation procedures contained in 33 CFR 325.7 or enforcement procedures such as those contained in 33CFR 326,4
and 326.5. The referenced enforcement procedures provide for the issuance of an administrative order requiring you to
comply with the terms and conditions of your pernut and for the initiation of legal action where appropriate. You will
be required to pay for any corrective measures ordered by this office, and if you fail to comply with such directive, this
office may in certain situations (such as those specified in 33 CFR 209.170) accomplish the corrective measure by
contract or otherwise and bill you for the cost.
6. Extensions. General condition l establishes a time limit for the completion of the activity authorized by this permit.
Unless there are circumstances requiring either a prompt completion of the authorized activity or a reevaluation of the
public interest decision, the Corps will normally give favorable consideration to a request for an extension of this time
limit.
Your signature below, as permittee, indicates that you accept and agree to comply with the terms and conditions of this
permit.
(PE MITT LLC (DATE)
. LANG WILCOX
This permit becomes effective when the Federal official, designated to act for the Secretary of the Army, has signed
below.
C1 - 660
(DISTRICT Cam tinder) 1EFFERS M. SCAVAGE, +COLONEL (DAT'I )
V
when the structures or work authorized by this permit are still in existence at the time the property is transferred, the terms and conditions of this
permit will continue to be binding on the new owner(s) of the property_ To validate the transfer of this permit and [lie associated liabilities associated
with compliance with its terms and conditions, have the transferee sign and date below.
(Transferee) (DATE)
zt1.S. GOVERNMENT PRINTING OFFICE: 1986 — 717 -425

Book 2959 Page 1904
Prepared by /return to: Brant H. Godfrey (Box 90)
NORTH CAROLINA
FORSYTH COUNTY
IIIIIIII IIIIIIIIINIIII IIII II IIIII II I III
2010030721 00038
FORSYTH CO, NC FEE $23.00
PRESETREO a RECORDED:
08 -17 -2010 10:25:00 AM
C. NORMAN HOLLEMAN
REGISTER OF DEEDS
By PATSY RUTH DAVIS
DPTY
BK: RE 2959
PG: 1904 -1907
DECLARATION OF RESTRICTIVE
COVENANTSFOR
TAX BLOCK 4609, LOT 3B
KNOW ALL MEN BY THESE PRESENTS: Whereas WESTVIEW DEVELOPMENT COMPANY,
a North Carolina Corporation having its principal office in Forsyth County, North Carolina (hereinafter
"Declarant'), is the owner of certain real property as shown on the survey map entitled "Lissara On -Site and
Off -Site Stream Preservation Buffers" dated January 22, 2008 by Coe Forestry and Surveying, more particularly
described in Exhibit "A" attached hereto and by this reference incorporated herein, and whereas Declarant
desires to impose certain restrictions and conditions upon present and future owners of said real property;
NOW, THEREFORE, Declarant hereby covenants and agrees, for itself and its successors and assigns,
with all persons, firms, corporations, or other parties hereafter acquiring title to any part of said real property,
that all of the said real property is hereby subjected to the following restrictions and conditions as to the use
thereof, said conditions and restrictions to be appurtenant to and to run with said real property, by whomsoever
owned.
The areas shown on the above - referenced survey of Tax Block 4609, Lot 3B are designated as stream
preservation buffers and shall be maintained in perpetuity in their natural or mitigated condition. No person or
entity shall perform any of the following activities within such stream preservation buffers:
a. fill, grade, excavate or perform any other land disturbing activities other than as heretofore
agreed to ( "excepted area ") by the U. S. Army Corps of Engineers, and which agreed to
work may be repaired or replaced but not expanded as to size or use
b. cut, mow, burn, remove, or harm any vegetation
C. construct or place any roads, trails, walkways, buildings, mobile homes, signs, utility
poles or towers, or any other permanent or temporary structures other than as heretofore
agreed to ( "excepted area ") by the U. S. Army Corps of Engineers, and which agreed to
work may be repaired or replaced but not expanded as to size or use
d. drain or otherwise disrupt or alter the hydrology or drainage ways of the stream
preservation buffer
Page 1 of 3

Book 2959 Page 1905
e. dump or store soil, trash, or other waste
I. graze or water animals, or use for any agricultural or horticultural purpose
g. except that one (1) driveway crossing shall be allowed within the length of "Stream
Preservation Buffer A" for a maximum of seventy -five (75) feet at a location to be
determined upon construction of a single - family residence on a future lot
This covenant is intended to ensure continued compliance with the mitigation condition of a Clean Water
Act authorization issued by the United States of America, U.S. Army Corps of Engineers, Wilmington District,
Action ID #200520968, and therefore may be enforced by the United States of America. This covenant is to run
with the land, and shall be binding on the Owner, and all parties claiming under it.
IN WITNESS WHEREOF, Westview Development Company has caused this instrument to be signed
in its corporate name by its duly authorized officer by authority of its Board of Directors, this 1 day of
AlDlusT , 20j!�!__.
WESTVIEW DEVELOPMENT COMPANY
By:
Brant H. Godfrey esie*t
NORTH CAROLINA - FORSYTH COUNTY
I certify that the following person personally appeared before me this day, that I have personal knowledge of the
identity of said person, and that he acknowledged to me that he signed the foregoing document: Brant H.
Godfrey, President, Westview Development Company, Declarant.
Date:
Virgin Nix Notary Pubik
[Stamp or Seal] y Co 'ssion ex ' es 6/28/2012
mac
VIRGINIA M. NIXON l
Page 2 of 3

t
Book 2959 Page 1906
EXHIBIT "A"
The following descriptions are the centerlines of stream preservation buffers extending a width of one - hundred
(100) feet.
BUFFER A: BEGINNING at a point, said point being the centerline of a stream in the south line of Westview
Development Company (Deed Book 2722, Page 2283, Forsyth County Registry) and the north line of Lissara
Partners, LLC (Deed Book 2805, Page 4368, Forsyth County Registry), said point being South 85° 41' 50" East
376.47 feet from the northwestern corner of Lissara Partners, LLC (Deed Book 2805, Page 4368, Forsyth
County Registry) and running thence from said Beginning point the following courses and distances: North 18'
43' 37" East 8.92 feet; North 88° 12' 48" East 18.01 feet; North 58° 01' 40" East 34.14 feet; North 5° 10' 57"
West 14.82 feet; North 46° 49' 12" East 21.83 feet; North 20° 23' 38" East 39.48 feet; North 12° 56' 36" West
21.17 feet; North 36' 31' 54" East 20.36 feet; North 14° 53' 49" West 10.40 feet; North 27° 42' 15" East 17.38
feet; North 2° 03' 17" East 19.17 feet; North 13 ° 26' 12" East 20.32 feet; North 54° 24' 04" East 41.50 feet;
North 5' 08' 30" East 30.06 feet; North 51° 06' 19" East 28.59 feet; North 88' 59' 14" East 12.39 feet; North
47° 15' 14" East 34.41 feet; North 79° 18' 56" East 14.21 feet; North 35' 19' 16" East 40.66 feet; North 65'
16' 05" East 18.27 feet; North 17' 56' 18" East 52.69 feet; North 85° 45' 35" East 19.91 feet; North 23 ° 19'
01" East 89.27 feet; North 30° 51' 49" East 38.71 feet; North 35° 00' 08" East 16.55 feet; North 7' 24' 44" East
36.03 feet; North 19° 50' 08" West 14.67 feet; North 21° 13' 51" East 20.25 feet; North 58° 0V 55" East 28.13
feet; North 33° 27' 50" East 50.84 feet; North 64° 59' 13" East 38.96 feet; North 34' 41' 45" East 27.70 feet;
North 9° 46' 59" West 32.34 feet; North 11° 49' 44" East 42.24 feet; North 31° 50' 42" East 16.83 feet; North
9° 34' 48" East 63.07 feet; North 33° 41' 16" East 21.84 feet; North 49' 03' 13" East 30.12 feet; North 74° 16'
01" East 11.56 feet; North 53' 30' 18" East 16.07 feet; North 73° 32' 52" East 16.27 feet to a point.
BUFFER H: BEGINNING at a point, said point being the centerline of a stream in the south line of Westview
Development Company (Deed Book 2722, Page 2283, Forsyth County Registry) and being North 85° 38' 40"
West 422.10 feet from the northwestern corner of Lissara. Partners, LLC (Deed Book 2805, Page 4368, Forsyth
County Registry) and running thence from said Beginning point the following courses and distances: North 41°
14' 30" East 13.17 feet; North 7° 35' 07" East 25.67 feet; North 31 ° 19' 53 " West 25.00 feet; North 7' 20' 51 "
East 18.35 feet; North 84° 46' 27" West 30.82 feet; North 61° 54' 32" West 17.07 feet; North 2° 18' 05" West
38.90 feet; North 19'- 38' -34" West 19.41 feet; North 66' 07' 01" East 30.62 feet; North 39' 01' 11" East 36.23
feet; North 8' 03' 34" West 36.15 feet; North 6° 22' 06" West 33.10 feet; North 72° 18' 03" East 11.84 feet;
North 36' 10' 42" East 29.42 feet; North 20° 07' 19" East 34.97 feet; North 5' 40' 43" West 39.16 feet; North
12° 18' 15" West 27.89 feet; North 8'45' 01" East 33.56 feet; North 35° 19' 29" East 37.53 feet; North 45° 00'
51" East 50.53 feet to a point.
Page 3 of 3

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DIVISION OF HIGHWAYS
FINAL SUBDIVISION PLAT APPROVAL
PROPOSED SUBDIVISION ROAD CONSTRUCTION
This is to certify that this plat meets the recording requirements of the Unified
STANDARDS CERTIFICATION
De v I pme t Ordina Subdivision Regulations for Lewisville /Forsyth County.
Estates At Lissara LLC
I G ,
\\
Review Officer of Forst' 1 County, certify that the map or plat to which this
APPROVED
DISTRICT
certification is affixed r et all statutory requirements for recording.
lam### - Street Address
Approved I
This the y of , 20 _
Director of PI nning/Rev'`ew Officqr
This the day of .r re-1- 20.
NORTH CAROLINA - FORSYTH COUNTY NORTH CAROLINA - FORSYTH COUNTY
The undersigned hereby acknowledge that I am (we are) the owners of the
property shown and described hereon and that I (we) hereby adopt this plan
and subdivision with my (our) free consent and upon approval by the
City -County Planning Board of Winston - Salem, and Forsyth County
- authorize that this plat be recorded in teh office of the Register of Deeds of 0
Forsyth County. /^(
,<5T'14TfS Af`ZISS61-44J Gee
Odrner Date '
Owner 50' Private Access,
W97 ! / lla 13PGTl LLC Date YTract III Common Area
Jj 1 I Private and Public
' This Survey is subject to any facts that may be disclosed by a full and Utilities Easement
accurate title search, NOT furnished me as of this date and may be
subject to easements, rights -of -way, restrictive covenants, Limbedost Lane
assessments, if any as the same may appear of record in the office of Plat Book 58, Page 1 Arc: 30.29', R: 75.00'
the Register of Deeds, Clerk of Court, Town or County Tax Office or N22 °12'07 "E, CH: 30.09'
which may have been acquired by prescriptive use.
863"
Arc: 35.86', R: 75.00' 38868
S70 °34'43"W, CH: 35.52'
Tract VII Common Area
and
35' Private Access and
Private and Public
Utilities Easement
0.525t Ac
(Previously recorded as a
35' Pdvate Access and
Private and Public
Utilities Easement
In Plat Book 58, Page 1)
3g�8i Nj0T7
�632s�
>� Part of:
n'
m Pin: 5876 -13- 5618.00
Block 4609B, Lot501 F
Estates At Lissara LLC
t
}
\\
NO °21'01 "E ^`'
Q CC -control Comer
55.74',Z
700, 1
)
b
0 �J
h� ry�m aF
/
9
/ o n�
�F� ,G
c
314• \ %
EIP
o 1 !U \
h \ \ 314-
\ EIP
i
�o
i
EIP
Book 63 Page 182
CERTIFICATE OF SUBDIVISION
CERTIFICATE OF CLOSURE L John E. Beeson. Professional Land Surveyor, cedify to one of the following: FORSYTH COUNTY REGISTER OF DEEDS
X a. That this plat is of a survey that creates a subdivision of land vrithin the area PLAT REGISTRATION
1, John E. Beeson, certify that this plat was drawn under my supervision from an actual of a county or municipality that has an ordinance that regulates parcels of land; I t • L
survey made under my supervision (description recorded in Deed Book b. That this plat is of a survey that is located in such portion of a county or municipality that is unregulated as to an Filed for Registration at '-•f' f I o'clock--p—M
Page or Plat Book 58 Page 1 -3 that the ratio of precision as calculated ordinance that regulates parcels of land; ,L ,., ,,1,,
is 1:10, 000 +; that this plat was prepared In accordance With G.S. 47 -30�7 s amended. c That this platys of survey of an existing parcel or parcels of land; This the Day of AI 9 �7 t , 20 and recorded
Witness my original si nature, registration number and Seal this tS day of�� d. That this plat is of a survey of another category, such as the recombination of existing parcels, a c lud-ordered survey
i or other exception to the definition of a subdivision; 2-
D 20 in Plat Book v J , Pa e V
�AJ e. That lh¢ information available l0 8ris surveyor is such that I am unable to make a d¢tertninafion to the best of my 9 9
�j�jljpy.l - L -1828 professional ability s to provisions contained in a. through d. abovepC
John EfBeeson, Professional Land Surveyor Registration Number /� - Filing Fqe Paid: Norman Holleman, Register of Deeds
�f ! ! Y{�- P�Cp+sL.- L -1828
John E. eson, P es onal Lantl Surveyor Registration Number By'
NORTH CAROLINA - FORSYTH COUNTY NORTH CAROLINA- FORSYTH COUNTY Depurfr- Assffiant
Plat Book(o,31 Page I:20 LOCATION MAP N.T.S. mMVin0 Rd
TRACT AREA NOTES:
• Tract VII: 0.525 Acres± 1312
""t1GlatllllOa, //777j o
10 11� . .. . Oyu 1 a ,�,
J •F . s 5� /" of •/2 /''� v,
X
t'
f
Part of:
Pin: 5876 -13- 5618.00
/Block 46098, Lot 501 F
r Estates At Lissara LLC
100' Stream Buffer
DB 2959, Pgs 1904 -1907
6 ��
286217 SF
6.571 tAc.
NOTE: Submission of a building site
plan that Includes the driveway location
Is required in order to assign an address
for lot 21 shown on this plat.
Pin: 5876 -22- 3851.00
Block 4609A, Lot OOOG
Lissara Partners LLC
408.49
N88° 01'39"W
EIP
® 314"
(Control
Corner
ce
�I
N:
�I
�I
col
iV (
Z I n Pin: 5876 -35- 3311.00
Block 4608, Lot 005A
Hilltops Farm LLC
e
ro
m
0
N
0 Gmmte
Monument
Control
Comer
0
4 tV
N 00
m �
U)
314'
EIP
9ti 0-'0
s2 •,� SUR•1 ..••�f4 .•
W
101
!9
S
North Ref: PB 58, Pg 1 -3
Dated: August 17, 2010
NOTES
1. All distances shown on this plat are horizontal distances.
2. 3/4" iron pipe at all corners unless otherwise noted.
3. There are no N.C.G.S. OR U.S.C. &G. or other Geodetic Survey Monuments within
2000' feet of this site.
4. All bearings shown on this plat are based on Plat Book 58, Page 1.
5. Parcel Areas are calculated using the coordinate method.
6. Total Number of Lots this Plat: 2
7. Total Acreage in lots this Plat: 7.096± Acres.
8. Submission of a building site plan that includes the driveway location is required in
order to assign address for lot 21.
9. Public Water
10. Private Sewer
11. Zoned: RSAO -S
12. Rotation from Plat Book North Reference to NC Grid- NAD83(2011): 1 °32'12" West
of North as shown.
Shallowford Road
PURPOSE:
The Purpose of this plat is to:
• Record lot 21 and Rerecord
Common Area (Tract VI)
• Common Area (Tract VI)
previously recorded in Plat Book
58, Page 1 as a 35' Private
Access and Private and Public
Utilities Easement
PROJECT:
L
fLS
N
J
CU
Ito
+(D- Z
LLJtt1
r
C14 ,N
I-'J(D
CLIENTS
Estates at Lissara, LLC.
1598 Westbrook Drive, Ste. 200
Winston- Salem, NC 27103
Phone: [phone]
DRAWN BY: ATC/TLBC
FIELD WORK BY:
ELE, CNK
DATE: 8.14.2015
JOB NO: 09100.001
SCALE: 1" = 100'
LEGEND
50 o 25 so too 200`
O EIP - Existing Iron Pipe
A IPS - New Iron Pipe
Q Stone - Stone(found)
SHEET NO:
• Pt. - Point on the ground
Q CC -control Comer
lam### - Street Address
®�
LINE LEGEND
Line Surveyed
-- Line Not Surveyed
flEESflfl BCflflTER, Pit
- - - - -- Tie Line
• Zoning Line(GIS)
CIVILENGINEERS LANDSURVEYORS
— — — — — — Easement Line
LAND PLANNING
— Easement CL
503HIGH STREET,WIN3TONSALEM,NC27401
Right -of -Way
OFFICE:)336)748 -0071 FAx:[phone]
WEB: wwnv.beesonengineering.com
CORPIL CA017

U.S. DEPARTMENT
S. GEOLOGIC ERIOR
A SURVEY
science for a changing world
80 °30'
39 970(
2"':
830
F
36 °00'
80 °30' "
Produced by the United States Geological Survey
North American Datum of 1983 (NAD83)
World Geodetic System of 1984 (WGS84). Projection and
1 000-meter grid: Universal Transverse Mercator, Zone 17S
10 000 -foot ticks: North Carolina Coordinate System of 1983
Imagery ..................... ..........................NAIP, August 2012
Roads ......................... .....................©2006 -2012 TomTom
Names ................................ ..........................GNIS, 2013
Hydrography ....................National Hydrography Dataset, 2012
Contours ..... .......................National Elevation Dataset, 2008
Boundaries ....................Census, IBWC, IBC, USGS, 1972 - 2012
The National Map
USTopo
27'30"
25'
CLEMMONS QUADRANGLE
NORTH CAROLINA
7.5- MINUTE SERIES
80 °22'30"
36 °07'30"
MN .
7° 57' )
141 MILS ( N
o 20
6 MILS
UTM GRID AND 2013 MAGNETIC NORTH
DECLINATION AT CENTER OF SHEET
U.S. National Grid
100,000 -m Square ID
NV
Grid Zone Designation
175
27'30"
SCALE 1:24 000
1 0.5 0 KILOMETERS 1 2
1000 500 0 METERS 1000 2000
1 0.5 0 1
MILES
1000 0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
~ FEET
CONTOUR INTERVAL 10 FEET
NORTH AMERICAN VERTICAL DATUM OF 1988
This map was produced to conform with the
National Geospatial Program US Topo Product Standard, 2011.
A metadata file associated with this product is draft version 0. 6.11
25'
• NORTH
CAROLINA
QUADRANGLE LOCATION
East Vienna Rural
Bend Hall
Farmington Clemmons Winston -
Salem West
Mocksville Advance Welcome
ADJOINING 7.5' QUADRANGLES
'97
'96
30000
=ET
'95
'94
5'
'93
'92
'91
190
189
2'30"
188
'87
'86
385DOOMN
36 °00'
80 °22'30"
ROAD CLASSIFICATION
Expressway Local Connector
Secondary Hwy Local Road
Ramp 4WD
Interstate Route C3 US Route O State Route
CLEMMONS, NC
2013