20240669 Ver 1_Will Brown Rd Chatham Co _ JD Request Packet 050724_20240507

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]: Will Brown Rd Driveway Access
2. Work Type: ❑✓ Private ❑Institutional ❑ Government ❑ Commercial
3. Project Description / Purpose [PCN Form 133d and 133e]:
Construction of a permanent driveway to access private club.
4. Property Owner / Applicant [PCN Form A3 or A41: Hickory Mountain Rifle & Pistol Club, Inc.
5. Agent / Consultant [PNC Form A5 — or ORM Consultant ID Number]:
Martin Richmond, Lakenheath, Inc.
6. Related Action ID Number(s) [PCN Form 135b]: N/A
7. Project Location — Coordinates, Street Address, and/or Location Description [PCN Form Blb]:
302 Will Brown Rd, Chatham Co NC
35.803825 N,-79.372282 W
8. Project Location —Tax Parcel ID [PCN Form Bla]: Chatham Co Parcel ID# 0001114
9. Project Location —County [PCN Form A2b]: Chatham
10. Project Location —Nearest Municipality or Town [PCN Form A2c]: Siler City
11. Project Information — Nearest Waterbody [PCN Form 132a]: Terrells Crek
12. Watershed / 8-Digit Hydrologic Unit Code [PCN Form 132c]: 03030002
Authorization: Section 10 ❑ Section 404 ❑✓
Regulatory Action Type:
❑ Standard Permit
❑✓ Nationwide Permit #
Regional General Permit #
Jurisdictional Determination Request
Section 10 and 404 ❑
❑Pre -Application Request
❑ Unauthorized Activity
❑ Compliance
❑No Permit Required
Revised 20150602

Jurisdictional Determination Request
A. PARCEL INFORMATION
Street Address: 302 Will Brown Rd
City, State:
Siler City NC
County: Chatham
Parcel Index Number(s) (PIN): 0001114
B. REQUESTOR INFORMATION
Name: Martin Richmond
Mailing Address: 2204 Lakenheath Ct
Raleigh, NC 27614
Telephone Number: [phone] mobile
Electronic Mail Address: [e-mail]
Select one:
I am the current property owner.
W] I am an Authorized Agent or Environmental Consultant'
Interested Buyer or Under Contract to Purchase
Other, please explain.
C. PROPERTY OWNER INFORMATION'
Name: Hickory Mountain Rifle & Pistol Club, Ir
Mailing Address: 1610 Sandy Branch Church Rd
Bear Creek, NC 27207
Telephone Number:
Electronic Mail Address:
i Must provide completed Agent Authorization Form/Letter.
Documentation of ownership also needs to be provided with request (copy of Deed, County GIS/Parcel/Tax Record).
Version: May 2017 Page 2

Jurisdictional Determination Request
D. PROPERTY ACCESS CERTIFICATION',4
By signing below, I authorize representatives of the Wilmington District, U.S. Army Corps of
Engineers (Corps) to enter upon the property herein described for the purpose of conducting on -
site investigations, if necessary, and issuing a jurisdictional determination pursuant to Section
404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899. I, the
undersigned, am either a duly authorized owner of record of the property identified herein, or
acting as the duly authorized agent of the owner of record of the property.
Martin Richmond, Lakenheath Inc.
Print Name
Capacity: ❑ Owner 0 Authorized Agents
4/25/24
Date
See Attached Agent Authorization
Signature
E. REASON FOR JD REQUEST: (Check as many as applicable)
❑ I intend to construct/develop a projector perform activities on this parcel which would be
designed to avoid all aquatic resources.
❑ I intend to construct/develop a projector perform activities on this parcel which would be
designed to avoid all jurisdictional aquatic resources under Corps authority.
I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps, and the JD would be used to avoid and minimize
impacts to jurisdictional aquatic resources and as an initial step in a future permitting
process.
0 I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps; this request is accompanied by my permit application
and the JD is to be used in the permitting process.
❑ I intend to construct/develop a project or perform activities in a navigable water of the
U.S. which is included on the district Section 10 list and/or is subject to the ebb and flow of
the tide.
0 A Corps JD is required in order obtain my local/state authorization.
LFI intend to contest jurisdiction over a particular aquatic resource and request the Corps
confirm that jurisdiction does/does not exist over the aquatic resource on the parcel.
I believe that the site may be comprised entirely of dry land.
❑ Other:
s For NCDOT requests following the current NCDOT/USACE protocols, skip to Part E.
4 If there are multiple parcels owned by different parties, please provide the following for each additional parcel on a
continuation sheet.
s Must provide agent authorization form/letter signed by owner(s).
Version: May 2017 Page 3

Jurisdictional Determination Request
F. JURISDICTIONAL DETERMINATION (JD) TYPE (Select One)
✓❑ I am requesting that the Corps provide a preliminary JD for the property identified herein.
A Preliminary Jurisdictional Determination (PJD) provides an indication that there may
be "waters of the United States" or "navigable waters of the United States"on a property.
PJDs are sufficient as the basis for permit decisions. For the purposes of permitting, all
waters and wetlands on the property will be treated as if they are jurisdictional "waters of
the United States". PJDs cannot be appealed (33 C.F.R. 331.2); however, a PJD is
"preliminary" in the sense that an approved JD can be requested at any time. PJDs do
not expire.
I am requesting that the Corps provide an approved JD for the property identified herein.
An Approved Jurisdictional Determination (AJD) is a determination that
jurisdictional "waters of the United States" or "navigable waters of the United
States" are either present or absent on a site. An approved JD identifies the limits of
waters on a site determined to be jurisdictional under the Clean Water Act and/or
Rivers and Harbors Act. Approved JDs are sufficient as the basis for permit
decisions. AJDs are appealable (33 C.F.R. 331.2). The results of the AJD will be
posted on the Corps website. A landowner, permit applicant, or other "affected
party" (33 C.F.R. 331.2) who receives an AJD may rely upon the AJD for five years
(subject to certain limited exceptions explained in Regulatory Guidance Letter 05-
02).
I am unclear as to which JD I would like to request and require additional information
to inform my decision.
G. ALL REQUESTS
Map of Property or Project Area. This Map must clearly depict the boundaries of the
review area.
Size of Property or Review Area +/- 12 acres.
❑✓ The property boundary (or review area boundary) is clearly physically marked on the site.
Version: May 2017 Page 4

Jurisdictional Determination Request
H. REQUESTS FROM CONSULTANTS
W]
Project Coordinates (Decimal Degrees): Latitude: 35.803825
Longitude: -79.372282
A legible delineation map depicting the aquatic resources and the property/review area.
Delineation maps must be no larger than 11x17 and should contain the following: (Corps
signature of submitted survey plats will occur after the submitted delineation map has been
reviewed and approved).6
■ North Arrow
■ Graphical Scale
■ Boundary of Review Area
■ Date
■ Location of data points for each Wetland Determination Data Form or tributary
assessment reach.
For Approved Jurisdictional Determinations:
Jurisdictional wetland features should be labeled as Wetland Waters of the US, 404
wetlands, etc. Please include the acreage of these features.
Jurisdictional non -wetland features (i.e. tidal/navigable waters, tributaries,
impoundments) should be labeled as Non -Wetland Waters of the US, stream, tributary,
open water, relatively permanent water, pond, etc. Please include the acreage or linear
length of each of these features as appropriate.
Isolated waters, waters that lack a significant nexus to navigable waters, or non -
jurisdictional upland features should be identified as Non -Jurisdictional. Please
include a justification in the label regarding why the feature is non jurisdictional (i.e.
"Isolated", "No Significant Nexus", or "Upland Feature"). Please include the acreage
or linear length of these features as appropriate.
For Preliminary Jurisdictional Determinations:
Wetland and non -wetland features should not be identified as Jurisdictional, 404,
Waters of the United States, or anything that implies jurisdiction. These features can be
identified as Potential Waters of the United States, Potential Non -wetland Waters of
the United States, wetland, stream, open water, etc. Please include the acreage and
linear length of these features as appropriate.
F] Completed Wetland Determination Data Forms for appropriate region
(at least one wetland and one upland form needs to be completed for each wetland type)
6 Please refer to the guidance document titled "Survey Standards for Jurisdictional Determinations" to ensure that the
supplied map meets the necessary mapping standards. http://www.saw.usace.army.mil/Missions/Regulatory-Permit-
Pro aam/Jurisdiction/
Version: May 2017 Page 5

Jurisdictional Determination Request
Completed appropriate Jurisdictional Determination form
• PJDs, please complete a Preliminary Jurisdictional Determination Form' and include the
Aquatic Resource Table
• AJDs, please complete an Approved Jurisdictional Determination Form'
A Vicinity Map
Aerial Photograph
USGS Topographic Map
Soil Survey Map
Other Maps, as appropriate (e.g. National Wetland Inventory Map, Proposed Site
Plan, previous delineation maps, LIDAR maps, FEMA floodplain maps)
W] Landscape Photos (if taken)
NCSAM and/or NCWAM Assessment Forms and Rating Sheets
NC Division of Water Resources Stream Identification Forms
Other Assessment Forms
' www.saw.usace.army.mil/Portals/59/does/regulatory/regdocs/JD/RGL 08-02 App A Prelim _JD_Form fillable.pdf
' Please see http://www.saw.usace.arM.mil/Missions/Re ug latory-Permit-Program/Jurisdiction/
Principal Purpose: The information that you provide will be used in evaluating your request to determine
whether there are any aquatic resources within the project area subject to federaljurisdiction under the regulatory
authorities referenced above.
Routine Uses: This information may be shared with the Department of Justice and other federal, state, and local
government agencies, and the public, and may be made available as part of a public notice as required by federal
law. Your name and property location where federal jurisdiction is to be determined will be included in the
approved jurisdictional determination (AJD), which will be made available to the public on the District's web site
and onthe Headquarters USAGE website.
Disclosure: Submission of requested information is voluntary; however, if information is not provided, the
request for anAJD cannot be evaluated nor can an AJD be issued.
Version: May 2017 Page 6

Appendix 2 - PRELIMINARY JURISDICTIONAL DETERMINATION (PJD) FORM
A. REPORT COMPLETION DATE FOR PJD:
B. NAME AND ADDRESS OF PERSON REQUESTING PJD: Martin Richmond, Lakenheath, Inc.
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
(USE THE TABLE BELOW TO DOCUMENT MULTIPLE AQUATIC RESOURCES AND/OR
AQUATIC RESOURCES AT DIFFERENT SITES)
State: NC County/parish/borough: Chatham City: Siler City
Center coordinates of site (lat/long in degree decimal format):
Lat.: 35.803825 Long.:-79.372282
Universal Transverse Mercator:
Name of nearest waterbody: Terrells Creek
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
❑ Office (Desk) Determination. Date:
❑ Field Determination. Date(s):
TABLE OF AQUATIC RESOURCES IN REVIEW AREA WHICH "MAY BE" SUBJECT TO REGULATORY
JURISDICTION.
Site
number
Latitude
(decimal
degrees)
Longitude
(decimal
degrees)
Estimated amount
of aquatic resource
in review area
(acreage and linear
feet, if applicable)
Type of aquatic
resource (i.e., wetland
vs. non -wetland
waters)
Geographic authority
to which the aquatic
resource "may be"
subject (i.e., Section
404 or Section 10/404)
Stream 1
35.800892
-79.372562
57 If
Non -wetland waters
404/401

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

SUPPORTING DATA. Data reviewed for PJD (check all that apply)
Checked items should be included in subject file. Appropriately reference sources
below where indicated for all checked items:
❑■ Maps, plans, plots or plat submitted by or on behalf of the PJD requestor:
Map: Preliminary Wetland Delineation Map, 4/25/24
❑ Data sheets prepared/submitted by or on behalf of the PJD requestor.
❑ Office concurs with data sheets/delineation report.
❑ Office does not concur with data sheets/delineation report. Rationale:
❑ Data sheets prepared by the Corps:
❑ Corps navigable waters' study:
❑ U.S. Geological Survey Hydrologic Atlas:
❑ USGS NHD data.
❑ USGS 8 and 12 digit HUC maps.
❑■
U.S. Geological Survey map(s). Cite scale & quad name: Silk Hope Quadrangle 1:24K
❑■ Natural Resources Conservation Service Soil Survey. Citation: Chatham co Soil Survey, Map Sheet 3
❑ National wetlands inventory map(s). Cite name:
❑ State/local wetland inventory map(s):
❑ FEMA/FIRM maps:
❑■ 100-year Floodplain Elevation is: NSA .(National Geodetic Vertical Datum of 1929)
❑■ Photographs: ❑ Aerial (Name & Date): NCOneMap, Feb 2021
or ■❑ Other (Name & Date): Site Photos, Dec 2022 and Jun 2023
❑ Previous determination (s). File no. and date of response letter:
❑■ Other information (please specify): Site Topography, LiDAR Map
IMPORTANT NOTE: The information recorded on this form has not necessarily
been verified by the Corps and should not be relied upon for later jurisdictional
determinations.
Signature and date of
Regulatory staff member
completing PJD
Signature and date of
person requesting PJD
(REQUIRED, unless obtaining
the signature is impracticable)'
' Districts may establish timeframes for requestor to return signed PJD forms. If the requestor does not respond
within the established time frame, the district may presume concurrence and no additional follow up is
necessary prior to finalizing an action.

Parcel and Ownership Records
Agent Authorization

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Lakenheath, Inc.
2204 Lakenheath Ct.
Raleigh, North Carolina 27614
AGENT AUTHORIZATION FORM
. yp
pARCEL ID: Chatham Co Parcel ID# 0001114
STREET ADDRESS: 302 Will Brown Rd
Name: --
Hickory Mountain Rifle & Pistol Club, Inc.
Representing:
The undersigned, applicant and/or property owners of the above noted property, do hereby authorize
Martin Richmond, President
Lakenheath, Inc.
2204 Lakenheath Court
Raleigh NC 27614
(919) 271-036g [e-mail]
As Agent in petitioning local, state, and federal agencies (US Army Corps of Engineers, NC Dept of
Environmental Quality. local municipalities, etc.) to act on my behalf and take all actions necessary for the
processing and issuance of relevant environmental permitting applications or requests, including access to the
property, project -related meedngs/discussions, and material submittals- This authorization shall continue in
effect until completion of contracted project tasks• or termination by the applicant and/or property owner.
Signature of Applicant/Property Owner:
Name - Printed
S�gna
Z '
MzdingAd*M
Tek p-bon�
City
Date
JU lP

Exhibits
1. Location Map
2. Aerial Photo/Review Area Map
3. USGS Topographic Map
4. NRCS Soil Survey Map
5. Site Topography Map
6. DEM/LiDAR Map
7. Preliminary Wetland Delineation Map

nu
i
it
M
J000
v
NRCS Soil Survey Map Will Brown Rd Tract NTS
Soil Survey of Chatham County, Map Sheet 3 302 Will Brown Rd O1/13/23
Chatham County Parcel# 1114 By: MRR

0 250
—,Z
Wilt-B MWh Ro4z:, olw
500 750
00
Ln
4/25/24

Site Photographs

Photo 5: Stream 1 within crossing area, July 2024.
Photo Log — Feb 2023
Will Brown Rd Tract, Chatham County NC
Page 3

NC DWR Stream Identification Form

NC Division of Water Quality - ethodo og entification of Intermittent and
Perennial Streams and Their Origins v. 4.11
NC DWO Stream Identification Form Version 4.11
Date: f / Z �' /2 Z-
ProjectlSite: �6A
Evaluator: �n...rs�
y
County:
Longitude:
Total Points:
Stream is at least intermittent
Stream Determination (circle one)
Other
if > 19 or perennial if ? 30"
Ephemeral 1� Perennial
e.g. Quad Name:
A_ Geomorphology (Subtotal =__17�
Absent
Weak
Moderate
Str ng
1 a Continuity of channel bed and bank
0
1
2
3
2. Sinuosity of channel along thalweg
0
1
2
3
3. In -channel structure: ex. riffle -pool, step -pool,
ripple -pool sequence
0
2
3
4. Particle size of stream substrate
0
1
3
5. Active/relict floodpiain
1
2
3
6. Depositional bars or benches
1
2
3
7. Recent alluvial deposits
1
2
3
8. Headcuts
1
2
3
9. Grade control
0
0.5
1,2
1.5
10. Natural valley
0
0.5
1.5
11. Second or greater order channel
No -
Yes = 3
artificial ditches are not rated; see discr
s in manual
B. Hvdrolociv (Subtotal = )
12_Presence of Baseflow
0
1
3
13_ Iron oxidizing bacteria
1
2
+3
14_ Leaf litter
5
1
0.5
0
15. Sediment on plants or debris
0
.5
1
1.5
16. Organic debris lines or piles
0
4.5
1
1.5
17. Soil -based evidence of high wat table?
No = 0
Yes 3
C. Biolow (Subtotal = ) "'
18. Fibrous roots in streambed
3,
1
0
19. Rooted upland plants in streambed
3
2
1
0
20, Macrobenthos (note diversity and abundance)
0
1
2
3
21. Aquatic Mollusks
0
1
2
3
22_ Fish
0
0.5
1
1,5
23. Crayfish
0
0.5
1
1.5
24. Amphibians
o
0.5
1
1.5
25. Algae
0
0.5
1
1.5
26. Wetland plants in streambed
FACW = 0.75; OBL m 1.5
Other = 0
'perennial streams may also be identified using other methods. See p. 35 of
manual.
Notes:
Sketch:
41