20240989 Ver 1_401 Application_20240725

Preliminary ORM Data Entry Fields for New Actions
ACTION ID 9: SAW- Begin Date (Date Received):
Prepare file folder ❑ Assign Action ID Number in ORM ❑
1. Project Name [PCN Form A2a]: Stanley Storage Boat and RV Storage
2. Work Type: ✓❑Private ❑Institutional ❑Government ❑Commercial
3. Project Description / Purpose [PCN Form B3d and B3e]:
The site is an approximate 23.5-acre tract located south of Patterson Avenue in Winston-Salem, Forsyth County, North Carolina. The
site is propsed for commericial development. Three stream crossings are required to consturct the project.
4. Property Owner / Applicant [PCN Form A3 or A4]: The Patterson Land Trust/JPB Storage LLC
5. Agent / Consultant [PNC Form A5 — or ORM Consultant ID Number]:
David Brame/Pilot Environmental, Inc.
6. Related Action ID Number(s) [PCN Form B5b]:
7. Project Location —Coordinates, Street Address, and/or Location Description [PCN Form Blb]:
Patterson Street
36.1524690/-80.2485460
8. Project Location —Tax Parcel ID [PCN Form Bla]: 6837-16-4605
9. Project Location — County [PCN Form A2b]: Forsyth
10. Project Location — Nearest Municipality or Town [PCN Form A2c]: Winston-Salem
11. Project Information — Nearest Waterbody [PCN Form 132a]: Leak Fork
12. Watershed / 8-Digit Hydrologic Unit Code [PCN Form 132c]: Upper Yadkin/03040101
Authorization: Section 10 ❑ Section 404 ✓❑
Regulatory Action Type:
Standard Permit
✓ Nationwide Permit 9
Regional General Permit 9
Jurisdictional Determination Request
Section 10 and 404 ❑
Pre -Application Request
Unauthorized Activity
Compliance
No Permit Required
Revised 20150602

rATI .
N:1 I C,5 H") IN'A
IV,,1 r 11,Z es
Office Use Only
Corps Action I D no. [Click to enter.] Date received: [Click to enter.]
DWR project no. Click enter.] Date received: [Click to enter.]
Site Coordinates:
Latitude (DD.DDDDDD): 36.152932'
Longitude (DD.DDDDDD):-80.248616'
Form Version 4.3. 1210412023
Pre -Construction Notification (PCN) Form
(Ver. 4.2, 12IM2023)
For Nationwide Permits and Regional General Permits and corresponding Water Quality Certifications
Please note: fields marked with a red asterisk are required. The form is not considered complete until all
mandatory questions are answered.
The PCN help document may be found at this link:
httas://edocs.dea.nc.aov/WaterResources/DocView.asax?dbid=0&id=2196924&cr=1
Page 1 of 20 PCN Form Version 4.3- December 4, 2023

A. Processing Information
County (counties) where project is located: *
Forsyth Additional (if needed).
Is this an ARPA project? *
0 Yes 0 No
If yes, ARPA project number:
* The project number can be found on the "Letter of Intent to Fund"
(LOIF) or "Offer and Acceptance Lette('. If you are unable to locate
Click or tap here to enter text.
your DWI ARPA Funding Project Number. please contact Corey
Basinger at corey. basingera(-).ncdenr.gov for further assistance.
Is this a NCDMS project?
(Click yes only if NCDMS is the applicant or co-
❑ Yes 0 No
applicant)
Is this a public transportation project?
(Publicly funded municipal, state, or federal road, rail,
❑ Yes 0 No
or airport project)
Is this a NCDOT project?
❑ Yes 0 No
If yes, NCDOT TIP or state project number:
Click to enter.
If yes, NCDOT WBS number:
Click to entF
0 Section 404 Permit (wetlands, streams, waters,
Clean Water Act)
la. Type(s) of approval sought from the Corps:
❑ Section 10 Permit (navigable waters, tidal
waters, Rivers and Harbors Act)
Has this PCN previously been submitted? *
❑ Yes 0 No
Please provide the date of the previous submission. *
Click to enter a date.
0 Nationwide Permit (NWP)
1 b. What type(s) of permit(s) do you wish to seek
❑Regional General Permit (RGP)
authorization?
❑ Standard (IP)
This form may be used to initiate the standard/ individual permit process with the USACE. Please contact your Corps
representative concerning submittals for standard permits. All required items can be included as attachments and
submitted with this form.
1 c. Has the NWP or GP number been verified by the Corps? *
❑ Yes 0 No
NWP number(s) (list all numbers ):
39
RGP number(s) (list all numbers ):
Click to enter.
Are you a federal applicant?
❑ Yes 0 No
If yes, please provide a statement concerning compliance with the Coastal Zone Management Act
Click to enter text
1d. Type(s) of approval sought from DWR (check all that apply):
❑ 401 Water Quality Certification — Regular
❑ 401 Water Quality Certification— Express
❑ Non-404 Jurisdictional General Permit
❑ Riparian Buffer Authorization
0 Individual 401 Water Quality Certification
Is this a courtesy copy notification
❑ Yes 0 No
Page 2 of 20 PCN Form Version 4.3- December 4, 2023

1 e.
Is this notification solely for the record because written approval is not required? *
For the record only for DWR 401 Certification: *
❑ Yes
0 No
For the record only for Corps Permit: *
❑ Yes
0 No
1f.
Is this an after -the -fact permit/certification application?
❑ Yes
0 No
1 g.
Is payment into a mitigation bank or in -lieu fee program proposed for
mitigation of impacts?
❑ Yes
0 No
If yes, attach the acceptance letter from mitigation bank or in -lieu fee program.
1 h.
Is the project located in any of NC's twenty coastal counties?
❑ Yes
0 No
1 i.
Is the project located within an NC DCM Area of Environmental
Concern (AEC)?
❑ Yes
0 No ❑ Unknown
1j.
Is the project located in a designated trout watershed?
❑ Yes
0 No
If yes, you must attach a copy of the approval letter from the appropriate Wildlife Resource Commission Office.
Trout information may be found at this link: http://www.saw.usace.army.miI/Missions/Regulatory-Permit-
Program/Agency-Coordination/Trout.aspx
Page 3 of 20 PCN Form Version 4.3- December 4, 2023

B. Applicant Information
1a.
Who is the primary contact? *
Mr. Jamie McCutchen
1b.
Primary Contact Email: *
[e-mail]
1c.
Primary Contact Phone: * (###)###-####
864-918-3676
1d.
Who is applying for the permit/certification? * (check
all that apply)
® Owner ❑ Applicant (other than owner)
1 e.
Is there an agent/consultant for this project?*
® Yes ❑ No
2.
Landowner Information
2a.
Name(s) on Recorded Deed:
THE PATTERSON LAND TRUST;KLINCK, PHILIP
TRUSTEE
2b.
Deed Book and Page No.:
3756/1877
2c.
Contact Person (for corporations):
Jamie McCuthchen
2d.
Address
Street Address:
2123 Old Spartanburg Road, Ste 184
Address line 2:
Click to enter.
City:
Greer
State/ Province/ Region:
South Carolina
Postal/ Zip Code:
29650
Country:
US
2e.
Telephone Number: (###)###-####
864-918-3676
2f.
Fax Number: (###)###-####
Click to entF
2g.
Email Address:
[e-mail]
3.
Applicant Information (if different from owner)
3a.
Name: *
same
3b.
Business Name (if applicable):
Click to enter.
3c.
Address: *
Street Address:
Click to enter.
Address line 2:
Click to enter.
City:
Click to enter.
State/ Province/ Region:
Click to enter.
Postal/ Zip Code:
Click to enter.
Country
Click to enter.
3d.
Telephone Number: * (###)###-####
Click to enter.
3e
Fax Number: (###)###-####
Click to enter.
Page 4 of 20 PCN Form Version 4.3- December 4, 2023

3f. Email Address: * Click to enter.
4. Agent/ Consultant (if applicable)
4a. Name: *
David S.Brame
4b. Business Name:
Pilot Environmental, Inc
4c. Address: *
Street Address:
743 Park Lawn Court
Address line 2:
Click to entE
City:
Kernersville
State/ Province/ Region:
NC
Postal/ Zip Code:
27284
Country:
us
4d. Telephone Number: (###)###-####
[phone]
4e Fax Number: (###)###-####
Click to entE
4f. Email Address:
[e-mail]
Agent Authorization Letter:
Attach a completed/signed agent authorization form or letter. A sample form may be found at this link:
https://www.saw.usace.army. mil/Missions/Reg ulatory-Permit-Program/Permits/2017-Nationwide-Permits/Pre-
construction-Notification/
Page 5 of 20 PCN Form Version 4.3- December 4, 2023

C. Project Information and Prior Project History
1. Project Information
1 a. Name of project: *
Stanley Storage Boat and RV Storage
1 b. Subdivision name (if appropriate):
NA
1c. Nearest municipality/town: *
Winston-Salem, NC
2.
Project Identification
2a.
Property identification number (tax PIN or parcel ID):
6837-16-4605
2b.
Property size (in acres):
23.5
2c.
Project Address:
Street Address:
360 Northgate Plaza Drive
Address line 2:
Click to enter.
City:
Winston-Salem
State/ Province/ Region:
NC
Postal/ Zip Code:
27105
Country:
US
2d.
Site coordinates in decimal degrees (using 4-6 digits
after the decimal point): *
Latitude (DD.DDDDDD): * 36.152932°
Longitude (-DD.DDDDDD): *-80.248616°
3. Surface Waters
3a. Name of nearest body of water to proposed project: *
Leak Fork
3b. Water Resources Classification of nearest receiving
C
water: *
The Surface Water Classification map may be found at this link:
https://ncdenr.maps.arcqis.com/apps/webappviewer/index.html?id=6e125ad7628f494694e259c80dd64265
Yadkin-PeeDee
3c. In what river basin(s) is your project located?
Choose additional (if needed)
3d. Please provide the 12-digit HUC in which the project is
030401011301
located: *
The Find Your HUC map may be found at this link:
https://ncdenr.maps.arcgis.com/apps/Publiclnformation/index.html?appid=ad3a85aOc6d644aOb97cdO69db238ac3
Page 6 of 20 PCN Form Version 4.3- December 4, 2023

4. Project Description and History
4a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of
this application: *
The site contains wooded land. Portions have been previously used for wasting activities. The site is
located in a commercial area of Winston-Salem.
4b. Have Corps permits or DWR certifications been obtained for this
❑ Yes X No ❑ Unknown
project (including all prior phases) in the past? *
If yes, please give the DWR Certification number and/or Corps
jClick to enter.]
Action ID (ex. SAW-0000-00000):
Attach any pertinent project history documentation
4b2. Is any portion of the work already complete?
❑ Yes X No
If yes, describe the completed work.
Click to enter text.
4c. List of other certifications or approvals/denials received from other federal, state or local agencies for work
described in this application not related to the 404 or 401.
�,IIGK io enter ie.
4d. Attach an 8'/ x 11" excerpt from the most recent version of the USGS topographic map indicating the location of
the project site.
4e. Attach an 8'h x 11" excerpt from the most recent version of the published County NRCS Soil Survey map
depicting the project site.
4f. List the total estimated acreage of all existing wetlands on the
0.249 acres
property:
4g. List the total estimated linear feet of all existing streams (intermittent
3,578 linear feet
and perennial) on the property:
4g1. List the total estimated acreage of all existing open waters on the
0 acres
property:
4h. Explain the purpose of the proposed project:
The purpose of the proposed project is to develop the site with a boat and RV storage facility.
4i. Describe the overall project in detail, including the type of equipment to be used: *
The overall project includes the construction of a boat and RV storage facility, associated parking lots, internal
roads and open storage areas. In order to construct the project and provide interconnection, it is necessary to
impact three streams with fill associated with the roadway. To facilitate development of the site, clearing and
grading is necessary. Graders, excavators and other heavy equipment will be used during grading and
construction of the site.
4j. Attach project drawings/site diagrams/depictions of impact areas for the proposed project.
4k. Will this activity involve dredging in wetlands or waters? *
❑ Yes X No
If yes, describe the type of dredging, the composition of the dredged material, and the locations of disposal area.
Click to enter text
Page 7 of 20 PCN Form Version 4.3- December 4, 2023

5.
Jurisdictional Determinations
5a.
Have the wetlands or streams been delineated on
the property or in
M Yes ❑ No ❑ Unknown
proposed impact areas?
Comments:
The site was delineated by Pilot in March 2023.
5b.
If the Corps made a jurisdictional determination,
❑ Preliminary ❑ Approved ❑ Emailed concurrence
what type of determination was made?
X Not Verified ❑ Unknown ❑ n/a
Corps AID number (ex. SAW-0000-00000):
Click to enter
Name (if known): David Brame/Michael Brame
5c.
If 5a is yes, who delineated the jurisdictional
Agency/Consultant Company: Pilot Environmental, Inc
areas?
Other: Click to enter
5d.
List the dates of the Corps jurisdictional determination or State determination if a determination was made by
either agency.
'lick to enter
5d1.
Attach jurisdictional determinations.
6. Future Project Plans
6a. Is this a phased project?
❑ Yes X No
6b. If yes, explain.
Click to enter.
Are any other NWP(s), regional general permit(s), or individual permit(s) used, or intended to be used, to
authorize any part of the proposed project or related activity? This includes other separate and distant crossings
for linear projects that require Department of the Army authorization but don't require pre -construction
notification.
No
7. Addresses of adjoining property owners, lessees, etc. whose property adjoins the waterbody (if more than can be
entered here, please attach a supplemental list)
Downgradient waters are located entirely on the site.
8. Scheduling of activity:
Upon receipt of NWP and WQC.
Page 8 of 20 PCN Form Version 4.3- December 4, 2023

D. Proposed Impacts Inventory
Impacts Summary
❑ Wetlands 0 Streams - tributaries
1 a. Where are the impacts associated with your project ❑ Buffers ❑ Open Waters
(check all that apply):
❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, complete this table for each wetland area impacted.
2a.
Site # `
2a1.
Impact
Reason/Type
2b.
Impact
Duration
2c.
Wetland Type
2d.
Wetland Name
2e.
Forested
?
2f.
Jurisdiction
Type*
2g.
Impact Area
(ac)
W1
Choose one
emp/ Perm
Choose one
Click to enter
Y/N
;hoose one
Click to enter
W2
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W3
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W4
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W5
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W6
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W7
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
choose one
Click to enter
W8
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W9
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W10
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W11
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W12
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W13
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W14
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W15
Choose one
Temp/ Perm
Choose one
Click to enter
"'N
Choose one
Click to enter
2g1. Total temporary wetland impacts
0 ac
2g2. Total permanent wetland impacts
0 ac
2g3. Total wetland impacts
0 ac
2h. Type(s) of material being discharged and the amount of each type in cubic yards:
Click to enter text.
2i. Comments:
Wetland impacts are not proposed
Page 9 of 20 PCN Form Version 4.3- December 4, 2023

3. Stream Impacts
If there are perennial or intermittent stream/ tributary impacts (including temporary impacts) proposed on the site,
complete this table for all stream/ tributary sites impacted.
** All Perennial or Intermittent streams must be verified by DWR or delegated local government
3a
3b.
3c.
3d.
3e.
3f.
3g.
3h.
Site
Impact Reason*
Impact
Impact Type*
Stream
Stream Type*
Jurisdiction
Stream
Impact
#*
Duration*
Name*
Type*
Width
length
(avg ft)
(linear
*
ft) *
S1
Crossing 1 —
Permanent
Crossing/
SA
Perennial
Both
4
56
Culvert/Endwall
Culvert
S2
Crossing1 - RipRap Fill
Permanent
Fill (Incl.
SA
Perennial
Both
4
36
Riprap)
S3
Crossing 2 —
Permanent
Crossing/
SB1
Perennial
Both
6.5
72
Culvert/Headwall/Endwall
Culvert
S4
Crossing 2 — RipRap Fill
Permanent
Fill (Incl.
SB1
Perennial
Both
6
35
Riprap)
S5
Crossing 2 - Temporary
Temporary
Dewatering
SB1
Perennial
Both
5.5
10
Construction/Coffers
S6
Crossing 3 —
Permanent
Crossing/
SC
Intermittent
Both
2
72
Culvert/Headwall/Endwall
Culvert
S7
Crossing 3 — RipRap Fill
Permanent
Fill (Incl.
SC
Intermittent
Both
2
30
Riprap)
S8
Crossing 3 - Temporary
Temporary
Dewatering
SC
Intermittent
Both
5.5
10
Construction/Coffers
3i1. Total jurisdictional ditch impact:
0 linear ft
3i2. Total permanent stream impacts:
301 linear ft
M. Total temporary stream impacts:
20 linear ft
34. Total stream and ditch impacts:
321 linear ft
3j. Comments:
Crossing 1
S1 — Includes 56 LF(224 SF) of permanent impact with placement of endwall and culvert culvert. The
upstream end
will tie to an existing culvert from off -site.
S2 — Includes 36 LF (144 SF) of permanent impact associated with the keyed -in riprap dissipater.
Crossing 2
S3 — Includes 72 LF(469 SF) of permanent impact with placement of headwall, endwall and culvert.
S4 — Includes 35 LF (210 SF) of permanent impact associated with the keyed -in riprap dissipater.
S5 — Includes 10 LF (55 SF) of temporary impact by coffer dams for pump around.
Crossing 3
S6 — Includes 72 LF(144 SF) of permanent impact with placement of headwall, endwall and culvert.
S7 — Includes 30 LF (60 SF) of permanent impact associated with the keyed -in riprap dissipater.
S8 — Includes 10 LF (55 SF) of temporary impact by coffer dams for pump around.
Page 10 of 20 PCN Form Version 4.3- December 4, 2023

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., individually list all open water impacts in the table below.
4a.
Site #*
4a1.
Impact Reason
4b.
Impact
Duration*
4c.
Waterbody Name*
4d.
Activity Type*
4e.
Waterbody
Type*
4f.
Impact area
(ac)*
01
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
02
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
03
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
04
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
05
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
4g.
Total temporary open water impacts
Click to enter. ac
4g.
Total permanent open water impacts
Click to enter. ac
4g.
Total open water impacts
Click to enter. ac
4h.
Comments:
Open water impacts are not proposed.
5.
Pond or Lake Construction
If pond or lake construction is proposed, complete the table
below. (*This
does NOT include offline stormwater
management ponds.)
5a.
5b.
5c.
5d.
5e.
Pond ID
Proposed use or
Wetland Impacts
(ac)
Stream
Impacts (ft)
Upland
#
purpose of pond
Impacts (ac)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
enter.
P2
Choose one
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
enter.
P3
Choose one
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
enter.
5f.
Total
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
enter.
5g.
Comments:
Ponds are not being constructed.
5h.
Is a dam high hazard permit required?
❑ Yes ❑ No
If yes, permit ID no.:
Click to enter.
5i.
Expected pond surface area (acres):
Click to enter.
5j.
Size of pond watershed (acres):
Click to enter.
5k.
Method of construction:
Click to enter.
Page 11 of 20 PCN Form Version 4.3- December 4, 2023

6. Buffer Impacts (DWR requirement)
If project will impact a protected riparian buffer, then complete the chart below. Individually list all buffer impacts.
6a. Project is in which protected basin(s)?
(Check all that apply.)
❑ Neuse ❑ Tar -Pamlico ❑ Catawba
❑ Jordan ❑ Goose Creek ❑ Randleman
❑ Other: Click to ente
Site #*
6b.
Impact Type*
6c.
Impact Duration*
6d.
Stream Name*
6e.
Buffer
Mitigation
Required?*
6f.
Zone 1 Impact*
(sq ft)
6g.
Zone 2 Impact*
(sq ft)
131
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B2
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
133
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
134
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B5
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
136
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
137
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
138
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B9
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B10
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
1311
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B12
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B13
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B14
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B15
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B16
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B17
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B18
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B19
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B20
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
6h. Total temporary impacts:
Zone 1: Click to enter sq ft
Zone 2: Click to enter. sq ft
6h. Total permanent impacts:
Zone 1: Click to enter sq ft
Zone 2: Click to enter. sq ft
6h. Total combined buffer impacts:
Zone 1: Click to enter. sq ft
Zone 2: Click to enter. sq ft
6i. Comments:
Buffer impacts are not proposed.
Please attach supporting documentation (impact maps, plan sheets, etc.) for the proposed project.
Page 12 of 20 PCN Form Version 4.3- December 4, 2023

E. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts through project design:
The applicant has designed the remainder of the proposed development to avoid impacts to wetlands and remaining
streams. Headwalls and endwall were used to reduce the size of the proposed impacts. There will be no significant
rerouting of drainage back to streams on the site. Therefore, there will be no secondary impacts by proposed
development. The width of the roadways were limited to the extent possible for passage of vehicles and heavy
equipment.
1 b. Specifically describe measures taken to avoid or minimize proposed impacts through construction techniques:
The clearing limits will be surveyed, staked and silt fencing and clearing limit fencing will be used. Disturbed areas will
be seeded and mulched to limit sediment from entering downgradient waters. Slope matting will be used as necessary
to stabilize graded slopes.
2. Compensatory Mitigation for Impacts to Waters of the U.S., Waters of the State, or Riparian Buffers
2a. If compensatory mitigation is required, by whom is it required? ❑ DWR ❑ Corps
(check all that apply)
2b. If yes, which mitigation option(s) will be used for this ❑ Mitigation Bank
project? * (check all that apply) ❑ In Lieu Fee Program
❑ Permittee Responsible Mitigation
3. Complete if using a Mitigation Bank
(Must satisfy NC General Statute143-214.11 (d1).)
3a. Name of mitigation bank:
Click to enter.
3b. Credits purchased/requested:
Type: Choose one
Quantity Click to enter.
Type: Choose one
Quantity Click to enter.
Type: Choose one
Quantity Click to enter.
Attach receipt and/or approval letter.
3c. Comments:
Mitigation is not proposed.
4.
Complete if Using an In Lieu Fee Program
4a.
Attach approval letter from in lieu fee program.
4b.
Stream mitigation requested:
Click to enter linear feet
4c.
If using stream mitigation, what is the stream temperature:
Choose one
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington
District's RIBITS website: (Please use the filter and select Wilmington district)
https://ribits.usace.army.mil/ribits apex/f?p=107:27:2734709611497::NO: RP:P27 BUTTON KEY:O
4d.
Buffer mitigation requested (DWR only):
Click to enter. square feet
4e.
Riparian wetland mitigation requested:
Click to enter. acres
4f.
Non -riparian wetland mitigation requested:
Click to enter. acres
Page 13 of 20 PCN Form Version 4.3- December 4, 2023

4g. Coastal (tidal) wetland mitigation requested: Click to enter. acres
4h. Comments:
Mitigation is not proposed.
5. Complete if Providing a Permittee Responsible Mitigation Plan
5a. If proposing a permittee responsible mitigation plan, provide a description of the proposed mitigation plan,
including mitigation credits generated.
'litrl- 4n nn+,nr
5b. Attach mitigation plan/documentation.
6.
Buffer Mitigation (State Regulated Riparian Buffer Rules) — DWR requirement
6a.
Will the project result in an impact within a protected riparian buffer
❑ Yes X No
that requires buffer mitigation?
If yes, please complete this entire section — please contact DWR for more information.
6b.
If yes, identify the square feet of impact to each zone of the riparian buffer that requires
mitigation. Calculate the
amount of mitigation required in the table below.
6c.
6d.
6e.
Zone
Reason for impact
Total impact
Multiplier
Required mitigation
(square feet)
(square feet)
Zone 1
Click to enter.
Click to enter.
Choose one
Dlick to enter.
Zone 2
Click to enter.
Click to enter.
Choose one
Click to enter.
6f. Total buffer mitigation required
lick to enter.
6g.
If buffer mitigation is required, is payment to a mitigation bank or
❑ Yes ❑ No
NC Division of Mitigation Services proposed?
6h.
If yes, attach the acceptance letter from the mitigation bank or NC Division of Mitigation
Services.
6i.
Comments:
Buffer mitigation is not required.
Page 14 of 20 PCN Form Version 4.3- December 4, 2023

F. Stormwater Management and Diffuse Flow Plan (DWR requirement)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers
❑ Yes 0 No
identified within one of the NC Riparian Buffer Protection Rules?
1 b. All buffer impacts and high ground impacts require diffuse flow or other form of stormwater treatment. If the
project is subject to a state implemented riparian buffer protection program, include a plan that fully documents
how diffuse/dispersed flow will be maintained.
All Stormwater Control Measures (SCM) must be designed in accordance with the NC Stormwater Design
Manual (https://deg.nc.,qov/about/divisions/energy-mineral-land-resources/energy-mineral-land-permit-
guidance/stormwater-bmp-manual).
Associated supplement forms and other documentation must be provided.
❑ Level Spreader
What Type of SCM are you
❑ Vegetated Conveyance (lower seasonal high water table- SHWT)
providing?
❑ Wetland Swale (higher SHWT)
(Check all that apply)
❑ Other SCM that removes minimum 30% nitrogen
❑ Proposed project will not create concentrated stormwater flow through the
buffer
For a list of options to meet the diffuse flow requirements, click here.
Attach diffuse flow documentation.
2.
Stormwater Management Plan
2a.
Is this an NCDOT project subject to compliance with NCDOT's
Individual NPDES permit NCS000250?
❑ Yes 0 No
2b.
Does this project meet the requirements for low density projects as
defined in 15A NCAC 02H .1003(2)? *
❑ Yes 0 No
To look up low density requirements, click here:
http://reports.oah.state. nc.us/ncac/title%2015a%20-%20environmental%20guaIity/chapter%2002%20-
%20environmental%20manage ment/subchapter%20h/15a%20ncac%2002h%20.1003.pdf
2c.
Does this project have a stormwater management plan (SMP)
0 Yes ❑ No
reviewed and approved under a state stormwater program or state -
approved local government stormwater program?
❑ n/a — project disturbs < 1 acre
Note: Projects that have vested rights, exemptions, or grandfathering from state or locally implemented
stormwater programs or projects that satisfy state or locally -implemented stormwater programs through use of
community in -lieu programs should answer "no" to this question.
2d.
Which of the following stormwater management program(s) apply?
0 Local Government
(Check all that apply.)
❑ State
If you have local government approval, please include the SMP on their overall impact map.
Local Government Stormwater Programs
0 Phase II ❑ USMP
❑ NSW ❑ Water Supply
Page 15 of 20 PCN Form Version 4.3- December 4, 2023

Please identify which local government stormwater program you are using.
City of Winston-Salem.
State Stormwater Programs ❑ Phase II ❑ HQW or ORW
❑ Coastal Counties ❑ Other
Comments:
Stormwater and sediment and erosion control plans have been prepared for review and approval by the City of
Winston-Salem.
Page 16 of 20 PCN Form Version 4.3- December 4, 2023

G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local)
❑ Yes X No
funds or the 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 (North Carolina) Environmental
❑Yes ❑ No
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
❑ Yes ❑ No
NEPA or SEPA final approval letter.)
Comments:
A NEPA or SEPA is not required.
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A
NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300),
Federally Non -Jurisdictional Wetlands /Classified Surface Waters
❑ Yes X No
(15A NCAC 2H. 1400) DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. If you answered "yes" to the above question, provide an explanation of the violation(s):
ACK to enter.
3. Cumulative Impacts (DWR Requirement)
3a. Will this project (based on past and reasonably anticipated future
impacts) result in additional development, which could impact nearby
i] Yes X No
downstream water quality?
3b. If you answered "no", provide a short narrative description:
There will be no additional impacts as a result of the proposed development.
3c. If yes, provide a qualitative or quantitative cumulative impact analysis in accordance with the most recent DWR
policy. (Attach .pdo
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project? I ® Yes ❑ No ❑ N/A
4b. If yes, describe in detail the treatment methods and dispositions (non -discharge or discharge) of wastewater
generated from the proposed project. If the wastewater will be treated at a treatment plant, list the capacity
available at that plant.
The site will discharge to the municipal system located on the site.
Page 17 of 20 PCN Form Version 4.3- December 4, 2023

5.
Endangered Species and Designated Critical Habitat (Corps Requirement)
5a.
Will this project occur in or near an area with federally protected
® Yes ❑ No
species or habitat? (IPAC weblink: https://www.fws.gov/ipac/ ffws.govl)
5b.
Have you checked with the USFWS concerning Endangered Species
❑ Yes 0 No
Act impacts? *
5c.
If yes, indicate the USFWS Field Office you have contacted.
Choose one
5d.
Is another federal agency involved?
❑ Yes 0 No ❑ Unknown
If yes, which federal agency?
Click to enter.
5e.
Is this a DOT project located within Divisions 1-8? *
❑ Yes 0 No
5f.
Will you cut any trees in order to conduct the work in waters of the
U.S.? *
®Yes ❑ No
5g.
Does this project involve bridge maintenance or removal? *
❑ Yes 0 No
5g1.
If yes, have you inspected the bridge for signs of bat use such as
staining, guano, bats, etc.? Representative photos of signs of bat use
❑ Yes ❑ No
can be found in the NLEB SLOPES, Appendix F, pages 3-7.
Representative photos of signs of bat use can be found in the NLEB SLOPES, Appendix F, pages 3-7. Link to
NLEB SLOPES document: http://saw-reg.usace.army.mil/NLEB/1-30-17-signed
NLEB-SLOPES&apps.pdf
If you answered yes to 5g1, did you discover any signs of bat use? *
❑ Yes ❑ No ❑ Unknown
If yes, please show the location of the bridge on the permit drawings/ project plans
5h.
Does this project involve the construction/ installation of a wind
turbine(s)?
❑ Yes 0 No
If yes, please show the location of the wind turbine(s) on the permit drawings/ project plans (attach .pdf)
5i.
Does this project involve blasting and /or other percussive activities
that will be conducted by machines, such as jackhammers,
❑ Yes 0 No
mechanized pile drivers, etc.?
If yes, please provide details to include type of percussive activity, purpose,
duration, and specific location of this
activity on the property (attach .pdf)
Page 18 of 20 PCN Form Version 4.3- December 4, 2023

5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated
Critical Habitat?
US Department of the Interior — Fish and Wildlife Service Official Species List from IPaC.
The northern long-eared bat (Endangered), bog turtle (Threatened due to similarity of appearance),
Schweinitz's sunflower (Endangered), and monarch butterfly (Candidate) are included by the IPaC as
federally listed species that occur within the project vicinity.
Bat hibernacula is not located on the site. Trees that could afford suitable summer roosting habitat
and culverts are present on the site. Limited clearing will be required to impact the stream.
Additionally, known occurrences are not identified within 2 miles of the site. Based on the small
amount of clearing required for installation, the proposed project is not likely to adversely affect the
northern long-eared bat. Additionally, Pilot completed the IPaC Beta determination key for NLEB
(Attached). The Dkey indicated that the project "may affect but is not likely to adversely affect the
NLEB."
Suitable habitat for Schweinitz's sunflower and the bog turtle will not be impacted by proposed
impacts. The disturbance areas contain wooded areas and streams that are not suitable habitat. The
proposed project is not likely to adversely impact these species.
The Monarch butterfly is a candidate species that is not subject to provisions of the ESA or
consultation with the service. The proposed project is not likely to adversely impact this species
should it become listed.
Attach consultation documentation.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as
an Essential Fish Habitat?
❑Yes x❑ No
Is there submerged aquatic vegetation (SAV) around
the project vicinity? *
El Yes 0 No El Unknown
Will this project affect submerged aquatic vegetation? *
❑ Yes X No ❑ Unknown
Explain: Click to ente
6b. What data source(s) did you use to determine whether your site would impact Essential Fish Habitat? a
Essential Fish Habitat Mapper — NOAA Fisheries
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data):
http://,qis.ncdcr.gov/hpoweb/
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 ❑Yes x❑ No
properties significant in North Carolina history and archaeology)?
Page 19 of 20 PCN Form Version 4.3- December 4, 2023

7b. What data source(s) did you use to determine whether your site would impact historic or archeological
resources? *
NC Historic Preservation Office's HPOWEB 2.0. Historic properties were not identified in the area of the impact or on
the site. A copy of the SHPO Map is included as an attachment.
7c. Attach historic or prehistoric documentation.
8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https://msc.fema.gov/portal/search
8a. Will this project occur in a FEMA-designated 100-year floodplain? *
❑ Yes X No
8b. If yes, explain how the project meets FEMA requirements.
Click to enter.
8c. What source(s) did you use to make the floodplain determination?
National Flood Hazard Layer from FEMA Web Map Service. A copy of the FEMA map is included as an
attachment.
H. Miscellaneous
Comments:
Thank -you for your assistance. Please contact David Brame at 336-708-4617 with any questions.
Attach pertinent documentation or attachments not previously requested
I. Signature *
X By checking the box and signing below, I, as the project proponent, certify to the following:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete, to
the best of my knowledge and belief;
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401
certification request within the applicable reasonable period of time;
• The project proponent hereby agrees that submission of this PCN form is a "transaction" subject to Chapter
66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• The project proponent hereby agrees to conduct this transaction by electronic means pursuant to Chapter 66,
Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• The project proponent hereby understands that an electronic signature has the same legal effect and can be
enforced in the same way as a written signature; AND
• As the project proponent, I intend to electronically sign and submit the PCN/online form.
Full Name: * David S. Brame
Signature: * gos_2
Date: * 7/22/2024
Page 20 of 20 PCN Form Version 4.3- December 4, 2023

Proposal for Environmental Services
Pilot Proposal 9120.1
June 10, 2024
AGENT AUTHORIZATION
This form authorizes Pilot to act as our agent in stream/wetland matters including U.S. Army
Corps of Engineers and North Carolina Division of Water Resources field verification and
permitting.
Property Address: 360 Northgate Plaza Drive
Applicant Information:
Name: JPB Storage, LLC
Address: 2123 Old Spartanburg Road, Ste 184
Greer, SC 29650
Telephone Number: 864-918-3676
Fax Number:
E-mail Address: [e-mail]
Signature:_ r ' C l Date: 6/10/24
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United States Department of the Interior
FISH AND WILDLIFE SERVICE
Asheville Ecological Services Field Office
160 Zillicoa Street, Suite B
Asheville, NC 28801-1082
Phone: [phone] Fax: [phone]
In Reply Refer To: 07/08/2024 19:10:32 UTC
Project Code: 2024-0112756
Project Name: Northgate Plaza Boat and RV Storage
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 designated critical habitat, that may occur within the boundary of your
proposed project and/or may be affected by your proposed project. The enclosed 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.).
Please note that new species information can change your official species list. 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. The Service recommends you visit the ECOS-IPaC website at
regular intervals during project planning and implementation to ensure your species list is
accurate or obtain an updated species 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
species and to determine whether projects may affect threatened and endangered species and/or
designated critical habitat.
A biological assessment (BA) or biological evaluation (BE) should be completed for your
project. A BA is required for major construction activities (or other undertakings having similar
physical impacts) considered to be 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))
(NEPA). For projects other than major construction activities, the Service suggests that a BE be
prepared to determine effects of the action and whether those effects may affect listed species
and/or designated critical habitat. Effects of the action are all consequences to listed species or
critical habitat that are caused by the proposed action, including the consequences of other

Project code: 2024-0112756 07/08/2024 19:10:32 UTC
activities that are caused by the proposed action. A consequence is caused by the proposed action
if it is reasonably certain to occur and would not occur "but for" the proposed action..
Recommended contents of a BA/BE are described at 50 CFR 402.12. More information and
resources about project review and preparing a BA/BE can be found at the following web link:
https://www.fws. gov/office/asheville-ecological-services/asheville-field-office-online-review-
process-overview.
If a Federal agency determines 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. The Service is not required to concur with "no effect" determinations from Federal action
agencies. If consultation is required, the Service recommends that candidate species, proposed
species, proposed critical habitat, and at -risk species be addressed within the consultation. More
information on the regulations and procedures for section 7 consultation, including the role of
permit or licensed applicants, can be found in the "Endangered Species Consultation Handbook"
at the following web link: https://www.fws.gov/media/endangered-species-consultation-
handbook.
Migratory Birds: In addition to responsibilities to protect threatened and endangered species
under the Act, 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 Service (50 C.F.R. Sec. 10.12
and 16 U.S.C. Sec. 668(a)). More information about MBTA and BGEPA can be found at the
following web link: https://www.fws.gov/program/migratory-birds.
We appreciate your consideration of Federally listed species. The Service encourages Federal
agencies to include conservation of threatened and endangered species in their project planning
to further the purposes of the Act. Please contact our staff at 828-258-3939, if you have any
questions. In any future correspondence concerning this project, please reference the
Consultation Code which can be found in the header of this letter.
Attachment(s):
• Official Species List
• USFWS National Wildlife Refuges and Fish Hatcheries
• Bald & Golden Eagles
• Migratory Birds
• Wetlands
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
2of13

Project code: 2024-0112756
07/08/2024 19:10:32 UTC
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:
Asheville Ecological Services Field Office
160 Zillicoa Street, Suite B
Asheville, NC 28801-1082
[phone]
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Project code: 2024-0112756
07/08/2024 19:10:32 UTC
PROJECT SUMMARY
Project Code: 2024-0112756
Project Name: Northgate Plaza Boat and RV Storage
Project Type: Commercial Development
Project Description: The site is being developed with a boat and RV storage facility. Several
stream crossings and USACE permits will be required to construct the
project.
Project Location:
The approximate location of the project can be viewed in Google Maps: https:
www. google.com/maps/(a)36.15245375,-80.2487365015988,14z
Um
Fyp. k
Counties: Forsyth County, North Carolina
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Project code: 2024-0112756 07/08/2024 19:10:32 UTC
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. Note that 1 of these species should be
considered only under certain conditions.
IPaC does not display listed species or critical habitats under the sole jurisdiction of NOAA
Fisheriesi, as USFWS does not have the authority to speak on behalf of NOAA and the
Department of Commerce.
See the "Critical habitats" section below for those critical habitats that lie wholly or partially
within your project area under this office's jurisdiction. Please contact the designated FWS office
if you have questions.
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.
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Project code: 2024-0112756
07/08/2024 19:10:32 UTC
MAMMALS
NAME
STATUS
Northern Long-eared Bat Myotis septentrionalis Endangered
No critical habitat has been designated for this species.
This species only needs to be considered under the following conditions:
• This species only needs to be considered if the project includes wind turbine operations.
Species profile: https:Hecos.fws.gov/ecp/species/9045
REPTILES
NAME
STATUS
Bog Turtle Glyptemys muhlenbergii
Similarity of
Population: U.S.A. (GA, NC, SC, TN, VA)
Appearance
No critical habitat has been designated for this species.
(Threatened)
Species profile: https:Hecos.fws.gov/ecp/species/6962
INSECTS
NAME
STATUS
Monarch Butterfly Danaus plexippus
Candidate
No critical habitat has been designated for this species.
Species profile: https:Hecos.fws.gov/ecp/species/9743
FLOWERING PLANTS
NAME
STATUS
Schweinitz's Sunflower Helianthus schweinitzii
Endangered
No critical habitat has been designated for this species.
Species profile: https:Hecos.fws.gov/ecp/species/3849
CRITICAL HABITATS
THERE ARE NO CRITICAL HABITATS WITHIN YOUR PROJECT AREA UNDER THIS OFFICE'S
JURISDICTION.
YOU ARE STILL REQUIRED TO DETERMINE IF YOUR PROJECT(S) MAY HAVE EFFECTS ON ALL
ABOVE LISTED SPECIES.
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.
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Project code: 2024-0112756 07/08/2024 19:10:32 UTC
BALD & GOLDEN EAGLES
Bald and golden eagles are protected under the Bald and Golden Eagle Protection Actl and the
Migratory Bird Treaty Act2.
Any person or organization who plans or conducts activities that may result in impacts to bald or
golden eagles, or their habitats3, should follow appropriate regulations and consider
implementing appropriate conservation measures, as described in the links below. Specifically,
please review the "Supplemental Information on Migratory Birds and Eagles".
1. The Bald and Golden Eagle Protection Act of 1940.
2. The Migratory Birds Treaty Act of 1918.
3. 50 C.F.R. Sec. 10.12 and 16 U.S.C. Sec. 668(a)
There are likely bald eagles present in your project area. For additional information on bald
eagles, refer to Bald Eagle Nesting and Sensitivity to Human Activity
For guidance on when to schedule activities or implement avoidance and minimization measures
to reduce impacts to migratory birds on your list, see the PROBABILITY OF PRESENCE
SUMMARY below to see when these birds are most likely to be present and breeding in your
project area.
1►/Juhl
BREEDING SEASON
Bald Eagle Haliaeetus leucocephalus Breeds Sep 1 to
This is not a Bird of Conservation Concern (BCC) in this area, but warrants attention Jul 31
because of the Eagle Act or for potential susceptibilities in offshore areas from certain
types of development or activities.
https:Hecos.fws.gov/ecp/species/1626
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 "Supplemental
Information on Migratory Birds and Eagles", specifically the FAQ section titled "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.
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Survey Effort (1)
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.
■ probability of presence breeding season I survey effort — no data
SPECIES JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
Bald Eagle+++ I I ++++ ++++ ++++ I I
Non -BCC
Vulnerable
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
• Supplemental Information for Migratory Birds and Eagles in IPaC https://www.fws.gov/
media/suDDlemental-information-mis7ratorv-birds-and-bald-and-s7olden-eas7les-mav-occur-
project-action
MIGRATORY BIRDS
Certain birds are protected under the Migratory Bird Treaty Acti and the Bald and Golden Eagle
Protection Act2.
Any person or organization who plans or conducts activities that may result in impacts to
migratory birds, eagles, and their habitats should follow appropriate regulations and consider
implementing appropriate conservation measures, as described in the links below. Specifically,
please review the "Supplemental Information on Migratory Birds and Eagles".
1. The Migratory Birds Treat. Act of 1918.
2. The Bald and Golden Eagle Protection Act of 1940.
3. 50 C.F.R. Sec. 10.12 and 16 U.S.C. Sec. 668(a)
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Project code: 2024-0112756
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For guidance on when to schedule activities or implement avoidance and minimization measures
to reduce impacts to migratory birds on your list, see the PROBABILITY OF PRESENCE
SUMMARY below to see when these birds are most likely to be present and breeding in your
project area.
BREEDING
NAME
SEASON
Bald Eagle Haliaeetus leucocephalus
Breeds Sep 1 to
This is not a Bird of Conservation Concern (BCC) in this area, but warrants attention
Jul 31
because of the Eagle Act or for potential susceptibilities in offshore areas from certain types
of development or activities.
https:Hecos.fws.gov/ecp/species/1626
Black -billed Cuckoo Coccyzus erythropthalmus
Breeds May 15
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA
t0 Oct 10
and Alaska.
https:Hecos.fws.gov/ecp/species/9399
Cerulean Warbler Setophaga cerulea
Breeds Apr 28
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA
t0 Jul 20
and Alaska.
https:Hecos.fws.gov/ecp/species/297
Chimney Swift Chaetura pelagica
Breeds Mar 15
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA
t0 Aug 25
and Alaska.
https:Hecos.fws.gov/ecp/species/9406
Eastern Whip -poor -will Antrostomus voci ferns
Breeds May 1
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA
t0 Aug 20
and Alaska.
https:Hecos.fws.gov/ecp/species/10678
Grasshopper Sparrow Ammodramus savannarum perpallidus
Breeds Jun 1 to
This is a Bird of Conservation Concern (BCC) only in particular Bird Conservation Regions
Aug 20
(BCRs) in the continental USA
https:Hecos.fws.gov/ecp/species/8329
Kentucky Warbler Geothlypis formosa
Breeds Apr 20
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA
t0 Aug 20
and Alaska.
https:Hecos.fws.gov/ecp/species/9443
Prairie Warbler Setophaga discolor
Breeds May 1
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA
to Jul 31
and Alaska.
https:Hecos.fws.gov/ecp/species/9513
Prothonotary Warbler Protonotaria citrea
Breeds Apr 1 to
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA
Jul 31
and Alaska.
https:Hecos.fws.gov/ecp/species/9439
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NAME
BREEDING
SEASON
Red-headed Woodpecker Melanerpes erythrocephalus Breeds May 10
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA to Sep 10
and Alaska.
https:Hecos.fws.gov/ecp/species/9398
Rusty Blackbird Euphagus carolinus Breeds
This is a Bird of Conservation Concern (BCC) only in particular Bird Conservation Regions elsewhere
(BCRs) in the continental USA
https:Hecos.fws.gov/ecp/species/9478
Wood Thrush Hylocichla mustelina Breeds May 10
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA to Aug 31
and Alaska.
https:Hecos.fws.gov/ecp/species/9431
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 "Supplemental
Information on Migratory Birds and Eagles", specifically the FAQ section titled "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 (1)
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.
■ probability of presence breeding season I survey effort — no data
SPECIES JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
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Bald Ea
Non-BCCe T+++ +0++ +1+� 7::::::: TT++ ++++ ++++ ++++ ++++ ++++ ++++
VulnerableMEN
Black -billed +++ 1
Cuckoo
BCC Rangewide
(CON)
Cerulean Warbler +++�
BCC Rangewide
(CON)
II I I I I I I I I I I I I I I I I I I I I I I I I II0+11111 1111 1111
+++ ++++ +++0 -1 1 1 I 1 +++ ++++ +++I I 14 ++++ ++++ ++++
Chimney Swift
BCC Ranewide 1111 Jill Jill Jill IIII IIII ll++ ++++ ++++
(CON) __{_ ____ ____ _ ____ __.
Eastern Whip -Poor -
will ++++ I I I I 1 1 1 I 11 1 1 1 I 1 I I I I++++ ++++ ++++ ++++ ++++ ++++
BCC Rangewide
(CON)
Grasshopper ++++
Sparrow ++++ ++++ +TT� +++ ++I+ ++++ + _�k T+++ ++++ ++++ ++++
BCC -BCR
Kentucky Warbler
BCC Rangewide
(CON)
Prairie Warbler
BCC Rangewide
(CON)
Prothonotary
Warbler
BCC Rangewide
(CON)
Red-headed
Woodpecker
BCC Rangewide
(CON)
4-1 1 1 1 1 1 1+++ +M III 11 1 1 f i+ I I I I I +
++++ ++++ 7777 TTT+ +++1 *010 *+++ ++++ ++++
■■■■ EL.
++++IIII 1 1 1 1.0+++ ++++
I I 1 ++ ++++ + I l l III +
I 1 010 *+0+ 01++ ++0+
Rusty Blackbird BCC -BCR ++++ *+11 *111114 ++++ ++++ ++++ ++++ ++++ ++++
Wood Thrush II i; �i�i iiilJill11111+0+ ++++ ++++
BCC Rangewide + +++ ++++ +++1 1 1� 1111`
(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/avoidins7-and-minimizinv--incidental-take-mis7ratorv-birds
• Nationwide conservation measures for birds https://www.fws.gov/sites/default/files/
documents/nationwide-standard-conservation-measures.pdf
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• 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
WETLANDS
Impacts to NWI wetlands and other aquatic habitats may be subject to regulation under Section
404 of the Clean Water Act, or other State/Federal statutes.
For more information please contact the Regulatory Program of the local U.S. Army Corps of
Engineers District.
Please note that the NWI data being shown may be out of date. We are currently working to
update our NWI data set. We recommend you verify these results with a site visit to determine
the actual extent of wetlands on site.
FRESHWATER FORESTED/SHRUB WETLAND
• PSS1A
RIVERINE
• RSUBH
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IPAC USER CONTACT INFORMATION
Agency: Pilot Environmental, Inc
Name: David Brame
Address: 743 Park Lawn Court
City:
Kernersville
State:
NC
Zip:
27284
Email
[e-mail]
Phone:
3363104527
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United States Department of the Interior
FISH AND WILDLIFE SERVICE
Asheville Ecological Services Field Office
160 Zillicoa Street
Asheville, NC 28801-1082
Phone: [phone] Fax: [phone]
In Reply Refer To: 07/08/2024 19:35:41 UTC
Project code: 2024-0003414
Project Name: Northgate Plaza
Federal Nexus: yes
Federal Action Agency (if applicable): Army Corps of Engineers
Subject: Technical assistance for'Northgate Plaza'
Dear David Brame:
This letter records your determination using the Information for Planning and Consultation
(IPaC) system provided to the U.S. Fish and Wildlife Service (Service) on July 08, 2024, for
'Northgate Plaza' (here forward, Project). This project has been assigned Project Code
2024-0003414 and all future correspondence should clearly reference this number. Please
carefully review this letter. Your Endangered Species Act (Act) requirements may not be
complete.
Ensuring Accurate Determinations When Using IPaC
The Service developed the IPaC system and associated species' determination keys in accordance
with the Endangered Species Act of 1973 (ESA; 87 Stat. 884, as amended; 16 U.S.C. 1531 et
seq.) and based on a standing analysis. All information submitted by the Project proponent into
IPaC must accurately represent the full scope and details of the Project.
Failure to accurately represent or implement the Project as detailed in IPaC or the Northern
Long-eared Bat and Tricolored Bat Range -wide Determination Key (Dkey), invalidates this
letter. Answers to certain questions in the DKey commit the project proponent to
implementation of conservation measures that must be followed for the ESA determination to
remain valid. Note that conservation measures for northern long-eared bat and tricolored bat
may differ. If both bat species are present in the action area and the key suggests more
conservative measures for one of the species for your project, the Project may need to apply
the most conservative measures in order to avoid adverse effects. If unsure which conservation
measures should be applied, please contact the appropriate Ecological Services Field Office
Determination for the Northern Long -Eared Bat and Tricolored Bat

Project code: 2024-0003414 IPaC Record Locator: 815-107659583 07/08/2024 19:35:41 UTC
Based upon your IPaC submission and a standing analysis completed by the Service, your project
has reached the following effect determination(s):
Species Listing Status Determination
Northern Long-eared Bat (Myotis septentrionalis) Endangered A
AA
Other Species and Critical Habitat that May be Present in the ACtricolored
The IPaC-assisted determination key for the northern long-eared bat bat does not
apply to the following ESA -protected species and/or critical habbt tay occur in your
Action area: _
Bog Turtle Glyptemys muhlenbergii Similarity of
• Monarch Butterfly Danaus plexippus Candidate:V
• Schweinitz's Sunflower Helianthus schweinitzii En ang
You may coordinate with our Office to determine eth ction may cause prohibited take
of the animal species listed above. Note that if a speci s listed t at may be affected by the
identified action before it is complete, additio r commen to ensure compliance
with the Endangered Species Act.
Next Steps 4&
Consultation with the Service is necessary. The project has a federal next(e.g., Federal funds,
permit, etc.), but you are not the federal 4tion agency or its designated (in writing) non-federal
representative. Therefore, the A conson status,4t incom 1 and no project activities
should occur until consultat' etween the Service ane Federal action agency (or designated
non-federal representativ pleted.
As the federal agency signated*on-federa resent ve deems appropriate, they should
submit their determination of effects to the Servi g the following.
1. Log into IP �lsing a ency email account and click on My Projects, click "Search by
record to or" to fi 1 is Project using 815-107659583. (Alternatively, the originator of
the proan add the agency representative to the project by using the Add
Merg&r W44he project home page.)
2. RJ%L,the angers to the Northern Long-eared Bat and Tricolored Bat Range -wide
ter on Key to ensure that they are accurate.
3. Click on Review/ Finalize to convert the `not likely to adversely affect' consistency letter
to a concurrence letter. Download the concurrence letter for your files if needed.
If no changes occur with the Project or there are no updates on listed species, no further
consultation/coordination for this project is required for the northern long-eared bat. However,
the Service recommends that project proponents re-evaluate the Project in IPaC if: 1) the scope,
timing, duration, or location of the Project changes (includes any project changes or
amendments); 2) new information reveals the Project may impact (positively or negatively)
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Project code: 2024-0003414 IPaC Record Locator: 815-107659583 07/08/2024 19:35:41 UTC
federally listed species or designated critical habitat; or 3) a new species is listed, or critical
habitat designated. If any of the above conditions occurs, additional coordination with the
Service should take place before project implements any changes which are fill or commits
additic
If you
Ashev
with tl
the
ssociated
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Project code: 2024-0003414 IPaC Record Locator: 815-107659583 07/08/2024 19:35:41 UTC
Action Description
You provided to IPaC the following name and description for the subject Action.
1. Name r
Northgate Plaza
2. Description
The following description was provided for the project'Northgate Plaza':
The site is being considered for a storage facility and will require several
crossings and a permit from the USACE.
The approximate location of the project can be viewed in
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Project code: 2024-0003414 IPaC Record Locator: 815-107659583 07/08/2024 19:35:41 UTC
DETERMINATION KEY RESULT
Based on the answers provided, the proposed Action is consistent with a determination of "may
affect, but not likely to adversely affect" for a least one species covered by this determination
key.
QUALIFICATION INTERVIEW
1. Does the proposed project include, or is it reasonably certain to cause, intentional take of
listed bats or any other listed species? AW AV
Note: Intentional take is defined as take that is the intended result
research, direct species management, surveys, and/or studies tIAW
harassment, collection, or capturing of any individual of a federally
species?
\Ni=
2. Is the action area wholly within Zone 2 of
eared bat and/or tricolored bat? AM
Automatically answered
No
3. Does the action area intersect
bat and/or tricolored bat? i
a
Automatically answered `4N
No
Does any component Ae action involve
turbines? Answer ' ' activities con,
gathering survey ' ormati inform the
turbines. _
Note: For
of the fedi
5. Is
ional take could refer to
handling/encountering,
,endangered or proposed
for northern long -
northern long-eared
or operation of wind
with the intention of
, or operation of wind
`yes' if the construction or operation of wind power facilities is either (1) part
not occur but for a federal agency action (federal permit, funding, etc.).
[ion authorized, permitted, licensed, funded, or being carried out by a
whole or in part?
6. Is the Federal Highway Administration (FHWA), Federal Railroad Administration (FRA),
or Federal Transit Administration (FTA) funding or authorizing the proposed action, in
whole or in part?
No
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7. Are you an employee of the federal action agency or have you been officially designated in
writing by the agency as its designated non-federal representative for the purposes of
Endangered Species Act Section 7 informal consultation per 50 CFR § .08?
Note: This key may be used for federal actions and for non-federal actions to facilita 7 consultation and
to help determine whether an incidental take permit may be needed, respectively. Thr questi r information
purposes only.
No
8. Is the lead federal action agency the Environmental ProteS&n A) or Federal
Communications Commission (FCC)? Is the EnvironmeAW ection Agency (EPA) or
Federal Communications Commission (FCC) funding or auth3rizi+the proposed action,
in whole or in part?
No
9. Is the lead federal action agency the Federal
M
10. [Semantic] Is the action area located
Note: The map queried for this question
additional information, please contact y(
Automatically answered
No
11. Does the action area contain�yl
or other karst features), mines,
12
13
Re4ulry Commission (FERC)?
roosts or ca4s (or
bat hibernaculum?
be displayed. If you need
sinkholes, fissures,
or tunnels that could provide habitat
for hibernating batAcont
'IV
No
Does the action areOJ talus or Caces
genic or naturally formed rock
shelters or crev' An rocky outcrops, tocliffs?
No
Will the act*n c s cts to a bridge?
Note: C ge uld be considered as bridges in this question.
No
14. ction result in effects to a culvert or tunnel at any time of year?
Yes
15. Does the culvert or tunnel equal or exceed 23 feet (7.0 meters) in length?
No
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Project code: 2024-0003414 IPaC Record Locator: 815-107659583 07/08/2024 19:35:41 UTC
16. Are trees present within 1000 feet of the action area?
Note: If there are trees within the action area that are of a sufficient size to be potential roosts for bats answer
"Yes". If unsure, additional information defining suitable summer habitat for the northern long-eared bat and
tricolored bat can be found in Appendix A of the USFWS' Range -wide Indiana Bat a)jj�North%[n long-eared bat
Survey Guidelines at:
guidelines.
Yes
17. Does the action include the intentional exclusion of bats
Note: Exclusion is conducted to deny bats' entry or reentry into a
bats, it should be done according to established standards. If youl
unsure whether northern long-eared bats or tricolored bats are A
structure?
fftive and to avoid harming
Fat exclusion and you are
s." Answer "No" if there are no
signs of bat use in the building/structure. If unsure, contact your local E ogical Services Field Office to help
assess whether northern long-eared bats or tricolored baAMMLpre ontact a Nuisance Wildlife Control
Operator (NWCO) for help in how to exclude bats fro �rstruc afely without causing harm to the bats (to
find a NWCO certified in bat standards, search the Intr et using search term 'National Wildlife Control
Operators Association bats"). Also see the White- sell espouse Te guide for bat control in
structures.
No
18. Does the action involve remova]dgWdification, or maintenance of a human -made structure
(barn, house, or other building) known or suspected to contain roosting bats?
19
No
Will the action cause co truction�ne or more new roads open to the public?
For federal actions, r `yes' when the construction or operation of these facilities is
either (1) part of th ederal action or (2) would not occur but for an action taken by a
federal agency ral ermit, funding, etc.).
No
20. Will th4ai
to incrNoteA
the federal action
etc.).. ,
No
e any construction or other activity that is reasonably certain
permanently or temporarily on one or more existing roads?
' when the construction or operation of these facilities is either (1) part of
ur but for an action taken by a federal agency (federal permit, funding,
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21. Will the action include or cause any construction or other activity that is reasonably certain
to increase the number of travel lanes on an existing thoroughfare?
For federal actions, answer `yes' when the construction or operation of these facilities is
either (1) part of the federal action or (2) would not occur but for a aken by a
federal agency (federal permit, funding, etc.).
No
22. Will the proposed Action involve the creation of a new water- ne con inant source
(e.g., leachate pond, pits containing chemicals that are no14S compliant)?
Note: For information regarding NSF/ANSI 60 please visit htt s://www.nsf.or /k ed e-librar /nsf-ansi-
standard-60-drinking-water-treatment-chemicals-health-effects
OF
No
23. Will the proposed action involve the creation of a new po ource discharge from a
facility other than a water treatment plant or t stem?
No
24. Will the action include drilling or blasti ?
No
25. Will the action involve military tr oke operations, o nt operations,
ex loding munitions, artillery^fin helicop= �rfixedyg aircraft use)?
26. Will the proposed action invoRq use of herbicides el sticides other than
herbicides (e.g., fungici s, insec s, or rod
No
27. Will the action inc e e activities that are reaso bly certain to cause chronic or
intense nighttim ise (abo urrent levels of ambient noise in the area) in suitable
summer habit r hern long-eared bat or tricolored bat during the active season?
Chronic n is not t is continuous or occurs repeatedly again and again for a long
time. So es chr nic or intense noise that could cause adverse effects to bats may
includ W n mited to: road traffic; trains; aircraft; industrial activities; gas
compressor s; loud music; crowds; oil and gas extraction; construction; and mining.
Note: Add *al information defining suitable summer habitat for the northern long-eared bat and tricolored bat
can be fo in Appendix A of the USFWS' Range -wide Indiana Bat and Northern long-eared bat Survey
Guidelines at: httDS://www.fws.i!ov/media/rani!e-wide-indiana-bat-and-northern-long-eared-bat-survev-
guidelines.
No
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28. Does the action include, or is it reasonably certain to cause, the use of permanent or
temporary artificial lighting within 1000 feet of suitable northern long-eared bat or
tricolored bat roosting habitat?
Note: Additional information defining suitable summer habitat for the northern long- *nd tricolored bat
can be found in Appendix A of the USFWS'Range-wide Indiana Bat and Northern to g-eareurvey
Guidelines at: https://www.fws.gov/media/range-wide-indiana-bat-and-norther eared -bat -survey -
guidelines.
No
29. Will the action include tree cutting or other means of kn 'n own or bringing down
trees, tree topping, or tree trimming?
Yes
30. Will the proposed action occur exclusively in an al a blished and currently
maintained utility right-of-way?
No
31. Does the action include emergency cutting r trimming of hazIte
ees in order to remove
an imminent threat to human safety or property? See hazard trat the bottom of the
key for text that will be added to response litters
11 X
Note: A "hazard tree" is a tree that is an immediate threat to lives, public health and s , or improved property.
No
32. Does the project intersect wi* the 0- 9.9% forest density category?
Automatically answered .
No
33. Does the project intersect with the 10.0- 19.9% forest density category map?
Automatically answered
No
34. Does the proje uAle ith the 20.0- 29.99QWst density category map?
14WJr
-
Yes 400'
35. Does t ct Arsect with the 30.0- 100% forest density category map?
36. Will the'%Wn cause trees to be cut, knocked down, or otherwise brought down across an
area greater than 40 acres in total extent?
No
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37. Will the proposed action result in the use of prescribed fire?
Note: If the prescribed fire action includes other activities than application of fire (e.g., tr utting, fire line
preparation) please consider impacts from those activities within the previous represent e questions in the key.
This set of questions only considers impacts from flame and smoke.
No
38. Does the action area intersect the northern long-eared bat spec' ist ar 7
Automatically answered
Yes
39. [Semantic] Is the action area located within 0.25 miles curt at is known to be
occupied by northern long-eared or tricolored bats?
Automatically answered
No
40. Is suitable summer habitat for the northern long-eared bat present within 1000 feet of
project activities?
If unsure, answer "Yes."
Note: Additioi
can be found i
Guidelines at:
guidelines.
Yes
lored bat
,y
41. Has a presence/probable absence summer bat survey targeting the northern long-eared bat
following the Service's n e-wide Indiana Ba sand Northern Long -Eared Bat Surve
Guidelines been con ed within the project area.
No
42. Are any of the t ropose or cutting ther ns of knocking down, bringing
down, toppin r t ' g suitable for no g-eared bat roosting (i.e., live trees
and/or snags _ es that have exfoliating ark, cracks, crevices, and/or cavities)?
Note: Ad n o 'on defining suitable summer habitat for the northern long-eared bat and tricolored bat
can be 3 pe A of the USFWS' Range -wide Indiana Bat and Northern long-eared bat Survey
Guidelines at: https./ .fws.gov/media/range-wide-indiana-bat-and-northern-long-eared-bat-survey-
uidelines.
S
43. Do you have any documents that you want to include with this submission?
No
DKey Version Publish Date: 07/03/2024
10 of 12

Project code: 2024-0003414 IPaC Record Locator: 815-107659583 07/08/2024 19:35:41 UTC
PROJECT QUESTIONNAIRE
Enter the extent of the action area (in acres) from which trees will be r;Poved - round up
to the nearest tenth of an acre. For this question, include the entire ar a where tree removal
will take place, even if some live or dead trees will be left standing
23.5
O.
DKey Version Publish Date: 07/03/2024 11 of 12

Project code: 2024-0003414 IPaC Record Locator: 815-107659583
07/08/2024 19:35:41 UTC
IPAC USER CONTACT INFORMATION
Agency:
Pilot Environmental, Inc.
Name:
David Brame
Address:
743 Park Lawn Court
Address Line 2:
Pilot Environmental
City:
Kernersville
State:
NC
Zip:
27284
Email
[e-mail]
Phone:
3367084617
LEAD AGENCY CONTACT INFORMATION
Lead Agency: Army Corps of Engineers
DKey Version Publish Date: 07/03/2024 12 of 12

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Surveyed Area center point
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* Local Historic Distric center point
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4
Drawing 1 ; '.< h'' `•r USGS Topographic Map
USGS Topographic Map- f� `' ;'; Patterson Avenue
Rural Hall and Walkertown, NC Approximate 23.5-Acre Tract
Quadrangles PIS Winston-Salem, Forsyth County, NC
Scale: 1"=2,000' PILOT E 4 q R04M:NTAL. kC Pilot Project9120

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Drawing 2
USDA Web Soil Survey
of Forsyth County, NC
Scale: 1" = 250'
}Y
LEGEND
4p'
.L' L Site Boundary
Web Soil Map
Patterson Avenue
kr.. Approximate 23.5-Acre Tract
Winston-Salem, Forsyth County, NC
L'IL0T Ek!' R01M:NTAL. hC ,�� Pilot Project9120

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� Site Boundary
Drawing 2APublished Soil Map
USDA Soil Survey F`� 1 -_ Patterson Avenue
of Forsyth County, NCApproximate 23.5-Acre Tract
`L Winston-Salem Forsyth Count NC
Published 1976 ��� y y,
Scale: 1"=250' hiLOT E%" RU4M:NTkL. h{ Pilot Project9120

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Drawing 3
USFWS NWI r i
Wetlands Mapper '�
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NWI Map
Patterson Avenue
Approximate 23.5-Acre Tract
Winston-Salem, Forsyth County, NC
Pilot Project 9120

6. :Fr
g
LEGEND
Site Boundary
' {1 %Annual Chance Flood Hazard
Regulatory Floodway
Sped al Flood4vay
Area of Undetermined Flood Hazard
0.2%Annual Chance Flood Hazard
Future Conditions 1 %Annual Chance Flood Hazard
�yAre@with Reduced Risk Due to Levee
. * ^
.ti2aBPI
Drawing 4
National Flood Hazard Layer
from FEMA Web Map Service }`
Scale: 1" = 250' PJLG�
• PILOT E% 5'' FO+IM -NT? L. KC
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FEMA FIRM
Patterson Avenue
Approximate 23.5-Acre Tract
Winston-Salem, Forsyth County, NC
Pilot Project 9120

_
r~ �
Potentially Non -
Jurisdictional Waters
WC 1-4
0.021 Ac.
WD 1-5
- 7
0.018 Ac.
sB2
285 LF
WF 1-10
i
sC 0.114 Ac.
145 LF
i
WE 1-9
0.059 Ac.
r %.,
THE LOCATIONS OF FEATURES SHOWN ON THIS
MAP ARE PRELIMINARY. THEY HAVE NOT BEEN
VERIFIED BY THE USACE. THIS MAP INCLUDES
GPS LOCATIONS OF DELINEATED FEATURES.
DELINEATED BY PILOT ON 3.31.2023. low
LEGEND
Site Boundary
Potential Non -Wetland Water (Perennial Stream)
Potential Non -Wetland Water (Intermittent Stream)
Potential Wetland Water
SA 1-5 Flag Number/Feature
DP-1 Q Data Point7*
ti
■ Culvert:
IIIIIIIIIIIIIIIIIF 2r
Drawing 5 4 ` �.{ Wetland Map
Aerial Imagery from ESRI Patterson Avenue
and Pilot GPS Data ���� Y Y, - �-_ Approximate 23.5-Acre Tract
Scale: 1" = 250' Winston-Salem Forsyth Count NC
Date: 4.3.2023 P L O T E k V A n A' N= NJ A L. p'C:_,;Pilot Project 9120

U.S. Army Corps of Engineers OMB Control #: 0710xxxx, Exp: Pending
WETLAND DETERMINATION DATA SHEET — Eastern Mountains and Piedmont Region Requirement Control Symbol EXEMPT:
See ERDC/EL TR-07-24; the proponent agency is CECW-CO-R (Authority: AR335-15, paragraph 5-2a)
Project/Site: 9120/Patterson Avenue City/County: Winston-Salem/Forsyth Sampling Date: 3.31.2023
Applicant/Owner: Gupton's Royal Design Group, PA State: NC Sampling Point: DP-1
Investigator(s): Pilot Section, Township, Range: NA
Landform (hillside, terrace, etc.): Swale Local relief (concave, convex, none): Concave Slope (%): 1
Subregion (LRR or MLRA): LRR P, MLRA 136 Lat: 36.153918' Long:-80.249534° Datum: wgs 84
Soil Map Unit Name: FcD2 - Fairview clay loam NWI classification: None
Are climatic / hydrologic conditions on the site typical for this time of year? Yes X No (If no, explain in Remarks.)
Are Vegetation Soil or Hydrology significantly disturbed? Are "Normal Circumstances" present? Yes X No
Are Vegetation Soil or Hydrology naturally problematic? (If needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present? Yes X No Is the Sampled Area
Hydric Soil Present? Yes X No within a Wetland? Yes X No
Wetland Hydrology Present? Yes X No
Remarks:
HYDROLOGY
Wetland Hydrology Indicators:
Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required: check all that apply)
—Surface Soil Cracks (136)
X Surface Water (Al) _True
Aquatic Plants (1314)
X Sparsely Vegetated Concave Surface (138)
X High Water Table (A2) —Hydrogen
Sulfide Odor (Cl)
—Drainage Patterns (1310)
X Saturation (A3) —Oxidized
Rhizospheres on Living Roots (C3)
_ Moss Trim Lines (1316)
X Water Marks (131) —Presence
of Reduced Iron (C4)
_ Dry -Season Water Table (C2)
_Sediment Deposits (132) _Recent
Iron Reduction in Tilled Soils (C6)
_Crayfish Burrows (C8)
_Drift Deposits (133) _Thin
Muck Surface (C7)
_Saturation Visible on Aerial Imagery (C9)
_Algal Mat or Crust (134) _Other
(Explain in Remarks)
_Stunted or Stressed Plants (D1)
_Iron Deposits (135)
_Geomorphic Position (D2)
_Inundation Visible on Aerial Imagery (137)
_Shallow Aquitard (D3)
X Water -Stained Leaves (139)
_ Microtopographic Relief (D4)
Aquatic Fauna (1313)
X FAC-Neutral Test (D5)
Field Observations:
Surface Water Present? Yes X No
Depth (inches): 1
Water Table Present? Yes X No
Depth (inches): 0
Saturation Present? Yes X No
Depth (inches): 0
Wetland
Hydrology Present? Yes X No
includes capillary fringe)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:
ENG FORM 6116-4-SG, JUL 2018 Eastern Mountains and Piedmont — Version 2.0

VEGETATION (Four Strata) - Use scientific names of plants.
Sampling Point: DP-1
Tree Stratum (Plot size: 30 )
1. Platanus occidentalis
2. Acer rubrum
3.
4.
5.
6.
7.
50% of total cover: 30
SaDlina/Shrub Stratum (Plot size: 15 )
1. Liquidambar styraciflua
2. Acer rubrum
3.
4.
5.
6.
7.
8.
9.
50% of total cover: 20
Herb Stratum (Plot size: 5 )
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
50% of total cover:
Woody Vine Stratum (Plot size: 30 )
1.
2.
3.
4.
5.
Absolute
Dominant
Indicator
% Cover
Species?
Status
30
Yes
FACW
30
Yes
FAC
60 =Total Cover
20% of total cover: 12
20 Yes FAC
20 Yes FAC
40 =Total Cover
20% of total cover:
_=Total Cover
20% of total cover:
=Total Cover
50% of total cover: 20% of total cover:
Remarks: (Include photo numbers here or on a separate sheet.)
8
Dominance Test worksheet:
Number of Dominant Species
That Are OBL, FACW, or FAC: 4 (A)
Total Number of Dominant
Species Across All Strata: 4 (B)
Percent of Dominant Species
That Are OBL, FACW, or FAC: 100.0% (A/B)
Prevalence Index worksheet:
Total % Cover of: Multiply by:
OBL species 0 x 1 = 0
FACW species 30 x 2 = 60
FAC species 70 x 3 = 210
FACU species 0 x 4 = 0
UPL species 0 x 5 = 0
Column Totals: 100 (A) 270 (B)
Prevalence Index = B/A = 2.70
Hydrophytic Vegetation Indicators:
_ 1 - Rapid Test for Hydrophytic Vegetation
X 2 - Dominance Test is >50%
X 3 - Prevalence Index is <-3.0'
4 - Morphological Adaptations' (Provide supporting
data in Remarks or on a separate sheet)
Problematic Hydrophytic Vegetation' (Explain)
'Indicators of hydric soil and wetland hydrology must
be present, unless disturbed or problematic.
Definitions of Four Vegetation Strata:
Tree - Woody plants, excluding vines, 3 in. (7.6 cm) or
more in diameter at breast height (DBH), regardless of
height.
Sapling/Shrub - Woody plants, excluding vines, less
than 3 in. DBH and greater than or equal to 3.28 ft
(1 m) tall.
Herb - All herbaceous (non -woody) plants, regardless
of size, and woody plants less than 3.28 ft tall.
Woody Vine - All woody vines greater than 3.28 ft in
height.
Hydrophytic
Vegetation
Present? Yes X No
ENG FORM 6116-4-SG, JUL 2018 Eastern Mountains and Piedmont - Version 2.0

SOIL Sampling Point: DP-1
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
(inches) Color (moist) % Color (moist) % Type Lo C2 Texture Remarks
0-18 2.5Y 4/2 80 7.5YR 4/6 20 C M Loamy/Clayey Prominent redox concentrations
'Type: C=Concentration, D=Depletion, RM=Reduced Matrix, MS=Masked Sand Grains.
2Location: PL=Pore Lining, M=Matrix.
Hydric Soil Indicators:
Indicators for Problematic Hydric Soils3:
Histosol (Al)
Polyvalue Below Surface (S8) (MLRA 147, 148)
2 cm Muck (A10) (MLRA 147)
Histic Epipedon (A2)
_Thin Dark Surface (S9) (MLRA 147, 148)
_Coast Prairie Redox (A16)
—Black Histic (A3)
—Loamy Mucky Mineral (F1) (MLRA 136)
(MLRA 147, 148)
—Hydrogen Sulfide (A4)
—Loamy Gleyed Matrix (F2)
—Piedmont Floodplain Soils (F19)
_Stratified Layers (A5)
X Depleted Matrix (F3)
(MLRA 136, 147)
_2 cm Muck (A10) (LRR N)
_ Redox Dark Surface (F6)
—Red Parent Material (F21)
—Depleted Below Dark Surface (A11)
—Depleted Dark Surface (F7)
(outside MLRA 127, 1479 148)
_Thick Dark Surface (Al2)
_Redox Depressions (F8)
_Very Shallow Dark Surface (F22)
_Sandy Mucky Mineral (S1)
_Iron -Manganese Masses (F12) (LRR N,
_Other (Explain in Remarks)
Gleyed Matrix (S4)
MLRA 136)
_Sandy
—Sandy Redox (S5)
_ Umbric Surface (F13) (MLRA 122, 136)
3Indicators of hydrophytic vegetation and
_Stripped Matrix (S6)
_Piedmont Floodplain Soils (F19) (MLRA 148)
wetland hydrology must be present,
Dark Surface (S7)
Red Parent Material (F21) (MLRA 127, 1479 148)
unless disturbed or problematic.
Restrictive Layer (if observed):
Type:
Depth (inches):
Hydric Soil Present? Yes X No
Remarks
ENG FORM 6116-4-SG, JUL 2018 Eastern Mountains and Piedmont — Version 2.0

U.S. Army Corps of Engineers OMB Control #: 0710xxxx, Exp: Pending
WETLAND DETERMINATION DATA SHEET — Eastern Mountains and Piedmont Region Requirement Control Symbol EXEMPT:
See ERDC/EL TR-07-24; the proponent agency is CECW-CO-R (Authority: AR335-15, paragraph 5-2a)
Project/Site: 9120/Patterson Avenue City/County: Winston-Salem/Forsyth Sampling Date: 3.31.23
Applicant/Owner: Gupton's Royal Design Group, PA State: NC Sampling Point: DP-2
Investigator(s): Pilot Section, Township, Range: NA
Landform (hillside, terrace, etc.): Side Slope Local relief (concave, convex, none): Slope Slope (%):
Subregion (LRR or MLRA): LRR P, MLRA 136 Lat: 36.153848' Long:-80.249482° Datum: wgs 84
Soil Map Unit Name: FcD2 - Fairview clay loam NWI classification: None
Are climatic / hydrologic conditions on the site typical for this time of year? Yes X No (If no, explain in Remarks.)
Are Vegetation Soil or Hydrology significantly disturbed? Are "Normal Circumstances" present? Yes X No
Are Vegetation Soil or Hydrology naturally problematic? (If needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present? Yes X No Is the Sampled Area
Hydric Soil Present? Yes No X within a Wetland? Yes No X
Wetland Hydrology Present? Yes No X
Remarks:
HYDROLOGY
Wetland Hydrology Indicators:
Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required: check all that apply)
—Surface Soil Cracks (136)
_Surface Water (Al) _True
Aquatic Plants (1314)
_Sparsely Vegetated Concave Surface (138)
_ High Water Table (A2) —Hydrogen
Sulfide Odor (Cl)
—Drainage Patterns (1310)
—Saturation (A3) —Oxidized
Rhizospheres on Living Roots (C3)
_ Moss Trim Lines (1316)
—Water Marks (131) —Presence
of Reduced Iron (C4)
_ Dry -Season Water Table (C2)
_Sediment Deposits (132) _Recent
Iron Reduction in Tilled Soils (C6)
_Crayfish Burrows (C8)
_Drift Deposits (133) _Thin
Muck Surface (C7)
_Saturation Visible on Aerial Imagery (C9)
_Algal Mat or Crust (134) _Other
(Explain in Remarks)
_Stunted or Stressed Plants (D1)
_Iron Deposits (135)
_Geomorphic Position (D2)
_Inundation Visible on Aerial Imagery (137)
_Shallow Aquitard (D3)
—Water-Stained Leaves (139)
Microtopographic Relief (D4)
Aquatic Fauna (1313)
FAC-Neutral Test (D5)
Field Observations:
Surface Water Present? Yes No
X Depth (inches):
Water Table Present? Yes No
X Depth (inches):
Saturation Present? Yes No
X Depth (inches):
Wetland
Hydrology Present? Yes No X
includes capillary fringe)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:
ENG FORM 6116-4-SG, JUL 2018 Eastern Mountains and Piedmont — Version 2.0

VEGETATION (Four Strata) - Use scientific names of plants.
Sampling Point: DP-2
Absolute Dominant
Indicator
Tree Stratum (Plot size: 30 )
% Cover Species?
Status
Dominance Test worksheet:
1.
Liquidambarstyraciflua
20 Yes
FAC
Number of Dominant Species
2.
Pinus virginiana
20 Yes
UPL
That Are OBL, FACW, or FAC: 3 (A)
3.
Acerrubrum
20 Yes
FAC
Total Number of Dominant
4.
Liriodendron tulipifera
10 No
FACU
Species Across All Strata: 5 (B)
5.
Percent of Dominant Species
6.
That Are OBL, FACW, or FAC: 60.0% (A/B)
7.
Prevalence Index worksheet:
70 =Total Cover
Total % Cover of: Multiply by:
50% of total cover:
35 20% of total cover:
14
OBL species 0 x 1 = 0
SaDlina/Shrub Stratum (Plot size: 15
)
FACW species 0 x 2 = 0
1.
Liquidambarstyraciflua
10 Yes
FAC
FAC species 50 x 3 = 150
2.
FACU species 25 x 4 = 100
3.
UPL species 20 x 5 = 100
4.
Column Totals: 95 (A) 350 (B)
5.
Prevalence Index = B/A = 3.68
6.
Hydrophytic Vegetation Indicators:
7.
_ 1 - Rapid Test for Hydrophytic Vegetation
8.
X 2 - Dominance Test is >50%
9.
3 - Prevalence Index is :53.0'
10 =Total Cover
4 - Morphological Adaptations' (Provide supporting
50% of total cover:
5 20% of total cover:
2
data in Remarks or on a separate sheet)
Herb Stratum (Plot size: 5 )
-Problematic Hydrophytic Vegetation' (Explain)
1.
Polystichum acrostichoides
15 Yes
FACU
'Indicators of hydric soil and wetland hydrology must
2.
be present, unless disturbed or problematic.
Definitions of Four Vegetation Strata:
3.
4.
Tree - Woody plants, excluding vines, 3 in. (7.6 cm) or
5.
more in diameter at breast height (DBH), regardless of
6
height.
7.
Sapling/Shrub - Woody plants, excluding vines, less
8.
than 3 in. DBH and greater than or equal to 3.28 ft
9
(1 m) tall.
10.
Herb - All herbaceous (non -woody) plants, regardless
11.
of size, and woody plants less than 3.28 ft tall.
15 =Total Cover
Woody Vine - All woody vines greater than 3.28 ft in
50% of total cover:
8 20% of total cover:
3
height.
Woody Vine Stratum (Plot size: 30 )
1.
2.
3.
4.
5
Hydrophytic
=Total Cover
Vegetation
50% of total cover:
20% of total cover:
Present? Yes X No
Remarks: (Include photo numbers here or on a separate sheet.)
ENG FORM 6116-4-SG, JUL 2018 Eastern Mountains and Piedmont - Version 2.0

SOIL Sampling Point: DP-2
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
(inches) Color (moist) % Color (moist) % Type Lo C2 Texture Remarks
0-18 10YR 4/6 100 Loamy/Clayey
'Type: C=Concentration, D=Depletion, RM=Reduced Matrix, MS=Masked Sand Grains.
2Location: PL=Pore Lining, M=Matrix.
Hydric Soil Indicators:
Indicators for Problematic Hydric Soils3:
Histosol (Al)
Polyvalue Below Surface (S8) (MLRA 147, 148)
2 cm Muck (A10) (MLRA 147)
Histic Epipedon (A2)
_Thin Dark Surface (S9) (MLRA 147, 148)
_Coast Prairie Redox (A16)
—Black Histic (A3)
—Loamy Mucky Mineral (F1) (MLRA 136)
(MLRA 147, 148)
—Hydrogen Sulfide (A4)
—Loamy Gleyed Matrix (F2)
—Piedmont Floodplain Soils (F19)
_Stratified Layers (A5)
_Depleted Matrix (F3)
(MLRA 136, 147)
_2 cm Muck (A10) (LRR N)
_ Redox Dark Surface (F6)
—Red Parent Material (F21)
—Depleted Below Dark Surface (A11)
—Depleted Dark Surface (F7)
(outside MLRA 127, 1479 148)
_Thick Dark Surface (Al2)
_Redox Depressions (F8)
_Very Shallow Dark Surface (F22)
_Sandy Mucky Mineral (S1)
_Iron -Manganese Masses (F12) (LRR N,
_Other (Explain in Remarks)
Gleyed Matrix (S4)
MLRA 136)
_Sandy
—Sandy Redox (S5)
_ Umbric Surface (F13) (MLRA 122, 136)
3Indicators of hydrophytic vegetation and
_Stripped Matrix (S6)
_Piedmont Floodplain Soils (F19) (MLRA 148)
wetland hydrology must be present,
Dark Surface (S7)
Red Parent Material (F21) (MLRA 127, 1479 148)
unless disturbed or problematic.
Restrictive Layer (if observed):
Type:
Depth (inches):
Hydric Soil Present? Yes No X
Remarks
ENG FORM 6116-4-SG, JUL 2018 Eastern Mountains and Piedmont — Version 2.0