20051117 Ver 1_Individual_20050622

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Wetland and Natural Resource PG wt:;;,•! .
Consultants, Inc. w"'•*"'�'
US Army Corps of Engineers
Attn: Mr. Todd Tugwell
6508 Falls of Neuse Road, Ste 120
Raleigh, NC 27615
Mr. Tugwell:
{ � 4
June 20, 2005
Attached is an application for an individual permit to construct three lakes as part of a
residential development. All of the following information is available in digital format and
will be forwarded to you upon your request.
Location
The project, Lissara Lake Subdivision, is approximately 132 acres in size and is located
north of Shallowford Road (SR 1001) and west of Conrad Road (SR 1305), approximately 2
miles west of Lewisville, in Forsyth County, NC. Coordinates (in decimal degrees) for the
site are 36.10690 North, 80.44910 West. The site contains an unnamed tributary of the
Yadkin River and adjacent wetlands in the Yadkin River Basin (8 -Digit Cataloging Unit
03040101)
Existing Site Conditions
The land use in the area surrounding the project consists of large lot residential dwellings,
forested tracts, and agricultural tracts. The area is currently subject to increasing
residential pressure.
The land use on the project itself is primarily in forest cover, which occupies
approximately 90% of the total acreage. The remaining acreage is made up by residences
and yards. The site contains several small intermittent tributaries which combine to
create a perennial stream that runs from south to north through the property. The
property is roughly rectangular in shape and the stream essentially bisects the property
along its length. The unnamed tributary drains to the Yadkin River approximately 1 mile
downstream of the site. The site also contains approximately 0.10 acres of wetlands.
Newton Office Clyde Office
PO Box 224 wnrinc.com 217 Paragon Parkway, #142
Newton, NC 28658 Clyde, NC 28721
828-465-3035 828-648-8801
828-465-3050 Fax [phone] Fax

Applicant's Stated Purpose
As stated by the applicant, the purpose of the project is to provide a recreational
waterskiing lake, an aesthetics pond, and a stormwater management facility.
Project Description
The project consists of a waterskiing lake, a stormwater management facility, an
aesthetics pond and two road crossings within a 132 acre residential development.
Development of the site will require clearing the proposed lake beds, grading the proposed
dam sites, filling necessary to impound the streams, and piping of streams to construct
roadways. Heavy equipment, including graders, pan scrapers, excavators, bull dozers, etc.
will be used for the construction of the project. Completion of the proposed project
would require the construction of 2 dams that impound water and support road crossings
and one dam that does not support a road crossing. Rights of ways for roads are proposed
to be 60 feet and side slopes for dams are proposed to be 3:1. Two road crossings are
necessary to access high ground. The proposed permanent impacts to stream channels
resulting from the placement of fill material associated with dams and road crossings
` totals 1,318 linear feet. The proposed impacts resulting from flooding streams totals
6,714 linear feet. Proposed permanent impacts to wetlands resulting from the discharge
of fill totals 0.04 acres. The proposed permanent impacts to wetlands resulting from
flooding the lakes total 0.08 acres. Plans included with this notice show the overall
proposed site layout as well as details of the proposed dam.
The applicant proposes to mitigate for impacts to stream channels by payment into the
North Carolina Ecosystem Enhancement Program. The applicant proposes payment for
1038 linear feet of impacts resulting from the construction of dams and payment for 2395
linear feet of impacts for all impacts resulting from flooding.
Thank you for your time and consideration and please call me at [phone] with any
questions that you may have.
st r rds,
ris Huysman
Cc: NC DWQ, Attn: Ms. Cyndi Karoly
1650 Mail Service Center
Raleigh, NC 27699-1650
Newton Office Clyde Office
PO Box 224 wnrinc.com 217 Paragon Parkway, # 142
Newton, NC 28658 Clyde, NC 28721
828-465-3035 828-627-0051
828-465-3050 Fax [phone] Fax

APPLICATION FOR DEPARTMENT OF THE ARMY PERMIT
(33 CFR 325)
IOMB APPROVAL NO, 0710-0003
Exoires December 31 9nnn
The Public burden for this collection of information is sestimated to average 10 hours per response, although the majority of applications should req e
5 hours or less. This includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and O
copleting and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of Z
m
information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Service Directorate of Information
Operations and Reports. 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302; and to the Office of Management and Budget,
Paperwork Reduction Project (0710-00031, Washington, DC 20503. Respondents should be aware that notwithstanding any other provision of Iawc-3
no person shall be subject to any penalty for failing to comply with a collection of Information if it does not display a currently valid OMB control M
number. Please DO NOT RETURN your form to either of those addresses. Completed applications must be submitted to the District Engineer havin p
jurisdiction over the location of the proposed activity. Y C
PRIVACY ACT STATEMENT
Authorities: Rivers and Harbors Act. Section 10, 33 USC 403; Clean Water Act, Section 404, 33 USC 1344; Marine Protection , Research and
Sanctuaries Act, 33 USC 1413, Section 103. Principal Purpose: Information provided on this form will be usad in evaluating the application for e
permit. Routine Uses: This information may be shared with the Department of Justice and other federal, state, and local government agencies.
Submission of requested information is voluntary, however, if Information is not provided the permit application cannot be evaluated nor can a permit
be issued.
One set of original drawings or good reproducible copies which show the location and character of the proposed activity must be attached to this
application (see sample drawings and instructions► and be submitted to the District Engineer having jurisdiction over the location of the proposed
activity. An application that is not completed in full will be returned.
tlT6NS 1 THRU 4 TO BE FILLED BY THE C vacs
APPLICATION NO. 2. FIELD OFFICE CODE 13. DATE RECEIVED
5. APPLICANT'S LJAME 1 I /
6. APPLICANT'S ADDRESS
C Z \(J
a. Residence
4. DATE APPLICATION COMPLETED
8. AUTHORIZED AGENT'S NAME AND TITLE )nn ngmranot regwrerll
9. AGENT'S ADDRESS
Pct 43 GX 2-2 'A
a. Residence
MIA
b. Business �c�(� (� b. Business �'�� (�U
1 V` \"C STATEMENT OF AUTHORIZATION
I hereby authorize, �A, 1.��1 \� � to act in my behalf as my agent in the processing of this application and to
iurnish, upon request, supplemental information in support of this permit application.
LASS A, 1"2\P,, 0 ai 0 .cf-M =N-�r
13. NAME OF WATERBOOY, IF KNOWN at.pp-w.)
U-7 "�A-t)V--�41,3 ',TDQ'\�
15. LOCATION OF PROJECT
wQSLi1-�-e 1.�
COUNTY STATE
'S. OTHER LOCATION DESCRIPTIONS, IF KNOWN, rsee �rructio u)
17. DIRECTIONS TO THE SITE
14. PROJECT STREET ADDRESS ofpp' tj.)
EAIG FORM 4345, 370 EDITION OF FEB 94 IS OBSOLETE.
(Proponent: CECW-OR)
�L

18. Nature of Activity Wcmar:pnnn Of proper, ,rrauae oil /esniesl
G�
7iv(-7)0&:) 0F G,"P' Div �S1G W l,
19. Project Purpose rDesarhe The remon Or pwpose Of the prOMa, see rrWr=iarsl
USE BLOCKS 20-22 IF DREDGED ANWOR FILL MATERIAL IS TO BE DISCHARGED
20, Reason(s) for Discharge
21. Type(s) of Material Being Discharged and the Amount of Each Type in Cubic Yards
Z -4C W 3 a-- �-\V'
22. Surface Area in Acres of Wetlands or Other Waters Filled i-
2
23. Is Any Portion of the Work Already Complete? Yes _ No X_ IF YES, DESCRIBE THE COMPLETED WORK
U
24. Addresses of Adjoining Property Owners, Lessees, Etc., Whose Property Adjoins the Waterbody (If more than can be entered here,
please attach a supplemental list).
25. List of Other Certifications or ApprovaWDenials Received from other Federal, State or Local Agencies for Work Described in This Application.
AGENCY TYPE APPROVAL- IDENTIFICATION NUMBER DATE APPLIED DATE
*Would. include but is not restricted to zoning, building and Hood plain permits
28. Application is hereby made for a permit or permits to authorize the work described in this application. I certify that the information in this
application is complete and accurate. I further certify that I possess the a to undertake the work described herein or am acting as the
duly ad a t of applicant.
11 SIGNATURE OF -A ATE SIGNATURE OF AGENT DATE
The application must be signed by erson who desires to undertake the proposed activity (applicant) or it may be signed by a duly
authorized agent if the statement i lock 11 has been filled out and signed.
18 U.S.C. Section 1001 provides that: Whoever, in any manner within the jurisdiction of any department or agency of the United States
knowingly and willfully falsifies, conceals, or covers up any trick, scheme, or disguises a material fact or makes any false, fictitious or
fraudulent statements or representations or makes or uses any false writing or document knowing same to contain any false, fictitious or
fraudulent statements or entry, shall be fined not more than $10,000 or.imprisoned not more than five years or both.
vcu
vI11 t UtlVltu
*Would. include but is not restricted to zoning, building and Hood plain permits
28. Application is hereby made for a permit or permits to authorize the work described in this application. I certify that the information in this
application is complete and accurate. I further certify that I possess the a to undertake the work described herein or am acting as the
duly ad a t of applicant.
11 SIGNATURE OF -A ATE SIGNATURE OF AGENT DATE
The application must be signed by erson who desires to undertake the proposed activity (applicant) or it may be signed by a duly
authorized agent if the statement i lock 11 has been filled out and signed.
18 U.S.C. Section 1001 provides that: Whoever, in any manner within the jurisdiction of any department or agency of the United States
knowingly and willfully falsifies, conceals, or covers up any trick, scheme, or disguises a material fact or makes any false, fictitious or
fraudulent statements or representations or makes or uses any false writing or document knowing same to contain any false, fictitious or
fraudulent statements or entry, shall be fined not more than $10,000 or.imprisoned not more than five years or both.

Lissara IP Narratives
June 15, 2005
Project Purpose and Need
Lissara LLC, the project proponent, proposes to construct a 28 acre
recreational and water skiing lake, an aesthetics pond and a stormwater
management facility in conjunction with development of the Lissara
subdivision in Forsyth County, North Carolina. There are no other property
owners that adjoin the waterbody that will be impacted.
The proponent needs the lake to provide the central recreational amenity
for the project which proposed the use of both vintage and competitive ski
boats to provide opportunities that are not available in the immediate
proximity. The ski lake should be long enough (2400 linear feet) and wide
enough (300 linear feet) to provide the competitive and novice skier and the
opportunities to practice their skills on smooth water without safety
concerns related to other crafts which are so prolific on public lakes. The
ski lake needs to be located entirely on the project area so as to limit
access.
The proponent further seeks to construct a stormwater management facility
on a perennial stream to limit the inflow of sediment to the proposed ski
lake. This sediment removing structure needs to be located upstream of the
ski lake and needs to be able to be dipped from high ground without lowering
the ski lakes pool. An aesthetics lake is proposed and is needed to offset
infrastructure costs associated with the development.
The impacted streams will be diverted while the clean fill is discharged into
the stream to construct the dams. All three dam will be constructed with
3:1 side slopes. The trapezoidal bases of the dams will impact a total of
1038 feet of linear streams. Approximately 240 cubic yards of discharge
will occur below the ordinary high water mark. The outlets of the dams will
utilize low -flow cool water design strategies.
The subject stream is mapped as an unnamed intermittent tributary to the
Yadkin River which has approximately 90 acres of drainage. The NC Division
of Water Quality has classified the Yadkin River as Class WSIV waters. The
subject stream has been assessed using the Stream Quality Assessment
Worksheet (USACE Wilmington, Version 06/03) based on prior land use and

Lissara IP Narratives
June 15, 2005
forested cover. The entirety of the stream at the Pond 1 has excess
sediment load. The stream is generally in poor to good condition.
Lissara Development Impact Table
IMPACT TYPE
Pond 1
Pond 2
Pond 3
Stream Filling
520 If (191 cy)
262 If (25 cy)
256 If (24 cy)
Waters Fillip
.08*
.03*
.02*
Waters Flooding
.83*
.04*
.03*
Perennial Flooding
4366
348
75
Intermittent Flooding
1514
134
277
* acreages are inclusive of stream surface area

Lissara IP Narratives
June 15, 2005
Avoidance and Minimization
The proponents have identified a need to create a lake based development
for water skiing using vintage water craft as well as competitive ski craft.
The proponents first evaluated other properties with lakes and found that
none with the dimensional and development requirements were for sale. The
dimensional requirements are necessary to ensure safe use of the lake. The
development requirements limit access to the general public and the lake
needs to meet all current dam safety requirements.
Topographical limitations and regional ground / surface water discharges
limit the ability of the proponent to excavate a lake of the required
dimensions into a floodplain or other flat area and achieve the project need.
The proposed site does not require excessive grading impacts and because
the lakes will impact all the stream length in the drainage there are limited
concerns relating to the upstream migration of aquatic organism.
One pond is required as a sediment control devise and is located such that all
sediment can be dipped from the structure without lowering the lake
elevation. This is required so as not to interfere with the use of the lake.
The aesthetic pond is needed to provide increased revenue to off -set the
capital cost of the project and to enhance the overall theme of the
development.
The proponent has avoided hard impacts to the greatest extent practicable
by situating the dam at its proposed location and by proposing a low -flow
cool -water riser -pipe structure. The proponent evaluated reducing the
flooded reach by moving the dam upstream. The unintended consequence is
that more hard impacts would be required for the dam. Impacts requiring
discharges to Waters of the US are limited to the construction of the dam
which will create additional regulated Waters of the US. The predominant
impacts of the project to streams are secondary in nature and result from
flooding.
The proponent considered alternative development concepts and determined
that the uniqueness of the current proposal provided the best potential for
success.

Lissara IP Narratives
June 15, 2005
Cumulative impacts resulting from the proposed project are minimized
through the reduction in scope and through design considerations including:
• Engineered low -flow cool -water discharge orifice
• Establishment of vegetated buffers along the lake shore

Lissara IP Narratives
June 15, 2005
Mitigation Proposal
Summary:
Wetlands and streams not impacted by the proposed development as well as
those areas restored and created under this proposal will be preserved
under a permanent protective covenant. Stream mitigation will be
accomplished through the NC Ecosystem Enhancement Program (NC EEP).
Wetlands:
Wetland impacts are below the mandated threshold for mitigation as
required by the NC Division of Water Quality. Though there is no specific
mandate for wetland mitigation the applicant will be off -setting the surface
area impacts to streams with the surface area of the impoundment. The
loss of 0.86 acres of stream surface area will be mitigated by the creation
of over 30 acres of surface waters.
Streams:
Stream impacts can be separated into two separate classes that merit
differing mitigation ratios based upon the effect of the discharge and
subsequent flooding. Impacts resulting from the construction of the
impoundment result in a permanent loss of waters while impacts associated
with flooding result in a net increase in regulated Waters of the U5.
The dam incorporates design elements that ensure that water quality will be
protected through a low -flow cool -water / aerating discharge.
Stream Mitigation Proposal for Secondary Impacts
Secondary impacts to stream will result from the flooding of a poor to good
quality stream. The flooding will alleviate sediment load from failing banks.
Stream restoration is proposed at a 0.5 to 1 ratio through the NC EEP for
the flooding impacts because they are secondary impacts to lower quality
streams. The ratio is in consideration of additional mitigative measures such
as design considerations.
Required Secondary Impact Mitigation Table
(0.5:1 Rntin Anrdiarl)
Pond 1
Pond 2
Pond 3
Total
Mitigation for Flooding
2183 If
174 If
38 If
2395 If

Lissara IP Narratives
June 15, 2005
Proposal for Primary Impacts
Primary (hard) impacts to streams and wetlands resulting from the
impoundment structure will be mitigated at a 1;1 ratio. The applicant
proposed to participate within the NC EEP for these impacts because the
onsite mitigation opportunities are non-existent
Required Primary Impact Mitigation Table
(1:1 Ratio Applied)
Onsite Mitigative Treatments and Restoration Plan
Within 90 days of the approval of the restoration plans the applicant will
provide to the US Army Corps of Engineers a plat that depicts the
preservation areas and the restrictive language.
Off -Site Mitigation Alternative / Ecosystem Enhancement Program
The proponent is seeking to mitigate through the NC EEP for all impacts.
Concurrently, the applicant is contemplating the preservation of 22,000
linear feet of stream channels in the vicinity of the project through the
establishment of conservation easements. The preserved streams will have
vegetated buffers and stable bed and bank.
Lake
Storm Facility
Pond
Total
Stream Filling520
If
262 If
256 If
1038 If
Onsite Mitigative Treatments and Restoration Plan
Within 90 days of the approval of the restoration plans the applicant will
provide to the US Army Corps of Engineers a plat that depicts the
preservation areas and the restrictive language.
Off -Site Mitigation Alternative / Ecosystem Enhancement Program
The proponent is seeking to mitigate through the NC EEP for all impacts.
Concurrently, the applicant is contemplating the preservation of 22,000
linear feet of stream channels in the vicinity of the project through the
establishment of conservation easements. The preserved streams will have
vegetated buffers and stable bed and bank.

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USACE AID# DWQ # Site # (indicate on attached
t STREAM QUALITY ASSESSMENT WORKSHEET
Provide the following information for the stream reach under assessment:
1. Applicant's name: &-A-A)(7 W jLQ4 2. Evaluator's name: 6-I&S j4(,)�JS�
3. Date of evaluation: M Gk A(_o 3 h Z C '� 57- 4. Time of evaluation: Dvol�
5. Name of stream: J11) YJ vV V-\ V 1:.12 6. River basin: vIAD V v'V
7. Approximate drainage area: PT�l 8. Stream order:
9. Length of reach evaluated:
11. Site coordinates (if known):
10. County:
12. Subdivision name (if any):_i,(�
13. Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location):
<� G�--'�\D
14. Proposed channel work (if any): ( �-AOj
15. Recent weather conditions: - % V2 --
16.
Z
16. Site conditions at time of visi
17. Identify any special waterway classifications known: _Section 10 _Tidal Waters Essential Fisheries Habitat
_Trout Waters _Outstanding Resource Waters Nutrient Sensitive Waters _Water Supply Watershed (I-IV)
18. Is there a pond or lake located upstream of the evaluation point? YES (NO) If yes, estimate the water surface area:
19. Does channel appear on USGS quad map? 6 NO 20. Does
channel appear on USDA Soil Survey? (om) NO
21. Estimated watershed land use: _% Residential _% Commercial _% Industrial _% Agricultural
� 0-2-3 % Forested % Cleared / Logged _% Other
22. Bankfull width: y —I
23. Bank height (from bed to top of bank): Z � �- S t
24. Channel slope down center of stream: _Flat (0 to 2%) _Gentle (2 to 4%) )x_Moderate (4 to 10%) _Steep (>10%)
25. Channel sinuosity: Straight _Occasional bends %< Frequent meander _Very sinuous _Braided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality.
Total Score (from reverse). Comments:

STREAM QUALITY ASSESSMENT WORKSHEET 01r�4- G
ese charactenstics are not assessed in coastal streams.
U0
#
CHARACTERISTICS
ECOREGION POINT
RANGE
Coastal
Piedmont
Mountain
SCORE
1
Presence of flow / persistent pools in stream
no flow or saturation = 0• strongflow = max points)�0
= 5
0 — 4
2
Evidence of past human alteration
0-6
extensive alteration = 0• no alteration = max points)�0
0 — 5
—
13
3
Riparian zone
�60
4
no buffer = 0• contiguous, wide buffer = max points)
—
(0 —5
4
Evidence of nutrient or chemical discharges
0 �)
-
extensive discharges = 0• no discharges = max points)
0-4
0
d
5
Groundwater discharge
0 — 3--)
0-4
U
no discharge = 0 springs, wetlands, etc. = max
6
Presence of adjacent floodplain
— 4
0-4
6
no floodplain = 0• extensive flood lain = maxpoints)
(0
--22
Z
a''
Entrenchment / floodplain access
0 — 5 ..
0 _ 4
0 — z�
(deeply entrenched = 0. fre uent floodin = max ints
/
8
Presence of adjacent wetlands
(no wetlands = 0; large adjacent wetlands = maxpoints)
0-. 6
0-4
9
Channel sinuosity
`
0 = 5.
0-4
J
extensive channelization = 0• natural meander = maxpoints)
10
Sediment input
extensive deposition= 0• little or no sediment = max points)
K'V 5'
0-4
0
11
Size die diversity of channel bed substrate
fine, homo enous = 0• lar e, diverse sizes = max ints
*.__
NA
0-4
(\
12
Evidence of channel incision or widening`0
_ 5
�+
(deeply incised = 0; 8t stable bed banks = max ints
0 — 4
5
j��
13
Presence of major bank failures
0-5=5
a0-5.�
severe erosion = 0• no erosion, stable banks =max ints
Z,
14
Root depth and density on banks
no visible roots = 0; ro dense roots thout = max points)3
0 — 4
— 5
C)
15
Impact by agriculture, livestock, or timber production
0-51-)
0-4
substantial impact =0• no evidence = max points
16
Presence of riffle-pool/ripple-pool complexes
b 3
no ri$les/ri les or is = 0• well-developed= max ints)
_
0-5
0` 6
4H
17
Habitat complexity
F.�(little
or no habitat = 0frequent,varied habitats =max
0 6
0-6
0—
18
Canopy coverage over streambed
���
0
no shadingvegetation = 0; continuous canopy= max ints)
— 5'
0
19
Substrate embeddedness
dee lv embedded = 0: loose structure = max)N�
,�
0-4
— 4
Z
20
Presence of stream invertebrates (see page 4)
\
no evidence = 0• common, numerous types = maxpoints)
0 —
0 — 5
G7
21
Presence of amphibians
no evidence = 0• common, numerous = max points)
0� 4
0 — 4
0 —
22
Presence of fish
no evidence = 0• common, numerous = max ints
0 —
0-4
�`4
C�
�
23
Evidence of wildlife use
0�1-6
0-5
no evidence = 0• abundant evidence = maxpoints)
Total Points Possible
100
00
TOTAL SCORE (also enter on first page)j
ese charactenstics are not assessed in coastal streams.
U0

STREAM QUALITY ASSESSMENT WORKSHEETOV-\�It * 05;;-
t)�PP2 r Laft-
„CZ)c Waraciensucs are not assessea in coastal sueams.
#
CHARACTERISTICS
- - -
ECOREGION POINT RANGE
,,-
Coastal
Piedmont
Mountain
SCORE
1
Presence of flow / persistent pools in stream
0-4
no flow or saturation = 0; strop flow = max ints
2
Evidence of past human alteration
0 5
--'
�Q
(extensive alteration = 0-, no alteration = max ints
%�
-
- 5
3
Riparian zone
Lp—
no buffer = 0• contiguous, wide buffer = max ints)
0- 4
0- 5
7
4
Evidence of nutrient or chemical discharges
extensive discharges = 0• no discharges = maxpoints)
-5
0-4
5
Groundwater discharge
U
no dischar e = 0 rips s, wetlands. etc.= max
0 -
0-4
`- 4
)
6
Presence of adjacent floodplain
A
%2
no floodplain = 0; extensive floodplain = max points)
0-4
p''
Entrenchment / floodplain access
0
0-4
J>
deet entrenched = 0; fr uent floodin = max ints
0,. Z
8
Presence of adjacent wetlands
no wetlands = 0; large adjacent wetlands = max points)
0
0- 4
0_
9
Channel sinuosity
�
0-4
extensive channelization = 0; natural meander = max points)015
i
10
Sediment input
t-5
0 — 4
�A
extensive deposition= 0; little or no sediment = max points)
11
Size & diversity of channel bed substrate
Z
fine, he -no enous = 0- lar e, diverse sizes = max ints
A*
0 — 4
0 —
i
12
Evidence of channel incision or widening -
0'_'5)
0-4
5
(deeply incised = 0• stable bed & banks = max ints
Z
13
Presence of major bank failures
a
severe erosion = 0• no erosion,stable banks = maxints
- 5
0 - 5
- 5
14
Root depth and density on banks
"
0-4
0 j
no visible roots = 0• dense roots out = max ints
�"
�`
15
Impact by agriculture, livestock, or timber production
substantial impact =0- no evidence = max points)
0-
0-4
0-
1
16
Presence of riffle-pooUripple-pool complexes
0,
0
no riffles/ripples or pools = 0, well-developed= maxpoints)
0 - 5
17
Habitat complexity
little or no habitat ,= 0 frequent varied habitats = max
0- 6
0-6
0 6
18
Canopy coverage over streambed
Q_ 5
no shading vegetation = 0; continuous canopy = maxpoints)
0-5
19
Substrate embeddednessA*
(deeply embedded = 0, loose structure = max
0-4
0
20
Presence of stream invertebrates (see page 4)
no evidence = 0• common,numerous types = maxpoints)
0-"
0 - 5
- 5
GJ
21
Presence of amphibians
\
0-4
no evidence = 0. common,numerous = max points)
O
22
Presence of fish
0 %
0-4
00
no evidence = 0• common, numerous = max points)
�.
23
Evidence of wildlife use
no evidence = 0• abundant evidence = maxpoints)
0-6
0-5
i
Total Points Possible
100
100
a00
TOTAL SCORE (also enter on first page)
„CZ)c Waraciensucs are not assessea in coastal sueams.

LL- C)
STREAM QUALITY ASSESSMENT WORKSHEET'` U�
I 1 -se chmaciensucs are not assessed in coastal streams.
#
CHARACTERISTICS
ECOREGION POINT RANGE
Coastal
Piedmont
Mountain
SCORE
1
Presence of flow / persistent pools in stream
no flow or saturation = 0, stron m
flow = ax ints
0
0 — 4
-�,5
2
Evidence of past human alteration
0 7
0-5
extensive alteration = 0; no alteration = maxpoints)
3
Riparian zone
no buffer = 0• contiguous, wide buffer = max points)r
0— 6)
0— 4
— 5
4
Evidence of nutrient or chemical discharges
extensive discharges = 0; no disc es = max points
0 _
0-4
0
5
Groundwater discharge
U
no discharge = 0; springs, m
wetlands, etc. = ax
— 3
0— 4
0—
6
Presence of adjacent floodplain
no floodplain = 0; extensive fl lain = max rots
0
0 —4
::1;—
Entrenchment / floodplain accessa" dee 1 y entrenched = 0: fre uent floodin = max ints
0'S,0-4
%J
8
Presence of adjacent wetlands '
(no wetlands = 0: large adjacent wetlands = maxpoints)
—6
!
0-4 —4
0 —
9
Channel sinuosity
0-5
0-4
— 3
extensive channelization = 0: natural meander = max points)
/
10
Sediment input
6-5
0-4
extensive deposition= 0, little or no sediment = max rots
-\'t
C�
11
Size & diversity of channel bed substrate
NA-)
0-4
fine, homogenous = 0• large, diverse sizes = max points)r
1
0
12
Evidence of channel incision or widening -
0
dee 1 incised = 0; stable bed & banks = max points)
--5,�
0-4
p —�
Presence of major bank failures
a13
severe erosion = 0• no erosion, stable banks = max points)06-5--
0 — 5
=5
`(^ '
14
Root depth and density on banks
5
E.
no visible roots = 0; dense roots thro out = max ints
0-3
0 — 4
—
15
I t b
Impact agriculture, livestock, or timber production
0(50-4
substantial impact =0; no evidence =max rots
0�
16
Presence of riffle-pool/ripple-pool complexes
no riffles/ripples les or is = 0; well-developed = max points)
0-5
17
Habitat complexity
little
— 6
0-6
/
<Q — 6
or no habitat = 0 frequent,0
varied habitats = max
.3
18
Canopy coverage over streambed
_ 5
0-5
no shadingvegetation = 0; continuous canopy= max ints)
0
19
Substrate embeddedness
d 1 embedded = 0• loose structure = max
N*
0— 4
0— 4
I
20
Presence of stream invertebrates (see page 4)
no evidence = 0• common,numerous types = maxpoints)
0-4
0-5
5
r
21
Presence of amphibians
no evidence = 0• common. numerous types = maxpoints)
0 — 4
0—
�O
22
Presence of fish
no evidence = 0; common. numerous = max points)��
0-4
0
E23
Evidence of wildlife use
0 — 6)
0-5
no evidence = 0• abundant evidence = max points)
Total Points Possible'
100
100
100
TOTAL`_.,
SCORE (also enter on first page)
I 1 -se chmaciensucs are not assessed in coastal streams.

DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Determination Manual)
Project / Site: Shallowford Road
Date: March 2005
Applicant/ Owner: Lanq Wilcox
County: Forsyth
Investigator: Huysman
State: North Carolina
Do normal circumstances exist on the site? Yes ® No ❑
Community ID:slough
Is the site significantly disturbed (Atypical situation)? Yes ❑ No ®
Transect ID:
Is the area a potential problem area? Yes ❑ No ®
Plot ID: 100's & 300's
(explain on reverse if needed)
OBL tree
VEGETATION
Dominant Plant Species
Indicator Stratum
Dominant Plant Species
Indic o Stratum
1. Acer rubrum
FAC tree
9. Alnus serrulata
FACW+ sapling
2. Acer negundo
FACW tree
10. Viburnum nudum
FACW+ shrub
3. Salix nigra
OBL tree
11. Woodwardia areolata
OBL herb
4.
❑ Drainage Patterns in Wetlands
12.
Secondary In
5.
® Oxidized Roots Channels in Upper 12"
13.
® Water -Stained Leaves
6.
❑ Local Soil Survey Data
❑ FAC -Neutral Test
14.
❑ Other (Explain in Remarks)
7.
15.
8.
16.
Percent of Dominant Species that are OBL, FACW, or FAC excluding FAC-).
100
Remarks:
HYDROLOGY
❑ Recorded Data (Describe In Remarks):
Wetland Hydrology Indicators
❑ Stream, Lake, or Tide Gauge
❑ Aerial Photographs
Primary Indicators:
❑ Other
® Inundated
® Saturated in Upper 12"
❑ No Recorded Data Available
❑ Water Marks
❑ Drift Lines
Field Observations:
❑ Sediment Deposits
❑ Drainage Patterns in Wetlands
Depth of Surface Water: 2 (in.)
Secondary In
Depth to Free Water in Pit: (in.)
® Oxidized Roots Channels in Upper 12"
® Water -Stained Leaves
Depth to Saturated Soil: (in.)
❑ Local Soil Survey Data
❑ FAC -Neutral Test
❑ Other (Explain in Remarks)
Remarks:

DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Determination Manual)
Project / Site: Shallowford Road
Date: March 2005'
Applicant / Owner: Lang Wilcox
County: Forsythe
Investigator:±1 an
State: North Carolina
Do normal circumstances exist on the site? Yes ® No ❑
Community ID:Mesic
Is the site significantly disturbed (Atypical situation)? Yes ❑ No ®
Transect ID:
Is the area a potential problem area? Yes ❑ No ®
Plot ID:
(explain on reverse if needed)
vine
VEGETATION
Dominant Plant Species
Indicator Stratum
Dominant Plant Species
Indicator Stratum
1. Liriodendron tulipifera
FAC tree
9. Toxicodendron redicans
FAC
vine
2. Acer negundo
FACW tree
10. Vitis spp.
FAC
vine
3. Fagus grandifolia
FACU tree
11. Eulalia viminea
FAC+
herb
4. Quercus alba
FACU tree
12. Polystichum acrostichoides FAC
herb
5.
Depth to Saturated Soil: + 48 (in.)
13.
❑ Other (Explain in Remarks)
6.
14.
7.
15.
8.
16.
Percent of Dominant Species that are OBL, FACW, or FAC excluding FAC-).
50%
Remarks:
HYDROLOGY
❑ Recorded Data (Describe In Remarks):
Wetland Hydrology Indicators
❑ Stream, Lake, or Tide Gauge
❑ Aerial Photographs
Primary Indicators:
❑ Other
❑ Inundated
❑ Saturated in Upper 12"
® No Recorded Data Available
❑ Water Marks
❑ Drift Lines
Field Observations:
❑ Sediment Deposits
❑ Drainage Patterns in Wetlands
Depth of Surface Water: none (in.)
Secondary Indicators:
Depth to Free Water in Pit: + 48 in.)
❑ Oxidized Roots Channels in Upper 12"
❑ Water -Stained Leaves
Depth to Saturated Soil: + 48 (in.)
❑ Local Soil Survey Data
❑ FAC -Neutral Test
❑ Other (Explain in Remarks)
Remarks: No indicators

SOILS
Map Unit Name
(Series and Phase): Wehadkee
Drainage Class: Poorly drained
Taxonomy (Subgroup): (We) Typic Fluvaquents
Confirm Mapped Type? Yes ❑ No
Profile Description:
Depth Matrix Colors Mottle
Colors Mottle Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munsell
Moist) Abundance/Contrast Structure, etc.
0-10 A 10YR 5/2
/ sandy clay loam
10-15 B .10YR 5/1
/ sandy clay loam
/
Hydric Soil Indicators:
❑ Histosol
❑ Concretions
❑ Histic Epipedon
❑ High Organic Content in Surface Layer in Sandy Soils
® Sulfidic Odor
❑ Organic Streaking in Sandy Soils
❑ Aquic Moisture Regime
❑ Listed On Local Hydric Soils List
❑ Reducing Conditions
❑ Listed on National Hydric Soils List
® Gleyed or Low-Chroma Colors
❑ Other (Explain in Remarks)
Remarks:
•�/ttT
.. V a V�fl\V V V I Vl urn I'mr% 1 wlr
Hydrophytic Vegetation Present? Yes ® No ❑
Wetland Hydrology Present? Yes ® No ❑
Hydric Soils Present? Yes ® No ❑
Is the Sampling Point
Within a Wetland? Yes ® No ❑
Remarks: Representative of wetlands within
the floodplain of the main tributary. These are
small areas of approximately 100 sq ft each and
are assessed to be old sloughs.
rnv 1 v / UOU0 / I41`1l.J
r7r,
�Jrr/r!J W Mil
61
110!
7,11si 'ZeAu
r,
Approximate Scale: 1 to 1000
Clemmons Quadrangle

SOILS
Map Unit Name
(Series and Phase):
Drainage Class:
Taxonomy (Subgroup): Confirm Mapped Type? Yes ❑ No ❑
Profile Description:
Depth Matrix Colors
(inches) Horizon (Munsell Moist)
Mottle Colors Mottle Texture, Concretions,
(Munsell Moist) Abundance/Contrast Structure, etc.
0-10 A 10YR 5/4
/ sandy clay loam
10-15 B 10YR 7/5
/ clay loam
Hydric Soil Indicators:
❑ Histosol
❑ Concretions
❑ Histic Epipedon
❑ High Organic Content in Surface Layer in Sandy Solis
❑ Sulfidic Odor
❑ Organic Streaking In Sandy Soils
❑ Aquic Moisture Regime
❑ Listed On Local Hydric Soils List
❑ Reducing Conditions
❑ Listed on National Hydric Soils List
❑ Gleyed or Low-Chroma Colors
❑ Other (Explain in Remarks)
Remarks: not a hydric soils
WFTI Ahln nS:r=of r1n r n1
�..
Hydrophytic Vegetation Present? Yes ❑ No ❑
Wetland Hydrology Present? Yes ❑ No ❑
Hydric Soils Present? Yes ❑ No ❑
Is the Sampling Point
Within a Wetland? Yes ❑ No ❑
Remarks: adiacent slopes are high ground
rnv I v / U / NHGS

Bank Material
Within the proposed flooded reach
the banks of the stream are
comprised primarily of highly
erodable saprolite and weathered
rock. Stream bed appears to have
excess bedload based on preliminary
d50 assessment
Instability
Within the proposed flooded
reaches are numerous areas with
high degrees of instability resulting
from a combination of bank
materials and historic land use.
Erosion is occurring below the root
zo ne and trees are f al I i ng i nto the
stream
Grade Control
Good grade control is present at the
upstream locations of the proposed
ponds. Grade control, in the form of
boulders stabilize the upstream
reaches but undercutting below the
root zone is evident immediately
below the grade control.

APPLICATION FOR DEPARTMENT OF THE ARMY PERMIT [L e OMB APPROVAL N 710-0003
(33 CFR 325) J Expires December 3 4
.The Public burden for this collection of information is sestimated to average 10 hours per response, although the majority of applications d re a
5 hours or less. This includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data nee and
completing and reviewing the collection of information. Send comments regarding this burden estimate or any other'aped of this to e e ,a ;
information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Service Directorate of Infof>�$�jon D
Operations and Reports. 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302; and to the Office of Management and Bu `tzi
Paperwork Reduction Project (0710-00031, Washington. DC 20503. Respondents should be aware that notwithstanding any other provision 0
no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB can G f
number. Please DO NOT RETURN your form to either of those addresses. Completed applications must be submitted to the District Engineer
jurisdiction over the location of the proposed activity. qn
PRIVACY ACT STATEMENT
Authorities: Rivers and Harbors Act. Section 10, 33 USC 403; Clean Water Act, Section 404, 33 U rinft arch and `L -
Sanctuaries Act, 33 USC 1413, Section 103, Principal Purpose: Information provided on this form I n aplication for a
permit. Routine Uses: This information maybe shared with the Department of Justice and other fe ra ate and m ni agencies.
Submission of requested information is voluntary, however, if Information is not provided the permit pp nnnor can a pertrtit
be issued.
One set of original drawings or good reproducible copies which show the location and character of the proposed activity must be attached to this f.
application (see sample drawings and instructions) and be submitted to the District Engineer having jurisdiction over the location of the proposed
activity. An application that is not completed in full will be returned.
/!TENS 1 THRU 4 TO BE FILLED BY THE CogpSj
APPLICATION NO. 2. FIELD OFFICE CODE 3. DATE RECEIVED
5. APP ICANT'S AME
'f7G
6. APPLICANT'S ADDRESS
Ll -Vv WSJ � I.L.C; tiC, Z�G Z3
4. DATE APPLICATION COMPLETED
S. AUTHORIZED AGENT'S NAME AND TITLE ry wgenr is nor re�unedl
9. AGENT'S ADDRESS
PCS p,GX ZZs,
AP'MJLAN 1'3 PHONE NOS. W/AREA CODE 10. AGENT'S PHONE NOS. W/AREA CODE
a. Residence a. Residence
b. Business ��� c�( tq /�/\ 4S✓ I b. Business SLU '�'� � v l'Z
STATEMENT OF AUTHORIZATION
I hereby authorize, ! I �� i to act in my behalf as my agent in the processing of this application and to
rurnish, upon request, supplemental information in support of this permit application.
LSS i2\P-,, V 0- ! ELCO\^C v i
13. NAME OF WATERBOOY, IF KNOWN of np w, wej 1 14. PROJECT STREET ADDRESS ui�Pa—bi�i
15. LOCATION OF PROJECT
COUNTY STATE
'6. OTHER LOCATION DESCRIPTIONS, IF KNOWN, ts"e mxri n,i
17. DIRECTIONS TO THE SITE
JulENG FORM 4,345, 7 EDITION OF FEB 94 IS OBSOLETE.
(Proponent: CECW-OR)

1 B. Nature of Activity (D—mprron or prorecT, rndrrae sN t",_w
a'F
19. Project Purpose rDesaree me reason or pwpose of me prat cr, see nutnrcno mj
USE BLOCKS 20-22 IF DREDGED AND/OR FILL MATERIAL IS TO BE DISCHARGED
20. Reason(s) for Discharge
21. Type(s) of Material Being Discharged and the Amount of Each Type in Cubic Yards
22. Surface Area in Acres of Wetlands or Other Waters Filled /see .mrrurnamr
23. Is Any Portion of the Work Already Complete? Yes - No y IF YES, DESCRIBE THE COMPLETED WORK
c„
24. Addresses of Adjoining Property Owners, Lessees, Etc., Whose Property Adjoins the Waterbody (If more than can be entered here,
please attach a supplemental list).
)`uLi
�l\ VVI<(L`\
L�5�
25, List of Other Certifications or ApprovaWDenials Received from other Federal, State or Local Agencies for Work Described in This Application.
AGENCY TYPE APPROVAL' IDENTIFICATION NUMBER DATE APPLIED DATE APPROVED DATE DENIED
'Would _include but is not restricted to zoning, building and flood plain permits
28. Application is hereby made for a permit or permits to authorize the work described in this application. I certify that the information in this
application is complete and accurate. I further certi4ATE
sess the a to undertake the work described herein or am acting as the
dulyZ�7
tof applicant.
SIGNATURE OFA SIGNATURE OF AG T DATE
The application must be signed by erson who desires to undertake the proposed activity (applicant) or it may be signed by a duly
authorized agent if the statement i lock 11 has been filled out and signed.
18 U.S.C. Section 1001 provides that: Whoever, in any manner within the jurisdiction of any department or agency of the United States
knowingly and willfully falsifies, conceals, or covers up any triak; scheme, or disguises a material fact or makes any false, fictitious or
fraudulent statements or representations or makes or uses any false writing or document knowing same to contain any false, fictitious or
fraudulent statements or entry, shall be fined not more than $ 10,000 or.imprisoned not more than five years or both.

Lissara IP Narratives
June 15, 2005
Pro ject Purpose and Need
Lissara LLC, the project proponent, proposes to construct a 28 acre
recreational and water skiing lake, an aesthetics pond and a stormwater
management facility in conjunction with development of the Lissara
subdivision in Forsyth County, North Carolina. There are no other property
owners that adjoin the waterbody that will be impacted.
The proponent needs the lake to provide the central recreational amenity
for the project which proposed the use of both vintage and competitive ski
boats to provide opportunities that are not available in the immediate
proximity. The ski lake should be long enough (2400 linear feet) and wide
enough (300 linear feet) to provide the competitive and novice skier and the
opportunities to practice their skills on smooth water without safety
concerns related to other crafts which are so prolific on public lakes. The
ski lake needs to be located entirely on the project area so as to limit
access.
The proponent further seeks to construct a stormwater management facility
on a perennial stream to limit the inflow of sediment to the proposed ski
lake. This sediment removing structure needs to be located upstream of the
ski lake and needs to be able to be dipped from high ground without lowering
the ski lakes pool. An aesthetics lake is proposed and is needed to offset
infrastructure costs associated with the development.
The impacted streams will be diverted while the clean fill is discharged into
the stream to construct the dams. All three dam will be constructed with
3:1 side slopes. The trapezoidal bases of the dams will impact a total of
1038 feet of linear streams. Approximately 240 cubic yards of discharge
will occur below the ordinary high water mark. The outlets of the dams will
utilize low -flow cool water design strategies.
The subject stream is mapped as an unnamed intermittent tributary to the
Yadkin River which has approximately 90 acres of drainage. The NC Division
of Water Quality has classified the Yadkin River as Class WSIV waters. The
subject stream has been assessed using the Stream Quality Assessment
Worksheet (USACE Wilmington, Version 06/03) based on prior land use and

Lissara IP Narratives
June 15, 2005
forested cover. The entirety of the stream at the Pond 1 has excess
sediment load. The stream is generally in poor to good condition.
Lissara Development Impact Table
IMPACT TYPE
Pond 1
Pond 2
Pond 3
Stream Filling
520 If (191 cy)
262 If (25 c)
256 If (24 cy)
Waters Filling
.08*
.03*
.02*
Waters Flooding
.83*
.04*
.03*
Perennial Flooding
4366
348
75
Intermittent Flooding
1514
134
277
* acreages are inclusive of stream surface area

Lissara IP Narratives
June 15, 2005
Avoidance and Minimization
The proponents have identified a need to create a lake based development
for water skiing using vintage water craft as well as competitive ski craft.
The proponents first evaluated other properties with lakes and found that
none with the dimensional and development requirements were for sale. The
dimensional requirements are necessary to ensure safe use of the lake. The
development requirements limit access to the general public and the lake
needs to meet all current dam safety requirements.
Topographical limitations and regional ground / surface water discharges
limit the ability of the proponent to excavate a lake of the required
dimensions into a floodplain or other flat area and achieve the project need.
The proposed site does not require excessive grading impacts and because
the lakes will impact all the stream length in the drainage there are limited
concerns relating to the upstream migration of aquatic organism.
One pond is required as a sediment control devise and is located such that all
sediment can be dipped from the structure without lowering the lake
elevation. This is required so as not to interfere with the use of the lake.
The aesthetic pond is needed to provide increased revenue to off -set the
capital cost of the project and to enhance the overall theme of the
development.
The proponent has avoided hard impacts to the greatest extent practicable
by situating the dam at its proposed location and by proposing a low -flow
cool -water riser -pipe structure. The proponent evaluated reducing the
flooded reach by moving the dam upstream. The unintended consequence is
that more hard impacts would be required for the dam. Impacts requiring
discharges to Waters of the US are limited to the construction of the dam
which will create additional regulated Waters of the US. The predominant
impacts of the project to streams are secondary in nature and result from
f looding.
The proponent considered alternative development concepts and determined
that the uniqueness of the current proposal provided the best potential for
success.

Lissara IP Narratives
June 15, 2005
Cumulative impacts resulting from the proposed project are minimized
through the reduction in scope and through design considerations including:
• Engineered low -flow cool -water discharge orifice
• Establishment of vegetated buffers along the lake shore

Lissara IP Narratives
June 15, 2005
Mitigation Proposal
Summary:
Wetlands and streams not impacted by the proposed development as well as
those areas restored and created under this proposal will be preserved
under a permanent protective covenant. Stream mitigation will be
accomplished through the NC Ecosystem Enhancement Program (NC EEP).
Wetlands:
Wetland impacts are below the mandated threshold for mitigation as
required by the NC Division of Water Quality. Though there is no specific
mandate for wetland mitigation the applicant will be off -setting the surface
area impacts to streams with the surface area of the impoundment. The
loss of 0.86 acres of stream surface area will be mitigated by the creation
of over 30 acres of surface waters.
Streams:
Stream impacts can be separated into two separate classes that merit
differing mitigation ratios based upon the effect of the discharge and
subsequent flooding. Impacts resulting from the construction of the
impoundment result in a permanent loss of waters while impacts associated
with flooding result in a net increase in regulated Waters of the U5.
The dam incorporates design elements that ensure that water quality will be
protected through a low -flow cool -water / aerating discharge.
Stream Mitigation Proposal for Secondary Impacts
Secondary impacts to stream will result from the flooding of a poor to good
quality stream. The flooding will alleviate sediment load from failing banks.
Stream restoration is proposed at a 0.5 to 1 ratio through the NC EEP for
the flooding impacts because they are secondary impacts to lower quality
streams. The ratio is in consideration of additional mitigative measures such
as design considerations.
Required Secondary Impact Mitigation Table
(0.5:1 Rntin Annlic d)
Pond 1
Pond 2
Pond 3
Total
Mitigation for Flooding
2183 If
174 If
38 If
2395 If

Lissara IP Narratives
June 15, 2005
Proposal for Primary Impacts
Primary (hard) impacts to streams and wetlands resulting from the
impoundment structure will be mitigated at a 1:1 ratio. The applicant
proposed to participate within the NC EEP for these impacts because the
onsite mitigation opportunities are non-existent
Required Primary Impact Mitigation Table
(1:1 Ratio Applied)
Onsite Mitigative Treatments and Restoration Plan
Within 90 days of the approval of the restoration plans the applicant will
provide to the US Army Corps of Engineers a plat that depicts the
preservation areas and the restrictive language.
Off -Site Mitigation Alternative / Ecosystem Enhancement Program
The proponent is seeking to mitigate through the NC EEP for all impacts.
Concurrently, the applicant is contemplating the preservation of 22,000
linear feet of stream channels in the vicinity of the project through the
establishment of conservation easements. The preserved streams will have
vegetated buffers and stable bed and bank.
Lake
Storm Facility
Pond
Total
Stream Filling
520 If
262 If
256 If
1038 If
Onsite Mitigative Treatments and Restoration Plan
Within 90 days of the approval of the restoration plans the applicant will
provide to the US Army Corps of Engineers a plat that depicts the
preservation areas and the restrictive language.
Off -Site Mitigation Alternative / Ecosystem Enhancement Program
The proponent is seeking to mitigate through the NC EEP for all impacts.
Concurrently, the applicant is contemplating the preservation of 22,000
linear feet of stream channels in the vicinity of the project through the
establishment of conservation easements. The preserved streams will have
vegetated buffers and stable bed and bank.

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jshown on black
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oao° 127'io. o" div 1 1 1 1 osb° 26' ao.00° IW. �:.I 1 080-126"0.00"W
Name: CLEMMONS Location: 860546 ft. N 1573011 ft. E
Date: 6/13/2005 Caption: Lissara
Scale: 1 inch equals 1000 feet
Copyright (C) 1998, Maptech, Inc

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USACE AID# DWQ # Site # (indicate on attached
al
STREAM QUALITY ASSESSMENT WORKSHEET
Provide the following information for the stream reach under assessment:
1. Applicant's name: _iA,r )67 jA% 1( 6,/) y
3. Date of evaluation:�6kA(_ t LF , -LC0 5-
5. Name of stream: VF y V � 1 t -t) Va vV L;12
7. Approximate drainage area: *I- (�C l�
9. Length of reach evaluated:
11. Site coordinates (if known):
;�pAP9 p
a
2. Evaluator's name:
4. Time of evaluation: Oyol'
6. River basin: AA-) V--tv'V
8. Stream order:
10. County:
12. Subdivision name (if any):
13. Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location):
14. Proposed channel work (if any): Lt�\l7) =L��
15. Recent weather conditions:- YZ
16. Site conditions at time of visit:
17. Identify any special waterway classifications known: _Section 10 _Tidal Waters _Essential Fisheries Habitat
_Trout Waters _Outstanding Resource Waters _ Nutrient Sensitive Waters _Water Supply Watershed (I-IV)
18. Is there a pond or lake located upstream of the evaluation point? YES(NO) If yes, estimate the water surface area:
19. Does channel appear on USGS quad map? YF NO 20. Does
channel appear on USDA Soil Survey? Com, NO
21. Estimated watershed land use: _% Residential _% Commercial _% Industrial _% Agricultural
% Forested _% Cleared / Logged _% Other
22. Banldiill width: y 23. Bank height (from bed to top of bank): Z — S
24. Channel slope down center of stream: _Flat (0 to 2%) _Gentle (2 to 4%) Moderate (4 to 10%) _Steep (>10%)
25. Channel sinuosity: Straight Occasional bends X Frequent meander _Very sinuous _Braided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality
Total Score (from reverse)._ Comments:

STREAM QUALITY ASSESSMENT WORKSHEET 0� 14- 0-'-
1--'l Wti > r' :._- t-,- / f �A V L
These charactensucs are not assessed in coastal streams.
U0
#
CHARACTERISTICS
ECOREGION POINT RANGE
Coastal
Piedmont
Mountain
-
SCORE
1
Presence of flow / persistent pools in stream
-
no flow or saturation = 0, strongflow = max points)
�0 5
0-4
2
Evidence of past human alteration
py
extensive alteration = 0• no alteration = max points)
0-6)
0-5
3
Riparian zone
�60
4
/`
no buffer = 0; contiguous, wide buffer = max points)(�0
-
5
4
Evidence of nutrient or chemical discharges
extensive discharges = 0• no discharges = max points)4�
0
0-4
0
a J
�
5
Groundwater discharge
0 _ �-\
0-4
U
no discharge = 0 rin s wetlands, etc. = max
6
Presence of adjacent floodplainrA
no floodplain = 0, extensive floodplain = maxpoints)
='
�� - 4
0-4
0 - 2
Z
p'
7dee
Entrenchment / floodplain access
0-5
0 - 4
0 -?
lv entrenched = 0; frequent flooding= max points)
8
Presence of adjacent wetlands
(o�-,
no wetlands = 0; large ad•acent wetlands = maxpoints)
a= 6
0-4
2
9
Channel sinuosity
p'_.5
0-4
0
extensive channelization = 0-, natural meander = max ints)
,
i3'J
10
Sediment input
0 -5
0-4
0 -
extensive de m
deposition= 0• little or no sediment = max points)
i
->
t
11
Size & diversity of channel bed substrate
.
NA* --
0-4
((7 5
fine, homogenous = 0• large, diverse sizes = maxpoints)
12
Evidence of channel incision or widening
5
dee lv incised = 0; stable bed & banks = maxpoints)
(�O\
0:-4
0 �5,-)
13
Presence of major bank failures
0-5
severe erosion = 0• no erosion, stable banks = max ooints
%
0 - 5
0 = 5,
14
Root depth and density on banks
�'- 3
Ems.,no
visible roots = 0. dense roots thro out = max ints
0 - 4
5
15
Impact by agriculture, livestock, or timber production
0-5
0-4
substantial impact -0• no evidence =max ints
Q
/
16
Presence of riffle-pooliripple-pool complexes
bL\3
0-5
(1- 6
4
Fi
no ri$les/riles or is = 0; well-develo = max points)
17
Habitat complexity
0-6
little or no habitat = 0 went, varied habitats = max
?)6
—6--)
18
Canopy coverage over streambed
(0-5
no shadingvegetation = 0; continuous canopy = maxpoints)
0 - 5'
o'-5)
19
Substrate embeddedness
/
(deeply embedded = 0; loose structure = max
N�
0-4
(0 - 4
\
_Z
20
Presence of stream invertebrates (see page 4)
�
no evidence = 0• common,numerous = maxpoints)0
-
0-5
0 -�
Q�
21
Presence of amphibians
�0
04
no evidence = 0• common, numerous = max points
:Z0�� 4
0-4
4
-
O
22
Presence of fish
0 _
0-4
�- 4
no evidence = 0; common,numerous = max points)
23
Evidence of wildlife use
0� 6
0-5
no evidence = 0; abundant evidence = maxpoints)
-
Total Points Possible
� "_ "
100
0100
S
TOTAL SCORE (also enter on first page)]
These charactensucs are not assessed in coastal streams.
U0

STREAM QUALITY ASSESSMENT WORKSHEETOv�-LL * 05;7
iucZ)c k,11dtde,tc115UUS die not assessed to coastal suvams.
#
CHARACTERISTICS
ECOREGION POINT RANGE
Coastal
Piedmont
Mountain
SCORE
1
Presence of flow / persistent pools in stream
p
0-4
no flow or saturation = 0• strongflow = maxpoints)�.
(0 5
Z
2
Evidence of past human alteration
0 - b�
0-5
CQ
(extensive alteration = 0; no alteration = max points)/
-5
3
Riparian zone
no buffer = 0• contiguous, wide buffer = max points
p_ 4
0- 5
v
4
Evidence of nutrient or chemical discharges
1
extensive discharges = 0• no discharges = max ints
_ 5
0-4
0� 4
*4
5
Groundwater discharge
�
U0-
no dischar e = 0; springs, s, wetlands. etc. = max
0-4
`- 4
6
Presence of adjacent floodplain
no floodplain = 0; extensive floodplain = max points)
0-4
��
Z
p''dee
Entrenchment / floodplain access
0-4
lv entrenched = 0; frequent flooding= maxpoints)0
0
8
Presence of adjacent wetlands
no wetlands = 0 ; I e adjacent wetlands = mar ints
0
0-4
0 - 2�
9
Channel sinuosity
extensive channelization = 0• natural meander = mar points)
m
015
0-4
10
Sediment input
extensive de sition= 0• little or no sediment = marc ints
0 _
�Size
FO
& diversity of channel bed substrate
/11
homo enous = 0' lar e, diverse sizes = max ints
`�
*fine,
0 - 5�
12
Evidence of channel incision or widening
0-5)
(deeply incised = 0• stable bed & banks = max points)y
0 - 45
13
Presence of major bank failures
�`
j�--
a�-d
(severe erosion = 0; no erosion,stable banks = max points)
5
0 - 5
- 5
14
Root depth and density on banks
.
H
no visible roots = 0; dense roots throughout = max points)
0 -.-3
0-4
15
impact by agriculture, livestock, or timber production
substantial impact =0• no evidence = maxpoints)
0-
0-4
16
Presence of riffle-pool/ripple-pool complexes
no riffles/ripples or pools = 0• well-developed= maxpoints)
0 , 3
0-5
-
17
Habitat complexity
0 6�
0-6
/0
—(little
or no habitat = 0 frequent varied habitats = Max
`0 - 6
-�
18
Canopy coverage over streambed
'
no shadingvegetation = 0• continuous cano v = max points)Q-
0-5
19
Substrate embeddedness
DTA*J
0-4
(deeply embedded = 0, loose structure = max
0-4)
20
Presence of stream invertebrates (see page 4)
0 -
0-5
no evidence = 0• commo numerous s = max ints
�
—
G5
21
Presence of amphibians
=
0-4
4
no evidence 0; common,numerous = maxpoints)4
`
O
22
Presence of fish
A
- *'
0-4
no evidence = 0; common. numerous = maxpoints)0
23
Evidence of wildlffe use
0-6-)
no evidence = 0• abundant evidence = maxpoints)
0-5
i
Total Points Possible
100
100
(T00
TOTAL SCORE (also enter on first page)
Z
iucZ)c k,11dtde,tc115UUS die not assessed to coastal suvams.

H��S-uwr'nf��
STREAM QUALITY ASSESSMENT WORKSHEET
l-aV �,AWACW cuZ)uc5 diG 1101 assessed In coastal su=s.
#
CHARACTERISTICS
ECOREGION POINT RANGE
Coastal
Piedmont
Mountain
SCORE
I
Presence of now / persistent pools in streamp`�
no flow or saturation = 0• strongflow = max points)
0 - 4
2
Evidence of past human alteration
0 7
0-5
extensive alteration = 0; no alteration = maxpoints)
3
Riparian zone
no buffer = 0; contiguous, wide buffer = max points)
0- 6)
p- 4
- 5
4
Evidence of nutrient or chemical discharges
extensive discharges = 0• no discharges = maxpoints)
0(---5
0-4
0
5
Groundwater discharge
U
no discharge = 0; springs,wetlands, etc. = max
_ 3
0- 4
0-
6
Presence of adjacent floodplain
no floodplain = 0, extensive fl lain = max points)
0
p- 4
- 2
Entrenchment / floodplain access
dee 1 y entrenched = 0 frequent flooding = max ints
0 - 5
0-4
0
%J
8
Presence of adjacent wetlands
no wetlands = 0; large adjacent wetlands = max points)
K-6
p - 4
0 -
9
Channel sinuosity
(extensive channelization = 0; natural meander = max points)
0 - 5
0 - 4
- 3
Z
10
Sediment input
extensive deposition= 0; little or no sediment = maxpoints)
-,-,-5
0-4
11
Size & diversity of channel bed substrate
fine homo enous = 0• large, diverse sizes = max ints
NA*
0-4
0 /�
12
Evidence of channel incision or widening •
- 5-�
0-4
(
'0_S
(deeply 8t incised = 0• stable bed banks = max points)0
/
13
Presence of major bank failures
a
severe erosion = 0• no erosion, stable banks = maxpoints)0
5
0-5
l=
d
14
Root depth and density on banks
E.,
no visible roots = 0• dense roots out =max rots
0-3
0-4
-5
rA
15
Impact by agriculture, livestock, or timber production0
C
j
substantial impact =0• no evidence = max points)5
0 - 4
0 5
I
;.:
16
Presence of riffle-pool/ripple-pool complexes
F`
no riffles/ripples les or is = 0; well-devel = max ints
p�
0-5
td '
17
Habitat complexity
0-6
0-6
6
little or no habitat = 0frequent,varied habitats = max
18
Canopy coverage over streambed
- 5
0-5 '
no shadingvegetation = 0; continuous cano = max points)
0
19
19
Substrate embeddedness
(deeply embedded = 0• loose structure = max
0-4
0-4
Presence of stream invertebrates (see page 4)
no evidence = 0 common, numerouspes= max points
0 >-4
0-5
U`
21
Presence of amphibians
no evidence = 0•
p
0-4
common, numerous = max points)
O
22
Presence of fish
no evidence = 0; common, numerous types = maxpoints)
0-4
0
N23
Evidence of wildlife use
0-
0-5
no evidence = 0; abundant evidence =max rots
y�
.". Total Points Possible
100
100
100
TOTAL SCORE (also enteeir on first page)
l-aV �,AWACW cuZ)uc5 diG 1101 assessed In coastal su=s.

DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Determination Manual)
Project / Site: Shallowford Road
Date: March 2005
Applicant / Owner: Lana Wilcox
County: Forsyth
Investigator: Huvsman
State: North Carolina
Do normal circumstances exist on the site? Yes ® No ❑
Community ID:slouoh
Is the site significantly disturbed (Atypical situation)? Yes ❑ No ®
Transect ID:
Is the area a potential problem area? Yes ❑ No ®
Plot ID:100's & 300's
(explain on reverse if needed)
OBL tree
VEGETATION
Dominant Plant Species
Indicato Stratum
Dominant Plant Species
Indicato Stratum
1. Acer rubrum
FAC tree
9. Anus serrulata
FACW+ sapling
2. Acer negundo
FACW tree
10. Viburnum nudum
FACW+ shrub
3. Salix nigra
OBL tree
11. Woodwardia areolata
OBL herb
4.
❑ Drainage Patterns in Wetlands
12.
Secondary Indicators:
5.
® Oxidized Roots Channels in Upper 12"
13.
® Water -Stained Leaves
6.
❑ Local Soil Survey Data
❑ FAC -Neutral Test
14.
❑ Other (Explain in Remarks)
7.
15.
8.
16.
Percent of Dominant Species that are OBL, FACW, or FAC excluding FAC-).
100
Remarks:
HYDROLOGY
❑ Recorded Data (Describe In Remarks):
Wetland Hydrology Indicators
❑ Stream, Lake, or Tide Gauge
❑ Aerial Photographs
Primary Indicators:
❑ Other
® Inundated
® Saturated in Upper 12"
❑ No Recorded Data Available
❑ Water Marks
❑ Drift Lines
Field Observations:
❑ Sediment Deposits
❑ Drainage Patterns in Wetlands
Depth of Surface Water: 2 (in.)
Secondary Indicators:
Depth to Free Water in Pit: (in.)
® Oxidized Roots Channels in Upper 12"
® Water -Stained Leaves
Depth to Saturated Soil: (in.)
❑ Local Soil Survey Data
❑ FAC -Neutral Test
❑ Other (Explain in Remarks)
Remarks:

DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Determination Manual)
Project / Site: Shallowford Road
Date: March 2005'
Applicant / Owner: Lang Wilcox
County: Fors he
Investigator: agygrnan
State: North Carolina
Do normal circumstances exist on the site? Yes ® No ❑
Community ID:Mesic
Is the site significantly disturbed (Atypical situation)? Yes ❑ No ®
Transect ID:
Is the area a potential problem area? Yes ❑ No ®
Plot ID:
(explain on reverse if needed)
FACU tree
VEGETATION
Dominant Plant Species
Indicator Stratum
Dominant Plant Species
Indicator Stratum
1. Liriodendron tulipifera
FAC tree
9. Toxicodendron redicans
FAC vine
2. Acer negundo
FACW tree
10. Vitis spp.
FAC vine
3. Fagus grandifolia
FACU tree
11. Eulalia viminea
FAC+ herb
4. Quercus alba
FACU tree
12. Polystichum acrostichoides FAC herb
5.
Depth to Free Water in Pit:+ 48 in.)
13.
6.
Depth to Saturated Soil: + 48 (in.)
14.
7.
Remarks: No indicators
15.
8.
16.
Percent of Dominant Species that are OBL, FACW, or FAC excluding FAC-).
50%
Remarks:
HYDROLOGY
❑ Recorded Data (Describe In Remarks):
Wetland Hydrology Indicators
❑ Stream, Lake, or Tide Gauge
❑ Aerial Photographs
Primary Indicators:
❑ Other
❑ Inundated
❑ Saturated in Upper 12"
® No Recorded Data Available
❑ Water Marks
❑ Drift Lines
Field Observations:
❑ Sediment Deposits
❑ Drainage Patterns in Wetlands
Depth of Surface Water: none (in.)
Secondary Indicators:
Depth to Free Water in Pit:+ 48 in.)
❑ Oxidized Roots Channels in Upper 12"
❑ Water -Stained Leaves
Depth to Saturated Soil: + 48 (in.)
❑ Local Soil Survey Data
❑ FAC -Neutral Test
❑ Other (Explain in Remarks)
Remarks: No indicators

SOILS
Map Unit Name
(Series and Phase): Wehadkee
Drainage Class: Poorly drained
Taxonomy (Subgroup): (We) Typic Fluvaauents
Confirm Mapped Type? Yes ❑ No
Profile Description:
Depth Matrix Colors Mottle
Colors Mottle Texture, Concretions,
(inches) Horizon (Munsell MoW) (Munsell
Moist) Abundance/Contrast Structure. etc.
0-10 A 10YR 5/2
/ sandy clay loam
10-15 B 10YR 5/1
/ sandy clay loam
/
Hydric Soil Indicators:
❑ Histosol
❑ Concretions
❑ Histic Epipedon
❑ High Organic Content in Surface Layer in Sandy Soils
® Sulfidic Odor
❑ Organic Streaking in Sandy Soils
❑ Aquic Moisture Regime
❑ Listed On Local Hydric Soils List
❑ Reducing Conditions
❑ Listed on National Hydric Soils List
® Gleyed or Low-Chroma Colors
❑ Other (Explain in Remarks)
Remarks:
..1— . vL. I L.mm�lr%I wI.4
Hydrophytic Vegetation Present? Yes ® No ❑
Wetland Hydrology Present? Yes ® No ❑
Hydric Soils Present? Yes ® No ❑
Is the Sampling Point
Within a Wetland? Yes ® No ❑
Remarks: _Representative of wetlands within
the floodplain of the main tributary. These are
small areas of approximately 100 sq It each and
are assessed to be old sloughs.
rnv 1 v / UOU0 / IVrSIrJ
NI
� r1 � /llrJi
Approximate Scale: 1 to 1000
Clemmons Quadrangle

SOILS
Map Unit Name
(Series and Phase):
Drainage Class:
Taxonomy (Subgroup): Confirm Mapped Type? Yes ❑ No ❑
Profile Description:
Depth Matrix Colors
(Inches) Horizon (Munsell Moist)
Mottle Colors Mottle Texture, Concretions,
(Munsell Moist) Abundance/Contrast Structure, etc.
0-10 A 10YR 5/4
/ sandv clav loam
10-15 B 10YR 7/5
/ clay loam
/
Hydric Soil Indicators:
❑ Histosol
❑ Concretions
❑ Histic Epipedon
❑ High Organic Content in Surface Layer in Sandy Soils
❑ Sulfidic Odor
❑ Organic Streaking in Sandy Soils
❑ Aquic Moisture Regime
❑ Listed On Local Hydric Soils List
❑ Reducing Conditions
❑ Listed on National Hydric Soils List
❑ Gleyed or Low-Chroma Colors
❑ Other (Explain in Remarks)
Remarks: not a hydric soils
WF=TI AKIN ncTC ea Krw r wi
.,..
r- . ............-. 1 owl's
Hydrophytic Vegetation Present? Yes ❑ No ❑
Wetland Hydrology Present? Yes ❑ No ❑
Hydric Soils Present? Yes ❑ No ❑
Is the Sampling Point
Within a Wetland? Yes ❑ No ❑
Remarks: ad'lacent slopes are high ground
r-nv 1 v / UJUti / NHti5

Bank Material
Within the proposed flooded reach
the banks of the stream are
comprised primarily of highly
erodable saprolite and weathered
rock. Stream bed appears to have
excess bedload based on preliminary
d50 assessment
Instability
Within the proposed flooded
reaches are numerous areas with
high degrees of instability resulting
from a combination of bank
materials and historic land use.
Erosion is occurring below the root
zone and trees are falling into the
stream
Grade Control
Good grade control is present at the
upstream locations of the proposed
ponds. Grade control, in the form of
boulders stabilize the upstream
reaches but undercutting below the
root zone is evident immediately
below the grade control.