20161124 Ver 1_401 Application_20161116

Quible
Quible & Associates, P.C.
ENGINEERING • ENVIRONMENTAL SCIENCES • PLANNING • SURVEYING
SINCE 1959
November 11, 2016
Jennifer Burdette
NCDWR, 401 & Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: Nationwide 18 PCN
Shepard Property
Ms. Burdette:
20161124
P.O. Drawer 870
Kitty Hawk, NC 27949
Phone:[phone]
Fax: [phone]
web: quible.com
NOV 16 2016
Please find enclosed a Pre -Construction Notification for the above referenced property located at 108
Pinnacle Court, Kitty Hawk, NC 27949.
The following documentation has been included (4 copies):
■ PCN Application
■ Site Plan
■ Relevant portion of USGS Topographic Quadrangle- Kitty Hawk with site identified
■ GIS Parcel Boundary and Aerial Photo
■ Agent Authorization
■ Mitigation Bank Acceptance Letter (GDSRB)
■ Copy of $240 Check payable to DEQ
■ Copy of USACE JD (SAW -2016-01324)
Please do not hesitate to contact the undersigned at [phone] if you have any questions or
comments concerning this project.
Sincerely,
Quiblessociates, P. C.
$I leo
Brian Rubino
CC: Kyle Barnes, USACE
Bruce Shepard

Quible
Quible & Associates, P.C.
ENGINEERING • ENVIRONMENTAL SCIENCES • PLANNING • SURVEYING
SINCE 1959
November 11, 2016
Mr. Kyle Barnes
US Army Corps of Engineers
2407 W. 5th Street
Washington, NC 27889-1000
Re: Nationwide 18 PCN
Shepard Property
Mr. Barnes:
P.O. Drawer 870
Kitty Hawk, NC 27949
Phone: [phone]
Fax: [phone]
web: quible.com
Please find enclosed a Pre -Construction Notification for the above referenced property located at 108
Pinnacle Court, Kitty Hawk, NC 27949.
The following documentation has been included:
■ PCN Application
■ Site Plan
■ Relevant portion of USGS Topographic Quadrangle- Kitty Hawk with site identified
■ GIS Parcel Boundary and Aerial Photo
■ Agent Authorization
■ Mitigation Bank Acceptance Letter (GDSRB)
■ Copy of $240 Check payable to DEQ
■ Copy of USACE JD (SAW -2016-01324)
Please do not hesitate to contact the undersigned at [phone] if you have any questions or
comments concerning this project.
Sincerely,
Quible & Associates, P.C.
'Em P6, r --
Brian Rubino
CC: Jennifer Burdette, NCDWR
Bruce Shepard

SOF WATe9Q
�7
O Y
Office Use Only:
Corps action ID no. _
DWQ project no.
Form Version 1.3 Dec 10 2008
Page 1 of 11
PCN Form — Version 1.3 December 10, 2008 Version
Pre -Construction Notification (PCN) Form
A.
Applicant Information
1.
Processing
1 a.
Type(s) of approval sought from the
Corps:
®Section 404 Permit El Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 18 or General Permit (GP) number:
1c.
Has the NWP or GP number been verified by the Corps?
❑ Yes
® No
1 d.
Type(s) of approval sought from the DWQ (check all that apply):
N 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e.
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
❑ Yes N No
For the record only for Corps Permit:
❑ Yes N No
1f.
Is payment into a mitigation bank or in -lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in -lieu
fee program.
N Yes
❑ No
1 g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
N Yes
❑ No
1 h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2.
Project Information
2a.
Name of project:
Shepard Property
2b. County:
Dare
2c.
Nearest municipality / town:
Kitty Hawk
2d. Subdivision name:
Pinnacle at Sea Scape
2e.
NCDOT only, T.I.P. or state
project no:
3.
Owner Information
3a.
Name(s) on Recorded Deed:
Applicant: Owner: Deborah and Bruce Shepard
3b.
Deed Book and Page No.
Book: 1802 Page: 0344
3c.
Responsible Party (for LLC if
applicable):
3d. Street address:
108 Pinnacle Court
3e. City, state, zip:
Kitty Hawk, NC 27949
3f.
Telephone no.:
252-489-8024
3g.
Fax no.:
3h.
Email address:
[e-mail]
Page 1 of 11
PCN Form — Version 1.3 December 10, 2008 Version

4.
Applicant Information (if different from owner)
4a.
Applicant is:
® Agent ❑ Other, specify:
4b.
Name:
4c.
Business name
(if applicable):
4d.
Street address:
4e.
City, state, zip:
4f.
Telephone no.:
4g.
Fax no.:
4h.
Email address:
5.
Agent/Consultant Information (if applicable)
5a.
Name:
Brian Rubino
5b.
Business name
(if applicable):
Quible & Associates, P.C.
5c.
Street address:
P.O. Drawer 870
5d. City, state, zip:
Kitty Hawk, NC 27949
5e. Telephone no.:
252.261.3300
5f.
Fax no.:
252.261.1260
5g.
Email address:
[e-mail]
Page 2 of 11

B.
Project Information and Prior Project History
1.
Property Identification
1a.
Property identification no. (tax PIN or parcel ID):
Pin #: 987609167016
1 b.
Site coordinates (in decimal degrees):
Latitude: 36.08534° N Longitude: 75.71104° W
1 c.
Property size:
0.383 acres (16,694 sq. ft.)
2.
Surface Waters
2a.
Name of nearest body of water (stream, river, etc.) to
UT to Albemarle Sound (Kitty Hawk Bay)
proposed project:
2b.
Water Quality Classification of nearest receiving water:
SC
2c.
River basin:
Pasquotank
map is available at http://h2o.enr.state.nc.us/admin/maps/
3.
Project Description
3a.
Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
The subject property currently contains a homesite and included with this application is a tax map/ aerial photo of the
entire property. The owners are in the process of creating a new family owned lot in the subject area depicted on the
Nationwide Site Plan, meeting all of the Town of Kitty Hawk requirements. Nearby properties include single family
residential home sites and undeveloped uplands and wetlands.
3b.
List the total estimated acreage of all existing wetlands on the property:
6,196 sq.ft.; 0.14 acres
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
0
3d.
Explain the purpose of the proposed project:
The purpose of this wetland impact permit request is for minor wetland fill impacts associated with the fill of 0.10 acres of
wooded Section 404 wetlands for a residential home site and to maintain sufficient setbacks from wetlands for an on-site
septic treatment system. This is the only area of 404 impacts that will be cumulatively required for this property.
3e.
Describe the overall project in detail, including the type of equipment to be used:
The property owner proposes to fill 0.10 acres of wetlands to accommodate a single family residence. Associated grading
will require minor wetland impacts. Equipment will include bulldozer, backhoe, and dump trucks.
Page 3 of 11
PCN Form — Version 1.3 December 10, 2008 Version

4.
Jurisdictional Determinations
4a.
Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
®Yes ❑ No Unknown
project (including all prior phases) in the past?
Comments:
4b.
If the Corps made the jurisdictional determination, what type
❑ Preliminary ® Final
of determination was made?
4c.
If yes, who delineated the jurisdictional areas?
Agency/Consultant Company:
Name (if known): EPI
Other: Kyle Barnes, USACE
4d.
If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
8/4/2016
5.
Project History
5a.
Have permits or certifications been requested or obtained for
❑ Yes ® No ❑ Unknown
this project (including all prior phases) in the past?
5b.
If yes, explain in detail according to "help file" instructions.
6.
Future Project Plans
6a.
Is this a phased project?
❑ Yes ® No
6b.
If yes, explain.
This will be the only 404 wetland impacts associated with this property and the remaining wetland area will be maintained.
Page 4 of 11

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
® Wetlands ❑ Streams - tributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
2b.
2c.
2d.
2e.
2f.
Wetland impact
Type of jurisdiction
number —
Type of impact
Type of wetland
Forested
(Corps - 404, 10
Area of impact
Permanent (P) or
(if known)
DWQ — non -404, other)
(acres)
Temporary T
W1 ®P ❑ T
fill
404/
❑ Yes
® Corps
0.10
non -riparian
® No
❑ DWQ
W2 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W3 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W4 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W5 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
2g. Total wetland impacts
0.10
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
3b.
3c.
3d.
3e.
3f.
3g.
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number -
(PER) or
(Corps - 404, 10
stream
length
Permanent (P) or
intermittent
DWQ — non -404,
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S2 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S3 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S4 ❑ P ❑ T
❑ PER
❑ Corps
[:11 NT
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
3h. Total stream and tributary impacts
3i. Comments:
Page 5 of 11

4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a.
4b.
4c.
4d.
4e.
Open water
Name of waterbody
impact number —
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
Temporary T
01 ❑P❑T
02 ❑ PEI T
03 ❑P❑T
04 ❑P❑T
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below.
5a.
5b.
5c.
5d.
5e.
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose
(acres)
number
of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f. Total
5g. Comments:
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWO)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a.
❑ Neuse ❑Tar -Pamlico El Other:
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b.
6c.
6d.
6e.
6f.
6g.
Buffer impact
number—
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
for
Stream name
mitigation
(square feet)
(square feet)
Temporary T
impact
required?
131 ❑ PEI T
El Yes
❑ No
❑ Yes
B2 ❑ P ❑ T
❑ No
133 ❑P❑T
[I Yes
❑ No
6h. Total buffer impacts
6i. Comments:
Page 6 of 11

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Fill will be sloped and stabilized to avoid impacts to wetland area that will not be filled. Septic system will be located as far
as possible from wetlands.
b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Silt fencing to be maintained until disturbed area is stabilized with grass.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State?
® Yes ❑ No
2b. If yes, mitigation is required by (check all that apply):
❑ DWQ ® Corps
2c. If yes, which mitigation option will be used for this
project?
® Mitigation bank
ElPayment to in-lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank: Great Dismal Swamp Restoration Banks
3b. Credits Purchased (attach receipt and letter)
Type Non-Riparian
Quantity 0.2
3c. Comments: 2:1 credits to impacts
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached.
❑ Yes
4b. Stream mitigation requested:
linear feet
4c. If using stream mitigation, stream temperature:
❑ warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested:
acres
4f. Non-riparian wetland mitigation requested:
4g. Coastal (tidal) wetland mitigation requested:
acres
4h. Comments:
Page 7 of 11
PCN Form — Version 1.3 December 10, 2008 Version

5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWO
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? If yes, you will have to fill out this entire form — please
contact the State for more information.
El Yes ® No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
Zone
6c.
Reason for impact
6d.
Total impact
(square feet)
Multiplier
6e.
Required mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund).
6h. Comments:
Page 8 of 11

E.
Stormwater Management and Diffuse Flow Plan (required by DWQ)
1.
Diffuse Flow Plan
1 a.
Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b.
If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes ❑ No
Comments:
2.
Stormwater Management Plan
2a.
What is the overall percent imperviousness of this project?
<30%
2b.
Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c.
If this project DOES NOT require a Stormwater Management Plan, explain why: This
is low density residential
construction on an existing platted lot.
2d.
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative
description of the plan:
N/A
❑ Certified Local Government
2e.
Who will be responsible for the review of the Stormwater Management Plan?
❑ DWQ Stormwater Program
❑ DWQ 401 Unit
3.
Certified Local Government Stormwater Review
3a.
In which local government's jurisdiction is this project?
Kitty Hawk
❑ Phase II
❑ NSW
3b.
Which of the following locally -implemented stormwater management programs
❑ USMP
apply (check all that apply):
❑ Water Supply Watershed
❑ Other:
3c.
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
4.
DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a.
Which of the following state -implemented stormwater management programs apply
❑ ORW
(check all that apply):
❑ Session Law 2006-246
❑ Other:
4b.
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
5.
DWQ 401 Unit Stormwater Review
5a.
Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b.
Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 9 of 11
PCN Form — Version 1.3 December 10, 2008 Version

F.
Supplementary Information
1.
Environmental Documentation (DWQ Requirement)
1 a.
Does the project involve an expenditure of public (federal/state/local) funds or the
❑ Yes
® No
use of public (federal/state) land?
1 b.
If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes
❑ No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c.
If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
El Yes
F1 No
letter.)
Comments:
2.
Violations (DWQ Requirement)
2a.
Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
❑ Yes
® No
or Riparian Buffer Rules (15A NCAC 2B.0200)?
2b.
Is this an after -the -fact permit application?
❑ Yes
® No
2c.
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3.
Cumulative Impacts (DWQ Requirement)
3a.
Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes
® No
additional development, which could impact nearby downstream water quality?
3b.
If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
4.
Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non -discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
An on-site septic treatment system will be installed to serve the proposed house.
Page 10 of 11
PCN Form — Version 1.3 December 10, 2008 Version

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
❑ Yes ® No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ® No
impacts?
❑ Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted.
❑ Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NC Natural Heritage Program
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
Mapping data and field investigations
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
❑ Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
National Register of Historic Places
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA -designated 100 -year floodplain?
® Yes ❑ No
8b. If yes, explain how project meets FEMA requirements: This type of fill is allowable with permit in AE zones.
8c. What source(s) did you use to make the floodplain determination? NFIP Flood Zone Maps (www.ncfloodmaps.com)
Bf'rAn Ivn{�S,�1D I
Applicant/Agent's Printed Name
Applicant/Agent's Signature
Date
(Agent's signature is valid only if an authorization letter from the applicant
isprovided.)
Page 11 of 11

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1114/"016
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108 Pinnacle Ct
KIT N HANK, NC 27949
Parcel: 027506004
PIN:987609167016
Subdivision: Pinnacle At Sea Scape
Lot-Blk-Sect: Lot: 4 K Residual Parcel
Blk: Sec:
Tax District: Kittv Hawk
Tax Appraisal Value: 560,100
Land 134,900
Building 396,200
Misc 29,000
t t. t,. t • .t. t t.
Tax Ownership
Deborah Lees-shepard Tice
Bruce Shepard Ttee
tilap Legend
Parcels ❑
,n��w.�wicn' aNr.�ron iv ruu ��,w n ,N^uia
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RE: Bruce Shepard and Deborah Lees -Shepard
108 Pinnacle Court
Kitty Hawk, Dare County, NC
As property owner, I authorize Brian Rubino to act as agent for the purpose of USACE Nationwide and
DWR Permitting associated with the Bruce Shepard and Deborah Lees -Shepard Property in the Pinnacle
at Sea Scape Subdivision in Kitty Hawk, NC.
D61;1� "_4ate - ro
Name:
Date r�'l
Name�j Y, Z

The Great Dismal Swamp RestorationBank, LLC
P. O. Box 6186 Phone [phone]
Chesapeake. VA 23323 Fax [phone]
November 7, 2016
Brian Rubino
Quible & Associates, P.C.
8 Juniper Trail
P.O. Drawer 870
Kitty Hawk, NC 27949
!?F Deborah and Bruce Shepard
Tyrell County, NC
Pear Mr. Rubino:
The following price quote is given in reply to your request for the purchase of 0.10 wetland mitigation credits (HUC Code 03010205)
from The Great Dismal Swamp RestorationBank Timberlake Farm. These credits are currently available from our Timberlake
mitigation bank.
The cost will be Two Thousand, Three Hundred Dollars ($ 2,300.00). This quote will expire on January 31, 2017. You will need to
submit to the USCOE the necessary application for said mitigation, and receive USCOE permission to furnish said required credits
from our Timberlake bank.
To complete this transaction, we will require payment in full. Once payment is received, the credit sale will be reported to the US
Army Corps of Engineers. Please provide and/or confirm the following information:
Corps Project #:
Waterway:
Permittee Name:
Locality of Impact:
Permit action (i.e., IP, NWP-39, enforcement, etc.)
Impacts (acres/linear feet):
Impacts NWI classification:
Impacts Hydrologic Unit Code: 03010205
Mitigation Bank, Permittee, and Consultant agree not to discuss with any other party the details and/or pricing of this agreement,
unless necessary for regulatory matters. Information contained herein shall be held in the strictest confidence.
Thank you for allowing us to quote on this project. We look forward to working with you.
Si cerely, jJ�
t
ly M. h eger - cc nting / Sales
GDSRB
CC: file

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U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SANN'-2016-01324 County: Dare U.S.G.S. Quad: NC -KITTY HAWK
Property Owner:
Address: .
Telephone Number:
NOTIFICATION OF JURISDICTIONAL DETERMINATION
Deborah Lees -Shepard
108 Pinnacle Court
Kittv Hawk, NC, 27949
Size (acres) 1.089
Nearest Waterway Atlantic Ocean
USGS HUC 03010205
Nearest Town Kitty Hawk
River Basin Albemarle
Coordinates Latitude: 36.0855
Longitude: -75.7113
Location description: The project area is located at 108 Pinnacle Court in the town of Kitty Hawk in Dare County,
North Carolina. The property has been partially developed with a single family residential dwelling and yard.
Indicate Which of the Following Apply:
A. Preliminary Determination
Based on preliminary information, there may be waters of the U.S. including wetlands on the above described project area
. We strongly suggest you have this property inspected to determine the extent of Department of the Army (DA)
jurisdiction. To be considered final, a jurisdictional determination must be verified by the Corps. This preliminary
determination is not an appealable action under the Regulatory Program Administrative Appeal Process (Reference 33
CFR Part 331). If you wish, you may request an approved JD (which may be appealed), by contacting the Corps district
for further instruction. Also, you may provide new information for further consideration by the Corps to reevaluate the
JD.
B. Approved Determination
There are Navigable Waters of the United States within the above described project area subject to the permit requirements
of Section 10 of the Rivers and Harbors Act and Section 404 of the Clean Water Act. Unless there is a change in the law
or our published regulations, this determination may be relied upon for a period not to exceed five years from the date of
this notification.
X There are waters of the U.S. including wetlands on the above described project area subject to the permit requirements of
Section 404 of the Clean Water Act (CWA)(33 USC § 1344). Unless there is a change in the law or our published
regulations, this determination may be relied upon for a period not to exceed five years from the date of this notification.
_ We strongly suggest you have the waters of the U.S. including wetlands on your project area delineated. Due to the
size of your property and/or our present workload, the Corps may not be able to accomplish this wetland delineation in a
timely manner. For a more timely delineation, you may wish to obtain a consultant. To be considered final, any
delineation must be verified by the Corps.
_ The waters of the U.S. including wetlands on your project area have been delineated and the delineation has been
verified by the Corps. We strongly suggest you have this delineation surveyed. Upon completion, this survey should be
reviewed and verified by the Corps. Once verified, this survey will provide an accurate depiction of all areas subject to
CWA jurisdiction on your property which, provided there is no change in the law or our published regulations, may be
relied upon for a period not to exceed five years.
X The waters of the U.S. including wetlands have been delineated and surveyed and are accurately depicted on the plat
signed by the Corps Regulatory Official identified below on August 4, 2016. Unless there is a change in the law or our
published regulations, this determination may be relied upon for a period not to exceed five years from the date of this
notification.
Page 1 of 2

_ There are no waters of the U.S., to include wetlands, present on the above described project area which are subject to the
permit requirements of Section 404 of the Clean Water Act (33 USC 1344). Unless there is a change in the law or our
published regulations, this determination may be relied upon for a period not to exceed five years from the date of this
notification.
X The property is located in one of the 20 Coastal Counties subject to regulation under the Coastal Area Management Act
(LAMA). You should contact the Division of Coastal Management in Morehead City, NC, at [phone] to
determine their requirements.
Placement of dredged or fill material within waters of the US and/or wetlands without a Department of the Army permit may
constitute a violation of Section 301 of the Clean Water Act (33 USC § 1311). If you have any questions regarding this
determination and/or the Corps regulatory program, please contact Kyle Barnes at 910-251-4584 or
Kyle.W.Ba rnesa.usace.a rmv.mil.
C. Basis For Determination: The wetlands that were identified on the property are part of a broad continuum of
wetlands adjacent to the Albemarle Sound and were identified utilizing the US Army Corps of Engineers 1987
Wetland Delineation Manual and the Atlantic and Gulf Coast Region Supplement
D. Remarks: The wetland in the project area is a shallow 0.142 acre pond.
E. Attention USDA Program Participants
This delineation/determination has been conducted to identify the limits of Corps' Clean Water Act jurisdiction for the
particular site identified in this request. The delineation/determination may not be valid for the wetland conservation
provisions of the Food Security Act of 1985. If you or your tenant are USDA Program participants, or anticipate participation
in USDA programs, you should request a certified wetland determination from the local office of the Natural Resources
Conservation Service, prior to starting work.
F. Appeals Information (This information applies only to apprgved jurisdictional determinations as indicated in
B. above)
This correspondence constitutes an approved jurisdictional determination for the above described site. If you object to this
determination, you may request an administrative appeal under Corps regulations at 33 CFR Part 331. Enclosed you will find a
Notification of Appeal Process (NAP) fact sheet and request for appeal (RFA) form. If you request to appeal this
determination you must submit a completed RFA form to the following address:
US Army Corps of Engineers
South Atlantic Division
Attn: Jason Steele, Review Officer
60 Forsyth Street SW, Room 1 OM 15
Atlanta, Georgia 30303-8801
In order for an RFA to be accepted by the Corps, the Corps must determine that it is complete, that it meets the criteria for
appeal under 33 CFR part 331.5, and that it has been received by the Division Office within 60 days of the date of the NAP.
Should you decide to submit an RFA form, it must be received at the above address by October 3, 2016.
**It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this
correspondence.**BARN ES.KYLE.WI LLIAM. DN: 'c=UStalty Io-UU5 Gmeernrnent ounDoD ou--LUAMA �pKo35397
Corps Regulatory Official:
« USA.cn=BARNESKriE.WIWAM.1388035397
1388035397
Date: 2016.08.04 14:40:07-09'00'
Date: August 4, 2016 Expiration Date: August 4. 2021
The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we
continue to do so, please complete our Customer Satisfaction Survey, located online at
http://re.izulatorv.LisacesLirvev.com/.

NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
410a Ak REQUEST FOR APPEAL,
Applicant: Deborah Lees -Shepard File Number: SANK -2016-01324 Date: Aueust 4.26 -1 -6 -
Attached
. 2016
Attached is: See Section below
INITIAL PROFFERED PERMIT (Standard Permit or Letter ofpermission)
A
PROFFERED PERMIT (Standard Permit or Letter ofpermission)
B
❑
PERMIT DENIAL -
C
-
®
APPROVED JURISDICTIONAL DETERMINATION
D
❑
PRELIMINARY JURISDICTIONAL DETERMINATION
F
SECTION I - The following identifies your rights and options regarding an administrative appeal of the above decision.
Additional inforination may be foundivace.army.i7fil-lissioi3s_'C'it_iI�'t'arks.-Re�7ulator�Pro�rraivandPennits.as px or
Corps regulations at 33 CFR Part 331.
A: INITIAL PROFFERED PERMIT: You may acceptor object to the permit.
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• OBJECT: If you object to the permit (Standard or LOP) because of certain terms and conditions therein, you may request
that the permit be modified accordingly. You must complete Section II of this form and return the form to the district
engineer. Your objections must be received by the district engineer within 60 days of the date of this notice, or you will
forfeit your right to appeal the permit in the future. Upon receipt of your letter, the district engineer will evaluate your
objections and may: (a) modify the permit to address all of your concerns, (b) modify the permit to address some of your
objections, or (c) not modify the permit having determined that the permit should be issued as previously written. After
evaluating your objections, the district engineer will send you a proffered pen -nit for your reconsideration, as indicated in
Section B below.
B: PROFFERED PERMIT: You may accept or appeal the permit
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, 'and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• APPEAL: If you choose to decline the proffered permit (Standard or LOP) because of certain terms and conditions therein,
you may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of
this form and sending the form to the division engineer. This form must be received by the division engineer within 60 days
of the date of this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process by
completing Section lI of this form and sending the form to the division engineer. This form must be received by the division
engineer within 60 days of the date of this notice.
D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or provide new
information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the
date of this notice, means that you accept the approved JD in its entirety, and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD, you may appeal the approved JD under the Corps of Engineers
Administrative Appeal Process by completing Section 1I of this form and sending the form to the district engineer. This form
must be received by the division engineer within 60 days of the date of this notice.

-*1N,
E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps regarding the
preliminary JD. The Preliminary JD is not appealable. If you wish, you may request an approved JD (which may be appealed),
by contacting the Corps district for further instruction. Also you may provide new information for further consideration by the
Corps to reevaluate the JD.
SECTION II - R.E UEST FOR APPEAL or OBJECTIONS TO AN INITIAL PROFFERED PERMIT
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your objections to an initial
proffered permit in clear concise statements. You may attach additional information to this form to clarify where your reasons or
objections are'addressed in the administrative record.)
ADDITIONAL INFORMATION: The appeal is limited to a review of the administrative record, the.Corps memorandum for the
record of the appeal conference or meeting, and any supplemental information that the review officer has determined is needed to
clarify the administrative record. Neither the appellant nor the Corps may add new information or analyses to the record.
However, you may provide additional information to clarify the location of information that is already in the administrative
record.
POINT OF CONTACT FOR QUESTIONS OR INFORMATION:
If you have questions regarding this decision and/or the
If you only have questions regarding the appeal process you may
appeal process you may contact:
also contact:
District Engineer, Wilmington Regulatory Division,
Mr. Jason Steele, Administrative Appeal Review Officer
Attn: Kyle Barnes
CESAD-PDO
2407 West 51' Street
U.S. Army Corps of Engineers, South Atlantic Division
Washington, NC 27889
60 Forsyth Street, Room 1OM15
[phone]
Atlanta, Georgia 30303-8801
Phone: [phone]
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel, and any government
consultants, to conduct investigations of the project site during the course of the appeal process. You will be provided a 15 day
notice of any site investigation, and will have the opportunity to participate in all site investiations.
Date:
Telephone number:
Signature of appellant oragent.
For appeals on Initial Proffered Permits send this form to:
District Engineer, Wilmington Regulatory Division, Kyle Barnes
For Permit denials, Proffered Permits and approved Jurisdictional Determinations send this form to:
Division Engineer, Commander, U.S. Army Engineer Division, South Atlantic, Attn: Mr. Jason Steele,
Administrative Appeal Officer, CESAD-PDO, 60 Forsyth Street, Room 10M15, Atlanta, Georgia 30303-8801
Phone: [phone]