20170532 Ver 1_401 Application_20170428

Charlotte•Meckrenburg
STORM Charlotte Storm Water Services
600 E. Fourth St, 140, Floor
WATER Charlotte, NC 28202-2844
Services
April 24, 2017:
Ms. Karen Higgins 2
NC Department of Environmental Quality, DWR 2 0 1 7 0 5 3
401/Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
Subject: After -the -Fact Pre -Construction Notification
4530 West Tyvola Road Maintenance Project grFRpgl��,
Charlotte, North Carolina
Dear Ms. Higgins:
Charlotte -Mecklenburg Storm Water Services (CMSWS) is hereby contacting NCDEQ-
Division of Water Resources, regarding jurisdictional impacts associated with the 4530
West Tyvola Road Maintenance project. On May 7, 2014, CMSWS 401/404 permitting
staff approved the plans for this project, indicating that the 39 linear feet (LF) of
proposed impacts fell below the threshold for written authorization of NCDWR under
NWP3/WQC3883. Written authorization from the USACE was sought and obtained on
July 3, 2014 (USACE Action ID: 2014-01206). The permit authorized the extension of a
pipe by 9 LF and 30LF of hard stabilization at the outfall of the pipe.
Upon notification of construction completion, CMSWS's Erin Shanaberger discovered
that CMSWS constructed more impacts than were authorized. In addition to 9 LF of pipe
extension and 30 LF of hard stabilization, an additional 10 LF of hard stabilization was
constructed to transition the newly constructed gabion baskets back to the grade of the
natural stream. Rip rap was necessary to prevent erosion during high flows and the
formation of a head cut that could undermine the newly constructed project.
Since this project (as constructed) exceeded the threshold for requesting written
authorization from NCDWR, CMSWS is submitting this after -the -fact pre -construction
notification for authorization under GC 4100.
I have enclosed a PCN form, the construction plans with the area of additional impacts
annotated, and photos of the completed work in addition to the original PCN and approval.
Please review and contact me with any comments or concerns.
Sincerely,
v.w.hw." Digitally signed by
STORM Erin Shanaberger
WATER Date: 2017.04.24
smvks 14:44:14 -04'00'
Erin Shanaberger
Water Quality Program Specialist
City of Charlotte Storm Water Services Division
Desk phone [phone]
Erin. [e-mail]
IR%E�\J D
App 2B 201
SENa.A VRPERM�-INS
STORM
To report drainage problems: 704 -336 -RAIN http://Stormwater.charmeck.org

Charlotte -Mecklenburg
STORM
Charlotte Storm Water Services
600 E. Fourth St., 14th Floor
WATER
Charlotte, NC 28202-2844
Services
enclosure:
Original Pre -Construction Notification & USACE approval
Photos of 4530 W. Tyvola Road Maintenance Project
4530 W. Tyvola Road Maintenance Annotated Project Plans
Cc: file
To report drainage problems: 704 -336 -RAIN http://stormwater.charmeck.org

Charlotte -Mecklenburg
STORM Charlotte Storm Water Services
600 E. Fourth St., 1411 Floor
WATERCharlotte, NC 28202-2844
` Services
Photos of -5601 Robinhood Road Maintenance Proiect
(USACE Action ID: 2014-01206)
1. View of newly constructed gabions with rip rap apron.
To report drainage problems: 704 -336 -RAIN http://Stormwater.charmeck.org

Cherione-Mecklenburg
STORM Charlotte Storm Water Services
600 E. Fourth St., 141h Floor
h
WATER Charlotte, NC 28202-2844
Services V
2. View of rip rap apron added to transition back to natural channel
+ y 4
To report drainage problems: 704 -336 -RAIN http://storm water. charmeck. org

R Charlotte-Mecklenbwg Charlotte Storm Water Services
STORM600 E. Fourth St, 141h Floor
--,,-.WATER Charlotte, NC 28202-2844
Services —E�
To report drainage problems: 704 -336 -RAIN http://Stormwater.charmeck.org

Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
A.
1.
Pre -Construction Notification (PCN) Form
Applicant Information s O �/p �4
tl
Processing �! .
1 a.
Type(s) of approval sought from the Corps:
��c
❑X Section 404 Permit ❑ Sectio il�f� Knit
1 b. Specify Nationwide Permit (NWP) number: 3 or General Permit (GP) number: I
ZA
1c.
Has the NWP or GP number been verified by the Corps?
❑X Yes ❑ No
1 d.
Type(s) of approval sought from the DWQ (check all that apply):
X❑ 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e.
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ
401 Certification:
❑ Yes X❑ No
For the record only for Corps Permit:
❑ Yes ❑ 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.
❑ Yes ❑X No
1g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yes ❑X No
1h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes ❑X No
2.
Project Information
2a.
Name of project:
4530 West Tyvola Road Maintenance Project
2b.
County:
Mecklenburg
2c.
Nearest municipality / town:
Charlotte
2d.
Subdivision name:
Reid Park
2e.
NCDOT only, T.I.P. or state project no:
3.
Owner Information
3a.
Name(s) on Recorded Deed:
3b.
Deed Book and Page No.
3c.
Responsible Party (for LLC if
applicable):
City of Charlotte -Storm Water Services (Storm Drainage Easement)
3d.
Street address:
4518 West Tyvola Road
3e.
City, state, zip:
Charlotte, NC 28208
3f.
Telephone no.:
3g.
Fax no.:
3h.
Email address:
Page 1 of 10
PCN Form — Version 1.4 January 2009

4. Applicant Information (if different from owner)
4a. Applicant is:
❑ Agent ❑X Other, specify: CMSWS; Erin Shanaberger
4b. Name:
Erin Shanaberger
4c. Business name
(if applicable):
City of Charlotte; Charlotte-Mecklenburg Storm Water Services
4d. Street address:
600 E. 4th Street
4e. City, state, zip:
Charlotte, NC 28202
4f. Telephone no.:
704-336-3927
4g. Fax no.:
4h. Email address:
[e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name:
5b. Business name
(if applicable):
5c. Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:
Page 2 of 10

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
14522121
1 b. Site coordinates (in decimal degrees):
ILatitude: 35.208872 Longitude: -80.905341
1 c. Property size:
0.25 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project:
Irwin Creek
2b. Water Quality Classification of nearest receiving water:
Class C
2c. River basin:
Catawba; HUC: 03050103
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:
An intermittent stream originates at the outlet of a storm water pipe system with steep, eroding banks. The pipe is perched at the outfall and the
existing concrete flume has broken off and sits in the channel bottom. Surrounding land use is a mix of single family residential properties, multi -family
residential, and commercial use.
3b. List the total estimated acreage of all existing wetlands on the property: 0
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 85
3d. Explain the purpose of the proposed project:
The purpose of the proposed project is to replace the deteriorated pipe system upstream of the outlet located at 4518 West Tyvola Rd and to stabilize tl
3e. Describe the overall project in detail, including the type of equipment to be used:
Typical construction equipment will be used to remove M replace existing pipe, pour new headwall, and construct gabion baskets.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (includingall prior phases)in the past?
❑X Yes ❑ No ❑ Unknown
Comments:
4b. If the Corps made the jurisdictional determination, what type
of determination was made?
Preliminary ❑X Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known): Kelly Thames
Agency/Consultant Company: Carolina wetland Services
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
USACE Action ID:2014-01206
July 3, 2014
5. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
❑x Yes ❑ No ❑ Unknown
5b. If yes, explain in detail according to "help file" instructions.
USACE Action ID: 2014-01206. This project was previously authorized under NWP 3 by the USACE but did not require written approval from NCDWR.
6. Future Project Plans
6a. Is this a phased project?
❑ Yes ❑X No
6b. If yes, explain.
Page 3 of 10
PCN Form — Version 1.4 January 2009

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
❑ Wetlands ❑X 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.
Wetland impact
number
Permanent (P) or
Temporary
2b.
Type of impact
2c.
Type of wetland
2d.
Forested
2e.
Type of jurisdiction
Corps (404,10) or
DWQ (401, other)
2f.
Area of
impact
(acres)
W1
Choose one
Choose one
Yes/No
-
W2
Choose one
Choose one
Yes/No
-
W3 -
Choose one
Choose one
Yes/No
-
W4 -
Choose one
Choose one
Yes/No
-
W5 -
Choose one
Choose one
Yes/No
-
W6 -
Choose one
Choose one
Yes/No
-
2g. Total Wetland Impacts:
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
Stream impact
number
Permanent (P) or
Temporary (T)
3b.
Type of impact
3c.
Stream name
3d.
Perennial (PER) or
intermittent (INT)?
3e.
Type of
jurisdiction
3f.
Average
stream
width
(feet)
3g.
Impact
length
(linear
feet)
S1 P
Culvert
Stream A
INT
Corps
3
9
S2 P
Gabion Baskets
Stream A
INT
Corps
3
30
S3 P
Rip rap apron
Stream A
INT
Corps
3
10
S4 -
Choose one
S5
Choose one
S6
Choose one
-
3h. Total stream and tributary impacts
49
3i. Comments:
Previously, 39 LF of impacts were authorized by the USACE under NWP 3, not requiring pre -construction notification to NCDWR because impacts
were less than 40 LF.
Page 4 of 10
PCN Form — Version 1.4 January 2009

4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then indivii ually list all open water impacts below.
4a.
Open water
impact number
Permanent (P) or
Temporary
4b.
Name of waterbody
(if applicable)
4c.
Type of impact
4d,
Waterbody
type
4e.
Area of impact (acres)
01
Choose one
Choose
O2 -
Choose one
Choose
03
Choose one
Choose
04
Choose one
Choose
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below.
5a.
Pond ID number
5b.
Proposed use or
purpose of pond
5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
(acres)
Flooded
Filled
Excavated Flooded
Filled Excavated
P1
Choose one
P2
Choose one
5f. Total:
5g. Comments:
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a. Project is in which protected basin?
❑ Neuse ❑ Tar -Pamlico ❑ Catawba ❑ Randleman ❑ Other:
6b.
Buffer Impact
number —
Permanent (P) or
Temporary
6c.
Reason for impact
6d.
Stream name
6e.
Buffer
mitigation
required?
6f.
Zone 1
impact
(square
feet)
6g.
Zone 2
impact
(square
feet
B1
Yes/No
132
Yes/No
B3 -
Yes/No
64 -
Yes/No
B5 -
Yes/No
136 -
Yes/No
6h. Total Buffer Impacts:
6i. Comments:
Page 5 of 10

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Gabion baskets were constructed over a traditional rip rap apron because bank slopes were too steep to place rip rap for fear it would wash out and
further impact downstream waters and subsequent erosion would take place. The pipe extension was as minimal as possible to provide public safety
along the adjacent roadway.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Appropriate erosion control techniques were employed throughout construction so as to minimize impacts to downstream waters. All work was
constructed in the dry.
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 ❑X 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
El Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter)
Type: Choose one
Type: Choose one
Type: Choose one
Quantity:
Quantity:
Quantity:
3c. Comments:
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
❑ Yes
4b. Stream mitigation requested:
linear feet
4c. If using stream mitigation, stream temperature:
Choose one
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested:
acres
4f. Non -riparian wetland mitigation requested:
acres
4g. Coastal (tidal) wetland mitigation requested:
acres
4h. Comments:
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.
Page 6 of 10
PCN Form — Version 1.4 January 2009

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation?
❑ Yes QX 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 7 of 10

E.
Stormwater Management and Diffuse Flow Plan (required by DWQ)
1.
Diffuse Flow Plan
1a.
Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ❑X No
within one of the NC Riparian Buffer Protection Rules?
1 b.
If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes ❑ No
2.
Stormwater Management Plan
2a.
What is the overall percent imperviousness of this project?
0%
2b.
Does this project require a Stormwater Management Plan?
❑ Yes 0 No
2c.
If this project DOES NOT require a Stormwater Management Plan, explain why:
Storm water infrastructure project does not increase existing impervious surface.
2d.
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
2e.
Who will be responsible for the review of the Stormwater Management Plan?
3.
Certified Local Government Stormwater Review
3a.
In which localgovernment's jurisdiction is thisproject?
❑ 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 8 of 10
PCN Form — Version 1.4 January 2009

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal/state/local) funds or the
0 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 ❑X 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
❑ Yes ❑ 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 0 No
or Riparian Buffer Rules (15A NCAC 213 .0200)?
2b. Is this an after -the -fact permit application?
OYes ❑ No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
This project was previously authorized by the USACE under NWP #3 for less than 40 LF of impacts to a jurisdictional stream. As a result of site
constraints encountered during construction (poor soil stability, steep slopes, safety concerns), additional impacts to Stream A were accrued in the
form of 10 LF of rip rap apron to tie in gabion baskets to the existing natural channel grade. This field change made total impacts greater than 40 LF,
requiring written authorization from NCDWR.
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in
❑Yes 0 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.
Not applicable.
Page 9 of 10
PCN Form — Version 1.4 January 2009

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
❑ Yes ❑X No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ❑X No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted.
-
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NCNHP database of Element Occurrences found no instances of protected species within a 1 -mile radius of the project area. NCNHP did not respond
to inquiry dated 5/12/14 by Carolina Wetland Services concerning this project.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ❑X No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
NOAA Fisheries: http:??sharpfin.n,fs.noaa.gov/website/EFH_Mapper/map.aspx
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
❑ Yes ❑X No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
Consulted NCSHPO online GIS service and Char-Meck Historie Landmarks commission and found no sites within the project limits. Corresponded via
letter on 5/12/14 with NCSHPO but received no response.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA -designated 100 -year floodplain?
❑ Yes X❑ No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination?
FEMA FIRM No. 3710453300J
Digitally signed by Erin
Erin Shanaberger
Erin Shanaberger
DN: cn=Erin Shanaberger, o, ou,
email=[e-mail]
Shanaberger otte.nc.us,FUB
03-20-2017
Date: 2017.03.15 11:27:38 -04'00'
Applicant/Agent's Printed Name
Date
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization
letter from the applicant isprovided.)
Page 10 of 10

1 2 3 4 3 S 6 NOTES: NOTES (cont.l:
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REWWEMENtS OF THE MOST CURRENT ETWOTONS OF THE CHARLOTTE DEPT. OF ENSURING THATALL EXISTING UTILITIES ARE LOCATED PRIOR TO BEGINNING
v r tl(
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TRANSPORTA(CDOT) WORN AREA TRAFFIC CONTROL HANOBOOK(W.T.CM.). THE CONSTRUCTION
A.
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MANUAL W UNIFORM TRAFFIC CONTROL DEMCES(M.U.TCD.). THE NORTH CAROLINA 1{. USE G.A55 I RIPRAP WIlH CSO R 12' DIAL N PROP. CHECK DAN AS SHOWN,
TO THE M.U.T.CD.• THE NGDOT
NE01mrm
DEPARTMENT OF TRAM SPCRTATON(NCCOT) SUPPLEMENT <.r +. •n..+ -
PER CLDS DETAIL 30.10.
ROADWAY STANDARD DRANNGS AND THE CURRENT EDITION OF THE NCDOT STANDARD •.'"
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2_ ALL PIPE JOINTS ARE TO BE MAPPED WITH NON -WOVEN GEOTE%TRE AT LEAST 12'
16. CONTRACTOR TO NOTIFY PROPERTY OWNER(5) PRIM+ TO RELOCATING ANY
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BEYOND THE JOINT WITH A MNNVN IY a OVERLAP.
E%IS19W FENCING TO MAINTAIN SEQORE COFINEMENT FOR PETS
696
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3. REMOVE. PROPERLY DISPOSE OF. AND REPLACE "STING PIPE. NO CONSTRUCTION
17. ANY EI65TNG FENCNC WITHIN THE PROP. STORM GRAN EASEMENT REMOVED
696
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4. REPLACE BACKFEL EXCAVATED MOM RPE TRENCH(ES) WITHIN RKHT-OF-WAY WITH 16. CONTRACTOR IS RESPONSIBLE FOR ADHERING TO ALL EROSION CONTROL _
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692
PROPO.En
--- /
69
SELECT BACKFILL MATERIA COMPACTED PER CONTRACT REQUIREMENTS. MEASURES AS NECESSARY PER CITY AND STATE REOUMEAWMTS. CONTRACTOR
S CONCRETE to BE REPLACED SHALT BE SAWCUT AND SHALL BE REMOVED IN FULL SHALL SEED ALL DISTURBED NRRMW$ AREAS A$ NEEDED PROJECTS
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SIDEWALK. AND DRIVEWAY. .,
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APPROVED EW Al. PER ENGINEER MATTING SHALL BE INSTALLED PER NCDElAt
STANDARDS AND SPE PONS. 20. CaNTRACTOR IS RESPONSIBLE FOR ALL DEAN UP a WOW AREA VICINITY MAP NTS
5
67Elevations
]. Al RIM ELEVATIONS LISTED ARE MEASURED AT CENTERLINE OF GRATE AT EDGE OF 21. ALL CROSS-SECTIONS SIgWN ARE WT LOOKING UPSTREAM.
of pipes were
PAVEMENT.
22 ALL PROPOSED STOR4WATER PPE SHALL BE CLASS Y UNLES NOTED
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raised upward to avoid
5.USE SAME SIZE RPRAP FOR APRONS AND TEMPORARY CHECK DAMS. OTHERWISE.
672
poor soil and dangerous
construction conditions
9. CONTRACTOR SHALL EMPLOY PUMP AROUND MEASURES DURING CONSTRUCTION AND 23. CONTRACTOR TO BUILD NON-STANDARD STRUCTURE PER NCDOT STANDARD
67
INSTALLATION OF 54 -INCH WE, HEADWALL AND RIPRAP APRON. DETAIL MOT. PAYMENT FOR NON-STANDARD STRUCTURE TO BE MADE
UNDER CCNTRACT SPECIAL PROVISION ON A PER VOLUME BASIS-
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10. WHEN ROOT PRUNING IS NECESSARY, CUT ROOTS CLEANLY USING A DISC MENCHER IN
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REWWEMENtS OF THE MOST CURRENT ETWOTONS OF THE CHARLOTTE DEPT. OF ENSURING THATALL EXISTING UTILITIES ARE LOCATED PRIOR TO BEGINNING
v r tl(
TRANSPORTA(CDOT) WORN AREA TRAFFIC CONTROL HANOBOOK(W.T.CM.). THE CONSTRUCTION
A.
Y
MANUAL W UNIFORM TRAFFIC CONTROL DEMCES(M.U.TCD.). THE NORTH CAROLINA 1{. USE G.A55 I RIPRAP WIlH CSO R 12' DIAL N PROP. CHECK DAN AS SHOWN,
TO THE M.U.T.CD.• THE NGDOT
NE01mrm
DEPARTMENT OF TRAM SPCRTATON(NCCOT) SUPPLEMENT <.r +. •n..+ -
PER CLDS DETAIL 30.10.
ROADWAY STANDARD DRANNGS AND THE CURRENT EDITION OF THE NCDOT STANDARD •.'"
O N
V �I
SPECIFICATIONS FOR ROADS AND STRUCTURES
15. CHECK DAM SHALL BE T1Y0 FEET (11 IN HEIGHT. e
O E" U
2_ ALL PIPE JOINTS ARE TO BE MAPPED WITH NON -WOVEN GEOTE%TRE AT LEAST 12'
16. CONTRACTOR TO NOTIFY PROPERTY OWNER(5) PRIM+ TO RELOCATING ANY
BEYOND THE JOINT WITH A MNNVN IY a OVERLAP.
E%IS19W FENCING TO MAINTAIN SEQORE COFINEMENT FOR PETS
3. REMOVE. PROPERLY DISPOSE OF. AND REPLACE "STING PIPE. NO CONSTRUCTION
17. ANY EI65TNG FENCNC WITHIN THE PROP. STORM GRAN EASEMENT REMOVED
REFUSESHALL BE BURIED ON SITE j
$HALL BE REINSTALLED OR REPLACED WTH EQUIVALENT
CEN AT
1. ALL TRAFFIC CONTROL DEVICE $ AND PROCEDURES SMALL CONFORM TO THE 13. CONTRACTOR I$ RESPONSIBLE FORCONTAGTNG APPROPRIATE PARTES h
REWWEMENtS OF THE MOST CURRENT ETWOTONS OF THE CHARLOTTE DEPT. OF ENSURING THATALL EXISTING UTILITIES ARE LOCATED PRIOR TO BEGINNING
v r tl(
TRANSPORTA(CDOT) WORN AREA TRAFFIC CONTROL HANOBOOK(W.T.CM.). THE CONSTRUCTION
A.
Y
MANUAL W UNIFORM TRAFFIC CONTROL DEMCES(M.U.TCD.). THE NORTH CAROLINA 1{. USE G.A55 I RIPRAP WIlH CSO R 12' DIAL N PROP. CHECK DAN AS SHOWN,
TO THE M.U.T.CD.• THE NGDOT
�
DEPARTMENT OF TRAM SPCRTATON(NCCOT) SUPPLEMENT <.r +. •n..+ -
PER CLDS DETAIL 30.10.
ROADWAY STANDARD DRANNGS AND THE CURRENT EDITION OF THE NCDOT STANDARD •.'"
O N
V �I
SPECIFICATIONS FOR ROADS AND STRUCTURES
15. CHECK DAM SHALL BE T1Y0 FEET (11 IN HEIGHT. e
O E" U
2_ ALL PIPE JOINTS ARE TO BE MAPPED WITH NON -WOVEN GEOTE%TRE AT LEAST 12'
16. CONTRACTOR TO NOTIFY PROPERTY OWNER(5) PRIM+ TO RELOCATING ANY
BEYOND THE JOINT WITH A MNNVN IY a OVERLAP.
E%IS19W FENCING TO MAINTAIN SEQORE COFINEMENT FOR PETS
3. REMOVE. PROPERLY DISPOSE OF. AND REPLACE "STING PIPE. NO CONSTRUCTION
17. ANY EI65TNG FENCNC WITHIN THE PROP. STORM GRAN EASEMENT REMOVED
REFUSESHALL BE BURIED ON SITE j
$HALL BE REINSTALLED OR REPLACED WTH EQUIVALENT
4. REPLACE BACKFEL EXCAVATED MOM RPE TRENCH(ES) WITHIN RKHT-OF-WAY WITH 16. CONTRACTOR IS RESPONSIBLE FOR ADHERING TO ALL EROSION CONTROL _
� - •
SELECT BACKFILL MATERIA COMPACTED PER CONTRACT REQUIREMENTS. MEASURES AS NECESSARY PER CITY AND STATE REOUMEAWMTS. CONTRACTOR
S CONCRETE to BE REPLACED SHALT BE SAWCUT AND SHALL BE REMOVED IN FULL SHALL SEED ALL DISTURBED NRRMW$ AREAS A$ NEEDED PROJECTS
"
PANEL SECTIONS MATCH EXISTING CROSS-SECTIONS WHEN REPLACING CURB. GUTTER, 19. CONTRACTOR MAINTAIN SITE. CONTRACTOR TACE ALL
SIDEWALK. AND DRIVEWAY. .,
ON
RESPONSIBLE MEASURES TO PREVENT TRACKING YUO/$OIL ON ACTIVE
ME SURE TO ENT
6. CONTRACTOR SHALL USE 100% BIODEGRADABLE EROSION CONTROL MATTING OR ROADWAYS. ANY MUD/SOL TRACKED ON PAVEMENT SMALL BE CLEANED DAL
APPROVED EW Al. PER ENGINEER MATTING SHALL BE INSTALLED PER NCDElAt
STANDARDS AND SPE PONS. 20. CaNTRACTOR IS RESPONSIBLE FOR ALL DEAN UP a WOW AREA VICINITY MAP NTS
]. Al RIM ELEVATIONS LISTED ARE MEASURED AT CENTERLINE OF GRATE AT EDGE OF 21. ALL CROSS-SECTIONS SIgWN ARE WT LOOKING UPSTREAM.
PAVEMENT.
22 ALL PROPOSED STOR4WATER PPE SHALL BE CLASS Y UNLES NOTED
5.USE SAME SIZE RPRAP FOR APRONS AND TEMPORARY CHECK DAMS. OTHERWISE.
e s
9. CONTRACTOR SHALL EMPLOY PUMP AROUND MEASURES DURING CONSTRUCTION AND 23. CONTRACTOR TO BUILD NON-STANDARD STRUCTURE PER NCDOT STANDARD
W m
INSTALLATION OF 54 -INCH WE, HEADWALL AND RIPRAP APRON. DETAIL MOT. PAYMENT FOR NON-STANDARD STRUCTURE TO BE MADE
UNDER CCNTRACT SPECIAL PROVISION ON A PER VOLUME BASIS-
:, F
y W
m
10. WHEN ROOT PRUNING IS NECESSARY, CUT ROOTS CLEANLY USING A DISC MENCHER IN
!O
ACCORDANCE NTH SECTION 01000 OF THE CITY OF CHARLOTTE L.ANOSCAPEppy
CONSTRUCTION STANDARDS. PRUNING SHALL BE PER THE LATEST STANDARD OF THE
q
LANDSCAPE CONSTRUCTION STANDARDS MANUAL (TMP.)
G
11. TREEPROTECTION SHALL BE N ACCORDANCE NTH CLD STD, 40.02 WHEN THE TREE
4 O
Is CLOSE TO THE YARN AREA TREE PROTECTION CLD SID. 40.12 SHALL BE USED.
e
12 CONTRACTOR SHALL VERIFY THAT EVS11NO SANITARY SEWER IS IRON AT PONT OF
CROS.SNG OF 16 -NCH STORM PPE. IF SANITARY SEWER Is VERIFIED TO BE
16
B ,$
G
O+CID OH'SO 1+00 1+50 2+00 �. 1H00 MGN -FERROUS. CONTRACTOR SNARL REPLACE WI7N 1D FEET OF IMP. TIERED
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ieel� _ WATER
LOWERING OF 6- TO 17
WATER MAIN

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action ID. 2014-01206 County: Mecklenburg USGS Quad: NC- Charlotte West
r
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION.
' 14 IT 11-IM19-W
Property Owner / Authorized Agent: CMSWS / Attn: Isaac Hinson R C i -HUED i, ��
Address: 600 E Fourth Street
Charlotte, NC 28202
Telephone No.: 704-336-6586
Size and location of property (water body, road name/number, town, etc.): This project is located at
4518 West TyvoIa Road in Charlotte, Mecklenburg County, NC. Coordinates are: 35.2087 N -
80.9054 W.
Description of projects area and activity: This verification authorizes permanent impacts to 39
LF of stream channel for the replacement/extension of a failing culvert with riprap apron.
Applicable Law: N Section 404 (Clean Water Act, 33 USC 1344)
❑ Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: Regional General Permit Number:
Nationwide Permit Number: 3
Additional Remarks and/or Special Permit Conditions:
1) Please be advised that if additional impacts to waters of the U.S., either on this property or
on/adjacent to this property and associated with this project/activity, are proposed at a later date,
those impacts will be combined with the current impacts to waters of the U.S. and will be reviewed
cumulatively. Generally, compensatory mitigation will be required if individual or cumulative (i.e.,
past and present) losses or degradation of waters of the U.S. are greater than 150 linear feet of
perennial or intermittent stream channel and/or 0.1 acre of wetland. Additionally, cumulative
impacts that result in the loss or degradation of greater than 300 linear feet of perennial or
intermittent* stream channel, and/or 0.5 acre of wetland, will be processed under an Individual
Permit. This verification of the.use of the Nationwide Permit Program for this project does not
imply that this office will necessarily approve any future proposal to impact waters of the U.S. on
this property and/or. associated with this projectlactivity.
* The District Commander has the ability to waive the 300 linear foot limit for intermittent streams
on a case-by-case basis. All requests for waiver must be in writing and shall include rationale for
the request
Y- -> i&�authorized#y ve refereneed permit provided it ilir �atrict acser "cam ith
the attached conditions and your submitted plans. Any violation of the attached conditions or deviation from
your submitted plans may subject the permittee to a stop work order, a restoration order and/or appropriate
legal action.
This verification will remain valid until the expiration date identified below unless the nationwide authorization
is modified, suspended or revoked. It, prior to the expiration date identified below, the nationwide permit
authorization is reissued and/or modified, this verification will remain valid until the expiration date identified
below, provided it complies with all requirements of the modified nationwide permit. If the nationwide permit
authorization expires or is suspended, revoked, or is modified, such that the activity would no' longer comply with
the terms and conditions of the nationwide permit, activities which have commenced (i.e., are under construction) or
are under contract to commence in reliance upon the nationwide permit, will remain authorized provided the activity
is completed within twelve months of the date of the nationwide permit's expiration, modification or revocation,
unless discretionary authority has been exercised on a case-by-case basis to modify, suspend or revoke the
authorization.

Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality
Certification. You should contact the NC Division of Water Quality (telephone [phone]) to determine
Section 401 requirements. You may also visit their website at: http://portal.ncdenr.org/web/wq/swp/ws/webscape
For activities occurring within the twenty coastal counties subject to regulation under the Coastal Area
Management Act (CAMA), prior to beginning work you must contact the N.C. Division of Coastal Management.
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other
required Federal, State or local approvals/permits.
. If there are any questions regarding this verification, any of the conditions of the Permit, or the Corps of
Engineers regulatory program, please contact Steve Kichefski at 828-271-7980.
Corps Regulatory Official Steve Kichefski Y "`' Date: July 3, 2014
Expiration Date of Verification: March 18, 2017
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 the Customer Satisfaction Survey located at our website at
http://per2.=.usace.pM.mil/survey.html to complete the survey online.
Determination of Jurisdiction:
A. ❑ Based on preliminary information, there appear to be waters of the US including wetlands within the above
described project area. This preliminary determination is not an appealable action under the Regulatory
Program Administrative Appeal Process ( Reference 33 CFR Part 331).
B. ❑ 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.
C. ® There are waters of the US and/or wetlands within 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.
D. ❑ The jurisdictional areas within the above described project area have been identified under a previous action.
Please reference jurisdictional determination issued . Action ID
Basis of Jurisdictional Determination:
There are stream channels located within the project area that exhibit indicators of ordinary high water marks. The
stream channel within the project area is an unnamed tributary to Irwin Creek which flows into the Lower Catawba
Watershed, Santee Basin, HUC: 03050103. The UT to Irwin Creek flows to the Atlantic Ocean via Irwin Creek,
Sugar Creek, the Catawba River and the Santee -Cooper River. The Catawba River is navigable -in -fact at the Mt.
Island Lake Dam.
Attention USDA Program Participants
This delineation/determination hag 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.
Appeals Information: (This information applies only to approved jurisdictional determinations as indicated in
B and C 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 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 1OM15
Atlanta, Georgia 30303-8801
Phone: [phone]
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 within 60
days of the issue date below.
**It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this
correspondence.**
Corps Regulatory Official: Steve Kichefski j I
Issue Date: July 3, 2014 Expiration Date: Five years from Issue Date
Copy Furnished:
Kelly Thames, Carolina Wetland Services, Inc., 550 E Westinghouse Blvd., Charlotte, NC 28273

Permit Number: 2014-01206
Permit Type: NW3
Name of County: Mecklenburg
Name of Permittee: CMSWS / Attn: Isaac Hinson
Date of Issuance: July 3, 2014
Project Manager: Steve Kichefski
Upon completion of the activity authorized by this permit and any mitigation required by the
permit, sign this certification and return it to the following.address:
U.S. Army Corps of Engineers
Attention: CESAW-RG-A
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
Please note that your permitted activity is subject to a compliance inspection by an U.S. Army
Corps of Engineers representative. If you fail to comply with this permit you are subject to
permit suspension, modification, or revocation.
I hereby certify that the work authorized by the above referenced permit has been completed in
accordance with the terms and conditions of the said permit, and required mitigation was
completed in accordance with the permit conditions.
Signature of Permittee
Date

NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS,AND PROCESS AND
REQUEST FOR APPl AI ;
Applicant: CMSWS / Attn: Isaac Hinson File Number: 2014-01206 Date: July 3, 2014
Attached. is: See Section below
INITIAL PROFFERED PERMIT Standard Permit or Letter ofpermission) A
PROFFERED PERMIT (Standard Permit or Letter of permission) B
PERMIT DENIAL C
APPROVED JURISDICTIONAL DETERMINATION D
X PRELIMINARY JURISDICTIONAL DETERMINATION F
SECTION I- The following identifies your rights and options regarding an administrative appeal of the above
decision. Additionalinformation may be found at
http://www.usace.arrny.aiil/CECW/Pa,c!es/regjnaterials.4spx or Corps regulations at 33 CFR Part 331._
A: INITIAL PROFFERED PERMIT: You may accept or 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 permit 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
emgleting Section- and sendingtlme for to the divisiumenginee
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 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.

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.
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.
If you have questions regarding this decision and/or the appeal
process you may contact:
Steve Kichefski, Project Manager
USACE, Asheville Regulatory Field Office
151 Patton Ave
RM 208
Asheville, NC 28801
828-271-7980
If you only have questions regarding the appeal process you may
also contact:
Mr. Jason Steele, Administrative Appeal Review Officer
CESAD-PDO
U.S. Army Corps of Engineers, South Atlantic Division
60 Forsyth Street, Room 1OM15
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 investigations.
of appellant or
For appeals on Initial Proffered Permits send this form to:
District Engineer, Wilmington Regulatory Division, Attn: Steve Kichefski, 69 Darlington Avenue,
Wilmington, North Carolina 28403
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]

ATTACHMENT
PRELIMINARY JURISDICTIONAL DETERMINATION FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PRELIMINARY JURISDICTIONAL
DETERMINATION (JD): 05/20/2014
B. NAME AND ADDRESS OF PERSON REQUESTING PRELIMINARY JD:
Charlotte - Mecklenburg Storm Water Services
POC; Mr. Isaac Hinson
600 E. Fourth Street
Charlotte, North Carolina 28202
C. DISTRICT OFFICE, FILE NAME; AND NUMBER: Wilmington District —
Asheville Regulatory Field Office CeSAk_1-R-(3-f} ; 5q.a-�iN-at�a(c �CMSwS -
qS3o xJ TyWC.0 I1a:�lAnc-Ka P(a1.
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION: 4530 V
West Tyvola Road, Charlotte, NC
(USE THE ATTACHED TABLE TO DOCUMENT MULTIPLE WATERBODIES
AT DIFFERENT SITES)
State NC County/parish/borough: Mecklenburg City: Charlotte
35.2087670 N, Long. 80.9054090 W.
Universal Transverse Mercator: NAD 83
Name of nearest waterbody: UT to Irwin Creek
Identify (estimate) amount of waters in the review area:
Non -wetland waters: 97 linear feet: 3'-4' width (ft) and/or 0.008 acre.
Cowardin Class: R4SB3
Stream Flow: Intermittent
Wetlands.
Cowardin Class:
Name of any4vatc�r-phnd _Qn the site that- hip@@n @nt,',f,'@d as be -t -tion 10
waters:
Tidal:
Non -Tidal:
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT
APPLY):
M Office (Desk) Determination. Date: July
® Field Determination. Date(s): May 12, 2014

1. The Corps of Engineers believes that there may be jurisdictional waters of the
United States on the subject site, and the permit applicant or other affected party
who requested this preliminary JD is hereby advised of his or her option to
request and obtain an approved jurisdictional determination (JD) for that site.
Nevertheless, the permit applicant or other person who requested this
preliminary JD has declined to exercise the.option to obtain an approved JD in
this instance and at this time.
2. In any circumstance where a permit applicant obtains an individual permit, or
a Nationwide General Permit (NWP) or other general permit verification requiring
"pre -construction notification" (PCN), or requests verification for a non -reporting
NWP or other general permit, and the permit applicant has not requested an
approved JD for the activity, the permit applicant is hereby made aware of the
following:'(1) the permit applicant has elected. to seek a permit authorization
based on a preliminary JD, which does not make an official determination of
jurisdictional waters; (2) that the applicant has the option to request an approved
JD before accepting the terms and conditions of the permit authorization, and
that basing a permit authorization on an approved JD could possibly result -in less
compensatory mitigation being required or different special conditions; (3) that
the applicant has the right to request an individual permit rather than accepting
the terms and conditions of the NWP or other general permit authorization; (4)
that the applicant can accept a permit authorization and thereby agree to comply
with all the terms and conditions of that permit, including whatever mitigation
requirements the Corps has determined to be necessary; (5) that undertaking
any activity in reliance upon the subject permit authorization without requesting
an approved JD constitutes the applicant's acceptance of the use of the
preliminary JD, but that either form of JD will be processed as soon as is
practicable; (6) accepting a permit authorization (e.g., signing a proffered
individual permit) or undertaking any activity in reliance on any form of Corps
permit authorization based on a preliminary JD constitutes agreement that all
wetlands and other water bodies on the site affected in any way by that activity
are jurisdictional waters of the United States, and precludes any challenge to
such jurisdiction in any administrative or judicial compliance or enforcement
action, or in any administrative appeal or in any Federal court; and (7) whether
the applicant elects to use either an approved JD or a preliminary JD, that JD
-- ---- wilr>re processed as soon as is pracfic`a— le. -Tumor her, anappr� JD, a pro ere
individual permit (and all terms and conditions contained therein), or individual
permit denial can be administratively appealed pursuant to 33 C.F.R. Part 331,
and that in any administrative appeal, jurisdictional issues can be raised (see 33
C.F.R. 331.5(a)(2)). If, during that administrative appeal, it becomes necessary
to make an official determination whether CVVA jurisdiction exists over a site, or
to provide an official delineation of jurisdictional waters on the site, the Corps will
provide an approved JD to accomplish that result, as soon as is practicable.
This preliminary JD finds that there "may be" waters of the United States on the
subject project site, and identifies all aquatic features on the -site that could be
affected by the proposed activity, based on the following information:
2

SUPPORTING DATA. Data reviewed for preliminary JD (check all that apply
- checked items should be included in case file and, where checked and
requested, appropriately reference sources below):
® Maps, plans, plots or plat submitted by or on behalf of the
applicant/consultant:
® Data sheets prepared/submitted by or on behalf of the'
applicant/consultant.
❑ Office concurs with data sheets/delineation report.
❑ Office does not concur with data sheets/delineation report.
❑ Data sheets prepared by the Corps:
❑ Corps navigable waters' study:
❑ U.S. Geological Survey Hydrologic Atlas:
❑ USGS NHD data.
❑ USGS 8 and 12 digit HUC maps.
® U.S. Geological Survey map(s). Cite scale & quad name:1:24,000,
Charlotte West, NC, Dated 1996.
® USDA Natural Resources Conservation Service Soi6Survey. Citation:
Mecklenburg County Soil Survey.
❑ National wetlands inventory map(s). Cite name:
❑ State/Local wetland inventory map(s):
❑ FEMA/FIRM maps:
❑ 100 -year Floodplain Elevation is:
of 1929)
(National Geodectic Vertical Datum
® Photographs: ❑ Aerial (Name & Date):
or ® Other (Name & Date):Site photographs of stream channel
(May, 2014)._
❑ Previous determination (s). File no. and date of response letter:
❑ Other information (please specify):
IMPORTANT NOTE: The information recorded on this form has not necessarily
been verified by -the Corps and should not be relied upon for later jurisdictional
determinations.
Signature and date of
Regulatory Project Manager
(REQUIRED)
,Z-
05/20/2014 05/20/2014
Signature and date of
person requesting preliminary JD
(REQUIRED, unless obtaining the
signature is impracticable)

Estimated
Site Latitude Longitude Cowardian Auatic Amount of Class of Aquatic
gq
Number Class Resource
Resource in
Review Area
Stream A N35.208767' W80.905409' R4SB3 97 linear feet non -section 10 — non -tidal

Corps Submittal Cover Sheet
Please provide the following info:
1. Project Name 4530 West Tyvola Road Maintenance Project
2. Name of Property Owner/Applicant: Charlotte -Mecklenburg Storm Water Services (CMSWS
3. Name of Consultant/Agent: CMSWS; Mr. Isaac Hinson, PWS
*Agent authorization needs to be attached.
4. Related/Previous Action ID number(s): N/A
5. Site Address: 4530 West Tyvola Road, Charlotte, NC
6. Subdivision Name: N/A
7. City: Charlotte
8. County: Mecklenburg
9. Lat: N35.2087670 Long: W80.905409° (Decimal Degrees Please)
10. Quadrangle Name: Charlotte West, NC, dated 1996
11. Waterway: UT to Irwin Creek
12. Watershed: Santee (HU# 03050103)
13. Requested Action:
X Nationwide Permit # 3
General Permit #
X Jurisdictional Determination Request
Pre -Application Request
The following information will be completed by Corps office:
AID:
Prepare File Folder Assign number in ORM Begin Date
Authorization: Section 10 Section 404
Project Description/ Nature of Activity/ Project Purpose:
Site/Waters Name:
Keywords:

Carolina Wetland Services
fir►
May 20, 2014
Mr. Steven Kichefski
U.S. Army Corps of Engineers
151 Patton Avenue, Room 208
Asheville, NC 28801
550 E WESTINGHOUSE BLVD.
CHARLOTTE, NC 28273
866-527-1177 (office)
704-527-1133 (fax)
Subject: Pre -Construction Notification Pursuant to Nationwide Permit No. 3
4530 West Tyvola Road Maintenance Project
Charlotte, North Carolina
Carolina Wetland Services Project No. 2014-3351
Dear Mr. Kichefski:
The West Tyvola Road maintenance project is located on the corner of West Tyvola Road and Shady
Lane at 4530 West Tyvola Road in Charlotte, North Carolina (Figure 1. USGS Site Location Map,
attached). The purpose of this project is to replace the existing culvert under Shady Lane and to install
a rip rap apron in accordance with City of Charlotte design standards. Charlotte —Mecklenburg Storm
Water Services (CMSWS) has contracted Carolina Wetland Services, Inc. (CWS) to provide Section
404/401 permitting services for this project.
Applicant Name: Charlotte -Mecklenburg Storm Water Services, Isaac J. Hinson, PWS
Mailing Address: 600 East Fourth Street, Charlotte, NC 28202
Phone Number of Owner/Applicant: 704-336-4495
Street Address of Project: 4530 West Tyvola Road, Charlotte, NC
Tax Parcel ID: 14522121 and 14522107
Waterway: UT to Irwin Creek
Basin: Santee (HU# 03050103)
City: Charlotte
County: Mecklenburg
Decimal Degree Coordinate Location of Project Site: N35.208767°, W80.905409°
USGS Quadrangle Name: Charlotte West, NC, dated 1996
Current Land Use
The project area is approximately 0.21 acre in extent and is located in a residential neighborhood.
Dominant vegetation within the project area consists of tulip poplar (Liriodendron tulipifera), cherry
(Prunus serotina), slippery elm (Ulmus rubra), kudzu (Pueraria montana), and Japanese honeysuckle
(Lonicera japonica), and Bermuda grass (Cynodon dactylon).
According to the Soil Survey of Mecklenburg County' (Figures 2 and 3. NRCS Soil Survey Maps,
attached), on-site soils consist of Cecil -Urban land complex, 8 to 15 percent slopes (CuB) and Enon
sandy loam, 2 to 8 percent slopes (EnB). Both Cecil -Urban land complex soils and Enon soils are well
drained soils. None of the on-site soils are listed on the North Carolina Hydric Soils List for
Mecklenburg CountyZ or on the National Hydric Soils List'.
t United States Department of Agriculture, 2013. Soil Survey of Mecklenburg County, North Carolina.
2 United States Department of Agriculture — Natural Resources Conservation Service, 1999. North Carolina Hydric Soils List, USDA-
NRCS North Carolina State Office, Raleigh
NORTH CAROLINA . SOUTH CAROLINA
WWW.CWS-INC.NET

4530 West Tyvola Road Maintenance Project May 20, 2014
Nationwide Permit No. 3 CWS Project No. 2014-3351
Jurisdictional Determination
On May 12, 2014, CWS scientists' Kelly Thames, Wetland Professional in Training (WPIT) and
Logan Hardin delineated jurisdictional waters of the U.S. within the project area. Jurisdictional areas
were delineated using the U.S. Army Corps of Engineers (USACE) Routine On -Site Determination
Method. This method is defined in the 1987 Corps of Engineers Wetlands Delineation Manua14, with
further technical guidance from the Eastern Mountains & Piedmont Regional Supplements, dated April
2012. A Wetland Determination Data Form representative of non jurisdictional upland areas has been
attached (DPI). No jurisdictional wetlands are located within the project limits.
Jurisdictional stream channels were classified according to recent USACE and North Carolina
Division of Water Resources (NCDWR) guidance. These classifications included sampling with a D -
shaped dip net, taking photographs, and defining approximate breakpoints (location at which a channel
changes classification) within each on-site stream channel. A NCDWR Stream Classification Form
and USACE Stream Quality Assessment Worksheet representative of Stream A are attached (SCP1).
The results of the on-site field investigation indicate that there is one jurisdictional stream channel (Stream
A) located within the project area (Figure 5, attached). Stream A is an unnamed tributary to Irwin Creek.
Irwin Creek is within the Santee River basin (HU# 03050103)6 and is classified as "Class C" waters by the
NCDWR. On -Site jurisdictional waters of the U.S. are summarized in Table 1, below.
Table 1. Summary of On -Site Jurisdictional Waters of the U.S.
Relatively Permanent Waters with Seasonal Flow
Seasonal RPWs are those streams that exhibit continuous flow seasonally. This flow regime is the result of a
lowering of the water table during dry periods that stops groundwater discharge to the stream channel.
Seasonal streams do not typically support aquatic life requiring year-round flow to support reproductive and
maturation stages.
Stream A exits a culvert underneath Shady Lane in the northern portion of the project area and flows
southeast across the project area for approximately 97 linear feet before flowing to its off-site
confluence with Irwin Creek. Stream A exhibited a moderate bed and bank, weak substrate sorting,
weak flow, moderate sinuosity, and an average ordinary high water width of three to four feet. A weak
presence of amphibians was observed. Stream characteristics indicate that continuous flow is present
for at least three months in a typical year. Stream A was classified as a Relatively Permanent Water
with seasonal flow (RPW) according to USACE/EPA guidance. Seasonal RPW Stream A scored 22
3 United States Department of Agriculture — Natural Resources Conservation Service, 2012. 2012 National Hydric Soils List by State.
4 Environmental Laboratory. 1987. "Corps of Engineers Wetlands Delineation Manual", Technical Report Y-87-1, US Army Engineer
Waterways Experiment Station, Vicksburg, Mississippi.
5 US Army Corps of Engineers, April 2012. Regional Supplement to the Corps of Engineers Wetland Delineation Manual: Eastern
Mountains and Piedmont Region. US Army Engineer Research and Development Center, Vicksburg, Mississippi.
6 "HU#" is the Hydrologic Unit Code. U.S. Geological Survey, 1974. Hydrologic Unit Map, State of North Carolina.
2
Jurisdiction
NCDWR
USACE
Approx.
Approx
USACE/EPA
Jurisdictional
SCP
Steam
Stream
Length
Acreage
g
Feature
Rapanos
Intermittent/
No.
Classification
Assessment
Linear
ac. )
Classification
Perennial
Score
Score
Feet 1
t �
Stream A
Seasonal RPW
Intermittent
SCP1
22
22
971f
0.008
On -Site Total:
9'
0.008 ac
Relatively Permanent Waters with Seasonal Flow
Seasonal RPWs are those streams that exhibit continuous flow seasonally. This flow regime is the result of a
lowering of the water table during dry periods that stops groundwater discharge to the stream channel.
Seasonal streams do not typically support aquatic life requiring year-round flow to support reproductive and
maturation stages.
Stream A exits a culvert underneath Shady Lane in the northern portion of the project area and flows
southeast across the project area for approximately 97 linear feet before flowing to its off-site
confluence with Irwin Creek. Stream A exhibited a moderate bed and bank, weak substrate sorting,
weak flow, moderate sinuosity, and an average ordinary high water width of three to four feet. A weak
presence of amphibians was observed. Stream characteristics indicate that continuous flow is present
for at least three months in a typical year. Stream A was classified as a Relatively Permanent Water
with seasonal flow (RPW) according to USACE/EPA guidance. Seasonal RPW Stream A scored 22
3 United States Department of Agriculture — Natural Resources Conservation Service, 2012. 2012 National Hydric Soils List by State.
4 Environmental Laboratory. 1987. "Corps of Engineers Wetlands Delineation Manual", Technical Report Y-87-1, US Army Engineer
Waterways Experiment Station, Vicksburg, Mississippi.
5 US Army Corps of Engineers, April 2012. Regional Supplement to the Corps of Engineers Wetland Delineation Manual: Eastern
Mountains and Piedmont Region. US Army Engineer Research and Development Center, Vicksburg, Mississippi.
6 "HU#" is the Hydrologic Unit Code. U.S. Geological Survey, 1974. Hydrologic Unit Map, State of North Carolina.
2

4530 West Tyvola Road Maintenance Project May 20, 2014
Nationwide Permit No. 3 CWS Proiect No. 2014-3351
out of a possible 100 points on the USACE Stream Quality Assessment Worksheet and 22 out of a
possible 63 points on the NCD" Stream Classification Form, indicating intermittent status (SCP1,
attached). Photographs A and B (Figure 5, attached) are representative of Seasonal RPW Stream A.
Agency Correspondence
Cultural Resources
A letter was forwarded to the State Historic Preservation Office (SHPO) on May 12, 2014 to determine
the presence of any areas of architectural, historic, or archaeological significance that would be
affected by the project. CWS also consulted the SHPO online GIS service? and the Charlotte
Mecklenburg Historic Landmarks Commission database and found no sites of architectural, historical,
or archaeological significance within the project limits.
Protected Species
A letter was forwarded to the North Carolina Natural Heritage Program (NCNHP) on May 12, 2014 to
determine the presence of any federally -listed, candidate endangered, threatened species or critical
habitat located within the project area. As of the date of this submittal, a response from the NCNHP
has not yet been received. Additionally, CWS consulted Element Occurrence sites provided by
NCNHP and found no occurrences of protected species within a one mile radius of the project limits.
Purpose and Need for the Project
The existing culvert underneath Shady Lane is failing and needs to be updated. The existing 18 -inch
reinforced concrete pipe (RCP) is undersized and is unable to convey the 25 -year storm event in
accordance with the City of Charlotte design standards. The downstream section of the existing
culvert is failing and has resulted in erosion and safety concerns near the road.
The purpose of the project is to replace the downstream section of an existing culvert underneath
Shady Lane. In addition, a rip rap apron will be installed at the culvert outlet in accordance with City
of Charlotte design standards. This project is necessary as there are severe erosion issues in close
proximity to Shady Lane associated with the existing culvert, which raises safety concerns for
pedestrians and vehicles.
Avoidance and Minimization
Impacts to on-site jurisdictional waters of the U.S. have been reduced to the maximum extent possible.
Proper sediment and erosion control measures will be used to minimize disturbances to downstream
waters. All work will be conducted in the dry.
The proposed 54 -inch RCP extension and rip rap apron is necessary as there are severe erosion problems
and safety concerns in close proximity to Shady Lane. The proposed culvert extension will address the
erosion problems and subsequently the safety concerns. Proposed permanent impacts total 39 linear feet
of jurisdictional stream channel. All temporary impacts have been avoided by maintaining the limits of
disturbances within the footprint of the proposed permanent impacts.
Proposed Impacts to Jurisdictional Waters
Under Nationwide Permit (NWP) No. 3, unavoidable permanent impacts to jurisdictional waters of the
U.S. associated with this project are limited to a total of 39 linear feet (0.003 acre) of stream channel
7 http://gis.ncdcr.govihpoweb/. Accessed May 12, 2014.
8 http://www.cmhpf.org/homehistoricproperties.htm. Accessed May 12, 2014.
3

4530 West Tyvola Road Maintenance Project May 20, 2014
Nationwide Permit No. 3 CWS Proiect No. 2014-3351
(Figure 6, attached). Temporary impacts have been avoided by maintaining the limits of disturbance
within the footprint of the proposed permanent impacts.
Eight feet of the downstream section of the existing 18 -inch RCP will be replaced with a new 54 -inch
RCP linear foot for linear foot and will also be extended by an additional nine feet of 54 -inch RCP.
Proposed impacts are the result of the installation of a nine foot extension of a 54 -inch RCP and a 30
linear foot rip rap apron at the outlet of the extended culvert capable of conveying a 25 -year storm event
(Figure 6, attached). In accordance with City of Charlotte's design standards, a rip rap apron is necessary
to protect the culvert's outlet. A plan view and a profile view of the proposed pipe extension and
associated rip rap apron is attached as Figure 6.
Table 2, below, summarizes the unavoidable impacts to on-site jurisdictional waters of the U.S.
Table 2. Summary of Impacts to On -Site Jurisdictional Waters of the U.S.
On behalf of CMSWS, CWS is submitting a Pre -Construction Notification Application with attachments
in accordance with Nationwide Permit General Condition No. 31, (attached) and pursuant to Nationwide
Permit No. 3. Due to the limited permanent impacts (less than 40 linear feet of jurisdictional stream
channel), this project does not require written authorization from the North Carolina Division of Water
Resources (NCDWR), formerly the North Carolina Division of Water Quality (NCDWQ).
Compensatory Mitigation
Permanent impacts to jurisdictional waters of the U.S. have been limited to 39 linear feet of stream
channel. Based on the evaluation of the channel, as documented in the USACE and NCDWR stream
forms, RPW Stream A exhibits minimal presence of biological indicators and therefore has low aquatic
function (LAF). Therefore, no mitigation is proposed for these impacts.
4
Temporary / PermanentApprox.
Jurisdictional
Intermittent /
Impact Type
NWP
Approximate
Feature
Perennial
No.Len
th l
Acreage
RPW Stream A
Intermittent
Armor
3
301f (Permanent)
0.002
RPW Stream A
Intermittent
Culvert
3
91f (Permanent)
0.0007
Stream Impacts (Total)
391f
0.003 acre
Stream Impacts (Temporary)
0 if
0 acre
Stream Impacts (Permanent)
391f
0.003 acre
On behalf of CMSWS, CWS is submitting a Pre -Construction Notification Application with attachments
in accordance with Nationwide Permit General Condition No. 31, (attached) and pursuant to Nationwide
Permit No. 3. Due to the limited permanent impacts (less than 40 linear feet of jurisdictional stream
channel), this project does not require written authorization from the North Carolina Division of Water
Resources (NCDWR), formerly the North Carolina Division of Water Quality (NCDWQ).
Compensatory Mitigation
Permanent impacts to jurisdictional waters of the U.S. have been limited to 39 linear feet of stream
channel. Based on the evaluation of the channel, as documented in the USACE and NCDWR stream
forms, RPW Stream A exhibits minimal presence of biological indicators and therefore has low aquatic
function (LAF). Therefore, no mitigation is proposed for these impacts.
4

4530 West Tyvola Road Maintenance Project May 20, 2014
Nationwide Permit No. 3 CWS Proiect No. 2014-3351
Please do not hesitate to contact Isaac Hinson at 704-336-4495 or [e-mail] should
you have any questions or comments regarding these findings.
Hi son,
Isaac J. Hi son, PWS
Wetland Specialist
feolll hames, WPIT
Project Scientist
Attachments: Figure 1. USGS Site Location Map
Figure 2. Current USDA-NRCS Mecklenburg County Soil Survey
Figure 3. Historic USDA-NRCS Mecklenburg County Soil Survey
Figure 4. Aerial Imagery Map
Figure 5. Approximate Jurisdictional Boundary Field Map
Figure 6. Proposed Impacts — Plan and Profile View
Pre -Construction Notification Pursuant to Nationwide Permit No. 3
NCDWR Stream Classification Form (SCP I)
USACE Stream Quality Assessment Worksheet (SCP I)
USACE Wetland Determination Data Form (DPI)
Preliminary Jurisdictional Determination Form
Representative Photographs
cc: Mr. Bryan Tompkins, U.S. Fish & Wildlife Service
File

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r
4 MeD �4-4
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I
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Soils - Description Legend
CII - Cecil-Urban land complex, 8-15% slopes `' ` ;
o Ur
� Project Limits
EnB - Enon sandy loam, 2-8% slopes
t\,-,t' 1,000 500 0 1,000 Feet
REFERENCE. HISTORIC NRCS-USDA SOIL SURVEY OF MECKLENBURG COUNTY, SHEET 6, DATED 1916.
� � t
SCALE 1" : 1000' DATE: 5-12-14 Historic NRCS-USDA Soil Survey FIGURE NO.
CWS PROJECT NO. DRAWN BY. [ I of Mecklenburg County^
2014-3351 KMT i� Cws 4530 W. Tyvola Road Maintenance Project V{
Charlotte, North Carolina /
IPPLICANT NO: CHECKED BY: +��^
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SCALE: 1 1, . 1 00, DATE. 5-12-14�FIGURE NO. Aerial Imagery
CWS PROJECT NO: DRAWN BY:
KIVIT 4530W. Tyvola Road Maintenance Project2014-3351 4
�P,PPLICANT NO: CHECKED BY: Charlotte, North Carolina
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SCALE: 1 1, . 1 00, DATE. 5-12-14�FIGURE NO. Aerial Imagery
CWS PROJECT NO: DRAWN BY:
KIVIT 4530W. Tyvola Road Maintenance Project2014-3351 4
�P,PPLICANT NO: CHECKED BY: Charlotte, North Carolina
TJB WWW.CWS-INC.NET CWS Project No. 2014-3351 -.00

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Q Project Limits
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g
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Photo Location and Direction
NOTE: JURISDICTIONAL WATERS OF THE U.S. WERE DETERMINED AND CLASSIFIED BY CWS, INC.
ON MAY 12, 2014. JURISDICTIONAL FEATURES HAVE NOT BEEN VERIFIED BY THE USACE. 50 25 0 50 Feet
REFERENCE: BACKGROUND GIS LAYERS PROVIDED BY MECKLENBURG COUNTY GIS DEPARTMENT, DATED 2009.
STREAM AND WETLAND LAYERS GENERATED BY CWS, INC., DATED MAY 2014.
SCALE: 1" : 50' DATE: 5-12-14 '� Approximate Jurisdictional FIGURE No.
CWS PROJECT NO: DRAWN BY: KMT
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Figure
6

Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre -Construction Notification PCN Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the
Corps:
®Section 404 Permit El Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 3 or General Permit (GP) number:
1 c. 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):
❑ 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 ❑ No
For the record only for Corps Permit:
❑ Yes ® 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.
❑ Yes
® No
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ 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:
4530 West Tyvola Road Maintenance Project
2b. County:
Mecklenburg
2c. Nearest municipality / town:
Charlotte
2d. Subdivision name:
N/A
2e. NCDOT only, T.I.P. or state
project no:
N/A
3. Owner Information
3a. Name(s) on Recorded Deed:
John Graves; Victor Malphurs
3b. Deed Book and Page No.
12583-844; 18537-799
3c. Responsible Party (for LLC if
applicable):
N/A
3d. Street address:
4518 West Tyvola Road; 4512 West Tyvola Road
3e. City, state, zip:
Charlotte, NC 28208
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
Page 1 of 12
PCN Form — Version 1.3 December 10, 2008 Version

4. Applicant Information (if different from owner)
4a. Applicant is:
❑ Agent ® Other, specify: Charlotte-Mecklenburg Storm Water Services
4b. Name:
Mr. Isaac Hinson, PWS
4c. Business name
(if applicable):
Charlotte-Mecklenburg Storm Water Services (CMSWS)
4d. Street address:
600 E. Fourth Street
4e. City, state, zip:
Charlotte, NC 28202
4f. Telephone no.:
[phone]
4g. Fax no.:
[phone]
4h. Email address:
[e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name:
Kelly Thames, WPIT
5b. Business name
(if applicable):
Carolina Wetland Services, Inc.
5c. Street address:
550 E. Westinghouse Blvd.
5d. City, state, zip:
Charlotte, NC 28273
5e. Telephone no.:
704-527-1177
5f. Fax no.:
704-527-1133
5g. Email address:
[e-mail]
Page 2 of 12
PCN Form — Version 1.3 December 10, 2008 Version

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
14522121 and 14522107
Latitude: 35.208767 Longitude: -
1 b. Site coordinates (in decimal degrees):
80.905409
(DD.DDDDDD) (-DD.DDDDDD)
1c. Property size:
0.21 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
UT to Irwin Creek
proposed project:
2b. Water Quality Classification of nearest receiving water:
Class C
2c. River basin:
Santee (HU# 03050103)
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 project area is approximately 0.21 acre in extent and is located in a residential neighborhood. Dominant vegetation
within the project area consists of tulip poplar (Liriodendron tulipifera), cherry (Prunus serotina), slippery elm (Ulmus
rubra), kudzu (Pueraria montana), and Japanese honeysuckle (Lonicera japonica), and Bermuda grass (Cynodon
dactylon).
3b. List the total estimated acreage of all existing wetlands on the property:
0
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
97 linear feet of intermittent stream stream
3d. Explain the purpose of the proposed project:
The existing culvert underneath Shady Lane is failing and needs to be updated. The existing 18 -inch reinforced concrete pipe
(RCP) is undersized and is unable to convey the 25 -year storm event in accordance with the City of Charlotte design
standards. The downstream section of the existing culvert is failing and has resulted in erosion and safety concerns near
the road.
The purpose of the project is to replace the downstream section of an existing culvert underneath Shady Lane. In addition, a
rip rap apron will be installed at the culvert outlet in accordance with City of Charlotte design standards. This project is
necessary as there are severe erosion issues in close proximity to Shady Lane associated with the existing culvert, which
raises safety concerns for pedestrians and vehicles.
3e. Describe the overall project in detail, including the type of equipment to be used:
Under Nationwide Permit (NWP) No. 3, unavoidable permanent impacts to jurisdictional waters of the U.S. associated
with this project are limited to a total of 39 linear feet (0.003 acre) of stream channel (Figure 6, attached). Temporary
impacts have been avoided by maintaining the limits of disturbance within the footprint of the proposed permanent
impacts.
Eight feet of the downstream section of the existing 18 -inch RCP will be replaced with a new 54 -inch RCP linear foot for
linear foot and will also be extended by an additional nine feet of 54 -inch RCP.
Proposed impacts are the result of the installation of a nine foot extension of a 54 -inch RCP and a 30 linear foot rip rap
apron at the outlet of the extended culvert capable of conveying a 25 -year storm event (Figure 6, attached). In
accordance with City of Charlotte's design standards, a rip rap apron is necessary to protect the culvert's outlet. A plan
view and a profile view of the proposed pipe extension and associated rip rap apron is attached as Figure 6. A track
hoe and other typical construction equipment will be used to construct this project
Page 3 of 12
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 /
project (including all prior phases) in the past?
Comments:
El Yes ®No El Unknown
4b.
If the Corps made the jurisdictional determination, what type
of determination was made?
El Preliminary El Final
4c.
If yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
4d.
If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5.
Project History
5a.
Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
❑ Yes ® No ❑ Unknown
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.
Page 4 of 12
PCN Form — Version 1.3 December 10, 2008 Version

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
W1 ❑ P ❑ T
❑ Yes
❑ Corps
❑ 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
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
Rip Rap
Seasonal RPW
Stream A
❑ PER
® INT
® Corps
❑ DWQ
3.5'
30'
S2 ®P ❑ T
Culvert
Seasonal RPW
Stream A
❑ PER
® INT
® Corps
❑ DWQ
3.5'
9'
S3 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S4 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
3h. Total stream and tributary impacts
39'
3i. Comments: Permanent Impacts to Jurisdictional Streams total 39 If (0.003 acre) of stream channel.
Page 5 of 12
PCN Form — Version 1.3 December 10, 2008 Version

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
01 ❑P❑T
02 ❑P❑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, then 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
K Total
5g. Comments:
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a.
❑ Neuse El Tar -Pamlico F1 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?
61 ❑P❑T
F1 Yes
❑ No
B2 ❑P❑T
El Yes
❑ No
B3 ❑P❑T
El Yes
❑ No
6h. Total buffer impacts
6i. Comments:
Page 6 of 12
PCN Form — Version 1.3 December 10, 2008 Version

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Impacts to on-site jurisdictional waters of the U.S. have been reduced to the maximum extent possible. Proper sediment and
erosion control measures will be used to minimize disturbances to downstream waters. All work will be conducted in the dry.
The proposed 54 -inch RCP extension and rip rap apron is necessary as there are severe erosion problems and safety
concerns in close proximity to Shady Lane. The proposed culvert extension will address the erosion problems and
subsequently the safety concerns. Proposed permanent impacts total 39 linear feet of jurisdictional stream channel. All
temporary impacts have been avoided by maintaining the limits of disturbances within the footprint of the proposed permanent
impacts.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Impacts to on-site jurisdictional waters of the U.S. have been reduced to the maximum extent practicable. Proper sediment
and erosion control measures will be used to minimize disturbances to downstream waters. All work will be constructed in the
dry.
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
❑Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter)
Type
Quantity
3c. Comments:
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
❑ Yes
4b. Stream mitigation requested:
linear feet
4c. If using stream mitigation, stream temperature:
❑ warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested:
acres
4f. Non -riparian wetland mitigation requested:
acres
4g. Coastal (tidal) wetland mitigation requested:
acres
4h. Comments:
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.
Page 7of12
PCN Form — Version 1.3 December 10, 2008 Version

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation?
❑ 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 12
PCN Form — Version 1.3 December 10, 2008 Version

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?
%
2b. Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: There is no change in impervious area
associated with this project.
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
® 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?
Mecklenburg County
® Phase II
3b. Which of the following locally -implemented stormwater management programs
❑ NSW
El 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 12
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
❑ Yes ❑ 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.
The project will not result in additional future development.
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.
N/A
Page 10 of 12
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?
A letter was forwarded to the North Carolina Natural Heritage Program (NCNHP) on May 12, 2014 to determine the
presence of any federally -listed, candidate endangered, threatened species or critical habitat located within the project
area. As of the date of this submittal, a response from the NCNHP has not yet been received. Additionally, CWS
consulted Element Occurrence sites provided by NCNHP and found no occurrences of protected species within a one
mile radius of the project limits.
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?
NOAA Fisheries: http://sharpfin.nmfs.noaa.gov/website/EFH_Mapper/map.aspx
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?
A letter was forwarded to the State Historic Preservation Office (SHPO) on May 12, 2014 to determine the presence of
any areas of architectural, historic, or archaeological significance that would be affected by the project. CWS also
consulted the SHPO online GIS service and the Charlotte Mecklenburg Historic Landmarks Commission database and
found no sites of architectural, historical, or archaeological significance within the project limits.
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:
8c. What source(s) did you use to make the floodplain determination? FEMA FIRM No. 3710453300J
C
Mr. Isaac Hinson, PWS
M-� 41h4�
05-20-2014
Applicant/Agent's Printed Name
Date
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization letter from the applicant
isprovided.)
Page 11 of 12
PCN Form — Version 1.3 December 10, 2008 Version

iNt_ ywu 6tream Identifientinn Fnrin Vareinn d II
Date: s- Z a U ��
ProjectlSite: f t
Latitude:
Evaluator: L L_Isil
county: YtU)4tW 6jt
Longitude: Wgo, I 05LJ-01
Total Points:
Stream is at tensa intermittent
Stream Determination (clrcie one)
Other 'Glyeaw
ifa 3 1�-
if 2 19 or perennial f 2 30" �
E
Ephemeral I er ► t Perennial
p
e. 9• Quad Name:
A. cieomor nolo Subtotal =
Absent
Weak
Moderate
Strong
18',Continuity of channel bed and bank
0
1
0.5 0
3
2. Sinuosity of channel along thalweg
0
1
0 0.5
3
3. In -channel structure: ex. riffle -pool, step -pool,
ripple -pool sequence
0
©
2
3
4. Particle size of stream substrate
0
1
2
3
5. Active/relict floodplain
1
1
2
3
6. Depositional bars or benches
0
1
FACW = 0.75; OBL = 1.5 Other = 0
3
7. Recent alluvial. deposits1
2
3
B. Headcuts
1
2
3
9. Grade control
0
0.5
1
1.
10. Natural valley
0
0.5
1
1.5
11. Second or greater order channel
No0
Yes = 3
o+unu= unu v. aro uvt +atcu, scu ulacuasions in manual -
B. Hvdroloav (Subtotal = . to I
12. Presence of Baseflow
0
2 3
13. Iron oxidizing bacteria
1
2 3
14. Leaf litter
1.5 1
0.5 0
15. Sediment on plants or debris
0
1 1.5
16. Organic debris lines or plies
0 0.5
1.5
17. Soil -based evidence of high water table?
No = 0
Yes -
k.. DIUIUUv 1.7UDioiai = h_.4z - ►
18. Fibrous roots in streambed 3
2)
1
0
19. Rooted upland plants in streambed
2
1
0
20. Macrobenthos (note diversity and abundance) G1
2
3
21. Aquatic Mollusks
1
2
3
22. Fish
0.5
1
1.5
23. Crayfish
0.5
1
1.5
24. Amphibians 0
1
1.5
25. Algae 0
0.5
1
1.5
26. Wetland plants in streambed
FACW = 0.75; OBL = 1.5 Other = 0
*perennial streams may also be identified using other methods. See p. 35 of manual.
Notes:
Sketch:

OFFICE USE ONLY: USACE AID# DWQ #
SCP1— Intermittent RPW Stream A
STREAM QUALITY ASSESSMENT WORKSHEET Abp
1. Applicant's Name: Charlotte -Mecklenburg Storm Water Services 2. Evaluator's Name: Kelly Thames, WPIT
3. Date of Evaluation: 5-12-14 4. Time of Evaluation: IPM
5. Name of Stream: Intermittent RPW Stream A 6. River Basin: Santee (HUC # 03050103)
7. Approximate Drainage Area:_pnrox. 9 acres 8. Stream Order: 1 st
9. Length of Reach Evaluated: 50 if 10. County: Mecklenburg
11. Location of reach under evaluation (include nearby roads and landmarks): located at 4530 West Tyvola Road in Charlotte, North
12. Site Coordinates (if known): N35.208767% W80.905409°
13. Proposed Channel Work (if any): n/a
14. Recent Weather Conditions: mild, sunny, 80s
15. Site conditions at time of visit: sunny, upper 70s
16. 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)
17. Is there a pond or lake located upstream of the evaluation point? YES SIf yes, estimate the water surface area:
18. Does channel appear on USGS quad map? YES NO 19. Does channel appear on USDA Soil Survey? YES NO
20. Estimated Watershed Land Use: 70 % Residential _% Commercial _% Industrial % Agricultural
10 % Forested 20% Cleared / Logged _% Other ( )
21. Bankfull Width: 3'-4' 22. Bank Height (from bed to top of bank): 15'- 20'
23. Channel slope down center of stream: _Flat (0 to 2%) -.L--Gentle (2 to 4%) _Moderate (4 to 10%) _Steep (>10%)
24. Channel Sinuosity: x 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): 22 Comments:
Evaluator's Signature ► r %°v V , " `°�� Date 5-12-14
This channel evaluation form is inted6d to be used only as a guide to assist landowners and environmental professionals in
gathering the data required by the United States Army Corps of Engineers in order to make a preliminary assessment of
stream quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement. Form subject to change — version 05/03. To Comment, please call 919-876-8441 x 26.

STREAM QUALITY ASSESSMENT WORKSHEET
SCPI — Intermittent RPW Stream A
* These characteristics are not assessed in coastal streams.
ECOREGION POINT
RANGE
#
CHARACTERISTICS
SCORE
Coastal
Piedmont
Mountain
1
Presence of flow persistent pools in stream
0 4
0-5
2
no flow or saturation= 0; strongflow = maxpoints)0-5
—
20-6
Evidence of past human alteration
0-5
0-5
0
extensive alteration = 0; no alteration = max points)
3
Riparian zone
0— 6
0— 4
0— 5
0
no buffer = 0; contiguous, wide buffer —'max points)
4
Evidence of nutrient or chemical discharges
0 — 4
0-4
0
extensive discharges = 0; no discharges = maxpoints)0-5
04Groundwater
5
discharge
0-3
0-4
0-4
1
Q
no dischar e = 0; springs, see s, wetlands etc. = maxpoints)
0.0
6
Presence of adjacent floodplain
0-4
0-4
0-2
0
no floodplain = 0; extensive. floodplain =max points)
x
2
Entrenchment / floodplain access
0— 5
0— 4
0— 2
1
a
(deeply entrenched = 0; frequent flooding= max points)
8
Presence of adjacent wetlands
0-6
0-4
0-2
0
no wetlands = 0; large adjacent wetlands = maxpoints)
9
Channel sinuosity
0-5
0-4
0-3
1
extensive channelization = 0; natural meander = max oints
10
Sediment input
0-5
0-4
0-4
1
extensive deposition= 0;little or no sediment = maxpoints)
I 1
Size & diversity of channel bed substrate
ISA*
0-4
0-5
1
fine, homogenous = 0; large, diverse sizes = max points)
12
Evidence of channel incision or widening
points
0-5
0-4
0-5
1
(deeply incised = 0; stable bed & banks = max
13
Presence of major bank failures
0-5
0-5
0-5
2
�4
severe erosion = 0; no erosion, stable banks = maxpoints)
14
Root depth and density on banks
0-3
0-4
0-5
2
no visible roots = 0; dense roots throughout = max points)H
Impact by agriculture or livestock production
0-5
0-4
0-5
2
15
substantial impact =0; no evidence = max points)
Presence of riffle-pool/ripple-pool complexes
0-5
0-6
2
16
no riffles/ripples or pools = 0; well-developed = max points)
0-3
QHabitat
l7
complexity
0-6
0-6
0-6
1
little or no habitat = 0; frequent, varied habitats = maxpoints)
18
Canopy coverage over streambed
0-5
0-5
0-5
1
no shading vegetation = 0; continuous canopy = maxpoints)
19
Substrate embeddedness
NA*
0-4
0-4
2
(deeply embedded = 0; loose structure -= max)
20
Presence of stream invertebrates
0 _- 4
0-5
0
(no evidence = 0; common, numerous types = maxpoints)
{'
21
Presence of amphibians
0-4
0-4
0-4
1
Q
no evidence = 0; common, numerous types = maxpoints)
d
22
Presence of fish
0-4
0-4
0-4
0
no evidence = 0; common, numerous types = maxpoints)
�3
Evidence of wildlife use
0-6
0-5
0-5
1
no evidence = 0; abundant evidence = maxpoints)
Total Points Possible
100
100
100
TOTAL SCORE (also enter on first page)
22
* These characteristics are not assessed in coastal streams.

WETLAND DETERMINATION DATA FORM - Eastern Mountains and Piedmont Region
Project/Site: 4530 W. Tyvola Road City/County: Mecklenburg Sampling Date: 5-12-14
Applicant/Owner: Charlotte- Mecklenburg Storm Water Services State: NC Sampling Point DP1 - Upland
Investigator(s): Kelly Thames, WPIT and Logan Hardin Section, Township, Range: Charlotte
Landform (hillslope, terrace, etc.): hillslope Local relief (concave, convex, none): none Slope (%): 0-2%
Subregion (LRR or MLRA): MLRA Lat.: N35.208767° Long.: W80.905409° Datum: NAD -
Soil Map Unit Name Cecil -Urban Land complex, 8-15% slopes (CuB) NWI Classification:
Are climatic/hydrologic conditions of the site typical for this time of the year? Yes X No (If no, explain in remarks)
Are vegetation soil or hydrology significantly disturbed? Are "normal Yes
Are vegetation soil or hydrology naturally problematic? circumstances" present?
(If needed, explain any answers in remarks)
SUMMARY OF FINDINGS
Hydrophytic vegetation present? No
Hydric soil present? No
Wetland hydrology present? No
Remarks:
Is the sampled area within a wetland? No
Data point is representative of a non jurisdictional upland area.
HYDROLOGY
Wetland Hydrology Indicators:
Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required; check all that apply)
_Surface Soil Cracks (136)
Surface Water (Al)
_True Aquatic Plants (1314)
_Sparsely Vegetated Concave Surface (138)
High Water Table (A2)
—Hydrogen Sulfide Odor (Cl)
—Drainage Patterns (1310)
Saturation (A3)
Oxidized Rhizospheres on Living
—Moss Trim Lines (1316)
Water Marks (131)
_ Roots (C3)
_ Dry -Season Water Table (C2)
Sediment Deposits (132)
—Presence of Reduced Iron (C4)
—Crayfish Burrows (C8)
Drift Deposits (133)
Recent Iron Reduction in Tilled
—Saturation Visible on Aerial Imagery (C9)
Algal Mat or Crust (64)
_Soils (C6)
_Stunted or Stressed Plants (D1)
Iron Deposits (65)
_Thin Muck Surface (C7)
_Geomorphic Position (D2)
Inundation Visible on Aerial
—Other (Explain in Remarks)
—Shallow Aquitard (D3)
Imagery (137)
—Microtopographic Relief (134)
Water -Stained Leaves (139)
_ FAC -Neutral Test (D5)
Aquatic Fauna (1313)
Field Observations:
Surface water present? Yes
No X Depth (inches):
Wetland
Water table present? Yes
No X Depth (inches):
hydrology
Saturation present? Yes
No X Depth (inches):
present? N
(includes capillary fringe)
Describe recorded data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:
There are no indicators of wetland hydrology present.
US Army Corps of Engineers Eastern Mountains and Piedmont Region

VtUt IA I IUN - use scientinc names oT
plants
Sampling Point: UP1 - Upland
50120 Thresholds
Absolute
Dominant
Indicator
20% 50%
Tree Stratum Plot Size (
30 ft.
)
Cover
Species
Status
Tree Stratum 3 7
1
Prunus serotina
8
Y
FACU
Sapling/Shrub Stratum 0 1
2
Liriodendron tulipifera
5
Y
FACU
Herb Stratum 18 45
3
Woody Vine Stratum 0 0
4
Dominance Test Worksheet
5
6
Number of Dominant
7
Species that are OBL,
8
FACW, or FAC: 0 (A)
9
Total Number of Dominant
10
Species Across all Strata: 4 (B)
13
= Total Cover
Percent of Dominant
Species that are OBL,
Sapling/Shrub
Plot Size (
15 ft.
Absolute
)
Dominant
Indicator
FACW, or FAC: 0.00% (A/B)
Stratum
% Cover
Species
Status
1
Ulmus rubra
1
FAC
Prevalence Index Worksheet
2
Total % Cover of:
3
OBL species 0 x 1= 0
4
FACW species 0 x2= 0
5
FAC species 21 x3= 63
6
FACU species 53 x4= 212
7
UPL species 30 x 5 = 150
8
Column totals 104 (A) 425 (B)
9
Prevalence Index = B/A = 4.09
10
1
= Total Cover
Hydrophytic Vegetation Indicators:
Herb Stratum Plot Size (
5 ft.
) Absolute
Dominant
Indicator
_ Rapid test for hydrophytic vegetation
% Cover
Species
Status
test is >50%
1
Pueraria montana
30
Y
UPL
—Dominance
index is 53.0*
2
Cynodon dactylon
30
Y
FACU
—Prevalence
Morphological adaptations* (provide
3
Lonicera japonica
15
N
FAC
supporting data in Remarks or on a
4
Trifolium repens
10
N
FACU
sheet)
5
Krigia dandelion
5
N
FAC
—separate
Problematic hydrophytic vegetation*
6
7
—(explain)
"Indicators of hydric soil and wetland hydrology must be
8
present, unless disturbed or problematic
9
10
Definitions of Vegetation Strata:
11
12
Tree -Woody plants 3 in. (7.6 cm) or more in diameter at
breast height (DBH), regardless of height.
13
14
Sapling/shrub- Woody plants less than 3 in. DBH and
15
greater than 3.28 ft (1 m) tall.
90
= Total Cover
Herb - All herbaceous (non -woody) plants, regardless of
Woody Vine
Absolute
Dominant
Indicator
size, and woody plants less than 3.28 ft tall.
Stratum Plot Size (
30 ft.
) % Cover
Species
P
Status
Woody vines -All woody vines greater than 3.28 ft in
1
height.
2
3
4
Hydrophytic
5
vegetation
0
= Total Cover
present? N
numbers here or on a
0% of the dominant vegetation is FAC or wetter.
US Army Corps of Engineers Eastern Mountains and Piedmont Region

SOIL
Samalina Point: DP1 - Ur land
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
(Inches) Color (moist) % Color (moist) % Type* Loc** Texture Remarks
0-20 5YR 5/6 100
clay loam
*Type: C=Concentration, D=Depletion, RM=Reduced Matrix, CS=Covered or Coated Sand Grains
**Location: PL=Pore Lining, M=Matrix
Hydric Soil Indicators: Indicators for Problematic Hydric Soils:
_Dark Surface (S7)
Histisol (Al) Polyvalue Below Surface (S8) 2 cm Muck (A10) (MLRA 147)
Histic Epipedon (A2) _(MLRA 147, 148) _Coast Prairie Redox (A16) (MLRA 147, 148)
Black Histic (A3) Thin Dark Surface (S9) Piedmont Floodplain Soils (F19)
Hydrogen Sulfide (A4) (MLRA 147, 148) (MLRA 136, 147)
Stratified Layers (A5) —Loamy Gleyed Matrix (F2) _Very Shallow Dark Surface (TF12)
2 cm Muck (A10) (LRR N)_ Depleted Matrix (F3) —Other (Explain in Remarks)
Depleted Below Dark Surface (A11)_ Redox Dark Surface (F6)
Thick Dark Surface (Al2) —Depleted Dark Surface (F7)
Sandy Mucky Mineral (S1) _Redox Depressions (F8)
(LRR N, MLRA 147, 148) _ Iron -Manganese Masses (F12) (LRR N, MLRA 136)
Sandy Gleyed Matrix (S4) _ Umbric Surface (F13) (MLRA 136, 122)
Sandy Redox (S5) _Piedmont Floodplain Soils (F19) (MLRA 148)
Stripped Matrix (S6) Red Parent Material (F21) (MLRA 127, 147)
*Indicators of hydrophytic vegetation and wetland hydrology must be present, unless disturbed or problematic
Restrictive Layer (if observed):
Type:
Depth (inches):
Hydric soil present? N
Remarks:
There are no indicators of hydric soils present.
US Army Corps of Engineers Eastern Mountains and Piedmont Region

ATTACHMENT
PRELIMINARY JURISDICTIONAL DETERMINATION FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PRELIMINARY JURISDICTIONAL
DETERMINATION (JD): 05/20/2014
B. NAME AND ADDRESS OF PERSON REQUESTING PRELIMINARY JD:
Charlotte - Mecklenburg Storm Water Services
POC: Mr. Isaac Hinson
600 E. Fourth Street
Charlotte, North Carolina 28202
C. DISTRICT OFFICE, FILE NAME, AND NUMBER: Wilmington District -
Asheville Regulatory Field Office
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION: 4530
West Tyvola Road, Charlotte, NC
(USE THE ATTACHED TABLE TO DOCUMENT MULTIPLE WATERBODIES
AT DIFFERENT SITES)
State NC County/parish/borough: Mecklenburg City: Charlotte
35.2087670 N, Long. 80.9054090 W.
Universal Transverse Mercator: NAD 83
Name of nearest waterbody: UT to Irwin Creek
Identify (estimate) amount of waters in the review area:
Non -wetland waters: 97 linear feet: 3'-4' width (ft) and/or 0.008 acre.
Cowardin Class: R4SB3
Stream Flow: Intermittent
Wetlands.
Cowardin Class:
Name of any water bodies on the site that have been identified as Section 10
waters:
Tidal:
Non -Tidal:
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT
APPLY):
❑ Office (Desk) Determination. Date:
® Field Determination. Date(s): May 12, 2014

1. The Corps of Engineers believes that there may be jurisdictional waters of the
United States on the subject site, and the permit applicant or other affected party
who requested this preliminary JD is hereby advised of his or her option to
request and obtain an approved jurisdictional determination (JD) for that site.
Nevertheless, the permit applicant or other person who requested this
preliminary JD has declined to exercise the option to obtain an approved JD in
this instance and at this time.
2. In any circumstance where a permit applicant obtains an individual permit, or
a Nationwide General Permit (NWP) or other general permit verification requiring
"pre -construction notification" (PCN), or requests verification for a non -reporting
NWP or other general permit, and the permit applicant has not requested an
approved JD for the activity, the permit applicant is hereby made aware of the
following: (1) the permit applicant has elected to seek a permit authorization
based on a preliminary JD, which does not make an official determination of
jurisdictional waters; (2) that the applicant has the option to request an approved
JD before accepting the terms and conditions of the permit authorization, and
that basing a permit authorization on an approved JD could possibly result in less
compensatory mitigation being required or different special conditions; (3) that
the applicant has the right to request an individual permit rather than accepting
the terms and conditions of the NWP or other general permit authorization; (4)
that the applicant can accept a permit authorization and thereby agree to comply
with all the terms and conditions of that permit, including whatever mitigation
requirements the Corps has determined to be necessary; (5) that undertaking
any activity in reliance upon the subject permit authorization without requesting
an approved JD constitutes the applicant's acceptance of the use of the
preliminary JD, but that either form of JD will be processed as soon as is
practicable; (6) accepting a permit authorization (e.g., signing a proffered
individual permit) or undertaking any activity in reliance on any form of Corps
permit authorization based on a preliminary JD constitutes agreement that all
wetlands and other water bodies on the site affected in any way by that activity
are jurisdictional waters of the United States, and precludes any challenge to
such jurisdiction in any administrative or judicial compliance or enforcement
action, or in any administrative appeal or in any Federal court; and (7) whether
the applicant elects to use either an approved JD or a preliminary JD, that JD
will be processed as soon as is practicable. Further, an approved JD, a proffered
individual permit (and all terms and conditions contained therein), or individual
permit denial can be administratively appealed pursuant to 33 C.F.R. Part 331,
and that in any administrative appeal, jurisdictional issues can be raised (see 33
C.F.R. 331.5(a)(2)). If, during that administrative appeal, it becomes necessary
to make an official determination whether CWA jurisdiction exists over a site, or
to provide an official delineation of jurisdictional waters on the site, the Corps will
provide an approved JD to accomplish that result, as soon as is practicable.
This preliminary JD finds that there "may be" waters of the United States on the
subject project site, and identifies all aquatic features on the site that could be
affected by the proposed activity, based on the following information:
2

SUPPORTING DATA. Data reviewed for preliminary JD (check all that apply
- checked items should be included in case file and, where checked and
requested, appropriately reference sources below):
® Maps, plans, plots or plat submitted by or on behalf of the
applicant/consultant:
® Data sheets prepared/submitted by or on behalf of the
applicant/consultant.
❑ Office concurs with data sheets/delineation report.
❑ Office does not concur with data sheets/delineation report.
❑ Data sheets prepared by the Corps:
❑ Corps navigable waters' study:
❑ U.S. Geological Survey Hydrologic Atlas:
❑ USGS NHD data.
❑ USGS 8 and 12 digit HUC maps.
® U.S. Geological Survey map(s). Cite scale & quad name:1:24,000,
Charlotte West, NC, Dated 1996.
® USDA Natural Resources Conservation Service Soil Survey. Citation:
Mecklenburg County Soil Survey.
❑ National wetlands inventory map(s). Cite name:
❑ State/Local wetland inventory map(s):
❑ FEMA/FIRM maps:
❑ 100 -year Floodplain Elevation is: (National Geodectic Vertical Datum
of 1929)
® Photographs: ❑ Aerial (Name & Date):
or ® Other (Name & Date):Site photographs of stream channel
(May, 2014).
❑ Previous determination (s). File no. and date of response letter:
❑ Other information (please specify):
IMPORTANT NOTE: The information recorded on this form has not necessarily
been verified by the Corps and should not be relied upon for later jurisdictional
determinations.
Signature and date of
Regulatory Project Manager
(REQUIRED)
05/20/2014
Signature and date of
person requesting preliminary JD
(REQUIRED, unless obtaining the
signature is impracticable)

Estimated
Site Latitude Longitude Cowardian Aquatic Amount of Class of Aquatic
Number Class Resource in Resource
Review Area
Stream A N35.208767' W80.905409' R4SB3 97 linear feet non -section 10 -- non -tidal

4530 W. Tyvola Road Maintenance Project May 20, 2014
Nationwide Permit No. 3 CWS Proiect No. 2014-3351
Photograph A. View of Seasonal RPW Stream A, facing downstream.
Photograph B. View of Seasonal RPW Stream A, facing upstream.