20170574 Ver 1_More Info Received_20170619

Homewood, Sue
From: Hugh Creed Associates, Inc, <[e-mail]>
Sent: Monday, June 19, 2017 9:45 AM
To: Bailey, David E CIV USARMY CESAW (US)
Cc: Joe Gonzales; Homewood, Sue
Subject: Re: Shiloh subdivision PCN, Guilford County; SAW -2017-00979
Attachments: Pilot 2850 - Shiloh Subdivision - Wetland Report_6.14.17.pdf; Shiloh Endangered Species
2017-06-19.pdf, Shiloh Essential Fish Habitat 2017-06-19.pdf, Shiloh Historic 2017-06-19.pdf,
Shiloh PCN 2017-06-19.pdf, Shiloh Stream Crossing 2017-06-19.pdf
Mr. Bailey,
Attached are the revisions to the PCN with additional information as requested by you and Ms. Homewood
for review and approval. Please let us know if you need any additional information.
Thank you,
Norris Z. Clayton
Hugh Creed Associates Inc., P.A.
1306 W. Wendover Ave.
Greensboro, NC 28408
Tele: 336-275-9826
Fax:[phone]
On 5/23/2017 3:09 PM, Bailey, David E CIV USARMY CESAW (US) wrote:
Messrs. Clayton and Gonzales,
Thank you for your PCN and attached information, dated 5/5/2017 (received 5/8/2017),
for the above referenced project. I have reviewed the information and need
clarification before proceeding with verifying the use of Nationwide Permit 29
(http://saw—reg.usace.army.mil/NWP2017/2017NWP29.pdf). Please submit the requested
information below (via e -mail is fine) within 30 days of receipt of this
Notification, otherwise we may deny verification of the use of the Nationwide Permit
or consider your application withdrawn and close the file:
1) Your PCN included impacts to streams, however these and other potential
jurisdictional boundaries have not been verified by the USACE. Please submit a
complete Jurisdictional Determination request (see attached), upon receipt of which
we will schedule a time for an on -site verification. If the property has already
been evaluated by a qualified environmental consultant, please provide documentation
of this evaluation including name of the firm, dates of evaluation, data sheets,
maps/field sketches, etc; once we receive this information we will determine if a
verification site visit is necessary.
2) The following sections of the PCN are missing information required for our
evaluation: F.5 and F.6.
3) The PCN must be signed by the applicant or agent (if agent authorization form is
signed by applicant and provided).

4) Sheet 2 lists the culvert lengths as 51 I.f. and 47 I.f., consistent with the
impact amounts listed in the PCN impacts S1 and S4, respectively. Note that all
impact amounts in the PCN and shown on the plans should be for linear feet of stream
(centerline) rather than culvert length. Please update Sheet 2 and the PCN (for all
itemized impacts) accordingly.
5) Sheet 2 shows the proposed 42- culvert is oriented such that the stream channel
exits the culvert aimed at a stream bank. Please re -design the culvert to align with
the up and downstream stream banks to avoid indirect impacts of erosion and sediment
loading into the stream. If slight re -alignment of the stream channel is necessary
at either end of the culvert, please include proposed cross sections of the stream
re -alignment, include the stream impact footprint and the proposed channel alignment
on the plans, and itemize the length of stream impacted as a permanent impact on the
PCN.
Please let me know if you have any questions.
-Dave Bailey
David E. Bailey, PWS
Regulatory Project Manager
US Army Corps of Engineers
CE -SAW -RG -R
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
Phone: [phone], Ext. 30.
Fax: [phone]
Email: David. E. Ba i l ey2@usace. army. m i l
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 http://corpsmapu.usace.army.mil/cm_apex/f?p=136:4:0.

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°BSS z CONSULTING ENGINEERS 8c LAND SURVEYORS
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JUNE 16, 2017
P.O. BOX 9623
1306 W. WENDOVER AVE.
GREENSBORO, N.C. 27408
FIRM LICENSE #C-0551
PHONE: [phone]
OR [phone]
FAX: [phone]
E—MAIL: HCA®TRIADBIZ.RR.COM

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INSTALLATION BEGINS. TOTAL
INSTALLATION TIME SHOULD BE LESS
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STONE 2
RIP—RAP DAM
INSTALL SANDBAGS TO DEWATER
OUTLET
CONSTRUCTION AREA.
3.
INSTALL PUMP AND DEWATERING
LINES.
4.
CUT OUT STREAMBED AND INSTALL
RIP—RAP OUTLET WITH TOP AT
EXISTING STREAMBED LEVEL.
INSTALL TEMPORARY STONE DAM
AND FILTER FABRIC.
5.
BEGIN PUMPING AND CONTINUE
PUMPING DURING STORM DRAIN
INSTALLATION.
6.
CUT DITCH FOR STORM DRAIN PIPE
WITH BACKHOE. LAY STORM DRAIN
PIPE ONE FOOT BELOW STREAMBED
AND INSTALL ENDWALL.
7.
IMMEDIATELY REMOVE SANDBAGS TO
DIVERT FLOW THROUGH STORM
DRAIN PIPE. SPREAD OUT STONE
DAM KEEPING RIP—RAP OUTLET
LEVEL WITH EXISTING
STREAMBEAD.
8.
SEED CONSTRUCTION SITE AS NEEDED.
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GONTRAGTOR 15 TO
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BEFORE ANY STREAM
DISTURBANGE OGGURS.
SANDBAGS
INLET PIPE
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JUNE 16, 2017
STREAM GROSS I NC S
PROFILES ANi7 r:)ETA I LS
SH I LOH
-151-7 HAPPY HILL ROAD
OAK RIDGE TOWNSHIP, GUILFORD COUNTY
OAK RIDGE, NORTH ACROLINA
DATE: MAY 2, 2017 SGALE:I"=100' 0 50 loo 20 SHEET: 2 OF 2
HUGH CREED ASSOCIATES, INC., P.A.
CONSULTING ENGINEERS & LAND SURVEYORS
P.O. BOX 9623
1306 W. WENDOVER AVE.
GREENSBORO, N.C. 27408
FIRM LICENSE #C-0551
PHONE: [phone]
OR [phone]
FAX: [phone]
E-MAIL: HCA®TRIADBIZ.RR.COM
NOTES:
1.
PRIOR TO INSTALLATION OF
SANDBAGS, CONTRACTOR TO
ENSURE ALL MATERIALS ARE ON—
SITE AND READY FOR INSTALLATION.
WEATHER CONDITIONS SHOULD BE A
STREAM
MINIMUM OF FIVE DAYS AFTER ANY
FLOW
RAIN EVENT AND NO FORECAST OF
RAIN FOR 48—HOURS AFTER
INSTALLATION BEGINS. TOTAL
INSTALLATION TIME SHOULD BE LESS
TEMP.
THAN EIGHT HOURS.
STONE 2
RIP—RAP DAM
INSTALL SANDBAGS TO DEWATER
OUTLET
CONSTRUCTION AREA.
3.
INSTALL PUMP AND DEWATERING
LINES.
4.
CUT OUT STREAMBED AND INSTALL
RIP—RAP OUTLET WITH TOP AT
EXISTING STREAMBED LEVEL.
INSTALL TEMPORARY STONE DAM
AND FILTER FABRIC.
5.
BEGIN PUMPING AND CONTINUE
PUMPING DURING STORM DRAIN
INSTALLATION.
6.
CUT DITCH FOR STORM DRAIN PIPE
WITH BACKHOE. LAY STORM DRAIN
PIPE ONE FOOT BELOW STREAMBED
AND INSTALL ENDWALL.
7.
IMMEDIATELY REMOVE SANDBAGS TO
DIVERT FLOW THROUGH STORM
DRAIN PIPE. SPREAD OUT STONE
DAM KEEPING RIP—RAP OUTLET
LEVEL WITH EXISTING
STREAMBEAD.
8.
SEED CONSTRUCTION SITE AS NEEDED.
STORM DRAIN
SIDE VIEW
TEMPORAR`r STREAM
GROSSINO FOR
STORM DRAIN INSTALLATION
NO SCALE
®,•��,�"CARO
=o �oFESSioti�
SEAL
10727
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JUNE 16, 2017
STREAM GROSS I NC S
PROFILES ANi7 r:)ETA I LS
SH I LOH
-151-7 HAPPY HILL ROAD
OAK RIDGE TOWNSHIP, GUILFORD COUNTY
OAK RIDGE, NORTH ACROLINA
DATE: MAY 2, 2017 SGALE:I"=100' 0 50 loo 20 SHEET: 2 OF 2
HUGH CREED ASSOCIATES, INC., P.A.
CONSULTING ENGINEERS & LAND SURVEYORS
P.O. BOX 9623
1306 W. WENDOVER AVE.
GREENSBORO, N.C. 27408
FIRM LICENSE #C-0551
PHONE: [phone]
OR [phone]
FAX: [phone]
E-MAIL: HCA®TRIADBIZ.RR.COM

PILL
P I LOT ENVI RON M E N T A L, I N C
June 14, 2017
Mr. Joe Gonzales
D. Stone Builders
2904 Lawndale Drive
Greensboro, North Carolina 27408
Reference: Wetland Delineation
Approximate 83 Acre Tract
7517 Happy Hill Road
Oak Ridge, Guilford County, North Carolina
Pilot Project 2850
Dear Mr. Gonzales:
Pilot Environmental, Inc. (Pilot) is pleased to submit this report of the wetland delineation for the
approximate 83 acre tract located at 7517 Happy Hill Road in Oak Ridge, Guilford County, North
Carolina.
Background
Wetlands are defined by the United States Army Corps of Engineers (USACE) and the United
States Environmental Protection Agency (EPA) as "those areas that are inundated or saturated
by surface or groundwater at a frequency and duration sufficient to support, and under normal
circumstances, do support a prevalence of vegetation typically adapted for life in saturated soil
conditions." In order for an area to be classified as wetland, hydrophytic vegetation, hydric soils,
and wetland hydrology indicators must be present.
Section 404 of the Clean Water Act (CWA) regulates the discharge of dredge and fill materials
into waters of the United States (lakes, rivers, ponds, streams, etc.), including wetlands. Waters
of the United States include the territorial seas, navigable coastal and inland lakes, rivers and
streams, intermittent streams, and wetlands. The EPA and the USACE jointly administer the
Section 404 program. Section 401 of the Clean Water Act grants each state the authority to
approve, condition, or deny any Federal permits that could result in a discharge to State waters.
Jurisdictional features include wetlands, open waters, ponds, lakes and perennial/intermittent
streams. Jurisdictional features are regulated by the USACE and North Carolina Department of
Environmental Quality -Division of Water Resources (NCDEQ-DWR). Permits are required prior
to impacting any jurisdictional feature. The type of permit required is specific to the type,
location and amount of impacts. Stormwater management plans and/or mitigation for proposed
impacts could be a requirement of the permit approval process.
PO Box 183, Kernersville, NC 27835
www.pilotenviro.com

Wetland Delineation
Pilot Project 2850
June 14, 2017
The findings and conclusions in this report are our opinions based on field conditions
encountered at the time of the site visit. Changes including, but not limited to, regulations,
weather, timber/vegetation removal and usage/development of the site or nearby properties
can alter the findings and opinions presented in this report. We recommend that this report only
be used for preliminary planning purposes. Agency verifications, followed by a survey of
jurisdictional features are required to determine the exact extent and locations of jurisdictional
features and are valid for a period of up to five years following issuance of a USACE Jurisdictional
Determination (JD) and/or NCDEQ-DWR Site Determination Letter.
Scope of Services
Pilot was contracted to perform a wetland delineation for the approximate 83 acre tract located
at 7517 Happy Hill Road in Oak Ridge, Guilford County, North Carolina. The site is identified by
the Guilford County Geographical Information System (GIS) as parcel identification number (PIN)
6899579267. The scope of services included a delineation of jurisdictional features (streams,
wetlands and other surface waters) on the site. The site boundary was not marked at the time of
our field delineation. Pilot was provided with a pdf map showing the approximate site boundaries.
Literature Review
Pilot reviewed the U.S. Geological Survey (USGS) Topographic Map, the U.S. Department of
Agriculture (USDA) Soil Survey of Guilford County, the U.S. Fish and Wildlife Service (USFWS)
National Wetland Inventory (NWI) Map and the Federal Emergency Management Agency (FEMA)
Flood Insurance Rate Map (FIRM).
The USGS Topographic Map (Drawing 1) depicts a pond located near the western site boundary.
The pond drains into another pond and an unnamed tributary to East Belews Creek located on
adjacent properties west of the site. Other surface waters or wetlands are not depicted on the
site. Several drainage swales that could contain surface waters or wetlands are depicted on the
site.
The USDA Web Soil Survey of Guilford County (Drawing 2) identifies the following mapping units
on the site: Clifford sandy loam (CkB), Clifford sandy clay loam (CI132), Dan River loam (DaA),
Nathalie sandy loam (NaB & NaQ Poplar Forest sandy loam (PoC & PoE) and Poplar Forest clay
loam (PpB2 & PpC2). The Clifford series consists of well drained, moderately permeable soils
that occur on hills and interfluves. The Dan River series consists of well drained, moderately
permeable soils that occur on floodplains. The Nathalie series consists of well drained,
moderately permeable soils that occur on hills and ridges. The Poplar Forest series consists of
well drained, moderately permeable soils that occur on gently sloping to steep uplands. The
DaA soil mapping unit is identified on the Hydric Soils List for Guilford County. The other soil
mapping units are not identified on the Guilford County Hydric Soils List.
2

Wetland Delineation
Pilot Project 2850
June 14, 2017
Pilot also reviewed the last USDA Published Soil Survey of Guilford County (Drawing 2A). The
published survey shows unnamed tributaries to East Belews Creek on the northwestern and
southwestern portions of the site. A wet area is depicted on the western portion of the site,
immediately up -gradient of the pond that is located near the western site boundary. Other
surface waters or wetlands are not depicted on the site.
The USFWS NWI Map (Drawing 3) depicts a freshwater pond near the western site boundary,
consistent with the USGS Topographic Map. Other surface waters or wetlands are not depicted
on the site.
Pilot reviewed the FEMA FIRM (Drawing 4) for the site. The FEMA FIRM identifies the site within
Zone X (an area outside of the 100 year flood zone).
Field Delineation
Pilot conducted the site visit on June 13, 2017. The site contains land that is being cleared and
graded and wooded land. Pilot was contracted to delineate surface waters (including ponds and
streams) and wetlands on the site.
A pond is located on the southern portion of the site. The pond is hydrologically connected to
down -gradient surface waters and wetlands by an intermittent stream that originates at the base
of the pond dam. A second pond is located near the western site boundary. The second pond is
hydrologically connected to a second pond and an up -gradient stream and wetlands. Based on
our observations, it is our opinion that the ponds are jurisdictional. The perimeters of the ponds
were flagged in the field using blue and white striped surveyor tape.
Streams are located on the southwestern and northwestern portions of the site. The streams,
with the exception of Stream ISB, have defined beds and banks, evidence of an ordinary high
water mark, meanders, substrate sorting and riffle pool complexes. Minnows, crayfish and
salamanders were observed in the streams. Based on our observations, it is our opinion that the
streams are perennial. Stream ISB was dry at the time of our site reconnaissance and had weaker
stream characteristics. It is our opinion that Stream ISB is intermittent. The centerlines of the
streams were flagged in the field with blue and white striped surveyor flagging.
Wetlands are located adjacent to the streams that cross the southwestern and northwestern
portions of the site. The wetlands are separated from surrounding uplands by topographic,
vegetation and/or soil breaks. USACE Wetland Determination Data Forms, supporting our
opinions, are included as attachments. The wetland boundaries were marked in the field with
red and white striped surveyor tape.
Drawing 5 shows the approximate locations of the ponds, streams, wetlands and data points and
is intended for preliminary planning purposes only.
3

Wetland Delineation
Pilot Project 2850
June 14, 2017
Watershed Classification
According to the NCDEQ-DWR, the site is located in the Roanoke River Basin. Unnamed tributaries
to East Belews Creek are located on the site. The NCDEQ-DWR has classified East Belews Creek as
Class B waters, in the vicinity of the site.
Agency Verification
Our delineation has not been verified by the USACE or the NCDEQ-DWR. Verification by these
agencies is recommended. The results of our delineation are subject to change during agency
verification. Following verification, we recommend that our flags be surveyed to determine the
exact location and extent of jurisdictional areas.
Closing
We appreciate the opportunity to provide our services to you. Please contact us at (336) 708-
4997 if you have questions or require additional information.
Sincerely,
David S. Brame
Project Manager
Michael T. Brame, PWS
Principal
Attachments: Drawing 1— USGS Topographic Map
Drawing 2 —
Web Soil Map
Drawing 2A—
Published Soil Map
Drawing 3 —
NWI Map
Drawing 4 —
FEMA Map
Drawing 5 —
Wetland Map
Wetland Determination Data Forms
il

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Drawing 1 USGS Topographic Map
USGS Topographic Map r ;> s��'. Shiloh Subdivision
Belews Creek, NC Quadrangle - Approximate 83 Acre Tract
Scale: 1" — 2 000' ; Oak Ridge, Guilford County, NC
r PILOT L N V I R O N M E N T A L. I N C Pilot Project 2850

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Drawing 2A
USDA Soil Survey
ofGuilford County, NC �
Published l977,Sheet 7 ��N
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LEGEND
Site Boundary
Published Soil Map
Shiloh Subdivision
Approximate 83 Acre Tract
Oak Ridge, Guilford County, NC
Pilot Project 2O5O
am

Drawing 3 r
f `
USFWS NWI
Wetlands Mapper `f PILO
Scale: 1"=400' 1.1p1 ENVIRONM@NTAL.1NL1 „
NWI Map
Shiloh Subdivision
Approximate 83 Acre Tract
Oak Ridge, Guilford County, NC
Pilot Project 2850

V
a
LEGEND
Site Boundary
1 %Annual Chance Flood Hazard
OR egulatory Flood vay
Special Floodvay
Area of Undetermined Flood Hazard
0.2V.Annual Chance Flood Hazard
[IF dure Conditions 1 1J. Annual Chance Flood Hazard
�Area with Reduced Risk Due to Levee
FEMA Map
Drawing 4
Shiloh Subdivision
National Flood Hazard Layer Approximate 83 Acre Tract
From FEMA Web Map Service PILOT w,
Scale: 1" - 1 000' Oak Ridge, Guilford County, NC
PI LOT E N V I R 0 N M E N T A L. I N C Pilot Project 2850

LJ
WC 1-34 \
FLAG NUMBERS/INFO
WETLAND FLAGS =
STREAM/Pond FLAGS = Q
Stream/Pond Flags = 125
Wetland Flags = 117
Total Flags = 242
Drawing 5
Aerial Imagery from ESRI
and Pilot Field Notes
Scale: 1" = 400'
Date: 6.13.17
SC 1-26
LEGEND
Site Boundary
F : - Pond
Perennial Stream
■ ■ ■ ■ ■ ■ Intermittent Stream r.
Wetlands
SCA 1-2
SA1-5 Flag Number
CB 1-4 -:'m -�
WCs 1-2 DP -1 • Data Point N
„J WAA 1-62
PB 1-12
SB 1-4,
11
�-a
k _ ■■■•.
THE LOCATIONS OF FEATURES SHOWN ON THIS MAP ARE PRELIMINARY AND
APPROXIMATE. THEY HAVE NOT BEEN VERIFIED BY THE USACE AND/OR THE NCDEQ-DWR.
THEY HAVE NOT BEEN SURVEYED OR GEOLOCATED.
PILGIr
PILOT INVIONONMAN T k L. I NIC
Wetland Map
Shiloh Subdivision
Approximate 83 Acre Tract
Oak Ridge, Guilford County, NC
Pilot Project 2850

WETLAND DETERMINATION DATA FORM — Eastern Mountains and Piedmont
Project/Site: Shiloh Subdivision City/County: Oak Ridge/Guilford Sampling Date: 6/13/17
Applicant/Owner: D. Stone Builders State: North Carolina Sampling Point: DP-1
Investigator(s): Brame, Pilot Section, Township, Range: NA
Landform (hillslope, terrace, etc.) Bottomland Local relief (concave, convex, none): Relatively flat
Slope (%): <1 Lat: 36.210460° Long: -80.031625° Datum: WGS 84
Soil Map Unit Name: Poplar Forest sandy loam (PoE) NWI Classification: None
Are climatic / hydrologic conditions on the site typical for this time of year? Yes X No (If no, explain in Remarks.)
Are Vegetation Soil or Hydrology significantly disturbed? Are "Normal Circumstances" present? Yes X No
Are Vegetation Soil or Hydrology naturally problematic? (If needed, explain any answers in Remarks.)
JUMMAKT UI' I-INUINUb — Attacn site map snowing sa piing point locations, transects, Important teatureS, etc.
Hydrophytic Vegetation Present? Yes X No
Hydric Soil Present? Yes X No Is the Sampled Area
within a Wetland? Yes X No
Wetland Hydrology Present? Yes X No
Remarks
1:III 791:7e1Wi7el7
Wetland Hydrology Indicators:
Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required;
check all that apply)
Surface Soil Cracks (136)
X Surface Water (Al)
True Aquatic Plants (1314)
Sparsely Vegetated Concave Surface (138)
X High Water Table (A2)
Hydrogen Sulfide Odor (Cl)
Drainage Patterns (B10)
X Saturation (A3)
X Oxidized Rhizospheres on Living Roots (C3)
Moss Trim Lines (B16)
Water Marks (131)
Presence of Reduced Iron (C4)
Dry -Season Water Table (C2)
Sediment Deposits (132)
Recent Iron Reduction in Tilled Soils (C6)
Crayfish Burrows (C8)
Drift Deposits (133)
Thin Muck Surface (C7)
Saturation Visible on Aerial Imagery (C9)
Algal Mat or Crust (134)
Other (Explain in Remarks)
Stunted or Stressed Plants (D1)
Iron Deposits (B5)
X
Geomorphic Position (D2)
Inundation Visible on Aerial Imagery (B7)
Shallow Aquitard (D3)
X Water -Stained Leaves (139)
Microtopographic Relief (D4)
Aquatic Fauna (1313)
X
FAC -Neutral Test (D5)
Field Observations:
Surface Water Present? Yes X No
Depth (inches): 1
Water Table Present? Yes X No
Depth (inches): Surface
Wetland Hydrology Present? Yes X No
Saturation Present? Yes X No
Depth (inches): Surface
(includes capillary fringe)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:

VEGETATION (Four Strata) - Use scientific names of plants.
Tree Stratum (Plot size: 30' )
1. Platanus occidentalis
Absolute
% Cover
20
Dominant
Species?
Y
Indicator
Status
FACW
2. Fraxinus pennsylvanica
20
Y
FACW
3. Betula nigra
10
N
FACW
4. Liriodendron tulipifera
20
Y
FAC
5.
7.
6.
8.
7.
10.
8.
30
= Total Cover
70
= Total Cover
Sapling/Shrub Stratum (Plot size: 30'
1. Alnus serrulata
20
Y FACW
2. Sambucus canadensis
5
N FACW
3. Cornus amomum
5
N FACW
4.
FACU species
X4=
5.
X5=
Column Totals:
6.
7.
8.
9.
10.
30
= Total Cover
Herb Stratum (Plot size: 30' )
1. Carex sp. 30 Y OBL
2. Impatiens pallida 10 Y FACW
3. Sambucus canadensis 5 N FACW
4.
5.
6.
7.
8.
9.
10.
11.
12.
45 = Total Cover
Woody Vine Stratum (Plot size: 30' )
1.
2.
3.
4.
5.
6.
0 = Total Cover
Remarks: (Include photo numbers here or on a separate sheet.)
Sampling Point DP -1
Dominance Test worksheet:
Number of Dominant Species
That Are OBL, FACW, or FAC: 6 (A)
Total Number of Dominant
Species Across All Strata: 6 (B)
Percent of Dominant Species
That Are OBL, FACW, or FAC: 100 (A/B)
Prevalence Index worksheet:
Total % Cover of:
Multiply by:
OBL species
x 1 =
FACW species
X2=
FAC species
X3=
FACU species
X4=
UPL species
X5=
Column Totals:
(A) (B)
Prevalence Index = B/A =
Hydrophytic Vegetation Indicators:
1 - Rapid Test for Hydrophytic Vegetation
X 2 - Dominance Test is > 50%
_ 3 - Prevalence Test is <_ 3.0'
4 -Morphological Adaptations' (Provide supporting
data in Remarks or on a separate sheet)
Problematic Hydrophytic Vegetation' (Explain)
'Indicators of hydric soil and wetland hydrology must
be present, unless disturbed or problematic.
Definitions of Vegetation Strata:
Tree - Woody plants, excluding vines, 3 in. (7.6 cm)
or more in diameter at breast height (DBH),
regardless of height.
Sapling/Shrub - Woody plants, excluding vines, less
than 3 in. DBH and greater than 3.28 ft (1 m) tall.
Herb - All herbaceous (non -woody) plants, regardless
of size, and woody plants less than 3.28 ft tall.
Woody vine - All woody vines greater than 3.28 ft in
height.
Hydrophytic
Vegetation
Present? Yes X No

SOIL
Sampling Point:
DP -1
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
(inches) Color (moist) % Color (moist) % Type' Loc' Texture Remarks
0-18 2.5Y 4/1 90
10YR 4/6 10 RM M L
'Type: C=Concentration, D=De letion, RM=Reduced
Matrix, CS=Covered or Coated Sand Grains.
'Location: PL=Pore Lining, M=Matrix.
Hydric Soil Indicators:
Histosol (Al)
Histic Epipedon (A2)
Black Histic (A3)
Hydrogen Sulfide (A4)
Stratified Layers (A5)
2 cm Muck (A10) (LRR N)
Depleted Below Dark Surface (A11)
Thick Dark Surface (Al2)
Sandy Mucky Mineral (S1) (LRR N,
MLRA 147, 148)
Sandy Gleyed Matrix (s4)
Sandy Redox (S5)
Stripped Matrix (S6)
Dark Surface (S7)
Polyvalue Below Surface (S8) (MLRA 147, 148)
Thin Dark Suface (S9) (MLRA 147, 148)
Loamy Gleyed Matrix (F2)
X Depleted Matrix (F3)
Redox Dark Surface (F6)
Depleted Dark Surface (F7)
Redox Depressions (F8)
Iron Manganese Masses (F12) (LRR N,
MLRA 136)
Umbric Surface (F13) (MLRA 136, 122)
Piedmont Floodplain Soils (F19) (MLRA 148)
Indicators for Problematic Hydric Soils3:
2 cm Muck (A10) (MLRA 147)
Coast Prairie Redox (A16)
(MLRA 147, 148)
Piedmont Floodplain Soils (F19)
(MLRA 136, 147)
Red Parent Material (TF2)
Very Shallow Dark Surface (TF12)
Other (Explain in Remarks)
3lndicators of Hydrophytic vegetation and
wetland hydrology must be present, unless
disturbed or problematic.
Restrictive Layer (if observed):
Type:
Depth (inches):
Hydric Soil Present?
Yes X No
Remarks:

WETLAND DETERMINATION DATA FORM — Eastern Mountains and Piedmont
Project/Site: Shiloh Subdivision City/County: Oak Ridge/Guilford Sampling Date: 6/13/17
Applicant/Owner: D. Stone Builders State: North Carolina Sampling Point: DP -2
Investigator(s): Brame, Pilot Section, Township, Range: NA
Landform (hillslope, terrace, etc.) Side Slope Local relief (concave, convex, none): Slope
Slope (%): 1-2 Lat: 36.210536° Long: -80.031367° Datum: WGS 84
Soil Map Unit Name: Poplar Forest clay loam (PpC2) NWI Classification: None
Are climatic / hydrologic conditions on the site typical for this time of year? Yes X No (If no, explain in Remarks.)
Are Vegetation Soil or Hydrology significantly disturbed? Are "Normal Circumstances" present? Yes X
Are Vegetation Soil or Hydrology naturally problematic? (If needed, explain any answers in Remarks.)
No
JUMMAKT UI' I-INUINUb — Attacn site map snowing sa piing point locations, transects, Important teatureS, etc.
Hydrophytic Vegetation Present? Yes X No
Hydric Soil Present? Yes No X Is the Sampled Area
within a Wetland? Yes No X
Wetland Hydrology Present? Yes No X
Remarks
1:III 791:7e1Wi7el7
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 (B10)
Saturation (A3)
Oxidized Rhizospheres on Living Roots (C3)
Moss Trim Lines (B16)
Water Marks (131)
Presence of Reduced Iron (C4)
Dry -Season Water Table (C2)
Sediment Deposits (132)
Recent Iron Reduction in Tilled Soils (C6)
Crayfish Burrows (C8)
Drift Deposits (133)
Thin Muck Surface (C7)
Saturation Visible on Aerial Imagery (C9)
Algal Mat or Crust (134)
Other (Explain in Remarks)
Stunted or Stressed Plants (D1)
Iron Deposits (B5)
Geomorphic Position (D2)
Inundation Visible on Aerial Imagery (B7)
Shallow Aquitard (D3)
Water -Stained Leaves (139)
Microtopographic Relief (D4)
Aquatic Fauna (1313)
FAC -Neutral Test (D5)
Field Observations:
Surface Water Present? Yes No X
Depth (inches):
Water Table Present? Yes No X
Depth (inches):
Wetland Hydrology Present? Yes No X
Saturation Present? Yes No X
Depth (inches):
(includes capillary fringe)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:

VEGETATION (Four Strata) - Use scientific names of plants. Sampling Point DP -2
Tree Stratum (Plot size: 30' )
1. Fraxinus pennsylvanica
2. Nyssa sylvatica
3. Acer rubrum
4.
5.
6.
7.
8.
Sapling/Shrub Stratum (Plot size: 30' )
1. Quercus alba
2. Liriodendron tulipifera
3. Fraxinus pennsylvanica
4.
5.
6.
7.
8.
9.
10.
Herb Stratum (Plot size: 30' )
1. Polystichum acrostichoides
2. Splenium platyneuron
3. Eulalia viminea
4. Rubus betulifolius
5.
6
Absolute
% Cover
Dominant
Species?
Indicator
Status
Dominance Test worksheet:
Number of Dominant Species
That Are OBL, FACW, or FAC: 6 (A)
Total Number of Dominant
Species Across All Strata: 7 (B)
10 N FACW
20 Y FAC
30 Y FAC
Prevalence Index worksheet:
Total % Cover of:
OBL species
FACW species
FAC species
FACU species
UPL species
Column Totals:
7.
Prevalence Index = B/A =
Percent of Dominant Species
That Are OBL, FACW, or FAC:
86 (A/B)
10.
11.
_ 1 - Rapid Test for Hydrophytic Vegetation
Prevalence Index worksheet:
Total % Cover of:
OBL species
FACW species
FAC species
FACU species
UPL species
Column Totals:
Multiply by:
x 1 =
X2=
X3=
X4=
X5=
(A) (B)
60 = Total Cover
10 Y FACU
20 Y FAC
10 Y FACW
4 -Morphological Adaptations' (Provide supporting
Hydrophytic
Vegetation
Present? Yes X No
7.
Prevalence Index = B/A =
Hydrophytic Vegetation Indicators:
g.
10.
11.
_ 1 - Rapid Test for Hydrophytic Vegetation
15 = Total Cover
Woody Vine Stratum (Plot size: 30' )
1. Toxicodendron radicans 5 Y FAC
X 2 - Dominance Test is > 50%
_ 3 -Prevalence Test is <_ 3.0'
40 = Total Cover
4.
4 -Morphological Adaptations' (Provide supporting
Hydrophytic
Vegetation
Present? Yes X No
data in Remarks or on a separate sheet)
5 N FAC
Problematic Hydrophytic Vegetation' (Explain)
'Indicators of hydric soil and wetland hydrology must
5 N FACU
30 Y FAC
5 N FAC
be present, unless disturbed or problematic.
7.
Definitions of Vegetation Strata:
Tree - Woody plants, excluding vines, 3 in. (7.6 cm)
or more in diameter at breast height (DBH),
regardless of height.
Sapling/Shrub - Woody plants, excluding vines, less
than 3 in. DBH and greater than 3.28 ft (1 m) tall.
Herb - All herbaceous (non -woody) plants, regardless
of size, and woody plants less than 3.28 ft tall.
Woody vine - All woody vines greater than 3.28 ft in
height.
8.
g.
10.
11.
12.
15 = Total Cover
Woody Vine Stratum (Plot size: 30' )
1. Toxicodendron radicans 5 Y FAC
2.
3.
4.
5
Hydrophytic
Vegetation
Present? Yes X No
6•
5 = Total Cover
Remarks: (Include photo numbers here or on a separate sheet.)

SOIL
Sampling Point:
DP -2
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
(inches) Color (moist) % Color (moist) % Type' Loc2 Texture Remarks
0-18 10YR 4/6 100
L
'Type: C=Concentration, D=De letion, RM=Reduced Matrix, CS=Covered or Coated Sand Grains.
2Location: PL=Pore Lining, M=Matrix.
Hydric Soil Indicators:
Histosol (Al)
Histic Epipedon (A2)
Black Histic (A3)
Hydrogen Sulfide (A4)
Stratified Layers (A5)
2 cm Muck (A10) (LRR N)
Depleted Below Dark Surface (A11)
Thick Dark Surface (Al2)
Sandy Mucky Mineral (S1) (LRR N,
MLRA 147, 148)
Sandy Gleyed Matrix (s4)
Sandy Redox (S5)
Stripped Matrix (S6)
Dark Surface (S7)
Polyvalue Below Surface (S8) (MLRA 147, 148)
Thin Dark Suface (S9) (MLRA 147, 148)
Loamy Gleyed Matrix (F2)
Depleted Matrix (F3)
Redox Dark Surface (F6)
Depleted Dark Surface (F7)
Redox Depressions (F8)
Iron Manganese Masses (F12) (LRR N,
MLRA 136)
Umbric Surface (F13) (MLRA 136, 122)
Piedmont Floodplain Soils (F19) (MLRA 148)
Indicators for Problematic Hydric Soils3:
2 cm Muck (A10) (MLRA 147)
Coast Prairie Redox (A16)
(MLRA 147, 148)
Piedmont Floodplain Soils (F19)
(MLRA 136, 147)
Red Parent Material (TF2)
Very Shallow Dark Surface (TF12)
Other (Explain in Remarks)
3lndicators of Hydrophytic vegetation and
wetland hydrology must be present, unless
disturbed or problematic.
Restrictive Layer (if observed):
Type:
Depth (inches):
Hydric Soil Present?
Yes No X
Remarks:

6/5/2017 Guilford County Endangered Species, Threatened Species,Federal Species of Concern, and Candidate Species
Endangered Species, Threatened Species,Federal Species of Concern,
and Candidate Species,
Guilford County, North Carolina
Updated: 03-25-2015
Common Name
Scientific name
Federal
Record Status
Status
Vertebrate:
Bald eagle
Haliaeetus leucocephalus
BGPA
Current
Carolina darter
Etheostoma collis lepidinion
FSC
Current
Invertebrate:
Vascular Plant:
Small whorled pogonia
Isotria medeoloides
T
Current
Nonvascular Plant:
Lichen:
Definitions of Federal Status Codes:
E = endangered. A taxon "in danger of extinction throughout all or a significant portion of its range."
T = threatened. A taxon "likely to become endangered within the foreseeable future throughout all or a
significant portion of its range."
C = candidate. A taxon under consideration for official listing for which there is sufficient information to
support listing. (Formerly "Cl" candidate species.)
BGPA =Bald and Golden Eagle Protection Act. See below.
FSC=Federal Species of Concern. FSC is an informal term. It is not defined in the federal Endangered Species
Act. In North Carolina, the Asheville and Raleigh Field Offices of the US Fish and Wildlife Service (Service)
define Federal Species of Concern as those species that appear to be in decline or otherwise in need of
conservation and are under consideration for listing or for which there is insufficient information to support
listing at this time.Subsumed under the term "FSC" are all species petitioned by outside parties and other
selected focal species identified in Service strategic plans, State Wildlife Action Plans, or Natural Heritage
Program Lists.
T(S/A) = threatened due to similarity of appearance. A taxon that is threatened due to similarity of appearance
with another listed species and is listed for its protection. Taxa listed as T(S/A) are not biologically endangered
or threatened and are not subject to Section 7 consultation. See below.
EXP = experimental population. A taxon listed as experimental (either essential or nonessential). Experimental,
nonessential populations of endangered species (e.g., red wolf) are treated as threatened species on public land,
for consultation purposes, and as species proposed for listing on private land.
https�//www.fws.gov/sleigh!species/cntyiisf/guilford.hfml 112

6/5/2017 Guilford County Endangered Species, Threatened Species,Federal Species of Concern, and Candidate Species
P = proposed. Taxa proposed for official listing as endangered or threatened will be noted as "PE" or "PT",
respectively.
Bald and Golden Eagle Protection Act (BGPA):
In the July 9, 2007 Federal Register( 72:37346-37372), the bald eagle was declared recovered, and removed (de-
listed) from the Federal List of Threatened and Endangered wildlife. This delisting took effect August 8,2007.
After delisting, the Bald and Golden Eagle Protection Act (Eagle Act) (16 U.S.C. 668-668d) becomes the
primary law protecting bald eagles. The Eagle Act prohibits take of bald and golden eagles and provides a
statutory definition of "take" that includes "disturb". The USFWS has developed National Bald Eagle
Management Guidelines to provide guidance to land managers, landowners, and others as to how to avoid
disturbing bald eagles. For mor information, visit httn://www.fws. ov/mi ratorybirds/haidea lg e htm
Threatened due to similari of a pearance(T(S/A)):
In the November 4, 1997 Federal Register (55822-55825), the northern population of the bog turtle (from New
York south to Maryland) was listed as T (threatened), and the southern population (from Virginia south to
Georgia) was listed as T(S/A) (threatened due to similarity of appearance). The T(S/A) designation bans the
collection and interstate and international commercial trade of bog turtles from the southern population. The
T(S/A) designation has no effect on land management activities by private landowners in North Carolina, part of
the southern population of the species. In addition to its official status as T(S/A), the US. Fish and Wildlife
Service considers the southern population of the bog turtle as a Federal species of concern due to habitat loss.
Definitions of Record Status:
Current - the species has been observed in the county within the last 50 years.
Historic - the species was last observed in the county more than 50 years ago.
Obscure - the date and/or location of observation is uncertain.
Incidental/migrant - the species was observed outside of its normal range or habitat.
Probable/potential - the species is considered likely to occur in this county based on the proximity of known
records (in adjacent counties), the presence of potentially suitable habitat, or both.
https:/twww.fw s.gov/rag ei gh/species/cntyl i sttgui I ford. htm I
212

6/5/2017 Species By County Report
U.S. Fish & Wildlife Service
ECOS
ECOS / Species Reports / Species By County Report
Species By County Report
The following report contains Species that are known to or are believed to occur in this county. Species with range unrefined past the state level
are now excluded from this report. if you are looking for the Section 7 range (for Section 7 Consultations), please visit the IPaC application.
County: Guilford, North Carolina s CSV
Need to contact a FWS field office about a species? Follow this link to find your local FWS Office.
Recovery Recovery Plan Recovery
Group Name Population Status Lead Office Plan Action Status Plan Stage
Flowering Small whorled pogonia Wherever Threatened New England Ecological Small Implementation Final
Plants (lsotda medeoloidec) found Services Field Office Whorled Progress Revision 1
Poaonia
https://ecos.fws.gov/ecp0/reports/species-by-current-range-county?n ps=37081
1/1

W32017
EFH Mapper
EFH Data Notice: Essential Fish Habitat (EFH) is defined by textual descriptions contained in the fishery
management plans developed by the regional Fishery Management Councils. In most cases mapping data can
not fully represent the complexity of the habitats that make up EFH. This report should be used for general
interest queries only and should not be interpreted as a definitive evaluation of EFH at this location. A
location -specific evaluation of EFH for any official purposes must be performed by a regional expert. Please
refer to the following links for the appropriate regional resources.
Query Results
Map Scale = 1:72,224
Degrees, Minutes, Seconds: Latitude = 36012'41" N, Longitude = 81058'9" W
Decimal Degrees: Latitude = 36.21, Longitude = -80.03
The query location intersects with spatial data representing EFH and/or HAPCs for the following
species/management units.
E FIJI
No Essential Fish Habitats (EFH) were identified at the report location.
HAPCs
No Habitat Areas of Particular Concern (HAPC) were identified at the report location.
iEFH Areas Protected from Fishing
No EFH Areas Protected from Fishing (EFHA) were identified at the report location.
hV://www.habitat.nova.gov/protectaVefWefhmapperindex.html 1/1

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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
Page 1 of 10
PCN Form — Version 1.4 January 2009
Pre -Construction Notification (PCN) Form
A.
Applicant Information
1.
Processing
1a.
Type(s) of approval sought from the Corps:
❑X Section 404 Permit ❑ Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 29 or General Permit (GP) number:
1c.
Has the NWP or GP number been verified by the Corps? 7_0
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
1e.
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 ❑X 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
1 g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑Yes ❑X No
1 h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes ❑X No
2.
Project Information
2a.
Name of project:
Shiloh Subdivision
2b.
County:
Guilford
2c.
Nearest municipality / town:
Oak Ridge
2d.
Subdivision name:
Shiloh
2e.
NCDOT only, T.I.P. or state project no:
3.
Owner Information
3a.
Name(s) on Recorded Deed.
Stone Mint, LLC
3b.
Deed Book and Page No.
DB 7807, pg. 289
3c.
Responsible Party (for LLC if
Joe oe Gonzales
3d.
Street address:
2904A Lawndale Ave.
3e.
City, state, zip:
Greensboro, NC 27408
3f.
Telephone no.:
336-362-6584
3g.
Fax no.:
336-288-6181
3h.
Email address:
[e-mail]
Page 1 of 10
PCN Form — Version 1.4 January 2009

4.
Applicant Information (if different from owner)
4a.
Applicant is:
❑ Agent ❑ Other, specify.-
pecify:4b.
4b.
Name:
4c.
Business name
(if applicable):
4d.
Street address:
i 4e.
City, state, zip:
4f.
Telephone no.:
4g.
Fax no.:
4h.
Email address:
5.
Agent/Consultant Information (if applicable)
5a.
Name:
Norris Z. Clayton
5b.
Business name
(if applicable):
Hugh Creed Associates, Inc., PA
5c.
Street address:
1306 W. Wendover Ave.
5d.
City, state, zip:
Greensboro, NC 27408
5e.
Telephone no.:
336-275-9826
5f.
Fax no.:
336-275-3379
5g.
Email address:
[e-mail]
Page 2 of 10

B.
Project Information and Prior Project History
1.
Property Identification
1a.
Property identification no. (tax PIN or parcel ID): PIN #6899579267
1 b.
Site coordinates (in decimal degrees):
Latitude: 36.2103 Longitude: 80.0304
1c.
Property size:
83.65 acres
2.
Surface Waters
2a.
Name of nearest body of water to proposed project:
UT to East Belews Creek
2b.
Water Quality Classification of nearest receiving water:
B
2c.
River basin:
Dan - Roanoke
j 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:
Property is vacant land, timbered 5-10+/- years ago, adjacent land is farmland and rural subdivisions
3b.
List the total estimated acreage of all existing wetlands on the property:
3c.
List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 2,585
3d. Explain the purpose of the proposed project:
Construction of a 63 lot rural subdivision with a community well and water system and individual septic fields
3e. Describe the overall project in detail, including the type of equipment to be used:
Clear & grade roads, install well house, water and septic lines, pump lines to septic fields, crossing creek twice. Equip. clover, track hoe & excavator
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 priorphases) in thepast?
El Yes ❑X No F-1 Unknown
Comments:
4b.
If the Corps made the jurisdictional determination, what type
of determination was made?
❑ Preliminary ❑ 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 ❑X No ❑ Unknown
5b.
If yes, explain in detail according to "help file" instructions.
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
la. Which sections were completed below for your project (check all that apply):
❑X 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.
2b.
2c.
2d.
2e.
2f.
Wetland impact
Type of impact
Type of wetland
Forested
Type of jurisdiction
Area of
number
Permanent (P) or
Corps (404,10) or
impact
Temporary T
DWQ (401, other)
(acres)
W1
Culvert
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:
Wetland Delineation prepared by Pilot Environmental, Inc. Please see attached.
Location map currently being prepared by the surveyor. This section will be completed after receipt of the survey.
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 (PER) or
Type of
Average
Impact
number
I Permanent (P) or
intermittent (INT)?
jurisdiction
stream
length
Temporary (T)
width
(linear
(feet)
feet)
S1 P
Culvert
Unnamed
PER
Corps
5
55
S2 T
Rip-Rap Dissapator
Unnamed
PER
Corps
5
36
S3 T
Const. Disturbance
Unnamed
PER
Corps
5
5
S4 P
Culvert
Unnamed
PER
Corps
5
51
S5 T
Rip-Rap Dissipator
Unnamed
PER
Corps
5
28
S6 T
Const. Disturbance
Unnamed
PER
Corps
5
5
3h. Total stream and tributary impacts
172
3i. Comments:
Two stream crossings to have culverts. S1 is 51 LF 54" RCP with rip-rap outlet, and S4 is 47 LF 42" RCP with rip-rap outlet for access road crossings.
98 LF of culverts, stream lengths 106 LF. permanent impact / 64 LF rip-rap outlets, temporary impact / and 10 LF construction disturbance, temporary
Impact = Total of 180 LF stream impact
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 individually list all oven water imnantc hPinw
4a.
4b.
4c.
4d.
4e.
Open water
Name of waterbody
impact number
(if applicable)
Type of impact
Waterbody
Area of impact (acres)
Permanent (P) or
type
Temporary T
01
Choose one
Choose
02
Choose one
Choose
03
Choose one
Choose
04
Choose one
Choose
4f. Total open water impacts
4g. Comments:
3. Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below.
5a.
5b.
5c. 5d.
5e.
Pond ID number
Proposed use or
Wetland Impacts (acres) Stream Impacts (feet)
Upland
purpose of pond
(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,
6c.
6d.
6g.
Buffer Impact
Reason for impact
Stream name
Buffer
Zone 1
Zone 2
number—
Permanent or
mitigation
impact
impact
Temporary ( T
required?
(square
(square
feet
feet
B 1
Yes/No
B2
Yes/No
B3
Yes/No
B4
Yes/No
B5
Yes/No
B6
Yes/No
6h. Total Buffer I:
mpacts
6i. Comments:
Nage 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.
Off-site septic areas are located across the stream from the lots. The access road and supply lines have to cross the stream. We grouped the supply
lines to the septic areas into two groups and crossed the stream with the access roads in the same crossing. We designed the crossings to be
perpendicular to the stream to minimize the impact.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Access road crossings are nearly perpendicular to the stream. Both pipes are to be buried one foot below the stream bed with the top of the rip -rap
placed at original stream bed elevation. During construction the stream will be sandbagged and pumped for dry installation to minimize steam impacts
2. Com ensato Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
I 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
❑ 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 Pro ram
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 ❑X 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.
6c.
6d.
6e.
Zone
Reason for impact
Total impact
Multiplier
Required mitigation
(square feet)
(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.
Local
requirements for low density development do not require diffused flow plan
❑ Yes ❑ No
2.
Stormwater Management Plan
2a.
i
What is the overall percent imperviousness of this project?
7.85%
2b.
2c.
Does this ro'ect re uire a Stormwater Management Plan?
If this DOES
❑ Yes No
I
project NOT require a Stormwater Management Plan, explain why:
Preliminary Plan was approved by the Town of Oak Ridge and Guilford County as a low density development and a Stormwater Management Plan is
not required.
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?
NSA
3.
Certified Local Government Stormwater Review
3a.
In which localgovernment's jurisdiction is thisproject?
Town of oak Ridge, NC
0 Phase 11
3b.
Which of the following locally -implemented stormwater management programs
❑ NSW
apply (check all that apply):
❑ USMP
❑ Water Supply Watershed
❑ Other:
3c.
Has the approved Stormwater Management Plan with proof of approval been
❑Yes 7X No
attached?
4. DWQ Stormwater Program Review
❑Coastal counties
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 E] 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
use of public (federal/state) land?
❑ Yes
FX� No
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
LO Yes
❑ No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c
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
letter.)
❑ Yes
❑ No
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,
F] Yes
No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b.
Is this an after-the-fact permit application?
El Yes
Q 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
additional development, which could impact nearby downstream water quality?
El Yes
No
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 pro'ect, or available capacity of the subject facility.
63 Lots with individual
su�-surface systems
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
habitat?
❑ Yes ❑X No
5b. Have you checked with the USFWS concerning Endangered Species Act
impacts?
❑ Yes ❑X No
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?
https://www.fws.gov/raleigh/species/cntylist/guilford.html
Please see attached
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish ;7—
❑ Yes ❑X No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
http://www. habitat. noaa. gov/protection/efh/efhmapper/index. html
Please see attached
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
status (e.g., National Historic Trust designation or properties significant in
❑ Yes ❑X No
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
NC State Historic Preservation Office website - http://hpo.ncdcr.gov/
Please see attached
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?
Joe Gonzales
June 16, 2017
Applicant/Agent's Printed Name
i App c gent's Signature
Date
(Agent's nat re valid only if an authorization
le er fr theapplicant isprovided.)
l�
Page 10 of 10