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Home My WebLink About20170865 Ver 1_401 Application_20170712Montalvo, Sheri A From: Montalvo, Sheri A Sent: Thursday, July 13, 2017 9:26 AM To: cdarnell@ecslimited.com Subject: Drive Shack Attachments: Agent Authorization Form.pdf Importance: High Follow Up Flag: Follow up Flag Status: Flagged Cory, We have received the PCN for the above. The signature page 10 of 10 was signed by you and will require an agent authorization form to be completed. I have attached one for your use. Once completed please email it back to me at sheri.montalvo(c-D,ncdenr.gov so that I can take the project off hold and forward through the review process. Thanks Sheri Montalvo Administrative Assistant 401 & Buffer Permitting Branch Division of Water Resources North Carolina Department of Environmental Quality 919-807-6303 (office) 919 807-6494 (fax) sheri.montalvoC�ncdenr.gov Physical: 512 N. Salisbury St., Ste 942-D, Raleigh, NC 27604 Mailing: 1617 Mail Service Center, Raleigh, NC 27699-1617 Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties. E�fc!e ECS SOUTHEAST, LLP Geotechnical • Construction Materials • Environmental 9001 Glenwood Avenue Raleigh, North Carolina 27617 Telephone 919-861-9910 Fax 919-861-9911 To: NCDWR, 401 and Buffer Permitting Unit Raleigh Regulatory Field Office 1617 Mail Service Center Raleigh, North Carolina 27699-1617 From: Cory Darnell ECS Southeast, LLP 9001 Glenwood Avenue Raleigh NC 27617 We are sending you the following items via: FedEx LETTER OF TRANSMITTAL Date: I July 11, 2017 1 Project No. 1 49: 4373 COPIES DATED DESCRIPTION 1 July 11, 2017 PCN Application Drive Shack These are transmitted as checked below: X For your use As requested REMARKS L��5 UM 2 2011 Please find the attached PCN application for Drive Shack located at 1021 Corporate Center Drive in Raleigh, Wake County, North Carolina. If you have any questions please contact Cory Darnell at (919) 861-9859 or at cdarnell@ecslimited.com COPY TO: SIGNED 7 0 8 6 5 E�fc!e ECS SOUTHEAST, LLP Geotechnical • Construction Materials • Environmental 9001 Glenwood Avenue Raleigh, North Carolina 27617 Telephone 919-861-9910 Fax 919-861-9911 To: NCDWR, 401 and Buffer Permitting Unit Raleigh Regulatory Field Office 1617 Mail Service Center Raleigh, North Carolina 27699-1617 From: Cory Darnell ECS Southeast, LLP 9001 Glenwood Avenue Raleigh NC 27617 We are sending you the following items via: FedEx LETTER OF TRANSMITTAL Date: I July 11, 2017 1 Project No. 1 49: 4373 COPIES DATED DESCRIPTION 1 July 11, 2017 PCN Application Drive Shack These are transmitted as checked below: X For your use As requested REMARKS L��5 UM 2 2011 Please find the attached PCN application for Drive Shack located at 1021 Corporate Center Drive in Raleigh, Wake County, North Carolina. If you have any questions please contact Cory Darnell at (919) 861-9859 or at cdarnell@ecslimited.com COPY TO: SIGNED i ECS CAROLINAS, LLP 'setting the Standard for Service'' �. Geotechnical • Construction Materials • Environmental • Facilities "Ckzs`F`�dEE;nSFirm `-,cue July 11, 2017 Ms. Stephanie Goss NC DWR, 401 & Buffer Permitting Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Reference: Pre -Construction Notification Application Request for NWP 14 Drive Shack 1021 Corporate Center Drive Raleigh, Wake County, North Carolina ECS Project No.: 49: 4373 Dear Ms. Goss: Please find a copy of the Pre -Construction Notification Application for the approximate 16 -acre site located at 1021 Corporate Center Drive, Raleigh, Wake County, North Carolina. The purpose of this project is to develop the site with a commercial entertainment and sports facility (driving range). Due to the limitations of site access, floodplains, and wetlands one culvert crossing is proposed across a perennial stream on site. On behalf of Drive Shack, I am requesting that a NWP 14 be issued to authorize the permanent impacts of stream (SA) 121 LF and stream (SD) 27 LF. Additionally, we are requesting a buffer authorization of 7,600 SF in Zone I and 5,300 SF in Zone II. The crossing was designed to allow construction and vehicle access to the central portion of the site. The attached permit application and associated exhibits provide details pertaining to the proposed project impacts. Please feel free to contact me at 919.861.9910 if you have any questions concerning this request of if additional information is required. Thank you in advance for your timely consideration of this matter. Sincerely, ECS Carolinas, LLP 1 11 ,, B - (� "V4 , w� Cory B. Darnell Environmental Project Manager Attachments Pre -Construction Notification Application Exhibits Figures NHP, USFWS, and SHPO Correspondence Minor Water Quality Application Fee 9001 Glenwood Avenue. Raleigh. NC • 27617-7505 • T: 919-861-9910 • F: 919-861-9911 • ,vww.ecslirnited,com ECS Capitd Services. PLLC • ECS Carolinas- LLP • ECS Central, PLL:; • ECS Flcali LLC - ECS Mid-Atianbc, LLC • ECS Midvrest, LLC • ECS Southeast, LLC • ECS Texas, LLP Office Use Only: Corps action ID no. DWQ project no. Form Version 1.4 January 2009 Pre -Construction Notification (PCN) Form A. Applicant Information 1. Processing 1 a. Type(s) of approval sought from the Corps: ® Section 404 Permit ❑ Section 10 Permit 1 b. Specify Nationwide Permit (NWP) number: 14 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 For the record only for DWQ because written approval is not required? 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 1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1h 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: Drive Shack 2b. County: Wake 2c. Nearest municipality / town: Raleigh 2d. Subdivision name: n/a 2e. NCDOT only, T.I.P or state project no: 3. Owner Information 3a. Name(s) on Recorded Deed: ALS Forestry and Farming, LLC 3b. Deed Book and Page No. 0140874, 00770 3c. Responsible Party (for LLC if applicable): Mr. Matt Stephens 3d. Street address: 319 Chapanoke Road, Ste 102 3e City, state, zip: Raleigh NC 27603 3f. Telephone no.: 3g. Fax no.: --- - 919 779 8649 919 779 7952 3h. Email address: _ mattstephens@bellsouth.net Page 1 of 10 PCN Form - Version 1.4 January 2009 4. Applicant Info'rmstion (If different from owner) 4s. Applicant is: ❑ Agent ® Other, specify: Developer 4b. Name: Mr. Trey Carter 4c. Business name (if a le): Drive Shack 4d. Street address: 1345 Avenue of the Americas, 45th Floor 4e. City, state, zip: New York, NY 10105 4f. Telephone no.: 479 644 5965 4g. Fax no.: 4h. Email address: tcarter@ddveshack.com 5. AgenbrAmultent Infonration (N applicable) 5a. Name: Mr. Cory Darnell 5b. Business name (if applicame): ECS Southeast, LLP 5c. Street address: 9001 Glenwood Avenue 5d. City, state, zip: Raleigh NC 27617 5e. Telephone no.: 919-861-9859 5f. Fax no.: 919-W1.9911 5g. Email address: cdarnelCecslimited.com Page 2 of 10 B. Project Infonnatlon and Prior Project History 1. Property Identification 1a. Property idendftcation no. (tax PIN or parcel ID): 10774764860 1b. Site coordinates (in decimal degrees): Latitude: 35.801892 Longitude: -78.739576 1c. Property size: 16 acres 2 Surface Waters 2a. Name of nearest body of water to proposed project: Richlands Creek 2b. Water Oualty Classilication of nearest receiving water: C; NSW 2c. River basin: Neuse 3. Project Description 3a. Describe the existing conditions on the site and the general land use kr the vicinity of the project at the time of this application: See Appendix 1 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 perenniaq on the property: 1,240 3d. Explain the purpose of the proposed project: See Appendix I 3e. Describe the overall project in detail, including the type of equipment to be used: See Appendix 1 4. Jurisdictional Determinations 4a. Have jurMidtional wetland or stream determinations by the Corps or State been requested or obtained for this property / proi all sin the ? ® Yes ❑ No ❑ Unknown Comments: �e visit erzi 7 with USACE and NCDWR 4b. if the Corps made the jurisdictional determination, what type of determination was made? ® Preliminary ❑ Final 4c. If yes, who delhieated the jurisdictional areas? Name (if known): Ken V11189 n Fa9uson Agency/Consultant Company: ECS Saftmt, LLP Other. 4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation. Ske vM 6OW17 vAh USAGE and NCDM 6. Project History 5a. Have permits or cerfi icatiOris been requested or obtained for[:]Yes® this p (including all prior phases) in the past? No ❑ Unkrtorm 5b. If yes, explain in detail according to `help tile' instructions. S. Future Project Pians 6a. Is this a phased project? ❑ Yes ® 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 ® Streams — tributaries ® Buffers ❑ Open Waters ❑ Pond Construction I 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 Te 2b. Type of impact 2c. Type of wetland 2d. Forested 2e. Type of jurisdiction Corps (404.10) or DWO (401, other) 21. Area of Impact (acnes) W1 - Choose one Choose one Yeaft - VV2 - Choose one Choose one YealNo - W3 - Choose one Choose one YesMo - W4 - Choose one Choose one YealNo - W5 - Choose one Choose one Yes/No we Choose one Choose one Yes No - 2g. Total Welland 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 (1) 3b. Type of impact 3c, Stream name 3d. Perennial (PER) or intermittent (INT)? 3e. Type of jurisdiction 31. Average stream width feet) �p length pinear feet) S1 P Culvert SA PER Corea 20 121 S2 P CWVWt SD PER Corps 10 27 S3 - Choose one - - S4 - Choose one - - S5 - Choose one - - S5 - Choose one - - 3h. Total stream and tributary Impacts 148 31. Comments: See Apps xVx 1 Page 4 of 10 PCN Form — Version 1.4 January 2009 4. Open Water impacts 9 there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of the U.S. than a1v list all open water Impacts beko►. 4a. Open water impact number Permanent (P) or Temporary (D 4b. Name of waterbody (if applicable) 4c. Type of impact 4d. Waterbody type 4e. Area of impact (acres) 01 - Choose one Choose 02 - Choose one Choose 03 - Choose one Choose 04 _ Choose one Choose M. Total open water Impacts 49. Comments: 6. Pond or Lake Construction If Pond or lake constnxsion proposed. complete the chart below. 5a. Pond ID number 5b. Proposed use or purpose of pond 5c. Wetland Impacts (acres) 5d. Stream Impacts (feet) 5e. 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 N yes, permit ID no: 51. Expected pond surface area (acres): .9. Size of pond watershed (acres): 51L Method of construction: S. Buffer Impacts (for DWA) If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts below. If any ds require m0kapaftlon.you MUST W out Section D of this form. 6a. Pmjed is in which protected basin? ® Neuse ❑ Tar-Pamko ❑ Catawba ❑ Randleman ❑ Other. 6b. Buffer Impact number _ Permanent (P) or Tem 60. Reason for impact 6d. Strom name 6e. Buffer mitlgation required? 6f. Zone 1 impact (square feet fig. Zone 2 impact (square feet B1 P Culvert Crossing SA NO 7.600 5.300 B2 P Culvert Crossing SD NO 0 0 B3 - YeslNo B4 - YesiNo By _ Yeeft B8 - Yom 6h. Total Butter Mnpacts: 7.600 5,300 61. Comments: Page 5 of 10 D. Impact Justification and Mitigation 1. Avoidance and Minimttation 1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project. See ApMWIX I 1 b. Specifically describe measures taken to avoid or minimize the proposed Impacts through construction techniques. See AppMft 1 2. CompsrmtM Mitigation for Impacts to Waters of the U.S. or Waters of the State 2a. Does the project require Compensatory Mitigation for ❑ Yes ® No Impacts to Waters of the U.S. or Wags of the State? 2b. If yes, mitigation is required by (check all that appy): ❑ 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 N 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 le Illialdng a t to In -lieu Fee Program 4a. Approval letter from in -Neu fee program Is attached. ❑ Yes 4b. Stream mitigation requested: linear feet 4c. If using stream mitigation, stream temperature: Choose one 4d. Buffer nation requested (DWQ only): square feet 4e. Riparian wetland midga#w requested: acres 4f. Non -riparian wetland mitigation requested: acres 4g. Coastal (Mal) wetland mitigation requested: acres 4h. Comments: 5. Complete N 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 S. Buffer Wtigation (State Regulated Riparian Buffer Rules) — required by DWQ 6a. WIN the projed result In an impact within a protected dpadan buffer that requires buffer mitigation? [3 Yes ® No 6b. If yes, then Identity the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the amount of mitigation required. Zone 8c. Reason for impact 6d. Total impact (square feet) Multiplier 6e. Required mitigation (square feet) Zone 1 3 (2 for Catawba) Zone 2 1.5 Of. Total buffer mitigation required: 6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank, perms tee responsible riparian buffer restoration, payment into an approved in -lieu fee fund). 6h. Comments: Page 7 of 10 E. Stormwater Management and Diffuse Flow Pian (required by DWQ) 1. Diffuse Fiow Plan 1a. Does the project include or Is it adjacent to protected riparian buffers Identified within one of the NC Riparian Buffer Protection Rules? ® Yes ❑ No 1 b. If yes, then is a diffuse flow plan included? If no, explain why. Stornmier Managanent Plan has been submMed to the City of Raleigh and is cunw* under reviews. ❑ Yes No 2. SborawaterManagement Pian 2a. What Is the overall percent imperviousness of this project? 51.6% 2b. Does this prolect require a Stormwater Management Plan? ® Yes ❑ No 2c. If this project DOES NOT require a Stormwater Management Plan, explain why: 2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan: The project has been u&naed to and is =mntly being reviewed by the CNy of Raleigh. 2e. Who will be responsible for the review of the Stormwater Management Plan? City of Raleigh 3. Certified Local Govermnent Stormwater Review 3a. In which local oovemmenrs Jurisdiction is this ? Cfty of Rafth 3b. Which of the following Iocally4mplemented stormwater management programs apply (check all that apply): ® Phase 11 ® NSW USMP Water Supply Watershed Other: 3c. Has the approved Stormwater Management Plan with proof of approval been attached? ❑ Yes CO No 4. D11 O Ston nwater Prograrn Review 4a. Which of the following state -implemented stormwater management programs apply (check all that apply): ❑Coastal counties ❑HOW ORW Session Law 2006-246 Other: 4b. Has the approved Stormwater Management Plan with proof of approval been attached? ❑ Yes ❑ No 5. DWQ 401 UMt 86ormwater Review 5a. Does the Stormwater Management Pian meet the appropriate requirements? ® Yes ❑ No 5b. Have all of the 401 Unk submittal requirements been met? ® Yes ❑ No Page 8 of 10 PCN Form — Version 1.4 January 2009 F. Supplementary Information 1. Environmental Documentation (DWO Requirement) 1a. Does the project involve an expenditure of public (federal/state/kxxd) finds or the Oyes ®No use of public (federal/state) land? 1b. 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)? 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 ❑ Yes ❑ No letter.) Comments: 2. Violations (DWO Requirement) 2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated Welland Rules (15A NCAC 2H .1300), DWO Surface Water or Wetland Standards, ❑Yes ® No or Riparian Buffer Rules (15A NCAC 2B .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): 3. Cumulative Impacts (DWO 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 DWCI policy. If you answered 'no,* provide a shat narrative description. 4. Sewage Disposal (DM Requirement) 4a. Clearly detall the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from The � "p%posedre proj Rah availablepacity of the Subject facility. Page 9 of 10 PCN Form — Version 1.4 January 2009 Q, end Spades and OesiOttdsd CrNW WbIW (COW ROP&WWO tial. VWtftP in or near an eree wilt feeder* ptmte d , spedss or tobw W Yee 13 No Sb. Have you checked wfih to USFWS omm en to EndenDmed Spaces Act Byes ❑ No So. if yes, kdoets to USFWS Field 0111ce you hens oonfard, d. ft VWW date sources did you use b del rmko whalteryour site would knp d Endertgered Spaces or Deeipnetad Cdticaa U8 Fbh OW WOM orrna mappf►g webaNe L 6 Fist Habidt (Co" ftgnks m" ft VO this project occur in or tied an ares deeipnated a eeprttiai fish hebtaN? Q Yes ® No lb. Whet t sources didyo use b down** udtslter your de would knpaot EseerdW Fish Habm? Mapper NMA Es W FW NdNd - T. EBsiori0 or Prd"ft Cattgrd resources (Corps tis4uMenrenq Ta. VIM ties occur in or neer an am Jhet the stele, federal or WW Sorrensnerffft hays dedWated es hevUtp Nhtoric'or ouilurd pies uvallor E3 Yes ®No stilus (a Z, Nd xW HWat Dud dedgristion or properties soAcmd in North CaroWn Ndmy and arcbesobgy)? 7b. VVhd data souron did you use to deiermkw whdhw your of would impact hWA tc or en011e060021 reeouroes? NC SHPQ fiL Flood Zone Desipmtlon (Cape ilei. VIAS this projectoom Ins FEMA-designated 100-year loodphdrk? ® Yes Cl No lb. JIM siqlaelrt how project meets FEMA ra4ulrsrtterttar 81idl�t en) nct baba pcPoMd whin Mtrr Rood in4. GortNndct► db poPoaad oroeetg wtN not.IMiblt lbw 11rom w watMs av b lhf+ propoaafl donbla 112'u11' botk a1wtL The oidYen w11 be Mtelaled a stdns bebw fha afnnm bed which wN abw agwgc Nis to mow utnaMlcted upatisafa MNrdowwewm at tnrcroa' g.'nw a n I las n0 ffN ASCE U Fbo&RAIM" haslet and Con*uftn rg**&n nfs. 8c. V" mm s(s) did you use to make the tioodpiein d&Mmtkteti0n? Faaf�n wp Cory S. Dwnd 07-O7-=7 AppYcerd/A®ent"s Prhled Nettie eidrs tele Pepe 10 of 10 Legend 0 Approximate Site Boundary jwl KING SUBDIVISION TRINITY WOODS Haripton inn & Suites Raleigh/Cary 104 i.RL .10 PNC Arena 021 Corporate Center Drive A13BURY lb PrDiric Rlcgc. F Few"', Client: DRIVE SHACK LLC. Project: 1021 CORPORATE CENTER DRIVE, RALEIGH WAKE COUNTY NORTH CAROLINA Title: SITE LOCATION MAP GOOGLE STREET MAP DATED 2016 WAKE COUNTY, NORTH CAROLINA Drawn By: Checked By: KJV I CBD Approved By: Date: WBF 1 4/12/2017 CS Project No: 49-4373 FIGURE 1 \ ! V LegendJ� ir Approximate Site BoundaryUNIT � '--- J "' • • Client: s. - dd DRIVE SHACK LLC. 47 L. ,�� • i - • i �" .N • • + _ T ; Project: , 1021 CORPORATE �',-A • • • �- s r +'`` t CENTER DRIVE, f: _ t ,;� •* , `ti. . f RALEIGH i WAKE COUNTY NORTH CAROLINA + :.� _ � .; � • i � '1 t . � ---. - �. - Title: `?� .- . *• ' t j' -v'( USGS TOPOGRAPHIC MAP RALEIGH, NC ! DATED 2014 mytopo.com -. ,.— ;f..^� f ,� a;` # 7 ' (��/ 1/� `�• T - 'ri ice. ; . ��f�'' �1� ' , �:.c:-`��`�__- - •`�+`'=` � Y I,' f �,�r\�` �` 3 4 !� • r `' i • �,� a� WAKE COUNTY, r° + fl• •' • �'' :.% r NORTH CAROLINA t l • J l Drawn By: Checked By: KJV CBD • • - �, ` _ 1 �. w . Approved By: Date: *,_ !, +• WBF 4/12/2017 •�� ` rt , • • �� `.. _ECS Project No: - .. 4 49-4373 Lin v r �+f t _ ` dab : i - FIGURE 2 .-, t _ _ _ .. .► 6V' . 4 -GK. I" 'ice 1 g Legend AUS O Approximate Site Boundary .E w CS ApD = Appling sandy loam , Client: CeD = Cecil sandy loam, G9B2 CgB2 = Cecil gravelly sandy loam DRIVE SHACK LLC. CgC2 = Cecil gravelly sandy loam DuB = Durham loamy sand , : Project: _ �..: _ DuC =Durham loamy sand x 1021 CORPORATE - , . � ��. ° �$ - CENTER DRIVE, WmE = Wedowee sandy loam RALEIGH WAKE COUNTY • NORTH CAROLINA Aea - 4 . Ilk ,. * Title: NRCS SOIL MAP r •- SOIL SURVEY WAKE COUNTY, NORTH CAROLINA s "b e ► �: 4 .1# DATED 1970 .s . ww► r SHEET 47 � 1 ° _ #.- , ' ,. 1:1,000 r` ' ago 44 • _ r *ail r .. _ Cel �". ! WAKE COUNTY # NORTH CAROLINA + N ( .� Drawn By: Checked By: r. KJV CBD •; Approved By: Date: WBF 4/12/2017 � C 7ECS Project No: ° 49 4373 e FIGURE 3 Legend ,� OApproximate Site Boundary �• a - 1 Client: IM DRIVE SHACK LLC. � y, r: .t. !, ` • . ... `� Project: WM Raw .a140 W-* 1021 CORPORATE as,Ia� x+I *c n Houle 4w�t nxe G 7 0 N F •'. = i rc ......m..i.i:m,.....+....�rri.�.�.«,, . s { t CENTER DRIVE, it+e. sa,isww>w.we. a4 i.. ,. +`. irr�w •.. • - RALEIGH ...a4 it 4wnalr.{a it 7•>i.a s,.mW ,«>L... � • ', (,r��[� Mbi 4efr ]M 4 4. M +L ii N + ar ! A fu Alli h.rwn 4 ' ,/I40R..YlI.rfR:i ,�►,.+b - yy 4M _ f I ,; ��*• _ WAKE COUNTY IIs • t rr qat [tre i•w,ra - ;r 1" C A F NORTH CAROLINA I.�r Vsiwil•1M r�,w»rea. V+nr t«. - V. r-- iM no A* +rr tllr•IaF•rJ wwa�,rsr �. _. - i�a4 rr r w+r +ot .., ►. rem, ssoa +. « , .w. Title: FEMA FIRM ,w.irw.+w►,>,a„r. .,�,,,, n..r,,....., _ _ � �'�;w .. .. .. MAP NUMBER: !N/M ;+sY iia w.,w wn wwr t74r:.lr aim r... !� 3720077400) 16,DATED 5/2/2006 'VWY/,, S,aM4 /+a4a,bFiMw /,�4 M4Me,Or. §'•�`w - .....�.,...rr.w SCALE: 'iir.:rt.wiis - 1 INCH = 290 FEET IIsi rr a i rw +a.: X40 ..i z� ..0 .,ra, �+.• - - ti _J-1" I.GN E X r x N ,S 1>AP lrll nl+]a, � •,nom lr.lf ,alA> rr>.1 rnt Arl,Y14•.. +• 'I . I •..4 1 '� l J ' R r t . I v I f w....,..f i WAKE COUNTY, w.. »r..a...,. 4 r r;: —11 Ti:. I fti J'131-1' +NORTH CAROLINA Mon .�.. tYrr'L„,4., 4„i,r N♦ i7 '`� � 5'1.1 � i }'• - Ilnlr6 i,r f,i'4, 4,v M4ri �• 1 �w.,.,>,,,,r,.,,,.. -- } 1 Drawn By: Checked By: •..r,r-avrs..w rr4,.r>, - KJV CBD Approved By: Date: r�11�i e■lrb wsrwall. we.:,. :;. P, ` ��'~ - WBF 4/12/2017 > .. _ er raw •-�. ... , �+ ,.. �,, r.4r>rrw�..nrrn.A1� • ECS Project No: ,. :... r..,..r�..� .r ... 49-4373 FIGURE 4 aaa•, �...r. .., ,. ....+.,. . Legend OApproximate Site Boundary N b( Wetlands - Freshwater Emergent - Freshwater Forestedi5hrub - Estuarine and Marine Deepwater - Estuarine and Manne - Freshwater Pond - lake - Rwenne other E Client: DRIVE SHACK LLC. ~ a a 1 Project: #r 1021 CORPORATE #` . CENTER DRIVE, RALEIGH WAKE COUNTY NORTH CAROLINA Title: ;�. USFWS NATIONAL WETLANDS INVENTORY MAP NOT TO SCALE r WAKE COUNTY, " NORTH CAROLINA r a Drawn By: Checked By: ` e e KJV CBD +� Approved By: Date: W BF 4/12/2017 ECS Project No: 49-4373 « ire FIGURE 5 THE STREAM/WETLAND LOCATIONS HAVE BEEN DELINEATED AND GPS'D BY ECS ON 12 APRIL 2017. THEY HAVE NOT BEEN VERIFIED BY THE USACE OR THE NCDENR-DWR. THEY HAVE NOT BEEN SURVEYED. THIS FIGURE SHOULD BE USED FOR PRELIMINARY PLANNING PURPOSES. Legend Approximate Site Boundary Approximate Stream Location Approximate 50 Ft Buffer Body of Water: Richlands Creek River Basin: Neuse = 50 Ft Buffer Classification: Class C; NSW Local Buffers: 30 Ft perennial waters, 100 Ft buffer for activities that exceed z 24% impervious coverage Length (Feet) SA = 1,109 SD = 131 El SD: 1-4 AW=10' Off Site Stream Buffer Encroachment SA: 45-70 (Richlands Creek) AW = 8-15' Client: DRIVE SHACK LLC. Project: 1021 CORPORATE CENTER DRIVE, RALEIGH WAKE COUNTY NORTH CAROLINA Title: STREAM/WETLAND LOCATION MAP SCALE: 1 INCH= 300 FEET WAKE COUNTY, NORTH CAROLINA Drawn By: Checked By: KCF CBD Approved By: Date: WBF 4/20/2017 ECS Project No: 49-4373 FIGURE 6 \a INTERSTATE 40 (400' PUBLIC R/W) a o .� sn••.w ° ii� �j_••/ t•�° eegaBasif-r,;-•�s �`•J �`!`,`.ey �e3 x e e�°®®•4®°°� o °.° °a J"i ties �s, •yI •I. i}�.�'y w i— 1 a .� •( w. �� f `_ '•C«+a mb g �v °� °� f aI s 46 I..+f+'�ts:.°• t Hr-, - ?'° f rl��t'" ` °egg—w^�_°'j e4 — ° • sw �• •`- _s ' = tat, _s•r•rm , ',"7'1 �\ .� I I I i l I \\ `\ ' + 1 1' `1 1 ' \ } I ', i 1 � � ` `. \ m•� `. `� I i I ' I I I l l l l / / / / I ) , l l / `---------- ---�\\``�`\�`� I�. :S [; `11♦ r ` \ . _ __ ` \`��\�. \ ;� \ ` ` \ ;. \`•___rn / i'� // I 11 / l / In li'C11' rlll ,u, 11 „ \♦\`_•g.``-_--� `� \\\```�\\\`;\ \ \`� �. .��'�'// 11111 `1'\1`1\ 11`11``\\\\\\`1//'I/I/+//JIl/`�/1„ / I \ � �`�O'`"—^``1\1\`��\\`�`�`�`\\``\`�\`"``\��`�`��` �`\;�;\�`�`��\.`.\`____,}•i'////iII III��11Ij111111111,1`\`I�\Ilil+l�/�,Il�l„'�''_;l///1, `a•., "_'1 1 1 1 .`\ ..\;; \`��` \``: �`. \``.\�� \ ``````` \ ___ T � '� , / 1 I I I , i + n 1 u + i i 'l/ r `i ♦ ','b\ \\ - -` \� �.\. \\`.``. �\\..\`.�`�.��` '�A��. ��r r rr/0 IFll�� I" /, It ��.�:`:`�`.\` t > `` , •LOY 2 21234 AC `\ 1 QF>�l N— W,,Ul � Mk- LOT3FIT ------------------ -'4 -.. 4 O •. H Z Z O U Q Oa z LOX ft 'T W "!_ minmlcmF ro ec ” "owsor"a "rn ru . TK vMr >m a "na Is mIF. am of buew .um/m wcmr sr"�oums u10 O •. H Z Z O U Q Oa z LOX ft 'T W IJIT��\_ \� ` SURVEY NOTE: "F ""°a TJNKEN KT"'"�" ""° PRELIMINARY W= nc wmcr oxovom er ol"larx um suncss"w¢ s°uE " FEET °cyie�.T Fe —k I FEE, �lu�'s a, f NOT FOR CONSTRUCTION ° J LLI J U W K2 s 0OGJ = CL 0w � a � U QU w R rc 9iT C1.0 a V / SITE DATA a.+w m IrAav n wawn •gym nr+. r r.r.r . r.r w.®rr Rr ansu��ar.Aen. w,m�� rra�Rw r ream �i rpiAA s~irr or to+r� O9re�r�i4ww.m ..r. =21:awmiw tsAr{ryRu�q�. Ma. LLYi -AAI RA�IYrA<TAa Kw I 1 INTERSTATE 40 yA��r ?4DD PUBLIC Rion 1(01 ��AwaraM iAnOtlR +Gr—ra — — — — — — t k kvo. O i s � A PROPOSED NRF DRrvx+c 8 RANGE r Aw I ---------------- I I PROPOSED STORMWATER � -------------- X11 POND PARCEL BT"m" ---- ---- ,r EXISTING LOT 1 f i }. Iry r�rrr tv ��..L � � � � ��,�� • � u wxsmunn� ro ec w ,�Ruxz wm Au .1 Riii Arron R 1 ST— ,JIG i II IIIII�IIII�y�k k1�. I I x II I III ��I�' I VIII 1, l i � 11 ' 1• � �1 1, y '>r . , PRELIMINARY NOT FOR CONSTRUCTION°D q g CL W F V5 i J QOUJ co-UJJ W EY D > > 0 9REEl NWER � C2.0 INTERS'T'ATE 40 � 1400' PUBLIC IM E _ - r,//,� V II PJ 1 1 > 1 1 rrrr rrrr n �r �- i 1 I l i 1, rrr lrrrrlru !/� i t ...s1_. - �� IIIA'I PARCEL A PROPOSEDowl I III I� ^ ge9 ARTIFIXI -NRF DRMNG PROPOSEDSTORMWATER / _ PON / ' D ////// Ns VY W --- PARCEL B- "4 1 11�1�'1;� ,— Q EXISTING i LOT 3 - �``_ I .r__ I ,'`111 1 '�'lrnanao.v •` _ ______________________________ r < V111, C WGU RAIMAGEEEGEO J �� _ , � k 1 y j 1 _________ -� 2'`_a•� ,_ � / vwvO6encdrtan J EXISTING `".�° f� a Q LOT l En � W Y W ` ATE �� SURVEY NOTE: >t till� Of —, A/_PRELIMINARY • ' �hy'/� nu coxsmucnan ro ac w �wnowr¢ �,H uu nc wmcv wowEn er nwnm wo wmcrMc. , Hcuec -C OlY 6 NNEiPI NO NL90i S,MIDMDS Mq 0.1 MN15 PdNi pbK. GHOER N.G 2T.�tY. NOT FOR CONSTRUCTION X. \ NEUSE RIVER`�'�__� RIPARIAN BUFFER ZONE 2 rye. STREAM SD PROPOSED • • \— HEADWALL PR85 LF OPOSED DOUBLE • 2'X11' BOX CULVERT ,1 1 ACOQAMIUAW [ fV ATIM1 STREAM SA I ZONE 1 F ` / `PACT E NEUSE RIVER \ • \ RIPARIAN BUFFER ZONE 2.-.- 1 FLOODWAY LIMITS APPROXIMATE LOCATION\/ ` \•1~ OF 100 YEAR FLOOD �� • ZONE 2�� I IMPACT pROPWALL\ NEUSE RIVERHEADWALL RIPARIAN BUFFER 2 ` ZONE 1 w 50' NEUSE FVERFER RIPARIAN SANITARY SEWER-/ t � . f EASEMENT i LEGEND W-1 j ® ZONE 1 PERMANENT IMPACTza-`•- [[� ® ZONE 2 PERMANENT IMPACT 1 ® FLOODWAY LIMITS .1 �� l� '\ \ ?\\ \'... r `FLOOOWAY LIMITS\ ` \��\ d�/ �..•.�\� STREAM SA ` RIP RAP d93• _\`` �.• �. 1 STREAM SA IMPACT: 121 LF 'i ,, 39� _ — - - - / \� • `�` _ STREAM SO IMPACT: 27 LF ,\ V, \ + GRAPHIC SCALE IN FEET 1 ZONE 1 IMPACT: 7,600 SF \ V - - NEUSE RIVER 0 15 30 60 { ZONE 2 IMPACT: 5,300 SF RIPARIAN BUFFER i \ i ZONE 1 FNA P CT Kimley* Horn D,B� SHEET NUMBER j.1eixmT 1021 CORPORATE CENTER DRIVE te KYUY H— uID A ATE1 W PREPARED FOR STREAM CROSSING EXHIBIT EX -1 421 F�TETIEMIF SMET, EUl( EW. FIL—. RC IMM Ax DRIVE SHACK RALEIGH, LLC. R,oBE, naso -u2. .m MWYLRYIIY-HORII.CW ,1w REN90H5 DATE BY COB RALEIGH HDRM UR(AIN Nanaul and Culrurol Resources May 4, 2017 Kevin Ferguson ECS Southeast, LLP 9001 Glenwood Avenue Raleigh, NC 27617 RE: Drive Shack Site; 49:4373 Dear Kevin Ferguson: ROT COOPER SUSI H. ELA-MILTON lwawl% NCN H DE -3432 The North Carolina Natural Heritage Program (NCNHP) appreciates the opportunity to provide information about natural heritage resources for the project referenced above. A query of the NCNHP database, based on the project area mapped with your request, indicates that there are no records for rare species, important natural communities, natural areas, or conservation/managed areas within the proposed project boundary. Please note that although there may be no documentation of natural heritage elements within the project boundary, it does not imply or confirm their absence; the area may not have been surveyed. The results of this query should not be substituted for field surveys where suitable habitat exists. In the event that rare species are found within the project area, please contact the NCNHP so that we may update our records. The attached 'Potential Occurrences' table summarizes rare species and natural communities that have been documented within a one -mile radius of the property boundary. The proximity of these records suggests that these natural heritage elements may potentially be present in the project area if suitable habitat exists and is included for reference. Tables of natural areas and conservation/managed area within a one -mile radius of the project area, if any, are also included in this report. Please note that natural heritage element data are maintained for the purposes of conservation planning, project review, and scientific research, and are not intended for use as the primary criteria for regulatory decisions. Information provided by the NCNHP database may not be published without prior written notification to the NCNHP, and the NCNHP must be credited as an information source in these publications. Maps of NCNHP data may not be redistributed without permission. The NC Natural Heritage Program may follow this letter with additional correspondence if a Dedicated Nature Preserve (DNP), Registered Heritage Area (RHA), Clean Water Management Trust Fund (CWMTF) easement, or Federally -listed species are documented near the project area. If you have questions regarding the information provided in this letter or need additional assistance, please contact Rodney A. Butler at rod n y b rtl r n_ cdcr.gov or 919.707.8603. Sincerely, NC Natural Heritage Program -,"Nothing Compares %, L:,,'f:fU20?-.urEi:ar.d ul, F—i P'c.T,_S '13?u> "'.L.-P.E="cgfac, ?crg3 5'11?ei I Rate; h ',.' _ K6 _- .-':ice Center I'r:aiiigh.NC:'.699-155! www.nuftAgC 151--.'Ci7-9iU? Natural Heritage Element Occurrences, Natural Areas, and Managed Areas Within a One -mile Radius of the Project Area Drive Shack Site Project No. 49:4373 May 4, 2017 NCNHDE-3432 Element Occurrences Documented Within a One -mile Radius of the Project Area Taxonomic EO ID Scientific Name Common Name Last Element Accuracy Federal State Global State Group Observation Occurrence Status Status Rank Rank Date Rank Crustacean 8854 Cambarus davidi Carolina Ladle Crayfish 1999-04-10 E 3 -Medium --- Significantly G3 S3 Rare Dragonfly or 32043 Coryphaeschna ingens Regal Darner 2004 -Pre H? 5 -Very --- Significantly G5 S2? Damselfly Low Rare Natural 30210 Dry-Mesic Oak --Hickory --- 2002-08-16 BC 2 -High --- --- G4G5 S4 Community Forest (Piedmont Subtype) Reptile 35531 Ophisaurus attenuatus Slender Glass Lizard 1979-09-13 H? 5 -Very --- Significantly G5 S2 Low Rare Vascular Plant 7563 Matelea decipiens Glade Milkvine 1972-05-24 H 4 -Low --- Significantly G5 S3 Rare Peripheral Natural Areas Documented Within a One -mile Radius of the Project Area Site Name Representational Rating Collective Rating Richland Creek Hardwood Forest R5 (General) C5 (General) Managed Areas Documented Within a One -mile Radius of the Project Area Managed Area Name Owner Owner Type Wake County Open Space Wake County: multiple local government Local Government North Carolina State University Agricultural Research North Carolina State University State Land Schenck Memorial Forest North Carolina State University State Definitions and an explanation of status designations and codes can be found at haps Hncnhde.natureserve.ora/content/help. Data query generated on May 4, 2017, source: NCNHP, Q1 January 2017. Please resubmit your information request if more than one year elapses before project initiation as new information is continually added to the NCNHP database. Page 2 of 3 NCNHDE-3432: Drive Shack Site May 4, 2017 1:22,644 Project Boundary o 0.175 0.35 0.7 mi EI Buffered Project Boundary 0 0.3 0.6 1.2 km NHP Natural Area (NHNA) �] Managed Area (MAREA) Page 3 of 3 Soames: Esri, HERE, DeL—na. Intwrnap, inaement P Corp.. GEBCO. USGS, FAO. NPS, NRCAN. G"Base, IGN. Kad-h r NL. Ordnance Sunay. Esri Japan, MET], Esri China (Hong Kong), smsstopo, Mapmylndia, O OpsnStraetMap bu oontnk—, and the GIS User Community North Carolina Department of Natural and Cultural Resources State Historic Preservation Office Ramona M. Bartos, Administrator Governor Roy Cooper Secretary Susi H. Hamilton June 8, 2017 Kevin Ferguson ECS Southeast, LLP Office of Archives and History Deputy Secretary Kevin Cherry Re: Drive Shack, 1021 Corporate Center Drive, Raleigh, ECS 49:4373, Wake County, ER 17-0942 Dear Mr. Ferguson: Thank you for your email of May 15, 2017, concerning the above project. We have conducted a review of the project and are aware of no historic resources which would be affected by the project. Therefore, we have no comment on the project as proposed. The above comments are made pursuant to Section 106 of the National Historic Preservation Act and the Advisory Council on Historic Preservation's Regulations for Compliance with Section 106 codified at 36 CFR Part 800. Thank you for your cooperation and consideration. If you have questions concerning the above comment, contact Renee Gledhill -Earley, environmental review coordinator, at 919-807-6579 or environmental.review(&,,ncdcr.gov. In all future communication concerning this project, please cite the above referenced tracking number. Sincerely, (2�� 693"Ramona M. Bartos Location: 109 East Jones Street, Raleigh NC 27601 Mailing Address: 4617 Mail Service Center, Raleigh NC 27699-4617 Telephone/Faa: (919) 807-6570/807-6599 rPtM NT '"F� United States Department of the Interior s FISH AND WILDLIFE SERVICE a Raleigh ES Field Office y �9 Post Office Box 33726 C"' s Raleigh, North Carolina 27636-3726 June 1, 2017 Kevin Ferguson ECS Southeast, LLP 9001 Glenwood Avenue Raleigh, NC 27617 Re: Drive Shack — Wake County, NC Dear Mr. Ferguson: This letter is to inform you that the Service has established an on-line project planning and consultation process which assists developers and consultants in determining whether a federally -listed species or designated critical habitat may be affected by a proposed project. For future projects, please visit the Raleigh Field Office's project planning website at https://www.fws. ovg_ /raleigh/o.html. If you are only searching for a list of species that may be present in the project's Action Area, then you may use the Service's Information, Planning, and Consultation System (IPaC) website to determine if any listed, proposed, or candidate species may be present in the Action Area and generate a species list. The IPaC website may be viewed at https://ecos.fws.gov/ipac/. The IPaC web site contains a complete and frequently updated list of all endangered and threatened species protected by the provisions of the Endangered Species Act of 1973, as amended (16 U.S.C. 1531 et seq.)(Act), a list of federal species of concern' that are known to occur in each county in North Carolina, and other resources. Section 7 of the Act requires that all federal agencies (or their designated non-federal representative), in consultation with the Service, insure that any action federally authorized, funded, or carried out by such agencies is not likely to jeopardize the continued existence of any federally -listed endangered or threatened species. A biological assessment or evaluation may be prepared to fulfill that requirement and in determining whether additional consultation with the Service is necessary. In addition to the federally -protected species list, information on the species' life histories and habitats and information on completing a biological assessment or evaluation and can be found on our web page at http://www.fws.gov/raleigh. Please check the web site often for updated information or changes. 1 The term "federal species of concern" refers to those species which the Service believes might be in need of concentrated conservation actions. Federal species of concern receive no legal protection and their designation does not necessarily imply that the species will eventually be proposed for listing as a federally endangered or threatened species. However, we recommend that all practicable measures be taken to avoid or minimize adverse impacts to federal species of concern. If your project contains suitable habitat for any of the federally-listed species known to be present within the county where your project occurs, the proposed action has the potential to adversely affect those species. As such, we recommend that surveys be conducted to determine the species' presence or absence within the project area. The use of North Carolina Natural Heritage program data should not be substituted for actual field surveys. If you determine that the proposed action may affect (i.e., likely to adversely affect or not likely to adversely affect) a federally-protected species, you should notify this office with your determination, the results of your surveys, survey methodologies, and an analysis of the effects of the action on listed species, including consideration of direct, indirect, and cumulative effects, before conducting any activities that might affect the species. If you determine that the proposed action will have no effect (i.e., no beneficial or adverse, direct or indirect effect) on federally listed species, then you are not required to contact our office for concurrence (unless an Environmental Impact Statement is prepared). However, you should maintain a complete record of the assessment, including steps leading to your determination of effect, the qualified personnel conducting the assessment, habitat conditions, site photographs, and any other related articles. With regard to the above-referenced project, we offer the following remarks. Our comments are submitted pursuant to, and in accordance with, provisions of the Endangered Species Act. Based on the information provided and other information available, it appears that the proposed action is not likely to adversely affect any federally-listed endangered or threatened species, their formally designated critical habitat, or species currently proposed for listing under the Act at these sites. We believe that the requirements of section 7(a)(2) of the Act have been satisfied for your project. Please remember that obligations under section 7 consultation must be reconsidered if: (1) new information reveals impacts of this identified action that may affect listed species or critical habitat in a manner not previously considered; (2) this action is subsequently modified in a manner that was not considered in this review; or, (3) a new species is listed or critical habitat determined that may be affected by the identified action. However, the Service is concerned about the potential impacts the proposed action might have on aquatic species. Aquatic resources are highly susceptible to sedimentation. Therefore, we recommend that all practicable measures be taken to avoid adverse impacts to aquatic species, including implementing directional boring methods and stringent sediment and erosion control measures. An erosion and sedimentation control plan should be submitted to and approved by the North Carolina Division of Land Resources, Land Quality Section prior to construction. Erosion and sedimentation controls should be installed and maintained between the construction site and any nearby down-gradient surface waters. In addition, we recommend maintaining natural, vegetated buffers on all streams and creeks adjacent to the project site. The North Carolina Wildlife Resources Commission has developed a Guidance Memorandum (a copy can be found on our website at (http://www.fws.gov/raleigh) to address and mitigate secondary and cumulative impacts to aquatic and terrestrial wildlife resources and water quality. We recommend that you consider this document in the development of your projects and in completing an initiation package for consultation (if necessary). 2 We hope you find our web page useful and informative and that following the process described above will reduce the time required, and eliminate the need, for general correspondence for species' lists. If you have any questions or comments, please contact John Ellis of this office at (919) 856-4520 ext. 26. Sincerely, Pito Benjamin Field Supervisor t . Ge,ii2C.h?'7ica+ • :.oniierU0''.Ion 1.'?.Lc rcJ,�; - .nr"vFr011nlclltal • Fc"i;lllt'c'S Agent Authorization Property/Site: Address of Site: Parcel Identification Number (PIN): Owner Information: �, Name: 241S i xeSA(`1 i ��w>;� r Z Address: �� f Ck4qr� )k /da k5L. NC 22603 Telephone Number: C' i 1-31 g�1q� Fax Number: ql 7- l - 7�5� (� L E-mail Address: (Y' ,q- `�S4fAevt 5@ &_/1( 5oiA , Y4 �7 Property Owner Certification: I, the undersigned, a duly authorized owner of record of the property/properties identified herein, do authorize representatives of the Wilmington District, U.S. Army Corps of Engineers (USACE) and/ or the North Carolina Division of Water Resources (NCDWR) to enter upon the property herein described for the purpose of conducting on-site investigations and issuing a determination associated with Waters of the U.S. subject to Federal/State jurisdiction under Section 404 and 401 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899. 1 also authorize ECS to act in my behalf in the processing of this request and to furnish supplemental information in support of this request, including stream/wetland matters in coordination with the USACE and the NCQWR, fold verification and permit application: Property Owner Signature: Date: S// Z/)