20170912 Ver 1_401 Application_20170724

EWELL
IP ENGINEERING CONSULTANTS, PC
July 21, 2017
US Army Corps of Engineers, Wilmington District, Regulatory Division
Jean Gibby
3331 Heritage Trade Drive, Suite 105
Wake Forest, NC 27587
North Carolina Division of Water Resources
Karen Higgins, 1617 Mail Service Center, Raleigh, NC 27699
Sue Homewood, 450 W. Hanes Mill Road, Suite 300, Winston Salem, NC 27105
Re: Pre -Construction Notification
Sping Park Slope Stabilization, Stream Restoration, Drainage & Roadway Improvements
Winston Salem, NC — Forsyth County
This submittal is a Pre -Construction Notification (PCN) for a slope stabilization and stream restoration
project in Winston Salem, NC. All construction associated with the project will be contained within
the right-of-way, City property, and/or within designated easements. Please find enclosed the
following information and data for this project:
1. PCN Application Form
2. Forsyth County Soils Map
3. COE Jurisdictional Determination
4. Topographic and Location Survey
5. Construction Drawings (1 set to USACE, 3 sets to DWR)
6. Check for $570 review fee to NC Division of Water Resources (no fee to USACE)
The streambank stabilization and stream restoration portion of this project is located between the 300
block of West End Boulevard and North Broad Street and will repair streambanks which have eroded
and are threatening the structural integrity of West End Boulevard, degrading water quality, and
negatively affecting the aquatic ecology. The piped system from Sixth Street to West End Boulevard
will be extended beyond the stream segment that has experienced catastrophic shear failure.
Improvements downstream will utilize natural channel design techniques to stabilize streambanks and
reduce storm water velocity in lieu of traditional engineering techniques such as rip -rap, gabion
baskets, and retaining walls. The main goal of the project is to stabilize the streambanks that have
already failed and provide floodplain management to prevent further degradation of the streambanks.
Other goals of the project are to improve water quality, reduce stream bank erosion, improve the
aesthetics of the stream corridor and enhance aquatic habitat.
If you have questions or need additional information, please feel free to contact me at 336-996-9974
Sincerely yours,
JEWELL Engineering Consultants, PC
Amy Black, PE
Post Office Box 2294, Kernersville, NC 27285-2294 ■ 311-A South Main Street, Kernersville, NC 27284
336-996-9974 ■ Fax [phone] ■ www.jewellengineering.pro

a
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:
1c. Has the NWP or GP number been verified by the Corps?
✓Yes No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
✓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
For the record only for Corps Permit:
because written approval is not required?
401 Certification:
Yes ✓No
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
Yes ✓No
fee program.
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
Yes ✓No
below.
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
Yes ✓No
2. Project Information
The City of Winston-Salem (City) has identified this site as experiencing severe streambank erosion and jeopardizing the
structural integrity of West End Boulevard. The City plans to replace deteriorated stormwater drainage infrastructure within this
project site and implement stabilization measures that would protect the stream, improve aquatic habitats, and improve water
quality downstream. The proposed streambank stabilization practices will utilize natural channel design techniques, and will
include boulder vanes, step pools, floodplain benching, bank sloping, vegetated geolifts, and live stake planting. The City has
contracted with Jewell Engineering Consultants for this project.
2a. Name of project:
Spring Park Slope Stabilization, Stream Restoration, Drainage & Roadway Improve
2b. County:
Forsyth
2c. Nearest municipality/ town:
Winston-Salem
2d. Subdivision name:
2e. NCDOT only, T.I.P. or state project no:
3. Owner Information
3a. Name(s) on Recorded Deed:
City of Winston-Salem
3b. Deed Book and Page No.
3c. Responsible Party (for LLC if
applicable):
Page 1 of 11; PCN Form — Version 1.4 January 2009

he3d. Street address:
PO Box 2511
3e. City, state, zip:
Winston-Salem, NC 27102
3f. Telephone no.:
4b.
3g. Fax no.:
Keith Huff, Stormwater/Erosion Control Director
3h. Email address:
Business name
(if applicable):
4.
Applicant Information (if different from owner)
4a.
Applicant is:
Agent Other, specify:
4b.
Name:
Keith Huff, Stormwater/Erosion Control Director
4c.
Business name
(if applicable):
City of Winston Salem
4d.
Street address:
P.O. Box 2511
4e.
City, state, zip:
Winston-Salem, NC, 27102
4f.
Telephone no.:
[phone]
4g.
Fax no.:
[phone]
4h.
Email address:
[e-mail]
5.
Agent/Consultant Information (if applicable)
5a.
Name:
Amy Black, PE
5b.
Business name
(if applicable):
Jewell Engineering Consultants, PC
5c.
Street address:
311-A South Main Street
5d.
City, state, zip:
Kernersville, NC 27284
5e.
Telephone no.:
[phone]
5f.
Fax no.:
[phone]
5g.
Email address:
[e-mail]
B. Project Information and Prior Project History
1 Property Identification: Spring Park
1 a. Property identification no. (tax PIN or parcel ID):
6825-88-8167
1 b. Site coordinates (in decimal degrees):
Latitude: 36.10119 Longitude: -80.25615
1 c. Property size: 2.96 acres
acres
2. Surface Waters
2a. Name of nearest body of water to proposed project:
Peters Creek
2b. Water Quality Classification of nearest receiving water:
C
2c. River basin:
Yadkin
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
The stream portion of the Spring Park Project Site (the Project Site) is located in the Northwest Ward, between the 300
block of West End Boulevard and N. Broad Street. Flow enters the stream from a piped drainage system that runs North from
Sixth Street to the stream head below West End Blvd. The stream channel parallels West End Blvd before running under
Broad Street en route to Peters Creek. The drainage area measures 0.07 square miles with a large portion of impervious area
from urban use. The bank ranges between 15 and 20 feet in height and has severe erosion that has compromised the
integrity of West End Blvd. The stream banks are vegetated with native grass, shrubs and some mature hardwood trees.
The stormwater drainage portion of this project is located between West Sixth Street and West End Boulevard and along
West End Boulevard. It will include 785 linear feet of pipe and 16 structures.
Page 2 of 11; PCN Form - Version 1.4 January 2009

3b. List the total estimated acreage of all existing wetlands on the property: 0 acres
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 750 feet
3d. Explain the purpose of the proposed project:
This project is proposed to address severe bank erosion of the unnamed tributary at Spring Park that is threatening the
integrity of West End Boulevard and contributing substantial sediment loads to the watershed. Through the use of natural
channel concepts, the streambank will be restored and stabilized to halt the erosion. West End Blvd. will be supported and
danger of failure will be reduced.
3e. Describe the overall project in detail, including the type of equipment to be used:
i. Prior to the start of soil or sediment disturbing work, erosion control measures will be installed (Sheets 4.0-4.1). These
will be temporary structures, and are to be removed after the project is complete.
ii. Clearing and debris removal will be conducted as needed to execute the goals of the project, however great care will
be exercised not to disturb the stream or to unnecessarily damage existing vegetation. All debris generated through
this work will be removed from the site.
iii. All in-channel work will be done in dry conditions using a pump around operation for flow diversion (Detail 5/4.1).
iv. Three cross vanes will be installed: two just downstream of the pipe outlet and one at the downstream end of the
project site. The cross vanes will be installed such that the energy of high flow events will be turned away from the
bank toward the stream center and dissipated, reducing the erosive force exerted against the bank. A series of riffles,
pools, and boulder/log step pools will be installed between the upstream and downstream cross vanes. A rock vane
will be installed near Station 103+50, a location with existing severe bank erosion. The toe of slope space behind the
rock vanes will be filled in with vegetated geolifts. The area around the installed structures will be planted with live
stake plantings of native woody species. Rock structures and plantings will be installed using track hoes and hand
labor. Locations of stream structures are shown on Sheets 8.0 and 8.1 and details of the structures are shown on
Sheet 8.2.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
,'Yes No Unknown
Corps or State been requested or obtained for this property /
Comments:
project (includingall prior phases in the past?
4b. If the Corps made the jurisdictional determination, what type
Preliminary /Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas?
Agency/Consultant Company:
Name (if known): Michael Brame
Pilot Environmental Inc.
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Mr. John Thomas with the USACE and Ms. Sue Homewood with the NCDEQ-DWR field verified the determinations on
December 9, 2015. Documentation attached.
5. Project History
5a. Have permits or certifications been requested or obtained for
Yes ✓No Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
Page 3 of 11; PCN Form — Version 1.4 January 2009

6a. Is this a phased project? Yes ✓No
6b. If yes, explain.
C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
Wetlands /Streams - tributaries Buffers Open Waters Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
2b.
2c.
2d.
2e.
2f. Area
Wetland impact
Type of impact
Type of wetland
Forested
Type of jurisdiction
of
number
type
Corps (404,10) or
impact
Permanent (P) or
DWQ (401, other)
(acres)
Temporary T
02
03
2g. Total Wetland Impacts:
04
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
3b.
3c.
3d.
3e.
3f.
3g.
Stream impact
Type of impact
Stream name
Perennial (PER) or
Type of
Average
Impact
number
intermittent (INT)?
jurisdiction
stream
length
Permanent (P) or
width
(linear
Temporary (T)
(feet)
feet)
S1 (T)
Restoration
Unnamed Trib
PER
404
10
569
S2 (P)
Fill
Unnamed Trib
PER
404
8
166
3h. Total stream and tributary impacts
735
3i. Comments: Permanent impacts are required to extend the piped system beyond the stream segment that has experienced
catastrophic shear failure during a storm in 2015. Temporary impacts are related to streambank stabilization, habitat
enhancement, and restoration.
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 indivi ually list all open water impacts below.
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
02
03
04
4f. Total open water impacts
0
Page 4 of 11; PCN Form - Version 1.4 January 2009

4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, then 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
P2
5f. Total:
0
5g. Comments:
5h. Is a dam high hazard permit required?
Yes No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a. Project is in which protected basin?
Neuse Tar -Pamlico Catawba Randleman Other:
6b.
Buffer Impact
number —
Permanent (P) or
Temporary T
6c.
Reason for impact
6d.
Stream name
6e.
Buffer
mitigation
required?
6f.
Zone 1
impact
(square
feet)
6g.
Zone 2
impact
(square
feet
B1
B2
B3
B4
B5
B6
6h. Total Buffer Impacts:
N/A
N/A
6i. Comments:
Page 5 of 11; PCN Form — Version 1.4 January 2009

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
All proposed impacts to jurisdictional stream channels are related to stabilizing eroding streambanks and restoring habitat.
Multiple engineering alternatives were considered, including hardened bank structures, but natural channel design parameters
were selected to most effectively accomplish project goals.
The project proposes no impacts to jurisdictional wetlands.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
All stream work will be performed in the dry using pump around operations and diversion. Where possible, stream work will
be performed from the bank and care will be taken to minimize the impacts to the stream. Standard erosion and sediment
control practices, including silt fence and erosion control matting, will be used throughout this project.
2. Compensatory 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 Waters of the State?
2b. If yes, mitigation is required by (check all that apply):
DWQ Corps
Mitigation bank
2c. If yes, which mitigation option will be used for this
Payment to in -lieu fee program
project?
Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
Type:
Quantity:
3b. Credits Purchased (attach receipt and letter)
Type:
Quantity:
Type:
Quantity:
3c. Comments:
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
N/A
4b. Stream mitigation requested:
linear feet
4c. If using stream mitigation, stream temperature:
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.
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
Yes ✓No
buffer mitigation?
1 a.
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.
1 b.
6c.
6d.
2.
6e.
Zone
Reason for impact
Total impact
Multiplier
Required mitigation
Yes ✓No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
This project will not contribute impervious surface to the watershed.
(square feet)
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1.5
6f. Total buffer mitigation required:
N/A
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:
E.
Stormwater Management and Diffuse Flow Plan (required by DWQ)
1.
Diffuse Flow Plan
1 a.
Does the project include or is it adjacent to protected riparian buffers identified
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.
Yes No
2.
Stormwater Management Plan
2a.
What is the overall percent imperviousness of this project?
polo
2b.
Does this project require a Stormwater Management Plan?
Yes ✓No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
This project will not contribute impervious surface to the watershed.
2d.
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:

2e.
Who will be responsible for the review of the Stormwater Management Plan?
3.
Certified Local Government Stormwater Review
3a.
In which local government's jurisdiction is this project?
✓Yes No
use of public (federal/state) land?
Phase II
3b.
Which of the following locally -implemented stormwater management programs
NSW
USMP
apply (check all that apply):
Water Supply Watershed
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
Other:
3c.
Has the approved Stormwater Management Plan with proof of approval been
Yes No
attached?
4.
DWQ Stormwater Program Review
Yes No
Comments:
Coastal counties
2.
Violations (DWQ Requirement)
HQW
4a.
Which of the following state -implemented stormwater management programs apply
ORW
(check all that apply):
Session Law 2006-246
or Riparian Buffer Rules (15A NCAC 213 .0200)?
Other:
4b.
Has the approved Stormwater Management Plan with proof of approval been
Yes No
2c.
attached?
3.
5.
DWQ 401 Unit Stormwater Review
3a.
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
F.
Supplementary Information
1.
Environmental Documentation (DWQ Requirement)
1 a.
Does the project involve an expenditure of public (federal/state/local) funds or the
✓Yes No
use of public (federal/state) land?
1 b.
If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
Yes ✓No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c.
If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
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,
Yes ✓No
or Riparian Buffer Rules (15A NCAC 213 .0200)?
2b.
Is this an after -the -fact permit application?
Yes ✓No
2c.
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3.
Cumulative Impacts (DWQ Requirement)
3a.
Will this project (based on past and reasonably anticipated future impacts) result in
Yes ✓No
additional development, which could impact nearby downstream water quality?

3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non -discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
N/A
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
Yes ✓No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
/Yes No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted.
Asheville, NC
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat? iPaC map on the fws.gov website showed no critical habitat.
Spoke with Byron Hamstead in Fish & Wildlife Asheville Field Office on 9/6/2016. Confirmed no impact.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
Yes ✓No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
NOAA Essential Fish Habitat Mapper (http://www.habitat.noaa.gov/protection/efh/efhmapper/index.htmi
Confirmed with Byron Hamstead in Fish & Wildlife Asheville Field Office on 9/6/2016.
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
✓Yes No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
GIS spatial data from National Register of Historic Places from nps.gov website. Project site is located within a 200+ acre highlighted area.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA -designated 100 -year floodplain?
Yes ✓No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? www.ncfloodmaps.com
Amy Black, PE
Jji/
)7
7/11/17
Applicant/Agent's Printed Name
Applicant/Agent's Signature (agent's
signature is valid only if an authorization letter
Date
from the applicant is provided.)

AGENT AUTHORIZA1711 ON FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. PLAN NO. PARCEL ID:
STREET ADDRESS: Spring Park at West End Boulevard, Winston Salem, NC 27106
Please print:
Property Owner: City of Winston Salem, NC
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Amy Black, PE, of JEWELL Engineering Consultants, PC
(Contractor / Agent) (Name of consulting firm)
to act on the City's behalf and take all actions necessary for the processing, issuance and acceptance of this
permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
City of Winston Salem
Keith Huff, Stormwater Director
101 North Main Street
Winston Salem, NC 27102
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the best of our
knowledge.
uthorized Signature
Authorized Signature
Date. Zvi 7 Date:

N
A
5�
�e
coir ag��a eventh St Project
Site
a � N
03
G
th St
cn Fifth St
3 �
0
o
v
Cn a T
Project Location Map
Spring Park
Slope Stabilization, Stream Restoration,
Drainage and Roadway Improvements
Winston Salem, NC
500 250 0 500 Feet July 2017 EWELL
JEC NO.: 15.149.034 ENGINEERING GONsuLTANTS, Pc
F'

aD FfC
j N
CIB FcC2 A
FcD2 FaC PcF FfE
FaD
` COA Project
PcF2 Site
FfC s�
a
G
Ft
DaA
fC
c
3 �
o
CUD CL
Forsyth County Soils Map
Spring Park
Slope Stabilization, Stream Restoration,
Drainage and Roadway Improvements
Winston Salem, NC
500 250 0 500 Feet July 2017 EWELL
JEC NO.: 15.149.034 ENGINEERING GONsuLTANTS, Pc

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW -2015-02581 County: Forsyth U.S.G.S. Quad: NC -WINSTON-SALEM WEST
NOTIFICATION OF JURISDICTIONAL DETERMINATION
Property Owner:
City of Winston-Salem Stormwater
Keith Huff
Address:
P.O. Box 2511
r9
(_ C®
Winston-Salem, NC, 27102
Telephone Number:
336 747-6962
Size (acres)
2.92
Nearest Town
Winston-Salem
Nearest Waterway
Peters Creek
River Basin
Coordinates
Upper Yadkin
Latitude: 36.101381
USGS HUC
03040101
Longitude: -80.256222
Location description: Winston-Salem Spring Park property located at intersection of Broad Street and 7'h Street, adjacent to
a tributary of Peters Creek, in Winston-Salem, Forsyth County, North Carolina.
Indicate Which of the Following Apply:
A. Preliminary Determination
_ Based on preliminary information, there may be waters of the U.S. including wetlands on the above described project area
. We strongly suggest you have this property inspected to determine the extent of Department of the Army (DA)
jurisdiction. To be considered final, a jurisdictional determination must be verified by the Corps. This preliminary
determination is not an appealable action under the Regulatory Program Administrative Appeal Process (Reference 33
CFR Part331). If you wish, you may rcquest an approved JD (which maybe appealed), by contacting the Corps district
for further instruction. Also, you may provide new information for further consideration by the Corps to reevaluate the
JD.
B. Approved Determination
_ There are Navigable Waters of the United States within the above described project area subject to the permit requirements
of Section 10 of the Rivers and Harbors Act and Section 404 of the Clean Water Act. Unless there is a change in the law
or our published regulations, this determination may be relied upon for a period not to exceed five years from the date of
this notification.
X There are waters of the U.S. including wetlands on the above described project area subject to the permit requirements of
Section 404 of the Clean Water Act (CWA)(33 USC § 1344). Unless there is a change in the law or our published
regulations, this determination may be relied upon for a period not to exceed five years from the date of this notification.
_ We strongly suggest you have the waters of the U.S. including wetlands on your project area delineated. Due to the
size of your property and/or our present workload, the Corps may not be able to accomplish this wetland delineation in a
timely manner. For a more timely delineation, you may wish to obtain a consultant. To be considered final, any
delineation must be verified by the Corps.
X The waters of the U.S. including wetlands on your project area have been delineated and the delineation has been
verified by the Corps. We strongly suggest you have this delineation surveyed. Upon completion, this survey should be
reviewed and verified by the Corps. Once verified, this survey will provide an accurate depiction of all areas subject to
CWA jurisdiction on your property which, provided there is no change in the law or our published regulations, may be
relied upon for a period not to exceed five years.
Page 1 of 2

_ The waters of the U.S. including wetlands have been delineated and surveyed and are accurately depicted on the plat
icial identified below on . Unless there is a change in the law or our published
signed by the Corps Regulatory Off
on for a period not to exceed five years from the date of this notification.
regulations, this determination may be relied up
_ There are no waters of the U.S., to include wetlands, present on the above described project area which are subject to the
permit requirements of Section 404 of the Clean Water Act (33 USC 1344). Unless there is a change in the law or our
published regulations, this determination may be relied upon for a period not to exceed five years from the date of this
notification.
_ The property is located in one of the 20 Coastal Counties subject to regulation under the Coastal Area Management Act
(CAMA). You should contact the Division of Coastal Management in Morehead City, NC, at [phone] to
determine their requirements.
Placement of dredged or fill material within waters of the US and/or wetlands without a Department of the Army permit may
constitute a violation of Section 301 of the Clean Water Act (33 USC § 1311). If you have any questions regarding this
determination and/or the Corps regulatory program, please contact John Thomas at 919-554-4884 x25 or
John T Thomas JRna usace.army.mil.
C. Basis For Determination: Site includes tributaries of Peters Creek which flows to the Fadkht River and on to the
Atlantic Ocean.
D. Remarks: Confirmed flagged limits by field inspection on December 8, 2015.
E. Attention USDA Program Participants
This delineation/determination has been conducted to identify the limits of Corps' Clean Water Act jurisdiction for the
particular site identified in this request. The delineation/determination may not be valid for the wetland conservation
provisions of the Food Security Act of 1985. If you or your tenant are USDA Program participants, or anticipate participation
in USDA programs, you should request a certified wetland determination from the local office of the Natural Resources
Conservation Service, prior to starting work.
F. Appeals Information (This information applies only to approved jurisdictional determinations as indicated in
B. above)
This correspondence constitutes an approved jurisdictional determination for the above described site. If you object to this
determination, you may request an administrative appeal under Corps regulations at 33 CFR Part 331.. Enclosed you will find a
Notification of Appeal Process (NAP) fact sheet and request for appeal (RFA) form. If you request to appeal this
determination you must submit a completed RFA form to the following address:
US Army Corps of Engineers
South Atlantic Division.
Attn: Jason Steele, Review Officer
60 Forsyth Street SW, Room 10M15
Atlanta, Georgia 30303-8801
In order for an RFA to be accepted by the Corps, the Corps must determine that it is complete, that it meets the criteria for
appeal under 33 CFR part 331.5, and that it has been received by the Division Office within 60 days of the date of the NAP.
Should you decide to submit an RFA il-OT
it must be received at the above address by February 11, 2015.
**It is not necessary to submit an RF orm to the
correspondence.*
Corps Regulatory Official: '
Office if you do not object to the determination in this
Date: December 11, 2015 Expiration Date:
Cc: Michael Brame Pilot Environmental P.O. Box 128 Kcrnersville NC 27285

The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we
continue to do so, please complete our Customer Satisfaction Survey, located online at
http•//reg,ulatory usacesurvev.com/.

NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
REQUEST FOR APPEAL..
Applicant: Kcith Huff File Number: SAW -2015-02581 Date: December 11. 2015
City of Winston-Salem.
Stormwater
Attached is:
See Section below
INITIAL PROFFERED PERMIT Standard Permit or Letter of permission
PROFFERED PERMIT Standard Permit or Letter of permission)B
B
PERMIT DENIAL
NPRELIMINARY
C
APPROVED JURISDICTIONAL DETERMINATION
D
JURISDICTIONAL DETERMINATION
E
SECTION I - The following identifies your rights and options regarding an administrative appeal of the above decision.
Additional information may be found at httk/Iwww usace.amiy mil/Missions/CivilWorks/Regulato!yProgramandPermits.aspx or
Corps regulations at 33 CFR Part 331.
A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• OBJECT: If you object to the permit (Standard or LOP) because of certain terms and conditions therein, you may request
that the permit be modified accordingly. You must complete Section II of this form and return the form to the district
engineer. Your objections must be received by the district engineer within 60 days of the date of this notice, or you will
forfeit your right to appeal the permit in the future. Upon receipt of your letter, the district engineer will evaluate your
objections and may: (a) modify the permit to address all of your concerns, (b) modify the permit to address some of your
objections, or (c) not modify the permit having determined that the permit should be issued as previously written. After
evaluating your objections, the district engineer will send you a proffered permit for your reconsideration, as indicated in
Section B below.
13: PROFFERED PERMIT: You may accept or appeal the permit
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• APPEAL: If you choose to decline the proffered permit (Standard or LOP) because of certain terms and conditions therein,
you may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of
this form and sending the form to the division engineer. This form must be received by the division engineer within 60 days
of the date of this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process by
completing Section II of this form and sending the form to the division engineer. This form must be received by the division
engineer within 60 days of the date of this notice.

D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or provide new
information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the
date of this notice, means that you accept the approved JD in its entirety, and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD, you may appeal the approved JD under the Corps of Engineers
Administrative Appeal Process by completing Section II of this form and sending the form to the district engineer. This form
must be received by the division engineer within 60 days of the date of this notice.
E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps regarding the
preliminary JD. The Preliminary JD is not appealable. If you wish, you may request an approved JD (which may be appealed),
by contacting the Corps district for further instruction. Also you may provide new information for further consideration by the
Corps to reevaluate the JD.
SECTION 11- REQUEST FOR APPEAL or OBJECTIONS TO AN INITIAL PROFFERED PERMIT
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your objections to an initial
proffered permit in clear concise statements. You may attach additional information to this form to clarify where your reasons or
objections are addressed in the administrative record.)
ADDITIONAL INFORMATION: The appeal is limited to a review of the administrative record, the Corps memorandum for the
record of the appeal conference or meeting, and any supplemental information that the review officer has determined is needed to
clarify the administrative record. Neither the appellant nor the Corps may add new information or analyses to the record.
However, you may provide additional information to clarify the location of information that is already in the administrative
record.
POINT OF CONTACT FOR QUESTIONS OR INFORMATION:
If you have questions regarding this decision and/or the If you only have questions regarding the appeal process you may
appeal process you may contact: also contact:
District Engineer, Wilmington Regulatory Division, Mr. Jason Steele, Administrative Appeal Review Officer
Attn: John Thomas CESAD-PDO
U.S. Army Corps of Engineers, South Atlantic Division
60 Forsyth Street, Room l OM 15
Atlanta, Georgia 30303-8801
Phone: [phone]
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel, and any government
consultants, to conduct investigations of the project site during the course of the appeal process. You will be provided a 15 day
notice of any site investigation, and will have the opportunitX to participate in all site investi ations.
Date: Telephone number:
of avaellant or
For appeals on Initial Proffered Permits send this form to:
District Engineer, Wilmington Regulatory Division, John Thomas,
For Permit denials, Proffered Permits and approved Jurisdictional Determinations send this form to:
Division Engineer, Commander, U.S. Army Engineer Division, South Atlantic, Attn: Mr. Jason Steele,
Administrative Appeal Officer, CESAD-PDO, 60 Forsyth Street, Room 1OM15, Atlanta, Georgia 30303-8801
Phone: [phone]

U
At
SB 1-15
LEGEND
FLAG NUMBERS/INFO
WETLAND FLAGS =F!i"
STREAM FLAGS =1!jj!jK
Stream Flags = 38
Wetland Flags = 0
Total Flag//s = 38
J' � • 4
a
Site Boundary
Perennial Stream
t
Wetlands (None Present)
Existing Culvert
SA1-5 Flag Number
DP -1 Q Data Point
4
BY MR. JOHN THOMAS WITH THE
USACE AND MS. SUE HOMEWOOD WITH THE NCDEQ-DWR ON DECEMBER 9, 2015. THIS EXHIBIT INCLUDES
GPS LOCATIONS OF JURISDICTIONAL FEATURES.
Drawing 5
Wetland Verification Map
2013 Satellite Imagery from
Google Earth and
Spring Park
PEI Field Notes
Approximate 2.92 Acre Tract
Winston-Salem, North Carolina
Scale: 1" = 100'
PEI No. 1555
§y
4
SA 1-23
Site Boundary
Perennial Stream
0 M 0 a 0 M Intermittent Stream
Wetlands (None Present)
Existing Culvert
SA1-5 Flag Number
DP -1 Q Data Point
THE LOCATIONS OF FEATURES SHOWN ON THIS MAP WERE VERIFIED
BY MR. JOHN THOMAS WITH THE
USACE AND MS. SUE HOMEWOOD WITH THE NCDEQ-DWR ON DECEMBER 9, 2015. THIS EXHIBIT INCLUDES
GPS LOCATIONS OF JURISDICTIONAL FEATURES.
Drawing 5
Wetland Verification Map
2013 Satellite Imagery from
Google Earth and
Spring Park
PEI Field Notes
Approximate 2.92 Acre Tract
Winston-Salem, North Carolina
Scale: 1" = 100'
PEI No. 1555