20180390 Ver 1_401 Application_20180318

SEGS
Southern Environmental Group, Inc.
5315 South College Road, Suite E
Wilmington, North Carolina 28412
910.452.2711 (office) • 910.452.2899 (fax)
Transmittal Letter
Date: 15 March 2018
To: Ms. Karen Higgins
Of: DWR 401 & Buffers Unit — Raleigh
512 North Salisbury Street —Archdale Bldg.
9'' Floor
Raleigh, NC 27604
Attached you will find:*
Proposal Sketch(es) PCN Signed Wetland Map
JD Package Report(s) Plans Information Request
201 80390
ma
Photo(s)
Other
Copies
Dated
Description
1
2/20/2018
Peete Farm Rd., Warren County, Pre -Construction Notification, with
accompanying attachments (5 copies)
1
$240 401 WQ Certification Filing Fee
*If noted items are NOT attached, please contact our office.
These are beine delivered:
our ev�ew an Process For your Records Returned for Correction(s)
Corrected and Returned For your Signature As Requested
Other:
By: Hand Delivery 4eiD UPS Regular Mail
Notes: Please feel free to call at 910.228.1841, should you have questions or concerns.
Signature and (Typed) Name: DanLutheran
Date: 3/15/18

Office Use Only:
Corps action ID no.
DWR project no.
Forth Version 1.3 Dec 10 2008
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
1d. Type(s) of approval sought from the DWR (check all that apply):
® 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
le. Is this notification solely for the record
because written approval is not required?
❑ Yes ® No
For the record only for DWR 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 1 h
below.
❑ Yes ® No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes ❑ No
2. Project Information
2a. Name of project:
Peete Farre Subdivision (see Appendix A)
2b. County:
Warren (see Appendix B)
2c. Nearest municipality / town:
Warrenton
2d. Subdivision name:
I NA
2e. NCDOT only, T.I.P. or state project no:
NA
3. Owner Information
3a. Name(s) on Recorded Deed:
Gaston Unique Properties LLC (see Appendices C & D)
3b. Deed Book and Page No.
1008/880
3c. Responsible Party (for LLC if applicable):
Michael Hough (see Appendix E)
3d. Street address:
751 West Fourth St. STE 400
3e. City, state, zip:
Winston Salem, NC 27101
3f. Telephone no.:
704-309-9880
3g. Fax no.:
NA
3h. Email address:
1 (Peete Farm Road Subdivision 2-20-18)

5F
4.
Applicant Information (if different from owner)
4a.
Applicant is:
❑ Agent ❑ Other, specify:
P fY:
4b.
Name:
4c.
Business name (if applicable):
4d.
Street address:
4e.
City, state, zip:
4f.
Telephone no.:
4g.
Fax no.:
4h.
Email address:
5.
Agent/Consultant Information (if applicable)
5a.
Name:
Dana A. Lutheran (see Appendix F)
5b.
Business name (if applicable):
Southern Environmental Group, Inc
5c.
Street address:
5315 South College Road, Suite E
5d.
City, state, zip:
Wilmington, NC 28412
5e.
Telephone no.:
910-452-2711 (office) or 910.228.1841 (cell -preferred)
5f.
Fax no.:
910-452-2899
5g.
Email address:
dluthera [e-mail]
B. Project Information and Prior Project History
1.
Property Identification
1a.
Property identification no. (tax PIN or parcel ID):
2061155951 (See Appendices C)
1 b.
Site coordinates (in decimal degrees):
Latitude: 36.53807 Longitude: -78.10991
1c.
Property size:
179.29 +/- (See Appendix B)
2.
Surface Waters
2a.
Name of nearest body of water (stream, river, etc.) to proposed project:
Lake Gaston (see Appendix F)
2b.
Water Quality Classification of nearest receiving water:
WS-V,B
2c.
River basin:
Roanoke River (03010106)
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:
Currently, the site is undisturbed and wooded. The surrounding land use is residential and/or vacant land. See
Appendix B.
3b.
List the total estimated acreage of all existing wetlands on the property:
Approximately 1.82 -acres (see Appendix A)
3c.
List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 1995 LF (see Appendix
A)
3d. Explain the purpose of the proposed project:
The purpose of the project is to construct roads that will service future residents of the proposed 88 lot subdivision.
3e.
Describe the overall project in detail, including the type of equipment to be used:
The project will consist of removing vegetation and substrate, within the three impact areas, installing appropriately
sized culverts, buried either 20% of the pipe diameter or 12", whichever is applicable, backfilling the areas with
clean earthen soil and then paving (see Appendix A). Earth moving equipment, such as backhoes, front end loaders,
dump trucks and excavators will be used to construct the parking lot.
2 (Peete Farm Road Subdivision 2-20-18)

4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the Corps
or State been requested or obtained for this property / project
El Yes ®No ❑Unknown
(including all prior phases) in the past?
Comments:
4b. If the Corps made the jurisdictional determination, what type of
Preliminary El Final
determination was made?
4c. If yes, who delineated the jurisdictional areas?
Agency/Consultant Company:
Name (if known): David Scibetta
Other: SEGi
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
SEGi submitted a Jurisdictional Determination Packet to the USACE Raleigh Field Office on 1/3/18. A site visit was
performed by the USACE on 2/6/18, at which time the wetland line was approved.
S. Project History
5a. Have permits or certifications been requested or obtained for this
❑ Yes ® No ❑ Unknown
project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
NA
6. Future Project Plans
6a. Is this a phased project?
❑ Yes ® No
6b. If yes, explain.
C. Proposed Impacts Inventory
1. Impacts Summary
la. Which sections were completed below for your project (check all that apply):
® Wetlands ® Streams - tributaries ❑ Buffers ❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
2b.
2c.
2d.
2e.
2f.
Wetland impact number
Type of impact
Type of wetland
Forested
Type of jurisdiction
— Permanent (P) or
(if known)
(Corps - 404, 10
Area of impact (acres)
Temporary
DWR — non -404 other
Wi ®P ❑ T
Road Crossing
Headwater Forest
® Yes ❑ No
® Corps ❑ DWR
724 SF / 0.016 AC
W2 ® P ❑ T
Road Crossing
Headwater Forest
® Yes ❑ No
® Corps ❑ DWR
780 SF / 0.017 AC
W3 ®P [:IT
Road Crossing
Headwater Forest
® Yes ❑ No
® Corps ❑ DWR
841 SF / 0.019 AC
2g. Total wetland impacts
2345 SF / 0.052 AC
2h. Comments: Please refer to Appendix A for details of the proposed impacts.
3 (Peete Farm Road Subdivision 2-20-18)

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 jurisdiction
Average
Impact
number -Permanent
intermittent (INT)?
(Corps - 404, 10
stream
length
(P) or Temporary
DWR - non-404,
width
(linear feet)
(T)
other)
(feet)
Sl ®P ❑ T
Road Crossing
Unnamed Trib
❑ PER ❑ INT
® Corps ❑ DWR
3.5'
40'
S2 ®P ❑ T
Road Crossing
Unnamed Trib
❑ PER ❑ INT
® Corps ❑ DWR
3.5'
45'
S3 ®P ❑ T
Road Crossing
Unnamed Trib
❑ PER ❑ INT
® Corps ❑ DWR
3.5'
S0'
3h. Total stream and tributary impacts
135'
3i. Comments:
The impacted area will be backfilled with natural streambed material to a depth of at least 12 inches or to the bottom
depth of the impacted area if shallower than 12 inches. See Appendix A for details.
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of the U.S.
then individually list all open water impacts below.
4a.
4b.
4c.
4d.
4e.
Open water impact
Name of
number - Permanent
waterbody
Type of impact
Waterbody type
Area of impact (acres)
(P) or Temporary (T)
(if
a livable
Ol ❑P❑T
4f. Total open water impacts
NA
4g. Comments:
S. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a.
5b.
5c.
5d.
5e.
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or
(acres)
number
purpose of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
NA
5f. Total
NA
NA
NA
NA
NA
NA
NA
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:
4 (Peete Farm Road Subdivision 2-20-18)

SEGi
6. Buffer Impacts (for DWR)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts below. If
any impacts require mitigation, then you MUST fill out Section D of this form.
6a.
❑ Neuse ❑ Tar -Pamlico ❑ Other: None
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b.
6c.
6d.
6e.
6f.
6g.
Buffer impact number
Reason for
Stream name
Buffer mitigation
Zone 1 impact
Zone 2 impact
— Permanent (P) or
impact
required?
(square feet)
(square feet)
Temporary
4g. Coastal (tidal) wetland mitigation requested:
4h. Comments:
S. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
B1 ❑P❑T
El Yes
❑ No
6h. Total buffer impacts
NA
6i. Comments:
D. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Impacts to wetlands and waters of the US has been limited to three road crossing. Slopes of the fill will be minimized
to the greatest extent practicable, while ensuring stability. Road were positioned to cross the wetland features as
perpendicularly as possible, while taking the steep terrain into consideration.
b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Silt fence, as well as other best management practices, will be utilized during the construction process. This is
necessary to ensure sediment does not discharge into the remaining wetlands and to mark the limits of authorized
impact.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State?
❑ Yes ® No
The proposed impacts are under the mitigation threshold for
this permit action.
2b. If yes, mitigation is required by (check all that apply):
❑ DWR ❑ Corps
2c. If yes, which mitigation option will be used for this project?
❑ Mitigation bank
❑ Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter)
Type:
Quantity:
3c. Comments:
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
❑ Yes
4b. Stream mitigation requested:
4c. If using stream mitigation, stream temperature:
❑ warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWR only):
4e. Riparian wetland mitigation requested:
4f. Non -riparian wetland mitigation requested:
4g. Coastal (tidal) wetland mitigation requested:
4h. Comments:
S. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
5 (Peete Farm Road Subdivision 2-20-18)

5G1
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWR
6a. Will the project result in an impact within a protected riparian buffer that requires buffer
mitigation? If yes, you will have to fill out this entire form — please contact the State for
❑ Yes ® No
more information.
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the amount of
mitigation required.
Zone
6c.
Reason for impact
6d.
Total impact
(square feet(square
Multiplier
6e.
Required mitigation
feet
Zone 1
3 (2 for Catawba)
Zone 2
1.5
6f. Total buffer mitigation required:
NA
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 DWR)
1. Diffuse Flow Plan
Ia. Does the project include or is it adjacent to protected riparian buffers identified within one of
the NC Riparian Buffer Protection Rules?
❑ Yes ® No
1b. 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?
75.3%
2b. Does this project 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 proposed development will require low density stormwater and CG010000 permits through NC DEMLR. These
permits are being sought by Brooks Engineering.
2e. Who will be responsible for the review of the Stormwater Management Plan?
❑ Certified Local Government
® DWR Stormwater Program
® DWR 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project?
NA
3b. Which of the following locally -implemented stormwater management programs apply (check all
that apply):
❑ Phase II
❑ NSW
❑ USMP
❑ Water Supply Watershed
❑ Other:
3c. Has the approved Stormwater Management Plan with proof of approval been attached?
❑ Yes ® No
4. DWR Stormwater Program Review
4a. Which of the following state -implemented stormwater management programs apply (check all
that apply):
❑ Coastal counties
❑ HQW
❑ ORW
® Session Law 2006-246
❑ Other:
4b. Has the approved Stormwater Management Plan with proof of approval been attached?
❑ Yes ® No
S. DWR 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
6 (Peete Farm Road Subdivision 2-20-] 8)

F. Supplementary Information
1. Environmental Documentation (DWR Requirement)
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public
❑ Yes ® No
(federal/state) land?
lb. 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 (North Carolina) Environmental
❑ Yes ❑ No
Policy Act (NEPA/SEPA)?
lc. If you answered "yes" to the above, has the document review been finalized by the State
❑ Yes ❑ No
Clearing House? (If so, attach a copy of the NEPA or SEPA final approval letter.) Comments:
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Wetland Rules (15A NCAC 2H .0500), Isolated Wetland Rules
(15A NCAC 2H .1300), DWR Surface Water or Wetland Standards, or Riparian Buffer Rules (15A
❑ Yes ® No
NCAC 2B .0200)?
2b. Is this an after -the -fact permit application?
❑ Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWR Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in additional
❑ Yes ® No
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 DWR policy. If you answered "no," provide a short narrative description.
The proposed work is part of a single and complete project, as it does not open -up adjacent lands to be developed,
has its own access, independent utilities, and is not part of a phased development that requires additional wetland
and/or stream impacts.
4. Sewage Disposal (DWR 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.
Sewer treatment will by individual septic systems.
S. 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 ® No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?
❑ Yes ® No
5c. If yes, indicate the USFWS Field Office you have contacted.
❑ Raleigh
❑ Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
NC Natural Heritage Program data base (see Appendix G) and visual evaluation of the property, by an experienced
biologist
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? NC Wildlife Service and the
NC Division of Water Resources water classification map.
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
❑ Yes ® No
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?
SEGi submitted a request for environmental review to the State Historic Preservation Office, for their review of the
project. Once their response has been received, it will be forwarded to the agencies.
7 (Peete Farm Road Subdivision 2-20-18)

SEGS
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: NA
8c. What source(s) did you use to make the floodplain determination?
The Warren County GIS website was used to make the flood zone determination (see Appendix H).
Dana A. Lutheran
j > �_
ruary 2018
20 FebDa
Applicant/Agent's Printed Name
Applicant/Agent's Signature
ee
(Agents signature is valid only if an authorization letter from the applicant is provided.)
8 (Peete Farm Road Subdivision 2-20-18)

5r -G1
Appendix A
Proposed Peete Farm Road S.D. Site Plan
and Wetland Impact Map
9 (Peete Farm Road Subdivision 2-20-18)

EROSION CONTROL
PLAN LEGEND
EXIST BOUNDARY
• • • • — EXST. STREAM
—IT NEW STORM PIPE
® NEW OUTLET PROTECTION
�5FTEMP. SILT FENCE
TEMP. CONSTRUCTION ENTRANCE
TEMP. STONE INLET PROTECTION
®
D TEMP. CHECK DAM
—LIMITS OF DISTURBANCE
REINFORCED STABILIZED CUTLET
EROSION CONTROL NOTES
I. THE ONLY SITE WORK TO BE ALLOWED TO TAKE PLACE
PRIOR TO THE FULL INSTALLATION OF EROSION CONTROL
MEASURES WILL BE THE CUTTING OF TREE S.CLEARING.
TREE REMOVAL OPERATIONS CANNOT BEGIN UNTIL PERMITS
ARE SECURED AND EROSION CONTROL MEASURES ARE IN
PLACE.
2. IN ACCORDANCE WITH THE NPOES GENERAL STORMWATER
PERMIT, THE FOLLOWING CONDITIONS MUST BE MET:
2.1. THE EROSION CONTROL PLAN MUST BE IMPLEMENTED -
DEVIATIONS ARE A VIOLATION OF THE PERMIT
2.2, A COPY OF ALL PLANS MUST BE RETAINED BY THE
PERMIT
2.3. DEPOSITION OF SEDIMENT OFFSITE OR IN A STREAM OR
WETLAND ARE CONSIDERED A VIOLATION OF THE PERMIT.
2.4. VISIBLE DEPOSITION OF SEDIMENT SHALL BE REPORTED
TO NCDEQ WITHIN 24 HOURSOF INSPECTION.
2.5. A RAIN GAUGE SHALL BE MAINTAINED ON SITE.
2.6. A WRITTEN RECORD OF THE DAILY RAINFALL AMOUNTS
SHALL BE RETAINED.
2.7. AT LEAST ONCE PERWEEK, EACH EROSION CONTROL
MEASURE SHALL BE INSPECTED TO ENSURE THAT ITIS
OPERATING CORRECTLY AND RECORDS MAINTAINED.
2.8. INSPECTIONS SHALL ALSO BE MADE WITHIN 24 HOURS
OF RAIN EVENTS OVER 1/2 INCH.
2.9. THE QUALITY OF ALL STORMWATER DISCHARGES SHALL
BE OBSERVED AND RECORDED.
2.10. IF ANY VISIBLE SEDIMENTATION IS LEAVING THE SITE OR
ENTERING WATERS OF THE STATE, CORRECTIVE ACTION
SHALL BE TAKEN IMMEDIATELY TO CONTROL THE
DISCHARGE OF SEDIMENTS.
3. SELF -INSPECTION RECORDS SHALL BE KEPT ON SITE AND
MADE AVAILABLE TO THE EROSION CONTROL INSPECTOR
UPON REQUEST.
4. ALL DRAINAGE EASEMENTS MUST BE GRASSED AND/DR
RIP -RAPPED PER THE PLANS TO CONTROL EROSION.
5. THE ESCAPE OF SEDIMENT FROM THE SITE SHALL BE
PREVENTED BY THE INSTALLATION OF EROSION AND
SEDIMENT CONTROL MEASURES AND PRACTICES PRIOR TO,
OR CONCURRENT WITH, LAND -DISTURBING ACTIVITIES.
6. EROSIONCONTROL MEASURES WILL BE MAINTAINED AT ALL
TIMES. IF FULL IMPLEMENTATION OF THE APPROVED PLAN
DOES NOT PROVIDE FOR EFFECTIVE EROSION CONTROL,
ADDITIONAL EROSION AND SEDIMENT CONTROL MEASURES
SHALL BE IMPLEMENTED TO CONTROL DR TREAT THE
AND SEDIMENT CE AND AN AMENDED PLAN SHOWNG MODIFIED EROSION BCONTROL APPROVED
DEVICES.
7 THE NENT SEEDING
WITHIN T7 DAYS OFCEIVE COMPLETION OF
FRGRADNG OPERATIONS,
8 ALL WORK IN THE NCD OT O BE DONE IN
ACCORDANCE WITH NCDOT RIGHT -OF TE
SPECIFICATIONS AND STANDARDS,
9. CONTRACTOR TO PROVIDE INLET PROTECTION AT EACH
STRUCTURE AS STORM SYSTEM IS CONSTRUCTED.
10 ALL INGRADING S AN D
STALLATIONSMUST BE DONE ON IN ACCORDANCE TROL NWITH THE
NCDEQ•S ENGINEERING STANDARD SPECIFICATIONS AND
DETAILS.
11. INSTALL AND MAINTAIN TEMPORARY SEDIMENT BASINS
DURING ROUGH GRADING.
12 PROVIDE VELOCIITIES WATERTIGHT
EXCEED 15 FFINTS T/SECO (SEEYP PE CHARRM )DRAINSWHERE
13. ALL PERIMETER SWALES, SLOPES, AND DITCHES, AND ALL
DAOPES YS. ALL STEEPERTHAN
TSLOPESI MUSTLL BE BE STABILIZED N1 7
14
DAYS.
DEVELOPMENT DATA
PROJECT NAME: PEETE FARM
PROPERTY ADDRESS: PEETE FARM ROAD
PIN NUMBER: 2061155951
PROPERTY SIZE: 179.089
PROPERTY OWNER: GASTON UNIQUE
PROPERTIES, LLC
ADDRESS: 751 WEST FOURTH ST
WINSTON SALEM, NC
PHONE: [phone]
CONTACT: JAY SHOTT
ENGINEER: BROOKS ENGINEERING
CONTACT: JOHN KINNAIRD, PE
ZONING DISTRICT: LR
MAX. BUILDING HEIGHT: 35'
MIN. LOT SIZE: 30,000sf
MIN. LOT WIDTH: 100• ® SETBACK
MIN. LOT DEPTH: 200'
SETBACKS:
FRONT: 30'
SIDE: 10•
REAR: 25'
NUMBER OF UNITS: 88
DISTURBED AREA: 10.9 ACRES
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Appendix B
Vicinity Map
10 (Peete Farm Road Subdivision 2-20-18)

v Feet
1 inch = 4.167 feet
Map Source: ESRI Street Maps
vicinay riaN
Peete Farm Road Property
Warrenton, Warren County, N.C.
1/2/2018
a
I
SEG'

Appendix C
Warren County Parcel Information & Map
I 1 (Peete Farm Road Subdivision 2-20-18)

Warren County, NC
RECN
25098
SUBNO
-999
NEWPIN
2061155951
MAPN
Fl 2E
DESCRIPTION
PEETE TRACT 3
PLAT—REFERENCE
1/331/9
NAME1
GASTON UNIQUE PROPERTIES LLC
NAME2
ADDR
751 WEST FOURTH ST STE 400
CITY—STATE
WINSTON SALEM NC
ZIP
null
TOWNSHIP
103
FIRE—DISTRICT—CODE
26
FLAG
NEIGHBORHOOD_CODE
2017
IMPROVEMENT CODE
V
SITUS ADDRESS
PEETE FARM RD
TOTAL—ASSESSED—VALUE 50826
LAND VALUE
5396368
BUILDING VALUE
0
OTHER VALUE
0
SALE—PRICE
600000
HEATED—AREA.
0

ASSESSED—ACRES
DEED—BOOK
DEED—PAGE
DEED—DATE
179.29
1008
880
Mon Apr 10 2017 20:00:00 GMT -0400 (Eastern Daylight
Time)

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Appendix D
NC Secretary of State Corporate Listing
12 (Peete Farm Road Subdivision 2-20-18)

2/20/2018
North Carolina Secretary of State Search Results
• Upload a PDF Filing • Order a Document Online • Add Entity to My Email Notification List
• View Filings • File an Annual Report/Amend an Annual Report
• Print an Amended a Annual Report form • Print a Pre -Populated Annual Report form
Limited Liability Company
Legal Name
Gaston Unique Properties, LLC
Information
Sosid: 1585357
Status: Current -Active
Annual Report Status: Current
Citizenship: Domestic
Date Formed: 4/3/2017
Fiscal Month: January
Registered Agent: Crumpler, Thomas T.
Addresses
Reg Office
380 Knollwood Street, Suite 700
Winston Salem, NC 27103
Mailing
751 West Fourth Street, Suite 400
Winston Salem, NC 27101
Company Officials
Reg Mailing
380 Knollwood Street, Suite 700
Winston Salem, NC 27103
Principal Office
751 West Fourth Street, Suite 400
Winston Salem, NC 27101
All LLCs are managed by their managers pursuant to N.C.G.S. 57D-3-20.
https://www.sosnc.gov/online services/search/Business_Registration_Results 1/1

Appendix E
Agent Authorization
13 (Peete Farm Road Subdivision 2-20-18)

DocuSign Envelope ID: 6D08D2A7-983E-442C-BC26-116929E5B35C
5F—G1
AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION: PEETE TRACT 3
LOT NO. PLAN NO. PARCEL I.D. 2061155951
STREET ADDRESS: Peete Faun Road
Property Owner (please print): Gaston Unique Properties LLC, _
The undersigned, registered property owner of the above noted property, does hereby authorize
Southern Environmental Group, Inc. (SEGi) to act on their behalf in matters regarding areas of
environmental concern.
Property Owner's Address (if different than property above):
751 West Fourth St. STE 400
Winston Salem, NC 27101
Telephone:
704-309-9880
We hereby certify the above information submitted in this application is true and accurate to the best of
our knowledge. �—
ooeuspnsa br AJU atJ )k71��
.J . — MR c
�;-Authorized Signature SEGi Authorized Signature
Michael Hough David Scibetta
Print Name Print Name
1./4/2018 1/2/2018
Date Date

Appendix F
DWR Water Classification Map
14 (Peete Farm Road Subdivision 2-20-19)
Surface Water Classifications:
Strearr, widex
23412)
Stream
ROANOKE RIVER (Lake
Name:
Gaston below normal full
power poo! elevation 200
IzSL)
resorption:
From North Caroline -Virginia
State Line to a line across
Lake Gaston following the
Warren -Northampton County
Line
Classification:
WS -VB
Date of
August 2, 1992
River Basin:
Roanoke
What does
IVore info
this Class.
rnean?
14 (Peete Farm Road Subdivision 2-20-19)

Appendix G
NC Natural Heritage Program T&E and Critical Habitat Report
15 (Peete Farm Road Subdivision 2-20-18)

ti
• � s
North Carolina Department of Natural and Cultural Resources
Natural Heritage Program
Governor Roy Cooper
January 5, 2018
Lindsey Stone
Southern Environmental Group
5315 S College Road
Wilmington, NC 28412
RE: Peete Farm; 2017 Folder
Dear Lindsey Stone:
Secretary Susi H_ Hamflton
NCNHDE-5018
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 [e-mail] or 919.707.8603.
Sincerely,
NC Natural Heritage Program
LARIM ADDRESS: Telephone- (919)7U7-810-1 LOCKnotd
1651 LW Service Center www_nerrhp_org 121 West Jones Street
Raleigh, NG 27699-1651 Raleigh, NC 2760

1/4/2018 Warren County Endangered Species, Threatened Species,Federal Species of Concern, and Candidate Species
U.S. Fish & Wildlife Servic:eI
Endangered Species, Threatened Species,Federal Species of Concern,
and Candidate Species,
Warren County, North Carolina
Updated: 11-13-2017
Common Name
Scientific name
Federal
Record Status
Status
Vertebrate:
American eel
Anguilla rostrata
FSC
Current
Bachman's sparrow
Aimophila aestivalis
FSC
Current
Bald eacle
Haliaeetus leucocephalus
BGPA
Current
Pinewoods shiner
Lythrurus matutinus
FSC
Obscure
Roanoke bass
Amhloplites cavifrons
FSC
Current
Invertebrate:
Atlantic pigtoe
Fusconaia masoni
FSC
Current
Dwarf wedgemussel
Alasmidonta heterodon
E
Current
Tar River spinymussel
Parvaspina steinstansana
E
Current
Yellow lance
Elliptio lanceolata
P
Current
Vascular Plant:
Prairie birdsfoot-trefoil
Lotus unifoliolatus var. helleri
FSC
Historic
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
https://www.fws.gov/raleigh/species/cntylisttwarren.htmi 1/2

1/4/2018 Warren County Endangered Species, Threatened Species,Federal Species of Concern, and Candidate Species
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.
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 http://www.fws.gov/migratorvbirds/baidea lg e.htni
Threatened due to similarity of aV11earance(T(S/A)l:
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 U.S. 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:ltwww.fws.gov/raleigh/species/entylisttwarren.htmi 2/2

No Natural Areas are Documented Within a One -mile Radius of the Project Area
No Managed Areas are Documented Within a One -mile Radius of the Project Area
Definitions and an explanation of status designations and codes can be found at https•//ncnhde natureserve org/cQntent/help. Data query generated on January 5, 2018; source: NCNHP, Q4 October 2017. Please resubn
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
Natural Heritage Element Occurrences, Natural Areas, and Managed Areas Within a One -mile Radius of the Project Area
Peete Farm
Project No. 2017 Folder
January 5, 2018
NCNHDE-5018
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
Bird
27971 Haliaeetus leucocephalus Bald Eagle 2009 E
2 -High Bald/Golden
Threatened G5
S3B,S3
Eagle
N
Protection
Act
Vascular Plant
2194 Carex tetanica Rigid Sedge 1961-05-29 H
4 -Low ---
Significantly G4G5
S1
Rare Peripheral
No Natural Areas are Documented Within a One -mile Radius of the Project Area
No Managed Areas are Documented Within a One -mile Radius of the Project Area
Definitions and an explanation of status designations and codes can be found at https•//ncnhde natureserve org/cQntent/help. Data query generated on January 5, 2018; source: NCNHP, Q4 October 2017. Please resubn
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-5018: Peete Farm
January 5, 2018
Project Boundary
Buffered Project Boundary
Page 3of3
1:27,033
0 0.225 0.45 0.9 mi
0 0.35 0.7 1.4 km
Sources: Esn. HERE, OeLorme, Intermap, m emem P Corp., GEBCO, USGS,
FAO, NPS. NRCAN. GeoSa , IGN, Kadaster NL, Ordnance Survey, Esn Japan,
pETi. Esn Chita (Hoop Konp). swisstopo. Mapmylr cia, ® OpenSM1eeW p
contrbulom and ft GIS User C-dy

5F C31
Appendix H
Warren County GIS Flood Map
0
16 (Peete Farm Road Subdivision 2-20-18)