20180473 Ver 1_401 Application_20180418

Preliminary ORM Data Entry Fields for New Actions r 2 0 1 8 0 4 7 3
SAW - 2015 - 236 BEGIN DATE [Received Date]:
Prepare file folder ❑
1. Project Name [PCN Form A2a]: Langtree Forcemain
2. Work Type: Private ❑ Institutional
3. Project Description / Purpose [PCN Form 133d and Be]:
Assign Action ID Number in ORM ❑
Government ❑ Commercial ❑✓
Installation of a forcemain sewer line and two pump stations.
4. Property Owner/ Applicant [PCN Form A3 or A4]: Langtree Dev, Cove Church, and G&M Partners
5. Agent / Consultant [PCN Form A5 - or ORM Consultant ID Number]: Atlas Environmental, Jennifer Robertson
6. Related Action ID Number(s) [PCN Form 135b]: None known
7. Project Location - Coordinates, Street Address, and/or Location Description [PCN Form 61b]:
Langtree Road, Mooresville NC. Near the intersection of Hwy 115
35.52876, -80.85473 4644699969, 4645832540, 4645836509, 4645930875
8. Project Location -Tax Parcel ID [PCN Form 61a]: 4645920293, 4655023305, various rights-of-way
9. Project Location — County [PCN Form A21b]: Iredell County
10. Project Location — Nearest Municipality or Town [PCN Form A2c]: Mooresville
11. Project Information — Nearest Waterbody [PCN Form 62a]: Davidson Creek: WS -IV CA
12. Watershed / 8 -Digit Hydrologic Unit Code [PCN Form B2c]: Upper Catawba, 03050101
Authorization: Section 10 ❑ Section 404
Regulatory Action Type:
Standard Permit
✓ Nationwide Permit # 12
❑ Regional General Permit #
❑ Jurisdictional Determination Request
❑✓ Section 10 & 404 ❑
Pre -Application Request
Unauthorized Activity
0 Compliance
❑ No Permit Required
Revised 20180313

-"40
i
VIRONMENTAL
US Army Corps of Engineers
Charlotte Regulatory Field Office
Attn: Mrs. Cathy Janiczak
151 Patton Ave, Room 208
Asheville, North Carolina 28801-5006
Re: Nationwide Permit 12 Request
Langtree Forcemain
Langtree Road, Mooresville NC.
Cathy/Jennifer:
March 26, 2018
NC Division of Water Resources
401 and Buffer Permitting Unit
Attn: Mrs. Jennifer Burdette
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Near the intersection of Hwy 115
The project applicants/property owners, The Langtree Development Company, The Cove
Church, and G&M Partners LLC, are requesting approval of the enclosed Nationwide Permit 12
application. There are 150 linear feet of stream and no wetlands within the project boundary.
The sewer line easement is 25 feet wide and the proposed temporary impacts to streams S1 -S5
include 121 linear feet for temporary trenching, equipment crossing, and bank stability. Stream
crossing S6 will be an aerial crossing so no temporary impacts are necessary at that stream
crossing. No permanent stream impacts are being proposed. All material removed will be
stockpiled during construction in high ground near the crossing and replaced after instillation.
Bank stabilization along the stream crossings will be carried out by using wooden stakes to
secure coir matting to the stream banks. Any stream substrate removed during trenching will be
replaced.
A previous final jurisdictional determination and 404 NWP 12 (401) has been issued for this
project. The final JD and 404 are referenced by Action ID # 2015-00236 and were issued on
June 24, 2015 by Ms. Tasha Alexander. A revised JD is being requested due to a change in the
sewer alignment. The previous 404 permit (401) expired March 18, 2017. The streams on site
are Davidson Creek tributaries to Lake Norman which is classified as WS -IV; CA waters by the
North Carolina Division of Water Resources. The streams are assessed to be relatively
permanent waters (perennial streams).
Enclosed are the necessary permit documents and additional project information. Thank you for
your attention to the enclosed delineation approval and permit application requests. Please
contact me if you need any additional information.
Best regards,
Jennifer L Robertson, President
JRobertsona-atlasenvi.com
ATLAS Environmental, Inc.
712 English Tudor Lane
Charlotte, North Carolina 28211
704-512-1206 / 828-712-9205
www.atiasenvi.com / Serving the Southeast US

I
A c
1RONMENTAL
Atlas Environmental Inc
Department of the Army
Wilmington District, Corps of Engineers
Attn: Scott McLendon, Chief Regulatory Division
PO Box 1890
Wilmington, North Carolina 28402-1890
-and-
NC Division of Water Resources, Water Quality Program
Wetlands, Buffers, Streams - Compliance and Permitting Unit
Attn: Karen Higgins
1650 Mail Service Center
Raleigh, North Carolina 27699-1650
I, the current landowner, lessee, contract holder to purchase, or right to purchase holder
of the property identified below, hereby authorize Wetland and Natural Resource
Consultants to act on my behalf as my agent during the processing of stream and
wetland delineation approval and/or permits to impact Wetlands and Waters of the US
that are regulated by the Clean Water Act and the Rivers and Harbors Act. Federal and
State agents are authorized to be on said property when accompanied by Wetland and
Natural Resource Consultants staff. Wetland and Natural Resource Consultants is
authorized to provide supplemental information needed for delineation approval and/or
permit processing at the request of the Corps or WQP.
Property Owner of Record: -t- IM LLC.
Contact Name:
Address: t q`10 —Z!)t (;&w akwL A v
Address: t•
Phone Number: ring %!9t. 555,2 k too
Fax Number: :2 CAA -WR L SSCA L
Property Name: �'t' 0
Project Address: tyG lS -t5t 55- t
Project Address:eW...nby�c
Tax PIN:
Signature:
Date:
Mooresville Office
3158 Charlotte Hwy
Mooresville, NC 281 f 7
Phone: [phone] /Fox. 704663-2927

-q"4IRONMENTAL
Atlas Environmental Inc
Department of the Army
Wilmington District, Corps of Engineers
Attn: Scott McLendon, Chief Regulatory Division
PO Box 1890
Wilmington, North Carolina 28402-1890
-and-
NC Division of Water Resources, Water Quality Program
Wetlands, Buffers, Streams - Compliance and Permitting Unit
Attn: Karen Higgins
1650 Mail Service Center
Raleigh, North Carolina 27699-1650
I, the current landowner, lessee, contract holder to purchase, or right to purchase holder
of the property identified below, hereby authorize Wetland and Natural Resource
Consultants to act on my behalf as my agent during the processing of stream and
wetland delineation approval and/or permits to impact Wetlands and Waters of the US
that are regulated by the Clean Water Act and the Rivers and Harbors Act. Federal and
State agents are authorized to be on said property when accompanied by Wetland and
Natural Resource Consultants staff. Wetland and Natural Resource Consultants is
authorized to provide supplemental information needed for delineation approval and/or
permit processing at the request of the Corps or WQP.. loarhel)t-
PropertyOwner of Record: -'a ►'�q fi'� C Oet/e O -
Contact Name: a y -C L o c, vn ct y1
Address: LfOl oUrErsh /%f /V(
Address:
Phone Number:
Fax Number: (70 9 30
Property Name:
Project Address:
Project Address:
Tax PIN: -! © 2"3 3 t/b / / 6
-77 Signature:
Date:
Mooresville Office
3158 Charlotte Hwy
Mooresville, NC 28117
Phone: [phone] /Fax: [phone]

IRONMENTAL
Atlas Environmental Inc
Department of the Army
Wilmington District, Corps of Engineers
Attn: Scott McLendon, Chief Regulatory Division
PO Box 1890
Wilmington, North Carolina 28402-1890
-and-
NC Division of Water Resources, Water Quality Program
Wetlands, Buffers, Streams — Compliance and Permitting Unit
Attn: Karen Higgins
1650 Mail Service Center
Raleigh, North Carolina 27699-1650
I, the current landowner, lessee, contract holder to purchase, or right to purchase holder
of the property identified below, hereby authorize Wetland and Natural Resource
Consultants to act on my behalf as my agent during the processing of stream and
wetland delineation approval and/or permits to impact Wetlands and Waters of the US
that are regulated by the Clean Water Act and the Rivers and Harbors Act. Federal and
State agents are authorized to be on said property when accompanied by Wetland and
Natural Resource Consultants staff. Wetland and Natural Resource Consultants is
authorized to provide supplemental information needed for delineation approval and/or
permit processing at the request of the Corps or WQP.
Property Owner of Record:
Contact Name: C(, ��hns
Address: l n Lu^gam -
Address:oor�-�s���
Phone Number: ��) - �O 5S- 3000
Fax Number: t 09 - G s S- 30 11i
Property Name: -1-11 0y�C- Uw'l "
Project Address: 91 Lr,5L�z-- 1�
Project Address: `1 t- X �- a 1
Tax PIN:
Signature:
Date: t - -" V
Mooresville Office
3158 Charlotte Hwy
Mooresville, NC 28117
Phone: [phone] /Fax. [phone]

O�O�WNAT �9QG
> 1 I�,Ju,✓)l.X
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
Page 1 of 10
PCN Form — Version 1.4 January 2009
Pre -Construction Notification (PCN) Form
A.
Applicant Information
1.
Processing
1 a.
Type(s) of approval sought from the
Corps:
®Section 404 Permit ❑Section 10 Permit
1b.
Specify Nationwide Permit (NWP) number: 12 or General Permit (GP) number:
1 c.
Has the NWP or GP number been verified by the Corps?
❑ Yes
® No
1 d.
Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e.
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
❑ Yes ® No
For the record only for Corps Permit:
❑ Yes ® No
1f.
Is payment into a mitigation bank or in -lieu fee program proposed for
mitigation of impacts? If so, attach the acceptance letter from mitigation bank
or in -lieu fee program.
❑ Yes
® No
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:
Langtree Sewer
2b.
County:
Iredell
2c.
Nearest municipality / town:
Mooresville
2d.
Subdivision name:
not a subdivision, sewer line
2e.
NCDOT only, T.I.P. or state
project no:
not a DOT project
3.
Owner Information
3a.
Name(s) on Recorded Deed:
G&M Partners, LLC / Langtree Development Co / The Cove Church
3b.
Deed Book and Page No.
2105/2052, 1360/1491, 1360/1494, and 2137/1100
3c.
Responsible Party (for LLC if
applicable):
Steve McLeod
3d.
Street address:
19701 D W. Catawba Avenue
3e.
City, state, zip:
Cornelius, North Carolina 28031
3f.
Telephone no.:
704-896-5552 x 104
3g.
Fax no.:
704-896-5546
3h.
Email address:
[e-mail]
Page 1 of 10
PCN Form — Version 1.4 January 2009

4. Applicant Information (if different from owner)
4a. Applicant is:
❑ Agent ❑ Other, specify:
4b. Name:
same as above
4c. Business name
(if applicable):
same as above
4d. Street address:
same as above
4e. City, state, zip:
same as above
4f. Telephone no.:
same as above
4g. Fax no.:
same as above
4h. Email address:
same as above
5. Agent/Consultant Information (if applicable)
5a. Name:
Jennifer L Robertson
5b. Business name
(if applicable):
Atlas Environmental, Inc.
5c. Street address:
712 English Tudor Lane
5d. City, state, zip:
Charlotte, NC 28211
5e. Telephone no.:
704-512-1206
5f. Fax no.:
no fax number
5g. Email address:
[e-mail]
Page 2 of 10
PCN Form — Version 1.4 January 2009

B.
Project Information and Prior Project History
1.
Property Identification
1a.
Property identification no. (tax PIN or parcel ID):
4644699969,4645832540,4645836509,4645930875,
4645920293, 4655023305, and various rights-of-way
along roads
1 b.
Site coordinates (in decimal degrees):
Latitude: 35.529119 Longitude: - 80.852668
1 c.
Property size:
4.77 acres
2.
Surface Waters
2a. Name of nearest body of water to proposed project:
Davidson Creek
2b. Water Quality Classification of nearest receiving water:
WS -IV, CA
2c.
River basin:
Catawba
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 sewer line route is mostly forested on the west side of NC Hwy 115, the route mostly follows existing
roads east of NC Hwy 115, land use in the vicinity includes forested areas, residential development, a church, and
commercial development
3b. List the total estimated acreage of all existing wetlands on the property: 0 Acres within project boundary
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 150 linear feet within
project boundary
3d.
Explain the purpose of the proposed project: to construct a sewer line
3e.
Describe the overall project in detail, including the type of equipment to be used: this project involves the construction of a
sewer line that will connect to a gravity sewer line being constructed by the Town of Mooresville, heavy earth moving
equipment will be used to grade and install the sewer line, 121 linear feet of temporary stream impacts are necessary
during construction, the stream beds will be re-established once construction at each stream crossing is complete.
4.
Jurisdictional Determinations
4a.
Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
® Yes ❑ No ❑ Unknown
Comments:
4b.
If the Corps made the jurisdictional determination, what type
of determination was made?
El Preliminary ®Final
4c.
If yes, who delineated the jurisdictional areas?
Name (if known): Jennifer L Robertson / Joel McSwain
ency/Consultant Company: Atlas Environmental, Inc.
tgther:
4d.
If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
JD Issued June 24th 2015. Previous final JD attached to permit application
5.
Project History
5a.
Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
❑ Yes ® No ❑ Unknown
5b.
If yes, explain in detail according to "help file" instructions.
Previous Corps Action ID # 2015-00236: 404 issued June 24, 2015: Previous 404 is attached to permit application
6.
Future Project Plans
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
1a. Which sections were completed below for your project (check all that apply):
❑ Wetlands ® Streams - tributaries ❑ Buffers ❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
2b.
2c. 2d.
2e.
2f.
Wetland impact
Type of jurisdiction
Area of
number
Type of impact
Type of wetland Forested
Corps (404, 10) or
impact
Permanent (P) or
(if known)
DWQ (401, other)
(acres)
Tem ora T
W1 -
Choose one
Choose one Yes/No
-
0
W2 -
Choose one
Choose one Yes/No
-
0
W3 -
Choose one
Choose one Yes/No
-
0
W4 -
Choose one
Choose one Yes/No
-
0
W5 -
Choose one
Choose one Yes/No
-
0
W6 -
Choose one
Choose one Yes/No
-
0
2g. Total wetland impacts:
0
2h. Comments: no wetland impacts are proposed
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
3b.
3c.
3d.
3e.
3f.
3g.
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number -
(PER) or
(Corps - 404, 10
stream
length
Permanent (P) or
intermittent
DWQ — non -404,
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
CH 100
S1 T
Excavation
UT to Davidson
PER
Corps
5
15
Creek
CH 200
S2 T
Excavation
UT to Davidson
PER
Corps
6
8
Creek
CH 300
S3 T
Excavation
UT to Davidson
PER
Corps
4
25
Creek
CH 400
S4 T
Excavation
UT to Davidson
PER
Corps
5
26
Creek
CH 500
S5 T
Excavation
UT to Davidson
PER
Corps
5
47
Creek
S6 -
Choose one
-
-
3h. Total stream and tributary impacts:
121
3i. Comments: Impacts S1 to S5 are in order from West to East across the sewer alignment. There is no stream impact along
CH 600. The sewer line crossing of CH 600 will be aerial.
Page 4 of 10
PCN Form — Version 1.4 January 2009

4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a.
Open water
impact number -
Permanent (P) or
Temporary T
4b.
Name of waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody
type
4e.
Area of impact (acres)
01 -
none
Choose one
Choose
0
02 -
none
Choose one
Choose
0
03 -
none
Choose one
Choose
0
04 -
none
Choose one
Choose
0
4f. Total open water impacts:
0
4g. Comments: there is no open water on site
5. Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below.
5a.
Pond ID
number
5b.
Proposed use or purpose
of pond
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
none
none
none
none
none
none
none
P2
Choose one
none
none
none
none
none
none
none
5f. Total:
0
0
0
0
0
0
0
5g. Comments: no pond construction is proposed
5h. Is a dam high hazard permit required?
❑ Yes ❑ No
If yes, permit ID no:
5i. Expected pond surface area (acres):
none proposed
5j. Size of pond watershed (acres):
none proposed
5k. Method of construction:
none proposed
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 mitiqlation, then you MUST fill out Section D of this form.
6a.Project is in which protected basin?
❑ Neuse ❑ Tar -Pamlico
® Catawba ❑ Randleman ❑ Other:
6b. 6c.
Buffer impact
number - Reason for impact
Permanent (P) or
Temporary (T)
6d.
Stream name
6e.
Buffer
mitigation
required?
6f.
Zone 1
impact
(square
feet)
6g.
Zone 2
impact
(square
feet
B1 - none
Yes/No
0
0
B2 - none
Yes/No
0
0
B3 - none
Yes/No
0
0
B4 - none
Yes/No
0
0
B5 - none
Yes/No
0
0
B6 - none
Yes/No
0
0
6h. Total buffer impacts:
0
0
6i. Comments: no impacts to protected buffers are proposed
Page 5 of 10
PCN Form - Version 1.4 January 2009

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
No permanent stream impacts are proposed for this project. The original stream bed elevations will be re-established once
construction is complete. No wetland impacts are proposed. The sewer line alignment was adjusted uphill to avoid wetland
impacts within 50' of Lake Norman.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
No permanent culverts are proposed along the sewer line. The access roads to the two pump stations have been aligned to
avoid additional stream impacts. The sewer line alignment was adjusted several times in order to avoid additional stream
impacts and wetland impacts.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State?
❑ Yes ® No
2b. If yes, mitigation is required by (check all that apply):
❑ DWQ ❑ Corps
2c. If yes, which mitigation option will be used for this
project?
❑ Mitigation bank
❑Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank: none
3b. Credits Purchased (attach receipt and letter)
Type: Choose one
Type: Choose one
Type: Choose one
Quantity none
Quantity none
Quantity none
3c. Comments: none
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:
0 linear feet
4c. If using stream mitigation, stream temperature:
Choose one
4d. Buffer mitigation requested (DWQ only):
none square feet
4e. Riparian wetland mitigation requested:
none acres
4f. Non -riparian wetland mitigation requested:
none acres
4g. Coastal (tidal) wetland mitigation requested:
none acres
4h. Comments: mitigation is not required
5. Complete if Using a Permittee Responsible Mitigation Plan
Ea.If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
not applicable
Page 6 of 10
PCN Form — Version 1.4 January 2009

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
❑ Yes ® No
buffer mitigation?
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
6c.
6d.
6e.
Zone
Reason for impact
Total impact
Multiplier
Required mitigation
(square feet)
(square feet)
Zone 1
none
none
3 (2 for Catawba)
none
Zone 2
none
none
1.5
none
6f. Total buffer mitigation required:
none
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).
not applicable
6h. Comments: no comments
Page 7 of 10
PCN Form — Version 1.4 January 2009

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?
<24% %
2b.
Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c.
If this project DOES NOT require a Stormwater Management Plan, explain why: less than 24% impervious sewer line
2d.
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
not applicable
2e.
Who will be responsible for the review of the Stormwater Management Plan?
not applicable
3.
Certified Local Government Stormwater Review
3a.
In which local government's jurisdiction is this project?
not applicable
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.
DWQ 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
5.
DWQ 401 Unit Stormwater Review
5a.
Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b.
Have all of the 401 Unit submittal requirements been met?
® Yes ❑ No
Page 8 of 10
PCN Form — Version 1.4 January 2009

F.
Supplementary Information
1.
Environmental Documentation (DWQ Requirement)
1 a.
Does the project involve an expenditure of public (federal/state/local) funds or the
❑ 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)?
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 (DWQ Requirement)
2a.
Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
❑ Yes ® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b.
Is this an after -the -fact permit application?
❑ Yes ® No
2c.
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3.
Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes ® No
additional development, which could impact nearby downstream water quality?
3b.
If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
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.
This project is construction of a sewer line that will connect to a municipal sewer line.
Page 9 of 10
PCN Form — Version 1.4 January 2009

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
❑ Yes ® 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.
-
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NCDENR Natural Heritage Program Map Viewer and GIS Layer
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?
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?
NCHPO GIS Service
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA -designated 100 -year floodplain?
❑ Yes ® No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? FEMA floodmaps GIS layer
Jennifer L Robertson
j �l�
3/26/18
Applicant/Agent's Printed Name
fd".
Applicant/Agent's Signature
Date
(Agent's signature is valid only if an authorization letter from the applicant
isprovided.)
Page 10 of 10
PCN Form — Version 1.4 January 2009

Sketch Map provided for Lan tree Sewer Impact illustrative purposes and g p t Map
preliminary planning only. Not
intended to be relied upon for
exact location, dimension, or
orientation. All findings and
assessments are subject to
verification from the Army Corps
of Engineers, NC Division of�: G
Water Resources, and/or other
appropriate local authorities. Do
not reproduce map set except in
its entirety.
Detail page 3
Detail page 2 - — -
-- —- —�
1'
------------
Legend
D Project Boundary Li DAR (ft)
2 Ft Contours = 750
o Streets 0 773.9
Delineation 797,7
-- Perennial 821.6
845.4
IRONMENTAL
---—-— - — - — --
I
I
I �
Detail page 4
Project Name: Langtree Sewer
Location: Langtree Road Mooresville NC, 28117
--1
---- --------- ---
Detail
1
0 500 1000 1500 2000 Ft
For: G&M Partners LLC, The Cove Church, and Langtree Development Company
Coordinates: 35.52870, -80.85545 Date: March 27, 2018
Page 1 of 5

i
Langtree Sewer Impact Map
Legend Impact S1
CH 100, Perennial, 15 LF
Q Project Boundary
- 2 Ft Contours
Streets
Delineation 0 200 400 600 Ft
Perennial
_. d IVOIRONMENTAL
Project Name: Langtree Sewer
Location: Langtree Road Mooresville NC, 28117
For: G&M Partners LLC, The Cove Church, and Langtree Development Company
Coordinates: 35.52870, -80.85545 Date: March 27, 2018 Page 2 of 5

Impact S2
CH 200, Perennial, 8 LF
Legend
Q Project Boundary
2 Ft Contours
Streets
Delineation
Perennial
.—A; .
Langtree Sewer Impact Map
Impact S3
CH 300, Perennial 25 LF
0 200 400 600 Ft
Project Name: Langtree Sewer
Location: Langtree Road Mooresville NC, 28117
For: G&M Partners LLC, The Cove Church, and Langtree Development Company
Coordinates: 35.52870, -80.85545
Date: March 27, 2018
Page 3 of 5

i
Langtree Sewer Impact Map
Impact S4
CH 400, Perennial, 26 LF Impact S5
CH 500, Perennial, 47 LF
Legend
Q Project Boundary
2 Ft Contours
Streets
Delineation 0 200 400 600 Ft
Perennial
Project Name: Langtree Sewer
Location: Langtree Road Mooresville NC, 28117
For: G&M Partners LLC, The Cove Church, and Langtree Development Company
Coordinates: 35.52870, -80.85545 Date: March 27, 2018 Page 4 of 5

Stream Impact Table
Impact #
ID
Impact Type
Amount
Type
Units
Authority
S1
CH 100
Temporary
15
Linear
Feet
404
S2
CH 200
Temporary
8
Linear
Feet
404
S3
CH 300
Temporary
25
Linear
Feet
404
S4
CH 400
Temporary
26
Linear
Feet
404
S5
CH 500
Temporary
47
Linear
Feet
404
Total Temporary Impacts 121 LF
No Permanent Impacts

US. ARMY CO
wILMIN RT0J OF ENGINEERS
Action ID. 2015 -Op DISTRICT
GENESERIT (REGIONAL AND oCounty: Ire U.S.G.S. Quad: NC-Moresville
NoPerfY Owner: NATIONWIDE
Address: Lan treeDevelo merit �E .VICATION
Telephone Number;
401 r,an tree Road Co. / Mark Lockman
Mooresvift
704-997- NC 28117
Z62�
Property Owner:
Address:
G&M payersLLC
Telephone Number:
/ Ste
19701 D. W Catawba hen McLeod
Cor lelius Ave.
28031
7�'C
PropenY OWller: The cove Church
Address. / Eric Johnson
TeI 19= Lan�tre
ephone Number: Mooresville NC 28117
704704-6-000
Nearest Town; resvi
Nearest W Moolle
aterwaY: Davidson Creek
River Basin/ I1I1C; Catawba / 03050101
Coordinates: 35.529119 N
-80.852668 W
1-013tlon description: The DMiPrt ie
Description Of Projects area and activity: The ermitt a e
tributaries to Day authorized to im act a roximatel 651f4
of an unnamed
idson Creek to install a sewer lint.
Applicable Law. ® Section 404 (Clean Water Act, 33 USC 1344)
❑ Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: Regional General Permit Number or Nationwide Permit Number: 12
SEE ATTACHED RGP or NWP GENERAL, REGIONAL, AND SPECIAL CONDITIONS
Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with the attached
conditions and your submitted application and attached information dated June 11, 2015_ Any violation of the attached
condns or deviation from your submitted plans may subject the permittee to a stop work order, a restoration order, a Class
I administrative penalty, and/or appropriate legal action.
This verification will remain valid until the expiration date identified below unless the nationwide/regional authorization is modified,
stspended or revoked. If, prior to the expiration date identified below, the nationwide/regional permit authorization is reissued and/or
mdified, this verification will remain valid until the expiration date identified below, provided it complies with all requirements of
the modified nationwide/regional permit. If the nationwide/regional permit authorization expires or is suspended, revoked, or is
mDdified, such that the activity would no longer comply with the terms and conditions of the nationwide/regional permit, activities
whch have commenced (i.e., are under construction) or are under contract to commence in reliance upon the nationwide/regional
permit, will remain authorized provided the activity is completed within twelve months of the date of the nationwide/regional permit's
expiration, modification or revocation, unless discretionary authority has been exercised on a case-by-case basis to modify, suspend or
revoke the authorization.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality Certification. You
should contact the NC Division of Water Resources (telephone [phone]) to determine Section 401 requirements.

«Permit No»
For activities occurring within the twenty coastal counties subject to regulation under the Coastal Area Management Act (CAMA),
prior to beginning work you must contact the N.C. Division of Coastal Management.
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other required Federal,
State or local approvals/permits.
If there are any questions regarding this verificatio any of the conditio s of the Permit, or the Corps of Engineers regulatory
program, please contact Tas Ale nder t 828-27 , ext. 226 or [e-mail].
Corps Regulatory Offici ate: June 24,201
asha Alexan er
Expiration nate of Verification: March 18, 2017
Copy furnished
Jennifer Robertson
Wetland and Natural Resource Consultants, Inc.
3158 Charlotte Highway
Mooresville, NC 28117

«Permit No»
Determination of Jurisdiction:
A. ❑ Based on preliminary information, there appear to be waters of the US including wetlands within the above described project
area. This preliminary determination is not an appealable action under the Regulatory Program Administrative Appeal Process
( Reference 33 CFR Part 331).
B. ❑ There are Navigable Waters of the United States within the above described project area subject to the permit requirements of
Section 10 of the Rivers and Harbors Act and Section 404 of the Clean Water Act. Unless there is a change in the law or our
published regulations, this determination may be relied upon for a period not to exceed five years from the date of this
notification.
C. ❑ There are waters of the US and/or wetlands within the above described project area subject to the permit requirements of
Section 404 of the Clean Water Act (CWA)(33 USC § 1344). Unless there is a change in the law or our published regulations,
this determination may be relied upon for a period not to exceed five years from the date of this notification.
D. ® The jurisdictional areas within the above described project area have been identified under a previous action. Please reference
jurisdictional determination issued June 22, 2015. Action ID: SAW -2015-00236.
Basis for Determination: See previously issued Jurisdictional Determination
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
and C above).
This correspondence constitutes an approved jurisdictional determination for the above described site. If you object to this
determination, you may request an administrative appeal under Corps regulations at 33 CFR Part 331. Enclosed you will find a
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
Phone: [phone]
In order for an RFA to be accepted by the Corps, the Corps must determine that it is complete, that it meets the criteria for appeal
under 33 CFR part 33 1.5, and that it has been received by the Division Office within 60 days of the date of the NAP. Should you
decide to submit an RFA form, it must be received at the above address within 60 of the issue date below.
**It is not necessary to submit o to the Division Office if you do not object to the determination in this correspondence.**
Cotes Regulatory Official:
Tasha Alexander
Issue Date of JD:
Expiration Date of JD: Five years from Issue Date
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://re--ulatM usacesurve coin/.

2015-00236
SPECIAL CONDITIONS
Please be advised that if additional impacts to waters of the U.S., either on this property or on/adjacent to this
property and associated with this project/activity, are proposed at a later date, those impacts will be combined with
the current impacts to waters of the U.S. and will be reviewed cumulatively. Generally, compensatory mitigation
will be required if individual or cumulative (Le., past and present) losses or degradation of waters of the U.S. are
greater than 150 linear feet of perennial or intermittent stream channel and/or 0.1 acre of wetland. Additionally,
cumulative impacts that result in the loss or degradation of greater than 300 linear feet of perennial or
intermittent* stream channel, and/or 0.5 acre of wetland, will be processed under an Individual Permit. This
verification of the use of the Nationwide Permit Program for this project does not imply that this office will
necessarily approve any future proposal to impact waters of the U.S. on this property and/or associated with this
project/activity.
* The District Commander has the ability to waive the 300 linear foot limit for intermittent streams on a case-by-
case basis. All requests for waiver must be in writing and shall include rationale for the request.
The stream bed must be restored to its pre -construction contours with the native bed material.

Action ID Number: 2015-00236 County: Iredell
Permittee: Langtree Development Co. / Mark Lockman
Date Verification Issued: June 24, 2015
Project Manager: Tasha Alexander
Upon completion of the activity authorized by this permit and any mitigation required by the permit, sign this
certification and return it to the following address:
US ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Attn.: CESAW-RG-A
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
Please note that your permitted activity is subject to a compliance inspection by a U. S. Army Corps of
Engineers representative. Failure to comply with any terms or conditions of this authorization may result in the
Corps suspending, modifying or revoking the authorization and/or issuing a Class I administrative penalty, or
initiating other appropriate legal action.
I hereby certify that the work authorized by the above referenced permit has been completed in accordance with
the terms and condition of the said permit, and required mitigation was completed in accordance with the permit
conditions.
Signature of Permittee
Date

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action ID: 2015-00236 County: Iredell U.S.G.S. Quad: NC -Mooresville
NOTIFICATION OF JURISDICTIONAL DETERMINATION
Property Owner: LanLytree Development Co. / Mark Lockman
Address: 401 Lanetree Road
Mooresville, NC 28117
Telephone Number: 704-997-2620
Property Owner: G&M Partners, LLC / J. Stephen McLeod
Address: 19701 D.W. Catawba Ave.
Cornelius, NC 28031
Telephone Number: 704-896-5546
Property Owner: The Cove Church / Eric Johnson
Address: 197 LanQtree Road
Mooresville, NC 28117
Telephone Number: 704-655-3000
Size (acres): 22.07 Nearest Town: Mooresville
Nearest Waterway: Davidson Creek Coordinates: 35.529119 N, -80.852668 W
River Basin/ HUC: Catawba / 03050101
Location description: The pro'ect is located within a 4,806 Ift sewer line corridor,parcels 4644699969 4645832540
4645930875,464592093,4655023305, and alon.2 road ri2hts-of-way, Mooresville Iredell County, North Carolina.
Indicate Which of the Following Apply:
A. Preliminary Determination
Based on preliminary information, there may be wetlands on the above described property. 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 Part 331). 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.
B. Approved Determination
There are Navigable Waters of the United States within the above described property 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 wetlands on your property 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.
— The waters of the U.S. including wetlands have been delineated and surveyed and are accurately depicted on the plat
signed by the Corps Regulatory Official identified below on . 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.
— 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 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 Tasha Alexander at 828-271-7980, ext. 226 or
[e-mail].
C. Basis for Determination:
The site contains wetlands as determined by the 1987 Corps of Engineers Wetland Delineation Manual and the
Regional Supplement to the Corps of Engineers Wetlands Delineation Manual: Eastern Mountain and Piedmont
Region(version 2.0). These wetlands are adjacent to stream channels located on the property that exhibit indicators of
ordinary high water marks. The stream channels on the property are unnamed tributaries (UT) to Davidson Creek
which flows into the Catawba / 03050101 River.
D. Remarks: A site visit was conducted on December 4, 2014 with Tamp Bandy, Wetland and Natural Resource
Consultants, Inc. The waters of the U.S. are accurately depicted on the map labeled Langtree Sewer Property — 22.07
acres, sheet AR -0,1 of 5, dated June 9, 2015. The site contains approximately 1,882 linear feet of stream and 0.21 acre
of wetlands.
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 1OM15
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 form, it must be received at the above address within 60 days of the issue date below.
**It is not necessary to submit ^RFA form to the Division Office if you do not object to the determination in this
correspondence.**
Corps Regulatory Official:
as a e ander
Issue Date of JD: June 24, 2015 Expiration Date: Five years from Issue Date
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
httpWre ulatory.usacesurvey.com/.
Copy furnished:
Jennifer Robertson
Wetland and Natural Resource Consultants, Inc.
3158 Charlotte Highway
Mooresville, NC 28117

A
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Yf:-`!n✓ar f. x t�.:. e3i 7:Y ^M1a.°V .'rt ti n Y 5
Applicant: Langtree Development Co. / Mark
File Number: SAW -2015-00236
Date: June 24, 2015
Lockman
Attached is: See Section below
INITIAL PROFFERED PERMIT Standard Permit or Letter of nnission A
HI PROFFERED PERMIT (Standard Permit or Letter of ermission) g
PERMIT DENIAL C
APPROVED JURISDICTIONAL DETERMINATION D
❑ PRELIMINARY 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 htt_p://wu-w.usace.army.mil/Missions/CivilWorks/ReaulatoaProLramandPennits Wx 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 Pennission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• OBJECT: if you object to the permit (Standard or LOP) because of certain terms and conditions therein, you may request
that the permit be modified accordingly. You must complete Section II of this form and return the form to the district
engineer. Your objections must be received by the district engineer within 60 days of the date of this notice, or you will
forfeit your right to appeal the permit in the future. Upon receipt of your letter, the district engineer will evaluate your
objections and may: (a) modify the permit to address all of your concerns, (b) modify the permit to address some of your
objections, or (c) not modify the permit having determined that the permit should be issued as previously written. After
evaluating your objections, the district engineer will send you a proffered permit for your reconsideration, as indicated in
Section B below_
B: PROFFERED PERMIT: You may accept or appeal the permit
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Pennission (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 terns and conditions, and approved jurisdictional determinations associated with the
permit.
• APPEAL: if you choose to decline the proffered pennit (Standard or LOP) because of certain ternis and conditions therein,
you may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section I I 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 11 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.

F • PREI 1MINARY JURISD1CT10
NAL DETERMINA 11UN.' 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 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.
SECTIC?NT! - RE, $'I FOR A.PPE�iI, or OBJ C'T1GtNS -PA N INITIAL PR�C3FF 1J 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: Tasha Alexander CESAD-PDO
828-271-7980 U.S. Army Corps of Engineers, South Atlantic Division
60 Forsyth Street, Room I 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 opportunity to
participate in all site investigations.
Date:
Telephone number:
Signature of appellant or agent.
For appeals on Initial Proffered Permits send this form to:
District Engineer, Wilmington Regulatory Division, Attn.: Tasba Alexander, 69 Darlington Avenue, Wilmington,
North Carolina 28403
For Permit denials, Proffered Permits and approved Jurisdictional Determinations send this form to:
Division Engineer, Commander, U.S. Army Engineer Division, South Atlantic, Attn: Mr. Jason Steele,
Administrative Appeal Officer, CESAD-PDO, 60 Forsyth Street, Room 10M15, Atlanta, Georgia 30303-8801
Phone: [phone]

�%tf
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17,
-77
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.' i`! . ��/<..�f\`. 1 1,'1 i •� l�, 1 !Il�il��l/�I�4i1'Y.,.�t��" � .
':,... LEGEND:
Jurisdictional Determination / Field Delineation Sketch
Wetland Sketch provided for lllustretive purposes in preft!nary planning use only. Not intended to be relied upon for exact location, dimensions, or orientation.
The field evaluation was conducted utilizing current methodologies which are consistent with those outlined in the 1987 US Army Corps Wetland Delineation
Manual, Regional Supplement, post Rapanos Supreme Court decision guidance (2007), and the latest NC Dtvision of Water Resources Methodology for
Idenillication of Intermittent and Perennial Streams and Their Origins. All findings and assessments made by Welland consultants regarding limits of jurisdiction
or permining requirements are subject to verification by the US Army Corps of Engineers, the NC Division of Water Quaiity, and other appropriate local authorities.
SITE: LANGTREE SEWER PROPERTY - 22.07 ACRES DATE: 6/9/2015
V0
LOCATION: MOORESVILLE, IREDELL COUNTY, NC
IRONMENTAL
MAP: AQUATIC RESOURCES SKETCH MAP - OVERALL
712 English Tudor Lane, Charlotte, NC 28211
s8O-819-778D • wwwadasem,&ca„ CLIENT: LANGTREE DEV. CO., THE COVE CHURCH, G&M PARTNERS, LLC
or *,4 0! : Perennial RPW(s)
♦ '" '► ft, . * : Seasonal RPW(s)
•'.. M4 : Non-RPW(s) **
0 : Jurisdictional Wetland(s)
Total Acreage of Site : 22.07 Acres
Existing RPW(s) : 1882 Linear Feet
Existing Wetlands) : 0.21 Acres
Sheet #:
0' 256' 500' 1000'
AR -0
SCALE 1" = 500' CONTOUR INTERVAL = 2 FT J 1 of 5