20170785 Ver 2_PCN Form Submission_20190409

D1�VR
�irlslan af Water Resources
Initial Review
Pre-Construction Notification (PCN) Form
September 29, 2018 Ver 3
Has this project met the requirements for acceptance in to the review process?*
F Yes
C' No
Is this project a public transportation project?"
� Yes r No
Change only rf needed.
BIMS # Assigned *
20170785
Is a payment required for this project?*
f No paymentrequired
� Fee received
F Fee needed - send electronic notification
Reviewing Office *
Mooresville Regional Office - [phone]
Information for Initial Review
1a. Name of project:
Cross-Charlotte Trail — Brandywine Road to Tyvola Road (B2T)
1a. Who is the PrimaryContact?*
Erin Shanaberger, PWS
1b. PrimaryContact Email:*
[e-mail]
Date Submitted
4/9/2019
Nearest Body of Water
Little Sugar Creek
Basin
Catawba
Water Classification
C
Site Coordinates
Latitude:
35.165123
A. Processing Information
County (or Counties) where the project is located:
Mecklenburg
Is this project a public transportation project?*
r Yes r No
Is this a NCDOT Project?*
C' Yes r No
1a. Type(s) of approval sought from the Corps:
,r! Section 404 Permit (w�etlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What type(s) of permit(s) do you wish to seek authorization?
Longitude:
-80.846275
Ve rsion# *
2
What amout is owed?*
r $zao.00
G $570.00
Select Project Reviewer"
Donna Hood:eads\drhood
1c. PrimaryContact Phone:*
[phone]
::

�J Nationwide Permit (NWP)
r Regional General Permit (RGP)
r Standard (IP)
1c. Has the NWP or GP number been verified bythe Corps?
G Yes r No
Nationwide Permit (NWP) Number:
Nationwide Permit (NWP) Number:
14 - Linear transportation
27 - Restoration
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
�J 401 Water Quality Certification - Regular
r Non-404 Jurisdictional General Permit
� Individual Permit
1e. Is this notification solelyfor the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
r 401 Water Quality Certification - 6cpress
r Riparian Buffer Authorization
1f. Is this an after-the-fact permit application?"
� Yes r No
1g. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
r Yes r No
1g. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
� Yes r No
Acceptance LetterAttachment
13-print_2017-06-21 XCLT b2t_CRL.pdf
1h. Is the project located in any of NC's twenty coastal counties?
� Yes r No
1j. Is the project located in a designated trout watershed?
C' Yes r No
B. Applicant Information
1d. Who is applying for the permit?
r Owner I�J Applicant (other than owner)
1e. Is there an Agent/Consultant for this project?
� Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
City of Charlotte and Right of EnUy Agreements
2b. Deed book and page no.:
2c. Responsible party:
Erin Shanaberger, PWS
2d. Address
Street Address
600 East Fourth Street
Address Line 2
�ty
Charlotte
Postal / Zip Code
28202
2e. Telephone Number:
[phone]
2g. Email Address:*
Erin. [e-mail]
S[ate / Awince / Region
NC
Country
USA
2f. Fax Number:
36.12KB
*
C' Yes r No
C' Yes r No

3. Applicant Information (if different from owner)
3a. Name:
Erin Shanaberger, PWS
3b. Business Name:
City of Charlotte, Engineering and Property Management
3c. Address
&reet Address
600 East Fourth Street
Address Line 2
�Y
Charlotte
Fbstal / Zip Code
28202
3d. Telephone Number:
[phone]
3f. Email Address:"
Erin. Shan a [e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
('rf appropriate)
1c. Nearest municipality I town:
Charlotte
2. Project Identification
2a. Propertyldentification Number:
NA
2c. Project Address
Street Address
Address Line 2
�Y
Postal I Zip Code
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:*
Little Sugar Creek
3b. Water Resources Classification of nearest receiving water:*
C
3c. What river basin(s) is your project located in?*
Catawba
3d. Please provide the 12-digit HUC in which the project is located.
03050103
4. Project Description and History
S[ate / Rwince I Region
NC
Country
USA
3e. Fax Number:
,.
2b. Property size:
State / Rovince I �gion
Country
4a. Describe the existing conditions on the site and the generel land use in the vicinity of the project at the time of this application:*
This project area is defined as Little Sugar Creek (LSC) from Brandywine Road to Tyvola Road located in the City of Charlotte, North Carolina (Figure 1). The Little Sugar Creek
watershed currently is a developing urban area. Per the U.S. Census Bureau, the population of Charlotte has increased from 540,828 people in 2000 to 731,424 people in 2010. Based
on historical aerials (1938, 1948, 1951, 1956, 1965, 1973, 1983, 1996, 2006, and 2008), most of the development in the watershed occurred betw�en 1973 and 1993. Over the last ri+ro
decades, this watershed and Little Sugar Creek have been a focus of the Charlotte-Mecklenburg Stormwater Services wtio has implement over a dozen projects in the watershed
focused on improving water quality in LSC. The watershed at the downstream end of the project area is approximately 37 square miles. It is located in a developing watershed and
partially drains parts of urban and sub-urban Charlotte, NC. The North Carolina Division of Water Resources (NC DWR) classifies Little Sugar Creek as a Class C water. The site is
located in the Catawba River Watershed (12-digit Hydrologic Unit 030501030102).
The project area comprises forested riparian areas paralleling Little Sugar Creek with adjacent commercial and residential areas. Typical on-site vegetation includes sweetgum
(Liquidambar sryraciflua), red oak (Quercus rubra), American sycamore (Platanus occidentalis), Japanese honeysuckle (Lonicera japonica), kudzu (Pueraria lobata), green ash
(Frapnus pennsylvanica), glossy privet (Ligustrum lucidum), Chinese privet (Ligustrum sinense), English ivy (Hedera helix), river cane (Arundinaria gigantea), golden bamboo
(Phyllostachys aurea), poison ivy (Toxicodendron radicans), greenbriar (Smilax rotundifolia), and various grasses (Festuca spp.).
Three jurisdictional stream channels (Streams A-C) located within the project area. On-Site jurisdictional waters drain to and include Little Sugar Creek. Little Sugar Creek is part of the
Lower Catawba River Basin (HUC 03050103) and is classified as "Class C Waters" by the NCDWR. According to the NCDWR.
No jurisdictional wetlands were identified within the project area.

4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r Yes r No C' Unknown
4c. If yes, please give the DWR Certification number or the Corps Action ID (exp. SAW-0000-00000).
SAW-2017-01325, DWR#17-0785
Project History Upload
17-0785-OS072017.pdf 804.94K6
SAW-2017-01325 XCLT Trail - Brandy�nnne to Tyvola (NWP14&27).pdf 3MB
4d. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR)
B2T_Fig2_USGS.pdf
819.41 KB
4e. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR)
B2T_F ig 3_SSURGOSoils. pdf
4f. List the total estimated acreage of all existing wetlands on the property:
4g. List the total estimated linear feet of all existing streams on the property:
8,492
1.73 MB
4h. Explain the purpose of the proposed project:"
The purpose of the project to construct a greenway trail and implement natural channel design techniques in order to stabilize bed and banks, increase dissolved oxygen, improve
habitat diversity and to protect low-water trail crossings.
4i. Describe the overell project in detail, including indirect impacts and the type of equipment to be used:*
The Cross-Charlotte Trail (XCLT) is a proposed 26-mile greenway trail proposed to stretch from the North-South Carolina state line, through the UNC Charlotte Campus and to the
Cabarrus County line. Through a partnership betv�.�en the City of Charlotte and Mecklenburg County, this trail will connect parks, landmarks, and major employment centers and will
serve both passive and active recreational opportunities for greenway users, wfiile maintaining and preserving the natural aspects of the corridor.
The B2T segment includes the construction of 1.5 miles of 12-foot wide greenway trail and in-stream enhancements located along Little Sugar Creek. This segment of trail will tie into
the ebsting Little Sugar Creek Greenway at Brandywine Road and will extend south to Tyvola Road. In general, the 26-mile corridor �vill utilize existing and maintained sanitary sewer
easement corridors in order to reduce clearing impacts, however, the B2T section of XCLT is heavily constrained by a number of factors including topography, access, grade-separation
issues, aerial and above-ground utilities and private commercial/residential properties.
In order to protect users of the trail by eliminating at grade crossings of busy roads, the alignment is proposed to pass through a culvert bcated beneath Park Road and East Woodlawn
Road. East Woodlawn and Park Roads are very busy thoroughfares. Moreover, the route is designed to be compliant with the Americans with Disabilities Act (ADA) and Charlotte-
Mecklenburg standards for trails and pathways, thus requiring a mawmum slope of approximately 5%. For this slope to be maintained and for the route to pass beneath Brandywine
Road, E Woodlawn Road and Park Road, grading and construction activities associated with the trail installation will impact Little Sugar Creek belowthe OHWM. These impacts will also
allow for the preservation of mature canopy species along the top of bank of Little Sugar Creek. A total loss of channel bed and stream function is not proposed by this project — only
minor bank/bed impacts on one side, as the trail runs parallel and below OHWM in a few locations (due to constraints).
The overall project includes the construction of approbmately 8,100 linear feet of a 12-foot wide greenway trail. Streamside impacts belowOMNM have been reduced to the maximum
e�dent practicable to minimize impacts to stream functions already degraded by the urban watershed. One section of greenv✓ay will necessitate excavation and fill below the OHWM
resulting in 391 linear feet of permanent — no net loss of WoUS in order to construct the trail running parallel along the edge of water, including applicable retaining walls, grading, and
bank stabilization.
391 If of streamside impacts below OFNUM are proposed, however, only 292 If will impact belowthe ebsting normal water surface elevation mainly associated with the section of stream
that has over-widened. Most of those impacts occur in an already heavily degraded section of Little Sugar Creek, where the bank has blown out and resulted in a channel width twice as
wide as sections immediately up and downstream including shear banks that are largely absent of vegetation. The width of the over-widened section is 35'-40', therefore, the proposed
condition seeks to return the normal baseflowwidth back to its natural condition while eliminating bank instabilities.
A BEHI/NBS assessment was performed in order to estimate bank erodibility. The results of the stream bank erodibility assessment demonstrated that in the ebsting condition, this
section of stream bank is producing approwmately 17 tons of sediment per year. In the proposed condition, bank erosion within this section �nrould be prevented, reducing the sediment
input to 0. Additionally, an NCSAM evaluation was conducted and determined that no further degradation of the aquatic environment �nould result in the proposed condition; therefore,
the project satisfies Regional Condition 3.1 since it will result in no-net-loss of WoUS including no further degradation of the aquatic environment.
Natural channel design techniques will be implemented to install four rock cross-vanes and associated constructed riffles at the low-water trail crossing locations. The purpose of the
structures will be to stabilize the bed and banks, increase dissolved oxygen concentrations, improve aquatic habitat diversity, and to protect the low-water crossings from the hydraulic
forces during storm events. 460 linear feet of stream enhancement (permanent — no net loss of WoUS) is proposed as part of this project.
Due to the highly-constrained project area, it is necessary for a portion of the construction activities to be conducted within the channel bed of LSC. Due to the size and drainage area
of LSC, it is not feasible to utilize measures, i.e. impervious dikes and pumped diversions, in order to wnrk in dry conditions. 4,720 linear feet of temporary sheam impacts are requested
to conduct construction activities including tracked back-hoe access, where greenway construction from the banks is not feasible. Temporary impacts have been minimized to the
greatest extent practicable in order to meet the needs of the project and do not pose adverse alterations to the exsting channel bed. An application to wnrk in the wet will be submitted
to NCDWR, Sediment and Erosion Control, which is typical for these types of projects.
Track hoes and other earth moving equipment is anticipated to be used on this project.
4j. Please upload project drewings for the proposed project.
B2T_Fig5d_Pot_Impacts.pdf 255MB
2019-03-29_Cross Charlotte Trail - EG20 Briar CreekTemp Crossing_11x17.pdf 99775KB
5. Jurisdictional Determinations
Sa. Have the wetlands or streams been delineated on the property or proposed impact areas?*
� Yes
Comments
f Np
Sb. If the Corps made a jurisdictional determination, what type of determination was made?*
F Preliminary (' Approved r Not Verified r Unknown f' WA
Corps AID Number:
SAW-2017-01325
r Unknown
Sc. If Sa is yes, who delineated the jurisdictional areas?

Name (if known):
Agency/Consultant Company:
Other:
Chris Tinklenberg, PWS
Kimley-Fbrn and Associates
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
January 3, 2018- Corps
August 7, 2017- DWR
Sd1. Jurisdictional determination upload
SAW-2017-01325 XCLT Trail - Brandy�nnne to Tyvola (NWP14&27).pdf 3MB
17-0785-OS072017.pdf 804.94KB
6. Future Project Plans
6a. Is this a phased project?"
� Yes r No
7b. If yes, explain.
When complete, the Cross-Charlotte Trail will include 26 miles of trail and connectors. Currently, half of the overall trail is in design or under construction. Per coordination w�th USACE
and NCDWR, any impacts associated with future phases of the project require compensatory mitigation, therefore, compensatory mitigation is proposed as part of this project. The City
of Charlotte will continue to address future phases of the project and mitigation requirements associated with those phases w�th USACE and NCDWR when necessary.
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activit�I?
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
r Wetlands II7 Streams-tributaries
� Open Waters I� Pond Construction
3. Stream Impacts
� Buffers
�,
❑ 3a. Reason for impact (?) 3b.lmpact type * 3c. Type of impact* 3d. S. name * 3e. Stream Type * 3f. Type of 3g. S. width* 3h. Impact
(?) Jurisdiction�` length*
S1 Stream-side area impact Permanent Other Little Sugar Creek Perennial Both 20 391
(belowOFM/M), construction Average(feet) Qinearfeet)
of greenway
32 Stream enhancement; Permanent Other Little Sugar Creek Perennial Both 20 90
installationofconstructed nverage(feet) (�inearfeet)
riffle and rock-cross vane
S3 Stream enhancement; Permanent Other Little Sugar Creek Perennial Both 20 100
installationofconstructed Average(feet) (linearfeel)
riffle and rock-cross vane
g4 Stream enhancement; Permanent Other Little Sugar Creek Perennial Both 20 140
installationofconstructed nverage(feet) pinearfeet)
riffle and rock-cross vane
S5 Stream enhancement; Permanent Other Little Sugar Creek Perennial Both 20 130
installationofconstructed Average(feet) (linearfeet)
riffle and rock-cross vane
S6 Temporary impacts Temporary Other Little Sugar Creek Perennial Both 20 4,700
necessarytoconduct Average(feet) pinearfeet)
construction activities
�g7 Temporary ford crossing Temporary Other Brair CreekLittle Sugar Perennial Both 20 20
Creek � 4verage(feet) pinearfeet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
851
3i. Total stream and ditch impacts:
875
3j. Comments:
3i. Total temporary stream impacts:
4720

One section of greenway will necessitate excavation and fill below the OFNVM resulting in 391 linear feet of permanent — no net loss of WoUS in order
to construct the trail running parallel along the edge of water, including applicable retaining walls, grading, and bank stabilization (Impact 1). Natural
channel design techniques will be implemented to install four rock cross-vanes and associated constructed riffles at the low-water trail crossing
locations resulting in 460 linear feet of permanent — no net loss of WoUS (Impacts 3-6). 4,720 linear feet of temporary construction impacts are
necessary to conduct construction activities including tracked back-hoe access, wfiere greenway conshuction from the banks is not feasible. 20 linear
feet of additional temporary construction impacts are necessary for a temporary stream crossing for construction activities and equipment. The project
will not result in a linear loss of WoUS, however, 0.079 acres of permanent strearirside area impacts belowthe OMNM are necessary to conshuct the
greenway trail.
E. Impact Justification and Mitigation �
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Avoidance and minimization efforts for the greenway include the avoidance of 555 linear feet of imacts below the OFNVM/stream-side area in twn
locations. The project will construct appro�mately 930 feet of elevated boardwalk in order to avoid additional sheam impacts. Moreover, instead of
installing culverted crossings within LSC, the project is proposing four low-water crossings and to install in-stream structures around those crossings in
order to protect the infrasture as wzll as to provide aquatic uplift. The trail footprint was reduced in the upper section by decreasing the shoulder width
on the stream side from 5-feet down to 2-feet wfiich allowed for the reduction in the overall permanent impacts below OHWM from 966 linear feet to
391 linear feet (0.079 acre), about a 40 % reduction in impact. .
1b. Specificallydescribe measures taken to avoid or minimize the proposed impacts through construction techniques:
Temporary impacts have been minimized to the greatest e#ent practicable in order to meet the needs of the project and do not pose adverse
alterations to the e�sting channel bed. Erosion control measures implemented during construction of the greenway will be removed immediatedly
following the activity and any disturbance will be returned to preconstruction conditions. Temporary bridge crossings will be utilized along haul roads in
order to avoid additional temporary stream 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 r No
2c. If yes, mitigation is required by (check all that apply):
r DWR fJ Corps
2d. If yes, which mitigation option(s) will be used for this project?
I7 Mitigation bank � Payment to in-lieu fee I� Permittee Responsible
program Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
Sedgefield Park-Dairy Branch
3b. Credits Purchased/Requested (attach receipt and letter)
Type: Quantity:
Stream
Attach Receipt and/or letter
13-print_2017-06-21 XCLT b2t_CRL.pdf
3c. Comments
36
36.12KB
I F. Stormwater Management and Diffuse Flow Plan (required by DWR) " I
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
C' Yes r No
If no, explain why:
Does not include nor is adjacent to riparian buffers identified within one of the NC Riparian Buffer Protection Rules.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
C' Yes r No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?
r Yes r No
Comments:

G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federallstate/local) funds or the use of public (federallstate) land?*
F Yes r No
�
1b. If you answered "yes" to the above, does the project require preparation of an environmental document pursuant to the requirements of the National or State (North Carolina)
Environme ntal Policy Act (NEPAISEPA)? *
C' Yes r No
Comments:
*
Greenway project and does not require preparation of an environmental document pursuant to the requirements of NEPA/SEPA.
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 26 .0200)? *
� Yes r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality? *
C' Yes r No
3b. If you answered "no," provide a short narrative description.
Greenway construction will not result in additional development.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
f Yes r No � fWA
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
Sa. Will this project occur in or near an area with federally protected species or habitat? *
C' Yes r No
Sb. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No
Sc. If yes, indicate the USFWS Field Office you have contacted.
Asheville
Sd. Is another Federal agency involved?*
C' Yes r No
Se. Is this a DOT project located within Division's 1-8?
� Yes r No
Sf. Will you cut anytrees in order to conduct the work in waters of the U.S.?
C' Yes r No
Sg. Does this project involve bridge maintenance or removal?
� Yes r No
Sh. Does this project involve the construction/installation of a wind turbine(s)?'
C' Yes r No
C' Unknown
Si. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
� Yes r No
Sj. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
A review of the North Carolina Natural Heritage Program (NCNHP) database on January 14, 2016 did not indicate known occurences of threatened or
endangered species �nnthin the project boundary. Additionally, a letter from USWFS dated February 22, 2016, concurred that no listed species or their
habitats are present within the project boundary.
Consultation Documentation Upload
12-NHP. project_report_phase_i_cross_charlotte_trai I_2547. pdf 1.1 S MB
12-USFWS_16-249_Cross charlotte Trail Brandywine to Tyvola Segment_Mecklenburg Co.pdf 174.48KB
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?'�

C' Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
NCNHP element occurrence database did not indicate the presence of EFH within the project boundary.
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?*
� Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
A letter from the North Carolina State Historic Preservation Office (SHPO) dated February 11, 2016 states that there are no known archeological sites
within the project area, however, the project will occur within the National Register-eligible Selwyn Village Historic District (MK2113). NCSHPO
recommends minimal mature tree removal in order to avoid adverse affects to the property's view shed. Minimal tree clearing will occur as part of this
project and will be predominatety limited to those areas immediately adjacent to LSC where the vegetation is made up of primarily invasive species and
young hardwoods.
7c. Historic or Prehistoric Information Upload
12-NC_SHPO_XCLT-B2T.pdf
8. Flood Zone Designation (Corps Requirement)
Sa. Will this project occur in a FEMA-designated 100-year floodplain? *
� Yes r No
109.45KB
Sb. If yes, explain how project meets FEMA requirements:
A flood impact analysis report, no-rise Impact certification, and individual floodplain development permit will be submitted to Mecklenburg County for
review and approval prior to construction/restoration activities. The results of the flood impact analysis show that there is no net increase in base flood
elevations.
Sc. What source(s) did you use to make the floodplain determination?"
FEMA FIRM No. 3710454100K
Miscellaneous
Comments
Miscellaneous attachments not previouslyrequested.
_SAW-2017-01325 XCLT Trail Modification Request-2019-04-09 B2T.pdf 4.14MB
Signature
*
�J By checking the box and signing below, I certify that:
• I have given true, accurate, and complete information on this form;
. I agree that submission of this PCN form is a"transaction" subject to Chapter 66, Artide 40 of the NC General Statutes (the "Uniform Electronic Transactions AcY');
• I agree to conduct this Iransaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions AcP');
. I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
• I intend to electronically sign and submit the PCN form.
Full Name:
Chris Tinklenberg
Signature
��/r-t��t 'rir.�l�°rr�°t�
Date
4/9/2019