20190524 Ver 1_PCN Form Submission_20190422

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02*10n of Water R"Ourc"
Pre -Construction Notification (PCN) Form
September 29, 2018 Ver 3
Initial Review
Has this project met the requirements for acceptance into the review process?*
r Yes
r No
Is this project a public transportation project?*
r Yes r No
Change only if needed.
BIMS # Assigned *
Version#*
20190524
1
Is a payment required for this project?*
* No payment required
What amout is owed?*
* Fee received
r $240.00
r Fee needed - send electronic notification
r $570.00
Reviewing Office* Select Project Reviewer*
Mooresville Regional Office - [phone] Alan Johnson:eads\adjohnsonl
Information for Initial Review
1a. Name of project:
Parkstone Place Subdivision
1a. Who is the Primary Contact?*
Richard Mogensen
1 b. Primary Contact Email:*
[e-mail]
Date Submitted
4/22/2019
Nearest Body of Water
Little Sugar Creek
Basin
Catawba
Water Classification
Warm
Site Coordinates
Latitude:
35.149
A. Processing Information
County (or Counties) where the project is located:
Mecklenburg
Is this project a public transportation project?*
r Yes r No
Longitude:
-80.846
1a. Type(s) of approval sought from the Corps:
V Section 404 Permit (wetlands, streams and waters, Clean Water Act)
F Section 10 Permit (navigable venters, tidal waters, Rivers and Harbors Act)
1 b. What type(s) of permit(s) do you wish to seek authorization?
P Nationwide Permit (NWP)
F- Regional General Permit (RGP)
r- Standard (IP)
1c. Primary Contact Phone:*
[phone]

1c. Has the NWP or GP number been verified by the Corps?
r Yes r No
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
#12 & #29
1d. Type(s) of approval sought from the DWR:
rJ 401 Water Quality Certification - Regular
F Non -404 Jurisdictional General Permit
F Individual Permit
29 - Residential Developments
F 401 Water Quality Certification - E)press
r Riparian Buffer Authorization
1e. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
1f. Is this an after -the -fact permit application?*
r- 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?
r- Yes r- No
Acceptance Letter Attachment
1h. lathe project located in any of NC's twenty coastal counties?
r Yes r No
1j. Is the project located in a designated trout watershed?
r- Yes r No
B. Applicant Information
1d. Who is applying for the permit?
R Owner r Applicant (other than owner)
1e. Is there an Agent/Consultant for this project?
r Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
Parkstone South, LLC
2b. Deed book and page no.:
Deed Book 33190-610 Parcel ID 17125220
2c. Responsible party:
Jeff Watson
2d. Address
Street Address
568 Jetton Street
Address Line 2
Suite 200
CKY
Davidson
Postal / Zip Code
28036
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
State / Rwince / Fegicn
NC
Country
USA
2f. Fax Number:
r Yes r No
ryes r No

1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/town:
Charlotte
2. Project Identification 1
2a. Property Identification Number:
2b. Property size:
17125220
2.74 acres
2c. Project Address
Street Address
5628 Closeburn Road
Address Line 2
city
State/ Ftovince / Re9un
Charlotte
NC
Posta / Zip Code
Country
USA
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:*
Warm
3c. What river basin(s) is your project located in?*
Catawba
3d. Please provide the 12 -digit HUC in which the project is located.
03050103-0102
4. Project Description and History
4a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application:*
Single family residence formerly on half of this property. House was demolished. The rest is two streams and associated flood plain. The site is surrounded by single family residences,
streets and a greenway.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r- Yes r No r- Unknown
4d. Attach an 8 1/2 X11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR)
ParkstonePlace_USGS. pdf
5.7MB
4e. Attach an 81/2 X11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR)
ParkstonePlace_SOILS.pdf 2.3MB
4f. List the total estimated acreage of all existing wetlands on the property:
0
4g. List the total estimated linear feet of all existing streams on the property:
648 If
4h. Explain the purpose of the proposed project:*
Eight house subdivision.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The areas outside the floodplain and buffers will be graded with typical earthmoving equipment such as excavators, bulldozers, compacters etc.
4j. Please upload project drawings for the proposed project.
Parkstone PI Site Plan & Cross-section.pdf 1.7MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
F Yes r" No f Unknown
Comments:
See Delineation Map & Data Forms
5b. If the Corps made a jurisdictional determination, what type of determination was made?
r- Preliminary r Approved r- Not Verified r- Unknown 6 NIA
Corps AID Number:

5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Richard K. Mogensen
Agency/Consultant Company: Mogensen Mitigation, Inc.
Other:
5d1. Jurisdictional determination upload
3a. Reason for impact (?)
Parkstone Stream Delin Map FINAL.pdf
504.46KB
PARKSTONE PLACE Photo Log.pdf
527.06KB
Parkstone Upland Data Form 042219.pdf
65.35KB
SWITC DP #2 UT #1.pdf
88.92KB
SWITC DP #3 UT #2.pdf
67.39KB
SWITC DP#1 UT #1.pdf
85.7KB
Parkstone Place NCSAM 042219.pdf
144.76KB
6. Future Project Plans
20
nearfee)
6a. Is this a phased project?*
Sewer line Crossing :--Temporary
r Yes r No
Excavation
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 projector related activity?
No
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
r- Wetlands R Streams -tributaries r Buffers
r- Open Waters r Pond Construction
3. Stream Impacts
❑
3a. Reason for impact (?)
3b.lmpact type *
3c. Type of impact*
3d. S. name*
3e. Stream Type *
(?)
3f. Type of
Jurisdiction*
3g. S. width *
3h. Impact
length*
S1
Culvert extension for
sidewalk required by the City
of Charlotte
Permanent
Culvert
UT #1
Intermittent
Corps
3
Average (feet)
20
nearfee)
S2
Sewer line Crossing :--Temporary
Excavation
lfT #1
Intermittent
Corps
3
Average (feet)
20
(linear feet)
31. Total jurisdictional ditch impact in square feet:
0
31. Total permanent stream impacts:
20
31. Total stream and ditch impacts:
40
3j. Comments:
31. Total temporary stream impacts:
20
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:
Every effort was made to minimize permanent stream impacts. Due to the small DA a riprap dissapator will not be used. The sewerline crossing ROW
and workspace has been minimized to the greatest extent practicable. Permanent impacts have been limited to 20 linear feet and temporary impacts
will be only 20 linear feet. UT2 to Little Sugar Creek will not be impacted.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The sewer line must be installed using open cut due to bedrock. All temporarily disturbed areas outside the permanent sewer ROW will be restored
using native seed mix and native hardwood trees planted at a density of 260 per ac.
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?

r Yes r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Very small impact required by the City. Low NCSAM score on intermittent stream channel.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
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?
r Yes r No
If no, explain why:
No riparian buffers on tributaries in Catawba HUC.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r 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:
Stormwater Plan under review by the City of Charlotte.
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
r Yes r No
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 2B .0200)?*
r Yes r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
r Yes r No
3b. If you answered "no," provide a short narrative description.
Area is already heavily developed.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r No r N/A
4b. Describe, in detail, the treatment methods and dispositions (non -discharge or discharge) of wastewater generated from the proposed project. If the wastewater will be treated
at a treatment plant, list the capacity available at that plant.
Project to connect to City sewer lines.
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?*
r Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No
5d. Is another Federal agency involved?*
r Yes r No r Unknown
5e. Is this a DOT project located within Division's 1-8?
r Yes r No
5f. Will you cut anytrees in order to conduct the work in waters of the U.S.?
r Yes r No
5g. Does this project involve bridge maintenance or removal?

r Yes r No
5h. Does this project involve the construction/installation of a wind turbine(s)?'
r Yes r No
5i. 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.?
r Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
USFWS Endangered Species, Threatened Species, Federal Species of Concern, and Candidate Species for Mecklenburg County, NC
Consultation Documentation Upload
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
NOAA Essential Fish Habitat Mapper
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?*
r Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
State Historic Preservation Office: http://gis.ncdcr.gov/hpoweb/
7c. Historic or Prehistoric Information Upload
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA -designated 100 -year floodplain?*
r Yes r No
8c. What source(s) did you use to make the floodplain determination?*
FEMA Mapping and/or Polaris Maps
Miscellaneous
Comments
No mitigation has been propsed due to the size and low quality of the stream to be impacted
Miscellaneous attachments not previously requested.
Parkstone Place PCN4-21-19-FINAL.pdf
ORM Form Parkstone Place NWP Application.pdf
Signature
V By checking the box and signing below, I certify that:
473.99KB
34.7KB
• 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, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act');
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act');
• 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:
Richard K. Mogensen
Signature
�vf�r tsi�%�''�arvzvr
Date
4/22/2019

PAW
MOGENSEN MITIGATION, INC
AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. PLAN NO. PARCEL ID:
STREET ADDRESS:
PROPERTY OWNER: _ i f 3 ?31(,
The undersigned, registered property owners of the above noted property, do hereby authorize
of—
(Contractor / Agent) J (Name'of consulting firm)'
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
By signing below, I authorize representatives of the Wilmington District, U.S. Army Corps of
Engineers (Corps) to enter upon the property herein described for the purpose of conducting on-
site investigations, if necessary, and issuing a jurisdictional determination pursuant to Section
404 of the Clean Waters Act and/or Section 10 of the Rivers and Harbors Act of 1899. I, the
undersigned, am the duly authorized owner of record of the property identified herein.
PROPERTY OWNERS ADDRESS (if different than property above):�%1 r i��n►�' �I✓�-�� �-- �'
PROPERTY OWNER CONTACT:
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Auth Signature
Date;
Authorized Signature
Date:

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16507-A NORTHCROSS DRIVE
HUNTERSVILLE, N.C. 28078
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FAX: [phone]
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ISSUED FOR
CONSTRUCTION
APRIL 17, 2019
DATE
PARKSTONE
SOUTH LLC
568 JETTON STREET
SUITE 200
DAVIDSON, NC 28036
PHONE: [phone]
[e-mail]
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REVISIONS
REV. NO: 1 REV. DATE: 4/17/2019
REVISED PER CITY COMMENTS
PROJECT NO.: 2018.34
SCALE: 1"=40'
DRAWN BY: CLR, PAB
CHECKED BY: MSL
SHEET NO:

PERMANENT SEEDING SPECIFICATIONS -8
LOW MAINTENANCE AREAS
DATES
STEEP SLOPES OR STONY,
SHALLOW OR DRY SOILS
DATES
TYPE
AUG. 25 - SEPT. 15
TALL FESCUE
FEB. 15 - MAR. 21
SERICEA LESPEDEZA
ACRE OF 10-10-10
KOBE LESPEDEZA
GENTLE SLOPES, AVERAGE SOILS
DATES
TYPE
AUG. 25 - SEPT. 15
TALL FESCUE
FEB. 15 - MAR. 21
SERICEA LESPEDEZA
DATES
KOBE LESPEDEZA
HIGH MAINTENANCE AREAS
AUG. 25 - SEPT. 15
SEEDING SCHEDULE & NOTES
RATE
100 LB/ACRE
30 LB/ACRE
10 LB/ACRE
RATE
80 LB/ACRE
20 LB/ACRE
10 LB/ACRE
GENTLE SLOPES,
SOILS WITH AVERAGE OR BETTER MOISTURE, COOL SITES
DATES
TYPE
RATE
AUG. 25 - SEPT. 15
BLEND OF TWO TURF -TYPE
200 - 250 LB/ACRE
OR LOBE
TALL FESCUES (90%) AND
50'
ACRE OF 10-10-10
TWO OR MORE KENTUCKY
FERTILIZER
DATES TYPE
BLUEGRASS VARIETIES (10%)
MAY 1 - AUG. 15 GERMAN MILLET
GENTLE SLOPES,
DRIER SOILS, PHYSICAL LIMITATIONS
AGRICULTURAL LIME-
DATES
TYPE
RATE
AUG. 25 - SEPT. 15
BLEND OF 50% KY -31 TALL
200 - 250 LB/ACRE
DATES TYPE
FESCUE AND 50% MIXTURE
AUG. 15 -DEC. 30 RYE (GRAIN)
120 LB/ACRE 2000 LB/ACRE GROUND
OF TWO OR MORE TURF TYPE
AGRICULTURAL LIME-
c,�
TALL FESCUES
GRASS -LINED CHANNELS, AVERAGE SOILS
ITIE-IN: 637.5 /NV 637.97
DATES
TYPE
RATE
AUG. 25 - OCT.
TALL FESCUE
200 LB/ACRE OR
GRADED SLOPES AND FILLS - THE ANGLE FOR GRADED SLOPES AND FILLS
SHALL BE NO GREATER THAN THE ANGLE WHICH CAN BE RETAINED BY
4 - 5 LB/1000 SF
GRASS -LINED CHANNELS, DRY SOILS
DATES TYPE RATE
APRIL 15 - JUNE 30 COMMON BERMUDA GRASS 40 - 80 LB/ACRE OR
1 - 2 LB/1000 SF
AMENDMENTS SHALL BE APPLIED AT THE RATE OF 4000 LB/ACRE OF GROUND
AGRICULTURAL LIMESTONE AND 1000 LB/ACRE OF 10-10-10 FERTILIZER.
DRY SOIL, GRASS -LINED CHANNELS SHALL USE 3000 LB/ACRE OF GROUND
AGRICULTURAL LIMESTONE AND 500 LB/ACRE OF 10-10-10 FERTILIZER.
MULCH SHALL BE APPLIED AT THE RATE OF 4000 LB/ACRE OF STRAW.
STRAW SHALL BE ANCHORED BY TACKING WITH ASPHALT. NETTING OR MULCH
ANCHORING TOOL. JUTE OR EXCELSIOR MATTING SHALL BE USED IN GRASS
LINED CHANNELS TO CALCULATED HIGH WATER DEPTH.
TEMPORARY SEEDING SPECIFICATIONS - TS
SLOPE
DATES TYPE
RATE AMENDMENTS
JAN. 1 - MAY 1 RYE (GRAIN)
120 LB/ACRE 2000 LB/ACRE GROUND
FEB. 15 - MAR. 21ANNUAL LESPEDEZA
50 LB/ACRE AGRICULTURAL LIME -
OR LOBE
STONE AND 750 LB/
50'
ACRE OF 10-10-10
80'
FERTILIZER
DATES TYPE
RATE AMENDMENTS
MAY 1 - AUG. 15 GERMAN MILLET
40 LB/ACRE 2000 LB/ACRE GROUND
300'
AGRICULTURAL LIME-
O
STONE AND 750 LB/
RIM: 641.16
ACRE OF 10-10-10
I
FERTILIZER
DATES TYPE
RATE AMENDMENTS
AUG. 15 -DEC. 30 RYE (GRAIN)
120 LB/ACRE 2000 LB/ACRE GROUND
640
AGRICULTURAL LIME-
c,�
STONE AND 1000 LB/
ACRE OF 10-10-10
ITIE-IN: 637.5 /NV 637.97
FERTILIZER
MULCH SHALL BE APPLIED AT THE RATE OF 4000 LB/ACRE STRAW.
STRAW SHALL BE ANCHORED BY TACKING WITH
ASPHALT. NETTING OR MULCH
ANCHORING TOOL.
OHP oL OHP
GRADED SLOPES AND FILLS - THE ANGLE FOR GRADED SLOPES AND FILLS
SHALL BE NO GREATER THAN THE ANGLE WHICH CAN BE RETAINED BY
VEGETATIVE COVER OR OTHER ADEQUATE EROSION
CONTROL DEVICES OR
STRUCTURES.
O
I " = 40'(HORZ.)
SEEDBED PREPARATION NOTES
SPACING GUIDE FOR SLOPE BREAKS
SLOPE
SPACING (FT.)
STEEP SLOPES 2.1
20'
3.1
35'
4.1
45'
LONG SLOPES 15-25%
50'
10-15%
80'
6-10%
125'
3-6%
200'
<3%
300'
1. SURFACE WATER CONTROL MEASURES TO BE INSTALLED ACCORDING TO
PLAN. COMPLETE GRADING BEFORE PREPARING SEEDBED.
2. AREAS TO BE SEEDED SHALL BE RIPPED AND SPREAD WITH AVAILABLE
TOPSOIL 3" DEEP ON SLOPES 2:1 OR FLATTER. TOTAL SEEDBED
PREPARED DEPTH SHALL BE 4" TO 6" DEEP. IF SOILS ARE
COMPACTED DURING GRADING LOOSEN TO A DEPTH OF 6" TO 8".
3. LOOSE ROCKS, ROOTS AND OTHER OBSTRUCTIONS SHALL BE REMOVED
FROM THE SURFACE TO PREVENT INTERFERENCE WITH ESTABLISHMENT
AND MAINTENANCE OF VEGETATION.
4. APPLY LIME ACCORDING TO SOIL TEST RECOMMENDATIONS. SOILS
WITH pH HIGHER THAN 6 NEED NOT BE LIMED. IF pH IS NOT
KNOWN, APPLY LIME ACCORDING TO SEEDING SPECIFICATIONS BELOW.
APPLY LIMESTONE AND INCORPORATE INTO TOP 4" TO 6" OF SOIL.
5. APPLY FERTILIZER ACCORDING TO SOIL TEST RECOMMENDATIONS. IF
NO SOIL TEST HAS BEEN PERFORMED, APPLY FERTILIZER ACCORDING
TO SEEDING SPECIFICATIONS BELOW.
6. ROUGHEN SEEDBED SURFACE PRIOR TO APPLICATION. GROOVE OR
PER NCDEQ NCESCM CHAPTER 6.02, TABLE 6.02a FURROW SLOPES STEEPER THAN 3:1.
7. SEE TABLE BELOW FOR STABILIZATION TIMEFRAMES FOR VARIOUS
DISTURBED CONDITIONS.
TEMPORARY SEEDING MAINTENANCE: RESEED AND MULCH ALL AREAS
WHERE SEEDLING EMERGENCE IS POOR, OR WHERE EROSION OCCURS.
DO NOT MOW. PROTECT FROM TRAFFIC AS MUCH AS POSSIBLE.
PERMANENT SEEDING MAINTENANCE: GRASS MUST BE MOWN TO
REDUCE COMPETITIVENESS WITH PERMANENT OR LONG TERM
VEGETATION. RE -SEEDING SHALL BE PROVIDED AS NEEDED TO
ENSURE ADEQUATE GROUND -COVER.
STABILIZATION TIMEFRAMES
SITE AREA DESCRIPTION
STABILIZATION
TIMEFRAME EXCEPTIONS
PERIMETER DIKES, SWALES, DITCHES AND SLOPES
7 DAYS
NONE
Oc HIGH QUALITY WATER (HOW) ZONES
7 DAYS
NONE
SLOPES STEEPER THAN J. 1
7 DAYS
IF SLOPES ARE 10' OR LESS IN LENGTH AND ARE NOT
STEEPER THAN 2. 1, 14 DAYS ARE ALLOWED.
SLOPES J. 1 OR FLATTER
14 DAYS
7 DAYS FOR SLOPES GREATER THAN 50' IN LENGTH
ALL OTHER AREAS WITH SLOPES FLATTER THAN 4.
14 DAYS
NONE, EXCEPT FOR PERIMETERS AND HOW ZONES
•e/
G.I
-1+00
0+00
1+00
2+00
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PHONE: [phone]
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568 JETTON STREET
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1 PHONE: [phone]
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REV. NO: 1 REV. DATE: 4/17/2019
REVISED PER CITY COMMENTS
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REV. NO: 1 REV. DATE: 4/17/2019
REVISED PER CITY COMMENTS
PROJECT NO.: 2018.34
SCALE: 1" = 40'(H) & 1" = 4'(V)
DRAWN BY: CLR, PAB
CHECKED BY: MSL
GRAPHIC SCALE SHEET NO:
40 0 20 40 80 160
( IN FEET) ■
1 inch = 40 ft.

16018
-W
Project Boundary
Streams
Top of Bank
Culverts
iM "a I a I
AAl%
0
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co
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0
April 2019
FIGURE 6

PARKSTONE PLACE SUBDIVISION
PHOTO LOG
4-3&4-19
Ut #1 Culvert to be Extended
Upland Data Point in Flood Plain

WETLAND DETERMINATION DATA SHEET — Atlantic and Gulf Coastal Plain Region
Project/Site: Parkstone Place Subdivision City/County: Mecklenburg Sampling Date: 4-4-19
Applicant/Owner: Parkstone South, LLC State: NC Sampling Point: UP #1
Investigator(s): R K Mogensen Section, Township, Range:
Landform (hillside, terrace, etc.): Flood Plain Local relief (concave, convex, none): Flat Slope (%): 1 %
Subregion (LRR or MLRA): LRR P, MLRA 135B Lat: 35.149 Long: 80.846 Datum: NAD -83
Soil Map Unit Name: Helena Sandy Loam (HeB) NWI classification: Upland
Are climatic / hydrologic conditions on the site typical for this time of year? Yes X No (If no, explain in Remarks.)
Are Vegetation Soil or Hydrology significantly disturbed? Are "Normal Circumstances" present? Yes No x
Are Vegetation Soil or Hydrology naturally problematic? (If needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present? Yes No X Is the Sampled Area
Hydric Soil Present? Yes No X within a Wetland? Yes No X
Wetland Hydrology Present? Yes No X
Remarks:
No signs of surface or subsurface hydrology on this floodplain to UT #2. UT #2 is incised and rarely floods this area. No signs of wrack on floodplain
Very wet year.
HYDROLOGY
Wetland Hydrology Indicators:
Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required: check all that apply)
_Surface Soil Cracks (136)
_Surface Water (Al) _Aquatic
Fauna (1313)
_Sparsely Vegetated Concave Surface (138)
_ High Water Table (A2) _
Marl Deposits (1315) (LRR U)
_ Drainage Patterns (B10)
_Saturation (A3) —Hydrogen
Sulfide Odor (Cl)
—Moss Trim Lines (1316)
—Water Marks (131) —Oxidized
Rhizospheres on Living Roots (C3)
_ Dry -Season Water Table (C2)
_Sediment Deposits (132) —Presence
of Reduced Iron (C4)
—Crayfish Burrows (C8)
—Drift Deposits (133) —Recent
Iron Reduction in Tilled Soils (C6)
_Saturation Visible on Aerial Imagery (C9)
_Algal Mat or Crust (134) _Thin
Muck Surface (C7)
_Geomorphic Position (D2)
—Iron Deposits (135) _Other
(Explain in Remarks)
_Shallow Aquitard (D3)
—Inundation Visible on Aerial Imagery (137)
_ FAC -Neutral Test (D5)
Water -Stained Leaves (139)
Sphagnum Moss (D8) (LRR T,U)
Field Observations:
Surface Water Present? Yes No
x Depth (inches):
Water Table Present? Yes No
x Depth (inches):
Saturation Present? Yes x No
Depth (inches): 24
Wetland Hydrology Present? Yes No X
(includes capillary fringe)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:
Groundwater encountered at 24 inches. This was after much rain in the area in March.
US Army Corps of Engineers Atlantic and Gulf Coastal Plain Region – Version 2.0

VEGETATION (Five Strata) - Use scientific names of plants.
Sampling Point: UP #1
Remarks: (If observed, list morphological adaptations below.)
US Army Corps of Engineers Atlantic and Gulf Coastal Plain Region - Version 2.0
Absolute
Dominant
Indicator
Tree Stratum (Plot size: 30' )
% Cover
Species?
Status
Dominance Test worksheet:
1.
Carpinus caroliniana
30
Yes
FAC
Number of Dominant Species
2.
Fagus grandifolia
25
Yes
FACU
That Are OBL, FACW, or FAC: 5 (A)
3.
Quercus falcata
25
Yes
FACU
Total Number of Dominant
4.
Fraxinus pennsylvanica
10
No
FACW
Species Across All Strata: 11 (B)
5.
Platanus occidentalis
5
No
FACW
Percent of Dominant Species
6.
Acer rubrum
5
No
FAC
That Are OBL, FACW, or FAC: 45.5% (A/B)
100
=Total Cover
Prevalence Index worksheet:
50% of total cover:
50
20% of total cover:
20
Total % Cover of: Multiply by:
Sapling Stratum (Plot size: 15' )
OBL species 5 x 1 = 5
1.
Ligustrum japonicum
50
Yes
FAC
FACW species 25 x 2 = 50
2.
Ilex opaca
20
Yes
FAC
FAC species 230 x 3 = 690
3.
Ligustrum sinense
20
Yes
FAC
FACU species 210 x4= 840
4.
Fraxinus pennsylvanica
10
No
FACW
UPL species 0 x 5 = 0
5.
Column Totals: 470 (A) 1585 (B)
6.
Prevalence Index = B/A = 3.37
100
=Total Cover
Hydrophytic Vegetation Indicators:
50% of total cover:
50
20% of total cover:
20
_ 1 - Rapid Test for Hydrophytic Vegetation
Shrub Stratum (Plot size: 15' )
2 - Dominance Test is >50%
1.
Ligustrum sinense
100
Yes
FAC
_
3 - Prevalence Index is <_3.01
2.
_
_ Problematic Hydrophytic Vegetation' (Explain)
3.
4.
5.
'Indicators of hydric soil and wetland hydrology must be
6.
present, unless disturbed or problematic.
Definitions of Five Vegetation Strata:
100 =Total Cover
50% of total cover:
50
20% of total cover:
20
Tree - Woody plants, excluding woody vines,
Herb Stratum (Plot size: 5' )
approximately 20 ft (6 m) or more in height and 3 in.
1.
Hedera helix
40
Yes
FACU
(7.6 cm) or larger in diameter at breast height (DBH).
2.
Festuca sop.
30
Yes
Sapling - Woody plants, excluding woody vines,
3.
Allium vineale
10
No
FACU
approximately 20 ft (6 m) or more in height and less
4.
Galium aparine
10
No
FACU
than 3 in. (7.6 cm) DBH.
5.
Ranunculus fascicularis
5
No
FAC
Shrub - Woody Plants, excluding woody vines,
6.
Juncus effusus
5
No
OBL
approximately 3 to 20 It (1 to 6 m) in height.
7'
Herb -All herbaceous (non -woody) plants, including
8.
herbaceous vines, regardless of size, and woody
9
plants, except woody vines, less than approximately 3
It (1 m) in height.
10.
11.
Woody Vine - All woody vines, regardless of height.
100
=Total Cover
50% of total cover: 50 20% of total cover: 20
Woody Vine Stratum (Plot size: 30'
)
1.
Vitis aestivalis
50
Yes
FACU
2.
Lonicera japonica
50
Yes
FACU
3.
4.
5.
Hydrophytic
100
=Total Cover
Vegetation
50% of total cover:
50
20% of total cover:
20
Present? Yes No X
Remarks: (If observed, list morphological adaptations below.)
US Army Corps of Engineers Atlantic and Gulf Coastal Plain Region - Version 2.0

SOIL Sampling Point: UP #1
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix
Redox Features
(inches) Color (moist) %
Color (moist) % Type' Loc2
Texture Remarks
1-2 7.5YR 3/1 100
Loamy/Clayey A Horizon
2-6 7.5YR 3/3 100
Loamy/Clayey B Horizon No Mottles
6-12 7.5YR 5/4 95
5
Loamy/Clayey Faint Mottles
12-24 7.5YR 4/6 100
Loamy/Clayey Some moisture
'Type: C=Concentration, D=Depletion, RM=Reduced Matrix, MS=Masked Sand Grains.
2Location: PL=Pore Lining, M=Matrix.
Hydric Soil Indicators: (Applicable to all LRRs, unless otherwise noted.)
Indicators for Problematic Hydric Soils3:
_ Histosol (Al)
—Thin Dark Surface (S9) (LRR S, T, U)
_ 1 cm Muck (A9) (LRR O)
_ Histic Epipedon (A2)
—Barrier Islands 1 cm Muck (S12)
_2 cm Muck (A10) (LRR S)
—Black Histic (A3)
(MLRA 1538, 153D)
—Coast Prairie Redox (A16)
—Hydrogen Sulfide (A4)
_ Loamy Mucky Mineral (F1) (LRR O)
(outside MLRA 150A)
_Stratified Layers (A5)
_Loamy Gleyed Matrix (F2)
_Reduced Vertic (F18)
—Organic Bodies (A6) (LRR, P, T, U)
—Depleted Matrix (F3)
(outside MLRA 150A, 1508)
5 cm Mucky Mineral (A7) (LRR P, T, U)
_ Redox Dark Surface (F6)
—Piedmont Floodplain Soils (F19) (LRR P, T)
—Muck Presence (A8) (LRR U)
—Depleted Dark Surface (F7)
_Anomalous Bright Floodplain Soils (F20)
_ 1 cm Muck (A9) (LRR P, T)
_ Redox Depressions (F8)
(MLRA 1538)
_ Depleted Below Dark Surface (A11)
_ Marl (F10) (LRR U)
—Red Parent Material (F21)
_Thick Dark Surface (Al2)
_ Depleted Ochric (F11) (MLRA 151)
_Very Shallow Dark Surface (F22)
_ Coast Prairie Redox (A16) (MLRA 150A)
_ Iron -Manganese Masses (F12) (LRR O, P, T) (outside MLRA 138,152A in FL, 154)
Sandy Mucky Mineral (S1) (LRR O, S)
_ Umbric Surface (F13) (LRR P, T, U)
—Barrier Islands Low Chroma Matrix (TS7)
_Sandy Gleyed Matrix (S4)
_ Delta Ochric (F17) (MLRA 151)
(MLRA 1538, 153D)
_Sandy Redox (S5)
Reduced Vertic (F18) (MLRA 150A, 1506) _Other (Explain in Remarks)
_Stripped Matrix (S6)
—Piedmont Floodplain Soils (F19) (MLRA 149A)
_ Dark Surface (S7) (LRR P, S, T, U)
_Anomalous Bright Floodplain Soils (F20)
_ Polyvalue Below Surface (S8)
(MLRA 149A, 153C, 153D)
3Indicators of hydrophytic vegetation and
(LRR S, T, U)
_Very Shallow Dark Surface (F22)
wetland hydrology must be present,
(MLRA 138,152A in FL, 154)
unless disturbed or problematic.
Restrictive Layer (if observed):
Type:
Depth (inches): Hydric Soil Present? Yes No X
Remarks:
This data sheet is revised from Atlantic and Gulf Coastal Plain Regional Supplement Version 2.0 to include the NRCS Field Indicators of Hydric Soils,
Version 8.0, 2016.
No signs of hydric soils although the soil does get moist at about 24".
US Army Corps of Engineers Atlantic and Gulf Coastal Plain Region – Version 2.0

Stream Reach Evaluation Form
Date:
4-4-19 1 Evaluator: I R K Mo ensen
Easting:
35.14695
Project:
Parkstone Place Subdivision Data Point #1 on UT#1
Northing:
50.727222
Total Points:
0
Stream is at least intermittent if > 19 or perennial if > 30*
17.0
(right -click the purple number and left -click Update Field to summarize points)
2
A.
Geomorphology
Absent
Weak
Moderate
Strong
SCORE
1a.
Continuity of channel bed and bank
0
1
2
3
2
2.
Sinuosity of channel along thalweg
0
1
2
3
2
3.
In -channel structure: riffle- / step- pool sequence
0
1
2
3
1
4.
Particle size of stream substrate
0
1
2
3
1
5.
Active/relic floodplain
0
1
2
3
2
6.
Depositional bars or benches
0
1
2
3
0
7.
Recent alluvial deposits
0
1
2
3
0
8.
Headcuts
0
1
2
3
1
9.
Grade controls
0
0.5
1
1.5
0.5
10.
Natural valley
0
0.5
1
1.5
1.5
11.
Second or greater order channel
No = 0
Yes = 3
0
Geomorphology
Subtotal
11.0
a Man-made ditches are not rated: see discussion in NCDWQ Manual
B. Hydrology
12.
Presence of Baseflow
0
1
2
3
2
13.
Iron Oxidizing Bacteria
0
1
2
3
2
14.
Leaf litter
1.5
1
0.5
0
0
15.
Sediment on plants or debris
0
0.5
1
1.5
0
16.
Organic debris lines or piles (Wrack lines)
0
0.5
1
1.5
1
17.
Soil -based Evidence of high water table?
0
No = 0
Yes = 3
0
0
24.
Amphibians
0
Hydrology
Subtotal
5.0
C. Biology
18.
Fibrous roots in streambed
3
2
1
0
0
19.
Rooted upland plants in streambed
3
2
1
0
0
20.
Macrobenthos (note diversity and abundance)
0
1
2
3
0
21.
Aquatic Mollusks
0
1
2
3
0
22.
Fish
0
0.5
1
1.5
0
23.
Crayfish
0
0.5
1
1.5
0
24.
Amphibians
0
0.5
1
1.5
0.5
25.
Algae
0
0.5
1
1.5
0.5
26.
Wetland plants in streambed
FACW= 0.75, OBL= 1.5, Other= 0
0
Biology Subtotal
1.0
* perennial streams may also be identified using other methods. See page 35 of NCDWQ manual.
Notes:
I certify that this evaluation conforms to the latest version of
the NCDWQ document entitled Methodology for Identification
Richard Mogensen
of Intermittent and Perennial Streams and their Origins.
Signature of Certified Evaluator
(version 4.11)
Form 4PC039

Stream Reach Evaluation Form
Date:
4-4-19 1 Evaluator: I R K Mo ensen
Easting:
35.14695
Project:
Parkstone Place Subdivision DP #2 UT#1
Northing:
50.727222
Total Points:
0
Stream is at least intermittent if > 19 or perennial if > 30*
24.0
(right -click the purple number and left -click Update Field to summarize points)
3
A.
Geomorphology
Absent
Weak
Moderate
Strong
SCORE
1a.
Continuity of channel bed and bank
0
1
2
3
3
2.
Sinuosity of channel along thalweg
0
1
2
3
2
3.
In -channel structure: riffle- / step- pool sequence
0
1
2
3
2
4.
Particle size of stream substrate
0
1
2
3
1
5.
Active/relic floodplain
0
1
2
3
0
6.
Depositional bars or benches
0
1
2
3
0
7.
Recent alluvial deposits
0
1
2
3
0
8.
Headcuts
0
1
2
3
2
9.
Grade controls
0
0.5
1
1.5
1.5
10.
Natural valley
0
0.5
1
1.5
1.5
11.
Second or greater order channel
No = 0
Yes = 3
0
Geomorphology
Subtotal
13.0
a Man-made ditches are not rated: see discussion in NCDWQ Manual
B. Hydrology
12.
Presence of Baseflow
0
1
2
3
3
13.
Iron Oxidizing Bacteria
0
1
2
3
2
14.
Leaf litter
1.5
1
0.5
0
0
15.
Sediment on plants or debris
0
0.5
1
1.5
0
16.
Organic debris lines or piles (Wrack lines)
0
0.5
1
1.5
0.5
17.
Soil -based Evidence of high water table?
0
No = 0
Yes = 3
0
0
24.
Amphibians
0
Hydrology
Subtotal
5.5
C. Biology
18.
Fibrous roots in streambed
3
2
1
0
1
19.
Rooted upland plants in streambed
3
2
1
0
2
20.
Macrobenthos (note diversity and abundance)
0
1
2
3
0
21.
Aquatic Mollusks
0
1
2
3
1
22.
Fish
0
0.5
1
1.5
0
23.
Crayfish
0
0.5
1
1.5
0
24.
Amphibians
0
0.5
1
1.5
0.5
25.
Algae
0
0.5
1
1.5
1
26.
Wetland plants in streambed
FACW= 0.75, OBL= 1.5, Other= 0
0
Biology
Subtotal
5.5
* perennial streams may also be identified using other methods. See page 35 of NCDWQ manual.
Notes:
Lower reach of UT #1 which seems more stream -like
I certify that this evaluation conforms to the latest version of
the NCDWQ document entitled Methodology for Identification
Richard Mogensen
of Intermittent and Perennial Streams and their Origins.
Signature of Certified Evaluator
(version 4.11)
Form 4PC039

Stream Reach Evaluation Form
Date:
4-4-19 1 Evaluator: I R K Mo ensen
Eastin :
35.14698
Project:
Parkstone Place Subdivision DP #3 UT #2
Northing:
50.727225
Total Points:
0
Stream is at least intermittent if > 19 or perennial if > 30*
42.5
(right -click the purple number and left -click Update Field to summarize points)
3
A.
Geomorphology
Absent
Weak
Moderate
Strong
SCORE
1a.
Continuity of channel bed and bank
0
1
2
3
3
2.
Sinuosity of channel along thalweg
0
1
2
3
3
3.
In -channel structure: riffle- / step- pool sequence
0
1
2
3
3
4.
Particle size of stream substrate
0
1
2
3
2
5.
Active/relic floodplain
0
1
2
3
1
6.
Depositional bars or benches
0
1
2
3
2
7.
Recent alluvial deposits
0
1
2
3
3
8.
Headcuts
0
1
2
3
0
9.
Grade controls
0
0.5
1
1.5
1.5
10.
Natural valley
0
0.5
1
1.5
1
11.
Second or greater order channel
No = 0
Yes = 3
3
Geomorphology
Subtotal
22.5
a Man-made ditches are not rated: see discussion in NCDWQ Manual
B. Hydrology
12.
Presence of Baseflow
0
1
2
3
3
13.
Iron Oxidizing Bacteria
0
1
2
3
3
14.
Leaf litter
1.5
1
0.5
0
1
15.
Sediment on plants or debris
0
0.5
1
1.5
1
16.
Organic debris lines or piles (Wrack lines)
0
0.5
1
1.5
1.5
17.
Soil -based Evidence of high water table?
0
No = 0
Yes = 3
0
0.5
24.
Amphibians
0
Hydrology
Subtotal
9.5
C. Biology
18.
Fibrous roots in streambed
3
2
1
0
3
19.
Rooted upland plants in streambed
3
2
1
0
3
20.
Macrobenthos (note diversity and abundance)
0
1
2
3
1
21.
Aquatic Mollusks
0
1
2
3
1
22.
Fish
0
0.5
1
1.5
0.5
23.
Crayfish
0
0.5
1
1.5
0.5
24.
Amphibians
0
0.5
1
1.5
0.5
25.
Algae
0
0.5
1
1.5
1
26.
Wetland plants in streambed
FACW= 0.75, OBL= 1.5, Other= 0
0
Biology
Subtotal
10.5
perennial streams may also be identified using other methods. See page 35 of NCDWQ manual.
Notes:
I certify that this evaluation conforms to the latest version of
the NCDWQ document entitled Methodology for Identification
Richard Mogensen
of Intermittent and Perennial Streams and their Origins.
Signature of Certified Evaluator
(version 4.11)
Form 4PC039

NC SAM FIELD ASSESSMENT RESULTS
user manual version z. -i
USACE AID #: NCDWR #:
INSTRUCTIONS: Attach a sketch of the assessment area and photographs. Attach a copy of the USGS 7.5 -minute topographic quadrangle,
and circle the location of the stream reach under evaluation. If multiple stream reaches will be evaluated on the same property, identify and
number all reaches on the attached map, and include a separate form for each reach. See the NC SAM User Manual for detailed descriptions
and explanations of requested information. Record in the "Notes/Sketch" section if supplementary measurements were performed. See the
NC SAM User Manual for examples of additional measurements that may be relevant.
NOTE EVIDENCE OF STRESSORS AFFECTING THE ASSESSMENT AREA (do not need to be within the assessment area).
PROJECT/SITE INFORMATION:
1. Project name (if any): Parkstone Place Subdivision 2. Date of evaluation: 04 April 2019
3. Applicant/owner name: Parkstone South, LLC 4. Assessor name/organization: Rich Mogensen, MMI
5. County: Mecklenburg 6. Nearest named water body
7. River basin: Catawba on USGS 7.5 -minute quad: Little Sugar Creek
8. Site coordinates (decimal degrees, at lower end of assessment reach): 35.1490, -80.8459
STREAM INFORMATION: (depth and width can be approximations)
9. Site number (show on attached map): stream 1 10. Length of assessment reach evaluated (feet): 184 ft
11. Channel depth from bed (in riffle, if present) to top of bank (feet): 1 ft ❑Unable to assess channel depth.
12. Channel width at top of bank (feet): 3 ft 13. Is assessment reach a swamp steam? ❑Yes ❑No
14. Feature type: ❑Perennial flow ®Intermittent flow ❑Tidal Marsh Stream
STREAM CATEGORY INFORMATION:
15. NC SAM Zone: ❑ Mountains (M) ® Piedmont (P) ❑ Inner Coastal Plain (1) ❑ Outer Coastal Plain (0)
16. Estimated geomorphic ❑A \1 J
valley shape (skip for ®B
Tidal Marsh Stream): (more sinuous stream, flatter valley slope) (less sinuous stream, steeper valley slope)
17. Watershed size: (skip []Size 1 (< 0.1 mil) ®Size 2 (0.1 to < 0.5 miz) ❑Size 3 (0.5 to < 5 mit) ❑Size 4 (>_ 5 mit)
for Tidal Marsh Stream)
ADDITIONAL INFORMATION:
18. Were regulatory considerations evaluated? ®Yes ❑No If Yes, check all that apply to the assessment area.
❑Section 10 water ❑Classified Trout Waters ❑Water Supply Watershed (❑I ❑II ❑III ❑IV ❑V)
❑Essential Fish Habitat ❑Primary Nursery Area ❑ High Quality Waters/Outstanding Resource Waters
❑Publicly owned property ❑NCDWR Riparian buffer rule in effect ®Nutrient Sensitive Waters
❑Anadromous fish ❑303(d) List ❑CAMA Area of Environmental Concern (AEC)
❑Documented presence of a federal and/or state listed protected species within the assessment area.
List species:
❑Designated Critical Habitat (list species)
19. Are additional stream information/supplementary measurements included in "Notes/Sketch" section or attached? []Yes ®No
1. Channel Water - assessment reach metric (skip for Size 1 streams and Tidal Marsh Streams)
®A Water throughout assessment reach.
❑B No flow, water in pools only.
❑C No water in assessment reach.
2. Evidence of Flow Restriction - assessment reach metric
®A At least 10% of assessment reach in -stream habitat or riffle -pool sequence is severely affected by a flow restriction or fill to the
point of obstructing flow or a channel choked with aquatic macrophytes or ponded water or impoundment on flood or ebb within
the assessment reach (examples: undersized or perched culverts, causeways that constrict the channel, tidal gates, debris jams,
beaver dams).
❑B Not A
3. Feature Pattern - assessment reach metric
®A A majority of the assessment reach has altered pattern (examples: straightening, modification above or below culvert).
❑B Not A
4. Feature Longitudinal Profile - assessment reach metric
❑A Majority of assessment reach has a substantially altered stream profile (examples: channel down -cutting, existing damming, over
widening, active aggradation, dredging, and excavation where appropriate channel profile has not reformed from any of these
disturbances).
®B Not A
5. Signs of Active Instability - assessment reach metric
Consider only current instability, not past events from which the stream has currently recovered. Examples of instability include
active bank failure, active channel down -cutting (head -cut), active widening, and artificial hardening (such as concrete, gabion, rip -rap).
®A < 10% of channel unstable
❑B 10 to 25% of channel unstable
❑C > 25% of channel unstable

6. Streamside Area Interaction — streamside area metric
Consider for the Left Bank (LB) and the Right Bank (RB).
LB RB
®A ®A
Little or no evidence of conditions that adversely affect reference interaction
❑B ❑B
Moderate evidence of conditions (examples: berms, levees, down -cutting, aggradation, dredging) that adversely affect
reference interaction (examples: limited streamside area access, disruption of flood flows through streamside area, leaky
or intermittent bulkheads, causeways with floodplain constriction, minor ditching [including mosquito ditching])
❑C ❑C
Extensive evidence of conditions that adversely affect reference interaction (little to no floodplain/intertidal zone access
[examples: causeways with floodplain and channel constriction, bulkheads, retaining walls, fill, stream incision, disruption
of flood flows through streamside area] or too much floodplain/intertidal zone access [examples: impoundments, intensive
mosquito ditching]) or floodplain/intertidal zone unnaturally absent or assessment reach is a man-made feature on an
interstream divide
Water Quality Stressors — assessment reach/intertidal zone metric
Check all that apply.
❑A Discolored water in stream or intertidal zone (milky white, blue, unnatural water discoloration, oil sheen, stream foam)
®B Excessive sedimentation (burying of stream features or intertidal zone)
❑C Noticeable evidence of pollutant discharges entering the assessment reach and causing a water quality problem
❑D Odor (not including natural sulfide odors)
❑E Current published or collected data indicating degraded water quality in the assessment reach. Cite source in "Notes/Sketch"
section.
❑F Livestock with access to stream or intertidal zone
❑G Excessive algae in stream or intertidal zone
❑H Degraded marsh vegetation in the intertidal zone (removal, burning, regular mowing, destruction, etc)
®I Other: (explain in "Notes/Sketch" section)
❑J Little to no stressors
8. Recent Weather — watershed metric (skip for Tidal Marsh Streams)
For Size 1 or 2 streams, D1 drought or higher is considered a drought; for Size 3 or 4 streams, D2 drought or higher is considered a drought.
❑A Drought conditions and no rainfall or rainfall not exceeding 1 inch within the last 48 hours
❑B Drought conditions and rainfall exceeding 1 inch within the last 48 hours
®C No drought conditions
9. Large or Dangerous Stream — assessment reach metric
❑Yes ®No Is stream is too large or dangerous to assess? If Yes, skip to Metric 13 (Streamside Area Ground Surface Condition).
10. Natural In -stream Habitat Types — assessment reach metric
10a. ®Yes ❑No Degraded in -stream habitat over majority of the assessment reach (examples of stressors include excessive
sedimentation, mining, excavation, in -stream hardening [for example, rip -rap], recent dredging, and snagging)
(evaluate for Size 4 Coastal Plain streams only, then skip to Metric 12)
10b. Check all that occur (occurs if > 5% coverage of assessment reach) (skip for Size 4 Coastal Plain streams)
❑A Multiple aquatic macrophytes and aquatic mosses W ❑F 5% oysters or other natural hard bottoms
(include liverworts, lichens, and algal mats) co ❑G Submerged aquatic vegetation
❑B Multiple sticks and/or leaf packs and/or emergent o Y ❑H Low -tide refugia (pools)
vegetation y ❑I Sand bottom
®C Multiple snags and logs (including lap trees) t Co ❑J 5% vertical bank along the marsh
❑D 5% undercut banks and/or root mats and/or roots ❑K Little or no habitat
in banks extend to the normal wetted perimeter
❑E Little or no habitat
*********************************REMAINING QUESTIONS ARE NOT APPLICABLE FOR TIDAL MARSH STREAMS************"***************
11. Bedform and Substrate —assessment reach metric (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
11a. ❑Yes ®No Is assessment reach in a natural sand -bed stream? (skip for Coastal Plain streams)
11 b. Bedform evaluated. Check the appropriate box(es).
®A Riffle -run section (evaluate 11 c)
®B Pool -glide section (evaluate 11 d)
®C Natural bedform absent (skip to Metric 12, Aquatic Life)
11 c. In riffle sections, check all that occur below the normal wetted perimeter of the assessment reach —whether or not submerged. Check
at least one box in each row (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams). Not Present (NP) = absent, Rare
(R) = present but < 10%, Common (C) _ > 10-40%, Abundant (A) _ > 40-70%, Predominant (P) _ > 70%. Cumulative percentages
should not exceed 100% for each assessment reach.
NP R C A P
❑ ® ❑ ❑ ❑ Bedrock/saprolite
® ❑ ❑ ❑ ❑ Boulder (256 — 4096 mm)
❑ ® ❑ ❑ ❑ Cobble (64 — 256 mm)
❑ ❑ ® ❑ ❑ Gravel (2 — 64 mm)
❑ ❑ ❑ ® ❑ Sand (.062 — 2 mm)
❑ ❑ ❑ ® ❑ Silt/clay (< 0.062 mm)
❑ ® ❑ ❑ ❑ Detritus
® ❑ ❑ ❑ ❑ Artificial (rip -rap, concrete, etc.)
11d. ®Yes ❑No Are pools filled with sediment? (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)

12. Aquatic Life — assessment reach metric (skip for Tidal Marsh Streams)
12a. ®Yes ❑No Was an in -stream aquatic life assessment performed as described in the User Manual?
If No, select one of the following reasons and skip to Metric 13. ❑No Water ❑Other:
12b. ®Yes ❑No Are aquatic organisms present in the assessment reach (look in riffles, pools, then snags)? If Yes, check all that
apply. If No, skip to Metric 13.
1 >1 Numbers over columns refer to "individuals" for Size 1 and 2 streams and "taxa" for Size 3 and 4 streams.
❑ ❑Adult frogs
❑ ❑Aquatic reptiles
❑ ❑Aquatic macrophytes and aquatic mosses (include liverworts, lichens, and algal mats)
❑ ❑Beetles
❑ ❑Caddisfly larvae (T)
❑ ❑Asian clam (Corbicula)
❑ ®Crustacean (isopod/amphipod/crayfish/shrimp)
❑ ❑Damselfly and dragonfly larvae
❑ ❑Dipterans
❑ ❑Mayfly larvae (E)
❑ ❑Megaloptera (alderfly, fishfly, dobsonfly larvae)
❑ ®Midges/mosquito larvae
❑ ❑Mosquito fish (Gambusia) or mud minnows (Umbra pygmaea)
❑ ❑Mussels/Clams (not Corbicula)
❑ ❑Other fish
❑ ❑Salamanders/tad poles
❑ ❑Snails
❑ ❑Stonefly larvae (P)
❑ ❑Tipulid larvae
❑ ®Worms/leeches
13. Streamside Area Ground Surface Condition — streamside area metric (skip for Tidal Marsh Streams and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB). Consider storage capacity with regard to both overbank flow and upland runoff.
LB RB
❑A ❑A Little or no alteration to water storage capacity over a majority of the streamside area
®B ®B Moderate alteration to water storage capacity over a majority of the streamside area
❑C ❑C Severe alteration to water storage capacity over a majority of the streamside area (examples: ditches, fill, soil compaction,
livestock disturbance, buildings, man-made levees, drainage pipes)
14. Streamside Area Water Storage — streamside area metric (skip for Size 1 streams, Tidal Marsh Streams, and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB) of the streamside area.
LB RB
❑A ❑A Majority of streamside area with depressions able to pond water >_ 6 inches deep
❑B ❑B Majority of streamside area with depressions able to pond water 3 to 6 inches deep
®C ®C Majority of streamside area with depressions able to pond water < 3 inches deep
15. Wetland Presence — streamside area metric (skip for Tidal Marsh Streams)
Consider for the Left Bank (LB) and the Right Bank (RB). Do not consider wetlands outside of the streamside area or within the normal
wetted perimeter of assessment reach.
LB RB
❑Y ❑Y Are wetlands present in the streamside area?
ON ON
16. Baseflow Contributors — assessment reach metric (skip for Size 4 streams and Tidal Marsh Streams)
Check all contributors within the assessment reach or within view of and draining to the assessment reach.
❑A Streams and/or springs (jurisdictional discharges)
❑B Ponds (include wet detention basins; do not include sediment basins or dry detention basins)
❑C Obstruction passing flow during low -flow periods within the assessment area (beaver dam, leaky dam, bottom -release dam, weir)
®D Evidence of bank seepage or sweating (iron in water indicates seepage)
®E Stream bed or bank soil reduced (dig through deposited sediment if present)
OF None of the above
17. Baseflow Detractors — assessment area metric (skip for Tidal Marsh Streams)
Check all that apply.
❑A Evidence of substantial water withdrawals from the assessment reach (includes areas excavated for pump installation)
❑B Obstruction not passing flow during low -flow periods affecting the assessment reach (ex: watertight dam, sediment deposit)
❑C Urban stream (>_ 24% impervious surface for watershed)
®D Evidence that the streamside area has been modified resulting in accelerated drainage into the assessment reach
❑E Assessment reach relocated to valley edge
❑F None of the above
18. Shading — assessment reach metric (skip for Tidal Marsh Streams)
Consider aspect. Consider "leaf -on" condition.
❑A Stream shading is appropriate for stream category (may include gaps associated with natural processes)
®B Degraded (example: scattered trees)
❑C Stream shading is gone or largely absent

19. Buffer Width — streamside area metric (skip for Tidal Marsh Streams)
Consider "vegetated buffer" and "wooded buffer" separately for left bank (LB) and right bank (RB) starting at the top of bank out
to the first break.
Vegetated Wooded
LB RB LB
RB
❑A ❑A ❑A
❑A >_ 100 feet wide or extends to the edge of the watershed
❑B ❑B ❑B
❑B From 50 to < 100 feet wide
❑C ❑C ❑C
❑C From 30 to < 50 feet wide
®D ®D ®D
®D From 10 to < 30 feet wide
❑E ❑E ❑E
❑E < 10 feet wide or no trees
20. Buffer Structure —
streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Vegetated" Buffer Width).
LB RB
®A ®A
Mature forest
❑B ❑B
Non -mature woody vegetation or modified vegetation structure
❑C ❑C
Herbaceous vegetation with or without a strip of trees < 10 feet wide
❑D ❑D
Maintained shrubs
❑E ❑E
Little or no vegetation
21. Buffer Stressors — streamside area metric (skip for Tidal Marsh Streams)
Check all appropriate boxes for left bank (LB) and right bank (RB). Indicate if listed stressor abuts stream (Abuts), does not abut but is
within 30 feet of stream (< 30 feet), or is between 30 to 50 feet of stream (30-50 feet).
If none of the following stressors occurs on either bank, check here and skip to Metric 22: ED
Abuts < 30 feet 30-50 feet
LB RB LB RB LB RB
❑A ❑A ❑A ❑A ❑A ❑A Row crops
❑B ❑B ❑B ❑B ❑B ❑B Maintained turf
❑C ❑C ❑C ❑C ❑C ❑C Pasture (no livestock)/commercial horticulture
❑D ❑D ❑D ❑D ❑D ❑D Pasture (active livestock use)
22. Stem Density — streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Wooded" Buffer Width).
LB RB
®A ®A Medium to high stem density
❑B ❑B Low stem density
❑C ❑C No wooded riparian buffer or predominantly herbaceous species or bare ground
23. Continuity of Vegetated Buffer — streamside area metric (skip for Tidal Marsh Streams)
Consider whether vegetated buffer is continuous along stream (parallel). Breaks are areas lacking vegetation > 10 feet wide.
LB RB
❑A ❑A The total length of buffer breaks is < 25 percent.
❑B ❑B The total length of buffer breaks is between 25 and 50 percent.
®C ®C The total length of buffer breaks is > 50 percent.
24. Vegetative Composition — streamside area metric (skip for Tidal Marsh Streams)
Evaluate the dominant vegetation within 100 feet of each bank or to the edge of the watershed (whichever comes first) as it contributes to
assessment reach habitat.
LB RB
❑A ❑A Vegetation is close to undisturbed in species present and their proportions. Lower strata composed of native species,
with non-native invasive species absent or sparse.
®B ®B Vegetation indicates disturbance in terms of species diversity or proportions, but is still largely composed of native
species. This may include communities of weedy native species that develop after clear -cutting or clearing or
communities with non-native invasive species present, but not dominant, over a large portion of the expected strata or
communities missing understory but retaining canopy trees.
❑C ❑C Vegetation is severely disturbed in terms of species diversity or proportions. Mature canopy is absent or communities
with non-native invasive species dominant over a large portion of expected strata or communities composed of planted
stands of non -characteristic species or communities inappropriately composed of a single species or no vegetation.
25. Conductivity — assessment reach metric (skip for all Coastal Plain streams)
25a. ❑Yes ®No Was conductivity measurement recorded?
If No, select one of the following reasons. ❑No Water ❑Other:
25b. Check the box corresponding to the conductivity measurement (units of microsiemens per centimeter).
❑A < 46 ❑B 46 to < 67 ❑C 67 to < 79 ®D 79 to < 230 ❑E >_ 230
Notes/Sketch:
2. Flow Restriction: culvert upstream concentrates flow, erdoing channel. 3,4,5. Pattern, LongPro, Instability: Straightening (upper section) and
downcutting (throughout). 13. Ground Surface: graded, compacted, mowed, tennis, parking > rapid runoff.

Draft NC SAM Stream Rating Sheet
Accompanies User Manual Version 2.1
Stream Site Name
Parkstone Place Subdivision
Date of Assessment
04 April 2019
Stream Category
Pb2
Assessor Name/Organization
Rich Mogensen, MMI
HIGH
(2) Baseflow
Notes of Field Assessment Form (Y/N) YES
Presence of regulatory considerations (Y/N) NO
Additional stream information/supplementary measurements included (Y/N) NO
NC SAM feature type (perennial, intermittent, Tidal Marsh Stream) Intermittent
USACE/
NCDWR
Function Class Rating Summary
All Streams
Intermittent
(1) Hydrology
HIGH
HIGH
(2) Baseflow
MEDIUM
MEDIUM
(2) Flood Flow
HIGH
HIGH
(3) Streamside Area Attenuation
HIGH
HIGH
(4) Floodplain Access
HIGH
HIGH
(4) Wooded Riparian Buffer
MEDIUM
MEDIUM
(4) Microtopography
NA
NA
(3) Stream Stability
MEDIUM
MEDIUM
(4) Channel Stability
HIGH
HIGH
(4) Sediment Transport
LOW
LOW
(4) Stream Geomorphology
MEDIUM
MEDIUM
(2) Stream/Intertidal Zone Interaction
NA
NA
(2) Longitudinal Tidal Flow
NA
NA
(2) Tidal Marsh Stream Stability
NA
NA
(3) Tidal Marsh Channel Stability
NA
NA
(3) Tidal Marsh Stream Geomorphology
NA
NA
(1) Water Quality
LOW
LOW
(2) Baseflow
MEDIUM
MEDIUM
(2) Streamside Area Vegetation
LOW
LOW
(3) Upland Pollutant Filtration
LOW
LOW
(3) Thermoregulation
MEDIUM
MEDIUM
(2) Indicators of Stressors
YES
YES
(2) Aquatic Life Tolerance
LOW
NA
(2) Intertidal Zone Filtration
NA
NA
(1) Habitat
LOW
LOW
(2) In -stream Habitat
LOW
LOW
(3) Baseflow
MEDIUM
MEDIUM
(3) Substrate
LOW
LOW
(3) Stream Stability
HIGH
HIGH
(3) In -stream Habitat
LOW
MEDIUM
(2) Stream -side Habitat
MEDIUM
MEDIUM
(3) Stream -side Habitat
MEDIUM
MEDIUM
(3) Thermoregulation
MEDIUM
MEDIUM
(2) Tidal Marsh In -stream Habitat
NA
NA
(3) Flow Restriction
NA
NA
(3) Tidal Marsh Stream Stability
NA
NA
(4) Tidal Marsh Channel Stability
NA
NA
(4) Tidal Marsh Stream Geomorphology
NA
NA
(3) Tidal Marsh In -stream Habitat
NA
NA
(2) Intertidal Zone
NA
NA
Overall
LOW
LOW

Preliminary ORM Data Entry Fields for New Actions
ACTION ID #: SAW -
Prepare file folder ❑
1. Project Name [PCN Form A2a]:
Begin Date (Date Received):
Assign Action ID Number in ORM ❑
2. Work Type: ❑✓ Private ❑ Institutional ❑ Government ❑ Commercial
3. Project Description / Purpose [PCN Form B3d and B3e]:
Eight home single-family subdivision.
4. Property Owner / Applicant [PCN Form A3 or A4]: Parkstone South, LLC
5. Agent / Consultant [PNC Form A5 — or ORM Consultant ID Number]:
Mogensen Mitigation, Inc.
6. Related Action ID Number(s) [PCN Form B5b]:
7. Project Location— Coordinates, Street Address, and/or Location Description [PCN Form Blb]:
Lat: 35.1498 Long: 80.8454, 5628 Closeburn Road, Charlotte, NC
8. Project Location— Tax Parcel ID [PCN Form Bla]: Parcel ID: 17125220
9. Project Location — County [PCN Form A2b]: Mecklenburg
10. Project Location — Nearest Municipality or Town [PCN Form A2c]: Charlotte
11. Project Information — Nearest Waterbody [PCN Form 132a]: Little Sugar Creek
12. Watershed / 8 -Digit Hydrologic Unit Code [PCN Form 132c]: Catawba 03050103
Authorization: Section 10 ❑ Section 404F,/—]
Regulatory Action Type:
❑ Standard Permit
✓ Nationwide Permit #
Regional General Permit #
✓ Jurisdictional Determination Request
Section 10 and 404 ❑
❑ Pre -Application Request
❑ Unauthorized Activity
❑ Compliance
❑ No Permit Required
Revised 20150602