20190831 Ver 1_401 Application_20190619

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SOIL & FORESTRY Le la (q
SERVICES $ P
OF THE CAROLINAS, PA ®®
PO Box 832 2 0 1 9 0 8
Mooresville,NC 28115 3 1
June 14, 2019
Project#19-1039
US Army Corps of Engineers NC DWR
Asheville Regulatory Field Office 401 &Buffer Permitting Branch
Attn: David Schaeffer Attn: Karen Higgins
151 Patton Avenue,Room 208 512 North Salisbury Street
Asheville,NC 28801-5006 Raleigh,NC 27604
Dear Mr. Schaeffer and Ms. Higgins:
We request the use of Nationwide Permit 18 for proposed impacts of 15 linear feet for a
proposed driveway culvert at Lot 7 of Alexander Acres in Mooresville,NC. The
submittal to the USACE is strictly a courtesy notice. Preconstruction notification is made
to the NC DWR as the Waters flow to Coddle Creek(WSII). The subject property is a 2-
acre parcel southeast of Mooresville on Alexander Acres Road. A single-family home is
proposed on the lot. The parcel is shown on the attached USGS Topo Quad vicinity map
and Soil Survey of Iredell County.
Specifically,we request 15 If of permanent stream impact associated with placement of a
36"culvert for a proposed driveway crossing. The property is within the Town of
Mooresville ETJ. A stormwater management plan is not required for a residential lot by
the Town. The parcel is zoned for low density development with a maximum of 1 house
per 1 acre. A 50' riparian buffer is required by the Town of Mooresville for intermittent
streams within WS-II-BW watershed. The culvert will be buried to maintain aquatic
passage at the existing channel slope.
PROJECT SUMMARY
Project Name Lot 7 Alexander Acres
Project Type Residential
Owner/Applicant TJS Builders, LLC
County Iredell
Nearest Town Mooresville
Waterbody Name UT Coddle Creek
Basin/Sub-basin Yadkin PeeDee
Index Number 03040105
Class WSII

IMPACT SUMMARY
Stream Impact(acres): 15
Wetland Impact(acres): 0
Open Water Impact(acres): 0
Total Impact to Waters of the U.S. (acres): 0.001
Total Stream Impact(linear feet): 15
Attachments:
Preliminary ORM Data Entry Fields for New Actions
Pre-construction Notification(PCN)Application Form
Agent Authorization
USGS Vicinity Map
Iredell County Soil Survey
USFWS NWI Map
Impact Map/Site Plan
NC DWR Stream Form
Wetland Data Form
Jurisdictional Determination Request(USACE only)with Vicinity Map,Air Photo,Prelim JD Form,Site
Pics
401 Permit Fee(DWR)
Please call if you have questions or comments regarding the information provided.
Sincerely,
�,l/hdGGf.
Wendell Overby
NC Licensed Soil cientist
NC Registered Forester

Of WArFR
o`' Qc • Office Use Only:
r- Corps action ID no.
. o -c DWQ project no.
Form Version 1.4 January 2009
Pre-Construction Notification (P,CN) Form
A. Applicant Information
1. Processing
la. Type(s)of approval sought from the Corps: ❑X Section 404 Permit ❑ Section 10 Permit
lb. Specify Nationwide Permit(NWP)number: 18 or General Permit(GP)number:
lc. Has the NWP or GP number been verified by the Corps? ❑Yes ❑X No
1d. 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
le. Is this notification solely for the record For the record only for DWQ For the record only for Corps Permit:
because written approval is not required? 401 Certification:
❑Yes ❑X No ❑X Yes ❑ No
If. 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 ❑ Yes ❑X No
or in-lieu fee program.
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h El Yes ❑X No
below.
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ❑Yes ❑X No
2. Project Information
2a. Name of project: Alexander Acres Drive Lot 7
2b. County: Iredell
2c. Nearest municipality/town: Mooresville
2d. Subdivision name: Douglas W. Carrigan
2e. NCDOT only,T.1.P. or state project no: N/A.
3. Owner Information
3a. Name(s)on Recorded Deed: TJS Builders, LLC
3b. Deed Book and Page No. 2580/1989
3c. Responsible Party(for LLC if Kerry Miller.
applicable):
3d. Street address: 101 Tarrington Avenue
3e. City,state,zip: Charlotte, NC 28205
3f. Telephone no.: 704 906-7105
3g. Fax no.:
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 0 Other, specify: Applicant is owner as presviously listed
4b. Name: Kerry Miller
4c. Business name TJS Builders, LLC
(if applicable):
4d. Street address: 101 Tarrington Avenue
4e. City,state,zip: Charlotte, NC 28205
4f. Telephone no.: 704 906-7105
4g. Fax no.:
4h. Email address: [e-mail]
5. Agent/Consultant Information(if applicable)
5a. Name: Wendell Overby
5b. Business name Soil& Forestry Services of the Carolinas, PA
(if applicable):
5c. Street address: PO Box 832
5d. City,state,zip: Mooresville, NC 28115
5e. Telephone no.: 704 239-2001
5f. Fax no.:
5g. Email address: [e-mail]
Page 2 of 10

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): 4677366315
lb. Site coordinates(in decimal degrees): Latitude: 35.5954 Longitude: -80.77045
1 c. Property size: 2.298 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project: Coddle Creek
2b. Water Quality Classification of nearest receiving water: WSII
2c. River basin: Yadkin-PeeDee
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:
Parcel is mixture of upland forest predominantly loblolly pine with a narrow riparian floodplain predominantly occupied by hardwoods.No site
improvements on the parcel.
3b. List the total estimated acreage of all existing wetlands on the property: 0
3c. List the total estimated linear feet of all existing streams(intermittent and perennial)on the property: 295
3d. Explain the purpose of the proposed project:
Property has been purchased for construction of single family home including a driveway requesting culvert installation
3e. Describe the overall project in detail, including the type of equipment to be used:
Lot will be developed for single family home including 36"culvert installed in existing creek for driveway.A backhoe will be used for culvert installation.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the ❑Yes ❑ No ❑X Unknown
Corps or State been requested or obtained for this property/ Comments:
project(including all prior phases)in the past?
4b. If the Corps made the jurisdictional determination,what type ❑ Preliminary ❑ Final
of determination was made?
4c. If yes,who delineated the jurisdictional areas? Agency/Consultant Company:
Name (if known): Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5. Project History
5a. Have permits or certifications been requested or obtained for ['Yes ❑No ❑X Unknown
this project(including all prior phases)in the past?
5b. If yes, explain in detail according to"help file"instructions.
6. Future Project Plans
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
la. Which sections were completed below for your project(check all that apply): _
❑ Wetlands © Streams—tributaries 0 Buffers ❑ Open Waters 0 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 impact Type of wetland Forested Type of jurisdiction Area of
number Corps(404,10)or impact
Permanent(P)or DWQ(401, other) (acres)
Temporary(T)
W1 - Choose one Choose one Yes/No -
W2 - Choose one Choose one Yes/No -
W3 - Choose one Choose one Yes/No -
W4 - Choose one Choose one Yes/No -
W5 - Choose one Choose one Yes/No -
W6 - Choose one Choose one Yes/No -
2g. Total Wetland Impacts: 0
2h.Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts(including temporary impacts)proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial (PER)or Type of Average Impact
number intermittent(INT)? jurisdiction stream length
Permanent(P)or width (linear
Temporary(T) (feet) feet)
S1 P Culvert UT Coddle Creek INT Corps 3 15
S2 - Choose one - -
S3 - Choose one - -
S4 - Choose one - -
S5 - Choose one - -
S6 - Choose one - -
3h.Total stream and tributary impacts 15
3i. Comments:
Stream impact the minimum necessary.Driveway will be installed perpendicular to creek
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. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number (if applicable) Type of impact Waterbody Area of impact(acres)
Permanent(P)or type
Temporary(T)
01 - Choose one Choose
02 - Choose one Choose
03 - Choose one Choose
04 - Choose one Choose
4f.Total open water impacts o
4g. Comments:
6. Pond or Lake Construction
If pond or lake construction proposed,then complete the chart below.
5a. 5b. 5c. 5d. 5e.
Pond ID number Proposed use or Wetland Impacts(acres) Stream Impacts(feet) Upland
purpose of pond (acres)
Flooded Filled Excavated Flooded Filled Excavated
P1 Choose one
P2 Choose one
5f. Total:
5g. Comments:
5h. Is a dam high hazard permit required? ID Yes 0 No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts(for DWQ)
If project will impact a protected riparian buffer,then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation,then you MUST fill out Section D of this form.
6a. Project is in which protected basin? ❑Neuse Tar-Pamlico ID Catawba 0 Randleman 0 Other:
6b. 6c. 6d. 6e. 6f. 6g.
Buffer Impact Reason for impact Stream name Buffer Zone 1 Zone 2
number— mitigation impact impact
Permanent(P)or required? (square (square
Temporary(T) feet) feet)
B1 - Yes/No
B2 - Yes/No
B3 - Yes/No
B4 - Yes/No
B5 - Yes/No
B6 - Yes/No
6h. Total Buffer Impacts:
6i. Comments:
Page 5 of 10

D. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Stream feature crosses entire parcel and is located near existing road.Therefore the house cannot be built between the stream and existing main
road.
lb. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Proposed impact minimum necessary for driveway construction.No impacts beyond length of culvert pipe.
2. Compensatory Mitigation for Impacts to Waters of the U.S.or Waters of the State
2a. Does the project require Compensatory Mitigation for ❑ Yes ❑X No
impacts to Waters of the U.S. or Waters of the State?
2b. If yes, mitigation is required by(check all that apply): ❑ DWQ ❑Corps
❑ Mitigation bank
2c. If yes,which mitigation option will be used for this El Payment to in-lieu fee program
project?
❑Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
Type:Choose one Quantity:
3b. Credits Purchased(attach receipt and letter) Type: Choose one Quantity:
Type:Choose one Quantity:
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a.Approval letter from in-lieu fee program is attached. ❑ Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: Choose one
4d. Buffer mitigation requested(DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal)wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a pemiittee responsible mitigation plan, provide a description of the proposed mitigation plan.
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 �X 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 3(2 for Catawba)
Zone 2 1.5
6f.Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed(e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
6h. Comments:
Page 7 of 10

E. Stormwater Management and Diffuse Flow Plan(required by DWQ)
1. Diffuse Flow Plan
la. Does the project include or is it adjacent to protected riparian buffers identified ❑ Yes OX No
within one of the NC Riparian Buffer Protection Rules?
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? 9.5
2b. Does this project require a Stormwater Management Plan? ❑Yes © No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
As per Town of Mooresville zoning ordinance;1 house proposed on lot of 1 acre of greater in size.Less than 12%impervious.
2d. If this project DOES require a Stormwater Management Plan,then provide a brief, narrative description of the plan:
2e. Who will be responsible for the review of the Stormwater Management Plan?
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project? Mooresville
El Phase II
3b. Which of the following locally-implemented stormwater management programs ❑ NSW
MP
apply(check all that apply): ❑�Water
Supply Watershed
Other.
3c. Has the approved Stormwater Management Plan with proof of approval been ❑Yes El No
attached?
4. DWQ Stormwater Program Review
O Coastal counties
❑HQW
4a. Which of the following state-implemented stormwater management programs apply DORW
(check all that apply): OSession Law 2006-246
❑Other:
4b. Has the approved Stormwater Management Plan with proof of approval been ❑Yes ❑ No
attached?
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)
la. Does the project involve an expenditure of public(federal/state/local)funds or the ❑Yes ❑X No
use of public(federal/state)land?
lb. If you answered"yes"to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State ❑Yes ❑No
(North Carolina) Environmental Policy Act(NEPA/SEPA)?
lc. If you answered"yes"to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.) ❑Yes ❑No
Comments:
2. Violations(DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules(15A NCAC 2H .0500), Isolated
Wetland Rules(15A NCAC 2H.1300), DWQ Surface Water or Wetland Standards, ['Yes ©No
or Riparian Buffer Rules(15A NCAC 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.
This project does not meet the criteria of private projects that can clearly result in cumulative impacts.The proposed development is small involving a
single lot with single family home proposed.
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.
Wastewater disposal will occur via onsite septic system installed uphill of the house and more than 50'from the existing stream.
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 orEl Yes �X No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act �Yes XJ 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?
NC Natural Heritage Program Search/Community database was used to search for elemental occurrences of state and federally protected species in
the vicinity of the project.One state threatened listed plant is shown as current on the Mooresville topo quad as well as an animal.
6. Essential Fish Habitat(Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ❑Yes El No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
No essential fish habitat located at project site.http//www.habitat.noaa.gov/proteclion/efh/efhmapper.html
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?
via HPOWEB GIS SERVICE:No cultural occurrences on the property.Site ID 0024 approximately 1 mile north(Hargrave House).
8. Flood Zone Designation(Corps Requirement)
8a.Will this project occur in a FEMA-designated 100-year floodplain? ❑Yes Ox No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s)did you use to make the floodplain determination?
Iredell County GIS
Wendell Overby 06-14-2019
Applicant/Agent's Printed Name Applicant/Agen' ' nature Date
(Agent's signature is vaIi o if an authorization
letter from the ap ' ant is provided.)
Page 10 of 10

- -----
gum FIIRETTRY
SERVICES
OF THE CAROLINAS, PA •
• PO BoX832
MooresVille, NC 28115
AGENT AUTHORIZATION FORM
•PROPERTY LEGAL DESCRIPTION:
eed
LOT NO. PLAN NO. PARCEL ID:
STREET ADDRESS!
Property Owner: Tas- PouL1e46--)25
The undersigned,registered property owners of the aboVe noted property,do hereby authorize
Wendell Overby,of Soil&Forestry Services of the Carolinas, PA
to act on my bebalf and take all actions necessary for the processing,issuance and acceptance
of this permit or certification and any and all standard and special conditions attached.
Property Ownersi Address(if different than property above):
/la/ 7.7;;40-141G-rp ) 1,1:7-
e49-A2-42•He ..zeS
Telephone:
We hereby certify the above information submitted in this application is true and accurate to
the best of our knowledge.
Aut ized Signature ature
Date: .5 z/ /-9 Date: 5- 2-4 I (5
•

I Lance D. Schamback, certify that this plat was drawn under my supervision from an actual
survey made under my supervision (deed description and/or Map Book: 38 , Page 53
•
That the boundaries not surveyed are indicated as drawn from information as shown on the
survey; that the ratio of precision as calculated is 1: 10,000+ that this map meets the
requirements of The Standards of Practice for Land Surveying in North Carolina (21 NCAC
56.1600). This 12 day of June , A.D. 2019.
Lance D. Schamback, PLS
LICENSE NUMBER: L-4295
___......_@;-:r I I I i e I I.I.•II•..----June 14, 2016
6g
p.8-
Lot 10
Picwyck Village Russell D. Richardson Concrete
P.B, 19, Pg. 100 Sarah J. Richardson Monument
Richard S. Bennett 1c O.B. 987, Pg. 1314 ound
0.F3' Tall
Virginia A. Bennett
Lot 54 D.B. 1341, Pg. 964 2-I.P. /k1'Y1 0
Avalon Subdivision
P.B. 65, Pg. 77 15�uTdi CO k55 fie
Lynn C. Turner & 2'I.P. 230,84 Total , .5622"\N 8O
RoD.Bb2532, Pg. 554 ert F. Turner Found NOso16136„X''216.75 ZV r� N g061D re Foundar
0.3' Tall
014.09 8.38 -- -53)! ' #4 Rebar
Found
1 1/2" Solid N -�;Setback (P• P9 `1 0.3' Tall
Iron Found r 1
II Lot 7 �1
v
II 2.29 Acres
ti I $\, Vl
Io KS
� 01
o I
• 'Lindsey Brook Curtis & es tO
Charles L. Curtis
D.B. 876, Pg. 13 Ilk 80' -' `\m ro
1 F1 m
Lot 8
C cl50' rip orlon buflardlnonce /'2 Douglas W. Carrigan Subdivision
oor5evtlle ' 3 CAN P.B. 38, Pg. 53
Im act Sl tli p Creek;="F6 f5 'F4 .N
I linear feet . ddle 1 C
UT��. �F8F7 1
_ F9 1 H
-_=F 4 F13 F12 F11 F10 1 0
15 Rebar 40'Setback (P.B. 38, Pg. 53)
Found
Flush }4 Rebar
R/W �,„ Found
9
E.O.P.-- — -- __-v-_. o - Concrete 0
E.O.P. ___—___-_. ------_----�— L1 -- — S1T50'45"W 230.40 N_- .---.------ Monument
R/W �_ Found
Alexander Acres Rd.
S.R. 1154 50' R/W
LINE TABLE
Notes. LINE LENGTH BEARING
1) This property may be subject Li 80.75 S1733'14"W
to any Easements, Rights—of—way, L2 49.45 N834834"W
and/or Restrictive Covenants.
2) Boundary information based Legend
on Map Book 38 at Page: 53, Deed
Book 2580 at Page 1989 as recorded GRAPHIC SCALE = Power Pole
in the lredell County Register of Deeds. E.O.P. = Edge of Pavement
4) This survey is of an existing 100 0 50 100 200 R/W = Right—of—way
parcel or parcels of land. I.P.S. = #4 Rebar Set
5) No N.C.G.S. or U.S.G.S. Monuments I • J1,— = Not to scale
could be located within 2000: ( IN FEET 0 = Telephone Pedestal
6) Area by coordinate method. va.4 = Water Meter
1 inch = 100 ft. ix
Vicinity Map
g N Boundary & Stream Survey SCALE: 1" = 100
d' 1,3916 vd 150 FOR
Landis HWY TJS Builders, LLC. FIELD BOOK:
HWY 152
S,no53
,?-i PROPERTY DESCRIPTION FILE: 2019-151
Lot 7,
Is TAX PARCEL ID:
Douglas W. Carrigan Subdivision 4677366315
Site 7c Q Schamback Surveying, P.A.
Plat Book 38, Page 53 Post Office Box 4143
c Mooresville, NC 28117
Coddle Creek Township lredell County, NC [phone]
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he maps prepared for this website are generated from recorded deeds,plats,and other public records.Users of these maps are hereby notified that the information
.rovided herein should be verified.Iredell County assumes no legal responsibilities for any of the information contained on this site.Users are advised that the use o
.ny of this information is at their own risk.All maps on this site were prepared using a 10005Ee"Grid based upon the North Carolina State Plane Coordinate System from
he 1983 North American Datum.The delinquent real property tax overlay is updated monthly.The information presented is not intended to be used or relied upon a
•fficial notice of tax liens.For additional information re.ardin. delin.uent taxes,contact the Iredell Coun Tax Collectors Office.

WETLAND DETERMINATION DATA SHEET-Eastern Mountains and Piedmont Region
Project/Site: Alexander Acres City/County: Mooresville Sampling Date: 5/10
, Applicant/Owner: TJS Builders,LLC State: NC Sampling Point: i
Investigator(s): W.Overby Section,Township,Range:
Landform(hillside,terrace,etc.): toe slope/riparian Local relief(concave,convex,none): non Slope(%): 2
Subregion(LRR or MLRA): LRR P,MLRA 136 Lat: 35.595485 Long:-80.777045 Datum: wgs8y
Soil Map Unit Name: Pacolet sandy clay loam NWI classification: palustrine
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
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, e
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 x No
Remarks:
HYDROLOGY
Wetland Hydrology Indicators: Secondary Indicators(minimum of two require
Primary Indicators(minimum of one is required:check all that apply) _Surface Soil Cracks(B6)
Surface Water(Al) _True Aquatic Plants(B14) —Sparsely Vegetated Concave Surface(BE
—High Water Table(A2) —Hydrogen Sulfide Odor(C1) x Drainage Pattems(B10)
Saturation(A3) —Oxidized Rhizospheres on Living Roots(C3) _Moss Trim Lines(B16)
_Water Marks(B1) —Presence of Reduced Iron(C4) _Dry-Season Water Table(C2)
Sediment Deposits(B2) _Recent Iron Reduction in Tilled Soils(C6) x Crayfish Burrows(C8)
Drift Deposits(B3) —Thin Muck Surface(C7) —Saturation Visible on Aerial Imagery(C9)
_Algal Mat or Crust(64) _Other(Explain in Remarks) —Stunted or Stressed Plants(D1)
Iron Deposits(B5) —Geomorphic Position(D2)
—_Inundation Visible on Aerial Imagery(B7) —Shallow Aquitard(D3)
_Water-Stained Leaves(B9) —Microtopographic Relief(D4)
_Aquatic Fauna(B13) —
FAC-Neutral Test(D5)
Field Observations:
Surface Water Present? Yes No x Depth(inches):
Water Table Present? Yes No x Depth(inches):
Saturation Present? Yes No x Depth(inches): Wetland Hydrology Present? Yes x No
(includes capillary fringe)
Describe Recorded Data(stream gauge,monitoring well,aerial photos,previous inspections),if available:
Remarks:
US Army Corps of Engineers Eastem Mountains and Piedmont—Version 2.0

VEGETATION(Four Strata) -Use scientific names of plants. Sampling Point: 1
Absolute Dominant Indicator
Tree Stratum (Plot size: 30FT ) %Cover Species? Status Dominance Test worksheet:
1. Acer rubrum 40 Yes FAC Number of Dominant Species
2. Liriodendron tulipifera 10 Yes FACU That Are OBL,FACW,or FAC: 3 (A)
3. Total Number of Dominant
4, Species Across All Strata: 7 (B)
5. Percent of Dominant Species
6. That Are OBL,FACW,or FAC: 42.9% (AlB)
7. Prevalence Index worksheet:
50 =Total Cover a Total%Cover of: Multiply by:
50%of total cover: 25 20%of total cover: 10 OBL species 0 x 1= 0
Sapling/Shrub Stratum (Plot size: ) FACW species 5 x 2= 10
1. Ligustrum sinense 30 Yes FACU FAC species 55 x 3= 165
2. FACU species 55 x 4= 220
3. UPL species 0 x 5= 0
4. Column Totals: 115 (A) 395 (B)
5. Prevalence Index =B/A= 3.43
6. Hydrophytic Vegetation Indicators:
7. _1-Rapid Test for Hydrophytic Vegetation
8. _2-Dominance Test is>50%
9. 3-Prevalence Index is s3.0'
30 =Total Cover 4-Morphological Adaptations'(Provide supporting
50%of total cover. 15 20%of total cover: 6 data in Remarks or on a separate sheet)
Herb Stratum (Plot size: ) _Problematic Hydrophytic Vegetation'(Explain)
1. Sambucus canadensis 5 Yes FAC 'Indicators of hydric soil and wetland hydrology must be
2. Boehmeria cylindrica 5 Yes FACW present,unless disturbed or problematic.
3. Definitions of Four Vegetation Strata:
4. Tree-Woody plants,excluding vines,3 in.(7.6 cm)or
5. more in diameter at breast height(DBH),regardless of
height.
6.
7. Sapling/Shrub-Woody plants,excluding vines,less
8. than 3 in.DBH and greater than or equal to 3.28 ft
(1 m)tall.
9.
10. Herb-All herbaceous(non-woody)plants, regardless
11 of size,and woody plants less than 3.28 ft tall.
10 =Total Cover Woody Vine-All woody vines greater than 3.28 ft in
50%of total cover: 5 20%of total cover: 2 height.
Woody Vine Stratum (Plot size:
1. Smilax rotundifolia 15 Yes FAC
2. Lonicera japonica 15 Yes FACU
3.
4.
5.
30 =Total Cover Hydrophytic
Vegetation
50%of total cover: 15 20%of total cover: 6 Present? Yes No x
Remarks:(Include photo numbers here or on a separate sheet.) '
US Army Corps of Engineers Eastern Mountains and Piedmont-Version 2.0

SOIL Sampling Point: 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) % Type1 Loc2 Texture Remarks
0-3 10YR 3/3 100 Loamy/Clayey
3-16 2.5YR 4/6 100 Loamy/Clayey
16-20 10YR 5/3 100 Loamy/Clayey
Type: C=Concentration,D=Depletion, RM=Reduced Matrix,MS=Masked Sand Grains. 2Location: PL=Pore Lining,M=Matrix.
Hydric Soil Indicators: Indicators for Problematic Hydric Soils:
Histosol(Al) _Polyvalue Below Surface(SB)(MLRA 147,148) _2 cm Muck(A10)(MLRA 147)
—Histic Epipedon(A2) _Thin Dark Surface(S9)(MLRA 147,148) Coast Prairie Redox(A16)
Black Histic(A3) _Loamy Mucky Mineral(F1)(MLRA 136) (MLRA 147,148)
—Hydrogen Sulfide(A4) _Loamy Gleyed Matrix(F2) —Piedmont Floodplain Soils(F19)
Stratified Layers(A5) _Depleted Matrix(F3) (MLRA 136,147)
2 cm Muck(A10)(LRR N) —Redox Dark Surface(F6) —Red Parent Material(F21)
Depleted Below Dark Surface(A11) _Depleted Dark Surface(F7) (outside MLRA 127,147,148)
—Thick Dark Surface(Al2) —Redox Depressions(F8) _Very Shallow Dark Surface(F22)
_Sandy Mucky Mineral(S1) _Iron-Manganese Masses(F12)(LRR N, _Other(Explain in Remarks)
—Sandy Gleyed Matrix(S4) MLRA 136)
_Sandy Redox(S5) _Umbric Surface(F13)(MLRA 122,136) 3lndicators of hydrophytic vegetation and
Stripped Matrix(S6) —Piedmont Floodplain Soils(F19)(MLRA 148) wetland hydrology must be present,
Dark Surface(S7) _Red Parent Material(F21)(MLRA 127,147,148) unless disturbed or problematic.
Restrictive Layer(If observed):
Type:
Depth(inches): Hydric Soil Present? Yes No X
Remarks:
This data sheet is revised from Eastern Mountains and Piedmont Regional Supplement Version 2.0 to include the NRCS Field Indicators of Hydric
Soils,Version 8.0,2016.
- US Army Corps of Engineers Eastern Mountains and Piedmont—Version 2.0

NC DWQ Stream Identification Form Version 4.11
Date: 540 //1 Project/Site: ALX4,,/pEt 4.cizes Latitude:
Evaluator: 0 VereoY County: Jt2 EbeZG Longitude:
Total Points: Stream Determination(circle one) Other
Stream is at least intermittent Ephemeral n en Perennial e.g. Quad Name.
if Z 19 or perennial if a 30* Zrp, P �� 'n7�QEJl//L LE
A. Geomorphology (Subtotal= 12- ) Absent Weak Moderate Strong
la Continuity of channel bed and bank 0 _ 1 2 0
2.Sinuosity of channel along thalweg 0 1 0 3
3. In-channel structure:ex. riffle-pool,step-pool, 0 1 2 3
ripple-pool sequence
4. Particle size of stream substrate 0 10 2 3
5.Active/relict floodplain 0 1 2 3
6. Depositional bars or benches 0 1 2 3
7. Recent alluvial deposits @ 1 2 3
8. Headcuts 0 0 2 3
9.Grade control 0 0.5 1 1.5
10. Natural valley 0 0.5 11 1.5
11.Second or greater order channel No<0 Yes=3 _
a artificial ditches are not rated;see discussions in manual
B. Hydrology (Subtotal = 8.5 )
12. Presence of Baseflow 0 1 Q 3
13. Iron oxidizing bacteria 0 1 0 3
14. Leaf litter 1.5 Q1 0.5 0
15.Sediment on plants or debris p 0.5 1 1.5
16.Organic debris lines or piles 0 t�5 1 1.5
17.Soil-based evidence of high water table? No=0 Yes=3Q
C. Biology (Subtotal= 8 )
18. Fibrous roots in streambed �}3 2 1 0
19. Rooted upland plants in streambed ® 2 1 0
20. Macrobenthos(note diversity and abundance) 0 01 2 3
21.Aquatic Mollusks SI
1 2 3
22. Fish 0.5 1 1.5
23.Crayfish 0 s. 1 1.5
24.Amphibians 0 0. 1 1.5
25.Algae 0 0.5 1 1.5
26.Wetland plants in streambed FACW=0.75; OBL= 1.5 Other=t
`perennial streams may also be identified using other methods.See p.35 of manual.
Notes:
Sketch:

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Preliminary ORM Data Entry Fields for New Actions
ACTION ID#: SAW- Begin Date(Date Received):
Prepare file folder El Assign Action ID Number in ORM
1. Project Name [PCN Form A2a]: Alexander Acres Lot 7
2. Work Type: NI.rivate Institutional ❑Government ❑Commercial
3. Project Description/Purpose [PCN Form B3d and B3e]:
Parcel purchased for construction of 1 single family home.One stream impact proposed for culvert installation to support driveway
construction.Impact of 15'proposed.
4. Property Owner/Applicant [PCN Form A3 or A4]: TJS Builders, LLC
5. Agent/Consultant [PNC Form A5 —or ORM Consultant ID Number]:
Wendell Overby Soil & Forestry Services of the Carolinas, PA
6. Related Action ID Number(s) [PCN Form B5b]:
7. Project Location—Coordinates,Street Address,and/or Location Description[PCN Form B lbj:
35.595485N,-80.777045. Alexander Acres Road, Mooresville, NC
8. Project Location—Tax Parcel ID [PCN Form Bla]:4677366315
9. Project Location—County [PCN Form A2b]: Iredell
10. Project Location—Nearest Municipality or Town [PCN Form A2c]: Mooresville
11. Project Information—Nearest Waterbody [PCN Form B2a]: Coddle Creek
12. Watershed/8-Digit Hydrologic Unit Code[PCN Form B2c]:03040105
Authorization: Section 10 El Section 404 0 Section 10 and 404
Regulatory Action Type:
II Standard Permit Pre-Application Request
0 Nationwide Permit# _Unauthorized Activity
Regional General Permit# Compliance
Jurisdictional Determination Request No Permit Required
Revised 20150602

Jurisdictional Determination Request
A. PARCEL INFORMATION
Street Address: Alexander Acres
City, State: Mooresville, NC
County: Iredell
Parcel Index Number(s)(PIN): 4677366315
B. REQUESTOR INFORMATION
Name: Wendell Overby
Mailing Address: PO Box 832
Mooresville, NC 28115
Telephone Number: 704 239-2001
Electronic Mail Address: [e-mail]
Select one:
I am the current property owner.
LII am an Authorized Agent or Environmental Consultant'
Interested Buyer or Under Contract to Purchase
ElOther,please explain.
C. PROPERTY OWNER INFORMATION2
Name: TJS Builders, LLC
Mailing Address: 1101 Tarrington Avenue
Charlotte, NC 28205
Telephone Number: 704 906-7105
Electronic Mail Address: [e-mail]
1 Must provide completed Agent Authorization Form/Letter.
2 Documentation of ownership also needs to be provided with request(copy of Deed,County GIS/Parcel/Tax Record).
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Jurisdictional Determination Request
D. PROPERTY ACCESS CERTIFICATION3,a
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 Water Act and/or Section 10 of the Rivers and Harbors Act of 1899. I,the
undersigned, am either a duly authorized owner of record of the property identified herein,or
acting as the duly authorized agent of the owner of record of the property.
Wendell Overby
Print Name
Capacity: ❑ Owner ❑✓ Authorized Agents
5/29/19
Date
u) 2o461
Signature
E. REASON FOR JD REQUEST: (Check as many as applicable)
❑ I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all aquatic resources.
❑ I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all jurisdictional aquatic resources under Corps authority.
I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps, and the JD would be used to avoid and minimize
impacts to jurisdictional aquatic resources and as an initial step in a future permitting
rocess.
I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps; this request is accompanied by my permit application
and the JD is to be used in the permitting process.
❑ I intend to construct/develop a project or perform activities in a navigable water of the
U.S. which is included on the district Section 10 list and/or is subject to the ebb and flow of
the tide.
HA Corps JD is required in order obtain my local/state authorization.
I intend to contest jurisdiction over a particular aquatic resource and request the Corps
Ed
confirm that jurisdiction does/does not exist over the aquatic resource on the parcel.
I believe that the site may be comprised entirely of dry land.
Other:
3 For NCDOT requests following the current NCDOT/USACE protocols,skip to Part E.
4 If there are multiple parcels owned by different parties,please provide the following for each additional parcel on a
continuation sheet.
5 Must provide agent authorization form/letter signed by owner(s).
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Jurisdictional Determination Request
F. JURISDICTIONAL DETERMINATION(JD)TYPE(Select One)
0✓ I am requesting that the Corps provide a preliminary JD for the property identified herein.
A Preliminary Jurisdictional Determination(PJD)provides an indication that there may
be`waters of the United States"or"navigable waters of the United States"on a property.
PJDs are sufficient as the basis for permit decisions. For the purposes of permitting,all
waters and wetlands on the property will be treated as if they are jurisdictional `waters of
the United States". PJDs cannot be appealed(33 C.F.R. 331.2);however,a PJD is
"preliminary"in the sense that an approved JD can be requested at any time. PJDs do
not expire.
El I am requesting that the Corps provide an approved JD for the property identified herein.
An Approved Jurisdictional Determination(MD)is a determination that
jurisdictional`waters of the United States"or"navigable waters of the United
States"are either present or absent on a site. An approved JD identifies the limits of
waters on a site determined to be jurisdictional under the Clean Water Act and/or
Rivers and Harbors Act. Approved JDs are sufficient as the basis for permit
decisions. AJDs are appealable(33 C.F.R. 331.2). The results of the AJD will be
posted on the Corps website. A landowner,permit applicant,or other"affected
party"(33 C.F.R.331.2)who receives an AJD may rely upon the AJD for five years
(subject to certain limited exceptions explained in Regulatory Guidance Letter 05-
02).
ElI am unclear as to which JD I would like to request and require additional information
to inform my decision.
G. ALL REQUESTS
Map of Property or Project Area. This Map must clearly depict the boundaries of the
review area.
nSize of Property or Review Area 2.298 acres.
0 The property boundary(or review area boundary)is clearly physically marked on the site.
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Jurisdictional Determination Request
H. REQUESTS FROM CONSULTANTS
Project Coordinates(Decimal Degrees): Latitude: 35.595485
Longitude: -80.777045
0 A legible delineation map depicting the aquatic resources and the property/review area.
Delineation maps must be no larger than 11x17 and should contain the following: (Corps
signature of submitted survey plats will occur after the submitted delineation map has been
reviewed and approved).6
• North Arrow
• Graphical Scale
• Boundary of Review Area
• Date
• Location of data points for each Wetland Determination Data Form or tributary
assessment reach.
For Approved Jurisdictional Determinations:
• Jurisdictional wetland features should be labeled as Wetland Waters of the US,404
wetlands,etc. Please include the acreage of these features.
• Jurisdictional non-wetland features(i.e. tidal/navigable waters,tributaries,
impoundments)should be labeled as Non-Wetland Waters of the US,stream,tributary,
open water,relatively permanent water,pond, etc. Please include the acreage or linear
length of each of these features as appropriate.
• Isolated waters,waters that lack a significant nexus to navigable waters, or non-
jurisdictional upland features should be identified as Non-Jurisdictional. Please
include a justification in the label regarding why the feature is non jurisdictional (i.e.
"Isolated","No Significant Nexus",or"Upland Feature"). Please include the acreage
or linear length of these features as appropriate.
For Preliminary Jurisdictional Determinations:
• Wetland and non-wetland features should not be identified as Jurisdictional,404,
Waters of the United States,or anything that implies jurisdiction. These features can be
identified as Potential Waters of the United States,Potential Non-wetland Waters of
the United States,wetland, stream,open water,etc.Please include the acreage and
linear length of these features as appropriate.
0 Completed Wetland Determination Data Forms for appropriate region
(at least one wetland and one upland form needs to be completed for each wetland type)
6 Please refer to the guidance document titled"Survey Standards for Jurisdictional Determinations"to ensure that the
supplied map meets the necessary mapping standards.http://www.saw.usace.army.mil/Missions/Regulatorv-Permit-
Program/Jurisdiction/
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Jurisdictional Determination Request
0 Completed appropriate Jurisdictional Determination form
• PJDs,please complete a Preliminary Jurisdictional Determination Form'and include the
Aquatic Resource Table
• AJDs,please complete an Approved Jurisdictional Determination Forms
U Vicinity Map
✓❑ Aerial Photograph
USGS Topographic Map
D Soil Survey Map
ElOther Maps,as appropriate(e.g.National Wetland Inventory Map,Proposed Site
Plan,previous delineation maps,LIDAR maps,FEMA floodplain maps)
Landscape Photos(if taken)
NCWAM and/or NCWAM Assessment Forms and Rating Sheets
▪ NC Division of Water Resources Stream Identification Forms
▪ Other Assessment Forms
' www.saw.usace.armv.mil/Portals/59/docs/regulatory/regdocs/JD/RGL 08-02 Apo A Prelim JD Form fillable.pdf
8 Please see http://www.saw.usace.armv.mil/Missions/Regulatorv-Permit-Program/Jurisdiction/
Principal Purpose:The information that you provide will be used in evaluating your request to determine
whether there are any aquatic resources within the project area subjectto federal jurisdiction underthe regulatory
authorities referenced above.
Routine Uses:This information may be shared with the Department of Justice and other federal,state,and local
government agencies,and the public,and may be made available as part of apublic notice as required by federal
law.Your name and property location where federal jurisdiction is to be determined will be included in the
approved jurisdictional determination(AJD),which will be made available to the public on the District's website
and on the Headquarters USAGE website.
Disclosure:Submission of requested information is voluntary;however,if information is not provided,the
request for an AJD cannot be evaluated nor can an AJD be issued.
Version:May 2017 Page 6