20121074 Ver 1_EEP Receipt_20130411

r_1;J
EF a
n�ement
PROGRAM
RECEIPT
April 11, 2013
Michael Moran
Ashley Furniture Industries, Inc.
One Ashley Way
Arcadia, WI 54612
Project:
Ashley Furniture
County:
Davie
DWQ#:
12-1074
COE#:
2012-01900
EEP #:
20864
Amount Paid:
$448,909.75
Check Number:
955444
The North Carolina Ecosystem Enhancement Program (NCEEP) has received a check as indicated above as payment for the
compensatory mitigation requirements of the 401 Water Quality Certification/Section 404/CAMA Permit(s) issued for the above
referenced project. This receipt serves as notification that your compensatory mitigation requirements assigned to NCEEP associated
with the authorized activity as specified below have been satisfied. You must also comply with all other conditions of this
certification and any other state, federal or local government permits or authorization associated with this activity including SL 2009-
337, An Act to Promote the Use of Compensatory Mitigation Banks, as amended by S.L. 2011-343.
The NCEEP, by acceptance of this payment, acknowledges that the NCEEP is responsible for the compensatory mitigation
requirements indicated below associated with the project permit and agrees to provide the compensatory mitigation as specified in the
permit. Mitigation responsibility assigned to the NCEEP is nontransferable. The mitigation will be performed in accordance with the
N.C. Department of Environment and Natural Resources' Ecosystem Enhancement Program In -Lieu Fee Instrument dated July 28,
2010.
River Basin
Stream Credits
Wetland Credits Buffer I& 11
HUC
(linear feet)
(acres) (Sq. Ft.)
Cold
Cool
Warm Riparian
Non -Riparian
Coastal Marsh
Yadkin
0
0
632 7.138
0
0 0
03040101
Refunds of payments made to NCEEP are only approved under certain conditions. All refund requests must be submitted in
accordance with EEP's refund policy at www.nceep.net. If you have any questions or need additional information, please contact
Kelly Williams at [phone].
Sincerely,
Michael Ellison
Acting Director
cc: Karen Higgins, NCDWQ Wetlands/401 Unit
John Thomas, USACE-; Tyler Crumbley, USACE-Raleigh
Bradley Luckey, agent
File
kutort ytg... ... Prot" OECD' .State,
NCDENR
North Carolina Ecosystem Enhancement Program, 1652 Mail Service Center, Raleigh, NC 27699-1652 / 919-707-8976 / www.nceep.net

.. _
: Ashley Furniture Industries, Inc. Action [Do SAW� 2012�0190111ro
Baltimore Manufacturing Facilities
r ExpansionDavie
Cnstructsons to Permittee; The Permittee must provide a COPY of this form to the Mitigation Sponsor, either an approved
Mitigation Bank or the forth Carolina Ecosystem Enhancement Program (NCEEP), who will then sign the form to verify the
transfer of the mitigation responsibility. Once the Sponsor has signed this form, it is the Permittee's responsibility to
ensure that to the U.S. Army Corps of Engineers (USACE) Project Manager identified on page two is in receipt of a signed
copy of this form before conducting authorized impacts, unless otherwise specified below. If more than one mitigation
Sponsor will be used to provide the mitigation associated with the permit, or if the Impacts and/or the mitigation will occur
in more than one 84git Hydrologic Unit Code (HUC), multiple forms will be attached to the permit, and the separate farms
€or each Sponsor and/or HUC must be provided to the appropriate mitigation Sponsors.
Instructions to Sponsor. The Sponsor must verify that the mitigation requirements shown below are available at the
Identified situ. By sloWng below, the SPonsor is accepting (mall responsiVility for the Identified mitigation, regardless of
o ether ar° not they have received payment from thea Per -ti(ttee Once the form is: slgritW, the Sponsor most update the
appropriate ledger and provide a copy of the signers form to the Permittee and to the USACE Bank/Ira-Lieu Pee Program
Manager, The Sponsor roust also comply with all reporting requirements established in their authorizing instrument,
errnifteri impacts and Compensatory Mitigation: Requirements:
Permitted impacts Requiring ;T:-Mitigati.o�n A5Y 8 -digit HUC and Basin, 03040101, upper Va ldn River Basin
Stream Impacts (Iinearfeet) Wetland Impacts (acres)
Warm Cool Cold Rmparian Rlparlan
Rmverine Non-rlverina Non -Riparian Coastal
,.._< _ _
v,
316 4.106
*If more than one mitigation sponsor will be used for the permit, only include impacts to be mitigated by this sponsor.
Je
Compensatory Mitigation Requirements:,ele 8 -dl It HLIC and Basin. 03040101 tipper Yadkin River Basin
art�i ! Coop Cold Riparian Riparian __
...,
Riverine Non-rlverina Non -Riparian Coastal
632 7A38
Mitlgatlor► Site Debited*
NCEEP
(List the Warne of the bank to be debited. For umbrella banks, also list the specific site. For NCEEP, HstNCEEP.. it the NCEEP
acceptance letter identifies a specific site, also list the specific site to be debited).
Staterrrent of Mitigation Liability Acceptance. I, the undersigned, verify that I am authorised to approve mitigation
transactions /car the Mitigation Sponsor shov�n below, and i certify that the Sponsor agrees to accept full responsibility for
providing the mitigation Identified in this document (see the table above), associated with the USACE Permittee and Action
lD number shown. I also verify that released credits (and/or advance credits for NCEEP), as approved by the USACE, are
currently available at the mitigation site identified above. Further, I understand that if time Sponsor fails to provide the
required compensatory mitigation, the USACE Wilmington District Engineer may pursue measures against the Sponsor to
ensure compliance associated with time mitigation requirements.
Mitigation Sponsor
risarne;
f
IQ
11 r�L X013
Date of Signature
Form Updated 18 September,
2012

Conditions for Transfer of Compensatory Mitigation CredltW
Once this document has been signed by the Mitigation Sponsor and the USAGE is in receipt of the signed form, the
Permittee is no longer responsible for providing the mitigation identified in this form, though the Permittee remains
responsible for any other mitigation requirements stated in the permit conditions.
Construction within jurisdictional areas authorized by the permit identified on page one of this form can begin only
after the USACE is In r cell t of a copy of this
,document signed by the Sponsor, Confirming that tl@e Sponsor ha
accepted responsibility for prWtding the'rnitigatiott tequir monts listed he=rein" For
atilhoriled Impacts conducted b
the North Carolina Department of Transportation (NCDOT), construction within jurisdictional areas may proceed upon
permit issuance, however, a copy of this form signed by the Sponsor must be provided to the USACE within 30 days of
permit issuance. NCDOT'remains fully responsible for the mitigation until the USACE has received this farm, confirming
that the Sponsor has accepted responsibility for providing the mitigation requirements listed herein,
Signed copies of this document must be retained by the Permittee, Mitigation Sponsor, and in the USACE
administrative records for bath the permit and the Bank/ILF Instrument. It is the Permittee's responsibility to ensure
that the USACE Project Manager (address below) Is provided with a signed copy of this form.
If changes are proposed to the type, amount, or location of mitigation after this form has been signed and returned to
the USAGE, the Sponsor must obtain case-by-case approval from the USACE Project Manager and/or North Carolina
Interagency Review 'ream (NCIRT). If approved, higher mitigation ratios may be applied, as per current District
guidance and a new version of this form roust be completed and included in the USACE administrative records for both
the permit and the Bank/li.F Instrument.
'this form is not valid unCess signed by the .mitigation Sponsor- and USAGE Project Manager. For questions regarding this
forra� or any of the cond€`tions of the permit authorization, contact the Project Manager at the address below.
Errsaif*
Bialelgh Beguiatory Field Office
U Army Carps of Engineers
3331 Heritage `trade Drive, Suite 105
tNake Forest, forth Carolina 27587
[e-mail] .mI
„w;,, march 28 ZCi1.3
Date of Signature
Current ��iilmingtan District mitigation guidance,sincluding Information an mitigation ratios, functional assessments, and
mitigation bank location and availability, and credit classifications (Including stream temperature and �yetiand grcrpir�gs) is
available at htt ribits,usace.arrny.m!l.
The wilrrtin�ton L}istr(ct is c�an�lttcd tcs r�rcv(cir7� tiF� irigl7est ?evef of sup�cast'to the pu61(c. ire hePp us ens€<re we canti,�ae tai alo scr ;afease cerrt�slet� the
Czrstorr,erSat(sfa�tianSurrte�=i�catedatrrurwed;siteethtt�: rc�uiet€�.usz�cesurve .fern/tocc€mpl=tett�es€a�veycrn!(rie,