20191005 Ver 1_PCN Form Submission_20190725

DWR
MOM— of Water Resources
Pre -Construction Notification (PCN) Form
September 29, 2018 Ver 3
tial Review
Has this project met the requirements for acceptance in to the review process?*
r Yes
r No
Is this project a public transportation project?*
G Yes r No
Change only if needed.
BIMS # Assigned
20191005
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Reviewing Office*
Raleigh Regional Office - [phone]
Information for Initial Review
1a. Name of project:
Person County RV Park
1a. Who is the Primary Contact?*
Heather Smith
1b. Primary Contact Email:*
[e-mail]
Date Submitted
7/25/2019
Nearest Body of Water
Mitchell Creek
Basin
Roanoke
Water Classification
C
Site Coordinates
Version# *
1
What amout is owed?*
r $240.00
r $570.00
Select Project Reviewer*
Stephanie Goss:eads\szgoss
1c. Primary Contact Phone:*
[phone]
Latitude: Longitude:
36.448361 -78.934655
FA. Processing Information u
County (or Counties) where the project is located:
Person
Is this project a public transportation project?*
r Yes r No
1a. Type(s) of approval sought from the Corps:
* Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What type(s) of permit(s) do you wish to seek authorization?
rJ Nationwide Permit (NWP)
F- Regional General Permit (RGP)
F Standard (IP)

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):
1d. Type(s) of approval sought from the DWR:
W 401 Water Quality Certification - Regular
F Non -404 Jurisdictional General Permit
F Individual Permit
29 - Residential Developments
r 401 Water Quality Certification - Express
r Riparian Buffer Authorization
1e. Is this notification solelyfor the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
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. Is the project located in any of NC's twenty coastal counties?
r Yes r No
1j. Is the project located in a designated trout watershed?
0 Yes r No
B. Applicant Information
1d. Who is applying for the permit?
W 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:
B&B Country Inn, LLC
2b. Deed book and page no.:
979:647
2c. Responsible party:
Joe Berryhill
2d. Address
Street Address
705 Berryhill Rd
Address Line 2
CKY
Roxboro
Postal / Zip Cade
27574
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
State / Frovinoe / Pagion
NC
Ceuntry
USA
2f. Fax Number:
r Yes r No
r Yes r No
C. Project Information and Prior Project History v
1. Project Information

1b. Subdivision name:
(if appropriate)
1c. Nearest municipality / town:
Roxboro
12. Project Identification
2a. Property Identification Number:
2b. Property size:
0918-00-82-6456.0000
25.69
2c. Project Address
Street Address
5189 Boston Rd.
Address Line 2
qty
State / Rovinee / fbgion
Roxboro
NC
Postal / Zip Cade
Country
27574
USA
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Mitchell Creek
3b. Water Resources Classification of nearest receiving water:*
C
3c. What river basin(s) is your project located in?*
Roanoke
3d. Please provide the 12 -digit HUC in which the project is located.
030101040602
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:*
The site was timbered in the recent past, 2017-2018. Successional vegetation, sweetgum, red maple, pines, and other herbaceous plants are found within the timbered areas. There
are two stream and wetland corridors, one near the entrance from Boston Rd. and one near the back of the property. The stream and wetland corridors are mainly forested, with two
existing forestry stream crossings. The forestry crossings are not ideal with some loss of function to the stream, especially the forestry crossing on Stream A. The Stream A crossing has
larger corrugated plastic pipe with smaller PVC pipes inside. This old crossing is inhibiting flow and the addition of a proper size culvert/pipe will allowfor better hydrologic connectivity.
Some areas within the forested stream corridor closest to Boston Rd. have significant storm damage from 2019. There are multiple large trees down across the stream channel closest
to Boston Rd. and adjacent to the stream. The stream channel near the back of the property loses bed and bank shortly after the existing forestry stream crossing and becomes a
wetland. The surrounding land use is predominatly forestry, agricultural and a few small single family homes.
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 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR)
Fig1_Roxboro Park USGS Map.pdf 572.45KB
4e. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR)
Fig3_Roxboro Park Soils Map.pdf 203.97KB
4f. List the total estimated acreage of all existing wetlands on the property:
0.22
4g. List the total estimated linear feet of all existing streams on the property:
710
4h. Explain the purpose of the proposed project:*
The purpose of this project is to develop the property into a residential RV park and provide trailer storage.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The stream and wetland crossing closest to Boston Rd (Stream A) will allow access to the residential trailers and the crossing at Stream B will provide access to the trailer storage. Both
streams will be impacted by the installation of pipes and necessary stabilization at the inlet and outlet of the pipes. Stream A will have 76' 48" HPDE installed and the Stream B crossing
Wil consist of a 20' 24" HDPE pipe. Both pipes will have riprap placed on the up and downstream ends for stability. Temporary impacts will occur on the upstream and downstream end
of the pipes for any needed dewatering of sediment and erosion control devices.
4j. Please upload project drawings for the proposed project.
C-6.pdf 2.16MB
5. Jurisdictional Determinations
Sa. Have the wetlands or streams been delineated on the property or proposed impact areas?*
F Yes r No r Unknown
Comments

5b. If the Corps made a jurisdictional determination, what type of determination was made?*
L• Preliminary r Approved r Not Verified r Unknown r NIA
Corps AID Number:
SAW -2019-00954
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Heather Smith
Agency/Consultant Company: VHB
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
Ross Sullivan visited the site on 6/5/2019 to verify stream and wetlands and issued a pre -JD on 6/10/2019.
5d1. Jurisdictional determination upload
SAW-2019-00954-PJD.PDF 1.22MB
6. Future Project Plans
6a. Is this a phased project?*
r Yes r No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activity?
CProposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
W Wetlands W Streams -tributaries r Buffers
F_ Open Waters r Pond Construction
2. Wetland Impacts
rReason (?) 2b. Impact type * ('i 2c. Type of W. * 2d. W. name * 2e. Forested* 2f. Type of 2g. Impact
-] I Jurisdicition * M area*
2 Road Fill/Mechanized P Headwater Forest Wetland A Yes Both 0.011
Clearing (acres)
2g. Total Temporary Wetland Impact 2g. Total Permanent Wetland Impact
0.000 0.011
2g. Total Wetland Impact
0.011
2h. Comments:
The total impacts are for sideslopes for road installation and mechanized clearing to within the limits of disturbance (LOD) to provide room for the
contractor to work.
3. Stream Impacts
31. Total jurisdictional ditch impact in square feet:
0
3a. Reason for impact (?)
3b.lmpact type *
3c. Type of impact*
3d. S. name*
3e. Stream Type *
3f. Type of
3g. S. width *
3h. Impact
❑
(?) IIJurisdiction*
length*
S1
48" HOPE Pipe
Permanent
Culvert
Stream
Perennial
Both
2Average
9(linear
(Feet)
feet)
32
48" HDPE Pipe
Temporary
Dewatering
Stream A
Perennial
Both
2
20
Average (feet)
(linear feet)
S3
24" HDPE Pipe
Permanent
Culvert
Stream B
Perennial
Both
2
30
Average (feet)
(linear feet)
S4
24" HDPE Pie
P
Tem ora
P rY
Dewatering JStream
9
B
Perennial
Both
LAV-��(�f-�)
10
(linearfeet)
31. Total jurisdictional ditch impact in square feet:
0

31. Total permanent stream impacts:
125
31. Total stream and ditch impacts:
155
3j. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
31. Total temporary stream impacts:
30
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The development avoided impacts to streams and wetlands by placing the residential development and trailer storage completely in the uplands.
Impacts to streams and wetlands are for road access to the residential development from Boston Rd. and the trailer storage near the back of the
property. The impacts to the streams and wetlands were minimized by using eAsting forestry stream crossings for the roads and crossing Wetland A at
a narrow point.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Staging areas will be kept out of jurisdictional areas and sediment and erosion control will be used to prevent sedimentation in the stream and
wetlands.
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:
The impact to wetlands is 0.011 acres and the impacts to the streams are along two separate streams, Stream A 95 linear feet, and Stream B 30 linear feet. These impact amounts are
belowthe mitigation threshold of 150 linear feet.
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:
The project is within the Roanoke River basin and is not subject to NC Riparian Buffer Protection Rules.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
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:
The project's impervious area is below the 24% impervious threshold for low density projects.
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 21-1.1300), 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.

The development of a residential RV park is not expected to create additional development. The development will use an existing NCDOT maintained
road for access to the parcel and the internal roads will be privately managed.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r Nor 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.
The development will be using a gravity public sewer.
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. 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 and Threatened Species and Species of Concern by County for NC" website. The only species listed for Person County are
aquatic species, Neuse River waterdog, Carolina madtom, Atlantic pigtoe, and dwarf wedgemussel. None of these species are within the Roanoke
River basin so there is no habitat for them within the project area.
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?*
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 online mapper. There are no known historic resources within 1.0 mile of the project site.
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?*
NC Flood Risk Information System Map Number 3720090800J, Panel 0908
Miscellaneous
Comments

Miscellaneous attachments not previously requested.
Signature
m By checking the box and signing below, I certify that:
• I have given true, accurate, and complete information on this form;
• I agree that submission of this PCN form is a "transaction" subject to Chapter 66, 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:
Heather Smith
Signature
Date
7/25/2019

AGENT AUTHORIZATION FORM
B&B Country Inn, LLC
NN��i00
lib
1�
Project Name: Roxboro RV Park
Project Location: Boston Rd NC
Date: March 2019
The undersigned does hereby authorize:
The Professional Engineers and Scientists VHB
of
(Contractor / Agent)
(Name of consulting firm)
to act on my behalf and take all actions necessary for the identification, preliminary verification, and
permitting of impacts to potential aquatic resources which may result from the abovementioned
project. I understand that representatives of the U.S. Army Corps of Engineers and N.C. Division of
Water Resources may perform on-site verification of these resources and grant permission for access for
this purpose.
Mailing Address:
Joe Berryhill- Owner
705 Berryhill Road
Roxboro, NC 27574-6742
[phone]
I hereby certify the above information submitted in this application is true and accurate to the
best of my knowledge.
J rryhill Date
ature

Figure 1 USGS Vicinity MapRoxboro RV ParkPerson County, NCMay 2019³2013 USGS Quadrangle Roxboro1,000 0 1,000500FeetLegendStudy AreaPIN 0918-00-82-6456.000
BostonRdFigure 3 Soils MapRoxboro RV ParkPerson County, NCMay 2019³1995 NRCS Soil SurveyMap Sheet 72500250125FeetLegendStudy AreaPIN 0918-00-82-6456.000
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Know what's below.
before you dig.Call
R
1 inch = ft.
GRAPHIC SCALE
( IN FEET )
60 BYDATEREVISIONS132456PROJECT NO.
SHEET NO.DRAWING ALTERATIONIT IS A VIOLATION OF LAW FOR ANY PERSON,UNLESS ACTING UNDER THE DIRECTION OFLICENSED ARCHITECT, PROFESSIONALENGINEER, LANDSCAPE ARCHITECT, ORLAND SURVEYOR TO ALTER ANY ITEM ONTHIS DOCUMENT IN ANY WAY. ANY LICENSEEWHO ALTERS THIS DOCUMENT IS REQUIREDBY LAW TO AFFIX HIS OR HER SEAL AND THENOTATION "ALTERED BY" FOLLOWED BY HISOR HER SIGNATURE AND SPECIFICDESCRIPTION OF THE ALTERATIONS.PROJECT ENGINEER/ARCHITECTPROJECT MANAGERDRAWN BY7DRAWING NAME:COPYRIGHT 2017SUMMIT DESIGN ANDENGINEERING SERVICESCMWH ([e-mail])MWH ([e-mail])18-0226PERSON COUNTY RV PARKROXBORO, NCBOSTON ROADCONSTRUCTION DRAWINGSCreatively Inspired - Technically ExecutedLicense #: P-0339504 Meadowland DriveHillsborough, NC 27278-8551Voice: [phone] Fax: [phone]www.summitde.netFIRST ISSUE DATEMTM ([e-mail])07-27-201818-0266_G
C-6 GRADING & STORM DRAINAGE PLANGRADING & STORM DRAINAGE NOTES:
1.THIS PROPERTY IS WITHIN THE ROANOKE RIVER BASIN. THERE ARE NO STORM
WATER REQUIREMENTS.
2.ALL WALLS EXCEEDING 4' IN HEIGHT SHALL BE DESIGNED AND CERTIFIED BY A
PROFESSIONAL ENGINEER.
3.ALL PIPE TO BE INSTALLED ON-SITE AND IN THE RIGHTS OF WAY SHALL MEET
OR EXCEED THE NCDOT ASTM AND AASHTO SPECIFICATION REQUIREMENTS
FOR SUCH PIPE MATERIAL. CONTRACTOR SHALL VERIFY APPROVAL WITH
NCDOT FOR ALL PIPE MATERIALS TO BE USED IN THE RIGHT OF WAY.
4.ALL WORK WITHIN NCDOT ROW SHALL COMPLY w/ 2012 NCDOT STANDARD
SPECIFICATIONS FOR ROADS AND STRUCTURES, NCDOT STANDARD
DRAWINGS, AND THE MUTCD STANDARDS.
5.ALL ON-SITE PIPE SHALL BE INSTALLED MEETING COVER, BACKFILL AND
BEDDING REQUIREMENTS PER THE MANUFACTURER'S RECOMMENDATIONS.
6.NCDOT PRE-CAST DRAINAGE STRUCTURES / MANHOLES CAN BE USED IN LIEU
OF NCDOT STANDARD BRICK OR CONCRETE CATCH BASINS. ANY DEVIATION
FROM THE SPECIFIED STRUCTURES SHALL BE APPROVED BY ENGINEER PRIOR
TO INSTALLATION AND SHALL MAINTAIN COMPLIANCE WITH ALL
CORRESPONDING NCDOT MATERIAL, DRAWING & DETAILED SPECIFICATIONS.
7.CONTRACTOR SHALL FIELD VERIFY THAT PROPOSED GRADES MATCH EXISTING
PAVEMENT AT ALL CONNECTION/TIE POINTS PRIOR TO FINAL LIFT OF ASPHALT.
CONTRACTOR SHALL NOTIFY ENGINEER IF DISCREPANCY OCCURS.
8.PROPOSED CONTOUR LINES REPRESENT FINISHED GRADE ELEVATIONS.
CONTOUR LINES MAY BE ADJUSTED AT THEIR BEGINNING, ENDING AND AT
STRUCTURES AS DIRECTED BY THE ENGINEER IN ORDER TO PROVIDE A
PROPER TIE-IN.
9.CONTRACTOR SHALL FIELD VERIFY TIE OUT POINTS, PROPOSED INVERTS, FFE'S
& FINISHED SURFACES PRIOR TO CONSTRUCTION TO AVOID CONFLICTS.
CONTACT ENGINEER IF DISCREPANCIES ARE FOUND.
10.ADDITIONAL DISTURBANCE MAY BE REQUIRED FOR FINAL SEEDING AND
PLANTING PREPARATIONS.
11.MONITOR, MAINTAIN, MOVE AND/OR ADD SILT FENCE, SILT FENCE OUTLETS,
AND J-HOOKS AS NEEDED BASED ON FIELD AND RUNOFF CONDITIONS AND AS
DIRECTED BY THE ENGINEER AND/OR COUNTY REPRESENTATIVE.
12.A SEDIMENTATION AND EROSION CONTROL PLAN MUST BE SUBMITTED TO
NCDEQ AND APPROVED PRIOR TO MOVING FORWARD WITH CONSTRUCTION.
13.IF AN OFFSITE SOIL SPOIL OR BORROW SITE IS UTILIZED, THEN THE DISTURBED
AREA FOR THE SPOIL/BORROW SITE MUST BE INCLUDED IN THE
LAND-DISTURBANCE PLAN AND PERMIT UNLESS THE SPOIL/BORROW SITE
ALREADY HAS A LAND-DISTURBING PERMIT.
14.SEE SIA FOR DETAILED NUTRIENT AND PEAK FLOW CALCULATIONS.
15.ALL REQUIRED STORM DRAINAGE AND BMP EASEMENTS TO BE PLATTED UPON
FINAL CONSTRUCTION OF NEW CONVEYANCES.
16. ALL GRASS SLOPES WHICH EXCEED 3:1 (H:V) SHALL UTILIZE NORTH AMERICAN
GREEN (NAG) CONSTRUCTION PRODUCTS TURF REINFORCEMENT MATS S150
OR APPROVED EQUAL UNLESS OTHERWISE SPECIFIED ON PLANS. MATS SHALL
BE INSTALLED PER MANUFACTURER'S SPECIFICATIONS AND STANDARDS.
CONTRACTOR SHALL COORDINATE INSTALLATION INSPECTION WITH
MANUFACTURER.
17.ALL UTILITY TRENCHING, BACKFILL, AND SUB-GRADE COMPACTION EFFORTS
SHALL MEET/EXCEED NCDOT REQUIREMENTS AND SPECIFICATIONS.
18.THE EARTHWORK ON THIS PLAN DOES NOT NECESSARILY BALANCE; OFFSITE
BORROW OR WASTE MAY BE REQUIRED.
19.PER NORTH CAROLINA BUILDING CODE APPENDIX J ALL FILL SHALL AT A
MINIMUM MEET 90% STANDARD PROCTOR DENSITY PER ASTM D 1557. ALL
OTHER PORTIONS OF EARTHWORK AND GRADING AT A MINIMUM SHALL
ADHERE TO THIS CODE SECTION. BUT IN NO WAY SHALL SUPERCEDE THE SITE
SPECIFIC GEO-TECHINICAL RECOMMENDATIONS.
20.ALL ENTRANCES SHALL BE IN ACCORDANCE WITH NCDOT STANDARDS.
GRADING & STORM LEGEND:
EXIST / PROPOSED
LIMITS OF DISTURBANCE &
TREE PROTECTION FENCE
EXISTING MAJOR CONTOUR
EXISTING MINOR CONTOUR
DROP INLET
CURB INLET
FLARED END SECTION (FES)
LIMITS OF DISTURBANCE
EXISTING STORM PIPE
PROPOSED STORM PIPE
LD
JUNCTION BOX
TREE PROTECTION FENCE
PROPOSED MAJOR CONTOUR
PROPOSED MINOR CONTOUR
WOODS LINE
100
98
TP TP
LD/TP LD/TP
DISTURBED AREA
12.72 ACRES
*NO NATURAL WETLANDS ARE IDENTIFIED ON THIS SITE.
*ALL SLOPES STEEPER THAN 3:1, AND DITCHES,
SHALL BE STABILIZED WITHING 7 DAYS
STABILIZATION TIMEFRAMES
Site Area Description Stabilization Timeframe Exceptions
Perimeter dikes, swales,
ditches and slopes 7 days None
High Quality Water (HQW)
Zones 7 days None
Slopes steeper than 3:1 7 days
If slopes are 10’ or less in length
and are not steeper than 2:1, 14
days are allowed
Slopes 3:1 or flatter 14 days 7 days for slopes greater than 50’
in length
All other areas with slopes
flatter than 4:1 14 days None, except for perimeters and
HQW Zones
US 5
0
1 /
B
O
S
T
O
N
R
O
A
D
76' - 48" HDPE
PIPE @ 2.10%
RV PARK OFFICE
PICNIC SHELTER
BATH HOUSE
TRAILER STORAGE
CABIN
SITE 2: 495 SF or
0.011 AC of Wetland Fill
SITE 1: 95 LF OF
PERMANENT STREAM
DISTURBANCE
OR 0.004 ACRES
SITE 1: 20 LF OF
TEMPORARY STREAM
DISTURBANCE OR 0.001 ABOVE AND BELOW PIPE
FOR INSTALLATION
AND STABILIZATION)
SITE 3: 30 LF OF
PERMANENT STREAM
DISTURBANCE
OR 0.001 ACRES
SITE 3: 10 LF OF
TEMPORARY STREAM
DISTURBANCE OR 0.0005 AC ABOVE AND BELOW PIPE
FOR INSTALLATION
AND STABILIZATION)
20' - 24" HDPE
PIPE @ 4%
SAW -2019-00954
U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW -2019-00954 County: Person U.S.G.S. Quad: NC- Roxboro
NOTIFICATION OF JURISDICTIONAL DETERNIINATION
Requestor: B&B Country Inn, LLC
Joe Berryhill
Address: 705 Berryhill Road
Roxboro, NC 27574-6742
Telephone Number: 336-598-1144
Size (acres) 7 Nearest Town Roxboro
Nearest Waterway Mitchell Creek River Basin Roanoke
USGS HUC 03010104 Coordinates Latitude: 36.448361
Longitude: -78.934655
Location description: The project area is situated north of Boston Road, west of U.S. Highway 501 in the town of Roxboro,
Person County, North Carolina. The project area consists of approximately 7 acres of the northern portion of Person County
parcel PIN 0918-00-82-6456.0000. The proiect area is shown on the attached map entitled "Figure 4A Jurisdictional
Resources" as existing within a bold red boundary labeled "Study Area."
Indicate Which of the Following Apply:
A. Preliminary Determination
® There appear to be waters, including wetlands on the above described project area/property, that may be subject to Section 404
of the Clean Water Act (CWA)(33 USC § 1344) and/or Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403). The
waters, including wetlands have been delineated, and the delineation has been verified by the Corps to be sufficiently accurate
and reliable. The approximate boundaries of these waters are shown on the enclosed delineation map dated 5/6/2019. Therefore
this preliminary jurisdiction determination may be used in the permit evaluation process, including determining compensatory
mitigation. For purposes of computation of impacts, compensatory mitigation requirements, and other resource protection
measures, a permit decision made on the basis of a preliminary JD will treat all waters and wetlands that would be affected in any
way by the permitted activity on the site as if they are jurisdictional waters of the U.S. This preliminary determination is not an
appealable action under the Regulatory Program Administrative Appeal Process (Reference 33 CFR Part 331). However, you may
request an approved JD, which is an appealable action, by contacting the Corps district for further instruction.
❑ There appear to be waters, including wetlands on the above described project area/property, that may be subject to Section 404
of the Clean Water Act (CWA)(33 USC § 1344) and/or Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403).
However, since the waters, including wetlands have not been properly delineated, this preliminary jurisdiction determination
may not be used in the permit evaluation process. Without a verified wetland delineation, this preliminary determination is
merely an effective presumption of CWA/RHA jurisdiction over all of the waters, including wetlands at the project area, which
is not sufficiently accurate and reliable to support an enforceable permit decision. We recommend that you have the waters,
including wetlands on your project area/property delineated. As the Corps may not be able to accomplish this wetland
delineation in a timely manner, you may wish to obtain a consultant to conduct a delineation that can be verified by the Corps.
B. Approved Determination
❑ There are Navigable Waters of the United States within the above described project area/property subject to the permit
requirements of Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403) and Section 404 of the Clean Water Act
(CWA)(33 USC § 1344). Unless there is a change in law or our published regulations, this determination may be relied upon for
a period not to exceed five years from the date of this notification.
❑ There are waters, including wetlands on the above described project area/property subject to the permit requirements of Section
404 of the Clean Water Act (CWA) (33 USC § 1344). Unless there is a change in the law or our published regulations, this
determination may be relied upon for a period not to exceed five years from the date of this notification.

SAW -2019-00954
❑ We recommend you have the waters, including wetlands on your project area/property delineated. As the Corps may not be
able to accomplish this wetland delineation in a timely manner, you may wish to obtain a consultant to conduct a delineation that
can be verified by the Corps.
❑ The waters, including wetlands on your project area/property have been delineated and the delineation has been verified by
the Corps. The approximate boundaries of these waters are shown on the enclosed delineation map dated DATE. We strongly
suggest you have this delineation surveyed. Upon completion, this survey should be reviewed and verified by the Corps. Once
verified, this survey will provide an accurate depiction of all areas subject to CWA jurisdiction on your property which, provided
there is no change in the law or our published regulations, may be relied upon for a period not to exceed five years.
❑ The waters, including wetlands have been delineated and surveyed and are accurately depicted on the plat signed by the
Corps Regulatory Official identified below on DATE. Unless there is a change in the law or our published regulations, this
determination may be relied upon for a period not to exceed five years from the date of this notification.
❑ There are no waters of the U.S., to include wetlands, present on the above described project area/property which are subject to the
permit requirements of Section 404 of the Clean Water Act (33 USC 1344). Unless there is a change in the law or our published
regulations, this determination may be relied upon for a period not to exceed five years from the date of this notification.
❑ The property is located in one of the 20 Coastal Counties subject to regulation under the Coastal Area Management Act (CAMA).
You should contact the Division of Coastal Management in Morehead City, NC, at [phone] to determine their
requirements.
Placement of dredged or fill material within waters of the US, including wetlands, without a Department of the Army permit may
constitute a violation of Section 301 of the Clean Water Act (33 USC § 1311). Placement of dredged or fill material, construction or
placement of structures, or work within navigable waters of the United States without a Department of the Army permit may
constitute a violation of Sections 9 and/or 10 of the Rivers and Harbors Act (33 USC § 401 and/or 403). If you have any questions
regarding this determination and/or the Corps regulatory program, please contact Joshua A. Deal at 919-554-4884 ext. 35 or
ioshua.a.deal( )usace.armv.mil.
C. Basis For Determination: The project area exhibits water bodies with indicators of ordinary high
water marks and wetland criteria as defined in the applicable regional supplement to the 1987
wetland delineation manual. The water bodies on the site are listed in the attached table See the
preliminary iurisdictional determination form dated 6/10/2019). This determination is based on a
field verification by Ross Sullivan (USAGE) on 6/5/2019.
D. Remarks: The water bodies in the proiect area were flared by VHB, and are shown within the study
area on the attached "Figure 4A Jurisdictional Resources."
E. Attention USDA Program Participants
This delineation/determination has been conducted to identify the limits of Corps' Clean Water Act jurisdiction for the particular site
identified in this request. The delineation/determination may not be valid for the wetland conservation provisions of the Food Security
Act of 1985. If you or your tenant are USDA Program participants, or anticipate participation in USDA programs, you should request
a certified wetland determination from the local office of the Natural Resources Conservation Service, prior to starting work.
F. Appeals Information (This information applies only to approved jurisdictional determinations as indicated in B.
above)
This correspondence constitutes an approved jurisdictional determination for the above described site. If you object to this
determination, you may request an administrative appeal under Corps regulations at 33 CFR Part 331. Enclosed you will find a
Notification of Appeal Process (NAP) fact sheet and request for appeal (RFA) form. If you request to appeal this determination you
must submit a completed RFA form to the following address:
US Army Corps of Engineers
South Atlantic Division
Attn: Jason Steele, Review Officer
60 Forsyth Street SW, Room 10M 15
Atlanta, Georgia 30303-8801

SAW -2019-00954
In order for an RFA to be accepted by the Corps, the Corps must determine that it is complete, that it meets the criteria for appeal
under 33 CFR part 331.5, and that it has been received by the Division Office within 60 days of the date of the NAP. Should you
decide to submit an RFA form, it must be received at the above address by Not applicable.
**It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this correspondence.**
Corps Regulatory Official: �- =
Date of JD: 6/10/2019 Expiration Date of JD: Not applicable
The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we
continue to do so, please complete the Customer Satisfaction Survey located at
http://corpsmapu.usace.anny.mil/cm_apex/f.?p=136:4:0
Copy furnished:
Agent: VHB
Heather Smith
Address: Venture 1, 940 Main Campus Drive, Suite 500
Raleigh, NC 27606
Telephone Number: 919-754-5019
E-mail: hsmith(a,vhb.com

PRELIMINARY JURISDICTIONAL DETERMINATION (PJD) FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PJD: 06/10/2019
B. NAME AND ADDRESS OF PERSON REQUESTING PJD: B&B Country Inn, LLC, Joe Berryhill, 705 Berryhill
Road,Roxboro, NC 27574-6742
C. DISTRICT OFFICE, FILE NAME, AND NUMBER: Wilmington District, Roxboro RV Park, SAW -2019-
00954
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION: The project area is situated north of Boston
Road, west of U.S. Highway 501 in the town of Roxboro, Person County, North Carolina. The project area consists of
approximately 7 acres of the northern portion of Person County parcel PIN 0918-00-82-6456.0000. The project area is
shown on the attached map entitled "Figure 4A Jurisdictional Resources" as existing withi a bold red boundary labeled
"Study Area."
(USE THE TABLE BELOW TO DOCUMENT MULTIPLE AQUATIC RESOURCES AND/OR
AQUATIC RESOURCES AT DIFFERENT SITES)
State: NC County: Person City: Roxboro
Center coordinates of site (lat/long in degree decimal format): Latitude: 36.448361 Longitude: -78.934655
Universal Transverse Mercator:
Name of nearest waterbody: Mitchell Creek
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
® Office (Desk) Determination. Date:6/10/2019
® Field Determination. Date(s):6/5/2019
TABLE OF AQUATIC RESOURCES INREVIEW AREA WHICH "MAY BE" SUBJECT TO REGULATORY
JURISDICTION.
Estimated amount of
Geographic authority to
Type of aquatic
Latitude (decimal
Longitude (decimal
aquatic resources in
resources (i.e.
which the aquatic resource
Site Number
review area (acreage
"may be" subject (i.e.,
degrees)
degrees)
wetland vs. non-
and linear feet, if
Section 404 or Section
wetland waters)
applicable
10/404)
Stream A
36.448634
-78.935311
475 If
Non -wetland
Section 404
Stream B
36.450016
-78.937796
235 If
Non -wetland
Section 404
Wetland A
36.449052
-78.935148
0.07 ac
Wetland
Section 404
Wetland B
36.449688
-78.938078
0.15 ac
Wetland
Section 404

1) The Corps of Engineers believes that there may be jurisdictional aquatic resources in the review
area, and the requestor of this PJD is hereby advised of his or her option to request and obtain an
approved JD (AJD) for that review area based on an informed decision after having discussed the
various types of JDs and their characteristics and circumstances when they may be appropriate.
2) In any circumstance where a permit applicant obtains an individual permit, or a Nationwide General
Permit (NWP) or other general permit verification requiring "pre- construction notification" (PCN), or
requests verification for a non -reporting NWP or other general permit, and the permit applicant has
not requested an AJD for the activity, the permit applicant is hereby made aware that: (1) the permit
applicant has elected to seek a permit authorization based on a PJD, which does not make an official
determination of jurisdictional aquatic resources; (2) the applicant has the option to request an AJD
before accepting the terms and conditions of the permit authorization, and that basing a permit
authorization on an AJD could possibly result in less compensatory mitigation being required or
different special conditions; (3) the applicant has the right to request an individual permit rather than
accepting the terms and conditions of the NWP or other general permit authorization; (4) the applicant
can accept a permit authorization and thereby agree to comply with all the terms and conditions of that
permit, including whatever mitigation requirements the Corps has determined to be necessary; (5)
undertaking any activity in reliance upon the subject permit authorization without requesting an AJD
constitutes the applicant's acceptance of the use of the PJD; (6) accepting a permit authorization (e.g.,
signing a proffered individual permit) or undertaking any activity in reliance on any form of Corps
permit authorization based on a PJD constitutes agreement that all aquatic resources in the review area
affected in any way by that activity will be treated as jurisdictional, and waives any challenge to such
jurisdiction in any administrative or judicial compliance or enforcement action, or in any
administrative appeal or in any Federal court; and (7) whether the applicant elects to use either an AJD
or a PJD, the JD will be processed as soon as practicable. Further, an AJD, a proffered individual
permit (and all terms and conditions contained therein), or individual permit denial can be
administratively appealed pursuant to 33 C.F.R. Part 331. If, during an administrative appeal, it
becomes appropriate to make an official determination whether geographic jurisdiction exists over
aquatic resources in the review area, or to provide an official delineation of jurisdictional aquatic
resources in the review area, the Corps will provide an AJD to accomplish that result, as soon as is
practicable. This PJD finds that there "may be" waters of the U.S. and/or that there "may be"
navigable waters of the U.S. on the subject review area, and identifies all aquatic features in the
review area that could be affected by the proposed activity, based on the following information:

SUPPORTING DATA. Data reviewed for PJD (check all that apply)
Checked items should be included in subject file. Appropriately reference sources
below where indicated for all checked items:
❑■ Maps, plans, plots or plat submitted by or on behalf of the PJD requestor:
Map:Deli neation Flagging Maps
❑■ Data sheets prepared/submitted by or on behalf of the PJD requestor.
❑ Office concurs with data sheets/delineation report.
❑ Office does not concur with data sheets/delineation report. Rationale:
❑ Data sheets prepared by the Corps:
❑ Corps navigable waters' study:
❑ U.S. Geological Survey Hydrologic Atlas:
❑ USGS NHD data.
❑ USGS 8 and 12 digit HUC maps.
❑■ U.S. Geological Survey maps). Cite scale & quad name:
1:24,000 Roxboro, NC
❑W Natural Resources Conservation Service Soil Survey. Citation: 1995 Person County, Map Sheet 7
❑ National wetlands inventory map(s). Cite name:
❑ State/local wetland inventory map(s):
❑ FEMA/FIRM maps:
❑ 100 -year Floodplain Elevation is: .(National Geodetic Vertical Datum of 1929)
❑■ Photographs: ❑■ Aerial {Name & Datey 2017 NCOneMap
or ❑■ Other (Name & Datey Site Photographs
❑ Previous determinations). File no. and date of response letter:
❑ Other information (please specify):
IMPORTANT NOTE: The information recorded on this form has not necessarily
been verified by the Corps and should not be relied upon for later jurisdictional
determinations.
6/10/2019
Signature and date of
Regulatory staff member
completing PJD
Signature and date of
person requesting PJD
(REQUIRED, unless obtaining
the signature is impracticable)'
1 Districts may establish timeframes for req uestor to return signed PJD farms. If the req uestor does not respond
within the established time frame, the district may presume concurrence and no additional follow up is
necessary prior to finalizing an action.

NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
REQUEST FOR APPEAL
Applicant: B&B Country Inn LLC Joe Berryhill File Number: SAW -2019-00954 Date: 06/10/2019
Attached is: See Section below
❑ INITIAL PROFFERED PERMIT Standard Permit or Letter ofpermission) A
❑ PROFFERED PERMIT Standard Permit or Letter ofpermission) B
❑ PERMIT DENIAL C
❑ APPROVED JURISDICTIONAL DETERMINATION D
® PRELIMINARY JURISDICTIONAL DETERMINATION E
SECTION I - The following identifies your rights and options regarding an administrative appeal of the above decision.
Additional information may be found at or http://www.usace.army.miliMissions/CivilWorks/RegulatoryProgramandPermits.aspx
or the Corps regulations at 33 CFR Part 331.
A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• OBJECT: If you object to the permit (Standard or LOP) because of certain terms and conditions therein, you may request
that the permit be modified accordingly. You must complete Section II of this form and return the form to the district
engineer. Your objections must be received by the district engineer within 60 days of the date of this notice, or you will
forfeit your right to appeal the permit in the future. Upon receipt of your letter, the district engineer will evaluate your
objections and may: (a) modify the permit to address all of your concerns, (b) modify the permit to address some of your
objections, or (c) not modify the permit having determined that the permit should be issued as previously written. After
evaluating your objections, the district engineer will send you a proffered permit for your reconsideration, as indicated in
Section B below.
B: PROFFERED PERMIT: You may accept or appeal the permit
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• APPEAL: If you choose to decline the proffered permit (Standard or LOP) because of certain terms and conditions therein,
you may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of
this form and sending the form to the division engineer. This form must be received by the division engineer within 60 days
of the date of this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process by
completing Section II of this form and sending the form to the division engineer. This form must be received by the division
engineer within 60 days of the date of this notice.
D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or provide new
information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the
date of this notice, means that you accept the approved JD in its entirety, and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD, you may appeal the approved JD under the Corps of Engineers
Administrative Appeal Process by completing Section II of this form and sending the form to the district engineer. This form
must be received by the division engineer within 60 days of the date of this notice.
E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps regarding the
preliminary JD. The Preliminary JD is not appealable. If you wish, you may request an approved JD (which may be appealed),
by contacting the Corps district for further instruction. Also you may provide new information for further consideration by the
Corps to reevaluate the JD.

SECTION& REQUEST FOR APPEAL or OBJECTIONS TO AN INITIAL PROFFERED PERMI
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your objections to an initial
proffered permit in clear concise statements. You may attach additional information to this form to clarify where your reasons or
objections are addressed in the administrative record.)
ADDITIONAL INFORMATION: The appeal is limited to a review of the administrative record, the Corps memorandum for the
record of the appeal conference or meeting, and any supplemental information that the review officer has determined is needed to
clarify the administrative record. Neither the appellant nor the Corps may add new information or analyses to the record.
However, you may provide additional information to clarify the location of information that is already in the administrative
record.
POINT OF CONTACT FOR QUESTIONS OR INFORMATION: Ir
If you have questions regarding this decision and/or the
If you only have questions regarding the appeal process you may
appeal process you may contact:
also contact:
District Engineer, Wilmington Regulatory Division
Mr. Jason Steele, Administrative Appeal Review Officer
Attn: Joshua A. Deal
CESAD-PDO
Raleigh Regulatory Office
U.S. Army Corps of Engineers, South Atlantic Division
U.S Army Corps of Engineers
60 Forsyth Street, Room 1OM15
3331 Heritage Trade Drive, Suite 105
Atlanta, Georgia 30303-8801
Wake Forest, North Carolina 27587
Phone: [phone]
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel, and any government
consultants, to conduct investigations of the project site during the course of the appeal process. You will be provided a 15 day
notice of any site investigation, and will have the opportunity to participate in all site investigations.
Date:
Telephone number:
Signature of appellant or agent.
For appeals on Initial Proffered Permits send this form to:
District Engineer, Wilmington Regulatory Division, Attn: Joshua A. Deal, 69 Darlington Avenue, Wilmington, North Carolina
28403
For Permit denials, Proffered Permits and Approved Jurisdictional Determinations send this form to:
Division Engineer, Commander, U.S. Army Engineer Division, South Atlantic, Attn: Mr. Jason Steele, Administrative Appeal
Officer, CESAD-PDO, 60 Forsyth Street, Room 1OM15, Atlanta, Georgia 30303-8801
Phone: [phone]