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80 <br /> USACE Wilmington District <br /> Compensatory Mitigation Responsibility Transfer Form, Page 2 <br /> Conditions for Transfer of Compensatory Mitigation Credit: <br /> • Once this document has been signed by the Mitigation Sponsor and the USACE is in receipt of the signed form, the <br /> Permittee is no longer responsible for providing the mitigation identified in this form, though the Permittee remains <br /> responsible for any other mitigation requirements stated in the permit conditions. <br /> • Construction within jurisdictional areas authorized by the permit identified on page one of this form can begin only after <br /> the USACE is in receipt of a copy of this document signed by the Sponsor, confirming that the Sponsor has accepted <br /> responsibility for providing the mitigation requirements listed herein. For authorized impacts conducted by the North <br /> Carolina Department of Transportation (NCDOT), construction within jurisdictional areas may proceed upon permit <br /> issuance; however, a copy of this form signed by the Sponsor must be provided to the USACE within 30 days of permit <br /> issuance. NCDOT remains fully responsible for the mitigation until the USACE has received this form,confirming that the <br /> Sponsor has accepted responsibility for providing the mitigation requirements listed herein. <br /> • Signed copies of this document must be retained by the Permittee, Mitigation Sponsor,and in the USACE administrative <br /> records for both the permit and the Bank/ILF Instrument. It is the Permittee's responsibility to ensure that the USACE <br /> Project Manager(address below) is provided with a signed copy of this form. <br /> • If changes are proposed to the type, amount, or location of mitigation after this form has been signed and returned to <br /> the USACE, the Sponsor must obtain case-by-case approval from the USACE Project Manager and/or North Carolina <br /> Interagency Review Team (NCIRT). If approved, higher mitigation ratios may be applied,as per current District guidance <br /> and a new version of this form must be completed and included in the USACE administrative records for both the permit <br /> and the Bank/ILF Instrument. <br /> Comments/Additional Conditions: <br /> This form is not valid unless signed below by the USACE Project Manager and by the Mitigation Sponsor on Page 1. Once <br /> signed,the Sponsor should provide copies of this form along with an updated bank ledger to:1)the Permittee,2)the USACE <br /> Project Manager at the address below,and 3)the Wilmington District Mitigation Office,Attn:Todd Tugwell,3331 Heritage <br /> Trade Drive, Suite 105, Wake Forest, NC 27587(email: todd.tugwell@usace.army.mil). Questions regarding this form or <br /> any of the permit conditions may be directed to the USACE Project Manager below. <br /> USACE Project Manager: Samantha Dailey <br /> USACE Field Office: Raleigh Regulatory Field Office <br /> US Army Corps of Engineers <br /> 3331 Heritage Trade Drive,Suite 105 <br /> Wake Forest, North Carolina 27587 <br /> Email: Samantha.!.Dailey@usace.army.mil <br /> DAILEY.SAMANTHA.J. <br /> Dig ita I ly signed by DAILEY.SAMANTHA.J.1387567948 <br /> DN:c=US,o=U.S.Government,ou=DoD,ou=PKI, <br /> ou=USA,cn=DAILEY.SAMANTHA.J.1387567948 <br /> 1387567948 <br /> Date:2018.04.06 10:57:15-04'00' <br /> April 6,2018 <br /> USACE Project Manager Signature Date of Signature <br /> Current Wilmington District mitigation guidance, including information on mitigation ratios, functional assessments, and <br /> mitigation bank location and availability, and credit classifications (including stream temperature and wetland groupings) is <br /> available at http://ribits.usace.army.mi1. <br /> Page 2 of 2 <br /> 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 <br /> Customer Satisfaction Survey located at our website at http://regulatory.usacesurvey.com/to complete the survey online. <br />