19970289 Ver 1_COMPLETE FILE_19970419

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
APPROVAL of 401 Water Quality Certification
Mr. Gregory and Ms. Elizabeth Lee
Route 2, Box 235A
Polkton, NC 28135
Dear Mr. and Ms. Lee:
Ag4j?EHNR
April 10, 1997
Montgomery County
WQC 401 Project #97028
You have our approval, in accordance with the attached conditions, to impact 0.01 acres of waters for the
purpose of construction of a pier at your house on Lake Tillery, as you described in your application dated 1
April 1997. After reviewing your application, we have decided that this fill is covered by General Water
Quality Certification Number 3099. This Certification allows you to use General Permit Number 030 when
it is issued by the Corps of Engineers.
This approval is only valid for the purpose and design that you described in your application. If you
change your project, you must notify us and you may be required to send us a new application. If total
wetland fills for this project (now or in the future) exceed one acre, compensatory mitigation may be required
as described in 15A NCAC 2H.0506 (h) (6) and (7). For this approval to be valid, you must follow the
conditions listed in the attached certification. In addition, you should get any other federal, state or local
permits before you go ahead with your project including (but not limited to) Sediment and Erosion Control,
Coastal Stormwater, Non-Discharge and Water Supply Watershed regulations. Also this approval will expire
when the accompanying 404 or CAMA permit expires unless otherwise specified in the General Certification.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing.
You must act within 60 days of the date that you receive this letter. To ask for a hearing, send a written
petition which conforms to Chapter 150B of the North Carolina General Statutes to the Office of
Administrative Hearings, P.O. Box 27447, Raleigh, N.C. 27611-7447. This certification and its conditions
are final and binding unless you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water
Act. If you have any questions, please telephone John Dorney at 919-733-1786.
Sincerely,
ton Howar? , Jr. P.E
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Wilmington Field Office
Fayetteville DWQ Regional Office
Mr. John Dorney
Central Files
970289.1tr
Division of Water Quality • Environmental Sciences Branch
Environmental Sciences Branch, 4401 Reedy Creek Rd., Raleigh, NO 27607 Telephone [phone] FAX # [phone]
An Equal Opportunity Affirmative Action Employer - 50% recycled/10%o post consumer paper

DEM ID: ACTION ID:
-%:7n289 M?
Nationwide Permit Requested (Provide Nationwide Permit ft A
JOINT FORM FOR Nationwide permits that require notification to the Corps of Engineers
Nationwide permits that require application for Section 401 certification
WILMINGTON DISTRICT ENGINEER WATER QUALITY PLANNING
CORPS OF ENGINEERS DIVISION OF ENVIRONMENTAL MANAGEMENT
DEPARTMENT OF THE ARMY NC DEPARTMENT OF ENVIRONMENT, HEAL-TH,
RO. Box. 1890 AND NATURAL RESOURCES
Wilmington, NC 28402-1890 P.O. Box 29535
ATM: CESAW CO-E 4aleigh, NC 2762 -0535
Telephone [phone]?iITN: MR. JOHN DORNEY
Telephone [phone] - 117 S
ONE (1) COPY OF THIS COMPLETED APPLICATION SHOULD BE SENT TO THE CORPS OF ENGINEERS.
SEVEN (7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT.
PLEASE PRINT.
1. Owners Name: (-x io c air i/ M L e:C A I d E [i Z AbeA Al L. if&
2. Owners Address: ?24' ,? QS?G- A
3. Owners Phone Number (Home): 7Qy Z (Work): 'SOS/- Pa,-21-33
4. If Applicable: Agent's name or responsible corporate official, address, phone number.
5. Location of work (MUST ATTACH MAP). County: M-?
Nearest Town or City: e
S ecific Location (Include road numbers, landmarks, etc.:
elk
%J e
-?-
6. Name of Closest Stream/River. ? e_ 'fi e e _ i Y'C'r
7. River Basin: V of S i n `
8. Is this project located in a watershed classified as Trout, SA, HQW, ORW, WS I, or WS II? YES [ J NOS}
9. Have any Section 404 permits been previously requested for use on this property? YES [ ] NO
If yes, explain.
10. Estimated total number of acres of waters of the U.S., including wetlands, located on project site: o C0?
11. Number of acres of waters of the U.S., including wetlands, impacted by the proposed project:
Filled:
-Drained:
Flooded:
Excavated: '
Total

12. Description of proposed work (Attach PLANS-8 UT' X 11" drawings only):
Lc A e- C-'.v k ? ?c -4 --2 S :!5 P C -- c_ z ? , , Ie
w,
13. Purpose-of proposed

Lt i
.t [71)'
14. State reasons why the applicant be J' ves that ?s activity must be carried out ' wetlands. Also, note Feasures
taken to minimize wetland impacts. t = E? ' t l
L e. , I •,v-N i7 A C 'i'ce C-1
You are required to contact the U.S. Fish and Wildlife Service (USFWS) and/or National Marine.Fisheries Service
(NMFS) regarding the presence or any Federally listed orproposed for listing endangered or threatened species r critical
NO [ ]
habitat in the permit area that may be affected by the proposed project. Have you done so? YE
RESPONSES FROM THE USFWS AND/OR NUTS SHOULD BE FORWARDED TO CORPS.
16. You are required to contact the State Historic Preservation Officer (SHPO) regarding the presence of historic
properties in the permit area which may be affected by the proposed project? Have you done so? YES [ ] NO [
RESPONSE FROM THE SHPO SHOULD BE FORWARDED TO CORPS.
17. Additional information required by DEM:
A. Wetland delineation map showing all wetlands, streams, and lakes on the property.
B. If available, representative photograph of wetlands to be impacted by project.
C. If delineation was performed by a consultant, include all data sheets relevant to the placement of the
delineation line. u'.
D. If a stormwater management plan is required fo , project attach copy.
E. What is land use of surrounding property? ?-! e -
F. If applicable, what is proposed method of sewage disposal?
Owner's Si Lure Date
E
G

FEB-28-1997 09:27
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