19930061 Ver 1_Complete File_20100726

State of North Carolina
Department of Environment, Health, and Natural Resources
512 North Salisbury Street * Raleigh, North Carolina 27604
James B. Hunt, Jr., Governor Jonathan B. Howes, Secretary
March 5, 1993
W. Trent Anderson
County Maintenance Engineer
N.C. Dept. of Transportation
P.O. Box 1551
Andrews, N.C. 28901
Dear Mr. Anderson:
Subject: Proposed Fill in
Road improvement,
Macon County
Project # 93061
Headwaters or Isolated Wetlands
SR 1105
Upon review of your request for Water Quality Certification
to place fill material in waters for road inprovements located at
SR 1105, in Macon County, we have determined that the proposed
fill can be covered by General Water Quality Certification No.
2732 issued January 21, 1992. A copy of the General Certification
is attached. This Certification may be used in qualifying for
coverage under Corps of Engineers' Nationwide Permit No. 14.
If you have any questions, please contact John Dorney at
919-733-1786
Sincerely,
93061.1tr
Attachment
oward, r. P . E .
cc: Wilmington District Corps of Engineers
Corps of Engineers Asheville Field Office
Asheville DEM Regional Office
Mr. John Dorney;
Central Files
P.O. Box 27687, Raleigh, North Carolina 27611-7687 Telephone [phone] Fax # [phone]
An Equal Opportunity Affirmative Action Employer
MEMORANDUM
TO: John Dorney
Planning Branch
SUBJECT: WETLAND STAFF REPORT AND RECOMMENDATIONS
***EACH ITEM MUST BE ANSWERED (N/A-NOT APPLICABLE)***,
INITIALS:
Reviewer : A..?
WQ Supv:
Date _;C
PERNIIT_YR: 93 PER14IT_NO: 0000061 COUNTY: MACON
APPLICANT NAME: NC DOT - PAVE SR 1105
PROJECT-TYPE: CULVERTS PERMIT TYPE: NW14
COE iI : DOT it :
RCD_FROM_CDA: DOT DATE _FRM_CDA: 01/6/93
REG_OFFICE: ARO RIVER-AND-SUB-BASIN-it: L,. ? ec.n•
,galbe,,,tS CY«R oy ay o 1
STREAM_CLASS : G _ 7-?-nv r
STR INDEX NO: ?.'
WL_IMPACT? : Y,0
WL_REQUESTED: /?/
HYDRO_CNECT?: DIN
MITIGATION?: Y/Q
WL_TYPE : .S79
WL_ACR_EST?: YIN
WL_SCORE (4) : 0
MITIGATION-TYPE:
MITIGATION SIZE:
IS WETLAND RATI14G SHEET ATTACHED?:CJ/N
RECOMMENDATION (Circle One): ISSUF ISSUE/COND DENY
COMMENTS:
cc: Regional Office
Central Files
93o6 I

o/ Hydrologically connected
o Hydrologically Isolated

Wetland type (select one) o Other
o Swamp forest o Shoreline •
o Bottomland hardwood forest V Stream channel
o Carolina bay o Salt marsh .
o Pocosin o Brackish marsh •
o Pine savannah o Freshwater marsh
o Wet flat o Bog/Fen
o Perched o Vernal pool
-. •••••••••?••???••?????o ??sum
•••••o.
??o.•??oo?o•??
?o?•o??ow
Water storage
Bank/Shoreline stabilization ? x 4.04 -
Pollutant removal

Sensitive watershed ' x 1
50 -
- t •
Dispersal corridor ( . Wetland score.
Special ecological attributes
Wildlife habitat _
x 1.50
Aquatic life value
' Recreation/Education „ .
Economic value Q x 0.25 - ?

Wetland area acres Wetland width feet
Nearest road -A/C S R if o d e.. r°2?P 1

J (l l?l E S t:, . 1 1 H H H I
GOVE=RNOR
-:,(iM HUNT
SECRETARY
MACON COUNTY
SR 1105
Mr. Bob Johnson
US Army Corps of Engineers
Reg. Field Office
Rm. 75, Grove Arcade Building
37 Battery Park Avenue
Asheville, N. C. 2£3801-714
Dear Mr. Johnson:
i
?1•u
DTV'1 1(.jtl _i f- 1'IIC;ItW?'IY
lJlE_I_Ir'.t1 (;. MORLEY'. JR.
STATE HIGHWAY ADMINISTRATOR
The North Carolina Department of Transportation is
proposing to construct and pave SR 1105, Carpenter Road, in
Macon County. In order to construct this project in
accordance with our current standards it will be necessary
to upgrade and extend an existing pipe culvert. At survey
station 5+80 the existing 30" CMP is to be replaced with 40
L.F. of 36" CMP. The existing culvert was installed in a
manner- that causes stream flow to fall 0.5 ft. into the
stream channel at the outlet end of the pipe. We propose to
install the new culvert slightly below the existing
streambed elevations to minimize impacts to wildlife habitat
and allow the existing stream gradient to remain as
unchanged as is physically possible.
The affected stream is an unnamed tributary to Mulberry
Creek which has a North Carolina Department of Environment,
Health, and Natural Re-sources classification of Class C -
Trout Water. No trout buffer zone encroachments or, channel
changes are involved on this project as all stream crossings
are perpendicular t.o the st.reanis.
The best manaciument. pr._tctict_;_ will k u_-'ed lu minimj e
and cont.rol sedimt?Ol.,;tic?rl And ero_-.ion on project-.. VI
construCt.ion for'enI II r•Ji 11 rc view .:tll cro. ion c C)nt.ro"l
(nt-;_i: ures d.'iI y E.Ca r'll';ili t..t(.10r) •ill,a (;l O^, 3. o1) tI t:. t :tlll I
e- ffr2c t-.ive.Jy co ntl; ) Ic.',?. l l 1.IIc t,E.;trln? d 1: •./:ic_ :.. aI e nctl.
functioning as rnl °ncJt <1, t.l1t?y wi.l i i 11 edIaI - etv b e I t:p t,ac;cd
with better device-. [he tuck <..i. L t. ==,creep .atld oLht_ I erosion
STATE OF NORTH CAROLINA
Department of Transportation
(;I1 11 .itiJ !'I. C. ' 81Y01
F'.i'?-)c., ...
control devices will b irl pI.:tce prior to removal of Lhf1
existing pipe culvert. and will remain in place unti ] the
project is stabilized.
By copy of this letter, we are requesting the N. C.
Wildlife Resources Commission to comment to you concerning
our request. Also, by copy of this letter to the N. C.
Division of Environmental Management, we are requesting
authorization under Section 401 of the Clean Water Act.
Enclosed are a location map, straight-line diagram,
plan/profile sheets, erosion control plans and details, and
a'U.S.G.S. Map) indicating project area and location of the
proposed culvert can the road. Please review this request
for authorization under Section 404 of the Clean Water Act.
If you have any questions concerning this applciation,
please contact me at [phone].
Sincerely,
V tA) • -F;?j
W. Trent Anders
County Maintenance Engineer
WTA/ rr
Enclosures
cc: Mr. Mickey Clemmon:-i, NCWRC
Mr. Eric Galamb, NCDEM
Mr. V. A. Edwards, P. E.
Y.?06/
APPLICATION FOR DEPARTMENT OF THE ARMY PERMIT 0UBAPPR0VAL N0.0710-0003
(33 CFR 325) EJrplres 30 Septembor 1992
Public reporting burden for this collection of information is estimated to average 5 hours per response for the majority of cases, including the time for reviewing Instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Applications for larger or more complex
projects, or those in ecologically sensitive areas, could take up to 500 fours. Send comments regarding this burden estimate or any other aspect of this collection of information,
Including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Service, Directorate for Information Operations and Projects, 1215 Jefferson
Davis Highway, Suite 1204, Arlington, VA 22202-4302; and to the Office of Managomont and Budget, Paperwork Reduction Project (0710-0003), Washington, DC 20503. Please
DO NOT RETURN your completed form to either of these addrssses. Completed application must be sulxmkted to the District Engineer Raving Jurtadlctlon over the
location of the proposed activity.
The Department of the Army permit program is authorized by Section 10 of the Rivors and Harbors Act of 1899. Section 404 of the Clean Water Ater and Section 103 of the Marine,
Protection, Research and Sanctuaries Act. These laws require permits authorizing activities in or affecting navigable waters of the United States, the discharge of drodgod or fill
material Into waters of the United States, and the transportation of dredged material for the purpose of dumping 4 into oooan waters. Information provided on this form will be used
in evaluating the application for a permit Information in this application is made a smatter of public record through issuance of a public notice. Disclosure of the informaton
requested is voluntary; however, the data requested are necessary in order to communicate with the applicant and to evaluate the permit application. It necessary Information is
not provided, the permit application cannot be processed nor can a permit be Issued.
One set of original drawings or good reproducible copies which show the location and character of the proposed activity must be attached to this application (see sample drawings
and instructions) and be submitted to the District Engineer having jurisdiction over the location of the proposed activity. An application that Is not m_ mp(etod.ln full will be returned.

1. APPLICATION NUMBER (To be assigned by Corps) 3. NAME, ADDRESS, AND TITLEOf--AUTHORtZ£D AGENT-
?
I
7 1v
+ Telephone no. during business hburs `VETLAN-DS GROUP
2. NAME AND ADDRESS OF APPLICANT ; WMER QUALITY SECTIC"1
ice n J? kn de «..
W ABC c ) (Residence)
.
No
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D
4
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4
A/C( (Office)
)
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na-
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o
P.D. Soy- J 5S
opQ
d Statement of Authorization: I horoby dosignato and authorize
to act in my
r
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C
2p 1 1
l
lication and to furnish
it a
hi
h
i
f
i
business h
ours
Telephone
no. du
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ng ,
pp
ng o
s perm
e process
t
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behalf as my agent
upon request, supplemental information in support of the application.
A/C ( ) (Residence)
ffi
321 - 4 l O S SIGNATURE OF APPLICANT DATE
(O
ce)
Arc c704)
4. DETAILED DESCRIPTION OF PROPOSED ACTIVITY
4a. ACTIVITY
UPi trade, and. expend.. a Pipe cvlver; on SR M)5, Carpenv,ec-
'Road) in MQCom CW44 MC-0 -This cvlveclz car6e5 ?S-?c't°?rl?loyJ o't
k,ribL&6t-.T -U3 Mulbe(rY Cceek wh?c% ha,-, a, DEM
Ua s5
4b. PURPOSE
SR 1 ?S {.o mee?, cuc-cen? t?1CD OT ?Var,darfs
vci der`
d
ve
I'
Pa
, an
,
D
iC"Xk sec,4io-t., anct cL i t,rtrmem? r avec? 'sec.c?nilary c-oo:r?s. .S
ere a
?or
yP
l
road co ns+ruc? i otv Prn j ecA-- w kece_ Azke,
one (. l) I o c.ak l ot\, on
PCOC OS-cd. roadway wide-1•, makes c?lver?, uPgradin? necesSQCy .
4c. DISCHARGE OF DREDGED OR FILL MATERIAL
FN(; POP" AIAI; Rpn Q1 EDITION OF JAN 9113 OBSOLETE (Propo t:CECWOR)
I/ ;? `L:QCA-t"101? MAP
?' ? 1 ySR I I d S'
I U CJ ! l1 )•. '11,1'\M r lull^ t+/ \fM l/1
IL• , ? ref, l,„ , n> 1. X711• L ' 11 ? V01? ..,,
???o ' v ,? -? ? 1 r ?, , S,, I;• 1 r 1711 _ _ ? ? v?IvYV ? I C?.,
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t 31) 13.3 ...L,
ONION a?
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133.
Ell,
jn Y.
yIDGE ! .IY ?? / .?'^ loin v Ito
23
f •?
/ FRANKUN) 1711110
4;, ?? ':;`or•1°°.0 e 1 `??? J s l519 02.
3 s)1 \
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t ?../
{714 .®7 .7 745 S '? 6e 1? Jo ??? 1731
64
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.19 o 1331 ? 12
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ELEv,
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\ 1411 37# .? /I#)
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1301 t
U 11
??790 13Ci 1LU ti'nu? , /C. CGLL.ISA
FALLS
4.1 ep Ill? ,.5 ` I11? IIJe ° 11]) it T. ,r It.e
``44 (/ SKYHI
`e 11 : -2-33 as ? i Ls s n t e 140 ??• ' e , ? l?r' se 1 To 7e Umr
I I11? 1111 '? 117. 117. ?? '11 le.l
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BLACK 1111 "71 u ]I MTN. / 6 n
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DRY
STANDING
la•.1 ? ? !ns a 1 ? ???
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1110 1117 14 ? 1431
1 I110'v. LHA 1.33 1 `.I 1670 A ..
INDIAN WILDLIFE ?' ?'•"•d/yya' to'? - J e v •ul ? , .? DOG MIN[
.ally .R v 1• / 0 feu 0?
i i .i9' c a? Sv 116 Ill) 11 v! '?/.(. le3r I -•? 106
BUCK Rd SCw1 N
Y Mi. 5 I
V / LL90 KNOB 1177 rtd_ EIEV, 7,804 1431 / e
1/ t
J _ 8E? Iu CO /0 F
-- MANAGEMENT 7 U.y1"yS`; no,? .,
_I gil•t - _!411 4 t#7 ..r 1 !: UTTLt :?01I
;\ TN /
?/ m? /J?? 1 y 2=r ?oNY R? O SCALY M
Vs : 6 J? [1[v. ..a DO AREA ?, _ \ f ?)y. • Nwron No \ 1s1t
,e.r Rd. Fr,1 +
(? \ _ F`71 os '- ?' _ Scoly ° I
/S \ 1107 I I 1e)• • '?? \1 ?/?/` v- {ft? ? o 1? GSAGt - / l \ y
no.
` \ 1107 \ '.+ ? evl ( 1p]}e 1411 ) i m1N.
• .?`. '? ?' C•1 Qf..r. 1100 ('..t6 II „No. {or. 4 ?'I
?-
1. 1`111 y> 1 O.lun.kr Rrd. 1434 ?_. ?..
---- " 1 6 SR l`j0 5 -
CARPEN-TeR RIB.
R A E
U N C O C 'A •1 D'• I y r A R U N
CoNS-(RUGYIOki ?
sTF? 15 4 3 S
G E 0 R G I A
MACON C O.
ROAD NAME CARPENTER ROAD --
'
S. R. 1105
.
6.972122
W. 0,
F R n tvl SR-1104 0+00 TO 15+35 E.O.P.
A Q D l T 10 I? .___ -
1 M PROVEM ENT - X
• TO BE PAV E b` --- X --
P POLES TO CAE MOVED 4
T. POLES TO BE MOVE D . 3 POLES 4 BOXES
W W l D T F-I __ 45'
SCALE I ??= 50
DATE 4 - 14 - 92
i

5+0
lit
Q)
0 4+95
J
r
0
O
5, yr
01
?n
^^Q`
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I
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V
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1 BRIDGE # 248
. „ I
JESSIE C. CARPENTER
705 B GRANADA TERRACE
MACON, GA. 31206 I
(2)

E.C. &GENEVA SAMS
525 MULBERRY ROAD
OTTO, N. C. 28763
(1)
cr-
Il
I
I --- 4 5 ---
I
SR-1104 0+00 1 1_ I 0+00 SP-:104
U '
SHIRLEY FRANKLIN CRONE 10+00 SDI 10+00
30 CARPENTER RD. 0
OTTO, N. C. 28734
0
I ? i
(6) 6 ?
0? 0
I-?- q 5 - a?

PL 9+00,

18" CMD ADD 18" CMP
D - ,

v0 I

I R.L. BURRELL
R.L. BURRELL 0D 49 PRENTISS BRIDGE RD.
49 PRENTISS BRIDGE RD. FRANKLIN, N.C. 28734
FRANKLIN, N. C. 28734
. 'y
I
(5)
(5) 0
OI
I 0
0
0
00

p

0
0 3:
0
PL 6+95 I 0 Cr- 6+95

0

JESSIE C. CARPENTER
705 B GRANADA TERRACE
MACON, GA. 31206
(4)
(2)

5+00
PL
30" CMP REPLACE WITH NEW 361- CMP
_ ?. 5+ PL
T - - -a?f
JESSIE C. CARPENTER
705 B GRANADA TERRACE
MACON, GA. 31206
(3)
5+00
15+00 I

5
15+00
IIARLEY JR. CARPENTER
P. 0. BOX 394
FRANKLIN, N. C. 28734 _
(8) I
I
I
PL
?L
a
I
_ 11+47
LARRY & SHIRLEY C. CRONE I
30 CARPENTER RD. I
OTTO, N. C. 28763 4
(7) 11+00
(6) 4
I I
O ?
V ,7
10+00
cr-
(5)
rl'
r,
i) 10+00
0
IIARLEY JR. CARPENTER
P. 0. BOX 394
FRANKLIN, N. C. 28734
(8)
PL
20+001 f 120+00
q Is,-)-
I

I ?

I--
4
I
I
E.O.P. 15+35 15+35 E.O.P.
(8) (8)
15+00 I I 15+00
Proposed Road ..................... -- -- -- I
Railroad ........................... --
C
Control of :access Lill( ................ ----- ;;
Slope Stake Line .................... ---
Bridge ............................. - -
Culvert ............................
Woods.* . . . . . . . . . . . . . . . . . . . . . . . . . . . ?.?.?'?.?'?'C'i •?.J p/ -r??.- •?_
Telephone or Telegraph Pole ......... .I:\I '.' -0- , witol & i
Tower Pole and Line................ .
Power Pole ......................... .A ir'Itoi, 6 1
Easenicia-Line ......................
11fowincr Unlit ....................... -?
Guard bail ........................ .
Sanitar Se%.'er Line ................. --• -'-S%
Water Line .........................
Gas Line ............... .......... cjts -o- N 1'I:lll'?JtiI:U h.XIS I C.
Chain Link fence ................... -? - ?-
Woven Wire Fence .................. -•4---0- -o--o-
Recrenet•aC1o11 ........................
Reforestacion .......................
Temporary Silt Ditch ................ I:>? •??I?
l;-
Temporary Silt Fence ................ -
Temporary Slope Drain ..............
Brush Lilarriei ........................
Silt Check Dane `type A ............... .?
Silt Check Dam Zype B ................
Sdc Basin 1I ,pe A .................... -? •
Silt Basin "I?rpe B ....................
Rock Silt Check Dane ................. s,
Carib l erne ......................... -} --} .-}
Tettip, Stone Ditch Checl
245.03 Temporary Silt Ditch .............................. TSo
245.05 Temporary Diversion , ,,,,,,,,,,,,,,,,,,, y TD
893.01 Temporary Silt Fence
890.05 Temporary Slope Drain with Earth Berm t- ..........
Silt Basin Type A .........................
245.02 Silt Basin Type B ...........................................
892.04 Temporary Rock Silt Check Type-A ..........
895.10 Temporary Rock Silt Check Type-B ......
892.01 Temporary Rock Sediment Dam Type-A ............
Temporary Rock Sediment Dam Type-B ,,,
897.01 Rock Pipe Inlet Protection Type-A j %
897.02 Rock Pipe Inlet Protection Type-B
894.01 Rock Silt Screen
245.04 Stilling Basin
Rock Inlet Protection:
896.01 Type A ............................... A ?.. OR -- A?
896.02 Type B ............................... B ? .. OR B)?
896.03 Type C ............................... C ? -- OR " C))
12 March, 1992
a
U. S. S. MAP a '
c` Mt,\,ry cn ?
o?
Allen Mtn 'nc?n:,s,,a E3 l \
'• 9753 ? 1 _•?'/ - ? .I.li. ?:? I
i Gap, ,
((/Blackoak 1; ;? , ?` ) •? ho ,
L7 0 •?.
\' 0 11 2081. - t
?f/ ?. ^ o
'(0 r
l3
,? l Cedar Cliff; . _ \ ?i - r t , 2
jrl?_ It
ndyGad,
Callvav..a?Car
Y
r->61 Chi 37
\i
/ ( 4 i ?\1I 1
}it
11 r? J oNV? `1' i % ?,i ??., ( ? ,,
f ?''Dot{bletop ` I??,5 ?`? Ha i?a
\ \t?C. Mt 1!-I?JJI'(r )?'? \?\ ?.., 1+ r,il, ?/ - i1 •/ ?? r- I„fRMI{ !!1+?_\\ •i?-
l 1
s;C /_ I 1 ) y
`._1T00??? !'r /? lll/ ?I?? ?? -? ? ?`\?\ ?, ?_ h?00? ? 'j 1? \? •` \ ,., Ij _?1.:.
?(I,. "?/// f ??. 1 r??` • _ 7 `, _ 1,? ! /? OW?S MLn J!
?K `06;? \\ ??- •7' 6p ?r??/, ( .,? I l
Issio eY "?hvh?? '\ ??/' i?S \il. _ r ,\?';? . ?. / ,` y ; y ?'•I
\\ \li}\\ \??\ \%^?\ ^ \\? /, (`/r'?? J .% 1 1( -\\,,. • I\ ??;.?\ ) ? 4,f+Qi \ ? `? \l.ih'i? !1 J f , \ J --/ •.? f ?',?(( \.? \
_ < ?(? i r\v?. V.? 1`I (• ?? 1 •? Ji ?s r•r \ 11 / - ++ 070 t
-.\..... \ 1 1 t%r=._-? t'? `? 1,'` ?' ?.., / I r / i1?. 1 l 1 ?, -.??1? n° r?-- 1 I ? f ?) 0 • ? ?. X01;
! ' 1 (;` \ \ J 1 r • ilt UlbC ?• )a ?,
\_ ?vIvvv Deer:Li ap-,1
II1? J? ) !''i .'I ?`= me
?` ????,tl II ?? •?o ?I??I %1? ?l?I SII ,'lll?• //i/' ? ' ? r'(?? ? ©M?l??'
\; \\ '\ .':'\ ( i111 I I I I? ill' (;1;: t• ?i \.• k % Nor
11'\\ \\\ `\ \? 1 o) ) I i? ,t\ ,il? i?,„ \\ C'r Newman 209
Kn
?\ \' (( //i \ !' i?l tee( Chapel i
/
Woflon Br
31
\\
io 1 I
2 7
Beasley it
Gap
OM G5S 6AI NO
\.)) i•? \ i _ 2144,\
Soo Orlkndo
CULVERT I E-= PL.aCEMENT
S-7A 5 +80
i
v
Zr L _ _
ti-
V
RoC K S l LT
,
SCREEKI
TO
BRIDGE
No, Z ?-S
M?LBERRy
CRECK }
PLAN
?`- FLOW
ExIS-T.
30 L.F. of
So " C.MP
HEMP. S1L-(
f ENC E
N.-T. 5.
FR0P: F1L?
SLOPE
7- 7
- i X I S7 C L. F. C P
C MP . .
PRO P <, 4 O
OF
i
STA S ?-?
S? I I - CARRENTEf? (GOAD
SCALE .:::_.
TEMPORARY SILT FENCE:
A temporary silt fence is commonly used at the toe of a fill section to prevent off-
site sedimentation. It is made of permeable filter fabric buried at the bottom,
stretched and supported by steel posts. The silt fence reduces the water flow while
retaining the sediment. They may also be used to divert water flow to protected
outlets. Silt fences need to be checked after each significant rainfall to ensure there
effectiveness. They must be maintained on a regular basis. Silt fences shall not be
installed across streams, ditches, or waterways.
AREAS OF USE:
• At toe of fill sections where sediment runoff can be stored and contained
inside the project limits.
DESIGN CRITERIA:
Material With Wire Without Wire
Fabric Type 3 Class A Type 3 Class B
Steel posts length 5 ft 5 ft.
Post spacing 10 ft. 6 ft. maximum
17 March, 1992
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18 March,1992
ROCK SILT SCREEN:

A rock silt screen is a low-level dam structure to be used in streams below culvert
sites. Rock silt screens shall be used to trap sediment transported by running water
and shall be placed in the stream below the construction site within the right-of-
way or easement boundary. The rock silt screen utilizes class B stone lined with #5
or #57 stone to produce a ripple-effect in the stream to settle the larger sediment
particles transported in the stream from the construction site. The trapped sediment
shall be cleaned out before the device is removed from the stream.
AREAS OF USE:
• In live streams below construction sites where construction occurs in or
adjacent to the stream.
• In live streams below a culvert construction site.
• Where it can be cleaned before it is removed from stream.
DESIGN CRITERIA:
• Structural stone - class B stone
• Sediment control stone # 5 or # 57 stone
• Dam height - 1.5 ft. minimum and 3 ft. maximum ( shall not be higher than
1 ft. above normal flow of stream)
37 March, 1992
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F:?

APPLICATION FOR DEPARTMENT OF THE ARMY PERMIT OMB APPROVAL NO. 0710-0003
(33 CFR 325) Explros 30 Septembor 1991
Public reporting burden for this collection of information Is estimated to average 5 hours per response for the majority of cases, including the time for reviewing Instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Applications for larger or more complex
projects, or d-ow in ecologically sonsidve areas, could take up tD 500 hours. Send comments regarding this burden estimate or any other aspect of this collection of Information.
Including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Service, Moctorate for Information Operations and Projects, 1215 Jefferson
Davis Highway, Suite 1244, Arlington, VA 22202.4302; and to the Office of Management and Budget, Paperwork Reduction Project (0710.0003), Washington, DC 20503. Please
DO NOT RETURN your completed form to either of those addresses. Completed application must be submitted to the District Engineer having jurisdiction over the
location of the proposed activity.
The Department of the Army permit program is authorized by Section 10 of the Rivors and Harbors Act of 1899. Section 404 of the Clean Water Act and Section 103 of the Marine,
Protection, Research and Sanctuaries Act. These laws require permits authorizing activities In or affecting navigable waters of the United States, the discharge of dredged or Wl
material Into waters of the United States, and the transportation of dredged material for the purpose of dumping it Into ocean waters. Information provided on this form will be used
in evaluating the application her a permit. Information in this application is made a matter of public record through issuance of a public notice. Disclosure of the information
requested is voluntary; however, the data requested are necessary in order to communicate with the applicant and to evaluate the permit application. If necessary information is
not provided, the permit application cannot be processed nor can a permit be Issued.
One sot of original drawings or good reproducible Copies which show the location and character of the proposed activity must be attached to this application (see sample drawings
and instructions) and be submitted to the District Engineer having jurisdiction over the location of the proposed activity. An application that is not completed In fu1 iabe retuned.

1. APPLICATION NUMBER (To be assigned by Caps) 3. NAME, ADDRESS, AND TI A ?
Tr^"q
• Telephone no. during business hours

2. NAME AND ADDRESS OF APPLICANT
W. Tcew knde« ;•,_i
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A Statement of Authorization: I hereby desi Wr% b authorize 1
. ? 1" --to act in my
,nd r e \,q l t1A Ci 28 1 0
Z69 pi;cz^
n mX-tu.ish
f ih 't a
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Telephone no. during business hours .
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as my agent
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upon roquost, supplerental information ini r t of the application.
A/C ( ) (Residence)
A/C(70c?) 321 - 4tOS (chats) SIGNATURE OF APPLICANT A141

OItA
L?:TETIL
DATE
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4. DETAILED DESCRIPTION OF PROPOSED ACTIVITY
4a ACTIVITY
`-VD uP3r-ade, and. t?x?er\L o- Pipe culuer; om SR 1105, CarpeAec-
Road) in Macom. Qwn?4 NC, iS culve(Az cacrje5 s-??eutfy.?'low o-? cL
k,ri6L&Var? ?-n Mvlbecrt? Cceek whicl\ I aS 4 DEM cla5si?ica,?ion o-?

4b. PURPOSE
SR 1105 -? meek cuc-cert?, tACOOT 5kamckariis
wider`
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?or ?yPica,? sec-4i0-t,, and cL Ii9nmer?-? ?or Paved sect?ndarY ro0L4. e iS
one. Lt) Ioc.akiors.. on W\is c'oad eons+ruc?fors, Prosec.?-- Wkece_ ?c
Prof os1r-d. roadwaL wia-?k" makes culvedL upooradinq ±neces?act? .
4c. DISCHARGE OF DREDGED OR FILL MATERIAL
i
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FNG FORM d3dr% Sin 41 EDITION OF JAN 91 IS OBSOLETE (Proponenl:CECW-0R)