20000809 Ver 1_Complete File_20000614

State of North Carolina
e
' Department of Environment
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P; 7%
and Natural Resources
Division of Water Quality -=I r
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
July 12, 2000
Rockingham County
DWQ Project No. 000809
SR 1114 Renn Road
APPROVAL of 401 Water Quality Certification
Mr. William D. Gilmore, P.E., Manager
Planning and Environmental Branch
North Carolina Department of Transportation
P.O. Box 25201
Raleigh, NC, 27611-5201
Dear Mr. Gilmore:
You have our approval, in accordance with the attached conditions and those listed below, to place fill
material in 0.0 acres of wetlands and relocate 180 linear feet of streams for the purpose of widening and
paving SR 1114 (Renn Road). The project should be constructed in accordance with your application dated
12 June 2000 (received 14 June 2000). After reviewing your application, we have decided that this fill is
covered by General Water Quality Certification Number 3289. This certification corresponds to the
Nationwide Permit Number 14 issued by the Corps of Engineers. In addition, you should acquire any other
federal, state or local permits before you proceed with your project including (but not limited to) Sediment
and Erosion Control, Non-Discharge and Water Supply Watershed regulations. This approval will expire
with the accompanying 404 permit, unless otherwise specified in the Water Quality Certification.
This approval is valid solely for the purpose and design described in your application (unless modified
below). Should your project change, you must notify the DWQ and submit a new application. If the
property is sold, the new owner must be given a copy of this Certification and approval letter, and is thereby
responsible for complying with all the conditions. If total wetland fills for this project (now or in the future)
exceed one acre, or of total impacts to streams (now or in the future) exceed 150 linear feet, compensatory
mitigation may be required as described in 15A NCAC 2H .0506 (h) (6) and (7). For this approval to
remain valid, you must adhere to the conditions listed in the attached certification and those listed below:
1.) Any culverts required for this project shall be installed in such a manner that the original stream profile
is not altered (i.e. the depth of the channel should not be reduced by a widening of the streambed).
2.) Sediment and erosion control measures shall adhere to design standards for sensitive watersheds (15A
NCAC 4B .0024).
3.) The relocated channel should be stabilized with bioengineering techniques. The use of rip-rap is
prohibited unless it is necessary to maintain the physical integrity of the stream, but the applicant must
provide written justification and any calculations used to determine the extent of rip-rap coverage
requested.
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 that conforms to Chapter 150B of the North Carolina General
Statutes to the Office of Administrative Hearings, P.O. Box 27447, Raleigh, N.C. 276 1 1-7447.
This certification and its conditions are final and binding unless you ask for a hearing.
1621 Mail Service Center, Raleigh, North Carolina 27699-1621 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 500o recycled/ 10010 post-consumer paper
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 919-733-9616.
Sincerely,
1 _
1 ?
ce Stevens"
Attachment C
cc: Wilmington District Corps of Engineers
Corps of Engineers Asheville Field Office
Asheville DWQ Regional Office
Central Files
ROAD CROSSING CERTIFICATION
GENERAL CERTIFICATION FOR PROJECTS ELIGIBLE FOR CORPS OF
ENGINEERS
NATIONWIDE PERMIT NUMBER 14 (ROAD CROSSINGS),
REGIONAL GENERAL PERMIT 193200031 AND NEUSE/TAR-
PAAILICO/RANDLEINiAN BUFFER
RULES
This General Certification is issued in conformity with the requirements of Section 401, Public
Laws 92-500 and 95-217 of the United States and subject to the North Carolina Division of
Water Quality (DWQ) Regulations in I5A NCAC 2H, Section.0500 and 15A NCAC 213 .0200
for the discharge of fill material to waters and wetland areas as described in 33 CFR 330
Appendix A (B) (14) of the Corps of Engineers regulations (i.e., Nationwide Permit No. 14 and
Regional General Permit 198200031) and for the Neuse, Tar-Pamlico and Randleman Buffer
Rules (15A NCAC 213 .0233-0259 and.0250). The category of activities shall include any fill
activity for road crossing and is limited to fill less than one-third of an acre. This Certification
replaces Water Quality Certification Number 2177 issued on November 5, 1987, Water Quality
Certification Number 2666 issued on January 21, 1992, Water Quality Certification Number
2732 issued on May 1, 1992 and Water Quality Certification Number 3103 issued on February
It, 1997. This WQC is rescinded when the Corps of Engineers re-authorizes Nationwide
Permit 14 or Regional General Permit 198200031 when deemed appropriate by the Director of
the DWQ.
The State of North Carolina certifies that the specified category of activity will not violate
applicable portions of Sections 301, 302, 303, 306 and 307 of the Public Laws 92-500 and 95-
217 if conducted in accordance with the conditions hereinafter set forth.
Conditions of Certification:
1. Proposed fill or substantial modification of wetlands or waters (including streams) under this
General Certification requires application to and prior written concurrence from the Division
of Water Quality;
2. In accordance with North Carolina General Statute Section 143-215.3D(e), any application
for a 401 Water Quality Certification must include the appropriate fee. If a project also
requires a CANIA Permit, one payment to both agencies shall be submitted and will be the
higher of the two fees;
3. In accordance with 15A NCAC 2H .0506 (h) compensatory mitigation may be required for
impacts to streams and/or wetlands. In addition, buffer mitigation may be required for any
project with Buffer Rules in effect at the time of application. A determination of buffer,
wetland and stream mitigation requirements shall be made for any Certification for this
Nationwide Permit. The most current design and monitoring protocols from DWQ shall be
followed and written plans submitted for DWQ approval as required in those protocols;
4. For any project involving a stream re-alignment, a stream relocation plan must be included
with the 401 application for written DWQ approval. Relocated stream designs should include
the same dimensions, patterns and profiles as the existing channel, to the maximum extent
practical. The new channel should be constructed in the dry and water shall not be turned
into the new channel until the banks are stabilized. Vegetation used for bank stabilization
shall be limited to native woody species, and should include establishment of a 30 foot wide
wooded and an adjacent 20 foot wide vegetated buffer on both sides of the relocated channel
to the maximum extent practical. A transitional phase incorporating coir fiber and seedling
establishment is allowable. Also, rip-rap may be allowed if it is necessary to maintain the
physical integrity of the stream, but the applicant must provide written justification and any
calculations used to determine the extent of rip-rap coverage requested. If suitable stream
mitigation is not practical on-site, then stream impact will need to be mitigated elsewhere;
5. Impacts to any stream length in the Neuse, Tar-Pamlico and Randleman River Basins
requires written concurrence from DWQ in accordance with 15A NCAC 213.0233, 15A
NCAC 213 .0259 and .0250 and 15A NCAC 2H .0500. New development activities located in
the protected 50-foot wide riparian areas (whether jurisdictional wetlands or not) within the
Neuse, Tar-Pamlico and Randleman River Basins shall be limited to "uses" identified within
and constructed in accordance with 15A NCAC 2B .0233, 15A NCAC 213 .0259 and .0250.
All new development shall be located, designed, constructed, and maintained to have
minimal disturbance to protect water quality to the maximum extent practicable through the
use of best management practices. Activities listed as "exempt" from these rules do not need
to apply for written concurrence under this Certification;
6. Placement of culverts and other structures in waters, streams, and wetlands must be placed
below the elevation of the streambed to allow low flow passage of water and aquatic life
unless it can be shown to DWQ that providing passage would be impractical. Design and
placement of culverts and other structures including temporary erosion control measures
shall not be conducted in a manner that may result in dis-equilibrium of wetlands or stream
beds or banks, adjacent to or upstream and down stream of the above structures. The
applicant is required to provide evidence that the equilibrium shall be maintained if
requested in writing by DWQ. Additionally, when roadways, causeways or other fill projects
are constructed across FEMA-designated floodways or wetlands, openings such as culverts
or bridges must be provided to maintain the natural hydrology of the system as well as
prevent constriction of the tloodway that may result in destabilization of streams or
wetlands;
7. If this Certification is used to access building sites, all lots owned by the applicant must be
buildable without additional fill beyond that allowed under other General Certifications.
Deed restrictions must be placed on the remaining wetlands and streams on these lots to
restrict future wetland and stream fill. DWQ shall be sent copies of all deed restrictions
applied to these lots;
S. That appropriate sediment and erosion control practices which equal or exceed those outlined
in the most recent version of the "North Carolina Sediment and Erosion Control Planning
and Design Manual" or the "North Carolina Surface Mining Manual" whichever is more
appropriate (available from the Division of Land Resources (DLR) in the DENR Regional or
Central Offices) shall be in full compliance with all specifications governing the proper
design, installation and operation and maintenance of such Best Management Practices in
order to assure compliance with the appropriate turbidity water quality standard;
9. All sediment and erosion control measures placed in wetlands or waters shall be removed
and the natural grade restored within two months after the Division of Land Resources has
released the project;
10. Measures shall be taken to prevent live or fresh concrete from coming into contact with
waters of the state until the concrete has hardened;
11. This Certification shall be utilized for roads from natural high ground to natural high ground.
The Certification for Nationwide Permit IS may not be used in conjunction with this
Certification to create high ground for road access;
12. If an environmental document is required, this Certification is not valid until a Finding of No
Significant Impact (FONSI) or Record of Decision (ROD) is issued by the State
Clearinghouse. All water quality-related conditions of the FONSI or ROD shall become
conditions of this Certification;
13. That additional site-specific conditions may be added to projects proposed under this
Certification in order to ensure compliance with all applicable water quality and effluent
standards;
14. When written concurrence is required, the applicant is required to use the enclosed
"Certification of Completion Form" to notify DWQ when all work included in the 401
Certification has been completed;
15. Concurrence from DWQ that this Certification applies to an individual project shall expire
three years from the date of the cover letter from DWQ or on the same day as the expiration
date of the corresponding Nationwide Permit 14 and Regional General Permit 193200031
whichever is sooner.
Non-compliance with or violation of the conditions herein set forth by a specific fill project may
result in revocation of this Certification for the project and may also result in criminal and/or
civil penalties.
The Director of the North Carolina Division of Water Quality may require submission of a
formal application for individual certification for any project in this category of activity, if it is
determined that the project is likely to have a significant adverse effect upon water quality or
degrade the waters so that existing uses of the wetland, stream or downstream waters are
precluded.
Public hearings may be held for specific applications or group of applications prior to a
Certification decision if deemed in the public's best interest by the Director of the North
Carolina Division of Water Quality.
Effective date: 1 June 2000
DIVISION OF WATER QUALITY
By
Kerr T. Stevens
Director
WQC # 3289
WrAldnds Tracking Projects _Owner Agent ? List
Totals si Print
Facility Name NCDOT SR 1114 Renn Road I County Rockingham
Project Number 00 0809 County2
0Inactive Region Winston-Salem
Project Type purpose of road widening I DCM Office
Location UT Belews Lake I COE Office Raleigh
401s Recvd Sent to Recvd
Recvd From Date Region Region
DOT 6-14-2000 6/21/2000
Last Total Total Total Mit Action 401 401 Totals Mit
Date Last Action Acres Feet Acres Feet
1 1 180.00 401 `
401
Total for Project:
Inspections/ Violations
Inspection Date Inspector Compliant Letter Type Date Sent
I
Reply Date Current St
J O Y ON ?J Inspect.
I I I I
M.EMOKANDUM
TO: John Dorney Regional Contact:
Non-Discharge Branch WO Supervisor:
Date:
SUBJECT: WETLAND STAFF REPORT AND RECOMMENDATIONS
Facility Name NCDOT SR 1114 Renn Road County Rockingham
Project Number 00 0809 County2
Recvd From DOT Region Winston-Salem
Received Date 6/14/00 Recvd By Region 6/30/2000
Project Type road widening
Certificates Stream Stream Impacts (ft.)
Permit Wetland Wetland Wetland Stream Class Acres Feet
Type Type. Impact Score Index Prim. Supp. Basin Req. Req. ME
F 14 Stream O Y O " F-- 22-27-(1) WSIV F-- 30,201. r__ 180.00 180.00 I -
Mitigation Wetland
MitigationType Type Acres Feet
Stream restoration Stream ?- 180.00
Is Wetland Rating Sheet Attached? Q Y 4 N Did you request more info? Q Y O N
Have Project Changes/Conditions Been Discussed With Applicant? Q Y * N
Is Mitigation required? Q Y 0 N Recommendation: Q Issue (0 Issue/fond O Deny
Provided by Region: Latitude (ddmmss) 361627 Longitude (ddmmss) 800101
Comments:
The WSRO recommends that this WO Certification he issued with the following condition:
" The relocated channel should be stabilized with bio-engineering instead of rip-rap.
cc: Regional Office
Central Office Page Number 1
Facility Name NCDOT 5R 1114 Renn Road
Project Number 00 0809
Comments (continued from page 1):
County Rockingham
Regional Contact: Jennifer Frye
Date: 7/7/2000
cc: Regional Office Page Number 2
Central Office
o y,
ETU,?,DS G'WUP
" .TF'I !?UI1ITY
STATE of NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
JAMES B. HUNT JR.
GOVERNOR
ROCKINGHAM COUNTY
June 12, 2000
U.S. Army Corps of Engineers
Regulatory Field Office
c/o Mr. Eric Alsmeyer
6508 Falls of the Neuse Rd., Suite 120
Raleigh, N.C. 27615-6814
SUBJECT: Stream Relocation; SR 1114 (Renn Road)
Dear Mr. Alsmeyer:
000009
Enclosed is an application package involving the relocation of at least 180
feet of an unnamed tributary to Belews Lake during the widening and
paving of this road. We have determined that shoulder widening will
impact the stream in its current location. The drainage area involved is
51.8 Acres and the ADF is 0.1 efs. Construction is scheduled to begin
prior to this winter if right of way is available.
The site is located in a Water Supply Watershed Protected Area and does
not involve any wetlands.
Please review and advise if you have further questions about any of the
information I have provided.
Yours very truly,
John B. Hunsinger
DISTRICT ENGINEER
\jbh
cc: Mr. J.M. Mills, P.E.
.,,Mr. John Hennesy, DEM (7)
Mrs. Renee Gledhill, State Historic Preservation Officer
DAVID MCCOY
SECRETARY
PAYMENT
RECEIVED
P. O. Box 2513 Reidsville, NC 27323-2513 Telephone No. 336-634-5644 Fax No. 336-634-5656
P ' 1 , 3
yd •. STAB
STATE OF NORTH CAROLINA . ?„ %!;ETU11D3 GMUP
ATER QUALITY SECTit;
DEPARTMENT OF TRANSPORTATION
JAMES B. HUNT JR. DAVID MCCOY
GOVERNOR SECRETARY
June 12, 2000 pAYNIENT
ROCKINGHAM COUNTY RECEIVED
Division of Environmental Management
John Hennesy, Wg Certification Unit
P.O. Box 29535
Raleigh, N.C. 27626-0535 000809
SUBJECT: SR 1114 (Renn Road)
Dear Mr. Hennesy:
Enclosed are seven (7) copies of the application package for your review.
Please do not hesitate to contact me if you have further questions about
any of the information I have provided.
Yours very truly,
WL'., d, SLQ-?-
ohn B. Hunsinger
DISTRICT ENGINEER
\jbh
Enclosures
P. O. Box 2513 Reidsville, NC 27323-2513 Telephone No. 336-634-5644 Fax No. 336-634-5656
I . 1
000000
DWQ ID:
t
CORPS ACTION ID: 71 1
I?iL1 L/RII UJ t:i1U ??, f?
NATIONWIDE PERbIIT REQUESTED (PROVIDE NATIONWIDE PERMIT n) Tr°t OJ^! ITY s i r
14
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERINUTS THAT REQUIRE:
PAYMENT
RECEIVED
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATION FOR SECTION 401 CERTIFCATION
3) COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OFTHIS COMPLETED FORM TO THE APPROPRIATE
FIELD OFFICE-OFTHE CORPS OFENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN
(7) COPIES NIUST-BE SENT TO THE NC DIVISION OF WATER
QUALITY. ATTN: JOHN DORNEY. 4401 REEDY CREEK ROAD.
RALEIGH. NC 27607. PLEASE PRINT OR TYPE.
1. OWNER'S NAT:
2. MAILING ADDRESS:
NC Department of Transportation
PO Box 2513
CITY: Reidsville
SUBDIVISION NAME N/A
STATE: NC
ZIP CODE: 27323-2513
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
b4AILING ADDRESS ABOVE):
SR 1114, Renn Road, Rockingham County
3. TELEPHONE NUMBER: (HOME)
N/A
(WORK) 336-634-5644
4. IFAPPLIC.ABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
John Hunsinger, District Engineer
(See above)
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Rockingham - NEAREST TOWN: Madison
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.)
1250' East of SR 1112 (Oak Level Church Road) South Side of Roadway
6. IMPACTED OR NEAREST STREAM/RIVER: Unnamed tributary - Belews Lake
RIVER BASIN: Roanoke
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER,. (SA),
HIGH QUALITY WATERS (HQW), OUTSTANDING RESOURSE WATERS (ORW), WATER _
SUPPLY (WS-I OR WS-In? YES ( ) NO ( X ) IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF E`iVIROMENTAL CONCERN (AEC)? YES( ) NO ( X )
7c. IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION?
8a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES ( ) NO ( X ) IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS
PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION):
8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FORTIES PROPERTY IN THE
FUTURE? YES( ) NO ( X) IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND:
G 1 Acre
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
0
10a. NUMBER OF ACRES ORWETLANDS IMPACTED BY THE PROPOSED PROJECT BY: .
FILLING:
FLOODING:
DRAINAGE :
EXCAVATION:
OTHER :
TOTAL ACRES TO BE IMPACTED: 0
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE-DISTANCE-BOTH-BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: 180 FT AFTER: 180 FT
WIDTFI BEFORE (based on normal high water contours): 12
FT
AVERAGEDEPTH:BEFORE: 0.5 FT AFTER: 0.5 FT
(2) STREAM CHANNEL IMPACTS-WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: X PLACE:N= OF PIPE IN CHANNEL:
CHANNEL EXCAVATION: COONSTRUCTION OF A DAM/FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? N/A
POND SURFACE AREA?
WHAT IS THE EXPECTED
12. DISCTIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 8112 BY 11 DRAWINGS ONLY)
Channel is to be maned to the south a minimum of 10' from existing
roadway using an excavator.
13. PURPOSE OF PROPOSED WORK: Allows the construction of a shoulder and
fill slope.
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
N/A
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE'FISHERIES SERIVEREGARDING THE-PRESENCE OF ANY FEDERALY
LISTED OR PROPOSED-FOR LISTING ENDANGERED OR THREATENED SPECIES OR
CRITICAL HABITAT IN=PERMIT AREA THAT MAY BE AFFECTED BY THE'PROPOSED
PROJECT. DATE CONTACTED: 6-12-00
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 BYTIIE PROPOSED PROJECT. DATE CONTACTED
6-12-00
17. DOES THETROJECT li IVOLVE AN M=NDTIURE OF PUBLIC FUNDS OT-THE USE OF
PUBLIC (STATE) LAND? YES ( X ) NO ( ) (IF NO, GO TO 16) _
a. IF-YES, DOES THE PROJECT-REQUIRE PREPERATION OF AN ENVIRONMENTAL
DOCUMENT PURUANTTO THE REQUIREMENTS OFTHE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES( ) NO (X )
b. IF YES, HAS THE DOCUMENT BEEN REFIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES ( ) NO (X )
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUME-NTATIONFROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL MATERIAL INTO
WETLANDS:
a. WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26, 29,
AND 38). ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY
MUST BE SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET
OF 1 INCH EQUALS I00 FEET OF THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED
BY PRODUCT.
c. IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA
SHEETS RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
c. WHAT IS LAND USE OF SURROUNDING PROPOERTY?
Woodlands & Farms
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
N/A
g. SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WTLANDS OR WATERS OFTHE US MAY NOT BE IMPACTED PRIOR TO:.
1) ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2) EITHER TEE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3) (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING "THE PROPOSED
ACTIVITY IS CONSISTENT-V*= THE NORTH CAROLINA COASTAL
MANAGEMENT PROGRAM,
1
t,?-- 6-12-00
0 'S/AGENT'S SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
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