19970606 Ver 1_COMPLETE FILE_19970707

State of North Carolina AM I
Department of Environment, LTX.;VA
Health and Natural Resources 4 •
Division of Water Quality
James Hunt, Governor p F H N F1
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
August 18, 1997
S & R Enterprises, L.L.C.
Box 794
Angier, NC 27501
WQC *970606
Harnett County
Dear Sirs:
The Division of Water Quality has reviewed your plans for the discharge of fill material
into 0.3 acres of waters and/or wetlands located at 415 Jan Street in Angier, in Harnett County
for residential development. Until the Corps of Engineers 1) delineates the wetlands on this lot
and 2) decides whether the fill of this lot is part of the larger impact on Jan Street, DWQ action
would be inappropriate. Therefore, we must place this project on hold due to incomplete
information for your 401 Certification as required by 15A NCAC 2H .0506. Until we receive
additional information, we are requesting (by copy of this letter) that the U.S. Army Corps of
Engineers place your project on administrative hold
Please provide us with information discussing the above two issues. Any documentation
such as maps and narrative that you can supply to address alternative designs for your project
may be helpful in our review of your 401 Certification. Depending on whether the Corps calls
the entire Jan Street development (and this lot) a single project, this project may require
compensatory mitigation as described in 15A NCAC 2H.0506(h). Please respond within two
weeks of the date of this letter by sending a copy of this information to me and one copy to Mr.
Ken Averitte at the Fayetteville Regional Office at Wachovia Bldg., Suite 714, Fayetteville, NC
28301. If we do not hear from you in two weeks, we will assume that you no longer want to
pursue this project and we will consider the project as withdrawn. I can be reached at 919-
733-1786 if you have any questions.
Sincerely,
o R. Domey
ter Quality cation Program
cc: Fayetteville DWQ Regional Office
Wilmington Office Corps of Engineers
Central Files
970606.nty
Division of Water Cluality • Environmental Sciences Branch
4401 Reedy Creek Rd., Raleigh, NC 27626-0535 - Telephone [phone] - FAX [phone]
An Equal OpportunityAffirmative Action Employer 50% recycled/ 10% post-consumer paper

MEMORANDUM PRINT NAMES:
Reviewer•
C0: JOHN DORNEY WQ SUPV.:
ENVIRONMENTAL SCIENCES BRANCH DATE:
SUBJECT: WETLAND STAFF REPORT AND RECOMMENDATIONS
PERMIT YR: 97 PERMIT N0: 0000606 COUNTY: HARNETT
APPLICANT PROJECT NAME TYPE: : S & R SUBDIVISION LOT ENTERPRISES, L.L.C. PERMIT TYPE: NW26
RCD_FROM CDA: APP DATE_FRM_CDA: 07/07/97
REG OFF
ZIVER AND SUB BASIN ??: 0306 STR INDEX N0: 18-68 /Z -(
***EACH ITEM MUST BE ANSWERED (USE N/A FOR NOT APPLICABLE)
?F
_OE ??: DOT ??:
C 'g?? •
??PFs
_ICE: FRO
STREAM CLASS: C SW
WL_IMPACT? ON
WL_REQUESTED:
WL_SCORE M :
MITIGATION?: Y/N
MITIGATION SIZE:
WL_TYPE : //v c-
WL_ACR_EST?: Y6
WATER IMPACTED BY FILL?: Y/6
MITIGATION-TYPE: (?)
DID YOU REQUEST MORE INFO?: Y/N
IS WETLAND RATING SHEET ATTACHED?: Y/N
HAVE PROJECT CHANGES/CONDITIONS BEEN DISCUSSED WITH APPLICANT?: ON
RECOMMENDATION (Circle One): ISSUE ISSUE/COND DENY
COMMENTS

r
1\
v o 0 n?
'C: Regional Office
Central Files
;0L r
?j
6 a.
Project N,
County
Name of t
_ Nearest Road
agree Wetland Wei
Wetland Location
on pond or lake
-on perennial stream
on intermittent stream
within interstream divide
other
Soil series
predominantly organic - humus, muck,
or peat
predominantly mineral - non-sandy
predominantly sandy
Hydraulic factors
_ steep topography
Cidtched or channelized
7 total wetland width a 100 feet
Adjacent land use
(within 1/2 mile upstream, upslope, or radius)
ffo?o ested/natural vegetation
?agricultur-, urban/suburban= %
impervious surface --- %
Dominant vegetation
(1)
(2)
(3)
Flooding and wetness
semipeimanently to permanently
flooded or inundated
seasonally flooded or inundated
m ermittanly flooded or temporary
surface water
no evidence of flooding or surface water

Wetland type (select one)*
Bottomland hardwood forest Pine savanna
fGIieadwater forest fotq Freshwater marsh
Swamp forest O Bog/fen
Wet flat hemeral wetland
Pocosin Carolina Bay
Bog forest Other
---_------*the -rating -- _s stem cannot be applied to salt or brackish marshes or stream channels___________
weight
R Water storage x 4.00 = rwfi
A Bank/Shoreline stabilization 0 x 4.00 = `-
T Pollutant remova l- * x 5.00 =
I Wildlife habitat x 2.00 =
N Aquatic life value x 4.00 = y:=
G Recreation/Education x 1.00 - >
Wetland
*Add 1 point if in sensitive watershed and >10% nonpoint disturbance within 1/2 mile upstream,
........... .PsloL)ez or radius ---------------------------------------------------------------------------
Ste- ?

C. ?:,.
P r
OEM ID: CORPS ACTION ID:
NATIONWIDE PENT REQUESTED (PROVIDE NATIONWIDE PERMIT
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1) NOTIFICATION TO THE CORPS OF ENGINEERS 2
Z) APPLICATION FOR SECTION 401 CERTIFICATION
3) COORDINATION W= TIM NC DIVISION OF COASTAL MANAGMU=
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE
FIELD OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN
(7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT
(SEE AGENCY ADDRESSES SHEET). PLEASE PRINT.
1. OWNERS NAME : • L
2. MAILING ADDRESS
777
SUBDIVISION NAME : ise s
CITY : a N STATE : N C_ ZIP CODE: 7Sy !
PROJECT LOCATION ADDRESS, INCLUDING SUBD;VISIO NAME (I OIFFE FROM
MAILING ADDRESS ABOVE) : 77K1n) !'? I S ~ _! f? 3 .N ? 4 e ?/
3 . PHONE NL'MBER (HOME) q j j 6,31 L/ s? (WORK) A Y-
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
S. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY : IAA l "e k k NEAREST TOWN OR CITY: ??l 'lr? f
1

S `D-)? SPECIFIC LOCATION (INCLUDE ROAD -
NUMBERS, LANDMARKS, ETC.) :
6. IMPACTED OR NEAREST STREAM/ RIVER : @ ( Ac K 'P, -.)-P , (2- ? -e e <
RIVER BASIN: c )c? 2-- 1:?c 14 ?-
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER
(SA), HIGH QUALITY WATERS (HQW), OUTSTADNMING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-II)? YES [ I NO ["r' IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES [ ] NO cvI?
7c. IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR
; LU?) DESI3NAI'IvN?
LIST OF COASTAL COUNTIES) , WHAT IS THE !-;"\M .,SG ?LAZNT
8a. HAVE ANY SECTION 404 PERMIT?EEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES [ I NO [ IF YES, PROVIDE ACTION I.D. NUMBER OF
PREVIOUS PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401
r^C9TT . Te a r'roN) -
8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES [ I NO [y1/ IF YES, DESCRIBE ANTICIPATED WORK:
2
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND: 7
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
a
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: > EXCAVATION: eI
FLOODING
0
OTHER:
DRAINAGE: TOTAL ACRES TO BE IMPACTED: ?
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (I:
RELOCATED, PROVIDE DISTANCE BOTFF BEFORE AND AFTER RELOCATION)
1
LENGTH BEFORE: N III FT AFTER: FT
WIDTH BEFORE (based on normal high water contours): FT
WIDTH AFTER: CT
AVERAGE DEPTH BEFORE: FT AFTER. T'T
(2) cTRTAM C?-ANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL:
CHANNEL EXCAVATION:
CONSTRUCTION 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 c- N e
WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
3
MECHANICAL EQUIPMENT 0 BE USED (ATTACH PLANS: S 1/2"\ 11" DRAWINGS
ONLY) .
.? _ r i • ?_ / \ ise s r i 1[? r. t ri t- d l ?? A G
\rn?m- } reSA e.
e-
13. PURPOSE OF PROPOSED WORK:
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED
OUT IN WETLANDS. (INCLUDE ANY MEASURES,TAKl-""N TO MINIMIZE WETLAND
IMPACTS) ?. -cS ACC)
%,?, -vtm A??, JJ f
15. YOU ARE REQUIRED TO CONTACT THE U.S. FISH k`ID WILDLIFE SERVICE
(USFWS) AND/OR NATIONAL MARINE FISHERIES SERVICE (NMFS) (SEE AGENCY
ADDRESSES SHEET) REGARDING THE PRESENCE OF ANY FEDERALLY LISTED OR
PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL HABITAT
IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT. RDATE
ESPONSES
CONTACTED: _
FROM THESE AGENCIES.)
16. YOU ARE REQUIRED TO CONTACT THE
(SHPO) (SEE AGENCY ADDRESSES SHEET)
PROPERTIES IN THE PERMIT AREA WHICH
PROJECT. DATE CONTACTED:
STATE HISTORIC PRESERVATION OFFICER
REGARDING THE PRESENCE OF HISTORIC
MAY BE AFFECTED BY THE PROPOSED
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND'
4
YES [ J NO f?J (IF NO, GO TO 18) _
a. IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA ENVIRONMENTAL
POLICY ACT?
YES U NO [ J
b. IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE?
YES [J NO [J
IF ANSWER TO 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
COMPLIANCE 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 OR FILL MATERIAL
INTO WETLANDS:
a. WETLAND DELINEATION MAP SHOWING ALL.'ETLANDS, STREAMS, LAKES
AND PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26,
29, AND 38) ALL STREAMS (INTERMITTENT AND PERMANENT) ON THE PROPERTY
MUST BE SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS SO FEET OR 1
INCH EQUALS 100 FEET OR THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE
IMPACTED BY PROJECT.
C. IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA
SHEZTS RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQU_RED.
e . WHAT IS LAND USE OF SURROUNDING PROPERTY? £, t- i ??
A)
f
IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL
5
+ ) .
g. SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE U.S. MAY NOT HE IMPACTED PRIOR TO:
1) ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2) EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF
ENVIRONMENTAL MANAGEMENT (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 WITH THE NORTH CAROLINA COASTAL MANAGEMENT
PROGRAM.
OWNER'S/AGENT'S SIGNATURE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
T'.-M- OWNER IS PROVIDED (18g.))
DATE
6
5EM lb: 9 "7 0 6 6 CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT 1):
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATION FOR SECTION 401 CERTIFICATION
3) COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEM[ENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE
FIELD OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN
(7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT
(SEE AGENCY ADDRESSES SHEET). PLEASE PRINT.
1. OWNERS NAME : Ste- C 4?: N 4"v- e ( `
2. MAILING ADDRESS:
g rte' , - - -
446
SUBDIVISION NAME:
CITY : STATE : N -- ZIP CODE : 7.5c)
PROJECT LOCATION ADDRESS, INCLUDING SUBD VISIO NAME (IF P-ZNT, FROM
MAILING ADDRESS ABOVE) : 'ham LL/ /5 ?. C\\A-t
T^ TBcONE NUMBER (::OME) jl ?n 7?/ ?? (WORK) . j$1-A'U
? .r
..ter r1
4, IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
?HONE NUMBER :
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: A 4?1\ NEAREST TOWN OR CITY: i? Y
n
-i ..4 to
,9 J
2
N
1
owl
c?
SPECIFIC LOCATION (INCLUDE ROAD
NUMBERS, LANDMARKS, ETC.):
6. IMPACTED OR NEAREST STREAM/RIVER: @ .Ac K 'Q, --)-e , e-? -e e <
?- ??' ??
RIVER BASIN:
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER
(SA), HIGH QUALITY WATERS (HQW), OUTSTA MING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-II)? YES [ ] NO IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA `DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES [ I NO [vJ'
7c. IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR
LIST OF COASTAL COUNTIES), WHAT iS HE =VD ;;S ? ?S:V (Li;?) uES I3NATION?
8a. HAVE ANY SECTION 404 PERMIT5-4 EEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES [ I NO IF YES, PROVIDE ACTION I.D. NUMBER OF
PREVIOUS PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION):
8b. ARE ADDITIONAL PERM;T REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES [ I NO [ IF YES, DESCRIBE ANTICIPATED WORK:
2

9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND: a 7
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:

10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING:
FLOODING:
0
EXCAVATION: 11
OTHER:
DRAINAGE: d'?. TOTAL ACRES TO BE ZXPACTED: r
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION)
1
LENGTH BEFORE: N ?1T FT AFTER: FT
WIDTH BEFORE (based on normal high water contot=s): FT
WIDTH AFTER: ITT
AVERAGE DEPTH BEFORE: Tyr AFTER. ;7'r
(2) gTRG AM CtLZUNNEL rMPACTS WILL RESULT FROM : (CHECK ALL THAT APPLY)
OPEN =ANNEL RELOCATION: PLACEMENT OF PIPE IN Ct.LtjML:
CHANNEL EXCAVATION: CONSTRUCTION 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 C N 42-
WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
3
ti
MECHANICAL EQUIPMENT.,TO BE USED (ATTACH PLANS: 8 1/2" 11" DRAWINGS
ONLY) . ?? } : ? ? ? 6 do ?

13. PURPOSE OF PROPOSED WORK: o
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED
OUT IN WETLANDS. ( INCLUDE ANY MEASURES, T_AKZ-NL TO MINIMIZE WETLAND
IMPACTS) : ?. ?2r n u

15. YOU ARE REQUIRED TO CONTACT THE U.S. FISH AND WILDLIFE SERVICE
(US-,WS) AND/OR NATIONAL MARINE FISHERIES SERVICE (NMFS) (SEE AGENCY
ADDRESSES SHEET) REGARDING THE PRESENCE OF ANY FEDERALLY LISTED OR
PROPOSED FOR LISTING ENDANGERED OR THREATS ED SPECIES OR CRITICAL HABITAT
IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT. RDATE
ESPONSES
CONTACTED:
FROM THESE AGENCIES.)
16. YOU ARE REQUIRED TO CONTACT THE
(SHPO) (SEE AGENCY ADDRESSES SHEET)
PROPERTIES IN THE PERMIT AREA WHICH
PROJECT. DATE CONTACTED:
STATE HISTORIC PRESERVATION OFFICER
REGARDING THE PRESENCE OF HISTORIC
MAY BE AFFECTED BY THE PROPOSED
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND' 190
4
YES [ l NO (Al (IF F NO, GO TO 18)
a. IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIROdMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA ENVIRONMENTAL
POLICY ACT?
YES U NO [l
b. IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE?
YES L I NO [ l
IF ANSWER TO 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
COMPLIANCE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOUZD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 'NEST 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 OR FILL MATERIAL
INTO WETLANDS:
a. WETLAND DELINEATION MAP SHOWING ALL,WETLANDS, STREAMS, LAKES
AND ?ONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26,
29, AND 38). ALL STREAMS (INTERMITTENT AND PERMANENT) ON THE PROPERTY
MUST BE SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OR 1
INCH EQUALS 100 FEET OR THEIR EQUIVALENT.
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.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IFr REQUIRED
e. WHAT IS LAND USE OF SURROUNDING PROPERTY? i .t
C?
tt__ l
?. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
5

g. SIGNED AND DATED AGENT ADTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE U.S. MAY NOT BE IMPACTED PRIOR TO:
1) ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2) EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF
ENVIRONMENTAL MANAGEMENT (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 WITH THE NORTH CAROLINA COASTAL MANAGEMENT
PROGRAM.
OWNER'S/AGENT'S SIGNATURE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED (ISg.))
DATE
6