20000630 Ver 1_COMPLETE FILE_20000515

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
L191WAA •
NC ENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
May 19, 2000
Stanly County
DWQ Project # 000630
APPROVAL of 401 Water Quality Certification
John and Elaine Bayus
905 Moss Springs Road, Apt. 603
Albermarle, NC 28001
Dear Mr. and Mrs. Bayus:
You have our approval, in accordance with the attached conditions and those listed below, to stabilize 88 feet of
shoreline on Lake Tillery in Stanly County, as you described in your application received by the Division of Water
Quality on May 15, 2000. 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 198200030
when the Corps of Engineers issues it. 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 Water shed regulations. This approval will expire when the accompanying 404 or
CAMA permit expires unless otherwise specified in the General Certification.
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 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 conditions. 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.
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 919-733-9646.
S' el
'Y,
eve
Attachment
cc: Corps of Engineers Asheville Field Office
Mooresville DWQ Regional Office
Jim Chisholm, Carolina Power and Light, 179 Tillery Dam, Mt. Gilead, NC 27306-0568
File Copy
Central Files
000630
Division of Water Quality • Non-Discharge Branch
1621 Mail Service Center, Raleigh, NC 27699-1621 Telephone [phone] FAX # [phone]
An Equal Opportunity Affirmative Action Employer • 50% recycled/10% post consumer paper
http://h2o.enr.state.nc.us/wetlandc.html
0001630
DWQ ID: CORPS ACTION ID:
NATIONWIDE PERMIT PtQVES'TD (PROVIDE NATIONWIDE PERMIT I)
P RUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PEIR THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION TO NC DIV. OF WATER QUALTTY FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
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
MUST BE SENT TO THE NC DIVISION OF WATER QUALITY, ATTN: JOHN DORNEY, 4401 REEDY
CREEK ROAD, RALEIGH, NC 27607. PLEASE PRINT OR TYPE.
A' F LL?itiC" !3f/Y?J
1. OWNERS NAME: k'/o //
H- Cl 2. MAILING ADDRESS: S- fI'L DSO ?l (_
LLJ w eu SUBDIVISION NAME :
? w
}? W CITY: A? I A L r STATE: /l C ZIP CODE: Zd'??? fa` PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM

MAILING ADDRESS ABOVE):
/'/yD AgOA10 t3Q ^--
F/lST Gt'.i'if/7 T?°?U?'fH??' ST.yyLY e47C?i6•J
TELEPHONE NUMBER: (HOME)Ze/ yr` - G/ `19 (WORK)
4. IF APPLICABLE: AGENTS NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER: .//lf 6, eAlse.-AH. ?AktciwA fio .er jLz1kb i ec, //fr/4(",y /AM A
qiv -y39 iasG /`yT tS/LcND, A"L' 7 73od -e3
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: S1?.v«Y NEAREST TOWN:
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ETC.)
1"1,4,4/ RCA-D SR / 7yo
&dzme f3?X fIDORAFSl /3G?eif'-'sC f 4o /-" it
T T c-'lW,0LE77rIQ POST tJ`??CC "J' .f/yT 4YC T
Svje tl,eD &Vlk 13,OX y,,, HZIt=R
I,
6. uApACTED OR NEAREST. STREAMIRIVER: 4,411r T/LL df,4'Y
RIVER BASIN:

(a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA),
HIGH QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-II)? YES -_K- NO 7 YES, EXPLAIN:
SOM C?c?dwTrLz 'WXe G-Ag ?/lGe Y
4" rn? S U
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES NO '2?_
(c) 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?
it /s ,10r- 4 ,0 ,0rrQ e c o g sr4L e e L'?T y
8. (a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES NO IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS
PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES NO_X_IF YES, DESCRIBE ANTICIPATED WORK:
(a) ESTIMATED TOTAL NUMBERS OF AeM IN TRACT OF LAND: ff fEET-
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: EXCAVATION:
FLOODING: OTHER :
DRAINAGE: TOTAL ACRES TO BE IMPACTED:
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: FT AFTER: FT
WIDTH BEFORE (based on normal high water oontours): FT
AVERAGE DEPTH BEFORE: FT AFTER: FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL:
CHANNEL EXCAVATION: CONSTRUCTION OF A DAM/FLOODING:

11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND?
WHAT IS THE EXPECTED POND SURFACE AREA? J?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 11 DRAWINGS ONLY)
R/Pf?,p ze- df xzlcEy AT L.4xcs HOC-E, al5ra ?et nL x'r
LyiLL i?C'T fXTE.?D 2 rc"?T 1ti'i9TLs,? tvNK U `/LTi'f? C'-<<'TH 13fI/1/?/E.e
t r
_wiLL dt PL.l?ED 6i?'DEK R/P/`?A? B4/3(r?/T /???L ?3E ?'sc`D
13. PURPOSE OF PROPOSED WORK: TD f1C"fP T//f 5114 O l1,41c
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO NIININM WETLAND IMPACTS)
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE 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. DATE CONTACTED: Y /Z . Zoo 0
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. DATE CONTACTED: := /Toy
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF
PUBLIC (STATE) LAND? YES( ) NO (><) (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 ( ) NO ( )
(b) IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE? YES ( ) NO ( )
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM 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 I INCH EQUALS 30 FEET OF 1
INCH EQUALS 100 FEET OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE "ACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
PLAN IF REQUIRED.
() ATTACH A COPY S LAND USE OFSURSTORMWATER ROUNDING PROPERTY?
(e) WHAT
(f) IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
(g) SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
I. ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE 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 WITH THE NORTH CAROLINA COASTAL MANAGEMENT
PROGRAM.
OWNER'S/AGE S SIGNATURE DAIS
(AGENT'S SIGNATURE VALID ONLY IF AUTHORIZATION LETTER FROM THE OWNER IS
PROVIDED).
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DWQ ID: CORPS ACTION ID:
WETLANDS
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDI 1*- '
PRE-CONSTRUCTION NOTIFICATION APPLICAWN
FOR NATIONWIDE PERMITS THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION TO NC DIV. OF WATER QUALTTY FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
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
MUST BE SENT TO THE NC DIVISION OF WATER QUALITY, ATTN: JOHN DORNEY, 4401 REEDY
CREEK ROAD, RALEIGH, NC 27607. PLEASE PRINT OR TYPE.
F-- p 1. OWNER'S NAME: yl/S
w
LLJ w 2. MAILING ADDRESS: ?OSV /JOSS SPfI/.t'? S R D.
<:c uj
CL_
X U3 SUBDIVISION NAME
CITY: f1L !3 , ?/.9R L r STATE: ZIP CODE: 2J'00 /
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
iIVIOZA Y AcyA'D Hp /l i?i? wC Ct> /3 ? MGR 3' L D6-L' s??Tio../ j/IY?E

TELEPHONE NUMBER: (HOME) Toy yf`- I/ 99 (WORK)
4. IF APPLICABLE: AGENTS NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER: /is> f ?N/S/,?o<N1. CrAf?c'c?vA Power iLl/f-//T eC. /Jf TaEA?1 A4HI
?'/O -y3g iasG - /'1T iLCRD, A"d 773oG - CS cc?
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Si'?.v«Y NEAREST TOWN: fl%?R wc?c?0 le
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ETC.)
1"1,4A-1 Ro,r D SR / 7Yo
?'?' fl/fiL o X f DORE51 Q?c,?? S eF //owc /-I
yr T c?G?yLtTE?:> Pe57 cc "-S Zlmar NYC T
6. IMPACTED OR NEAREST. STREAM/RIVER: 1_,4Ar T'/LLC.P7Y
RIVER BASIN:

7. (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA),
HIGH QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-In? YES _.K NO IF YES, EXPLAIN:
SOH eclAlT?z (, Xe 44.r1' /ll E? Y fo;e_
lv c' S v
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES NO _&-
(c) 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?
/T IS 410r L,0&,vrr0 w?Tiriv ft eA4s1;4L -de, r-y
8. (a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES NO j(_ IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS
PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES N0_2?_IF YES, DESCRIBE ANTICIPATED WORK:
9. (a) ESTIMATED TOTAL NUMBERS OF AeM IN TRACT OF LAND: LE 6Et T`
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: EXCAVATION:
FLOODING: OTHER :
DRAINAGE: TOTAL ACRES TO BE IMPACTED:
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: FT AFTER: FT
WIDTH BEFORE (based on normal high water contours): FT
AVERAGE DEPTH BEFORE: FT AFTER: FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL:
CHANNEL EXCAVATION: CONSTRUCTION OF A DAMNLOODING:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAWING TO THE POND?

WHAT IS THE EXPECTED POND SURFACE AREA? / 'c7x- -
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 11 DRAWINGS ONLY)
.}/ Z&P T?' b'f Pl./?FV ?fT LAK£S HOC-E, D/sT4N?E ?'f 8S'
T r tya-t- .+%"T fxTE.dO 7- r'cET l?i9%G? tyi9/? U. F/<T/?i? ?'LDTN 13r??n'iE.e
w,cL /3t PLACED c1A'yE.e R/PREP B©B???r df vs?v
opf-rt'Y /? GEAS?"? fy<.? G??o?..?A ?:r-?a°L<;yf/T Cc?
13. PURPOSE OF PROPOSED WORK: Ty ff, 'fCP Z Mf7 SlloRE

14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
)p7Rf5rRyt SNd," Ef A/.1t
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE 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. DATE CONTACTED: ?_ /Z . Zee,-
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. DATE CONTACTED: ,y Z
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF
PUBLIC (STATE) LAND? YES ( ) NO ()() (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 ( ) NO ( )
(b) IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE? YES ( ) NO ( )
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM 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
29,
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS THE I4 21 26,PROPERTY MUST
AND 38). ALL STREAM (INTERMITTENT AND poWANENT)
BE SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OF 1
INCH EQUALS 100 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.
() ATTACH A COPY OF OF SURROUNDING PROPERTY? PLAN IF REQUIRED.
e WHAT S LAND USE
O t' w.ric.Q ?' --
(f) IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
Ill'-" Ste' G ' /.S a S G
(g) SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US 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 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.
?j,? DAB . e?OG?
OWNER'S/AGE S SIGNATURE
:??
(AGENT'S SIGNATURE VALID ONLY IF AUTHORIZATION LETTER FROM THE OWNER IS
PROVIDED).
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C4 a 000
9% low
Ape
SO V
hh
eop:
AP
y ?
a
tit
d N s ? ? .?
Et 3 t
1\ 7 Z