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HomeMy WebLinkAbout20020908 Ver 1_COMPLETE FILE_20020611 1"WIGCI F. Gt151ey, k. OVe1110r William G. Ross Jr., Secretary h O G Nort Carolina Department of Environment and Natural Resources ? r : UG Alan W. Klimek, P.E. Director > -I 1 Division of Water Quality O -? &. Paul Frymier and Kerri Martin 5423 Lance Drive Knoxville, TN, 37909 APPROVAL of 401 Water Quality Certification Dear Mr. Frymier and Ms. Martin: June 18, 2002 DWQ# 02-0908 Washington County You have our approval, in accordance with the attached conditions, to place fill in 0.014 acre of vegetated wetlands in order to construct a single-family residence on your property near Roper in Washington County, as described in your application received by the Division of Water Quality on June 11, 2002. After reviewing your application, we have determined that this fill is covered by General Water Quality Certification Number 3371, which can be downloaded from our web site at http:Hh2o.enr.state.nc.us/ncwetlands . This Certification allows you to use your CAMA Permit when it is issued by the NC Division of Coastal Management. 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, Non-Discharge and Water Supply Watershed regulations. Also this approval will expire when the accompanying 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 in writing and you may be required to send us a new application for a new certification. If the property is sold, the new owner must be given a copy of the 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). 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 conforming to Chapter 1508 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 Tom Steffens or Deborah Sawyer in our Washington Regional Office at (252) 946-6481 or Cyndi Karoly in our Central Office in Raleigh at (919) 733-9721. in rely, Klimek, E. AW K/cbk Attachments cc: Corps of Engineers Washington Field Office Washington DWQ Regional Office Central Files File Copy Doug Huggett 020908 N. C. Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 (919) 733-7015 NCDENA Customer Service 1 800 623-7748 DIVISION OF COASTAL MANAGEMENT FIELD INVESTIGATION REPORT APPLICANT'S NAME: Paul Frymier and Kern Martin 2. LOCATION OF PROJECT SITE: Washington County off US Highwy 64, on Mallard Cove Road, adjacent to the Albemarle Sound near Roper, North Carolina Photo Index - 2000: 134-1566; V-22 1995: 133-1408; K-3 State Plane Coordinates - X: 2,733,700 Y: 808,200 Roper North Quadrangle Lower Right Corner 3. INVESTIGATION TYPE: CAMA/D&F 4. INVESTIGATIVE PROCEDURE: Dates of Site Visit - 19 March 2002 Was Applicant Present - Yes 5. PROCESSING PROCEDURE: Application Received - 24 May 2002 Office - Washington 6. SITE DESCRIPTION: (A) Local Land Use Plan - 1994 Washington County Land Use Plan Land Classification From LUP - Conservation (Water, Wetlands)/Transition (Land) (B) AEC(s) Involved: Estuarine Shoreline (C) Water Dependent: No (D) Intended Use: Private (E) Wastewater Treatment: Existing - None Planned - Single Family Residence Septic Tank System (F) Type of Structures: Existing - Bulkhead along ±100' shoreline, ±80' of 8" drainage line along west boundary of property. Planned - Slope, fill and grade site, modify the existing drainage system, construct single-family residence (G) Estimated Annual Rate of Erosion: None Source - Applicant 7. HABITAT DESCRIPTION: [AREA] DREDGED FILLED OTHER (A) Vegetated Wetlands 1600 ft2 (404) (B) Non-Vegetated Wetlands Manmade Basin (C) Other (Uplands) 14,400 ft2 Slope/Grade/Seed (D) Total Area Disturbed: ±16,000 ft2, 0.3 ac (E) Primary Nursery Area: No (F) Water Classification: SB Open: No 8. PROJECT SUMMARY: The applicant proposes to fill a 404 wetland area, fill slope and grade uplands, modify the existing drainage system, and construct a single family residence. Frymier/Martin Beach Cottage Project Washington County Project setting The project site is located off U.S. Hwy 64 on Mallard Cove Road, adjacent the Albemarle Sound near Roper in Washington County. A review of our Archives Topographic Maps indicates that there are no historical or archeological sites within the project area. The site is a 0.8 acre tract of land owned by Paul D. Frymier and Kerri Frymier-Martin. The property measures ±100' along the Albemarle Sound shoreline and extends ±350' landward of the shoreline. An existing bulkhead provides shoreline stabilization. A ±1,600 ftZ depression located ±40' landward of the Albemarle Sound shoreline has been delineated as 404 wetlands by Tom Walker of the U.S. Army Corps of Engineers (USACOE). A copy of the USACOE Notice of Jurisdictional Determination is included in the application package. The vegetation on the site consists of scattered pines mixed hardwoods, and upland grasses. The site and surrounding properties generally slope from south to north (toward the Albemarle Sound) and from west to east. Surface run-off from adjacent properties to the west of the site are directed through an existing ditch and 8 inch drainage pipe down the west boundary of the site. The drainage line ends ±85' from the Albemarle Sound. The surface run-off then sheet flows east into the depression that has been delineated as 404 wetland. Under high flow conditions, the surface run-off continues to sheet flow to the east, off the site and into an existing man-made canal. The Albemarle Sound is classified as "SB" by the Environmental Management Commission, with "best uses" being primary recreation, aquatic life propagation and survival, fishing, and wildlife. Project description The applicant proposes to fill, slope and grade a ±15,000 ftZ area from the existing ±100' bulkhead landward for a distance of ±160'. Included in this area is ±1,600 ftZ of delineated 404 wetland, ±600 ftz of which is to be filled. The remaining ±1,000 ftZ will not be altered and will continue to function as wetland. The drainage system will be modified as follows: the existing 8" drainage pipe running along the west boundary of the site will be extended ±60 ftZ. 2. the drainage pipe will then turn east and run under the fill material, directing surface run-off into the remaining ±1,000 ftZ of 404 wetland. 3. a "highwater overflow" pipe will run north for ±40' from the remaining wetland area, through the existing bulkhead to provide drainage during periods of heavy rainfall or high tides (wind driven) coming over the bulkhead.. The applicant also proposes to construct a single-family residence on the site. The residence is to be located ±150 landward (south) of the Albemarle Sound on grassed high ground. Fryinicr/Martin Beach Cottage Project Washington County Page Two Anticipated impacts The project as proposed will result in the filling of ±600 ft2 of 404 wetland. The proposed drainage system design (particularly the highwater overflow pipe) will modify the existing drainage pattern. Guy C. Pearce - 30 May, 2002 zi Project Narrative for Applicants Paul Frymier and Kerri Martin May 21, 2002 We propose to fill an area (approximate overall perimeter dimensions 160 ft long by 100 ft wide) at the front of a lot adjacent to the Albemarle Sound in Roper, North Carolina in the Mallard Cove area. The lot is bulkheaded on the north side, adjacent to the Sound. The lot is roughly level (see original plan view) with a small low area near the north edge of the lot. Water from a grove of small pines across a marl road on the south side of the lot drains onto the lot through a small culvert under the road. Currently, the water runs north down an open ditch (see drawing 1), through an approx. 30 foot length of approx. 8 inch drainage pipe, and then exits the pipe and follows the contour of the ground to the east, enters another short piece of approx. 8 inch corrugated drainage line and then spills out onto the front of the lot, forming a small wet area during periods of high rainfall (typically the winter and spring). The area was delineated by Mr. Tom Walker in the Washington, NC office of the Army Corps of Engineers (see drawing 1, total area of wet area approximately 1600 square feet). A copy of the letter from Mr. Walker attesting to his delineation visit is attached. We propose adding two additional sections of drainage line and fill material to allow the northwest side of the lot to stay dry, while maintaining the wetland portion closer to the east edge of the lot (see drawing 2). An overflow drainage line will be added to allow water to flow out of the wetland area to the Sound in the event of high water coming over the bulkhead or during periods of unusually high rainfall. The wetland area is saturated in the late winter and spring but essentially dry during most of the summer months. The result of the added sand and drainage lines will be to fill about 600 sq. feet of the wetland area on the northwest side of the lot. We will be building a small, single family cottage on the upland portion of the property (see drawing 2 for location and footprint). Also attached is a drawing of the lot showing the adjacent property owners and the location of the property on Hwy. 64 in Roper, NC about 1-2 miles west from where Hwy. 32 splits off at the "Y" and heads north for the Albemarle Sound Bridge. It Form - DCM-MP-1 APPLICATION (To be completed by all applicants) b. City, town, community or landmark 1. APPLICANT a. Landowner: I%V, FrZYMIX 'AAD Name t46M MAMAI Address 5423 L4WL PA W- City 4)DXdIuf, State c. Street address or secondary road number MAU= COVE fcb60 orf buy 61 d. Is proposed work within city limits or planning jurisdiction? Yes'_ No e. Name of body of water nearest project (e.g, river, creek, souid, bay) • ALSEMAOUS SQV&!Q Zip q? Day Phone 5-21 3563 Fax ?r?-q2q- 707.6 b. Authorized Agent: Name WA Address City State 3. DESCRIPTION AND PLANNED USE OF PROPOSED PROJECT a. List all development activities you propose (e.g. building a home, motel, marina, bulkhead, pier, and excavation and/or filling activities. 7th FI(.(- ANO LANDSCME R,E S 1 o&v T7A L Lpr- sue awsnel =,A) Of= Q SINGAe- F4MiV1 _R S?W-AK15- Zip Day Phone Fax c. Project name (if any) C{nM1M1AA4eTTN '96WJ4 CoTMAF, NOTE: Pert will be issued in name of landowner(s), andlor project name. 2. LOCATION OF PROPOSED PROJECT a. County %tJ101 I,fATW b. Is the proposed activity maintenance of an existing project, new work, or both? h) In c. Will the project be for public, private or commercial use? d. Give a brief description of purpose, use, methods of construction and daily operations of proposed project. If more space is needed, please attach addi `onal pages. WE A Tb FILL *V SQttwE Ff? OF ?watmp as pier- °F :51A)G[.4. 15;5MIry. f1E51L?IrE DEVEJ/?itA_f,??T_ '4qL\i?t1-F'NE t7.,? A61AWK T ,v IOpp wi1.L - a uNriuFA;174E Flt[ A4A?e14L Cs400 MIL SE B2X)4 W TD 71- SITS. W 'PUMP 712LtC ACWSS cxot VO fb277CtJ of 774E. X07 = 'W42 ? ra g6 F-#U GD Is skAAiL J 7%E F-11L OUL BE SAZW ey ft VO- Revived 03/95 Form DCM-MP-1 4. LAND AND WATER CHARACTERISTICS a. Size of entire tract b. Size-of individual lot(s) 9uQY_-' COT' c. Approximate elevation of tract above MHW or NWL 3l- of d. Soil type(s) and texture(s) of tract . , ..SAuy>y (,fin it Ct V e. Vegetation on tract yplll(aUS PAZWCOWt A774 Val i wenwo G,l E41S ' f. Man-made features now on tract g. What is the CAMA Land Use Plan land classification of the site? (Consult the local laid use plan.) Conservation Developed Rural' Transitional Community Other h. How is the tract zoned by local government? i. Is the proposed project consistent with the applicable zoning? Yes No IWA (Anach zoning compliance certificate, if applicable) Has a professional done for the tract? If yes, by whom?. archaeological assessment been Yes _ X No k. Is the project_ located in a National Registered Historic District or does it involve a National Register listed o igible property? Yes No. 1. Are there wetlands on the site? 'X Yes No Coastal (marsh) Other_ If yes, has a delineation been conducted? y?5 (Attach &cunsentadon, if available) in. Describe existing wastewater treatment facilities. S$?f?G ARZC.tACQ ,Qd147k? ?acflall-T n. Describe location and type of discharges to waters of the state. (For example, surface runoff, sanitary wastewater, industrial/commercial effluent, "wash down" and residential discharges.) o. Describe existing drinking water supply.source. 5. ADDITIONAL INFORMATION In addition to the completed application form, the following items must be submitted: • A copy of the deed (with state application only) or other instrument under which the applicant claims title to the affected properties. If the applicant is not claiming to be the owner of said property, then forward a copy of the deed or other instrument under which the owner claims title, plus written permission from the owner to carry out the project. • An accurate, dated work plat (including plan view and cross-sectional drawings) drawn to scale in black ink on an 8 1/2" by 1 V white paper. (Refer to Coastal Resources Commission Rule 7J.0203 fol• a detailed description.) Please note that original drawings are preferred and only high quality copies will be accepted. Blue-line prints or other larger plats are acceptable only if an adequate number of quality copies are provided by applicant. (Contact the U.S. Army Corps of Engineers regarding that agency's use of larger drawings.) A site or location map is a part of plat requirements and it must be sufficiently detailed to guide agency personnel. unfamiliar with the area to the Revised 03195 Form DCM-MP-1 site. Include highway or secondary road (SR) numbers, landmarks, and the like. • A Stormwater Certification, if one is necessary. 6. CERTIFICATION AND PERMISSION TO ENTER ON LAND • A list of the names and complete addresses of the adjacent waterfront (riparian) landowners and signed return receipts as proof that such owners have received a copy of the application and plats by certified mail. Such landowners must be advised that they have 30 days in which to submit comments on the proposed project to the Division of Coastal Management. Upon signing this form, the applicant further certifies that such notice has been provided. Name 1 ANO NF--LW GAW-4AN Address 73 TDW#J!; tp i?=Q 221 PirVIM M0-09ViUF- Of+ 4 5661 Name 'SF_an?OM- AU&N Address ?S ZCZ NC 1 WY S2 SOUTN ?kertc PLYiwOUTI+ 61C 27a 6 Z Ai~errre- Al/A *ddress IV e:OQ GyU Pierre SOU • A list of previous state or federal permits issued for work on the project tract. Include permit numbers, perminee, and issuing dates. WA O • A check for ade payable to the Department of Environment, Health, and Natural Resources (DEHNR) to cover the costs of processing the application. • A signed AEC hazard notice for projects in oceanfront and inlet areas. • A statement of compliance with the N.C. Environmental Policy Act (N.C.G.S. 113A - 1 to 10) If the project involves the expenditure of public funds or use of public lands, attach a statement documenting compliance with the North Carolina Environmental Policy Act. I understand that any permit issued in response to this application will allow only the development described in the application. The project will be subject to conditions and restrictions contained in the permit. I certify that to the best of my knowledge, the proposed activity complies with the State of North Carolina's approved Coastal Management Program and will be conducted in a manner consistent with such program. I certify that I am authorized to grant, and do in fact, grant permission to representatives of state and federal review agencies to enter on the aforementioned lands in connection with evaluating information related to this permit application and follow-up monitoring of the project. I further certify that the information provided in this application is truthful to the best of my knowledge. This is the day of Ahb- YCOZ Print Name- ?YMI M?? Signature Landomw or A?tfwnZed gent Please indicate attachments pertaining to your proposed project. * DCM MP-2 DCM MP-3 DCM MP-4 DCM MP-5 DCM MP-6 Excavation and Fill Information Upland Development Structures Information Bridges and Culverts Marina Development NOTE. Please sign and date each attachment in the space provided at the bottom of each form. 400 copies of this public document were printed at a total cost of $52.48 or $ .13 per copy. Revised 03/95 Form DCM-MP-2 EXCAVATION AND FILL (Except bridges and culverts) Attach this form to Joint Application for LAMA Major Permit, Form DCM-MP-1. Be sure to complete all other sections of the Joint Application that relate to this proposed project. Describe below the purpos6 of proposed excavation or fill activities. All values to be given in feet. Average final F-*d n Project Length Width Depth Depth Access channel (MLW) or (NVVL) Canal Boat basin Boat ramp Rock groin Rock breakwater Other C Fi (Excluding shomline stabilization) E ?? - d?f1A MSC. MSL 1. EXCAVATION VIA a. 'Amount of material to be excavated from below MHW or NWL in cubic yards b. Type of material to be excavated c. Does the area to be excavated include coastal wetlands (marsh), submerged aquatic vegetation (SAVs) or other wetlands? Yes No d. Highground excavation in cubic yards 2. DISPOSAL OF EXCAVATED MATERIAL /r/? a. Location of disposal area b. Dimensions of disposal area c. Do you claim title to disposal area? Yes No if no, attach a letter granting permission from the owner. d. Will a disposal area be available for future maintenance? Yes No If yes, where? Revised 03/95 Form DCM-MP-2 e. Does the disposal area include any coastal wetlands (marsh), SAVs or other wetlands? Yes No f. Does the disposal include any area in the water? Yes No If Yes, (1) Amount of material to be placed in the water Il10NE (2) Dimensions of fill area 10x 100' I AJCIUO104 AW F72 of W l3r4U* (3) Purpose of fill 3. SHORELINE STABILIZATION a. Type of shoreline stabilization Bulkhead Riprap b. Length b. Will fill material be ' coastal wetlands (marsh), SAVs or ther wetlands (40y) Yes o If Yes, (1) Dimensions of fill area ,006-salr-r acn? Aa ;- (2) Purpose of fill ZAI F- VAn I AWROYC Ae41 446 c. Average distance waterward of MHW or NWL d. Maximum distance waterward of MHW or NWL 5. GENERAL. e. Shoreline erosion during preceding 12 months (Source of irijormadon) f. Type of bulkhead or riprap material g. Amount of fill in cubic yards to be placed below water level (1) Riprap (2) Bulkhead backfill h. Type of fill material i. Source of fill material 4. OTHER F LL ACTIVITIES (Excluding Shoreline Stabilization) a. Will tl material be brought to site? Yes No a. How will excavated or fill material be kept on site and erosion controlled? CIZADC- D pop SEFDio b. What type of construction equipment will be used (for example, dragline, backhoe, or hydraulic dredge)? '1U 1;"C, TV 51 . M 0 Steer 1. c. Will wetlands be crassed in transporting equipment to project site? Yes No If yes, explain steps that will be taken to lessen environmental impacts. 4 PAUL M Applicant or Project Name Signature 3/ 3 0/a2 Date 400 copies of this public document were printed at a total cost of $11.00 or $ .03 per copy. Revised 03/95 Form DCM-MP-3 UPLAND DEVELOPMENT (Construction and/or land disturbing activities) Attach this form to Joint Application for CAMA Major Permit, Form DCM-MP-1. Be sure to complete all other sections of the Joint Application that relate to this proposed project. a. Type and number of buildings, facilities, units or structures proposed 61044E 1Cj5dA1[_V pre5lo ce b. Number of lots or parcels f7WA45 LDTl h. Projects that require a CAMA Major Development Permit may also require a Stormwater Certification. Has a site development plan been submitted to the Division of Environmental Management for review? Yes _ X No If yes, date submitted Describe pro osed method of sewage disposal. C j. Have the facilities described in Item i. above c. Density (give the number of residential units and the received state or local approval? ,l units per acre) 1IAQWI (Attach appropriate documentation) Size of area to be graded, filled or disturbed including.r,oads, ditches, etc. 166 Pr x 00 Fr k. Describe location and type of proposed discharges to waters of the state (for example, surface runoff, sanitary wastewater, industrial /commercial effluent, "wash down" and residential discharges). 5Q2SMi ' COX106a If the proposed project will disturb more than one acre of land, the Division of Land Resources must receive an erosion and sedimentation control plan at least 30 days before land disturbing activity begins. If applicable, has a sedimentation and erosion control plan been submitted to Division of Land Resources? Yes No If yes, date submitted List the materials (such as marl, paver stone, asphalt, or concrete) to be used for paved surfaces. Ill ZA g. Give the percentage of the tract within 75 feet of MHW or NWL, or within 575 feet in the case of an Outstanding Resource Water, to be covered by impervious and/or built-upon surfaces, such as pavement, buildings, rooftops, or to be used for vehicular driveways or parking. 1. Describe proposed drinking water supply source (e.g. well, community, public system, etc.) m. Will water be impounded? Yes No If yes, how many acres? n. If the project is a oceanfront developmept when was the lot(s) platted and recorded? ?J or Project Name Nt, Signature v - / - g/3afc?2. C Date Revised 03/95 Owners to West: Jeanette Allen : 4 6 4 s 2 3t a Z'?•7 Nfi'?4'Jr /00•x• n Sff'isi? J?'f•f• i ? ' lift •-S N 2' 2 WW RS ? r Owners to East: r r Brian and Helen Galligan ! ri Jt r ? l- /J S 4S'40 'W 109.3 Mx >Z 1~ ? M? to A M / ?.CtaNk'T?C /!7f 00, m w 1 Q ooa'0 CD CD C? W tv ?..?. Z 0 C: 3 CD N Ca 00 N? Nw C Q 3 CD 1 r- 0 0 0 N L?j :z a) C a) rn ca c cz cz U a) c? w LL 0 3 Z `:ti:\?'\\``\\ti\\`t\\\\\\\\\\\\ `?`\\\\ti\ v o p a) aC a) m `- M O CU 0 cc z co -1c m .C z E ? 3 c j Q .n L O Q v? a O LO 11 -0 c (D T C V W C c f? a) IL O C. O O? CL ^^O CD a) c a) rn c? c ? ? .S c o ? '0 _U W 'D C co O C. O IL O LO c . -d U ? cn a O V O C c -o U CO C O O 0- 0 co _W W W Cf) a) U cn N a`) N c .c a) a) 0.8 O .? c -0 cn U O 0 0 a) W /a) VJ 1 O I O O + ?J + 0 co „ fn c6 J U) O O ^L' W E U- CO N CZ %-- O 0- N N N L L z EN cn?z v ? •,_ cz L co a) C?Z _Y3N ac"? Q Csoo L U C O CL O C CO) cn O co z C E -v c L O U C N 00 -v I ? L (D 0o E c rncD c c v co W c`u N m ? ? acui s •- L O 7 ? C p m O (n cu Q O LO if .C N co O N C co rn c Mo x w 0 + O In C N N C U "O CO a) O U 0.9 a) V= C -? U N O o °- o ?a a) W a) U) O O CU J .-: (A O co co cn .O m O ` ?C X a) ca b U O C a U co -0 O O w co a) w a? CO O co J CD O \'J _N E LL 75 MN CZ %#.- O 00 T _ L E Q) co -E Zco EN co ::3 co C p) co Q? '3 dCL-co Q cur) :t U.S. ARMY CORPS OF ENGINEERS Wilmington District Action ID: Property Address / telephone Number. Size andlocatior' of) Property(jwaterbody, Highwayrname/number, town, etc.) t 1 t ? 7 ?z r.7 I / . e d 77. r? n r i` • r Indicate Which o$ the following apply: • There arawetlands on the above d bedrproperty which we str glysuggest should be delineated surveyeg. i&s Meyed wpt a%rdmust be verif cq.,b r staff before the Corps will image a final jurisdidional detorminado'S on your property. ' Because gf the size of your property and our present workload, our identification and delineation of your wetlands cannot be accom =tlana?p in timely m'You may wish to em nsultant tmore timely delinea , tyour consultant has a wetland line o property, Corps staF, a 'ew it, and, ' ' ' accurate, we strongly mend that you have ttre'line surveyed for final ap 1 by the Corps. a Corps will not make a final jurisdictional determination on your property witheNpt an approved survey. • The wetlands on your lot have been delineated, and the limits of Corps jurisdiction have been explained to you. Unless there is a change in the law or our published regulations, this determination may be relied upon for a period not to exceed d rceyears from the date of this notification. f rvs. • There are no wetl esent on the above described property which are subject to the permit requircmcnt?,.o ection 404 of the Clean (S-USC 1344). Unless 4r changc i .1 aw or our WbS-hed regulations, this de oration maybe relied upopJor eriod not to exceed ffiree years fro' the date of this notification. • The project is located in one of the 20 Coastal Counties. You should contact the nearest State Office of Coastal Management to determine their requirements. Placement of dredged or fill material in wetlands on this property without a Department of the Army permit is in most cases a violation of Section 301 of the Clean Water Act (33 USC 1311). A permit is not required for work on the property restricted entirely to existing high ground. If you have any questions regarding the Corps of Engineers regulatory program, please contact 101 2- - 17 -4-4 Property owner/Authorized Agent S/igi;gzure Project Manager Signature .. I--, Date Expiration Date SURVEY PLAT OR FIELD SKETCH OF DESCRIBED PROPERTY AND THE WETLAND DELINEATION FORM MUST BE ATTACHED TO THE YELLOW (FILE) COPY OF THIS FO. ea !?? d, G.r ! e rr i ?/ ?',, { -..v ; p? ro o? MAW Porm Sib ?? ?/ u k ? 1OC 92 4 Q -e r'?f4r 7'/?- County: W4 h h 5 7 v Notification of Jurisdictional Determination Agent ZCC/7C01d 53AE» ,svm i2vgn 86 %?=L6 Z9Z Z:.:C: Z00Z,oZ-EVX akC'4 0a U JUN ? ? ? Development Type FEE DCM % DWQ . ; (143001601 435100093 1625 6253 24300 1602 435100095 23d4?1' 1. Private, non-corm arrial development that does not involve MO 100%(S250) D° (SO) the filling or excavation of any wellands or open water areas: 11. Public or commercal development that does not involve the filling or 540D 100%($400) 0%(SO) excavation of any wetlands or open water areas: Ill. For development that involves the filling and/or excavation of up to 1 acre of wetlands and/or open water areas, determine If A. B, C, or D below applies: III(A). For Private, non-commensal development If General water Quality S25D 100%(S250) 0%($0) Certification No.3301 (see attached) III(B): For public or commercial development if General water Quality 540D 100%(5400) D°? (gp) Certification No.3301 (see attached) can be applied: III(C). If General Water Quality Certification No. 3301 (see attached) could be applied, but DCM staff determined that additional review and 540D 60%(S240) 40% (5160) written DWQ concurrence is needed because of concerns related to water quality or aquatic life: III(D)_ If General Water Quality Certification No. 3301 (see attached) WD 60%(S240) 40%($160) can not be applied IV. For development that involves the filling and/or excavation of more $475 60% (5265) 40% (5790) than one acre of wetlands and/or open water areas ?Gtv?1 Timm 4.rrj 1•- Y?uTroN 0 A),AA 0 4 j 6"