HomeMy WebLinkAbout20030989 Ver 1_Fax_20030930~nvironrnental~ Cons~u~.~a:nts, P.A
Road Raleigh, North Carplina 27614 Talyone: (919) 846-5900 1•'ax; (914') 84b-94G7
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The fallowing items are being faxed. Number of pages incliyding trartsmi a1 sl~eet:~~
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CONTACT ~ f1,T (~ I9) 84G-590o.
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transr~lission in error, please notify us iuamcdistely by telephone arrd retort! the faxed documents to u!: at the above address
via the United Statr,s Postal Service.
Charlotte Office: rcc -_ ro Office: ~1,icko~r (7fFicc
;
236 LcPhillip Crnart, Suite C' 3$17-E I,awndale Drive ,
622 Coen Mountain Lanc
C.'.oncord, NC 2$U2S Greensboro, NC 27455 Tflylors~ illc, NC 2$681
Pl~one: {704} 720-9405 Phone: (336) 54Q-$234 Phone {828} ei35-SZ32C1
Fox: f704) 72C)-y4CK' Fax: (3:16} S4U-8235 Fax: 1$7$) G35.5620
F.ACSINIILE SHEET
I~.K NO. ~919~ B9~G-9~B7
H1~Rr) C(7PY SENT:
US Regular Mail ~ Hand Delivery
Overrtight No Hard Capy Seat
Item 5
PI~EI-lMlNARY ACCEPTANCE l.?ETERM'IJVATIQN
REQUEST FORM
This form must be used to obtain a preliminary payment acceptance date rmination
from the North Carolina Wetlands Restoration Program for alt projects with estimated
mitigation requirements exceeding 5 acres of wetlands or 2,Q00 feet of stream.
Section A• Xo be cam leted by the U S Army Cams of Engineers
1. US ACOE representati a ame ~~, l~
2. US ACOE field office
3. US ALOE Permit or Action mbar
4. Estimated mitigation requirements:
a. Wetland mitigation requirements? yes _na
b. Stream mitigation requirement? _~yes _ __ no
c. Wetland types} impacted and estimated mitigation:
f2iparian, acres
Non-~'~iparian, acres_
f. Stream type(s) and estimated mitigation:
Cold water stream, feet:
Cool water stream, feet:~,~`~.~`~
Warm water stream, feet:
Section B• To be completed by the anpiicant
instructions:
Payment to the NCWI~P is a voluntary option which the applicant can chose as a means of
satisfying mi#igatian requirements. in order for the Carps to obtain a prelimin2 ry
determination of avai{ability from the NGWRP, please complete all of the information
requested below and fax to the North Carolina Wetlands Restoration Program at (919) 733-
5321, or mail to: NC Wetlands Restoration Program, Division of Water Qualih+, P.O. Box
29535, Raleigh, NC 27$26-0535.
2.
3.
4.
AppNcant name:~u~% ~~~~>_.; ~ >t,`~~~r ~''i ~~
8 digit U.S.G.S. cataloging unit in hic proj ct is located: ~ ' -'
River Basin in which jest is located:
Project description;
Fax Gompleted form to NGWRP: (919)733-5321
Or mail to: NC Wetlands Restoration program
Division of Water 4uality
p.0. E3ox 29535, Raleigh,
NC 27'626-0535
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