19900376 Ver 1_COMPLETE FILE_19900101

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OFFICE: [phone] COMPANY 407 S. BROAD STREET
EDENTON, N.C. 27932
",When You Think Real Estate Think Rich!"
COV?TY
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4 gANI
r
P E R Q U
(/In t APPLICATION
`???'• ?/?1` FOR
l WATER OUALITY CERTIFICATION
PERMIT TO EXCAVATE AND/OR FILL
EASEMENT IN Lr+N05 COVERED BY WATER CAMA PERMIT FOR MAJOR DEVELOPMENT
Department of the Army
Department of Administration State of North Carolina
(GS116.11) Department of Natural Resourci?3.215.3(c1,u113Ap1181opment (3Corps 3 CFR 209.320.3 9?minEton piste
(GS 113.229, 143.215.3(a)(1).
Please type or print and fill in all blanks. If information is not applicable, so indicate-by placing N/A in blank,
Applicant Information
A. Name
8. Address
Las
City or Town State
First Middle
P. O. Box or Route 79?0?
G Zip Code Phone
II. Location of ProRosed Project:
A. County hn oa n I 1ID
o ?e,.kti 40?,? ?? ??, ray c,?n ?U
8. 1. City, town, community or landmark 4 1
2. Is proposed work within city limits? Yes. No X - I ?y
C. Crvek, river, sound or bay upon/Ayhich project is located or nearest named body of water to project -
111. Description of Project 2, New work X
A. 1. Maintenance of existing project
8. Purpose of excavation or fill
Irngth?._width depth
1. j\cccsc channel
length.---.- width
2. Boat basin ?_Jcpth
length width_.?.?_.?depth
3. Fill area depth
length width
4. Other
C. 1. Bulkhead length Average distance waterward of MHW (shoreline)
2. Type of bulkhead construction (material)
D. Excavated material (total for project)
1. Cubic yards 2 Type of material
E. Fill material to be placed belnw MHW (see also VI. A)
1. Cubic yards 2 Type of material
IV. Land Type, Disposal Area, and Construction Equipment:
A. Dues the area to be excavated include any marshland, swamps or other wetland? Yes No he Does the disposal Ica include any marshland, swamps or other wetland? Yes -.-No
C. Disposal Area
1. Location -
2, po you claim title to disposal
U. Fill material x>uree if till is to be trucked in
E. How will excavated material be entrapped and erosion controlled?
I . 1 vpc of equipment to be used
G. Will marshland be crossed in transporting equipment to project site? If yes, explain
OA F-81
lev Inr'R
. .. ?? , uc3C71bt)
.ommercial
p,., 3. Housing Development or Industrial
4. Other Fc i j
J
8. 1. Lot size(s)
r? 2. Elevation of lot(s) above mean high water
3. Soil type and texture
4. Type of building facilities or structures
S. Sewage disposal and/or waste water treatment A. Existing
8. Describe -- Planned
6. 'Land Classification'(urcle one) DEVELOPED TRANSITIONAL COMMUNITY
CONSERVATION OTHER RURAL
VI. Pertaining to Fill and Water Quality: AIM (See CA MA L nd-tlse Nlan
A. Does the proposed project involve the pcement of rill material
6. I. Will any runoff or discharge enter adjacent waters as a result of project activityhor planned use of the No
area following project completion? Yes-No 2. Type of discharge
3. Location of discharge
VII. Present rate of shoreline erosion (if known):
VIII. List permit numbers and issue dates of previ u O partment of Arm Co
work in project area, if applicable: Y Corps of Engineers or State permits for
IX. Length of time required to complete project:
X. In addition to the completed application form, the following items must be provided:
A. Attach a copy of the deed (with State application only) or other instrument under which applicant
claims title to;he-affected property. OR if 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 on his land.
S. Attach an accurate work plat drawn to scale on 8% X 11" white paper (see instruction booklet for
details). Note: Original drawings preferred - only high quality copies accepted.
C. A copy of the application and plat must be served upon adjacent riparian landowners by registered or
certified mail or by publication (G.S. 113-229 (d))Enter date served
D. List names and complete addresses of the riparian landowners with property adjoining applicant's.
Such owners have 30 days in which to submit comments to agencies listed below.
-------------
XI. Certification requirement: 1 certify that to the best of my knowledge, the proposed activit • -)m
with the State of North Carolina's approved coastal management pro y pl ies
manner consistent with such -! ogr.m- gram and will be conducted in a
XII. Any permit issued pursuant to this application will allow only the development described in this appli.
cation and plat, Applicants should therefore describe in the application and plat all anticipated devel-
opment activities, including construction, excavation, filling, and land clearing.
DATE
Pplicant•s Signature
O& F-82
Rev. 10178 SEE REVERSE SIDE FOR MAILING INSTRUCTIONS

SAW26-
DEPARTMENT OF THE ARMY
WILMINGTON DISTRICT, CORPS OF P.O. BOX 1890
WILMINGTON, NC 28402-1890
ATTN: CESAW-CO-E
PRE-DISCHARGE NOTIFICATION FORM FOR NATIONWIDE PERMIT 26
of the conditions
If item 4.7. (below) is 10 acres or more aor if pplicant a Must submit an
NOTES: are not met, the listed in Section B. (below)
Please contact the District for forms an
permit application.
individual
information. Certification from
is required to obtain a Section 401 Water quality
NW? 26 to be valid. This certification should
Applicant
the State of North Carolina for notification.
be furnished with this pre-discharge PLEASE PRINT
A.
1, OWNERS NAME:

2. OWNERS ADD SS:
3 (WORK)
/ ??/_ ? 7/_1/9 /3
, OWNERS PHONE NUMBER (HOME): 9i
4, LOCATION OF PLANNED WORK: COUNTY: ROAD NUMBERS, ETC.):
loo)
SPECIFIC LOCATION ( CLUDE STREAAME ,
aq d
5, DESCRIPTION OF PROPOSED WORK:
I ?? `? G P
6, PURPOSE OF PROPOSED WORK:
S APPROXIMATE SIZE OF WATERS AND WTHEILL BE (EXPRESS
ADVERSELY MODIFIED AS A R
IN TENTHS OF ACRES)
INFORMATION THAT THE APPLICANT BELIEVES IS APPROPRIATE:
i.

,,,.f YOU HAVE KNOWLEDGE OF THE EXISTENCE OF ENDANGERED SPECIES ON OR
.AR THE PROPOSED PROJECT AREA? YES [ ] NO
IF YES, INDICATE WHAT SPECIES.
10.' DO YOU HAVE KNOWLEDGE OF HISTORIC PROPERTIES WHICH ARE LISTED OR
DETERMINED ELIGIBLE FOR LISTING ON THE NATIONAL REGISTER OF HISTORIC
PLACES THAT OCCUR IN THE VICINITY OF THE PROPOSED PROJECT? YES [ j NO [?f
11. WILL THE ACTIVITY INTERFERE WITH NAVIGATION? YES [ J NO [vJ'
B. CONDITIONS. THE FOLLOWING CONDITIONS MUST BE MET FOR THE NATIONWIDE
PERMITS TO BE VALID (33 CFR 330.5-.6):
MET NOT MET
1. DISCHARGE OF DREDGED OR FILL MATERIAL WILL NOT
OCCUR IN THE PROXIMITY OF A PUBLIC WATER SUPPLY
INTAKE.
2. DISCHARGE OF DREDGED OR FILL MATERIAL WILL NOT [v? [ ]
OCCUR IN AREAS OF CONCENTRATED SHELLFISH PRODUCTION
UNLESS THE DISCHARGE IS DIRECTLY RELATED TO AN AUTHORIZED
SHELLFISH HARVESTING ACTIVITY.
3. THE ACTIVITY SHALL NOT SIGNIFICANTLY DISRUPT THE [? [ )
MOVEMENT OF THOSE SPECIES OF AQUATIC LIFE INDIGENOUS TO
THE WATERBODY (UNLESS THE PRIMARY PURPOSE OF THE FILL IS
TO IMPOUND WATER).
4. DISCHARGE OF DREDGED OR FILL MATERIAL SHALL CONSIST [/J [ J
OF SUITABLE MATERIAL FREE FROM TOXIC POLLUTANTS IN TOXIC
AMOUNTS.
5. ANt STRUCTURE OR FILL AUTHORIZED SHALL BE PROPERLY [?? [ j
MAINTAINED.
6. THE ACTIVITY WILL NOT OCCUR IN A COMPONENT OF THE [? [ J
NATIONAL WILD AND SCENIC RIVER SYSTEM; NOR IN A RIVER
CURRENTLY DESIGNATED BY CONGRESS AS A "STUDY RIVER" FOR
POSSIBLE INCLUSION.
7. THE CONSTRUCTION OR OPERATION OF THE ACTIVITY WILL [L [ j
NOT IMPAIR RESERVED TRIBAL RIGHTS.
''PRACTICES. THE FOLLOWING MANAGEMENT PRACTICES SHALL BE
D TO THE MAXIMUM EXTENT PRACTICABLE. FAILURE TO COMP LY WITH THESE
.•r CTICES MAY BE CAUSE FOR REQUIRING AN INDIVIDUAL PERMIT. APPLICANT
' SHOULD PROVIDE EXPLANATION FOR MANAGEMENT PRACTICES NOT MET.
MET NOT MET
' 1. DISCHARGE OF DREDGED OR FILL MATERIAL INTO WATERS
?' [ J
/ OF THE UNITED STATES SHALL BE AVOIDED OR MINIMIZED
THROUGH THE USE OF OTHER PRACTICAL ALTERNATIVES.
2. DISCHARGES IN SPAWNING AREAS DURING SPAWNING [VY [ J
SEASONS SHALL BE AVOIDED.
3. DISCHARGES SHALL NOT RESTRICT OR IMPEDE THE
MOVEMENT OF AQUATIC SPECIES INDIGENOUS TO THE WATERS OR
THE PASSAGE OF NORMAL OR EXPECTED HIGH FLOWS OR CAUSE
THE RELOCATION OF THE WATER (UNLESS THE PRIMARY PURPOSE
OF THE FILL IS TO IMPOUND WATERS).
F WATER [?7 [ J
,
4. IF THE DISCHARGE CREATES AN IMPOUNDMENT O
ADVERSE IMPACTS ON THE AQUATIC SYSTEM CAUSED BY THE
ACCELERATED PASSAGE OF WATER AND/OR THE RESTRICTION OF
ITS FLOW SHALL BE MINIMIZED.
IDED J [ J
[
.
5. DISCHARGE IN WETLAND AREAS SHALL BE AVO v
6. HEAVY EQUIPMENT WORKING IN WETLANDS SHALL BE PLACED [o/ [ J
ON MATS.
7. DISCHARGES INTO BREEEDING AREAS FOR MIGRATORY y/ [ 1
WATERFOWL SHALL BE AVOIDED.
8. ALL TEMPORARY FILLS SHALL BE REMOVED IN THEIR [ l
ENTIRETY.
OWNER'S SIGNAT E DATE
IF APPLICABLE:
AGENT'S NAME:
AGENT'S ADDRESS: _
AGENT'S PHONE NUMBER:
AGENT'S SIGNATURE DATE
--?
.? WETLAND DETERMINATION FORM
COORDINATOR: 101 TIME : _ DATE : ?/ /, /,?'j?COUNTY:
N
QUAD: ?'44.Hhl, EAREST TOWN. WATERWAY: / p t C?
PROPERTY OWNER:(NAME/ADDRESS)ZON: /? FF PARTY DOING WORK:(N
AME/ADDRESS)
L VA N
A/o ty, (p
PHONE : PHONE:(
) -
OTHER INDIVIDUALS PRESENT:
IS PROPERTY UNIFORM V-___'OR SEPARATE DISCRETE VEGETATIVE UNITS
VEGETATION: (IN ORDER OF DOMINANCE, DRAW LINE ABOVE NON-DOMINANT SPECIES)
TREES: SPECIE ---X COVER--INDICATOR GROUND COVER: SPECIES-% COVER-INDICATOR
1. 't7a.f' /14UU.,K 1
3. r p, 1- 2.
4. 3.
5 4.
5.
SAPLINGS/SHRUBS: 6.
1. "? 8.
2 . 8.
3. WOODY VINES:
5. 2.
X OF DOMINANT SPECIES (OBL.- FAC.) j2 S OAR INDICATORS:
HYDROPHYTIC VEGETATION: YES NO BASIS:
TYPICAL:I/(COMPLETE BELOW)
' SOIL:
SERIES:
MOTTLED: S NO MATR
BASIS: ,
ATYPICAL:_(COMPLETE BACK)
M"L H IC SOILS LIST. YESI/ NO
COLOR: HYDRIC SOILS: YES
HYDROLOGY:
INUNDATED: YES NO DEPTH OP-WATER:
SATURATED SOILS: YES NO DEPTH TO SATURATION/WATER TABLE
OTHER INDICATORS:
BAS
ATYPICAL SITUATION: YES NO NORM, CONDITIONS: YES yN0
WETLAND DETERMINATION: WETLAND: ? NON-WETLAND:
PHOTOS TAKEN: YES NO_ AUT TY: 10 404 10/404 NONE
JURISDICTION: ABOVE HEAD TAW ERS ISOLATED —ADJACENT P #
DETERMINED BY: (,(J
&TYICAL SITUATIONS
f,
10, -
TIM.
. fpz OF.ALTERATION :
EFFECT ON VEGETATION:
PREVIOUS VEGETATION:
HyDROPHYTIC VEGETATION: YES - NO
SOILS:
TYPE OF ALTERATION:
EFFECT ON SOILS:
PREVIOUS SOILS:
HYDRIC SOILS: YES _ NO
HYDROLOGY:
TYPE OF ALTERATION:
EFFECT ON HYDROLOGY:
PREVIOUS HYDROLOGY:
WETLAND HYDROLOGY: YES_ NO -
AUTHORITY: SECTION 10__ 404 10/404 _ NONE__
S # PHOTOS ADJACENT TAKEN ? YES NO
JURISDICTION: ABOVE HEADWATER ISOLATED
TIONWIDE ? YES No
ATTACH DRAWING W/P OTO ANGLES AND DIM ENSIONS:
l/
44,441-6 4142
%IA-41V

WETLAND DETERMINATION FORM
INATOR:.W w
COORD
NEAgEST TOWN.
4UAD' (NAME/
3. 2•
4. THER INDICATORS:
5. SPECIES (OBL.-
y OF DOMINANT BASIS:
_..,,.?- sTtON : YES NO _
PHONE:(
DRAW LINE ABOVE
GROUND COVER:
1.
2.
3.
4.
NON-DOMINANT SPECIES)
SPECIES-x COVER-INDICATOR
3. 5.
4. 6.
5. 7.
SAPLINGS/SHRUBS:
8.
1. WOODY VINES:-
1.
2.
TIME:
i-?CO UNTY . +
DATE: /12-/ s
• tv
-,WATERWAY fj0
ADDRESS)
1TION: PARTY DOING 410RK:(NAME/
IS PROPERTY UNlr"n" " _
ORDER OF DOMINANCE'
VEGETATION: (IN My cc (610
TREES : SPECIES- . (©1o
22
?. V (COMPLETE BELOW)
TYPICAL
S-0
SERIES:,
MOTTLED:
BASIS :
(COMPLETE BACK)
ATYPICAL:,
• YES NO -
?/ DEPT F WATER:
HYDRA YES EPTH TO
INUNDATED: NO
SATURATED SOILS : YES?NO,
OTHER INDICATORS:
BASIS
ON HYDRIC SOILS LIST.
0`•,_
;,._ , HYDRIC SOILS: YES -
SATURATION/WATER TABLE
_NO
N CONDITIONS : YES.--NO
WETuWD HYDROLOGY : YES
L SITUATION : YES- NO-"'-?NON-WETLAND :
ATYPICA INATION: WETLAND 10/404 _ NONE _
WETLAND DETERM Y: 10 _ 404` NWP
AUTHO ADJAC NT
N : YES- - 0 W--jATERS I- ISOLATED _
PHOTOS TAB ABOVE HEAD
JURISDICTION: pETERMINED BY:

?g OFI ??RATION :
EFFECT ON VEGETATION :_..
BUTION
gyDR VEG'ZTATION
,REV OPU?TG
0 ALTERATION:
EFFECT ON SOILS:
PREVIOUS SOILS:??-
-EYDRIC SOILS : ` ES
R ORATION
TYPE OF ROLOGY:_
EFFECT ON OLOGY:
AT`lL SITl1ATI0NS

PREVIOUS AYD ` '"' -?
D VDROLOGY YES
10 / 4p 4----- NONE ACJ ENT ? 0
404--. TED YES `
`?S 5' ATERS_- OLA `PgOTOS TARE
ORITY : SECTION 10
IF
1 ipNS:
N?R
Jul 0, : A
BOVE L10-.- DIME
YES
NATIONWDWINGG W/Pg TO ANGLES A?
ATTACK