19951191 Ver 1_COMPLETE FILE_19950110

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr„ Governor
Jonathan B, Howes, Secretary
A, Preston Howard, Jr., P.E., Director
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November 13, 1995
Stanly County
DEM Project # 951191
APPROVAL of 401 Water Quality Certification
Mr. Robert & Ms. Amy W. Cohen
Post Office Box 545
Norwood, North Carolina 27320

Dear Mr. & Ms. Cohen:
You have our approval to place fill material in wetlands or waters for the purpose of constructing
a boat house and pier on Lake Tillery at 17903 Margie Lane in Allen Acres, as you described in your
application dated 4 November 1995. After reviewing your application, we have decided that this fill is
covered by General Water Quality Certification Number 2674. This certification allows you to use
Nationwide Permit Number 030 when it is issued by the Corps of Engineers.
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.
For this approval to be valid, you must follow the conditions listed in the attached certification. In
addition, you should get any other federal, state or local permits before you go ahead with your
project.
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 Environmental Management under Section 401
of the Clean Water Act. If you have any questions, please telephone John Domey at 919-733-1786.
Sincerely,
ston Howard, Jr. P.E.
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Asheville Field Office
Mooresville DEM Regional Office
Mr. John Domey
Central Files
951191.1tr
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 5096 recycled/ 10% post-consumer paper
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DEM ID: ACTION ID:
Nationwide Permit Requested (Provide Nationwide Permit #):
JOINT FORM FOR
Nationwide permits that require notification to the Corps of Engineers
Nationwide permits that require application for Section 401 certification
WILMINGTON DISTRICT ENGINEER
CORPS OF ENGINEERS
DEPARTMENT OF THE ARMY
P.O. Box 1890
Wilmington, NC 28402-1890
ATTN: CESAW-CO-E
Telephone [phone]
WATER QUALITY PLANNING
DIVISION OF ENVIRONMENTAL MANAGEMENT
NC DEPARTMENT OF ENVIRO
AND NATURAL RESOURCES ;? `?,.,? i
P.O. Box 29535
Raleigh, NC 27626-0535
ATTN: NM JOHN DORNEY
Telephone (919) -33-5983 -17 3 3 - !'7 8
ONE (1) COPY OF THIS COMPLETED APPLICATION SHOULD BE SENT TO THE CORPS OF ENGINEERS.
SEVEN (7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT.
PLEASE PRINT. n A . X)
.,
1. Owners Name:
2. Owners Address:
3. Owners Phone Number (Home): (Work):4,14/ -3 Si77 _2Y &ULC
4. If Applicable: A,ge/nt's name or responsible corporate official, address, phone num
A
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5. Location of work (MUST ATTACH MAP). County:
Nearest Town or City: L-
Specific Location (Include road numbers, landmarks, etc.):
M
ell czA-
el,
(L(hilt , 1747. 4'M P19AA dlI M i A-aA h ?1? r7 s? rrrt 4?1oi?? P .A n J
6. Name of Closest
7. River Basin:
8. Is this project located in a watershed classified as Trout, SA, HQW, ORW, WS I, or WS II? YES [ ]
9. Have any Section 404 permits been previously requested for use on this property?
If yes, explain.
NO V/
YES[ ] NO V
10. Estimated total number of acres of waters of the U.S„ including wetlands, located on project
11. Number of acres of waters of the U.S., including wetlands, impacted by the proposed project:
Filled:
-Drained-
Flooded:
Excavated:
Total Impacted: k' J+
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12. Description of proposed work (Attach PLANS-8 1/2" X 11" drawings only):
13. Purpose-of proposed work.
JCJ
14. State reasons why the applicant be ' yes that this active musoe carried gut ' q?jwetlands. Also, ote measures
taken to minimize wetland impacts j? ,_(?j- ?k t A,(
1
15. You are required to contact the U.S. Fish and Wildlife Service (USFWS) and/or National MarineTisheries Service
(NMFS) regarding the presence or any Federally listed or proposed for listing endangered or threatened species or critic
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habitat in the permit area that may be affected by the proposed project Have you done so? YES[ ] NO
RESPONSES FROM THE USFWS AND/OR NMFS SHOULD BE FORWARDED TO CORPS.
16. You are required to contact tho State Historic Preservation Officer (SHPO) regarding the presence of histo i
properties in the permit area which may be affected by the proposed project? Have you done so? YES [ ] NO [ 1K
RESPONSE FROM THE SHPO SHOULD BE FORWARDED TO CORPS.
17. Additional information required by DEM:
A. Wetland delineation map showing all wetlands, streams, and lakes on the property.
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. If a stormwater management plan is required for this project, attach
E. What is land use of surrounding property? i JU=Ii?7C
F. If applicable, what is proposed meihod of sewage disposal?
I
Signature
Date

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