20001448 Ver 1_Complete File_20001117

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512 N. Salisbury St. Raleigh NC 27604 Phone [phone]
Daniel Lynch 00-1448
Subject: Daniel Lynch 00-1448
Date: Tue, 13 Feb 200108:53:56 -0500
From: Bob Zarzecki <[e-mail]>
Organization: Division of Water Quality; 401 Certification Unit
To: deborah sawyer <[e-mail]>
CC: John Dorney <[e-mail]>, Cyndi Bell <cyndi.bell@ncmai].net>
Deborah,
I received a call from Mr. Lynch last week. He has a lot in Pamlico Co.
on which he is proposing to fill wetlands (swamp) w/n 50 feet of the
"marsh line" for a proposed garage and swamp. He sent in a 401 request
and we sent him a "more info" letter stating that it looked like he
would have to proceed with a variance. He has been trying to contact
you for a site visit. Please call him (252-249-1556 or mobile [phone])
or let me know if you want me to schedule a time to visit his site.
- Bob
Bob Zarzecki
Environmental Specialist III - DENR/ DWQ
401 Wetlands Certification Unit

1 of 1 2/14/01 11:53 AM
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
AW161-
Mr. Bmfid Lynch
51 Parson Road-A
Grantsboro, NC 28529
Dear Mr. Lynch:
1 '
•
10
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
November 27, 2000
DWQ # 001448
Pamlico County
On November 17, 2000 the Division of Water Quality (DWQ) was notified by receipt of
your applications regarding your plan to fill wetlands for the purpose of constructing a home off
of NCSR 1005 on Beard Creek in Pamlico County. Approval from DWQ is required to disturb
this area. If you are applying for a Major Variance (impacts within 30 feet of the estuarine
shoreline) please complete 3 copies of the enclosed application. If you plan to only impact Zone
2 (from 30 to 50 feet of the shoreline), the enclosed Minor Variance application must be
completed. In any case we believe that a site visit by DWQ's Washington Regional staff would
be helpful to determine where the buffer rules apply to this lot. Please call Ms. Deborah Sawyer
at (252) //6481 for this help.
P call Bob Zarzecki of my staff at [phone] if you have any questions or
would require copies of our rules or procedural materials. This project will remain on hold as
incomplete in accordance with 15A NCAC 2H .0505(c). The processing time for this application
will begin when this information is received. If we do not hear from you by writing within three
(3) weeks we will assume you no longer want to pursue the project and will consider it
withdrawn.
Sincerely,
C G Yl?z
//"'J" John R. Dorney
Cc: Washington DWQ Regional Office
Washington Corps of Engineers
File Copy
Central Files
Bob Zarzecki,
Wetlands/401 Unit • 4401 Reedy Creek Road • Raleigh, North Carolina 27607
Telephone [phone] FAX # [phone]
An Equal Opportunity Affirmative Action Employer
50% recycled/ 10% post consumer paper
001448
U.S. ARMY CORPS OF ENGINEERS
Wilmington District
Action ID:
I r,'
a
NOV 1 7
County: pig 1 "L zG J
Notification of Jurisdictional Determination
Property owner/Authorized Agent
Address
ZIA"?S6o/D Svc 2gS29
Telephone Number C25Z 2- Z 716
Size and Location of Propertt (waterbody, Highway name/ umber, tow/n/n, etc.) ,
C- f" t c? ?.e-,'?? ?S t oc..G n-% -r-?P _;a-,-, S CP OF N4yt ?UD?CN?
Indicate Which of the following apply: 04)ute'f 4D &-.uJ- cree4.
• There 4-- wetlands o the above describe properly which by e strongly suggest s4ouldd b/deloeated and
surve e The surved wetland lines in t be verified b ru r staff before thellCor s ill ake a final
jurisdic ional deter nation on your prop ity. .
• Because of the s ze of your proper y and our pr . ent workload, o identific ion and deli ation o our
wetlands canno he accomplished lin a timely anner. You may ish toe loy a consul nit to o ain a
more timely del neation of thew lands. Once our consultant h s flagged wetland line n the p perty,
Corps staff will eview it, and, if ' is accurate, e strongly recd mend tha ou have th line su eyed for
final approval y the Corps. Th Corps will n make a final jur • ictional eterminatio on you property
an ap oved survey.
,without
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 Nnrr6 years from the date of this notification.61-
• There a e no wetla ds present on th above descr bed property which are su 'ect to t e p mit
require ents of Sect on 404 of the Cie n Water Act 3 USC 1344)/Unless there ' a Chang in t e law
or our blished reg lations, this deter ination may e relied upon i 11 a period not o excee th e years
from th date of this notification.
lr ?• 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.Q S2 ? 809- 2808
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 re arding the Corps of Engineers regulatory program, please contact
L ?31(ecvwne at ( Z) ?'j - ? 6
Property owner/Authorized Agent Signature
Project Manager Signature
Date 77 I zOgg (7 Expiration Date 7 [LY IZdu V
SURVEY PLAT OR FIELD SKETCH OF DESCRIBED PROPERTY AND THE WETLAND
DELINEATION FORM MUST BE ATTACHED TO THE YELLOW( (FILE) COPY OF THIS FORM.
SM 4 ?it/L'IJ 1, !J 0"? Lva'? litA
CFSAW Form / a ;1 1 oc-r 92 plo)er-? C? Q? ? ? F P aye ? ?e k,r-, d

DEM ID:
0D1448
CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #):
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:

1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATION 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 SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL, MANAGEMENT
(SEE AGENCY ADDRESSES SHEET). PLEASE PRINT.
1. OWNERS NAME:
2. MAILING ADDRESS
51 i?a???rsnh Rel - R
/1 LL SUBDIVISION NAME: wire 5?m N?
CITY: G'7QYITS6OV'd STATE: Al G, ZIP CODE: c?
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
3. TELEPHONE NUMBER (HOME) : aSAollV9 7Al (WORK) : 015'k 01y9 ISS(o
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
7-0
rr'l
C-73 -?G
r
"< rn
?= '1
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL HOTOGRAPHY WITH SCALE):
COUNTY: NEAREST TOWN OR CITY: Qr4AQQL6d e
1
N(IMBERS, I,AIDMARKS, ETC. )
_SPECIFIC LOCATION (TNCLUDE ROAD

-4
nn 13 cr rj ( rte ? -- ( s K--
6. IMPACTFD OR NEAREST STREAM/RIVER: ?%Y,A ,-_C?[e--K--
RIVER BASIN: N W. e'
?, a. IS DROJECT LOCATED NEAR WATER CLASSIFIED. AS TROUT, TIDAL SALTWATER.
(SP.1, HIGH QUALITY WATERS (HOW), OUTSTAN NG RESOURCE WATER`' (ORW), WATER
SUPPLY (WS-I OR. WS-II)? YES [ J NO (VI IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES [ J NO (V111,
'7c. 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?
ura 1 t,) I 4h s2r v • Ges .
8a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES [ J NO [?r IF YES, PROVIDE ACTION I.D. NUMBER OF
PPEVIOUS PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION):
8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE.
FUTURE? YES ( J NO (W/ IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER. OF ACRES IN TRACT OF LAND:
1. V
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
2
I 0a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE. PROPOSED PROJECT BY:
FILLING: • QJ? EXCAVATION:
FLOODING: OTHER: ---?
TOTAL ACRES TO BE IMPACTED: •'? J
DPJ?INAGE:
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED; PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION)
LENGTH BEFORE: dl/ 14 FT AFTER: All# FT
F`T
WIDTH BEFORE (based on normal high water contours):
WIDTH AFTER: FT
/? FT AFTER: ?T
AVERAGE. DEPTH BEFORE :
(2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL:
CH_-NNEL EXCAVATION: CONSTRUCTION OF A DAM/FLOODING:
OTHER
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?

12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DRAWINGS
ONLY) :
uJIL, ?? A al1
ck

v
12. PURPOSE OF PROPOSED WORK: 5e, P, G? O.,j ?
3
14. STATE P.EASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BF CARRIED
')UT IN WETI,ANDS. (INCLUDE ANY MEASUPES TAKEN TO MIi,1I:MIZE WETLAND
IMPACTS):
/? abs? ?,?,.•.c..., 4.1 / ?.. t fios R rr w ITAY-0 111h Ld t) . Ala r/'v of
lot ?5. YOU ARE REQUIRED TO CONTACT THE U.S. FISH AND WILDLIFE SERVICE
(USFWS) AND/OR NATIONAL MARINE FISHERIES SERVICE (NMFS) (SEE AGENCY
ADDRESSES SHEET) REGARDING THE PRESENCE OF ANY FEDERALLY LISTED OR
PROPOSED FOR. LISTING ENDANGERED OR. THREATENED SPECIES OR CRITICAL HABITAT
IN THE PERMIT AREA THAT MAYBE-AFFECTED BY THE. PROPOSED PROJECT. DATE
CONTACTED: (ATTACH RESPONSES
FROM THESE AGENCIES.)
16. YOU AR.E--f?EQUI-RED-TO-CONTACT THE STATE HISTORIC_PRESERVAmI-ON__oFFICER
(SHPO) (SEE AGENCY ADDRESSES--SHEET) REGARDING THE PRESENCE OF HISTORIC -
PROPEF.TIES IN-I`FiE PERMIT AREA WHICH MAY BE AFFECTED BY THE PROPOSED
PROJECT. DATE CONTACTED:
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND?
YES [) NO M (IF NO, GO TO 18)
a. IF YES, DOES THE PROJECT REQUIRE PREPARATION OF A.N ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA ENVIRONMENTAL
POLICY ACT?
YES [J NO (J
b. IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE?
YES [I NO [ ]
IF ANSWER TO 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
COMPLIANCE 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, RA-LEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
4
18 . THE FOLI,OWTFJ(-, ITEMS SHOULD BF: TNCLUDED WITH THT.S APPLTCATION T F
PROPOSED ACT?!,TT.TY TNVnT,VFSI THE DTSCHAR-,F I)F F,KCAVATFD OR F'TLI_, MATF'RT-;,
INTO WETLANDS:
a. WETLAND i>ELIPiE?1TION MAP 1{OWING; AT L WE':LANF, STRF:A_M.S, L?.K.F
A.PdD POp]D", ON THE PROPEFT'l (FOR tlT.'i InNW%DF_. PFFMTT NU11FEi? ?
AMID 'ft ? A.I.T. STREAMS (INTERM-TTENT A.ND PFPMAHFHT) ON THE )P(iiPERTV
MUST BE SHOWN ON THE MAP. MAP SCALES SHOULD BE L INCH E rIAT,S F'F "" OP. 1
INCH EOUALS 100 FEET OP THEIR EQUIVALENT.
h. TF AVAILABLE, RFPRESENTATTVE PHO'I'OC,R",PH -)F' T(-) BF
IMPACTED BY PROJECT.
C . T F DELINEATION WAS PER FORMF,D BY A CONSTIL`1.'ANT, T.NCLUDE ALL DATA
'7HEETS RELEVANT TO THE PLACEMENT OF THE DEL.INEATT_ON DINE.
d. ATTACH A. COPY OF THE STOPMWATFR MANA(,r.MFNT LAN T7 R.FQr7T RED .
e . Wf"_T TS T,AND r7SF. OF Sr7RRnUNDTNO PROPFR','Y .r1_,tQ
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 U.S. 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
ENVIRONMENTAL MANAGEMENT (WATER QUALITY) CERTIFICATION, AND
3) (IN T11E 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.
l1LQ.M?
OWNER.' S; AGE T' S SIGNATURE
-a9-(51,?
DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHOR-lZATION LETTER FROM
THE OWNER IS PROVIDED (18g.))
5

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®01448
U.S. ARMY CORPS OF ENGINEERS
Wilmington District
Action ID:
Wr:
o. a, .
County: F'17 L ZG a
Notification of Jurisdictional Determination
Property owner/Authorized Agent
Address
6if.-I'L601 a Svc // 2gSZy
Telephone Number C25 -Z 2 1- Z ILL
Size and Location of Propert (waterbody, Highway name/ umber, tow/ , etc.)
? ???Sa-? IS ?a cl I `'1 &?/? ? ? L?are3
. ?G.? a.e-? &1A: t1(1 t.s ?aL w ? n-, -Ve C n-,44' S ?to OF /VGC? ?O??Gc
Indicate Which of the following apply: ot4)GgCC^i- +-, I. / Gr eel .
• There a wetlands o the above describe property which e strongly suggests ould b del' eated and
surveye . The surved wetland lines in t be verified byrur staff before thetcorps ill Make a final
jurisdic ional deter nation on your prop trty. .
• Because of the s ze of your proper y and our pr , ent workload, o identileterminatio ion and Jelin ation o ti ur
wetlands canno be accomplished in a timely anner. You may ish to oy a consul nt too a
more timely del neation of thew lands. Once our consultant h s flaggeetland line n the p perty,
Corps staff will eview it, and, if ' is accurate, e strongly reco mend tha have th line su eyed for
final approval y the Corps. Th Corps will n make a final jur ictional on you property
without an ap oved survey.
OThe 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 +rtr6 years from the date of this notification.
IFN
• There a e no wetla ds present ion th above descr bed property which are sub?J'ect tote p mit
require ents of Sect on 404 of the Cie n Water Act 3 USC 1344)/Unless there j? a Chang in t e law
or our blished re lations, this deter ination may e relied u on lOr a period nottto excee th e years
g p
from th date of this notification.
lr co 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.Q s2 ) 8os- 2808
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 re arding the Corps of Engineers regulatory program, please contact
L(? at?ZS?1
Property owner/Authorized Agent Signature
Project Manager Signature
Date `7(Zglgg V
Expiration Date 7122 t!Zdo V
SURVEY PLAT OR FIELD SKETCH OF DESCRIBED PROPERTY AND THE WETLAND
DELINEATION FORM MUST BE ATTACHED TO THE YELLOW (FILE) fCOPY OF THIS FORM.
cfe C,
CESAW Form Snn LL X r (( r
10a92 !? JPGr q Gw ti P? P ?? el 6 arc GQ
001448
DEM ID: CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #):
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
i
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATION FOR SECTION 401 CERTIFICATION
3) COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FO__PM TO THE APPROPRIATE
FIELD OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN
(7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT
(SEE AGENCY ADDRESSES SHEET). PLEASE PRINT.
1. OWNERS NAME:
2. MAILING ADDRESS:

l t SUBDIVISION NAME: ?nifa ??'1m rte,
CITY: alroGy -Te601rd STATE: -Al C ZIP CODE: a?
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
3. TELEPHONE NUMBER (HOME) : $ p"?y9 '?/b yi (WORK) : aSa a 4iq ISS'(t
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
n -<
_'
rn
"< rTl
o --I
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL HOTOQRAPHY WITH SCALE):
COUNTY: ? NEAREST TOWN OR CITY: 0 reA °a0 e
1
NUMBERS, LANDMARKS, ETC.)
SPECIFIC LOCATION (INCLUDE ROAD
loindin
1
6. IMPACTED OR NEAREST STREAM/RIVER: ll?xr_AS iC re-f-K-
RIVER BASIN: N ewe, --
7'1 . IS DROJECT LOCATED NEAR WATER. CLASSIFIED AS TROUT, TIDAI: SALTWATER
(SA), HIGH QUALITY WATERS (HQW), OUTSTANYNG RESOURCE WATERS (ORW), WATER.
SUPPLY (WS-I OR. WS-II)? YES [ ] NO [ J IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
I-NAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES [ ] NO [
7c. 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?
? u ra 1 ti 4h sir v ces
Sa. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES [ ] NO [?J IF YES, PROVIDE ACTION I.D. NUMBER OF
PREVIOUS PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION):
Sb. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES [ ] NO [W/ IF YES, DESCRIBE ANTICIPP_TED WORK:
9a. ESTIMATED TOTAL NUMBER. OF ACRES IN TRACT OF LAND:
1.1
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
2
10A. NUMBER OF ACRES OF WETLANDS IMPACTED BY TH??E????P,,R??OPOSED PROJECT BY:
FILLING: - ± EXCAVATION: 1v%n
IY/?
FLOODING : All A OTHER:
DRAINAGE: TOTAL ACRES TO BE IMPACTED : • ' J
fy?
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
PELOCATED, PP.OVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION)
LENGTH BEFORE: FT AFTER: ET
WIDTH BEFORE (based on normal high water contours): FT
WIDTH AFTER: /?*- FT
AVERAGE DEPTH BEFORE: FT AFTER:
(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:
OTHER
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?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DP.AWT_I11(-,S
ONLY)
'??? •?,i I iJtti ?? V? __ rock AAk% 5? vim, Svna //
CSC
v
13. PURPOSE OF PROPOSED WORK: ?J",e pi Q iOVe
3
1?. STATE REASONS WHY IT IS BELIEVE[) THAT THIS ACTIVITY MUST BE CARRIFI)
OUT IN WETLANDS. 'INCLUDE ANY MEASURES TAKEN TO MI:,IIMI^E WETLAND
IMPACTS): ,
/?D ??r?f? n.o?rsn 4.J I l / n L Ta 1 ih5 IrP? r /t/1 ail it in Ld w . A& re0 t-i
-r L??+`?
lot
15. YOU ARE R.EQU?R.ED TO CONTACT THE U.S. FISH AND WILDLIFE SERVICE
? i
iL'SFWS) AND/OR NATIONAL MARINE FISHERIES SERVICE (NMFS) (SEE AGENCY
ADDRESSES SHEET) REGARDING THE PRESENCE OF ANY FEDERALLY LISTED OR
PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL HABITAT
IN THE PERMIT AREA THAT MAYBE AFFECTED BY THE PROPOSED PROJECT. DATE
CONTACTED: (ATTACH RESPONSES
FROM THESE AGENCIES.)
16. YOU ARE--_R_EQUI-RED-T-0-CONTACT THE STATE HISTORIC-_PRESERVAT-I-ON-OFFICER. r.
(SHPO) (SEE AGENCY AD DRESSES -.SHEET) REGARDING THE PRESENCE OF HISTORIC -!?
PROPERTIES IN -_T'TiE PERMIT AREA WHICH MAY BE AFFECTED BY THE-PROPOSED
PROJECT. DATE CONTACTED:
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OP THE USE OF
PUBLIC (STATE) LAND?
YES ( ] NO 0 ( I F 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 TO 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
COMPLIANCE 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, RAC SIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
4
18. THE FnT,I,OWINr TTEMS SHO[TT,D RE INr'LUDED WITH THTS A."PLTCATTnN IF
PPOPr„ F,n A(-T"":rTTY TNVnT,VF.S THE DTSr'HAR(;r' '-)F EYCAVATFD nR FTI,L MATFPT:1i,
INTO WETLANMS
?. WETLAND DELINEATION MAP SNP")(vIP1?= P.i,1, WETLANDS, '1'RF"7 MM
' Ott E PROPEP.TY (FA)R NA'I'IOPIW?DF PFR?IIT N[?MBE?.S 1 1'?, L, ??
?SIh POhID; ?i
PERMANENT) ON THE PP.o?PEPT'i'
AND 38i ALL STREAMS (IiITERMTTTFNT AND
MUST RE SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 INCH EnrTAL S 5 0 FF ?'-R 1
INCH EQUALS ino FEET OR THEIR EQUIVALENT.
h. TF AVAILARLE, REPRESENTATIVE PHOTn' PAPti nF WE'?I,APdDS Tn BE
IMPACTED BY PROJECT.
c. T_F DELINEATION WAS PERFOPMED BY n. cnNS[1LTANT, TNrL[InE \I,T, DATA
SHEETS RELEVANT Tn THE, PLACEMENT OF THE DELINEATION LTNE.
d. ATTACH A COPY OF THE STORMWATFR MANAGEMENT LA11 T,"' R.FQUIRED.
WJITT TS T,AND USF. nE MpRoriNDIi]r. PRnPF'RTY? ?---
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
a. SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE,': WETLANDS OR WATERS OF THE U.S. 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
ENVIRONMENTAL MANAGEMENT (WATER QUALITY) CERTIFICATION, AND
3) (IN = TT=TY 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.
IILQ.M?J?-
OWNER'S%AGE T'S SIGN?.TURE
C-a9-qq
DATE
(AGENT'S SIGNATURE VALID ONLY
TF AUTHORS7ZA7ION LETTER FROM
THE OWNER IS PROVIDED (18g.))
5
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001448
U.S. ARMY CORPS OF ENGINEERS
Wilmington District
Action ID:
"(IOU
County: Pa 1 "L 6 a i
Notification of Jurisdictional Determination
Property owner/Authorized Agent
Address
2
Telephone Number j z? -2"- Z 71 b
Size and Location of Propert (waterbody, Highway name/umber, tow , etc.)
1.61 u?i e In IOC,.kP2 Ofd W./&D " OuJ
t,r' c?.>.e^1 (n? G? t? ?aLw ? n? P ?i?-. S Ce cc 1<VS ??L?+?tt(Y
Indicate Which of the following apply: 014)ucC4 Greef1 .
• There a wetlands o the above describe property which re strongly suggests ould b del' eated and
surveye . The sure ed wetland lines m 1t be verified by our staff before the(Corps ill Make a final
jurisdic Tonal deter nation on your prop rty. -
• Because of the s ze of your proper y and our pr , ent workload/hs identileterminatio ion and deli ation o our
wetlands corm(, be accomplished in a timely nner. You msh to oy a consul nit too ?ain a
more timely del neation of the w lands. Once our consultant flaggeetl and line n the perty,
Corps staff will eview it, and, if is accurate, e strongly reco nd tha have th line su eyed for
final approval y the Corps. Th Corps will n make a final jur tional on you property
without an an oved survey.
OThe 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 t#sreg years from the date of this notification.
• There a e no weda ds present Fon th above descr bed property which are subject tote p mit
require ents of Sect on 404 of the Cle Water Act 3 USC 1344)Unless there je; a Chang in t e law
or our blished reg lotions, this deter ination may e relied upon r a period not(to excee th a years
from th date of this notification.
It 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.Q s2 ) 909- Z808
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 re arding the Corps of Engineers regulatory program, please contact
A( (e 0a to at (ZS-2) ,q?,S: - W6
Property owner/Authorized Agent Signature
Project Manager Signature
Date ` Z 1 ZS 1 q q V
Expiration Date 714 110" V
SURVEY PLAT OR FIELD SKETCH OF DESCRIBED PROPERTY AND THE WETLAND
DELINEATION FORM MUST BE ATTACHED TO THE YELLOW (FILE) COPY OF THIS FORM.
11
kA, "A cf e
'y L
CFSAW Form 56I L ? rr (
1 ocr 92 P10 &r- w
?t144
DEM ID: CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #):
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE: y
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATION 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 SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT
(SEE AGENCY ADDRESSES SHEET). PLEASE PRINT.
1. OWNERS NAME:
C)
rn ?
c r-ri
rn z
2. MAILING ADDRESS: Rdy-l6y% kck. ft
LL ll SUBDIVISION NAME: B ira SYlm r',
CITY: G'PGy 'K6o1rd STATE: IV C ZIP CODE: aaoU4
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE) :
3. TELEPHONE NUMBER (HOME) (WORK) : 016sA_ ajiq I SSt-
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL HOTOGRAPHY WITH SCALE):
COUNTY: NEAREST TOWN OR CITY: Q reA 12A o e
-I
1
_ SPECIFIC LOCATION (INCLUDE ROAD
NUMBERS, LANDMARKS, ETC.) a Q,? y. o y-

6. IMPACTED OR NEAREST STREAM/RIVER: iC.?'Q K-
RIVED. BASIN: N ewe-'
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER.
(SA), HIGH QUALITY WATERS (HQW), OUTST?AN[•ING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR. WS-II)? YES [ ] NO [VI IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN ,A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES [ ] NO (V?'
7c. 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?
3ura1 w i-fh 5erv cts .
8a. HAVE ANY SECTION 909 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES [ ] NO [?r IF YES, PROVIDE ACTION I.D. NUMBER OF
PREVIOUS PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 901
CERTIFICATION):
8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES [ ] NO [W/ IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND
I.I
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
I -1-
2
1.0a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: • o EXCAVATION: AVm
FLOODING: OTHER: ?l
DP.AINAGE: TOTAL ACRES TO BE IMPACTED: J
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE DISTANCE BOTH BEFORE, AND AFTER RELOCATION)
LENGTH BEFORE: All FT AFTER: N/ FT
WIDTH BEFORE (based on normal high water contours)
WIDTH AFTER:
AVERAGE DEPTH BEFORE: N/A FT AFTER: AMA FT
(2) STREAM CHANNEL IMPAC"S WILL RESULT FROM: (CHECK A.LL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL:
CHANNEL EXCAVATION: CONSTRUCTION OF A DAM/FLOODING:
OTHER:
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?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DRAWINGS
ONLY) :
1 kI - f - - - -j _ J I /,..
e tiul ild ub a fPA IfiOV- '4I 1&? ? Dad 473V
13. PURPOSE OF PROPOSED WORK: `J"C' Ei Q,?OVes
1 FT
V

3
STATE REASONS WHY IT IS BELIEVED THAT TFti l:C'TI':%I'P'i MUST Bh' 1R.PIED
nt7T IN WFTI,7. SIDS . 'INCLUDE ANY MEASURES TAFEN To MI1,IrMI^ E WETLAND
IMPACTS)
i5. YnU ARE REQUIRED TO CONTACT THE U.S. FISH AND WILDLIFE SEPVTCF
(USFWS) PSID/nR NATIONAL MARINE FISHERIES SEP.VICF, (NMFS) (SEE AGENCY
?. i
ADDRESSES SHEET) REGARDING THE PRESENCE nF ANY FEDERALLY LISTED OR
PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL HABITA'T'
IN THE PEPh?IT AREA THAT MAY-BE AFFECTED BY THE. PROPOSED PROJECT. DATE
CC-N'_"ACTED: (ATTACH RESPONSES
FROM THESE AGENCIES.)
16. YOU ARE-SQUIRED-TO-CONTACT THE STATE HISTORIC__PRESERVAT-LON__OFFICER , C
(SHPO) (SEE AGENCY ADDRESSES-SHEET) REGARDING THE PRESENCE OF HISTORIC
PROPERTIES IN-THE PERMIT AREA WHICH MAY BE AFFECTED BY THE"PROPOSED
PROJECT. DATE CONTACTED:
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OP THE USE OF
PUBLIC (STATE) LAND?
YES [] NO M (IF NO, GO TO 18)
a. IF YES, DOES THE PROJECT REQUIRE PREPARATION OF PSI 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 (I
IF ANSWER TO 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
COMPLIANCE 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, RPM SIGH,
NORTH CAROLINE. 27603-8003, TELEPHONE [phone].
4
i8. THE FOT.T,OWING ITEM" SHOUT,D RE INCLUDEI'. WITH TFiTS APPLICATION TF
pRnpC,SF.'D A(- '-rTTY INVnT,VES THE DT_SCHAPl,F OF E;•:7AV71TFU OR FILL MATF'PIai,
INTO WETLANDS:
?. V1ETLAldD DELINFATT0H MAP "1•1,?W1NG AiI, WE':LANI`S, STRE 'Il.MS , FE
_Cll) PONI1:? (-TI PROPEr^T'( (FOF IdATIONWTIDE PEP-hlTT NUPIBF:P.. T i,
AND ?81 ALL STREAMS (INTEPMTTTFNT AND PFPMAI'IE1,1'1') ON THE PPC', FFP'I'`"
MUST BE SHOG7N ON THE MAP. MAP SCALES SF{nr1T,D BF T INUIT EQUALS FFF.^' OP I
INCH EQUALS 100 FEET OR THEIR EQU'IVALEN`T'.
h. T F .-VATLABLF, REPRESENTATTVE PHO'rnr,,.p.pl7 (-)F TCl BF
IMPACTED PY PROJECT.
r. TF DELINEATION WAS PEPFOPMF;D BY A CON5;[1T,TAN'T', 1-N(7I_,UPF ALI, DATA.
SHEETS PFLFVAhIT TO THE PLA(7FMF.NT OF THE DELINEATT )N LINE.
A r I n,Cli ?' Cr>P`t OF THF. STnRMWATF.R MANArFMF NT DLAN T F' REQTT-I PF P .
Wli_''" IS LAND USF OF Sr1RRr[iCdDTTdO PR.OPF R'P'f? _9-rI-jQ f'f_, vmc.,9% --
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
q. SI,NED AND DATED AGENT AUTHORIZATION LETTFR, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE U.S. 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
ENVIRONMENTAL MANAGEMENT (WATER QUALITY) CERTIFICATION, AND
3) (IN TFE7 TPY=TY 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.
l1LQ.M?
OWNER.' S, AGE T' S SIGNT-.TUR.E
-- DAT E
(AGENT'S SIGNATURE VALID ONLY
IF AUTHOR-7ATION LETTER FROM
THE OWNER IS PROVIDED (18g.))
5
PARSONS ROAD
PC
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an 10r ?V? CF
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.40 /7 MME
001448
U.S. ARMY CORPS OF ENGINEERS
Wilmington District
Action ID: County: pA 1 "L SGs)
Notification of Jurisdictional Determination
Property owner/Authorized Agent
Address S I (d/Sow R0.2
?i???s?o\? ? Svc / 2gSZ?
Telephone Number C25Z 1 2"- 2 716
Size and Location of Propertt (waterbody, Highway name/ umber, tow/p), etc.)
. q a'-J Q InT locoW oke ??so" IZ 0C4
5.. ?G.?`?.c w?. ??, ", Lam ..? Q-, -,P RR c a_-k, s'Ae of k4 I oD?Gyx?
Indicate Which of the following apply: 64Y4tv+f Gree4.
• There ale- wetlands o the above describe property which a strongly suggests ould b del' Bated and
surveye . The surved wetland lines m t be verified byrur staff before the(Corps ill hake a final
jurisdic Tonal deter nation on your prop Irty. • Because of the s ze of your proper y and our ent workload, o identific ion and deli ation o our
wetlands can no be accomplished in a timely nner. You may ish to e loy a consul ant too ain a
nt h s flagged wetland line n thp perty,
more timely del neation of thew lands. Onur consulta
Corps staff will eview it, and, if ' is accuratestrongly reco mend tha ou have th line su eyed for
final approval y the Corps. Th Corps will n ake a final jur ictional eterminatio on you property
without an an oved survey.
OThe 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 tars years from the date of this notification.
mit
• There a e no wetla ds present on tIn above described property which are su 'ect tote /eyears
require ents of Sect on 404 of the Cie Water Act 3 USC 1344) Unless there ' a chang in law
or our blished reg lations, this deter nation may e relied upon r a period not o excee th from th date of this notification.
Ir r• 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-Q s2 ? 808- Zgpg
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 re arding the Corps of Engineers regulatory program, please contact
II at (2S2) ?, - 14t6
Property owner/Authorized Agent Signature
Project Manager Signature
Date `:7 l Zg l q 1 V
Expiration Date 7 4lr `20-V
SURVEY PLAT OR FIELD SKETCH OF DESCRIBED PROPERTY AND THE WETLAND
DELINEATION FORM MUST BE ATTACHE D TO THE YELLOW (FILE) COPY OF THIS FORM.
, I,e
tom
CESAW Form ljy u -

,
??e?
ut^x c( e L y
0, C
1 OCr 92
npageG ?Qr4c , 41f- (A
.
p
r 001448
DEM ID: CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #) :
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE: i

1) NOTIFICATION TO THE CORPS OF ENGINEERS ('l
2) APPLICATION FOR SECTION 401 CERTIFICATION

3) COORDINATION WITH THE
NC DIVISION OF COASTAL
MANAGEMENT CJ - -?
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 SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT -
(SEE AGENCY ADDRESSES SHEET). PLEASE PRINT.
1. OWNERS NAME:
2. MAILING ADDRESS: S l i°dY71.8 IZOI . f
LL SUBDIVISION NAME: &jra 6, *jo r,6e
CITY: ?PG?y1T?1?01rd STATE: G ZIP CODE: AY"4
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
3. TELEPHONE NUMBER (HOME) : d$v? y9 ?/? (WORK) : aS?A_ CIJYq J'SS(o
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
M,?P OR AERIALp•HOTOQRAPHY WITH SCALE) :
COUNTY: t'?[ y1ry ?I Q NEAREST TOWN OR CITY: r ah 0 e _
1
_ SPECIFIC LOCATION (TNCLUDE ROAD
NUMBERS, LANDMARKS, ETC.) : / aa*yyck ? )oy-c

h
6. IMPACTED OR NEAREST STREAM/RIVER: Cae?triki Cv-ev-K-
RIVER BASIN: N W( Q.
7a. 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 [ ) NO [ ) IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES [ ) NO (vl?'
7c. 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?
?uraI 4jt-fh 5eru us
8a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES [ ] NO [?? IF YES, PROVIDE ACTION I.D. NUMBER OF
PREVIOUS PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION):
8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES [ ] NO [W/ IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND
l.I
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
I.lZ
2
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: + (?? EXCAVATION: N?1
FLOODING: OTHER:
,? ! 1
DRAINAGE: fv TOTAL ACRES TO BE IMPACTED: •'?-?
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE D.TSTANCE BOTH BEFORE AND AFTER RELOCATION)
LENGTH BEFORE: lVlla FT AFTER: FT
WIDTH BEFORE (?(h/ased on normal high water contours):
WIDTH AFTER: All
107
AVERAGE DF.PTH BEFORE: /•?? _ FT AFTER: ['Ac FT
(2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK A.LL THAT APPLY)
OPEN CHANNEL RELOCATION: _ PLACEMENT OF PIPE IN CHANNEL:
CHANNEL EXCAVATION: CONSTRUCTION OF A DAM/FLOODING:
OTHER:
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?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DRAWINGS
ONLY) :
-6'u Lk- ?v rip I iya kill (fock 14?-th saw ( sm,4 // t,-dsk)l 11 ck=

FT
13. PURPOSE OF PROPOSED WORK: fee e, ?+ -
3
19. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED
OUT IN WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MiNT_.M.IZE. WETLAND
IMPACTS):

rw'
1
? 0 t*J
• ?
lZf_ l1? s `ra ? n 4.!K
1c; . YOU ARE REQUIRED TO CONTACT THE U.S. FISH AND WILDLIFE SERVICE ?.-
IUSFWS) AND/OR -NATIONAL MARINE FISHERIES SERVICE (NMFS) (SEE AGENCY
ADDRESSES SHEET) REGARDING THE PRESENCE OF ANY FEDERALLY LISTED OR
PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL HABITAT
IN THE PERMIT AREA THAT MAYBE AFFECTED BY THE PROPOSED PROJECT. DATE
CONTACTED: (ATTACH RESPONSES
FROM THESE AGENCIES
16. YOU ARE QUIRES 1P?J-CONTACT THE STATE HISTORIC __PAESERVAT-ION--OFFICER
(SHPO) (SEE AGENCY- ADDRESSES-.SHEET) REGARDING THE PRESENCE OF HISTORIC - ;' -
PROPERTIES IN I`FE PERMIT AREA WHICH MAY BE AFFECTED BY THE-PROPOSED
PROJECT. DATE CONTACTED:
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OP. THE USE OF
PUBLIC (STATE) LAND?
YES [] NO M (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 TO 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
COMPLIANCE WITH THE NORTH CAROLINA. ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
D=RECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST- JONES STREET, RA-LEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
4
18. THE FOT,LOWING ITEMS .SHOUT,D BE INCLITT) ED WITH THT.S A,PPL,I(7 ATION Ic
PR.OPnSECi A.r "iTTY INVOLVES THE DISCHAP(-,F ')F' EXCAVATFT) nP FILT. MATEPlAiT
TNT() WETLANDS:
a . WETLAND DELINEATION MP.P SHOWING Ai:1., GvETT_,ANDS , S T REAMS ,
".ND P(DNf)S ,N ^.'HF: PROPE R T Y ( FOP NATInh]WT1)F PERMIT NUMBERS
:-'9, AND 38) ALL STREAMS (INTERMITTENT AND PEPMANFNT) ON THE PP.r)PERT`,
MUST BE SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 INCH E(;!UALS 70 F'FE'P OR 1
INCH EQUALS 100 FEET OP THEIR EQUTVALENT.
h. T-F AVAILABLE., REPRESENTATIVE PHnTO(',PAPH ?")F' WE'PI??.ITDS F(-) BE
IMPACTED P.Y PROJECT .
IF DELIrTF,ATION WAS PERFORMED BY A MNSUT,TP.NT, TNCI, UIDE ALL
SHEETS PFLRVANT Tn THE PLACEMENT OF' THE DELTNF.ATION I,TNE.
d. ATTACH A COPY OF THE STnRMWATEP MANAGEMENT FLAN 1 F REQUTRED.
Wfy*--r Ic LAND TTSE OF STTRROUNDTTIG PRnPERTY? _9Y' A7F9_-- f--rS1d SL'1r. -
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 U.S. 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
ENVIRONMENTAL MANAGEMENT (WATER QUALITY) CERTIFICATION, AND
3) (IN = T5,=TY 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.
-o-'LtA's-,
OWNER'S!AGE T'S SIGNATURE
DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED (18g.))
5
PARSONS ROAD
PC
q
r• 44, AI"E 60' R/N'

0 co

SF/ q-

sownp t c:)

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it
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"'t@ ?71
AWE: amp GW FLoAD RATEAit4f' Av vw&-Giocs-B,
WS A90PE rr IS LGb^ MV dV A/V V ' FLOW 20W.
,ten er A sUS'NEI' fL'1"P
AA hwH ?? 441 L A. LYNCH
H4p°E.??S7GN?f4L E'7tiGrAltER wed Wh
,a?,csr?-i o L,a? sc?vfra4 ffAYSMw LYNCH
?3 LOT,I 7, A41?s. ?:`•SL?T1g1?/
oare: oc /?. /9b9 Wm
SCALE: i? 6o' zww. or M7. 5, MWVSNP MMXV GbMV;rY, JN.C
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HIV &Oor/4 ~r m or T/f H4A xv CQ fimisTRr

001448
U.S. ARMY CORPS OF ENGINEERS
Wilmington District
NOV
Action ID:
County: pA f Yl L ZG
Lue?i
Notification of Jurisdictional Determination
Property owner/Authorized Agent
Address !::? 1 fir/So" I'? P& C
/ 2gS29
Telephone NumberC{5 Z ? 2"- Z 716
Size and Location of
1.C1 -A,--Je
waterbody, Highway nname?/J?)umber, tow , etc.)
?
?O.C,W 0tT 1•'??SD? OaJ
mow.JLi.'? ?aC'1 W'? G"1 11 taLwc?- 0:!'1 4-le i7-??I'?'1 S'Ge 1 !Vcc S 10-p<-""A
INN
Indicate Which of the following apply: 04) c4CZ4 i? &,v1 cree4.
• There a wetlands o the above describe property which e strongly suggest sl)ould b/delj4Seated and
surveye . The surved wetland lines m t be verified byrour staff before the<Corps ill make a final
jurisdic ional deter nation on your prop rty. -
• Because of the she of your proper y and our pr . ent workloadIhs identi/eterminatio ion and deli ation o our
wetlands canno be accomplished in a timely nner. You msh tooy a consul nt topo ain a
more timely, del neation of the w lands. Once our consultant flaggeet land line n the perty,
Corps staff will eview it, and, if ' is accurate, e strongly reco nd tha have th line su eyed for
final approval y the Corps. Th Corps will n make a final jur tional on you property
without an app oved survey.
OThe 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 tir6 years from the date of this notification.
• There a e no wetla ds present on th above descr bed property which are su 'ect to t e p mit
require ents of Sect on 404 of the Cle Water Act 3 USC 1344)Unless there ' a chang in t e law
or our blished reg lations, this deter ination may a relied upon r a period not o excee th e years
from th date of this notification.
lr co 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-Q s2 ? 8os- 2808
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 rIt rding the Corps of Engineers regulatory program, please contact
L( at(ZS?) g?s? - W
Property owner/Authorized Agent Signature
Project Manager Signature
Date `7 In I q q 6/ Expiration Date 7 [LQ lZdu V
SURVEY PLAT OR FIELD SKETCH OF DESCRIBED PROPERTY AND THE WETLAND
DELINEATION FORM MUST BE ATTACHED TO THE YELLOW (FILE) COPY OF THIS FORM.
17
CESAW Form Sne 4 L P / r
IOCT92 f?' eGl K ?t?? GI Q? e"1Cv,V?
DEM ID: O TJ 4 4 8 CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #):
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:

1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATION FOR SECTION 401 CERTIFICATION
3) COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT m
< rn
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE C7 -1
FIELD OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN
(7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT
(SEE AGENCY ADDRESSES SHEET). PLEASE PRINT.
1. OWNERS NAME: D
2. MAILING ADDRESS: S I j?dy SAys Rok
L SUBDIVISION NAME: _&ira :S?lm 00-
CITY: _?+PQY1???O?rd STATE: Al G ZIP CODE:
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
3. TELEPHONE NUMBER (HOME) : dSdo?yg7/b (WORK) : CASE cy9 ISS(o
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
M-?P OR AERIAL HOTOQR.APHY WITH SCALE) : r
COUNTY: Q NEAREST TOWN OR CITY: d rdl PA 0 e
-I
1
_ SPECIFIC LOCATION (INCLUDE ROAD
NUMBERS, LANDMARKS, ETC.) V ?1 el fla'tyCA ore,

h
6. IMPACTED OR NEAREST STREAM/RIVER: 1a?6?%v-A5, C r-ty-K..
RIVER. BASIN: W ease;
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER
(SA), HIGH QUALITY WATERS (HQW), OUTSTANIyING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR. WS-II)? YES [ ] NO ( ] IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES [ ] NO [wll?
7c. 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?
? ura l i l4h 5?er y a c is .
8a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES [ ] NO (?r IF YES, PROVIDE ACTION I.D. NUMBER OF
PREVIOUS PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION) :
8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES ( ] NO (?j IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND:
1.1
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
/,J,
2
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: • O'? EXCAVATION:
FLOODING: OTHER:
DRAINAGE: Fv TOTAL ACRES TO BE IMPACTED: • n ?2
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE DISTANCE BOTH BEFORE, AND AFTER RELOCATION):
LENGTH BEFORE: All FT AFTER: FT
WIDTH BEFORE (based on normal high water contours)
WIDTH AFTER:
AVERAGE DEPTH BEFORE: FT AFTER: FT
(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:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE
WATERSHED DRP_INING TO THE POND?
WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DRAWINGS
ONLY) :
61 I Aff7- z -4b .60e*Aad A I ( /M a u ? 'pus ? a ?vehtc,&4 f back.
e, vvy, CAMI
13. PURPOSE OF PROPOSED WORK: SC?E?i GJQ0V
--? FT
3
14. STATE REASONS WHY IT IS RELIEVED THAT THIS AC-TT'IITY M(1S- BE CAPRLF
(NIT IN WETLANDS,. (INCLUDE ANY MEASr?RES TAFFN T(-) M7?17MT,',E WETLAND
IMPACTS) --- _-
,rrrsent
YOU ARE P.EQUTRFD TO CONTACT THE U.S. FISH AND WILDLIFE SF.P.VT_CF
(USFW`) AND!OR. NATIONAL MARINE FTSHERTFS SERVTrF (NMFS1 (.rEF.. AGENCY
ADDRESSES !7HEET) REGARDING THE. PRESENCE OF ANY FEDERALLY LISTED OR
PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL HABITAT
IN THE PEPMIT AREA THAT MAY-BE AFFECTED BY THE PROPOSED PPO,JECT. DATE
CONTACTED: _ (ATTACH RESPONSES
FROM THESE AGENCIES.)
16. YOU ARE r?EQUIRED-TO-CONTACT THE STATE HISTORIC,_PRESF:RVATTON--DF'FICER r( r
(SHPO) (SEE AGENCY- ADDRESSES--SHEET) REGARDING THE PRESENCE OF HISTORIC -
PROPERTIES !N-THE PERMIT AREA WHICH MAY BE AFFECTED BY THE-PROPOSED
PROJECT. DATE CONTACTED:
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OP THE USE OF
PUBLIC (STATE) LAND?
YES () NO l'1 (IF NO, GO TO 18)
a. IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DO-CU14ENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA ENVIRONMENTAL
POLICY ACT?
YES [J NO (J
b. IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE?
YES [] NO (]
IF ANSWER TO 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
COMPLIANCE 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, RFi.EIGH,
NORTH CAPOLINA 27603-8003, TELEPHONE [phone].
4
18. THF. FOLLOWING ITEMS SffnULD P.F. INCLUDED WTTH THIS APPLTCATION TF
PROPOSED A(-T'VTTY INVnI,VES THE PIS(-HAP.(-,F. IF EXCAVATED (RP FILL MAT`;PI_aI.
INTO WETLANDS:
a. WE'f?,AND DELINEATION MA.P SHOWICdG AT?L WETLANDS, STRFAr9S, 1,AEES
AND PO P7 -)N THE PROPERT't (FOR NATIOtdWT.i)F PERMIT NUMBERS 1aµ,,
AND ?8; ALL STREAMS (TNTER.MITTENT AND PF'PMAHENT) API THE ?FCFF:RTY
MUST BE SHOWN 'DN THE MAP. MAP SCALES SHOULD BF. L INCH E OTJA!,S FFF "' "-'P 1,
INCH EQUALS 100 FEET OR THEIR EQU.TVALENT.
n. TE AVAILABLE, REPRESENTATIVE PH0Tn(-,.APH (-)F WE':"LAITDS `PCB BF
IMPACTED RY PROJECT.
C. IF DELINEATION WAS PERFORMED B'f A CONSULTANT, INCLUDE ALL, DATA
SHEETS RELEVANT TO THE PLACEMENT OF THE DELINEATION T,TNF.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PTAH TF RFQCJTRED.
e. Wf? T IS LAND USE nF STJRR.OUNDIN(-, PRnPER.T'Y".' C?taf-l..P?S11LsL?!????
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 U.S.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
ENVIRONMENTAL, MANAGEMENT (WATER QUALITY) CERTIFICATION, AND
3) (IN T11E 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.
l1LQ.?u?-
OWNER' S/AGE T'S SIGNATURE
c -aci - Ciq
DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED (18g.))
5
MRSONS ROWO
PC
*6'•
OO. J?
4

h
*-,,, pvlyll
an coT 5F
L/V\ AO"
^Lai

.? i
???.•? CAROh/4 •.
o ,,..N. y •.
%51 MA-
s
t?
_? S ??ZS o =
I'to
%a s
*ucp
h
\1
60'R/H'
co
q%*
O
- ft oxtph/ Ss/ C)
s""'' 1 \
TMrLJw Ab?
sww.m ?
_ ? E,I`rIS
A
E? w
A" &WAV / M?1 0111 Y
plpp O
Ab'm «
I
7 ?.
?a
AOW..4 - 10 mw
a ?

/4 "f1?741"NG?: A X4P Or " T ,SAOWT " .S1r MOV ? RJ ?W
/'V W6W 14 ~F 14 Gam' M F PAAC CO CO REG/SMr
er
MICH HmffS, A
Amvrmm LAW szeWM r
O%7YTAL , NC •
ZW7r. ACr. /?, 1909 "AV G23
SCALE: /" , 60' OR M. Br
NOTE: A4WD aV fLOW A4rEW4o 6 AV J7G/B/-A?I ",
WS A4b°L Mrr IS LoL^AMV WAY ;4 ' fL" 2 0 41W:
A S~Y APP
'Q4/14tEL A, LYNCH
ffRYSTAW LYNCH
loro 7, ANWT, T,`smrxw/
MV. 5, 7O WNSNP MM I= COMMY, N. C
,AGW tORPER

001448
U.S. ARMY CORPS OF ENGINEERS
Action ID:
Wilmington District
Afr
r;
PA L zc,?
County:
Notification of Jurisdictional Determination
Property owner/Authorized Agent
Address

CZLr., s o? Alc- -7g67Z9
Telephone Number C25 Z 21- 2 -716
Size and Location of
y, Highway name/ umber, tow/?, etc.)
k,e-e Off ??Se?-+ IS oa J
C L; •? . _ . e -1 li,x,' o?n , S to c. Jc ?- 0-? ' -,P
014Y4c14 Gree4 . ?
Indicate Which of the following apply:
• There a wetlands o the above describe property which e strongly suggests ould b del' eated and
surveye . The sure ed wetland lines in t be verified by(our staff before the(Corps ill Make a final
jurisdic Tonal deter nation on your prop Irty.
• Because of the s ze of your proper y and our pr ent workload/hs identific ion and deli ation o our
wetlands canno be accomplishe in a timely nner. You msh to a loy a consul nt to o ain a
more timely delineation of thew lands. Once our consultant flagged wet land lin n the p perty,
Corps staff wieview it, and, if ' is accurate, e strongly reco nd tha ou have th line su eyed for
final approval y the Corps. Th Corps will n make a final jur tional eterminatio on you property
without an ap oved survey.
OThe 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 t*pr6 years from the date of this notification,
mit
• There a e no wetla ds present Fon th above descr'bed property which are su 'ect to J e /eyears
require ents of Sect on 404 of the Cie, n Water Act 3 USC 1344)/Unless there' a Chann law
or our blished reg lations, this deter ination may e relied upon r a period not o excee from th date of this notification.
It 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.Q S2 ) 90g. 2808
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 re arding the Corps of Engineers regulatory program, please contact
-U-waw,e at c s,2 -,q,7, s: 14/16
Property owner/Authorized Agent Signature
Project Manager Signature
Date `7 (Z9116 V Expiration Date 711 114QV
SURVEY PLAT OR FIELD SKETCH OF DESCRIBED PROPERTY AND THE WETLAND
DELINEATION FORM MUST BE ATTACHED TO THE YELLOW (FILE) COPY OF THIS FORM. de L' 0 C,
CFSAW Form 566 ily., oar 92
10 ??? (' a (J A ?
DEM ID:
UU'i448
CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #) :
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
;:o --a
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATION FOR SECTION 401 CERTIFICATION m
3) COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT rn m
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 SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT
(SEE AGENCY ADDRESSES SHEET). PLEASE PRINT.
1. OWNERS NAME:
2. MAILING ADDRESS

S I ????rseh Ref - 1?
SUBDIVISION NAME: Rin frA r?
CITY: V?PGYITS?01rd STATE: N ?. ZIP CODE: al??
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
3. TELEPHONE NUMBER (HOME) : 5h_ a?tyq 7lb (WORK) : asaL adl'19 13'S(
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
S. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL HOTOC?RAPHY WITH SCALE):
COUNTY: It V-A NEAREST TOWN OR CITY: Q ra aA o e_
1
_ SPECIFIC LOCATION (INCLUDE ROAD
NUMBERS, LANDMARKS, ETC.) : Q?Y?l ore

h
6. IMPACTED OR NEAREST STREAM/RIVER: 11 ? iy-AS C v- e-e K-
RIVER BASIN: N W. Q
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER
(SA), HIGH QUALITY WATERS (HQW), OUTSTANV-NG RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-II)? YES [ ] NO [ ] IF YES, EXPLAIN:
1. V
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES [ ] NO [Vlf
7c. 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?
? u ra I -fh ser u , c.c.s ,
8a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES [ ] NO [?r IF YES, PROVIDE ACTION I.D. NUMBER OF
PREVIOUS PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION):
8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES [ ] NO [W/ IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND:
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
2
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: • 05 EXCAVATION:
?VIl
FLOODING: OVI,4 OTHER:
DRAINAGE: TOTAL ACRES TO BE IMPACTED:
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
FELOCATED, PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION):
LENGTH BEFORE: All FT AFTER: ?N FT
WIDTH BEFORE (based on normal high water contours)
WIDTH AFTER : 111A
AVERAGE DEPTH BEFORE: IV? FT AFTER: M.1A FT
(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:
OTHER:
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?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DP.AWINGS
ONLY) :
1x11 d?-rQn n r? - I I / wnau '??•? avev,?'?d JfZclLt
i
?l ? Fm
13. PURPOSE OF PROPOSED WORK: 5c e,
R,100d
3
' BE CARRIED
1_4 STATE REASOCIS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST
CCU'" IN WETL?LIDS. 'INCLUDE ANY MEASURES TAKEN TO M7:'JIMIZE WETLAND
IMPACTS):

.4' a

4, k~Aey /ti Ldw. , Alarea"i

THE U.S. FISH AND WILDLIFE SERVICE ,-
_ YOU ARE REQUIRED TO CONTACT
lTS vS) AND/OR 51;.TIONFS M_AP.INE FISHERIES SERVICE' (NMFS) (SEE AGENCY
?.
ADDRESSES SHEET) REGARDING THE PRESENCE OF ANY FEDERALLY LISTED OR
PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OF CF.IT CAL HABITAT
1N THE PEPI.17T AREA THAT MAY-BE- AFFECTED BY THE PROPOSED PROJECT. DATE
CONTACTED: (ATTACH RESPONSES
FROM THESE AGE11CI ES
16. YOU ARE QUIR?fl1T?J-CONTACT THE STATE HISTORIC-_P_RESEP.VaT?T-ON-D FICE?
(SHPO) (SEE AGENCY ADDRESSES--SHEET) REGARDING THE PRESENCE OF HISTORIC - -
PROPERTIES IN'"_Fr PERMIT AREA WHICH MAY BE AFFECTED BY THE - PROPOSED
PROJ'E"CT. DATE CONTACTED: -
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND?
YES [] NO M (IF NO, GO TO 18)
a. IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTA.I,
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 ADMINiSTRLATION STATE CLEARINGHOUSE?
YES [ ] NO (I
IF ANSWER TO 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
COMPLIANCE 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].
4
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF
PR.OPr`SEP ACT`JTTY INVOLVF..S THE DTSCHAP(;F OF EXCAVATED nP. FT--j-,T, MA.TEPT_AL
INTO WETTANDS :
a. WETLAND DEhIfiEATION MAP SHOWING ALL WETLANDS, STREASIS, L,?_E:ES
PSID POf1P: ')N THE' PROPEP.T't (FOR NATIONWT:)E PERMIT NtJMBF.?_S 1 4,
Q AND 38) ALL STREAMS (IN'CERMIT'IFNT?ND PERMANENT) ON THE ?POFrR'C'.'
MUST BE SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 INCH EQ[JALS 5S FEET OP 1
INCH EQUALS 100 FEET OP THEIR EQ[JIVALENT.
h. T F A`JAILABLF., REPRFSENTATTVE PHOT(-)G APH OF WE-LAHPS TC) BF
IMPACTED BY PROJECT.
c. IF DELINEATION WAS PEPFOP14FD BY A CONSULTANT, INCLUDF ALL DATA
SHEETS RFLEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
d. ATTACH A. COPY OF THE STOP_MWATER MANAGEMENT aLAN I F P.Ep[7ZP.FD.
I. WIi.T IS LAND [JSF ()F S[JRP.O[iNDTNG PROPERTY? _1?-tom
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
g. SIGNED AND DATED AGENT AUTHORIZATION LETTFP, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE U.S. 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
ENVIRONMENTAL MANAGEMENT (WATER QUALITY) CERTIFICATION, AND
3) (IN T= TPY=TY 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.
l1LQ.?
OWNER' S/AG7 T'S SIGNATUPE
DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZP_TION LETTER FROM
THE OWNED. IS PROVIDED (18g. ) )
5
13IRSONS ROAD
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001448
U.S. ARMY CORPS OF ENGINEERS
Wilmington District
Action ID:
County: Pfi M -L ZG a
Notification of Jurisdictional Determination
Property owner/Authorized Agent
Address P "(.('O" k c)a 2
?i lc :2!2-G7 2I
Telephone Number C2.52 2" - Z 716
Size and Location of Property(waterbody, Highway name/number, tow , etc.)
(. ucI e Lof- loc'.?e1 ofd iJa'(So Out
?. ?G.?.?.e-? (,An: G?-? t? ac- n-, 4-,P c p,-k, S. ?e of kCV? 'M5
Indicate Which of the following apply: o4)"c,--f" 4-, &-v 1 cree4 .
• There a wetlands o the above describe property which a strongly suggests ould b del' eated and
surveye . The sure ed wetland lines in t be verified by(ur staff before the(Corps ill make a final
jurisdic Tonal deter nation on your prop trty. • Because of the s ze of your proper y and our ent workload, o identific ion and deli ation o our
wetlands canno be accomplishe in a timely nner. You may ish toe loy a consul nt too ain a
more timely del neation of the w lands. Onur consultant h s flagged wetland line n the p perty,
Corps staff will eview it, and, if ' is accuratestrongly reco mend tha ou have th line su eyed for
final approval Zed he Corps. Th Corps will n ake a final jur ictional eterminatio on you property
without an ap survey.
O' 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 *w6 years from the date of this notification. Aie
'it
• There a e no wetla ds present Fon th above descr bed propert?Trl which are su 'ect to t e /eyears
require ents of Sect on 404 of the Cie Water Act 3 USC 1344nless there ' a chang in e law
or our blished reg lations, this deter ination may a relied upon a pe riod not o excee th from th date of this notification.
V V 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-Q ?2 ) gvg 2808
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 re arding the Corps of Engineers regulatory program, please contact
t ?0? at X7.5? 1 _4? - (,C 6
Property owner/Authorized Agent Signature
Project Manager Signature
Date n 1ZgJ q V Expiration Date -7 11f 4Za-St
SURVEY PLAT OR FIELD SKETCH OF DESCRIBED PROPERTY AND THE WETLAND
DELINEATION FORM MUST BE ATTACHED TO THE YELLOW (FILE) COPY OF THIS FORM.
CESAW Form 565 4 L P r /r //
i ocr 92 I0? PGr y r? ti f P l Rr?O !^
P? T r
?? p n
()01448
v
DEM ID:
CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #):
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
-4-
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATION 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 SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT
(SEE AGENCY ADDRESSES SHEET). PLEASE PRINT.
1. OWNERS NAME:
2. MAILING ADDRESS: S Rd v_-sah flek' R
L l SUBDIVISION NAME: adiy a SM0 N '.
CITY: Qflakyl-T46OY'd STATE: _Jy C ZIP CODE: A? "4
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
3. TELEPHONE NUMBER (HOME) : ASA01419,j74 i (WORK)
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
:C7 ;- 2
m
C7 -?
_rn
c m
m z
S. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
M_7?P OR AERIAL HOTOGRAPHY WITH SCALE):
COUNTY: ? Q NEAREST TOWN OR CITY: C rdl00. 0 e?
1
_ r SPECIFIC LOCATION (INCLUDE ROAD
NUMBERS, LANDMARKS, ETC .)

Ih
6. IMPACTED OR NEAREST STREAM/RIVER: \rdS re-e K_
RIVER BASIN: N W, e'
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER
(SA), HIGH QUALITY WATERS (HQW), OUTSTANIyING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-II)? YES [ ) NO [VI IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA. OF ENVIRONMENTAL CONCERN (AEC)? YES [ ] NO [V-f
7c. 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?
? u. ra l tj4h 57er v c_es .
8a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES [ ] NO (?? IF YES, PROVIDE ACTION I.D. NUMBER OF
PREVIOUS PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION) :
8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES ( J NO (W/ IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIM-ATED TOTAL NUMBER. OF ACRES IN TRACT OF LAND:
i. I
9b. ESTIM.ATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
'. a
2
10a. NUMBER OFr ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: • OJT EXCAVATION:
FLOODING: 91 OTHER: DPAINP.GE: Al
TOTAL ACRES TO BE IMPACTED: J
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION):
LENGTH BEFORE: IVI FT AFTER: /?/? FT
WIDTH BEFORE (based on normal high water contours)
WIDTH AFTER: AVERAGE DEPTH BEFORE: NI& FT AFTER: [v?q" FT
41
(2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL:
CH_ASINEL EXCAVATION: CONSTRUCTION OF A DAM/FLOODING:
OTHER:
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?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DRAWINGS
ONLY) :
?? p 1?tfL ? ru fait 1?'mn 54 vtid
Ck

N? FT
7
13. PURPOSE OF PROPOSED WORK:
??
3
I
=?. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVIT'.' MUST BE CARRIED
!INCLUDE ANY MEASURES TAKEN TO M_?.rTM7ZE WETLA=ND
OU I21 WETLAIICS.
IMPACTS): -
F r0 Air a rea A r? , KI
Ala rol'o tj

_I. YOU ARE REQUIRED TO CONTACT THE U.S. FISH AND WILDLIFE SERvlCE
'USF,iS) AND/OR-NATIONAL MARINE FISHERIES SERVICE (NMFS, (SEE AGENCY
ADDRESSES SHEET) REGARDING THE PRESENCE OF ANY FEDERA=LLY LISTED OR
PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITIC HABIT?_T
IN THE PERMIT ARE.. THAT MAY-BE-AFFECTED BY THE PROPOSED PP.OJECT. DATE
CONTACTED: (ATTACH RESPONSES
1ROM THESE AGENCIES.)
16. YOU ARE-TEQUI-P.£fl-T?O-CONTACT THE STATE HISTORIC__P_R .SERVATZ-ON-OFFICE=
(SHPO) (SEE AGENCY ADDRESSES --SHEET) REGARDING THE PRESENCE OF HISTORIC
PROPERTIES lN-TTiiE_PERMIT AREA WHICH MAY BE AFFECTED BY THE-PROPOSED
PROJECT. DATE CONTACTED:
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND?
YES [] NO IF NO, GO TO 18)
a. IF YES, DOES THE PROJECT REQUIRE PREPARATION OF M ENVIRONMENTA-L
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA ENVIRONMENT?
POLICY ACT?
YES [] NO []
b. IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAR.OLIN..
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE?
YES [] NO []
IF ANSWER TO 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
COMPLIANCE WITH THE NORTH CAROLINA ENVIRONMENTA=L 2OLTCY 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].

4
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF
PROPOSED ACT77TITY INVOLVES THE. DTSCEiARGF. nF EXCAVATED nP FILL MATEPIAL
INTO WETLANDS:
a. WETLAND DELINEATION MAP SHOWING Ai,L WE'fLANDS, STREAMS, LAEES
A`]D PON[).`' ON THE PRnPERTY (FOP NA.TTnNwT i)E PERMIT NUMP,ER.`' 1 8
?R AND 38). ALL STREAMS (INTEPM7TTENT AND PERMAHENT) ON TFIF PP.OPER.T`:'
MUST BE SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 ICI CH EnUAi,S0 FEET (:,,p I
INCH EQUALS 100 FEET OR THEIR EQUIVALENT.
b. TF AVAILABLE, REPRESENTATIVE PHOTCK(PA.PH OF WETLA.NI)S 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. ATTACH A COPY OF THE STORMWATF.R MANAGEMENT DLAN ILLF R.EQtJIPED.
Wt?AT Tc I,,',I,ID USE nF SURROTINDIN G PPnPFP-,Y
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 U.S.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
ENVIRONMENTAL MANAGEMENT (WATER QUALITY) CERTIFICATION, AND
3) (IN TTE7 TTY-ENTY 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.
l1LQ,?
OWNER'S/AGE T'S SIGNATURE
-a?-(51, ?
DATE
(AGENT'S SIGNATURE' VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER TS PROVIDED (18g.))
5
MRSONS ROAD
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