20001019 Ver 1_COMPLETE FILE_20000802

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
D E N R
August 4, 2000
DWQ# 00-1019
Wilkes County
Roy Roger Gregory
4091 Clingman Road
Ronda, NC, 28670
APPROVAL of 401 Water Quality Certification
Dear Mr. Clayton:
You have our approval, in accordance with the attached conditions, to place fill in 0.10 acre of wetlands for the purpose of
pasture improvement, as you described in your application received by the Division of Water Quality on August 2, 2000 and
follow-up correspondence received on August 3, 2000. After reviewing your application, we have decided that this fill is
covered by General Water Quality Certification Number 3106. This Certification allows you to use Nationwide Permit 18 when
the Corps of Engineers issues it. In addition, you should set any other federal, state or local permits before you go ahead with
your project including (but not limited to) Sediment and Erosion Control, Coastal Stormwater, Non-Discharge and Water Supply
Watershed regulations. Also this approval will expire when the accompanying 404 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 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 150B
of the North Carolina General Statutes to the Office of Administrative Hearings, P.O. Box 27447, Raleigh, N.C. 276 1 1-7447.
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 John Dorsey at 919-733-9646.
Sincerely,
n Kerr T. Stevens
Attachment
cc: Corps of Engineers Raleigh Regulatory Field Office
Winston-Salem DWQ Regional Office
Central Files 7
File Copy
001019
Non-Discharge Branch • 1621 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX # [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post consumer paper
-
DEt1 ID: n i ! 1®19 Copps ACT-c", 'D:
NATIONrdIDE PER11IT REQUESTED (?RG`IIDE :1 _ :DE PERttI ;;
ZE-CONSTRUCTION NOTIFICATION APPLICATION
ct: NATIONWIDE PERMITS THAT rR-EQUIRF
PAYMENT
1) NOTIFICATION TO TEZ CORPS OF EZIGINEERS
SECTION 401 CERTI-TICATION
2) ABPLICATION FOR RECEIVED
" 3) COORDINATION WITH :H TIC DIVISION OF COASTAL ilf?27AGE21EZIT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLET.':D FGRZ1 TO THE APPROPR_TATE
FIEIZ OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDPESSES SHEET). SE77E:1
(7) COPIES SHOULD BE SENT TO THE N.C. DI'iT_SICtd CE' E.I'i! CCPMENTAI, M_AP TAGEMENT
(SEE AGENCY ADDRESSES SHEET). ?LEASE ?RINT.
1. OW'N E R S Nr_ ]E : O d n [7
2. 'TAILING ADDRESS: C L i N19 n-> 6I?) R D
sUBDIVISICN .ir??E: 41A
CITY:. R0tlQA STATE: Z7 CODE: ZR(. r7o
PROJECT LCCATICN ADDRESS, INCLUDING SUBDIVISION N ME (IF DIFFERENT FR0,
MAILING ADDRESS- .A-BOVE) -
3. TELEPHONE NUMBER (HOME) 984-?57d (rvCRK) :
4. IF _PPLIC-_BLE: AGE'NT'S N?l E OR RES'CNSI3LE CORPCR.ATE OFFICI?S , ADDRESS,
PHONE NUMBER:
nl I ??
S
s. CCAT-Ctl C-E ;WORK (pROV_I-7 .. __?...?L. :scS ToecG A=..__
;'iAP OR AERIAL PHOTCGRAPHY ;v -^ i SCALD.;
COUNTY . 11 1 I L E -S vl7-A ES = TC;dI1 C^ /JO R?
IL KES

SPECIFIC LCCATICN (INCLUDE ROAD
NUMBERS, LA2IDPAARi<S, ETC.) iAKE FZ'T 73 Q oFF D?' S-']7 /?1oRT1? q2/
7a /,/OR[nJ I Lkp-- -e 6 IV/LF-S 7 -'KtJ LE-177- 0,Q L N9 rY1 A N ROAD
ROPE-Kj- ctq l.r'Fr-- ZIDE- CLIN4 1"AN J{Q 'p-P•
5. IMPACTED OR NEAREST STREA`i/RIVE... 1// /-?
RIVEP. 3AS IN :
7a. IS PROJECT LOCATED NEAR WATER CLYSSI:DED -S TROUjT, TIDP.I, 'A-LTWATER
(SA), HIGH QUALITY WATERS (HQW), CUTS"_' IDING RESCURCE 7 ATERS (ORW) , rI?_TER.
SUPPLY (WS-I OR WS-11)? ES [ ] NO ? IF ES EXPLA_ I.

7b. IS THE PROJECT LOCATED r=HIN a NCRTH CAROLINA DIVISIC?i GF CCAS'^_.L
Y-2?.NAGFMENT r? SEA OF ENVIRONMENTAL CONCERN (AEC) ? YES [ ] NO ?Q
7c. IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR
LIST OF COASTAL COUNTIES), WHAT IS THE LA'TD USE PLAN (LUP) DESIGNATION?
Sa. HAVE ANY SECTIdN 404 PERMITS EEEN'.PREVICUSLY REQUESTED FOR 'USE. ON
THIS PROPERTY? YES [ J NO [X IF YES, PROVIDE ACTION .1.D. NUMBER OF
PREVIOUS PERMIT AND ANY ADDITIONAL INFOR,M.ATION (INCL.UDE.2HCT000PY OF 401
CERTIFI.CATION):
3b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED =0R THIS PROPERTY IN THE,
FUTURE? YES [ ] NO ?Q IE YES, DESCRIEE ?'ITICIPATED rvOR?.
9a. ESTIMATED TOTAL "TUMBER CE' ACRES --'I -7-AC7 CF

aNi::-r
10rs . NUMBER OF ACRES OF `r7ETLASlDS ;;!P':.CTED f3'Y PRCP(;SED BY :
FILLING:
FLOODING:
DRAINAGE:
EXCAVATION:
OTHER:
TOTAL ACRES TO BE I2?fPACTED:
D.
WE! L?Np Arze A ?Pai?lq ?Jpp
10b. (1) STRE- M CH-?Ulil L TO BE IMPACTED BY THE PROPOSED PROJECT (I?
RZLCC.3TDD, PROVIDE DIST.INCL BOTH 3--F",-RE' ?,ID TDP RDLCC..TICN) .
LENGTH BEFOP.E. AT_7... G
r?!DT:: BEFORE (based on normal Na'__ con urs)
ii---DTH AFTER: U
A7,,-ERAGE DEPTH BEFORE. ?N FTFR. Q FT
(2) STREAM CH7;17`IEL r io?C^S ;i ?.ESUL^ =?OP? (C EC:t ??i, THTT aooT,y)
OPEN C 1_P?NNEL RELOCATION: PLACEMENT OF PIPE I'`I CcLAI 1EL :
CH.A.NNEL EXCAVATION: CCiTST-=CTION OF ?. DAM ?C0D114G:
OTHER: FILL WILL 0-1-E-AN
1I.. IF CONSTRUCTION OF A •POND IS PRCPCSED, W.H-?LT IS THE, SIZE OF THE
WATERSHED DRAINING TO THE POND? Nlli?
WrAT IS THE EXPECTED POND SURFACE ARF:_? Nlra
12. DESCRIPTION OF PROPOSED WCR? INCLUDING DISCUSSION OF TYPE OF
M=LANICAI EQUIPMENT TO BE USED (ATTACH PLANS: ° 1/2" X 11" DRAWTIGS
ONLY):
I-ILL ,?1fz??1 DF S?R?N? /,-??? Wi77-? CLt?1n1 St?oT 1?ocK
s
^r)rrn,;T OF DR,OPCSED ;i?P,:' -1N1?011? FCR t r?Rm?n1?? D?11CZom??T

11 . STF:TE REASOi1S WiUf IT Is BELL .:D T"H_S !\CTi'??':. I,IUS. BE EU
CUT IN 'r7 ETLArlDS. (INCLUDE P.N'1 ifE?.SUr.ES Eil TC M1N1M--ZE WE -, LA-,',l D
Ii- CTS) .
i 5 I'S hI D T=+J A W 67 L iAN D AR t1-1
15YOU ARE REQUIRED TO CONTACT THE U.S. ISr. ?.ND WILDLIFE SERVICE
(US"r'WS) r`ID/OP. NATION?_L MARINE FISHERIE., SE?.VICE ;NM-S) (SEE AGENCY ?nc:l.(?A;-,
?.DDRESSES SHEET) REGARDING THE PRESENCE OF i*I`! FEDE?,.LLLY LISTED OR
P ROPOSED FOR LISTING ENDANGERED OR 1'::RF.c.- ENED SPECIES 0R CRITICAL
IN THE PEP??IT AREA THAT 1?aY _ 5c,_ ? F F ECTED 3Y THE PROPOSED P.°.OvE.CT. DATE
CON--ACTED: (ATTACH RESPONSES
ROM THESE AGENCIES. )
_b YOU ?RE'QUI-RE -T-O-CON-T_.CT . :._ HIS C_-?-c S RVrT? N_JF'FICFR ??'•y
(SH:PO) (SEE 'AGENCY ?-DDRES.S-ES--Si?EET) ^RTGARDING W ?r
: THE PRESENCE Or H_STOR'CE
PROPERTIES. I:]-i .? PERMIT AREA +HIC: 3E AFFFCTEED 3' PROPOSED
PRCJECT. DATE- CONTACTED:
1.. DOES THE PRO-CT INVOLVE All ?.`tP?:1D=TURF OF PU3?=C =u IDS OR THE IISE OF
PU3LIC Sm_: _-7) LAND?
YES [ j :1C (IE N0, GO .O 1
a. ' ES, DOES THE PROJEECT ..Eti _RE PREPARATION OF ??N7 ENVERONMENT=?
DCC`v`MENT PURSU?NI TO THE REQUIRE:?fE.,_:, C- T'-"--:' NCRTH C RCLIi1?. ElI`;IRONMENT:! ,
POLIO'! CT"
N C:
..??:..•_..EN'" C? :n?SINIST...._ICN ?--.__ C??:...I. ?r.OU?_

S7?--7- CLE 7 NGHCi;S:; TO DI'lISI-N
COMP -1ANCE WITH THE NORTH CA:R0LIN:. ENV_RCNMENTAL POLICY ACT.
:.OC_.,:",H U. D
C:iROLINA DEPARTZMENT OF ADMINISTPATICN, 'NEST DONES Ti EE'_, fAIEI?H,
wav.:.,. fie-: ._„c-C??.. i?`a?,, "••-•?_.-•.e _. v. -:?r+ __x.-4- _ _.•t__:anrS'rM??: .,w?:ti'^??. -
18. THE FOLLOWING ITEMS SHOULD BE I[:CLUDED 'el=;. THIS APPLICATION
PROPOSED ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OR FILL MATERIA-
INTO. WETLANDS :
a. WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES
AND PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26,
29, AND 38). ALL STREAMS (INTERMITTENT ACID PERMANENT) ON THE PROPERTY
MUST BE SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OR 1
INCH EQUALS 100 FEET OR THEIR EQUIVALENT.
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 2LACE14ENT OF THE DELINEATION LINE.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLP.N IF REQUIRED.
e. WHAT IS LAND USE OF SURROUNDING PROPERTY?
NOT- WJtTL.AW() a2C-Y? pRo hpERT4 A-4o SuRRou?ID/
O?cR?4 IS usa POR F=AR»llr-?
IF APPLICABLE, WHAT IS PROPCSED METHOD OF SEWAGE DISPOSAL?
c. SIGNED AND DATED AGENT AUTHCRIZA.TION LETTER, IF APPLICABLE.
NO WETI-kNTDS 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
ENVIRCNMENTAL MANAGEMENT (WATER QUALITY) CERTIFICATION, AND
3) (IN = TrrE-.VTY CC? :ST.4.L C.^.D':?T^_ ,- ONLY) , r? LETTER FROM THE
NORTH CAROLINA DIVISION OF COASTAL, Ma.NAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA CCASTAL NL.nz?GEMENT
? ROCF,.lM . .

-OW E AGENT' s S 7P.TT]R
(AGENT'S SIGNATURE VALI71 ONL`=
IF AUTHORILIATION LETTER FROM
THE OWNER IS PROVIDED (1Sr.))
5
?71
Tr.
s

00 1019, Roy R. Gregory, Wilkes Co.
Subject: 00 1019, Roy R. Gregory, Wilkes Co.
Date: Thu, 03 Aug 2000 13:19:46 -0400
From: Jennifer Frye <[e-mail]>
Organization: NC DENR Water Quality
To: "cyndi.karoly" <cyndi.karoly @ ncmail. net>
Cyndi,
I went to the site this morning and it does not appear to me that what
they want to do is going to have any major impact. First, the
"channel" may not even be considered a channel. I did not find any
critters, nor did it have stream characteristics like pools, riffles,
overbank shelves, etc. It appeared to me that it was more like a linear
wetland, developed due to a natural spring. It has also been previously
impacted by cattle grazing. I e-mailed John Thomas to find out what
they considered this - since they have issued a NWP 18 for 0.003 acres.
He may not have even looked at it. Second, they all told me (land-owner
and contractors) that they do not plan to develop the site for
commercial use. The reason for impact is due to DOT's 421 project. The
new road has been constructed as such that the property is question is
considerably lower in elevation. Mr. Gregory assured me that he just
wanted to put his (actually Junior Johnson's) cattle back on the land.
They all just stared at me when it became evident to them that I had no
freaking idea WHO Junior Johnson is. I committed ANOTHER Damn Yankee
faux pax - I did not know the local racing hero! oops!
Anyway, I wasn't quite clear on why, if they just wanted to graze the
land, they needed to have the land elevated. So, I just made it clear
to them that if any development (other that agriculture) was to occur, I
would be back. No threat - just a nice friendly conversation on how I
go past the property all the time when I am in the field.
So, after this lengthly e-mail .... I did do a staff report - not much to
it - just that I recommend that the 401 be issued. Also, if you do
issue the 401, FAX a copy of it to Keith Bradley at 336-984-2044. It
will get them off our back quicker.
Call me if you have any questions.
Jen
Jennifer Serafin Frye
Division of Water Quality
NC Department of Environment and Natural Resources
Winston-Salem Regional Office
Winston-Salem, NC 27107
Voice: 336-771-4608 ext. 275 Fax: [phone]
I of 1 8/4/00 11:44 AM
MEMORANDUM
TO: John Dorney Regional Contact: Jennifer Frye
Non-Discharge Branch WO Supervisor: 1 arry Cable
Date:
SUBJECT: WETLAND STAFF REPORT AND RECOMMENDATIONS
Facility Name Roy Roger Gregory ry ` t+.1 ,'. ,, County Wilkes
Project Number 00 1019 County2
Recvd From APP Region Winston-Salem
Received Date 8/2/00 Recvd By Region
Project Type
Certificates Stream Stream Impacts (ft.)
Permit Wetland Wetland Wetland Stream Class Acres Feet
Type Type Impact Score Index Prim. Supp. Basin Req. Req. ME

Mitigation Wetland
MitigationType Type Acres Feet

Is Wetland Rating Sheet Attached? Q Y Q N Did you request more info? Q Y 0 N
Have Project Changes/Conditions Been Discussed With Applicant? Q Y 0 N
Is Mitigation required? Q Y O N Recommendation: Q Issue 0 Issue/Cond 0 Deny
Provided by Region: Latitude (ddmmss) Longitude (ddmmss)
Comments:
The WSRO recommends that this 401 WO certification be issued,
cc: Regional Office
Central Office Page Number 1
Roy Roger Gregory 001019
Subject: Roy Roger Gregory 001019 r
Date: Wed, 02 Aug 2000 11:10:29 -0400
From: Cyndi Karoly <[e-mail]>
To: [e-mail], [e-mail], [e-mail]
Jennifer, a guy named Keith Bradley is handling an application for Roy
Roger Gregory in Wilkes County. Gregory is of advanced age, and Bradley
is a first-time clueless applicant. Bradley says it's a
"small"/intermittent stream, but I'm not sure he understands any of the
technical terms.
We just got the application and check today for 296 if stream impact,
with the correct application fee, so Rob can proceed with deposting the
check. Bradley neglected to include any kind of maps, so I'm holding
the file since he's already mailed 7 copies of the maps to my
attention. When the package is complete (maybe by end of week), I'll
put the file in triage. Keith also mailed or faxed a copy of the PCN to
you (without maps). I told him since he'd already sent that, he might
as well send you the maps.
I told him I suspected that the application would be forwarded to you
following triage, due to the scale of impact. But I told him I couldn't
speculate as to whether or not avoidance/mitigation would be required -
that'll be your call. So the official copy of the app should go out to
you in next week's mail, but you may have the pcn and maps before you
get it from us. If you care to proceed with the review, the project has
been assigned DWQ# 001019. If not, just make time whenever you can
after you get it, as usual.
Hope I haven't confused anybody.
1 of 1 8/2/00 11:11 AM

,
CO
1, RPS 1' O Ej VC YNE? ,
DsS i RICA'
'
'
w LJNII' ON
I
action ID. ?0002i j77 County Wilkes
GENERAL PERMIT (R'-q,GIOia; L AND NATION-V TDE) VERIFICATION
:'ropem O??ne: Agent Roti Roger '' °^ _-?
..ddress 4091 CIinemar Rnad Ronda. N 286", 0

Cciephone ?No. 33 994-3570
Size and Location of project ?water?ay, ad nam:./number, to??:t. ?ac,1 Ro?Roger Gre?orv's
`
nroner^, located off of Chm-,ma _ Read _ 23091. ad, = an unnamed uibutar of Little
Hun:in-_ Creek near Clingr.-an. unty North Carolina.
Description of Activity
Minor discharee of fill ressltin
4
0.10 are 0.003 acre ,? im acts to'.he
tmribu
jurisdictional waters of a.n unr,a of Li?tlc Creek,
Section 404(Clean Water . 1.4=1 only.
Section 10 (PUver and Harbor Act o 1899) only.
Section 404 and Section 10.
NWP 1 R Nationwide Pl-r nit Nurnbe
,kny violation of the conditions o uhe Re ional General or N ationtik, de Pe=h reform td above
-may subject the permittce to a stop work rd;---, a restoration order, and,,or appropriate legal
a?ticn.
T^as Depa-nment of the Army Re3ional neral Nzionwide Perm-ft verification does not rei:eve
t::e u-xdersigred perrnittee of the responsi ility to obtain any ot:"ter required Federal, Sta'.e or
local appravJ, Jpermi*s. The peyrrnd-t=e y needy to contact at) riate State and local agencies
be ore begirsiing work.
Regulawry Project Mar:agcr Sigrarure ? -
Date July 2l. 2000 ?xpirarcn atc_ Ft an' 1 1. 2002
SURVEY PLATS, FIELD SKETCH, Wt-LAND DELINE"'T:ON FORA, CC., MUST BE
ATTACHED TO THE FILE COPY OF IS FORM, IF REQUIRED OR AVAILABLE.

DE1l ID: CORPS ACTION :D:

1#10rrdIDE PER111'r REQUESTED (7R? i ?C, ii i= P i i. .

t.cs:
RE-CONSTRUCTION NOTIFICATION APPLICATION

NATIONWIDE PERMITS THAT REQUIRE: PAYMENT

1) NOTIFICATION TO THE C ORPS OF ENGINEERS RECEIVED
a) APPLICATION FOR SECTI ON 401 CERTIFICATION
3) COORDINATION W=2 THE NC DIVISION OF COASTAL MANAGEtfE:TT
SEND THE ORIGINAL AND (1) COPY OF THIS CO, LETED FORit TO THE APPROP_ 7ATE
FIELD OFFICE OF T= CORPS CF E:7GINEERS (SEE AGENCY LDP JSrS SHEET) . ST-VEN
(7) COPIES SHOULD BE SENT TO THE N.C. DI'IISIOCi OF _7'4VIRCN,-1ENTAL Mi.P`IAGEcSE:iT
(SEE AGENCY ADDRESSES SHEET) ?LEASE '?'Tm
1. O?v ERS N2_M_7 : 0 ?d n
2. 1. 7=1NG ADDRESS: 4o 1 1 C L I,N19 n-i 61?j R D
SU3DIVISICN 41A
CITY: R'o hl [7ia ST'T ZI_ CODE: Z F? 70
PROJECT LOCATION ADDRESS, I iCLUDI`iG SUBDIVISION N?!-iE (IF DIFFERENT FRCM
NAILING ADDRESS ABOVE):
3. TELEPHONE NUMBER (HOME) 9?4-?571? (;vcRx) .
4. IF APPLICABLE: AGENT'S N?_ ME OR RES?CNS7_3LL CORPOFaT OFFICIAL, ADDRESS,
PHONE NUMBER: N/ /,I

5. LCCAT_CN CF WCRK (PPOV-
;•+ ?? OR AERIAL PHCTOGPAPHY WITH SC.aLZ
COUNTY: WILES IE:,R?S: TOWN CR __,_. \16R-1-P
IL KES loo
I '
SPECIFIC LCCATICN (INCLUDE ROAD
i clBERS, LtVIC ARKS, ETC.) iAKE ?,r 73 Q cFF or= =-77 lloRTl-/ 4z/
-Ta /Jop -l lnJ lLlC'? t3E,'n ?JI?LFS 7'?RrJ LEi=r onJ Lt N9 m A nJ ROAL
PR C PZR Ir j o nl L r'?-77 S I -DE- CL i N 4 /"/AN R 1) /z /,-;,, c. `
5. IMP?_C'I'LD OR NEAREST STREr,M/RIVE7,
RI-TER BASIN:
7a. IS PROJECT LOCATED NEAR WATE'a CLASSIFIED AS TP.CUT, TIDAL, SALT'r7ATEP.
(SA), HIGH QUALITY WATERS ('r'QW), CUTSTA:TDI1 RESCUF.CE -,,gATER.S (ORW), PiATEP.
SUPPLY (WS-I OR WS-1-7)? YES ( ] `TO YES, EXPLAIN:
7b. IS THE PROJECT LCCATED `rill:7, NCRT:: CAP.CLI:1A DIVISIC'N OF COASTA:,
M.-.NAGEMENT AREA: OF ENVIRONMENTAL CONCERN (AEC) ? YES [ ] NO ?Q
7c. IF THE PROJECT IS LOCATED WITH!--N A COASTAL COUNTY (SEE PAGE 7 FOR
LIST OF COASTAL COU"NTIES), -al--AT IS THE LAND USE PLAl7 (LUP) DESIGNATION?
a
8a. FaVE ANY SECTION 404 PE:4'4ITS BEEN' PREVIOUSLY REQUESTED FOR USE. ON '
THIS PROPERTY? YES [ ] NO [>Q IF YES, PROVIDE ACTION I.D. NU"ABER CF
PREVIOUS PERMIT AND ANY ADDITIONAL 7NFORIu-TION ( INCLUDE . 2HOTCCOPY OF 401
CERTIFICATION):
8b. ARE ADDITION? PERMIT REQUESTS EXPECTED FCR THIS PROPERT'_' IN THE
E77 URD? YES ; ] NO I YES, DESCRIBE A1T CIPATED WORN.
9a . ESTI LATED TOTAL UMBER OF ACRES 711 '7' CT OF L,:%-ND:
?? ?.-..?_:.(:?'?ED ?n.?.T ?L .'ILT :'?L?i E:? vL ?C.??.. .,. J1u_'.T..•.??r:. .mil, lJ ?.?__. .. _'?? .: ..-?_--'__ ., _.?
ot"I E
NU['1Bc OF eiET i. -NDS _: ?:'.C D ;! PRC° 'ScG ?RO•Jr! T 3Y:
FILLING:
FLOODING:
EXCAVATICH
OTHER:
DRAINAGE: TOTAL AC?FS TO BE :.. ACTED:
kloT WE LAND ArzE A -ZTR14HQ'ZR
100. (1) =T EZ?M CHA1,I11EL TO BE IMPACTED 3'' THE PROPOSED PROJECT (1-
R LOC,?TSD, PROVIDE ,DIST.7NCS -POTY ?S: CRS .,: ID .-F -R RS?OC.?T;CIJ) .
=TGTH BEFORE. 4 _ A- G
±iDT.1 BEFORE (based on normal W contours)
,,TT_DTH AFTER: CJ '`"
AVERAGE DEPTH BEFORE. ?)4 r
(2) STPE•M ?s7NEL TC-S ,i7 - CUL RCM (C CH ?=-LL THAT ApPLY)
OPEN C:iANNEL RELCC. TICN: OF PI?E IN C ?a1NiiIEL.
CH:kNNEL EICr.VATION: C:iIS7R?C7I0ii OF ?. DPii/ (CODING:
OTHER: FILL WILL CLt N Sio7' FEoce 99G
11.. IF CONSTRUCTION_ Or A •PCND 1S ?RC OSED, WFAT 1S. THE-_ SIZ;J_ OF THE,
WATERSHED DRP.INIVG TO THE POND?
WYAT IS THE EXPECTED POND SURFACE ? E ..
12. DESCRIPTION OF PROPOSED WCR:? 71'C`,UDI`iG DISCUSSIC.i CF TYPE OF
LSEC iyNICAL EQUIPMENT TO BE USED (A--T'-CH PUNS: ° 1; 2" X 11" DRAWINGS
ONLY)
PILL r1R?? OF SPRjt,1j 14E-,qD W /T74 CLL-X)/I 5t4o7- I?CCK
rJRPOS? c,F Pr.o^csFD 'riOR'' T? ?NPi-? oQE FoR PA Rrii t42 D?VCZo?m??1_
-- -
STAT R E..?G[i? W;,'I IT I CIE. ?? .....'C "in_S ACTi'il"_ 3E _..P.RT :U
.OUT IN P7ETLANDS. (INCLUDE ALLY MEA-?,._... %. 'Etl TO MI?III°lI ?r7ETLAlID
II-?cACTS)
IS IS t? W -7LAND ARE?
YOU RE REQUIRED TO CONT.^.CT A1ID r1iL L_-? SERVICE
(UScrIS) -ID/OR--NATION?, MAP.I?IE E S P.I? S??.`JIC (NM=S) SEE AGENCY
?-DDP.ESSES SHEET) REGARDING THE PRESE:iC OE ?SI'/ : EDr PAi 1 LISTED GP. "
PROPOSED FOR LISTING ENDPrIGEP.ED OR _.... _E IED SPECIES C:: CRITICP.L r?-BIT AT
IN THE PE?'IIT AP.E?. T: _T ?M-3E-AF _ _ 3'_ THE PROPOSED PROJECT. DATE
CONTACT ED: - (ATTACH RESPONSES
_ ROM THESE
AGEi'iCI?S
IOU DoE K?QUTR D O?ON::_CT _..? ?_.__? ?_.LrTT '?i?JFICE..G?
(S-?O) (SEE AGENCY ADDRESSES c-!E^"'1 ?,E RD ?1G --HE PRES E,,iCD O, n_STORIC
PROP?RT_ES .N m:E PEP,I?IT AF. y. ,I'r.IC 3E '7-7-TED H'-' THE-PPOPOSED
PP10,7ECT . DATE CONTACTED:
17. DOES THE PROJECT INVOL" OF ?UDLIC _??iDS OR i-SD 0_
YES (? *IG (I_ _AC, O
a. _- YE DOES THE PRCJECT ti PREPARATION OF ? I ELTJIROITMENT-
DCC:2,!TNT PURSU??IT TO _..E RE UI..E:?E., _ .. _ T:,.. NCRTc: CARCL--NA EI7,7IR0 MENT?.",
D0,7 ACT"
.T(C-:.-i-
S
:iT..__. C:.....,._;dGi".?.'U;., T?, .._•i_?_??i O." ?., _3GTii-'..1'.r.? ?.i??Vi-?.GD:?'.Y.. ..?....?-.`IL
CCi?D?? uNC' WITH THE NORT' CARCLINA E:+C.?.CN`1ENT?L PGLIC' CT.

C:. 0L7NA DEPART?IE\NT )- :LDMT_N_Srr?T_ iv, _o WEST JONES P?'L vl':,

18. THE FOLLOWING ITEMS SHOULD BE INCLUDED W:TH TE'.IS APPLICATION 1
PROPOSED ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OR FILL iVATERI:IL
INTO.WETLANDS:
a. WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES
AND PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26,
29, AND 38). ALL STREAMS (INTERMITTENT AND PERMANENT) ON THE PROPERTY
MUST BE SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS SO FEET OR 1
INCH EQUALS 100 FEET OR THEIR EQUIVALENT.
.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. ATTACH A COPY OF THE STORM`ATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT IS LAND USE OF SURROUNDING PROPERTY?
NOT- t4tT LA"t) t?2 r/i/S PRO PEFlSj PND
?O ? CRS, 15 u ?L Fo (? 1= A R r? 1 X15
IF APPL=CABLE, WHAM IS PR02CSED METHOD OF SEW__GE DISPOSr.L?
c. SIGNED AND DATED AGENT AUTHORIZATION 'LETTER, IF APPLICAB-LE.
NC=: WETLANDS OR WATERS OF 'THE U.S. MAY NOT BE IMPACTED PRIOR TO:
1) ISSUANCE OF A SECTION 404 CORPS OE ENGINEERS PERMIT,
2) EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF
ENVIRONMENTAL Y-kNAGEMENT (WATER QUALITY) CERTIFICATION, AND
3) (IN = 27= TY CCASTAL COU'N^_'I:L'S CNLY) , A LETTER FROM THE
NORTH CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NC- C.?ROLIN: _ COASTAL. i-L-.N_AC-EIVE T
PROGRA14.
" I -? ?L n_. /- , () ?.--? A_4
OW7 (') /AGENT ' S S l_?N-ATUR?r-
(AGENT'S SIGNATURE VALI- ONLY
IF"AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED (i8r.))
?71 l
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