20001403 Ver 1_COMPLETE FILE_20001102

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Kerr T. Stevens, Director M, A,
Bill Holman, Secretary
/ Foh •
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
November 14, 2000
Wake County
DWQ Project # 001403
APPROVAL of 401 Water Quality Certification and Neuse Buffer Rules with Additional Conditions
Blue River Development Company, Inc
c/o David Bannister
2117 Highway 70E
Garner, NC 27529
Dear Sirs:
You have our approval, in accordance with the attached conditions and those listed below, to impact 90 linear feet of stream
channel and the associated riparian buffers in Wake County for the purpose of road crossing construction, as you described in your
application received by the Division of Water Quality on November 2, 2000. After reviewing your application, we have decided that
this fill is covered by General Water Quality Certification Number 3287. This certification allows you to use Nationwide Permit
Number 39 when the Corps of Engineers issues it. This approval is also valid for the Neuse River buffer rules (15A NCAC 2B .0233). In
addition, you should get 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 Water shed regulations. This approval will
expire when the accompanying 404 or CAMA 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. If the property is sold, the new owner must be given a copy of
this 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) (6)
and (7). For this approval to be valid, you must follow the conditions listed below and in the attached certification.
1. Clearing associated with the construction of the road crossing must not exceed 90 linear feet and/or 1/3 acre of riparian buffer.
Mitigation will be required if these limits are exceeded.
2. Diffuse flow at non-erosive velocities must be provided for all stormwater run-off prior to entering buffer.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing. You must act within 60
days of the date that you receive this letter. To ask for a hearing, send a written petition, which conforms to Chapter 150B of the
North Carolina General Statutes to the Office of Administrative Hearings, P.O. Box 27447, Raleigh, N.C. 27611-7447. This
certification and its conditions are final and binding unless you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water Act. If you have any
questions, please telephone John Dorney at 919-733-9646.
S'
e T. t ens
Attachment
cc: Corps of Engineers Raleigh Field Office
Raleigh DWQ Regional Office
Neal C. Floy, 7908 Audubon Drive, Raleigh, NC 27615
Linwood Byrd, Byrd surveying, 112E Johnston Street, Smithfield, NC 27520
File Copy
Central Files 001403
Division of Water Quality • Non-Discharge Branch
1621 Mail Service Center, Raleigh, NC 27699-1621 Telephone [phone] FAX # [phone]
An Equal Opportunity Affirmative Action Employer • 50% recycled/10% post consumer paper
http://h2o.enr.state.nc.us/wetiandc.html
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DEM ID: 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 r-` ` ray ?'
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: -g'??? iCl vex- -G •-- DGJJ 1 (? ?afnl STr4
2. MAILING ADDRESS: ZI 1, l?ha??0?y -70
l SUBDIVISION NAME: ?Py.LJt4ck- -?
CITY: GU-r Y?..r STATE: 0 • G • ZIP CODE: Z-7629%
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE): T AUJ
Sy i S l Cv\ kom OW T r t?ti 1 -Y?- . O?N S R 777 00
3. TELEPHONE NUMBER (HOME): (WORK): -7 7 Z- 22 2-0
4. IF APPLICABLE: AGENTS NAME OR RESPONSIBLE CORPO
NUMBER:
TE OFFICIAL, ADDRESS, PHONE
is
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP OR
AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: bio.e. NEAREST TOWN OR CITY: Cr0-'r kle?f'
PAYMENT
RECEIVED
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS. LANDMARKS. ETC.):
1
6. IMPACTED OR NEAREST STREAM/RIVER: ??'? 1Y 1 ?WKXi` ?J•? ?1?(?Cf??
RIVER BASIN:
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER
(SA), HIGH QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER SUPPLY
(WS-1 OR WS-11)? YES [ ] NO [ X ] IF YES, EXPLAIN:
7b. IS THE PROJECT IS LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT 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: (no)
8a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROPERTY? YES [ ] NO [ X ] 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 [ X ] IF YES, DESCRIBE ANTICIPATED WORK:
9A. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND: 40 0.U-eS
9B. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:Z -70-CdQs
I OA. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING:
FLOODING:
DRAINAGE:
EXCAVATION:
OTHER: '('00-0? cross_2 %TEDe!- 1 y\ C_??y)2`
TOTAL ACRES TO BE IMPAC: Zloa 2

10B. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION): n
"1 FT
i
WIDTH BEFORE (based on normal high water contours): 2. FT
WIDTH AFTER: 2., 1 FT
AVERAGE DEPTH BEFORE: i FT AFTER: I FT
LENGTH BEFORE: FT AFTER:
(2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: [ J PLACEMENT OF PIPE IN CHANNEL: (V']
CHANNEL ELEVATION: [ J CONSTRUCTION OF A DAM/FLOODING: ( J
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%:" x 1 I" DRAWINGS ONLY):
(O o'J

13. PURPOSE OF PROPOSED WORK: f\,-e? rOaJ- LanS? ry?c?'?,p?? -?? S?,-b8;y ?s?o?'1
14. STATE REASONS WHY IT 1S BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS):
L.
15. 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 CIRTICAL HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY
THE PROPOSED PROJECT. (ATTACH RESPONSES FROM THESE AGENCIES.)
DATE CONTACTED: Not Required - Performed by the Corps of Engineers
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER (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: Not Required Performed by the Corps of Engineers
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF PUBLIC
(STATE) LAND?
YES [ ] NO [X ] (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[X]
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, RALEIGH, NORTH CAROLINA 27603-8003, TELEPHONE [phone].
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OR FILL MATERIAL 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. SCALES SHOULD BE I 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 PLACEMENT OF THE DELINEATION LINE.

d. ATTACH A COPY OF THE STORM WATER MANAGEMENT PLAN IF REQUIRED.
0-a 6
e. WHAT IS LAND USE OF SURROUNDING PROPERTY? IS1 0"-\
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? 0`nS?
g. SIGNED AND DATED BY 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 THE TWENTYCOASTAL COUNTIES ONLY), A LETTER FROM THE NORTH CAROLINA
DIVISION OF COASTAL MANAGEMENT STATING THAT THE PROPOSED ACTIVITY IS
CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT PROGRAM.
OWNER'S / A NT'S SIGNATURE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
/O 10 Zooo
DATE
THE OWNER IS PROVIDED (I 8G.))
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001403.
DEM ID:
CORPS ACTION ID:
.4
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #): 3
PRE-CONSTRUCTION NOTIFICATION APPLICATION ;

FOR NATIONWIDE PERMITS THAT REQUIRE: g
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.
L OWNERS NAME: -ti1 iC1 Vi° I1'?' • clo- TIC- c) clu 1 C? 0.r f\* STG(
2. MAILING ADDRESS:
F
SUBDIVISION NAME: ?c j,,4c - E44v-e-,s
CITY: STATE: O .C. ZIP CODE: 2-75Zq
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (1F DIFFERENT FROM /
MAILING ADDRESS ABOVE): " x/11 SAr-k 124+/_>
V i s 'l (M QocA1 a T rUdti S R -2-7 0 0
3. TELEPHONE NUMBER (HOME): (WORK): -I 7 Z- Z220
4. IF APPLICABLE: AGENTS NAME OR RESPONSIBLE
NUM
TE OFFICIAL, ADDRESS, PHONE
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP OR
AERIAL PHOTOG,RA_PHY WITH SCALE):
COUNTY: U)o_.k NEAREST TOWN OR CITY:
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ETC.):
4411 1,." , _70;-: --cam l? lni P_ fk?,? ?d ?51227c?1 . ot- 5P- 2300
O
is
PAYMENT
RECEIVED
?? b?7?Ci W l?oo,?Ci?
6. IMPACTED OR NEAREST STREAM/RIVER: ?
RIVER BASIN: I V Pau- ? R, uej/
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 [ X ] IF YES, EXPLAIN:
7b. IS THE PROJECT IS LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT 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: (no)
8a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROPERTY? YES [ ] NO [ X ] 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 [ X ] IF YES, DESCRIBE ANTICIPATED WORK:
9A. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND: 4 o awe s
9B. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:; 70.GCgs
I OA. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING:
FLOODING:
DRAINAGE:
EXCAVATION:
OTHER: rOo4k cro?S _p P? rC-V\cw\ V,-e,
TOTAL ACRES TO BE IMPACTED: 2-PD 2
I OB. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION): //??
LENGTH BEFORE: FT AFTER: "1D FT
WIDTH BEFORE (based on normal high water contours): 2. FT
WIDTH AFTER: Z FT
? I
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 ELEVATION: [ ) CONSTRUCTION OF A DAM/FLOODING: [ J
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%:" x I I" DRAWINGS ONLY):
> (o t? C?os?, ???¢, -? Su-?l? ? ?Si cry ?ea? P rv? -fir
13. PURPOSE OF PROPOSED WORK: '(\-CJ,D (-Oo-CL L(?I1A r,-c. A-; &r V ts\ ova
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS):
S (?aann m-. \0-e, r tbSSAol AD aLC C S ?\
1013. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION): CID LENGTH BEFORE: FT AFTER: qO FT
i
WIDTH BEFORE (based on normal high water contours): 2 FT
WIDTH AFTER: 2.1 FT
AVERAGE DEPTH BEFORE: FT AFTER: 1 FT
(2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: [ J PLACEMENT OF PIPE IN CHANNEL: (?J
CHANNEL ELEVATION: [ J CONSTRUCTION OF A DAM/FLOODING: [ J
OTHER:
1 1. 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%:" x 11" DRAWINGS ONLY):
) ( O aj V? + r.CA ISi c3? cLzo-eAo o mey\-?
?r
13. PURPOSE OF PROPOSED WORK: f\-e. (-O L?,r,s} r?? jy? ?? s?-?O?V lS???/?
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS):
10B. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION): II
LENGTH BEFORE: FT AFTER: ">IO FT
i
WIDTH BEFORE (based on normal high water contours): 2. FT
WIDTH AFTER: II FT
AVERAGE DEPTH BEFORE: FT AFTER: I FT

(2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: [ ] PLACEMENT OF PIPE IN CHANNEL: [ ?]
CHANNEL ELEVATION: [ ] CONSTRUCTION OF A DAM/FLOODING: [ J
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%z" x I I" DRAWINGS ONLY):
13. PURPOSE OF PROPOSED WORK: f\-d? f-00j- Lr>nsy rl'-L 1p?/t '?p( SU-1'0&\j ts%O?
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS):
1 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 CIRTICAL HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY
THE PROPOSED PROJECT. (ATTACH RESPONSES FROM THESE AGENCIES.)
DATE CONTACTED: Not Required Performed by the Corps of Engineers
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER (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: Not Required - Performed b the Co s of Engineers
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF PUBLIC
(STATE) LAND?
YES [ ] NO[ \X ] (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[ X ]
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 'T-HE
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].
\'
L . .
I8. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OR FILL MATERIAL 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. SCALES SHOULD BE I 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 PLACEMENT OF THE DELINEATION LINE.
.f
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT ISLAND USE OF SURROUNDING PROPERTY? 5?+-b??y lS1 CM QQ (?C1 W
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? Q'V;te
g. SIGNED AND DATED BY 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 THE TWENTYCOASTAL COUNTIESONLY), A LETTER FROM THE NORTH CAROLINA
DIVISION OF COASTAL MANAGEMENT STATING THAT THE PROPOSED ACTIVITY IS
CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT PROGRAM.
OWNER'S / A NT'S SIGNATURE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
/o 101 zoo o
DATE
THE OWNER IS PROVIDED (18G.))
C
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