20010102 Ver 1_COMPLETE FILE_20010125

State of North Carolina
Department of Environment LT.WMA,
and Natural Resources ? •
Division of Water Quality
p
Michael F. Easley, Governor C A l R
William G. Ross, Jr., Secretary D C ? V
Kerr T. Stevens, Director
January 31, 2001
DWQ# 01-0102
Davidson County
John D. Ellington
441 Nottingham Drive
Lexington, NC, 27292
APPROVAL of 401 Water Quality Certification
Dear Mr. Ellington:
You have our approval. in accordance with the attached conditions, to excavate in.0.11 acre of waters in order to improve boat access to
the pier on your property on Abbotts Creek in Davidson County, as you described in your application received by the Division of Water
Quality on January 25, 2001. After reviewing your application, we have decided that this fill is covered by General Water Quality
Certification Number 3280. This Certification allows you to use Regional Permit Number 198200030 when the Corps of Engineers issues it.
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 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 which conforms 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,
Stevens
Attachment
\J v
cc: Corps of Engineers Raleigh Regulatory Field Office
Winston-Salem DWQ Regional Office
Central Files
File Copy 010102
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
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #): P%J V
PRE-CONSTRUCTION NOTIFICATION APPLICATION
-FOR NATIONWIDE PERMITS THAT REQUIRE:.
N
Lo 1) NOTIFICATION TO THE CORPS OF ENGINEERS
-2) APPLICATION FOR SECTION 401.CERTIFICATION
3) COORDINATION. WITH THE NC DIVISION OF COASTAL baNAGEMENT
'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
(SEE1 AGNCY. ,ADDRESSES SHEET) PLEASE PRINT.
•
1....: OWNERS..-NAME. ...
2 . MAILING- ADDRESS : , 4-
SUBDIVISION NAME-y.
• CITY: STATE'S C : ZIP CODE {
PROJECT'LOCATION DRESS, INCLUDING SO DIVISIO NAME (IFDIFF FROM
MAILING'ADDRESS- ABOVE) O ...._ . U? ?r . _ i X?? - TWA iv
i r ? aaon
'pecel ?¢.se.?' oa `:•L"=ag Lp:?.?; SIG 1 6-+?'? . ; : X31... 9?'? ? .
3. TELEPHONE NUMBER (HOME) : J 7 e1 ??7 r Q1 (WORK)
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 TOPOGRAP IC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE): N
COUNTY: j w) i DPI NEAREST TOWN OR CITY:
1 PAYMENT
RECEIVED

SPECIFIC LOCATION (INCLUDE ROAD
NUMBERS, LANDMARKS, ETC .) : if3R 54,w 4- P(-Q_-m^- x `? L $ It

6. IMPACTED OR NEAREST STREAM/RIVER:. t )D:jtS cree-
RIVER BASIN: ?i J"
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER
(SA), HIGH QUALITY WATERS (HQW), OUTST gZNG RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-11)? YES [ ] NO Q/J IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A. NORTH CAROLINA-DIVISION OF. CO TAL
[
. ;.MANAGEMENT AREA OF ENVIRONNENTAL.'CONCERN (AEC)?- 'YES. [ ] . -NO -
IF. THE PRO4ECT,.IS LOCATED WITHIN A COASTAL COUNTY. (SEE PAGE 7 FOR
LIST.OF COASTAL COUNTIES), WHAT IS THE'LAND USE PLAN..(LUP) DESIGNATION?'
:.
S.a. '.HAtE ANY .SECTrIfSN 404 `PERMITS ' EER :PREVIOUSLY 'REQUE9TED';FOR 'USE ON ... .
THIS PROPERTY? YES _ [ ] NO IF YES," PROVIDE -ACTION- I. D.r-- NUMBER OF -
PREVIOUS 'PERMIT . AND ANY: ADDITIONAL INFORMATION. (INCLUDE • PHOTOCOPY OF 401:
CERTIFICATION): -
8b. ARE ADDITIONAL PE T 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
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10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: w S n e EXCAVATION;
FLOODING: p OTHER:
DRAINAGE: TOTAL ACRES TO BE IMPACTED : `?--
? -
b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
lZELOCATED, PROVIDE DISTANCE-. BOTH BEFORE AND.AFTER. RELOCATION
LENGTH BEFORE: E'T AFTER EIT
WIDTH.BEFORE:(based on normal high water co urs).
-
t,Y f'ttl-L. .. j: FT
WIDTH AFTER'....
AVERAGE. DEPTH BEFORE: FT AFTER: -==--
- 'C L g , ESIIL OM -'(CHECK ALL THAT APPLY)
2),¢ E . , cis
_. ?t ?.• ? ,J-` ;i a,, r3? z .; .? Y:.,
;OFD=PIPE IN'CHANIJEL
NT
. PLACEME
OPEN CI?ANNEL RELOCAT
CHHANNEL. EXCAVAT CONSTRUCTION OF A DIEM/r',QODING:
OTHER: x.? h.:: , • _ ..
ld:.•.IF-CONSTRIICTION• OF A:.POND. IS PTtOPAS .'U' iT.•IS. THE S Z?.QF• THE„
WATERSHED DRAINING TO TH£ POND?
WHAT IS THE EXPECTED POND SURFACE-AREA
Nl? 12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF WING5
MECHANICAL EQUIPMENT TO B USED (ATTACH P S:
ONLY) : 1., . - ?

l
(j J

N, 016ts
13. PU'RPOSE' OF PROPOSED WORK: _
xfvb li? 0.44 A LL-es
. • 3
'goal 11 ll 1411 01.0

14. STATE REASONS WHY IT--IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED
OUT IN WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND
IMPACTS):
Gt. aced, ?`o,J , l
4= LA-r-,e- ?? .
'15.- YOU -ARE -REQUIRED TO CONTACT, THE.U.S. FISH AND WILDLIFE SERVICE
(USFWS) AND/OR-_i TIONAL MARINE FISHERIES -SERVICE .(NMFS). (SEE..AGENCY.
-ADDRESSES„SHEET). REGARDING THE.,-PRESENCE OF ANY. FEDERALLY .LISTED, OR.
'PROPOSED- FOR LISTING?END.ANGERED OR THREATENED SPECIES OR CRITICAL HABITAT
;IN rTHE„ PERMIT AREA THAT •'MAY-BE-AFFECTED BY THE PROPOSED PROJECT...... DATE.
CONTACTED: (ATTACH "RESPONSES
?E'ROM THESE AGENCIES.)
16.E YOU, ARE--EQU-IS D-,W--GONTACT, THE STATE HX.STORIC,.ERESERVATZ0N_QFFICER BIr
(S.HPO) (SEE AGENCY AD S_ SHEET)tEGARDING' THE PRESENCE OF HISTORIC
PROPERTIES?•N Ea PERMIT AREA.WHICH.:MAY'BE AFFECTEp BY"THE PROPOSED
PROJECT. DATE CONTACTED:
• :?i yr.. '? yxffy. Aj rr? nrZ ?. 3'1.1, _ •-y
17 DOES,THE'PROJECT. INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC : (STATE j y LAND?
YES [J NO (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 [ J NO [ J
b. IF YES, HAS THE DOCUMENT'BEEN`REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE?
YES [ J 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].
4-

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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. 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 PLACEMENT OF THE DELINEATION LINE.
d. ATTACH A COPY OF THE STORMWATEW.;MANAGEMENT PLAN-.IF REQUIRED.
e. WHAT IS LAND USE OF.SURROUNDING PROPERTY? f. -IF APPLICABLE, ;WHAT IS `PROPOSED METHOD OF SEWAGE'-DISPOSAL?
'g. SIGNED AND DATED AGENT: AUTHORitATI(5N'-LETTER;. IF APPLYCAB-LE.
NOTEz WETLANDS...OR WATERS` •OF 'THE U-. S. MAY NOT BE IMPACTED.PRIOR' TO:
1) ISSUANCE' OF- A SECTI'ON' 40.t'. CORPS OF ENGINEERS PERMIT',
2) EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF
ENVIRONMENTAL MANAGEMENT (WATER QUALITY) CERTIFICATION, AND
3) (IN THE 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.. • .. . _
. OWNER' S/AGENT'S'SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
-IF-AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED (18g.))
5
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DEM ID: 0 1 ®1 0 2 CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #) : Re 3 O
FOR NATIONWIDE PERMITS THAT REQUIRE:.
o PRE-CONSTRUCTION NOTIFICATION APPLICATION
1) NOTIFICATION TO THE CORPS OF ENGINEERS
-2)- APPLICATION FOR SECTION 401.CERTIFICATION
3) COORDINATION. WITH THE NC DIVISION OF COASTAL bmmGEMENT
pw?l
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,yAG?NCY..ADDRESSES.SHEET.). PLEASE PRINT.
i :" . OWNERS.. NAME ?'. ; 'l?`?) c+ .
2. MAILING ADDRESS:. ?5r1 10 b?`? ` Nt A M' ?•
t _ ' SiJBDIVISION' NAME:...
CITY ,! ?'' STATE ey t Cam` ZIP CODE: ?%4
PROJECT=,LOCATION" DRESS, INCLUDING SII DIVISIO NAME (IF DIFFE?FROM
MAILING.ADDRESS--ABOVE) s A 0 .. aC g w.a ") N
sa?? o a "; :.1. aid ? LA:Ke.1 - BK I 6 n C} '7
3. TELEPHONE NUMBER (HOME) : ?O `I e!?1e3? I QI (WORK) : - - ?--r ?_______
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 TOPOGRAP IC
MAP OR AERI PHOTOGRAPHY WITH SCALE): N ,,///?
COUNTY:- rJ D NEAREST TOWN OR CITY: ,VEG.
PAYMENT
1 RECEIVED
Yri?
???""" _-.Aa.cw"'t: ~F'fi'==__.._''C> '?'n...?.a Jax.?•: ?_y-:-_'3 C'- =^'?'?^"`k.,.n.?9;:3d:4.:-.

SPECIFIC LOCATION
44
t.Q
(INCLUDE ROAD

NUMBERS, LANDMARKS, ETC.) : ??,-?`'? `, o-„e
TV- PIA
e?.
6. IMPACTED OR. NEAREST STREAM/RIVER: - 9./l )ate ?r??
RIVER BASIN:
T
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER
(SA), HIGH QUALITY WATERS (HOW), OUTSTAN NG RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-II)? YES [ ] NO ( IF YES, EXPLAIN:
?14ANAGEMENT AREA OF ENVIRONME TAL: • .„CONCERN (AEC)? . 'YES. .NO
[ j
If.. .,THE PRO%7ECT IS LOCATED WITHIN A COASTAL COUNTY. (SEE PAGE 7 FOR
LIST. OF COASTAL COUNTIES) , WHAT 'IS THE 'LAND USE PLAN "'(LIIP) DESIGNATIONf *_
;x ic.F ??Y:. ??? -+?' M ? f .??'%..s,vf [?.C?3 .:qtr +' ?4"; ,C _> ":`.I•" . :£ 2 ''Y;iL? !? '?02I`'?cI .;,,.:+T'4'.t;r't=;
.8a. HA'V'E ANY SECTION 404_ `PERMITS ` EEN :PREVIOUSLY 'REQIIEJTED';FOR 'IISE 'ON
THIS PROPERTY? YES [ ] NO IF YES, "PROVIDE "ACTION-I.D.•-NUMBER OF
PREVIOUS'PERMTT AND ANY. ADDITIONAL INFORMATION. (INCILIUDE. PHOTOCOPY OF- 402,
CERTIFICATION):
8b. ARE ADDITIONAL PE T REQUESTS EXPECTED FOR-THIS PROPERTY IN THE
FUTURE? YES [ ) NO [/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:
S
2
7b.. IS THE PROJECT LOCATED WITHIN A. NORTH CAROLINA'-DIVISION OF,CO TAL
N . [ .

10a. NUMBER OF ACRES OF WETLANDS IMPACTED'BY THE PROPOSED PROJECT BY:
EXCAVATION: A "O
FILLING:
FLOODING •. , . d OTHER: DRAINAGE: TOTAL ACRES TO BE IMPACTED:
Ob. ('1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
LOCATED, PROVIDE DISTANCE' BOTH BEFORE AND AFTER RELOCATION
LENGTH BEFORE: FT AFTER
~WIDTH BEFOREbased on normal high water CO urs). FT
1l. t "I 'l • T
? 1. ? ..... v .a .j. .
WIDTH AFTER:.'
FT FT
AFTER:
AVERAGE DEPTH BEFORE:
T EAM CHANN L CT3 SUL OM (CHECK ALL THAT APPLY)
. , f 2) , . , .. , , _ _ •ps.'. _ ...., ....
•
':: • . T, ti? ,...r'i r.:yrx .?:? `; PI,ACEMENT'OF
OPEN CAZiNNEL RELOCAT ?IPE IN'CIIAIJNEI
CHpiNNEL.EXCAVAT CONSTRUCTION-OF A DAM/FLQODING:
OTHER:
11... I F .CONSTRIICTION. OF A . -POND _ IS PROPAS WH4T.•IS . THE S ZFs • OF • THE,
WATERSHED DRAINING TO THE POND?
WHAT IS THE EXPECTED POND SURFACE. AREA
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OWING5
^ MECHANICAL EQUIPMENT TO B USED (ATTACH P S: 8 2'f lla
&jj
ONLY) :
_ , r ? _ i
4-1
13. •PU-RPOSE' OF PROPOSED WORK:
A-r?D ? o,4? 'A c
3

i

14. STATE REASONS WHY IT-IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED
OUT IN WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND
IMPACTS):
aro bs e CL
6Z-

*,or) w,l

15.-.YOU.hRE-REQUIRED TO CONTACT'THE V.S. FISH AND WILDLIFE SERVICE
(USFWS) AND/OR-4 ATIONAL MARINE -FISHERIES oSERVICE '.(NMFS) ,. (SEE..AGEN _ __ (;URA
_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-•MAY'-•BE-AFFECTED BY THE PROPOSED PROJECT,.-,. DATE.
CONTACTED:y (ATTACH -RESPONSES
FROM THESE AGENCIES.)
16;.-" YOU, ARE- -nQU-1-REia-9'O .CONTACT THE STATE HISTORIC _03ESERV.ATZON-OFFICER B?
(SHPO) SEE AGENCY AD,ORESSES_.SHEET)?'-REGARDING THE°PR£SENC£ OF HISTORIC
'Ta
PROPERTIESfTL PERMIT :AREA WHICH MAY 'BE AFFECTED BY' TF?E PROPOSED
_ __.. :_
17.% 5._ .r{ .j.. ?,?' ,]„AF;7 .?.•1
PROJECT. DATE CONTACTED:-
a
. ._.?.,....,.... ..,._.y -5 ?t:: j. '? S ` '?i J..r ,)LSJS ?r,. ?1.+- 'YV ,kt ? Fin `T2•!
DOES:THE PROJECT INVOLVE AN :EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
_Y_.. __.. _..._ _ .
PUBLIC ? (STATES ...LAND??_.... ...,.. _.....?? d.'"
YES [] NO (IF NO, GO TO 18) '-
a. TF YES, .DOES THE.PROJECT REQUIRE PREPARATION OF AN 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 [J NO [J
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-

•i
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. 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'.
ci. 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 STORMWATER-;MANAGEMENT PLAN.-.I.F REQUIRED.
e. WHAT IS LAND USE OF SURROUNDING PROPERTY?
f. -IF APPLICABLE,.'WHAT IS'-PROPOSED METHOD OF SEWAGE'-DISPOSAL?
s..
A
g. SIGNED AND BATED.AGENY7AUTHOP ZATXdN"tETTERI* IF APPLYCASLE: "
woo : 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 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.......
Q:6L 10'. • OWNER'S/AGENT'S' W_??r_t
SIGNATURE •
(AGENT'S SIGNATURE VALID ONLY
-IF-AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED (18g.))
5
DATE
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