20010249 Ver 1_COMPLETE FILE_20010216

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APPROVAL of 4EH Water Qua ty Certification and Neuse Diver ELF Ruffles
Ills. Bessie - ynck5s
Fit Cf5ce Sox
C?ha_ FL "73"
Cear Ms. Feynoid-
You Five ctx agpaaaal, in acoocdarace with the attaci-ad core, to place faH in 5%O acriE7
fit of water ftr -kr= purpose of cais ruc&V a seawall a 450 Toby 57yson Road. Cul[cw- or:
-borpe L=-K&, as !c3 des=-bed in your apeiication dazed F--tx--wry, aD. 200:1. Arm reviewi= your
a ppliicator, -MF 'he a domed t i E fis M is covered by C-ea~-a 'N=-- Quairty Cc-. lion der"
:2B0 This Catffc Effm a3oas yw Io use Region21 Permit Nesrb--- 03D mher,, the Cccps of 1=,rawer=
ii ;moues it. in adds on, ycu s~ culd oe any c iler federal, sue, or kcal pe mil; bey you cc aheac
with yooff Pow i?chica>c (EA, rC t hTited to) Sediment and E-msan Ocintoi, Cowl StL?u water.
!!ion-Dis<sarp--- and W.c=r Sup-c+ i' ---,ed regulations. Also this approval will expire w€-jen the
accomparry?ing A14 oc CAMA permit expires unless otheSaise sgerified in the General
Certificadcm
T hiss arprcvs is cr y 3rTd x to pugpp se and design t>?-= ycu des=-.1i--ed in ycur appiacajon. If
you ctenge your prizipcL you a s, no0Y us and send us a rew a;.aicaac?rt if, the pmperty is sold. tie
w osws? be Dien a C`OY Gf this can ,iron and apa r kcer and s thereby respcrsbk far
exlmpiy c worth al t uns- This; Via' shall expire when fnE aYT.-spcrnding Najonwide Permit:
expires or as ethaanise prDviced b ste General CertificaticrL if loin wEt n fills fort is proect (now
c)r in the i ahm` a* acre, cbrrpensaDry mitigatca arty be rzYuired as described in 15A
UCAC 2H -0-506 - For fii is approval to be valid, you mu- jDIdK J-he ccr )Griffons Ism7 in ti•te a-chhed
Certifies r-.L
If you bo rc arm any of isle cooditt of this ce.,5 r?, you rray ask for an adu?d-icator-y
aririg. `you n',1?•c act uffrin 10 days of t E date that you r e&e #iis let?e*. To ask for a Fearing,
send a wrten pefflkn, vAirch cArkrns to C' mpter 1508 of Jhes- North Ca-Dirs Gererai Stcatke s to ti-ire
'ffm of Fcimiris ,- l awry P.O. Box 27447, RaleigtL ?LC_ 276611-74-E-7. This cerffication and
its cond'rticrs are loaf and bi'ffM urkss you ask for a heyarkr?gg_
This LntEr des fire: Z of tie Division of Way Quai¢y ux3r-- Section 401 of tre C1eaa
Water Act_ N you have arq questions, ple`=? teLephone John DomL-f at 9119-733--% "u_
Stev
Attac hrneI
cc: Corps of Emniineefs Ashe-Me f=ield Owe
pSlxje,w-Tjc- rj%Q FRegbnal Cffc---.
File Copy
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Ritaiad Cry; lfYar itfli-+=ta Fvwer Co
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010249
DWQ ID: CORPS ACTION ID:
NATIONWIDE PER-NUT REQUESTED (PROVIDE NATIONWIDE PERMIT T)
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS Tt{.AT REQU-IRE:
441
1) NOT FIC ATION TO i nIE CORPS OF ENGD4EERS /SSpE??
2) APPLICATION FOR SECTION 401 C-=R.=CATION
3) COORD2N AilON WITH TlHE NC DIVISION OF COASTAL MA.NAGEtifEV-I
SEND TIC ORIC-2NAL AND (1) COPY OF THIS COMPLETED FORM TO = AFFROPRIATE
- FIELD OFF7C=- OF HE CORPS OF E_NGNEERS (SEE AGENCY ADDRESSES SHEET). SEVEN
(7) COPIES MUST BE SENT TO THE NC DIVISION OF WATER
H?N CREEK ROAD.
ti QUALITY. ATTN: JO -DORM-EY. 4401 REED
RALEIGH. NC 27607. PLEASE PRLTTT OR TYPE.
1. O Wti ER' S NAME: r ?I
2. 'v AU-2- -G ADDRESS: D Jo C g
fi
SUBDIVISION NAIME
CiT`f: E?1 Dot ?. S T A ZIP CODE:
PROJECT LOCATION ADDRESS, L\ CLU`D2NG SUBDIVISION NAME (IF D rT EREN 1 FRO-ri
.vLkM-' 1G ADDRESS ABOVE):_? b'?z Rn0j
?. TELEPHONENuIvfBER: (HOB) S?®? oZ9?-???`? ,NORK)
4. T.F APPLICABLE: AGENT'S NANfE OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
P: rO?NEL1?1LtitB cR:
3 'N A7, 7'fth AAA ??we?" ? D•
Y nay IA
5. LOCATION OF WORK (PROVIDE A MAP, PREF EPL-k3LY A COPY OF USGS TOPOGRAPHIC
,lvfAP OR AEU-\-L PHOTOGR.A2HY `NTIH Srr4LE):
mot,, ?1
Vl C. rn ?
COLiv-N',-/. -?VE-A?RESTTOWN: ?" ash?e#-5 m
?rn
rri o -ZE:
-i

SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, L.U DMIARKS, ECT.)
S R S I I z1
r -r V-Y. C?
6. IMPACTED OR NEAREST S i REA ?URIVER: ?A k e ?s ( e r ti's
RIVER BASU :jZryWe S4ee- Lo(o o(oao3
7a. IS PROJECT LOCATED NE.+R WATER CLASS=' D AS TROL TI, TIDAL SALTWATER, (SA),
HIGH QUALITY WATERS h'QW?, Of i ST?-L L,tG RESOL'RSE W ATERS (ORW), WATER _
SUPPLY (WS-I OR WS-II)? YES (X ) NO ( ) IF YES, EYPLA.I`i:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF E-NVIROZI E_`+ 1 AL CONCERN (AEC)? YES( ) NO (X )
7c. IF THE PROJECT IS LOCATED WTI-II`N A COASTAL COUNTY (SEE PAGE 7 FOR I T OF
COASTAL COT,=i S), WHAT IS THE LAND USE PL..-1(LUP)-,DESIGNATION?
8a. HAVE ANY SECTION 404 PERlv=S BEEN PREVIOUSLY REQUESTED FOR USE ON TMS
PROJECT? YES ( ) NO (X) IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS
PER-MIT AND AL`tY ADDITIONAL INFORMATION ( INCLUDE PHOTOCOPY OF 401
CERTIFICATION):
8b. ARE ADDITIONAL PERIMIT REQUESTS F=ECTED FOR THIS PROPERTY IN THE
Fj77J-RE? YES( ) NO ()<) IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL N-UMBERS OF ACRES IN TRACT OF LAND: dg G M e.
9b. ESTIti1ATED TOTAL NUZNM ER OF ACRES OF W ETL INDS LOCATED ON PROJECT SITE:
10a. NUMBER OF AC.^S OF `? L..?YDS IMPACTED BY THE PROPOSED PROJECT BY: N/A
FILLING: t-YCAVATION:
FLOODIING: O IPIER :
DRAINAGE : TOTAL ACRES TO BE IMPACTED:
10b. (1) STREAM CH.`4-NjfEL TO BE ItiiPAC: ?'D BY THE PROPOSED PROJECT (IF N
RE4.OCA ED, PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOC.?TION: 1 `I 1?
LENGTH BEFORE: FT Ar i cR: r i1
WITH BEFORE (based on nc=.al liah wale- contours): FT
AVERAGE DEPTH BEFORE: AFTER: F"i
(2) S i"RE.\:M CI-.Al,Ntic .. L1iPACTS `WILL R?aSLZT FRONT: (CHECK ALL TIHAT APPLY)
OPEN CHANNEL RELOCAilCN: PLA=ENI' OF PIPE IN CH- NNEL. _ N
CF- Nib EXCAVATION: COONS TRU=,oN OF A DA-MIFLOODING.
OT?R: ?,4 ryk Lenrn?h A Sfigb?L?2?1TIoYtr
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF TME WATERSI- -D
DRALN-LI iG TO THE POND? R WHAT IS THE EXP-=
POND SURFACE AREA?
12. DISCIZPTION OF PROPOSED WORK L`iCLUI) iG DISCUSSION OF TYPE OF NIECHAIN ICAL
EQUIP-Na-- 71 TO BE USED? (ATTACH PLAuNS; 31/2 BY I1 DRAWL(GS ONLY)
Grlvt-k d0-AD
- by ,h4tfd. Y' csl/ C'4?.ti s `li
r
1 rl 7zl la ° r, Cif t P ?? a J-.C? L rJ) ct f-2 p (hccq L -,06-c-
S.rtn,ra.o. 'S ?1tia,. ?'S c??..?,o'?' -t.(?tis+- ?.«. ?-rtc? .iw q.. ?.ht ?.CC.E?ev^.. ?Cl-e?..p? ltx:ru,'?c.F?t .
13. PURPOSE OF PROPOSED WORK. -743 AQ ?.
14. STA l r_ REASONS R r f IT IS B EL, T--,/7E D -l HAT THIS ACTIVITY'vfUST B E CARRIED Ot; i 1N
?
WES ( INCLUDE AVY vIE-.ySUIRES TA=E N, TO iVlIIvFL-1, 1 IZ WE11AND D,IPACTS)
Eli. YOU ARE REQUIRED TO CONTACT THE US FISH A1ND W7.DLIFE SERVICE AN-D/OR
NATIONAL MAR.iNE FISHERIES SERIVE REGARDING TIC PRESENCE OF ANY FEEDER.ALY
LIS 1=D OR PROPOSED FOR LISTING ENDANGERED OR THREE-ITE:NED SPECIES OR
CRITICAL HABITAT IN THE PE111 IIT AREA THAT MAY BE AFFE}iED BY THE PROPOSED
PROJECT. DATE CONTACTED:
16. YOU ARE REQU'RED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING TrID PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT ARE.
WHICH LaY B E AFr C T cD B Y THE PROPOSED PROJECT. DA T E CONTAC T ED .
17. DOES THE PROJECT lia4/OLVE A1N E:C'EN?ITURE OF PUBLIC FUNDS OT THE USE OF
PUBLIC (STATE) LAND? YES ( ) NO X) (IF NO, GO TO 16) _
a. IF YES, DOES Try PROJECT REQUIRE PREPERATION OF AN EWIRONIIa'-NTAL
DOCUME`7 PURUAINT TO THE REQUIREMENTS OF TIM NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES ( ) NO ( )
b. IF YES, HAS THE DOCUMENT BEEN MF:E-ED THROUGH THE NORTrI CAROLINA
DEPART-'V=, l OF ADMINFISTRATION STATE CLEARINGHOUSE YES ( ) NO ( )
IF ANSWER 17b IS YES, TI-IE1N SUBMIT APPROPRL4 L DOCUNM-N TATIONFROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROL-rNA E-NVIRON'vIENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. =YS BAGGEZT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMEINT.OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
18. THE F OLLO`VING =NfS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES TIE DISCHARGE OF EXCAVATED OF F T M.A.TE-Rl Lk . INTO
WET.AINDS:
a. WETLkND DELD4E-ATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES; ANiD
PONDS ON THE PROPERTY (FOR NATIONWIDE PERIMIT NUlffiERS 14, 18, 21, 26, 29,
A1W 38). ALL STREAlM (Ii`tT'RivII1'IFNT AND PERMANENT) ON THE PROPERTY
MUST BE SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 IINCH EQUALS 50 FEET
OF 1 INCH EQUALS 100 FEET OF THEIR EQUTVAL 2, T.
b. IF AVAILABLE. REPRESENTATIVE PFOTOGRAPH OF WE 1 LANDS TO BE LNI TACTED
BY PRODUCT.
c. IF DELINEATION WAS PERFORviED BY A CONSULTANT, INCLUDE ALL DATA
SHEE'i S RELEVANT TO T?IE PLArEMEtiT OF T-H-PDELIN"GATIOIN LL?i tE.
d. ATTACH A COPY OF THE STORIvIWATER MANAGEVEi NT PLAN IF REQLZRED.
(? e. 'WHAT IS LkND USE OF SURROUNDING PROPOERTY?
V
IF APPLICABLE. WHAT IS PROPOSED MEi""'T.-IOD OF SEWAGE DISPOSAL?
L
g. SIGNED Ai`+D DATED AGENT AlJTHORIZaTION LETTER, I" APPLICABLE. OV I
NOTE: WTLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
1) ISSUANCE OF A SECTION 404 CORPS OF ENGNEERS PEIPU-471,
2) E_TrER T'HE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CER. =ICATION, AND
3) (Ri THE TWENTY COASTAL COTJ=S ONLY), A LETTER FROM THE NORT:-i
CAROL-NA DIVISION OF COASTAL MANAGE'NfE.+ i STATNN'G TeriE PROPOSED
ACiTV 1 i Y IS CONSISTZ--N'TWITri T:-!E NORTH C AROLNA COASTAL.
MANNAGE:MEV7 PROGRAM.
xo"?-Lel, --
0 : R' S/AGENT'S SIG: TURE D ATE
(AGE:.NT"S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
TIC OWNER IS PROVIDED).

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DWQ ID: -J 1 L 2 4 9 CORPS ACTION ID:
NATION-WIDE P=41T REQUES ED (PROVIDE NATIONWIDE PERMIT T)
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRRE:
1) NO r!CA i SON TO -Cr!ECORPS OF F-NGi-iIEFRS
2) APPLICATION FOR SECTION 401 CER=CATION
3) COORDIINATMN «"17H TIC NC DIVISION OF COASTAL. 21ANAGEtiIE`+T
SEND THEE ORIGLN+AL rNV-D (1) COPY OF THIS COMPLETED FORM TO THE.kpp;ROPRIAT
FELD OFFICE OF THE OORPS OF E_`+GE EF.RS (SEE AGENCY ADDRESSES S'IE ). SEVEN
(7) COPIES MUST BE SENT TO THE NC DIVISION OF WATER
QUALITY AT•Ty • TOIL- DORNV-EY. 4401 REEDY CREEK ROAD.
RALEIGH. NC 27607. PLEASE PRINT OR TYPE.
OW-NER'S NAME:
2. y1:A..ILIi+G ADDRESS:
SUBDIVISIONNANIE
i;
CITY: D lL h a- STA ?" l ZIP CODE:
PROJECT LOCATION ADDRESS. INCLUDING SUBDIVISION NAME (IF D c1 ERE`T FROM
tiL4II iNG ADDRESS ABOVE,-. r°7 7Jo ` Iztll? •^•
"401 ISSUED"
3. TELcPHONE Nti`?tBER: (FiO??)? 9 i-v,?2? J NORK)
4. IF .?.PPLICABLE: AGE'NT'S NAME OR RESPONSIBLE. CORPORATE OFFICIAL, ADDRESS,
PHONE iNL i'y B cR:
NAnrahlqkA
h
5. LOCATION OF WORK (PROVIDE A NIAP. PREFERABLY A COP 'l OF USGS TOPOGRAPHIC
MAP OR.kaUkL. P HOTOGRAr"HY `v? =11-1 5-1-Al-E):
e
COU T'C: F1 %?SorL -Nc?RESTTGW;v`:? /??ti,v}-5 •?• C i
rn :E:
r-ri
o -z-?
SPECIFIC LOCATION (INCLUDE ROAD NL?IBERS, LANDMARKS, ECT.)
:10 //`f5
r fiU.h. 0 iL ?rz .. y' A f 5
6. IMPACTED OR NEAREST S T RE.??t/RNER: 6? e ?-s e r?/? (e
RIVER BASIii:--hetynie6Sec a- 0 5
'i a. IS PROJECT LOCATED NLAIR WA! ER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA),
NIGH QUALITY WATERS,IQW), OUTSTa.NDING R.ESOURSE WATERS (ORW), WATER _
SUPPLY (WS_I OR WS--M? YES ( X ) NO ( ) lFYES, EXpLA.IN:
7b. IS THE PROJECT LOCATED WITH-1V A i FORTH CAROLINA DIVISION OF COASTAL
NL\.vAGEtiiE`+T ARE A OF E`4 OZN M-l i AL CONCERN (AEC)? YES( ) NO (x )
7c. IF THE PROJECT IS LOCATED W`MHfN A COASTAL. COUNTY (SEE PAGE 7 FOR I T OF
COASTAL COUNTIES), WHAT IS THE LAND USE PL..N (LUP)_.DESIGN. 77ON?
ga. HAVE ANY SECTION 104 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? 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 PE.R?41T REQUESTS E--,TECiED FOR THIS PROPERTY INT'rID
Fu-FURE? YES( ) NO ()<) IF YES, DESCRIBE ANTICIPATED W ORK:
9a. ESTIMATED TOTAL NUMBERS OF ACRES INTRACT OF LAND: ?? A G ? c'
9b. ESTDIATED TOTAL NL`:'viBE.R. OF ACRES OF WEiL?'vDS LOCATED ON PROJECT SITE:
/V
IOa. NUyiBER OF ACRES OF `NEiL.kNDS UvIPACTED BY TIC PROPOSED PROJECT BY: NI A
FILLING.
FL00DLNG:
DRA.L?NAGE :
EXCAVATION:
OTHER :
TOTAL ACRES TO BE IMPACTED:
i
10b. (1) STREAM CH.?`+?iEL TO BE LtitPA=mD- BY THE PROPOSED PROJECT (IF n?
REI,.OC.1 cD, PROVIDE DISTANCE BOTH BEFORE A?TD AFTER RELOCATION:
LENGTH BE- FORE: FT AF ER: F-1
WIDTH BE: ORE (ba-scd on normal nigh water contours): F -1
AVERAGE DEPTH B E: ORE: F
(2) SiI2E.?:?t CFL c LViP.?CTS `,VII L r2ESLZT F ZOtit: (CHECK ALL THAT APPLY)
OPEN CF:AINNF- RELOCATION: PL-kC MENT OF PIPE IN CHAIYV EL; _ R
CHANNE EXC.-.VA70Ll : COONSiRUCTiON CF A DA.NWFLOODfNG.
OT:R: R/Y Lip nc,I.ii u? Sfiph:1 !-LATi v,_ `i l7 YT
U
11. IF CONS .RUC T ION OF A POND IS PROPOSED, WH.-?T IS THE SIZE OF Th--E WATERSHED
DRAII -DiG TO T r y POND? N 1 R WHAT IS THE EXP=-D-
POND SLRFACE AREA?
12. DISCTIPTiON OF PROPOSED WORK D, !CLUDIi iG DISCUSSION OF TYPE OF IIEC_HYICAL
EQLTIPtiiE:VT TO BE USED? (ATTACH PL -VNS; 31/2 3Y 1 I DRAW24GS ONLY)
Y) !11 e G h a rr t c a j a y= ?-n ba 126 iz
GtJO/-I? CYON? hV ?j/?I1?. P ?. C-f!/ e
C$.?R -?'JL (Jt?Cr 0'))01P U?
c< F-e r m(L-1
`).tt?1i"?a• a ?-zr)..?,Q, ?;`.)c??.,.vy'?"-tfl?.s+- ?.a.?i?zc_ cn.._a,. ??u:'? ??,iYw^,. n-?? ? filt.f?u.?..cu?. .
13. PURPOSE OF PROPOSED WORK: S ow P_ ,5 /D -W,
14. STATE REASONS tv;.^f IT IS BELIEVED it- 4T T'riIS ACTIVITY 1fCiST BE CARRIED OGT LV
WEiL..'4-DS (IIICLL'DE ANY ,'YIEASU;kES T.k:{F?t TO MD,,rU l= WE'TLALL\rD D- lPACTS)) -
115. YOU ARE REQUIRED TO CONTACT TdE US FISH AND WTr .DLIFE SERVICE AND/0R
NATIONAL N ARLINIE FISHERIES SERIVE REGr1RD LN THE PRESENCE OF rl`+Y FEDER.?L.Y
LIS TED OR PROPOSED FOR IIST LNG E-NDANGERED OR THPEkTENED SPECIES OR
CR 771CAL HABITAT IN TIHE PERMMIT AREA THAT MAY BE AFFFE 1ED BY TIC PROPOSED
PROJEC'i. DA r- CONTACTED: ?1" `
16. YOU ARE REQLu ED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDNG THE PRESENCE OF HISTORIC PROPERTIES IN = PERMIT AREA
WHICH ,,ti(AY B E AFFECTED B Y T tom. PROPOSED PROJECT. DA T E CONTAC T ED
17. DOES THE PROJECT L"4-/OLV c AtN E'fi'E`-Di FMRE OF PUBLIC FUi`-DS OT THE USE OF
PUBLIC (STATE) LAND? YES ( ) NO X-) (IF NO, GO TO 16) _
a. IF YES, DOES -i:-:E PROJECT REQUIlZE PREPERATION OF AN E-NVMONVfENTAL
DOCUNLENT PURUAI`1T TO THE REQUIlZEyfENTS OF TrIE NORTr- CAROLINA
ENVIRON'tly 1TAL POLICY ACT? YES( ) NO( )
b. IF YES, HAS THE DOCUMENT BEEN RaF=,WED T raOUGH THE NOR-1-r! CAROLINA
DEPARTVIE`1T OF ADtyfR4 -ISTRz`LTION STATE CLE- A.R "GHOUSE YES ( ) NO ( ) .
IF ANSWER i7b IS YES. THEN SUBMIT APPROPRLa E DOCLIVfE:tiiATIONFROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROL-NA E-NVIRONiI[ENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEA.R.I GROUSE REVIEW PROCESS SHOULD BE
DIRECTED TOMS. CH RYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT.OF ADMINISTRATION, 116 WEST JONES STKEMT, RkLE.iGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
13. THE- FOLLOWING IT=MS SHOULD BE INCLUDED WITH TMS APPLICATION lF PROPOSED
A 11 1 f INVOLVES THE DISCHARGE OF E:?CAVATED OF FELT MATERIAL INTO
w-? 1 L.-ups:
Syr !? a. WE-IL.-\,NDELINEATION NIA SHOWING ALL. WETLANDS, S UE-AMS, LAKES; AN-D
V PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NLNMERS 14, 18, 21, 26, 29,
AND 38). ALL S=-\IM (II,fTRM E: 1 AND PER2MAINF-NT) ON tHE PROPERTY
MUST BE SHOWN ON Tr>E W2. v1AP SCALES SHOLZ.D BE 1 RICH EQUALS ;0 FErT
J OF 1 INCH EQUALS l00 FEET OF THEIR EQLZVAL.E NT.
b. IF AVAIIABLE. REPRESENTATIVE PHOTOGRAPH OF W`E T LAi-DS TO BE INMACT D
BY PRODUCT.
i11 c. IF D T kTION WAS PERFORMED BY A CONSULTANT, D CLUDE ALL DATA
IY SHE,:="1S RE =vAINT, TO TIm- PL6LCENfE3N1T OF TFIE DELINEATION LNE.
d. ATTACH A COP Y OF THE STOR11fl.VA-lER MANAGENIENT PLAN IF REQUIRED.
e. WHAT IS LAND USE OF SURROUNDING PROPOERTY?
N/A
a. Ai)?LICAB I_E. W:-AT IS PROPOSED tiLETHOD OF SEWAGE DISPOSAL?
c
SIGNED AIND DATED ACE`iT AUTHORIZ-TION LEI 1I'r APPLICABLE. ,V I
NOTE: WTL ANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
1) ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PE.R, IT,
2) ErTH R THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3) (Iii THE TWENTY COASTAL COUNTIES ONLY), A LE I MR FROM THE NORTH
CAROLINA DIVISION OF COASTAL. MANAGEMENT STATING THE PROPOSED
AC T l=IS CONSIS Z-,4 ' `,VT, H T,iE(OR-i F.1-AROI T"NA COAST.kL. -
MANAGE_'4TN+ T PRCGR?,Vt,
i '
OWNER'S/AG?ti-I"S SICK TuL DATE
(AGENT'S SICNATLR-E V?-LM 01-+ZY
IF AU HORIZ.-?TION LETirR FROM
TIC OWNER IS PROVIDED).

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