20011177 Ver 1_COMPLETE FILE_20010802

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Michael F. Easley
Governor
William G. Ross, Jr., Secretary
Department of Environment and Natural Resources
Gregory J. Thorpe, Ph.D.
Division of Water Quality
September 21, 2001
Stephen M. Whitley
PO Box 285
Norwood, NC 28128
Subject:
Lake Bottom Excavation
Stanly County
DWQ# 011177
APPROVAL OF 401 Water Quality Certification
Dear Mr. Whitley,

You have our approval, in accordance with the attached conditions and those listed below, to excavate approximately 0.05 acres of lake
bottom on Lake Tillery in the Yadkin-Pee Dee River Basin, Stanly County based on your revised application dated September 15, 2001.
After reviewing your application, we have decided that this activity is covered by General Water Quality Certification Numbers 3280. This
certification allows you to use General Permit Number 30 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. 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 revised application except as modified below. 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). This approval shall expire when the corresponding Nationwide Permit expires or as otherwise provided in the General
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. 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 Domey at 919-733-9646.
Since
/.?
Gregory J. T rpe, PhAttachment

North Carolina Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mal Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (t-ocation)
nAn 7 4?oc /a.--- N n+n ?4. C&07 14--% .....Mwa...,,, ....i.........a.....?..i

Michael F. Easley
Governor
William G. Ross,Jr.Secretary
Department of Environment and Natural Resources
Kerr T. Stevens
Division of Water Quality
13 Z?
D # 0 -1-
JY\ VA County
Dear Mr.
On the Div' on of Water Quality (DWQ) wa ofified by receipt of our
applications regarding your plan to for the purpose of in
County. Approval from DWQ is required to disturb these . Please provide seven c-02-
of the following information and refer to the DWQ # listed above in your reply. In particular as described in
15A NCAC 2B .0502, we will require you to I rty. Please show
these on maps of suitable scale (for instance 1" = 100 t) so we can begin to determine your projects'
compliance with 15A NCAC 21-1.0500.
Please call me at [phone] if you have any que lions or would require copies of our rules or
procedural materials. This project will remain on hold as inc mplete in accordance with 15A NCAC 2H
.0505(c). The processlg time for this application will begin Min this information is received. If we do not
hear from you by writing within three (3) weeks we will assume y u no longer want to pursue the project and
will consider it withdrawn.

Sincerely,
1 C+.
?s
John R. Dorney
e
`qL ??
Cc:? DWQ Regional Office -
k Corps of Engineers
File Co v
. PY
Central Files
?T-6 N
Division of Water Quality 1650 Mad Service Center Raleigh, NC 27699-1650
Wetlands/401 Unit: [phone]
Fax: [phone]
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Michael F. Easley
Governor
William G. Ross, Jr., Secretary
Department of Environment and Natural Resources
Gregory J. Thorpe, Ph.D.
Division of Water Quality
September 21, 2001
Stephen M. Whitley
PO Box 285
Norwood, NC 28128
Subject:
Lake Bottom Excavation
Stanly County
DWQ# 011177
APPROVAL OF 401 Water Quality Certification
Dear Mr. Whitley,
You have our approval, in accordance with the attached conditions and those listed below, to excavate approximately 0.05 acres of lake
bottom on Lake Tillery in the Yadkin-Pee Dee River Basin, Stanly County based on your revised application dated September 15, 2001.
After reviewing your application, we have decided that this activity is covered by General Water Quality Certification Numbers 3280. This
certification allows you to use General Permit Number 30 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. 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 revised application except as modified below. 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). This approval shall expire when the corresponding Nationwide Permit expires or as otherwise provided in the General
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. 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 Domey at 919-733-9646.
Sinjc?e
?
l 06 Vrpe, A /.?
Gregory J. T PhAtta
chment
- -cc: Corps of Engineers Asheville Feld Office
Mooresville DWQ Regional Office
File copy
North Carolina Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mal Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
nin 700 4700 1..6......% n4n ?+c ecn? 1{....\ L."-11 .n....... w+n L.........J........+q... A. I
September 15, 2001
Mr. Todd St. John
Wetlands Unit- Parkview Bldg.
2321 Crabtree Blvd.
Raleigh, NC 27604
Re: DWQ-011177
Dear Mr. St. John:
Pursuant to my telephone conversation with Mr. John Dorney on September 14, 2001, I am
forwarding for your consideration the following:
1. Copy of the approval letter by the U.S. Army Corps of Engineers
2. Physical survey for my property
3. Copy of map from plat book of Stanly County (my property is lined in red)
4. Map of Town of Norwoods' new water and sewer lines (my property is located at the
#20 manhole site)
5. Self-addressed stamped envelope
The construction company, which installed the towns' new water and sewer lines, allowed for two
years an abnormal amount of silt to be discharged into the cove adjoining my property. This was
a result of no filter fabric being installed to contain the erosion.
Mr. Dwight Smith, town manager for Norwood, who shared with me this map, has informed me
of his intention to help with the cost of this project. Whether or not this bears fruition, the cove
needs cleaning as walking in the cove finds one burrowing well up ones legs in soft silt.
I would also like to make it clear that I have no intentions of deepening or widening the cove.
I wish only to clean the cove area that adjoins my property, which is approximately 1800 sq. ft.
There are two lots between my property and the main channel. These areas will not be disturbed.
The water level is to be lowered beginning September 22, 2001 and is to be down approximately
ten days for maintenance to the Lake Tillery Dam. I hope to have the work completed during this
time.
Anything you can do to help with this project will be greatly appreciated.
Sincerely yours,
Stephen M. Whitley ?y
PO Box 285
Norwood, NC 28128
704-474-3246
enclosures 5
US RRMY CORPS.'ENGRS ID :18282714858 SEP 14'01 14:30 No .003 P . C2

U.S. ARMY CORPS OF FNGINEERS
WILMINGTON DISTRICT
Action Id. 200131192 County Stanly_ Quad MOUNT GILEAD WEST
GENERAL PERMIT (REGIONAL AND NA'T'IONWIDE) VERiFTCXrInN
Property owner: Stephen M. Whitley
Address: PO Box 285
Norwood, NC 28128
Telephone No: 704 474-3246
Zone: 17 UTM or LAT/LONG: North: 3897458 Last: 581583
Size and Location of project (water body, road natne/number, town, etc.) on Lake Tillery near Norwood, Stanly
County, North Carolina
Description of Activity: Excavate approximately 148 cubic yards of accumulated sediment from approximately
2,000 SF of open water on Lake Tillery for recreational use. Maximum area dimensions are 100 ft long, 20 ft wide
and 2 ti' deep.
Applicable Law: _X Section 404 (Clean Water Act, 33 U.S.C. 1344)
(chock all that apply) Section 10 (River and Ilarbors Act of 1899)
Authorization: 198200030 Regional General Permit Number
Your work is authorized by this Regional Gcneral (RGP) or Nationwide Permit (NWP) provided it is accomplished in
strict accordance with the attached conditions and your submitted plans. If your activity is subject to Section 404 (if
Section 404 block above is checked), before beginning work you must also receive a Scclion 401 water quality
certification from the N.C. Division of Environmemal Management, telephone [phone]. For any activity within
the twenty coastal counties, before beginning work you must contact the N.C. Division of Coastal Management, "
telephone [phone].
Please read and carefully comply with the atrachod conditions of the RGP or NWP. Any violation of the conditions of
the RGP or the NWP referenced above may subject the permittee to a stop work order, a restoration order, and/or
appropriato legal action.
This Department of the Army R.GP or NWP verifinition does not relieve the permittee of the responsibility to obtain
any other required Federal, Stale, or local approvalxlpermitsA ltc permittee may need to contact appropriate State and
local agencies before beginning work.
If there are any questions regarding this authorization or any of the conditions of the General Permit or Nationwide
Permit, please contact the Corps Regulatory Official specified hclow.
Date: September 14, 2001
Corps Regulatory Official: Stephen D. Chapin Telephone No.; [phone]
Expiration Date of Verification: 31 Decpmber 2004
SURVEY PLATS, MELD SKETCH, WETLAND DELIM :A-DON FORMS, PROJECT PLANS, ETC., MUST BE
A'1TACFIED TO THE FILL COPY OF THIS FORM,1FREQtl1RFT> OR AVAILABLE.
CHSAW Foryn $91
Rsvlaed.hity 1995
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Stephen Whittley
Post Office Box 285
Norwood, NC 28128
Dear Mr. Whittley:
August 21, 2001
DWQ # 011177
Stanly County
On August 2, 2001 the Division of Water Quality (DWQ) was notified by receipt of your applications regarding your plan to
dredge a portion of Lake Tillary for the purpose of deepening the water at your lot in Acorn Acres s/d in Stanly County. Approval from
DWQ is required to disturb these waters. Please provide seven copies of the following information and refer to the DWQ # listed above
in your reply. In particular as described in 15A NCAC 2B .0502, we will require you provide a map which depicts the location of the
dredging as well as the area of the dredging. Please show these on maps of suitable scale (for instance 1" =100 feet) so we can begin
to determine your projects' compliance with 15A NCAC 2H .0500.
Please call Cynthia Van Der Wiele 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.
pDorney
Cc: Mooresville DWQ Regional Office
Asheville Corps of Engineers
File Copy
Central Files
Wetlands/401 Unit 1650 Mail Service Center Raleigh, NC 27699-1650 Ph: [phone] Fax: [phone]
rvucnaei r. r-asiey, uovernor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Gregory J. Thorpe, Ph.D.
Acting Director
Division of Water Quality
tG'C3Et
Customer Service
1 800 623-7748

MUST BE SENT TO THE NC DIVISION OF WATER QUALITY, ATTN: JOHN DORNEY, 4401 REEDY
CREEK ROAD, RALEIGH, NC 27607. PLEASE PRINT OR TYPE.
1. OWNERS NAME: f7c-lp H fA) 11h, tv H TL L ?I
2. MAILING ADDRESS:
SUBDIVISION NAME : 14 d e ? lrR-e-r
CITY: N-a d STATE: Old L ZIP CODE: 2-f 2
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
DWQ ID; .. O 1 7 7 CORPS ACTION ID:
N!TIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT
PRE-CONSTRUCTION NOTIFICATION APPLICATION
.?, FOIgNATION?ME,PERM[ITS THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION TO NC DIV. OF WATER QUALITY FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
r? y ,
?StD THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
o OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN (7) COPIES
MAILING ADDRESS ABOVE):
TELEPHONE NUMBER: (HOME) 70 L- '? 7 - 3 2 f, (WORK) 70 `F R S 3 -S-18 G.
4. IF APPLICABLE: AGENTS NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER: ^`l'4
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: S7-- &-,-I NEAREST TOWN: l?/02 k o 0_6
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ETC.)
?!,'? e-n i,r l oc fr rc-? o N T r €.?c-? d /=o,e
6. IldPACTED OR NEAREST
Y ? #
RIVER BASIN: 0 F)? E-r- R/ ? ETA- t
P/I ? ,, Av
?g4tD

7. (a) 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,,V, IF YES, EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES NO _Z_
(c) 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? A'/R
8. (a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES NO )4, IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS
PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES NO A IF YES, DESCRIBE ANTICIPATED WORK:
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND:
(b) ESTIMATED TOE L NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: .vo NE EXCAVATION: A.- c -
FLOODING: do 4 r OTHER
? IV-6-
DRAINAGE:- /ya -C TOTAL ACRES TO BE IMPACTED: ti'O A'C_
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED, )v/ff-
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: FT AFTER: FT
WIDTH BEFORE (based on normal high water contours): FT
AVERAGE DEPTH BEFORE: FT AFTER: FT
(b) (2) STREAM CHANNEL IMPACTS WELL RESULT FROM: (CHECK ALL THAT APPLY) Allq
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL:
CHANNEL EXCAVATION: CONSTRUCTION OF A DAM/FLOODING:
2
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? 4//,4
WHAT IS THE EXPECTED POND SURFACE AREA? 4111f
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 11 DRAWINGS ONLY)
c- na vc- ,r4 7 Ak ' Co,lf7W4iCr1ov
0 ? lY^y- TC? ?' ?b?'?L?- ?. /n'ETS f?G1 TftE" Gl?i 0 re ?,Qs;,rcD ,
14.
STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDJE ANY MEASURES TAKEN TO bIINII = WETLAND ZIPACTS)

15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE 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: :nl-A
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED: ,- 4
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS O'R THE USE OF
PUBLIC (STATE) LAND? YES ( ) 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( ) NO( ) N?
(b) IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE? YES ( ) NO
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT. w?
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].
3
r4
13. PURPOSE OF PROPOSED WORK: A1= Ge9-,o9-Ti` Y/

18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL MATERIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LADS, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26, 29, -
AND 38). ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST
BE SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OF 1
INCH EQUALS 100 FEET OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE. N,w
(d) ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED. A/
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY? ,f kR ? T! -
(fl IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? " I^
(g) SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
(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/AGENTS SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY IF AUTHORIZATION LETTER FROM THE OWNER IS
PROVIDED).
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DWQ m: 011177-
CORPS ACTION m
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #)
-? PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOICNATION E.PERMITS THAT REQUIRE:
THE CORPS ATER QUA ALITY FOR SECTION 401 CERTIFICATION
`' APPLICATION TO N
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
MUST BE SENT TO THE NC DIVISION OF WATER QUALITY, ATTN: JOHN DORNEY, 4401 REEDY
CREEK ROAD, RALEIGH, NC 27607. PLEASE PRINT OR TYPE.
117, t? H I TL
1. OWNER'S NAME:
2. MAILING ADDRESS: ,? • e A 1 Z 9.5- A'e 21),
?
SUBDIVISION NAME: /dz B ,? A Rcs
CITY: NQ K ?J 4 o h STATE: Af C- ZIP CODE: 2-9 /Z.
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
3. TELEPHONE NUMBER: (HOME) '0 -'f 7 - 3 Z E, (WORK) 70 8 3
7. (a) 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-In? YES NO X IF YES, EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES NO
(c) 7 THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION? N /R
8. (a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES NO )e- IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS
PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES NO A IF YES, DESCRIBE ANTICIPATED WORK:
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND:
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
10. (a) NUMBER OF ACRES OF WETLANDS MIPACTED BY THE PROPOSED PROJECT BY:
FILLING: No NE
FLOODING: a 4
EXCAVATION: A-1c
OTHER : .tn u
DRAINAGE: /ye N t -,TOTAL ACRES TO BE IMPACTED: "A,16-
(b) (1) STREAM CHANNEL To BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION: -
LENGTH BEFORE:--- F-T AFTER: FT
AFT
WIDTH BEFORE (based on normal high `water contours):
.AVERAGE DEPTH BEFORE -._ ,. . _. --FT AFTER:
(b) (2) STREAM CHANNEL, RAPACTS WILL RESULT FROM:'(CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: - - =- M PLACEMENT OF PIPE IN CHANNEL:
- _ .:.:.CH[ANNEL EXCAVATION: CONSTRUCTION OF A DAM/FLOODING:
OTHER:
r .
T
2
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? 4114
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 11 DRAWINGS ONLY)
A-21 ra vc s??r ?.ev Gyve c. .? ?JI ? y 72-t- coN fr,26,cr<v.?
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUD ANY MEASURES TAKEN TO IvIINIMME WETLAND IMPACTS)
?Ez?E7YTio ??A-? /.i ? QC?A2i rte
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL N ARINE FISHERIES SERVICE 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:
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) 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 O'RTHE USE OF
PUBLIC (STATE) LAND? YES ( ) 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 ( ) NO ( ) N?
(b) IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE -CLEARINGHOUSE? -YES wj NO ( )
- -
i1-
IT 7?-
IF ANSWER 17b IS YES,-THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TOMS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH,."'',
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
3 -
13. PURPOSE OF PROPOSED WORK:
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WTIH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF 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 STREAM (INTER IITTENT AND PERMANENT) ON THE PROPERTY MUST
BE SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS SO FEET OF I
INCH EQUALS 100 FEET OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE. Ark
(d) ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY?,(k.,ej-,j 7-/e ?/•4 rr l ?zs/?1 ?T1?'L-:
(T) IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? Ail#
(g) SIGNED APED DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US 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 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'IHE NORTH CAROLINA COASTAL MANAGEMENT
PROGRAM
- - OWNS S/AGE 1 SI_ . -A_TURE . DATE :.
(AGENTS SIGNATURE VALID ONLY IF .AUTHORIZATION LETTER FROM THE OWNER IS
PROVIDED).
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