19960616 Ver 1_Complete File_19960711

State of North Carolina IT1
j Department of Environment, LTMMAI
Health and Natural Resources 1 • •
Division of Water Quality
Ja m es B. Hunt, J r., Governo r
Jonathan B. . Howes, Secretary I FE N F1
A. Preston Howard, Jr., P.E., Dire cto r
July 11, 1996
Onslow County
DWQ Project # 960616
APPROVAL of 401 Water Quality Certification and ADDITIONAL CONDITIONS
Mr. David E. Weaver
3001 New Hope Road
LaGrange, NC 28551
Dear Mr. Weaver.
You have our approval to place fill material in 0.03 acres of wetlands or waters for the purpose of
constructing a residence at Lot 82, Chadwick Shores subdivision, as you described in your application dated
26 June 1996. After reviewing your application, we have decided that this fill is covered by General Water
Quality Certification Number 2733. This certification allows you to use Nationwide Permit Number 18
when it is issued by the Corps of Engineers.
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 this
approval to be valid, you must follow the conditions listed in the attached certification. A deed restriction
shall be placed on the property to prevent fill of the remaining wetlands. In addition, you should get any
other federal, state or local permits before you go ahead with your project.
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 919-733-1786.
Sincerely,
e on HoD,,r. .
AS A-]
At tachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Wilmington Field Office
Wilmington DWQ Regional Office
Mr. John Dorney
Central Files
960616.1tr
Division of Water Ouality • Environmental Sciences Branch
Environmental Sciences Branch, 4401 Reedy Creek Rd., Raleigh, NC 27607 Telephone [phone] FAX # [phone]
An Equal Opportunity Aff irmative Action Employer • 50% recycled/10% post consumer paper

RECEIVED
JUN 2 71996
ENVIRONMENTAL SCIENCES
.. III
David E. Weaver
3001 New Hope Road
La Grange, NC 28551
John Dorney
Division of Environmental Management
N.C. Department of Environment, Health
4410 Reedy Creek Road
Raleigh, NC 27607
Dear Mr. Dorney:
401 ISSUED
June 26, 1996
and Natural Resources
Enclosed are copies of an application to the U. S. Army
Corps of Engineers for a permit to fill or cover a small
area of wetlands. I have drawn the proposed fill areas on a
map of the lot on which we are constructing our personal
residence.
The lot is located in a residential subdivision known
as Chadwick Shores which is between Sneads Ferry, NC and
U.S. 210 to the northern access to Topsail Island in Onslow
County. Additional directions are on the permit
application.
Ms. Janet Russell of the Wilmington CAMA Office has
been to the property when issuing a walkway and dock permit.
If additional information is needed, please let me
know. Thanks for your consideration of this permit
application.
David E. Weaver
. . w -"*
Y?4
401 ISSUED
DEM ID: CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #):
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1) NOTIFICATION TO TEZ CORPS OF ENGINEERS
2) APPLICATION FOR SZCTION 401 CERTIFICATION
3) COORDINATION WITH THE NC DIVISION OF COASTAL bnwAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COLLETED 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 : -Dl-? 1) /c/ r 4?0e'q ye- r
2. MAILING ADDRESS: go ?e w ??o,2c, Rc/ ?'? LW-
SUBDIVISION NAME:
CITY: STATE:
PROJECT LOCATION ADDRESS, INCLUDING SUBD
MAILING ADDRESS ABOVE) : kbi 22, , ('
ZIP CODE:
,v . c
151'
SI)ON NAME (I/T DIFFERENTL
r/, t1J t r 1. 'g 17 0 V C S ?CA f
3. TELEPHONE NUMBER (HOME) : cJ/? 'a0 y? (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 TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY : NEAREST TOWN OR CITY: 1-11
l???rv N1

-1 -

1? 4" •
SPECIFIC LOCATION (INCLUDE ROAD
NUMBERS, LANDMARKS, ETC.): ?C ?? f? ?' ?f? laaC r tJ c ?? S?Z c c s o r / -? u
1-716 U Sc' A-,' koz? Fl is Nc?.?, dtY? 78S' OA A u-,e
P d (see
I c l /te• rr C N. d &ia
sQ
6. IMPACTED O NEARES STREAM/RIVER: _ & II/h/ d ("-r tc
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-I OR WS-II)? YES QK] NO [ ] IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES x NO [ ]
7c. IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR
LIST OF COASTAL COUNTIES)-,N WHAT IS THE LAND USE PLAN (LUP) DESIGNATION?
P'?S; c'")I-A /
{
Sa. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES [Xj NO [ ] IF YES, PROVIDE ACTION I.D. NUMBER OF
PREVIOUS PERMIT ANDfY? ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION) : 122/3 062,3 1 bDo,,c h, Drrviu?rs Ouu.jeY)
8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES [ J NO [ IF YES, DESCRIBE ANTICIPATED WORK:
1
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND: k e5S )4erc
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:

2

10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: EXCAVATION: '/k/q
FLOODING: OTHER:
DRAINAGE:
TOTAL ACRES TO BE Il4PACTED:
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION):
LENGTH BEFORE: X.), 0 FT AFTER: FT
WIDTH BEFORE (based on normal high water contours): FT
WIDTH AFTER: FT
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 EXCAVATION: .\ CONSTRUCTION OF A DAM/FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE
WATERSHED DRAINING TO THE POND? ?/91
WHAT IS THE EXPECTED POND SURFACE AREA? It-, - d}
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DRAWINGS
ONLY) :
o yr C !a.vC' re
V` C S ci/t ?J G
<'.y ?v??.?,'c' e
13. PURPOSE OF PROPOSED WORK: 10 DyO u clc P AI
u s c o /7714-cr e - /I AJ & 0 /h l l.seao ogye i4 ,A,'
Csr cltAJr'c .
3
Y. 6 4
f?
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED
OUT IN WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND
IMPACTS):
D e e Cl - ra t ?Y r a .vs _ _ _'? u u_/ c- /4- S`d -z--

Oi lit 0 7e S, rte-,G/,r
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 CRITICAL HABITAT
IN THE PERMIT AREA THAT MAY BE FFEC ED BY THE PROPOSED PROJECT. DATE
CONTACTED: - J - -Q 7-1,20A-'s G (ATTACH RESPONSES
FROM THESE AGENCIES.) w - S Nc ccsSlLyY) C ijp / I/ ;71
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 ROPOSED
PROJECT. DATE CONTACTED: - (n-/C1 -R6 r?CJo ve"',"'utoc nr,?cc n,cv c ?.
ilicr would r?crr?e ,? hpr Y-4,0-4" Cs'
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 (I NO [ ]
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].
4

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 STORMWATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT IS LAN']D USE OF SURROUNDING PROPERTY?
?cS , ?o J / j 4 1
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?

g. SIGNED AND DATED 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 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/ S SIGNATURE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED (18g.))
DATE
5
05-17-1996 09:00AM
LEGEND:
EIS = EXISTING IRON STAKE
EIP = EXISTING IRON PIPE
NIS = NEW IRON STAKE
R/W RIGHT-OF-WAY
I CENTERLINE
REFERENCE:
LOT 82, BLOCK A
M.B. 19, PG. 76
S
LIMIT OF A04 WETLANDS
SEE NOTE 1
\ ,.rte~qap F(/
\ C"
FAti M CR
h/FN Fk
1 Qv q F
S wR yi
EIP 6 , 018"F? cti cy
9 66' £ F's q?aR
10.00? ?t'Ql 4^'F
3.00' _ ? E'P \ \
0 9.. EIP J
_ Fn o pvsc d
00i// afr1q
Ppp r o X 60'XAOI
or 1,&oo s8 P,
0.67 ACRES
LOT 81
NOTES:
1) ALL 404 WETLANDS INFORMATION
WAS PLOTTED FROM A MAP ENTITLED
WETLANDS SURVEY SHOWING PROPERTY
OF F. WILLIAM METCALF' PREPARED BY
BARDEN LANIER, R.L.S., DATED 12/02/91
AND REVISED 12/12/91. CONTACT U.S.
ARMY CORPS OF ENGINEERS FOR
CURRENT STATUS ON VALIDITY OF LINES.
S 49'42'46" W
5.02'
1

C1-IADWIC
K
F:1 DU Jb W I I IEIS
-- S 39'58'22" E 30.00' R/W
-" 225.00' TO ? COVE COURT
PER M.B. 19. PG. 76
-4 r
-?'- - -
Rw---1?? HONES URIVE
"?•?11, CARp'?•
SItAL i
C l-ilia ;
p0,? SURVy.k
•• ....•.
•
S. ••
'•
a?
FROM QUADRANT SURVEYING INC PA TO
60' R/W
- R/W_
PHYSICAL S U R VE-Y RATIO OF PRECISION 1:10,000.
THIS IS TO CERTIFY THAT THIS MAP IS A TRUE THE HEREON AS ACOMPIL BY AN AL SURVEY OF
THE PREMISES AND TWAT THERE ARE NO
ENCROACHMENTS ACCORDING TO THE BEST OF
MY KNOWLEDGE (EXCEPT AS MOWN).
I"AP IS NOT PREPARED FOR RECORDINC.
S?/t /94
DOMINICK S. BUTCH, R.L.S., L-2713
LOT 82, BLOCK A
CHADWICK SHORE
STUMP SOUND TOWNSHIP
ONSLOW COUNTY N.C.
SURVEY FOR DAVID E. WEAVED AND
_1MFE MARGARET 8. WEAVER
QUADRANT SURVEYING, INC.,P.A. SCALE 1w = 50' DATE s 17 as
106 MARINE BLVD. F.B. visc
JACKSONVILLE,
206 N.C. 28540 FILE NO. 82A-CS 960506
919-346-2067
4554440 P.01
SITE-7
CHADWICK SHORES DR
CHADWICK SHORES OR
' VICINITY SKETCH '
( NOT TO SCALE )
TOTAL P.01
t

FULLARD CREEK
m
I ?
V
I ?
I 4b
I f17 ?I
I p6l
LINE DI ON DISTANCE
Tt 53'24 JOE 27.52
72 N 36 30.90
T3 230 Z E 24.02
T S80' 24 2278
T5 SS 6 35.83
T5 S527554 30.84
T7 N743 1 14.50
T8 N 8W56 57 E 13.10
Tg 34'2030 9.D8
0 N 33' S1 3231
T11 51 16.28
2 21 02
3 23.08
7 2 t 18
a 21 x4.25
5 1 3 20.84
T17 44 4a 34.08
TW a 2276 48 35.42
TITLE REF.
O.S. 800 P. 211
M.B. 19 P. 76
SL- 1728
CHADWICK SHORES
EIS ON EDGE
OF MARSH
I1/.
225'

THIS PLAT ACCURATELY DEPICS THE BOUNDARY OF JURISDICTION UNDER SECTION 404 OF THE
CLEAN WATER ACT, AS IT WOULD BE DETERMINED BY USING THE 1987 'FEDERAL MANUAL FOR
IDENTIFYING AND DEUNEA71NG JURISDICTIONAL WETLANDS'. UNLESS THERE IS A CHANGE IN THE
LAW OR OUR PUBLISHED REGULATIONS, THIS DETERMINATION OF THE LIMITS OF SECTION 404
JURISDICTION MAY BE RELIED UPON FOR A PERIOD NOT TO EXCEED THREE YEARS FROM THIS DATE.
DATE
LOT 80
X15
404 WETLAND
BOUNDARY
(DEC. 1991)
/2
37-l
LOT 81
D.B. 800 P. 211
- 0 /__)? I C;1 /I/ 61.. -
gUFRVE`I T",e LIN6
CERTIFICATE OF SURVEY AND ACCURACY
EIS ON EDGE I, BARDEN LANIER CERTIFY THAT PHIS MAP WAS
OF MARSH DRAWN UNDER MY DIRECTION ANd SUPERVISION
FROM AN ACTUAL SURVEY OF LAND; THAT THE
ERROR OF CLOSURE AS CALCULATED BY LATITUDES
AND DEPARTURES 1S 1:10,000+ WITNESS MY
NAND AND SEAL THIS THE 3RD DAY OF DCT08ERI
1991
ABARDEN LAMER, j I L-1223
/14
/13
p 1 17
11 A
NORTH CAROLINA
COUNTY
I. NOTARY PUBLIC OF THE COUNTY A
C
AFORESAID, CERTIFY THAT •
e v
PERSONALLY APPEARED BEFORE E ON THIS
DAY AND ACKNOWLEDGED THE EXECUTION OF
THE FOREGOING INSTRUMENT.
5 WITNESS MY HAND AND 0F?1CIA STAMP OR
THIS / Z DAYOF,
r
!''
JJ
AD 1992.
SEALL..
,
'
.
/
?

/6 NOTARY PUBLIC •'?j/
MY COMMISSION EXPWf?
NOTARY
f7 P
1
loflD
LOT 83 o,0
,
.•u

LOT 82 ?nun„?
D.B. 800 P. 211
EIS L-7927' 5.00' EIS au.u?
Rm884.46' S50'01138'W S50'01'38"W
CHADW I CK SHORES DRIVE 60' R/W
SIGNATURE
TITLE
LEGEND:
• EIS = EXISTING IRON STAKE
= ACTUAL SURVEYED LINES
- - = LINES PLOTTED FROM MAP
OF RECORD
• # SET HUB k TACK
GRAPHIC SCALE
60 0 30 60 120
( IN FEET )
1 INCH = 60 ft.
WETLANDS SURVEY
SHOW 14G PROPERTY OF
F. WILLIAM M ETCALF
STUMP SOUND TWP., ONSLOW COUNTY, N.C.
BARDEN LANIER AND ASSOCIATES
LAND SURVEYING-LAND PLANNING-MAPPING
239 NEW BRIDGE STREET
JACKSONVILLE N.C. 28540
PHONE: [phone]
DECEMBER 2, 1991 (REV.) DEC. 12, 199.1
SCALE 1' - 60'
F.B. 356 P. 77,79-81
JOB NO. 914605
4
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DEM ID: ACTION ID:
Nationwide Permit Requested (Provide Nationwide Permit #): ze
JOINT FORM FOR
Nationwide permits that require notification to the Corps of Engineers
Nationwide permits that require application for Section 401 certification
WILMINGTON DISTRICT ENGINEER
CORPS OF ENGINEERS
DEPARTMENT OF THE ARMY
P.O. Box 1890
Wilmington, NC 28402-1890
ATTN:• CESAW-CO-E
Telephone [phone]
WATER QUALITY PLANNING
DIVISION OF ENVIRONMENTAL MANAGEMENT
NC DEPARTMENT OF ENVIRONMENT, HEALTH,
AND NATURAL RESOURCES
P.O. Box 29535
Raleigh, NC 27626-0535
ATTN: MR. JOHN DORNEY
Telephone [phone]
ONE (1) COPY OF THIS COMPLETED APPLICATION SHOULD BE SENT TO THE CORPS OF ENGINEERS.
SEVEN (7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT.
PLEASE PRINT.
1. Owners Name: Ae U ?'Jec- Z/ GG :%o10w-
2. Owners Address: ,max ?o y?7 C?c ref, Cif Ile,
3. Owners Phone Number (Home): 0/0 - 30? S - 33,7'?v (Work):
4. If Applicable: Agent's name or responsible corporate official, address, phone number:
5. Location of work (MUST ATTACH MAP). County: QNSGycJ
Nearest Town or City: J'Cex K, rr
Specific Location (Include road numbers, landmarks, etc..): LDr/'?? ?L,OC,?
?OU?JU ?6'1/LrLan.r,.r?V / 1 /?p?C /?I?.S,o; G S'.OG? Ale-
40 e?,J ices Ls: C r- e7.5- o-Z,:::;l 4, %s. - l
6. Name of Closest Stream/River: S/ /h_f?
7. River Basin: Ci?.Os OAP
i
8. Is this project located in a watershed classified as Trou4 9S
9. Have any Section 404
If yes, explain.
10. Estimated total number of acres of waters of the U.S., including wetlands, located on project site:
11. Number of acres of waters of the U.S., including wetlands, impacted by the proposed project:
Filled: /7- A a S
i
Drained:
Flooded:
Excavated:
Total Impacted:
I, or WS H? YES 4 NO [ ]
been previously requested for use on this property? YES [ J NO
.</?'? '°r
?T 3s"?3s
A

12. Description of proposed work (Attach PLANS-8 1/2" X 11" drawings only): 4al
./r.
6C7/DA) 4 G'? /l rA) S??/r1 aiv:f L ci!1 4,
t14 -C 564
13. Purpose of proposed work: v c o7o I Q e a iN b?o? ?"? o zx rla 0 c-4 .
X- ?jr
14. State reasons why the applicant believes that this activity must be carried out Z wetlands. Also, note measures
taken to minimize wetland impacts. ?u "'
/,s ,0 S?aDLG i?id 7- JZx A7el ?eNr' ty s+7.sr -.e I D.". •??G,?:N? 7J?ir
15. You are required to contact the U.S. Fish and Wildlife Service (USFWS) and/or National Marine,Fisheries Service
(NMFS) regarding the presence or 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. Have you done so? YESX NO [ ]
RESPONSES FROM THE USFWS AND/OR NMFS SHOULD BE FORWARDED TO CORPS.
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? Have you done so? YESX NO [ ]
RESPONSE FROM THE SHPO SHOULD BE FORWARDED TO CORPS.
17. Additional information required by DEM:
A. Wetland delineation map showing all wetlands, streams, and lakes on the property.
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. If a stormwater management plan is required for this project, attach copy.
E. What is land use of surrounding property? 1,el Volt ' 6--
R If applicable, what is proposed method of sewage disposal?
? CU
Owner's Signature Date

11 bl' 1' 23'SE

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