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HomeMy WebLinkAbout19960603 Ver 1_Complete File_19960624State of North Carolina Department of Environment, Health and Natural Resources Division of Water Quality James B. Hunt,Jr., Governor Jonathan B. Howes, Secretary A. Preston Howard, Jr., P.E., Directo r APPROVAL of 401 Water Quality Certification Mr. Danny Tolar N.C. Dept. of Transportation P.O: Box 3279 Asheville,-- NC 28802 M1.9MA,'T 0 10 A&41 ?EHNF? July 11, 1996 Buncombe County DWQ Project# 960603 Dear A4r. Tolar: You have our approval to place fill material in 0.01 acres of wetlands or waters for the purpose of improving SR 2726, as you described in your application dated 6 June 1996. After reviewing your application, we have decided that this fill is covered by General Water Quality Certification Number 2735. This certification allows you to use General Permit Number 031 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. 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 ,homing. 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 revigw 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, Atu cc' Air .1tf chment Wilmington District Corps of Engineers Corps of Engin4ers Asheville Field Office Asheville DWQ Regional Office Mr. John Domey Central Files r, '.E. 960603.1tr Division of Water Quality Environmental Sciences Branch Environmental Sciences Branch, 4401 Reedy Greek Rd.,' Raleigh, NC 27607 Telephone 919-733-1786 FAX # 733-9959 An Equal Oppo unity Affirmative Action Employer 50% recycled/10% post consumer paper R`, P.O. Box 32? P.O O :R Asheville, N.C. 96 Q June 6, 1996 Mr. David Baker U.S. Army Corp of Engineers Regulatory Field Office 151 Patton Ave. Rm. 143 Asheville, NBC. 28801-5006 Dear Mr. Baker: JUN 2 419% We are providing a package of design sketches concerning wetlands that will be impacted by this project. We have enclosed a completed N. C. D. E. M. application for your use. We are planning on replacing a pipe in an unnamed tributary flowing across S.R. 2726. This is not a trout stream nor a tributary to one. 1 a ? w NOTIFICATION FORM INFORMATION SHEET Nationwide permits that require notification to the Corps of Engineers Nationwide permits that require application for Section 401 certification A. NOTIFICATION- TO THE CORPS OF ENGINEERS DISTRICT ENGINEER. (REFER TO ITEM B. BELOW FOR DIVISION OF ENVIRONMENTAL MANAGEMENT APPLICATION RE- QUIREMENTS AND SPECIFICALLY NOTE NWP 26 DIFFERENCE.) Certain nationwide permits require notification to the Corps of Engineers before work can proceed. They are as follows: NWP 5 (only for discharges of 10 to 25 cubic yards) NWP 7 NWP 13 (only for stabilization activities in excess of 500 feet in length or greater-than an average of one cubic yard per running foot) NWP 14 (only for fills in special aquatic sites, including wetlands, and must include a delineation of affected special aquatic sites) NWP 17 NWP 18 (required when discharge exceeds 10 cubic yards or the discharge is in a special aquatic site and must include a delineation of the affected special aquatic site, including wetlands) NWP 21 (must include a delineation of affected special aquatic sites, including wetlands) NWP 26 (only for greater than 1 acre total impacts and must include a delineation of affected special aquatic sites, including wetlands) NWP 33 (must include a restoration plan of reasonable measures to avoid and minimize impacts to aquatic resources) NWP,37 NWP:38 (must include a delineation of affected special aquatic sites, including wetlands) For activities that may,be authorized by the above listed nationwide permits that require notification, the applicant shall not begin work a. Until notified that the work' may, proceed under the nationwide permit with any special conditions imposed by the District Engineer, or b. If notified that an individual permit may be required, or c. Unless 30 days (calendar) have passed from the time a complete notification is received by the District Engineer apd no notice has been received from the District Engineer, and required state approvals have been obtained. Required state approvals include: 1) a Section 401 water quality certification if authorization is requested for a discharge of dredged or fill material, and 2) an approved coastal zone management consistency determination if the activity will affect the coastal area. Use of NWP 12 also requires notification to the District Engineer, but work may not begin until written concurrence is received from the District Engineer. The time periods described above do not apply. Furthermore, requirements to notify the U.S. Fish and Wildlife Service (USFWS), the National Marine Fisheries Service (NMFS), and the State.Historic Preservation Office (SHPO), as indicated below and on the notification form, do not apply. , B.. APPLICATION TO DEM FOR NATIONWIDE PERMIT SECTION 401 CERTIFICATION. Certain nationwide permits require an application to DEM in order to obtain Section 401 water quality certification. They are;NWP 6, NWP 12, N%T 15, NWP 16, NWP 17, NWP 21, NWP 33, NWP 34, NWP 38, and NWP 40. Certain nationwide permits were issued general certifications d an require no application. They are NWP 3, NWP 4, NWP 5, NWP 7,. NWP 20, NW 22, NWP 23 (requires notification to DEM), NWP 25, NWP 27, NWP 32, NWP 36, and NWF37. Ile following nationwide permits were issued general certifications for only limited activities: NWP 13 (for projects less than 500 feet in lengihM&T 4 (for projects that impact waters only), NWP 18 (for projects with less than 10 cubic ya ds of fill ip waters only),'and NWP'26 (for projects with less than or equal to one-third acre fill of waters or wetlands). Projects that do not meet these criteria require application for Section 401 water quality certifications. C. NOTIFICATION/APPLICATION PROCEDURES. The attached form should be used to obtain approval from the Corps of Engineers and/or the N.C. Division of Environmental Management as specified above. The permittee should make sure that all necessary information is provided in order to avoid delays. One copy of the completed form is required by the Corps of Engineers and seven copies are required by DEM. Plans and maps must be on 8 1/2 x 11 inch paper. Endangered species requirement: For Corps of Engineers notifications only, applicants must notify the U.S. Fish and Wildlife Service-and/or the National Marine Fisheries Service regarding the presence of endangered species that may be affected by the proposed project: U.S. FISH AND WILDLIFE SERVICE NATIONAL MARINE FISHERIES SERVICE RALEIGH FIELD OFFICE HABITAT CONSERVATION DIVISION P.O. Box 33726 Pivers Island Raleigh, NC 27636-3726 Beaufort, NC 28516 Telephone (919) 856-4520 Tolf nhn- fa 1 (]. '77o Historic resources requirement: For Corps of Engineers notifications only, applicants must notify the State Historic Preservation Office regarding the presence of historic properties.that may be affected by the proposed project. STATE HISTORIC PRESERVATION OFFICE N.C. DIVISION OF ARCHIVES AND HISTORY 109 East Jones Street Raleigh, NC 27601 Telephone (919) 733-4763 Information obtained from these agencies should be forwarded to the Corps. DEM ID: 9 6n a o2_ ACTION ID: Nationwide Permit Requested (Provide Nationwide Permit #): 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 (919) 251-4511 WATER QUALITY PLANNING DIVISION OF ENVIRONMENTAL MANAGEMENT NC DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES P.O. Box 29535 Raleigh, NC 27626-0535 d ATTN: MR. JOHN DORNEY Telephone (919) 733-5083 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: NC. Der. at 7Rf?hlSfUft7?4Tf07Cl 2. Owners Address: P.O. [30)C 3279 ASrtfC-V[[LE, KC Z88a? 3. Owners Phone Number (Home): (Work): 08 - z 74 ASKEMLE. tic 7-880? .5. Location of work (MUST ATTACH MAP). County: (3(Azm e C- NearesttTown or City: 8LAC(? I?CT?cG? h(C Specific Location'(Inelude road numbers, landmarks, etc.): 57K 7- 7Z.C RQGW SbD4 RGA-0 F(d7M SK Z7Z-+ EAEERL?p 70 E.O.M. 6. Name of Closest Stream/River. 5WA-tI1 A"QA RI UER 7. River Basin: SWP44 4A(OA EWER 8. Is this project located in a watershed classified as Trout, SA, HQW, ORW, WS I, or WS H? YES [ NO lVJ 9. Have any Section 404 permits been previously requested for use on this property? YES [ ] NO [cf If yes, explain. , 10. _Estimated total number of acres of waters of the U.S., including wetlands, located on project site: a 03 A-C 11. Number of acres of waters of the U.S., including wetlands, impacted by the proposed project: Filled: Drained: Flooded: Excavated. 010( AC Total Impacted: O. 0 ( AC 4. If Applicable: Agent's name or responsible corporate official, address, phone number. 12. Description of proposed work (Attach PLANS-8 112" X 11" drawings only): V4 P f P & -Z VE REPLACED -(K (1 U+C1 W ED M Q 07ARY FLO a) tKG /-cgms 5 Z7Z6 13. Purpose of proposed work: 70 CAC(C ( MTE- Tff C- Vet (DEf /l ei 44 b PA-U WC aF 5R zTZG, 14. State reasons why the applicant believes that this activity must be carried out in wetlands. Also, note measures taken to nunimi e wetland impacts. NEE- A8QUG ALL R00 7k(F. AKb EQQEQAR Y MEASOk S 70 comTROL AFSQ SC-"-D(MCEJSTATToU WILL BtE (M UzCp - 15. You are required to contact the U.S. Fish and Wildlife Service (USFWS) and/or National Marine. Fisheries Servic (NMFS) regarding the presence or any Federally listed orproposed for listing endangered or threatened species or critic, habitat in the permit area that may be affected by the proposed project. Have you done so? YES [ ] NO [v RESPONSES FROM THE USFWS AND/OR NMFS SHOULD BE FORWARDED TO CORPS. COPY za K.C.vf.Ps 16. You are required to contact the State Historic Preservation Officer (SHPO) regarding the presence of histori properties in the permit area which maybe affected by the proposed project? Have you done so? YES[ ] NO [v 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? AGR(C(JLr-U2C-l RESMEKTZ4-L F. If applicable, what is proposed method of sewage disposal? Nl? Owner's(Signature Date 5c ? pReP N.C. DEPAPTMENT OF TRANSPOPTATION DIVISoNi OF- HIGHWAYS SLCONDARY ROAD SURVEY ECT S Z72?, ROB( ROAD TION FROM 5R Z7 Z4- EASTERL`? -M E 0, IBC C YP GRADE. BhSC PMT nRAlkt r vUhN t? IT Y 107 OUNTY ?u?titg TOWNSIIIP DATE lSC LE ? !, = 50 ' NOTES 4s' ?( zz.5- 54CH sc ?? PRop ? 'STA f o -F-oo To STS z? + 9 S PHEPARF-r) By JQ ? j_ Q _ 4' -zzc- BUKOD ALB E to +?I - ----- - ---- - - - c?? 53 e (PE PIPE 1 ? 8?5 30'-36" CMP ---- -- -- ---< <? ?-0 +()0 40'-f8" CMP_ --= DkWLI (Pa ZQ +29--- --- - -- - -- Cmz PIPE ?4fSQ 40'- f5"CfAP _Z7t04- ----??-I5`' CiY?C'---- CROSS f'(PE C N Y= Buklcomos: OWNER OF P01 DISTANCE FROM CENTER OF PROPOSED PROJECT STATION LEFT RIGHT O ES ? + 48 ZZ-4-ZB ' 17 21? , FOWER DR R= CPL TES rr v 4--- Std. # EROSION CONTROL DETAILS AND SPECIFICATIONS -Symbol gg P-a-g 245.03 Temporary Silt Ditch 245.05 Temporary Diversion 893.01 Temporary Silt Fence 890.05 Temporary Slope Drain with Earth Berm - v1 s ` 245.01 Silt Basin Type A ----- - 245.02 ............................... .. . - Silt Basin Type .B _0 ------ VI --- -10 892.04 . • ______ __ Temporary Rock SiltCheck.............................. Type-A ....... 7//7 VI 12 895.10 Temporary Rock Silt Check Type-B 892.01 Temporary Rock Sediment Dam Type-A 892.02 ............ Temporary Rock Sediment Dam Type-B VI -18 --' - VI - 20 897.01 Rock Pipe Inlet Protection -•--- o 0 ,° ?° ° ' VI - 22 --- 894.01 Rock Silt Screen ...................................... ° ... ° __ ?°_? __ _-- vT 24 245.04 Stilling Basin. ...... .................................... ... ® ----- VI - 26 ----- --• Rock Inlet Protection: 896.01 Type A ------------------ A •- ----..... -:OR --,q . v1- 30 896.02 Type B B OR •- B- ---- VI - 32 896.03. , . Type C .......... ..................... C ..OR C) VI . 34 7JES/GN f-Oi2 S/L 7/i?J/•? J/7C C ! _Z O/- _L ?C yE G k E D ? I?E.F' y S'? a R n) ? ??E.v ?- ?s;•VD C !_ E,s??vE.v u ?i 7? Cv/,?E,V ,S?,gLf ,cuLl I 2 '? Z&-A'67X DF Z?/STI?.f'8F_2? AREA 16 ;. 6. 5 1 (S ..?3.7) z? ?I (5, B./4-? 21 L Elirrs? ole .visrz1RB rD AREA 26a LEivG7;5? aF 1?/ST'URBED ,gRER 3c L ENGT.S? OF -D/STU,QBED ARE?9 bbl 3a? ., F. ROADWAY DITCH AND MEDIAN LINING GUIDELINES Percent of Grade Type of Lining Recommended 0 Straw and Tack 1 2 Erosion Control Matting 3 -- - 4 Synthetic Roving 5 --- greater Stone 4 0+ WOODS EUCE4& S 6RD pR J ,:I Yf I zo I ^54? R/W I ( R I /SWA L? TLS ODUE RD ??A+?Of-, ?fC 17I ALL. S(LT PAS(c,(S ARC (Se 5) ® GR DEZ I ` (I S7t-VEi? VEROi?(CA 31s CRONE ? 8 ?784 - 534- !-'?`??? I of Ly rLE cm Afr? Q?, IBC 20778 ?I o? ?? ZI zl =?z'' Cme f N 'k WOODS N? «u x ?? 983 - Z9 GAR F?EY??? _ ! t ((? 3Zo L`{ TLE COVE ?(ILW A(v( ?6p (.?U 4?ES d Tg I sl?fR- gya,?UR , K C 28178 ?? O d \-W (L(A-A FLOC( D I 1573 - 148 "R?W ! R W I t5 EvEL4a Fp\zELL 27, 5' CR 15-73-44- Ott I FP LLOk I i ° { $ -,7FL PED I I? I? I) I Eu LLy" FF O ZS ELL Qr- , a 171 1573- (50 RtC(f0,Pb GE( ALD PE(•LA (?D LME COUE: ' RD , N " l1? P?Z(CCc Rid . sou +. ??, rye ?-8 7760 6AS7 WA l h(C 720 S 6 C7R? . 36 " CM L ?xl x t 7 8 3 -A f Gt Q? ?-VEL?q sC0'TT IIIR-36G _6K AR ti l 51.,E - ? . pis O GEGRG(A ?,AcktWM? I4R5- f6o I? LA-W Q 34 L? TLE COU E Rb , SWW4A-I (CA , 9C Z@'778 Z $ i \9(LkLA S A-f-WETrE DA-U G f-fi 7r--Rl R/W . R 5OtL D(< Z WcoDS I X I8 aI? . ? I ,I kE?I-i?? ? C?E?A-CE FR(ZSELL ?I - x? -?! 1573 - f ¢? - i. of Illzl ? I ?8 8 Goo- LAUREL )6N E. OLk' kATt , KC za7I l?c?t?C w I I w(PIES' z21 a7v 2t r 7 '? I sH?D t 0 MAUDC KV3WSOW CLE) . 40 L? T-LE CoVE RD, SWAUAgOA, KlC 2977a FPCtc WALL o f? L4TLE COUe .' RO r3 5WA4,(OARIGA . IlC' 2-x!778 ( I ?aCL% ?? 1716 40 f8"CMP i 1 w PRO ??c 4 ore _ _ •/d Y?i Ig IZ ? Ia Z N m O O_ ?c nZ m P.!1 D O C Z D Z I .7P .14=- 5\? \ .e3 c .12 u? d'i' :;::a f/ C w:` i)e `iLy. w .PS -u 10.12 Iwo $I'%:%' T 8 iu .IB ?? II`^ INS Ilo a '5} / 1 V, b dodo d A y 9 ,- c 95 I° c: i.zn Jm 5` 0 ~ Y u z as o. 'N?m a A onrreo V? Rd. 4 e ??0 J JS il:, , --, 1 DSO Rd. SF D?o? w ,d ? w I a w >I p .a. .JO N 1 'P11 Gup 41 /.13 o ° /• o I o Iw \ 9 Oy u ~ 149 1I w l b a / ?07\? ?.? ?/f vl7o w? VI- - 1.15 9 Z V ~ A A H L O 9 6 0 6 0 3 4011SSU?' N,C: DEPAPTIVI NT OF TRANSPOPTATION D IVI SON OF-HIGHWAYS SLCONDARY ROAD SURVC 4' .??uz?? R` NOTIFICATION FORM INFORMATION SHEET Nationwide permits that require notification to the Corps of Engineers Nationwide permits that require application for Section 401 certification A. NOTIFICATION- TO THE CORPS OF ENGINEERS DISTRICT ENGINEER. (REFER TO ITEM B. BELOW FOR DIVISION OF ENVIRONMENTAL MANAGEMENT APPLICATION RE- QUIREMENTS AND SPECIFICALLY NOTE NWP 26 DIFFERENCE.) Certain nationwide permits require notification to the Corps of Engineers before work can proceed. They are as follows: NWP 5 (only for discharges of 10 to 25 cubic yards) NWP 7 NWP 13 (only for stabilization activities in excess of 500 feet in length or greater-than an average of one cubic yard per running foot) NWP 14 (only for fills in special aquatic sites, including wetlands, and must include a delineation of affected special aquatic sites) NWP 17 NWP 18 (required when discharge exceeds 10 cubic yards or the discharge is in a special aquatic site and must include a delineation of the affected special aquatic site, including wetlands) NWP 21 (must include a delineation of affected special aquatic sites, including wetlands) NWP 26 (only for greater than 1 acre total impacts and must include a delineation of affected special aquatic sites, including wetlands) NWP 33 (must include a restoration plan of reasonable measures to avoid and minimize impacts to aquatic resources) NWP 3.7 NWP38 (must include a delineation of affected special aquatic sites, including wetlands) For activities that may be authorized by the above listed nationwide permits that require notification, the applicant shall not begin work a. Until notified that the work may proceed under the nationwide permit with any special conditions imposed by the District Engineer, or b. If notified that an individual permit may be required, or c. Unless 30 days (calendar) have passed from the time a complete notification is received by the District Engineer and no notice has been received from the District' Engineer, and required state approvals have been obtained. Required state approvals include: 1) a Section 401 water quality certification if authorization is requested for a discharge of. dredged or fill material, and 2) an approved coastal zone management consistency determination if the activity will affect the coastal area. Use of NWP 12 also requires notification to. the District Engineer, but work may not begin until written concurrence is received from the District Engineer. The time periods described above do not apply. Furthermore, requirements to notify the U.S. Fish and Wildlife Service (USFWS), the National Marine Fisheries Service (NMFS), and the State.Historic Preservation Office (SHPO), as indicated below and on the notification form,. do not apply. B. APPLICATION TO DEM FOR NATIONWIDE PERMIT SECTION 401 CERTIFICATION. Certain nationwide _ permits require an application to DEM in order to obtain Section 401 water quality certification. They are NWT 6, NWP 12, NWP 15, NWP 16, NWP 17, NWP 21, NWP 33, NWP 34, NWP 38, and NWP 40. Certain nationwide permits were issued general certifications and require no application. They are NWP 3, NWP 4, NWP 5, NWP 7, NWP 20, NWP 22, NWP 23 (requires notification to DEM), NWP 25, NWP 27, NWP 32, NWP 36, and NWP 37. The following nationwide permits were issued general certifications for only limited activities: NWP 13 (for projects less than 500 feet in length), NWP 14 (for projects that impact waters only), NWP 18 (for projects with less than 10 cubic yarns of fill in waters only),`and NWP 26 (for projects with less than or equal to one-third acre fill of waters or wetlands): Projects that do not meet these criteria require application for Section 401 water quality certifications. C. NOTIFICATION/APPLICATION PROCEDURES. The attached form should be used to obtain approval from the Corps of Engineers and/or the N.C. Division of Environmental Management as specified above. The permittee should make sure that all necessary provided in order to avoid delays. One copy of the completed form is required by the Corps of Engineers o and seven copies are required by DEM. Plans and maps must be on 8 1/2 x 11 inch paper. Endangered species requirement: For Corps of Engineers notifications only, applicants must notify the U.S. Fish and Wildlife Service-and/or the National Marine Fisheries Service regarding the presence of endangered species that may be affected by the proposed project: U.S. FISH AND WILDLIFE SERVICE NATIONAL MARINE FISHERIES SERVICE RALEIGH FIELD OFFICE HABITAT CONSERVATION DIVISION P.O. Box 33726 Pivers Island Raleigh, NC 27636-3726 Beaufort, NC 28516 Telephone (919) 856-4520 TPlenhnnn (01 Ul '774 Conn Historic resources requirement: For Corps of Engineers notifications only, applicants must notify the State Historic Preservation Office regarding the presence of historic properties that may be affected by the proposed project. STATE HISTORIC PRESERVATION OFFICE N.C. DIVISION OF ARCHIVES AND HISTORY 109 East Jones Street Raleigh, NC 27601 Telephone (919) 733-4763 Information obtained from these agencies should be forwarded to the Corps. j DEM ID: ACTION ID: Nationwide Permit Requested (Provide Nationwide Permit #): JOINT FORM FOR Nationwide permits that require notification to the Corps of Engineers Nationwide permits that require application for Section 401 certification WII,MINGTON DISTRICT ENGINEER CORPS OF ENGINEERS DEPARTMENT OF THE ARMY P.O. Box 1890 Wilmington, NC 28402-1890 ATTN: CESAW-CO-E Telephone (919) 251-4511 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 (919) 733-5083 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: N. C. DEPT. CF 7R WS63R-O (WCU 2. Owners Address: P.O. M 3Z7?, f[SFfEWLLE, KC_- Z.96G? 3. Owners Phone Number (Home): (Work): 08 - Z 74- 4. If Applicable: Agent's name or responsible corporate official, address, phone number- P.O. 00k/ 3279 ASH-EVLL.LG. tic z880?- .5. Location of work (MUST ATTACH MAP). County: 13OgGim6 C- Nearest Town or City: 8l-ACk MT-9, I?fC Specific Location *(Include road numbers, landmarks, etc.): S(R Z7? -C RO.OW SOIL ROA•0, E&IM SR Z7?-+ eASTERL? TO E. G• M . 6. Name of Closest Stream/River. 5WA9KA"CA PI UER 7. River Basin: SWP41984408 R y ER 8. Is this project located in a watershed classified as Trout, SA, HQW, ORW, WS I, or WS II? YES [ J NO D1 9. Have any Section 404 permits been previously requested for use on this property? YES [ ] NO [Vf If yes, explain. . 10. Estimated total number of acres of waters of the U.S., including wetlands, located on project site: O. 03 A-C 11. Number of acres of waters of the U.S., including wetlands, impacted by the proposed project: Filled: Drained: Flooded: Excavated: 010( AC Total Impacted: 0 . 0 (•- AC- 12. Description of proposed work (Attach PLANS-8 1/2" X 11" drawings only): ON P ( 6 E 70 fFE KEPLACED -(K WCl W ED M Q 07ARY PL0 a J JKG &KSS S Z7ZC 13. Purpose of proposed work: 70 HAC(UMTE TFfC- W(DEU/Me 44 b PA-U[9(3 OF SCE z7Z6. 14. State reasons why the applicant believes that this activity must be carried out in wetlands. Also, note measures taken to mmupke wetland impacts. 5(EE ABOUCE Au- R0U c7?lr iAicCD iC(?[??}R y MC-I?SU(??S -M cQUTROL A9D SAD( 7ATloU WILL 3F- UVLIZEp 15. You are required to contact the U.S. Fish and Wildlife Service (USFWS) and/or National:Marine,Fisheries Servic (NMFS) regarding the presence or any Federally listed orproposed for listing endangered or threatened species or critica habitat in the permit area that may be affected by the proposed project. Have you done, so? YES [ ] NO [V RESPONSES FROM THE USFWS AND/OR NMFS SHOULD BE FORWARDED TO CORPS. COPY Ta 9-C.W.R9 16. You are required to contact the State Historic Preservation' Officer (SHPO) regarding the presence of histori properties in the permit area which may be affected by the proposed project? Have you done so? YES [ ] NO (V. 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? / GARCU1 TUBE RES(DEMML F. If applicable, what is proposed method of sewage disposal? 91/14 owner' signature Date t'°° noz - ^ noe ? h 1103 sot I 133 G BLACK MOUNTAIN t a .