20010645 Ver 1_Complete File_20010427

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STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY LYN O TWPETT
GOVERNOR SECRETAKY
Bridge Maintenance Unit
P. O. Box 1150
r?l Fayetteville, N. C. 28302
?st/Qr
March 28, 2001
010645
USACOE
Mr. Dave'l'impy
Wilmington Regulatory Field Office
P O. Box 1890
Wilmington, N. C. 28402-1890
RE: Robeson County Bridge Number 140 Replacement (TIP B-3037)
LOCATION: SR-2435 Crossing Ashpole Swamp
Dear Mr. Timpy:
We are providing herewith an application package and copies of N.C. Department of Transportation
Hydraulics Unit sketches (plan and profile) asa part of a project involving the replacement of an existing
bridge with a new bridge. The project should be let to contract by July 01, 2001.
To our knowledge, no wetlands are involved and total fill in water is expected to be less than 0.01 acre. This pipe is
not located in a high quality water area.
Please review this material, and if additional information is needed, please contact our office.
Thank you for your cooperation and assistance in this matter.
Sincerely
?:
L. L. U ole, Jr, P.E.
Division Bridge Maintenance Engineer
Attachments
CC: T. R. Gibson, P.E. Division Engineer John Hennessey-DWQ-7 Copies W/Attachments PAYMENT
Mrs. Renee Gledhill-Earley State Historic Preservation Officer
Mike Crocker-US Fish & Wildlife Service RECEIVED
Jim Rerko-Division Environmental Officer
P. O. Box 1150 - Fayetteville, N. C. 28302 - PHONE: [phone] - FAX {910}486-1959
010645
DWQ ID: CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #):
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATION FOR SECTION 401 CERTIFICATION
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 SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL
MANAGEMENT (SEE AGENCY ADDRESSES SHEET). PLEASE PRINT.
1 OWNERS NAME : Tr ??Y - G-, ? c3 s°,r-? _ ?? OoT 7.4. 4. Z
2. MAILING ADDRESS:

SUBDIVISION NAME:
CITY: \ ?--?-E STATE: t-AC- ZIP CODE:
2S)'LS oZ
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE)
p?..? SQ- 24"35 ?c_-R.._oss ?-'S?.'C?t??-E- '?••rsP•^M, ?
3. TELEPHONE NUMBER (HOME): (WORK) c? ?o ' 4Qjtc - 1 4°? 3
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL,
ADDRESS, PHONE NUMBER: Mf-r- P- S /N.- c--
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS
TOPOGRAPHIC MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: V, s? ?.-A NEAREST TOWN OR CITY:
1
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ETC`:,):
S(L z 4-3 S A c-?oss ?'s?a Pc?? Sv-fA--AP
6. IMPACTED OR NEAREST STREAM/RIVER: ?' `-'H Po LE Sv.1At?l(?
RIVER BASIN: L jtA'%yZ
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 [ ] NO [)G] IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES[ ] NO X
7c. 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?
N?A
8a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? 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 PERMIT 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: ,?,-K/A.
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: G7
FLOODING: GO
DRAINAGE:
OTHER:
TOTAL ACRES TO BE IMPACTED: O
c?:)
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE DISTANCE..BOTH BEFORE AND AFTER RELOCATION):
LENGTH BEFORE: I O (? FT AFTER: 14- c FT
WIDTH BEFORE (based on normal high water contours): 9 S FT
WIDTH AFTER: R S FT
AVERAGE DEPTH BEFORE: 3 FT AFTER: 3 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: (. y3'M%CV ,E wZ 3 Seo'j r3rtiCGiE
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? N /P-
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DRAWINGS
ONLY) : ?en•?oyG Erc.sz ??.?,c-, (o Spp?^" L T+«?gct. S..st?sTC2.
(Lc F`oott- /T?t-mot. ?osTSl RJCL?OL^? /?•wacC? ?iJ
3 Co.? ?cL? ?- ,c,, ,. ?,o Sz _`. (? too c-?? ,
??? ? k ? X C.. /sue PTO Cz- 4 r-?O C 2/'-•-.?'?S '['cam ?E
!C7 GP ---
13. PURPOSE OF PROPOSED WORK: Qr-PtA?--? STQrJc-TJCLC..ti.-?..?(
'V-') E j::- k c--\, ir--- r--? 77- ?5 q--\ oc..f-- .
3
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED
OUT IN WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND
IMPACTS) : ?-A f p-
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR 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 ,[?]
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 LAND USE OF SURROUNDING PROPERTY? ??--

f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
V-4 /P
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) o A'LETTER FROM HE
NORTH CAROLINA DIVISION OF COASTAL MANAGEMENT'STATT#Q THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
PROGRAM.
-Ve.. G-, • P?Sor-' Z?aev OWNER'S/AGENT'S SIGNATURE
(AGENT'S SIGNATURE VALID-ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED (18g.))
04-/it/o/
DATE
5
AGENCY ADDRESSES
ENDANGERED SPECIES:
U.S. FISH AND WILDLIFE SERVICE
RALEIGH FIELD OFFICE
P.O. BOX 33726
RALEIGH, NC 27636-3726
TELEPHONE [phone]
NATIONAL MARINE FISHERIES SERVICE U.S. FISH AND WILDLIFE SERVICE
HABITAT CONSERVATION DIVISION ASHEVILLE FIELD OFFICE
PIVERS ISLAND 160 ZILLICOA STREET
BEAUFORT, NC 28516 ASHEVILLE, NC 28801
TELEPHONE [phone] TELEPHONE[phone]
HISTORIC RESOURCES:
STATE HISTORIC PRESERVATION OFFICE
N.C. DIVISION OF ARCHIVES AND HISTORY
109 EAST JONES STREET
RALEIGH, NC 27601
TELEPHONE (919) 733=4763
STATE REGULATORY AGENCIES:
MR. JOHN DORNEY
DIVISION OF ENVIRONMENTAL MANAGEMENT
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT, HEALTH, AND NATURAL
RESOURCES
4401 REEDY CREEK ROAD
RALEIGH, NORTH CAROLINA 27607
TELEPHONE [phone]
CORPS OF ENGINEERS FIELD OFFICES:
RALEIGH REGULATORY FIELD OFFICE
US ARMY CORPS OF ENGINEERS
6508 FALLS OF THE NEUSE ROAD,
SUITE 120
RALEIGH, NC 27615
TELEPHONE [phone]
WASHINGTON REGULATORY FIELD OFFICE
US ARMY CORPS OF ENGINEERS
POST OFFICE BOX 1000
WASHINGTON, NC 27889-1000
TELEPHONE [phone]
MR. STEVE BENTON
DIVISION OF COASTAL MANAGEMENT
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT, HEALTH, AND NATURAL
RESOURCES
POST OFFICE BOX 27687
RALEIGH, NORTH CAROLINA 27611-7687
TELEPHONE [phone]
FAX [phone]
ASHEVILLE REGULATORY FIELD OFFICE,.
US ARMY CORPS OF ENGINEERS
151 PATTON AVENUE, ROOM 143
ASHEVILLE, NC 28801-5006
TELEPHONE [phone]
WILMINGTON REGULATORY FIELD OFFICE
US ARMY CORPS OF ENGINEERS
POST OFFICE BOX 1890
WILMINGTON, NC 28402-1890
TELEPHONE [phone]
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STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY LYNDO TIPPETT
GOVERNOR SECRETARY
Bridge Maintenance Unit
P. O. Box 1150
Fayetteville, N. C. 28302
March 28, 2001
USACOE 010645
•?l
Mr. Dave Timpy
Wilmington Regulatory Field Office
P O. Box 1890
Wilmington, N. C. 28402-1890
RE: Robeson County Bridge Number 140 Replacement (TIP B-3037)
LOCATION: SR-2435 Crossing Ashpole Swamp
Dear Mr. Timpy:
We are providing herewith an application package and copies of N.C. Department of Transportation
Hydraulics Unit sketches (plan and profile) as a part of a project involving the replacement of an existing
bridge with a new bridge. The project should be let to contract by July 01, 2001.
To our knowledge, no wetlands are involved and total fill in water is expected to be less than O.bl acre. This pipe is
not located in a high quality water area.
Please review this material, and if additional information is needed, please contact our office.
Thank you for your cooperation and assistance in this matter.
Sincerely
L. L. U ole, Jr, P.E.
Division Bridge Maintenance Engineer
Attachments
CC: T. R. Gibson, P.E. Division Engineer ,??c Ps r
John Hennessey -DWQ-7 Copies W/Attachments ptA
Mrs. Renee Gledhill-Earley State Historic Preservation Officer Cr ( i j
Mike Crocker-US Fish & Wildlife Service
Jim Rerko-Division Environmental Officer
P. O. Box 1150 - Fayetteville, N. C. 28302 - PHONE: [phone] - FAX: [phone]

010645
DWQ ID:
CORPS ACTION ID:

NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #):
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATION FOR SECTION 401 CERTIFICATION
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 SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL
MANAGEMENT (SEE AGENCY ADDRESSES SHEET). PLEASE PRINT.
1. OWNERS NAME : T?¢ s?Y C"l ? c3 So•--? - ?\c_Oo /7.y, ?.?r, Eac-?? ,
2. MAILING ADDRESS: vPo P??x \ \ S
SUBDIVISION NAME:`, ?P+
CITY: F/?`t E cT?? ?-`-E STATE: t--AC- ZIP CODE: 'Z.$'? 02
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE) : ??P?? Soc-? C-? • '" P?? ?Q? \ ' d
v._. Scz. 'z 43S Prc-a?ss
3. TELEPHONE NUMBER (HOME) : (WORK) : 3
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL,
ADDRESS, PHONE NUMBER: Ae- P- S /-"- - >0?lc,--
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS
TOPOGRAPHIC MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: '-.arcSo'-4 NEAREST TOWN OR CITY: SZ..? vJ ?-4.N O
1
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ETC.):
S 2 z 4-3 S A ?-¢ oss 5?-4 Po Sw'& ? 4
6. IMPACTED OR NEAREST STREAM/RIVER: /S- S" 4o LE 'Sv-tAPA e
RIVER BASIN: l--'j'Am -rL-
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 [ ] NO [x] IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES[ ] NO X
7c. 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?
8a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES [ ] NO [X] IF YES, PROVIDE ACTION I.D. NUMBER OF
PREVIOUS PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDEPHOTOCOPY OF 401
CERTIFICATION):
8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES [ ] NO [>,?-I•F-YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND: -:2-1
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT
SITE: f5 -0
2
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: EXCAVATION: G?
FLOODING: O OTHER: c?
DRAINAGE: ~ O TOTAL ACRES TO BE IMPACTED: C?
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION):
LENGTH BEFORE: I O Go FT AFTER: Io FT
WIDTH BEFORE (based on normal high water contours): q57 FT
WIDTH AFTER: 9 S FT
AVERAGE DEPTH BEFORE: 3 FT AFTER: 3 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: ?G P??-E E,?-yT??L-, SPA ?j2?Ck?E w/ 3 spE?,., (3R.j0LiE
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE 'SIZE OF THE
WATERSHED DRAINING TO THE POND? p-s/ti
WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DRAWINGS
ONLY) : ?ErnavG
cZ-c_ F?ocz. /T,, n. J•?,sc-sl ?Q.O?--,E
3
?GP ,
13. PURPOSE OF PROPOSED WORK: Qr 4t-?'e- y
3
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED
OUT IN WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND
IMPACTS) : }-A / p-
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR 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
X`]
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 LAND USE OF SURROUNDING PROPERTY? Q_?QL??--

f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
?-4 /P
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 Off'
ENVIRONMENTAL MANAGEMENT (WATER QUALITY) CERT37IOATtON AND
3) (IN THE TWENTY COASTAL COCTNTlES ON'L'Y) , A 'X ktTER FROM 'TSE
NORTH CAROLINA DIVISION OF COASTAL MANAGEMENT STATIkG-THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTALMANAGEMENT
PROGRAM.
OWNER'S/AGENT'S SIGNATURE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED (18g.))
o ? z /o /
i-- DAT E
5
AGENCY ADDRESSES
ENDANGERED SPECIES:
U.S. FISH AND WILDLIFE SERVICE
PALEIG14 FIELD OFFICE
P.O. BOX 33726
RALEIGH, NC 27636-3726
TELEPHONE [phone]
NATIONAL MARINE FISHERIES SERVICE U.S. FISH AND WILDLIFE SERVICE
HABITAT CONSERVATION DIVISION ASHEVILLE FIELD OFFICE
PIVERS ISLAND 160 ZILLICOA STREET
BEAUFORT, NC 28516 ASHEVILLE, NC 28801
TELEPHONE [phone] TELEPHONE[phone]
HISTORIC RESOURCES:
STATE HISTORIC PRESERVATION OFFICE
N.C. DIVISION OF ARCHIVES AND HISTORY
109 EAST JONES STREET
RALEIGH, NC 27601
TELEPHONE [phone]
STATE REGULATORY AGENCIES:
MR. JOHN DORNEY
DIVISION OF ENVIRONMENTAL MANAGEMENT
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT, HEALTH, AND NATURAL
RESOURCES
4401 REEDY CREEK ROAD
RALEIGH, NORTH CAROLINA 27607
TELEPHONE [phone]
CORPS OF ENGINEERS FIELD OFFICES:
RALEIGH REGULATORY FIELD OFFICE
US ARMY CORPS OF ENGINEERS
6508 FALLS OF THE NEUSE ROAD,
SUITE 120
RALEIGH, NC 27615
TELEPHONE [phone]
WASHINGTON REGULATORY FIELD OFFICE
US ARMY CORPS OF ENGINEERS
POST OFFICE BOX 1000
WASHINGTON, NC 27889-1000
TELEPHONE [phone]
MR. STEVE BENTON
DIVISION OF COASTAL MANAGEMENT
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT, HEALTH, AND NATURAL
RESOURCES
POST OFFICE BOX 27687
RALEIGH, NORTH CAROLINA 27611-7687
TELEPHONE [phone]
FAX [phone]
ASHEVILLE REGULATORY FIELD OFFICE_
US ARMY CORPS OF ENGINEERS
151 PATTON AVENUE, ROOM 143
ASHEVILLE, NC 28801-5006
TELEPHONE [phone]
WILMINGTON REGULATORY FIELD OFFICE
US ARMY CORPS OF ENGINEERS
POST OFFICE BOX 1890
WILMINGTON, NC 28402-1890
TELEPHONE [phone]
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0106 45
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY LYNDO TIPPETT
GoV I?RNOR ' ?.. SECRETARY
Bridge Maintenance Unit\
P. 0. Box 1150
Fayetteville, N. C. 28302
Division of Environmental Management
John I lennessey. WQ Certification I Init
P. 0. Box 29535
Raleigh, N. C. 27626-0535
Dear Mr. I Iennesscy:
March 28, 2001
01 0645
Please find seven (7) copies of an application form and attached check in the amount of $ 200.00 for Water Quality
Certification Permits and for your review of this project.
I I'vou have any questions or comments, please call me at 910-829-6345.
Thank you for your assistance in this matter.
Sincerely
X11 ?
L. E. (lpoie, .I r, 1'. E.
Division Bridge Maintenance Engineer
Attachments
I /-I
P
AYMENT
RECEIVED
P. O. Box 1 150 -Fayetteville, N. C. 28302 - PHONE: [phone] - FAX: [phone]

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