20081555 Ver 1_Individual_20110124

Strickland, Bev
From: Steenhuis, Joanne
Sent: Monday, January 24, 2011 4:33 PM
To: Strickland, Bev
Subject: FW: Shelter Creek Quarry 08 1018
Attachments: Response to USACE RFAI 12-17-10.pdf; Supplement Info to Accompany Mitigation Proposal
1-7-11 v2.pdf; Individual Permit Application 1-19-11.pdf
Bev,
I will be sending you a CD with a new revised map for the mine
Joanne
From: Dana Lutheran jmailto:dlutheran(Qbsegi.usl
Sent: Monday, January 24, 2011 11:35 AM
To: Steenhuis, Joanne
Subject: Fw: Shelter Creek Quarry
Joanne,
According to your 14 January email, you and Ronnie Smith have determined the following information is
necessary, in order to write the IP for the Shelter Creek Quarry. Please find below SEGi's response to each of
your requests:
1. The chart labeled 4a needs to be corrected. (a) add CC as an isolated wetland; (b) remove JJ
and LL form being impacted; and (c) show how much of KK is to be impacted. The
attached letter, dated 17 December 2010, submitted to your office on the same date, contains an
exhibit which provides the revisions requested here.
2. Revise impact map showing: (a) that JJ and LL are no longer proposed to be impacted; (b) that
KK is only partially proposed to be impacted; (c) phase boundaries; and (d) limits of
disturbance. See aforementioned 17 December letter.
3. In the 7 January 2011 letter, please change Page 2 to read 12.5%, instead of 5%. Page 2 has
been revised to reflect 12.5% (see attached).
4. Provide a more detailed description of the proposed mitigation project, which includes: (a) a
construction sequence (where it will start and end); (b) any temporary impacts necessary to
access areas to be graded down, not connected to high ground; (c) how and where topsoil will
be removed; (d) where the top soil will be stored during the grading process; (e) what is
intended to replace it; and (0 how the enhancement areas are to be restored. The site consists
of several upland fingers, that are oriented in a north-south direction. Heavy machinary, such as
backhoes and dump trucks, will begin excavation in the southern most points of these fingers and will
work their way out (up/north) from there. It is not anticipated that any temporary impacts will take place
with the mitigation project. All proposed excavation areas are accessible via high ground. Excavated
topsoil will be used to create hummocks, within the proposed, created wetland areas. Topsoil not used
for the purpose of creating hummocks will be stored in upland areas, on-site, in the form of berms.
These spoil areas will be stabilized, as required by an approved sediment and erosion control
plan/permit. It is anticipated that hydric soils will emerge over time. Enhancement of the open water
features will be carried out by draining the ponds and then planting with wetland species listed within
the 7 January 2010 letter, you referenced in your letter. To keep the features from holding
water, ditches (through uplands) will be created to connect the features to the adjacent, proposed
wetland.
5. The DWQ and USACE recommend removing the non-riparian weltand creation from the
mitigation plan and would like to see mitigation for the remaining acreage through the NCEEP
(or other HUC bank). Payment to the bank would have to take place prior to the commencment
of Phase 11A, 1B, and I1B. This will be finalized today.
Additionally, during our phone conversation held 18 January 2011, you stated the application must
reflect the current land owner. Therefore, I have revised the first page of the IP Application to reflect
the change in ownership (see attached).
It is SEGi's understanding that our submittal and your acceptance of the information, found within and attached
to this email, is all that is needed to complete for the DWQ to issue the permit. However, should you find you
need clarification, please do not hesitate to call me.
Thank you for your continued assistance with this project.
Dana
Sr-Gi
Southern Environmental Group, Inc.
5315 South College Road, Suite E
Wilmington, NC 28412
Phone: [phone]
Fax: [phone]
Mobile: [phone]
From: "Steenhuis, Joanne" <joanne.steenhuis0)ncdenr.gov>
To: Dana Lutheran <dlutheran(a)segi.us>
Cc: "Smith, Ronnie D SAW" <Ronnie.D.SmithO)usace.army.mil>; "Mcmillan, Ian" <ian.mcmillanCa1ncdenr.gov>; "Shiver,
Rick" <rick. shiver(a ncdenr.gov>; "Steenhuis, Joanne" <joanne.steenhuis(a)ncdenr.gov>
Sent: Fri, January 14, 2011 1:15:28 PM
Subject: Shelter Creek Quarry
Dana,
I have attached the information necessary to accurately complete the application package
,5outkern Lnvironmcntal Group, Inc.
53 15 South College Roan, Suite F- • Wilmington • NC • 2841 2
rhone: ? 10.452.271 1 • rax: ? 10.452.2899 • nmaii: o{fice@s,i.us
17 December 2010
Electronic Mail
Mr. Ronnie Smith
US Army Corps of Engineers - Regulatory Division
69 Darlington Avenue
Wilmington, NC 28403
Ronnie.D.Smithkusace.army.mil
Re: Shelter Creek Quarry Individual Permit
USACE AID #: SAW-2008-01720
DWQ Project #: 08-1555
Dear Mr. Smith,
[SEGI Project #: 06-010.01]
Thank you for taking the time to meet with Mr. David Syster and myself, to discuss the Shelter Creek
Quarry Individual Permit Application, currently under review by the USACE and DWQ. During our
meeting, the USACE stated a mitigation proposal was needed to complete IP application. This letter serves
to provide the required information outlined at that meeting as well as the preliminary mitigation proposal.
1. An updated "Milestone Map" that illustrates wetland impacts anticipated to
take place within 5 years of the mitigation site's commencement date, as well as a
commencement date, for the mitigation work;
Previously, SEGI submitted a milestone map that illustrated no wetland impacts within the
first five years. Since that submittal, that has changed. The Applicant believes approximately
7.97 AC of wetlands would be impacted within the first five years. The table below provides
the acreages for the impact areas. For locations of the impact areas, please see Attachment 1 -
Cursory Wetland Determination and Proposed Mitigation.
Impact Area Wetland Impact Acreage within First
5 Years Type
(404, Isolated)
A 1.4 404
B 0.8 404*
C 3.8 404
J 0.11 Isolated
K 0.16 Isolated
AA 1.2 404*
DD 0.49 404
Total 7.96
Total Mitigated Acreage 5.96
]able 1. Proposed wetland impacts to take place within ) years (' lnaicates "low value" wetland, which are not
being mitigated)
2 A LIDAR exhibit that illustrates historic wetland areas within the Croomsbridge property;
Please see Attachment 1 - Cursory Wetland Determination and Proposed Mitigation.
3. NCEEP costs for 2:1 and 1:1 mitigation-to-impact ratios, available NCEEP sites and/or
private mitigation banks within the HUC and, if any, the dates of credit availability for those
sites;
NCEEP
There are four (4) NCEEP sites located within the project HUC follows (see Attachment 2 -
NCEEP Mitigation Projects within Project HUC 03030007). They are as follows: Haw's Run
(PID 92154); Wallace Deer Club - Blanchard Tract (PID 92155); Wallace Deer Club -
Swinson Tract (PID 92103); and Wallace Deer Club - Tract 3-5 (PID 719). According to Ms.
Kelly Williams, with the NCEEP, as soon as a mitigation site is approved, credits become
available for that site. Thus, credits area available for all of the aforementioned mitigation
sites. Currently, the NCEEP In-Lieu Fee Schedule reflects the following fee per unit (AC), in
the Higher Fee HUs: Riparian Wetlands - $62,210/AC and Non-Riparian - $44,883/AC. The
NCEEP only sells credits in 1/4 AC increments. To mitigate through the NCEEP, a 2:1
mitigation-to-impact ratio would be required for those impacts proposed to take place within
5 years and a 1:1 mitigation-to-impact ratio for the remainder.
Hofmann Forest Wetland Mitigation Bank
This private mitigation bank is located within 50 miles of the project site, but it is not located
within the same HUC or drainage basin (see Attachment 3 - Hofmann Forest Vicinity Map).
Hofmann Forest only offers non-riparian mitigation credits. Thus, any riparian wetland
impacts would need to be offset using the NCEEP. Hofmann Forest has been completed and
credits are available. The credits are issued upon request and the fee mimics the NCEEP's
ILF schedule. However, Hofmann Forest does not limit the credits to be sold in 1/4 AC
increments. Because the mitigation bank is located outside the projects HUC, the mitigation-
to-impact ratio would increase to 3:1 for impacts proposed to take place within the first five
years and 2:1 for impacts proposed to place five years out.
Mitigation Cost Analysis through the NCEEP and Hofmann Forest
Based on the current NCEEP ILF schedule, the Applicant would expect to pay the following
cost for mitigation credits through the NCEEP and the Hofmann Forest:
CEEP

Time Line Habitat (Riparian

/Non-riparian) Mitigated Impact

Acreage NCEEP Credits

AC
Cost
Within 5 years (2:1) NR 5.96 12.0 $538,596.00
Outside 5 years (1:1) NR 28.54 28.75 $1,290,386.25
R 6.51 6.75 $419,917.50
Total 41.01 47.5 $2,248,889.75
OFMANN FOREST
Time Line Type (Riparian
/Non-riparian) Mitigated Impact
Acreage Hofmann Forest
Credits AC Cost
Within 5 years (3:1) NR 5.96 17.88 $802,508.04
Outside 5 years (2:1) NR 28.54 57.08 $2,561,921.64
R (NCEEP) 6.51 6.75 $419,917.50
Total 41.01 74.98 $3,784,347.18
Table 2. Cost comparison between the NCEEP and the Hofmann Forest Wetland Mitigation Bank
4. A comprehensive cost analysis for applicant responsible mitigation that should include, but is
not limited to; the cost of land, machinery, vegetation, environmental work (GPS of wetland
line, etc.), survey work (drawings), hydric material, labor, etc.;
Applicant responsible mitigation is anticipated to cost approximately $940,000. Below, you
will find a breakdown of costs associated with the proposed permitt ee responsible mitigation
project:
Land $250,000
Engineering $10,000
Surveying $20,000
Wetland Consulting $30,000
Planting (vegetation and planting) $35,000
Grading Work $545,000
Soil & Erosion Control $25,000
Monitoring $25,000
Total Mitigation Cost $940,000
A 20% contingency buffer added to the Total Mitigation Cost elevates the potential cost of
the mitigation project to $1.13 million.
5. Include permittee responsible, alternative, mitigation site information, and why they were not
practicable;
Four (4) sites were considered in the search. Site selection was ranked and identified based
upon criteria that consider the potential for success, location within the project's drainage
basin, replacement values, anticipated long-term viability, feasibility, and cost. Each site is
discussed below:
Alternative Site I
Shaw Highway Site: At more than 1200 AC, this site was too large for the scope of
the Applicant's mitigation project. The current landowner was not interested in
subdividing the parcel and has since gone under contract by a third party. Therefore,
this site is not a practical alternative.
Alternative Site 2
3600 Acre Davis Farm Tract: As with the Shaw Highway Site, this site was too large
for the scope of the project and the landowner was not interested in subdividing.
Therefore, this site is not economically feasible.
Alternative Site 3
23 Acre Hwy 53 Site: On its own, this site is not large enough produce the acreage
necessary to offset the wetland impacts associated with mining project, and the
Applicant was unable to secure land contiguous to the site. In addition, based on
SEGi's field observations, the site would be difficult to establish hydrologic
conditions necessary to meet the criteria. Therefore, this site is not a logistically,
practicable alternative.
Alternative Site 4
Croomsbridge Road Site: The 158-acre site is situated adjacent to the North East
Cape Fear River. A cursory of the property indicates approximately 85.0 AC of
wetlands exist within the parcel boundaries (see Attachment 1 - Cursory Wetland
Determination and Proposed Mitigation). The tract exhibits characteristics similar to
that of the Quarry site. For instance, the two sites occupy a nearly identical landscape
position, in relation to their respective waterway; both are similar in related soil
types; and the two sites appear to be almost identical in vegetation composition and
succession. In addition, the two sites are both subject to the same seasonal overbank
flooding events, from their adjacent watercourse. Based on the comparison of the two
tracts and the cost of the land, the Croomsbridge road appears to be the most
practicable alternative.
6. The relation between the mitigation site and the Shelter Creek Quarry (e.g., location within
the flood plain, soils, etc.); and
Please see item 45, Alternative Site 4, above.
Z The mitigation-to-impact ratio will be 1:1 for wetland impacts proposed to take place 5 years
out from the commencement date of the mitigation work. Impacts to wetlands within the first
5 -years shall be offset with a mitigation-to-impact ratio of 2:1. If additional wetland impacts,
above that stated within the mitigation proposal, become necessary within the first 5 years, a
modification to the permit would be required prior to impacts taking place. Provide
preliminary mitigation proposal, which should include but is not limited to an area map that
depicts location, acreages, type of mitigation to occur (e.g., enhancement, restoration,
creation, etc.) and type of habitat proposed, brief planting plan, monitoring plan and success
criteria.
In total, the impact of 43.72 AC of wetlands (including both 404 and 401 jurisdictional
wetlands is necessary to facilitate the continued operation of the Shelter Creek Quarry. The
Applicant has agreed to mitigate for 41.01 AC of the impacted wetlands (total wetland
impacts minus acreage of "functionally, low value" wetlands). Please see Attachment 4 -
Shelter Creek Quarry Wetland Summary Spreadsheet for acreage calculations, including
acreages for impacts to riparian and non-riparian wetlands.
With that said, for impacts proposed to take place within the first five years, the Applicant has
agreed to compensate at a 2:1 mitigation-to-impact ratio. For simplicity's sake, within this
section, acreages have been rounded to whole numbers. It is anticipated, within the first five
years, the Applicant will need to impact approximately 8.0 AC (see Attachment 5 - Milestone
Wetland Impact Map). Of those 8.0 AC, 2.0 AC (impact areas B and AA) have been deemed
as "low value" wetlands. Therefore, 6.0 AC of wetland mitigation is necessary to offset the
impacts proposed to take place within the first five years. To offset the remaining
requirement, the Applicant intends to create/restore/enhance 41.0 AC of wetlands. In total, the
Applicant's proposes to create/restore/enhance 47.0 AC of wetlands (41.0 + 6.0 = 47.0).
However, preliminary investigations show the tract yielding approximately 55.0 AC of
wetland mitigation. Further broken down reveals the site has the potential to yield 31.0 AC of
riparian wetlands and 24.0 AC of non-riparian (see Attachment 1 - Cursory Wetland
Determination and Proposed Mitigation).
In conjunction with the creation/restoration/enhancement activities, the Applicant also
proposes to place the entire site into preservation. The Applicant and SEGi feel the proposed
mitigation plan is sufficient to offset temporal and permanent impacts to wetlands and will
result in no net loss of wetlands.
The proposed Success Criteria for wetland success will be based on the presence of the three
criteria described in the 1987 USACE Wetland Delineation Manual'. The mitigation site will
be deemed successful once it meets the three wetland parameters outlined in the manual and
as further described in below:
Vegetation
Vegetative data will be gathered including survival data of the planted specimens and
the presence of nuisance species. Species diversity and composition will be noted. For
success criteria to be met, we would expect a survival rate of 320-planted trees per
acre after 2 years, and 260 trees per acre after 5 years. No one species should account
for more than 20% of the composition. Any areas that do not meet these requirements
will be spot-planted.
Hydrology
Hydrologic monitoring within the site will consist of determining the water level at
various locations across the site to verify the presence of wetland hydrology during
the growing season. Monitoring wells will be installed to a depth of 20 inches and
will be sealed with sand and bentonite. These wells will take a daily reading of the
water table depth and this data will be processed into graphs and plotted against
National Weather Service rainfall data for the area. Success criteria of the hydrologic
parameter requires the site to exhibit one or more of the primary indicators; or two or
more, of the secondary indicators of hydrology as outlined in the 1987 Army Corps of
Engineers Wetlands Manual, for twelve percent of the growing season, under normal
conditions (e.g. normal rainfall, normal temperatures, etc..).
Soils
Soils will exhibit soil profiles typically found in wetlands.
A comprehensive mitigation plan will be submitted to the USACE for approval. Upon said
approval, implementation of the mitigation plan will begin. Note: wetland impacts will not
take place until commencement of the mitigation project has begun.
SEGi understands that our submittal and your acceptance of the enclosed information is all that remains to
complete the Individual Permit Application. Should I have forgotten anything or you deem additional
information is necessary, please feel free to email me at dlutherankse._ius or contact me at 910.452.2711.
As always, thank you for your continued time and assistance with this project.
Sincerely,
1 z
Dana A. Lutheran
Project Manager
Enclosures: Attachment 1 - Cursory Wetland Determination and Proposed Mitigation Map
Attachment 2 - NCEEP Mitigation Projects within Project HUC 03030007
Attachment 3 - Hofmann Forest Vicinity Map
Attachment 4 - Shelter Creek Quarry Wetland Summary Spreadsheet
Attachment 5 - Milestone Wetland Impact Plan
Cc: Ms. Joanne Steenhuis - DWQ WiRO (Hand Delivery)
Mr. Steve Holland - Client (US Mail)
Mr. Stephen Rynas - DCM, CAMA Consistency Coordinator (Electronic Mail)
'US Army Corps of Engineers. Regulatory Guidance Letter, No. 02-02. Subject: Guidance on Compensatory Mitigation Projects
for Aquatic Resource Impacts under the Corps Regulatory Program Pursuant to Section 404 of the Clean Water Act and Section
10 of the Rivers and Harbors Act of 1899.
5outhem Environmental Group, Inc.
5315 South College }load, `juite F, • Wilmington, NC 28412
Fhone: 910.452.271 1 • Fax:[phone] • Finail: of iCC0se-i.us
7 January 2011
Electronic Mail
Mr. Ronnie Smith
US Army Corps of Engineers
69 Darlington Avenue
Wilmington, NC 28403
Ronnie.D.Smithkusace.army.mil
Re: Revised Mitigation Acreages and Supplemental Information to Accompany the Proposed
Mitigation Plan, Submitted to the USACE on 12/17/10, for the Shelter Creek Quarry
USACE AID: 2008-01720
DWQ Project #: 05-1555
Dear Ronnie,
The following information reflects revised creation, restoration and enhancement acreage potentials, at the
Croomsbridge Road mitigation site. In addition, the proposed planting plan and further monitoring requirements
are outlined within in this correspondence.
Preliminary calculations produce the following potential mitigation acreages, for the Croomsbridge Road
Mitigation Site (please reference the attached Cursory Wetland Determination and Potential Mitigation Map for
details):
Type of Mitigation Potential Acreage
Enhancement 3.2
Restoration 0.25
Creation (Riparian) 30.53
Creation (Non-riparian) 24.05
Total 58.03
The following species will be included in the planting plan for the mitigation site (Note: "R" indicates the
species will be planted in riparian wetland areas and "NR" indicates species will be planted in Non-riparian
wetland areas):
Green Ash (R, NR)
River Birch (R, NR)
Willow Oak (NR)
Laurel Oak (NR)
Cypress (R, NR)
Titi (NR)
Wax Myrtle (NR)
Swamp Gum (R)
American Elm (R, NR)
The success criteria for this wetland mitigation project will be addressed in terms of three parameters:
vegetation, soils and hydrology. Success criteria will be based upon the following:
* Species survival will meet or exceed 320 trees/acre after 3 years and 260 trees/acre after 5 years. No one
species should account for more than 50% of the composition (any areas that do not meet these
requirements will be spot-planted);
* Hydric soil development (e.g., accumulation of an organic layer, the presence of hydrogen sulfide, etc.);
and
* Hydrology is found within the first 12" for greater than 12.5% of the growing season.
Success of the mitigation site will be monitored annually and the findings submitted to the relevant agencies by
31 December of each year.
As always, should you have questions regarding the content of this letter or you desire further information,
please call me at 910.452.2711.
Sincerely,
Dana A. Lutheran
Project Manager
Enclosures (1)
Cc: Joanne Steenhuis - WiRO 401 Wetlands Unit
Application for Department of the army Permit OMB APPROVAL NO. 0710-0003
(33 CFR 325) Expires December 31, 2004
The Public burden for this collection of information is estimated to average 10 hours per response, although the majority of applications should require 5 hours or less. This includes the
time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments
regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters
Service Directorate of Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302; and the Office of Management and Budget, Paperwork
Reduction Project (0710-0003), Washington, DC 20503. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to
comply with a collection of information if it does not display a current valid OMB control number. Please DO NOT RETURN your forms to either of those addresses. Completed
applications must be submitted to the District Engineer having jurisdiction over the location of the proposed activity.
PRIVACY ACT STATEMENT
Authorities: Rivers and Harbors Act, Section 10, 33 USC 403; Clean Water Act, Section 404, 33 USC 1344; Marine Protection, Research and Sanctuaries Act, 33 USC 1413, Section 103.
Principal Purpose: Information provided on this form will be used in evaluating the application for a permit. Routine Uses: This information may be shared with the Department of
Justice and other federal, state, and local government agencies. Submission of requested information is voluntary, however, if information is not provided the permit application cannot be
evaluated nor can a permit be issued.
One set of original drawings or good reproducible copies which show the location and character of the proposed activity must be attached to this application (see sample drawings and
instructions) and be submitted to the District Engineer having jurisdiction over the location of the proposed activity. An application that is not complete in full will be returned.
(ITEMS 1 THRU 4 SHOULD BE FILLED BY THE CORPS)
1. APPLICATION NO. 2. FIELD OFFICE CODE 3. DATE RECEIVED 4. DATE APPLICATION COMPLETED
(ITEMS BELOW T O BE FILLED BY APPLICANT)
5. APPLICANTS NAME 8. AUTHORIZED AGENT'S NAME AND TITLE (an agent is not required)
Shelter Creek Capital, LLC (Owner/Applicant) d/b/a Southern Environmental Group, Inc. (Ms. Dana A. Lutheran)
Shelter Creek Quarry
6. APPLICANTS ADDRESS 9. AGENT'S ADDRESS
12121 NC Highway 53 East 5315 S. College Road, Suite E
Maple Hill, North Carolina 28454 Wilmington, North Carolina 28412
7. APPLICANT'S PHONE NOS. W/AREA CODE 10. AGENT'S PHONE NOS. W/AREA CODE
a. Residence a. Residence
b. Business 910.259.0601 (o) b. Business 910.452.2711 (o) or 910.228.1841 (m)
11. Statement of Authorization
I hereby authorize, Ms. Dana Lutheran, of SEGi to act in my behalf as my agent in the processing of this application and to furnish, upon request, supplemental
information in support of this permit application.
See Attached Letter of Agency
APPLICANTS SIGNATURE DATE
NAME, LOCATION AND DESCRIPTION OF PROJECT OR ACTIVITY
12. PROJECT NAME OR TITLE (if applicable)
Shelter Creek Quarry
13. NAME OF WATERBODY, IF KNOWN (if applicable) 14. PROJECT STREET ADDRESS (if applicable)
Holly Shelter Creek 12121 NC Highway 53 East
15. LOCATION OF PROJECT Maple Hill, North Carolina 28454
Pender North Carolina
COUNTY STATE
16. OTHER LOCATION DESCRIPTION, IF KNOWN (see instructions)
The proposed project site is located on the south side of NC 53 east of Burgaw, NC. Please see the attached
documentation for a complete description of the site.
17. DIRECTIONS TO THE SITE:
From Wilmington, travel west on I-40 to the NC 53 exit. Turn left onto NC 53. The site is located approximately 9.8
miles down on the left side of the road.
ENG FORM 4345, JUL 97 EDITION OF FEB 94 IS Proponent: CECW-OR
OBSOLETE
18. Nature of the Activity: (Description of Project, include all features)
Please see the attached documentation for a complete description of the proposed project.
19. Project Purpose: (Describe the reason or purpose of the project, see instructions)
To expand an existing limestone mine in northeastern Pender County. Please see the attached documentation for
additional information.
USE BLOCKS 20.22 IF DREDGED AND/OR FILL MATERIAL IS TO BE DISCHARGED
20. Reason(s) for Discharge
Expansion f an existing limestone quarry. Please see the attached documentation for additional information about
the reason for the purposed discharge.
21. Type(s) of Material Being Discharged and the Amount of Each Type in Cubic Yards
Only clean fill material will be used. The cubic yardage is unknown at this time as it will be dependent on the final
mine reclamation.
22. Surface Area in Acres of Wetlands or Other Waters Filled: (see instructions)
Approximately 42 acres.
23. Is Any Portion of the Work Already Complete? Yes No X IF YES, DESCRIBE THE COMPLETED WORK
24. Addresses of Adjoining Property Owners , Leases, Etc., Whose Property Adjoins the Waterbody (if more than can be entered here, please attach a
supplemental list )
Please see the attached documentation for a list of adjacent property owners.
25. List of Other Certifications or Approvals/Denials Received from other Fedral, State or Lacal Agencies for Work Described in this Application.
Please see the attached documentation for a list of other authorizations.
26. Application is hereby made for a permit or permits to authorize the work described in this application. I certify that the information in this application is
complete an accurate. I further certify that I possess the authority to undertake the work described herin or am acting as the duly authorized agent of the
applicant.
1-19-11
Signature of Applicant Date Signature of Agent Date
The application must be signed by the person who desires to undertake the proposed activity (applicant) or it may be signed by a duly authorized agent if the
statement in block 11 has filled out and signed.
18 U.S.C. Section 1001 provides that: Whoever, in any manner within the jurisdiction of any department or agency of the United States knowingly and willfully
falsifies, conceals, or covers up any trick, scheme , or disguises a material fact or make any false fictitious or fraudulent statements or representations or makes or
uses any false writing or document knowing same to contain any false, fictitious or fraudulent statements or entry, shall be fined not more than $10,000 or
imprisoned no more than five years or both.