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Home My WebLink About19960975 Ver 3_More Info Received_20120213APPLICATION FOR DEPARTMENT OF THE ARMY PERMIT OMB APPROVAL NO 0710 0003 (33 CFR 325) EXPIRES 31 August 2012 Public reporting burden for this collection of Information is estimated to average 11 hours per response including the time for reviewing instructions searching NkAsting 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 Executive Services and Communications Directorate Information Management Division and to the Office of Management and Budget Paperwork Reduction Project (0710 -0003) Respondents should be aware that notwithstanding any other provision of law no person shall be subject to any penalty for falling to comply with a collection of information if it does not display a currently valid OMB control number Please DO NOT RETURN your form 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 Section 103 33 USC 1413 Regulatory Programs of the Corps of Engineers Final Rule 33 CFR 320 332 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 and the public and may be made available as part of a public notice as required by Federal law 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 completed in full will be returned (ITEMS 1 THRU 4 TO BE FILLED BY THE CORPS) 1 APPLICATION NO 2 FIELD OFFICE CODE 3 DATE RFCEIVED 4 DATE APPLICATION COMPLETE (ITEMS BELOW TO BE FILLED BYAPPLICANT) 5 APPLICANTS NAME 8 AUTHORIZED AGENTS NAME AND TITLE (an agent is not required) First Phu Middle Last- Edwards First John Middle M Last- Massoy Company - Columbus county Municipal Airport Company — Talbert 8 Bright Inc E-mail Address — PEDWARDS@COLUMBUSCO ORG E mail Address — JMASSEY@TSI1LM COM 6 APPLICANTS ADDRESS 9 AGENTS ADDRESS Address 467 Airport Road Address 4810 Shelley Dnve City — Whltevilie State — NC Zip — 28472 Country — USA C 1Y — W irninglon State — NC Zip — 28405 Country — usA 7 APPLICANTS PHONE NOs W /AREA CODE. 10 AGENT'S PHONE NOs WIAREA CODE a Residence b Business c Fax a. Residence b Business c Fax (910) 642 6187 (910) 763 -5350 (910) 762 -6281 STATEMENT OF AUTHORIZATION 11 1 hereby authorize John M Massey PE to act in my behalf as my agent in the processing of this application and to furnish upon request, supplemental bon in support of this permit application APP ANTS SIGNATURE DATE NAME LOCATION AND DESCRIPTION OF PROJECT OR ACTIVITY 12 PROJECT NAME OR TITLE (see uut uchons) Colmb s County Ahport P rellol Taxiway Runw y S fety ImprovemaNS Weiland Relocation a d Mmgetion and Installation of Culled es associated Environmental Assessme 1, USACE Action ID- SAW 2008x0851 13 NAME OF WATERBODY IF KNOWN (d applicable) 14 PROJECT STREET ADDRESS (dapprrabie) Camp Branch (Lumber River Basin) Address 467 Airport Road .- 15 LOCATION OF PROJECT Latitude N 34 1V 28" Longitude W TO 42 W City Whlteville State - NC / Tip 28472 16 OTHER LOCATION DESCRIPTIONS IF KNOWN (see instructions) State Tax Parcel ID seoatfaclanentm Municipality Section- sm Aea&~asi Township - LamnMWnft Range - 17 DIRECTIONS TO THE SITE From ILM US 76 West to US 701 Bypass South to Alrport Road Continue down Airport Road and arrive W 4§72polrt Ta�ffQ ad End) u[IVK WAIEROUAIJTY ENG FORM 4345 SEPT 2009 EDITION OF OCT 2004 IS OBSOLETE N0sAtD6TMMV § 0CW OR P. 18 Nature of Activity (Description of project, Indude all features) Construction of a parallel Taxiway along Runway 6 24 and connection (Stub) Taxiways Improvements /Expansion of Runway End 24 Safety Area Ciffsite Relocation of Wetlands Mitigation and Culvert Installation see attachment # 2 19 Project Purpose (De ribs the anon or purpose f th pro] I ee Instmdions) The Taxiway and Runway Safety Area construction and Wetland Relocation projects are to Improve overall Airport Safety based on FAA Design Standards and Regulations see attachment # 3 USE BLOCKS 20 23 IF DREDGED AND /OR FILL MATERIAL IS TO BE DISCHARGED 20 Reason(s) for Discharge FIII material must be placed to allow construction of the taxiway and runway safety area Improvements to elevations necessary to meet grading criteria based on FAA Design Standards 21 Type(s) of Material Being Discharged and the Amount of Each Type in Cubic Yards Type Type Type Amount in Cubic Yards Amount in Cubic Yards Amount in Cubic Yards 46 100 CY (Soil) 22 Surface Area in Acres of Wetlands or Other Waters Filled (see atsbucbons) Acres 7 86 AC (Parallel Taxiway) 0 5 AC (Runway Safety Area Improvements) 8 6 AC (Wetlands Mitigation to be relocated offsite) Or Liner Feet 30 feet (culvert) 23 Description of Avoidance Minimization and Compensation (see Instrudums) TM WxaYmW w" aMYAngusbMhftd Wn.mm rvdM prtldcrKd, -."W d. a NO wM dAUMU CCU IMW d .IWM Dr AA. TMWWaJ .A- NW — 1,.—d —hapotdfem 91 —1 MyaVgdniyi a[dda xtdd�mAYed me ep+ret® WW W dammed Pe ar w�dwamd MV-h add_ dr sl,L rltpmM parsldl Waxy •9 tb mntrueeed or erYnwi6KpeCW.ed WPd MMAn YidM edr mNntlN reuNMpx 1Iw 10npllWnym eeroena 0'e� 0.11 a &daryNn lib. w bu W nn �MArmm aOOwatlsfloW M a,Mv dmb. Wam roan Nh0 � qV 24 Is Any Portion of the Work Already Complete? Yes C] No IF YES DESCRIBE THE COMPLETED WORK 25 Addresses of Adjoining Property Owners Lessees Etc Whose Property Adjoins the Waterbody (If more than an he to ed here please attach a s pp em [at Irst) Address- SEE ATTACHMENT #1 City — State — Zip — 26 List of Other Certifications or Approvals/Denials Received from other Federal State or Local Agencies for Work Described in This Application AGENCY TYPE APPROVAL IDENTIFICATION NUMBER DATE APPLIED DATE APPROVED DATE DENIED SEE ATTACHMENT #4 for AGENCY COORDINATION Would include but is not restricted to zoning budding and flood plain permits 27 Application is hereby made for a permit or permits to authorize the work descn bed in this application I certify that the information in this application is complete and accurate I further certify that I possess the authority to undertake the work described herein or am acting as the duty authorized agent of the applicant Z /3 /I z SIGNATURE OF APPLICANT DATE NATUR OF ENT DATE The application must be signed by the person who desires to unde ke proposed activity ant) or it may be signed by a duly authorized agent if the statement in block 11 has been filled out and signed 18 U S C Section 1001 provides that Whoever in any manner within the funsdicbon 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 makes 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 not more than five years or both ENG FORM 4345 SEPT 2009