20071362 Ver 1_Application_20070809

t~l'R Use oDly: Farm Version March OS
07- 1 362
USACE Action ID No. DWQ Na
~~Y particular item is not applicable to this project, please enter "Not Appliabk" a "N/A'.) -
I. ProowisQ
II.
1. Check all of the approval(s) requested for this project:
X Section 4041'~errnrit ^ Riparian or Watershed Buffer Rules
^ Section 10 Permit Isolated Wetland Permit from DWQ
^ 401 Water Quality Certification ^ Express 401 Water Quality Certification
2. Nationwi~, Regional of General Permit Number(s) Requesbed:_~imnl
3. If this notification is solely a courtesy copy because written ap~oval for the 401 Certificxition
is not required, check here: ^
4. If payment into the North Carolina Ecosystem Enhancemeirt Program (NCEEP) is ~oposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section VIII,
and check here: ^
S. If your project is located in arty of North Carolina's twenty coastal oozmties (listed on page
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), choc
~~ ~" `.a 0-.6 !
i ~~~!
Applidwt Intorsattioo ~'a
AU G ; - L001
1. C~va~cf/~~pplic~t Infocmaaa~n
_ DEiVR - VMA7ER QUALITY
NamC: `A~V~'~- ~ .,1NiT1 ~:D~~a11~ STrlriuuerGR sRatiCH
,,.
Mtu Add~:2l l Dnv~e
TalLhaaree $,„2312
Telephone Number: 850-385.1968 Fax Nun~t:
Umail Address:
2. Ag~oat/Co~naultant Iufotmaiioa (if aapp~abk). A signed and dated cep9- of the Agent
Anthociratiat letter mulct be attacked if the Agent beer y authority for the
ov~ner/applicant.
Name: John W. Patrick III
Mailing Address: ~,QQ~Walker~,,,!
g/avnesville N C. 2~~$,¢
Telephone Ntnnber: 828-456-5742 Fax N~miba:
~~ iinROOs
Page S of l3

E-mail Address: MMI) [e-mail]
IIL Project Intor®atjoe
Attach a vfcieity r~ clearly showing toe loagion of the pr+opaty wish t+eapect to local
swdt as towaa„ rivets, and roads. Also peaviide a detected sine ~ showing pr+opdiy
boundturies and dcvel~opmeltt plms in re~tion far sunk ltd Beth tltevtgoity map
~ site plea must induda a scale and north artxror: The ~ ~ of all b~,
impervio~ s-, a ct6er faciltios nw~ bo i~lttdocl. I~p~ossd>ley the and pans a~Oaid
include the typ~propriNUe USC#S Tqp~~ Qtad ~d I~BtCS 3oi1 Satvay ~ the pt+aperty
boua~ries outlined. Platt ~, ar other maps mxY ba itt~ladmd at tie ~~ dam,
so loa~g as the pcopcaty is deuly domed. Foc ads~iativra ~md rihutiae parpos~s, the
USAGE i+an do be aa~anitiad tat alteett ~ t ~l bgr 17-iudt ~'am~at;
bstwav~r. flWQ may p~ ~ ~Y si>sa. 1~1f~Q ptbta ftd!-siaae' ea~aetcu~auan
~ ts#fiar dent a srl thoet vstrsivtt of ~ If fill-asa Phm ane
roduood' o a small awe sum the ~ final vet is ~ the ~ be ~ that
the project has bean pied on hold until docdp~ taMpr a~ prawided.
1. Name of project: Avery Patrick Culvert Extension
2. T.I.P. Project Number or State Project Number (NCDOT tanly):
3. Property Idemific~tion Number (Tax PIN): 7684-34-2608
4. Location
Subcllvision AiriMe {itw`duda ~ '~ VWr iQ t
tp (inolud~ rclitd ~mnb~~, pc~;, ~~ _ .. ,.
S. Site coardiaates (Far liter per, sttdt as a tva~d or uy attach a sheet that
sepraa~:ly fiats the cxx~rd~es fbt each ~ of a ~ w~'body.)
Decimal Degt~eea (6 digit min): 'N ~
~ - tas` - P=~.~'
6. Property siu (ac
7. Name of newt
i~~ ~~
8. River Bssi~a~:.,;~_

(Na-tiee -this must be tote of Noah Carolina's aevettboen daaugm~ed mgor tiv+at basins. The
River Basin map is available at httn:/ih2o.eaac.statc.nc.ualad~mrrinrf/.)
9. Describe the vonditiions ~ the site snd gdtaxl bmd u'e in the vicioi4y of the projat
at the time of this ~:
of two houses (houeMe >?~ not votl ytr- resid~ial davr>t~artetit.
upa.aea ~ inrioos
Page 6 of 13

10. Deacnbe ~ ovetaU projer~ in detail, including lire type of oquipoa~ to be usod:i
11. Ex~uin the P t~wffthe ptapoeeed woti
1V. Prbr Project Hiat~ry
If juti~dictiaaal detelctuintrtioas and/or panmifs ht~+e tequ~e~ptl s~d/ec- uhlrtned fosr flora
p~ ( ~ ~ of t~ha asalas } ~a tic p ~ ~. Tfe
the USAGE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approvod wetland, stream and
buffer impacts, along with associated mitigation (where applicable). ff this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules. None
Y. Fntnre Project Pbw
As+e ~Y p ~' this projecC? if ao, de~be the parod work,
and provide j~oa far the ex~ctusion of this writ from the application.
None
vL Proposed Impacts to waaxa of the United 3tat+esJWatea~- of fire State
It is the applicant's (ar ag~t'a) ~1ity m dctermine, delineatie and m~ ail imoipecffi m
w open water, and stream channels arnoocialed wide dta p%yeot. Fad unprat mmR be
lisbod sftpr~ly in tlse tabu bctmr- (e.g., cutvart i~tf#tion should be d s~mpaty fmm
rp~sp ~ l~)• He sure m indicate if an is Y. AU dpvsed .
permma~t and temporary, must be listed, and moat be feted snd cknrly i~dantil~b~ia on ~i
accompanying sire prem. All vredutds and waters, and aD steams (inkarmitt~eat a0d Pte)
upa.ma ~ virzflos
Paige 7 of 13

should be shown on a delineati~ou map, whether or not impat~a an prapoeod to- these ay~ns.
Wetland and stram tvaluatio~n and dalinr norms ~oold be inc~ded as atppmquiate.
Plw~ogtctphs m~- be iucludod ~ the discantioai. If this Pau'P ~ Y ~
wr~ltutd or stream mi~ig~ation, list and describe the impel in Sotxon VIII. below Tf additional
space is needed for listing or description, please attach a separate sheet.
Provide a written description of the proposed impacts: tnafall 30' of Culvrxt to exteid pro-
existing culvert. Cover the culvert back with rip-rap, clay dirt, and gravel to form the mad
base.
2. Individually list Weiland impacts (if applicable). N/A . Types of impacts include, but are not
limited to mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc.
For dams, seaarateh- List imt~acts due to both structure and flooding.

Wetland Imparx
Site Number
(indicate on map)

Type of Impact
Type of Wetland
(e.g., forested, mush,
harbaoeous, bag, etc.). Lowed within
i ~ y~
~n
no Dbtanoe to
Nearest
gym
Seat Area of
Impact
{acres)

Total Wetland Impacx (a~+es)
3. List the total acreage (estimated) of ail existing Wetlands on the poly:
4. hulividuetlly list all imtxatttittxatt tanid petetwtittl att~tm inf. Be strne to i~de'y ~r
impacts. Stt+eatn impacts include, but arc tat limited ~ pllaad~t of fll or csulvats, clam
coastrrtction, floodi~, rth~ st~tbilizatic~a amities {e.g, cena~at wlllla, ripahp, cnb
walls, gabions, etc., excavaf~ion, ditching~'stxagl~, ebc. If stiraunt won is prapo~ed,
~ ptaol'ilts ~ tht: litaatr foot~int for bath the aigintl and d isms
mud be included. To calculate multi X wi then divide 43 560.
5traam Impacx Aver~rge Area of
Number Stream Name Type oSlmpacx Pte? Stream Width Lmigtit Impsxt
indicate on Before Seat aces
A ~OverBow E~aoaion Parnn~sl 4" ~~
B Fill ~ Peraattial a~ 30'
Total Stream Impact M' teiogth soil ar+~ge) 30' .0068
Upd~oed I1/1/2005
Page 8 of 13

5. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atiautic
Ocean and any other water of the U.S.). Open water impacts include, but are not limited to
fill excava ' floodi bulkheads, etc.
Oj Sfte,Nt~im
indicate on Name of Waucbody
f if a1Pl~-We) Type of Impact pake, Pond, ofestwrY. sound, baY,

etc. I

acxes

Total Open Water Impact (aa+es)
b. List ~e cumulative impact to all Waters of the U_S_ resukinQ ftnm tl~e .m~iec~•
Stream Im, ages 0068 - - -
Wetlarai Im t acres
Water Im acres
Total Im to Waters of the U. S. acres
Total Stream feet : 30'
7. Isolated Waters
Do any isolated waters exist on the property? ^ Yes ^ No
Describe ail impacts to isolated waters, and include the type of water (wetland or stte~am) and
the size of the proposed impact (acres or linear feet). Please Hate that this section only
applies to waters that have speciScally been determined to be isolated by the USACE.
8. Pond Creation
If construction of a pond is proposed, associated wedand and stre:un impacts should be
included above in the wetland and stream impact secxions. Also, the proposed pond should
be described here and illustrated on any maps included with this cation.
Pond to be creates in (check all that apply): ^ uplands tstream ^ wetlands
Describe the method of wnstraction (e.g., datn/embankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or Propose of pond (c.&, li`-estock watering, irrigation, aesthetic, trout pond,
local stormwater requin~nterrt, etc.):
Current land use in the vicinity of ~e pond:
Size of watershed draining to pond: Expected porsi surface area:
VII. Impact JnatiBcatiion (Avoidsooe sad Miaimizatiaa)
Specifically descnbe measrues taken to avoid the proposed impacts. It may be useful to provide
i~onnation related to site aonsttaints sueli as topography,. building a aooessibility, and
financial viability of the pmject. The appticaat may attach diawiggs of alternative, lower-impact
site layouts, and explain why these design options were not feasbk. Also how impacts
t~ i vtrioos
Page 9 of 13

were minimized once the desired site plan was developed. If appTicsbk, cbscuss construction
techniques to be followed dining construction to reduce impacts. Following the lay of the land
this entrance minimizes impact on the Iand by creating an entrance that follows dye lands natural
grade. If we were to enter from any other spot we would create a driveway that was steep and
fiilt of switchbacks which would Have a potential for erosion and soft corners. in addition we feel
that this will improve the fie-existing condition of the paved road, as this improvement will
widen the road and wdi ~ stress of the bottom side of the curve. We arc working with a local
engineer that is completing our erosion control plan in order to prevent arty unnecessary damage
tQ the property.
ice. il~itigattiae
UWQ~ - ln. accor~anc~ with ISA NCAC 2N .4504, ~ may be required by the NC
Division of Water Q~lity for projects involving greater than or equal to one acre of impacts to
freshwater v~+~tlands or .greater than. or equal to 150 linear feet of total imp®cts to perennial
streams.
USACE - In accordance with the Final Notice of Issuance and Modificaltion of Nationwide
Permits, .published in the Federal Register on January 15, 2002, mitigation will be inquired when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed Examples of mitigation that may be appropriate and practicable include,
but are oat limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWf~ to consider the application comrpl~ete for processing. Any applicxition
lacking a required mitigation plan or NCEEP concurrence shall be placed on hold as incomplete.
An a~ maY also choose to nwiew tht cntreirt ~gttidelines for s men in I3WQ's
Draft Technical Guide for Stn~+m Work in North Carolina, available at
~tlp://h2o.enr.state.nc.us/ncwetlands/strmpde.html.
1. P~vide abrief mesa-ef the -imposed .mitigation plan. Tire desixiptioa should .provide
as much information as possible, including, but not limited to: site location (attach directions
and/or. map, if offsite), affected. stream and. river basin,. type and amount (acreageJlinear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation eascenent, etc-), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
t~a.c«i >>nrtoo3
Page 10 of 13

2. Mitigation may also be made by payment into the North Carolina Ecosystem Enhancement
Program (NCEEP}. Please note it is the applicant's responsibility to contact the NCEEF at
[phone] to determine availability, and written approval from the NCEEP indicating
that they are wilt to accept payment for the mitigation must be attacls~d~ do this form. For
additional information regarding the application process for the NCEEP, check the NCEEP
website at htto://h2o.enr.state.nc.us/wt>4/index.htm. If use of the-NCEEP is proposed, please
check the appropriate box on page five and provide the following information:
Amount of stream mitigation requested (linear feet):
Amount of ~bu€fer miti$atiert requested{ feet}
Amount of Riparian wetland mitigation requested (acres):
Amount of Men-riparian. d man. r~ec~ested (.acres):
Amount of Coastal wetland mitigation requested (acres):
IX. Eavironmental Docame®tatlon (repaired by DWQ)
1. Does the project involve an expenditure of lic (federal/statrJlocai) fiords or the use of
public (foderallstabe) land? Yes ~ No X
2. If yes, does the project require preparation of an environmental documenrt pursuant to the
requirements of the National or North Carolina Environmental Policy Ad (NEPA/SEPA)?
Note: If you are not sure vfiether a NEPA/SEPA document is required; call the SEPA
coordinator at (919 733-5083 to review current thresholds for emiromnental documentation.
Yes ^ No {]
3. If yes, has fhe document review been finalized- by the Mate L'learinghouse? if so, please
attach a copy of the NEPA or SEPA final approval lettier. Yes ^ No ^
X. Proposed Impacts on Riparian and Watershed Buffers (repaired by DWQ)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
rahtired: smote and. k~. buffers asseeiated with- the prejed. Tire applicant must also provide
justification for these impacts in Section VII above. All proposed impacts mum be listed herein,
and tuner be clearly ider~fuible on the accompanying site plan. All buffets must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional f2i~ce .may be included. as appropriate.. Photographs may also be included at the
applicant's discretion.
1. Will the project impact protected riparian buffers identified within ISA NCAC 2B .0233
(Meuse), 1 SA NCAC 2B .4259 (Tar-Pamlico), I SA NCAC 02B .4243 (Catawba) l SA NCAC
2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify 1? Yes ^ No ^
upa.aea >>naoos
Page 11 of 13

2. If "yes", identify the square feet and acreage of impact to each wne of the riparian buffers.
If buffer mitigation is required calculate the required amount of mitigation by applying the
buffer multiplicrs.
XL
3.
Roquined
Zoe ._ r. Muhiplier tu:t:..~:....
1 ~ ( 3 (2 for Catawba) I I
I- 2 ~ 1.5
T0~ i I I
• Zane 1 axta~ods oat 3o foatpapa~c~h snm the taQ of the nar bank of cbamd; Zanc 2
additional 20 fact from the edge of Zone 1.
If buffer mitigation is required, please discuss what
Donation of Property, Riparian Buffer Restoration /
Riparian Buffer Restoration Fund). Please attach all
within 1 SA NCAC 2B .0242 or .0244, or .0260.
Stormwater (regnired by DWQ)
Describe impervious acreage (existing and proposed) versus total acreage on the site. Discuss
stormwater controls proposed in order to protect surface waters acrd dovt-rrstream fc+om
the property. If percent impervious surface exceeds 20'/0, please provide calculations
demonstrating total proposed impervious lever.
~t
Sewage Bisptlaud {~regnired by D~W-Q)
Clearly detail the tiltimate treamrent methods. and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
XIII. Violations (regnired by DWQ)
Is this site in violation of DWQ Wetland Rules (1 SA NCAC ZH .0500) or any Buffer Rules?
Yes ^ No X
Is this an after-the-fact permit application? Yes ^ No X
XIV. Cmm~lative Impacts (regnired by DWQ)
Will this project (based on past and reasonably anticipated future impacts) result in additional
development, which could impact nearby downstream water quality? Yes ^ No ^
axtanda an
type of mitigation is proposed (i.e.,
Enharicernent, or Payment into the
appropriate information as identified
upa.c«t ~ tnrzoo3
Page 12 of 13

If yes, please submit a qualitative or quantitative cumulative impact analysis in accordance with
the most recent North Carolina Division of Water Quality policy posted on our website at
hit p://h2o.enr.state.nc.us/ncwetlands. If no, please provide a short narrative description:
XV. OtLer Circnmstanca fOptionalr
It is the applicant's re~onsJbility to submit the applicatiion sufficiently in advance of desired
constzuction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the ~s control).

Appt~dlndA,g~ats Su/aupe Date
(Agent's signature is valid tinly if an authorization letter from the applianlt is pnotiided)
via rrnnoos
Page 13 of 13

Avery , -~roM JUar-~
10~ ~ 110 ~ ~ahf I t J
Co~.~oa~ni~ • 91 acre
LOAbf
North
_~
--~
~~
'~'`
~, -~. ,_
1~
,:
li

Soil Survey for ?6g4-34-26(18 Avery Patrick Culvert Extension
Rnilc
the South West corner.
N~~
Scale
~n the 1-laywood bounty Rfiap the strearn (reservoir overffP~ow) is eiot listed. '1The strewn in
question sits North West of the road We would like to extend the pme-existing culvert up
the strewn and build a road bed that enters the property with the PIIml 76~be3~®2608 on

USGS Topographic Quad Map for 7684-34-2608 Avery Patrick Culvert Extension
N ~
~Ob
Scale
On the Haywood County Map the streari (reservoir overflow) is not listed. The stream in
question sits North West of the road. We would like to extend the pre-existing culvert up
the stream and build a road bed that ewers the property with the PIN 7684-34-2b08 on
the South West corner.

Topography for 7684-34-2608 Avery Patrick Culvert Extension
T
~~~~~
~ ~ /'1 J
~.
L

On the Haywood County Map the stream (reservoir overflow) is not listed The stream in
question sits North 'LVest of the road. ~e would like to extend the pre-existing culvert up
the stream and build a road bed that erners the property with the PIN 7684-34-2608 on
the South West corner.
F
N (Q~
Scale

Hydrology for 7684-34-2608 Avery Patrick Culvert Extension
(Hydrology
1 ~~
0
72
1~
o~
,N
2\489
1„2A~0 378
2608 ~''
CAB C~4j50
~44p)
7.ri
ti
~./~+
4n the Haywood County map the stream (reservoir overftow) is not listed. The stream in
question sits North West of the road. We would like to extend the pre-existing culvert up
the stream and build a road bed that emers the property with the PIN 7684-34-2608 on
the South West corner.
f
~ ~D
a -~
S c~~L

J

~~

Page l of 1
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http: //www2. undersys. com/scriptsltestadv/usiwebd. dlUusi?formis=theme2&MouseX=1538c... 8/ 1 /2007

Lori Beckwith,
This letter is to inform and permit the authorization of John W. Patrick III to act on my
behalf as the Authorized Agent. Please recognize that John W. Patrick III has the
permission to obtain any pern~its that are required through the U.S. Army Corps of
Engineers.
Sincerely,
Avery Patrick
~_ I
Avery Patrick Date

,~ ZnstB 662598 Book 70 Fr~~
ag3m~tu~+h"~~~ ~~~~~-~!~<''i~!. ~ ~ pQs • 2 06/05/2007 Ol : 36 : 26pm
Da:~d jc ~~ ;„~-;~ ~~,;.~~,~t County Tax Copeda '
_ .~ --~
Excise Tax -0- Do NOT write above this lino. Recording: Time, Book and Page
North Caroiina C~~itclairn ~~ed
This instrument prepared by: Wm. I . Mi 11 ar TITLE NOT CHECKED BY PREPARER
Brief description for the Index raC s a er n e i s
This Deed made this 5th day nt u ne , 20 07 , by and between Grantor and Grantee:
Enter in appropriate block for each party: Name, address, county, state and if appropriate entity (i.e., corporation, Partnership). The
designation Grantor and Grantee as used herein shall include all parties, their heirs, successors and assrgna and shall include singular,
plural, masculine, feminine or neuter as required by contest.
Grantor: MARION LOUISE PATRICK, by and through her Attorney In Fact,
JOHN W. PATRICK, II
__
rantee: AVERY A. PATRICK
Transfer of Ownership: Grantor, for a valuable consideration paid by Grantee, the receipt of which is hereby adcnawtedged, has remised and
released and does hereby remise, release and forever quitclaim to Grantee, the Property described below:
Property: City of '
Township of _ y sV ,County of Haywood ,North Carolina.
This property was acquired by Grantor by an instrument recorded in Book .Page County.
A map showing the property is recorded in Plat Book ,Page County'
The legal description of the Property is:
"TRACT ONF: BEGINNING at the Southwest corner of Spanier (Book 202, page 292) Lot 108 and
rung with Spanier's line N 02-24 F. 143.7 feet to the Northernmost point of Lot 108, at a stream:
thence with the stream and the line of "t"he Balsam Resorts. Inc. (Book 359, page 357) N 60-2U-32 W
l OR.83 feet and N ? 1-56.47 W 12.02 feet; thence 1~;aving the stream but continuing with ~1~he Balsam
Resorts. lnc. line N 14-06-33 F. 104.92 feet to the Northernmost outside boundary line of the Walker
In ! he: Hills property; thence with that boundary Iinc S 86-U6-16 W 6U.0 feet; thence S 43-St-16 1W
?70.45 feet to a point in the line of Lot 111; thence with the northern line of Lot 111 and Lot 110 S
75-57 I~. 1 X0.0 feet to the B[;GINN1NCi, containing 0.66 acres.
TKAC"I' 'fWO; BEGINNING at a point in the centerline of The High Road, Barton's corner (Book
442, page 1523)with Lot 109, and runs with the centerline of said road N 78-59 W 115.7 feet to th4
common corner of Lots 109 and 110; thence, continuing with the road, N 74-48 W 121.2 to a point,
rorncr hctwe:en Lot 110 and 1 1 1; thence following the centerline of the road N 74-48 W 76.2 feet
and S 62- I 0 W 36.55 I~et to the point of i»tcrsection with another road; thence N 54-00 W 36.8 lest
te- the: common corner between Lot I 1 1 and Lot 112: thence with the line between said lots N 09-18
Vd 1 R6.4ti feet; thence with the north lxxcndary of Lot 112, S 75-OS F.. 145.3 feat to a point. common
curne:r between lots 112 and 11 l ; thence with the north boundaries of tots 11 I and i 10 S 75-57 E
110.0 feet to a point, the line of i.ot 108 (Spanier. Book 202. page 292); thence with Spanier'ti
~te;ste:rn line S 02-24 V4' -)8.7 feet to the common corner between Lots 108 and 109; thence with the
line bct~a~~cn said lots S 72-SR W' 171.2 feet to a point in the center of The High Road; thence with
the center of said road S 07-22 W 102.4 feet to the BEGINNING, and BEING Lots 109, 110, and
1 1 1 nl' Walker In The Hills as shown on a plat from deeds b~~ .-ames `T. Herron dated 7-15-1968.
Continued on Page 2
After recording mail to: W I M
Tax Lot No. pert
Paroet tderriifrer No.
Verified By
nn the
day of
County,
~-
i