19991035 Ver 2_CAMA Application_20060919

('o3sverz
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor Charle S J
September 18, 2006
x...12 --'
s . Ones, Director William G. Ross Jr., Secretary
MEMORANDUM: SFP 19p
TO: Noelle Lutheran
401
Div. of Water Quality
FROM: Doug Huggett, Major Permits Coordinator
SUBJECT: CAMA / Dredge & Fill Permit Application Review
Applicant: Forest Sound HOA
Project Location: Howard's Lane, adjacent to the AIWW in Hampstead, Fender Co.
Proposed Project: To replace the breakwater and perform maintenance dredging along
channel and within basin
Please indicate below your agency's position or viewpoint on the proposed project and return
this form by October 4, 2006. If you have any questions regarding the proposed project,
please contact Heather Coats at (910) 796 -7424, when appropriate, in -depth comments with
supporting data is requested.
Lf0/
REPLY: ._ W21r7EA1
This agency has no objection to the project as proposed.
This agency has no comment on the proposed project. 5Y5
This agency approves of the project only if the recommended changes are
incorporated. See attached.
is agency objects to the project for reasons described in the attached
comments.
SIGNED & /"A— DATE
127 Cardinal Drive Ext., Wilmington, North Carolina 28405 -3845
Phone: 910 - 796 -72151 FAX: 910 - 395 -39641 Internet: www.nccoastaimanagement.net
An Equal Opportunity 1 Affirmalive Action Employer - 50% Recycled 1 10 °6 Post consumer Paper

Development Type
FEE
DCM %
14300 1601435100093 1625 6253
DWQ
24300 1602435100095 2341
I. Private, non<ommerclal
development that doesnol involve
$250
100% (5250)
0% (SO)
the filling or excavation of any
wetlands or open water areas:
,
II. Public orcommercial development
that does not involve the filling or
$400
100%(S400)
0% (SO)
excavation of any wetands or open
water areas:
III. Fordevelopmenl that involves Ne
filling and/or excavation of up to 1
acre of wetiands and /or open water
areas, determine if A, B, C. or D
below applies:
III(A). For Private, non-commercial
development, If General water Quality
$250
100%($250)
0% (SO)
Certification No.3301 (see attached)
can be applied:
III(B): For public or commercial
development, if General water Quality
§400
100% (5400)
0% (SO)
Certification No.3301 (see attached)
can be applied:
111(C). If General Water Quality
Certification No. 3301 (see attached)
((S
could be applied, but DCM staff
determined that additional review and
99
60% (5240)
40% (5160)
written DWQ concurrence is needed
because of cancems related to water
quality or aquatic life:
III(D). If General Water Quality
Certification No. 3301 (see attached)
5400
60%(S240)
40% (5760)
can not be applied:
N. For development that involves
-
thefillingand/orexcavationofmore
5475
60 %(S265)
40%($190)
than one acre of wetlands and/or
open water areas:

DIVISION OF COASTAL MANAGEMENT
FIELD INVESTIGATION REPORT
1. APPLICANT'S NAME: Forest Sound HOA
2. LOCATION OF PROJECT SITE: The project site located on Howard's Lane, adjacent to the AI W W, in
Hampstead, Pender Countv.
Photo Index - 2000: 26 -337: E, F(4) 1995: 26 -320: 0,P(9) 1989: 4 172 28: R,S(7)
State Plane Coordinates - X: 224122 Y: 2397875
Lat: 34 °21'30.72930 "N Long: 7740'54.16390" W
3. INVESTIGATION TYPE: CAMA / Dredge & Fill ROVER FILE 9: Q080716A
4. INVESTIGATIVE PROCEDURE: Dates of Site Visit — 08/07/06
Was Applicant Present —No
5. PROCESSING PROCEDURE: Application Received — Complete on 08/29/06
Office— Wilmington
6. SITE DESCRIPTION:
(A) Local Land Use Plan — Pender County
Classification From LUP — Community
(13) AEC(s) Involved: PT, EW
(C) Water Dependent: Yes
(D) Intended Use: Private
(E) Wastewater Treatment: Existing — N /A
Planned - N/A
(F) Type of Structures: Existing — Upland Basin with Finger Piers, Bulkhead, and Boat Ramp, thro 80'
Breakwaters, and Upland Gazebo
Planned — Replacement of existing breakwater and maintenance dredging.
of the existing boat basin and access channel
(G) Estimated Annual Rate of Erosion: N/A Source —N /A
7. IIA131TAT DESCRIPTION: [AREAL
DREDGED FII I Fn nru r_n
(A) Vegetated Wetlands
(I3) Non - Vegetated Wetlands - open water
13200 ft.2
160 ft.'
(incor) orated)
(C) Other (Shal low bottom)
28350 ft'
22500 ft.2
(E) Primary Nursery Area: No
(F) Water Classification: SA -ORW Open: No
8. PROJECT SUMMARY: The applicant is proposing to replace the existing breakwater and perform
maintenance dredging along the entrance channel and within the boat basin.
127 Cardinal Drive Ext., Wilmington, North Carolina 28405 -3845
Phone: 910 - 796 -72151 FAX: [phone] Unternet: www.nccoastalmanagement.net
An Equal Opportunity 1 Atfirmative Action Employer - 50% Recycled 110% Post Consumer Paper

Forest Sound HOA CAMA Permit
Page Two
9. PROJECT DESCRIPTION:
The project site is located on Howard's Lane, adjacent to the AIWW, in Hampstead, Pender County. To get to
the site from Wilmington take US Hwy 17 N to Forest Sound Road. Turn right onto Forest Sound Road, which
after approximately 0.6 miles becomes Corcus Ferry Road. Continue approximately 1.3 miles down Corcus
Ferry Rd. to Howard's Lane. Take a right onto Howard's Lane. Travel approximately 0.2 miles until you reach
the site on the left. The property is the common area for the existing Forest Sound subdivision and is located at
the S -bend on Howard's Lane.
The current elevation of the property averages approximately 8' above Mean Sea Level (MSL) and is
approximately 3.9 acres. In 1982, CAMA permit #81 -82 was issued for the construction of a high ground boat
basin with a connecting channel cut through coastal marsh to provide boat access to the Atlantic Intracoastal
Waterway (AIWW). The project was constructed in 1985. In 1999, CAMA Permit # 128 -99 was issued to
replace the bulkhead and perform maintenance dredging. The boat basin measures 270' in length by 105 - in
width and is currently —1.5' to —2' in depth at Normal Low Water (NLW). The existing channel measures
approximately 660' in length by 20' in width, and ranges from —2' to —4' in depth at NLW. Current depths were
provided by the authorized agent of the applicant and were obtained via soundings at low water. There is also an
existing concrete boat ramp and 20 finger piers currently within the boat basin. The basin provides dockage for
40 boats. There is an existing gazebo on the high ground portion of tine property. The high ground is vegetated
primarily with lawn grasses and Wax Myrtle (NIyrica cerifera). There are coastal wetlands located on the
waterward boundary of the site, which run the entire width of the property (approximately 130'). The landward
portion of the coastal wetlands consist mainly of Glasswort (Salicorrria sy3p), Spikegrass (Dislichlis .vpiceaa) and
Sea Oxeye (Borrichia fi-wescens). They extend approximately 30' landward from Normal High Water (NH W),
and transition waterward to an estimated 30' fringe of Smooth Cordgrass (Spartina crhern flo a) below NI-M7.
The Pender County Land Use Plan classifies the upland areas of this project as Community. The seaters of the
project site are classified as SA -ORW by the NC Division of Water Quality. The NC Division of Nlarine
Fisheries has NOT designated this area of the AIWW as a Primary Nursery Area, and the waters adjacent to
the proposed project are closed to the harvesting of shellfish.
PROPOSED PROJECT:
The applicant is proposing to replace the two existing 80' breakwaters along the shell bank within tite existing
footprint. The replacement ti ould result in the use of approximately 160 linear feet of vinyl wall. "File applicant
is also proposing maintenance dredging within the channel and boat basin. The dimensions of the proposed
dredging within the channel would be approximately 660' in length by 20' in width. The dimensions for the
proposed excavation within the boat basin would be 270' in length by 105' in width. The final project depth for
both the boat basin and the channel would be --4' at Normal Low Water (NLW). Approximately 1538 cubic
yards of material would be dredged. The applicant proposes to dredge using a clamshell bucket to truck and to
place the spoil material on the high ground portion of the lot. The applicant states that appropriate sediment
control measures will be used to control runoff from the disposal site. Once the material dewaters, the applicant
would spread it on the high ground area of the site.
127 Cardinal Drive Ext., Wilmington, North Carolina 28405 -3845
Phone: 910 - 796 -72151 FAX: [phone] Internet: www,nccoastalmanagement.net
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10. ANTICIPATED IMPACTS
The excavation of the boat basin and channel would disturb approximately 41550 ft.' of shallow bottom. The
dredging operation will likely result in a temporary increase in turbidity. The installation of the breakwater
would impact approximately 160 square ft. of shallow bottom. The high ground disposal would result in at least
22,500 square feet of land disturbance. More land may be disturbed as a result of final spreading and grading of
the material once it has dried. The depth and width of the channel would not be increased above what was
originally authorized by previous permits.
Submitted by: Heather Coats Date: September 15, 2006 Office: Wihnin"tou
127 Cardinal Drive Ext., Wilmington, North Carolina 28405 -3845
Phone: 910 - 796 -72151 FAX: [phone] Internet: www.nccoastalmanagement.net
An Equal Opportunity IAflirmalive Action Employer— 50% Recycled 110% Post Consumer Paper

Sep 11 06 08:51p Hal Fogleman 810- 2703374 p,2
Forest Sound Marina Breakwater Replacement and Maintenance Dredging
Project Narrative
Forest Sound is an existing subdivision located off of Highway 17 N in Hampstead, NC,
Pender County. In June, 1982, CAMA Major Permit #81 -82 was issued for the
construction of u high ground marina basin with a connecting channel cut through coastal
marsh providing boating access to the Atlantic Intracoastal Waterway. The project was
constructed in 1985. The marina is used by the property owners within the subdivision.
The basin has an existing vinyl bulkhead that was replaced about 6 years ago. The free-
standing wooden breakwaters in the area where the dredged channel goes through the
marsh are ('ailing and the applicant wishes to replace them with vinyl. The replacement
consists of approximately 160 linear feet of vinyl wall.
The applicant is requesting to perform maintenance dredging of the existing basin (105'
wide by 270' long) and the connecting channel (660' long by 20' wide.) Current
soundings at low tide have been provided by the applicant and are shown on sheets I and
4 of 6. Water depths currently range from 2.5' to 5' deep at low tide within the project
area. The final project depth after dredging would be -4' at low tide in the basin and the
channel. The applicant proposes to use a clamshell to perform the dredging work.
Approximately 1500 cubic yards of materials are to be dredged. A 22,500 square foot
disposal area has been designated on the high ground portion of the common area
adjacent to the boat basin (see drawing 2 of 6.) Appropriate sediment control measures
will be used to control sediment runoff from the spoil disposal site. Once the material
dewntcrs and begins to dry, it is to be spread out on high ground around the site.
Anticipated Impacts
The high ground spoil dispw d will result in at least 22,500 square feet of land
disturbance. More land may be disturbed as a result of the spreading and final grading of
the spoil material once it has dried. The dredging operation will likely result in
temporary turbidity and alteration of approximately 41,550 square feet of shallow
bottom.
No federal or coastal wetlands are to be disturbed as a result of this work. The original
depth and width of the channel will not be increased above what was authorized in 1982.

Form DCM -MP -I
rte;
APPLICATION`
(To be completed by all applicants)
—_- b. City, town �qmmunity or I dmark
1. APPLICANT V/ aP 5 den J
a. Landowner: L/DA' 5 WA 0-05-10
Name &nJ J/ero&C9WYVTS
Address J &
rr �
IIA 6. Lax( /
City I�tt�r P Case State /vU
Zip c LL� Day Phone NI/t
Fax ./li
Authorized Agent:
Name A I s a,� l lhf� Ln�r Yl
Address
c. Street address or secondary road number
))f.
/fS6d. Is proposed work within city Ijmits or planning
Jurisdiction? Yes 2L No
e. Name of body of water n est prof t (e.g. river,
creek, sound, bay) _C (t��s
3. DESCRIPTION AND PLANNED USE
OF PROPOSED PROJECT
LL La. List all development activities you propose (e.g.
building a home, motel, marina, bulkhead, pier, and
excavation and /or filling activities.
City i�Iem�,S�ec(� State /�� c Ore v
Zip a� Day Phone b Is the proposed activity maintenance of an t
Fax AJ
c. Project name (f any)
GeV-
NOTE: Permit WX be ija d in rrarra ojlandowur(r), and /or
PMjeu name.
2. LOCATION OF PROPOSED
PROJECT
a. County
Revised 0.3/95
exis mg
project, new work, or both? rybjA4c#WOU
c. Will the project be fqr public, private or coipmercial
use ?�/
d. Give a brief description of purpose, use, methods of
construction and daily operations of proposed
project. If more space is needed, please attac
additional p g �d 1 C�Gi1�
vd

I
Norm DCM -AiP -I
4. LAND AND WATER m. Describe existing wastewater treatment facilities.
CHARACTERISTICS
a. Size of entire tract 2. 9 j
b. Size of individual lot(s)�
c. Approximate elevation pf tract above MHW or
NWL SS
d. Soil type(s) and texture(s) of tract
i new k�
e. Vegetation on tract _n: -,5S
n.. Describe location and type of discharges to waters
of the state. (For example, surface runoff, sanitary
wastewater, industrial /commercial effluent, "wash
down" and residential discharges.) ,
f V 11 1
o. Describe existing drinking water supply source.
f. Man -made features tray CG /rY>7/
r10ct .! J /Onyx F 64Pmt Gk, 5. ADDITIONAL INFORMATION
g. What is the CAMA Land Use Plan land
classification of the site? (co uu du local lurid we Plan,)
_ Conservation Transitional
_ Developed Community
_ Rural _ Other
h. How is the tract zoned by local government?
L Is the proposed project consistent with the applicable
zoning? % Yes _ No
(Aaach zoning compUance certificate, if appUaabl,)
j. Has a professional archaeological assessment been
done for the tract? _ Yes
No
If yes, by whom? Q4
k. Is the project located in a National Registered
Historic District or does it involve a National
Register listed o eligible property?
_ Yes ' � No
1. Are there wetlands on the site? A- Yes _ No
Coastal (marsh) - -�— Other I,I
If yes, has a delineation been conducted? 1)IPT-
(Arad, docvmentntion, if mailable) - �1
Revised 03195
In addition to the completed application form, the
following items must be submitted:
A copy of the deed (with state application only) or
other instrument under which the applicant claims title
to the affected properties. If the applicant is not
claiming to be the owner of said property, then
forward a copy of the deed or other instrument under
which the owner claims title, plus written permission
from the owner to carry out the project.
• An accurate, dated work plat (including plan view
and cross - sectional drawings) drawn to scale in black
ink on an 8 1/2" by 11" white paper. (Refer to
Coastal Resources Commission Rule 7!.0203 for a
detailed description.)
Please note that original drawings are preferred and
only high quality copies will be accepted. Blue -line
prints or other larger plats are acceptable only if an
adequate number of quality copies are provided by
applicant. (Contact the U.S. Army Corps of
Engineers regarding that agency's use of larger
drawings.) A site or location map is a part of plat
requirements and it must be sufficiently detailed to
guide agency personnel unfamiliar with the area to the

R E- C Li V Lt �J
Form DCM-MP-I DCM YiILMING i ON, NC
n!�_ g 1 2006
site. Include highway or secondary road (SR)
numbers, landmarks, and the like. 6. CERTIFICATION AND PERMISSION
®A Slormwater Certification, if one is necessary. TO ENTER ON LAND
® A list of the names and complete addresses of the I understand that any permit issued in response to this
adjacent waterfront ( riparian) landowners and application will allow only the development described in
signed return receipts as proof that such owners the application. The project will be subject to conditions
have received a copy of the application and plats and restrictions contained i-i the permit,
by certified mail. Such landowners must be advised
that they have 30 days in which to submit comments I certify that to the best of my knowledge, the proposed
on the proposed project to the Division of Coastal activity complies with the State of North Carolina's
Management. Upon signing this form, the applicant approved Coastal Management Program and will be
further certifies prat such notice has been provided. conducted in a manner consistent with such program.
Name 1A1151 I certify that I am authorized to grant, and do in fact,
Address /,: C /r f..r / ni l rl s d migrant permission to representatives of state and federal
Phone / review agencies to enter on the aforementioned lands in
/) f connection with evaluating information related to this
Name„ Sc-'Y- permit application and follow -up monitoring of the
Address /-n77e , ilk
Project.
Phone
Name . //
Address / V
Phone
A list of previous state or federal permits issued for
I further certify that the information provided in this
application is truthful to the best of my knowledge.
Q .emu,(
This is the k— day of _, 19 6
work on the project tract. Include permit numbers, Print Name Pan,)✓ /noS /n/ �� /tia!/ � fl)�
permittee, and issuing
� Yd�7 la tes. g� ala3J��C� SigratureL/ � A(LL5. i j V orAu h ed/ A
r g
rn
® A check for $250 made payable to the Department of
Environment, Health, and Natural Resources
(DEHNR) to cover the costs of processing the
application.
® A signed AEC hazard notice for projects in
oceanfront and inlet areas.
• A statement of compliance with the N.C.
Environmental Policy Act (N.C.G.S. 113A - 1 to
10) If the project involves the expenditure of public
funds or use of public land's, attach a statement
documenting compliance with the North Carolina
Environmental Policy Act.
Revised 03195
Please indicate attachments pertaining to your proposed
project.
�L DCM MP -2
DCM MP -3
DCM MP-4
_ DCM MP -5
_ DCM MP-6
Excavation and Fill Information
Upland Development
Structures Information
Bridges and Culverts
Marina Development
NOTE. Please sign and date each attachment in the
space provided at the bottom of each form.

0
c.
d.
Form DCM -M2,,
S . ��
UC T 1
( -�`t uction within Public T-ustS)
Attach this form to Joint Application for CAMA Major
Pe hit Form DCM -MP -1. Be sere to complete all
oth r proposed of the joint'
which relate 10
this proposal proje,.� f
a DOck(s) and /or Pier(.) i
(1) Commercial , Y
(L) Number community _ Private,
(3) Length
(4) Width
(5) ringer, Piers y�
Cl) Number — No
(li) Length
(iii) Width
(6) -Piatio m(s)
CI) Number -- No
G7 Length
Width
(7) Number of siips proposed
(8) Proximity of sou nrre ad a e
ProPery Iines 1 ` nt riparian
(9) Width of water body
(10) Water depth at wale: ward
MLW orNV'L mil} of p1ei at
Boathouse (mcludinQ
(1) covered iifr,)
Comm
(3) Lines — P ivaze
(3) Width
Groin (e_g- wood, smile,.
(1) Number ).
BIeaL-waIlrr ((e -g wood, shy je )
() Average distance uom
wetlands /0 rw > NWL or
imum distana beyond MEW, 1\�{�
wetlands a� or
R=vis d 0/
f.
RECEIVED
DCM WILMINGTON, NC
AUG 2 9 2006
e• Mooring uoys
m
(I) Comercial
(Z) NumbLT Privat
P) Des
cription of buoy
(Color, inscription, six
anchor, etc.)
(4) Width of water body
Disance buoy(s)
shoreline l�" places beyond
Mooring
tore CnoatIi
(1) o r, moorin�
Mooring
o Pnmgs, etc•)
(3) Number �t3 _ PrivaL
(�) Length
(4) Width
0
a• Dther (mauve eonmlcic

Form DCM -MP -2
EXCAVATION
AND FILL
(Except bridges and culverts)
Attach this form to Joint Application for CAMA Major
Permit, Form DCM -MP -1. Be sure to complete all
other sections of the Joint Application that relate to this
proposed project.
Describe below the purpose of proposed excavation or
fill activities. All values to be given in feet.
Access
channel
(Ml-w) or (NWL)
Canal
Boat
basin
Boat
ramp
Rock
groin
Rock
breakwater
Other
(Excluding
shoreline
stabilizzaion)
Average Final
Existing Project
Length Width Death Death
1. EXCAVATION
a. Amount of material to be excavated from below
MHW or NWL in cubic yards
b. Type of material to be excavated l✓lG�
c. Does the area to be excavated include coastal
wetlands (marsh), submerged aquatic ve;&atlon
(SAVs) or other wetlands? _ Yes V No
d. Highground excavation in cubic yards Ai kt
2. DISPOSAL OF EXCAVATED
MATERIAL
a. Location of /•
111;0) 4LU �. . • 11 •.
b. Dimensions of disposal area
IlE:!Ltrd.:
c. Do yo claim title to disposal area?
Yes _ No
If no, attach a letter granting permission from the
owner.
d. Will a disposal ,area be available for future
maintenance? V Yes _ Nq
If yes, where? Snmfi //alb
RECEIVED
DCM WILMINGTON. NC
AUG 2 � 2006
Revised 03195
air
i
\�K
of hx
.wars' �n
l�
1. EXCAVATION
a. Amount of material to be excavated from below
MHW or NWL in cubic yards
b. Type of material to be excavated l✓lG�
c. Does the area to be excavated include coastal
wetlands (marsh), submerged aquatic ve;&atlon
(SAVs) or other wetlands? _ Yes V No
d. Highground excavation in cubic yards Ai kt
2. DISPOSAL OF EXCAVATED
MATERIAL
a. Location of /•
111;0) 4LU �. . • 11 •.
b. Dimensions of disposal area
IlE:!Ltrd.:
c. Do yo claim title to disposal area?
Yes _ No
If no, attach a letter granting permission from the
owner.
d. Will a disposal ,area be available for future
maintenance? V Yes _ Nq
If yes, where? Snmfi //alb
RECEIVED
DCM WILMINGTON. NC
AUG 2 � 2006
Revised 03195

Form DCM -MP -2
e. Does the disposal ar include any coastal wetlands
(marsh), SAVs or er wetlands?
Yes No
f. Does the disposal i ode any area in the water?
Yes No
3. SHORELINE STABILIZATION
a. Type f shoreline stabilization
Bulkhead Riprap
b. Length
c. Average distance waterward of MHW or NWL
d. Maximum distance watt 'rward of MHW or NWL
e. Shoreline erosion during pr eding 12 months
(Source ofinformanon)I t\
f. Type of bulkhead or riprap material
e
g. Amount of fill in cubic yards to be placed below
water level
(1) Riprap
(2) Bulkhead backfil
h. Type of fill material
i. Source of fill material
4. OTHER FILL ACTIVITIES
(Excluding Shoreline Stabilization)
a. Will fill material be rought to site?
Yes V No
Revised 03/95
If yes,
(1) Amount of materig7 /t be placed in the
water V
(2) Dimensions of fill area
(3) Purpose of fill
b. Will fill material be placed in coastal wetlands
(marsh), SAVs or o er wetlands?
Yes No
If yes,
(1) Dimensions of fill area -
(2) Purpose of fill '
5. GENERAL
a. How will excavated or fill material be ept on site
and erosion controlled?
I:
b. What type of construction equipment will be used
(for example, dragline, backhoe, or hydraulic
dredge)? I i i i I
C. Will wetlands be cussed in transp mg equipment
to project site? _ Yes No
If yes, explain steps that will be taken to lessen
environmental impacts.
/7 IJ AlIInC. i GLV
Applicant or Project Name
Signature
Date -7 1 � C- --IVE0
DCM WILMINGTON. NC
AUG 2 9 200E

Form DCM -MP-3
RECEIVED
UPLAND
DCM WILMINGTON, NC
�%
"IIG 2 9 2006
DE ® ELOPMENT
(Construction and /or land disturbing activities)
05L 64 QI 'f o r' 04 > II J
o
��l � �
Attach this form to Joint Application for CAMA Major h. Projects tha�#tyuire a CAMA Major velopment
Permit, Form DCM -MP -1. Be sure to complete all Permit may also require a Stormwater Certification.
other sections of the Joint Application that relate to this
Proposed project. Has a site development plan been submitted to the
Division of Enviro ental Management for review?
a. Type and number of buildings facilities, units or Yes /s N p
structures proposed / If yes, date submitted 5 I
11 PI
b. Number of lots or parcels
c. Density (give the number of residential units and the
units per acre)
d. Size of area to be graded, filled or disturbed
including roads, ditches, etc.
e. If the proposed project will disturb more than one
acre of land, the Division of Land Resources must
receive an erosion and sedimentation control plan at
least 30 days before land disturbing activity begins.
If applicable, has a sedimentation and erosion
control plan bee bmitted to the Division of Land
Resources? Yes No
If yes, date submitted
f. List the materials (such as Marl, paver stone,
asphalt, or concrete) to be used for paved surfaces.
i. Describe pro p "sed method of sewage disposal.
j. Have the facilities described in IYefn above
received state or local approval? ✓_
(A=ch appropriate dommetvation)
k. Describe location and type of proposed discharges to
waters of the state (for example, surface runoff,
sanitary wastewater, industrial /commercial effluent,
wash down" and residential discharges).
J
I. Describe proposed drinking water supply source
(e.g. well, community, ppf�I' system, etc.)
/ ;1
M. Will water be impounded? _ yes No
If yes, how many acres? _
n. If the project is a oceanfront developme hen
was the lot(s) platted and recorded?
g. Give the percentage of the tract within 75 feet of JApptican ProiectNam 'e (QvP7� hif� LLMHW or NWL, or within 575 feet in the case of an
Outstanding Resource Water, to be covered by impervious and /or built -upon surfaces, such as
pavement, buildings, rooftops, or to be used for vehicular driveways or parking. a
Revised 03/95 400 copies of this public document were printed at a total cost of $7.00 or $ .02 er copy. PY•

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