19840852 Ver 1_COMPLETE FILE_19940913

DEM ID: ACTION ID:
Nationwide Permit Requested (Provide Nationwide Permit ft _ O
. JOINT FORM FOR
Nationwide permits that require notification to the Corps of Engineers
Nationwide permits that require application for Section 401 certification
WILMINGTON DISTRICT ENGINEER
CORPS OF ENGINEERS
DEPARTMENT OF THE ARMY
P.O. Box 1890
Wilmington, NC 28402-1890
ATTN: CESAW-CO-E
Telephone [phone]
WATER QUALITY PLANNING
DIVISION OF ENVIRONMENTAL
NC DEPARTMENT OF ENVIRON3
AND NATURAL RESOURCES
P.O. Bor. 29535
Raleigh, NC 27626-0535
ATTN: MR. JOHN DORNEY
Telephone [phone]

SFP 13 1994
ONE (1) COPY OF THIS COMPLETED APPLICATION SHOULD BE SENT TO THE CORPS OF ENGAMMS-
SEVEN (7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT.
PLEASE PRINT.
1. Owners Name: at n 1 e_C Pau S+ /L«jer 'yJeU T?0rc4 aLk)C ?lJe 1(e??
2. Owners Address: ZZv t-k1V"e-X,1 tre Wl 1rnkA - lJ? 2-94Dq
3. Owners Phone Number (Home): qio " 3'Z - &78D (Work): g/0' 3413
4. If Applicable: Agent's name or responsible corporate official, address, phone number:
3. Location of work (MUST ATTACH MAP). County: _ _ N g-w Aa M Ve r
Nearest Town or City:
J ?t
'R q ILL
Specific Location (Include road numbers, landmarks, etc.): and h'[J?rv h Csrn?f i ee il
?VIC?^NS ?tcrv? ?e--('+- rn ?-rt'S1' ??e,lar?f?r ?? a (Q.ke SE'L chn?.?
rya. fa ?I he. I? P-t- . Jeeaj-er-Vl S - rY? f- rry Irv /a.rij?b
6. Name of Closest Stream/River: dA
7. River Basin: A)A
8. Is this project located in a watershed classified as Trout, SA, HQW, ORW, WS I, or WS H? YES [ ] NO (}?
9. Have any Section 404 permits been previously requested for use on this property? YES [ ] NO
If yes, explain.
10. Estimated total number of acres of waters of the U.S., includin etlands orated on project site: ?a S
11. Number of acres of waters of the U.S., including wetlands, impacted by the proposed project:
Filled: 2
Drained:
Flooded:
Excavated:
Total Impacted:
NOTES
AAACWS _ THIS PARCEL DOES NOT APPEAR TO BE LOCATED WITHIN 2,000. OF N.C. GRID CONTROL.
t*) SURVE REFERENCES OR 1459 PG 1767 P B Oct PG 48 P B PG /6
THIS .SURVEY APPEARS IV BE OF AN EXISTING PARCEL OR PARCELS OF LAND.
F''y O4 THIS PARCEL APPEARS TO BE LOCATED IN ZONE "C" AS DESIGNATED BY FIRM MAP,
a COMMUNITY NO. 370166 PANEL DATED 04115186
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VICINITY /
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JENRETTE I I I I? 164.92' /
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I I i I I t NOW OR FORMERLY
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PLAT FOR:
DEW. EY , L Q'QRQEA UDC, ` JR.
I HARNETT TOWNSHIP NEW HANOVER COUNTY NORTH CAROLINA I
DATE: MARCH 05,4992 WOL/LAS/MES .
LEGEND
1, WILLIAM D. LEWIS, JR., CERTIFY THAT THIS PLAT WAS DRAWN BY ME, OR
•wnFa ,uY SuPFRVISION. FROM AN ACTUAL SURVEY MADE BY ME, OR UNDER
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