20180421 Ver 1_401 Application_20180318

Water Resources
Environmental Quality
Division of WdWr Resourco9
LIAR 19 20181""
�15A
Water Ouallty Raglonal Operation
Asheville Rmlonal Office
201 80421
COURTESXtate of North Carolina
fl)QPr nt of Environmental Quality
Division of Water Resources
02H .0506(b)(4) Water Quality Certification,
Notification of Work in Trout Watersheds
FORM: TroutWS 11-2017
Notification of Work in Trout Watersheds Form
A. Applicant Information
1. Processing
la. Specify Nationwide Permit (NWP) number: 1,3> or General Permit (GP) number: Sec
1 b. Has the NWP or GP number been verified by the Corps?
Yes No
1c. Does the project meet all the Conditions of the applicable Water Quality
Certification
Yes No
Please note that your project may be subject to the Sediment and Erosion Control Program and/or Trout
Buffers implemented by the Division of Energy, Mineral, and Land Resources. Find more Info at: https://
e .nc. ov/aboutldlvisions/ener -mineral-land-resources/erosion-sediment-control
1. Project Information
a. Name of project:
V aid �2 6' STf�BIL/ZQ'T/o�/ �iQD,JEC%
b. County:
, 9a, we 0M
c. Nearest municipality / town:
'BLeK
1. Owner Information
a. Name(s) on Recorded Deed:
fply.,N N Q�� ,Tu, -`y 7Weeea6ed VONWo5kel
3b. Responsible Party (for LLC if
applicable):
c. Street address:
77 `j i �p U P 04 LLL V—RD
3d. City, state, zip:
l4ex AuNTf41Al Ne ,2 ?%/i
3e. Telephone no.:
0 q0 0- j _ gq /
f. Email address:
n o y -d am 1q/?- t c c3 (Aa i [ -Copy l
4. Agent/Consultant Information (if applicable)
a. Name:
�tjN
b. Business name
(if applicable):
c. Telephone no.:
d. Email address:
B. Project Information

Ow er/AAgen�t's Printed Name
Jo wd N van -1 c eke d
Owner/Agents Signature
(Agents signature Is valid only if an authorization letter from the owner Is provided.)
Date 34 6 %

1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
04% 1 a 79q ooODcc
1b. Site coordinates (in decimal degrees):
Latitude: gr- b'29 S 4 Longitude:-�'z•'Zs b
(DD.DDDDDD) (-DD.DDDDDD)
1. Project Description
a. Explain the purpose of the proposed project (continue on back):
See 6 deZ'
b. Describe the overall project in detail, including the type of equipment to be used:
C. Stream Impacts: Please list all proposed impacts to the stream
1a. Stream Name: �Blgo p lwtz'
1b.
Type of Impact
Average stream
width (linear feet)
Impact length
(linear feet)
Bank Stabilization - Sloping and Revegetating dee i C
/$ e,
Bank Stabilization - Sloping and Riprap/Armoring
Bank Stabilization - Gabion Baskets 1 Retaining Wall
Culvert Installation ulvert Diameter:
Temporary Impacts for required dewatering activities
Other (describe):
1c. Comments: dank S z+ � z wl ow /t7' i'9 VV

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Water Quality Regional Operations Section
NCDEQ —Division of Water Resources
828 296 4662 office
828 2319634 mobile
2090 U.S. Hwy. 70
Swannanoa, N.C. 28711
E'/Wali convispondence in and frons this address is subject to tire,
AJnrth Carolina ,public Recon -Is Law and may he disclosed to third parties.
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