20051662 Ver 1_Complete File_20050505

OCIf-21-2005 01:14 PPl (ARMSTRONG, INC. 252 943 3300 P. 01
Armstrong Inc
PO Box 96
Pantego, NC 27860
[phone] Phone
[phone] Fax
Date: 1 - r l u
To: yc:?? -??
Attn:
Thanks,
Noell Morris
Armstrong, Inc
OCT-EI-2005 FRI 01:37 TEL:[phone] NAME:DWQ-WETLANDS P.', 1
O'cl,-21-2005 01:14 PM ARMSTRONG, INC. 252 943 3302 P.02
D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or
provide new information.
• ACCEP'T': You do not need to notify the Corps to accept an approved JI). Failure to notify the Corps within 60 days of the date of
this notice, means that you accept the approved JD in its entirety, and waive all rights to appeal the approved JD.
APPEAL: If you disagree with the approved JD, you may appeal the approved JD under the Corps of Engineers Administrative
Appeal Process by completing Section II of this form and sending the form to the division engineer. This form must be received by
th3 division engineer within 60 days ofthe date of this notice.
E: PRI LI.MINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps
regarding the preliminary JD. The Preliminary JD is not appealable. if you wish, you may request an approved
JI) (which may be appealed), by contacting the Corps district for further instruction. Also you may provide new
information for further consideration by the Corps to reevaluate the JD.
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your
objections to an initial proffered permit in clear concise statements. You may attach additional information to
this form to clarify where your reasons or objections are addressed in the administrative record.)
ADDITIONAL INFORMATION; The appeal is limited to a review of the administrative record, the Corps
memorandum for the record of the appeal conference or meeting, and any supplemental information that the
review officer has determined is needed to clarify the administrative record. Neither the appellant nor the Corps
may add new infonnation or analyses to the record. However, you may provide additional information to clarify
the location of information that is already in the administrative record.

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If you have questions regarding this decision If you only have questions regarding the appeal process you
anc{lor the appeal process you may contact: may also contact:
US Army Corps of Engineers Mr. Michael F. Bell, Administrative Appeal Review
attn: William Wescott Officer
Post Office Box 1000 CF,SAD-ET-CO-R
Washington, NC 27889 U.S. Army Corps of Engineers, South Atlantic Division
25?-975-1616 60 Forsyth Street, Room 9M15
Atlanta, Georg 30303-8801
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel, and any
government consultants, to conduct investigations of the project site during the course of the appeal process. You
Avill be provided a 1.S day notice of any site investigation, and will have the opportunity to participate in all site

Date: Telephone number:
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DIVISION ENGINEER:
Commander
U.S. Artny Engineer Division, South Atlantic
60 Forsyth Street, Room 91Vi 15
Atlanta, Uoorgia 30303-3400
Page 8 of 8
OCT-21-20051 FP.I 01:37 TEL:[phone] HAi1E: DWQ-WETLAhdDS P 2
AO? W AT ?9Q
X111VAGz

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
October 19, 2005
DWQ Project # 05-1662
Hyde County
Mr. Jeff Berger
4316 Blackbeard Road
Virginia Beach, NC 23455
Subject Property: Slades Creek - Lots 4, 5 and 6
Slades Creek [030307, 29-34-40,SA, HQW, NSW]
Approval of 401 Water Quality Certification with Additional Conditions
Dear Mr. Berger:
You have our approval, in accordance with the attached conditions and those listed below, to place fill
within or otherwise impact 0.25 acres of forested wetlands for the purpose of constructing a driveway to
access uplands adjacent to Slades Creek at the subject property, as described within your application
dated July 28, 2005, and received by the N.C. Division of Water Quality (DWQ) on August 28, 2005.
After reviewing your application, we have decided that the impacts are covered by General Water Quality
Certification Number(s) 3404 (GC3404). The Certification(s) allows you to use Nationwide Permit(s)
NW 14 when issued by the US Army Corps of Engineers (USACE). This letter shall also act as your
approved Authorization Certificate for impacts to the protected riparian buffers per 15A NCAC 2B .0233.
In addition, you should obtain or otherwise comply with any other required federal, state or local permits
before you go ahead with your project including (but not limited to) Erosion and Sediment Control, and
Non-discharge regulations. Also, this approval to proceed with your proposed impacts or to conduct
impacts to waters as depicted in your application shall expire upon expiration of the 404 or CAMA
Permit.
This approval is for the purpose and design that you described in your application. If you change your
project, you must notify us and you may be required to send us a new application. If the property is sold,
the new owner must be given a copy of this Certification and approval letter and is thereby responsible for
complying with all conditions. If total fills for this project (now or in the future) exceed one acre of
wetland or 150 linear feet of stream, compensatory mitigation may be required as described in 15A
NCAC 2H .0506 (h). This approval requires you to follow the conditions listed in the attached
certification and any additional conditions listed below.
The Additional Conditions of the Certification are:
1. Impacts Approved
The following impacts are hereby approved as long as all of the other specific and general
conditions of this Certification (or Isolated Wetland Permit) are met. No other impacts are
approved including incidental impacts:
401 Oversight/Express Review Permitting Unit
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / Internet: httn://h2o.enr.state,nc.us/ncwctl Inds
None hCarolina
vVatura!!y
An Equal Opportunity/Affirmative Action Employer- 50% Recycled/10% Post Consumer Paper
Mr. Jeff Berger
Page 2 of 5
October 19, 2005
Amount Approved Units Plan Location or Reference
404/CAMA Wetlands 0.25 acres PCN pages 8 and 9 of 12
2. No Waste, Spoil, Solids, or Fill of Any Kind
No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas beyond
the footprint of the impacts depicted in the Pre-Construction Notification. All construction
activities, including the design, installation, operation, and maintenance of sediment and erosion
control Best Management Practices, shall be performed so that no violations of state water quality
standards, statutes, or rules occur.
3. Erosion and sediment control practices must be in full compliance with all specifications governing
the proper design, installation and operation and maintenance of such Best Management Practices in
order to protect surface waters standards:
a. The erosion and sediment control measures for the project must be designed, installed,
operated, and maintained in accordance with the most recent version of the North Carolina
Sediment and Erosion Control Planning and Design Manual.
b. The design, installation, operation, and maintenance of the sediment and erosion control
measures must be such that they equal, or exceed, the requirements specified in the most
recent version of the North Carolina Sediment and Erosion Control Manual. The devices
shall be maintained on all construction sites, borrow sites, and waste pile (spoil) projects,
including contractor-owned or leased borrow pits associated with the project.
C. Sufficient materials required for stabilization and/or repair of erosion control measures and
stormwater routing and treatment shall be on site at all times.
4. Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum extent
practicable. If placement of sediment and erosion control devices in wetlands and waters is
unavoidable, they shall be removed and the natural grade restored within six months of the date that the
Division of Land Resources has released the project;
5. Protective Fencing - The outside buffer, wetland or water boundary and along the construction corridor
within these boundaries approved under this authorization shall be clearly marked with orange warning
fencing (or similar high visibility material) for the areas that have been approved to infringe within the
buffer, wetland or water prior to any land disturbing activities to ensure compliance with 15A NCAC
213 .0233 and GC 3404;
6. Diffuse Flow (No Review)
All constructed stormwater conveyance outlets shall be directed and maintained as diffuse flow at
non-erosive velocities through the protected stream buffers such that it will not re-concentrate
before discharging into a stream as identified within 15A NCAC 213 .0233 (5). If this is not
possible, it may be necessary to provide stormwater facilities that are considered to remove
nitrogen. This may require additional approval from this Office.
7. No Impacts Beyond those in Application
No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas beyond
the footprint of the impacts depicted in the Pre-construction Notification. All construction
activities, including the design, installation, operation, and maintenance of sediment and erosion
Mr. Jeff Berger
Page 3 of 5
October 19, 2005
control Best Management Practices, shall be performed so that no violations of state water quality
standards, statutes, or rules occur.
8. Deed Notifications
Deed notifications or similar mechanisms shall be placed on all retained jurisdictional wetlands,
waters and protective buffers in order to assure compliance for future wetland, water and buffer
impact. These mechanisms shall be put in place prior to impacting any wetlands, waters and/or
buffers approved for impact under this Certification Approval and Authorization Certificate. A
sample deed notification can be downloaded from the 401/Wetlands Unit web site at
http://h2o.enr.state.nc.us/newetlands. The text of the sample deed notification may be modified
as appropriate to suit to this project.
9. Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable
Buffer Rules, and any subsequent modifications, the applicant is required to return the attached
certificate of completion to the 401 Oversight/Express Review Permitting Unit, North Carolina
Division of Water Quality, 1650 Mail Service Center, Raleigh, NC, 27699-1650.
Violations of any condition herein set forth may result in revocation of this Certification and may result in
criminal and/or civil penalties. The authorization to proceed with your proposed impacts or to conduct
impacts to waters as depicted in your application and as authorized by this Certification, shall expire upon
expiration of the 404 or CAMA Permit.
If you do not accept any of the conditions of this Certification (associated with the approved wetland or
stream impacts), you may ask for an adjudicatory hearing. You must act within 60 days of the date that
you receive this letter. To ask for a hearing, send a written petition, which conforms to Chapter 150B of
the North Carolina General Statutes to the Office of Administrative Hearings, 6714 Mail Service Center,
Raleigh, N.C. 27699-6714. This certification and its conditions are final and binding unless you ask for a
hearing.
Any disputes over determinations regarding this Authorization Certificate (associated with the approved
buffer impacts) shall be referred in writing to the Director for a decision. The Director's decision is
subject to review as provided in Articles 3 and 4 of G.S. 150B.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water
Act and the Neuse riparian buffer protection rule as described within 15A NCAC 2B .0233. If you have
any questions, please telephone Cyndi Karoly or Ian McMillan at 919-733-1786.
AWK/ym
Sincerely,
r 4-6121,
Alan W. Klimek, P.E.
Enclosures: GC 3404
Certificate of Completion
Mr. Jeff Berger
Page 4 of 5
October 19, 2005
cc: Bobby Armstrong, Armstrong, Inc., P.O. Box 96, Pantego, NC 27860
USACE Washington Regulatory Field Office
Kyle Barnes, DWQ Washington Regional Office
DLR Washington Regional Office
File Copy
Central Files
Filename: 051662S fadescreekL.ots4,5,6(Hyde)40 l
Triage Check List
Date: ProJe6t Name: .
DWQ#: 05V 166 County:
To: ? " ARO Kevin B arnett. "
? FRO Ken Averitte
? MRO Alan Johnson
? RRO Mike Horan

From:
L"J W?O
? WiRO
? WSRO
Telephone : (919)
Tom Steffens and Kyle Barnes
Noelle Lutheran
Daryl Lamb
? ur for your evaluation.
The file attached. is being forwarded.?is,
ce.
Please call if you nee&, ' Lan
? Stream length impacted. `?
? Stream determination
? Wetland determination and distance to blue-line surfa.ce'"waters on USFW topo maps
? Minimization/avoidance issues
? Buffer Rules' (Neuse, Tar-Pamlico,'Catawba, Randleman)
? Pond fill
? Mitigation Ratios
? Ditching
? Are the stream and or wetland mitigation sites available and viable?
? Check drawings for accuracy
? Is the application consistent with pre-application meetings? ' -
? Cumulative impact concern
Comments:
0 ? -1 to LP 2
U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action ID. 200511835 County: Hyde USGS Quad: Pamlico Beach ou"
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Property Owner / Authorized Agent: Jeff Bereer
Address: 4316 Blackbeard Road
Virginia Beach, Virginia 23455
Telephone No.: 757-286-5756
Size and location of property (water body, road name/number, town, etc.): Property contains approximately 247 acres
located off of NCSR 1149 adiacent to Neal Creek, Wood Creek and Slades Creek, southwest of Scranton, Ilyde
County, North Carolina. The project area for this permit is lust the road crossing consisting of 0.25-acre of
wetland impact.
Description of projects area and activity: Construct driveway to access uplands adiacent to Slades Creek. Driveway
crossing will impact 0.25 acres of non-riparian Section 404 wetlands.
Applicable Law: ® Section 404 (Clean Water Act, 33 USC 1344)
? Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: Regional General Permit Number:
Nationwide Permit Number: 14
Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with the attached
conditions and your submitted plans. Any violation of the attached conditions or deviation from your submitted plans may subject the
permittee to a stop work order, a restoration order and/or appropriate legal action.
This verification is valid until the NWP is modified, reissued, or revoked. All of the existing NWPs are scheduled to be modified,
reissued, or revoked prior to March 18, 2007. It is incumbent upon you to remain informed of changes to the NWPs. We will issue a
public notice when the NWPs are reissued. Furthermore, if you commence or are under contract to commence this activity before the
date that the relevant nationwide permit is modified or revoked, you will have twelve (12) months from the date of the modification or
revocation of the NWP to complete the activity under the present terms and conditions of this nationwide permit. If, prior to the
expiration date identified below, the nationwide permit authorization is reissued and/or modified, this verification will remain valid
until the expiration date identified below, provided it complies with all new and/or modified terms and conditions. The District
Engineer may, at any time, exercise his discretionary authority to modify, suspend, or revoke a case specific activity's authorization
under any NWP.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality Certification. You
should contact the NC Division of Water Quality (telephone [phone]) to determine Section 401 requirements.
For activities occurring within the twenty coastal counties subject to regulation under the Coastal Area Management Act (LAMA),
prior to beginning work you must contact the N.C. Division of Coastal Management in Washington, NC, at [phone].
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other required Federal,
State or local approvals/permits.
If there are any questions regarding this verification, any of the conditions of the Permit, or the Corps of Engineers regulatory
program, please contact William Wescott at 252-975-1616 extension 25.
ti
Corps Regulatory Official VLX Date: 08/26/2005
Expiration Date of Verification: 03/18/2007
Page 1 of 8
1§@TgV§J
AU G 3 1 2005
DENR-,NPJERQUALIT`( W
YItTwiDS AND STOtUd1" MR BRAN
I,t ,_ Determination of Jurisdiction:
Based°on preliminary information, there appear to be waters of the US including wetlands within the above described project area.
'" I'jhis preliminary determination is not an appealable action under the Regulatory Program Administrative Appeal Process
(?Reference 33 CFR Part 331).
? There are Navigable Waters of the United States within the above described project area subject to the permit requirements of
Section 10 of the Rivers and Harbors Act and Section 404 of the Clean Water Act. Unless there is a change in the law or our
published regulations, this determination may be relied upon for a period not to exceed five years from the date of this
notification.
® There are waters of the US and/or wetlands within the above described project area subject to the permit requirements of Section
404 of the Clean Water Act (CWA)(33 USC § 1344). Unless there is a change in the law or our published regulations, this
determination may be relied upon for a period not to exceed five years from the date of this notification.
? The jurisdictional areas within the above described project area have been identified under a previous action. Please reference
jurisdictional determination issued . Action ID
Basis of Jurisdictional Determination: Area exhibits the three parameters specified in the 1987 USACE Wetlands Delineation
Manual and is adincent to Shades Creek which is a tributarv to the Punno River (AIWW).
Corps Regulatory Official:
Date 08/26/2005
Copy Furnished:
NC Division of Water Quality
NC Ecosystem Enhancement Program
Armstrong, Inc.

Page 2 of 8
August 26, 2005
Regulatory Division
Action ID No. 200511835
Jeff Berger
4316 Blackbeard Road
Virginia Beach, Virginia 23455
Permit Special Conditions
Your work is authorized by Nationwide Permit 14 provided it is accomplished in strict
accordance with the attached General Conditions and the following Special Conditions:
a. All work authorized by this permit must be performed in strict compliance with the
submitted plans, which are a part of this permit.
b. The Permittee shall mitigate for 0.25 acre of wetlands associated with this
project by payment to the North Carolina Ecosystem Enhancement Program
(NCEEP) in an amount determined by the NCEEP sufficient to perform 0.50 acre
of non-riparian wetland restoration mitigation in the Tar-Pamlico River Basin
(HUC 03020105). This permit is valid only after the Permittee has made fiill
payment to the NCEEP, and the NCEEP has made written confirmation to the
District Engineer, that it has received payment and agrees to accept responsibility
for the mitigation work required, pursuant to Paragraph IV.D. of the
Memorandum of Understanding between the North Carolina Department of
Environment and Natural Resources and the U.S. Army Corps of Engineers,
Wilmington District, dated November 4, 1998.
If you have not already done so, you should contact Ms. Cyndi Karoly, North Carolina
Division of Water Quality, telephone [phone], regarding Section 401 Water
Quality Certification. This nationwide permit does not relieve you of the responsibility to
obtain other required State or local approval. This verification will be valid for two years
from the date of this letter unless the nationwide authorization is modified, reissued or
revoked.
Thank you for your time and cooperation. Questions or comments may be addressed
to Mr. Wescott, Washington Regulatory Field Office, telephone [phone],
extension 25.
Action ID Numb cr:200511835 County:IIyde
Permittee: Jeff BerIzer
Date Permit Issued: 8/26/2005
Project Manager: William Wescott
Upon completion of the activity authorized by this permit and any mitigation required by the permit,
sign this certification and return it to the following address:
US ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
WASHINGTON REGULATORY FIELD OFFICE
Post Office Box 1000
Washington, NC 27889
Please note that your permitted activity is subject to a compliance inspection by a U. S. Army Corps of
Engineers representative. If you fail to comply with this permit you are subject to permit suspension,
modification, or revocation.
I hereby certify that the work authorized by the above referenced permit has been completed in
accordance with the terms and condition of the said permit, and required mitigation was completed in
accordance with the permit conditions.
Signature of Permittee
Date
Page 3 of 8
CESAW-RG-W DATE: 08/26/2005
MEMORANDUM FOR RECORD
SUBJECT: Consideration of Compensatory Mitigation and Potential Impacts to Endangered Species, Cultural Resources
and Essential Fish Habitat.
1. Action ID. 200511835
2. Project Name and Location: Jeff Berner, Slades Creek, SW of Scranton
3. Mitigation [Section 404(b)(1) Guidelines].
a. Has applicant avoided and minimized impacts to the maximum practicable extent? YES
If NO, Explain:
b. Is compensatory mitigation necessary? YES
Explain: in-lieu payment to NCF.EP at a 2:1 restoration ratio for 0.25-acre of impact to non-riparian
Section 404 wetlands.
4. Endangered Species (Section 7 of the ESA).
a. Will any threatened or endangered species or their critical habitats be affected by this project? NO
If YES, describe steps taken to address concerns:
5. Cultural Resources (Section 106 of the NHPA).
a. Will any Cultural Resources be impacted by this project? NO
b. If YES, describe steps taken to address concerns:
6. Essential Fish Habitat (50 CFR Part 600, Magnuson-Stevens Act).
a. Is this a project that "may adversely affect essential fish habitat"? NO
b. If YES, describe steps taken to address concerns:
Corps Regulatory Official:`
Page 4 of 8
JURISDICTIONAL DETERMINATION (Revised 8/13/04)
U.S. Army Corps of Engineers
DISTRICT OFFICE: CESAW-RG-W
FILE NUMBER: 200511835
PROJECT LOCATION INFORi1IATION:
State: NC
County: Hyde
Center coordinates of site (latitude/longitude): 35.479047 N / 76.536617 W
Approximate size of area (parcel) reviewed, including uplands: 247 acres.
Name of nearest waterway: Slades Creek
Name of watershed: Tar-Pamlico River Basin
JURISDICTIONAL DETERMINATION
Completed: Desktop determination ? Date:
Site visit(s) [S] Date(s): 7/19/2005
Jurisdictional Determination (JD):
Preliminary JD -Based on available information, ? there appear to be (or) ? there appear to be no "waters of the United States" and/or
"navigable waters of the United States" on the project site. A preliminary JD is not appealable (Reference 33 CFR part 331).
El Approved JD -An approved JD is an appealable action (Reference 33 CFR part 331).
Check all that apply:
? There are "navigable waters of the United States" (as defined by 33 CFR part 329 and associated guidance) within the reviewed area.
Approximate size of jurisdictional area:
Q There are "waters of the United States" (as defined by 33 CFR part 328 and associated guidance) within the reviewed area.
Approximate size of jurisdictional area: 0.25 acre--PROJECT AREA.
? There are "isolated, non-navigable, intra-state waters or wetlands" within the reviewed area.
Decision supported by SWANCC/Migratory Bird Rule Information Sheet for Determination of No Jurisdiction.
BASIS OF JURISDICTIONAL DETERMINATION:
A. Waters defined under 33 CFR part 329 as "navigable waters of the United States":
? The presence of waters that are subject to the ebb and flow of the tide and/or are presently used, or have been used in
the past, or may be susceptible for use to transport interstate or foreign commerce.
B. Waters defined under 33 CFR part 328.3(a) as "waters of the United States":
? (1) The presence of waters, which are currently used, or were used in the past, or may be susceptible to use in
interstate or foreign commerce, including all waters which are subject to the ebb and flow of the tide.
(2) The presence of interstate waters including interstate wetlands'.
[] (3) The presence of other waters such as intrastate lakes, rivers, streams (including intermittent streams), mudflats, sandflats, wetlands,
sloughs, prairie potholes, wet meadows, playa lakes, or natural ponds, the use, degradation or destruction of which could affect interstate
commerce including any such waters (check all that apply):
? (i) which are or could be used by interstate or foreign travelers for recreational or other purposes.
? (ii) from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
? (iii) which are or could be used for industrial purposes by industries in interstate commerce.
? (4) Impoundments of waters otherwise defined as waters of the US.
? (5) The presence of a tributary to a water identified in (1) - (4) above.
? (6) The presence of territorial seas.
? (7) The presence of wetlands adjaccriC to other waters of the US, except for those wetlands adjacent to other wetlands.
Rationale for the Basis of Jurisdictional Determination (applies to any boxes checked above). Ifthe jurisdictional water or wetland is not
itself a navigable tivater of the United States, describe connection(s) to the doivnstream navigable waters. If B(1) or B(3) is used as the Basis of
Jurisdiction, document navigability and/or interstate commerce connection (i.e., discuss site conditions, including why the waterbody is
navigable and/or hoiv the destruction of the tivaterbody could affect interstate or foreign commerce). If B(2, 4, S or 6) is used as the Basis of
Jurisdiction, document the rationale used to make the determination. IfB(7) is used as the Basis of Jurisdiction, document the rationale used to
make adjacency determination: Area exhibits the three parameters specified in the 1987 USACE Wetlands Delineation Manual and is adjacent
to Slades Creek which is a tributary to the Pungo River (AIWW).
Page 5 of 8
Lateral Extent of Jurisdiction: (Reference: 33 CFR parts 328 and 329)
? Ordinary High Water Mark indicated by: ? High Tide Line indicated by:
? clear, natural line impressed on the bank ? oil or scum line along shore objects
? the presence of litter and debris ? fine shell or debris deposits (foreshore)
? changes in the character of soil ? physical markings/characteristics
? destruction of terrestrial vegetation ? tidal gages
? shelving ? other:
? other:
Mean High Water Mark indicated by:
? survey to available datum; ? physical markings; ? vegetation lines/changes in vegetation types.
Q Wetland boundaries, as shown on the attached wetland delineation map and/or in a delineation report prepared by: Land Management
Group
Basis For Not Asserting Jurisdiction:
? The reviewed area consists entirely of uplands.
? Unable to confirm the presence of waters in 33 CFR part 328(a)(1, 2, or 4-7).
? Headquarters declined to approve jurisdiction on the basis of 33 CFR part 328.3(a)(3).
? The Corps has made a case-specific determination that the following waters present on the site are not Waters of the United States:
? Waste treatment systems, including treatment ponds or lagoons, pursuant to 33 CFR part 328.3.
? Artificially irrigated areas, which would revert to upland if the irrigation ceased.
? Artificial lakes and ponds created by excavating and/or diking dry land to collect and
retain water and which are used exclusively for such purposes as stock watering, irrigation, settling basins, or rice growing.
? Artificial reflecting or swimming pools or other small ornamental bodies of water created
by excavating and/or diking dry land to retain water for primarily aesthetic reasons.
? Water-filled depressions created in dry land incidental to construction activity and pits excavated in dry land for the purpose of
obtaining fill, sand, or gravel unless and until the construction or excavation operation is abandoned and the resulting body of water
meets the definition of waters of the United States found at 33 CFR 328.3(a).
? Isolated, intrastate wetland with no nexus to interstate commerce.
? Prior converted cropland, as detemiined by the Natural Resources Conservation Service. Explain rationale:
? Non-tidal drainage or irrigation ditches excavated on dry land. Explain rationale:
? Other (explain):
DATA REVIEWED FOR JURSIDICTIONAL DETERMINATION (mark all that apply):
? Maps, plans, plots or plat submitted by or on behalf of the applicant.
?', Data sheets prepared/submitted by or on behalf of the applicant.
? This office concurs with the delineation report, dated , prepared by (company):
? This office does not concur with the delineation report, dated , prepared by (company):
Data sheets prepared by the Corps.
? Corps' navigable waters' studies:
? U.S. Geological Survey Hydrologic Atlas:
Q U.S. Geological Survey 7.5 Minute Topographic maps: Pamlico Beach
U.S. Geological Survey 7.5 Minute Historic quadrangles:
? U.S. Geological Survey 15 Minute Historic quadrangles:
® USDA Natural Resources Conservation Service Soil Survey: sheet 31
? National wetlands inventory maps:
? State/Local wetland inventory maps:
? FEMANIRM maps (Map Name & Date):
? 100-year Floodplain Elevation is: (NGVD)
? Aerial Photographs (Name & Date):
? Other photographs (Date):
? Advanced Identification Wetland maps:
® Site visit/determination conducted on: 7/19/2005
Applicable/supporting case law:
Other information (please specify):
Wetlands are identified and delineated using the methods and criteria established in the Corps Wetland Delineation Manual (87 Manual) (i.e., occurrence of
hydrophytic vegetation, hydric soils and wetland hydrology).
'The term "adjacent" means bordering, contiguous, or neighboring. Wetlands separated from other waters of the U.S. by man-made dikes or barriers, natural river
berms, beach dunes, and the like are also adjacent.
Page 6 of 8
NOTIFICATION OF ADMINIS"t'IZA'rlVE APPEAL OPTIONS AND PIZOCESS AND
1ZEQL11?S'[' 1 OR APPEAL
Applicant: Jeff Berger File Number: 200511835 Date: 8/26/2005
Attached is: See Section below
INITIAL PROFFERED PERMIT (Standard Permit or Letter of A
permission)
PROFFERED PERMIT Standard Permit or Letter of permission) B
_ PERMIT DENIAL C
APPROVED JURISDICTIONAL DETERMINATION D
_ PRELIMINARY JURISDICTIONAL DETERMINATION E
UAW.
SECTION I -The following identi ties your rights and options regarding an administrative appeal of the above
decision. Additional information may be found at litti):Hwww.tisacc.army.rnil/inet/functions/cw/cecwo/red or
Corps regulations at 33 CPR Part 3' ) 1.
A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your signature
on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all rights to appeal the
permit, including its terms and conditions, and approved jurisdictional determinations associated with the permit.
• OBJECT: If you object to the permit (Standard or LOP) because of certain terms and conditions therein, you
may request that the permit be modified accordingly. You must complete Section II of this form and return
the form to the district engineer. Your objections must be received by the district engineer within 60 days of
the date of this notice, or you will forfeit your right to appeal the permit in the future. Upon receipt of your
letter, the district engineer will evaluate your objections and may: (a) modify the permit to address all of your
concerns, (b) modify the permit to address some of your objections, or (c) not modify the permit having
determined that the permit should be issued as previously written. After evaluating your objections, the
district engineer will send you a proffered permit for your reconsideration, as indicated in Section B below.
13: PROFFERED PERMIT: You may accept or appeal the permit
ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your signature
on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all rights to appeal the
permit, including its terms and conditions, and approved jurisdictional determinations associated with the permit.
• APPEAL: If you choose to decline the proffered permit (Standard or LOP) because of certain terms and
conditions therein, you may appeal the declined permit under the Corps of Engineers Administrative Appeal
Process by completing Section II of this form and sending the form to the division engineer. This form must
be received by the division engineer within 60 days of the date of this notice.
2: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative
Appeal Process by completing Section II of this form and sending the form to the division engineer. This form
oust be received by the division engineer within 60 days of the date of this notice.
Page 7 of 8
D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or
provide new information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the date of
this notice, means that you accept the approved JD in its entirety, and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD, you may appeal the approved JD under the Corps of Engineers Administrative
Appeal Process by completing Section II of this form and sending the form to the division engineer. This form must be received by
the division engineer within 60 days of the date of this notice.
E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps
regarding the preliminary JD. The Preliminary JD is not appealable. If you wish, you may request an approved
JD (which maybe appealed), by contacting the Corps district for further instruction. Also you may provide new
information for further consideration by the Corps to reevaluate the JD.
SEC'T'ION II - REQUEST FOR APPEAL or OBJECTIONS TO AN INITIAL PROFFERED PERMIT
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your
objections to an initial proffered permit in clear concise statements. You may attach additional information to
this form to clarify where your reasons or objections are addressed in the administrative record.)
ADDITIONAL INFORMATION: The appeal is limited to a review of the administrative record, the Corps
memorandum for the record of the appeal conference or meeting, and any supplemental information that the
review officer has determined is needed to clarify the administrative record. Neither the appellant nor the Corps
may add new information or analyses to the record. However, you may provide additional information to clarify
the location of information that is already in the administrative record.
POINT OF CONT ACT FOR QUESTIONS OR INF ORMATION:
If you have questions regarding this decision If you only have questions regarding the appeal process you
and/or the appeal process you may contact: may also contact:
US Army Corps of Engineers Mr. Michael F. Bell, Administrative Appeal Review
attn: William Wescott Officer
Post Office Box 1000 CESAD-ET-CO-R
Washington, NC 27889 U.S. Army Corps of Engineers, South Atlantic Division
252-975-1616 60 Forsyth Street, Room 9M15
Atlanta, Georgia 30303-8801
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel, and any
government consultants, to conduct investigations of the project site during the course of the appeal process. You
will be provided a 15 day notice of any site investigation, and will have the opportunity to participate in all site
investigations.
Date: Telephone number:
Signature of appellant or agent.
DIVISION ENGINEER:
Commander
U.S. Army Engineer Division, South Atlantic
60 Forsyth Street, Room 9M15
Atlanta, Georgia 30303-3490
Page 8 of 8
Sladescreek, Jeff Berger, Hyde Co, 20051662
Subject: Sladescreek, Jeff Berger, Hyde Co, 20051662
From: Cyndi Karoly <[e-mail]>
Date: Tue, 13 Sep 2005 15:28:52 -0400
To: debbie Edwards <[e-mail]>, Laurie J Dennison
<[e-mail]>, Cynthia <[e-mail]>, Bev Strickland
<[e-mail]> /6K /5?'6
Does anybody know the whereabouts or story on this file. Noelle at the Armstrong
Company is calling, claiming to have spoken with several "she's" over the past few
days, although Noelle didn't bother to write any of these names down. It appears that
it was just reed on 9/1/05, but Noelle thinks someone told her it was issued and in
the mail, but BIMS only shows receipt. Any info before I waste an hour re-tracing
the whole story? Thanks.
1 of 1 9/13/2005 3:51 PM
Office Use Only: Form Version March 05
20051662
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
1. Processing

1. Check all of the approval(s) requested for this project:
® Section 404 Permit ? Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
® 401 Water Quality Certification ? Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: NWP 14
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
4. If payment into the North Carolina Ecosystem Enhancement Program (NCEEP) is proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section VIII,
and check here:
5. If your project is located in any of North Carolina's twenty coastal counties (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 , check here: ?
p
C CSC Q?lCg D
II. Applicant Information
SEP 1 2005
1. Owner/Applicant Information
Name: Jeff Berger DEN - WATFR Q11411T,----
Mailing Address:4316 Blackbeard Rd DS ANDSTORfMgERBuxH
Virainia Beach, VA 23455
Telephone Number: 757-286-5756 Fax Number:
E-mail Address:
2. Agent/Consultant Information (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name: Bobby Armstrong
Company Affiliation: Armstrong, Inc
Mailing Address: PO Box 96
Panteao, NC 27860
Telephone Number: 252-943-2082 Fax Number: 252-943-3308
E-mail Address: [e-mail]
Page 5 of 12
III. Project Information
5.
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: Sladescreek Lot 4,5 & 6
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN):
4. Location
County: Hyde Nearest Town: Scranton
Subdivision name (include phase/lot number):
Directions to site (include road numbers/nanies, landmarks, etc.): Hwy 264 E towards
Swanquarter, Rt on 1139, Rt on 1142 to Sladesville, Rt on 1143, Lefton 1149. Go past 1150
and turn left on first dirt road.
Site coordinates (For linear projects, such as a road or utility line,
separately lists the coordinates for each crossing of a distinct waterbody.)
Decimal Degrees (6 digits minimum): ON
6. Property size (acres):
7. Name of nearest receiving body of water: Sladescreek - Tributary to Puneo Creek
8. River Basin: Pamlico River
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admin/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: Forrested
attach a sheet that
ow
Page 6 of 12
10. Describe the overall project in detail, including the type of equipment to be used:
Dump truck and small tractor. Hauling loads of sand to construct a road.
11. Explain the purpose of the proposed work: Gain access to a higher ground lot.
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE 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 approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules. No permits
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
No
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. Each impact must be
listed separately in the tables below (e.g., culvert installation should be listed separately from
riprap dissipater pads). Be sure to indicate if an impact is temporary. All proposed impacts,
permanent and temporary, must be listed, and must be labeled and clearly identifiable on an
accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial)
should be shown on a delineation map, whether or not impacts are proposed to these systems.
Wetland and stream evaluation and delineation forms should be included as appropriate.
Photographs may be included at the applicant's discretion. If this proposed impact is strictly for
wetland or stream mitigation, list and describe the impact in Section VIII below. If additional
space is needed for listing or description, please attach a separate sheet.
1. Provide a written description of the proposed impacts: Haul in loads of sand to build a road
400' long x 28' wide impacting '/a acre land.
Page 7 of 12
2. Individually list wetland impacts. Types of impacts include, but are not limited to
mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc. For dams,
separately list impacts due to both structure and flooding.
Wetland Impact
Site Number
(indicate on map)
Type of Impact Type of Wetland
(e.g., forested, marsh,
herbaceous, bog, etc.) Located within
100-year
Floodplain
(yes/no) Distance to
Nearest
Stream
linear feet Area of
Impact
(acres)
1 Fill Forrested Yes >500 .25 acre

Total Wetland Impact (acres) .25
3. List the total acreage (estimated) of all existing wetlands on the property: Undetermined at
this time
4. Individually list all intermittent and perennial stream impacts. Be sure to identify temporary
impacts. Stream impacts include, but are not limited to placement of fill or culverts, dam
construction, flooding, relocation, stabilization activities (e.g., cement walls, rip-rap, crib
walls, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is proposed,
plans and profiles showing the linear footprint for both the original and relocated streams
must be included. To calculate acreage, multiply length X width, then divide by 43,560.
Stream Impact
Number
indicate on ma
Stream Name
Type of Impact
Perennial or Intermittent? Average
Stream Width
Before Impact Impact
Length
(linear feet) Area of
Impact
(acres)

Total Stream Impact (by length and acreage)
5. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.). Open water impacts include, but are not limited to
fill, excavation, dredging, floodin , drainage, bulkheads, etc.
Open Water Impact
Site Number
indicate on ma Name of Waterbody
(if applicable)
Type of Impact Type of Waterbody
(lake, pond, estuary, sound, bay,
ocean, etc. Area of
Impact
acres

Total Open Water Impact (acres)
Page 8 of 12
6. List the cumulative impact to all Waters of the U.S. resulting from the ro'ect.
Stream Impact (acres):
Wetland Impact (acres): .25
Open Water Impact acres):
Total Impact to Waters of the U.S. (acres) .25
Total Stream Impact (linear feet):
7. Isolated Waters
Do any isolated waters exist on the property? ? Yes ? No
Describe all impacts to isolated waters, and include the type of water (wetland or stream) and
the size of the proposed impact (acres or linear feet). Please note that this section only
applies to waters that have specifically been determined to be isolated by the USAGE.
8. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ? uplands ? stream ? wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Current land use in the vicinity of the pond:
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts. We will use minimum width
necessary to provide access. The road will need to be wide enough for emergency vehicles to
enter.
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
Page 9 of 12
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on January 15, 2002, mitigation will be required 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 not 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 DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCEEP concurrence shall be placed on hold as incomplete.
An applicant may also choose to review the current guidelines for stream restoration in DWQ's
Draft Technical Guide for Stream Work in North Carolina, available at
http//h2o.enr.state.nc.us/ncwetiands/strmuide.litm1.
1. Provide a brief description of the proposed mitigation plan. The description 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 (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
In-lieu payment to NCEEP
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 NCEEP at
[phone] to determine availability, and written approval from the NCEEP indicating
that they are will to accept payment for the mitigation must be attached to this form. For
additional information regarding the application process for the NCEEP, check the NCEEP
website at http://112o.cnr.state.nc.us/wrp/indcx.litin. 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 buffer mitigat on requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres): .5 acres
Amount of Coastal wetland mitigation requested (acres):
Page 10 of 12
IX. Environmental Documentation (required by DWQ)
1. Does the project involve an expenditure of public (federal/state/local) funds or the use of
public (federal/state) land? Yes ? No
2. If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No
3. If yes, has the document review been finalized by the State Clearinghouse? If so, please
attach a copy of the NEPA or SEPA final approval letter. Yes ? No
X. Proposed Impacts on Riparian and Watershed Buffers (required by DWQ)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office 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 15A NCAC 2B .0233
(Neuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 02B .0243 (Catawba) 15A NCAC
2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify V Yes ? No
2. If "yes", identify the square feet and acreage of impact to each zone of the riparian buffers.
If buffer mitigation is required calculate the required amount of mitigation by applying the
buffer multipliers.
Zone# I Impact I Multiplier I Required
i..,,..,._,, r--.N r:.. .: ..
3 (2 for Catawba)
1.5
Total I I I
• Zone I extends out 30 feet perpendicular from the top of the near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
3. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e.,
Donation of Property, Riparian Buffer Restoration / Enhancement, or Payment into the
Riparian Buffer Restoration Fund). Please attach all appropriate information as identified
within 15A NCAC 2B .0242 or .0244, or .0260. None
Page I I of 12
XI. Stormwater (required by DWQ)
Describe impervious acreage (existing and proposed) versus total acreage on the site. Discuss
stormwater controls proposed in order to protect surface waters and wetlands downstream from
the property. If percent impervious surface exceeds 20%, please provide calculations
demonstrating total proposed impervious level. Impervious existing 0%
Impervious proposed .1 %
XII. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
Perk and septic permits if necessary
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H.0500) or any Buffer Rules?
Yes El No
Is this an after-the-fact permit application? Yes ? No
XIV. Cumulative Impacts (required 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
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
http://h2o.enr.state.nc.us/newetlands. If no, please provide a short narrative description:
This will result in the impact of /1% of impervious surface on 247 acres.
XV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction 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 applicant's control).
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12

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