19920093 Ver 1_COMPLETE FILE_19920101

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State of North Carolina
Department of Environment, Health, and Natural Resources
Division of Environmental Management
512 North Salisbury Street • Raleigh, North Carolina 27604
James G. Martin, Governor George T. Everett, Ph.D.
William W. Cobey, Jr., Secretary Director
June 4, 1992
Mr. A. C. Lar.imore
wi.nston-Salem/Forsyth County Schools
1605 Miller Street
Winston-Salem, North Carolina 27103
Dear Mr. Lari.more:
Subject: Proposed Fill in Headwaters or Isolated Wetlands
Winston-Salem/Forsyth County Schools Sewer Line
Forsyth County
DEM Project # 92093, COE Project # 199201790
Upon review of your request for Water Quality Certification.
to place fill material in 0.23 acres of wetlands for sewer line
installation located at West Forsyth High School. and Southwest
Elementary School in. Forsyth County, we have determined:that the
proposed fill can be covered by General Water Quality
Certification No. 2664 issued January 21, 1992. A copy of the.
General Certification is attached., This Certification may be
used in qualifying for coverage under Corps of Engineers'
Nationwide. Permit No. 12. An additional condition is that the.
relocated stream channel near lots 17 and 18 should be replanted
with native trees or shrubs to enhance bank stabilization.
If you have any questions, please contact. John Dorney at
919/733-5083.
Sincerely,
GTE: JD
Attachment
of
rge T. Everett
cc: Wilmington District Corps of Engineers
Corps of Engineers Asheville Regional office
Winston-Salem DEM Regional Office
Mr. 'John Dorney REGIONAL OFFICES
Asheville File$0ooresville Raleigh Washington Wilmington
704/251-6208 919/486-1541 704/663-1699 919/571-4700 919/946-6481 919/395-3900
Winston-Salem
919/896-7007
Pollution Prevention Pays
P.O. Box 29535, Raleigh, North Carolina 27626-0535 'Telephone [phone]
An Equal Opportunity Affirmative Action Employer

May 26,1992
DIVISION OF ENVIRONMENTAL MANAGEMENT
MEMORANDUM
TO: John Dorney
THROUGH: M. Steven Mauney
FROM: Ron Linville
Subject: 401 Certification Review
Winston-Salem/Forsyth County
#92093
Forsyth County
Schools
After meeting with the engineer for this project, the WSRO did
not find it necessary to conduct a site visit as the individual wetland
areas were very small in size and the majority of these are located in a
somewhat suburban environment which should not be significantly or
substantially impacted by the installation of the sewer line. Adjacent
land uses would be expected to impact much more than the proposed
pipe installation. This project site(s) consist of only 0.23 acre.
The WSRO is however concerned that the proposal to move the
creek as detailed in the application at Lots 17, 18, and 25D will create
a piping effect which may contribute to storm event flash flows,
erosion and lower stream sedimentation problems. This bend is not
adressed specifically in the 401 Permit. The straightening of this
bend in the creek should be avoided if at all possible and anti-erosion
measures taken to insure adequate stabilization of the creek banks
(which may be steep already from erosion on the southern side) both
at the bend site and below the bend site. These measures should
include revegetation of the site(s) with NCWRC approved seedings or
plantings.
As a further note, the WSRO is not aware of any significant
historic or wildlife sites located on the proposed worksite(s). Further
review of the historical aspects of this area may be worthwhile as the
engineer indicated that he had difficulty in getting responses from the
agencies that he contacted. There are known Indian archaeological
sites along the Yadkin River, however, the WSRO has no knowledge of
any at this location.
MSM/rl
c c: WSRO
Central Files
MEMO
DATE:
TO:
SUBJECT:

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From:
? ? STATE 4
o North Carolina Department of Environment,
Health and Natural Resources
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QUA.
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DEM ID: ?Zc)?3
ACTION ID: 199201790
JOINT APPLICATION FORM FOR
NATIONWIDE PERMITS THAT REQUIRE NOTIFICATION TO THE DISTRICT ENGINEER
NATIONWIDE PERMITS THAT REQUIRE SECTION 401 CERTIFICATION CONCURRENCE
NATIONWIDE PERMITS THAT REQUIRE INDIVIDUAL 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]
1
M nY Q 1992

WATER QUALITY PLANNING
DIVISION OF ENVIRONMENTA
NC DEPARTMENT OF ENVIRON
AND NATURAL RESOURCE
P.O. BOX 29535
RALEIGH, NC 27626-0535
ATTN: MR. JOHN DORNEY
Telephone (919) 733-
ONE (1) COPY OF THIS COMPLETED APPLICATION SHOULD BE SENT TO THE CORPS OF
ENGINEERS. SEVEN (7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF
ENVIRONMENTAL MANAGEMENT. PLEASE PRINT.
1. OWNERS NAME: Winston-Salem/Forsyth County Schools
2. OWNERS ADDRESS: 1605 Miller Street
Winston-Salem, NC 27103
3. OWNERS PHONE NUMBER (HOME): [phone] (WORK) :
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER: A.C. Larimore
1605 Miller Street
Winston-Salem, NC
5. LOCATION OF PLANNED WORK (ATTACH MAP).
COUNTY: Forsyth
NEAREST TOWN OR CITY: Clemons
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ETC.):
West Forsyth Hirsh School
1735 Lewisville-Clemons Road
6. NAME OF CLOSEST STREAM/RIVER: Muddy Creek
7. RIVER BASIN: Yadkin
8. IS THIS PROJECT LOCATED IN A WATERSHED CLASSIFIED AS TROUT, SA, HQW, ORW,
WS I, OR WS II? YES [ ] NO [X] Class "C"
9. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROPERTY? YES. [X] NO [ ] _.
IF YES, EXPLAIN. see attached letter from CnrDG of F„O;neers
10.,.,..- ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
0:25 Acres t_ _.
4
H
-2-
11. NUMBER OF ACRES OF WETLAND IMPACTED BY THE PROPOSED PROJECT:
FILLED: 0.23 Acres
DRAINED:
FLOODED
EXCAVATED: 0.23 Acres +
TOTAL IMPACTED: n_23 AcrPG +
12. DESCRIPTION OF PROPOSED WORK (ATTACH PLANS): install sanitary sewer outfall
13. PURPOSE OF PROPOSED WORK: upgrade wastewater treatment at West Forsyth
High School and Southwest Elem. School
14. STATE REASONS WHY THE APPLICANT BELIEVES THAT THIS ACTIVITY MUST BE
CARRIED OUT IN WETLANDS. ALSO, NOTE MEASURES TAKEN TO MINIMIZE WETLAND
IMPACTS. stem will tie to Muddy Creek Outfall
15. YOU ARE REQUIRED TO CONTACT THE U.S. FISH AND WILDLIFE SERVICE
(USFWS) AND/OR NATIONAL MARINE FISHERIES SERVICE (NMFS) REGARDING THE PRESENCE
OR ANY FEDERALLY LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED
SPECIES OR CRITICAL HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE
PROPOSED PROJECT. HAVE YOU DONE SO? YES [X1 NO_[ 1
RESPONSES FROM THE USFWS AND/OR NMFS SHOULD BE ATTACHED.
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT': AREA WHICH
MAY BE AFFECTED BY THE PROPOSED PROJECT?
HAVE YOU DONE SO? YES 1X1 NO [ 1
RESPONSE FROM THE SHPO SHOULD BE ATTACHED.
17. ADDITIONAL INFORMATION REQUIRED BY DEM:
A. WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, AND LAKES ON
THE PROPERTY.
B. IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PROJECT.
C. IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
D. IF A STORMWATER MANAGEMENT PLAN IS REQUIRED FOR THIS PROJECT, ATTACH
-COPY.
E. WHAT IS LAND USE OF SURROUNDING PROPERTY? residential/agricultural
F. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
-cirayl ty sewer tntreatm-nf. nl ant. 11 Mllllrfv (`nr it t Tv-a;4f-mnn4- D1 .-+
0 h7NER' S SIGNATURE-- DATE
7 . i
461v?tr?-

DEPARTMENT OF THE ARMY
WILMINGTON DISTRICT, CORPS OF ENGINEERS
P.O. BOX 1890
WILMINGTON, NORTH CAROLINA 28402-1890
IN REPLY REFER TO
Regulatory Branch
May 4, 1992
Action ID. 199201790, CESAW-C092-J-034,
Winston-Salem/Forsyth County Schools
c/o Mr. A. C. Larimore
1605 Miller Street
Winston-Salem, North Carolina 27103
Dear Mr. Larimore:
Nationwide Permit No 12
Reference is made to your request dated April 13, 1992, regarding the
West Forsyth High School and Southwest Elementary School wastewater disposal
improvements project. As was outlined in a letter from Mr. W. Max Brady of
Brady Surveying (consultant for the site), this aforementioned sewer line
project includes the proposed 8-inch sewer line from West Forsyth High School
and Southwest Elementary School to the existing Muddy Creek Interceptor,
located off the Lewisville - Clemmons Road, adjacent to an unnamed tributary
of Muddy Creek, west of Winston-Salem, Forsyth County, North Carolina.
Reference is also made to the site visit conducted on September 4, 1991, by
Mr. John Thomas of my staff at the site of the proposed sewer line projects.
The purpose of the site visit was to review plans for the aforementioned sewer
line project, and to inspect the site for waters and wetlands subject to
Department of the Army permitting authority.
The site visit revealed and the plans/profiles for the aforementioned
project (plans received from Max Brady on April 13, 1992) showed that you
propose construction for the proposed 8-inch sewer line below natural grade
within a 40-foot construction easement adjacent to the aforementioned creeks.
Also your plans and profiles show other sections of proposed sewer line
located on high ground without discharge of fill into regulated areas.
For the purposes of the Corps of Engineers' Regulatory Program, Title 33,
Code of Federal Regulations (CFR), Part 330.6, published in the Federal
Register on November 22, 1991, lists nationwide permits. Authorization,
pursuant to Section 404 of the Clean Water Act, was provided for the discharge
of material for backfill or bedding for utility lines, including outfall and
intake structures, provided there is no change in pre-construction contours.
Your work is authorized by this nationwide permit provided it is
accomplished in strict accordance with the enclosed conditions. Please be
aware that this authorization does not relieve you of the responsibility to
obtain any other required or local approval. You should contact Mr. John

,'4
-2-
Dorney, North Carolina Division of Environmental Management, [phone],
to obtain the necessary Section 401, Water-Quality Certification prior to
starting work.
This verification will be valid for 2 years from the date of this letter
unless the nationwide authorization is modified, reissued, or revoked. Also,
this verification will remain valid for the 2 years if, during that period,
the NWP authorization is reissued without modification or the activity
complies with any subsequent modification of the NWP authorization. If during
the 2 years, the NWP authorization expires or is suspended or revoked, or is
modified, such that the activity would no longer comply with the terms and
conditions of the NWP authorization, activities which have commenced (i.e.,
are under construuctinn.)-6r" are under contract to commence in reliance upon the
NWP will remain authorized provided the activity is completed within 12 months
of the date of the NWP's expiration, modification or revocation, unless
discretionary authority has been exercised on a case-by-case basis to modify,
suspend, or revoke the authorization.
Thank you for your time and cooperation. If you have any questions,
please contact Mr. Thomas, Raleigh Regulatory Field Office, telephone (919)
846-0648.
Sincerely,
Vie, e Wri Pt
C Regulatory Branch
Enclosure
f
t BRADY SURVEYING COMPANY, P.A.
2990 Bethesda Place, Suite 601-B
Winston-Salem, North Carolina 27103
[phone]
May 13, 1992
Archaeology/Historic Preservation Section
507 North Blount Street
Raleigh, North Carolina
RE: Regarding the presence of Historic Properties
Sewer 0utfall for Winston-Salem/Forsyth County Schools
West Forsyth High School and Southwest Elem. School
To whom it may concern;
This letter is to inform you of the proposed wastewater
disposal improvements project in Forsyth County, Clemmons, North
Carolina for the Winston-Salem/ Forsyth County Schools. The
proposed project does contain areas classified as wetlands.
Enclosed is a map showing the approximate location of the
proposed sewer outfall.
For more information please call at [phone].
-110 04-1- -
W. Max Br 4?, W. V RLS
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BRADY SURVEYING COMPANY, P.A.
2990 Bethesda Place, Suite 601-B
Winston-Salem, North Carolina 27103
[phone]
May 13, 1992
N.C. Wildlife Resources Commission
512 North Salisbury Street
Raleigh, North Carolina
RE: Regarding the presence of any listed Endangered or
Threatened Species
Sewer Outfall for Winston-Salem/Forsyth County Schools
West Forsyth High School and Southwest Elem. School
To whom it may concern;
This letter is to inform you of the proposed wastewater
disposal improvements project in Forsyth County, Clemmons, North
Carolina for the Winston-Salem/ Forsyth County Schools. The
proposed project does contain areas classified as wetlands.
Enclosed is a map showing the approximate location of the
proposed sewer outfall.
For more information please call at [phone].
A) -el
W. Max Bra y, RLS
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APPROVA TT 708
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plans does not constitute approval far

---,j
Tax Block 4404
Lot 25D
Board of Education of Forsyth County/ '
TBM
Nall In 15' Beech Tree Sedim 331 xe 10'Waxln5'D Elev. 742.47' // 324-00
/
MH #10 Sediment Basin #5
STA 27+94.91 10'L x 10'W x 4'D
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OS JAN.1 04, to
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Lot 18 Lot 17 Lot 16

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Sta. 42+95, L 40'
Move creek over as close as Nall in 20" Mople
possible to school property line Elev. a 461.80
and Rip-Rap both sides of baII - ?
---- with Class I./- _
-

-
-- - 41+0 -- - -- K --- Sediment Basin #8
- 18'L x10'W x 4'D
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Tax Block 4404 INV - 755.00 plans du
Lot 25D rtust be f,
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this prOJL

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40
DEPARTMENT OF THE ARMY
WILMINGTON DISTRICT, CORPS OF ENGINEERS
P.O. BOX 1890
WILMINGTON, NORTH CAROLINA 28402-1890
IN REPLY REFER TO
Regulatory Branch
May 4, 1992
Action ID. 199201790, CESAW-C092-J-034, Nationwide Permit No. 12
Winston-Salem/Forsyth County Schools
c/o Mr. A. C. Larimore'
1605 Miller Street
Winston-Salem, North Carolina 27103 WETLA,vQS G 061
WATER Qt1ALlTY aECI't --2 i
Dear Mr. Larimore:
Reference is made to your request dated April 13, 1992, regarding the
West Forsyth High School and Southwest Elementary School wastewater disposal
improvements project. As was outlined in a letter from Mr. W. Max Brady of
Brady Surveying (consultant for the site), this aforementioned sewer line
project includes the proposed 8-inch sewer line from West Forsyth High School
and Southwest Elementary School to the existing Muddy Creek Interceptor,
located off the Lewisville - Clemmons Road, adjacent to an unnamed tributary
of Muddy Creek, west of Winston-Salem, Forsyth County, North Carolina.
Reference is also made to the site visit conducted on September 4, 1991, by
Mr. John Thomas of my staff at the site of the proposed sewer line projects.
The purpose of the site visit was to review plans for the aforementioned sewer
line project, and to inspect the site for waters and wetlands subject to
Department of the Army permitting authority.
The site visit revealed and the plans/profiles for.the aforementioned
project (plans received from Max Brady on April 13, 1992) showed that you
propose construction for the proposed 8-inch sewer line below natural grade
within a 40-foot construction easement adjacent to the aforementioned creeks.
Also your plans and profiles show other sections of proposed sewer line
located on high ground without discharge of fill into regulated areas.
For the purposes of the Corps of Engineers' Regulatory Program, Title 33,
Code of Federal Regulations (CFR), Part 330.6, published in the Federal
Register on November 22, 1991, lists nationwide permits. Authorization,
pursuant to Section 404, of the Clean Water Act, was provided for the discharge
of material for backfill or bedding for utility lines, including outfall and
intake structures, provided there is no change in pre-construction contours.
Your work is authorized by this nationwide permit provided it is
accomplished in strict accordance with the enclosed conditions. Please be
aware that this authorization does not relieve you of the responsibility to
obtain any other required or local approval. You should contact Mr. John
o 0
•
-2-
Dorney, North Carolina Division of Environmental Management, [phone],
to obtain the necessary Section 401, Water Quality Certification prior to
starting work.
This verification will be valid for 2 years from the date of this letter
unless the nationwide authorization is modified, reissued, or revoked. Also,
this verification will remain valid for the 2 years if, during that period,
the NWP authorization is reissued without modification or the activity
complies with any subsequent modification of the NWP authorization. If during
the 2 years, the NWP authorization expires or is suspended or revoked, or is
modified, such that the activity would no longer comply with the terms and
conditions of the NWP authorization, activities which have commenced (i.e.,
are under construction) or are under contract to commence in reliance upon the
NWP will remain authorized provided the activity is completed within 12 months
of the date of the NWP's expiration, modification or revocation, unless
discretionary authority has been exercised on a case-by-case basis to modify,
suspend, or revoke the authorization.
Thank you for your time and cooperation. If you have any questions,
please contact Mr. Thomas, Raleigh Regulatory Field Office, telephone (919)
846-0648.
Sincerely,
G. Wayne Wright
Chief, Regulatory Branch
Enclosure
,.?? .... -3-
Copies Furnished (without enclosure):
Mr. John Parker
Division of Coastal Management
North Carolina Department of Environment,
Health and Natural Resources
Post Office Box 27687
Raleigh, North Carolina 27611-7687
Mr. John ?rney
Water ality Section
Divislion of Environmental Management
No,th Carolina Department of Environment,
Health and Natural Resources
Post Office Box 27687
Raleigh, North Carolina 27611-7687
Regional Office Manager
N.C. Department of Environment,
Health and Natural Resources
8025 North Point Boulevard
Winston-Salem, North Carolina 27106
Copy Furnished (with enclosure):
Brady Surveying Company
c/o Mr. W. Max Brady, Jr.
2990 Bethesda Place, Suite 601-B
Winston-Salem, North Carolina 27103
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DEM ID: ?2-03
F-Q c J/ a 1`r
NO C32]ECTION
WILDLIFE RESO R `'S CG MISSIU'&4?
ACTION ID: 199201790
JOINT APPLICATION FORM FOR
NATIONWIDE PERMITS THAT REQUIRE NOTIFICATION TO THE DISTRICT ENGINEER
NATIONWIDE PERMITS THAT REQUIRE SECTION 401 CERTIFICATION CONCURRENCE
NATIONWIDE PERMITS THAT REQUIRE INDIVIDUAL 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 MANAGEMENT
NC DEPARTMENT OF ENVIRONMENT. HE AND NATURAL RESOUR 5N.. C
P.O. BOX 29535
RALEIGH, NC 27626-0535
ATTN : MR. JOHN DORNEY MAY 1 41992
Telephone [phone]eg
B®
LANpS GR t-
ONE (1) COPY OF THIS COMPLETED APPLICATION SHOULD BE SENT TO HE WW'S'ECT'
ENGINEERS. SEVEN (7) COPIES SHOULD BE SENT TO THE N.C. DIVIS
ENVIRONMENTAL MANAGEMENT. PLEASE PRINT.
1. OWNERS NAME: Winston-Salem/Forsyth County Schools.
2. OWNERS ADDRESS: 1605 Miller Street
Winston-Salem, NC 27103
3. OWNERS PHONE NUMBER (HOME): [phone] (WORK) :
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER: A.C. Larimore
1605 Miller Street
Winston-Salem, NC
5. LOCATION OF PLANNED WORK (ATTACH MAP).
COUNTY: Forsyth
NEAREST TOWN OR CITY: Clemons
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ETC.):
West Forsyth Hirsh School
1735 Lewisville-Clemmons Road
6. NAME OF CLOSEST STREAM/RIVER: Muddy Creek
7. RIVER BASIN:
Yadkin
8. IS THIS PROJECT LOCATED IN A WATERSHED CLASSIFIED AS TROUT, SA, HQW, ORW,
WS I, OR WS II? YES [ ] NO [XJ Class "C"
9. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROPERTY? YES [X] NO [ ]
IF YES, EXPLAIN. see attached letter from rnrnGs of FnrinPPrs
10-- ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
0;25'Acres t
-2-
11. NUMBER OF ACRES OF WETLAND IMPACTED BY THE PROPOSED PROJECT:
FILLED: 0.23 Acres +
DRAINED:
FLOODED:,
EXCAVATED: 0.23 Acres +
TOTAL IMPACTED: 0.23 Ar,rps +
12. DESCRIPTION OF PROPOSED WORK (ATTACH PLANS): install sanitary sewer outfall
13. PURPOSE OF PROPOSED WORK: upgrade wastewater treatment at West Forsyth
High School and Southwest Elem. School
14. STATE REASONS WHY THE APPLICANT BELIEVES THAT THIS ACTIVITY MUST BE
CARRIED OUT IN WETLANDS. ALSO, NOTE MEASURES TAKEN TO MINIMIZE WETLAND
IMPACTS. stem will tie to Muddy Creek Outfall
15. YOU ARE REQUIRED TO CONTACT THE U.S. FISH AND WILDLIFE SERVICE
(USFWS) AND/OR NATIONAL MARINE FISHERIES SERVICE (NMFS) REGARDING THE PRESENCE
OR ANY FEDERALLY LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED
SPECIES OR CRITICAL HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE
PROPOSED PROJECT. HAVE YOU DONE SO? YES [X] NO [
RESPONSES FROM THE USFWS AND/OR NMFS SHOULD BE ATTACHED.
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA WHICH
MAY BE AFFECTED BY THE PROPOSED PROJECT?
HAVE YOU DONE SO? YES [X] NO [ ]
RESPONSE FROM THE SHPO SHOULD BE ATTACHED.
17. ADDITIONAL INFORMATION REQUIRED BY DEM:
A. WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, AND LAKES ON
THE PROPERTY.
B. IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PROJECT.
C. IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
D. IF A STORMWATER MANAGEMENT PLAN IS REQUIRED FOR THIS PROJECT, ATTACH
-COPY.
E. WHAT IS LAND USE OF SURROUNDING PROPERTY? residential/agricultural
F. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
..
OWNER'S SIGNATURE:. DATE
V