20040755 Ver 1_Complete File_20040510

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Departrnent of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
August 23, 2005
DWQ # 20040755
Nash County
CERD MAIL - RETURN RECEIPT REQUESTED
Forrest Boone
2621 Boone Road
Elm City, NC 28722
Subject Property: Boone Farm SR 1744, Nashville, NC
Tar River [03-03-02,28-(36), WS-IV B NSW CA]
NOTICE OF WITHDRAWL
Dear Mr. Boone:
On May 10, 2004, you requested a 401 Water Quality Certification from the Division of Water
Quality (DWQ) for your project. We wrote to you on July 6, 2004 discussing concerns that we have
regarding the design of the project and stating that it would be placed on hold for three weeks giving
you time to address DWQ's concerns. As of today, DWQ has not received a response to this request.
Therefore, your file is hereby considered withdrawn and will not be reviewed until DWQ's earlier
concerns are addressed. Once you have collected sufficient information to have a complete
application (please see our July 6, 2004 letter for the missing information), you will need to reapply
for DWQ approval. This includes submitting a complete application package with the appropriate
fee.
Please be aware that you have no authorization under Section 401 of the Clear Water Act for this
activity and any work done within waters of the state would be a violation of North Carolina General
Statutes and Administrative Code. Please call Mr. Ian McMillan at 919-715-4631 if you have any
questions or concerns.
Permitting Unit
cc: Raleigh DWQ Regional Office
Raleigh Corps of Engineers
Central Files
File Copy
Filename: S:\2005 Correspondence\04-0755 Forrest Boone (Nash) Withdrawal.doc
401 Oversight/Eapress 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: h=://h2o enr state nc us/ncwetlands
R=1
An Equal opporgmity/Affimnative Action Employer - 50% Recycled/10% Post Consumer Paper
Sincerely,
WA7- Michael F. Easley, Governor
4
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G William G. Ross Jr., Secretary
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North Carolina Department o
t7 Alan W. Klimek, P. E. Director
--! Division of Water Quality
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Coleen H. Sullins, Deputy Director
Division of Water Quality
July 6, 2004
DWQ Project # 04-0755
Nash County
Page 1 of 2
CERTIFIED MAIL: RETURN RECEIPT REQUESTED
Forrest Boone
2621 Boone Road
Elm City, NC 28722
Subject Property: Boone Farm, SR1744, Nashville, NC
Tar River [03-03-02, 28-(36), WS-IV B NSW CA]
REQUEST FOR MORE INFORMATION
Dear Mr. Boone:
,
On May 10, 2004, the Division of Water Quality (DWQ) received your application dated May 5,
2004 to impact 0.01 acres of wetlands and 4,180 square feet (ft) of protected riparian buffers to
construct the proposed bulkhead along the Tar-River. The DWQ has determined that your
application was incomplete and/or provided inaccurate information as discussed below. The
DWQ will require additional information in order to process your application to impact protected
wetland, streams and/or buffers on the subject property. Therefore, unless we receive the
additional information requested below, we will have to move toward denial of your application
as required by 15A NCAC 2H .0506 and 2B .0259(8) and will place this project on hold as
incomplete until we receive this additional information. Please provide the following
information so that we may continue to review your project.
Additional Information Requested:
`1':' Impact Justification - Mike Horan of our Raleigh Regional Office met you on your
property to review your proposed plans to construct a bulkhead along the Tar-River. Mr.
Horan has determined based on information obtained during his site visit that the proposed
wetland and buffer impacts can be avoided and that the proposed bulkhead is not needed.
As such this office is moving towards the denial of your project, unless you can provide
additional justification for the proposed bulkhead.
2. Supplemental Information - If you decide to proceed with your request to construct the
proposed bulkhead or dock, then you will need to provide a site plan that clearly depicts the
existing conditions (property boundaries, river, streams, wetlands, buffers, etc.) and any
?0-'A-'
N. C.,Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
(919)'733-1786 (phone), 919-733-6893 (fax), (httoJ/h2o.enr.state.nc.us/ncwetlands)
Forrest Boone
Page 2 of 2
July 6, 2004
proposed impacts to wetlands, waters or buffers. The site plan shall be at a legible scale of
1"=100' feet of finer.
Please note that you may grade and fill Zone 2 (outer 20 feet) of protected buffers providing that
the area. is revegetated (you can use grass), diffuse flow is maintained and the health of the
existing vegetation within Zone 1 is not compromised. This activity is designated as "exempt"
within the buffer rule and does not require written authorization from the DWQ. You can also fill
up to 1/10 of an acre of wetlands (under General Certification No. 3402) within Zone 2 (or
elsewhere on your property) without receiving written authorization from the DWQ (see attached
GC3402).
Please respond within three weeks of the date of this letter by sending this information to me in
writing and Mike Horan of the DWQ Raleigh Regional' Office. If we do not hear from you
within three weeks, we will assume that you no longer want to pursue this project and we will
consider the project as withdrawn.
This letter only addresses the application review and does not authorize any impacts to wetlands,
waters or protected buffers. Please be aware that any impacts requested within your application
are not authorized (at this time) by the DWQ. Please call`Mr. Bob Zarzecki at 919-733-9726 if
you have any questions regarding or would like to set up a meeting to discuss this matter.
Sincerely,
JRD/bz
Enclosures: GC3402
, LOVIIUI
Dorney,
), Wetlands / 40 Unit
cc: Mike Horan, DWQ Raleigh Regional Office
USACE Raleigh Regulatory Field Office
File Copy
Central Files
Filename: 040755
MEMO DUIM
TO: John Dorney Regional Contact: _Michael Horan
Non-Discharge Branch WO Supervisor: Ken Sch,ister
Date:
SUBJECT: WETLAND STAFF REPORT AND RECOMMENDATIONS
Facil y liame Forrest Boone County Nash
Project Number 04 0755 County2
Recd Proton IPP' Region Raleigh
Rece*d Date 5/10104 Recvd By Region
Proj4ct,Type bulkhead wnstructihn
Certificates Stream Stream Impacts (ft.)
Permit NVetland Wetland Wetland Stream Class Acres Feet
Type T? pe Impact Score Index prim. supp. Basin Req, Req.
-
ffBR Buffcrs • -O NT r 287-1 ;1 WS1V NSW B 30,302. 0.09 F- r-{F--
Mitigation Wetland
M*ationType Type Acres Feet L U`-

Is Wetland Rating Sheet Attached? 0 Y 0 N Did you request more info? 0 Y 0 N
Have Project Changes/Conditions Been Discussed With Applicant? 0 Y 0 N
Is Mitigation required? 0 Y 0 N Recommendation: 0 Issue 0 Issue/Cond 0 Deny
Providjed by Region: Latitude (ddmmss) 355058 Longitude (ddmmss) 775524
Comments:
(6/15/04),Negds to be placed On-Hold for supplemental information such as site elan and mans
cc: RegionailOffice
Central Office Page Number 1
Triage Check List
Date: a 5 - 13 - oti
Project Name: ?°?^^^
DWQ#: oW -035S
To: ? ARO Mike Parker
? FRO Ken Averitte
? MRO AlanJohnson
RRO teve Mitchell
--------------- -
From: !&b
County:
? waRO
? wiRo
? WSRO
(alas".
Tom Steffens
Noelle Lutheran
Daryl Lamb
Telephone : (919) '433 -qULCo
The file attached is being forwarded to your for your evaluation.
Please call if you need ass'"* ce.
? Stream length impacted
? Stream determination
? Wetland determination and distance-to blue-line surface waters on USFW topo .maps
? Minimization/avoidance issues
>?uffer Rules (Meuse ar-Pamlic Catawba, Ran dleman)
? -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: kNe. - Otftse d
_ pMQW ?#I .ne eA be.%-*_r ASAQy ; In k wh a•?.2 okta s gt H? s ?l4e ,

Office Use Only: Form Version May 2002
USACE Action ID No. DWQ No. O
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
I.
II
Processing
1. Check all of the approval(s) requested for this project:
0 Section 404 Permit 0 Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
? 401 Water Quality Certification
2 Nationwide, Regional or General Permit Number(s) Requested:
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: D
41 If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (verify availability with NCWRP prior to submittal of PCN), 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: ?
Applicant Information_
1. Owner/Applicant Information
Name: Forrest Boone WETLANDS 1401 GR0JE
Mailing Address: 2621 Boone Road
Elm City NC 27822 AY Y 2004
WATER ®JpJ a cgr
i Telephone Number: [phone] Fax Number: [phone]
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:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
Page 5 of 5
2.
III.
Project Information
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-?ize 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: Boone Farm
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): 3716009702720
4. Location
County: Nash Nearest Town: Nashville
Subdivision name (include phase/lot number): Farm
Directions to site (include road numbers, landmarks, etc.): Proceed-North. on NC 58
5. Site coordinates, if available (UTM or Lat/Long)N35 °50' 58.0" W077055123-711
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Property size (acres): 38.6
7. Nearest body of water (stream/river/sound/ocean/lake): Tar River
8. River Basin: Tar-Pamlico
(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/.)
Describe the existing conditions on the site and general land use in the vicinity of the project at
the time of this application: Shallow wet area that traps trash and debris due to fluctuation
of river level.
Page 6 of 6
4
10. Describe the overall project in detail, including the type of equipment to be used:
Track hoe, Bulldozer, & Dump truck "
11 Explain the purpose of the proposed work: Prevent flooding and trapping of trash and debri
on shoreline of river. I wish to fill this area so management and maintenance of this area can be
obtained.
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
cr: ifications 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.
N/A
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.
N/A
VI. Proposed Impacts to Waters of the United States/Waters of the State
I't 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. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent and
temporary, must be listed herein, and must be clearly identifiable on an accompanying site plan.
All wetlands and waters, and all streams (intermittent and perennial) must 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
4t 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.
Page 7 of 7
f
1. Provide a written description of the proposed impacts: Fill area adjacent Tar River.
2. Individually list wetland impacts below:
Wetland Impact
Site Number
(indicate on ma)
Type of Impact* Area of
Impact
(acres) Located within
100-year Floodplain**
(es/no) Distance to
Nearest Stream
(linear feet)
Type of Wetland***
1 Bulkhead 0.09 ac Yes 0 Freshwater

* List each impact separately and identify temporary impacts. 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.
* 100-Year floodplains are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online at http:/hvww.fema.gov.
***' List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond, Carolina
Bay, bog, etc.) Indicate if wetland is isolated (determination of isolation to be made by USACE only).
List the total acreage (estimated) of all existing wetlands on the property: 0.28 Ac
Total area of wetland impact proposed: 0.1
3 Individually list all intermittent and perennial stream impacts below:
i
Stream!;Impact
Site Number
(indicate on ma)
Type of Impact* Length of
Impact
(linear feet)
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
(please secif )
N/A

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap,
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, 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.
** Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
wwwtuscs.cov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.tol2ozone.coni,
www6manouest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site:
Page 8 of 8
f Y i

4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact
Site Number
(indicate on ma) -
Type of Impact* Area of
Impact
(acres)
(if Name applicable) Wateplicabllee) Type of Waterbody
(lake, Pand> estuary, sound,
bay, ocean, etc.)
N/A

List each impact separately and iaenttty temporary impacts. impacts include, but are not limited to: fill, excavation, dredging, flooding,
drainagf, bulkheads, etc.
5.I Pond Creation N/A
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 stonnwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
V1I. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
i>iformation 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.
Area Presently can not be mowed or maintained. Bulkhead installation will allow maintenance
of this area for a single residence dwelling.
VIII. Mitigation
PWQ - 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 freshwater
wetlands or greater than or equal to 150 linear feet of total impacts to perennial streams.
Page 9 of 9
., t
U$ACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, 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 NCWRP 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/ncwetlands/strmgide.html.
I.; 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.
N/A based on permit requested.
i
21 Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP). Please note it is the applicant's responsibility to contact the NCWRP at
[phone] to determine availability and to request written approval of mitigation prior to
submittal of a PCN. For additional information regarding the application process for the
NCWRP, check the NCWRP website at htip://h2o.enr.state.nc.us/wrp/index.htm. If use of the
NCWRP is proposed, please check the appropriate box on page three and provide the following
information:
i
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
Page 10 of 10

IX. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federal/state) funds or the use of public
(federal/state) land?
Yes ? No
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 ?
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 ?
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.
W;ll the project impact protected riparian buffers identified within 15A NCAC 2B .0233 (Meuse),
15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and Water Supply
Buffer Requirements), or other (please identify )?
Yes N No ? If you answered "yes", provide the following information:
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* (square act feet) Multiplier Required
n
1 4180 3 12,540
2 1.5
Total
Zone 1 extends out 3U feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
Page 11 of 11
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B.0242 or.0260.
Riparian buffer restoration.
XI. Stormwater (required by DWQ)
Dejscribe impervious acreage (both 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.
Impervious acreage is 0.08 acres. All other areas will be seeded to permanent grass.
XII. Sewage Disposal (required by DWQ)
i
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.
NSA
XIII. Violations (required by DWQ)
i
Is this site in violation of DWQ Wetland Rules (I 5A NCAC 2H .0500) or any Buffer Rules?
Yes ? No
Is this an after-the-fact permit application?
Yes ? No D
XIV. 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).
Vpplicant/Agent's Signature ate
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12
y Parcel Print l Page 1 of
Parcel Print Display
Parr_pl Infnrmatinn
Parcel Number 371600970272U
Owner Name; I EDWARDS J D INVESTMENTS LLC
Owner Mailiag Address 4119 SHEEP PASTURE RD
City, State SPRING HOPE NC
Zip Code 27882
Parcel Address 4582 4617 ADOLPHUS T BOONE RD
Total Taxable Value $0.00
Municipality 0
Township COOPERS
Visible Layers:
Streets, Parcels
Date/TSme Stamp The data effective date This map is prepared for the inventory of real property found within this jurisdiction, and is compiled
from recorded deeds, plats and other public records and data. Users of this map are hereby notified
is: that the aforementioned public primary information sources should be consulted for verification of
Januaty 29, 2004 the information contained on this map. The County assumes no legal responsibility for the
9:2:24 am Monday, November 17, information contained on this map.
2003 at 12:00 pm.
t_?.__u___?__.........? .,,...1. «,...../...?../«......el.?.-art h4m'
1/29/2001
• THIS SECTION ON DELIVERY
• COMPLETE SECTION
4 ..Complete items 1. 2, and 3..Also complete A 1
''item 4 if Restricted Delivery is desired. 0 Agent
¦ y-rint your name and address on the reverse dresser
so that we can return the card to you. B Recelv` (Printed Name) C. Date of Deliven
¦ Attach this card to the. back of the mailpiece, Z
or on the front if space permits.
1. Article Addressed to: D. ds deliveryaddress different from item 1? Yes
If YES, enter delivery address below: ? No
Forrest Boone
2621 Boone Road
Elm City; NCB
DWQ# 04-0755 - Nash
2. Article Number
(Transfer from sendce labeo
^°--? 3811, August 2001
i
n
'ACertiffed Mail: O Express Mail .
M Registered Return Receipt for,Merchandisf
J 13 Insured Mail 66.O.D.
4. -Restricted Delivery? (Extra Fee) 0 Yes
7004 0750 0003 3326 7074
Domestic Return Receipt 102595
UNITED STATES POSTAL SERVICE First-Class Mail
Postage & Fees Paio .
USPS
Permit No. G-10
• Sender. Please print your name, address, and ZIP+4 in this box •
r
NC DENR Division of Water Quality
Wetlands/401 Certification Unit
2321 Crabtree Boulevard, Suite 250
Raleigh, NC 27604
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