19930863 Ver 1_COMPLETE FILE_19931012

DEPARTMENT OF THE ARMY
WILMINGTON DISTRICT, CORPS OF ENGINEERS NOV 2 2 ``.
P.O. BOX 1890 1?`?i
WILMINGTON, NORTH CAROLINA 28402-1890
4VETLAE\!EI;;
IN REPLY REFER TO November 5, 1993 affi "E , DALE ('f
Regulatory Branch
Action ID. 199400133 and Nationwide Permit No. 26 (Headwaters and Isolated
Waters)
Mr. Milton Kirkland
720 West Main Street
Jamestown, North Carolina 27282
Dear Mr. Kirkland:
Please reference the site-visit of June 8, 1992, conducted by Mr. John
Thomas of my staff at your property located off of SR 1834 (Kendale Road)
adjacent to an unnamed tributary of West Fork Deep River, Sandy Ridge,
Guilford County, North Carolina. Also in attendance at this meeting was
Mr. Paul Blanchard of Davis Martin & Powell (engineering consultant for site).
The purpose of this meeting was to review plans for construction of a pond on
the aforementioned tributary, and to inspect the site for waters and wetlands
subject to Department of the Army permitting authority.
Reference is also made to your letter and attached site plans dated
October 6, 1993, for the aforementioned project provided by Mr. Eddie
MacEldowney of Davis Martin & Powell. The meeting of June 8, 1992, revealed
that the proposed site is located adjacent to, and above the headwaters of, an
unnamed tributary to West Fork Deep River. An existing pond (approximately
0.41 acres in area) is located within the proposed new pond site. The review
of the proposed development plans indicates that construction of the pond will
involve adverse modification to 0.58 acres of wetlands on the site and would
include excavation impacts to the existing 0.41 acre pond. Total impacts for
the new pond would be approximately 0.99 acres.
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 was
provided, pursuant to Section 404 of the Clean Water Act, for discharges of
dredged or fill material into headwaters and isolated waters provided:
a. the discharge does not cause the loss of more than 10 acres of waters
of the United States;
b. the permittee notifies the District Engineer if the discharge would
cause the loss of waters of the United States greater than one acre in
accordance with the "Notification" general condition. For discharges in
special aquatic sites, including wetlands, the notification must also include
a delineation of affected specific aquatic sites, including wetlands; and
c. the discharge, including all attendant features, both temporary and
permanent, is part of a single and complete project.

-2-
Your work is authorized by this nationwide permit provided it is
accomplished in strict accordance with the enclosed conditions and provided
you receive a Section 401 water quality certification from the North Carolina
Division of Environmental Management (NCDEM). You should contact Mr. John
Dorney, telephone [phone], regarding water quality certification
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 nationwide permit authorization is reissued without modification or the
activity complies with any subsequent modification of the nationwide permit
authorization. If during the 2 years, the nationwide permit 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 nationwide permit,
activities which have commenced (i.e., are under construction) or are under
contract to commence in reliance upon the nationwide permit will remain
authorized provided the activity is completed within 12 months of the date of
the nationwide permit'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)
876-8441.
Sincerely,
G. Wayne Wright
Chief, Regulatory Branch
Enclosure

-3-
Copy Furnished (with enclosure):
Davis Martin Powell & Associates, Inc.
c/o Mr. Eddie MacEldowney
218 Gatewood Avenue, Suite 102
High Point, North Carolina 27262
Copies Furnished (without enclosure):
Mr. John Parker
North Carolina Department of
Environment, Health and
Natural Resources
Post Office Box 27687
Raleigh, North Carolina 27611-7687
Mr. John Dorney
Water Quality Section
Division of Environmental Management
North Carolina Department of
? Environment, Health and
V Natural Resources
Post Office Box 27687
Raleigh, North Carolina 27611-7687
Regional Office Manager
North Carolina Department of
Environment, Health and
Natural Resources
8025 North Point Boulevard
Winston-Salem, North Carolina 27106
State of North Caroll'na
Department of Environment, VIVA
Health and Natural Resources A74**
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, , Secretary
? E H N F?
A. Preston Howard, Jr., P.E., Director
November 1, 1993
Mr. Milton Kirkland
720 West Main Stteet.
Jamestown, N.C. 27282
Dear Mr. Kirkland:
Subject: Proposed fill in Wetlands or Waters
Pond construction
Guilford County
DEM Project # 93863
Upon review of your request for 401 Water Quality Certification
to place fill material in 0.58 acres of wetlands or waters which are
tributary to West Fork Deep River for pond construction located at
Kendale Road in Guilford County as described in your submittal dated 6
October 1993, we have determined that the proposed fill can be covered
by General Water Quality Certification No. 2671. A copy of the
General Certification is attached. This Certification may be used in
qualifying for coverage under. Corps of Engineers' Nationwide Permit
No. 26.
If this Certification is unacceptable to you, you have the right
to an adjudicatory hearing upon written request within thirty (30)
days following receipt of this Certification. This request must be in
the form of a written petition conforming to Chapter 150B of the North
Carolina General Statutes and filed with the Office of Administrative
Hearings, P.O. Box 27447, Raleigh, N.C. 27611-7447. Unless such
demands are made, this Certification shall be final and binding.
If you have any questions, please contact John Dorney at 919-733-
1786.
Sincerely,
93863.1tr P.P eston oward, P. E.
Attachment
cc: Wilmington District Corps of Engineers
Corps of.Engineers Raleigh Field Office
Winston-Salem DEM Regional Office
Mr. John Dorney
Central Files
Eddie Mac Eldowney; Davis-Martin-Powell and Ass., Inc.
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post-consumer paper
Or-
,v

MEMORANDUM PRINT NAMES: _ L
Reviewer:-
TO : John Dorney WQ Supv.:dam
Planning Branch DATE: 3 lc_,,',
SUBJECT: WETLAND STAFF REPORT AND RECOMMENDATIONS
***EACH ITEM MUST BE ANSWERED (USE N/A FOR NOT APPLICABLE) ***
PERMIT YR: 93 PERMIT NO: 0000863 COUNTY: GUILFORD
APPLICANT NAME: MILTON KIRKLAND
PROJECT-TYPE: POND PERMIT-TYPE: NW26
COE_#: DOT-#:
RCD_FROM_CDA: APP DATE _FRM CDA: 10/07/93
REG_OFFICE: WSRO RIVER-AND-SUB-BASIN-#:
STREAM-CLASS: ,,) S - L a
WL_IMPACT?: YIN
WL_REQUESTED : 0. 6
WL SCORE (# ): 3`{. d2 S-
HYDRO_CNECT?: (Y)N
STR_INDEX_NO: I 1 - 3--(0-3)
WL_TYPE : .--
WL_ACR_EST? : Y'N
WATER IMPACTED BY FILL?: Y,Nj
MITIGATION?: Y*1'
MITIGATION TYPE: Aj/t MITIGATION SIZE:
IS WETLAND RATING SHEET ATTACHED?:(Y?N
RECOMMENDATION (Circle One): IS5 ISSUE/COND DENY
COMMENTS : G cam. -
6 6i,! CL.rA / fl G-i
"I
3

c
cc: Regional Office.
Central Files

Project nameZ2Zr%,L&- k i Y / /9 Nearest road
County Wetland area acres Wetland width feet

•
•
•
? Hydrologically connected
? Hydrologically isolated
Wetland type (select one) &'-.bther //Z ;
? Swamp forest ? Shoreline •
? Bottomland hardwood forest ? Brackish marsh
? Carolina bay ? Freshwater marsh
? Pocosin ? Bog/Fen •
? Pine savannah ? Ephemeral wetland
? Wet flat •
The rating system cannot be applied to salt marshes. +

••••.•••••.••••••••••••••••••«
•..•••.••••.••.•••••.++••sum
•
Water storage : >::><:::>::<::<:>::::>::::>

?._
Bank/Shorelinestobilization
?>>><'<'`?`<? -

;;: ....>:<.:;:....;::.:;.;:.> •
Pollutant removal
..................... .
Sensitive watershed __ >`::
x 1
50 •

Travel corridor =_ .
't Wetland score.

. +
Special ecological attributes :
I
Wildlife habitat

0
:;:<::::: x 1.5 =

>::>::

•
Aquatic life value •

Recreation/Education
-? -'
_<< •

Economic value x0.25-
-
»< <`
>i:.x.. .

+

. • .... • . • . • .. • • • ... •
• . • . . . • • . . ._. • .. • . • • . • .. • +4 b 10 0 • 0 0 0 0 9 9 0 0

Name of evaluator Date

EHNR - ENVIRONMENTAL MANAGEMENT
.0311 CAPE FEAR RIVER BASIN 2B .030r
Classification
Name of Stream Description Class Date Index No.
Mill Branch From a point 0.5 mile upstream of mouth WS-IV NSW CA 8/3/92 16-41-6-5-(2)
to New Hope River Arm of B. Everett Jordan
Lake
Parkers Creek From source to Chatham County SR 1716 WS-IV&B NSW 8/3/92 16-41-8-(1)
Parkers Creek From Chatham County SR 1716 to New WS-IV&B NSW CA 8/3/92 16-41-8-(2)
Hope River Arm of B. Everett Jordan Lake
Windfall Branch From source to U.S. Hwy.64 WS-IV NSW 8/3/92 16-41-9-(1)
Windfall Branch From U.S. Hwy. 64 to New Hope River Arm WS-IV NSW CA 8/3/92 16-41-9-(2)
of B. Everett Jordan Lake
Beaver Creek From source to a point 0.3 mile down- WS-IV NSW 8/3/92 16-41-10-(0.5)
stream of Wake County SR 1141
Reedy Branch From source to Beaver Creek WS-IV NSW 8/3/92 16-41-10-1
Beaver Creek From a point 0.3 mile downstream of Wake WS-IV NSW CA 8/3/92 16-41-10-(2)
County SR 1141 to New Hope River Arm
of B. Everett Jordan Lake
Little Beaver Creek From source to a point 0.1 mile upstream WS-IV NSW 8/3/92 16-41-11-2-(1)
of Chatham-Wake County Line
Little Beaver Creek From a point 0.1 mile upstream of Wake- WS-IV NSW CA 8/3/92 16-41-11-2-(2)
Chatham County Line to New Hope River
Arm of B. Everett Jordan Lake
Weaver Creek From source to a point 0.5 mile upstream WS-IV NSW 8/3/92 16-41-12-3-(1)
of mouth
Weaver Creek From a point 0.5 mile upstream of mouth WS-IV NSW CA 8/3/92 16-41-12-3-(2)
to New Hope River Arm of B. Everett
Jordan Lake
HAW RIVER From dam at B. Everett Jordan Lake to WS-IV 8/3/92 16-(42)
Cape Fear River (junction with Deep River)
Shaddox Creek From source to Haw River WS-IV 8/3/92 16-43
DEEP RIVER DRAINAGE AREA
DEEP RIVER (including From source in backwaters of High Point . WS-IV CA 8/3/92 17-(1)
High Point Lake at Lake to dam at High Point Lake (City
normal pool elevation) of High Point water supply intake)
East Fork Deep River From source to a point 0.4 mile down- WS-IV 8/3/92 17-2-(0.3)
stream of Guilford County SR 1541
East Fork Deep River From a point 0.4 mile downstream of WS-IV CA 8/3/92 17-2-(0.7)
Guilford County SR 1541 to High Point
Lake, Deep River
Long Branch From source to a point 0.5 mile down- WS-IV 8/3/92 17-2-1-(1)
stream of Guilford County SR 1541
Long Branch From a point 0.5 mile downstream of WS-IV CA 8/3/92 17-2-1-(2)
Guilford County SR 1541 to East Fork
Deep River
West Fork Deep River From source to a point 0.3 mile down- WS-IV 8/3/92 17-3-(0.3)
stream of Guilford County SR 1850
"K x West Fork Deep River From a point 0.3 mile downstream of WS-IV CA 8/3/92 17-3-(0.7)
12
DAVIS - MARTIN - POWELL & ASSOCIATES, INC.
dM
P 218 October 6 GATEWOOD , 199 AVENUE 3 SUITE102
Re: Milton Kirkland
Residential Dam and Pond
Job No. E-1650
Mr. John Dorney
Water Quality Planning
Division of Environmental Management
NC Department of Environmental Health and Natural Resources
PO Box 29535
Raleigh, North Carolina 27626-0535
Dear Mr. Dorney:
We have enclosed seven (7) copie of a completed Joint Application
Form for the above referenced project. Also enclosed above with
each copy is an 8 1/2" x 11" copy of the construction plan
indicating the proposed wetland impacts. Based upon these plans the
following wetlands impacts are anticipated:
Filled: 0.09 Ac±
Excavated: 0.49 Ac±
Total 0.58 Ac±
A copy of a complete set of construction plans along with a copy of
this letter will be mailed to Mr. Ron Linville for his review and
comments.
We appreciate your assistance and look forward to receiving
approval for this project at an early date. If you should have any
questions or require additional information, please give us a call.
Very truly yours,
-PQWEWf) & ASSOCIATES
EM/acf
ENGINEERING LANDPLANNING SURVEYING
•
- HIGH POINT, NC 27262
PHONE
- [phone] FAX[phone]
L. McNeill, P.E.
c: Milton Kirkland
Ron Linville - DEHNR - Water Quality
John Thomas - Corps of Engineers
File
OEM ID:
ACTION ID:
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 ENVI NMENT, HEALTH,
AND NATURAL RESO
Q u j '
P.O. BOX 29535'
RALEIGH, NC .27626-05 ;
ATTN: MR. JOHN DORNE OCT - 7 1993
Telephone [phone]
ONE (1) COPY OF THIS COMPLETED APPLICATION SHOULD BE SENT TT Tlib iECT'10N
ENGINEERS. SEVEN (7) COPIES SHOULD BE SENT TO THE N.C. DIVISION
ENVIRONMENTAL MANAGEMENT. PLEASE PRINT.
1. OWNERS NAME: Milton Kirkland
2. OWNERS ADDRESS: 720 West Main Street
Jamestown. NC 27282
3. OWNERS PHONE NUMBER (HOME): (WORK): (9191454-6131
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE. CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
5. LOCATION OF PLANNED WORK (ATTACH MAP).
COUNTY: Guilford
NEAREST TOWN OR CITY : High Point
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ETC.):
Kendale Road ( S.R. 1834 ) 0.8 North of Skeet Club Road
6. NAME OF CLOSEST STREAM/RIVER: Deep River
7. RIVER BASIN: Cape Fear
8. IS THIS PROJECT LOCATED IN A WATERSHED CLASSIFIED AS TROUT, SA, HQW, ORW,
WS I, OR WS II? YES [ ] NO [X] WSlll
9....HAVE ANY SECTION 404. PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROPERTY? YES [ ] NO [X] `
IF YES, EXPLAIN.
10. ESTIMATED* TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
0.6847 Acres ±
2/3/92

-2-
11. NUMBER OF ACRES OF WETLAND IMPACTED BY THE PROPOSED PROJECT:
FILLED : 0.09 AC
DRAINED:
FLOODED:
EXCAVATED: .49 AC ±
TOTAL IMPACTED : 0.58 AC
12. DESCRIPTION OF PROPOSED WORK (ATTACH PLANS) : Construct a proposed residential
pond and dam
13. PURPOSE OF PROPOSED WORK: Create an aquatic habitat for fish and water
fowl
14. STATE REASONS WHY THE APPLICANT BELIEVES THAT THIS ACTIVITY MUST BE
CARRIED OUT IN WETLANDS. ALSO, NOTE MEASURES TAKEN TO MINIMIZE WETLAND
IMPACTS. The applicant believes that the benefits of the proposed pond as an aquatic habitat
provide credible justification to impact wetlands
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
f SPECIES OR CRITICAL HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE
PROPOSED PROJECT. HAVE YOU DONE SO? YES EX] 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
THF- 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? Agricultural
F. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
R'S SIGNATURE
DATE

DEM ID: 1?32to
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
r
WILMINGTON DISTRICT ENGINEER
CORPS OF ENGINEERS
DEPARTMENT OF THE ARMY
P.O. BOX 1890
WILMINGTON, NC 28402-1890
ATTN: CESAW-CO-E
Telephone [phone]
ACTION ID:
WATER QUALITY PLANNING
DIVISION OF ENVIRONMENTAL MANAGEMENT
NC DEPARTMENT OF HEALTH.,.._ _
AND NATURAL RES E I` M I s'
P.O. BOX 29535
RALEIGH, NC .27626- , ,,,
ATTN: MR. JOHN DO 1 I ?v,i
Telephone [phone]_
ONE (1) COPY OF THIS COMPLETED APPLICATION SHOULD BE SENT-M.-TH M0
ENGINEERS. SEVEN (7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF
ENVIRONMENTAL MANAGEMENT. PLEASE PRINT.
1. OWNERS NAME: Milton Kirkland
2. OWNERS ADDRESS: 720 West Main Street
Jamestown, NC 27282
3. OWNERS PHONE NUMBER (HOME): (WORK):
(9191454-8131
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
5. LOCATION OF PLANNED WORK (ATTACH MAP).
COUNTY: Guilford
NEAREST TOWN OR CITY: High Point
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ETC.):
Kendale Road [ S.R. 1834 ] 0.8 North of Skeet Club Road
6. NAME OF CLOSEST STREAM/RIVER: Deep River
7. RIVER BASIN: Cape Fear
8. IS THIS PROJECT LOCATED IN A WATERSHED CLASSIFIED AS TROUT, SA, HQW, ORW,
WS I, OR WS II? YES [ ] NO [X] WS111
9.-HAVE ANY SECTION 404-PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROPERTY? YES [ ] NO [X]
IF YES, EXPLAIN.
10. ESTIMATED. TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
0.6847 Acres ±
2/3/92

-2-
11. NUMBER OF ACRES OF WETLAND IMPACTED BY THE PROPOSED PROJECT:
FILLED : 0.09 AC t
DRAINED:
FLOODED:
EXCAVATED : 9 AC t
TOTAL IMPACTED : 0.58 AC
12. DESCRIPTION-OF PROPOSED WORK (ATTACH PLANS): Construct a proposed residential
pond and dam
13. PURPOSE OF PROPOSED WORK: Create an aquatic habitat for fish and water
fowl
14. STATE REASONS WHY THE APPLICANT BELIEVES THAT THIS ACTIVITY MUST BE
CARRIED OUT IN WETLANDS. ALSO, NOTE MEASURES TAKEN TO MINIMIZE WETLAND
IMPACTS. The applicant believes that the benefits of the proposed pond as an aquatic habitat
provide cre i e justification to impact wetlands
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 ( l
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 [x1 NO [ J
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? Agricultural
F. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
Septic Tank and SubSurface Nitrification
R'S SIGNATURE
DATE
MMORMIN
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