19950383 Ver 1_COMPLETE FILE_19950412

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A, Preston Howard, Jr., P.E., Director
APPROVAL of 401 Water Quality Certification
Mr. Bobby Gene Johnson
Route 1, Box 807
Mt. Gilead, N.C. 27306
Dear Mr. Johnson:
?EHNR
April 21, 1995
Montgomery County
DEM Project # 95383
FILE COQ;
You have our approval to place fill material in 416 square feet of waters for the purpose of
installing a boat house with boat lift at Lot 29, off of SR 1175 on Lake Tillery, as you described in
your application dated 11 April 1995. After reviewing your application, we have decided that this fill
is covered by General Water Quality Certification Number 2674. This certification allows you to use
General Permit Number 030 when it is issued by the Corps of Engineers.
This approval is only valid 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.
For this approval to be valid, you must follow the conditions listed in the attached certification. In
addition, you should get any other federal, state or local permits before you go ahead with your
project.
If you do not. accept any of the conditions of this certification, you may ask for an adjudicatory
hearing. You must act within 30 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, P.O. Box 27447, Raleigh, N.C. 27611-7447. This certification and
its conditions are final and binding unless you ask for a hearing.
This letter completes the review of the Division of Environmental Management under Section 401
of the Clean Water Act. If you have any questions, please telephone John Domey at 919-733-1786.
Attachment
S' rely
J
i
ton Howard, Jr.
cc: Wilmington District Corps of Engineers
Corps of Engineers Wilmington Field Office
Fayetteville DEM Regional Office
Mr. John Domey
Central Files
95383.1tr
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

DEM ID: C) 5 ]? O
ACTION ID: ?.,
Nationwide Permit Requested (Provide Nationwide Permit #):
JOINT FORM FOR 40118,
?
Nationwide permits that require notification to the Corps of Enginee uzz)
Nationwide permits that require application for Section 401 certification
WILMINGTON DISTRICT ENGINEER WATER QUALITY PLANNING
CORPS OF ENG ERS DIVISION OF ENVIRONMENTAL MANAGEMENT
DEPA El I OF THE ARMY NC DEPARTMENT OF ENVIRONM
P.O. Box 0 AND NATURAL RESOURCES
Wilmi ton,"N 28402-1890 P.O. Box 29535
A : CESA O-E Raleigh, NC 27626-0535
le hone -4511 ATTN: MR. JOHN DORNEY L /APR
p (919) Telephone (919) 4M-50e 13 3 = 1'x''4 G 1995
ONE (1) COPY OF THIS COMPLETED APPLICATION SHOULD BE 'SENT TO THE C OH Ofi IN
SEVEN (7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMEI? ivl7k?GEl
PLEASE PRINT.
1. Owners Name:

7 3?
d 4/
C _
2. Owners Address: T 06? L(i - : /P_.9
3. Owners Phone Number (Home): 2-1T ? i!? - !Llz2 _ (Work): 21?2 V- 5?`,F 2 a,12 :Z
4. If Applicable: Agent's name or responsible corporate official, address, phone number:
5. Location of work (MUST ATTACH MAP). County: A, L, / ~T6-z-zz cZ C?C C~
Nearest Town or City: Al
[_?', / ?,4 Q 4!
Specific Location (Include road numbers, landmarks, etc.): ?'aci -1 jl)or7 st
6. Name of Closest Stream/River:
7. River Basin:
e
8. Is this project located in a watershed classified as Trout, SA, HQW, ORW, WS I, or WS II? YES [ ] NO [-I-
9. Have any Section 404 permits been previously requested for use on this property? YES [ ] NO If yes, explain.

10. Estimated total number of acres of waters of the U.S., including wetlands, located on project site:
11. Number of acres of waters of the U.S., including wetlands, impacted by the proposed project:
Filled:
-Drained:
Flooded:
Excavated:
Total Impacted:
.10 , },
12. Description of proposed work (Attach PLANS-8 1/2" X 11" drawings only):
LI fja 0h I,`+ i a /J/JG?r D44 D
'i CtJ, t It 4 br?,R T ?`F'1
13. Purpose of proposed work: A ©u S - i t µ ; FT-
14. State reasons why the applicant believes that this activity must be carried out in wetlands. Also, note measures
taken to minimize wetland impacts.
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[ ] NO [
RESPONSES FROM THE USFWS AND/OR NMFS SHOULD BE FORWARDED TO CORPS.
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 [ ] NO PI
RESPONSE FROM THE SHPO SHOULD BE FORWARDED TO CORPS.
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? }-L-0 Ake-
F. If applicable, what is proposed method of sewage disposal?
S"-

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I, JON
MY SUPEE
S1PPEERM
INDICAM
PAGE
1: I R.
G.147
REGISTRA'
IR fly.

. CERTIFY Wt IRIS PLAT WAS DRAWN UNDER
IOM AN ACTI.W. SURVEY wDE UNDER MY
D DESCRIlnW RECORDED IN BOOK 282
IT INE BOWWW NOT SURVEYEU ARE CLEARLY
N FROM QJPI A17ON FOUND IN BOOK ,
ME RATIO OF PRECISION AS CALCULATED LS
LT THIS PLAt WAS PREPARED IN ACCORDANCE
MENDED. WITNESS MY ORIGINAL SIGNATURE.
PER AND SEAL IRIS 0-M DAY OF JULI
JON E. BRUNNER
L - 3357
/
1. JON E BRUNNER. HEREBY CERTIFY
THAT THIS SURVEY IS OF A EXISTING
PARCEL OR PARCELS OF LAND.
1. JON E BRUNNER, HEREBY CERTIFY
THAT THIS PROPERTY SHOWN IS NOT
IN A FLOOD HAZARD ZONE.
CARip??Nq
SEW?
e- L73357 -%
EXISTING 1• oN~hN..M??
IRON PIPE T BRV .?`
N..giN??M
nr?'?R NG 1•
PIPE
CP&L
LAKE TILLERY
.4 %1 /\
pt 00 z
_
ti
LOT 27
Au / sou OETR 29 t/2
LOTS 29 & 30 /
/ 0.33 ACRE
LOT 29
EXISTING 5/8' /
y REAR /
LOT 30
EXISTING IRON 3R04,U
EXISTING 314*
IRON ROD
1?
LOT 31

1•
PIPE
EXISTING 2•
IRON PIPE
NIS
NOTESr
1i NO NCGS TRAVERSE STATION W00 2000.
2 TFAS MAP IS NOT oftz 4DED FOR mica vAnoN.
-"" -' FOR--""-' BRUNNER LAMB =Af< nNG
O. BOX 364
BOBBY G. & MILDRED C. P.
JOHNSON ROCKI KINGHA GHaM, N. C.
FAIRWAY SHORES SUBDMSION UAP a PH. ( 910 ) 895 - 1202
30 15 0 30 60 90 SCALE 1_=3o,
DATE: JULY 18 1994
JOB 136-94
SCALE IN F'FFT OB 282 PG 334
-mow .... ?
The boathouse will be 16 feet wide extending 26 feet into the lake. The roof
of the boathouse will be flat and be used as a patio area.

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