19950457 Ver 1_COMPLETE FILE_19950503

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
A4 reel
E3 F= F1
May 9, 1995
Montgomery County
DEM Project # 95457
APPROVAL of 401 Water Quality Certification
Ms. Mary Northington, Secretary
Holiday Shores
Route 1, Box HS-5
Troy, N.C. 27371
FILE COW I
Dear Ms. Northington:
You have our approval to place fill material in 0.003 acres of wetlands or waters for the purpose
of rebuilding a boat dock fishing pier at your property on Lake Tillery, as you described in your
application dated 2 May 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 Stamtes 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 919-7-33-1786.
ston Howard, Jr. P. .
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Wilmington Field Office
Fayetteville DEM Regional Office
Mr. John Domey
Central Files
95457.1tr
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 1096 post-consumer paper
"?ECE/VED
DEM ID: ACTION ID: M4 Y Q? tem...
??NMENT?,
Nationwide Permit Requested (Provide Nationwide Permit ft
. Aati„H
JOINT FORM FOR EES
Nationwide permits that require notification to the Corps of Engineers
Nationwide permits that require application for Section 401 certification
GTON DISTRXT ENGINEER WATER QUALITY PLANNING
CO OF ENG RS DIVISION OF ENVIRONMENTAL MANAGEMENT
DEP F THE ARMY NC DEPARTMENT OF ENVIRONMENT, HEALTH,
P. O. Box hW6 AND NATURAL RESOURCES
2e in n, "LT C 28402-1890 P.O. Box 29535
Raleigh, NC 27626-0535 401 ISSUED
: CESO-E
hone (919) ) -4511 ATTN: MR JOHN DORNEY
Telephone (919) -733-%8313 3 - J S
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:
Holiday Shores
2. Owners Address:
Route 1, Box HS-5, 't'roy, NC 27371-
3. Owners Phone Number (Home): 910 - ? 7 2 -19 3 4 (Work):
4. If Applicable: Agent's name or responsible corporate official, address, phone number.
l•_rs. `?ary Northington, Secretary (adaress & Phone above)
Farris Brantley, Pres. , 3032 Jorthampton i)r.,Charlotce,,.gC 2J210
Lans-Davia Brown,Uontractor 7`4-'i4-o1?8
5. Location of work (MUST ATTACH MAP). County: 4ontgoraery
Nearest Town or City: t. G ii e ad
_
Specific Location (Include road numbers, landmarks, etc.): Turn off 11(;24,27, "g o r t h on .r C 1150
past rioodrun to Holiday Shores ltd aria turni left, go past Clubhouse and
turn left to waterfront.
6. Name of Closest Stream/River. Fee Dee giver-Lake 1iilery
7. River Basin:
Pee Dee
8. Is this project located in a watershed classified as Trout, SA, HQW, ORW, WS I, or WS II? YES [ JS iV B-C 4dS
9. Have any Section 404 permits been previously requested for use on this property? YES [ ] NO [;d
If yes, explain.
10. Estimated total number of acres of waters of the U.S., including wetlands, located on project site: 1vE?
11. Number of acres of waters of the U.S., including wetlands, impacted by the proposed project:
Filled: • 0033057
-Drained: _
Flooded:
Excavated:
Total Imnacted: ' 0
12 escription of proposed work (Attach PLANS-8 1/2"X 11" drawings only): Boat a u c k /f i s n i n-? r i er
41 . h Jo, r
13. Purpose of proposed work: P lac e f o r b oat s t o d, c x/ f or f' Q i, P r i? u L n a t &i itL a p--e i t
14. State reasons why the applicant believes that this activity must be carried out in wetlands. Also, note measures
taken to minimize wetland impacts. H e r s are for r e c r e a t e ona 1 purposes for w h i e li
property was purchased
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 orproposed 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 NUTS 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 [ ]
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 island use of surrounding property? R e s i u en t al & re c r e a t i oaa 1
F. If applicable, what is proposed method of sewage disposal? Private s e 1=tic t aiik s
AA
's Signature
Date

?Q GWN
D

z?
Pit
T POC K ` ??Si4rn1
clt eR?1?tIG?pf I

v..,,,.,/ iiivnC?> if )>iv> /{vim
mARx /re, P7laiti16r72, 4 SEe
9 71 Sox H .S -- 5"
T,; py, N-c X-7371
W /-I/- EXTE,vp
'U#7Z- & APpRaA'. z 3 - /era
qio-372_19341
v
W
Q
i
1

c