19951049 Ver 1_COMPLETE FILE_19951012

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
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C) FE F1
October 12, 1995
Nash County
DEM Project # 951049
APPROVAL of 401 Water Quality Certification
Mr. William R. Shea
15 Brook Valley
Mobil Home Park
Rocky Mount, North Carolina 27804
FIL, CDC,
Dear Mr. Shea:
You have our approval to place fill in approximately 1 acre of wetlands or waters for the purpose
of constructing a home at Lot 16, Wollen Mill Drive (SR 1531), as you described in your application
dated 25 September 1995. After reviewing your application, we have decided that this fill is covered
by General Water Quality Certification Number 2671. This certification allows you to use Nationwide
Permit Number 26 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 60 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 Dorney at 919-733-1786.
Sincerely,
OP o!Holrd?,Jr.
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Raleigh Field Office
Raleigh DEM Regional Office
Mr. John Domey
Central Files
951049.1tr
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
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DS M _IP: q ( g ACTION ID:
Nationwide Permit Requested (Provide Nationwide Permit #): csC?6 NOW
JOINT FORM FOR
Nationwide permits that require notification to the Corps of Engineers
Nationwide permits that require application for 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 MANAGE.?IENT-_?®.n _--
H t .T ,
NC DEPARTMENT OF ENVIRONMENT,;
AND NATURAL RESOURCES
P.O. Boy. 29535
Raleigh, NC 27626-0535 SEP Z 8 IM
ATTN: MR JOHN DORNEY
Telephone [phone]
ONE (1)'COPY OF THIS COMPLETED APPLICATION SHOULD BE SENT TO THE CORPS OF ENd VEERS.
S9VEN (7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT.
PLEASE PRINT. o . 1-1
1. Owners Name:
2. Owners Address:
3. Owners Phone Number (Home): 919 9sf 9'z 7y?1 (Work): 914 22= = 8Y
4. If Applicable: Agent's name or responsible corporate official, address, phone number.
5. Location of work (MUST ATTACH MAP). County: Nearest Town or City: Keay C) 4'Specific Location (Include road numbers, landmarks, etc.): GU % A60 I t wle"

rs i2 1 f
6. Name of Closest Stream/River.
7. River Basin: -Fa J^
8. Is this project located in a watershed classified as Trout, SA, HQW, ORW, WS I, or WS II? YES [ J NO ?A
9. Have any Section 404 permits been previously requested for use on this property? YES [ ] NO Pq
If yes, explain.
10. Estimated total number of acres of waters of the U.S., including wetlands, located on project site:
UN?itiY?c??it/ -
11. Number of acres of waters of the U.S., including wetlands, impacted by the proposed project:
Filled:
Drained: Nr? IU C
Flooded: Iu O A-) C
Excavated: _ ire
Total Impacted: Q Q azu ( 4_(pX42
17 1
12. l;escription of proposed work (Attach PLANS-8 1/2" X 11" drawings only):
13. Purpose of proposed work: Fke S ? a& A i ?e ? K 4tJ?2_ rye-
e14. State reasons why the applicant believes that this activity must be carried out in wetlands. Also,
taken to minimize wetland impacts.
©e c ?eLL.o ?F a,,. A=R .,; C), rt & ir-i re
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 [VJ
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 maybe affected by the proposed project? Have you done so? YES[ ] NO Fe-]
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?
F. If applicable, what is proposed method of sewage disposal? Owner's Signature Date

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Date I V`tt '`i? Time lo;3,
WHILE YOU WERE OUT
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Phone G9 q U r
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AREA CO E NUMBER EXTENSION
TELEPHONED PLEASE CALL
CALLED TO SEE YOU WILL CALL AGAIN
WANTS TO SEE YOU URGENT
RETURNED YOUR CALL
Message AS `7 fV ^ l
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Signed
N.C. Dept. of Environment, Health, andd) Natural Resources
- ??^' R.?..m.l nn Rorvrlnrl Panar
tam In q 5 1 ACTION IP:
Nationwide Permit Requested (Provide Nationwide Permit #): E J
JOINT FORM FOR
Nationwide permits that require notification to the Corps of Engineers
Nationwide permits that require application for Section 401 certification o h z
Aa? U
WILMINGTON DISTRICT ENGINEER WATER QUALITY PLANNING v °*?
CORPS OF ENGINEERS DIVISION OF ENVIRONMENTAL MANAGEMENT ? CV =Qo
DEPARTMENT OF THE ARMY NC DEPARTMENT OF ENVIRONMENT, HEALTHo
P.O. Box 1890 AND. NATURAL RESOURCES h
-Wilmington, NC 28402-1890 P.O. Box 29535
ATTN: CESAW CO-E Raleigh, NC 27626-0535
Telephone [phone] ATTN: MR. JOHN DORNEY
Telephone [phone]
61 IE (1)' COPY OF THIS COMPLETED APPLICATION SHOULD BE SENT TO THE CORPS OF ENGINEERS.
SrVEN (7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT.
PLEASE PRINT..
1. Owners Name:
2. Owners Address:
3. Owners Phone Number (Home): (Work): 9/g '°r g'I
4. If Applicable: Agent's name or responsible corporate official, address, phone number.
5. Location of work (MUST ATTACH MAP). County-
Nearest Town or City: Fea(
R
Specific Location (Include road numbers, landmarks, etc.): -7 /
6. Dame of Closest Stream/River.
7. River Basin: Txr
8. Is this project located in a watershed classified as Trout, SA, HQW, ORW, WS I, or WS II? YES [ ] . NO
9. Have any Section 404 permits been previously requested for use on this property? YES [ J NO Pq
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: %
12. Description of proposed work (Attach PLANS-8 1/2" X 11 drawings only):
13. Purpose of proposed work: P d P fl 4,fo 9 ??e d C1?2 +Arrvx,0_
?5 ?'cfB,r?S
14. State reasons why the applicant believes th this activity must be carried out in wetlands. Also,
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 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 [yJ
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 K ]
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? R ?S
R If applicable, what is proposed method of sewage disposal?

Owner's Signature Date
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