19950467 Ver 1_COMPLETE FILE_19950110

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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ID F== F1
May 11, 1995
Stanly County
DEM Project # 95467
APPROVAL of 401 Water Quality Certification
Mr. C. Gerald Andrews
23212 Swift Island Road
Albemarle, N.C. 28001
C ??eAceRFS
Dear Mr. Andrews:
You have our approval to place fill material in 0.011 acres of wetlands or waters for the purpose
of constructing a boathouse/pier on Lake Tillery, as you described in your application dated 4 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 Pen-nit 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.
Sincerely,
ston oward, Jr. P.E.
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Asheville Field Office
Mooresville DEM Regional Office
Mr. John Domey
Central Files
95467.1tr
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
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401 ISSUED
Mr. John Dorney
Water Quality Planning
Division of Environmental Management
NC Dept. of Environment, Health, and Natural Resources
P. O. Box 29535
Raleigh, NC 27626-0535
Dear Mr. Dorney
C. Gerald Andrews
23121 Swift Island Road
Albemarle, NC 28001
RECavED
MAY 04"
ENVIRONMENTAL SCIENCES
nDA krn4
Attached are two copies of a permit to excavate approximately 125 cubic yards of earth
material and construct a pier/boathouse. Also attached is a plan showing the proposed
pier. If you need more information, please call. Thank you for your help in this matter.
Sincerely yours /J
C. Gerald Andrews

DEM ID:
ACTION ID:
Nationwide Permit Requested (Provide Nationwide Permit #):
JOINT FORM FOR
Nationwide permits that require notification to the Corps of Engineers
Nationwide permits that require application for Section 401 certification
MINT ON DIS T ENGINEER WATER QUALITY PLANNING
CO OF ENG ERS DIVISION OF ENVIRONMENTAL Mil ?_a
DEP E OF THE ARMY NC DEPARTMENT OF ENVIRON`I',EAL 41. P.O. Box AND NATURAL RESOURCES
Wilmin n, C 28402-1890 P.O. Box 29535
A CESA -CO-E Raleigh, NC 27626-0535
ephone (919) 1-4511 ATTN: MR. JOHN DORNEY
Telephone [phone] q 3 3 - 1118 ?
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: C. 6,5g A L Iq A] ?) tQ E VJ -'S
2. Owners Address: 2 3 z/ z .5 wl FT x,51-6 N D 4 &6 CM i91PL 6 N e ZBod l
3. Owners Phone Number (Home): -7c
(Work): Na Al C
4. If Applicable: Agent's name or responsible corporate official, address, phone number:
5. Location of work (MUST ATTACH MAP). County: .ST-,9 N k Cov.y -'/
L B E M A,e L E
Nearest Town or City: 14
Specific Location (Include road numbers, landmarks, etc.): .SAC /f-77-4C,0*f? 1V)1q3i°
6. Name of Closest Stream/River:
7. River Basin:
z- xi- K C E? 1,

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8. Is this project locatediin a watershed classified as Trout, SA, HQW, ORW, WS I, or WS II? YES [ ] NO f"4
9. Have any Section 404 permits been previously requested for use on this property? YES [ ] NO K]
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:

, 011 #(a,

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12. Description of proposed work (Attach PLANS-8 1/2" X 11" drawings only):
13. Purpose of proposed work: ?O A-Td USE ?/-'??
14. State reasons why the applicant believes that this ac icy mist b caned n wetlands. Also, note measures
taken to minimize wetland impacts. a ?4 i Ha u 5 l"/
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 [)Q
RESPONSES FROM THE USFWS AND/OR NMFS SHOULD BE FORWARDED TO CORPS.
16. You are required to contact thq. State Historic Preservation Officer (SHPO) regarding the presence of histori
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 is land use of surrounding property? )C--S /-D E:W T/+L-
F. If applicable, what is proposed method of sewage disposal? :5 CEP T/ G 7-E: L-1
Owner's Signature Date

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