19960509 Ver 1_COMPLETE FILE_19960522

State of North Carolina
Department of Environment,
Health and Natural Resources 1 • •
Division of Water Quality
James B. Hunt,Jr., Governor
Jonathan B. Howes, Secreta ry p E H N 1I
A. Preston Howard, Jr., P.E., Director
July 17, 1996
L and S Leasing
P.O. Box 931
Salisbury, NC 28144
Dear Mr. Sirs:
Re: Proposed land clearing of wetlands
Forsyth County
DWQ# 960669
COE# 199602288
On 12 July 1996 we were notified of your plans to fill 0.47 acres of wetlands for the
purpose of expanding a development lot on the Lawson Property off of SR 1120 near
Winston-Salem in Forsyth County. In addition to the permit from the U.S. Army Corps of
Engineers, you are required to seek approval from the N.C. Division of Water Quality to
till in these wetlands. The enclosed application needs to be completed and returned to us
with 7 copies of the application, supporting maps and documentation.
Please call me at 919-733-1786 if you have any questions.
Sincerely,
qoo R. Dor ney
r Quality Certific- tion Program
cc: Winston-Salem DWQ Regional Office
Wilmington Corps of Engineers
Central Files
Raleigh Field Office Corps of Engineers
960669.app
Division of Water Quality • Environmental Sciences Branch
Environmental Sciences Branch, 4401 Reedy Creek Rd., Raleigh, NC 27607 Telephone [phone] FAX # [phone]
An Equal Opportunity Affirmative Action Employer • 50% recycled/10% post consumer paper

U.S. ARMY CORPS OF ENGINEER
WILMINGTON DISTRICT
Action ID. 199602288 County ForsZh O
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATI
Property Owner/Agent L&S Leasing. Inc.
Address Post Office Box 931. Salisbury. North Carolina 28144
Telephone No. [phone]
Size and Location of project (waterway, road name/number, town, etc.) L&S Leasing
development lot on the Lawson Property. located off of Clemmonsville Road (S.R. 1120).
adjacent to an unnamed above headwaters tributary of Salem Creek, south of Winston-Salem, in
Forsyth County. North Carolina.
Description of Activity
Proposed facility development that would result in approximately 0.47 acres of impacts to the
Jurisdictional waters of an unnamed above headwaters tributary to Salem Creek.
X_Section 404 (Clean Water Act, 33 USC 1344) only.
Section 10 (River and Harbor Act of 1899) only.
Section 404 and Section 10.
NWP 26 Nationwide Permit Number.
Any violation of the conditions of the Regional General or Nationwide Permit referenced above
may subject the permittee to a stop work order, a restoration order, and/or appropriate legal
action.
This Department of the Army Regional General/Nationwide Permit verification does not relieve
the undersigned permittee of the responsibility to obtain any other required Federal, State, or
local approvals/permits. The permittee may need to contact appropriate State and local agencies
before beginning work.
Regulatory Project Manager Signature C
Date June 12. 1996 Expiration ate Jana
SURVEY PLATS, FIELD SKETCH, WETLAND DELINEATION FORM, ETC., MUST BE
ATTACHED TO THE FILE COPY OF THIS FORM, IF REQUIRED OR AVAILABLE.
(3
pj4p_ --' q?v 5'o,(
U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT 41"?
Action ID. 199602288 County Forsyth
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Property Owner/Agent
Address Post Officc

Telephone No. [phone]
Size and Location of project (waterway, road name/number, town, etc.) L&S Leasing
development lot on the Lawson Property. located off of Clemmonsville Road (S.R. 1120),
adjacent to an unnamed above headwaters tributary of Salem Creek, south of Winston-Salem. in
Forsyth County, North Carolina.
Description of Activity
Proposed facility development that would result in approximately 0.47 acres of impacts to the
jurisdictional waters of an unnamed above headwaters tributary to Salem Creek.
X_Section 404 (Clean Water Act, 33 USC 1344) only. 1 1E D
Section 10 (River and Harbor Act of 1899) only. r''? L. ! `-- • . • :7 : ; ir; N
Section 404 and Section 10. Jul
;car
NWP 26 Nationwide Permit Number. }
t/l!'}l?•.``T?, j??1-tit, ..1I7
Any violation of the conditions of the Regional General or Nationwide Permit refexen?ed, above _
may subject the permittee to a stop work order, a restoration order, and/or appropria`fie"Ieg'al
action.
This Department of the Army Regional General/Nationwide Permit verification does not relieve
the undersigned permittee of the responsibility to obtain any other required Federal, State, or
local approvals/permits. The permittee may need to contact appropriate State and local agencies
before beginning work.
Regulatory Project Manager Signature C
Date June 12. 1996 Expiration rate January 21. 1997
SURVEY PLATS, FIELD SKETCH, WETLAND DELINEATION FORM, ETC., MUST BE
ATTACHED TO THE FILE COPY OF THIS FORM, IF REQUIRED OR AVAILABLE.
State of North Carolina
Department of Environment, "7
Health and Natural Resources ` 09WyWA
?
Division of Environmental Management
James B. Hunt, Jr., Governor ?1,A
Jonathan B. Howes, Secretary
H
A. Preston Howard, Jr., P.E., Director ID E N F=1
May 31, 1996
Forsyth County
DEM Project # 960509
APPROVAL of 401 Water Quality Certification and ADDITIONAL CONDITIONS
L & S Leasing, Inc.
P.O. Box 931
Salisbury, NC 28144
Dear Sirs:
You have our approval to place fill material in 0.49 acres of wetlands or waters for the purpose of
constructing a commercial development at Clemmonsville Road near Griffin Road, as you described in
your application dated 17 May 1996. 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. The relocated
streambed shall be similar to that present on the site today. Additional wetland fills except for road
crossings and utilities will require additional review and approval from DEM and may not be granted.
Stormwater from the detention pond shall be directed to sheetflow into the remaining wetlands at non-
erosive velocities. 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,
ton Howard, Jr. 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
Hap Royster
960509.1tr
Environmental Sciences Branch, 4401 Reedy Creek Rd., Raleigh, NC 27607 Telephone [phone] FAX # [phone]
An Equal Opportunity Affirmative Action Employer • 50% recycled/10% post consumer paper

Forsyth Carter
Brokerage
May 17, 1996 ?t0 1 I+J0UI_:L->
Mr. David Sawyer
US Fish and Wildlife Service
Raleigh Field Office
P.O. Box 33726
Raleigh, NC 27636-3726
Dear Mr. Sawyer:
We are applying for a joint 401/404 Water Quality Certification to allow us to develop a
building on a 3 acre site in Forsyth County.
Attached please find a locator map and a copy of our application. This land has never
been developed and has no buildings on site. Our understanding from DEM is that you
will write us a letter which we can submit with our application.
We are working on an extremely tight time frame and would appreciate a response as
quickly as possible.
We appreciate your prompt attention to this matter.
Sincerely,
Hap Royster
Enclosure
WINSTON-SALEM - CHARLOTTE • GREENSBORO
380 KNOLLWOOD ST. SUITE 440 WINSTON-SALEM, NC 27103-1834
SbR? TEL [phone] FAX [phone]
"Designated Member(s), Society of Industrial and Office RealtorsO"
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DEM 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 ENVIRONMENT, HEALTH,
AND NATURAL RESOURCES
P.O. BOX 29535
RALEIGH, NC 27626-0535
ATTN: MR. JOHN DORNEY
Telephone [phone]
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: L & S Leasing, Inc.
2. OWNERS ADDRESS: P.O. Box 931
Salisbury, NC 28144
3. OWNERS PHONE NUMBER (HOME): N/A (WORK): [phone]
4. IF APPLICABLE: AGENT'S NAME OR-RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER: Henry P. Royster, Jr. - Forsyth Carter Brokerage
380 Knollwood Street. Suite 440
Winston-Salem. NC 27106
[phone](w) [phone](h)
--- 5. LOCATION OF PLANNED WORK (ATTACH MAP).
COUNTY: Forsyth
NEAREST TOWN OR CITY: Winston-Salem
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ETC.):
Clemmonsville Road; 800'± ?Iest of Griffin Road intersection.
6. NAME OF CLOSEST STREAM/RIVER: Salem Creek / Yadkin River
7.=' RIVER BASIN: Peedee
8.' IS THIS PROJECT LOCATED IN A WATERSHED CLASSIFIED AS TROUT, SA, HQW, ORW,
NS I, OR WS II? YES [ J NO [X]
9. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROPERTY? YES [ I NO [XI
IF YES, EXPLAIN.
10. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
0.47 acres±
2/3/92
-2-
11. NUMBER OF ACRES OF WETLAND IMPACTED BY THE PROPOSED PROJECT:
FILLED: 0.47
DRAINED: -0-
FLOODED: -0-
EXCAVATED: -0-
TOTAL IMPACTED: .047
12. DESCRIPTION OF PROPOSED WORK (ATTACH PLANS):
13. PURPOSE OF PROPOSED WORK: Commercial development of property
14. STATE REASONS WHY THE APPLICANT BELIEVES THAT THIS ACTIVITY MUST BE
CARRIED OUT IN WETLANDS. ALSO, NOTE MEASURES TAKEN TO MINIMIZE WETLAND
IMPACTS. We have shifted the building as far as possible on the site
to minimize impact on the wetlands. We have also proposed
to install a wet detention pond.
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 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 [ ] 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
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.
'-,-1. IF A STORMWATER MANAGEMENT PLAN IS REQUIRED FOR THIS PROJECT, ATTACH
..COPY.
E. WHAT IS LAND USE OF SURROUNDING PROPERTY? Industrial
F. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
Public Sanitarv Sewer Citv of Winston-Salem
OWNER'S SIGNATURE DATE
Forsyth Carter
Brokerage
,//////1131/111111
May 17, 1996
Mr. David Brock
State Historical Preservation Office
109 East Jones St.
Raleigh, NC 27601-2807
Dear Mr. Brock:
We are applying for a joint 401/404 Water Quality Certification to allow us to develop a
building on a 3 acre site in Forsyth County.
Attached please find a locator map and a copy of our application. This land has never
been developed and has no buildings on site. Our understanding from DEM is that you
will write us a letter which we can submit with our application.
We are working on an extremely tight time frame and would appreciate a response as
quickly as possible.
We appreciate your prompt attention to this matter.
Sincerely,
All_?
Hap Royster
Enclosure
WINSTON-SALEM - CHARLOTTE • GREENSBORO
380 KNOLLWOOD ST. SUITE 440 WINSTON-SALEM, NC 27103-1834
Slat TEL [phone] FAX [phone]
"Designated Member(s), Society of Industrial and Office Realtors"
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DEM 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 ENVIRONMENT, HEALTH,
AND NATURAL RESOURCES
P.O. BOX 29535
RALEIGH, NC 27626-0535
ATTN: MR. JOHN DORNEY
Telephone [phone]
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: L & S Leasing, Inc.
2. OWNERS ADDRESS: P.O. Box 931
Salisbury, NC 28144
3. OWNERS PHONE NUMBER (HOME): N/A (WORK): [phone]
4. IF APPLICABLE: AGENT'S NAME OR-RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER: Henry P. Royster, Jr. - Forsyth Carter Brokerage
380 Knollwood Street SU to 440
Winston-Salem. NC 27106
[phone](w) [phone](h)
---- 5. LOCATION OF PLANNED WORK (ATTACH MAP).
COUNTY: Forsyth
NEAREST TOWN OR CITY: Winston-Salem
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ETC.):
Clemmonsville Road; 800'± 4est of Griffin Road intersection.
6. NAME OF CLOSEST STREAM/RIVER: Salem Creek / Yadkin River
r
7.? RIVER BASIN: Peedee
J - .
,8 f IS THIS PROJECT LOCATED IN A WATERSHED CLASSIFIED AS TROUT, SA, HQW, ORW,
WS I, OR WS II? YES [ ] NO [X]
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:
0.47 acres±
2/3/92
-2-
11. NUMBER OF ACRES OF WETLAND IMPACTED BY THE PROPOSED PROJECT:
FILLED: 0.47
DRAINED: -0-
FLOODED: -0-
EXCAVATED: -0-
TOTAL IMPACTED: .047
12. DESCRIPTION OF PROPOSED WORK (ATTACH PLANS):
13. PURPOSE OF PROPOSED WORK: Commercial development of property
14. STATE REASONS WHY THE APPLICANT BELIEVES THAT THIS ACTIVITY MUST BE
CARRIED OUT IN WETLANDS. ALSO, NOTE MEASURES TAKEN TO MINIMIZE WETLAND
IMPACTS. We have shifted the building as far as possible on the site
to minimize impact on the wetlands. We have also proposed
to install a wet detention pond.
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 [ J 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 [ 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
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.
r
,•'D.. IF A STORMWATER MANAGEMENT PLAN IS REQUIRED FOR THIS PROJECT, ATTACH
:COPY.
E. WHAT IS LAND USE OF SURROUNDING PROPERTY? Industrial
F. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
Public Sanitary Sewer City of Winston-Salem
OWNER'S SIGNATURE DATE

DEM 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 ENVIRONMENT, HEALTH,
AND NATURAL RESOURCES
P.O. BOX 29535
RALEIGH, NC 27626-0535
ATTN: MR. JOHN DORNEY
Telephone [phone]
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: L & S Leasing, Inc.
2. OWNERS ADDRESS: P.O. Box 931
Salisbury, NC 28144
3. OWNERS PHONE NUMBER (HOME): N/A
(WORK): [phone]
4. IF APPLICABLE: AGENT'S NAME OR-RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER: Henry P. Royster, Jr. - Forsyth Carter Brokerage
380 Knollwood Street. Suite 440
Winston-Salem. NC 27106
[phone](w) [phone](h)
---- 5. LOCATION OF PLANNED WORK (ATTACH MAP).
COUNTY: Forsyth
NEAREST TOWN OR CITY: Winston-Salem
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ETC.):
Clemmonsville Road; 800'± Test of Griffin Road intersection.
6. NAME OF CLOSEST STREAM/RIVER: Salem Creek / Yadkin River
7.--RIVER BASIN: Peedee
IS THIS PROJECT LOCATED IN A WATERSHED CLASSIFIED AS TROUT, SA, HQW, ORW,
WS I, OR WS II? YES [ ] NO [X]
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:
0.47 acres±
2/3/92
05/20/1996 14:56 7046362284 KLUTTZ REAMER ET Al- PAGE 02
96 FRl 4:30 PM FORSYTH CARTER BROKERAGE FAX NO. 9107335222 P. 3
-2-
11. NUMBER OF ACRES OF WETLAND IMPACTED BY THE PROPOSED PROJECT:
FILLED: 0.47
DRAINED: -0-
FLOODED:
EXCAVATED: -0---
TOTAL IMPACTED: .047
12. DESCRIPTION OF PROPOSED WORK (ATTACH PLANS):
13. PURPOSE OF PROPOSED WORK: Commercial develo`Ment of propertZ
14. STATE REASONS WHY THE APPLICANT BELIEVES THAT THIS ACTIVITY MUST BE
CARRIED OUT IN WETLANDS. ALSO, NOTE MEASURES TAKEN TO MINIMIZE WETLAND
IMPACTS. We have shifted the building as far as possible on the site
tention
IS. YOU ARE REQUIRED TO CONTACT THE U.S. FISH AND*WILDLIFE SERVICE
(USFWS) AND/OR NATIONAL MARINE FISHERIES SL"RVICE (WS) REGARDING THE PRESENCE
OR ANY FEDERALLY LISTED OR PROPOSED FOR LISTING tNDANCERED OR THREATENED
SPECIES OR CRITICAL KABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE
PROPOSED PROJECT. HAVE YOU DONE 507 YES ( j NO [ I
RESPONSES FROM THE USFWS AND/OR NMP'S 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 WMICH
MAY BE AFFECTED BY THE PROPOSED PROJECT?
HAVE YOU DONE SO? YES ( NO ( J
RESPONSE FROM THE SHPO SHOULD BE ATTACHED.
17. ADDITIONAL INFORMATION REQUIRED BY DEM:
A. WETLAND_DELIIIEATION 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.
•'?.. IF A 3TORMWATER MANAGEMENT PLAN IS REQUIRED FOR THIS PROJECT, ATTACH
E. WHAT IS LAND USE OF SURROUNDING PROPERTY? Industrial
F. IF APPLICABLE, SHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
Public Sanitary Sewer City of Winston-Salem
BEESON ENGINEERING
503 HIGH STREET
WINSTON-SALEM, NC 27101
910 748-0071 1
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