20081520 Ver 1_Shoreline Stabilization_20081003

The following is an abbreviated application form for those applying for a 401 Water
Quality Certification to impact FERC (Federal Energy Regulatory Commission)
regulated lake shore or bottom under the U.S. Army Corps of Engineers Permit
GP30. This Application cannot be used for wetland or stream impacts. Please
provide seven (7) copies of this application and supporting information as well as a
non-refundable application fee to the Division of Water Quality of $200.00 for
impacts of to lake bottom of less than 1 acre and $475.00 for impacts to lake bottom
of greater or equal to 1 acre.
Applications should be sent to:
Division of Water Quality Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
1. Applicant Information
1. Owner/Applicant Information
Name: J eco kii (1P
Mailing Address: 1?. 0 .
08- 1 520
kf4(r_"90w12 Do
OCT 3 2008
DENR - WATER QUALITY
WETLANDS AND sTORMWATER BRANCH
Telephone Number:
E-mail Address: E
Fax Number:?sp --71q9S 3U1Z
>2-
2. Agent Information (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name: t4IA
Company Affiliation:
Mailing Address:_
Telephone Number: l Fak Number:
E-mail Address:
II. Project Information
Attach a vicinity map clearly showing the location of the property with respect to
local landmarks such as towns, rivers, and roads. Also provide a detailed site
plan showing property boundaries and development plans in relation to
surrounding properties. You may use the diagram below to make a hand sketch of
your project. Also, see the example below for guidance. Both the vicinity map and
site plan must include a scale and north arrow. The footprints of all buildings,
impervious surfaces, or other facilities must be included.
1.
Location
n?
County: DAY GD5o 1L, Nearest Town: 14
Subdivision name or site address (include phase/lot number): Lit _)t X144-?.2d??n ?
Directions to site please include road numbers, landmarks, etc. (This is not Le-yunq1-0t, N
nPePeenrv if nn ndPnuate vicinity man is included)- !?N Ah hr-. 41,11 . * R 411 cqa .Ahff") .
2. Describe the existing land use or condition of the site at the time of this
application: l mye romZ! fed I g2reSS 150Wn (1 oiAed
3. Property size (acres): 3. L D AC.'
4. Nearest body of water (stream/river/sound/ocean/lake): 14, o?VN Rc cY, L A1,e.
5. Describe the purpose of the proposed work: 4r:?o nb?a % n cp lac ypz rY1 ? ?- ?o rr-,6. List the type of equipment to be used to construct the project: +('i -CO
/-) I CO A ??P(nen} wit1 ` bwh Si K. t4c#4*,,el zriYe.-
lA ??-}1
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls,
etc.) below the normal pool lake level in square feet or acres: N? '? Aek-?'1 _ Y-i fRhP,
N o Reial n ?ng 1 14?I - rr)yya f »•f'
tdPAP61 -?DLu 04- Wf4'F9rf9rrmDunN 'O i2ern0c P 1000, s S% cc
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8. a. Amount of impact (including all clearing, back fill, excavation, rip rap,
retaining walls, etc.) above the normal pool lake level and 50 feet land-ward in
square feet or acres: No +_-XCA vaT? oil ryp r? or ?efial ni ? I IQ l S
n?_ ._ .^I I.nL,n 1o..e1 r?A r= r) 4',mod-
b. Please describe vegetation above the normal pool lake level and 50 feet land-
ward to be impacted (number of trees for instance): (9t prl = i?'1 p 5
bone k o'M oo A-reQ S
'Agent's Signature Date
gnature is valid only if an authorization letter from the applicant is provided.)
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