20110140 Ver 1_Application_20110210

~~~' 2 0 1 1 0 1 4 0
The following is an abbreviated application form for those applying fora 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 $240.00 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
I. Applicant Information
~~~~~~~D
FEB ~ 0 2011
DENR -WATER QUALITY
/~ STORMWATER BRANCH
I. Owner/Applicant Information
Name: "rows Boo p
Mailing Address: 23D9 H~oVelz ~Vt:
2E~(Not-DS@~uRG . 0~ 43ob8
Telephone Number: (o I~l • ~~d ~ 0563 Fax Number:
E-mail Address: '~ow- pt BooA (a~ `(~ It0o . toM
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:
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Address:
Fax Number:
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
County: ~~y t DS ° I`I Nearest Town: SouTff IMvN'r
Subdivision name or site address (include phase/lot number): 133'1 WPtTERFoR~ 1'otNTE DR
Directions to site please include road numbers, landmarks, etc. (This is not
necessary if an adequate vicinity map is included): T- 05 To IkX~ N (~To rl ,_ N ~ NW'(_ b
Snu~T~l R iNTo ~1~GtITS SRN Poi-JTt prt WI~DuI°'~ IkuESS RD• , R oN
VuP~t~-VAN !•4eyRt~K. R•o. IZ oN {n/h1~~froR~ Po~N1E R~- . LoT ors l.EF1
2. Describe the existing land use or condition of the site at the time of this
application: DEVEt~oPED PkRC~I.~ Fx-STiI~G I{aus~ rN ~u13~1VI51oN
3. Property size (acres): ~ • D1 I~G
4. Nearest body of water (stream/river/sound/ocean/lake): ~(l~~ ~oGl~ L~~
5. Describe the purpose of the proposed work: To 57~3~ t.t~ E ~N ERop iN lSi
~Rt/t,l~~ hN~ PRoTEt.T tT f~ZOrK F~QTttEtt ~~stoN
6. List the type of equipment to be used to construct the project:
~oQC.#!T , '~oNT I~oADE1Z Off TR~I4c.K- t+oE
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls,
etc.) below the normal pool lake level in square feet or acres:
Zlo ~q. ~
8. a. Amount of impact (including all
retaining walls, etc.) above the normal
square feet or acres: ~ I y ~
clearing, back fill, excavation, rip rap,
Wool lake level and 50 feet land-ward in
b. Please describe vegetation above the normal pool lake level and 50 feet land-
ward to be impacted (number of trees for instance): 5- fo TREES WIU. BE ~MA.c)V~t7
Td INSTM.~. Tttl PI~PabED ~t+orZEWNE STAt~tt-t~kTtoN
~~~ _,
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

US Army Corps Of Engineers Field Offices and County Coverage
Asheville Regulatory Field Office Alexander Cherokee Iredell Mitchell Union
US Army Corps of Engineers Avery Clay Jackson Polk Watauga
151 Patton Avenue Buncombe Cleveland Lincoln Rowan Yancey
Room 208 Burke Gaston Macon Rutherford
Asheville, NC 28801-5006 Cabarrus Graham Madison Stanley
Telephone: [phone] Caldwell Haywood McDowell Swain
Fax: [phone] Catawba Henderson Mecklenburg Transylvania
-~- Raleigh Regulatory Field Office Alamance Durham Johnston Rockingham Wilson
US Army Corps Of Engineers Alleghany Edgecombe Lee Stokes Yadkin
ad Ashe Franklin Nash Surry
S++ite.l•?A ~Qls.~ ~8.~t.Q,~4-~ Caswell Forsyth Northampton Vance
Rafei~r~dC-s'u}6f~5 Granville Orange Wake
Telephone: [phone] Davidson Guilford Person Warren
Fax: [phone] Halifax Randolph Wilkes
Washington Regulatory Field Office Beaufort Currituck Jones Pitt
US Army Corps Of Engineers Bertie Dare Lenoir Tyrrell
Post Office Box 1000 Camden Gates Martin Washington
Washington, NC 27889-1000 Carteret* Green Pamlico Wayne
Telephone: [phone] Chowan Hertford Pasquotank
Fax: [phone] Craven Hyde Perquimans *Croatan National Forest Only
Wilmington Regulatory Field Office Anson Duplin Onslow
US Army Corps Of Engineers Bladen Harnett Pender
Post Office Box 1890 Brunswick Hoke Richmond
Wilmington, NC 2 8402-1 890 Carteret Montgomery Robeson
Telephone: [phone] Columbus Moore Sampson
Fax: [phone] Cumberland New Hanover Scotland
US Fish and Wildlife Service /National Marine Fisheries Service
US Fish and Wildlife Service US Fish and Wildlife Service National Marine Fisheries Service
Raleigh Field Office Asheville Field Office Habitat Conservation Division
Post Office Box 33726 160 Zillicoa Street Pivers Island
Raleigh, NC 27636-3726 Asheville, NC 28801 Beaufort, NC 285 ]6
Telephone: [phone] Telephone: [phone] Telephone: [phone]
North Carolina State Agencies
Division of Water Quality Division of Water Quality State Historic Preservation Office
401 Wetlands Unit Wetlands Restoration Program Department Of Cultural Resources
1650 Mail Service Center ] 619 Mail Service Center 4617 Mail Service Center
Raleigh, NC 27699-1650 Raleigh, NC 27699-1619 Raleigh, NC 27699-4617
Telephone: [phone] Telephone: [phone] Telephone: [phone]
Fax: [phone] Fax: [phone] Fax: [phone]
CAMA and NC Coastal Counties
Division of Coastal Management Beaufort Chowan Hertford Pasquotank
1638 Mail Service Center Bertie Craven Hyde Pender
Raleigh, NC 27699-1638 Brunswick Cumtuck New Hanover Perquimans
Telephone: [phone] Camden Dare Onslow Tyrrell
Fax: [phone] Carteret Gates Pamlico Washington
NCWRC and NC Trout Counties
Western Piedmont Region Coordinator Alleghany Caldwell Watauga
3855 Idlewild Road Ashe Mitchell Wilkes
Kemersville, NC 27284-9180 Avery Stokes
Telephone: [phone] Burke Surly
Mountain Region Coordinator Buncombe Henderson Polk
20830 Great Smoky Mfi. Expressway Cherokee Jackson Rutherford
Waynesville, NC 28786 Clay Macon Swain
Telephone: [phone] Graham Madison Transylvania
Fax: [phone] Haywood McDowell Yancey

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-~dson County Map Output Page
Page 1 of 2
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Scale: 1 in. = 145 ft. ry
Parcel Number : 0604(1A0000005 Land Units: 1.07 AC
Pin Id : 6618-02-99-2829 Deed Book: 1846 Pg: 1487
ABOOD TER1 M TRi1STEE
Owner : 10419 TORRINGTON DRIVE Deed Date: 02/26/2008
POWELL OH 430650000
Property Address: 001337 WATERFORD POIN"fl RD Account Number: 000009093590
Township: Cotton Grove Exempt Code:
Building Vahie: $435,400 Other Building Value: $36,260
Land Value: $170,000 Market Value: $641,660
http://webgis.co.davidson.nc.us/servlet/com.esri.esrimap.Esrimap?ServiceName=davidso... 10/13/2010

VEGETATE DISTURBED AREA
ABOVE SLOPE

. \\//~ EXISTING GRADE

~ II ~,~~
I CLASS 1 RIP RAP ~~~ .
1 ~ i
~
2
I
EROSION CONTROL FABRIC ~ ~~(,
--~
\
_-
IAKE
BOTTOM --
TYPICAL CONDITIONS
• 12" TO 36" ERODED CUT
WAVE EXPOSURE
10/26/10
FoR: TOM ABOOD
LOCATION: #~ J~J~7 WATERFORD POINTS
RESERVOIR: HIGH ROCK LAKE
PROJECT: SHORELINE STABILIZATION PROGRAM
PHASE I SITE EVALUATION
YADKIN, INC. - BADIN, NORTH CAROLINA
DRAWING TITLE: DETAIL
MINOR RIP RAP STABILIZATION 2

~ VEGETATION AND EROSION
"~~,T
%
\\/ CONTROL FABRIC
%
/
/\\/ \ EXISTING GRADE
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CLASS 2 RIP RAP ~ ~1~-
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EROSION I
CONTROL FABRIC -~~
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~i'~\~~~\/ SAKE BOTTOM

TYPICAL CONDITIONS
• 36" TO 72" ERODED CUT
• WAVE EXPOSURE
10/26/10
FoR: TOM ABOOD
LOCATION: #~ 337 WATERFORD POINTS
RESERVOIR: HIGH ROCK LAKE
PROJECT: SHORELINE STABILIZATION PROGRAM
PHASE I SITE EVALUATION
YADKIN, INC. - BADIN, NORTH CAROLINA
i DRAWING TITLE: DETAIL
MODERATE RIP RAP STABILIZATION 3

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