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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 wetiand or stream impacts. Please
" provide seven (7) copiei of -i}ils 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
1. Owner /Applicant Information
Name:_•_•fqor¢.Y 66W456 Amb WmAN& $TuENw6
Mailing Address: IVA RiyER 1DE t>g1ye
-- lt;�c�Nf7TojJ Nc:. Z��,`l a.. • -•._ —. •
Telephone Number :_5t3 2(�0 'lZov Fax Number:
E -mail Address: sc "5+UWKi La? Amd1f , cotri
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: nS /.
Company Affiliation: /
Mailing Address:
Telephone Number: Fax 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
plan showing property boundaries and development plans in relatio
surrounding properties. You may use the diagram below to make a hand sket,
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:_ bAgIV)!i!&! Nearest Town: ,,bymmoar
Subdivision name or site address (include phase/lot number): WA7E%AW tKVtJ S r r 4
Directions to site please include road numbers, landmarks, etc. (This is not
necessary if an adequate vicinity map is included): I- v a Td NC ttwl S . Souni 7"u
eniArI4IXAneL%*r . Q1/ h r t wl IJwaie -`nm - Cn,tr116A,Wr &AAn I GLT• - .,ttbb..77,7, Ac.
WIVE , rpe,'E2TY DN LEF- ,
2. Describe the existing land use or condition of the site at the time of this
application :_ Ex ISTif* HouSE 64 WW t✓RotJ'T (,vT
3. Property size (acres): A m?.> X • 0 q D At2E5
4. Nearest body of water ( stream / river /sound/ocearL4ake): h� C-i 116Gk �,Wg
5. Describe the purpose of the proposed work: 'To RCCog S'i RUCT 2EPt hCN
6. List the type of equipment to be used to construct the
7. Amount of impact (including all excavation, backfll, rip rap, retaining walls,
etc.) below the normal pool lake level in square feet or acres:
_ (ar1 Z 5Ca • F'i'
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: 17,3j'2. K. F•1'
b. Please describe vegetation above the normal pool lake level and 50 feet land-
ward to be impacted (number of trees for instance): ►Jo VC-(?STA -TAMP WIL
1 i
Applicant Ag 2re Signature
(Agent % — 1 is valid only if an
letter from the applicant is provided.)
NEW A'bu2�S5
1 '3331 �E¢►TI1GC
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fukKC �R�ST �
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US Army Corps Of Engineers Field Offices and County Coverage
Regulatory Field Office
Alexander Cherokee
Iredell
Mitchell Union
Corps of Engineers
(Fax:
Avery Clay
Jackson
Polk Watauga
IS Avenue
Buncombe Cleveland
Lincoln
Rowan Yancey
Burke Gsston
Rutherford
_
NC 29801""-- -06
Cabamts Graham
_Macon
Madison
Stanley
: (828) 271.4854
Caldwell Haywood
McDowell
Swain
2714858
Catawba Henderson
Mecklenburg
Transylvania
Regulatory Field Office
Alemance Durham
Johnston
Rockingham Wilson
lyRaleigh
US Army Corps Of Engineers
Allegheny Edgecombe
Leo
Stokes Yadkin
6508 Falls 9F His Nouso Roe
Asho Franklin
Nash
Surry
004e -i49
Caswell Forsyth
Northampton
Vance
Relelgh, NG 2;6IS.
Granville
Orange
Wake
Telephone. (919) 876.8441
Davidson Guilford
Person
Warren
Fax: (919) 876 -5283
Davie Halifax
Randolph
Wilkes
Washington Regulatory Field Office
Beaufort Currituck
Jones
Pitt
US Army Corps Of Engineers
settle Darn
Lenoir
Tyrrell
Post Office Box 1000
Camden Gates
Martin
Washington
Washington,NC 27889 -1000
Carteret* Gran
Pamlico
Wayne
Telephone: (232) 975 -1616
Chowan Hertford
Pasquotank
Fax: (2$2) 975 -1399
Craven Hyde
Perquimans
*Creston National Forest Only
Wilmington Regulatory Field Office
Anson Duplin
Onslow
US Army Corps Of Engineers
Bladcn Harnett
Fender
Post Office Box 1890
Brunswick Hoke
Richmond
Wilmington, NC 18402 -1890
Carteret Montgomery
Robeson
Telephone: (910) 2514511
Columbus Moore
Sampson
Fax: (910)251-4025
Cumberland Now Hanover Scotland
US Fish and Wildlife Service J National Marine Fisheries Service
US Fish and Wildlife Service
US Fish and Wildlife Service
National Marino Fisheries Service
Raleigh Field Ofte
Asheville Field 011fco
Habitat Conservation Division
Post Office Box 33726
160 Zillicoa Street
Pivers Island
Raleigh, NC 27636.3726
Asheville, NC 28801
Beaufort, NC 28516
Telephone: (919) 856.4510
Telephone: (828) 665.1195
Telephone: (252) 728.5090
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
1619 Mail Service Center
4617 Mail Service Center
Raleigh, NC 27699.1650
Raleigh, NC 27699.1619
Raleigh, NC 27699.4617
Telephone: (919) 733 -1786
Telephone: (919) 733.5208
Telephone: (919) 7334763
Fax: (919) 733 -6893
Fax: (919) 733 -5321
Fax: (919) 715.2671
CAKA and NC Coastal Counties
Division of Coastal Management
Beaufort -
Chowan
Hertford Pasquotank
1638 Mail Service Center
Bertio
Craven
Hyde Fender
Raleigh, NC 27699.1638
Brunswick
CUrrituck
New Hanover Perquimans
Telephone: (919) 733.2293
Camden
Dam
Onslow Tyrrell
Fax: (919) 733 -1495
Carteret
Gates
Pamlico Washington
NCWRC and NC Trout Counties
Western Piedmont Region Coordinator
Allegheny
Caldwell
Watauga
3855 Idlewild Road
Asho
Mitchell
Wilkes
Kemersville, NC 27284 -9180
Avery
Stokes
Telephone: (336) 769 -9453
Burke
Surly
Mountain Region Coordinator
Buncombe
Henderson
Polk
20830 Great Smoky Mtn. Expressway
Cherokee
Jackson
Rutherford
Waynesville, NC 28786
Clay
Macon
Swain
Telephone: (828)452.2546
Graham
Madison
Transylvania
Fax: (828) 506.1754 Haywood McDowell Yancey
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VEGETATION AND EROSION
CONTROL FABRIC
~- EXISTING GRADE
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CLASS 2 RIP RAP
2
EROSION CONTROL FABRIC -----4"'
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LAKE BOTTpM
TYPICAL CONDITIONS
36" TO 72" ERODED CUT
WAVE EXPOSURE
FOR: G & STEPHANIE STUEBING
LOCATION: LOT 44, WATERSHIP DOWNS
RESERVOIR: HIGH ROCK LAKE
PROJECT- SHORELINE STABILIZATION PROGRAM
PHASE I SITE EVALUATION
YADKIN, INC. - BADIN, NORTH CAROLINA
DRAWING TITLE: DETAIL
MODERATE RIP RAP STABILIZATION 3
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