HomeMy WebLinkAbout20140180 Ver 1_Shoreline Stabilization_20140224The following is an abbreviated application form for those applying for a 401 Water Quality
Certification to impact FERC (Federal Energy Regulatory Commission) regulated lake sho
bottom under the U.S. Army Corps of Engineers Permit GP30. This Application ck a used
for wetland or stream impacts. Please provide seven (7) copies of this application apporting information as well as a non - refundable application fee to the Division of Water Q of $240.00 for impacts of to lake bottom of less than 1 acre and $570.00 for impacts to lake boof grea er
or equal to 1 acre.
Applications should be sent to:
Division of Water Quality 401 Oversight/Express Review Permitting
1650 Mail Service Center
Raleigh, NC 27699 -1650
I. Applicant Information
1. Owner /Applicant Information
Name: p hd y i p a. r.cl CYA "I 1 i C e_ i r\A
Mailing Address: �� FI y- d ayk c c�
Telephone Number: G I E: tf3 Fax Number:
E -mail Address: rY"i I I 1 i c- C v,�
Agent Information (A signed and dated copy of the Agent Authorization letter must be attached
if the Agent has signatory authority for the owner /applicV.Q
Name: K0 �4
Company Affiliation:
Mailing Address:
4) 0 a d� .
orc�, NG,z g�rL 8
Telephone Number: �%D�/- �%3�' �j l G Fax Number:
E -mail Address:
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II. Project Information I i F E B 2 4' :"-" 14
ect to h
Attach a vicinity map clearly showing the location of the property with resp
as towns, rivers, and roads. Also provide a detailed site plan showing propel 1"9AA�' -•` erancn
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.
Location
County f eA Y J Ul- Nearest Town �%
1 ii d a- �' y '.3 ''x
Subdivision name or site address (include phase/lot number) i 11 Ce i Cdr t
Directions to site please include road numbers, landmar s, etc (This is not necessary if an adequate
vicinity map is included) kLO U LI +,C> -TiJ l_0 i 6_ ►J M Eu'n.'c)
2 Describe the existing land /use or condition of the site at the time of this application
3 Property size (acres) i/' s c t-- 2 L
4 Nearest body of water (stream/nver /sound/ocean/lake) N 1 L c T. I l e- tl
5 Describe the purpose of the proposed work CJ % O 2r` ri 0 ni
6 List the type of equipment to be used to construct the project 0,74 b +
7 Amount of impact (including all excavation, backfill, np rap, retaining walls, etc ) below the
normal pool lake level in square feet or acres d k b
8 a Amount of impact (including all clearing, back fill, excavation, np rap, retaining walls, etc )
above the normal pool lake level and 50 feet land -ward in square feet or acres
2 �'..� D 4/ cr X-, PC, to d b9e)
8 b Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instance) rU n j J &' n A o .(
-2-11
Date
(Agent's signature is valid only if an authorization letter from the applicant is provided )
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Dixie Land Surveying, PLLC
Linaenae No P -0335
4278 Cotmtq Club Road, Wadeebma, N C. 28170
Phone: f704i.894.8810
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LOCATION MAP (N.T S.) 'J �` r '- 'J \ Plat of Property Surveyed For
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Notes (s if applicable) Phillip King
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x e dR dt t— .r b..r.mm 0-w µ.rµ.µµ1 .-� .--� r--. �. r and wife
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em ••m•l-d m . mr 0-.t. .-- ,-� ,� .� ,—� .� , J ,- Millicent King
. rat. p..pul7 tlr dthh . 7ra wan Y.0-
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�.. e.ew 'J 'J '-' ' �' '-' 0 077 ACRE = 3,332 7 SQ FT
x 4. Yea O.MVA by 0µ-r0-10-
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686 Berry Hill Drv. B. Center Twtap., stenly County. NC
Sane I inch - 20 R.
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r ,� ,� ,_, �, Mary Beach / Lot 1 342 / P B 1. PG 214
0' 20 40' 80'
For Reference sae.
D.B. 383. PG 637 / PIN 8684 -04-94 -8760
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