20150254 Ver 1_Shoreline Stabilization_20150309

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 five (5) copies of this application and
supporting information as well as a non-refundable application fee to the Division rof,�
Quality of$240.00 for impacts to lake bottom of less than 1 acre and $570.001 P
lake bottom of greater or equal to 1 acre.
Applications should be sent to: 2 0 1 5 0 2 5 4
Division of Water Quality 401 Oversight/Express Review Permitting
1650 Mail Service Center
Raleigh, NC 27699-1650
VLIrMAR
. Applicant Information
1 Owner/Applicant Information 0 9 2015
Name JEFFREY LATCHAW
Mailing Address 2319 PENNINSULA AVENUE souRCEs
SHELBY NC 28150 401&BUFFER PERMITTING
Telephone Number 704-300-9990 Fax Number-
E-mail Address ieff(M-aualtechindustries com
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 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 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 CLEVELAND Nearest Town SHELBY
Subdivision name or site address (include phase/lot number) 2319 PENNINSULA AVE, SHELBY,
NC28150
Directions to site please include road numbers, landmarks, etc. (This is not necessary if an adequate
vicinity map is included)
2 Describe the existing land use or condition of the site at the time of this application
RESIDENTIAL WITH SPARCE GRASS AND ERODING SHORELINE
3 Property size (acres) 0 5
ACRES
4 Nearest body of water (stream/river/sound/ocean/lake) MOSS LAKE

5 Describe the purpose of the proposed work BANK STABILATION WITH CONCRETE
SEAWALL AND PATIO
6 List the type of equipment to be used to construct the project TRACK HOE & SKIDSTEER
7 Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc ) below the
normal pool lake level in square feet or acres 684SQUARE FEET
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-
TOTAL DISTURBED AREA 4171 SF
8 b Please describe vegetation above the normal pool lake level and 50 feet landward to be
impacted (number of trees for instance) SPARCE GRASS TO BE RESOWN
0
A pl nt/ gent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided )

ELIZABETH AVE
NOTES: SITE
1. ALL MATERIAL AND WORKMANSHIP TO MEET ALL STATE AND LOCAL CODES. DEBBIE
2. ASSUMED BEARING CAPACITY 2000PSF. ALL FOOTINGS TO BEAR IN FIRM
UNDISTURBED SOIL FREE OF ORGANICS. 1 1/2
3. CONCRETE TO HAVE 3000 PSI 28 DAY STRENGTH. NO CALCIUM CLORIDE ADD
MIXTURES RE . 1 MAX
4. BAR TO BE GRADE 60 COLD BENT FREE OF DIRT OR SCALE. MINIMUM LAP
18". MINIMUM CLEARANCE TO FORM 2" AND 3" TO SOIL
5. ALL DISTURBED AREAS ABOVE LAKE LEVEL TO BE STABILIZED WITH GRASS AND NC DOT CLASS 1 OR CLASS "B"
1' THICK WITH MIRAFI FABRIC
MAINTAINED UNTIL A THICK DENSE STAND IS ACQUIRED. oHOLLY LN
UNDERLAYMENT
W
VICINITY SKETCH
EL738.8'+Z— 7 736.0'
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<4
RIP RAP SECTION
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sm
CALCULATED BACKFILL 1026FT3: 38.0 ( 0 15480
YD3 (6.6FT3/FT SHORELINE)
000#5 WASHED STONE WRAPPED IN MIRAFI RIP RAP TO EXISTING
FABRIC WITH 4" PERFORA7ED PIPE TO THE CITY OF KINGS MOUNTAIN
DAYLIGHT OR THRU WALL ..F GRADE 736 CONTOUR IS HIGH-WATER LEVEL "MOSS LAKE"
SLOPES TO WALL
LIMITS OF DISTURBED AREA
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1 1 2" WEEP HOLES ;�,' O.C. IPE %
WITH #5 WASHED STG�NE IN FABRIC p 0 Z C14f
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RIP RAP OVER FABRIC _j
< JEFFREY S. ROARK 04 (n ,-..Lu
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DS 1575 PG 1322
RIP RAP AS REQUIRED
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THOMAS W. MAYHEW
DO 1281 PG 1880; 08 1417 PG 738
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PLAN VIEW
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SCALE: 1 20'-0" N
--- SHEEP
.WALL SECTION C-1
SCALE: NTS
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