20081216 Ver 1_Application_20080811

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 of Water Quality of $240.00
for impacts to lake bottom of less than 1 acre and $570.00 for impacts to lake bottom of greater or
equal to I acre.
Applications should be sent to: 0 8 1 2 1 5
Division of Water Quality 401 Oversight/Express Review Permitting D [ C (R OWE
1650 Mail Service Center I.? LL ?a ??ff
Raleigh, NC 27699-1650 A U G 1 1 U
2008
1. Applicant Information DENR - WATER QUALITY
A I x, WETLANDS AND STORMWATER BRANCH
1. Owner/Applicant Information
Name: Dj? w l tt?d?t,? ih
Mailing Address: 4 SON pa
A-t it
Telephone Number: 3/0 ?2 3 Fax Number:
E-mail Address:
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: Ro ?to = 2 I 1 " k? 2
Company Affiliation: f3 u, (C? Cw;v la ok
Mailing Address: O °l LJ, I 1 cc z On- k Noer oed /U -c-. 7- r/ 2- F
Telephone Number: 7 y cI L1 3 g 6 Cv / (e, Fax Number:
E-mail Address: _T 73 L.( ) 61 V LJ ro /!?? l I ? ?-
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: _SJL* I&I Nearest Town:
fiu Waocf
Subdivision name or site address (include phase/lot number): MOt41,T,4,h Vit,-J CS?Q A
Directions to site please include roja?d, numbers, landmarks, etc. (This is not necessary if an adequat 3r 3`?. ?fJ
vicinity map is included): t-1 Ak4 kd 46 0011 1 77--n I.
//?? / T 1n

2. Describe the existing land use or condition of the site at the time of this application:
3. Property size (acres): -I- N c, g c
4. Nearest body of water (stream/river/sound/ocean/lake): L-/\ , T 11,Ftz
5. Describe the purpose of the proposed work: 5 ? C ?? E S r} 16 i / - . n ? ' , q J
6. List the type of equipment to be used to construct the project: 13 t? b e c{-
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below theJJ
normal pool lake level in square feet or acres: z-1 5- V -2- 10 5 ?T
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:
8.b. Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instance): ew-''? Ced , Q J l /0 kl i_jl?-- F d
f 5 S E nJ t`> N ?QG pea :j?3L bu + t -,s w y f f o loo ?ra? 0.C r c k
1,4& -9 -
Applicant/Agent's Sign,
(Agent's signature is va:
N9??3
? „a I TzR; l
R ? CUo?wFO?Q
N C_ 2-gl 2-9

cant is provided.)
Map of 49693 Quail Trail Rd Norwood, NC by MapQuest

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Norwood, NC 28128-8485
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A U G 1 1 2008
UENR - WATER QUALITY
WETLANDS AND STORMWATER BRANCH
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Progress Energy
Lake i:l°aaerr?-,rr
cio Business Services
Progress Enemy
P.C. Sex 1551, PEB 3A
Ra e.-Ch, NO 27602
PERMIT LETTER
NAP1E D? ld G64461" _ SUBDIVISION Fyty&-" VAAd 0 PA*+ 1
ADDRESS 4q f k2 4-11 CfPF tr -bCV- f&-( LOT ? 311,
TY, STATE. ZIP tallvf ? , N.C. dv wl
Your cur-ent lease ith Fregress Energy :PEC) and the Guidelines fcr the Use c` Leased PTaerties at Laks Tillery prrjide that, scbiect
to certair raqufrementS, YOU may construct and maintain a pier, wharf and a nia-stary baet-ouse at ! ake Tillery. PE, does ro, cb :: ct
tc the nstcllation of 9 be rip -ap ma'.elal for shore ine stabilization proviced the rsquired permits are accuired.
NOTE: A pier, wharf and a one-story boathouse must be erected over that portion of Lake Tillery immediately
adjacent to your leased premises and in the location herein approved by PEC. Encroachments that are not
promptly relocated after written notice to do so from PEC subjects your lease to possible termination.
Additionally, you may not construct or install other imp rovemertsistructures, i.e., roof overhangs, driveways,
porches, decks over land, garages, buildings, storage buildings, wells or septic tanks on your leased premises.
As required under your lease, you must permit PEC, its officers, agents, employees and otter authorized
persons to enter the leased premises at any and all times for the purpose of inspecting the leased premises
and your compliance with the terms and conditions of your lease.
The United States army Corps of Engineers has iss-,--_f a regiorai tenaraf perrit covering -his type of authorized wcr? - a °opy
,voic', s Mcbec ror your ass stance arra info ;maticn. Please be advised of tha req .,emert ir pa-agrapr 2.a. of said Permit (paga ,?
r<,garcirxd the nreu to apply 'or and obtai a `ZJater Cuality Cer;ificalln horn the North Ca, o1 a Divisicr of Water Cuality in acror
Jancevvif, Sec*ici `01o-t7eC'ea,lWzturAct.
r u may ,se this let-.er as PEGS perrniss'on in yetu application fcr a oLi ?-g permit from 'he appropriate Iviontgcnery Ccunty lrispeci on
Office.,-Slant,, Co x!v, Planing Departme ,t c i construe the specific tacilties sa: forr atxrra a7 c in aoplyirg for the appropriate ce-C`ice-
ii3n fmm iha state It you have nct corl.dated consxt.cticn of your facili:ies within the next three (3) montns from the date cf this
eater, PECs permiSsicr shall expire. req. ' `(G , i to submit ano:har application to PEC, along A+`th an atdaioral- $Kru n3nref0dah!e
application fee. "=C's approval heraLmder is s?,bject :o your camp: iance with the teems and xndit ens of Yaw lease and 3uidefines: icr
the Use of teased..':,=Erties of Lake Tilln, (as they rm- to amer!deJ -rom Vine m time;.
Please see the reverse side of this doc meat to describe the impro mments you plan to construct
I/,,-a hereby ce-tif, t! a: the above-specified A k complies with -:rcgress Energy's facilities scecif'catiens ir, effect at the time of appli-
pet, t.
cetic-i4S-N
E)
_-EE . Uh _ DATE
<:IP
OGRESS ER E"RESENTl i VE"S S'SW= UPE DATE
13
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North Carolina Department of Cultural Resources
State Historic Preservation Office /
Peter B. Sandbeck, Administrator
Michael F. Easlev, Governor Office of Archives and Historv
Lisbeth C. Evans, Secretary
Division of Historical Resources
Jeffrey J. Crow, Deputy Secretary David Brook, Director
ER 08-1499
Received June 17, 2008
Due July 10, 2008
NATIONWIDE PERMIT REVIEW
APPLICANT: Robert Gallagher
(for Donald & Sharon Goodwin)
PO Box 961
Norwood, NC 28128
Project Location: Stanly County
Proposed Project: Soil Disturbance, 49693 Quail Trail Road, Norwood, Lake Tillery
The North Carolina State Historic Preservation Office has received the application
for the above project and our comments are noted below.
Additional information is needed (maps, photographs, other).
'o comment.
We have reviewed the requested information and have no comment.
Signed `
Renee ledhill-Ear ey
Environmental Review Coordinator
State Historic Preservation Office
4617 Mail Service Center
Raleigh, NC 27699-4617
Phone - 919/807-6579
FAX - 919/807-6599
Date :711 1 /09