20081427 Ver 1_401 Application_20080908

DUKE POWER LAKE MANAGEMENT, EC12-QEY?r
P. O. BOX 1006 i
CHARLOTTE, NC 28201-1006 1 4 2 7
704-382-1567 OR TOLL FREE 1-800-443-5193
APPLICATION FOR PERMIT TO STABILIZE THE SHORELINE IN NORTH CAROLINA
Please type or print and fill in all blanks. If information is not applicable, so indicate by placing N/A
in blank. PLEASE SUBMIT APPLICATION AND APPROPRIATE DUKE POWER FILING FEE, PAYABLE
TO DUKE POWER, TO ABOVE ADDRESS.
1. Applicant Information
A. Name FIekCL-Q.? F. W .lsah
B. Mailing Address 11 % b s 6 (,&N C O ye- /VL 7-104
C. Telephone ( 02091A -7-71
`72 _'s
_JW r= rM
II. Location of Proposed Project g r=n ()
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A. Lake ^EP 1 2008
B. Street Address
C. County DENR-WATER QUALITY
L tLc ci e I I WETLANDS AND STORMWATER BRANCH
D. City, Town, Community or Landmark 54y
*} r5 v; (L Cs
E. Section Lot # (+ Subdivision K I Or
F. Directions to property by road T_-'1I I\1 4-d mow. ( 3L- W pn
I?,.?u t 5?j) On PEn.A
L of 4 on Str4e Paa k_ /n Q,cJlf or S} ?z?hn 2 0" E menba I -o-f-4 on
G. Latitude and longitude for the project site S g0 , cj
H. Please submit a map showing the coordinates or a detailed map (USGS quad map, city
map, etc.) showing the exact location of the project site. (NOTE: Latitude/longitude
coordinates can be found on internet site, www.mapsonus.com. Directions: Don't
register, click "Maps", enter address, draw map, select "Map Clicking Will...", select
"Lat/Long", click map)
III. Description of Project
A. Length of wall 15-(),
B. Material j .? kecC
C. Distance from property line/shoreline It -Ooll ow c,t. S+ n? S (io re (; n -e--
IV. Intended Use of Project Area
A. Private X
B. Commercial
V. Applicant Signature
PLEASE NOTE THE FOLLOWING:
311IN-1 Date g 22 in
• A COPY OF THE COMPLETE APPLICATION WITH A ROAD MAP SHOWING LOCATION OF THE PROPERTY MUST BE SUBMITTED TO: US
ARMY CORPS OF ENGINEERS, 151 PATTON AVENUE, ROOM 208, ASHEVILLE, NC 28801-5006
• A COPY OF THE "DUKE POWER APPLICATION FOR PERMIT TO STABILIZE THE SHORELINE IN NORTH CAROLINA" AND SEVEN (7)
COPIES OF THE COMPLETED "NC DIVISION OF WATER QUALITY PRE-CONSTRUCTION NOTIFICATION APPLICATION" MUST BE
401 WATER QUALITY CERTIFICATION APPLICATION
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 seven (7) copies of this application and supporting information as well as a non-
refundable application fee to the Division of Water Quality of $200.00 for impacts to lake bottom of less
than 1 acre and $475.00 for impacts to lake bottom of greater or equal to 1 acre.
APPLICATIONS TO BE SENT TO:
DIVISION OF WATER QUALITY WETLANDS UNIT
1650 MAIL SERVICE CENTER
RALEIGH, NC 27699-1650
1. Applicant Information
Owner/Applicant Information
Name Fletcher Wilson
Mailing Address 4108 Glencove Ct
Winston-Salem, NC 27106

Telephone Number 336-817-9771
Fax Number
E-mail Address [e-mail]

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 Chip Bridges
Company Affiliation CBC Custom Shorelines, Inc.
Mailing Address 628 Oakridge Farm Hwy
Mooresville, NC 28117

Telephone Number 704-660-5111
Fax Number 704-660-5969
E-mail Address [e-mail]
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.
Location
County Iredell Nearest Town Statesville
Subdivision name or site address (include phase/lot number): NIA
1. Directions to site - please include road numbers, landmarks, etc. (This is not necessary
if an adequate vicinity map is included): T- 9 q IQ ho ff w; 4 3 (Q - LC EA 6)7
.k l50 - 2,ct1 F or) Pj ?fi-, - Lof - on S4-Afe P4ak-- i4?ht oA St_Tohhs
12 {? on C At on b o_ L O -P o r, PD, ? J i l l L LO-P4- o 'n
S unn?j Ag-
2. Describe the existing land use or condition of the site at the time of this application:
0odc Lo +
3. Property size (acres): ( , L4
4. Nearest body of water (stream/river/sound/ocean/lake): N 0 (Lm rrr,
5. Describe the purpose of the proposed work:
riE(dS?ar,e S}-AOtc.rrcE+ wA((. To Cow-F??-ol C2yS?c?•-,
6. List the type of equipment to be used to construct the project: Local w ; it W5
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below
4' X 15-o
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:
I , Y 1So'
b. Please describe vegetation above the normal pool lake level and 50 feet land-ward to
be impacted (number of trees for instance): u) Dod J
Applicant/Agent's Signature Date
Z
(Agent's signature is valid only if an authorization letter from the applicant is provided)
Please approximately sketch the following information on this plan (please provide dimensions
for each item, such as 10 ft. x 100 ft.):
1) All proposed vegetation clearing (provide dimensions)
2) Location of rip rap or fill to be placed above the Full Pond elevation
3) Location of rip rap or fill to be placed below the Full Pond elevation
4) The location of any proposed structures such as buildings, retaining walls, docks, etc.
5) The location of any excavation or dredging below the Full Pond elevation.
6) Location of construction access corridors.

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DIRECTIONS BY ROAD FORM
Lake Use Permit Applicants and Contractors: Ease of locating the proposed project
site can have a big impact on permit processing time. Please complete this form
and return it along with your completed permit application to:
DUKE POWER
C/O LAKE MANAGEMENT - EC 12 Q
P. O. BOX 1006
CHARLOTTE, NC 28201-1006
1-800-443-5193
Applicant's Name- Fletcher Wilson
Lake Name: Norman
Subdivision Name: N/A
Property Section: Lot (s): 1&2
City: Statesville County:Iredell
State: NC Zip: 28166
Telephone: [phone]
Type of Permit
Requested
"Circle":
Private Facility
Commercial Facility
Excavation
tabilization
Conveyance
Miscellaneous Uses
Directions (from major road or highway): I-77 N to exit 36 - West on Hwy 150 -
Right on Perth - Left on State Park - Right on St John - Right on E Monbo - Left on
Pineville - Left on Sunny Path Lane
Descriptive Structure (s) on Property (i.e. brick garage, white fence mobile home,
etc.
Property on left - Lot 1 &2
*Note. Please use the back of this form, if desired, to draw us a map to the site.
251 Sunny Path Ln, Statesville, NC - Google Maps
Address Sunny Path
CO., ) SI3? Statesville, NC 28677
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Subject: Fwd: 9/15108
See if this works better.
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9/15/2008