20171350 Ver 1_Shoreline Stabilization_20171023

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October 20, 2017
Division of Water Quality Wetland Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
My signature below authorizes Sonny Tyson of Sonny's Construction to act as my agent to file
abbreviated application form for 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 GP 30.
Ken Martin
201 Martin Circle
Wadesboro, NC 28170
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OCT 2 3 2017
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• The following is an abbreviated application form for those applying for a 401Water
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 $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 Wetland Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
I. Applicant Information
1. Owner/Applicant Information
Name: Ken Martin
Mailing Address 201 Martin Circle 9867 Pine Tree Road
Wadesboro, NC 28170 Norwood, NC 28128
Telephone Number: [phone] Alt 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: Son" Tyson
Company Affilaition: Sonny's Construction
Mailing Address: 186 Vineyard Road
Norwood. NC 28128
Telephone Number: [phone] Fax Number
E-mail address: son ny(cDson nysconstruction. com
Il. 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: Stanly Nearest town: Norwood, NC
Subdivision name or site address(include phase/lot number)
9867 Pine Tree Road Lots 152 & part of 153 &154 Country Club Estates
Directions to site please include road numbers, landmarks,etc (This is not
Residential home with grass lawn and natural area (Sec included snap)
From Albemarle, NC, South on US Hwy 52, In Norwood, bear left on Fork Road
Left on Piney Point Road
Left on Pine Tree Road - 9867 is on the left, lakeside
2. Describe the existing land use of the site at the time of this
application:
Residential home with grass lawn and natural area
3. Property size (acres): Approx .21 acres
4. Nearest body of water(stream/river/sound/ocean/lake): Lake Tillery
5. Describe the purpose of the proposed work:
Replace 112 feet seawall and with rip rap 2 to 1 slope on lake side
6. List the type of equipment to be used to construct the project:
Excavation equipment and carpenter's tools
7. Amount of impact (including all excavation, backfill, rip rap, reatining walls,
etc.) below the normal lake pool level in square feet or acres:
448 Square feet
8. a.Amount of impact (including all clearing, backfill, excavation rip rap,
reatianing walls, etc.) above the normal pool lake level and 50 feet landward in
square feet or acres:
560 Square feet
b. Please describe vegetation above the normal pool lake level and 50 feet land-
ward to be impacted(number of trees for instance):
Natural area covered with grass and vegetation.
No Xegetation to be affected.
October 20, 2017
Date
(Agent's signature is valid only if an authorization letter from the applicant is provided)

Lake (Full Pond)
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 evacuation or dredging below the Full Pond
elevation.
6)Location of construction access corriders.

Ken Martin
9867 Pine Tree Road
Norwood, NC 28128
9867 Pine Tree Road Lots 152 & part of 153 &154 Country Club Estates

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im Albemarle, NC, South on US Hwy 52, In Norwood, bear left on Fork Road
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I on Pine Tree Road - 9867 is on the left, lakeside
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River ',laven
Road Ciel
Mi G4ead
EEI
im Albemarle, NC, South on US Hwy 52, In Norwood, bear left on Fork Road
I on Piney Point Road
I on Pine Tree Road - 9867 is on the left, lakeside