20090563 Ver 1_Shoreline Stabilization_20090518

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 1 acre.
Applications should be sent to:
`V'
Division of Water Quality 401 Oversight/Express Review Permitting 115 MAY 1 1 U' 10
A?
1650 Mail Service Center g 20Q9
Raleigh, NC 27699-1650 DENR - WATER QUALITY
WETLANDS AND STORMWATER BRANCH
1. Applicant Information
Owner/Applicant Information
Name: 1-r d I ? ? l I I (_C" If _k::? t
Mailing Address: .:I-? r rte Q rC 0-yon. L' 0,J
Telephone Number: 1 (-)(A7Fax Number: ?Y
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:
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.
r
US Army Corps Of Engineers Field Offices and County Coverage
Asheville Regulatory Field Office Alexander Cherokee Iredell
k Mitchell Union
Polk Watauga
US Army Corps of Engineers Avery Clay
Buncombe Cleveland son
Jac
Lincoln Rowan Yancey
151 Patton Avenue Burke Gaston Macon Rutherford
Room 208
NC 28801-5006
Asheville Cabarrus Graham Madison Stanley
,
Telephone: [phone] Caldwell Haywood
Catawba Henderson McDowell
Mecklenburg Swain
Transylvania
Fax: [phone]
Raleigh Regulatory Field Office Alamance Durham Johnston Rockingham Wilson
Yadkin
St
k
US Awry Corps Of Engineers Alleghany Edgecombe
li Lee
h
N o
es
Surry
6508 Falls of the Neuse Road n
Ashe Frank
Caswell Forsyth as
Northampton Vance
Suite 120
NC 27615
Raleigh Chatham Granville Orange Wake
,
Telephone: [phone] Davidson Guilford
lif
H Person
Randolph Warren
Wilkes
Fax: [phone] ax
a
Davie
Washington Regulatory Field Office Beaufort Currituck Jones
Lenoir Pitt
Tyrrell
US Army Corps Of Engineers Bertrc Dare
Gates
d Martin W ashington
Post Office Box 1000
NC 27889-1000
Washington en
Cam
Carteret, Green Pamlico Wayne
,
Telephone: [phone] Chowan Hertford
de
H
C Pasquotank
Perquimans
'Croatan National Forest Only
Fax: [phone] y
raven
Wilmington Regulatory Field Office Anson Duplin Onslow
Pender
US Army Corps Of Engineers Bladen Harnett
Brunswick Hoke Richmond
Post Office Box 1890
Wilmington, NC 28402-1890 Carteret Montgomery Robeson
Telephone: [phone] Columbus Moore Sampson
tland
S
Fax: [phone] Cumberland New Hanover co
US Fish and Wildlife Service / National Ma rine Fisheries Servic e
US Fish and Wildlife Service National Marine Fisheries Service
US Fish and Wildlife Service Asheville Field Office Habitat Conservation Division
Raleigh Field Office
Post Office Box 33726 160 Zillicoa Street. Pivers Island
NC 28516
Beaufort
Raleigh, NC 27636-3726 Asheville, NC 28801
Telephone: [phone] ,
Telephone: [phone]
Telephone: [phone]
North Carolina State Age ncies
Division of Water Quality State Historic Preservation Office
Division of Water Quality Wetlands Restoration Program Department Of Cultural Resources
401 Wetlands Unit 1619 Mail Service Center 4617 Mail Service Center
1650 Mail Service Center NC 27699-1619
Raleigb Raleigh, NC 2 7 699146 1 7
Raleigh, NC 27699-1650 ,
Telephone: [phone] Telephone: [phone]
Telephone: [phone] Fax: [phone] Fax: [phone]
Fax: [phone]
LAMA and NC Coastal Counties
Beaufort Chowan Hertford Pasquotank
Division of Coastal Management Bertie Craven Hyde Pender
1638 Mail Service Center
Brunswick
Cumtuck
New Hanover Perqunrt?nc
Raleigh, NC 27699-1638 Camden Dare Onslow Tyrrell
Telephone: [phone] Carteret Gates Pamlico Washington
Fax: [phone]
NCWRC and NC Trout C ounties
Western Piedmont Region Coordinator Alleghany Caldwell
Mitchell Watauga
Wilkes
3855 Idlewild Road Ashe
Avery Stokes
Kernersville, NC 27284-9180 Burke Surry
Telephone: [phone]
Mountain Region Coordinator Buncombe

Cherokee Henderson
Jackson Polk
Rutherford
20830 Great Smoky Mtn. Expressway
Clay Marten Swain
Waynesville, NC 28786 raham
( Madison Transylvania
Telephone: [phone]
g
Fax: [phone] Haywood McDowell Yancey
1. Location
County. 02? Cc ?Y,?7 yr c Nearest Town: (C
tom(? (l, _
Subdivision name or site address (include phase/lot number): ° :
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:
3. Property size (acres): i_Cc !,e
4. Nearest body of water (stream/river/sound/ocean/lake):
5. Describe the purpose of the proposed work:
t-Y
r t
6±p r5y-
6. List the type of equipment to be us d to construct the project: 0_r_0
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below the
normal pool lake level in square feet or acres:
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:
1 /_
8.b. Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instance):
Applicant/Agent's Signature Date
(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 Ful Pond elevation
3) Location of rip rap or fill to be placed below the Fug Pond elevation
d) 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.
HUNtER VILLE. NC 28070 FAX [phone]
SAND ?
(D PINNACLE LAND SURVEYING, PA
KLAUS E. KRUEGER PLS L-3808
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t t \?caftan,
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LAKE NORMAN 41 - SEA _
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•• ° SuRa•? ?w
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1 ?' KR
T<I '!!/!1l IIII III.`\l\
I Land under Water
Pier & Land from 760.0'
\ Elevation
to property line as shown
Now or Formerly
Duke Power Company
Elevation DB 2225 PG 539
781.7' r i Map PGS 548 & 549
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Aj fig, I

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764.1'
? I
F I

?`•
C9
I r Fountain dk
Pool Area
Lot 2
& Part 3 .,
& St i N 29,755 SQ.F'f.
Now or Formerly ?C 0.6831 ACRES
Lee G. Orlic

& wf Jeanette S.
19 gyp I
Patti Area

DB 9854 PG 736 I
-re 2771
Covered Deck
65.0
/finished
1
1.0 8aserl?ant
Brick do Frame
f 22512 1.7 ..+
t3 o-
J t3
b 30
1'
.
33.0' ? 0
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Porch ?
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Ap, a
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S I well
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Kcept as apeciticolly stated or shown on this plat,`
Wy does not reflect any of the following; easements,
ncurnb nl?cee. restrictive covenants. subdivision restrlatitme.
S r *014w W"41 use regulotions, and any other facts
?ot a ocn?piete title examination may disclose.
it
EIP

BASE FLOOD ELEVATION 761.0'
FIRST FLOOR ELEV. - 771.1'
SECOND FLOOR ELEV. - 780.7'
GARAGE ELEVATION - 771.0'
LOWEST ADJACENT ELV. - 770.6'
HIGHEST ADJACENT ELV - 777.0'
A/C ELEVATION - 775.1'
Lot5&6
Now or Formerly
Kenneth J. Dols
& wf Lourdes Grace
DB 7492 PG 279
UtAlti -red

0 25 50 100
1 inch = 50 ft-
P` pT?
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SITE
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Catawba Ave Exit 28
viCINITy MAP - Not to Scale
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LEGEND
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