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20070358
The following is an abbreviated application form for those applying fora 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 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 Wetlands Unit
1650 Mait Service Center
Raleigh, NC 27599-1650
I. Applicant Information ~ '
I. Owner/Applicant Info atiq~
Name-. ~ .u !-1ft S<'-
Mailing Address: j ~ U` ~ ~ K~~x~• c
Cti~ c~~o ~ ~L.. ~cri~5 ~
Telephone Number: ~~3 ~>~. /y5"( Fax Number: ~¢•`t 'YES: 3y~~
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.)
Company Affiliation:
Mailing Address:
Telephone Number: ~2Y_ ~gy_ ~ E• ~'~ Fax Number: ';Z~`l '~f!>S~ ~f,7
E-mail Address: ~ ~..: - ~ '• G~ FV-in> spt=mss: ~•~*-
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 mus ~ e included.
~• , ~:
~~ ~ ,.
1. Location / ~ -~ . ~~~
County. ~~~C'(~ / ~ st Town:
Subdivision name or site address `(include phse t n ber : e ~` ~v
Directions t~si~,e,~l~ase include road nu lan ks, et : (This is not
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~w~~s~ary~ an adequaf~+0i~cinity map is inc de
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2_ Describe the existing land use or condition of the site at the time of this
application: ~n•-. ~~. ~~~
3. Property size (acres): ~~ ~ ~ r'c-~ ~ 1
Nearest body of water (stream/river/sound/ocean/lake): f~~~ '~~ ~`~~af~,'
Describe the purpose of the proposed work:-1 :~~ ~ ~ -~-t-~b ~~ ~ '~
~~2 ~ ~F ~, .tee- ~ ~,C`•.y ~ /.v(? __ o~ s- - ~:.~~- %ecy ~ -~kj
6. List the type of equipme/nt to be used to construct the project:
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls,
etc.) below the normal pool lake level in square feet or acres: .G 6~~~re5
.7 F'C o-{-~c. c j. e~
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-w din
square feet or acres: - G ~~ ~v {g'`
~~ - - - ( _ 1. _ _ [... _ ,, . ~ 1 ~L.~ ~a _ / ~.,. r~ n ,-~.'
b. Please describe vegetation above the normal pool lake level and 50 feet land-
ward to be impacted (number of trees for instance): ~ i~cvc ~ ~-~.~o.~: d .
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App icant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
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Please approximate#y sketch the following irrformatian on this plan
(please provide dunensions far each [tem, such as 10 ft. x 100 ft):
1) All proposed vegetation deazing (provide dimensiansj.
.2) Location of r~ rap ar fill to be placed above the Fug Pand elevation
S) l.acatiarr of rip rap or fill to be placed below the Fult Rand elevation
4) The locatiarr of any proposed stivctures such as buildings, retaining
walls docks, etc.
5) The location of any excavation ar dredging below the Full Pond
elevation.
6) Location of construction access corridors.
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Fenn 398578 (9-06)
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LAKE
DUKE ENERGY LAKE SERVICES DUKE ENERGY PERMIT N0.
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cour`vTYJL ~~~~ /~ PRIVATE FACILITIES PROGRAM ~ 0 a 7 ~ 3
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PERMIT APPLICATIO FORM
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o First MI Last Sign ure (Required) Date
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Check the appropriate box. Stationary Pier Slip Style Dock Platform Style FACILITY SQUARE
(Fg. 1) (Fg. 3 & 4) Dock (Fig. 2 & 5) FOOTAGE
Use:
1 Individual 2 Common
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^ 1^ 2
^ 1^ 2 Stationary Surface Area:
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Status: Floating Surface Area:
1 Existing 2 Proposed ^ 1^ 2 ^ 1^ 2 ^ 1^ 2 ~z
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Type of Facility: Total Surface Area:
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^ Check box rf uncovered dock. ^ Check boxrf unwvered dock. ^ See attached.
FIG. 1 FIG. 2 FIG. 3 FIG. 4 FIG. 5 FIG. 6 (other)
If application is for a common use facility, additional waterfront property owners using the facility appoint the individual(s). Listed in
W the applicant information section of this form as the agent applying for permit. All parties using the facility for permanent mooring
must be waterfront property owners (i.e., eligible for individual facilities) and must sign below: (use additional sheet if needed).
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Name Address Date
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Condition of Pier: ^ Good ^ Fair ^ Poor Permitted: ^ Yes ^ No ^ Denied
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Final Inspection Completed: Date, Initial
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Comments•
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Form 398578 (5-06)
LAKE ~.._ DUKE ENERGY LAKE SERVICES DUKE ENERGY PERMIT N0.
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PRIVATE FACILITIES PROGRAM PREVIOUS PERMIT N0. +~.,s~
PERMIT APPLICATIO M ~~~ 't
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BUILDING PERMIT N0. ~ ~
~>$ First MI Last Signature (Required) Date
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,:' Check the appropriate boor. Stationary Pier Slip Style Dock Platform Style Bast Ramp or FACILITY SQUARE
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FOOTAGE
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1 Individual 2 Common
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^ 1^ 2 Stationary Surface Area:
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Type of Facility: Total Surface Area:
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i= 1 Stationary 2 Floating 3 Combination ^ 1 ^ 1 ^ 2 t~ 3 ^ 1 ^ 2 ^ 3 ^ 1 FTC
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^ (]red- taaotd uncovered ~ l~edt box 'd uncovered dock. ^ See attadred.
FlG. 1 FlG. 2 FIG. 3 FIG. 4 FIG. 5 FIG. 6 (other)
If application is for a common use facility, additional waterfront property owners using the facility appoint the individual(s). Listed in
'~ ` the applicant information section of this form as the agent applying for permit. All parties using the facility for permanent mooring
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;:.::mow:: Condition of Pier: ^ Good ^ Fair ^ Pbor Pprmitbed: ^ Yes ^ No ^ Denied
Final Inspection Completed: Date, Initial
ComnKnts:
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' Iredell County
ZONING PERMIT
227 South Center St. PO Boz 788 States ille. NC 28687 Phone 704-878-3118
Call Sanitarian between 8 a.m. & 9 a.m. Statesville 704-878-5305 Mooresville 704-664-5281
Permit #: 13884420 Subdi~-ision:
Proposed L se: Single Family Township: 1700 Davidson
Location of Propem-: 000 BEATEN PATH RD MOORESVILLE NC 38117
Parcel #: 4627939035.001 7_oning: R20
I,ot #: 1 Size:.689 Flood Plain: No \1-atershed: WSIV-CA
.\pplicanr. ,IONN QUiNN O~~'ner: Robert & Dora Johnsen
:\ddress: _\ddress: 318 Beaten Path Rd
Mooresville_ NC 281 IS
I Phone: Phone: !
I'ropert\- Recorded: Yes Sitc Plan Re~-ic\t•ed: Communitt- \\ atcr: No Communiri- Sewer:
1. nermittrd the follm~ing minimam rrgi~irements mast he met, anless Health Dcaartmeri rcquices more land area, or oth cr
gti,aGfications are indicated in the comments.
\Ln. Lot _\rca: 30000 Min. Front Yard: 3i ft Min. Left Sidc ~~ard: 15 ft
Min. I.ct \\~idtl:: 100 '~Iin: Rear Yard: 50 ft Min: F.i~ht ~idc Ward: 15 ft
~Fn. i~umlx•r Parking Spacc•~: \Ias. Built tTnon .area:
(;ommcnts:
HOLD BUILDING PERMIT TILL PLAT HAS BL):N RECORDED
_`~_ __, ~g~ ~_
Directions: '~ ~ =~' ~ `- ~''~ " ` ° ~ - - ,
Brawlev School Rd_ ri~~ht Blume Rd. rieht Beaten Path Rd
Zoning Permit/Inspection Fee 0/
Site flan Re~-ie~~- Fee 0
L:m-imnmcnral 13calth ?~ie~r S~-stem /0
J-:nv-ironmental Health Existing tiv aom 0
'Dotal I~ccs:
FEES
S4S.00
S0.00
53 SD.00
S0.00
S39S.00
I eeruf~ ti.:.[ .;!! srucmivn~ made i:. thi> ::Pi lie:uinn and :mc ,.nachul d„runxn[z .ere true. annt~l.;e, and o,rrcei u, iLc he~~ „1 .:n Lnu~e!ed~c and bi!ieC rd .,rr
~.~:d.. ,....:i[i~. ! [.n ~,:<c:r,1 tL:., lai-e i•:!,~*nu[!un mn be ~ ^und~ brcrv~e:in~-,~i !him [nt~l:eui ,.. \~.nh~,nnd ! Ic.J[L i)cn,.i [.~_ _ ,:.: 1 iu nin~i_
~'c ~~`xri 11, , ~: ,.i n~... ,a , ,.: n u .,. cr,m r.. aL[i.e ~ c.;luati,n ~; ian:c,i~m a;,d u, rcl~::..,.. r ....i. r [.r.;: .~ua;ic , ,.:cx[.
\pj~licant:
Date:
3 n[m-rcYundablr Ecc vES-35.00 is chargc~i [tn all Permit aPPlicatir,ns.
Printru: I0 .9 '006
DUKE ENERGY LAKE SERVICES
EC12-Q
P O BOX 1006
CHARLOTTE, NC 28201-1006
704-382-1567 or TOLL FREE 1-800-443-5193
APPLICATION FOR PERMIT TO STABII.IZE 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 ENERGY FILING FEE, PAYABLE TO DUKE ENERGY,
TO ABOVE ADDRESS.
L Applicant In
A. Name
B. Mailing
IL
C. Telephone: ~~~. ~~ ~. /~5
Location of Propo9ed Project
A. Lake ~U~ ~c.,'`s a q
B. street Address 3i$ ` ec L'cc.c.~ ~ ~-~ ,
C. County .~~~ d~ fl
D. City, town, community or landmark 6 Qc~f~S.: t f fe ~ ,,
E. Section Lot # Subdivision
F. Directions to property by road n ~,;,_~ ~. c.,,,, g ; ~~,~,,, IF
f~ ~~~ ~ 93 -- 9~i!
G. Latitude and longitude for the project site ~~:~~ ,~~ ~ ,~. 3y 3s ' 3 -;~ ; SSA (~/ t
H. Please submit a map showing the coordinates or a detailed map (USGS quad map, city ap, etc.) showing the
exact location of the pmject site. (NOTE: Latitude/ longitude coordinates can be found on Internet site,
www.maasonus.com. Directions: Don't register, click "Maps", enter addmss, draw map, select "Map
Clicking Will... ", select "Lat/Long", click map)
III. Description of Project
A. Len ~, (~, t
gth of wall
B. Material ; G
C. Distance from property IineJsh reline Lp~ f; Q; ~~~
IV. Intended Use of Project Area
A. Private
B. Commercial ~,...~
V. Applicant Signature ~-/~ Date
PLEASE NOTE THE FOLLOWING:
• A COPY OF THE COMPLETED APPLICATION WITH A ROAD MAP SHOWING LOCATION OF THE PROPERTY
MUST BE SUBMITTED TO: ZIS ARMY CORPS OF ENGINEERS, 1 Sl PATTONAV~ - R0011I 208,
ASHEYILLE, NC 28801-5006
• 2 COPIES OF THE "DUKE ENERGY APPLICATION FOR PERMIT TO STABII.IZE THE SHORELINE IN NORTH
CAROLINA", PHOTOGRAPHS OF THE SHORELINE TO BE STABILIZED, AND FIVE (5) COPIES OF THE
COMPLETED "NC DIVISION OF WATER QUALITY PRE-CONSTRUCTION NOTIFICATION APPLICATION"
MUST BE SUBMITTED WITH THE DIVISION OF WATER QUALITY APPLICATION FEE TO:
NCDIVISION OF WATER QUALITY
ATTENTION: CYNDI gAROLY
PARgVIEW BLDG., 2321 CRABTREE BL 1'D.
RALEIGH, NC 27604
9I9~733-1786
G:U..AKEMGMT1Package InfonnationlNC Shoreline Stabilization Application.doc
318 Beaten Path Road, Mooresville, NC, 28117 -Google Maps
' Address 318 Beaten Path Rd
~~ Mooresville, NC 28117
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http://maps.google.com/maps?~-q&h1=en&q=318+Beaten+Path+Road,+Mooresville,+NC,... 2/21 /2007
DUKE ENERGY DIRECTIONS BY ROAD FORM
Lake Use Permit AppGeants and Contractors: Ease of locating We proposed project site can have a big
impact on permit processing time. Please complete this form and return rt along with Sour completed
permit application to:
DUKE ENERGti'
C/O LAKE SERVICES - E(' 12 Q •'~
PO BOX 1006
CHARLOTTE, NC 28201-1006
1-800-443-5193 or Option 5
~- - f -off e
Applicant's Name ~ ~~ i S '''`~
rSe _
Street Address (at lake): ~ a +e /„~,~ ~„l ~ iL~eSS ( J~~ ~~ p
-f Vf ' ~ ~ ~l f /jeG-'tee /
Lake Name: ~ {~ ~~~~ u,
Subdivision Name: _ ~~~~\; ~ ----
Property Section: # - - - - ~`/V ~~~f ~ ~~' ~j(~/
[~~,` `f Lot / /
City: ---1 "`~( (~S~ ~ ~ l e Corm __-L--1 'e ~ I'
ty --
State: ~ ~ Zip: ~~
Telephone: ~~ ~! ~ 3b (~
Directions (from major road or highway: ~ /~MQ /~ /
`i / ~ '~ n r
~~ f- f- cr.~ /je~-~ e rat //G~ ~o~
Descriptive Structure(s) on Property (i.e. brick garage, white fence, mobile home, etc):
~,~QC c~ ,~ ~ ~ 6
'Note: Ptease use the back of this torm if desired to draw us a map to the site.
g~aU[-AKEMGMT~Package tnformatiodDiroctioas by Road ForaiEoc
August 18, 2006
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