20041574 Ver 1_Complete File_20040923

O?O? W A T ?RQG
? Y
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
October 26, 2004
DWQ# 04-1574
Gaston County
Mr. Chad Plaster
8936 Glade Spring Ln., #201
Charlotte, NC 28216
APPROVAL of 401 Water Quality Certification and Authorization Certificate per the Catawba River Buffer
Protection Rules (15A NCAC 2B .0243) with Additional Conditions
Dear Mr. Plaster:
You have our approval, in accordance with the attached conditions and those listed below, to place fill
in or to otherwise impact approximately 0.009 acre of waters and 0.009 acre of protected riparian buffer for the
purpose of installing riprap along approximately 121 linear feet of shoreline on Lake Wylie, as described in your
application received on September 23, 2004. After reviewing your application, we have determined that this
project is covered by Water Quality General Certification Number 3402, which can be viewed on our web site
at http://h2o.enr.state.nc.us/ncwetlands. The General Certification allows you to use Nationwide Permit
Number 39 once it is issued to you by the U.S. Army Corps of Engineers. Please note that you should get any
other federal, state or local permits before proceeding with your project, including those required by (but not
limited to) Sediment and Erosion Control, Non-Discharge, and Water Supply Watershed regulations.
The above noted Certification will expire when the associated 404 permit expires unless otherwise
specified in the General Certification. This approval is only valid for the purpose and design that you described
in your application. If you change your project, you must notify us in writing, and you may be required to send
us a new application for a new certification. If the property is sold, the new owner must be given a copy of the
Certification and approval letter; and is thereby responsible for complying with all conditions.
In addition to the requirements of the certification, you must also comply with the following conditions:
1. No trees shall be removed from the buffer except for those along the immediate shoreline from the buffer,
and impacts to the ground cover shall be kept to a minimum during the installation of the riprap.
2. No trees shall be removed for the construction of the proposed deck.
3. Stormwater discharge points shall be constructed in a manner such that the potential receiving streams (of
the discharge) at the site will not be impacted due to sediment accumulations, scouring or erosion of the
stream banks.
4. Upon completion of the project, the applicant shall complete and return the enclosed "Certificate of
Completion" form to the 401/Wetlands Unit of the NC Division of Water Quality.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing. You
must act within 60 days of the date that you receive this letter. To ask for a hearing, send a written petition that
conforms to Chapter 150B of the North Carolina General Statutes to the Office of Administrative Hearings, 6714
o hCarolina
Nrt
Natna!!ry
North Carolina Division of Water Quality 610 East Center Ave., Suite 301 Mooresville, NC 28115 Phone [phone] Customer Service
Internet: h2o.enr.state.nc.us FAX [phone]
An Equal Opportunity/Affirmative Action Employer - 50% Recycled/10% Post Consumer Paper
Mail Service Center, Raleigh, N.C. 27699-6714. This certification and its conditions are final and binding unless
you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water Act.
If you have any questions, please telephone Alan Johnson in the Mooresville Regional Office at 704-663-1699 or
Cyndi Karoly in the Central Office in Raleigh 919-733-9721.
Sincerely,
Alan W. Klimek, P.E.
AJ/aj
Attachments
cc: Army Corps of Engineers, Asheville
Cyndi Karoly, Wetlands Unit
Central Files
MEMORANDUM
TO: John Dorney Regional Contact: Alan Johnson
Non-Discharge Branch WO Supervisor: Bex Gleason
Date:
SUBJECT: WETLAND STAFF REPORT AND RECOMMENDATIONS
Facility Name Chad Plaster
Project Number 04 1574
Recvd From APP
Received Date 9/23/04 Recvd By Region
Project Type shoreline stabilization
County Gaston
County2
Region Mooresville
Certificates Stream
Permit Wetland Wetland Wetland Stream Class Acres Feet
Type Type Impact Score Index Prim. Supp. Basin Req. Req.
GP-3-0- water & OO Y _0N F__ 11-(117) ws1V cA 30,834. 0.03 121.00
CBR rBuffers d ? ON
F-F-F-1--30,834. 0.01 r-
r
I - O Y O N I -F-rI -f x 1 -F__
Mitigation Wetland
MitigationType Type Acres Feet

Is Wetland Rating Sheet Attached? Q Y O N Did you request more info? Q Y O N
Have Project Changes/Conditions Been Discussed With Applicant? pQ Y O N
Is Mitigation required? Q YQ N Recommendation: Q Issue O Issue/fond O Deny
Provided by Region: Latitude (ddmmss) Longitude (ddmmss)
Comments:
Staff visited the site on October 21 02 04. Applicant requests approval for the installation of rip rag_
and the construction of a deck in the buffer zone.
Wave action has severly undercut the bank along the length of the lot. Trees were undermined and
layjna in the lake. No trees are to be removed except for those undermine along the shoreline.
No trees are to be removed for the construction of the deck.
MRO will issue,
cc: Regional Office
Central Office Page Number 1
MEMORANDUM
TO: John Dorney Regional Contact: Alan Johnson
Non-Discharge Branch WO Supervisor: Rex Gleason
Date:
SUBJECT: WETLAND STAFF REPORT AND RECOMMENDATIONS
Facility Name Matthews Commons Subdivision c% Centex Homes
Project Number 03 1501
Recvd From APP
Received Date 11/26/03 Recvd By Region 12/5/2003
Project Type Residential Subdivision Development
County Mecklenburg
County2
Region Mooresville
Certificates Stream
Permit Wetland Wetland Wetland Stream Class Acres Feet
Type Type Impact Score Index Prim. Supp. Basin Req. Req.
39 rHWLWT- _0N F_- 11-138-1 F _cF_ 30,838. 0.05 322.00
Mitigation Wetland
MitigationType Type Acres Feet

Is Wetland Rating Sheet Attached? 0 Y 0 N Did you request more info? Q Y 0 N
Have Project Changes/Conditions Been Discussed With Applicant? Q Y 0 N
Is Mitigation required? 0 Y (0 N
Provided by Region: Latitude (ddmmss) 35 4 8
Recommendation: OQ Issue 0 Issue/fond 0 Deny
Longitude (ddmmss) 80 43 28
Comments:
--Staff visited the site on December 151h. The applicant requests approval to impact 52 linear feet of
perennial stream , 272 If feet of intermittent stream, and .045 acre of wetland. The site is primarily-_
pasture and woodlands. The ma.ior portions of the streams on site are not to be impacted and will be
located in green space.
--Fft-two (52) If of the perennial stream along the north side of the property will be impacted by the
construction of a road crossina. The two remaining intermittent streams on site that will be im acp ted
are marginally intermittent. One might considered them to be ephemeral rather than intermittent.
Recommend approval. Issued from MRO.
cc: Regional Office
Central Office Page Number 1
Triage Check List
Date: `?- 30 . 2400%A Project Name: Ghd P kct s, /
DWQ#: 0kA t 3"14
County: Ga 5-10-N
To: ? ARO Kevin Barnett ? WaRO Tom Steffens and Kyle Barnes
? FRO Ken Averitte ? WiRO Noelle Lutheran
isu. MRO Alan Johnson ? WSRO Daryl Lamb
RRO Mike Horan
From: Telephone : (919) -733 3S14
The file attached is being forwarded to our for your evaluation.
Please call if you need asostance.
? Stream length impacted
? Stream determination
? Wetland determination and distance to blue-line surface waters on USFW topo maps
? Minimization/avoidance issues
? Buffer Rules (Neuse, Tar-Pamlico, Catawba, Randleman)
? Pond fill
? Mitigation Ratios
? Ditching
? Are the stream and or wetland mitigation sites available and viable?
? Check drawings for accuracy
? Is the application consistent with pre-application meetings?
? Cumulative impact concern
Comments: QQc?_ Z NSI off. 't'-.`fV
a[9@WWP=1
SEP 2 3 2004
DENR. WATER QUALITY
DS AND STO(tMN ATER BRANCH
The following is an abbreviated application form fo> se 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 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 Mail Service Center 041-574
Raleigh, NC 27699-1650 1. Applicant Information

1. Owner/Applicant In
Name:
Mailing Address:

Telephone Number: '7U3 (,,), 3,4 66 I Fax Number: 4 ?' y (, E! y Z I
E-mail Address: C..1-.ciL:1 g2 1,a? c-4, C u :1,7
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.
Location
County: /,iis7glj-. Nearest Town: gel rnvrg T
Subdivision name or site address (include phase/lot number): Lv
Directions to site please include road numbers, landmarks, etc. ( is is not
necessary if an adequate vicinity map is included): 1-Fl,S S r? ex T A 7 rU /_?/rnu a ?-
Lef'r, 7',,a ,-Cex, - r rom 19 . j' A-,„l ? 7? A/I/IiGY .' oc r.srr, /?f'T? n Ta
Z">s
Tyr n k f T v N Tv w,'i?,?W "Ir Dr, TU- r r i r l', ) T v r Fe ? ?? UrP t?c??oC f «
2. Describe the existing land use or condition of the site at the time of this
application: _S; r,g, ie ?cLn, I i 'U haiise
3. Property size (acres): , y 3 u Gres
4. Nearest body of water (stream/river/sound/ocean/lake):
5. Describe the purpose of the proposed work:5L re.l , a e .S -tUb /24, T, &,;,J 9' floc k
i!?fi nsTr??T,'v n
6. List the type of equipment to be used to construct the project: & e,,T IP' Ato_Pz4 49
Amount of impact (including all excavation, backfill, rip rap retaining walls,
etc..) below the normal pool lake level in square feet or acres: 3Ls
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: : n ; Mu / i 4j noc T u s r l :,j rU19 S fit .''n G a a/1
Applicant/Agent's Signature 15ate
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
b. Please describe vegetation above the normal pool lake level and 50 feet land-
ward to be impacted (number of trees for instance): /I Trees 1hv T A,,-,e hee.n c,?r
G? -r /,A, . I 1 l"-v ,rf3yr?!>;C A) uT/l e r ,'.N aA? r
Lake (Full Pond)
poc ?
O-
ax J
o a dra y
Pr
Full Pond
Shoreline
ASP
v*T'v f r G v T7rea S ?? T or,
131 fT T? ?v?1 ?an c.??
fvlip?v, rl'? rr
PC r
4? i-?„? wal/??wy
f'gp?wr?l K j
15
,1 (iID roll
!a'X
IO'P / Fu 11
r?
?1cce5 ?5
Please approximately sketch the following information on this plan
(please provider dimensions for each item, such as 10 ft. x 140 ft):
1) All proposed vegetation clearing (provide dimensions)
,2) Location of rip rap or fill to be planed above the Full Pond elevation
3) Location of rip rap or fill to be placed below the Full Pond elevation
d) The location of any proposed structures such as buildings, retaining
warns. docks, etc.
S) The location of any excavation or dredging below the Full Pond
elevation.
6) Location of construction access corridors.
S.:
`i

zzl-r
f Th-2
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 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 Mail Service Center
Raleigh, NC 27699-1650 n
w
04157 SEP 232004
1. Applicant Information I)CNR. WATER QUALITY
1. Owner/Applicant Infprrn%ion
Mailing Address:
Telephone Number:
E-mail Address: G
Fax Number: AQ r,' /i ( 3 Y9
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.
1. Location
County: [,,ast®k3
Nearest Town: RGl a2en T
Subdivision name or site address (include phase/lot number): La' _
Directions to site please include road numbers, landmarks, etc. (A is is not
necessary if an adequate vicinity map is included): T -fS S T, Q x Tcf & /rr,a•,uT
terra i 1raDvFeX,`rrar4a rIh&W'273 AeDPGY 3m Yes- ?'arn t?rTaj?T?
X73 Ql S?„c.G RYJ? _ f 1A;x, ?7 c?Ora ?rn ?/P M r /o e,?, 72 /'Slbiir?Qh?R
-'vrn kfT a»Ta Ur, rvr? r+;ShT an 7-a .hvre9-l ct'/y??(.
2. Describe the existing land use or condition of the site at the time of this
application: -5;nLe :64.,J g I'?5;?/e??T?'U? hvc??p V P?- Gons?r?z'T,'?rn
3. Property size (acres): a 6 3 aGl-ts
4. Nearest body of water (stream/river/sound/ocean/lake): Lo-ke
5. Describe the purpose of the proposed work:5Aa rt l ; n e :5±411 0:Z s T, cay? ct POG k
C0 4SkV-L?,'® n
6. List the type of equipment to be used to construct the project: ca-r' 4-Alzrap
7. Amount of impact (including all excavation, backfill, rip rap retaining walls,
etc,.) below the normal pool lake level iq square feet or acres: knorox ?l1 c
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
sc
Applicant/Agent's Signature ate
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
b. Please describe vegetation above the normal pool lake level and 50 feet land-
ward to be impacted (number of trees for instance):_ll ?roes ziw r A&.-,e hee" v J-
Lake (Full Pond)
Full Pond
Sho line'
Umf
area 17r1 y 1? /'v
ofT? ?,- 1 a ?...P / ?l l
?'Q("x ???? 7v fv????n?
fv/Iplv,'r? CvNTor
1:+c a bore
)?br

}hoc 3,"
f?GY?T,'n? watl«y
rsr? rod
4O'IC I Pore
la 'x
Oml?
ey :: ?
skate the faNwAV Wormatioo on #ft p
{Pte pfvkie dhmslons for each q„ such as 10 ft. x 100 ft);
1) M proposed vegetstlon dew (prov a dkmm* ons)
Locate of rip rup or to be plated above the Full Pond win
3) Loc h of rip rap or M to he placed below the Fun Pond dwelo n
d) The Wation "Proposed structures with bWkkvs, retM
wafts docks, etc.
6) The lc?c&Om of any oxwotion or ' ng below the Full Pond
elevetkmL
d) Location of construction ac condors.
,.,
?$ iS rhP ?oGUT,'GYl d f'7'h?
Zl T
W
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 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:
04 1 574
Division of Water Quality Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
I. Applicant Information
1. Owner/Applicant
Mailing Address:
D ?^
SEp -93204
?'? ST?R?I?ALI
?MCy
D
Telephone Number: 7a3 6,A 3 4(, C I Fax Number: ?L{ Zi l 3 Vq
E-mail Address: G. r j,-m `,a.
< L71'i?
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:
H. 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: [,,as -to j, Nearest Town: ( l'412,o n T
Subdivision name or site address (include phase/lot number): ftsl?g Pry LoT' g _
Directions to site please include road numbers, landmarks, etc. (This is not
necessary if an adequate vicinity map is included): T-V S n Q,x i T A7 ru &&",WT
/,& r__r AaW'OV.•r..-.., A .11_..17? ..__-,-.- 1- '! -- r'-- -
Turn lrfT a»Tv wl'r15 pW1,I " Dr, 7uryl r1'S hT 0,-'7 7-a S /l vre
2. Describe the existing land use or condition of the site at the time of this
3. Property size (acres): y 3 &GXcs
4. Nearest body of water (stream/river/sound/ocean/lake): L.e_?&_ U/ . t
5. Describe the purpose of the proposed work5Aur-&_1; n e S ±rA_a,' /; 2a T, tOi c OW k
Cnns7ryL?!?d n
6. List the type of equipment to be used to construct the project: &vbcu-j' 4B' Aa4aP
7. Amount of impact (including all excavation, backfill, rip rap retaining walls,
etch) below the normal pool lake level i? square feet or acres:
*ccx -3&s
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: rn ; h • Ma / ; m nac r us r i n r'a/) is-be,
n a ,/;A
Applicant/Agent's Signature )fate ' '
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
b. Please describe vegetation above the normal pool lake level and 50 feet land-
ward to be impacted (number of tree for instance): /I Tres 7fw 7' hvIe heen -
.- ., _ 11,9 )_ _ - _.. __- _I'm A/. _.-TL- - I - _ _,_
Lake (Full Pond)
OOC ?
ah 'X 3; "
Full Pond f!? T,>„? wot k Hwy
Sho line, 411X
? l
rv rd?
yr dr) y ?,;p
rd
T?- Qrear g fl' a ?•..PFu1!
I ? ,! g
O"x IC Tv fv)l Pony
fvllpP"f'' ANTr
G a 60"P
?br

a IV (a'
Dec K
,fICleS ?
Please M"Xirnately sketch the follow" formation on this plan
Olem provkle d enslo ns for each ft% such as 10 ft. x 100 ft):
1) M pi opo vege to n clearing (provide dirwnsians)
Location of rip rep or fill to be placed almme the Full P? devadon
3) Locates of rip rep or 1111 to be placed below the Fug Pond elevation
4) The location of proposed structum such as bungs, retah*V
Wells, docks, etc.
6) The location of any exca"Oon or drWding below the pull Pond
elevation.
6) Location of construction access corridors.
' /) ? bplc.,f- u/l Pore

Z,VT
A-
s ;s r?P lo?u?,-?? df'Th.e
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 of to lake bottom of less than 1 acre and $475.00 for impacts to lake bottom
of greater or equal to 1 acre. 0 4 1 5 7 4
Applications should be sent to:
Division of Water Quality Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
I. Applicant Information
0 ???a V
?D
SEP D
2 3 2004
?;Wi; - WATER
AND S10%iA UAL/Ty
RBR*M
1. Owner/Applicant
Name: (_bG
Mailing Addr
Telephone Number: 703 &A 3 ti(,6 l Fax Number: ?y ( 3 Vq 7/
E-mail Address: Gf.uc?D. C ca n?
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.
1. Location
County: [,as 7®h Nearest Town: (e lW,&r, T
Subdivision name or site address (include phase/lot number): , TPrs Lard
---?--
Directions to site please include road numbers, landmarks, etc. ? not
necessary if an adequate vicinity map is included):_I-E& S T, Q_;K i` l- A7 Tu &/m"
?a r-r r -r/dorf-ex%rL,224Q, jQ [J,& az a73 Anor?lr 3n,'/er Turn L -if- ?
/ a a ' ? >
r s
7? lO ' t r T s '
"turn ItfT anTv w?'r?5pwl"r r, Turn ?^i5hT orr 7-el shvreu rey
2. Describe the existing land use or condition of the site at the time of this
application: ; ,noLe 'elby - r GonSTruZ'T,'?vt
3. Property size (acres): . y 3 & icyes
4. Nearest body of water (stream/river/sound/ocean/lake):_/_u.ke U/.P rile__
5. Describe the purpose of the proposed work:, LO,,-- ; n e .S fah / 2u T, J2O ct pc-Gk
6Q4STrrft '-'vQ
6. List the type of equipment to be used to construct the project: B,ri eu7- 4*IAd)*,P
7. Amount of impact (including all excavation, backfill, rip rap retaining walls,
etch) below the normal pool lake level i? square feet or acres:
t - /J. A ,_. X11 L _ -AI _- L-9-._ _,
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: fn: n * ma / ,,m Del-7- us r ; a rb/) 1 t .'., a '10
b. Please describe vegetation above the normal pool lake level and 50 feet land-
ward to be impacted (number of treed for instance):. _lI ?re es 7iia 7° hyrB het" ?. ?--
G?t lc.: G? f???6tyra,.?Pfif. /?/d cflflpr 7-
Applicant/Agent's Signature 15ate
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Lake (Full Pond)
Full Pond
Sho line'
area vr1 y ?,? ro
oft)rdPr' afT a RW
?
G uTrPo
? x VI F 7a f'v)l
-llo p"110 ?Nrr
C, band
IG r
Et

la IX (a'
19M I?

Please approxirna" sketch the fo owing Information on Oft plan
Olsm provide dinnensions for each Item, such as 10 ft. x 140 ft):
1) All proposed vegetation clearing (provide dimensions)
.2) Location of rip rep or fill to be placed above the Full Pond elevation
3) Location of rip rep or fill to be placed below the Pull Pond elevation
4) The location of any proposed structures such as buildings, retaining
walls, docks, etc.
v) The location of any excavation or Wglng below the Full Pond
elevation.
6) Location of conshviction access corridors.
OO ?3a'
?Gri7,?n? Wa?/C?y
r,p rep
bylmx- v/l ford
ZVT
47
,,,
I aGUl,'GY1 d f'7?h,e
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 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 Mail Service Center
Raleigh, NC 27699-1650
041574
QLE c?2 o
SEP 2 3 2009
1. Applicant Information
1. Owner/Applicant In
Name:
Mailing Address:
D SRAN? WATER QUALITY
ORMINATER BRANCH
Telephone Number: 703 6 A 3 4 G G/ Fax Number: C zi 4 3 X19 ?
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.
1. Location
County: (a57o? Nearest Town: 8,eja ,,n T
Subdivision name or site address (include phase/lot number): I # T ,45 LyT
Directions to site please include road numbers, landmarks, etc(I is is not
necessary if an adequate vicinity map is included): I -Sd S T, ?' x ,` 1T a 7 Tu & &mawT
?s
Tern lefT a»Tv w,'r5?o,`? fir, TUr? Y'iS / T r//'7 TG' $ harel?C?iG.(.
2. Describe the existing land use or condition of the site at the time of this
application:;, eie JL4,J., !`65;,JeeT,'a1 hOUS yYA-Je -- 60y+5TrI,_C rI4
I If
3. Property size (acres): 9 3 a r-Ke-S
4. Nearest body of water (stream/river/sound/ocean/lake):_L,<A Ce UX /, le__
5. Describe the purpose of the proposed work:SLOY-ed n e .S ±ab /2u T. t" ct pw-k
CnnsTr??? ,d r,
6. List the type of equipment to be used to construct the project: ca:r
7. Amount of impact (including all excavation, backfill, rip rap retaining walls,
etc,) below the normal pool lake level in square feet or acres: &? ii-,S
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: fn: n '4v /; m iyl_ t u s r n Pa/) 1 s a s"?
b. Please describe vegetation above the normal pool lake level and 50 feet land-
ward to be impacted (number of treep for instance): 11 Tr"s 7;Iw r Aa,.e hee" LI
Applicant/Agent's Signature ate
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Lake (Full Pond)
Full Pond) y?-? ,,? wbt ky
Sho llne,,recf,?1 xr
?D i ? ??1tld?
rip
artu orgy ro ?.
?Vrdpr fr a w.PFull ?? b?l?,x full Porgy
G v7-frearrf
(fix lai ffi Ta F ?l
fvllp y?,'r+? err v.,,??r.cT,rd n
I f/ bbr-e ,f ILl eS
r
ft
Va

ZaT
1.:
1.3 The
?aGUT,'GYl d ?7'h e