20010987 Ver 1_COMPLETE FILE_20010702

F WATF
\O?O 9oG Michael F. Easley
Governor
7 William G. Ross, Jr., Secretary
Department of Environment and Natural Resources
Kerr T. Stevens
Division of Water Quality
July 5, 2001
DWQ# 01-0987
Lincoln County
Mitchell D. Sherrill
7408 Webbs Road
Denver, NC, 28037
APPROVAL of 401 Water Quality Certification
Dear Mr. Sherrill:
You have our approval, in accordance with the attached conditions, to place fill in 0.009 acre of waters in order to
stabilize the shoreline on your property on Lake Norman in Lincoln County, as described in your application received by the
Division of Water Quality on July 2, 2001. After reviewing your application, we have decided that this fill is covered by
General Water Quality Certification Number 3280, which can be viewed on our web site at
http://h2o.enr.state.nc.us/ncwetIands . This Certification allows you to use Regional Permit Number 198200030 when the
Corps of Engineers issues it. In addition, you should get any other federal, state or local permits before you go ahead with
your project including (but not limited to) Sediment and Erosion Control, Coastal Stormwater, Non-Discharge and Water
Supply Watershed regulations. Also this approval will expire when the accompanying 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. If total wetland fills for this project (now or in the future) exceed one acre, compensatory
mitigation may be required as described in 15A NCAC 2H .0506 (h). For this approval to be valid, you must follow the
conditions listed in the attached certification.
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 which conforms to
Chapter 150B of the North Carolina General Statutes to the Office of Administrative Hearings, P.O. Box 27447, Raleigh,
N.C. 27611-7447. 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 Cyndi Karoly at 919-733-9721 or Pete Colwell in DWQ's Mooresville Regional Office at
704-663-1699.
Attachment
cc: Corps of Engineers Asheville Regulatory Field Office
Mooresville DWQ Regional Office
Central Files
File Copy
Sincerely,
r V ns
010987
North Carolina Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)

o i o9 87
To: Duke Power Lake and Shoreline Management, Corp of Engineers, and John Dorney, NC Division
of Water Quality.
From: Mitchell D. Sherrill 401 ISSUED
Re: Shoreline Stabilization and Pier Permit for Lot 39 on Shady Meadow Lane, Lincoln Co., Lake
Norman, and Denver, NC. 28037
Date: June 26, 2001
In the package I have included the following:

1. Lincoln County Building Permit
2. Copies of the engineered drawings for the pier _.r .
3. Copy of an area map of Lincoln Co. indicating the location of the project
4. Copy of a map with latitude and longitude coordinates (Mapblast did not show lot 39, so I pulled up
the closest possible coordinates)
5. Copy of the NC Division of Water Quality (DWQ) Pre-Construction Notification Application.
6. Appropriate Fees: Duke Power ( $200.00 private Facilities, Shoreline Stabilization, Irrigation Pump)
and $200.00 NC Division of Water Qualities
The proposed location of the improvements is on a lot that is less than one acre (.880) and the impacted
shoreline is less than 150 feet (110-125 feet). In August of 2000 Ann Duncan met with Janet Sherrill
(Realty Agent) and myself to discuss the possibilities of a pier and stabilization on the property. The pier
and stabilization would be confined to an area that is within the property boundaries since the curvature of
the shoreline extents back into the property.
Please contact Mitch Sherrill at East Lincoln High School [phone] or at home (704) 483 - 1638 if
there are any questions.
Thank you,

Mitch Sherrill
P4rMFNr
RECc/VCU
Pk Duke
r
A D..k E-V C-p-,
December 18, 2000
Mitchell Sherrill
7408 Webbs Road
Denver, NC 28037
401 ISSUED
01 0987
RE: Shoreline Management Program Permit Application(s)
Pier/Stabilization @ Lake Norman
Dear Mr. Sherrill:
Duke Power
526 South Church Street
P.O. Box 1006
Charlotte, NC 28201-1006
Enclosed you will find the Shoreline Management Program Permit Application forms and "Duke Power's
Shoreline Management Guidelines". The purpose of the program is to comply with Federal Energy Regulatory
Commission (FERC) orders and requirements for authorizing facilities constructed inside the project boundary
of Duke's licensed lakes.
The applications will be reviewed after they have been completed and returned to Duke Power Lake
Management - EC12Q, PO Boa 1006, Charlotte, NC 28201-1006. Please use your mailing address on the
application(s) and make certain all copies of the 3-part application form are legible. No activity is allowed
inside the project boundary until you receive final written authorization from our office. The following must
accompany the permit application(s) before the review process will be initiated:
1. The completed application(s) including both proposed and existing facilities. Include the Duke Power
permit number if one has been previously assigned to an existing structure.
2. A copy of a registered survey of the property. Indicate the proposal's location from your property into the
project boundary.
3. The form describing directions by road to the proposed construction/activity, including street address and
section/lot number (if applicable), and the area of the planned construction marked on the grid map.
4. Copy of county building permit.
5. Latitude and longitude of the project site. Include a map showing the coordinates or a detailed map (USGS
quad map, city map, etc.) showing the exact location of your project site. (NOTE: Latitude/longitude
coordinates can be found on internet site, www.mapblast.com)
6. A check, payable to Duke Power, for the Duke Power application filing fee (see enclosed Duke Power fee
schedule).
FOR STABILIZATION APPLICATIONS, PLEASE NOTE THE FOLLOWING:
A COPY OF YOUR APPLICATION INCLUDING LATITUDE AND LONGITUDE COORDINATES (can be
found on internet site, wNNtiv.mapblast.com) must be sent to the Corp of Engineers at 151 Patton Avenue, Room
208, Asheville, NC 28801-5006. ADDITIONALLY, SEVEN (7) COPIES of the NC Division of Water Quality
(DWQ) Pre-Construction Notification Application and the DWQ application fee must be provided to the NC
Division of Water Quality, Attention: John Dorney, 1621 Mail Service Center, Raleigh, NC 27699-1621.
Thank you for your cooperation in working with us through the Private Facilities Permitting Program. Should
you have any questions or need further assistance please contact me at 704-382-8573 or Dennis Whitaker at
704-382-1594. You may also call our Toll Free number, 1-800-443-5193, and select the appropriate option.
Sincerely,
Ann L. Duncan
Lake Management Representative
Group Environment, Health and Safety
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DUKE POWER LAKE ]MANAGEMENT, EC12-Q
P O BOX 1006
CHARLOTTE, NC 28201-1006
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
if.
III.
n,
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B. Mailing Address
_?
1. ?r r r'%., i
C. Telephone:- 00 4 1 b 3
Location of Proposed Project
A. Lake t v^ti,
B. Street Address
C. County
D. City, town, community or landmark r, 7.
E. Section Lot #
F. _? ??-
<<_ Subdivision
erections to property ?byroad G

a map showing the coordinates or a detailed map (USGS quad map, city
`
map, etc.) showing the exact location of the project site.
coordinates can be found on internet site, www.mapblast.comm? E: Latitude/ longitude

c N-(

Latitude and longitude for the project s'te
Please submit ?? 1 1 f
Description of Project
A. Length of wall S -f
B. Material -L/ - , ?._ ` , f
C. Distance from property line/shoreline
Yittended Use of Project Area
A. Private ?
B. Commercial (''/
Applicant Signatur q
Date ( •-_? ?
PLEASE NOTE THE FOLLOWING:
• A COPY OF THE COMPLETED APPLICATION WITH A ROAD MAP SHOWING LOCATION OF
THE PROPERTY MUST BE SUBMITTED TO: USARMYCORPS OFENGINEERS, ISI
PATTONAVE. -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
SUBMITTED WITH THE DIVISION OF WATER QUALITY APPLICATION FEE TO:
NC DIVISION OF WA TER QUALITY
ATTENTION- JOHN DORNEY
1621 MAIL SERVICE CENTER
RALEIGH, NC 27699-1621
919-733-1786
1 11101M.Ssh
2x4 RAILING CAP
X4 POSTS
Z PICKETS
4 O.C. MAX

GALVANIZED
JOIST HANGER
N A-A & Al -A 1
JOIST CONNECTION AND HANDRAIL DETAIL
ANDRAILS NOT REQUIRED
NER DECK (SECTION Al-Al)
7-24-
ISIONS DRN DATE HKD DATE
SECTION B-B
TYPICAL PILING-TO-FRAMING
BOLT DETAIL
PIER SYSTEM
MITCH SHERRILL
LOT #39 SHADY MEADOW LANE
LINCOLN COUNTY, NC
SECTIONS AND DETAILS
-24-ma ea or -14
-00 ?? sq opt
DATE ?
Ms DWG. N0. MS-001
OSTS ANd
AILING

4x4 RAILING POSTS, 4 SPACES ® 4'-5"f
LOCATED AROUND ALL EDGES OF DECK
UPPER DECK
SCALE: 1 "-4'
HANDRAILS AND DECKING
NOT SHOWN FOR CLARITY
4x4 POSTS AND
RAILING
1
2x4 RAILING CAP
>•x4 POSTS
2 PICKETS
4° o.c. MAX

GALVANIZED
JOIST HANGER
GALV ANGLE
W/ 4 HODS
GALV. BO?TS
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DETAIL 4

s
SECTION A-A & Al -Al
TYPICAL JOIST CONNECTION AND HANDRAIL DETAIL
NOTE: HANDRAILS NOT REQUIRED
FOR LOWER DECK (SECTION Al-Al)

O CHANGED H.R. POST SPACING
RELEASED OR CONSTRUCTION

REVISIONS SMC
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DRN 7-24-00
7-14-00

DATE

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APP -24-00

7-14-00
DATE
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DEL) r 3'-10" t
NOTE: ALL FRAMING FOR UPPER
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ALL JOISTS MAY BE 2x12s
;KING
-ARITY
7-- 2-2x12's
3x3xY4" GALV ANGLE
-4" LONG W/ 4 HOLES
FOR %'*0 GALV. BOLTS
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ENGINEERING
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4x4 RAILING POSTS, 4 SPACES C,
LOCATED AROUND ALL EDGES OF-
I
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iKY4" GALV AN LE
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Ye"0 GALV. BO S
UPPER DECK
SCALE: 1 "-4'
HANDRAILS AND DECKING
NOT SHOWN FOR CLARITY
I
DETAIL 4
NOTE: ALIGN JOIST AND 4x4 NUiS
r
(SUPPORTS FOR STAIRS TO SECOND LEVEL)
2-20 2's
3x3y)4' GALV ANGLE
4" LONG W/ 4 HOLES
FOR -%"o GALV. BOLTS
I
DETAIL 1
TYPICAL AT
FRAMING CORNERS
BOTTOM DECK
SCALE: 1 "=4'
HANDRAILS AND DECKING
NOT SHOWN FOR CLARITY
DETAIL 2
TYPICAL AT
FRAMING 'T' JOINTS
WORLDWIDE ENGINEERING
CONSULTING ENGINEERS & PLANNERS
6009 SOUTH NC HIGHWAY 16
MAIDEN, N.C. 28650-9033 USA
PHONE [phone] FAX: [phone]
EMail: hgnmckay®bellsouth.net
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4x4 RAILING POSTS, 4 SPACES ® 4'-5"f
LOCATED AROUND ALL EDGES OF DECK
UPPER DECK
SCALE: 1 "=4'
HANDRAILS AND DECKING
NOT SHOWN FOR CLARITY
14x4 POSTS ANd
RAILING
s

SEE DETAIL 1
8'-3"
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1 6'-11" 5
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DOUBLE BAND 2x12s
13'-9"
12'-0"
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SEE DETAIL 3
7
2x8 IST
® 1 0.
12
11'-0"t
22'-0"
NOTE: ALIGN JOIST AND 4x4 Puvs
(SUPPORTS FOR STAIRS TO SECOND LEVEL)
BOTTOM DECK
SCALE: 1"=4'
HANDRAILS AND DECKING
NOT SHOWN FOR CLARITY
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NOTE: ALL FRAMIt
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ALL JOISTS MAY
LINCOLN COUNTY
Building and Land Development
302 North Academy Street
Lincolnton, NC 28092
-------
Application Number ---------
.
.
---------------------------
.
01 1067
-----------------
Property Address
. . . . . .
SHADY MEADOW Date 5/03/01
PIN . LANE
Parcel ID . . • . • • 4615 -10 -35 -0974 -
Application description 72821

Subdivision Name PIERS
_
Property Use . . . .

Property Zoning . . . .
Application valuation _
*SINGLE FAMILY DISTRICT
. . . . 3000
Owner

------------------------ Contractor

BRIDGEWATER COMPANY LLC _

PO BOX 3608 CALLAWAY HOMES INC/TRIPP
MOORESVILLE P O BOX 448
NC 28117
DENVER
NC 28037
------ Structure information 900 SQ FT PIER04) 483-1419
r
Other struct info . . . . . BP TOTAL SQFT
EXISTING USE 900.00
PROPOSED USE RES

--- LENGTH OF STRUCTURE
IER
P27

Permit BUILDING
Additional desc . . ---------------------
PERMIT - RESIDENTIAL _________
Permit Fee . . . . 30. 00
Issue Date 5/03/01
_____________ Valuation
__ 3000

Other Fees ----------------
___
__________

• • • • • .
ZONING RESIDENTIAL ___ _
25.00
Fee summary Charged Paid
Credited
-------- _ Due

Permit Fee Total
30.00 ---------- -
30
00 ---------

Other Fee Total 25.00
.
.00
25
00
.00
Grand Total 55.00 .
'00
55
00 •00
.
.00 .00
b
------------------------------------------- ___
Building inspections must be scheduled the da
inspection. Please call for inspections to 7y prior O 736-8434.
Calls after 3:00 PM will not be scheduled for the next days
activity.
DUKE POWER 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
PO BOA; 1046
CHARLOTTE, NC 28201-1006
1-800-443-5193
Applicant's Name: ro I }'(_1k' O. h rV, ; I
Street Address (at lake): 1(1C1? I rl?
Lake Name: LI r-- ?J r f'r-& r\
Subdivision Name: ?J Z, t,-, _c
Property Section: Lot # .:?, C\1
City: I) C ? \ v-i \ County: L- 1 KL-0
State: L? c zip:
Telephone: y 31 .2? ,3f
Type of Permit Requested
"Circle":
(Lrivate Facility
Commercial Facility
Excavation
?tabi Izal` n?
Conveyance
??tiscel laneous?l.lses
Directions (from major road or highway):
? 1 ? 1 \
(D}e1scriptive Structure on Property (i.e. brick garage, white fence, mobil ho e, etc):
C\,,- -& 10_ ??.ih1 Iwo l.a?i ?I `, V"tvr1
1 ct >? 1
V, C-1 C,
'Note: Please use (lie back of this form if desired to draw us a neap to the site.
GPAIA AKENIGM I71.MI'1'M/1)IILIV I10N'? IxX' lillccti?c 1)etr 11/15/1)s
DUKE POWER COMPANY
P O BOX 1006
EC-12Q
CHARLOTTE, NC 28201-1006
704-382-1567 OR TOLL FREE 1-800-443-5193
APPLICATION FOR PERMIT TO STABILIZE THE SHORELINE
Please type or print and fill in all blanks. If information is not applicable, so indicate by
placing N/A in blank. PLEASE SUBMIT APPROPRIATE FILING FEE, PAYABLE
TO DUKE POWER COMPANY.
1.
U.
Applicant Information
A. Name f YI i L el l
B. Address " y eb s
C. Telephone: ( D y 73 - I L
Location of Proposed Project
A.
C.
D.
E.
L0-W
M. Descri
IV.
V.
?B
f9?°
County L N C.0I ?,.,
City, town, community or landmark
Lake pr rn a o .
Section Lot q
Direction ``,,tott11 property by road
``
e-rr, I
0

A. Length of wall

,B. Material V -G, a- Q, c ?" V-
C. Distance from property line/shoreline. 3 4J
Intended Use of Project Area
A. Private_ pf '1 VJ'( .
B. Commercial Ki/A
Applicant Signature It Date _ • -?? - C. )
PLEASE SUBMIT COPY OF APPLICATION TO:
US ARMY CORPS OF ENGINEERS
151 PATTON AVE. - ROOM 143
ASHEVILLE, NC 28801-5006
a Fo.2')
DWQ ID: _ CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #)_
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN (7)
ATTN: JOHN DORNEY 4401 REEDY CREEK ROAD RALEIGH NC
27607. PLEASE PRINT OR TYPE.
1. OWNER'S NAME: --M .I tL k 1 0 I t v^ i 1,
2. MAILING ADDRESS: bb 5 RC-x
SUBDIVISION NAME
CITY: -STATE: _ ZIP CODE:- J),eM vc.r
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE): L,o }- 3 q s 6x t Ov-,,?ew 1-N?. Q-ai-, ve- ,
3. TELEPHONE NUMBER: (HOME) _ (WORK) 14 d3 _ sbg 1
4. IF APPLICABLE: AGENTS NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: NEAREST TOWN: _
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.) -
6. IMPACTED OR NEAREST STREAM/RIVER: _ RIVER BASIN: _ L'c? ii Or Tv- t
7. (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA),
HIGH QUALITY WATERS (HQW), OUTSTA ING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-1I)? YES E] NO Lq-TF EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES Q NO ly
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION?
(a) HAVE ANY SECTIO 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES E] NO IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION): _
(b) ARE ADDIT NAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES E] NO IF YES, DESCRIBE ANTICIPATED WORK:
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: L QS S
-N,, 1Cie re
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE: <V?Fj S
00xiL.
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: EXCAVATION: _
FLOODING: _ OTHER : _
DRAINAGE : _ TOTAL ACRES TO BE IMPACTED:
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: _ FT AFTER: _ FT
WIDTH BEFORE (based on normal high water contours): _ FT }JI'
AVERAGE DEPTH BEFORE. - FT AFTER: FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: _ PLACEMENT OF PIPE M CHANNEL: _
CHANNEL EXCAVATION: _ CONSTRUCTION OF A DAM/FLOODING:
OTHER: - r7
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? WHAT IS THE EXPECTED POND SURFACE AREA?
0 -
12. DESeRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 11 DRAWINGS ONLY)
13. PURPOSE OF PROPOSED WORK: *f I V`C-? ? I Q?- r IS `Orl-
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT,A;R? THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: ro
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WI IICI I MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED-. ICJ A
17. DOES THE PROJECT INVOLV AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF
PUBLIC (STATE) LAND? YES [10 [:] (IF NO, GO TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES Q NO 0
(b) IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES 0 NO 0
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL MATERIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14,18,21,26,29, AND 38).
ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OF 1 INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
(d) ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
(e) VtHAT IS LAND USE OF SURROUNDING PROPERTY? _
(f) IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
I . ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLIWACOASTAL MANAGEMENT
PROGRAM, to A\ i 1 I n C-) n, II
OWNER'S/AGENT'S SIGNATURE DATE
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(AGENTS SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).

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13

Form 398578(R9-85)
SHORELINE MANAGEMENT PROGRAM
PERMIT APPLICATION FORM
NC 1 SC 2
Co. No
Lake o r rYla PJ
APPLICANT
Name: t f?
Address: :2L
I.D. No
Utility Co. Aky,_
Previously Form 06940
Permit No.
Grid Sect.
Ownership: Ownership: 1(5 Lease

Telephony
Signature
Circle the appropriate number below
Ramp &
Marine Shoreline
Pier Railway Boathouse Stabilization Other
USE:
1. Individual 1) 1 1 Q
2. Common 2 2 2 2
STATUS:
1. Existing 1 1 1 1
2. Proposed © 2 2 Q
MATERIALS:
1. Concrete 4. Treated wood 1 1 1 4 1 C
2. Masonry 5. Untreated wood 2 5 3 2 5 2
3. Metal 6. Other 3 0) 6 3 6 3 oc
FLOTATION: ha
1. Plastic cylinders 1 1
2. Styrofoam 2 2
3. Other 3 3
TYPE OF FACILITY:
1. Permanent 1 ('?
2. Floating 2 2
3. Combination 3 3
Fig. 1

Fig. 2
Pier Dimensions: See Figure Above
Condition of Pier: ? Good ? Fair
Permitted: ? Yes ? No Date:
information:
By:
I"
v ;tY •:7kiI Z y<
COMMON USE PERMIT
If this application is for the common use of a facility, those parties using the facility appoint the individual listed in the
applicant section of this form as the agent applying for the permit. All parties using the facility must sign below.
Name Date Address
t -- _ d 7 11
Fig. 3 Fig. 4 Fig. 5 Fig. 6 (other)
Pier surface area sq. ft.
Float surface area D 1v? sq. ft.
? Poor