20200340 Ver 1_PCN Form Submission_20200304

DWR
mrlslon of Water Resources
Pre -Construction Notification (PCN) Form
September 29, 2018 Ver 3
Initial Review
Has this project met the requirements for acceptance in to the review process?*
r Yes
r No
Is this project a public transportation project?*
G Yes r No
Change only if needed.
BIMS # Assigned
20200340
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Reviewing Office *
Nboresville Regional Office - [phone]
Information for Initial Review
1a. Name of project:
Cowans Ford Floating Bulkhead Ramp and Storage Project
1a. Who is the Primary Contact?*
Tony Nardo
1b. Primary Contact Email:*
[e-mail]
Date Submitted
3/4/2020
Nearest Body of Water
Lake Norman
Basin
Catawba
Water Classification
WS-N, B, CA
Version#*
1
What amout is owed?*
IT $240.00
r $570.00
Select Project Reviewer*
Alan Johnson:eads\adjohnson1
1c. Primary Contact Phone:*
[phone]
Site Coordinates
Latitude: Longitude:
35.441845-80.960761
A. Processing Information U
County (or Counties) where the project is located:
Lincoln
Is this project a public transportation project?*
r Yes r No
1a. Type(s) of approval sought from the Corps:
W Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What type(s) of permit(s) do you wish to seek authorization?
* Nationwide Permit (NWP)
* Regional General Permit (RGP)
7 Standard (IP)

1c. Has the NWP or GP number been verified by the Corps?
r Yes r No
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
r 401 Water Quality Certification - Regular
r Non-404 Jurisdictional General Permit
r Individual Permit
36 - Boat Ramps
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR401 Certification:
For the record only for Corps Permit:
V 401 Water Quality Certification - E)press
V Riparian Buffer Authorization
1f. Is this an after -the -fact permit application?*
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
Acceptance Letter Attachment
1h. Is the project located in any of NC's twenty coastal counties?
r Yes r No
1j. Is the project located in a designated trout watershed?
r Yes r No
B. Applicant Information
1d. Who is applying for the permit?
r Owner W Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
r Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
Duke Energy Corp; DUKE POWER CO REAL EST DV
2b. Deed book and page no.:
1221-329,393-297
2c. Responsible party:
Michael Brissie - Duke Energy Carolinas, LLC
2d.Address
Street Address
257 Duke Lane
Address Line 2
City
Stanley
Postal / Zip Cate
28164
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
State / Province / Region
NC
Country
USA
2f. Fax Number:
r Yes r No
r Yes r No
3a. Name:
Joseph Arcella, PE, PMP

3b. Business Name:
Duke Energy Carolinas, LLC
3c.Address
Street Address
257 Duke Lane
Address Line 2
City
Stanley
Postal / Zip Code
28164
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Tony Nardo
4b. Business Name:
HDR Engineering of the Carolinas
4c.Address
Street Address
440 South Church Street, Suite 900
Address tine 2
City
Charlotte
Postal / Zip Code
28202
4d. Telephone Number:
[phone]
4f. Email Address:*
a nthony. n a rdo@hd ri nc. com
Agent Authorization Letter*
Signed Agent Cert of Auth Form 03032020.pdf
State / Province / legion
NC
Country
USA
3e. Fax Number:
State / Rmince / legion
NC
Country
USA
4e. Fax Number:
20.31 KB
C. Project Information and Prior Project History C^U
1. Project Information
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/ town:
Lowesville
2. Project Identification
2a. Property Identification Number:
78530; 56191
2c. Project Address
Street Address
Address Line 2
city
Postal / Zip Code
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Lake Norman
3b. Water Resources Classification of nearest receiving water:*
WS-N, B; CA
2b. Property size:
45
State / Rmince / legion
Country

3c. What river basin(s) is your project located in?*
Catawba
3d. Please provide the 12-digit HUC in which the project is located.
030501011204
4. Project Description and History
4a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application:*
Approbmately 45.0 -acre site comprised of an eAsting rip rap levee, maintained grass area, and roadside right-of-way. Land use in the vicinity of the proposed Project consists of
residential, power generation, and open water/recreational uses.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r Yes r No r Unknown
4d. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR)
03_CovensFord_Topo_PCN.pdf 368.21<13
4e. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR)
04_CowansFord_Soils _PCN.pdf 326.32KB
4f. List the total estimated acreage of all existing wetlands on the property:
0
4g. List the total estimated linear feet of all existing streams on the property:
0
4h. Explain the purpose of the proposed project:*
Install a storage area and launch ramp for a floating bulkhead, as well as an associated access road.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
A concrete storage pad and launch ramp will be installed using conventional construction techniques and equipment. A layer of rip rap will be installed with a layer of crushed stone on
top of that to form a base. Concrete will then be installed on the base for the rails to be mounted to.
4j. Please upload project drawings for the proposed project.
09_lmpact_Figure _20200224.pdf 367.93KB
10_TC_Figure.pdf 9.9MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No O Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved r Not Verified r Unknown r N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
5d1. Jurisdictional determination upload
6. Future Project Plans
6a. Is this a phased project?*
r Yes r No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed projector related activity?
FD. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
r Wetlands r Streams -tributaries r Buffers
W Open Waters r Pond Construction

4.Open Water Impacts
4a. Site #
4a1. Impact Reason
4b. Impact type
4c. Name of waterbody 4d. Activity type :114e.
Waterbody type
4f. Impact area
P1
Launch Ramp
P
Lake Norman
Fill
Lake
0.14
4g. Total temporaryopen water Impacts: 4g. Total permanent open water impacts:
0.00 0.14
4g.Total open water impacts:
0.14
4h. Comments:
Permanent fill impacts, belowfull pond elevation of 760 ft, associated with the proposed launch ramp, have the following volume totals: concrete =
183.3 cubic yards (cy); Class A rip rap = 1,111.7 cy; #57 stone = 162.4 cy, Class 1 rip rap = 100.1 cy; total fill = 1,557.5 cy.
E. Impact Justification and Mitigation v
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The project was designed for the launch ramp to be as small as practicable to reduce footprint. All concrete slabs for the launch ramp will be poured in
upland areas and then installed, no live concrete will be poured into the lake.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Live concrete will not be allowed to enter the waterway and all appropriate erosion and sediment control device will be installed and maintained
throughout the duration of the project. A turbidity curtain will be utilized during construction of the ramp to minimize sediment dispersal (Figure 10).
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for impacts to Waters of the U.S. or Waters of the State?
r Yes f• No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
% mitigation is proposed. According to Regional Condition 23, open water impacts are designed to result in no more than minimal adverse effects.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
r Yes C No
If no, explain why:
The existing buffer area is maintained and devoid of woody vegetation.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes C No
2b. Does this project meet the requirements for low density projects as defined in 15ANCAC 02H .1003(2)?
C Yes r No
Comments:
The project impacts do not exceed the 30 % impervious surface threshold.
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
r Yes C No
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)? *
r Yes C No
3. Cumulative Impacts (DWR Requirement)

3a. Will this project result in additional development, which could impact nearby downstream water quality?*
r Yes r No
3b. If you answered "no," provide a short narrative description.
The ramp will be used for the deployment of a floating bulkhead for the inspection of the nearby dam.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r Nor NIA
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or habitat?*
r Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No
5c. If yes, indicate the USFWS Field Office you have contacted.
Asheville
5d. Is another Federal agency involved?*
r Yes r No
5e. Is this a DOT project located within Division's 1-8?
r Yes r No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
r Yes r No
5g. Does this project involve bridge maintenance or removal?
r Yes r No
5h. Does this project involve the construction/installation of a wind turbine(s)?'
r Yes r No
r Unknown
51. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
r Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
IPac and NCNHP Data E)Vlorer
Consultation Documentation Upload
Cowans_USFWS_20200224.pdf 2.81 MB
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
NOAA Essential Fish Habitat Online Mapper
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal governments have designated as having historic or cultural preservation status?*
r Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
NIPS National Register of Historic Places (NRHP) GIS Public Dataset and the N.C. Historic Preservation Office HPOWEB GIS Web Service
7c. Historic or Prehistoric Information Upload
Cowans_Ford_SHPO_20200224.pdf 1.68MB
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-yearfloodplain?*
r Yes r No
8b. If yes, explain how project meets FEMA requirements:
A No -Rise Certificate has been submitted to Lincoln County. Project activities will not increase the base flood elevation.
8c. What source(s) did you use to make the floodplain determination?*
FEMA FIRM Panel 4612K
Miscellaneous
6

Comments
Miscellaneous attachments not previously requested.
01_CowansFord_Vicinity.pdf
353.03KB
02_CowansFord_Aerial _v2. pdf
368.81 KB
05_CowansFord_NCLD.pdf
357.07KB
06_CowansFord_Cultural.pdf
246.76KB
07_CovransFord_Flood.pdf
442.42KB
08_CowansFord_WOUS.pdf
323.29KB
Floodplain Development Permit Application_20200302.pdf
1.66MB
Signature
® By checking the box and signing below, I certify that:
• I have given true, accurate, and complete information on this form;
• I agree that submission of this PCN form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act');
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act');
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
• I intend to electronically sign and submit the PCN form.
Full Name:
Tony Nardo
Signature
is,kl Alardo
Date
3/4/2020

PATH: \\CLT-SRV02\GIS\PROJECTS\DUKE_ENERGY\10185727_CWF_FLOATING_BULKHEAD\7.2_WIP\MAP_DOCS\MXD\PERMIT\01_COWANSFORD_VICINITY.MXD - USER: ANARDO - DATE: 2/12/2020
COWANS FORD FLOATING BULKHEAD RAMP AND STORAGE AREA
FIGURE 1
PROJECT VICINITY
SECTION 401/404 PCN
(CLIENT LOGO)
0 1.5Miles
O
DATA SOURCE: ESRI OpenStreetMap andthe GIS User Community
LEGEND
Study Area (45.00 acres)
NC
Lincoln County
Study Area
PATH: \\CLT-SRV02\GIS\PROJECTS\DUKE_ENERGY\10185727_CWF_FLOATING_BULKHEAD\7.2_WIP\MAP_DOCS\MXD\PERMIT\02_COWANSFORD_AERIAL.MXD - USER: ANARDO - DATE: 2/12/2020
COWANS FORD FLOATING BULKHEAD RAMP AND STORAGE PROJECT
FIGURE 2
PROJECT AERIAL
SECTION 401/404 PCN
(CLIENT LOGO)
0 1,500Feet
O
DATA SOURCE: Bing Hybrid Aerial Imagery
LEGEND
Study Area (45.00 acres)
Parcel
LAKE NORMAN SOUTH
PATH: \\CLT-SRV02\GIS\PROJECTS\DUKE_ENERGY\10185727_CWF_FLOATING_BULKHEAD\7.2_WIP\MAP_DOCS\MXD\PERMIT\03_COWANSFORD_TOPO.MXD - USER: ANARDO - DATE: 2/12/2020
COWANS FORD FLOATING BULKHEAD RAMP AND STORAGE PROJECT
FIGURE 3
USGS TOPOGRAPHIC QUADRANGLE
SECTION 401/404 PCN
(CLIENT LOGO)
0 2,000Feet
O
DATA SOURCE: USGS 24K Topographic Maps:Lake Norman South (1993); USA Topo Map GISService
LEGEND
Study Area
Topgraphic Quadrangle
PATH: \\CLT-SRV02\GIS\PROJECTS\DUKE_ENERGY\10185727_CWF_FLOATING_BULKHEAD\7.2_WIP\MAP_DOCS\MXD\PERMIT\04_COWANSFORD_SOILS.MXD - USER: ANARDO - DATE: 2/12/2020
COWANS FORD FLOATING BULKHEAD RAMP AND STORAGE PROJECT
FIGURE 4
NRCS SOIL SURVEY OF LINCOLN & MECKLENBURG COUNTIES, NORTH CAROLINA
SECTION 401/404 PCN
(CLIENT LOGO)
0 1,000Feet
O
DATA SOURCE: USDA NRCS Soils Survey ofLincoln County NC and Mecklenburg Couty(2019); Bing Hybrid Aerial Imagery
LEGEND
Study Area
Soil Map Unit
Hydric Rating
1 - 32%
66 - 99%
CeB2 –Cecil sandy clay loam, 2 to 8 percent slopes, moderately erodedPeC2–Pacolet sandy clay loam, 8 to 15 percent slopes, moderately erodedPeC2–Pacolet sandy clay loam, 8 to 15 percent slopes, moderately erodedUd–Udorthents, loamy
PaD –Pacolet sandy loam, 15 to 25 percent slopes
On-Site Soils LincolnMecklenburg
PATH: \\CLT-SRV02\GIS\PROJECTS\DUKE_ENERGY\10185727_CWF_FLOATING_BULKHEAD\7.2_WIP\MAP_DOCS\MXD\PERMIT\05_COWANSFORD_NCLD.MXD - USER: ANARDO - DATE: 2/12/2020
COWANS FORD FLOATING BULKHEAD RAMP AND STORAGE PROJECT
FIGURE 5
NATIONAL LAND COVER DATABASE 2016 LAND COVER
SECTION 401/404 PCN
(CLIENT LOGO)
0 2,000Feet
ODATA SOURCE: National Land Cover Database, (2016).Multi-Resolution Land Characteristics (MRLC) Consortium,US Geological Survey
LEGEND
Study Area
Open Water
Developed, Open Space
Developed, Low Intensity
Developed, Med. Intensity
Developed, High Intensity
Barren Land (Rock/Sand/Clay)
Deciduous Forest
Evergreen Forest
Mixed Forest
Shrub/Scrub
Grassland/Herbaceous
Pasture/Hay
Cultivated Crops
Woody Wetlands
""
*#
$$
$$$$
$$
*#
*#
$$
$$$$
LN0797 J. P. Hager House
MK1783 Gen William Lee Davidson Mini Park (Approximate site)
LN0602 Cowans Ford Dam
LN0544 Log House LN0547 McLean-Pitts Gin House
LN0543 Sifford-Hager Farmstead
LN0559 Martha's Chapel and Cemetery
LN0545 Dr. William B. McLean Outbuildings (McLean-Sifford Farm)
PATH: \\CLT-SRV02\GIS\PROJECTS\DUKE_ENERGY\10185727_CWF_FLOATING_BULKHEAD\7.2_WIP\MAP_DOCS\MXD\PERMIT\06_COWANSFORD_CULTURAL.MXD - USER: ANARDO - DATE: 2/12/2020
COWANS FORD FLOATING BULKHEAD RAMP AND STORAGE PROJECT
FIGURE 6
CULTURAL RESOURCES
SECTION 401/404 PCN
(CLIENT LOGO)
0 2,000Feet
ODATA SOURCE: NCHPOWEB GIS database;National Park Service, NRHP GIS Public Dataset
LEGEND
Study Area
1-Mile Buffer
NC SHPO National Register
DOE
NC SHPO Points
""Study List individual entry
*#Determined Eligible - DOE
$$Surveyed Only
PATH: \\CLT-SRV02\GIS\PROJECTS\DUKE_ENERGY\10185727_CWF_FLOATING_BULKHEAD\7.2_WIP\MAP_DOCS\MXD\PERMIT\07_COWANSFORD_FLOOD.MXD - USER: ANARDO - DATE: 2/12/2020
COWANS FORD FLOATING BULKHEAD RAMP AND STORAGE PROJECT
FIGURE 7
NHD, NWI, AND FEMA FLOOD ZONES
SECTION 401/404 PCN
(CLIENT LOGO)
0 1,000Feet
ODATA SOURCE: FEMA National Flood Hazard Layer(NFHL); USGS National Hydrography Dataset (NHD);NCDEQ DWQ Surface Water Classifications GIS;USFWS National Wetlands Inventory (NWI)
LEGEND
Study Area
USGS NationalHydrography Dataset
USFWS National WetlandsInventory Dataset
Lake Norman 760 ft Line
NCDEQ Surface WaterClassification
WS-IV,B;CA
WS-IV;CA
FIRM Panel
FEMA Data
100-Year Flood Zone
500-Year Flood Zone
PATH: \\CLT-SRV02\GIS\PROJECTS\DUKE_ENERGY\10185727_CWF_FLOATING_BULKHEAD\7.2_WIP\MAP_DOCS\MXD\PERMIT\08_COWANSFORD_WOUS.MXD - USER: ANARDO - DATE: 2/12/2020
COWANS FORD FLOATING BULKHEAD RAMP AND STORAGE PROJECT
FIGURE 8
DELINEATED WATERS OF THE U.S.
SECTION 401/404 PCN
(CLIENT LOGO)
0 1,500Feet
O
DATA SOURCE: Bing Hybrid Aerial Imagery
LEGEND
Study Area
Lake Norman 760 ft Line
Topographic Contours (2 ft)
P1 - Lake Norman
County Of Lincoln, North Carolina
Planning & Inspections Department

302 North Academy Street, Suite A, Lincolnton, North Carolina 28092 • Telephone [phone] • Fax [phone]

Floodplain Development Permit Application
(Please type or print)

SECTION I: General Provisions (APPLICANT READ AND SIGN)

1. No work of any kind may start until a permit is issued.

2. The permit may be revoked if any false statements are made herein.

3. If revoked, all work must cease until permit is re-issued.

4. Development shall not be used or occupied until a Certificate of Compliance is issued.

5. The permit will expire if no work is commenced within six months of issuance.

6. Applicant is hereby informed that other permits may be required to fulfill local, state, and
federal regulatory requirements.

7. Applicant hereby gives consent to the Local Administrator or his/her representative to make
reasonable inspections required to verify compliance.

8. THE APPLICANT, CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO THIS
APPLICATION ARE, TO THE BEST OF MY KNOWLEDGE, TRUE AND ACCURATE.

_____________________________________________________ ______________________________
(Applicant’s Signature) (Date)

SECTION 2: Proposed Development (To be completed by the APPLICANT.)
NAME ADDRESS TELEPHONE NUMBER
1. Applicant:
_______________________________________________________________________________
2. Builder:
_______________________________________________________________________________
3. Engineer:
_______________________________________________________________________________
PROJECT LOCATION:
To avoid delay in processing the application, please provide enough information to easily identify
the project location. Provide the street address, lot number or legal description (attach) and,. A
sketch attached to this application showing the project location would be helpful.
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
2 of 4
DESCRIPTION OF WORK (Check all applicable boxes):
A. STRUCTURAL DEVELOPMENT
Activity Structure Type
[ ] New Structure [ ] Residential (1-4 family)
[ ] Addition [ ] Residential (more than 4 family)
[ ] Alteration [ ] Nonresidential (Flood-proofing? [ ] Yes)
[ ] Relocation [ ] Combined Use (residential & commercial)
[ ] Demolition [ ] Manufactured (Mobile) Home
[ ] Replacement (In Manufacture Home Park? [ ] Yes)

ESTIMATED COST OF PROJECT: $_____________________

B. OTHER DEVELOPMENT ACTIVITIES
[ ] Clearing [ ] Fill [ ] Mining [ ] Drilling [ ] Grading
[ ] Excavation (except for structural development checked above)
[ ] Watercourse Alteration (including dredging and channel modifications)
[ ] Drainage Improvements (including culvert work)
[ ] Road, Street, or Bridge Construction
[ ] Subdivision (new or expansion)
[ ] Individual Water or Sewer System
[ ] Other (Please specify):
____________________________________________________________________
After completing Section 2, APPLICANT should submit form to the Local Administrator for review.

SECTION 3: Floodplain Determination (To be completed by the LOCAL ADMINISTRATOR.)
The proposed development is located on
FIRM Panel No. ________________________ Dated ________________

The proposed development:
[ ] Is NOT located in a Special Flood Hazard and NO FLOODPLAIN DEVELOPMENT PERMIT IS
REQUIRED).
[ ] Is partially located in the SFHA, but building/development is not.
[ ] Is located in a Special Flood Hazard Area. FIRM zone designation is __________.
“100-year” flood elevation at the site is: ______ft. NGVD (MSL)
[ ] unavailable
[ ] Is located in the floodway.
[ ] See Section 4 for additional instructions.
Signed ________________________________________________ Date _____________________

3 of 4
SECTION 4: Additional Information Required
(To be completed by LOCAL ADMINISTRATOR.)

The applicant must submit the documents checked below before the application can be
processed:

[ ] A site plan showing the location of all existing structures, water bodies, adjacent road, lot
dimensions, and proposed development.
[ ] Development plans, drawn to scale, and specifications, including where applicable: details for
anchoring structures, proposed elevation of lowest floor (including basement), types of
water-resistant materials used below the first floor, details of flood-proofing of utilities
located below the first floor, and details of enclosures below the first floor.
Also,_____________________________________________________________________
_________________________________________________________________________
[ ] Subdivision or other development plans. (If the subdivision or other development exceeds 50
lots or 5 acres, whichever is the lesser, the applicant must provide “100-year” flood elevations if
they are not otherwise available.)
[ ] Plans showing the extent of watercourse relocation and/or landform alterations.
[ ] Change in water elevation (in feet) ____________.
[ ] Meets ordinance limits on elevation increases.
[ ] Yes [ ] No
[ ] Top of new compacted fill elevation ___________ft. NGVD (MSL).
[ ] Flood-proofing protection level (nonresidential only) ____________ft. NGVD (MSL). For flood -
proofed structures, applicant must attach certification from registered engineer or architect.
[ ] Certification from a registered engineer that the proposed activity in a regulatory floodway will
not result in any increase in the height of the “100-year” flood. A copy of all data and
hydraulic/hydrologic calculations supporting this finding must also be submitted.
[ ] Other:
_______________________________________________________________________________
_______________________________________________________________________________

SECTION 5: PERMIT DETERMINATION (To be completed by LOCAL ADMINISTRATOR.)
I have determined that the proposed activity:
A. [ ] Is
B. [ ] Is not
in conformance with provisions of Local Law #_________, 19____. The permit is issued subject to
the conditions attached to and made part of this permit.
Signed ___________________________________________________ Date _________________

A. If Box A is checked, the Local Administrator may issue a Development Permit upon payment of
designated fee.
B. If Box B is checked, the Local Administrator will provide a written summary of deficiencies.
Applicant may revise and resubmit an application to the Local Administrator or may
request a hearing from Board of Appeals.

4 of 4

APPEALS: Appealed to Board of Appeals? [ ] Yes [ ] No
Hearing date: ________________________________

Appeals Board Decision – Approved? [ ] Yes [ ] No

Reasons/Conditions: ____________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

SECTION 6: AS-BUILT ELEVATIONS
(To be submitted by APPLICANT before Certification of Compliance is issued.)
The following information must be provided for structures that are part of this application. This
section must be completed by a registered professional engineer or a licensed land surveyor (or
attach a certification to this application). Complete 1 and 2 below:

1. Actual (as-built) elevation of the top of the lowest floor, including basement (in Coastal High
Hazard Areas, bottom of loses horizontal structural member of the lowest floor, excluding
piling(s) and columns) is: ______________ft. NGVD (MSL)

2. Actual (as-built) elevation of flood-proofing protection is ______________ft. NGVD (MSL).

SECTION 7: COMPLIANCE ACTION (To be completed by LOCAL ADMINISTRATOR)
The Local Administrator will complete this section as ap plicable based on inspection of the
project to ensure compliance with the community’s local law for flood damage prevention.

INSPECTIONS: Date ___________________ by ___________ deficiencies? [ ] Yes [ ] No

Date ___________________ by ___________ deficiencies? [ ] Yes [ ] No

Date ___________________ by ___________ deficiencies? [ ] Yes [ ] No

SECTION 8: CERTIFICATE OF COMPLIANCE (To be completed by LOCAL ADMINISTRATOR.)
Certificate of Compliance issued by: _________________________________ Date ____________
COWANS FORD ACCESS RAMP INSTALLATION
LINCOLN COUNTY FLOODPLAIN DEVELOPMENT PERMIT APPLICATION
VICINITY MAP(CLIENT LOGO)
0 0.1Miles
O
LEGEND
Approximate Project Boundary
Lake Norman
Cowans Ford Dam