20091279 Ver 1_401 Application_20091209

09-12?9
November 8, 2009
I am writing this letter to authorize Bob Martin from Martin Enterprises to be my
Agent for shoreline stabilization and erosion control. This project is on
Lake Glenville, North Carolina. My address is 40 Guise Lane, Cashiers,
N.C. 28717.
Bob Martin will be our Agent in applying and completing our permit
applications regarding this project.
This letter authorizes you to contact Bob Martin directly concerning -this
Shoreline strabilization and erosion control project.
Sincerely,
IfL ?-?,? LCD ??E G?c .?-
Genevieve W. Clarke
,303 Xl?1J
PAID
6 6,WK"tF_r I'lC'. 28736
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State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
September 25, 2000
Jimmy Chisholm
Carolina Power and Light Company
179 Tillery Dam Road
Mt. Gilead, NC, 27305
And
Joe Hall
Duke Power and Lake Management
P.O. Box 1006
Charlotte, NC, 28201-1006
A ffl?!?TA
IT ?
D E N R
Re: General 401 Water Quality Certification for Lake and Reservoir Activities
Dear Messrs. Chisholm and Hall:
The purpose of this correspondence is to clarify the provisions and process relative to NC
Division of Water Quality's General 401 Water Quality Certification Number 3280 which correspond to
the U.S. Army Corps of Engineers General Permit 198200030. We understand that you receive
numerous requests from lakefront property owners inquiring about the permit requirements for activities
they propose to conduct on the waterfront. After you have determined the property owner needs to
obtain a permit for dredging or shoreline stabilization from you, we understand they are then instructed
to obtain the necessary 404/401 Permits. These property owners should pursue the following sequence
of events to determine their 404/401 permit needs. We have coordinated this letter with the U.S. Army
Corps of Engineers so that it relates equally to both permitting programs.
1. The U.S. Army Corps of Engineers is the lead agency and accordingly determines 404 requirements
for all projects. Applicants should first contact the appropriate Corps field office representative for
their county. To identify which counties are handled by a particular Corps regulatory field office or
to find the appropriate individual in the regulatory staff, the public can access the Wilmington
District Regulatory Homepage at www.saw.usace.amiy.mil/wettands/regtour htm or read from the
list on Appendix A. The Corps staff will determine if a 404 Permit is required, and if so, which
particular one. It is important that the applicant learn specifically which Nationwide or Regional
General Permit applies to their work. For lake and reservoir activities, General Permit 198200030
(also called General Permit 30 or GP 30), is often the appropriate permit. The matching General
Certification for GP 30 is the subject of this correspondence.
2. Application for GP 30 involves submittal of detailed plans, location maps, and other supplemental
information explaining the nature and scope of the work to the Corps. If the work is detennined to
comply with all conditions of GP 30, the Corps will then issue a"tear sheet" to the applicant, either
on-site or by mail, that qualifies as the Corps' written confirmation that the proposed work complies
with this regional general permit. It is important for applicants to note that GP 30 always requires
written concurrence from the Corps.
Non-tisdiarge Branch 2321 Crabtree Blvd Parkviea Raleigh, North C?Vaina 27604
Telephone [phone] Bldg FAX p 733.9959
An Gq?AW o vtool oMy Aftemabve AwOson GryMOyer W% fecrckw10% pass Canumlof fur
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3. If the Corps tells an applicant that no 404 is required for their project, then no 401 Certification is
required. However, applicants should note that projects located within the Neuse River, Tar-Pamlico
River, or Randleman Reservoir Basins may require approval of Buffer Rules for projects within
these watersheds. In such cases, the applicant should call the appro priate DWQ Regional Office
staff (Appendix B) to discuss the project. The Regional Office staff' may elect to perform a site visit
to review the site conditions and discuss the buffer approval or variance process.
4. If the Corps requires a 404 Permit, then a 401 Water Quality Certification is required. In tine case of
GP 30, DWQ has a matching General Certification (GC 3280), which is attached. The fast thing the
applicant should do is carefully read GC 3280 to determine whether written concurrence is required.
Written DWQ concurrence is required if the activity involves any fill, dredging or excavation of
waters or wetlands. This includes any waterward extension of the shoreline, excavation of boat
basins (even during lake draw-down periods), bank stabilization practices that involve any new fill in
waters ('including any amount of new rip-rap placement), boat ramps involving placement of fill in
waters, and new dredging. Activities which do not require written goncurrence for GC 3280 include
seawall repairs that do not require any new fill in waters, and the placement of pilings for docks,
piers and boathouses. It is vital that the applicant understands the difference between "No 401
Required" versus "No Written Concurrence for the 401 Required." No 401 is required only if no
404 is required. If a 404 is required, a 401 is always required. If the scope of work falls below the
thresholds for written concurrence on the 401, the conditions of GC 3280 still apply, and the
applicant does not have to submit a formal request for approval from DWQ for their specific project.
However, the applicant is still required to follow all of the conditions of GC 3280, which you can
copy for them or they can download from our web site. A speed limit sign is a useful analogy to
explain this - a driver needs to took for and obey the speed limit sign on a road, but does not have to
obtain a letter from a police officer saying he has permission to drive down the road.
5. If a project does require written concurrence for GC 3280, then the applicant must provide a written
application to the Division of Water Quality. We have prepared a special link entitled "A Lake
Dweller's Guide to the 401 Water Quality Certification Process" on the 401/Wetlands Unit web site
at httn-l/h2o enr state.ne.us/newetlands . This site contains information to guide the applicant
through this process, including links to the Pre-Construction Notification (PCN) application form.
Copies of the appropriate web pages are attached herein for you to provide to applicants without
internet access. If the applicant has already filled out a PCN form for the Corps, they can simply r
copy this PCN form for DWQ. In brief, the applicant is required to provide seven copies of the PCN
form, an application fee made out to the Division of Water Quality ($200 if total impacts fall below
I acre of waters/wetlands and 150 linear feet of streams, $475 if above these tlesholds), and good
quality vicinity and local maps depicting the impact. The reason we require seven copies is that we
act as a state clearinghouse, and provide copies to five other agencies, which saves the applicant
from this requirement. Provided that the applicant has included all of the required information,
applications such as these are quickly issued by DWQ. The GC 3280 applications that are placed on
hold are usually deficient in maps. Applicants can save themselves time by preparing good maps
with scales and north arrows. The vicinity map must clearly depict their property within the county
or city. The site map must clearly show their property boundaries, and the location, nature and
extent of the impacts. USGS topo maps are typically the most useful type of site map for individual
property owners to use as a base for their site map. Impacts must be quantified on the map and in the
form as an area (i.e. 0.5 acres, not just shoreline length). If an applicant needs help filling out the
application form, they should contact the appropriate DWQ Regional Office Staff, or Cyndi Karoly
at [phone] in the DWQ Central Office.
Thank you for your attention. if you have any questions, please telephone John Dorney at 919-733-
9646 or Cyndi Karoly at [phone]. .
Sincerely,
John Mracy
.11
14.
The Basics of the 401 Water Quality Certification Process
401 Water Quality Certification Program - The Basics
Section 401 of the Clean Water Act delegates authority to the states to issue a 401 Water Quality
Certification for all projects that require a Federal Permit (such as a Section 404 Permit). The "401" is
essentially a verification by the state that a given project will not degrade Waters of the State or
otherwise violate water guatfir standards. The following is a basic outline of the 401 review process in
North Carolina: •
When do you need to request a 401 Water Quality Certification?
If the U.S. Army Corps of Engineers determines that a 404 Permit is required because your
proposed project involves impacts to wetlands or waters, then a 401 Water Quality Certification is also
required The Corps also determines which type of permit is applicable to your work, a Nationwide,
Regional, Generator Individual Permit. For each of the Nationwide, Regional or General Permit, a
matching General Certification must be issued by DWQ in order for the Permit to be valid. An lndividua
401 Water Quality Certification is necessary if an Individual 404 Permit is required. Once the Comps ha;
determined which type of permit you should request, you can read the matching General Certifications
on the DWQ web page. Please read the applicable Certifications very carefully, and note whether or n(
written concurrence/notification is required by DWQ. If written concurrence/notification is not required,
and your project meets all of the conditions of the General Certification, you do not need to submit a
formal application or receive a signed 401 Water Quality Certification for your particular project If the
General Certification states that written concurrence is necessary, please note the following steps
necessary to obtain your 401 Certification.
Fill out a Pre-Construction Notification
In North Carolina, you use a single form to request both a 404 Permit and 401 Certification. Thi
PCN Form can be downloaded directly. Please note, this form will be revised later in 1999 when the
final versions of the new Nationwide Permits are issued. Just follow the instructions on the form. You
should also include a cover letter explaining your project, oj?also encouraged is provide any a site supporting
ap 0
scale) depicting all the proposed impact areas. Y
documentation available, such as correspondence received from the Corps of Engineers or
photographs- Remember, the more clearly you describe your project, the more quickly we can review
your application. You will need to submit this application to the Corps and provide seven copies of the
entire application to DWQ. If you do not provide seven. copies, your application will be returned as
incomplete. DWQ will distribute the copies to five other state agencies, as well as the appropriate DM
regional office, which saves you time and expense.
DATER QUALITY pLA 4ffi fax=919-715-x637 May 15 '01 1005 P. 02/04 '
LAKE AND RESERVOIR ACTIVITY CERTIFICATION
GENERAL CER IFICATION POR PROJECT'S M IGIBI.:E FOR CORPS OF
ENGINEERS REGIONAL PERMTr NUMBER 1982(M30 (TVA, nP y4m r
REGULAM PUBLIC UTTI T'rIFSI AND REGIONAL PERNtiT 1982(10079 (COE
LAKE AND RESERVOIR MAINTENANCE REPAIR AND 9ONS'1_?ION
ACT[VTMS) AND NEiTSI?ITAR PM AN R
This General Certification is issued in conformity urith the requirements of
.Section 401, Public Lams 92-500 and 95-217 of the United States and subject to the
North Carolina Division of Water Quality Regulations in 15A NCAC M Section .0500
and 15A NCAC 2B 0200 fqr the discharge of fill material to waters and wetland areas
as described in the Wilmineon Districts Regional (CreMd) Peanit Number 198200030
and Regional Permit Number 198200079 and for the Neuse, Tar-Pamlico and Randleman
Buffer Rules (15A N'CAC 213.0233..0259 and.0250). This Certification replaces Water
Quality Certification (WQC) Number 2674 issued on January 21, 1992 and Water
Quality Certification Number 3099 issued on Pebruary 11, 1997. This WQC is rescinded
when the Corps of Engineers re-authorizes these Regional General Permits or when
deemed appropriate by the Director of the DWQ.
The State of North Carolina certifies that the specified category of activity will
not violate applicable portiohs of Secretions 301, 302, 303, 306 and 307 of the Public Laws
92-500 and 95-217 if conducted in accordance with the conditions hereinafter set forth.
Conditions of Certification:
1. Activities which rpquue approval under either of these Oweml Permits but
do not result in fill, dredging or excavation of waters or Aretlands (such as
docks, piers or boathouses) do not require written concurrence from the
Division of Water Quality as long as they comply with all other conditions of
this General Certification. However, Condition No. 5 is applicable to all
streams in basins 1xith riparian area protection rules.
2. In accordance with North Carolina General Statute Section 143-215.31)(e),
any request for v?vritten concurrence for a 401 Water Quality Certification
must include thq appropriate fec. If a project also requires a CAMA Permit,
one payment to both agencies shall be submitted and will be the higher of the
two fees. The fee shall be collected and distributed between the two agencies
in accordance with agreements reached between the Division of Water
Quality and the *Division of Coastal Management;
3. Activities which result in fill. dredging or excavation of waters or wetlands
under this Generic) Ccrtificatiuu 1Cyuh.: written concurrence from the Di-•izion
of Water Quality:
4. Measures shall be taken to prevent live or fresh concrete from coming i ?•.contact with waters of the state until the concrete has hardened;
biATEF Ql1Al.ITy P1.ft#41NG Fax:919-M-'5637 - :,. :taay .t? .'vt; . tv •w r . w4 y+ . - t...
5. Impacts to any stream length in the Neuse'and Tar-Pamlico River Basins
requires written concurrence from DWQ in accordance with 15A NCAC
2B.0233 and 15A NCAC 213 .0259. New-development activities located in
the protected 50-foot wide riparian areas (whether jurisdictional wetlands or
not) within the 14euse and Tar-Pamlico River Basins shall be limited to "uses"
identified within and constructed in accordance with 15A NCAC 2B 0233
and 15A NCAC 213.0259. All new development shall be located, designed,
constructed, and, maintained to have minimal disturbance to protect water
quality to the maximum extent practicable through the use of best
management practices;
6. That appropriate sediment and erosion control practices i?hich equal or exceed
,
those outlined W the most recent version of the "Borth Carolina Sediment and
Erosion Control Planning and Design Manual" or the "North Carolina Surface
INfi.ning Manual" whichever is more appropriate (available from the Division
of Land Resources (DLR) in the DENR Regional or Central Offices) shall be
in full compliance with all specifications governing the proper design,
installation and operation and maintenance of such Best Management
Practices in order to assure compliance with the appropriate turbidity Nvater
quality standard;
7. Rip-rap shall be Zic stalled adjacent to bulkheads in freshwater lakes to ensure
protection habitat. Construction
floating structures shallnotlre, ted at
least three feet above any wetlands, and
periodically on the bottom:
8. All sediment anc erosion control measures placed in wetlands or waters shall
be. removed and a natural grade restored after the Division of Land
Resources has relea.sed the project;
9. If an environmental document is required, this Certification is not valid until a
Finding of No Signficant Impact (FONSI) or Record of Decision (ROD) is
issued by the State Clearinghouse. All water quality-related conditions of the
FONSI or ROD Shall become conditions of this Certification;
10. Picrs and boat houses shall be constructed to provide for storage and rei-d al
of scNvagc rather than allowing rw? , waste or other sewage to be disposed
directly into surface waters',
11. Additional site--specific conditious may be added to projects proposed with
fill under this Certification in order to ensure compliance v:ith all applicable
Warcr duality and G1I IUCnc standards;
' WATER (QUALITY RAKING Fax:[phone]b37

12. Concurrence from DWQ that this Certification applies to an individual project
shall expire three years from the date of the cover letter from DWQ or on the
same day as the expiration date of the corresponding Regional Permit
198200030 or 198200079, whichever is sooner,
13. When written concurrence is required, the applicant is required to use the
enclosed Certification of Completion form to notify DWQ when all work
included in the 401 Certification has been completed.
Non-compliance with or violation of the conditions herein set forth by a specific
fill project shall result in revocation of this Certification for the project and may result in
criminal and/or civil penalties.
The Director of the North Carolina Division of Water Quality tvay require
submission of a formal application for individual certification for any project in this
category of activity, if it is determined that the project is likely to have a significant
adverse effect upon water quality or deb ade the waters so that existing uses of the
wetland or downstream waters are precluded.
Public hearings may be held for specific applications or group of applications
prior to a Certification decision if deemed in the public's but interest by the Director of
the North Carolina Division of Water Quality.
Effective date: I rune 2000
DIVISION Ole WATER QUALITY
By
Kerr T_ Stevens
Director
WQC # 3280

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: 09 - 12 7 9
Division of Water Quality 401 Oversight/Express Review Permitting
1650 Mail Service Center
Raleigh, NC 27699-1650 I. Applicant Information $P81D
-
1. Owner/Applicant Informati'o'n)) /?
Name: 61 rl 6. J F V(, VU (_,, ? A ?" jE C? GCJ 1?
Mailing Address: ? o /V (?'eI Ve-
F-0r1- L?.rul'F? _. ,33N9
Telephone Number: 2 " 5 ?' 53 9 Fax Number:
E-mail Address: (-1) oc-q rke, ex c f e_...
2. Agent Information (A signed and dated copy of the Agent Authorization letter must be attached
if the Agent has signatory authority for the owner/applicant.)
Name: U h a r f? n
Company Affiliation: D 8s 6 5A J I
Mailing Address: Zr3 01 J-3 6 >6 -S 0 r all tllaE 'Ale. "9=
Telephone Number: 8?$ -° ly-2-? 0017 Fax Number: 60-S -,,226 :2 8g-7
E-mail Address: p'PaL i 0& S6
H. Project Information
'241
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.
0 ?
US Army Conn Of Engineers Field Offices and County Coverage
Asheville Regulatory Field Office Alexander Cherokee hedell Mitchell Union
US Army Corps of Engineers Avery Clay Jackson Polk Watauga
151 Patton Avenue Buncombe Cleveland Lincoln Rowan Yancey
Room 208 Burke Gaston Macon Rutherford
Ashevlle, NC 28801-5006 Cabauus Graham Madison Stanley
Tdgftw (828) 2714954 Caldwell Haywood McDowell Swam
Fax: [phone] Catawba Henderson Medfle nbu m Transylvania
Raleigh Regulatory Field Office Alamanoe Durham Johnston Rod irigham Wilson
US Amy Corps Of Engineers Alleghany Edgecombe Lee Stokes Yadkin
6508 Falls of the Neuse Road Ashe Franklin Nash Surry
Suite 120 Caswell Forsyth Northampton Vance
Ueig% NC 27615 Chatham Granville Orange Wake
Telephone: [phone] Davidson Guilford Person Warren
Fax: [phone] Davie Halifax Randolph Wilkes
Washington Regulatory Fnedd Office Beaufort Crn ituck Jones Pitt
US Army Carps Of Engineers aortic Date Lenoir Tyrrell
Post Oboe Box 1000 Camden Gates Martin Washington
Wash? 7889-1000 Carteret* Green Pamlico Wayne
T 5-1616 Chan Hafford PasjAftik
Fax: ) -1399 Craven Hyde Peaquimans -Cmatan National Forest Only
Wilaningtm Regulatory Field Office Anson Duplin Onslow
US Army Corps Of Engineers Bladen Harnett Pender
Post Office Box 1890 Brunswick Hoke Richmond
Wilmington, NC 28402-1890 Carteret Montgomery Robeson
Telephone: [phone] Columbus Moore Sampson
Fax: [phone] Cumberland New Hanover Scotland
US Fish and Wildlife Service / National Marine Flsberies Service
US Fish and Wildlife Service US Fish and Wildlife Service National Marine Fisheries Service
Raleigh Field Office Asheville Field Office Habitat Conservation Division
Post Office Box 33726 160 Zillicoa Street Pivers Island
Raleigb, NC 27636-3726 Asheville, NC 28801 Beaufort, NC 28516
Telephone: [phone] Telephone: [phone] Telephone: [phone]
North Carolina State Agencies
Division of Water Quality Division of Water Quality State Historic Preservation Office
401 Wetlands Unit Wetlands Restoration Program Department Of Cultural Resources
1650 Mail Service Center 1619 Mail Service Center 4617 Mail Service Center
Raleigh, NC 27699-1650 Raleigh, NC 27699-1619 Raleigh, NC 27699-4617
Telephone: [phone] Telephone: [phone] Telephone: [phone]
Fax: [phone] Fax: [phone] Fax: [phone]
CAMA and NC Coastal Counties
Division of Coastal Management Beaufort Chowan Hertford Pasquotank
1638 Mail Service Center Bertie
Brunswick Craven
Cuaituck Hyde Ponder
New Hanover Perquanans
Raleigh, NC 27699-1638 d
C Dare Onslow Tyrrell
Telephone: [phone] en
am
et
t
C Gates Pamlico Washington
Fax: [phone] ar
er
NCWRC and NC Trout Counties
Western Piedmont Region Coordinator Alleghany Caldwell Watauga
3855 ldlewihd Road Ashe Mitchell Wilkes
Kernetsville, NC 27284-9180 Avery Stokes
Telephone: [phone] Burke Surry
Mountain Region Coordinator Buncombe Henderson Polk
20830 Great Smoky Mtn. Expressway Cherokee Jackson Rutherford
Waynesville, NC 28786 Clay
ham
G Macon
Madison Swain
Transylvania
Telephone: [phone] ra
Fax:-[phone] Haywood McDowell Yancey
5
1. Location
County: Nearest Town:
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): J'`5a,r (`JtSt1t ? ?'J yr` f 6 rv A /Jc#ZTtV s213 &,6
L/7. ;fii-E Je Nc ' 'o sV_ L Lr- E.a R) &14,r 61 w? s1.0 yc?
Vt? L vOL -rc> Zwg% 1) t2 *u ,.W oyQ r/(?-J 7'a `?lG f4+*9 L ee,+41<
2. Describe the existing land use or condition of the site at the time of this application:
3. Property size (acres): I _57/ 4-C»?;_,N " J>wa z LvT
4. Nearest body of water (stream/river/sound/ocean/lake): 1-4-K E "J" V&LiL
5. Describe the purpose of the proposed work: `TO Cow;T1x"-T /t"
fl c a-w t i- PAP e-A-P TOE P 442 C=i
T
6. List the type of equipment to be used to construct the project: "W4a4_"? 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: 334 1 ' Sz,,c)avec Dv-
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:
3 3Z t- SQWit!-R.t rCC b`r Pm P$IC_T" 4-(Zf t 4-16av"f- tom ' cit.
8.b. Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instance): -S ?'? 4nY_MvIi % Of S OktMOW 11" 140
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
fp
Please approximately sketch the following information on this plan
(please provide dkmnsions 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 Fug Pond elevation
S) Location of rip rap or fill to be placed below the FUN Pond elevation
4) 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.
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 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 ENERGY FILING FEE, PAYABLE TO DUKE ENERGY,
TO ABOVE ADDRESS.
I. Applicant Information
A. Name 6 'e'l
B. Mailing Address a S-66 N C `7 -/=A
C. Telephone:q sy - JZo I- 55-3
i ,4c1t-Je.,-dr.(T L , 33308
II. Location of Proposed Project
A. Lake _ a L,05A) yfl LLjF .
B. Street Address _ 1(o 6 u t a4 e.
C. County T ILS o n
D. City, town, community or landmark
E. Section ___I_ Lot # Subdivision
F. Directions to property b road
rn,4.? Tc
G.
H.
S UJ IT2-SQ_L- ?
l: fJOe-TN ON 107 T D
C 3tiJE 6i,-- AD e41>;
Latitude and longitude for the project site
Please submit a map showing the coordinates or a detailed map (USGS quad map, city map, etc.) showing the
exact location of the project site. (NOTE: Latitude/ longitude coordinates can be found on internet site,
www.maysonus.com. Directions: Don't register, click "Maps", enter address, draw map, select "Map Clicking
Will...", select "Lat/Long", click map)
III. Description of Project
A. Length of wall 60 t +
B. material_iii-rfo L 1)t&y grn-ac f- GLi-.sS Q 91P knip
C. Distance from property line/shoreline 2-o t t -
IV. Intended Use of Project Area
A. Private
B. Commercial
V. Applicant Signature t gfhft aj && Date ; i?7?;/?). UU?3
PLEASE NOTF, THE FOLLOWING:
• 2 COPIES OF THE "DUKE ENERGY APPLICATION FOR PERMIT TO STABILIZE 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:
NC DIVISION OF WATER QUALITY
ATTENTION.- CYNDI KAROLY
PARKVIEW BLDG., 2321 CRABTREE BLVD.
RALEIGH, NC 27604
919-733-1786
YALAKEMGM71Package InformationM Shoreline Stabilization Application.doc
k (ATTACHMENTS)
BIO-ENGINEERING AND SHORELINE STABILIZATION MITIGATION
TECHNIQUES
FOR LAKES MANAGED BY DUKE ENERGY LAKE SERVICES
I. Bio-engineering
A. Definition
Bio-engineering is an effective scientific method, using a combination of natural and living
materials, to stabilize eroded banks along the shoreline. Bio-engineering techniques vary
according to a number of factors, including but not limited to; slope, soil type and wave action.
Often a combination of techniques may be utilized to effectively control erosion in areas with
varying condition.
B. Benefits
In addition to controlling erosion and the aesthetic value of a more natural shoreline, the use of
native plants create additional habitat for wildlife. A permit and written authorization for any
shoreline stabilization project is required from Duke Energy Lake Services. By utilizing bio-
engineering as the primary stabilization technique, the permit application fee for shoreline
stabilization is waived.
C. Native Plant Species
COMMON NAME
SPE IE
SOFT RUSH JUNCUS EFFUSUS
ARROW ALUM PETANDRA VIRGINICA
SHALLOW SEDGE CAREX LURIDA
SILKY DOGWOOD CORNUS AMOMUM
TUSSOCK SEDGE CAREX STRICTA
BUTTONBUSH CEPHALANTHUS OCCIDENTALIS
GRAY DOGWOOD CORNUS RACEMOSA
YELLOW IRIS IRIS PSEUDACORUS
VIRGINIA BLUEFLAG IRIS VIRGINICA
PICKEREL WEED PONTEDERIA CORDATA
BLACK WILLOW SALIX NIGRA
SOFT STEM BULRUSH SCIRPUS VALIDUS
GREEN BULRUSH SCIRPUS ATROVIRENS
EELGRASS VALLISNERIA AMERICANA
WOOLGRASS SCIRPUS CYPERINUS
Note: Other plant species that are not listed may also de acceptauie. rum q=tu1 u1m iur, mm
native to Duke Energy lakes should not be considered and will not likely be approved.
G0dj.A KOr`rnTWkW ti ao-gti k&ansWnAW Aupd 18.2006

(ATTACHMENT 8)
D. I bniam
Bio-engineering techniques normally include minor grading to allow for the installation of a rip
rap toe, rock gabion, Bio-log®, crib wall or similar structure in high energy areas. The structures
are then enhanced by the addition of naturW/living material. For example.
1. hve stakes - branches art from living material and planted with stems and buds pointed
upward. Initially they offer little to no soil reinforcement but do so after the first growing
season once a root system becomes established. Often used with other techniques and
conducted during the dormant season.
2. live fasciae - branched bundled and secured together and placed in a very shallow trench
along the toe of the eroded bank or in the bank face. They are usually installed in conjunction
with geotextile fabrics above a rip rap or gabion toe.
3. brush nudiess - includes both live stakes and live fascines. Provides protection of the
shoreline upon installation and can be used in layers beginning just above a rip rap or gabion
toe.
4. pl=ant moos - plantings with intact root stock. Placed directly into the bank face with the soil
compacted around the root stock.
E. Follow qp activities
Riparian Zone Management Information: Duke Energy will design and publish an informational
piece that will provide property owners with a range of information about bio-engineering
techniques, material sources, information sources and the value of riparian zone. This will be the
final project in the Riparian Zone Management Initiative and will serve as a compilation of the
on-going efforts through the year 2000.
IL Mitigation
A. General Guidance
Mitigation proposals should provide realistic but substantial allowances for reducing and
relieving the impact of the proposed shoreline stabilization technique proposed. In general,
mitigation activities should enhance the wildlife habitat in the immediate area of the stabilization
activity and may consist of but are not limited to; enhancing fish cover under an approved pier or
similar structure, maintaining a natural vegetative buffer along the entire shoreline of the lot,
placing or maintaining secured cover and perching habitat (e.g. root wads, stumps, Well trees,
etc.) along portions of the shoreline.
GP& AKEMGM91P? b$m=fM\&O- ima. b&un tioadm
AWid 18.2006
'Lr
(ATTACHMENT 8)
B. Review Timd ame
Applicants for proposed shoreline stabilization activities identified in the Shoreline Stabilization
Technique Selection Criteria (Attachment 1) that require wildlife agency review and/or mitigation
must send their applications to the district game and fisheries biologist of the applicable NC/SC
agency for a minimum 30-day review and comment period. In the absence of any finding of
significant adverse impacts on fish and wildlife resources during this 30-day review period, the
applicant will be allowed to proceed without further notice to send their completed application to
Duke Energy Lake Services for approval. If there are findings of significant impact and those
impacts are not adequately mitigated, then the applicant will not be allowed to proceed with the
proposed stabilization activity. Applicants should make every effort to comply directly with
resource agency recommendations.
C. Agencv Review
Lake (NC) James, Rhodhiss, (SC) Wylie (SC) (SC) Fishing Creek, Great
Lookout Shoals, Norman, Falls/Rocky CAL, Wateree,
Mtn. Island, Wylie (NC) Kcowee, JwAssee, Gaston
Shoals, 99-Islands
Agency Contact Mr. Chris Goudreau Mr. Dick Christie Mr. Roh Ahle
NC Wildlife Resources SC Department of Natural SC Department of Natural
Commission Resources Resources
Rt. 6, Box 685 PO Box 4496 PO Box 167
Miarion, NC 28752-9229 Rock Hill, SC 29732 Columbia, SC 29202
*Applicants should fill out the Duke Energy Shoreline Stabilization Application form completely,
attach any applicable mitigation proposals and send along with a cover letter to the agency
contact.
**Agency correspondence must also be attached before sending the final application to Duke
Energy for approval.
Gpdj AVj MOMrjsu ? G n 1ntournsfimdoc Amt 18.2006
a
Attachment L
Duke Power
Catawba-Wateree Project No. 2232
Keowee-Toxaway Projed No. 2503
Shoreline Stabilization Technique Selection Process
Shoreline
Stabilization
Application
Is the bank
height less than
3 feet? .-
Applicant can use
hardening structures.
(and,,, pplicant can only
e bioengineering
Seawalls not allowed, enhanced rip rap.
o seawalls or
imple rip rap.
Environmental Stabilization not
Bottomisrrd HaNwss? allOWed

Project area Review/approval and potential mitigation.
classification
No stabilization allowed in
IMZ's from Marsh - June to
limit impacts to fish spawning.
Requires state wildlife agency
(e.g., NCWRC, SCDNR)
Is the bank Is the bank
height less than <height less than
2 feet? 3 feet?
Mitigation requirements
determined by state
wildlife agency.
' Applicant can use
hardening structures.
Mitigation requirements
determined by state
wildlife agency.
`
3??
Attachment L
Duke Power
Catawba-Wateree Project No. 2232
Keowee-Toxaway Project No. 2503
Shoreline Stabilization Technique Selection Process
General conditions:
All seawalls must have Class B or larger rip[-rap extending 6 feet lakeward from the base.
-Considering current lake level operating targets and variability and the desire to prevent unnecessary impacts, rip
rap must be confined to the area between 6' below full pond elevation and no more than one foot above full pond
elevation to the maximum practicable extent. Potential exceptions Include areas where entire placement is above
the FERC project boundary, where banks are already eroded above the full pond elevation or where severely
eroded banks must be sloped back or terraced to provide minimum bank stability.
-Seawalls are not allowed in areas with an average eroded bank height or less than 3 feet.
-Proposals for stabilization where bank height is less than 2.feet can utilize approved bio-engineering techniques
and enhanced rip-rap techniques only.
-The bank height Is the average height of the eroded shoreline (measured from the original lake bed to the top of the
eroded bank) in the area to be stabilized.
-Bio-engineering techniques within an IMZ require applicant to provide photo evidence of successful vegetation
establishment at 1 year point Sio-engineering is a stabilization approach that utilizes natural and living material.
Bio-engineering techniques may Include use of rip-rap with live stakes, rock filled gabions, live staked crib walls,
biologs, and numerous other activities.
Applicant can use bioengineering, rip-rap, seawalls or any combination of stabilization techniques where use of
hardening structures are allowed.
-Stabilization in an IMZ requires review/approval by the applicable state wildlife agency and reasonable mitigation
requirements as determined through consultation with the state wildlife agencies.
-Stabilization is not allowed from March 1 through June 30 in areas identified as IMZs in the SMP.
-New or expanded stabilization activities (excluding Bio-engineering) may not be undertaken within the 50'
Environmental offset associated with an Environmental classification in the SMP.
-Cut/fill
-Stabilization in areas classified as Natural due to the presence of significant cultural resources, should not have
artifacts impacted by utilizing any shoreline stabilization techniques.

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Energy®
October 27, 2009
Genevieve & Haygood Clarke
2500 NE 37th Drive
Ft. Lauderdale, FL 33308
Duke Energy Lake Services
PO Box 1006 / EC12Q
Charlotte, NC 28201
RE: Application for Private Facility F-lExcavation ?X Shoreline Stabilization E] Miscellaneous
Reservoir Uses
Glenville - - 40 Guise Lane
Dear Prospective Lake Use Permit Applicant:
Enclosed you will find the current Duke Energy Lake Services Fee Schedule which became effective January 1,
2002, the applicable Shoreline Management Program Permit Application(s), the Duke Energy Nantahala Area
(DENA) Shoreline Management Guidelines (SMG) which became effective July 1, 2003, and the DENA Private
Facilities Users Agreement. 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 Application(s) will be reviewed after being completed and returned to Duke Energy Lake Services - EC12Q,
PO Box 1006, Charlotte, NC 28201-1006. PLEASE USE YOUR MAILING ADDRESS ON THE
APPLICATION(S) and type or print information for legibility. No activity is allowed inside the project boundary
until you receive written authorization from our office, and no approval will be given to anyone other than the
property owner. A check made pavable to Duke Energy for the appropriate filing fee (see enclosed fee
schedule) must accompany the following before the review process will be initiated. A completed DPNA
Users Agreement must be signed by the adjacent property owner and included with each application. An
application is not considered complete without the signed Users Agreement.
PIER/DOCK/STABILIZATION:
1. The completed application(s) (for pier structures include both proposed and existing facilities). Include the
Duke Energy permit number if one has been previously assigned to any existing structure on the
property.
2. The form describing directions by road (including section and lot number if applicable), and the area of the
planned construction/activity marked on the grid map (if enclosed).
3. Copy of a registered survey of the property, showing proposal's location from your property into the project
boundary.
4. Copy of county building permit, if one is required by the county. (Applicable to pier structures only except for
Burke County which requires a building/shoreline protection permit for stabilization.)
5. Other information, including mitigation plans or cultural resource consultation documentation, if applicable.
6. Latitude and Longitude coordinates must be supplied in order to process the application. Coordinates can be
obtained from www orbisinc comisn/.
FOR NORTH CAROLINA STABILIZATION:
1. TWO (2) COPIES of the NC Division of Water Quality (DWQ) Pre-Construction Notification Application (can
be found on internet site, http:11h2o.enr.state.ne.us/ncwetlands/lake.him[) and the DWQ application fee must be
provided to the NC Division of Water Quality, Attention: John Dorney, Parkview Building, 2321 Crabtree
Blvd., Raleigh, NC 27604
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 call the Lake Representative for the Nantahala Area (828-369-
4513), or you may call Toll Free 1-800-443-5193.
Sincerely,
Lake Services
www.duke-energy.com
Duke
r ,Energya
Duke Energy Lake Services
PO Box 1006 / EC12Q
Charlotte, NC 28201
DUKE ENERGY NANTAHALA AREA (DENA) PRIVATE FACILITIES
"USER AGREEMENT" LETTER
(You may use this letter and fill in the requested information. Please Print)
Date "c ],1 U,
TO: Duke Energy
c/o Lake Services- EC 12Q
P. O. Box 1006
Charlotte, NC 28201-1006
RE: (Lake Name) ?/I-k G=c, tllu
?i
(Street Address)
(Subdivision/ Lot #) "77 5c.:{JZ?r2( c? 66?, 60
(Applicant's,full name) ft f`ti11 Et it CL?'llr hereby agrees to comply with all requirements
and conditions set forth by Duke Energy's Lake Services' office, or any federal, state or local agencies
pertaining to our Private Facilities application to construct a C'B ?rN- yN ?RISI -fz- ?ii''Z s' -cc
on Lake Grp>?y? In addition, Uwe have read and agree to comply with Duke Energy's Shoreline
Management Guidelines (SMG) and understand that written authorization must be obtained from Duke's
Lake Services' office prior to beginning any activity/construction within the Project boundary. The
construction will be completed as described in the approved private facilities program application and within
twelve (12) months from the date of approval by Lake Services. Failure to complete construction within the
build-out period will require the applicant to file a new application within the then-current guidelines. The
filing will include any applicable fees and security deposits.
I/we attest to be the owner or lease holder of the tract of land immediately adjoining the Project boundary
where the proposed facility is to be constructed.
Uwe understand the physical location on my/our lot in relation to the common property line with Duke Energy,
the FERC Project boundary, and any deeded flood easements or required building setbacks.
I/we understand that this lake was constructed as a working hydropower reservoir for the primariy purpose of
producing cost-effective electric energy and that this remains as the lake's primary purpose. I/we understand
that the lake and its associated hydropower station are operated by DENA under the terms of a license issued
by the Federal Energy Regulatory Commission (FERC) and that there will be no change in hydro project
operations as a result of the construction and/or use of any facilities that I/we may be allowed to place within
the FERC Project boundary or on DENA-owned property.
I/we understand that lake levels will rise and fall over time in response to weather events and hydro project
operations.
DP NA PRIVATE FACILITIES USERS AGREEMENT
Page 1 of 5
Final Rev_ I & 13/03
www.duke-energy.com
Uwe acknowledge that DENA provides no guarantee of any specific quantities (except those identified in the
Low Inflow or Hydro Project Maintenance and Emergency Protocols) or quality of water in the lake.
I/we acknowledge that DENA does not guarantee that an approved facility will always have sufficient water
depth to be accessible by boat or for other water depth related recreation activities.
Uwe understand that the structures to be installed are my/our property and I/we therefore agree to be fully
responsible for the permitted reservoir use including maintaining structures in good repair. If the facility is
deemed unsafe by a Lake Services Representative, Uwe agree to repair or remove the facility at my/our own
expense and within the specified timeframe. This responsibility is considered to transfer automatically along
with ownership and leases of the adjoining tract.
Uwe understand that as an owner or lease holder of property directly adjacent to DENA's Project boundary
I/we enjoy the same rights and privileges for general recreational use and enjoyment of the Project lands and
waters as are afforded the general public. Uwe understand that as an adjoining property owner I/we may, with
proper written approval, be considered for expanded privileges as specified in the DENA SMG.
I/we understand that certain activities specified in the SMG are prohibited because of the DENA lakes small
size, environmental concerns, boating capacity limitations, safety considerations and other reasons.
Uwe understand that ownership/interest in a Common Use Facility eliminates the option for me/us to also have
a separate facility on any other lot within the affected subdivision that Uwe own or lease.
Uwe understand that Lake Services' approval of the requested reservoir use in no way constitutes assignment
of an interest in real property (i.e. land rights). The approval is granted and maintained solely at Duke's
discretion. I/we also understand that the permitted use may be revoked at any time by Duke Energy or its
successors for any reason whatsoever. If the approval is revoked, I/we agree to remove the facility at my/our
own expense within the specified timeframe set by Lake Services.
I/we specifically waive any claim for consequential damages arising out of or relating to this application,
Duke's approval or denial of it, or Duke's subsequent revocation of approval, and Uwe specifically understand
and acknowledge that, because Duke Energy can revoke the permitted use at any time, I/we are not entitled to
reliance damages.
I/we understand that there will be no change in hydro project operations as a result of construction and/or
utilization of the permitted proposed structures.
Uwe understand that the proposed structure will be used only for the purposes described in the information
submitted to Lake Services and other appropriate governing bodies for approval.
Uwe understand that this lake is open for use by the general public and that maintaining safe and lawful public
use is one of the primary lake management objectives of DENA.
Uwe understand that the use for which we are applying is a private use and it should not interfere with the
general public's safe and lawful use of the lake.
I/we understand lake use permit holders have the authority to prevent others from trespassing on the structures
they have built. I/we also understand that Uwe, however, do not have any authority to impede anyone from
DP NA PRIVATE FACILITIES USERS AGREEMENT
Final Rev. 10/13/03
Page 2 of 5
pursuit of the lawful public recreation enjoyment of FERC Project lands and waters. Except as specified
otherwise in the SMG or other DENA documents (e.g. Public Safety Plans), anyone may fish around/under
structures built by others, may walk/wade/fish within the FERC Project boundary or any DENA-owned
peripheral strip, boat in the lake's waters, etc. without having to get anyone's permission to do so. Boaters may
not block ingress/egress to piers/docks.
Uwe understand that every reasonable effort must be made to minimize any adverse impact on fish, wildlife,
and other natural resources.
Uwe understand that trees and vegetation growing within the Project boundary play an important role in the
overall environmental condition of the lake. The ecological benefit the vegetation has on the fish and wildlife
habitat supports a sound and healthy lake environment. I/we also understand that unauthorized removal of
shoreline vegetation (i.e. button bushes, willows, cattails, etc.) and/or disturbance of the shoreline buffer may
result in suspension or denial of lake use permitting requests and require me/us to re-establish the vegetation, if
the disturbance is found to be in violation of the state or county watershed buffer regulations or Duke Energy
Nantahala Area Vegetation Management Requirements.
I/we agree to notify Lake Services when construction is completed. During the construction period, the
weather-proof "Duke Energy Approved Lake Use Activity" sign (to be provided by Lake Services) must be
posted at the job site, visible from the water's edge.
I/we agree to notify Lake Services if the property is sold and provide the name and address of the new owner.
The new owner has 180 days following the date of closing on the property purchase to sign this agreement and
its conditions.
Uwe agree to fully disclose all information regarding the approved private facility to any prospective
buyer/leaseholder of the property and any new owner/leaseholder. I/we agree that Duke Energy Lake Services
will be notified immediately of any sale/transfer of the property and the transfer of the permit to the new
owner/leaseholder.
I/we agree that Duke Energy may enter into agreements with third parties permitting use of the Project property
that promotes the overall recreational purposes of the Project.
I/we agree that this agreement confers no right to construct or maintain public and private beaches, marinas or
campgrounds.
Uwe agree that the adjacent Duke Energy Project property shall be used exclusively for non-commercial
recreational purposes.
Uwe agree not to rent, lease or otherwise allow third parties (except for temporary use by guests, family
members, and renters of the residential property) to use any structures permitted to me/us by DENA.
Uwe agree not to allow any use of the adjacent property and will exercise due care and diligence to prevent all
other persons that are affiliated with my/our property (including invitees, family members, guests, etc.) to
violate an applicable federal, state or local law or regulation. Examples include but are not limited to nudity,
illegal discharge of firearms or fireworks, controlled substance abuse, public drunkenness, public urination or
defecation, or other activities determined to be a nuisance by law enforcement officials.
DP NA PRIVATE FACILITIES USERS AGREEMENT
Final Rev. 10/13/03
Page 3 of 5
I/we agree to exercise all care and due diligence to preserve and maintain the character of the DENA's adjacent
property. Uwe agree to comply with the DENA Vegetation Management Requirements. I/we agree further to
not allow sewage, including discharge from septic tanks (or similar facilities) or boat holding tanks, garbage,
trash, or other waste material to be discharged or dumped into the reservoir, tributaries or adjacent property.
I/we understand that as an adjoining property owner I/we can make no change in land form of land within the
FERC Project boundary or land owned by DENA, such as grading, excavation or filling without prior written
approval by Lake Services.
I/we agree that only floating piers/docks (unless otherwise authorized by DENA in writing) will be placed on
the Project property and that no piers/docks or structures will be built on Project property without prior written
authorization by DENA.
I/we agree for myself/ourselves, members of my/our family, guests and invitees that I/we assume all risks of
personal injury or property damage incident to my/our occupancy and use of the premises; including but not
limited to any personal injury or property damage which may be sustained as a result of flood waters or in
connection with the rise and fall of water in the reservoir as a result of floods or of the operation of Duke
Energy's hydro electric facilities. I/we as the adjoining property owner further agree that I/we will indemnify,
protect, defend, and save harmless Duke Energy from any and all loss, cost, claims damages, expenses,
judgments and causes of action for all injuries and damages sustained by the members of my/our family,
guests, and invitees arising or claimed to have arisen in connection with their occupancy or use of the DENA-
permitted facility(s).
I/we agree to comply with all FERC orders (as modified or interpreted by FERC), with all other applicable
FERC Rules and Regulations imposed by Duke Energy, and with all rules or regulations imposed on Duke
Energy by any governmental agency.
I/we understand this user's agreement does not have an expiration date and is transferable to the next property
owner provided the new owner signs a new agreement within 180 days following the date of closing on the
property purchase.
I/we have included a check for the applicable filing fees and security deposits and copies of all other necessary
permits.
I/we acknowledge that DENA has the right to charge reasonable user's fees for private use of its property and
that failure to pay any applicable user's fees in a timely manner can result in the suspension or cancellation of
any previously approved lake use permit.
I/we agree to maintain any prescribed mitigation activities that are required in order to gain approval for
facility construction, as long as the facility exists.
I/we agree that camping is only allowed in designated areas.
I/we recognize that I/we have the continuing responsibility to ensure that the constructed structures are
maintained in good repair, including, but not limited to maintenance of the dock and boat slips, and proper
erosion control within the permit area and along the shoreline, and agree to take all reasonable steps necessary
to meet this responsibility. I/we agree to maintain all structures within the Project boundary on DENA-owned
property in a sound condition and in a neat appearance and pay all costs for said maintenance.
DP NA PRNATE FACILITIES USERS AGREEMENT
Final Rev. 10/13/03
Page 4 of 5
Uwe agree that if any action is taken by Duke Energy to enforce any provision, covenant or agreement
contained in this user agreement or DENA SMG or if Duke Energy is required to retain an attorney to enforce
any provision, covenant or agreement contained in this user agreement or SMG (including, without limitation,
the payment of fees due hereunder or the removal of an encroachment constructed in violation of this user
agreement or SMG), then Duke Energy shall be entitled to recover all of its reasonable costs associated with
such an action, including but not limited to, attorneys' fees and court costs incurred in such action and/or
enforcement; provided, however, that the undersigned shall be entitled to recover all of its reasonable costs
associated with such an action, including but not limited to, attorneys' fees and court costs incurred in such
action and/or enforcement if judged to not be in violation of any provision of the User Agreement or SMG.
1/we agree that Uwe have read and will abide by the DENA SMG published under separate cover.
I/we understand that Lake Services representatives may issue Stop Work Directives for any violations of the
SMG or engagement in prohibited acts or activities on DENA property as specifically identified in the SMG.
Uwe understand that persons found to be in violation will be subject to DENA sanctions which can include: 1)
restoration of the impacted area at the person's expense; 2) loss of consideration of any future lake use
permitting activities for up to five years for improper vegetation removal or until vegetation is satisfactorily re-
established (even if there is a change in property ownership); 3) revocation of a previously issued permit and
loss of consideration of any future lake use permitting activities and/or reinstatement of the revoked permit; 4)
increases in fees; 5) modification or removal of non-complying structures; and/or 6) further legal action being
taken by DENA.
Sincerely,
Genevieve W. 61-arke;
(Applicant's Name)
L4o GtL i Se_
Lake Street Address
C'o-Sk1* C -X87 117
City/State/Zip Code
c6 99" 743--7?.?Lf
Lake Phone Number
(Designated Duke Energy Agent)
Applicant's Signature
Y7
Home Street Address
City/State/Zip Code
,15 0
Home Phone Number
Date:` 6-c. ) 6 two U 7
Date:
DP NA PRIVATE FACILITIES USERS AGREEMENT
Final Rev. 10/13/03
Page 5 of 5
DUKE ENERGY 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 ENERGY
C/O LAKE SERVICES - EC 12 Q
PO BOX 1006
CHARLOTTE, NC 28201-1006
1-800-443-5193 and select Option 5
Applicant's Name: (?E'i t C' If f 61 ?' kj. L LO r' k c-'-
Street Address (at lake): 4 0 lI LLI S C: L C? t 1 C?
Lake Name: La t< ";'Len VI I
Subdivision Name: ?IF?1. SwrTi7,2?
Tax Parcel ID (if known): Lot # City: County:
State: /V e
Latitude:
Telephone:
Zip: Z- (d '717
Longitude:

Directions (from major road or highway):
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