20100079 Ver 1_401 Application_20100110

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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.
20100079
Applications should be sent to:
Division of Water Quality 401 Oversight/Express Review Permitting @ rm 0l
1650 Mail Service Center Lpm
Raleigh, NC 27699-1650
1. Applicant Information JAN 2 20,10
?D
DENR - WATER QUALITY
1. Owner/Applicant Information WETLANDS AND STORMWATER BRANCH
Name: 1^y1 ary, ??n D
Mailing Address: 7 Ca jC
Telephone Number. O?'??? oZ? Fax Number:
E-mail Address:
2. Agent Information (A signed and dated copy of the Agent Authorization letter must be attached
if the Agent has signatory authority for the owner/applicant.)
Name:
LLc- - & en p V
Company Affiliation 2r'PS Sint -
Mailing Address: ) ? o 1l o L L&-s Oe-n ue-r- --L) L 0103-7
Telephone Number. Ja K ° - A 1- 15 b-? Fax Number.
E-mail Address:
H. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local landmarks such
as towns, rivers, and roads. Also provide a detailed site plan showing property boundaries and
development plans in relation to surrounding properties. You may use the diagram below to make a
hand sketch of your project. Also, see the example below for guidance. Both the vicinity map and site
plan must include a scale and north arrow. The footprints of all buildings, impervious surfaces, or other
facilities must be included.
1. Location
County: L I n c 0 `t n Nearest Town: 1 t lpo
Subdivision name or site address (include phase/lot number): Ica ( o± 2 7 g
Directions to site please include road numbers, landmarks, etc. (This is not necessary if an adequate
vicinity map is included):
tU4 C
V (3-
2. Describe the existing land use or condition of the site at the time of this application: c
I Property size (acres):
4. Nearest body of water (stream/river/sound/ocean/lake): a-n
5. Describe the purpose of the proposed work: SA-c?h t U z e S 1, r L ? ne-
6. List the type of equipment to be used to construct the project: R.O&i (LOC4, U,4 5 of r Cc. Luc-,
St } Fenca.- , rip rap
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below the
normal pool lake level in square feet or acres: S R Q S q- -4
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:
8.b. Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instance): -ISL
T& L
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Please approximately sketch the following Wormation on this plan
(please provide dimensions for each Kern, 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 Ftdl Pond-elevation
3) Location of rip rap or fill 1 to be placed below the - Ful Pond elevation
4) The location of any proposed structures such as buildings, retaining
walls, docks, etc.
5) The location of any excavation or d?+edging below the Full Pond
elevation.
6) Location of construction access corridors.
r= Lincoln County, NC
r `+ Office of the Tax Administrator GIS Mapping Division
Lincoln County and its mapping contractors assume no legal responsibility for [ r.
+ J the information contained on this map. This map is not to be used for land
conveyance. The map is based on NC State Plane Coordinate System 1983 NAD.
Date: 1/25/2010 Scale: 1 Inch = 123 Feet

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Photo No,
Available
31732
.a 203 ...
o 30178
325?
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58458
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313051
Lincoln Count, 015 anx z x

Map 4615-12 Mailing GOODSON ANN MACKAY
PO BOX 3486
Account 0221850 Address MOORESVILLE NC 28117
Deed 2148-236 Recorded 9/17/2009 Sale Price $370
000
Land Value $519,218 Total Value $519,218 Previous Parcel ,
Description LAKE LOT VAC. Deed Acres 0
Address WINDWARD POINT LN
Township CATAWBA SPRINGS Tax Acres
Tax/Fire District DENVER 0.46
Improvement No Improvements
Zoning Calculated
Di
t
i
t Voting Precinct Calculated Acres
s
r
c
Acres
R-SF DENVER (DN29) 0.46
0.46
Watershed Class Sewer District
WS-IVC 0.46 Not in the sewer district 0
46
2000 Census County Tract Block .
37109
37109 071200 1001 0.37

Flood Zone Description 071200 1999 0.1

AE SPECIAL FLOOD HAZARD AREA BASE ELEVATION DET Panel

X NO FLOOD HA7ARn ERMINED - 100 YEAR 4615 0.03
- - - - - ' '"I Al 1I-YIIUj FURM
Lake Use Permit
Applicants and Contractors: Ease of locating
impact on permit pmoessing time. Please complete this form and in turn a proposed project t;tte can have a big
permit application to: it along with your completed
DUKE ENERGY
CIO LAKE SER VICES - ;E{
PO BOX 1006
CHARLOTTE, NC 28201-1
1-900-443-5193 or Option
Applicant's Name: C Goy?S O 6l
Street Address (at lake):
1 10 3 L-I -9-4 --- !tom
Lake Name: 'j\ i',,tteti ?j
Subdivision Name:
Property Section: Lot # -
City- nk )4 t- County: t ?1L U )
State: v? a f Zip: g 03-7
Telephone:. L4 m c ; --I ` C'
Directions (60M major road or lt%hway):
1??- • an LA3?e-bbs I C-hu-,,-c.h
DmcTiptive Struculre(s) on Property (Le. brick garage, whine f'M
E
`Note: Please Use the back of this form if desired to draw us a map to the
gPapI.AKEMGMT/pact. LQ SOW at = by Road Fotmd.
12Q

(n cConr)-e- ! I Rot 9 L.P+ on
home. etc):
AvUM IS, 2W6
DUKE ENERGY
ECl ? SERVICES 2 () ) 0 0 7
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.
1. Applicant Information
A. Name fin 0 d? Q r1
B. Mailing Address 01 DO (`S U, k
C. Telephone: -Du y g?7 2 39
i
H. Location of Proposed Project
d ??
A. Lake N D C rh c--
B. Street Address L.? ; r,rl w c, r-J P L Q ,,P- fct.rc e I ! O 3 (4 "J S q CCrnla+,) L0
C. County n t.-L, t n
D. City, town, community or landmark fJ-,0 n?-t- ?L. -Q 03
E. Section Lot # Subdivision
F. Directions to prgperty by road o aA-C, r ? >? ?? one =re ?ri _ ?4?C fir" 3?-
G. Latitude and longitude for the project site La ? . 35.53197a3 Lo O • `1 5 8 a a 1 S
H. Please submit a map showing the coordinates or a detailed map (USG quad map, city map, etc.) showing the
exact location of the project site. (NOTE: Latitude/ longitude coordinates can be found on internet site,
www.mat)sonus.com. Directions: Don't register, click "Maps", enter address, draw map, select "Map Clicking
Will...", select "LaVLong", click map)
III. Description of Project j
A. Length of wall } O
B. Material
C. Distance from prope line/shoreline .J-, l i o r pe-r L -P% .er 1,0- S red "?-?
IV. Intended Use of Project Area
1
A. Private ,z'"
B. Commercial
V. Applicant Signature/ Date ?02 5`?-<t7
PLEASE NOTE 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
@ ! tea'
919-733-1786
JAN, 2C;C
Y:\LAKEMGM'IlPackage Infonnation\NC Shoreline Stabilization Application.doc
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