20070568 Ver 1_Application_20070329

,_ 20p7G568
The following is an abbreviated application form for those applying fora 401 Water
Quality Certification to impact FERC (Federal Energy Regulatory Commission)
regulated lake shore or bottom under the U.S. Army Corps of Engineers Permit
GP30. This Application cannot be used for wetland or stream impacts. Please
provide seven (7) copies of this application and supporting information as well as a
non-refundable application fee to the Division of Water Quality of $200.00 for
impacts of to lake bottom of less than 1 acre and $475.00 for impacts to lake bottom
of greater or equal to 1 acre.
Applications should be sent to:
Division of Water Quality Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
I.
Applicant Information
1. Owner/Applicant Info
Name:_ i•J___ ~~I
Mailing Address: ?
Telephone Number:
E-mail Address: $~~
2.
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Fax Number: ?~Sf
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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: ~A+'?~- *~ !~'~~
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Address:
II. Project Information
Fax Number:
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 ~ 1
County: ~i°~~L ~ Nearest Town: °~
Subdivision name or site address (include phase/lot number): ~+ ~'' /~ A~cG~! ,4Gtt•~`S'
Directions to site please include road numbers, landmarks, etc. (This is not
necessary if an adequate vicinity map is included):
.Z'n1,a~w.s Ms~•r•~li~ ~Z+a+w, ~fi7' ~ Rrr.+O~~.r.,.1' ~K~•csr ~2(6~"l'
2. Describe the existing,~and~se or condition of the site at the time of this
aprrlication: ~•A/('r~ 1T~•~r ~ f' d~ ~r'~~'~~ MI t~'~~ .
G~-D ~ !S ~,v~ ~4E'f.
3. Property size (acres,
4. Nearest body of water (stream/river/sound/ocean/lake): ~ ~~
5. Describe the purpose of the proposed
S~-bn~. ~ S'%j~
6. List the type of equ~ippment to be used to construct the project: ~~Or-~`--~ ~+~ $~ 5~4~-
7. Amount of impact (including all excavation, backfill, rip rap retainin walls,
etc.) below the normal pool lake level in square feet or acres: <<~~t~= 2?a ~''-~~
vY ~-'~Nx» ~ . r~r ~l ~t~-~te... ,d~~ fr 15r~ c- ,
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: ~o X 2 ^ ~°
b. Please describe vegetation above the normal pool lake level and 50 feet land-
ward to be impacted (number of trees for instance): ~ V~ A~ aJ pia ~~~..
~.
3la'?I'b"7
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

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Rlee app~xinta~~y ~kat+ch the f g i~f~rman ~n a plan
~pieaae pr~vi~~ ~n~lnn~ ~~ e~c~ item, our ~a ~~ ft. x ~I~ ft~
'~~ X411 pr~gp~~ +~at~tiran ~learln~ jp~trraw~ida ~irn~~n~~~
.~~ i~~+~adti~n +af rip rip ~ fill #Q ire played a6~~ava #1~+~ F~itl Ponca el~~i+~n
3~ Loceti~an +~f rip rep fill #~ ~e placid 6~lot~' tFre F~ F'an~d el~e~ation
4~ ~ ir~cation of a ~ar~poaad atctut~ea a~ taulldln~s, r~t~lnin~
walls, do~~k~~
~ The action ~f any excav~rkion +~r ~d~in~ ~e~o~ s Fall I~~nd
oleva~ian.
B~ Locac~n ~-f oa~n~trnctian access corrid~ar~.

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. FEET ; ~ r '~ ~ rye ` ^ ~ ~'~, ,.,
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`~E
80° 67' 30' ~ ~ yr ~~~ ' O
< ~ ~ ~ _ . -~~ ~ o
Produced l~r the U.S. Geologiq E ~,~~ o -~ ~ ~
~~ o
Revised by the U.S. Forest Sen ~ ~ ~, 350
Areas outside the National Forest 5 ' ~ ~ ~ Qy'~ /~
Contrd.by i1SGS, NOS/DiOAA and Nora ~~ ~ - ° ~. `'.~, e
piiotogiapl~taken 1983Partlal ~ dl ~ j •" ~`~'~~ ~ v '~
~~~ o ~;
0
1000-amber llniversai Transw.rse Mercaty _ ~i ~ ~
_ }
North American Da4mi of 1983 (NAD f33; ~ , ~ ; ~ -` 6 -~
The values of i6e shift betaaeeu NAD 27 ~ ~ ~ ~ 1 ' I ~ ~~ ~~ r, 1
are obtainable from National ~ ~~ ~ ~` xc~=~ ~` :~ ~ ~ ~'
''~' Na~National Forest (G~.~~..~ -J_ ~
~~a~ ~M~ lalN.ii Q~ ~ ~ ' \ ~ ~ h
l,~-~h~holdings may exist io other Naflooi S ~ ~ ~ ~ , ~ -;. +~ w \\~ '
This map Ls not a legal land )•me or omuners ~~~ ~ ~ ~~~ -~
subject to change and long, and may ha F'~- } '. _ ~ '. ~ t,,~ , '~
Unsmveyed lam net~not offk9al. n befrn o n ~ ~ tr . ~~ ~ \' I~ ~ .~ _

lMBER ARC.LENOTH DELTA ANGLE CHORD DIRECTION TANOENI' RADIUS CHORD LENGTH] MARGIE LANE
az 13 A4'00 41 N x4'0613 E x3.72 50.00 73.zo I (45' R/1~ \_

'~~ TIE LINE
N 42'54'38" E `~
EN IN
47:27 CUL-DE-5AC EIP
N ~
~~ BRIG(

~~ 2~WV
V
AILBOx TIE UNE
~
' N 25'
6477" E
t
EIP
~ M 9
DIR
~ ~ O ~ wELL 1 I
~
RANDALLS FERRY RD. ~ 1
~ ~ ~~ 74 ACRE
~ 0
~ DRMER .
VICINITY MAP (NOT TO SCALE) 4~ ~~S UNE
A5 SHOWN t BY COORDINATE
~ METHOD
' 1.'
b' ~
i.
ALLEN ACRES ~ O R~DDISTURBED IRON Roo .
~J~+
P. B. 15, P. / U (~
~ ~ NIP NEW IRON PIPE
EN EXISTING NAIL
X
T
IRON PIPE
~ IS
ING
I E1P E
UOT UNDERGROUND OAS TANK
,~ CLF CHAINUNK FENCE
~ WM WATER METER
3
JOSEPH B. SPEIGHT ~ SON
' R~ RIGHT OF WAY
~
D.B. 885. P. 224 ry
~n ~ ~ CL 'CENTERLINE
~
2 ~ ~*

~~
~' O
n ~
~ y o7•osea
UGT
~' I
a ` • '
+
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~ N 41'09'52" W
03 NIP
14
. ~ NOTE: THIS LAND IS NOT LOCATED IN A
0]
~
TIE LINE
a ~
s HAZARDOUS FLOOD AREA AS DETERMINED BY

Z °%
S 43'28'00" W NIP ,
~P~ '
FIRM FLOOD INSURANCE RATE MAP

,H,
90.00
r ~I-~~P~ COMMUNITY-PANEL N0. 371a7C017a D
i EFFECTIVE DATE: SEPTEMBER z1, 2000

PLAYGROUND
EXISTING EQUIPMENT
SEA WALL '

HVAC , t ~ ~""
~'o
III` , ~'~^~ f `

EIP UNIT / -,~
~,
RAEWOOD iNC.
~ ~` ;~ , . ~ ° `
D.B. 4l7Q P. 280
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i'~.
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TILLERY
ti
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PIER de \
BOAT HOUSE /V
.1,
2
~~
v% ~
N
PROPERTY OF •
CAROIJNA POWER d: .~,
LIGHT COMPANY .
~ ~~
~.
NOTE: ALL. DISTANCES SHOWN HEREON ARE
MEASURED HORIZONTAL DISTANCES IN FEET
UNLESS NOTED OTHERWISE.
NOTE: THIS SURVEY IS SUBJECT TC ANY
FACTS WHICH MAY BE .DISCLOSED BY A
FULL AND ACCURATE TITLE SEARCH.
NOTE: ALL UNES ARE OLD UNES
UNLESS NOTED OTHERWISE.
CERTIFY THAT
MY SUPERVISI(
THE RATIO OF PRECISION AS COM
LATITUDES AND DEPARTURES IS 1
AND WAS BALANCED BY 1HE COb
PROPOSED - c_;,
IN GROUND I ~`r~F 1~~~~~Il;: ui~ a '~: v i ~Ei.,t' j ,,
POOL I ~ ~na~urnr~:n nRA~
fl W..CUFF MARTIN
t D.B. 779, P. 830
' NOTE: THIS MAP OR DRAWING AND ANY
~ ACCOMPANYING D MENTS ARE FURNISHED
t TO THE PERSON(S NAME THEREON AND IS
' FOR THEIR EXCLU VE USE.
NO ALTERATIONS ARE PERMITTED BY
t ANYONE UNlE33 AUTHORIZED BY
t ROOELL E. HUNSUCKER k ASSOC., INC.
THIS MAP IS NOT FOR RECORDATION.
~ S 72'45'30" W
5.06
i DIR
TIE 41NE DIR
S 28'00 00" W~/
49.00
~. \
ti
EIP
,,1~I111111/~/, ,
THAT: SEAL ':
L-488 ct:

S 177 5~52~ E
19.98
EIP
(CP~cL)
DEED REF.:
D.B. 081. P. a7sa
P.B..15, P. 78
PHYSICAL SURVEY FOR
ROBERT A. COHEN
and
AMY W. COHEN
EAST CENTER T1NP., STANLY CO., NC
SCALE: 1 "r50'
15 APRIL 2005 MAP N0, 05042
ROGELL E. HUNSUCKER do ASSOCIATES, INC.
ROGELL E, HUNSUCKER P.L.S. L-2488
P,O. BOX '760 ALBEMARLE, N.C:
28002-0780 [phone]

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