20100287 Ver 1_Shoreline Stabilization_20100419

2 0 1 0 0 2 8 7
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:
Division of Water Quality 401 Oversight/Express Review Permitting ati @ ? i L
1650 Mail Service Center 'll V
Raleigh, NC 27699-1650 APR 1 L' 2 G ;L
1. Applicant Information PA I D DEVR - W4TER QUALITY
WETU4 03 AND ? 10RN*5, A E-R IdI CH
1. Owner/Applicant Information
Name: .1.. Taru'is AGrTin
Mailing Address: /'0 f Ad"LSL 0ri,I 6'1' +S LG.../C'
easAi'x "V e Telephone Number: p/f Yost Fax Number:
// E-mail Address:
?CG
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: Lsri'?/ s? ?a> J/"• G??A' !ss`?.rs C O? .10,vZe
Company Affiliation:
Mailing Address:
WG „_7 9325'
Telephone Number: .3.341 ,213 SZ.3I Fax Number:
? ? Q.na%/ •l.?•ti
E-mail Address: /_IfA," Irlh
11. 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.
I . Location
County: d..1? Nearest Town:
Subdivision name or site address (include phase/lot number): /D'f
Directions to site please include road numbers, landmarks, etc. (This is not necessary if an adequate
vicinity map is included): AR,?"' wY ?'r7 Z ik',/ /j?
2. Dese *be th existinn land use oT condition of the ite t the time of this application:
C1 a7Z A 1ne- C syl C'O"Vf O ??ZSidn? L'GSiz /,V/ 4? S??rz'/ice
3. Property size (acres):
4. Nearest body of water (stream/river/sound/ocean/lake): l?yecp
Describe the purpose of the proposed work:
6. List the type of equipment to be used to construct the project:
%M?'
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below the
normal pool lake level in square feet or acres:
A5 -0
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): ?/J f «???- ,.moo
's Signature
Date
XV
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
SEP-8-2009 16:11 FROM:DWO-WETLANDS 9197336893 TO:913366941900 P:5/5

Z/
lPleaee aWaW alley sl h the following sennabion an We ;plan
(pkme pnwl& Oenwiona for a ftm% omb as 10 R. x IN It):
1) AN proposed vagsta an ctaarlnd (provide dlownduns )
.21 LGocdton or rip rap or fill to be p1mahd above the FMS pond elevatlan
3) Location or rip rap or fill to be plsced below the Fk* Pond elevAun
4) The ImMion of any proposed sbw v sh as bullding% retaining
w4vs, docks, etc,
5)''he bedian or mw excwndian .or drsdging bdgw the Fug ftno
elevaftm
d) Lo ph of condrucom a"Ou corridom.
,, res-";/v a^161
Gd/Y-liiLt' i,.,,?,1?

Mar 30 10 09:03a Martin And Co 9194931304 p.1
cuumitemm Cwttn as?a4-doas
ofta ft+emmmatt
Larry V. Butts
741 Rudd Ridge Road
Yanceyvxiie, NC 27379
336-213-5231
1 JARVIS MARTIN. OWNER OF LAKE LOT AT 109 WHISPERING PINES
LANE, BOAT DOCK 0391, HAVE CONTRACTED CUSTOM CUTS OUTDOOR
MAINTENANCE TO PLACE RIP RAP STONE ALONG SHORELINE TO HELP
PREVENT EROSION. I GIVE LARRY BUTTS JR (DBA. CUSTOM CUTS
OUTDOOR MAINTENANCE) ANY SIC,NATORY AUTHORITY NEEDED EN THIS
MATTER. IF QU OR CONCERNS PLEASE CALL 101"93-
4093
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