20100412 Ver 1_401 Application_20100527

05/24/2010 15: Be 3365995414
Apphatat hftuation
OWW/Appiicaant InfbmAdon
Name-
Mailing Address:
i'?
20100412
The fallowing to an abW*vIated applie4tiaa foam fur tEtane a
CQwg*
"Wia m to Inspect MC (Federal Eava ? Cho a 4U1 W+ettt lake ghee
battotom under the U.S. Aran C Gp3o. n& A UfttMad manot be ache Ahura d
for wetland or gtr?eam imp"_ klM Probe tlve (S) copies of this applimtJon OW hnarmad' as we" as a non-"ftuftble aPOCAUM too to the won or grater all N*Porft
at
for ianyp Ch to lake bottom of tests tlnaae 1 acre sand SMoo for IM Qu tY $240.00 equal to 1 acre. Pis to lake bottom of grneater or
ApplIftil m 60W be smt to:
lplvbkn of Water Quality 4010vetetigittWAWW Ravfew Pettmitting
100 Mats ? Center
RaWlIs, NC 210!.1689
1.
I
2.
Telephone Number;
&mAfi Address:
?s?cao?sre IUC16b".)y bg14 P.1
CL.AYTO14 CONTRACTORS PAGE 03
SPA
1.9AY ?; `t 20 fD
Vii T!A'?DENR? WER L"JALITy
r+P3D „TCR.',Pi .rER 9RtANCH
Number:
Agent Ietfora<tention (A signed and dated copy of the Agent Authorization letter must be attecttod
if the Agent has Itignittay authority for the owner18mlicant.)
Name:
Comm Affiliation:
Mailing Address:
Telephone Number.
E-mail Address;
II. Paniect Intbraation
Fax Number: --
Attach a vkIWty map clearly showing the location of the property with respect to local landmarks such
as towels, rivers, and goads, Also provide a detailed Bite plan showing property boundaries and
development plans in relation to surrounding properdes. you may ease the diagram below to make a
hand sketch of your project. Also, see the example below fot guidance. Both the vicinity tt"P and site
PIMA mast iaclteda 4 SCak and north an?ow. 1'ht footprints of all buildings, impervfows surface:R, or other
facilities must be included.
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05/24/2019 15:06 3365996414
1 • 1=1ktidn
9192005170 TO : 3365199641 q
CLAYTON CONTRACTORS
P.2
PAGE 02
county.. ANearest "Fomvtt:
Subdivision name or site address ('"clvdc
phaarJiat number); 01?ler?..?cQ .
Dimcdons to site phase Include re&d numbers, laydmatko, exc.
('Phis is not necessary if an We
vicittitY Mop is included): I'll,
2. Describe the existing land use or cmdidon of the site at the time of this application:
3. Property &ie (ate):
4. Newest body of water (stxWmhiver/ &oceaMakc); , 1
5. Describe the ptttpvsa of proposed work; D
6. List the type of equipment to be used to construct the project:
?. Amount of impact (including all excavation, backin sip tap, retains g walls, .) beiaw the
normal pool lake level in square feat or acres; ?
B.a. Amount of impact (including all clearing, back fill, excavation, rip rap, mtainiing W&US?
above the IIQnW pool lake el nyd O feat landward in Vt ar?feat or acres;
2 . C r
8,b. Please describe vegetation above the normal pool lake level and SO feet landward to be impacted
(number of trees for instance): S r. _
on"
Due J
Is valid curly if an adthorization letter fmm the applicant
iIV
CLAYTON CONTRACTORS, INC. 711 -A N. Main Street
J 'o'
ROXBORO, NORTH CAROUN M73
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PLAT OF ` "°? p 63o?VS?»
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CUNNINGHAM TOWNSHIP
PERSON COUNTY, NORTH CAROLINA
PREPARED OY 77
J WALTER JONES, ?N. %]Il? y 9
O.>,. hU M4 Rf61STEREO LAND SURVEYOR N>..A, 1961
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