20191289 Ver 2_Shoreline Stabilization_20201201

Submission Form
Pre -Filing Meeting Information
Before submitting this form please ensure you have submitted the Pre -Filing Meeting Request Form as we will not be able
to accept your application without this important first step. The Pre -Filing Meeting Request Form is used in accordance
with 40 C.F.R. Section 121.4(a) "At least 30 days prior to submitting a certification request, the project proponent shall
request a pre -filing meeting with the certifying agency" and in accordance with 40 C.F.R. Section 121.5(b)(7), and (c)(5)
all certification requests shall include documentation that a pre -filing meeting request was submitted to the certifying
authority at least 30 days prior to submitting the certification request. Click here to read more information on when this
form is needed prior to application submission or here to viewthe form.
Attach documentation of Pre -Filing Meeting Request here:
Pre -Submittal Meeting Request Form.pdf 422.6KB
Pre -fling Meeting or Request Date 10/27/2020
ID# 20191289 Version 2
I. Applicant Information [15A NCAC 02H .0502(a)]
Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all
mandatory questions are answered.
Primary Contact Email * [e-mail]
Rease provide an email address for payrrent and requests for pure information here.
Owner Information:
Name: * Alan Cunningham
Email: * [e-mail]
Phone Number:* [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
20911 Cinnamon Tree Ln
Address Line 2
City
State / Frovince / Region
Cornelius
NC
Fbstal / Zip Code
Country
28031
us

Is there an agent working on the
project? *
Agent/Consultant Information
.................................................................................................................
Name:
Company Affiliation:*
Email:
Phone Number:*
Mailing Address:*
F Yes
f^ No
Janice Estep
CBC Stone & Recycling, LLC
[e-mail]
[phone]
(XXX)XXX-XXXX
Address
638 Oakridge Farm Hwy
Address Line 2
City
Mooresville
Fbstal / Zip Code
28115
Asigned and dated copyof the Agent Authorization letter:*
Auth. Form.pdf 188.02KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* Cunningham Dredge
State / Province / Fbgion
NC
Country
United States
If your project has a formal name please use this. If your project does not hake a formal name, please identify your project by
the owner name and proposed acti\ity (Jones Property Access Road, Smith Guest House, etc.) List in parentheses any
other names that have been used to identify the project in the past.
1. Provide a vicinity map (i.e. street map) clearly showing the location of the property with respect
to local landmarks such as towns, rivers, and roads.*
r Upload File
r Lookup address
Upload Map: PlatMap.pdf
Vicinity Maps.pdf
Directions.pdf
Latitude:* 35.488737
554.75KB
1.88MB
256.07KB
Longitude:*-80.893540
2. Provide a detailed site plan showing property boundaries and proposed locations of vegetation clearing,
structures (buildings, retaining walls, docks, impervious surfaces, etc.), rip rap, excavation or dredging
below Full Pond/ Normal Water Level elevations, and construction access corridors. You may use the
diagram under section 12.normal pool lake level/normal water level*
Site Plan.pdf 313.76KB
Buffer Form.pdf 338.99KB
Please use the diagram at the link below:
https://edocs.deq.nc.gov/WaterResources/0/edoc/616616/Shoreline%20Layout.docx

3. Attach a photograph of the shoreline/ buffer proposed to be stabilized. (Include a scale of some sort- a
yard stick, shovel handle, etc.)*
Dredge Area Pic s.pdf 1.92MB
4. Location of the property (where work is to be conducted)
Nearest Town:* Cornelius
County: * Mecklenburg
Lake/ river/ ocean adjacent to Norman
property:
Subdivisions name or site address: * 20911 Cinnamon Tree Ln. Lot #6 Keel Bay
Include phasdot nun ber
Directions to site:*

610 E Center Ave
Mooresville, NC 28115
Take Evergreen St to E Center Ave
43s(0.1mi)
Head east toward Evergreen St
108 ft
Turn right onto Evergreen St
417 ft
Turn right onto E Center Ave
2 min (0.5 mi)
Continue on S Church St to S Main St
2 min (0.6 mi)
Turn left onto S Church St
0.5 mi
Turn right onto College St
0.1 mi
Continue on S Main St. Take NC-115 S, Langtree Rd and I-77 S/US-21 S
to Bethel Church Rd in Cornelius
14 min (8.4 mi)
Turn left onto S Main St
1.2 mi
Continue onto NC-115 S
2.1 mi
Turn right onto Langtree Rd
1.1 mi
Use the left 2 lanes to turn left to merge onto I-77 S/US-21 S
3.1 mi
Take exit 28 for US-21 S toward Catawba Ave/Lake Norman/Cornelius
0.2 mi
Keep right at the fork, follow signs for Lake Norman and merge onto W
Catawba Ave
0.8 mi
Drive to Norman Colony Rd
2 min (0.7 mi)
Turn right onto Bethel Church Rd
0.3 mi
Turn right onto Norman Colony Rd
Destination will be on the left
0.4 mi
20925 Cinnamon Tree Ln
Cornelius, NC 28031
Rease include road nacres and numbers, landmarks etc.
5. Describe the existing land use or condition of the site at the time of this application:*

Residential
Fbsidential, undeveloped, etc.
6. Property Size 1.501
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
Dredge a 40' x 40' area for new dock. Dredge by barge. Haul material out
by land.
8. How will the work be done? * W From Land
17 From Water
9. Total amount of disturbance below the normal pool lake level/ normal water level:*
(including all clearing, back fill, excavation, rip rap, retaining walls, etc.)
177.17 cubic yards
square feet
10. Total amount of disturbance above the normal pool lake level/ normal water level and 50 feet
land -ward:*
(including all clearing, back fill, excavation, rip rap, retaining walls, etc.)
0' above on dredge
10' x 50'
construction access
in subdivision (500
sf )
square feet
11. Please describe the vegetation above the normal pool lake level/ normal water level and 50 feet
landward to be impacted:*
(nunber of trees, for instance)
Grass buffer, no trees removed, no disturbance to buffer. Dredge by
barge, material hauled off by land and left onsite at Keel Bay HOA
common area. Silt fence installed for erosion control.
Sketch: Dredge Application.pdf 3.79M13
Dredge Spoils Info.pdf 2.7MB
Sketch.pdf 236.87KB
Application Fee:
Once the application has been accepted. You will need to send a corresponding fee in with the appropriate DWR#. The
application fee is as follows (pursuant to G.S. 143-215.3D):
0 $240.00 for impacts to lake (below normal water level) of less than 1 acre
0 $570.00 for impacts to lake (below normal water level) of greater or equal to 1 acre
By digitally signing below, I certify that:
o I, the project proponent, hereby certifies that all information contained herein is true, accurate, and complete to the
best of my knowledge and belief
o I, the project proponent, hereby requests that the certifying authority review and take action on this CWA 401
certification request within the applicable reasonable period of time.
o I agree that submission of this Shoreline Stabilization online form is a "transaction" subject to Chapter 66, Article 40 of
the NC General Statutes (the "Uniform Electronic Transactions Act");
o I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes
(the "Uniform Electronic Transactions Act");
0 1 understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
o I intend to electronically sign and submit the Shoreline Stabilization online form.

Full Name:* Janice Estep
Signature:

Initial Review
Is this accepted into the review
process?*
Project Number:* 20191289
Select Reviewer:*
Select Reviewing Office
Has payment been received?*
What amount is owed?*
rYes allo
Version:* 2
Alan Johnsomeads\adjohnsonl
Mooresville Regional Office - [phone]
r No Payment Needed
r Fee Received
r Need Fee - send electronic notification
r $240.00
f $570.00

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT N0. n _ PLAN NO. _ PARCEL ID:
STREET ADDRESS: �/ G1AJ,%J4M0h) -rF-Er LN
e012^47 r14S N)C- a$o3 1
Please print:
Property Owner: L4-J _ GUNjw 0'* 4w
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
n of 1 LLB..
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
Telephone: 763 -6s6 - 38q 9
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
lAu 90zedSi na Authorized Signature
Date: / V
Date:

cRa m wur � slw+a xo ru.m
•[. XL wty�,.F4�ry
A Mn� YSYi! a .mn�
wrtt�um�� � g ru � �anec
ri ir.E�ehaq.�xw m O +.a�gl�-�o�lifgp.
W ��NOlu � soa
�°�IIr ras�InF
•oN aF6 (II At �IX�F4 nC__-qO�� �uVln
' ShTV61rM!-1s
� �IVF�IGa!
�Rfn 50unu¢
M] Pmou BACi � A� e
�1H[�Iwn v mea.3 cl! �efi4aa mNn. ne
•' awn tbL � ea WF ,uPrxF .v'Mi as
9Yr �S� V¢ v pmp wcrDa [a
NACRubg .4ix CY1vWGG
mm
€
I
MTSA WPTAYAT95 I E-
287e2/015 a®IE 1fAY
TRumpits
ti'1e32/459
16.896 AC,+— TQTAL PHASE 1
12.812 AC.-+-- TOTAL THIS MAP
w et1 � smpn�Wea���NOyy�, � e.4rEmW
c"�a�w v.N"w � moweeas m �,sr�"s,wW wi.il"'bi
rt�syy srvpn! i oqW .xJS. a NTc
+nwi b� r.�w,y N.�wsaameeh� br
Ma O�r N1't.W W��fv ! rvmmv 4 v� �Ml1eW0 RUA
hn �lmv.ria..npns. Fyy u'o w
iLvepns�
mamFG veyq M ��
ea, Arta
Mg-n"..."�
r -59 y{oR
LAKE PROPERTY WV. LLC
30102/931, 30102/938
I I _
I Teaa/sxs _ _
€ L PPH 2o-20MDM
-
I = 2a+se/eal
Po 2f-Tlo
NaMYo4s
�ipfu�gatra. i
�.iE3Ti1ly �•l:]r
lltttJNC 1[tt1 i.5GI�
�9=R[fiu.:3 ait iJr43[l�
kRE..a3�#ii�tRRtL.k':i
FR tR'!£YGTJt�i • � �llt�
tt<1t11MsgYCLY�>AI:hY'r
� >•ttGt1Y:L" tRttttl:V±1�
R.IA11 �""h f�C rtttti. l!
�,vttEl:393_ a� iE� yt�
of30 301U2, v#C[ Rt
hAF ®Olt 3B PAGE
���4tlYkecltRRf3Y1�RR�.HY.ICR
IDllaraUi tFiF6U�t9[GiSYfl©
tGAI>lI.'Jr�.plt\lilli�ttlFYir 311G
]IIileIs•1�.::SL�i:]S���F: � 1gCi
Ai'Ikiid.��koiTlrfil2Yv �>L-a
�- i6lyest-R11�tt[illtRRi�.'#:1eR
u'Iita::�Esriri +a.ttcynalelt3r
areTz°� �x rw+cslr�urrt
ta#tt+.�cr�nrca� iFrkr -�
tsrrin�TRwesr �=�rR:
twoa��RtF:a �.zrrtckvrn.R nld tr�T:�tcTulwalofTf� tpF�rs+R�
REC .4TTtaraon
:311 G -,
r C05A �3 �56 p�118S'C 8/�'♦
SR �` — t
i
i
i
DEYDMONSURVEYS
417E s-
CHW(POOYEY, P3762
sc1LT: 1- " ee.
oa 3o:9x a: va
Fw
PHYSICAL SURVEY / MAI, ALAI
ROBEH7 D MON PLS #y899
m PC,is,
3704 NC 1iiGf A 11S nOAT1i
P.O. 494-PDMFE NC 28o37
1EU1{Y 70Wk5HIP
KEEL BAY
PHON _ 704 031490
11EC=laURC COMY, NJ
PHASE. ONE - MAPFA?L1
7114f483/2r7o
SOB/
R#Y6L41NG P+VtCfL 00113216
.Z-, A T[T,,,
L 2 " 15-a5
10510/M
eO n so l:il
Y
A
I

Sri
Kj
1

&o§
"Z
0
� «
O
/
�
k
\
�
�
d
k
/
»
c
�
5

i
O
ll1�A

Foil Pond/
Normal Water Level
Shoreline
"o
removed
T�
La ke
(At Full Pond/Normal Water Level)
40 31 c�k
yap
�s
�Omse.
Please approximately sketch the following information on this plan, length of shoreline
(provide dimensions for each item, such as 10 ft x 100 f) *:
1. All proposed vegetation clearing
2. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
3. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
4. Location of any proposed structures such as buildings, retaining walls, docks, etc.
5. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
FORM: SSGP 10-2013 Page 3 of 3

>
>
C
n
T
°
�
�
o
C7
co
m
m
(n
m
@
v
�
m
a
At
3 N
C
d
3
o O
o
j
o
Q
�k
U5
_
n rn
� o 0
L
°> d w
o
b
CD
n
�.
C3 j a
D
C �
N 5.
C r`g
\\O
O -i
O
c ?
� o
n
i
o S
W
N
N
O
o ogm_,
cm
N p 5
mK
Z
i►
�►
o
3 a =,
in
w_
o
o
m
rn
O
�04.3�
7
N -1
Z 7;
n a
y
C
p
C
o
N
O
0
0
ti
a
W
v
o
a
°o
.N.,
m
aZ
O
°
9c
CD
z
co
n
m
m
m'
m
cZ�
°
N O Q y o
r
o
w
S
@ p
m
°
o
m
n
m
a
@
Q
-
O O
P
O O
Z
i4

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: aa5 ft 6rnrry4-wp" -rR-EF 11J- _County; _k4g�j�
Owner: #W 60,11 /?n/g /"'�_'X
Print
Contractor/agent:
Print I Si
The approval is for the purpose and design described in your application. Impacts not indicated in the
application is a violation of the Buffer Rule. Site specific work should be provided in the application. [15A NCAC
02H .0506 and 15A NCAC 02B .0243(8)]
Trees are not allowed to be removed from Zone 1 of the Buffer (within 30 ft of the full pond elevation), unless
approved. Exception, those trees that are severely undermined along the immediate shoreline can be removed.
Minimal shaping and sloping along the immediate shoreline is allowed. [15A NCAC 02B .0243(6)]
Benching, grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 02B .0243 (6)]
Beaches, impervious patios, impervious walkways, etc. are not allowed in the buffer unless specifically approved
by the Division. There are limitation on size for decks. [15A NCAC 02B .0243(4) and (6)]
Work to be conducted from land must indicate an access and indicate any trees that are to be removed. The
work corridor should be described. The approved access corridor shall be restored. Staging, spoil, construction
material must be outside the buffer. [15A NCAC 02H .0502 and 15A NCAC 02B .0243 (4), (6), (8)]
Stormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
discharges must be at the natural elevation and discharged prior to entering the buffer directed as diffuse or
sheet flow at non -erosive velocities to the lake. [15A NCAC 02B .0243(5), (6)]
Acknowledgement of Notification
11 'L " '' ' ` hereby state that I have been informed of the Catawba
Riparian Buffer Rule. Any wa conducted in the buffer, not specifically stated in the application and approved
by the Division of Water Resources (DWR), is a violation and subject to enforcement. Due diligence will be
taken such that the construction will be built within substantial compliance and intent of the 401 Water
Quality Certification and Buffer Rules, the approved plan(s) and specification(s), and other supporting
materials.
Signature (owner): Date: /° s �a

-}�.
r
.��� '�.
''-'irr
,�

a®

Duke Energy Excavation Permit Application Form
FOR DUKE ENERGY USE ONLY
Dyke File No.
Application Fee S Security Deposit $ Check # Date Recv'd Initials
Date of Duke Energy Lake Services, applicant and/or contractor on -site inspections Date tt> 'Z ZINtials-40—yi
Date Final Protection/Avoidance Area Markings Field - Verified
Approved to Start Work By * :
Date Completion Required
Date Passed Closeout Inspection*
(Print)
Date of Any Approved Extension
Initials
Initials
Date_
(sign)
Initials
Any Stop Work Orders or SMG Violations*? (check one) DYes ❑No (If Yes, explain in PART V)
Date Deposit Refunded Initials Date Permit Database Updated Initials
* forward copy of approved application (all pages, plus any attachments that Duke Energy changed) back to applicant
with Approval Letter and highlight any changes. File copies of Approval and Close-out Checklists and any Stop Work
Orders with application
Part I. Applicant Information (.Please Print)
Name Akatan �� vtn +�inam Telephone
Email address: ',
Lake Address Mailing Address (if different)
09 11 Q s n nanna A 7L abRll r1nrnMnn j�?_Ln,___
Ce'rneAlos Me- 61&S1 j2orn ,t>'6tEAC, am,31
Contractor Company
Contractor Contact Person s,,; ce. '5 6i,r D Telephone 7104 _ l reb - 5ILL
I
Contractor Email Address: j n Fo & c6-- Sin e-&nei Ce CUCI'l ng . corn
LAKE LOT INFORMATION
Lake lhlerman County City C2r,nel', ►s5 State -tLc,Tax Map No.
Subdivision _ �Ai eel Gau Lot / Section No. Lot # (� Lot Sizet. a Acres
Duke Energy Page 4 of 13 rev 10/1/2019
Excavation Program

Duke Energy Excavation Permit Application Form
Are there any Co -Applicants'? (check one) ❑Yes ffNo (If Yes, include names, street
addresses or lot numbers, pier numbers, phone numbers, and email addresses in Part V —
Additional Information)
* Co -Applicants exist when the proposed work is being done under a single application, will be
performed by a single contractor as one continuous project, and is done to benefit multiple
owners / lease holders of Project -front properties within a single development. There can be no
more than 4 co -applicants in addition to the lead applicant on any application.
Do not continue the application until an on -site inspection has been conducted between a
Duke Energy Lake Representative and the applicant and/or the excavation contractor.
NOTE. Initialling this portion of the application by a Lake Representative in no way
constitutes approval or eminent approval of the excavation or any other lake use permitting
activity.
Date of on -site inspection 10 7'7 20
Initials (Duke Energy) J F-Y-M
(applicant/contractor)
Duke Energy Page 5 of 13 rev 10/1/2019
Excavation Program

Duke Energy Excavation Permit Application Form
Part II. Description of Project
A. Basic Informati
1. Type of excavation: (check one) PTNew excavation ❑ Maintenance excavation
2. Purpose of excavation: (check one) ❑ Boat Access Channel
❑ Water Intake Channel ❑ Wastewater Discharge Channel
O'Other (spec): +neap cgZ�,
3. Lake user category: (check one) ErPrivate ❑Residential Marina
❑Commercial Marina ❑Public
❑Other (specify):
4. Max. Excavation Area Dimensions (ft): Length qQ r Width Lit) Depth 3 r
(Note. include additional area dimensions if necessary so response to #S beloii, equals max. area
dimensions in 94)
S. Volume of Excavated Material (TOTAL for the project): 1-1-1.1-1 Cubic yards
6. Type of material removed (applicant determines by field sample if practical): d , r$ l S k It
7. Excavation Site area: 0. 11 O Acre (s) Disposal Site area: ©, Q:A Acres)
8. Total Disturbed Area (including equipment staging area): d ..Q.5 Acre (s)
9. Does the ect meet the requirements of the applicable General Permit? (check one)
es qo
10. Do you claim title to the disposal area? (check one) ❑Yes No
11. Do you claim title to the equipment staging area? (check one) ❑Yes Q
12. Are there any water-treatmacilities within 50 feet of the proposed excavation area?
(check one) Yes �!o
(If Yes, specify):
13. How will the excavated material be entrapped and the erosion controlled? (e.g_ .see attached
erosion control plan and disposal area design): -K)+re&Ae. b4 1--arse- . —'Dredg-e— rr*A-erlal
A-Q be V-a"Ied ou+ lmnd u5:n3 C6n5*rvC{ion Cxuess road and
leek 0" ,SL <e 'In l.o rwnoh o re o, LoC(X+ed cx+ '),W 5O ± kend erso n
1(see c3,:0or-bedeed) Erio5tov\ Con-�ral�ed bq 511i fence.
Duke Energy Page 6 of 13 rev 10/10019
Excavation Program

Duke Energy Excavation Permit Application Form
14. Type(s) of excavation equipment to be used: Lon3 reach e-kM\)O Ov,
15. WiII waters or wetlands be crossed in transporting equipment to or from the site?
(check one) ®Yes ❑No
(Ifyes, explain) 6� \,�,r9e�
16. Will return water re-enter the reservoir? (Check one) ❑Yes CNo
(If'Yes, speck point(s) of re-entry and show on Excavation Area Drawing)
❑N/A
17. Is there an existing facility (e.g. pier) that access is being maintained to by conducting the
excavation? ❑Yes Mo
(If Yes, provide the existing permit number. If No, include a scaled drawing of the proposed
facility). Permit # ne&u dllc�
rn,$- GppIIed 1r01L
18. Total planned duration of the work (Include first equipment mobilization, excavation
through final mitigation measures complete):
START 'a, / a k FINISH
(Month) (Year) (Month) (Year)
Duke Energy Page 7 of 13 rev 10/112019
Excavation Program

w
vo
O-
V "Ell
a
"
o
I
r
� F �
35
fdCS
S.
0
h
a
S
;+
�
O
�
x
C
0
a
x-
•
T
m
m
b
9
u
rt
a

r
w
o
m
o
w"
CTJ
cu ;..
o • td
-�
<D
@
n
oCD
a
n o
CD
M CD
�
N
cs
•�
��
Iro
�
0
k
a
m
R
C7
�
e
Q.
d
a
a

Duke Ener Excavation Permit Aimlication. Form
C. Applicant's Simatures
- — gr,c�rea. W\eme Chet
Comments: Ne.t9klbo�s: Joe E
aoq;5 C 1 nruman i re Ln.
C o; r%ev, u5 , XMC 9L8631
O-c v3d E V s6,61,e, Ser-+°nof
'aaIya U` O-JAer Henderson lam,
(°orne-ItiQs, W! abb3t
Applicant Name (print) 41-4nl CuVnlwO
Applicant Signature* Date
Co -Applicant Name (print)
Co -Applicant Signature* Date
Co -Applicant Name (print)
Co -Applicant Signature* Date
Co -Applicant Name (print)
Co -Applicant Signature* Date
Co -Applicant Name (print)
Co -Applicant Signature*
Date
*Per my sib ature, the information provided in this application is correct to the best of my
knowledge.
Duke Energy Page 14 of 13 rev 10IM-1 il9
Excavation Program

Excavation Project User's Agreement Letter
(Please fill in the blanks. Please Print)
Date iol d.5 l ao
TO: Duke Energy
c/o Lake Services - EC 12Q
526 S. Church Street
Charlotte, NC 28202
RE: Excavation For (Subdivision and LotWsor Other Project Name)
Ac)Q i 10, n fYi.iYlnm Trree. I�L _ _ � � Lo 1,' ep_i CYl
(Lake/County/City) Npr,A QAN /meWI
(Applicant's full name) IA\N���trri, hereby agrees to comply with all
recommendations, requirements and/or c ditions of Duke Energy, General Permit(s) (if
applicable) and other federal, state and local agency requirements pertaining to the application to
excavate for the purpose of a ,neck) &CVL,
In addition, Uwe have read and agree to comply with Duke Energy's current Shoreline
Management Plan (SMP) or other applicable guidelines, much of which is repeated herein, and
understand that written authorization must be obtained from Duke Energy Prior to beginning any
activity within the Federal Energy Regulatory Commission (FERC) project boundary or on Duke
Energy property associated with a reservoir, collectively referred to as Project Boundary. The
excavation will be completed as described in the approved application and within eighteen (18)
months from the date of written approval by Duke Energy, unless specifically noted otherwise in
the application or unless Uwe obtain approval for a single, time extension (maximum of one year)
in writing from Duke Energy. I/we understand that if the SMP or other applicable guidelines or
rules change during any extension period, I/we will be expected to comply with the new
requirements to the maximum extent practicable. I/we also recognize that failure to complete the
excavation within this build -out period will require the filing of a new application within the then -
current SMP or other applicable guidelines and the new application must include any applicable
fees and security deposits.
1/we attest to be the owner(s) or lease holder(s) of the land immediately adjoining the Project
Boundary where the excavation activity is to take place, or if not the owner or lease holder, Uwe
have included proof of title to the property and written authorization from the owner(s) or lease
holder(s) to carry out the proposal within the Project Boundary adjacent to their land.
Uwe attest to be the owner(s) or lease holder(s) of the land that will be used for equipment
staging and disposal of excavated material or if not the owner or lease holder, 1/we have included
proof of title to the property and written authorization from the owner(s) or lease holder(s) to
carry out the work on their land.
nee Fwgy Page 1 xev 4/6/2020

Uwe understand that all excavation work must be done directly in front of my/our property and as
specified in Duke Energy's approval. I/we also understand that access channels must run
perpendicular to the shoreline while within the third of the cove area that is nearest my/our
property.
I/we understand that for proposed excavations, I/we must notify the appropriate local, state and
federal agencies in advance of the activity by sending them a completed copy of Duke Energy's
Excavation Permit Application Form and other required information. I/we understand that
written authorization and/or other permits may be required by some of these agencies and such
required authorizations must be obtained before I/we submit the final application to Duke
Energy.
At FERC-licensed reservoirs, Uwe understand that except for maintenance excavations, any
excavation exceeding 2000 cubic yards of material removed or any excavation or shoreline
stabilization work needed to support an application that requires FERC review does itself require
specific review and approval by the FERC before Duke Energy can issue any approvals.
I/we agree that unless specifically approved otherwise in the application, explosives will not be
used as part of this excavation activity.
I/we understand that every reasonable effort must be made to minimize any adverse impact on
fish, wildlife and other natural resources.
.Uwe understand that applicants in South Carolina proposing excavations that are not covered
under the General Permit, or are greater than 150 cubic yards, must receive prior written
authorization from the South Carolina Department of Health and Environmental Control
(SCDHEC) or the US Army Corps of Engineers (as applicable) before submitting the completed
application to Duke Energy.
Uwe agree that excavation activities will not occur during the months of March, April, May and
June because of the potential impacts to fish spawning areas.
Uwe understand that trees and vegetation growing within or adjoining the take play an important
role in its overall environmental condition, and the ecological benefit the vegetation has on fish
and wildlife habitat directly supports a sound and healthy lake environment. Uwe also understand
that unauthorized removal of shoreline vegetation (e.g. button bushes, willows, cattails, etc.)
and/or disturbance of the shoreline buffer may result in suspension or denial of lake use
permitting requests, forfeiture of security deposits and require re-establishment of vegetation at
my/our expense, particularly if the disturbance is found to be in violation of state or local
ordinances or impacts FERC project buffers.
1/we agree all excavated material will be placed in upland areas, landward of the Project
Boundary, and confined to prevent erosion and sedimentation back into the lake or nearby
streams.
Duke Energy Page 2 Rev: 41&2020

Uwe agree to adequately stabilize all excavated material and all disturbed shoreline to prevent
erosion and runoff into the lake.
Uwe understand that the double handling of excavated material will not be allowed; therefore, all
excavated material must be placed above the Project Boundary in one handling.
Uwe have designed the hydraulic excavation process (if any will be used) so that return water re-
enters the lake in the same general vicinity and cove as the excavation, to the maximum extent
practicable.
1/we agree that the proposed excavation will not be for the purpose of creating additional
shoreline, will not alter the Project Boundary or the full pond contour, and will not impact
threatened or endangered species, historic properties, or environmentally -important areas, unless
special public entity provisions were made in the application.
I/we recognize that it is my/our responsibility to clearly locate in the field and label on my/our
work area drawings any areas that require specific protection or avoidance during this excavation
work. Examples of these protection/avoidance areas include but are not limited to, any
Environmental Areas, Natural Areas or Impact Minimization Zones as identified by Duke
Energy; jurisdictional wetlands; historic properties; rare or threatened species; and buried gas,
water, sewer, electric or communications lines. I/we agree to provide my/our contractor with a
copy of these work area drawings showing these areas to stress the necessary protection
measures.
Uwe agree that if any archaeological resources (e.g. pottery shards, Indian artifacts, etc.) are
discovered during the excavation, work shall be halted immediately. I/we will then notify Duke
Energy and the State Historic Preservation Office to determine what measures, if any, I/we must
pursue to protect or salvage the archaeological resources.
I/we agree that any excavation from within the Project Boundary will not exceed the volume as
outlined in the application and will remove and disturb only what is absolutely necessary to
achieve the project's stated purpose.
I/we agree to be fully responsible for the permitted lake use and 1/we understand that this
responsibility is considered to transfer automatically along with ownership and leases of the
adjoining tract.
Uwe understand Duke Energy representatives may issue Stop Work Directives for violations of
the SMP or other applicable guidelines and other consequences may result from such violations,
including but not limited to suspension or cancellation of approved permits, increases in fees,
modification or removal of non -complying structures and restoration of disturbed areas at my/our
own expense or loss of any consideration for future lake use permits. Uwe agree to immediately
comply with any Stop Work Directives, to fully cooperate with Duke Energy and other agencies
as necessary, and to perform the necessary remedial actions within the specified time frame.
Duke Emrgy Page 3 Rev: 4/6/2020

Five agree to develop any required mitigation plans and to complete any required mitigation
activities at my/our own expense within the specified time frames. I%we recognize that the
excavation work is not considered complete and deposits will not be refunded until the
mitigation requirements (if any) have been satisfactorily fulfilled.
Uwe agree to notify Duke Energy by phone when the excavation is initiated and to ensure that
during the excavation eriod Uwe will post Duke Energy's approval letter in a clear waterproof
bag at the job site and visible from the water's edge.
Uwe agree to notify Duke Energy in writing when the excavation is completed (including any
required mitigation measures) and that the excavation was completed per the approved
application, so a close-out inspection can be performed.
1/we recognize security deposits will not be refunded if any violations of the SMP, other
applicable guidelines, or this user's agreement occur.
Uwe understand there will be no change in hydro project operations as a result of the excavation
and/or utilization of the excavated area.
Uwe agree to maintain the work area in a safe condition and to fully indemnify and save Duke
Energy harmless from any and all claims; liability, loss or damage that may arise from this
excavation project.
Five understand that this user's agreement does not, in any way, constitute the transfer of any
rights in real property and that my/our use and enjoyment of FERC project and Duke Energy
lands and waters shall not hinder the general public's lawful use and enjoyment of the same.
Sincerely,
ALA,I 04rvair444-m
Applicant's Name (Print)
Co -Applicant's Name (Print)
Co -Applicant's Name (Print)
Co -Applicant's Name (Print)
Co -Applicant's Name (Print)
Co -Applicant's Signature
Co -Applicant's Signature
Co -Applicant's Signature
Co -Applicant's Signature
Duke Fnern Page 4
Page Rev' 4:&2020

b0zot$u - rtil4
For Registration Fredrick Smith
Register of Deeds
Mecklenburg County, NC
Electronically Recorded
2018 Apr 05 08:57 AM RE Excise Tax- $ 1390.00
Book: 32580 Page: 914 Fee: $ 26.00
Instrument Number: 2018040153
NNURTH CAROLI A GENERAL WARkANTY DELL
Excise Tax; S 1,390,00
Parcel Identifier �o. 0O 113239 Vuri fiC.d by Co -um- on >he —clay raf . 20
MaW..Box to: (JRA ..`CEl'.
This iastiutnertt was prel aced by: T1 ebeau 8c Associates. PA 1960O \l`. Catawba Avenue B1d . A. Ste. [ 00, Cornelius,NC
Brief description for the hidex; L DT G. Keel Fiat'
THIS DEED made this 3rd day of April � �. 20 18 , by and her.veen
GRANTOR
Balasubrainanian Palani&w.9y, and spouse, Radhai Raman-nnly
1 ,32 Summer Feld Circle
Brea, CA 92521
GRANTEE
)Van C. Cunnirtg[Farn . and wife. Kimberly K. Cunnifighaln
2L91 I CinnainciiTree Lane
Corn ell �Is,NC 2SO3I
Enter in aplar'ctpt'iate block for each Ciranttir anal Cir�uire,;;_ [1tL;11C., nia=li;3g aiiclress, �tlid, i f al?jsa"opriate, character taf entitY�, e.�'
corporatioll or partttersbip,
1'4ie. designarion Grantor and Grantee as use.l hei•eitt shall inch clesaicl parties, their heit-s. s.iccessons, .aid assigns, anct shall i€ichides;n ilar,
-9i111-al, nnscidiiie, feminine or neuter ns required by context.
WIT 71 SSI: 1-1. that the Giran i.r, fi r ri ec n:sideratit n p;licl by the Grantee. the receipt.cif Which is hereby acknowledged, lass and by
These grew-ncs Glees gram, bargain- sell and conv,- nni o the Grantee it fee sintple, ,JI that certain IN', parcel ofland or condo-minium will
siniateci In the Cityof Y cQrileliIts Tolxnship. lieeklcnburp* C.ounry..
North Carolina and more parr cnlarl.y described a ffall�7�.:s:
BFING all of Lot 6 of keel Bad Subdivision, Phase ("net Map 1 as Shown Gin ma i thereo"recordcd in Mal Book 59 i Page -469 in
the Mccklenbur�- Cennty Public [�Udslry.
Being a portion ofthe properr,- acquired by Grautor by instrurneut recor6cd in Book 31343 at Pate 77? is the Meckle iburt, 'uhltc
l�et�istr�.
The property hereinabo%-z described was acquired by Grantor by itiAT-Urn;nt Te-coidf-d in Book page
All or a patTi(1ti of the property= herein conveyed _ includes or X does not include the primary resIdence. of,--- Ccirant[)r_
A mu sl;owjng the Qbo e descrited t-o eTl y is roc orded in Pha Book 59 Lc— 469
NC Bar A , x: 3Lion Pc n`- No- 3 6 9 ; Cl 6. R,-yisecl 1 >'r-_ ';::i _ !0I
, - - T?as s=..�-tla,rt it.saa_ iat:s been apl,r;vcd b�'_
tinuxt by .aQ:2'.cnin-a 1 ilh flll". NC x1ar Asm- iz.,kn - i 0S `- No:t€1 Carol;-. 131, :iSSO68,L�€1a -- N(, Helr i-G: e:: Na -{
Submitted electronically by—Thebeau and Associates"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Mecklenburg county Register Of Deeds.

blal-o2su - 1-U-10
TO HAVE AND TO HOLD the afara�aid lot or parcel of land and all pri vileges and appurtenances thereto belonging to the [grantee in fee
simple.
And the Grantor cotenants with the Grantee, that Granter is seized of the preauses in lee simple. has the right to convey the same in fee
simple., Char title is mat-ketable and free and clear of all encumbrances. and that Granror w,11 warrant and defend the title against the lsaWfOl
cluitns of all persons whensoever, other than the following exceptions:
All such valid and enforceable easements and restrictions of record.
IN WITNESS ;I+,'HL•'1d1::C F, the Grantor has duly executed the foregoing as of the day atud year first ove. 'Written.
SLAI:...
(Entity Nance) Printffype :' ne. _l3.01&Lubratrtanian Palanisatny
By:
�...=
Priattfype NaMe k Title:.__ Printil`ype Name:-R,,jdjjai RatnAsal2n7 _
By.
PrintrFype Name & 'Title:
w _ (SEAL)
Print/Type Name: --
By- SEAL
PrintrFype Name &.'Title: _ _ Printflype Name: -_
State of North Carolina _ - Connty ur City of Mecklenburg r ,,
1, the undersigned rotary Public of the County or City of f= L k and State, ,daresaid, certify that
Balasubramanian Palanisamy, and s tpou,s -, Radhai personally appeared before me this day and acknov,-R!dged 4iedae,
execution of the foregoing insirurrmew for the purposes therein expressed. Witness my hand �11 Notarial, cramp or sea{ Phis 3rd dayof
April , 20 18 1
My Commission fxpires:
s ,
(Affix Sral� 1
X �� 4 •.
State of.__ ........................._.— -County or City of .....
-- r- App#. RxDjrps Ja<l ur tar. r ?419
I. the undersigned -Notary Public of the County or City of . .....................___� and Sta e a ores at . ca �= a
personally appeared before ine rhis day and acknowledged the due
execution of the foregoing instriment far the purposes therein expressed. Witness my hand and Notarial stamp or seal this ..................... duty of
2ll
:1+1} Commission Expires,"
(Affix Seal)
Nutar.° `s Printed or Typed Newc
Notary Public
State of - - County of City of
1, the undersigned Notary Public of the County or City of and State aforesaid, certify that
personalty came before me this day and acknowledged that
_he is the
of
a ]North Carolina nr
corporatioMintlted liability company/general piainerslup/limited partnership (strike through the
inapplicable.), and that by authority duly given and at- the act of such entity. _he signed the foregoing instrument in its name on its
behalf as its act snd deed. Witness my hand and :latarial stamp nr seal, this -...._....._. day (if 2(.).,....,,.
My Commission E'Xpires:
( A fli x Sea])
Notary's Printed or Typed'Mmile
tary Public
Pape of,
NC Bar Asmxiation Ibrm -ro. Ibis standard Fora: has been approved by:
Trio€ed try Agr43cntenf ti;ith the 1'C' ttar ft.ss�ialion 1981 Hart i Crrcrtin€ Ba Ass[ .iation —NC Bar Forni No, ti

Project Name/address: r ri MC- County:
I_acation Address: ®050,U r �- Lv1C d I
Parcel #: �
ParceVlot size
Disposal area required (sq ft and/or acreage)
Acknowledgement of Notification
I' �rar
am aware that the site must adhere to all state regulations
and ruldingsediment and erosion control and water quality_ And give permission for
.r% I A
Name of Individual and G6mpany
to dispose of their dredge material at the above stated location
Owner:
Print
Date: W :.2L-) =u
Along with form, please provide:
Aerial of parcel/lot (County GIS)
Photo of proposed spoil site
Identified proposed spoil site
� yr s n,,3 -s mot., C
rv,e,,3�Tcr'`

,n (0
q (n
- c, I
0 (n
03
C)
w
01
CD
-0
0 (D
0
cn-
tb D c
a <D
CD
3
(D
0
CL
0 CD
cr
o CL
rL
CD
Q T4
wpp,
0
C =F (D
CL
(D X-
CL gb.t
(D
0
X
'0 Colony Point.LrQ,
cb
C)
77
& IR
:3 <
a- 0
0
3
CD
:3
tL
co
0
0
cn
CD W i
7,o L
CL
sn
40
law
TWT
RUS
0 uetoxot4
f06Z
Moto')

m -P
.-w;..4m
� � s oJtV m.,i ¢m15 n R1.v
+�i4is�vEVK�`irtS1 a wx'Pn
• �ft�r � a Wf�: s.0.v xvaMx M¢a
� T .X w1Rr. OCIYnrt. .
+�it`sWM v�ctmv10 mr �� xwo'
r MS � wr�Rvm�m sa,�wVU
w`�4�s�rNaos � a ski puryn
' �t mr ei'�a�.wa,am.R xo
Fm�n laafc� w i, m W� nz9 9�a[S�oSu ti:�M,+i,v�,t e9 i�,
m:m„.nwvm xwz .°L4°own wu.+a w.usce
16.896 AC.+- TOTAL PHASE 1
12.812 AC.+- TOTAL THIS MAP
m cv g .Mn W 1af u+•�+smM GY N
� �u Yd+w. 0. a.a m� � � H.• wwm H om Yw.i m
w et,•mk�`r�✓ me em.®ten `� � x` ro.r. w mmiw� uw u.� •=nl
mm�,ea �e a m N e
Ow. wsN.y d'smr. ream.
aapy we,awe. �Ne M Ny#�� s mmW �.'n a R6.
•,•v Rb'.1 arsh o.v m.
k }la er 6W eliF.-
L.
tub n•r..��Mmti-.v u� san ame.p
mrc�non-0-0 boa - uw �x•v w�.A `� 6
�R # �N�IdbrWi,.1� `mw
STn�VF xxcw,H G9ouw
r
LAKE PROPERTY INV. LLC
30302/931, 3GI02/938
g
f {�
moor. I .•w w m„
me HEAt'fY TwVH'C I ETFIYI. B6A'1iY
yyTZFM B&,' I
G 2k32/019 __ __
:a
1355 AC.+- j
7I a S E e '
FP[ 762-2' 67766 SF
ElW !-
3 HILLY BHA06Y
9267/917 t
2JM Ar— -
90190SF
Rr ���Htw1
1�iEi•:f•.4}Y•rwE.•x.!
��ifciinl�E�•Ib'!
IDii•1.T.�e"ac�ilD!
I`iV•EE �'i�Ei'L!
SLM.�ilil,�
�II1�CEvi4]H4�iilT1�
�EtiF5ka4Ei:9'_IrW
EfrvlL•Aii�Y�Y6+! -
�di.Z?1Cdllil:.s,.
tAli�xvuix+!}y�E Is-1-
IRfs�EkriF (i�F"b
9•FF>•E�H&ICEt:-E➢�
tKH. Sfi�L?ii]�wEii#1�
wr•
��>arr>fffsyvaFa�}:��u�
�1a6raru,o� ium�>rx.�.xs1�
��sx;.•y>om��saer�
i4i�"'11.,,1rc'asa�ssm'aasazmo
so•'wac>a•1�nea;�MOM
E�feL`O�ik[S]• �Flil!51G�p
EM`11bFTlsIHC =� MiiY{i[YL.k©
}ml Z ��l>�•>•�F1L�
bit
1�f�wRE:�i'15t '•Yf
itE6RZFRliH1/
� "+� �f
2
__-1AKE-�
'-=HOBYdN�r_
y�`�•S� - M•ra unxw
f L-2 PB 15-45
1
r`><
a7s}Ac..-
A
=-N9AYAN�--
HA9m AHKBNET1iY
65MSF
-
� 7mu•
Ds
28762/818 I SpUsig�
E 13PS2/iH8
-
p
0.768ACa-`•-. . l
33"usp
J i L
1�
I-W4 AC-1
. , 45915 SF t
,y� ,nrr{m•, �� 5 .w
l
i�r u Q�n s .�`.'•.ctt 1l
[{m�uYjs1\J
1_l+
49939SF
m —'
rcc
740
- COS. GREEM1TBPI.T
' 672 A ..-
UC W
11.71 SF
I yea/49z Irrwcr um��
� �
$
I 178Bz/529 _ 4AP1Y KAI� MV.
L-42 P8 10-298
I € 28169/90l
OEDMON SIIRVM
\L-93 P8 29-710
UiGYioc �utF - tg3�
�¢¢IY JUv
25P.16/H45
.mc I• scr a, w. cyerns wu3sn m,.nrtc
+'
HA3e 9-]9-15
DEDMON SFly w,F 6_1-1s 11s ]oem r: w,
PHYSICAL SURVEY/ FINAL PLAT
FORRODERTO
3704 NC HIGHWAY AG NORTH
C;HWA, PLS djBggBAI
KEEL B
o_P.O.SOxggq-DENVER,
SITE
LEmLEY TOnsmip
HC z8037 WUNSY• NC
EM�LCKM—�BURC
PHONE-1 4 8j 9N-CS
x
IsHASE ONE - 1 _ A ,�
FAX 7"483J],7o wal
WVfw i➢MO1¢/FVEI'SOoea SiRiw, H>` rn ownwie CP ......-. _.._
e��
IMMLVING PARCEL 00113216
_� e�..nvxt'i u--«aR�....

tSJr7dub - t1bz1
For Registration J. David Granberry
Register of Deeds
Mecklenburg County, NC
Electronically Recorded
2016 Nov 01 03:46 PM RE Excise Tax: $ 0.00
Book: 31308 Page: 627 Fee: $ 26.00
Instrument Number: 2016149234
NORTH CAROLINA NON -WARRANTY DEED
Excise Tax: $p
Parcel Identifier No._A portion of 00113216 _ Verified by County on the day of 20
By: _
Mai VBox to: GRANTEE
This instrument was prepared by: Cornish Law, PLLC 8936 Northpointe Executive Park Drive, Sane 195, Huntetsviile, NC 28078
NO TITLE SEARCH
Brief description for the Index- Keel Bay common area
THIS DEED made this Ist day ofNovember, 2016, by and between
Kaneel Bay Development, LLC, a North Carolina limited liability
company
PO Box 37229
Charlotte, WC 29237-7299
Keel Bay Homeowners Association, Inc., a North
Carolina non-profit corporation
PO Box 37229
Charlotte, NC 28237-7299
The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and shall include
singular, plural, masculine, feminine or neuter as required by context.
WITNESSETB, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of Which is hereby acknowledged, has
and by these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that certain lox, parcel of late} ar
condominium unit situated in the City ofCornelius, MecklenbwgCounty, North Carolina and more particularly desenbed as follows:
BEING all of that certain lot identified as "COS GREENBELT" totaling approximately 2.678+- acres on Plat Book 59 Page
469 recorded in the Mecklenburg County Register of Deeds.
The property hereinabove described was acquired by Grantor by instrument recorded in Book 30369 page 406.
All or a portion of the property herein conveyed : includes or _x— does not include the primary residence of a Grantor.
A map showing the above described property is recorded in Plut Book 59 page 469.
Page t d2
Submitted electronically by "Cornish Law, PLLC"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Mecklenburg county Register of Deeds,

041 JUB - POZ6
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee
in fee simple.
The Grantor makes no warranty, express or implied, as to title to the property hereinabove described.
IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year first above written,
Kaneel Bay Development, LLC
VN--::) -\- W-
By:
Lawrence W. Mashburn, Member/Manager
State of North Carolina - County of Mecklenburg
1, the undersigned Notary Public of the County of Mecklenburg and State aforesaid, certify that Lawrence w,
Mashburn personally came before me this day and acknowledged that he is the Member/Manager of Kaneel Bay
Development, LLC, a North Carolina limited liability company, and that by authority duly given and as the act of such entity,
he signed the foregoing instrument in its name on its behalf as its act and deed_ Witness my hand and Notarial stamp or seal,
this 1st day of November, 2016.
Z .
No ublic (Affix Seal)
My Commission Expires: 6/7/2019
Page 2 of
1`tt,µt11f1!!!1s`r +
A R A p,•.,.
c
COU,
fl17111t t1\*`

Catawba Indian Nation
Tribal Historic Preservation Office
1536 Tom Steven Road
Rock Hill, South Carolina 29730
November 19, 2020
Attention: Janice Estep
Natural Green Scapes Services, LLC
Re. THPO # TCNS # Project Description
2021-937-4 Alan Cunningham — 20911 Cinnamon Tree Lane
Dear Ms. Estep,
The Catawba have no immediate concerns with regard to traditional cultural properties,
sacred sites or Native American archaeological sites within the boundaries of the
proposed project areas. However, the Catawba are to be notified if Native American
artifacts and 1 or human remains are located during the ground disturbance phase
of this project.
If you have questions please contact Caitlin Rogers at 803-328-2427 ext. 226, or e-mail
[e-mail].
Sincerely,
Wenonah G. Haire
Tribal Historic Preservation Officer

ID#* 20191289 Version* 2
Regional Office* Mooresville Regional Office - [phone]
Reviewer List* Alan Johnson
Pre -Filing Meeting Request submitted 1O/2712020
Contact Name * Janice Estep
Contact Email Address* [e-mail]
Project Name * Cunningham Dredge
Project Owner` Alan Cunningham
Project County* Mecklenburg
Owner Address: Street Address
20911 Cinnamon Tree Ln.
AC&E—ss Line 2
aty Slate / Frovince / R�qm
Cornelius NC
RCstalI Zip Code Country
28031 United States
Is this a transportation project? * r Yes r: No
Type(s) of approval sought from the DWR:
* 401 Water Quality Certification - F 401 Water Quality Certification -
Regular Express
r Individual Permit r Modification
W Shoreline Stabilization
Does this project have an existing project ID#?
r Yes G No
Do you know the name of the staff member you would like to request a meeting with?
Alan Johnson
Please give a brief project description below.
Dredge a 40' x 40' area for new dock.
Please give a couple of dates you are available for a meeting.
10/28/2020

10/29/2020
10/30/2020
11 /212020
Please attach the documentation you would like to have the meeting about.
Cunningham oredge.pdf 1.91 MB
pdf ody
By digitally signing below, I certify that I have read and understood that per the Federal Clean Water Act Section
401 Certification Rule the following statements:
This form completes the requirement of the Pre -Filing Meeting Request in the Clean Water Act Section 401 Certification
Rule.
• I understand by signing this form that I cannot submit my application unti 130 calendar days after this pre -filing
meeting request.
• 1 also understand that DWR is not required to respond or grant the meeting request.
Your project's thirty -day clock started upon receipt of this application. You will receive notification regarding meeting location
and time if a meeting is necessary. You will receive notification when the thi rty-day clock has expired, and you can submit an
application.
Signature
Submittal Date 10/27/2020

/ot
n>
�m
mCl)
zo
�m
z C)
cn

�" J
0