20100778 Ver 1_Shoreline Stabilization_20100920

2Q 1 p() 7 7 8
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 seven (7) 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 of to lake bottom of less than 1 acre and $570.00 for impacts to lake bottom of greater
or equal to 1 acre. UP AL 1
Applications should be sent to:
y+ r\ 1i f
Division of Water Quality 401 Oversight/Express Review Fermitting DU
1650 Mail Service Center P
Raleigh, NC 27699-1650
`E•'?ftr•u
'Irby 47?:?.e
I. Applicant Information
1. Owner/Applicant Information
Name:
Mailini
Telephone Number: :33?- Z3 y 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:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number.
E-mail Address:
II. 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: /) c) Nearest Town: C7 ?? (I
?1?J1
Subdivision name or site address (include phase/lot number): -_RA?r1LA
Directions to site please include road numbers, landmarks, etc. (This is not necessary if an adequate
vicinity map is included): A 0 t C-l on LA Le- G-? ti( o
2. Describe the existing land use or condition of the site at the time of this application:
3. Property size (acres):
4. Nearest body of water (stream/river/sound/ocean/lake): tt V C' n , l? _
5. Describe the purpose of the proposed work: Sew V?t_ 5? ?? W aver
50 ?-}-
6. List the type of equipment to be used to construct the project: {3Gck ??e_
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below the
normal pool lake level in square feet or acres: 1_?)- 0 3 . ? k
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
\ Nt J'kn

Applicant/Agent's Signatui+e / Dark
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

Fig. A Anatomy Of A Retaining Wall
CAP BLOCK
CONCPETE
- r,
ADHESIVE
74V
,?? ?''fit
REINFORCEMENT, :' :• ?
FJECOMPACTED
.. ?.
PIN
NATIVE SOIL

16" x 12' x
BLOCK * "T
3
"
3
BACKSET
.. CRUSHED
`
L
P
ECO
' MOCK
,
MPACTEO
:
NATIVE SOIL
+"'• "
,
}r?',' '•.,
?L E C '. Y
j
I" LEVELING".., * . UNDISTURBED
SAND
.4'
4" TO 6"
NATIVE SOIL
COMPACTED
BASE MATERA
zr ro 2a"
U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action ID: SAW-2007-03231
County: Person
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Property Owner: Russell Terry
Mailing Address: 500 Rainey Ridge Road ]^
Semora, NC 2 7 3 x 3
Telephone No.: [phone]
Location of property: 500 Rainey Ridge Road, Rec. # 890; northwest of Concord, North Carolina
Site Coordinates: 36.4761°N 79.1251°W USGS Quad: Leasburg
Waterway: Hyco Lake River Basin: Dan HUC: 03010104
Description of projects area and activity (see page 2 for a summary of authorized impacts): Discharge of fill material for
replacement of 1101f of seawall and 2501f of riprap, in accordance with the drawings submitted on 9/4/2007.
Applicable Law: ® Section 404 (Clean Water Act, 33 USC 1344)
? Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: Regional General Permit Number: 30
Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with the attached conditions and
your submitted plans. Any violation of the attached conditions or deviation from your submitted plans may subject the permittee to a stop
work order, a restoration order and/or appropriate legal action.
This verification is valid until the NWP is modified, reissued, or revoked. All of the existing NWPs are scheduled to be modified,
reissued, or revoked prior to March 18, 2007. It is incumbent upon you to remain informed of changes to the NWPs. We will issue a public
notice when the NWPs are reissued. Furthermore, if you commence or are under contract to commence this activity before the date that the
relevant nationwide permit is modified or revoked, you will have twelve (12) months from the date of the modification or revocation of the
NWP to complete the activity under the present terms and conditions of this nationwide permit. If, prior to the expiration date identified
below, the nationwide permit authorization is reissued and/or modified, this verification will remain valid until the expiration date identified
below, provided it complies with all new and/or modified terms and conditions. The District Engineer may, at any time, exercise his
discretionary authority to modify, suspend, or revoke a case specific activity's authorization under any NWP.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality Certification. You should
contact the NC Division of Water Quality (telephone [phone]) to determine Section 401 requirements.
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other required Federal, State or
local approvals/permits.
If there are any questions regarding this verification, any of the conditions of the Permit, or the Corps of Engineers regulatory program,
please contact Eric Alsmeyer at telephone [phone], ext 23.
Corps Regulatory Official 6 Date: 10/10/2007 Verification Expiration Date: 12/31/2010
Summar 'of Authorized Impacts and Re
uired Mid ation

Action ID
NWP / GP
Open Water (ac)
Wetland (ac) !1 5
Unim ortant Steam (It)
Important Stream (If)
# # Temporary Permanent Temporary Permanent Temporary Permanent Temporary Permanent
SAW-
2007-
03231
30
0.02

Im act Totals 0 0.02 0 0 0 0 0 0
Total Loss of Waters of the U.S. (ac) 0.02
Required Wetland Mitigation (ac) Total Loss of Waters of the U.S. (10 0
Required Stream Mitigation (10
Additional Remarks and/or Special Permit Conditions:
No compensatory stream/wetland mitigation is required.