20110247 Ver 1_Application_20110315

2 0 1 1 0 2 4 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 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 $475.00 for impacts to lake bottom
of greater or equal to 1 acre.
Applications should be sent to:
Division of Water Quality Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
1.
Applicant Information
1. Owner/
Nan
Mai
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Telephone Number: Fax Number:
E-mail Address: 11n Y 1?01 Z c 1< (0 M
2. Agent Information (A signed and dated copy of the Agent Authorization letter
must be attached if the, Agent has signatory authority for the owner/applicant.)
Name:_
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
II.
Project Information
Attach a vicinity map clearly showing the location of the property with respect to
local landmarks such as towns, rivers, and roads. Also provide a detailed site
plan showing property boundaries and development plans in relation to
surrounding properties. You may use the diagram below to make a hand sketch of
your project. Also, see the example below for guidance. Both the vicinity map and
site plan must include a scale and north arrow. The footprints of all buildings,
impervious surfaces, or other facilities must be included.
1. Location
County: V62 Ib'$'OM Nearest Town: $ObLTK1KOIJT
Subdivision name or site address (include phase/lot number):
Directions to site please include road numbers, landmarks, etc. (This is not
necessary if an adequate vicinity map is included):
2. Describe the existing land use or condition of the site at the time of this
application: E?c15T?N(? j?ttgLiC BEwak
3. Property size (acres):
4. Nearest body of water (stream/river/sound/ocean/lake): RI&O @?EYZ LWC
5. Describe the purpose of the proposed
St(o2EL?t?1? A14D PQ.o`t l
u
6. List the type of equipment to be used to construct the proj
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls,
etc.) below the normal pool lake level in square feet or acres:
100 a, a-
S. 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: Uebo !5 t .'FTC
b. Please describe vegetation above the normal pool lake level and 50 feet land-
ward to be impacted (number of trees for instance): ?Jo TgEE S WILL W [Mf,*CTED
151 TEt'1~ pkPO I2 ?gAF} tWIATwN
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
US Army Corps Of Engineers Field Offices and County Coverage
Asheville Regulatory Field Office Alexander Cherokee Iredell Mitchell Union
US Army Corps of Engineers Avery Clay Jackson Polk Watauga
151 Patton Avenue Buncombe Cleveland Lincoln Rowan Yancey
Room 208 Burke Gaston Macon Rutherford
Asheville, NC 28801.5006 Cabarrus Graham Madison Stanley
Telephone: [phone] Caldwell Haywood McDowell Swain
Fax: [phone] Catawba Henderson Mecklenburg Transylvania
Raleigh Regulatory Field Office Alamance Durham Johnston Rockingham Wilson
US Army Corps Of Engineers Alleghany Edgecombe Lee Stokes Yadkin
650 Falls aftle*wseaeed Ashe Franklin Nash Surry
Swiw440 Caswell Forsyth Northampton Vance
Ralsio, O;G-,}?iiF - chmims Granville Orange Wake
Telephone: [phone] Davidson Guilford Person Warren
Fax: [phone] Halifax Randolph Wilkes
Washington Regulatory Field Office Beaufort Currituck Jones Pitt
US Army Corps Of Engineers Bertie Dare Lenoir Tyrrell
Post Office Box 1000 Camden Gates Martin Washington
Washington, NC 27889-1000 CartereN Green Pamlico Wayne
Telephone: [phone] Chowan Hertford Pasquotank
Fax: [phone] Craven Hyde Perquimans 'Croatan National Forest Only
Wilmington Regulatory Field Office Ansou Duplin Onslow
US Army Corps Of Engineers Bleden Harnett Pender
Post Office Box 1890 Brunswick Hoke Richmond
Wilmington, NC 28402-1890 Carteret Montgomery Robeson
Telephone: [phone] Columbus Moore Sampson
Fax: [phone] Cumberland New Hanover Scotland
US Fish and Wildlife Service! National Marine Fisheries Service
US Fish and Wildlife Service US Fish and Wildlife Service National Marine Fisheries Service
Raleigh Field Office Asheville Field Office Habitat Conservation Division
Post Office Box 33726 160 Zillicoa Street Pivers Island
Raleigh, NC 27636.3726 Asheville, NC 28801 Beaufort, NC 28516
Telephone: [phone] Telephone: [phone] Telephone: [phone]
North Carolina State Agencies
Division of Water Quality Division of Water Quality State Historic Preservation Office
401 Wetlands Unit Wetlands Restoration Program Department Of Cultural Resources
1650 Mail Service Center 1619 Mail Service Center 4617 Mail Service Center
Raleigh, NC 27699.1650 Raleigh, NC 27699.1619 Raleigh, NC 27699-4617
Telephone: [phone] Telephone; [phone] Telephone: [phone]
Fax; [phone] Fax: [phone] Fax: [phone]
Division of Coastal Management
1638 Mail Service Center
Raleigh, NC 27699-1638
Telephone: [phone]
Fax: [phone]
Western Piedmont Region Coordinator
3855 Idlewild Road
Kemersville, NC 27284-9180
Telephone: [phone]
Mountain Region Coordinator
20830 Great Smoky Mtn, Expressway
Waynesville, NC 28786
Telephone: [phone]
Fax: [phone] Haywood McDowell Yancey
CAMA and NC Coastal Counties
Beaufort Chowan
Bertie Craven
Brunswick Currituck
Camden Dare
Carteret Gates
NCWRC and NC Tro ut Counties
Alleghany Caldwell
Ashe Mitchell
Avery Stokes
Burke Surry
Buncombe Henderson
Cherokee Jackson
Clay Macon
Graham Madison
Hertford
Hyde
New Hanover
Onslow
Pamlico
Pasquotank
Ponder
Perquimans
Tyrrell
Washington
Watauga
Wilkes
Polk
Rutherford
Swain
Transylvania
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VEGETATION AND EROSION
\?r\ CONTROL FABRIC
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EROSION CONTROL FABRIC----01"' G]
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LAKE BOOM
TYPICAL CONDITIONS
36" TO 72" ERODED CUT
WAVE.EXPOSURE
02/23/11
FOR: BUDDLE CREEK SWIM AREA
LOCATION: ALCOA POWER GENERATING INC
RESERVOIR: HIGH ROCK LAKE
PROJECT: SHORELINE STABILIZATION PROGRAM
PHASE I SITE EVALUATION
YADKIN, INC. - BADIN, NORTH CAROLINA
DRAWING TITLE: DETAIL
MODERATE RIP RAP STABILIZATION 3