HomeMy WebLinkAbout20110729 Ver 1_Shoreline Stabilization_2011080820110729
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
1650 Mail Service Center
Raleigh, NC 27699-1650
1. Applicant Information I
f IF
1. Owner/Applicant Information
Name:
Mailing Address:
Telephone 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:
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.
Fax Number:
?/9
DUKE ENERGY LAKE SERVICES
EC12-Q
P O BOX 1006
CHARLOTTE, NC 28201-1006
704-382-1567 or TOLL FREE 1-800-443-5193
APPLICATION FOR PERMIT TO STABILIZE THE SHORELINE IN NORTH CARQLWA
Please type or print and fill in all blanks. If information is not applicable, so indicate by placing N/A in blank. PLEASE
SUBMIT APPLICATION AND APPROPRIATE DUKE ENERGY FILING FEE, PAYABLE TO DUKE ENERGY,
TO ABOVE ADDRESS.
Applicant
A. Name
B. Mailing Address C,,1'7r /OW /
C. Telephone:
II. Location of Proposed Project
A. Lake/` /G
B. Street Address /
C. County
y_:9z,?/JCr1-"!L
D. City, town, community or Ian(
E. Sectiot???' ?- Lot #
F. Directions to prot)ertv by road
G. Latitude and longitude for the project site
H. Please submit a map showing the coordinates or a detailed map (USGS quad map, city map, etc.) showing the
exact location of the project site. (NOTE: Latitude/ longitude coordinates can be found on internet site,
www.mawouus.com. Directions: Don't register, click "Maps", enter address, draw map, select "Map Clicking
Will...", select "Lat/Long", click map)
III. Description of Project ,
A. Length of wall
B. Material , ..;.
C. Distance from property line/shoreline
IV. Intended Use of Project Area
A. Private "'?
B. Commercial
V. Applicant Signature Date
PLEASE NOTE THE FOLLOWING:
2 COPIES OF THE "DUKE ENERGY APPLICATION FOR PERMIT TO STABILIZE THE SHORELINE IN NORTH
CAROLINA", PHOTOGRAPHS OF THE SHORELINE TO BE STABILIZED, AND FIVE (5) COPIES OF THE
COMPLETED "NC DIVISION OF WATER QUALITY PRE-CONSTRUCTION NOTIFICATION APPLICATION"
MUST BE SUBMITTED WITH THE DIVISION OF WATER QUALITY APPLICATION FEE TO:
NC DIVISION OF WATER QUALITY
ATTeNTION.• CYNDI KAROLY
PARKVIEW BLDG., 2321 CRABTREE BLVD.
RALEIGH, NC 27604
919-733-1786
Y:ILAKEMOMTPackage InfWantimM Shoreline Stabilization Application.doc
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6374 Mountainside Dr, Hickory, NC 28601-
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• OwnerName:CARLISLE BRYAN KEITH
• MailingAddress:6374 MOUNTAINSIDE DR
• City:HICKORY
• State:NC
• Vp:286010000
• Tax Account#., 116300
• Land Units:1.00
• Land Type:LT
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• Lega1:BK 1387 PG 760 YR 02 ST 0.0
• NCPIN:3704134664
• Parcel-0:08 SEC16 50
• Total Value: $93,000.00
• Fire District:G CHAPEL
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