20110926 Ver 1_401 Application_20111011

2 0 1 1 0 9 2 6
DUKE POWER LAKE MANAGEMENT, 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
CAROLINA
Please type or print and fill in all blanks. If information is not applicable, so indicate by placing NIA in
blank. PLEASE SUBMIT APPLICATION AND APPROPRIATE DUKE POWER FILING FEE, PAYABLE
TO DUKE POWER, TO ABOVE ADDRESS.
1. Applicant Information
A. Name TO f%
B. Mailing Address
?2rv 9-- dj 0 ?. "r'?v?+?c, ?r I rnv •? 16 (-, Z?LI L
C. Telephone 33(, - 3441
11. Location of Proposed Project ( T7)& ?,
A. Lake
B. Street Address Z? on cr,_ 5 -41 Ae J
C. County -1 +rc.dc.t1
D. City, Town, Community or Landmark S?k?z t)i
E. Section Lot # Subdivision
I? ? ?r? +y1c'.J'e. °'frsl Gi ? (J?
F. Directions to property by road y-j -1 tj t'0 -r/- 4 LIZ
old. tyw- ?-A.
G. Latitude and longitude for the project site ?,? 4
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, vvviw.mapsonus com. Directions: Don't register, click "Maps", enter
address, draw map, select "Map Clicking Will...", select "Lat/Long", click map)
eae a?
eae. Dc"q i jpilV11 Ui rrojeci
A. Length of wall I
11S
B. Material
C. Distance from property line/shoreline 1
IV. Intended Use of Project Area
A. Private X
B. Commercial -
'V. Applicant Signature
&vr Date ti
PLEASE NOTE THE FOLLOWING:
A COPY OF THE COMPLETE APPLICATION WITH A ROAD MAP SHOWING LOCATION OF THE PROPERTY MUST BE SUBMITTED TO: US
ARMY CORPS OF ENGINEERS, 959 PATTON AVENUE ROOM'/ 208, ASHEVILLE NC 28801-5006
o A COPY OF THE "DUKE POWER APPLICATION FOR PERMIT TO STABILIZE THE SHORELINE IN NORTH CAROLINA" AND SEVEN (7)
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, PHONE. [phone]

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:
v?nad??t Lw
3. Property size (acres):
4. Nearest body of water (stream/river/sound/ocean/lake): LPL A;
5. Describe the purpose of the proposed work:
6. List the type of equipment to be used to construct the project:
LtiC.e'V4vf,O '- A Y .IN a yo_? : ?
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below
1!_?' '/' Sa
8. a. Amount of impact (inrliAinn all rlpnrinn hark fill Pvrnwatinn rin
etc.) above the normal pool lake level and 50 feet land-ward in square feet or acres:
t /-5-' X 2_'
b. Please describe vegetation above the normal pool lake level and 50 feet land-ward to
hP imnar_JP.ri ?ll IPrIr1Pr of trees for inctanrp)
.,} 19
?-
App ilcant/Agernr Signature Date
(agent's signature is valid only if an authorization letter from the applicant is provided)

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
Owner/Applicant Information
Name: 70 i?' NA-rr 410`° ?
Mailing Address
r-06' . t') C_ 1012_
2
Telephone Number:
E-mail Address:
0r'T 1 9 2011
DENR - WATER DUALITY
WoUnde atec Branch

P - 3 5 q - I I` 3 Fax Number:

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.)
i A I
Name: 'L iir? e=u e CV (_ ("" ?. 10 4... Y
Company Affiliation: ( %-vices L l A"4,; ?
Mailing Address: J 1 L Fi? ?. 1 r+? Yh•? -? >J ?- 1
Telephone Number: 0q Fax Number:
E-mail Address: oc,,b le- 6, j cw%c,ijt-e_r L, bc'?L_, t-4_-VJ
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.
i
1. Location
County: 11 A Lm Nearest Town

Subdivision name or site address (include phase/lot number): LJO r:IwRC_te_ " 61 aA L0? Z
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:
3. Property size (acres): 4 S"3 acy&s
4. Nearest body of water (stream/river/sound/ocean/lake):
5. Describe the purpose of the proposed work: rJ k 4)1-e- ?' 'j°? • 1' 2c: f? °'
6. List the type of equipment to be used to construct the project:' w I-Z e`er'
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below the
normal pool lake level in square feet or acres: I o - X 67
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:
! 1.5-' X 3'
8.b. Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instance): A ,.1, `tie-1 °-"`
I tom, -
Appl gent's Signature
(Agent's signature is valid only if an
1412;1 Z 11
P Date
n letter from the applicant is provided.)
USGS Store - Digital File Download
Search: 275 Windmere Isle Dr, Statesvill
Address or Place [Search Help]
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5-40.069N, 80-67,9350
SNG 178 Nd 0311 471

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Find a place on the map rNavigabon Help]
C NAVIGATE:
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map around, zoom in and out.
c: MARK POINTS:
Click on a place to add a marker'
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Switch between Navigate and Mark Points at any time.
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http://usgs0l .srv.mst.edu/store3//digital_download/mapping_ap.JSP 9/27/201

1, RUFUS JACKSON LOVE CERTIFY THAT THIS MAP WAS DRAWN FROM AN ACTUAL SURVEY UNDER MY
E. MOMBO RD.
o DIRECT SUPERVISION, THAT THE RATIO OF PRECISION IS 1:10,000+ BEFORE ADJUSTMENTS- AND AT
THE ANGULAR ERROR WAS < 7.5 SECONDS PER TURN. ,
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= WITNESS MY HAND AND OFFICIAL SEAL THIS / -DAY OF
STATE PARK
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LOT 1
CHRISTC PHER CANOVAI #5 LAKE
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10-63-8032
DB 1 •131 PG 1173
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REBAR "1 12.50' ANDR
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S 3911'02"W 93.98' #4 PIN 4710-62-9748
REBAR DB 2079 PG 1434

\ \\ Course Bearing Distance
\ L1 S 42'23 E 56.48
L2 S 47'19'42" E 41.91
L3 S 41*56'57" E 16.69
Curve Radius Length Chord Chord Bear.
Cl 127.50 48.09 47.81' 1 N 16'54 01" W
FOUNDATION SURVEY
NOTES:
FOR CRAIG ROSE11 SAN

nonnrnTV rnC Onnl
A i n u A one n%ic o_ ..,c n A ni A 1. THIS PROPERTY LIES ON LAKE NORMAN.
2. AREA DETERMINED BY COORDINATE COMPUTATION.