20110980 Ver 1_Triage Check List_20111104 (2)

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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 CAROLINA
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
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III
Applicant Information
A Name _ GRANT & LINDA SMITH
B Mailing Address 8435 LISMORE ST CLEMMONS NC 27012
C Telephone [phone]
Location of Proposed Project
A Lake LAKE JAMES
B Street Address BRAXTON GATE DR
C County BURKE
D City town community or landmark MORGANTON
E Section Lot # 196 Subdivision SOUTH POINTE
F Directions to property by road _ FROM MORGANTON TAKE HWY 126/ TL ONTO SOUTH POINTE DR
/TL ONTO PEMBROKE DR/ TR ON BRAXTON GATE DR TO PROPERTY ON THE LEFT
G Latitude and longitude for the project site _LATITUDE 35 76007 N LONGITUDE 81 8295-) W
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
N51%N in 1psonus (1111!
Description of Project
A Length of wall 244 LINEAR FEET
B Material RIP RAP
C Distance from property line/shoreline—WILL FOLLOW EXISTING SHORELINE
IV Intended Use of Project Area
A Private YES
B Commercial 1
V Applicant Signature Date to h I 1
Agent Signature Phone-828 659 1000_Fax_828 659 1001_
PLEASE NOTE THE FOLLOWING
• A COPY OF THE COMPLETED APPLICATION WITH A ROAD MAP SHOWING LOCATION OF THE PROPERTY
MUST BE SUBMITTED TO US ARMY CORPS OF ENGINEERS 151 PATTONAVE - ROOM208
ASHEVILLE NC 28801 50
• 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 JOHNDORNEY
PARKVIEW BLDG 2321 CRABTREE BLVD
RALEIGH, NC 27604
919 733 -1786
08/ 17/ 1 l ssb