20120004 Ver 1_401 Application_20120112

December 10 2011
Duke Energy Lake Services
ED12 Q
PO Box 1006
Charlotte NC 28201 1006
Re Shoreline Stabilization Permit Application
9124 Shorewood Place Belmont NC 28012
Lot 10 Misty Waters Subdivision Gaston County
To Whom It May Concern
20120004
ED
ecDo
SAN 3 zoiz
DENR WATER QUALITY
KIE DS AND STORIMUTER 8RA H
We wish to stabilize the shoreline at the above noted property before building our new home
Please review and grant our application for a permit for recommended stabilization
Any questions feel free to call us at 540 230 1451
Sincerely
Katherine C Kokalis
PO Box 705
Belmont NC 28012

20120004
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 a plication and suppo, rtin
information as well as a non refundable application fee to the ivision 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 flD
Division of Water Quality 401 Oversight/Express Review Pei mitting
1650 Mail Service Center
Raleigh, NC 27699 1650
Applicant Information
Ownei /Applicant Information
Name _ k8i"h" rr U &,r,& -Ph
Mailing Addiess 9D d3y )(, 2 0'�
u AL ► ,_
Telephone Numbei St 1 Lk5 I Fax Number
E mail Address 4-4xu ka k,A, L �� �� C-60v
2 Agent Information (A signed and dated copy of the Agent Authorization letter must be attached
if the Agent has signatory aukooiity for the owner /applicant Y 1G1
Name
Company Affiliation
Mailing Address
Telephone Numbei
E marl Address
II Protect Information
(1) N 3 2012
ax Number ..c LMOS AND STORMWATER BRANCH
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 suriounding 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 impeivious surfaces of other
facilities must be included

Location
County L a Sh j Neatest Town
Subdivision name or site address (include phase /lot number) �,� i,`t� I wa Y��(L� [7
Directions to site please include road numbers landmarks etc (This is not necessary if an adequate
vicinity map is included) Nctt Aid
2 Describe the existing land use or condition of the site at the time of this application
3 Property size (acres) I JA
4 Nearest body of water (streanViivei /sound /ocean /lake) L-�.,k4 & W ►�( t C>
5 Describe the purpose of the proposed wo_ikr �c�,a4 or-i Of �k/4 44 �t., LAA) gA-L �
e r a S 1 or,) Cj-+ � , 4z . «4,e . o- Q t_.v(l re,&A A w c-p- A Cs D i To
101 QL Q9 - ►,,)i II �N0 � LAA lCUI`r n CL a0C,k
6 List the type of equipment to be used to construct the pioject bttic k, l,,>e.oi rj� r n4 A. Oriv�e�»,v1�L
7 Amount of impact (including all excavation backfill rip iap retaining walls etc ) below the 1
normal pool lake level in square feet or acres NOkxe-
8 a Amount of impact (including all clearing back fill excavation iip tap retaining walls etc )
above the normal pool lake level and 50 feet land ward in square feet or acres
A rp� aol . �2 LezA Jt 1�,1
8 b Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instance) A p p ro Y, NAJ el 14 4 ru-S –1 , o k 4t.4 nn �
bh it IL LAI Q 0 a,., O. S � r, won. Q sC— ,�i Qra1
1�a�1 C- no �— 124 l 0 Yo t
Applicant /Agents Signature Date
(Agents signature is valid only if an authorization letter florin the applicant is piovided )

Tree Schedule
T 1
2 oak
T 2
3 oak
T 3
10 pine
T-4
T oak
T5
15 oak
T6
18 cedar
T7
4 cedar
TS
3 cedar
T9
6 pine
T 10
8 pine
T 114
oak
T 12
7 cedar
T 13
6 oak
Note
Usted trees are all directly on shoreline In area to be rip
rapped Several are growing horizontal out over the water
Lake Wylie (at Full Pond)
Propo d Dodd b 45 Mng (outfrom h rel ) by
20 wed Mir 8' swim platf rm If id
Paul & Kathy Kokalis
9124 Shorewood Place
Belmont NC 28012
Rip rap 121 W x 8 D x4 T
Less than 1 below water
line at full pond
T 11
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Lat 35.171310

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DUKE ENERGY LAKE SERVICES
ECl2 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
I Applicant Information
A Name
B Marling Address
C Telephone y D c1 3 D -1 1 1 5 '% - 2�3 Q '! C)'T
II Location of Proposed Project
A Lake \4q4 Le.
2
B Street Address
C County C� [t 4 _ }
D City town community or landmark
E Section Lot # 10 Subdivision ItA
F Directions to property by road i '7 I 60J.--4L
G Latitude and 10—ngitudeftir the project sit -35 '7 lz-y , i 0'i,
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 mansonos.com Directions Don t register click Maps enter address draw map select "Map Clicking
Will select 'LatlLong" click map)
III Description of Project
A Length of wall 8, Ut o 5 5 L,'h
B Material r- E124
C Distance from p erty li a /shoreline P4
IV Intended Use of Project Area
A Private
B Commercial pp
V Applicant Signature Date / 1
ELEASENOTE 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 NC27604
919 733 1786
Y U AKEMQM Vackage InformationWC Shorelme Stabilization Application doc

DUKE ENERGY DIRECTIONS BY ROAD FORM
Lake Use Permit Applreaats sad Contractors- Ease of locating the proposed project site can have a big
impact application on
�t pmcewmg time. Pieria Complete this form and return tt along with your completed permit
DUKE ENERGY
CIO LAKE SERVICES - EC 12 Q
PO BOX 1006
CHARLOTTE, NC 28201 -1006
1- 800 - 443 -5193 and select Option 5
Applicant s Name K �g- G w p� Q IC,blClg 'A5
Street Address (at lake)
[Ake Name WL 1 •
Subdivision Name
Tax Par+cd ID (If known)
Lot,* i b
City- _�,„��1- County —,ti� -,.L)
state. —I to zip- a o
Latitude. --4�3 t p i otwwde
Tdephoae: 0 " Z 3 -b— j
Dtrecttons 000 major toad or highway)
Descnpbve Structures) on Property (Le. brick garage,, white fence, mobile home, etc)
A is o %NNQt twt ch
,a"KO,GART/Pae,.lnfw� by Road Fom Am
8!16109