20120105 Ver 1_401 Application_20120212

SEP -14 -2005 06 13 FROM DWO- WETLANDS 9197336893 TO 918284953050
20 1 20 1 0 5
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 US Army Corps of Engineers Pemrt
GP30 This Application cannot be used for wetland or stream impacts. PIease
provide seven (7) copies of tins application and supporting information as well as a
non - refundable application fee to the Division of Water Quality of $200 00 for
impacts of to lake bottom of less than I acre and $475 00 for impacts to Is a bottom
of greater or equal to I acre
Applications should be sent to
Division of Water Quahty Wetlands Unit
1554 Mail Service Center
Raleigh, NC 27599 -1650
1 Applicant Information
1 Owner /Applicant /Information f
Nmne LL ?v v ^ c L. J'L.
Ndat� Address C Nf /'R
2
Telephone Number
E -mast Address _ i
-) 1-f 49 Fax Number
Agent Info on (,A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has si�atory authontyfor the owner /apphcant )
Name / -�ct y �c Cc 'd c u / /-1
Company .A ffiltatson,.
Meing Address 3_.��-_ -1 vo =( n.
i Mr -phone tvumuer_41) li J 1 J X-1 y Z Fax
E-mail Address _ t" o r-i e- e- G n 4 CO- e m s"
IL Project Information
VV"
Attaoh a vicinity map clearly showing the location of the pmperty with respect to
local landmarks such as towns rivers, and roads Also provide a detailed site
plan shmng property boundaries and development pI z�eI ti to
surrounding properties You may use the diagram below to � 0�i ch of
F ��
�0% U
4N PV4TF 2
09 -13 -2005 19 47 MARINE CONSTRUCTION CO 8284953040 '41VCHPArpl
P 1/5

-L- Ub 1,3 FROM DWO- WETLANDS 9197336893
TO 918284953050 p 2/5
your project Also see the example below for guidance Both the vlcouty map and
site plan must include a scale and north arrow The footpnx* of all buildings,
unpervious surfaces, or other facilities must be mcluded.
Location 1/ /►
County C a Ld c✓ c i Nearest Town (y-�rc► n �a_/ j
Subdivision name or site address (include phase/lot number) Ia a ,- „ P" # a
Directions to site please include road numbers, landmarks, etc (This is not
necessary if an adequate unity maap is znc ud _
2 Describe the exa tmg land use or condition of the site at the �je of this
application -W ev t i e a t- , 1 Cc" -I vV" t I- .
3 Property size (acres) /
4 Nearest body of water (stream Inver /soundlocem4ake) /-Q4,
5 Desenbe theipurpo,5e of the proposed work S Q �a �� Z U, �f e r r^, -e
1„ e .0 j.plI -
6 List th a of egmpment to be used to construct the project _ �= x e � va�G •
,ICT 7 _S'-�c a --
7 Amount of impact (includma all ezcavatum t,.,tq» y, „ft....�«,.._.__
et
8 a Amount of impact (including all clearing, back fill, excavation, rap rap,
reta =g walls, etc ) above the normal pool lake level and 54 feet land -ward M
square feet or acres v o V t & a e
b Please describe vegetation above the normal pool t e level and 50 feet land-
ward to be impacted (number of trees for instance) _ V, w Tr C, e
Applic ant! t s Srgnafiire Date
(Agent's gnature is valid only of an authorzation letter from the applicant as provided )
09 -13 -2005 19 47 MARINE CONSTRUCTION CO e284q"M4a

DUKE POWER LAKE MANAGEMENT, EC12 -Q
P O BOX 1006
CUARLOTTE, 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 POWER FILING FEE,
PAYABLE TO DUKE POWER, TO ABOVE ADDRESS
L Applicant Informahon J
A. Name %y�c ��- -1 c�,ea'i
B Mailing Address /
Y _ �
APo
C Telephone _ 0 -)It
IL Location of Proposed Protect
A Lake s o t o �� n r if
B Street Address _ i g SP� h at u�' o I.J
C County e c
D City town community or landmark A,,, �� / jr Yc. 33
E Section Lot # J (.— Subdivision �, a
F Directions to nroverty by road %r`, r �� -vr,. r �,, I
G Latitude and longitude for the protect site
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 mternet site, www mapblastcom)
HL Description of Project
A. Length of wall 162
`
B Material_ LZ/a - d
C Distance from property lmelshorehne , ?
IV Intended Use of Project Area
A Prwate_ L/
B Commercial
V Applicant Signature � �,� Date ''���•. c 4 , C t
PLEASE NOTE THE FOLLOK&&
• A COPY OF THE COMPLETED APPLICATION WITH A ROAD MAP SHOWING LOCATION OF
THE PROPERTY MUST BE SUBMITTED TO USARMYCORPS OFENGINEERS, ISI
PATTONAT� -ROOM 208, ASHEVILLE, NC 28801 -5006
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
1650 MAZE SERVICE CENTE"12
RALEIGH, NC2769"6S0
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Address 6185 Plantation Pointe Dr
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