20120168 Ver 1_Shoreline Stabilization_20120215

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 a, 2 0 1 2 0
Division of Water Quality 401 Oversight/Express Review Permitting 1 6 $
1650 Mail Service Center
Raleigh NC 27699 1650
JjApplicant Information
Owner /Applicant Information
'Name -- -r ;E-4 c- L- v * a a N 5 ra c
Mailing Address
Telephone Number c -}mow Fax 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 A liation 1-rsY a �r �"- , �0
Mailing Address 25(e 2 )-e, track ))r �em%2. c
Telephone Number ��a 7, /- 5-1G 7 Fax Number
E mail Address _ LK,ti t4pF r s�. Cp/Lj TD
►�J A F
II Protect Information s
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
1 Location. -�- `
County
Subdivision ✓P� (� Nearest Town ✓mss/,
name or site address (include phase/lot number) �' 7 ?r,i„
Directions to site please include road numbers landmarks etc s is not necessary if an adequate
vicinity map is included) r do
1 -4 7 I- .. I .- — .-�
2 Describe the existing land use or condition of the site at the time of this application
!
OProperty size (acres) ,r 7 - C4 C K-e S
4 Nearest body of water (stream/nver /sound/ocean/lake) I- 'd) �� r Y1
.1t i `C
the purpose of the proposed work ( .� 0
IC7
-n
R
�M
rn
Q
O
_
r

6 List the type of equipment to be used to construct the project ����� 4- ` el bet rermi --S
7 Amount of impact (including all excavation backfill np rap etauung wall�etc be low the
normal pool lake level in square feet or acres fee�-�¢ /�
to II Oe �A ecrl �
a
8 a Amount of impact (including all clearing back fill excavatio rip rap etaming walls etc )
1 above the normal pool lake level and 50 feet land ward m square fee acres
8 b Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted (number
of trees for instance) k?
7yerc r!C
k/ti AOS t QrCkS QnCi �t%1�i�✓� }nQ X42;5 i,r�ikJ
i authorization letter from the applicant is provided )

W- .rte
• 1
J
.y
Y ` .
• , d..�w.
it T1
u
H
Ilk
W- .rte
• 1
J
.y
Y ` .
• , d..�w.

Go :)Ste- earth feet 400
meters, 100 A
cro

The maps prepared for
g;;this website are
generated from recorded
deeds, plats, and other public records. Users of these maps are hereby notified that the
information provided herein should be verified. Iredell County assumes no legal
responsibilities for any of the information contained on this site. Users are advised that
the use of any of this information is at their own risk. All maps on this site were prepared
using a 1000aETm Grid based upon the North Carolina State Plane Coordinate System
from the 1983 North American Datum. The delinquent real property tax overlay is
updated monthly. The information presented is not intended to be used or relied upon as
official notice of tax liens. For additional information regarding delinquent taxes, contact i
he Iredell County Tax Collector's Office.
Addresses
!n
Hooks
i .
Straets3 new
Ra-
i_w•.
Ste ±•
• _
"aM Rao:
- _?ca: Raatl
Rte'JM "Y
Countyline
City Limits
-
Lake Norman
1
Fa+re�s
°
NC Count %es
j 1 :17C Feet
http: /ii