20120763 Ver 1_401 Application_20120812

DUKE POWER LAKE MANAGEMENT, EC12 -Q 012 ? 6 3
P. O. BOX 1006
CHARLOTTE, NC 28201 -1006
704824567 OR TOLL FREE 1.8004436198
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.
1. Applicant Information
_
A.
Name .id h
B.
Mailing Address ( D 9'
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ad l c: G�-
G � ri p, f� f l i d A." G
C.
Telephone -2v
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11. Location of Proposed Project
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A.
Lake
B.
Street Address _
5Dd
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C.
County p" id
45!
-
D.
City, Town, Community or Landmark
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E.
Section Lot #
Z-
Subdivision
F.
Directions to property by road �" ? 7 N
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L�-� vn 131,4 vle w 5 G4o,,1
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41~.t4% ✓ . 4 4A
G. Latitude and longitude for the project site
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.mapsonus.com. Directions: Don't register, cli rf:A
address, draw map, select "Map Clicking Will... ", select °Lat/Long °, click mapII I. Description of Project 1 3 2012 A. Length of wall g D O _
B. Material
C
C. Distance from property line /shoreline
VA rER Q
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(Ju : l[ f of (O L L�•'sf %►� SG,er•�••,l• h�
IV. Intended Use of Project Area
A. Private X
B. Commercial
V. Applicant Signature o (' ��,0 Date
PLEASE NOTE THE FOLLOWING:
• ARMY CORPS OF ENGINEERS, 151 AtTTON AVENUE, ROOM ZDB, ASHEVILL� NC 28801-5006 ROPERTY MUST BE SUBMITTED TO: US
• 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 APPUCAT10N FEE TO: NC DIv1SION OF WATER QUALITY, ATTENTION. Cyndi
Karo/y, PARKWEW BLDG., 2321 CRABTREE BLVD., RALEIGH, NC 27604, PHONE. [phone]

401 WATER QUALITY CERTIFICATION APPLICATION
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 seven (7) copies of this application and supporting information as well as a non-
refundable application fee to the Division of Water Quality of $200.00 for impacts to lake bottom of less
than 1 acre and $475.00 for impacts to lake bottom of greater or equal to 1 acre.
APPLICATIONS TO BE SENT TO:
DIVISION OF WATER QUALITY WETLANDS UNIT
1650 MAIL SERVICE CENTER
RALEIGH, NC 27699 -1650
I. Applicant Information
Owner /Applicant Information
Name
John Cousins
Mailing Address
109 Woods Hole Ct
Mooresville, NC 28117
Telephone Number
704 -360 -2385
Fax Number
E -mail Address
jxcousins @aol.net
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
Chip Bridges
Company Affiliation
CBC
Mailing Address
638 Oakridge Farm Hwy
Mooresville, NC 28115
Telephone Number
704 - 660 -5111
Fax Number
704 - 660 -5969
E -mail Address
cbcseawalls(aawindstream.net
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.
Location
County Iredell Nearest Town Mooresville
Subdivision name or site address (include phase /lot number): The Point

1. Directions to site — please include road numbers, landmarks, etc. (This is not necessary
if an adequate vicinity map is included): W e5VL n--
(� O i, ti� u n U C -F�- .� Vj'1 ce �.•.,, l,Fel.� Uti. �. y� �n t -
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2. Describe
��� the existing land use or condition of the site at the time of this application:
3. Property size (acres):
4. Nearest body of water (stream /river /sound /ocean/lake): /l./►ZIQ.ti,/
5. Describe the purpose of the proposed work: -rb 1 " �� - 5 L"h �J% a
6. List the type of equipment to be used to construct the project
13a c%kk
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below
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:
/` 5 :?Oo
b. Please describe vegetation above the normal pool lake level and 50 feet land -ward to
be impacted (number of trees for instance): j
S EL ig h,. 4-6
to 201
Applicant/Agent's Signature
(Agents signature is valid only if an authorization letter from the applicant is provided)

Lake (Full Pond)
Full Pond
Shoreline S
Please approximately sketch the following information on this plan (please provide dimensions
for each item, such as 10 ft. x 100 ft.):
1) All proposed vegetation clearing (provide dimensions)
2) Location of rip rap or fill to be placed above the Full Pond elevation
3) Location of rip rap or fill to be placed below the Full Pond elevation
4) The location of any proposed structures such as buildings, retaining walls, docks, etc.
5) The location of any excavation or dredging below the Full Pond elevation.
6) Location of construction access corridors.
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DUKE ENERGY DIRECTIONS BY ROAD FORM
Lake Use Permit Applicants and Contractors: Ease of locating the proposed project site
can have a big impact on permit processing time. Please complete this form and return it along
with your completed permit application to:
Duke Energy
C/O LAKE SERVICES — EC 12Q
PO BOX 1006
CHARLOTTE, NC 28201 -1006
1- 800 -443 -5193 and select Option 5
Applicant's Name: John Cousins
Street Address (at Lake)_109 Woods Hole Ct
Lake Name: Norman
Subdivision Name: The Point
Tax, Parcel ID (if known):_4635124132 Lot 82
City: Mooresville County:_Iredell
State: NC Zip: 28117
Latitude: 35.5326 Longitude:_ 80.9241
Telephone: 704 - 360 -2385.
Directions (from major road or highway):
I -77 North to Exit 33 — West on Williamson Rd — Left on Brawley School — Around circle to
the Point Dr. Left on Meeting House Cir — 2 °d left on Vineyard Dr. Left on Falmouth Rd —
1" right on Woods Hole Ct
Descriptive Structure (s) on Property (i.e. brick garage, white fence, mobile home, etc.):
Lot to left of 109 Woods Hole Ct -

108, Woods Hole Court, Mooresville, NC - Google Maps
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Address 108 Woods Hole Ct
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Get Google Maps on your phone
�5 Text the word "GMAPS" to 46645 3
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