20120823 Ver 1_Shoreline Stabilization_20120830

The following is an abbreviated application form for those applying for a 401Water
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 $240.00 for
impacts of to lake bottom of less than 1 acre and $475.00 for impacts to lake bottom
of greater or equal to 1 acre.
Applications should be sent to:
Division of Water Quality Wetland Unit
1650 Mail Service Center
Raleigh, NC 27699 -1650
I.
Applicant Information
1. Owner /Applicant Information
Name:
Mailing Address
Sonny Tyson
186 Vineyard Road
Norwood, NC 28128
Telephone Number: (704) 438 -1865 Alt Number
E -mail address: c;r,� I �a >cu_;s?sf ; ic�r._; sir.
20120823
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 Affiilaition:
Mailing Address:
Telephone Number:
E -mail address:
H. Project Information
Fax Number
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: Stanly Nearest town: Norwood, NC
Subdivision name or site address(include phase/lot number)
Tillery Beach Sixth Addition Lot 915
Directions to site please include road numbers, landmarks,etc (This is not
Residential home with grass lawn and natural area
From Albemarle, NC, South on US Hwy 52 In Norwood Left on Pee Dee Avenue
Right on Lehue Parker Road, Right on Berry Hill Drive, Right on Vineyard Road
186 Vineyard Road on the left
2. Describe the existing land use of the site at the time of this
application:
Residential home with grass lawn and natural area
3. Property size (acres) Approx .2 acres
4. Nearest body of water (stream /river /sound/ocean/lake): Lake Tillery
5. Describe the purpose of the proposed work:
Demolish and replace existing boathouse and seawall, backfill seawall with crushed
stone, install rip rap on front of wall. Dredge 1500 sq ft area for boathouse to
remove accumulated sediment.
6. List the type of equipment to be used to construct the project:
Excavation equipment, carpenter tools
7. Amount of impact (including all excavation, backfill, rip rap, reatining walls,
etc.) below the normal lake pool level in square feet or acres:
1500 Square feet for seawall construction and dredging
8. a.Amount of impact (including all clearing, backfill, excavation rip rap,
reatianing walls, etc.) above the normal pool lake level and 50 feet landward in
square feet or acres:
300 Square feet
b. Please describe vegetation above the normal pool lake level and 50 feet land-
ward to be impacted(number of trees for instance):
Natural area covered with grass and vegetation.
o vegatation to be impacted
August 23, 2012
App scant/ nts' ignature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided)

Lake (Full Pond)
Remove existing wood seawall and boathouse.
Replace seawall and boathouseto
Both to be constructed of
4 "x 4" & 2 "x 6" .04 pressure treated lumber
Seawall
60 lineal feet seawall
to be replaced
Back fill w /2"
washed stone 4"
from base
4" Rip Rap
2 to 1 slope
in front of wall
Proposed Boathouse I
1500 sq ft area under
boathouse to be
dredged, to remove
accumulated debris
Full Pond
Shoreline
(Lake Tillery)
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 evacuation or dredging below the Full Pond
elevation.
6)Location of construction access corriders.

Sonny Tyson
186 Vineyard Road
Norwood, NC 28128
Tillery Beach Sixth Addition Lot 915

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