20120863 Ver 1_401 Application_20120912

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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 I acre and $570.00 for impacts to take bottom of greater or
equal to 1 acre.
Applications should be sent to:
Division of Water Quality 401 Oversight/Express Review Permitting
1650 Mail Service Center
Raleigh, NC 27699 -1650 r
L Applicant Information
0
1, OwnedApplicant Information
Name:
Mailing Address:
Telephone Number.
E-mail Address:
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2. Agent Information (A signed and dated copy of the Agent Authorization letter must be attached
if the Agent has signatory authority for the owner /applicant.)
Name: &L-
Company Affiliation: COIL- Eyt�[,�ar'
Mailing Address: 0 . 60A 304 64- OV L-LLJ?- koo' 13 i e
Telephone Number: i? ?- 2y3 -0017 Fax Number: &$• �%�13- (pa 4► b
E -mail Address: --- �.-�QO '� (n @ ,r„�Qi.
It. 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,
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5 E P 1 9 2012
DENR - WAT'EF. QU JiL
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1. Location
County: MQC6-k7 Nearest Town: A�'A L/ t'.4gn n J( t
Subdivision name or site address (include phase/lot number): i-0-1-41e
Directions to site please include road numbers, landmarks, etc. (This is not necessary if an adequate
vicinity map is included): ICIO 't FrA.n k&; 6LC - 5 T'
WAlt&"t4-
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2. Describe the existing land use or condition of the site at the time of this application.ame5/'�..
3. Property size (acres): ! A'MC + --
4. Nearest body of water ( stream /river /sound/ocean /lake): Al a-
5. Describe the purpose of the proposed work: '� S'3- Bic /��. syo� u.�� �as�m•
w r/r y2y s T�ruc �, i--o �► trr� per ya ra f--
6. List the type of equipment to be used to construct the project: �E���� f 39+26►<r�6b a•T
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below the
normal pool lake level in square feet or acres: 75 0 5 ®t glr LOS Non
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:
:25-0 ' S Ca ` /P-Q DJL !y Q&T /I Fbot
8.b. Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instance): Y �'f" tea �Ba�£ nra�+�nF�e- Pooc.JMP*eTEJ6
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McMs or- Ip" j h 1>l.7rnETFR LESS,
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Applicant/Agent's Signatup Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

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DUKE ENERGY LAKE SERVICES
lEC12 -Q
P O BOX 1006
CRABLOTJCE,INC 28201.1006
704-382-1567 or TOLL FREE 1- X10.443 5193
APPLICATION FOR PERMIT TO STABILi%R THE SHORELINE IN NORTH CAROLINA
Please type or print and fill in all blanks. If information is not applicable, so indicate by placing NIA in blank. PLEASE
SUBMIT APPLICATION AND APPROPRIATE DUKE ENERGY FILING PER, PAYABLE TO DUKE ENERGY,
TO ABOVE ADDRESS.
1. Applicant Imformatiop
A. Name
B. Mailing Address
C. Teiephone• 740 d
Il. Loestion of Proposed Project
A. Lake d(,, 4 �d
B. SEreet Address �dr'
C. Comity
D. City, town, aommunity or landmark
E. Section Lat N Subdivisio0
61, F. Directions to rope fry road - Pf )Ads
G. Latitude longitude for the project site D — S
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.mapsontts con. Dbvetions; Don't register, click "Wisps ", enter address, draw map, select "Map Clicking ,
Will... ", select "LadLong ", click map)
III, Description of Project
A. Lereg<h of wail 360
B. Material Df1)f STS =ft uirtli R1P gap -r�orm
C. Distance from property lindshorehne &o' f
IV. Intended Use of Project Area
A. Private 406m S 0E ,� !
8. Commercial_ _ !
V. Applicant Signature 0 �* I Date
FOLL�( 00 � xk��l
1EASEMOTE
• 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 (S) 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:
a
NC DIVISION OF WATER QU4Ln7
ATTENTION: CYNDIILAROLY
PABKVIEW BLDG., 3321 CRABTREEBLVD. t
RALEIGH, NC 27604
919.733 -1786
Y U AKEMOMMOCkGM tnronnatton%NC Shwdina Stabftauon Appitcatim doe

PVDuke
Energy,
August 14, 2012
Seites Milner, Jr.
1031 Millstone Pt.
Bogart, GA 30622
RE: Application for Private Facility
Nantahala - - 496 Lake Shore Drive
Dear Prospective Lake Use Permit Applicant:
Duke Energy Cake Services
PO Box 1006 / EC12Q
Charlotte, NC 28201
r-lExcavation Q Shoreline Stabilization F-1 Miscellaneous
Reservoir Uses
Enclosed you will find the current Duke Energy Lake Services Fee Schedule which became effective January 1,
2002, the applicable Shoreline Management Program Permit Application(s), the Duke Energy Nantahala Area
(DENA) Shoreline Management Guidelines (SMG) which became effective July i, 2003, and the DENA Private
Facilities Users Agreement. The purpose of the program is to comply with Federal Energy Regulatory
Commission (FERC) orders and requirements for authorizing facilities constructed inside the project boundary of
Duke's licensed lakes.
The Application(s) will be reviewed after being completed and returned to Duke Energy Lake Services - EC12Q,
PO Box 1006, Charlotte, NC 28201 -1006. PLEASE USE YOUR MAILING ADDRESS ON THE
APPLICATION(S) and type or print information for legibility. No activity is allowed inside the project boundary
until you receive written authorization from our office, and no approval will be given to anyone other than the
property owner. A check made payable to Duke Energy for the appropriate filing fee (see enclosed fee
schedule) must accompany the following before the review process will be initiated. A completed DPNA
Users Agreement must be signed by the adjacent property owner and included with each application. An
application is not considered complete without the signed Users Agreement.
PIER/DOCK/STABILIZATION:
1. The completed application(s) (for pier structures include both proposed and existing facilities). Include the
Duke Energy permit number if one has been previously assigned to any existing structure on the
property. '
2. The form describing directions by road (including section and lot number if applicable), and the area of the
planned construction/activity marked on the grid map (if enclosed).
3. Copy of a registered survey of the property, showing proposal's location from your property into the project
boundary.
4. Copy of county building permit, if one is required by the county. (Applicable to pier structures only except for
Burke County which requires a building/shoreline protection permit for stabilization.)
5. Other information, including mitigation plans or cultural resource consultation documentation, if applicable.
6. Latitude and Longitude coordinates must be supplied in order to process the application. Coordinates can be
obtained from www.orbisinc.com/sme/.
FOR NORTH CAROLINA STABILIZATION:
1. TWO (2) COPIES of the NC Division of Water Quality (DWQ) Pre- Construction Notification Application
(can be found on internet site, hitp:llh2o.enr. state .nc.uslncwetiandsliake.htmi) and the DWQ application fee
must be provided to the NC Division of Water Quality, Attention: Cyndi Karoly, 401 Permitting Unit, 1650
Mail Service Center, Raleigh, NC 27699 -1650.
Thank you for your cooperation in working with us through the Private Facilities Permitting Program. Should you
have any questions or need further assistance, please call the Lake Representative for the Nantahala Area (828-
369- 4513), or you may call Toll Free 1- 800 - 443 -5193.
Sincerely,
Lake Services
www duke - energy com

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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:
Applicant's Name:
Street Address (at
Lake Name:
DUKE ENERGY
C/O LAKE SERVICES - EC 12 Q
PO BOX 1006
CHARLOTTE, NC 28201 -1006
1- 800 -443 -5193 and select Option 5
.f
Descriptive Structure(s) on Property (i.e. brick garage, white fence, mobile home, etc):
/ • / `
gpal/LAKEMOMT/Package Information/Directions by Road Form doc
8/26/09

Agent Authorization Letter
To Whom it May Concern:
This letter is to authorize Bob Martin of Bob's Docks, P.O. Box 304, Glenville, NC,
28736, (phone 828 - 743 -0017, cell 828 - 226 -2047) to act as our agent in all matters
pertaining to applications, permits, documents and the construction for the shoreline t
stabilization project for:
496 Lakeshore Drive
Nantahala Highlands Subdivision on Lake Nantahala
Topton, NC 28781
Please contact Mr. Martin for any questions or matters relating to this project.
Owner of Property;
Designated Agent:
i
Nancy Milner
Dated as of September 6, 2012
Bob Martin, for Bolds Docks
Dated d 9— ZZ' —"/ Z---

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