20120993 Ver 1_401 Application_20121012

20120993
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 tinder 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 lake 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 P
Raleigh, NC 27649.1650
I. Applicant Information
1, Owner /Applicant Information t j
f ,c°
Name: W�
Mailing Address- Address: D r e "
Telephone Number: 1311Itt - Fax Number: -
E -mail Address: a," -'°
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: A00—
Company Affiliation:
Mailing Address: P•O e'0)e' 5—ay
Telephone Number: gZR- ZZ4 -ZD9;'P Fax Number: F�ZB- 74/3 -6r66
E -mail Address: ."02%koa -S'A a 0-0 •C-4'"`
II. 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 an-ow. The footprints of all buildings, impervious surfaces, or other
facilities must be included.
n5
DENR WF+TI =H QUALITY
Wetlands & Stnrmwatep Branch

Location
County: H `rAAI Nearest Town:
Subdivision name or site address (include phasellot number):
� 76-IQ N, (°.
Directions to site please include road numbers, landmarks, etc. (This is not necessary if an adequate
vicinity map is included): flew A'9^1612110 `oU." mLI&Ay1✓ N_wY_. l•1LST 7 u/fiyAwl Ad
7L,7.,, R16.1-17" .' e! 07Wd.r_ .
L b W� GouL sTJbrxe s OwT �ea++�- �� Gt< eFF6b t oT,�`8 Alf �►o�ue -Z A44t eaTS
2. Describe the existing land use or condition of the site at the time of this application: /VI O x
3. Property size (acres): i S_/I'cO-SS
4. Nearest body of water (stream/river /sound /ocean/lake): 4#0-- F_ 'V*"'�, 0; f-?'
5. Describe the purpose of the proposed work: Zo Ar_*gg yLz_ s,A�O_a f-c rev
�Afy AAe Xn N� a. �4e AAw Q eF sWO"
d. List the type of equipment to be used to construct the project:,
7. Amount of impact (including all excavation, backfill, rip rap, retraining walls, etc.) below the
normal pool take level in square feet or acres: Z23"_
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:
ZZS' SQ I=r..
8.b. Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instance): h f/3 Pi S moon i� 0- S t
Ld*IkfL A6Zd &4;V #vo izr® .aura 4sgr'64
4Fpplicant /Agent's Signatoe Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

w

' .. -
June 25, 2012
201 2099 3
Duke Energy Lake Services
PO Box 1006 / EC12Q
Charlotte, NC 28201
Mike & Pam Smith
5710 Central Avenue North f`
Tampa, FL 33604
►�iiT,
RE* Application for XPrivateFacility Excavation OShoreline Stabilization Miscellaneous
Nantahala - - Wayah Road Lot # 8
Reservoir Uses
Dear Prospective Lake Use Permit Applicant-
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 1, 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 /snip/
FOR NORTH CAROLINA STABILIZATION:
1 TWO (2) COPIES of the NC Division of Water Quality (DWQ) Pre - Construction Notification Application
(can heJound on internet site, hup Ah2o enr state ne.us/ncwetlands /lake Mint) 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 Pennitting Program. Should you
have any questions or need further assistance. please call the Lake Representative for the Nantahala Area (828-
3694513), or you may call Toll Free 1 -8¢0 -443 -5193
Sincerely,
Lake Services
[�i
@ d_.1/ LM
nr T 2 c,
DENR - WA7EH DUALITY

DUKE ENERGY LAKE SERVICES
ECl2 -Q
P O BOX 1006
CHARLOTTE, 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 ENERGY FILING FEE, PAYABLE TO DUKE ENERGY,
TO ABOVE ADDRESS.
1. Applicant Information
A. Name M /
B. Mailing Address 5 1 1 0 l ) #'rA I Zl llQ
C. Telephone: ARM / 3 ? 1
a,
IL Location of Proposed Project
A. Lake A1 0-
B. Street Address 1*
C. County
D. City, town, community or landmark c
E. Section t Lot ## Subdivision M i
F. Directions to trronertv by road `vhm t-a -n-AA' h'n _
G. Latitude and longitude for the project sitars , I &'i 8 / —&E -Vte 70
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/ Iongitude coordinates can be found on internet site,
www.-mapsonus.com. Directions: Don't register, click "Maps ", enter address, draw map, select "Map Clicking
Will... ", select "Lat/Long", click map)
III. Description of Project r
A. Length of wall �°D Y- —
B. Material C t93S 3 A?/ r' R -P
C. Distance from property line /shoreline ZD ` f
IV. Intended Use of Project Area
A. Private k
B. Commercial
V. Applicant Signature Date
PLEASE NOTE THE FOLLOWING:
• 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 (5) 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: CYNDI KAROLY
PARKVIEW BLDG., 2321 CRABTREE BLVD.
-- RALEIGH, NC 27604
919- 733 -1786
Y U AKEMONflVackage infotmation\NC Shoreline Stabilization Application doc

DUDE ENERGY DIREC'T'IONS 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
CIO LAKE SERVICES - EC 12 Q
PO BOX 1006
CHARLOTTE, NC 28201 -1006
1- 800443 -5193 and select Option 5
Applicant's Name: kt JM r �A
Street Address (at lake): &A4z w ah - d
Lake Name: �.
Subdivision Name:�� -�
Tax Parcel ID (if known): L Lot #
City: / Ob County: OLt? d-Je)
State: _ N Zip: _ a 8 7 $
Latitude: .7 /"J' l'/ Longitude: - R3-0 R701
Telephone;— ?13- 23?- / 3 -
Directions (from major road or highway):
from i✓ !;n - bid a/1PA y Rd, UJ e5 7L j urn �►9 �-� or) t G� ali
(o�ott- 5 o1 u rat C o+-tu r) TCu(- LJcv" /�ald 1Q.// aA. ")ay t�
ca' & d h_ e j�f , �C.Ua/ ! �t �e Ju rv.
Descriptive Structure(s) on Property (i.e. brick garage, white fence, mobile home, etc):
q Md .
9Pa1/LAKEMGMT1Pa&39c InfonnationlDirections by Road Form doc 8/29

Duke
(57 Energy.
Duke Energy Lake Services
PO Box 1006 / EC12Q
Charlotte, NC 28201
DUKE ENERGY NANTAHALA AREA (DENA) PRIVATE FACILITIES
"USER AGREEMENT" LETTER
(You may use this letter and fill in the requested information. Please Print)
Date /L31- it/ ® % Z
TO: Duke Energy
c/o Lake Services- EC 12Q
P. O. Box 1006
Charlotte, NC 28201 -1006
RE: (Lake Name)
(Street Address) 17D H% %icy
(Subdivision / Lot #) H7
(Applicant's full name) 15�l wt e SM /%A% hereby agrees to comply with all requirements
and conditions set forth by Duke Energy's Lake Services' office, or any federal, state or local agencies
pertaining to our Private Facilities application to construct a
on Lake401AV &4 . In addition, Mve have read and agree to comply with Duke Energy's Shoreline
Management Guidelines (SMG) and understand that written authorization must be obtained from Duke's
Lake Services' office prior to beginning any activity /construction within the Project boundary. The
construction will be completed as described in the approved private facilities program application and within
twelve (12) months from the date of approval by Lake Services. Failure to complete construction within the
build -out period will require the applicant to file a new application within the then - current guidelines. The
tiling will include any applicable fees and security deposits.
Uwe attest to be the owner or lease holder of the tract of land immediately adjoining the Project boundary
where the proposed facility is to be constructed.
1 /we understand the physical location on my /our lot in relation to the common property line with Duke Energy,
the FERC Project boundary, and any deeded flood easements or required building setbacks.
I /we understand that this lake was constructed as a working hydropower reservoir for the primariy purpose of
producing-cost- effective electric energy and that this remains as the lake's primary purpose. Uwe understand
that the lake and its associated hydropower station are operated by DENA under the terms of a license issued
by the Federal Energy Regulatory Commission (FERC) and that there will be no change in hydro project
operations as a result of the construction and /or use of any facilities that I /we may be allowed to place within
the FERC Project boundary or on-DENA-owned property.
I /we understand that lake levels will rise and fall over time in response to weather events and hydro project
operations.
UP NA PRIVATE FACILITIES UJERS AGREEMENT Final Rev 10/13/03
Page 1 of 5

Uwe acknowledge that DENA provides no guarantee of any specific quantities (except those identified in the
Low Inflow or Hydro Project Maintenance and Emergency Protocols) or quality of water in the take.
1/we acknowledge that DENA does not guarantee that an approved facility will always have sufficient water
depth to be accessible by boat or for other water depth related recreation activities.
I /we understand that the structures to be installed are my /our property and I /we therefore agree to be fully
responsible for the permitted reservoir use including maintaining structures in good repair. If the facility is
deemed unsafe by a Lake Services Representative, Uwe agree to repair or remove the facility at my /our own
expense and within the specified timeframe. This responsibility is considered to transfer automatically along,
with ownership and leases of the adjoining tract. {
Uwe understand that as an owner or lease holder of property directly adjacent to DENA's Project boundary
1 /we enjoy the same rights and privileges for general recreational use and enjoyment of the Project lands and
waters as are afforded the general public. I /we understand that as an adjoining property owner I /we may, with
proper written approval, be considered for expanded privileges as specified in the DENA SM(i,
I /we understand that certain activities specified in the SMG are prohibited because of the DENA lakes small
size, environmental concerns, boating capacity limitations, safety considerations and other reasons.
1 /we understand that ownership /interest in a Common Use Facility eliminates the option for me /us to also have
a separate facility on any other lot within the affected subdivision that I /we own or lease.
I /we understand that Lake Services' approval of the requested reservoir use in no way constitutes assignment
of an interest in real property (i.e. land rights). The approval is granted and maintained solely at Duke's
discretion. Uwe also understand that the permitted use may be revoked at any time by Duke Energy or its
successors for any reason whatsoever. If the approval is revoked, I /we agree to remove the facility at my /our
own expense within the specified timeframe set by Lake Services.
I /we specifically waive any claim for consequential damages arising out of or relating to this application,
Duke's approval or denial of it, or Duke's subsequent revocation of approval, and Uwe specifically understand
and acknowledge that, because Duke Energy can revoke the permitted use at any time, I /we are not entitled to
reliance damages.
Uwe understand that there will be no change in hydro project operations as a result of construction and/or
utilization of the permitted proposed structures.
I /we understand that the proposed structure will be used only for the purposes described in the information
submitted to Lake Services and other appropriate governing bodies for approval.
1 /we understand that this lake is oxen for use by the general public and that maintaining safe and lawful public
use is one of the primary lake management objectives of DENA.
I /we understand that the use for which we are applying is a private use and it should not interfere with the
general public's safe and lawful use of the lake.
I /we understand lake use permit holders have the authority to prevent others from trespassing on the structures
they have built. I /we also understand that I /we, however, do not have any authority to impede anyone from
DP NA PRIVATE FACILITIES USERS AGREEMENT Final Rev 10/13/03
Page 2 of 5

pursuit of the lawful public recreation enjoyment of FERC Project lands and waters. Except as specified
otherwise in the SMG or other DENA documents (e.g. Public Safety Plans), anyone may fish aroundlunder
structures built by others, may walk/wade /fish within the FERC Project boundary or any DENA -owned
peripheral strip, boat in the lake's waters, etc. without having to get anyone's permission to do so. Boaters may
not block ingress /egress to piers/docks.
I /we understand that every reasonable effort must be made to minimize any adverse impact on fish, wildlife,
and other natural resources.
I /we understand that trees and vegetation growing within the Project boundary play an important role in the
overall environmental condition of the take. The ecological benefit the vegetation has on the fish and wildlife
habitat supports a sound and healthy lake environment. I/we also understand that unauthorized removal of
shoreline vegetation (i.e. button bushes, willows, cattails, etc.) and/or disturbance of the shoreline buffer may
result in suspension or denial of lake use permitting requests and require me/us to re- establish the vegetation, if
the disturbance is found to be in violation of the state or county watershed buffer regulations or Duke Energy
Nantahala Area Vegetation Management Requirements.
[/we agree to notify Lake Services when construction is completed. During the construction period, the
weather -proof "Duke Energy Approved Lake Use Activity" sign (to be provided by Lake Services) must be
posted at the job site, visible from the water's edge,
[/we agree to notify Lake Services if the property is sold and provide the name and address of the new owner.
The new owner has 180 days following the date of closing on the property purchase to sign this agreement and
its conditions.
I /we agree to fully disclose all information regarding the approved private facility to any prospective
buyer /leaseholder of the property and any new owner /leaseholder. I /we agree that Duke Energy Lake Services
will be notified immediately of any sale /transfer of the property and the transfer of the permit to the new
owner /leaseholder.
[/we agree that Duke Energy may enter into agreements with third parties permitting use of the Project property
that promotes the overall recreational purposes of the Project.
Ilwe agree that this agreement confers no right to construct or maintain public and private beaches, marinas or
campgrounds.
I /we agree that the adjacent Duke Energy Project property shall be used exclusively for non - commercial
recreational purposes
I /we agree not to rent, lease or otherwise allow third parties (except for temporary use by guests, family
members, and renters of the residential property) to use any structures permitted to me /t►s by DENA.
l /we agree not to allow any use of the adjacent property and will exercise due care and diligence to prevent all
other persons that are affiliated with my /our property (including invitees, family members, guests, etc.) to
violate an applicable federal, state or local law or regulation. Examples include but are not limited to nudity,
illegal discharge of firearms or fireworks, controlled substance abuse, public drunkenness, public urination or
defecation, or other activities determined to he a nuisance by law enforcement officials.
DPNAPRIVATFFACILI TIES USERS AGREEMEWr Final Rev WL,0403
Page 3 of 5

I /we agree to exercise all care and due diligence to preserve and maintain the character of the DENA's adjacent
property. I /we agree to comply with the DENA Vegetation Management Requirements. 1 /we agree further to
not allow sewage, including discharge froth septic tanks (or similar facilities) or boat holding tanks, garbage,
trash, or other waste material to be discharged or dumped into the reservoir, tributaries or adjacent property.
I /we understand that as an adjoining property owner Uwe can make no change in land form of land within the
FERC Project boundary or land owned by DENA, such as grading, excavation or filling without prior written
approval by Lake Services.
Uwe agree that only floating piers /docks (unless otherwise authorized by DENA in writing) will be placed on
the Project property and that no piers /docks or structures will be built on Project property without prior written
authorization by DENA.
Uwe agree for myself /ourselves, members of my /our family, guests and invitees that Uwe assume all risks of
personal injury or property damage incident to my /our occupancy and use of the premises; including but not
limited to any personal injury or property damage which may be sustained as a result of flood waters or in
connection with the rise and fail of water in the reservoir as a result of floods or of the operation of Duke
Energy's hydro electric facilities. I /we as the adjoining property owner further agree that I /we will indemnify,
protect, defend, and save harmless Duke Energy from any and all loss, cost, claims damages, expenses,
judgments and causes of action for all injuries and damages sustained by the members of my /our family,
guests, and invitees arising or claimed to have arisen in connection with their occupancy or use of the DENA -
permitted facility(s),
Uwe agree to comply with all FERC orders (as modified or interpreted by FERC), with all other applicable
FERC Rules and Regulations imposed by Duke Energy, and with all rules or regulations imposed on Duke
Energy by any governmental agency.
I /we understand this user's agreement does not have an expiration date and is transferable to the next property
owner provided the new owner signs a new agreement within 180 days following the date of closing oil the
property purchase.
Uwe have included a check for the applicable filing fees and security deposits and copies of all other necessary
permits.
I /we acknowledge that DENA has the right to charge reasonable user's fees for private use of its property and
that failure to pay any applicable user's fees in a timely manner can result in the suspension or cancellation of
any previously approved lake use permit.
I /we agree to maintain any prescribed mitigation activities that are required in order to gain approval for
facility construction, as long as the facility exists.
I /we agree that camping is only allowed in designated areas.
I /we recognize that I /we have the continuing responsibility to ensure that the constructed structures are
maintained in good repair, including, but not limited to maintenance of the dock and boat slips, and proper
erosion control within the permit area and along the shoreline, and agree to take all reasonable steps necessary
to meet this responsibility. I /we agree to maintain all structures within the Project boundary on DENA -owned
property in a sound condition and in a neat appearance and pay all costs for said maintenance.
UP NA YRIVAIL- rACILITIES USERS AGREEMENI i Enal Rev 10:13%03
Page 4 of 5

a
1 /we agree that if any action is taken by Duke Energy to enforce any provision, covenant or agreement
contained in this user agreement or DENA SMG or if Duke Energy is required to retain an attorney to enforce
any provision, covenant or agreement contained in this user agreement or SMG (including, without limitation,
the payment of fees due hereunder or the removal of an encroachment constructed in violation of this user
agreement or SMG), then Duke Energy shall be entitled to recover all of its reasonable costs associated with
such an action, including but not limited to, attorneys' fees and court costs incurred in such action and /or
enforcement; provided, however, that the undersigned shall be entitled to recover all of its reasonable costs
associated with such an action, including but not limited to, attorneys' fees and court costs incurred in such
action and /or enforcement if judged to not be in violation of any provision of the User Agreement or SMG.
I /we agree that I /we have read and will abide by the DENA SMG published under separate cover.
1 /we understand that Lake Services representatives may issue Stop Work Directives for any violations of the
SMG or engagement in prohibited acts or activities on DENA property as specifically identified in the SMG
I /we understand that persons found to be in violation will be subject to DENA sanctions which can include: 1)
restoration of the impacted area at the person's expense; 2) loss of consideration of any future lake use
permitting activities for up to five years for improper vegetation removal or until vegetation is satisfactorily re-
established (even if there is a change in property ownership); 3) revocation of a previously issued permit and
loss of consideration of any future lake use permitting activities and /or reinstatement of the revoked permit; 4)
increases in fees; 5) modification or removal of non - complying structures; and /or 6) further legal action being
taken by DENA.
Sincerely,
/JCL! it .P ,( ,,e &/r IY4
(Applicant's Name)
Lake Street Address
TU P / -b.c/
V.
City/State/Zip-Code
S2-&-3Z1 - 323
Lake Phone Number
(Designated Duke Energy Agent)
'0
..
S710
Home Street Address
City /S ate /Zip Code
fTO J57 15W
Home Phone Number
Date: y
Date:
DP NA PRIVATE FACILITIES USERS AGREEMENT Final Rev 10/13/03
Page 5 of 5

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BANK HEIGHT DETERMINATION
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