HomeMy WebLinkAbout20121043 Ver 1_Shoreline Stabilization_2012111320 12 10 43
ne following it an abbre -.-fated 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 C.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:
Division of `'mater Quality 401 Oversight/Express Review Permitting
1650 'Mail Service Center D
Raleigh,'_` C 27699 -1650 � � � � �'' � ✓ 1 3 2012
I. Applicant Information ► , DENR . Wf,I�K 4
PP � weeands s a e atIrY
ranch
1. Owner /Applicant Information '
Name:
MailinE
Telephone Number: �e � si ry-,V y 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: 78'1 � &WILrvl _
Company Affiliation:
Mailing Address:
Towns Construction 204 Dogwood fme
Telephone Number. Mt Gilead, NC47306 Fax Number: � / ®� h�✓' 9' 13jP11
10-A29-13"
E -mail Address: b ulch b rfw Ail c e ru ry' n
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 arrow. The footprints of all buildings, impervious surfaces, or other
facilities must be included.
_or
1. Location
County_ Nearest Town: -�
Subdivision name or site address (include phasellot numb): & O
Directions to site please include road numbers, landmarks, etc • (This is not necessary if an adequate
vicinity map is included):
2. Describe the existing land use or condition of the site at the time of this application:
3. Property size (acres): / -U
4. Nearest body of water (staeaminvedsound/ocean/lake):
5. Describe the purpose of the proposed work: At.&A40- .�
6. List the type of equipment to be usUd to conshW � project: �°' °°' ° C&r
7. Amount of i (including all excavation, backfill, rip rap, walls, etc.) below the
normal pool lake level in square feet or acres:
8.a. Amount of imact (including all clearing, back fill, excavation, rip rap, retaining walls, etc.)
above spool lake level and 50 feet land -ward in square feet or acres:
V � ' 6'
8.b. Please describe vegetation above the normal pool Lake level and 50 feet landward to be impacted
(number of trees for instance):
WM
Applicant/Agenes Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided)
,Brown's Construction
104 Dogwood bane
Mt Gilead, N"7306
910499.18$4 ,_
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11 -5 -12
Brown's Construction
104 Dogwood Lane
Mt Gilead N.C. 27306
910- 439 -1384
I Sherrill D. Williams give Butch Brown of Brown's Construction my
permission to act as my agent in securing permission, permits and
construction to be done at 17344 Randall's Ferry Rd. Norwood N.C.
28128
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Date ®k - 7 } ZV/Z_
Map Output Page 1 of 1
Brown's Construction
104 Dogwood Lane
Mt Gilead, NC 27306
910.439-1384
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