20130138 Ver 1_Application_20130212

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20 130'68
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 1 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 D =� V�� �
1650 Mail Service Center U9
Raleigh, NC 27699 -1650 FEB 12 2 013
I. Applicant CM-WAYMMAWY n
1. Owner /Applicant Information
Name:
Mailing Address: O T ox. MOD
p / br. M 4a 167 A/C • 2200 i
Telephone Number. 704 S $ 2 5'7 S.L Fax Number.
E -mail Address: to _'i <_ P c.. e*3 Q m k; Z "w..
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.) /! .))nn_
Name: 'Rob E p_4 6Z1k)J R &. %;i p_ 1 1. J� Lz S i eJ§- CprV TrL A4S
Company Affiliation: /
Mailing Address: 10 S2G 4JI- J& w A a A 4� 446MEf.60 X 812
Telephone Number.
E -mail Address:
IL Project Information
70`4 4 3 a O (0 I L Fax Number.
;Lbw- ja0 4 1.) t_J �yjAN+Q_V4� . N
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.

L)l

1. Location
County: _ s� Pry Nearest Town: 1, 10
Subdivision name or site address (include phase/lot number):
Directions to site please include road numbers, landmarks, etc. (This is not necessary if an adequate
vicinity map is included): •
it p prat `'t V. 112.110
2. Describe the existing land use or condition of the site at the time of this application: F- e�S�ciia
3. Property size (acres): _ & a. r e I=s
4. Nearest body of water ( stream /river /sound/ocean/lake): Le. ,l %"i 1 l a-r-
5. Describe the purpose of the proposed work: R er * Io r I s r_e_ 4w vi
6. List the type of equipment to be used to construct the project: TAac -ko'vS 11f%3A
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below the
normal pool lake level in square feet or acres: (o Dr�- aG 2 f{-
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:
•w kewss-
8.b. Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instance): LI 71-e r, Cr S 4, -N aP uA o1" b JZ 6),
Iff
i
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

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CQo T-4 X ot T:+ AjoouE
d T-i X�f 13 Ego
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North Carolina Department of Cultural Resources
State Historic Pr+eservaati(m Office
Ramona M B®ema, Astor
Beverly Sava Peahr, Govemor
Lim& A. ColiSIe. Se mmay
JcffmyJ• Gow. Deptq SeMtKy
September 24, 2012
Robert Gallagher
Boat Houses on Tillery
10579 Willow Oak Road
Norwood, NC 28128
OBim of Archives and y
Diviumi of thorn d Room=
David Brook. Dicecmr
Re. Bruce Smith, Soil Dis=bance, 22216 Oakwood Road, Albemarle, Lake Tillery, Stanly County,
ER 12 -1700
Dear Mr. Gallagher
Thank you for your email of September 1% 2012, concerning the above project
We have conducted a review of the project and are aware of no historic resources which would be affected by
the project Therefore, we have no comment on the project as proposed.
The above comments are made pursuant to Section 106 of the National Historic Preservation Act and the
Advisory Council on Historic Preservation's Regulations for Compliance with Section 106 codified at 36 CFR
Part 800.
Thank you for your cooperation and consideration. If you have questions concerning the above comment,
please contact Renee Gladhill-Earley, eaviroamental review coordinator, at 919 - 807 -6579. In all future
communication concerning this projoi, please cite the above - referenced tucking number.
Sincerely,
Ramona M. Barters

Stanly County GIS
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Page 1 of 1
Tax Record:
19938
PIN:
656604738294
Owner:
SMITH BRUCE C
PO BOX 1000
ALBEMARLE NC 28002
�
� �2=216AKWOOD RD
�! 1,248
W a Year Built:
1964
Acres/Lots:
LOL
Deeds:
Jh.�a R
` t off 1
Subdivision:
�+ r OAKWOOD PARK
' Values:
Land - $75,600
Building- $26,969
` !" Other Structure - $2,908
`�:'k '
Sale Date:
Friday, March 10, 1989
Sale Amount:
con cf%f%
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