20130180 Ver 1_401 Application_20130213

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20 130 18 0
DUKE ENERGY LAKE SERVICES
PO BOX 1006
MAIL CODE: EC12Q
CHARLOTTE, NC 28201 -1006
TOLL FREE 1- 800443 -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 the blank.
PLEASE SUBMIT THE APPLICATION AND APPROPRIATE DUKE ENERGY FILING FEE, PAYABLE
TO DUK E ENERGY, TO THE ABOVE ADDRESS.
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I. Applicant Information _ P_k
A.
B. Mailing Address: 3135 CuMM 1N6, G.' 30b*0
C. Telephone: #/Z — 559- Z95AlA
II. Location of Proposed Project
A. Lake: Jer-AY4 02204- %Is�' [Sew, �iCE 2F�s2V�E
B. Street Address: LaT' Z8-0 S O�£Ll DIQlY6
C. County: 00Ktvvy
D. City, town, community or landmark: G S
E. Section: Lot #: Subdivision: 2 KL RV
F. Directions to property by road: FPM � /077 7'U/1N DK rD J'l�t
G. Latitude/Longitude for the project site (optional):4or 35.7357.SL " LoN — cu. q5 1Z
H. Please submit a map showing the coordinates and the exact location of the project site. (NOTE:
Latitude/longitude coordinates can be found on internet site ha ;UAm%orbisinc.com /smo/)
Ill. Description of Project
A. Length of wall: ,4P?oy4lA zoo
B. Material: pV.Ese iaor, t1 612
C. Distance from property line/shoreline: ON SHO R1: U+4jv
IV. Intended Use of Project Area
A. Private: X
B. Commercial:
V. Applicant Signature _ Dater Z0/3
Two (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 or Karen Higgins
1650 Mail Service Center
Raleigh, NC 27699 -1650
Gpaf\tAKEMGT\Pa*age Informauon \Package Information \NL SS App
RevbW 11.29.12

2 ®130 180
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 Cotes 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 tq lake bottom of greater or
equal to 1 acre.
Applications should be sent to:
Division of Water Quality 401 Oversight/Express Review
1650 Mail Service Center
Raleigh, NC 27699 -1650
Applicant Information
Owner /Applicant Information
Name:
Mailing Address:
-?,135 Aw e/d6E- ey-
6UMMiN6 6 A 3c 64
Telephone Number. 1 -559 -29419 Fax Number
E-mail Address: , 1: � c✓ ,,n/. Srwa CAB /A 6&- & &144i� mNj
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: 0#40 F_/t/S'(��
Company Affiliation:(/�LE1'�11�jJ,��f
Mailing Address: A90 2025- 09)eK01U Z& 713
Telephone Number. M L/ AQ7 S
... Fax Number. &&Z-23 9222
E-mail Address: e v ?3 AP &0
R. 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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1. Location
County: J?Xlle-W Nearest Town: �LLfJt✓/
Subdivision name or site address (include phase/lot number): 842 (AkE_ 107' 48 V
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: Ovs 4 b
3 Property size (acres): /. S6 04Creas
4. Nearest body of water (stream/ river /sound/ocean/lake): We (rY2 4AXFs
S. Describe the purpose of the proposed work: )T*Af MOM /0 F, 70&J Cline JMV r— CO E ONO;
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7.
Amount of impact (including all excavation, backtill, rip rap, retaining walls, etc.) bell/ow the
normal pool lake level in square feet or acres: % -
8.a. Amount of impact (including all clearing, back fill, excavation, rip rap, retaining walls, etc.)
above the normal pool take lgvgl and 50 feet land -ward in square feet or acres:
8.b. Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instance): x . —!(J %teas As eL�
,
PP'l f% c( t�inlpr�
(Agent's
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Signature Date
is valid only if an authorization letter from the applicant is provided.)

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Please approximately sketch the following information on this plan
(please provide dimensions for each Kern, such as 10 IL x 100 ft):
1) All proposed vegetation doming (provide dimensions).
2) Location of rip rap or fell to be placed above the Full Pond - elovation
3) Location of rip rap or fill to be placed below the Full Pond elevation
d) The location of any proposed 9 uctwes such as buildings, retaking
waft, dodos, etc.
S) The location of any excavation or dredging below the Full Pond
elevation.
6) Location of construction access corridors.
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