20071063 Ver 1_401 Application_20070619 (23)

~'` A, 11)
~^ GC~GO~'IC~p
JUN 1 9 2007
i7Elvr~ -WATER QUALITY
'vYGTtfWDS ANq STORAINNITER BRANCH
2007~Ob~
the following is an abbreviated application form for those applying far a 44X '4~iate
Quality C~cation to. impact lC (it`ederal Energy Regala#ory troxumxssFout
regulated Lake shore ar bottom under the U.S. Army Corps of l~ngineers Permit
C??30. Tld:; AppIicafion cannot be used for voe8ayid ar stream impacts. P3eas~~
provide seven {7} copies of this application and supporting information as we[1 a3 :l
non refiindable application fee to ttie Division of Water Quality of ~Ot1.04 fog-
impede of to lake bottom of less than 1 aere and $475.00 for impacts to lobe batta3m
of gzeater or equal to 1 acre, j (~
:[lrvision of 't~Vater Quality We~a3ads unit
:1&50 lvxail service center
~leigh,l~TC ~~'699~-650
L" Applicant Infornoataon
1. 4ws~erlApplicant Tnfamnation
~, _ ~o g~~
R iSo set t9 ~u) II Te-oa~1
t
ERIC C. Ai.Stl~tt!!"R
Reg+ Brsicl. r~) ~-
US Army tarps
pf Engineers r~~e~atlEO~ t+i.;use Load
u~Te 120
wum~on tic F~f:ree, ~c: ~ ~ ~-ss, ~
Telephone Number. 336 ~'4~- ' 3Z o Y Fax Number. 336 - 59~ - 3 Z!8
E-mail Adti~s: Cba.r k~-~ ~_ ~hv ba.r~rrt~:1 • cow "..~.
2. Age ~pxmation (A signed and dated copy of the Agenk Authorization letter
must be artaahed of the Agent has signatory autl~oxity for the ownPx/applicant.)
N:~e: Cec: l gar ~-r'
Company rlffiliatian: ~ yv~ w-ha~ nnan0. ~'f __--_---
Matlixag Address: _ .._.`~~_......_
Telephone Number. Fax Number: _.._-..._._M._.
E-mail. Address- _ _-~_~.._
II. Project Information
Attach a vicinity map clearly showing the location of the property with respect ro
local landmarks such as towns, rivers, and roads. Also provide a detaileds~te
plan showing property boundaries and develop~nant plans in .relatioir t~
surrounding properties. You may ose the diaglcamt balow'to make a hand sketch of

youx project. Also, seethe example below for guidance. Both the vicinity map an;!
site plan must include a scale and north arrow. The footprints of al! buildir~:,,
impervious surfaces, ar other f~lities must be included.
I. Location
~~ounty: ~'fX501~ Nearest Town: ~~°hrior'0/
,yubdivksian name or site address (include phasellot number}:__ j_p~~~ =J~~~~,'~,q
Iaixee4ions to site please include road nwnbers, Iandtnarks, etc_ (This is nc~t: ~J~'~
necessary if an adequate vicinity nYap is included): j= Yn,~(ZaX ba~~2_ ~. __... --
tJ.. r_~_I., in.. r-~-~. _ __ _ ~ a_ ...__ .~
2. }3escribe the e~cisting land us or ndltion of the site at the time of thi•,
application; _ ~ It°_ k 1 nu ~t a t~~
3. Property size (acres): i. ~ ~ ~~.(~~ -._.~._..~_._..___.-.
4. l~Tearest body of water (strearn/riverlsotmd/acean/Lake):
~C~..._-_._---._.. _._... -.
~. l~esc ' e the purpose of the proposed work: n r,GV~-, L°1(OS tOt~_~- ~~~ ~i_
6. List the type of equipm~eat to be used to const2uct dze project•~f~v~~_~Sd,.~~.
7. Amount of impact (includi~ all excavation, backfill, rip rap, retaining walls,
etc.) Uelaw the normal pool Like level in square feet or acres: 23S ` x 3 P _= __~0 _
$. a..4mount of impact (including all clearing, back fill, excavation, rip r~~,
retaining walls, etc.) above the uorn~l oal lake level and 50 feet land-w3.rd in
square feet or sores: 235 7~ _ _J~ D~ G~ea ~ ~ rna- I { "] Sn CI(

b. Please describe vegetation above the normal pool lake
wa~rd to be impact~d (cumber of trees for instanec):~vnc
Its+S ~WiGx{ ~i` .~Y. /~rrta~,nY_ 7.n ~v~.S~j..
~ ~.
r
and :ii) feet land-
rges ~ ~~rc~rw_.
,l1 ,
.-~pl~licautlAgent's Signature T Dace, ~~~~~
(Agent's signature is valid only if ~ authoxi; anon letter from the at~plicant is iorovidE;d.)
inn irnn ~~ soor.~

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~1~1~@ a~A~xit 5161 ~1'iQ ~ ~1 ~~i~
'Y;9 :~,9!! pix-E~ase~ vye~ion ~ea~in~ (prawide ~dinl~'i~Eriis~
. ~;i lE~a~t#io~ ~ ~ apt ~r SIR ~ ate ptai at~ove~~ ~u~ P~acr~! ~l'~~~~
~;~ lE.dcatia~ ai` r%p mwap ~r fill #,ar tae RIB! [~la+~ the ~R €d ~e~a3i~~
~~~ 71k~e ~~~~i~a~a~ a~ att~~' ~~trpt~~~ sbt~e~ h a~ ~ailcl'in~s, r~i`,~ihi[i~~
t~s: dl+~~ts, ~etic.
:~~ Thy &-c~~d;irrn. o~ ~.~ ex~tian~ or xlgin~ be~Ow't~o i=~,u Pare
V.'t~t~illD[~.
~~ Lean ~~ ~ar~r~4rticf~an ac~~ss ~orr~c~~s:

5 ~X3 /
~ >C3 ~
~Pb~ r~xir~,~~ate~+.~nn~fciath~~~3sFe~~~g i~or~~ ~ ~t~ ~E~~
~~~ ~.A~#IiD~b ~ f~ ~4A' ~t~ ail pt~I S~+it fie ~it14i9 ~I~.~c~ltfi
,3~ ~.licc~un ~ rya ,~ iii 1 ~~ ~,~ ply flow ~h~ ! P'~ttt~l ~v~i?e~tt
~~~ T! ~c~uti~at~ of ~~ ~r~~ ~~ ~ ~~dun~s, re~iinit
th+~~&Y ~d~e~c~,
~~ "~~~ tiQn of ar~~ aax~tian +ac ~adgit~r~ h+wr a F+991 p~~c~
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