20130543 Ver 1_Application_20130522

/
20130543
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 OversighWiliress Review Permitting ' . /' (,Oki
1650 Mail Service Center ( $ W
Raleigh, NC 27699 -1650
I. Applicant Information IV O
1. Owner /Applicant Information
Name:
Mailing
0
Telephone Number: �d T ' �/ 7 - 0" Fax Number: ���� ��Y-,,�D
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: e tal e & o4ttAaoQ l� ' *)1#1SJLeV,
91 Company Affiliation:
Mailing Address: 10 : / "J Dq,
Telephone Number: )e y r/ 3 9 d G ( Fax Number:
E -mail Address: Sw, .._ /o/ `�U iq A,/ 1 /Va'S lot C *17
II. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local landmarks s
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.

1. Location
County: Nearest Town: / lIU _ JV4
Subdivision name or site address (include phase/lot number): �� ✓C'� J3 e.IC
Directions to site please include road numbers, landmarks, etc. (This is not necessary if an adequate
vicinity map is included): ,� 51 -/o we4AP sd Y06
�4J -/o ;2,o et, ri yr 4 ew �D , - //e .Ai fie,,
2. Describe the existing land use or condition of the site at the time of this application: Ars:ejeah&I
3. Property size (acres): /I- aLC. R 6
4. Nearest body of water (stream/river /sound/ocean/lake): C. KfEl I 1
5. Describe the purpose of the proposed work: 5 ko Q t ! er✓M- S4* b= T
6. List the type of equipment to be used to construct the project: I O&c- Aa w 13ek eft4
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below the
normal pool lake level in square feet or acres: /ssW S 3 0
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:
3 TO sd F4
8.b. Please describe vegetation above the normal pool lake level and 50 feet landward to be, impacted
(number of trees for instance): v & e/ )0 A-- S I%-
it/Agent's Signature " Date
signature is valid only if an authorization letter from the applicant is provided.)

L�o
33 q
33 o sti 14
lu fu1)
�i p
�&p
.LPG `,
Favod
��a. `4
f6 -ja
G6a'9�

North Carolina Department of Cultural Resources
State Historic Preservation Office
Ramona M. Bartos, Administrator
Governor Pat McCrory
Secretary Susan Kluttz
May 13, 2013
Robert Gallagher
Boat Houses on Tillery
10579 Willow Oak Road
Norwood, NC 28128
Office of Archives and History
Deputy Secretary Kevin Cherry
Re: John Stegall, Soil Disturbance, 10548 Willow Cove Road, Norwood, Lake Tillery, Stanly County,
ER 13 -0826
Dear Mr. Gallagher:
Thank you for your letter of May 1, 2013, 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 Gledhill- Earley, environmental review coordinator, at 919- 807 -6579. In all future
communication concerning this project, please cite the above - referenced tracking number.
Sincerely,
Ramona M. Bartos

ConnectGIS Feature Report
Page I of 2
A t �IS This map is prepared for the inventory of Real Property found within this jurisdiction, and is compiled from recorded deeds, plats and other public records and data. Users of
IN 1 V the map are hereby notified that the aforementioned public primary information sources should be consulted for verification of the information contained on this map. The
'-ED HC5UNG Stanly County Geographic Information Systems Division of the Office of Information Technology assumes no legal responsibility for the information contained on this map.
Also, when the deeds and or plats are viewed for a parcel, the Stanly County Register of Deeds Office makes no guarantees regarding the collection, accuracy, authenticity, or
use of these records. The web site is for informational use and convenience only. The Register of Deeds shall in no way be held responsible for errors or omissions in these records nor for any actions resulting from their
use. The official records are kept in the Stanly County Register of Deeds Office. To view deeds on this site you must install the Altema77FF viewer. To install, please visit httpJ/www.altematiff.com/instalI-je/
Red Roetts
(� ROMIs
V } paeceis
City Limits
El
filrra Lam// _V■ � � � � �az�
�L
)
1 : 20 Feet
http:// stanly .connectgis.com/DownloadFile. ashx? i=_ ags _mapt206f8d3f43e4d9aab984918fec l Ofc9x.htm &t =pri... 5/21/2013

ConnectGlS Feature Report
Page 2 of 2
0BIECTID
6621
Tax Record
24844
Owner Name
STEGALL JOHN A
Owner Name 2
STEGALL JENNIFER H
Mailing Address
822 DR BLAIR RD
Mailing Address 2
city
MARSHVILLE
State
NC
Zip
28103
PIN
657302563942
Deed Acres
0
Lots
1
Physical Address
10548 WILLOW COVE RD
District Code
112
District Desc
CENTER FD
Township Code
122
Township Desc
EAST CENTER TWP
Descriptionl
VACANT
Year Bulk
Finished Area
0
Land Value
123410
Building Value
0
Other Value
24108
Total Value
147518
Landuse Record
No
Date Sold
6/21/201212:00:00 AM
Sale Amount
150000
Deed Book
1410
Deed Page
268
Plat Book
5
Plat Page
115
http: / /stanly. connectgis. com/ DownloadFile. ashx? i=_ ags _mapf206f8d3f43e4d9aab9849l8fec l Ofc9x.htm &t=pri... 5/21/2013