20130542 Ver 1_Shoreline Stabilization_20130522

20130542 t9o,
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 seven (7) copies of this application and
information as well as a non - refundable application fee to the Division of Water Q t,.ui:�'i?Alb00
for impacts of to lake bottom of less than 1 acre and $570.00 for impacts to lake bottom of greater
or equal to 1 acre. D
Applications should be sent to: rel g �pss
PP
T.
Division of Water Quality 401 Oversight/Express Review Permitting" t
1650 Mail Service Center 6 qo fkyae. -�d IW
Raleigh, NC 27699 -1650
Ox� e, NC ZQoo
I. Applicant Information
1. Owner /Applicant Information
Name: &140#v a? � o b >s r e wJ i� R- L1C: J aryl i oIc L !-
Mailing Address: /S'1 4 ti 1.'r d e—
Telephone Number: 17D 4-4l'll" 7- 13.S`-"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:
Company Affiliation:
Mailing Address:
Telephone Number:
E -mail Address:
II. Project Information
'de,
26+094W6 Fax Number:
16 IA'fwz UJind. W71.1104-
At ZSI
5 I
MAY 2 1 ?.013
NR -WATER c}UAury
Attach a vicinity map clearly showing the location of the property with respect t
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 5 WI�r ��qq
County: Nearest Town: !'r d e-M -C-it le-
Subdivision name or site address (include phase/lot number): _'ffOra. I- ��✓��✓
Directions to site please include road numbers,
vicinity map is included):
O"Pa 2, Y
etc. (This is not necessary if an adequate
.yLa /c t vd'7i �.rds/
2. Describe the existing land use or condition of the site at the time of this application: a 4IOA Jk1
3. Property size (acres): _ l d c.J- GS
4. Nearest body of water ( stream /river /sound/ocean/lake): 1Te- •
5. Describe the purpose of the proposed work: e" b'w e-
6. List the type of equipment to be used to construct the project: d' e 6 dc-61A
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below 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 lake level and 50 feet land -ward in square feet or acres:
/ 2.0 o 6 g F/
8.b. Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instance): S S
Applicant/Agent's Signatures l/ s Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

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North Carolina Department of Cultural Resources
State Historic Preservation Office
Ramona M. Banos, Administrator
Governor Pat McCrory
Secretary Susan Khan
May 13, 2013
Robert Gallagher
Boat Houses on Tillery
10579 Willow Oak Road
Norwood, NC 28128
Office of Archives and Ustory
Deputy Secretary Kevin Cherry
Re: Raymond Bostian, Soil Disturbance, 50440 Haven Bend Road, Albemarle, Lake Tillery, Stanly County,
ER 13-0887
Dear Mr. Gallagher.
Thank you for your letter of May 6, 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 2 of 2
OBJECTID
11489
Tax Record
9032
Owner Name
RIVERBRIDGE LP
Owner Name 2
C/O RAYMOND E BOSTIAN
Mailing Address
151 RAY UN DR
Mailing Address 2
City
LEXINGTON
State
NC
Zip
27295
PIN
657704649909
Deed Acres
0
Lots
1
Physical Address
50440 HAVEN BEND RD
District Code
116
District Desc
EASTSIDE FD
Township Code
108
Township Desc
N ALBEMARLE #1 TWP
Descriptionl
DWELLING
Year Built
1987
Finished Area
3199
Land Value
368000
Building Value
224767
Other Value
69634
Total Value
662401
Landuse Record
No
Date Sold
1/1/201112:00:00 AM
Sale Amount
0
Deed Book
1070
Deed Page
806
Plat Book
Plat Page
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