20130956 Ver 1_Application_20130904

20130958 � &E ED
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
1650 Mail Service Center
Raleigh, NC 27699 -1650
I. Applicant Information
1. Owner /Applicant Information
Name:
Mailini
Telephone Number:
E -mail Address: SeAPD
Fax Number:
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: 2611dn i c l a il)s 1
Company Affiliation:
Mailing Address:
Telephone Number: X D 15 - X J 1 - VS I Fax Number: Yt? 3 - 94 1 - 5L513
E -mail Address:
H. 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. Bc
plan must include a scale and north arrow. The footprints of all buildings,
facilities must be included.

1. Location
County: I ZZO S to ri Nearest Town: D C_ 1 FYI, ai-r
Subdivision name or site address (include phasellot number): 29_1erhamn P014--
Directions to site please include road numbers, landmarks, etc. (This is not necessary if an adequate
vicinity map is included): '-V Sfee- (YI49
2. Describe the existing land use or condition of the site at the time of this application:u.uY�
3. Property size (acres): A 4-i Vacavit Lv t
4.
RI
7.
Nearest body of water (stream/river /sound/ocean/lake):
Describe the purpose of the proposed work:
List the type of equipment to be used to construct the project:
Amount of impact (including all excavation, backfill, rip rap,
normal pool lake level in square feet or acres:
Skid Slur n16 Eck Ioeder
walls, etc.) below the
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: ,
8.b.
Imi-t-
Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instance): L its &f l I to c.2 _d : a. Ae-ti-r " der b r U.S Gi ,
a e-f cS fiii =%-c
pp ' nt's Sigag6re Date
(Agent's guature is valid only if an authorization letter from the applicant is provided.)

THIS IS TO CERTIFY THAT ON THE 19TH DAY OF _��SI , 20la_ AN ACTUAL SURVEY WAS MADE UNDER MY SUPERVISION OF
THE PROPERTY SHOWN ON THIS PLAT, AND THAT THE BOUNDARY LINES AND THE IMPROV TS, IF ANY, ARE AS SHOWN HEREON. THIS PLAT
MEETS THE MINIMUM STANDARDS OF PRACTICE FOR LAND SURVEYING IN NORTH CAROL[ , BOARD RULE .1600 (21 NCAC 56) AND THE RATIO OF
PRECISION DOES NOT EXCEED AN ERROR OF CLOSURE OK ONE (1) FOOT PER 10,000 T PERIMETER SURVEYS NOR 20 SECONDS TIMES
THE SQUARE ROOT OF THE NUMBER OF ANGLES TURNED.
2 SIGNED
OJAMES MAUNEY ASSOC T S, P.A.
PROFESSIONAL SURVEYORS
L SUBJECT PROPERTY IS ZONED R-R 6405 WILKINSON BLVD., SUITE I1
SETBACKS PER PB 67, PGS 63 -68 FRONT 30, LICENS T, O. 28012
Lflf
SE DR SIDE, 15• LICENSE NO. C -2373
P0� REAR, 40' 50• LAKE BUFFER TELL 704 -829 -9623
2. THIS MAP REPRESENTS A SURVEY OF AN EXISTING PARCEL OF LAND. FAX, 704 - 829 -9625
1/
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24' C&O
4>tdi2
OVAS
24' C&G 9
8
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LOT 110
to
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3. ALL DISTANCES SHOWN ARE HORIZONTAL GROUND DISTANCES.
4. THIS SURVEY WAS PERFORMED WITHOUT BENEFIT OF A TITLE COMMITMENT REPORT. JAMES
MAUNEY L ASSOCIATES, PA DOES NOT CLAIM THAT ALL MATTERS OF RECORD WHICH MAY OR
MAY NOT AFFECT THE SUBJECT PROPERTY ARE SHOWN HEREON.
S. ELEVATIONS BASED ON LAKE WYLIE WATER LEVEL DATED C6/19/20I3.ELEVATI13N-567.14
H/w
t
it
sTar:��
REP PB 67-66
LOT 109
19765 Sq. Ft
0.454 Acres
Naaw,ww 78.68 LAKE wYLIE
SURVEY OF
LOT 109 REFLECTION POINTS PHASE 1
SOUTH POINT TOWNSHIP, GASTON COUNTY, NORTH CAROLINA _
PREPARED FOR BENNY YEARGAN AND ELAINE YEARGAN
SCALE I' =30' FLOODCF,RT/FICATION
THIS4SYVC £RM77NAT7HRSUBJECTPROPFR7T IS NOT
MAP BOOK 67 PAGE 66 L0CA7IDaASPECULF ZOODHAZIRDARE(ACCORDBYGTO
THE CVRRW 1Z00DBVSVAANCRRA7EMAP.
DEED BOOK PAGE COMMUMIY/PANEL 3M2035M
F.FFEC77VRDA7E MARCH Z 2009
rRFW cc nPAWN w RFVrccn r....,..,,,.,,,�., RAwn ZONE X
LEGEND
bf;}B
M - CURB A GUTTER
CI - CATCH BASH
OR - EXSTMG IRON ROD
z
IPST - IAlIP POSE
P8 - POWER BOX
R/W - R!G{I- OF-WAY
RCP - REND CONCRETE PIPE
,y
SB - SEWER BOX
p
a
SQ.FT. - SQUARE FEET
TB - MEPHONE BOX
W
"°'x
LOT 108
LOT 109
19765 Sq. Ft
0.454 Acres
Naaw,ww 78.68 LAKE wYLIE
SURVEY OF
LOT 109 REFLECTION POINTS PHASE 1
SOUTH POINT TOWNSHIP, GASTON COUNTY, NORTH CAROLINA _
PREPARED FOR BENNY YEARGAN AND ELAINE YEARGAN
SCALE I' =30' FLOODCF,RT/FICATION
THIS4SYVC £RM77NAT7HRSUBJECTPROPFR7T IS NOT
MAP BOOK 67 PAGE 66 L0CA7IDaASPECULF ZOODHAZIRDARE(ACCORDBYGTO
THE CVRRW 1Z00DBVSVAANCRRA7EMAP.
DEED BOOK PAGE COMMUMIY/PANEL 3M2035M
F.FFEC77VRDA7E MARCH Z 2009
rRFW cc nPAWN w RFVrccn r....,..,,,.,,,�., RAwn ZONE X

THIS IS TO CERTIFY THAT ON THE _19TH_ DAY OF - JUNE - -_ , 201a- AN ACTUAL SURVEY WAS MADE UNDER MY SUPERVISION OF
RY LI
THE PROPERTY SHOWN ON THIS PLAT, AND THAT THE BOUNDANES AND THE IMPROV ENTS, IF ANY, ARE AS SHOWN HEREON. THIS PLAT
MEETS THE MINIMUM STANDARDS OF PRACTICE FOR LAND SURVEYING IN NORTH CAROLI BOARD RULE .1600 (21 NCAC 56) AND THE RATIO OF
PRECISION DOES NOT EXCEED AN ERROR OF CLOSURE OF ONE (1) FOOT PER 10,000 F T F PERIMETER SURVEYE NOR 20 SECONDS TIMES
THE SQUARE ROOT OF THE NUMBER OF ANGLES TURNED.
SIGNED
41 O NOTES JAMES MAUNEY ASSOC T S, P.A.
X71 PROFESSIONAL SURVEYORS
1. SUBJECT PROPERTY IS ZONED- R -R 6405 WILKINSON BLVD., SUITE 11
SETBACKS PER PB 67, PGS 63 -68 BELMONT. NC 28012
Q OR FRONT-, 30' LICENSE NO. C -2373
POZNj� REARS 40' 50' LAKE BUFFER TEL- 704- 829 -9623
LPK� FAX 2. THIS MAP REPRESENTS A SURVEY OF AN EXISTING PARCEL OF LAND. 704- 829 -9625
3. ALL DISTANCES SHOWN ARE HORIZONTAL GROUND DISTANCES.
4. THIS SURVEY WAS PERFORMED WITHOUT BENEFIT OF A TITLE COMMITMENT REPORT. JAMES
SITE MAUNEY & ASSOCIATES, P.A. DOES NOT CLAIM THAT ALL MATTERS OF RECORD WHICH MAY OR
MAY NOT AFFECT THE SUBJECT PROPERTY ARE SHOWN HEREON.
5. ELEVATIONS BASED ON LAKE WYLIE WATER LEVEL DATED 06 /19 /2013.ELEVATION= 567.14 \�1111111111111///�
VICINITY MAP — —R1 67za'c&G �oQ.�SS��,_/y�
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ACK I REFS PB 67-66
ILEGEND
61
C&G - CURB & GUTTER
CB - CATCH BASIN
1
EIR - EXISTING IRON ROD
a
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LPST - LAMP POST
PB - POWER BOX
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,6'OAK
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SB - SEWER BOX
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TB - TELEPHONE BOX
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SURVEY OF
8 LAKE WYLIE
C"-S" v;
PREPARED FOR BENNY YEARGAN AND ELAINE YEARGAN
FLOOD CERTIFICATION
LOT 109
19765 Sq. Ft
0.454 Acres

Please appminradely sketch the fo0owing Wa nrafim on t% Plan
(pftwe provide dkmenglans for each Item, such as jd n. x I It):
1) AN proposed vegetaflon closing (MWde dintensiions)
A Location of rip rap or fill to be placed above the FUN Pond elevatlan
3) Lotion of rip rap or fill to be placed below the Fui Rond elevation
4) The location of any proposed shuetum swh as buildings, retalning
vrallls' docks, e#ic.
5) The location of any excavation or driedging bdow the Fug mid
elevation.
6) I.crc ti of cormtra eMm axm carMors.
A l
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n
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3253 Lake Pointe Dr, Belmont, NC 28012 Directions, Location and Map I MapQuest Page 1 of 1
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Map of:
3253 Lake Pointe Dr
Belmont, NC 28012 -6749
Notes
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02013 MapQuest, Inc. Use of directions and maps is subject to the MapQuest Terms of Use. We make no guarantee of the accuracy of their content, road conditions or
route usability. You assume all risk of use. View Terms of Use
http: / /www.mapquest.com/ print ?a --app.core.e3e7d83c2O775aae l 39e7Oea 8/29/2013

Driving Directions from 3990 Charlotte Hwy, Clover, South Carolina 29710 to 3253 Lak... Page 1 of 2
Notes
4 mapquty
Trip to:
3253 Lake Pointe Dr
Belmont, NC 28012 -6749
10.98 miles / 18 minutes
3990 Charlotte Hwy, Clover, SC 29710 -8083
1. Start out going south on SC-49 S toward Blucher Cir. Map 2.6 Mi
rlvn
274 2. Turn right onto SC -274. Map 0.9 Mi
11 r"47"q 3. Turn slight right onto Pole Branch Rd / SCA77 (Crossing into North 1.9 Mi
i77 Carolina). Map
<@> 4. Pole Branch Rd / SC -177 becomes S New Hope Rd / NC -279. Map 1.0 Mi
3253 Lake Pointe Dr, Belmont, NC 28012 -6749
httn:// www. manauest. com/D rint? a= an n.core.e3e7d83c2O775aael39e7Oea 8/29/2013
73 5. Turn right onto Armstrong Rd / NC -273. MaD
2.4 Mi
r+
6. Turn right onto South Point Rd. Mao
1.2 Mi
r+
7. Turn right onto Reflection Pointe Blvd. Map
0.2 Mi
8. Keep left at the fork to continue on Reflection Pointe Blvd. Mal)
0.07 Mi
9. Take the 1st left onto Lake Pointe Dr. Ma D
0.7 Mi
10. 3253 LAKE POINTE DR is on the left. Map
3253 Lake Pointe Dr, Belmont, NC 28012 -6749
httn:// www. manauest. com/D rint? a= an n.core.e3e7d83c2O775aael39e7Oea 8/29/2013

Driving Directions from 3990 Charlotte Hwy, Clover, South Carolina 29710 to 3253 Lak... Page 2 of 2
Total Travel Estimate: 10.98 miles - about 18 minutes
BOOKTRAVEL with maplquest ($77) 577 -5766
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©2013 MapQuest, Inc. Use of directions and maps is subject to the MapQuest Terms of Use. We make no guarantee of the accuracy of
their content, road conditions or route usability. You assume all risk of use. View Terms of Use
httn:// www. manauest. com/ print ?a= ann.core.e3e7d83c2O775aae 139e70ea 8/29/2013