HomeMy WebLinkAbout20131049 Ver 1_Shoreline Stabilization_20130919The 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 supporting information as well as a
non - refundable application fee to the Division of Water Quality of $200.00 for
impacts of to lake bottom of less than 1 acre and $475.00 for impacts to lake bottom
of greater or equal to 1 acre.
Applications should be sent to:
Division of Water Quality Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699 -1650
L46
I. Applicant Information.
1. Owner /Applicant Information
Name:
Mailing Addre i:� J',
Telephone Number: ibL1-
E -mail Address: c>AA:i
2. Agent Information (A si ned an
must be attached if
Name:
Company Affil'
Mailing Addres
Telephone Number:
E -mail Address:_
II. Project Information
l2
�Aomt
Fax Number:
s,
of the Agent Authorization letter
ority for the owner /applicant.)
Fax Number:
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
r
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.
Location 11
County: Gcl'c nr\ Nearest Town: 2 Moral
Subdivision name or site address (include phase /lot number):
Directions to site please include road numbers, landmarks, et . (This is not
necessary if an adequate vicinity map is included): Q_, _
2. Describe the existi g land use or condition of the site at the tim of
applic,ation: ,,,��r�_� S,� —
3. Property size (acres): I o
4. Nearest body of water (stream/river/sound/ocean/lake):�_c�%� 1 e
the,purpose of the proposed
6. List the type of \ equipmment t be used
construct the project:
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls,
etc.) below the norm 1 \yo�ol 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: ,,
b. Please describe vegetation above the normal pool lake level and 50 feet
ward to be impacted (number of trees for instance):
9
Applicant /Agent's Signat "<\\ UMC
(Agent's signature is valid onTylif an authorization letter from the applicant is provided.)
Full Pond
Shoreline
Cc, r- V- I\ �v —
J"
Please approximately sketch the following information on this plan
(please provide dimensions for each item, such as 10 ft. x 100 ft):
1) All proposed vegetation clearing (provide dimensions)
2) Location of rip rap or fill to be placed above the Full Pond elevation
3) Location of rip rap or fill to be placed below, the Full Pond elevation
4) The location of any proposed structures such as buildings, retaining
walls, docks, etc.
5) The location of any excavation or d4dging below the Full Pond
elevation.
6) Location of construction access corridors.
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Map data @20t3 Google _....... ..... ............ ........ .... ---- _ ..... ________________________ ....
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Charlotte, NC
.
1.
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2.
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5.
Turn left onto Park St
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Turn left onto S Central Ave
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8.
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9.
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10.
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11.
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1 r 410jiOlG�Er Rd, [�(�DlOOtNC 28012
These directions are for planning purposes only. You my find that construction projects, traffic, weather, or other events my cause
conditions to differ from the map results, and you should plan your route accordingly. You must obey all signs or notices regarding your route.
Map data @20t3 Google _....... ..... ............ ........ .... ---- _ ..... ________________________ ....
__________________________________�
Directions w eren't right? Rease f ind your route on rnaps.google.corn and click "Report a problerd' at the bottom left.
httpsmmaps.g oog|�����s—d&saddr=oharl otte,+wC&daddr= 410+ Jim+ Grim+Road,+ Bel mont,+wc&hl=en&g eocode=p*pGQldiW4u-ymB— 2/2
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