20131102 Ver 1_Shoreline Stabilization_20131015

2 0 1 3 1 1 0 2
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: 7 �, \ 1 "'. " �<N &�_
Mailing Address:
Telephone Number: � � 6 — (OV � - I I H _L Fax Number:
E -mail Address: I A�
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: 1
Mailing Address:
Telephone Number: - S Vl -
E -mail Address: M D _-
II. Project Information
.I
S L -IR
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 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.

I . Location
County: G'L' n Nearest Town: ICJ Mr�nT
Subdivision name or site address (include phase /lot number): ��41 e)� ko,r� a �0+ 122
Directions to site please include road numbers, landmarks,_ etc. (This is not necFssary if an adequate
vicinity map is included): R__ a. rJ `S�,Q�
2. Describe the existing land use or condition of the site at the time of this application:
3. Property size (acres): U1 J
4. Nearest body of water (streanVriver /sound /ocea�n/l�ake):
5. Describe the purpose of the proposed work:
6. List the type of equipment to be used to construct the project: \JV_ &I
s osJ"
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below the
normal pool lake level in square feet or acres: L 5
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 ins uare feet or acres:
8.b. Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instancy): C fo, � 1 n. � m,
�Z////
ApplicantAgent's SignatureZ Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

Oct 10 13 10.20a
10/10/2013 09.53 8035473565
MASTERS ODNSTRUCTION
SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION: 1
LOT w— i2� PLAN No. PARCEL ID: QOS -'�105 22 �l
STREET ADDRESS: L t" �S P0 J e-
�T
�0Please print: 1 y 1
Property Owner: -1c.ti aeA � . Ml ± =
Property Owner: J 1 i 1 t an 1;k►
The undersigned, registered property owners of the above noted property, do hereby authorize
of Co4r"V.C� o r,
,Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
A Telephone: , 1
We hereby certify the above information submitted in this applicat on is true and accurate to the
best of our knowledge.
Authorized Signature Author d signature
Date: i I D! 13 Date: 101 l a I?)
p.2
PAGE 62/02
E EI E
OCT 1 5 2013

10/4/13 Charlotte, NC to 4413 Stoney Pointe Ct, Belmont, NC 28012- Goog I e Maps
Directions to 4413 Stoney Pointe Ct, Belmont, NC 28012
19.2 mi — about 36 mins
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Map data 92013 Google
https://maps. g oog Ie.com/maps?F d&source= s—d&saddr= C harl ofte, + N C&daddr= 4413+ Stoney- Poi nte+ Ct,+ Bel mont, + N C &hl = en&g eocode= F c- F GQldiW4u-". . . 112

10/4/13 Charlotte, NC to 4413 Stoney Pointe Ct, Belmont, NC 28012- Google Maps
Charlotte, NC
�F
1. Head southwest on S Tryon St toward E 4th St go 0.5 mi
About 2 mins total 0.5 mi
2. Turn right onto W Hill St go 0.1 mi
total 0.6 mi
3.
Take the ramp onto 1 -277 S
go 0.6 mi
About 1 min
total 1.2 mi
74 4.
Continue onto US -74 W
go 9.8 mi
About 15 mins
total 11.0 mi
5.
Turn left onto Park St
go 0.6 mi
About 1 min
total 11.6 mi
6.
Continue onto Keener Blvd
go 0.9 mi
About 2 mins
total 12.5 mi
7.
Turn left onto S Central Ave
go 0.3 mi
About 1 min
total 12.8 mi
8.
Continue onto S Point Rd
go 5.0 mi
About 8 mins
total 17.8 rni
9.
Turn right onto Reflection Pointe Blvd
go 0.3 mi
About 1 min
total 18.1 n-ti
10.
Turn left onto Lake Pointe Dr
go 1.0 mi
About 3 mins
total 19.2 mi
11.
Turn right onto Stoney Pointe Ct
go 59 ft
total 19.2 mi
4413 Stoney Pointe Ct, Belmont, NC 28012
These directions are for planning purposes only. You may find that construction projects, traffic,
weather, or other events may 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 ©2013
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Directions weren't right? Please find your route on maps.google.com and click "Report a problem" at the bottom left.
https: / /maps.g oog I e.com/maps?f =d& source= s_d &saddr= Charlotte, +N C &daddr= 4413 +Stoney+Poi me +Ct,+ Belmont,+ N C &hl =en &g eocode= Fc -F GQldi W4u -"... 2/2

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VICINITY MAP AF If
NO SCALE �oG
,�.E N2 57' N384 'OT "E �j
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L-11-1MB:67 -63
(NAD83 NC GRID)
SIT o aura 6-
LAYE
n-
ol 50 ��-2.11 FFFER QESTRtGno+s J 571 FEMA
F- SEE D / % ELEVATION FIELD LOCATED
LOT 122
�/- -- /
REFLECTION / / Uj PER POINTS FEMA FIRM PANEL 3 71 0 3591 00K
/ w
\, PHASE 1 DATED 03 -02 -2009
MB: 67 PG 63 -68 f/ f `b °" LAKE WYLM
'q p` 51,042 SQ.FT.1/ j 7' PER MB: 67-63
1 LOT 121 ` �� 1.1718 ACRE 1 / LACK EWYLIENA_E�THE56s 40
REFLECTION 3! / % �-r ELEVATIONS USED LEVEL TO LINE.
POINTE ;j TAX# 005 - 4031 -22
PHASE 1 o -A. t VACANT LOT 1 " BOUNDARY ofsaaTODR
P: 67 PG 63 -8u° N # 44Y3 ft �' BASED UPON DUKE ENERGY
Z '�..- \ i LAKE DATUM FOR SPILLWAY
40- R f AT TIME OF SURVEY. LOT
1 `
(PER 4N, �AC� I i ,��' NJO O6 23•E ARE SUBJECTNTO ACCRETION,
M$' 61-
7 OT 119 YARD 70 � FONT 'A 4.65' EROSION. AVULSION AND REVULSION
REFLECTION ,` wAT`RS EDGE) 1
ri OF LAND.
o
POINTS -
PHASE 1 Nnc 63 rtc cao [x•21' 92 63 tm 88
aa�� G r+ �+C c St6227.9767 2
MB: 67 PG 63 -68 , t393643.97sa ?TP a l t �; '¢; µ8:6'j pe9°m I
N2A O4 3� "E 5�401'S8" w°MV o 1 nL-- 325 65 p � 500 YN
�F � E •� � -�'�.y,7� 7� -^! 1 ` p6 ._ 02 TRiS151dLT� a U1�yeE 9
FOUND 1U !T
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PUS NAIL 440' pRtvAT4 J t'JE1�TLFWES „`y^ �� <.. C.. - ✓� /
NAD 83 NC GRID 46 -=�
(�. N 5:6059,2450 '•h8 �� / 4� °` r
ri ✓
r
E 1393649.4580 --• \ ryR7 ° � ( ,q
LOT 118
REFLECTION
v .o
POINTS
MB: 67 PSG 63 -68 °� " stsssars iocr�_
t o
IS
\ 500 YV 8 T1-55
^--"� o P
NOT ZS I
! � �- �•-�'! � ✓�� Amass sua� i 1
THIS LOT MAY BE SUBJECT TO THOSE
EASEMENTS AND RESTRICTTONS FOUND IN a cS
DEEDS: -722, 1941 -607, 3835 -217 t _ iS LOT 1 3
3835 -2 8
�' REFLEC*0N
IN 41 io'35.E / POhwF
PHASE 1
MB: 67 PG 3 -68
THIS LOT IS SUBJECT TO THAT DECLARATION vou.o \
OF COVENANTS, CONDITIONS AND RESTRICTIONS
APPLICABLE TO REFLECTION POINTE PHASE 1
RECORDED IN THE GASTON COUNTY
REq TER OF pEEBS IN DEED.3843 -399.
& A AMENDED.
A PORTION OF THIS LOT LIES WITHIN IN A SPECIAL FLOOD \ 9 y O l a
HAZARD AREA PER FEMA FIRM PANEL d7' O 1 I 6'
37103591OCK DATED 3 -2 -2009.
THIS LOT IS SUBJECT TO ANY _ 6
EASEMENTS, AGREEMENTS, OR RIGHTS-
OF \� SO "A
-WAY OF RECORD PRIOR TO DATE OF c2� 4i ���T 4�a J; o w o.
THIS PLAT, WHICH WAS NOT VISIBLE AT THE LOT 117 6� qr ` Y+
THE OF OUR INSPECTION. REFLECTION \ \ 4� A 43 O/
AREA CALCULATED BY COORDINATE METHOD POINTS
NO NCGS TRAVERSE STATION WITHIN 2000', PHASE 1
MB: 67 PG 63 -68
THIS PROPERTY ZONED R -R GASTON COUNTY � �, l _•„�. '� c;
THIS PROPERTY MAY BE SUBJECT TO ADDITIONAL EASEMENTS INCLUDING THE FLOODING OR
RAISING OF WATERS OF THE CATAWBA RIVER AND CLEARING OF TREES ETC ON THE�PERTlr-
LYING BELOW ELEVATION 580.00. (SEE DEED: 1941- 9607)
LEGEND
TP - TELEPHONE PEDESTAL^
& � a- � jy 0 L�A� \\ \ 97 R 9
RSV - SANITARY SEWER VALVE 1K $ a
U
rva
WV - WATER _VALVE 0 25 50 > 00 150
WM-- - -WATER METER \
A
CS - CATCH BASIN
PS - PRESSURE SEWER SERVICE o
GRAPHIC SCALE 3 ir_cii _ 50 ft.