20131118 Ver 1_Application_20131017

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 Debra S Schneider
Mailing Address: 1977 West Emery Church Rd, Linden, PA 17744
Telephone Number: 570 - 772 -1668 Fax Number: 570 - 322 -7991
E -mail Address: debra.schneider @wfadvisors.com
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 Aff iliation:
Mailing Address: _
Telephone Number:
E -mail Address:
Fax Number:
II. 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. 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: Iredell Nearest Town: Troutman
Subdivision name or site address (include phase /lot number): Lot 4 Twinn Coves on Morrison
133 Honeydew Circle, Troutman, NC
Directions to site please include road numbers, landmarks, etc. (This is not necessary if an adequate
vicinity map is included): 1 -77 to exit42. Left onto highway 21, left onto Perth Rd. right onto State Park
Rd., left onto Morrison Farm Rd, Left onto Stillwater, left onto Honeydew Circle.
2. Describe the existing land use or condition of the site at the time of this application: Wooded lot,
not developed
3. Property size (acres)
5.04 acres
4. Nearest body of water ( stream /river /sound /ocean /lake): Lake N
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5. Describe the purpose of the proposed work: Shoreline Stabilization. Repair and restore shoreline to
prevent future erosion.
6. List the type of equipment to be used to construct the project: Skid Steer
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below the
normal pool lake level in square feet or acres: Impact area between L7 and L13 or approximately 170
feet of shoreline, and 2 to 5 feet below normal pool lake level or 340 to 850 Square feet. Our intent is
to impact this area as little as possible. Excavation, back fill and rip rap to stabilize shoreline.
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:
Impact area between L7 and L13 or approximately 170 feet of shoreline, and 5 feet above normal
pool lake level or 850 Square feet. Our intent is to impact this area as little as possible.
Removal of trees, excavation, and rip rap
8.b. Please describe vegetation above the normal pool lake level and 50 feet landward to be
impacted (number of trees for instance): Removal of trees and under brush along shoreline. Removal
of under brush and trees to gain access to shoreline. Minimal impact to any trees over 3 inches in
diameter.
pplicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

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