The URL can be used to link to this page

Home My WebLink About20140042 Ver 1_Application_20140113The 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: 2 0 1 4 0 0 4 2 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: ` ! )AVI1_) 4 Mailing Address: I� r_ Q_ ' 1IQ cV__ Imo+ JAN 1 3 204 Telephone Number: Fax Number: E -mail Address: n4.i b?iurvc\ 2. Agent Information (A signed and dated copy of the Agent Authorization letter must be attached if the Agent has signatory authority fo( the owner /applicant.) Name: - , Ie,_ Company Affiliation: Mailing Address: W5 74-13 r� e. ! Telephone Number: -O E -mail Address: I,.Gt3, ti, s 2 , n I (s f0,7, --- ; )? 1 Fax Number: .4-�X -i9 D 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: Nearest Town: Subdivision name or site address (include phase /lot num Directions to site please i lude road mbers, landmark vicinity map is included): - .J e �, L. -•, etc. (This is not necessary if an adequate 2. Pescribe the existing land use or condition of the site at the time of this application: 3. Property size (acres): I5 (J 4. Nearest body of water (stream /river /sound /ocean )'lake 5 Describe the purpose of the proposed work 6 List the type of equipment to be used to construct the protect ►n �1CG v�� (��'i ��-` 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 8 b Please describe vegetation above the normal pool I impacted (number of trees for instance) Applicant/Agent's Signature Date (Agent's signature is valid only if an authorization letter level and 50 feet landward to be the applicant is provided ) NOTES: • PROPETM M11, 64: aR6xa 70 FAXOMM OR 40 0 40 _ __ 80 120 UNRECORDED RAOHS Or WAYS OR EASEUEMS • OMER WMFY ALL SUGAM AND ZMNMC GRAPHIC SCALE - FEET MMMATION3 ►NOR TO MY PLANNING OR camwc- • OY�EN9 5 0P MA. 9PRKtN9 OO® N U OPEAT D �`. A nOID M06neAmN OF ALL WEN6WN:. � �4 OICIiAL WAY OF BCE M RE OAR MUW CE � lacexm - --- sE 01 UNc UK � - KAMM ORMO 1131 ►aEEw o e t�UIO TEtEPIgNC PB 41 -60 �— � p�'",PC No>m� -� 852/692 CP . OOIIYRD PONT Nom MNQDy z /N . RIOIn -OF -WAY w . WK or PAWIDR CA 6 mms 0 . umin POLL PORCH &C /K- �re7P 1130 dy ; 0.62 AC. +- Only .i 14 PIN i S ' \ ; so, 8 C, 04 PIN DEDI/ON SURVEYS \ \ PORCH o pp a° >• O�1 %4cc�ss 05' 8 PB 41 -60 1699/2222 �a �>t�ilE:}r4• �c1r:1� ��>• �rszsir•�1�� :>r c� ��:ar.� i[T:IiLf� i[A}[, >• t: �- t- iF1�a.6S PHYSICAL SURVEY FOR DAVID E. PYLIPO`AT & MARY PYLIPOW LOT #1130 OF THE POW ON NORMAN O 139 SHELBURNE PL. MOORESVXJE NC DAM 7 -16-13 Ila] m 1318 Pa 20"' 1' - 4d 41 P0: b OAMOSON TOWMMP IREDELL COUNTY. NC CHUCK POOVEY, PLS 03762 ROBERT DEDMON, PLS #3609 3704 NC HO-MAY #16 NORTH 1.- BO%- 194 -- -DENVER.- NC -28037 PHONE: 704/483/4900 FAX: 704 483 2170 ,,%3 AN Acpm. r am I am. ft HE I mom CP I+0a P07Nrlss 1 I vlam" MAP 1 � �F IT X SHEU"W PL PORCH &C /K- �re7P 1130 dy ; 0.62 AC. +- Only .i 14 PIN i S ' \ ; so, 8 C, 04 PIN DEDI/ON SURVEYS \ \ PORCH o pp a° >• O�1 %4cc�ss 05' 8 PB 41 -60 1699/2222 �a �>t�ilE:}r4• �c1r:1� ��>• �rszsir•�1�� :>r c� ��:ar.� i[T:IiLf� i[A}[, >• t: �- t- iF1�a.6S PHYSICAL SURVEY FOR DAVID E. PYLIPO`AT & MARY PYLIPOW LOT #1130 OF THE POW ON NORMAN O 139 SHELBURNE PL. MOORESVXJE NC DAM 7 -16-13 Ila] m 1318 Pa 20"' 1' - 4d 41 P0: b OAMOSON TOWMMP IREDELL COUNTY. NC CHUCK POOVEY, PLS 03762 ROBERT DEDMON, PLS #3609 3704 NC HO-MAY #16 NORTH 1.- BO%- 194 -- -DENVER.- NC -28037 PHONE: 704/483/4900 FAX: 704 483 2170 ,,%3 AN Acpm. r am I am. ft HE I mom CP I+0a P07Nrlss 1 I vlam" MAP 1 � �F IT X SHEU"W PL c� ��:ar.� i[T:IiLf� i[A}[, >• t: �- t- iF1�a.6S PHYSICAL SURVEY FOR DAVID E. PYLIPO`AT & MARY PYLIPOW LOT #1130 OF THE POW ON NORMAN O 139 SHELBURNE PL. MOORESVXJE NC DAM 7 -16-13 Ila] m 1318 Pa 20"' 1' - 4d 41 P0: b OAMOSON TOWMMP IREDELL COUNTY. NC CHUCK POOVEY, PLS 03762 ROBERT DEDMON, PLS #3609 3704 NC HO-MAY #16 NORTH 1.- BO%- 194 -- -DENVER.- NC -28037 PHONE: 704/483/4900 FAX: 704 483 2170 ,,%3 AN Acpm. r am I am. ft HE I mom CP I+0a P07Nrlss 1 I vlam" MAP 1 � �F IT X SHEU"W PL Iredell WEB HOVING See Below for Disclaimer Addresses Infrastructure NonResidential Use Residential Use Streets Interstate Ramp Main Road Local Road Residential Private Inactive City Lin-iits Parcels Hc)oks Parcels Lake Nom-lan NC Counties vw -W, S \ � 1 553 Feet ` IBJECTID Address Street Name 0330 155 SHELBURNE PL SHELBURNE State Zip 40ORESVILLE NC 28117 e maps prepared for this websrte are generated from recorded deeds, plats, and other public records Users of these maps are hereby notified that the information ovided herein should be verified Iredell County assumes no legal responsibilities for any of the information contained on this site Users are advised that the use of any of is information is at their own risk All maps on this site were prepared using a 1000x€"' Grid based upon the North Carolina State Plane Coordinate System from the 1983 :)rth American Datum The delinquent real propertytax overlay is updated monthly The information presented is not intended to be used or relied upon as official notice tax liens For additional information regarding delinquent taxes, contact the Iredell County Tax Collector's Office � s_ T ", '� M . - ti CONNECTGIS COLK "VE5 f4cswv� '-"RI11 k %R.'l INN D IRM: TTRUCKFARI4+ 3709720070202 ? 2? I ED '19 - A ID al Area R C , • • R-20 DFIRM: 3 709 720070202142 C DFIRM.- 3 7097206 7020214 • -0 - i '-a jVcdf.Area ti R-20 0 1 :553 Feet iredell Printed January 09, 2014 See Below for Disclaimer IBJEMD Address 0330 1SS SHELBURNE PL TATE ZIP IC 28117 Street Name SHELBURNE e maps prepared for this website are generated from recorded deeds, plats, and other public records Users of these maps are hereby noted that the inforrnatn owded herein should be verified Iredell County assumes no legal responsibilities for any of the information contained on this site Users are ad%Ased that the use of any is information is at their own risk All maps on this site were prepared using a 10005 E— Grid based upon the North Carolina State Plane Coordinate System from the 1% :)rth American Datum The delinquent real propertytax overlay is updated monthly The information presented is not intended to be used or relied upon as official note 4' 0 r �• ^east.. - �:: as ,:..�„�.�s.+- 1 01 3 yz „fir �� :: ��.; �� ` _' — �, _ a ,� ?� - � � . >. , ,,,� `, � "� -�` �� ..mom � u. ..��.�i su...� A6,.� � ��, p'Hu � IZ x�..: `�� ' w ' a � Mo Ra pow