20140180 Ver 1_Shoreline Stabilization_20140224

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 sho
bottom under the U.S. Army Corps of Engineers Permit GP30. This Application ck a used
for wetland or stream impacts. Please provide seven (7) copies of this application apporting information as well as a non - refundable application fee to the Division of Water Q of $240.00 for impacts of to lake bottom of less than 1 acre and $570.00 for impacts to lake boof grea er
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: p hd y i p a. r.cl CYA "I 1 i C e_ i r\A
Mailing Address: �� FI y- d ayk c c�
Telephone Number: G I E: tf3 Fax Number:
E -mail Address: rY"i I I 1 i c- C v,�
Agent Information (A signed and dated copy of the Agent Authorization letter must be attached
if the Agent has signatory authority for the owner /applicV.Q
Name: K0 �4
Company Affiliation:
Mailing Address:
4) 0 a d� .
orc�, NG,z g�rL 8
Telephone Number: �%D�/- �%3�' �j l G Fax Number:
E -mail Address:
h. -n
LIU L
II. Project Information I i F E B 2 4' :"-" 14
ect to h
Attach a vicinity map clearly showing the location of the property with resp
as towns, rivers, and roads. Also provide a detailed site plan showing propel 1"9AA�' -•` erancn
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.

Location
County f eA Y J Ul- Nearest Town �%
1 ii d a- �' y '.3 ''x
Subdivision name or site address (include phase/lot number) i 11 Ce i Cdr t
Directions to site please include road numbers, landmar s, etc (This is not necessary if an adequate
vicinity map is included) kLO U LI +,C> -TiJ l_0 i 6_ ►J M Eu'n.'c)
2 Describe the existing land /use or condition of the site at the time of this application
3 Property size (acres) i/' s c t-- 2 L
4 Nearest body of water (stream/nver /sound/ocean/lake) N 1 L c T. I l e- tl
5 Describe the purpose of the proposed work CJ % O 2r` ri 0 ni
6 List the type of equipment to be used to construct the project 0,74 b +
7 Amount of impact (including all excavation, backfill, np rap, retaining walls, etc ) below the
normal pool lake level in square feet or acres d k b
8 a Amount of impact (including all clearing, back fill, excavation, np rap, retaining walls, etc )
above the normal pool lake level and 50 feet land -ward in square feet or acres
2 �'..� D 4/ cr X-, PC, to d b9e)
8 b Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instance) rU n j J &' n A o .(
-2-11
Date
(Agent's signature is valid only if an authorization letter from the applicant is provided )

r
�ILe
�fi FtX
1 r,)a 'P+ T-mfcL c- +
� ).,> LA 11 P® N rj
O +6.1 �� PCC-t

North Carolina, Stanly County
I S10ba18,.31mm Ca4h 7bt tbb ow tau 4nm .tldu
A oD dh.d wp.*.rlm ram .o ..to.l •µr7 m.h amr
0-6.01 ••2•.•1µo from d.tl d..m�tlaal nemdtl m te8.s
Eml D.0. 783, M 037 / PEW 606404A46700
?O
.SAL T TtB-y 8e h / Let. 349 / P.H. 7, P0. 2m
L -4171 1'J1µ 0. bmd..lr od M..1.4 .r arub bdb.md ..
Y d.drd mm r b ram bamm.a.o .1 ..m .. A—
q 6µ1m TM the 2db d V ' ' u a.Mubbd r V IMM
C fL � °� . i � •m as 47-M ..
.ne.ad.& M.— � .r a..t
0140-14
rofessio al Land Nurveyor # L 4171 Date
sw, m •rdns Y a .p,lrbr
a 1rµ Ib 1µ•a7 C.M. a l.bdhbi. d red 7ahb W....0- d • e.my r
W.t W e dh— Wm mm!! pr..r d brA
h thin W. 1µw7 r brut b • Putl®d . ••®4 - tM r
--• P.sm r m m .db. Wm .•rind. Purr d rod;
X u &W d a. roomer
L "M a..u.q Y d m afstm8 Puad v P..aN. d hod ad der o«
—m . e..11.µ 4 Ot.Nte..a memr .u..e
a 1nµ W. 1uw7 r d m .tlµly ho0dbe 0-P albu .1.µ60S 0-r emort
eatmS .mb r a amµ.em.e n.
-W&d .mr}
a Wm W..m.y r d .cam stpx .oer .. th. ,.embb.tbo d obthlr
a 7bµ 1L. 1-µµa •Ueo w .� m Ih d odedhat t Q.
•o•••7r r lash t.mw7or Y
mrbr m 0µb • dllrmhaem m W. bM d 101 .o._ ptem,drd
.bNUS r m tb P1e.rlr. aeat.totl la W Wnry► (4 ab*
0 0
N �B:
Dixie Land Surveying, PLLC
Linaenae No P -0335
4278 Cotmtq Club Road, Wadeebma, N C. 28170
Phone: f704i.894.8810
omdb [e-mail]
I8P♦
1
MF* r
Mahe 1L fins "
\ DA M% PQ M 4
AN
r r r r r o�
d mm. D..o
LV W/ O...mml
w
Review offl a fon stain, Coonty
1
I A
j 0-.d.. am_ d • .W piny.
I Wt thr IbP r Plm m .hr tub. C tmnla. r .n..
I Ono .9 •1•mb9 mnd .p..b e. mmaba.
1
I N.d . cube..
I
--------------------------------------------
a \
. A0-• g " ''� Ada ``` \ \
\
TRUE ORTH
OPS
.vc. mar: d %`� 4 \ a ! \ ;'► • >�
�TILLERY.__. 0-i ; w.+,,..i,�,. t' .e4• �b a` .. t `� `. Il
X91 0R :aCeoq.by \J
N 36 2072 W / 7 ♦ \
LEGEND —' '� �� �� �' r r �� w �� 60.20- >� \ x'
an IL GUVWmW
..mem.a .7µ60b em '' •-� .-� •� .--� .� .-� �, /,-, i e`� \ 46 TNt Pfi. Oil / �� \ °s. \ y°
er.m Pr
3. �2a y
My - m w
ov i.m Rod Pmµ
Pr . rub Pepe Poona �—� r �� r �� .---. .—� �� �� .--� i � 0-2.40- d
du . M.4 y y4 N.o Pooµ � r--' •--• .--� .� .� .—� .—� .� .� .--� .—' •--� Dam \ / / �9 \ X / \ \\
du - R.D Bm
NCL - Nub Bat Cmta.lm. �� �� r r� �� •—� •—� .� �� r �� �/ �y
1PCL -Nan Poem CmmAm. 0 \ \ \\
AV:caua.em hlmemutFmm .-� .-� ,-' .--� r .-� r .-� -LAM, r .-+ / \ - - - - - -- -_ / � \ \\
ate o -. F.. Nat ea putted re set r r TMURY r r r / / \ / % d� / �► Iw
x - cow: Not t \ 9
LOCATION MAP (N.T S.) 'J �` r '- 'J \ Plat of Property Surveyed For
,RY=_=_=
0-o
Notes (s if applicable) Phillip King
S L b IW am '/wind' dlffit a w d Mb elm �' �' r--� �� �� i—�
-��
x e dR dt t— .r b..r.mm 0-w µ.rµ.µµ1 .-� .--� r--. �. r and wife
.-� .-�
em ••m•l-d m . mr 0-.t. .-- ,-� ,� .� ,—� .� , J ,- Millicent King
. rat. p..pul7 tlr dthh . 7ra wan Y.0-
- -"
�.. e.ew 'J 'J '-' ' �' '-' 0 077 ACRE = 3,332 7 SQ FT
x 4. Yea O.MVA by 0µ-r0-10-
-
-_-
686 Berry Hill Drv. B. Center Twtap., stenly County. NC
Sane I inch - 20 R.
_-
r ,� ,� ,_, �, Mary Beach / Lot 1 342 / P B 1. PG 214
0' 20 40' 80'
For Reference sae.
D.B. 383. PG 637 / PIN 8684 -04-94 -8760
D.tm01 /10 /14 Dm.e Rn XW P0-. 1