20140213 Ver 1_Shoreline Stabilization_20140307

20140213
The following is an abbreviated application form for those applying for 0&'1l "aterA HIi7t
4st-i 't-eation t 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. Pleat p ov cc >pc�stithsfttityh'citiUn n_ Sus 007a,iii
f t" i o l 'ke Sint "t n_ of thss fflA Ifatre and $570.00 for impacts to lake bottom of greater or
equal to I acre. a
Applications should be sent to:
'Di,� is� i2).niof ` r'Iiter Ets, �y tfi v �rsi ht %Iaapr��ss`Review I4� rmittin�g, D f
I �5014,1ai1 TE,viceTC .rater
ItairiglrN IIWRV 11059
I. Applicant Information
1. Owner / Applmant Information
Name: �t�C-La'
Mailing Address 7LI
'41&&d Q
& «__
P kc
t__ ZV/ 6
Telephone Number- 7cA' L131' W' Fax Number
E -mail Address- PNAJ_PftA '�_ b-ia 1, ,eavl
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
Mailing Address
Telephone Number- Fax Number
E -mail Address.
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 protect 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

I Location
County 7Z°�P, Nearest Town
Subdivision name or site address (include phase/lot number)
Directions to site please include road numbers, laandm DZ etc.
vicinity map is included)• �MAcI
gas ib4,- AQL.Cr_
CAv_Qa�
PC &LrL 4--'b w< �d +
is is not necessary if an adequate
:Rc> OZz
JDG (JL
2. Describe the - existing land use or condition of the site at the time of this application
3 Property size (acres) , gZ 0 L x's
4 Nearest body of water ( stream /river /sound /oceati/lake). /W11.9
5 Describe the p ose o the 0 e work (XG(i \IR(FO
6 List the type of equipment to be used to constrict the project ��e� //r, LW tip
7 Amount of impact (including all excavation, backtill, rip rap, retaining walls, etc ) below the
normal pool lake level in square feet or acres- 2 Vn' f,-k
8 a Amount of impact (including all clearing, back 011, excavation, rip rap, retaining wa s, etc )
above the normal pool lake level and 50 feet land -ward in square feet or acres- a ifs
8 b ___. Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instance) L
Apple nt/Agc j's Signature Date
(Age t s signature is valid only it an authorization letter from the applicant is provided )

O Alcoa Power Generating Inc.
Yadkin Division
AI.COA Post Office Box 576
Baden, North Carolina 28009 -0576
Application, for,Activity Permit for Reservoir and Shoreline Alteration
(Excavation, Dredge, and Fill)
Pnnt orb" all knformafion below and return to APGI, Yadkin Dwiskon, P O Box 576, Highway 740, Baden, N C 28009
SECTION ONE - BACKGROUND INFORMATION
1 Full Name (adjoining property owner')
2 Permanent Mailing Address 023 (� oDflrl
completed by the
t-r,.—
3 Local Address (if ditent)
4 Telephone(Busness� �7 I ANLM-Ift- nenti 764-121-V 6 (Local;
5 ax No and _ 1� �' `� i"16-6
6 Reservt�ir, . l~ r �� 6 - 7 Township IdWS 'F 8 County
�Cy�
g ��j -'�' 41�1.E_ o� 10 Section
11 Lot No U 'f' 12 Tax Map No �� 7
13 Dirra th property (rf n use the enclosed d sheet to ode us mavloz;23
a site)
3 M� f x A�� its �c�-� �ok(e,� �/t �o
L
14 Is the shoreline a" the property described above designated as a "High Cultural Probability Zone" n Yadkn's Shoreline Management Plan (leave blank If
you do not know) ❑ Yes ❑ No
SECTION 1 WO- 4NFORMATION FOR RESERVOIR AND SHORELINE ALTERATION (attach the following to the application)
1 Map of the reservoir area where the excavation is proposed - applicant must attach a map of the area of the reservoir and adjoining shoreline property owned
by the applicant where excavation is proposed The map must dearly exhibit the area of the proposed excavation and to what depth (contour elevation) the
excavation is proposed
2 Description of the planned excavation - applicant must attach a written description of the planned excavation including an estimate of the reservoir bottom to be
modified and the amount of material to be removed from the resenvor
3 Plan for disposal of excavated material - applicant must atkach a written description of their plans for disposing of the excavated sediment No sediment may
be disposed of within the FERC project boundary (655 foot contour), or on property owned or managed by Yadlan or Alcoa.
4 Resource impacts assessment- applicant must attach a bnefwRrtten description ofthe potential impacts of the proposed eaca'vation adnnty on surrounding
reservoir resources, including impacts to water quality and fish habitat if there is any vegetation growing in or around the area of proposed excavation, it _.
—shoutd be noted and the areg§'bfv€gd don shouldbe photographed, and photos included with application-
5 Schedule for conducting the proposed excavation - applicant mast attach a written schedule for completing the proposed excavation
6 Agency Approvals - applicant must attach copies of written concurrence with the proposed excavation from the following agencies (refer to Instructions for
Appfrcabon for ActruvrTyPermd for Res e►vorr and Stx>-dine Excav9onr
U S Army Corps of Engineers
• North Carolina Dimon of Water Quality
• North Carolina Department of Cuftal Resources (required in "High Cultural Probability Zones')
7 Non - refundable permitting fee- applicant must include a check or money order made payable to APGI, Yadlan Division in the amount of $100 00
SECTION THREE (to be completed by the applicant)
I hereby apply for apemntm pe foan thepboveAescnbed shoreline abaration at High Rock Resavorr I agree to abide by all applicable nequmni:M of
Yadkm' sShorolmeMariagemmtPIMtheeondrtionsoftheAchvityPemutforRe ?mrand,ShorelmAlten' ton (ETCavalion,Dredge;cmdEU)andother
Yadkm prooedu= ant regtnreme;1& I also agree that no w A will begmurrtnl I mcave anAcftwt vPvmrt signed by Ya&=
� rrfsSgnaoa Dater
Page 1 of 2
Write Copy — Yadkin mazy Copy — Applicant Pink Copy — Other

ConnectGIS Feature Report
Page 1 of 1
Rowan2
Printed December 02 2013
AWCONNKTGIS
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Is information was prepared from the Rowan County NC Geographic Information System Rowan County has made substantial efforts to ensure the accuracy of location
and labeling Information contained on this site The information provided is a representation of various City and County data sources and does not serve as an official map
Rowan County promotes and recommends the Independent venficatlon of any Information contained on this site by the user Rowan County makes no warranty or other
assertion as to the fitness of the maps for any particular purpose and neither Rowan County nor It s agents or employees shall be liable for any claim alleged to have
resulted from any use thereof
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