20071406 Ver 1_Shoreline Stabilization_20070816

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The following is an abbreviated application form for those applying fora 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 seven (7) copies of this application and supporting information as well as a
non-refundable application fee to the Division of Water Quality of $200.00 for
impacts of to lake bottom of less than 1 acre and $475.00 for impacts to take bottom
of greater or equal to 1 acre.
07-406
Applications should be sent to:
Division of Water Quality Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
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I. Applicant Information
1. Owner/Applicant Information
Name: ~~ r-~.~ T~ a .
Mailing Address:^-tq'~ ~ ~~~ ~
Telephone Number:_
E-mail Address: cl
2.
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~rt`4!d NR ~~ w~'r~~ Spurr
n~ ~, .n or(?3~iqugTSR BRANCH
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~_?z- Fax Number: `7Cb ~
Agent Information (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signato ~ autho~'t~ for the off r~plicant.)
Name: ~ yq ~(e. I J d~ ~N ~-,~c?(" ~ ~/L,~ ~-I' ~- ' ~- ~ .
Company Affiliation:
Mailing Address: ~S %~ D .' ~ : ~ ~~'
(l. p`7 ~-- 2K o
Telephone Number:~D~f'ZO ~ _ ~Z. Fax Numb ~
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

le below for guidance. Both the vicinity map and
your project. Also, see the examp
site plan must include a scale and north bewncludedootprints ~of ail buildings,
impervious surfaces, or other facilities m
l . Location L ~ Nearest Town: ~ ~ n~• ~
CO~~ ~ include hasc/lot number): € +s •~ ~ a u
Subdivision name or site address (' P
Directions to site please include road numbers, landmarks, etc. (This is not
necessary if an adequate vicinity map is included):
2. Describe the existing land use or condition of the site at the time of this
application: a "
size acres • S
3. Property ( ):
n ;(' v~n~. V~
4. Nearest body of water (stream/river/sound/ocean/lake): ~~--
5. Describe the purpose of the proposed work:
~ ~o c' q- ad ~ ct r`a
f . List the type of equipment to be used to construct the prof

'1. Amount of impact (including all excavation, backfill, rip rap, retaining walls,
etc.) below the normal pool lake le ~ in~uare feet or acres:
g, a. Amount of impact (including all clearing,
retaining walls, etc.) above the normal pool 1
square feet or acres: 1 ~ •
back fill, excavation, np rap,
level and 50 feet land-ward in
b. Please describe vegetation above thf norm~an e) 1 lake level and 50 feet land-
ward to be impacted (number of trees i~S
i~ 114.)
Date
ApplicandAgent's Signature
(Agent's signature is valid only if an authorization letter from the applicant is provide .

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Please approximately sketch the following information on this plan
(please provide dimensions far each ttem, such as 10 fti x 100 ft):
1}Ali proposed vegetation clearing (provide dimensions}.
.2} Location of rip rap ar fill to tie placed aborre the Ft~ Pond~elevatlon
3} Location of rip rap ar fi(( to be placed below the Fug Pbnd elevation
4) The location of any proposed structures such ass buildings, retaining
walls, docks, etc.
5} The location of any excavation or dredging belavv the Full Pand
elevation.
6) Location of construction access corridors.

Scratch pad
is Lot 2 Eastwind Cove, Denver, NC 28037-7427, United States
2: Untitled item
Highway 16 & Webbs Road

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