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HomeMy WebLinkAbout20071464 Ver 1_Application_20070829r L 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 lake bottom of greater or equal to 1 acre. ~ ,n ~ , Applications should be sent to: Division of Water Quality Wetlands Unit 1650 Mail Service Center Raleigh, NC 27699-1650 I. Applicant Information rAt ,~~ El~~ RECEIVED 0 7_ 1 4 6 4 ~~,JG ~: ~ Z00r `N~TLIddD;, ptJU ,'f~Rt;~~AfW_R 3P.AtJCH Owner/Applicant Information Name: (Zot~~T + Wi.~c,t~.~ (S~uy~~u:~l~Thf Mailing Address: ~ito7- GR~N~.>;~~i+ A2iv~ (~ R~G-N~~3Gt~ i tiL Z'1~a'7 Telephone Number: ~~~w 5~ ' f ~ -1 Fax Number: E-mail Address: 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: ~ ~/k 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 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: W++~N + C~=-w~.G~R-y Nearest Town: CLt~t~ FiC~•-t. Subdivision name or site address (include phase/lot number): i,cr i ts1 ~~u;Ti~pe+~N'i Directions to site please include road numbers, landmarks, etc. (This is not i~ti;~1g•(ZRtE necessary if an adequate vicinity map is included): ctNT rt('. -~cL'~I ~i Tv c~iA~Dla ~~Ck-E 12oA'D (s t2 i ~ bZ 5~e kT F1- Tc: Oct ~Ln7tl ~'T tt ~ ~jN ~[~'f 2. Describe the existing land use or condition of the site at the time of this application: ~R~S!ttdU ~~ oN i.~T iN (~-s~y'~N~~/~- 4~t3~t'yi~lt~l~'. 3. Property size (acres): 1 ~~'~ f Air: 5 4. Nearest body of water (stream/river/sound/ocean/lake): F,~Prpi~i ~~'E 5. Describe the purpose of the proposed work: ,To ~Tf~~+i.~~ M.- EX1Si Iht(~ EP-OtJi~f~ ~v-G-~irJE Ib~A Prr~ t~c;T' I~t' ~~cw. `F~~T~E~°- E~rc~~~N 6. List the type of equipment to be used to construct the project: P:~y3~-;- ~vrtati• 'T~tL~~~+~ aR- P~At,K1~E 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: ~ ~ ~~ ~~ '~~~ b. Please describe vegetation above the normal pool lake level and 50 feet land- ward to be impacted (number of trees for instance): ~ •-~~ TRCcS e~ U~-tt-~p ~~ A-N-~ (~DiTtot.9 W~U, ~ ~~yc-r~ -'("o tNSi'~ru. ~tt~ 51`I~131~t~~A~~C~~~1 --~ ~ --v Date (Agent's signature valid only if an authorization letter from the applicant is provided.) US Army Corps O[ Engineers Field Offices and County Coverage Asheville Regulatory Field Office Alexander Cherokee Iredell Mitchell Union US Army Corps of Engineers Avery Clay Jackson Polk Watauga 151 Patton Avenue Buncombe Cleveland Lincoln Rowan Yancey Room 208 Burke Gaston Macon Rutherford Asheville, NC 28801-5006 Cabarrus Graham Madison Stanley Telephone: (828) 271.4854 Caldwell Haywood McDowell Swain Fax: (828) 271.4858 Catawba Henderson Mecklenburg Transylvania Raleigh Regulatory Field Office Alamance Durham Iohnston Rockingham Wilson US Army Corps Of Engineers Alleghany Edgecombe Lee Stokes Yadkin 6508 Falls of the Neuse Road Ashe Franklin Nash Sung Suite 120 Caswell Forsyth Northampton Vance Raleigh, NC 27615 Chatham Granville Orange Wake . Telephone: (919) 876-8441 Davidson Guilford Person Warren Fax: (919) 876-5283 Davie Halifax Randolph Wilkes Washington Regulatory Field Office Beaufort Currituck Jones Pitt US Army Corps Of Engineers Bertie Dare Lenoir Tyrrell Post Office Box 1000 Camden Gates Martin Washington Washington, NC 27889-1000 Carteret' Green Pamlico Wayne Telephone: (252) 975-1616 Chowan HeRford Pasquotank Fax: (252) 975-1399 Craven Hyde Pcrquimans 'Croatan Nation al Forest Only Wilmington Regulatory Field Office US Army Corps Of Engineers Post Office Box 1890 Wilmington, NC 28402-1890 Telephone: (910) 251-451 I Fax: (910) 251025 US Fish and Wildlife Service Raleigh Field Office Post Office Box 33726 Raleigh, NC 27636-3726 Telephone: (919) 856-4520 Anson Duplin Onslow Bladen Harnett Pender Brunswick Richmond Carteret ontgomery Robeson Columbus Moore Sampson Cumberland cw anover Scotland US Fish and Wildlife Service /National Marine Fisheries Service US Fish and Wildlife Service Asheville Field Office 160 Zillicoa Street Asheville, NC 28801 Telephone: (828)665-1195 National Marine Fisheries Service Habitat Conservation Division Pivers Island Beaufort, NC 28516 Telephone: (252) 728-5090 North Carotins State Agencies Division of Water Quality 401 Wetlands Unit 1650 Mail Service Center Raleigh, NC 27699-1650 Telephone: (919) 733-1786 Fax: (919) 733-6893 Division of Water Quality Wetlands Restoration Program 1619 Mail Service Center Raleigh, NC 27699-1619 Telephone: (919) 733-3208 Fax: (919) 733-5321 State Historic Preservation Office Department Of Cultural Resources 4617 Mail Service Center Raleigh, NC 27699-4617 Telephone: (919) 733.4763 Fax: (919) 715-2671 CAMA and NC Coastal Counties Division of Coastal Management Beaufort Chowan Hertford Pasquotank 1638 Mail Service Center Bertie Craven Hydc Pender Raleigh, NC 27699-1638 Brunswick Currituck New Hanover Perquimans Telephone: (919) 733-2293 Camden Dare Onslow Tyrrell Fax: (919) 733-1495 Carteret Gates Pamlico Washington NCWRC and NC Tro ut Counties Western Piedmont Region Coordinator Allcghany Caldwell Watauga 3855 Idlewild Road Ashe Mitchell Wilkes Kernersville, NC 27284-9180 Avery Stokes Telephone: (336} 769-9453 Burke Suny Mountain Region Coordinator Buncombe Henderson Polk 20830 Great Smoky Mm. Expressway Cherokee Jackson Rutherford Waynesville, NC 28786 Clay Macon Swain Telephone: (828) 452-2546 Graham Madison Transylvania Fax: (828) 506-1754 Haywood McDowell Yancey ~~t ~f~-~ _________ .....------~_..__ . _ __ .. _-_ __.._._...___.... -____.__ _ .- -- __ __ . _..____._ ._-.-. __. ,----..__.___--------_~-_4. 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