20071565 Ver 1_401 Application_20070917

07-1565
~Clt~ followit,~? i5 au abbreviated application forte for those applyimg fora 40z ~tiVate:
ft sality Ce.r7:ification to i~upact 1FEhC (Federal Energy Regulatory i~axuxni;~s~arl~n)
regulated la'lce shore or bottom under the U.S. AxAny Corps oY Engineers 1'e:rtnil
(:;??30. Tkui;: Application cannot be used for wetl:rrtd or ,tream impacts. :P!le;ts~~
provide seveln. ('7~ copies ol'this application and supporting iatormattot~ as well a ~ :;
aon-reiLndable applicabio~a >t'ee to the Division of Water Quality o.f $2Qa,(10 ?'a~•
unp•acts of ral lake bottauu of less fh:~tn 1 acre and $475.00 for impacts to laJ;:e bOttlur;
of greater or equal to 1 acre.
A~.llplications should be sent to:
Dii vision of '4~''ater Quality Wetlands l,Jnit
;l~i:~A 1V]<aal Set, vice Center
1lZaleigh, h1C; ;!'7699-1650
1:. Applicant Inforuxatiot>.
J.. Owzu;c,~ 4pplieant
1VCa.i]ing .Address:
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Etuc c. ~•t ;3f.Flla 1rIE:~t
(~c'9U~6IC~fy Brctlcl;
US Army Corps
of Engineers
Wilmington District

TI,l;,phona Number: ~(0 . e~6C,3_
E••nLarl Address: ~r nn 1vtaLr
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2. Aben~: ?~lfaxxx~ation (A signed and dated copy of the At;ent Authorization le:tt,::r•
:must bc: atTachod if tha Agent lzas signatory autho~.ty for the owner/applic~t.)
N;rt:ae:
Coc~ipany Affiliation:
Mas'1T:ng Address:
Telephone Number: Z~ax N'urz',ber: _ D ~~.~~~~
E-:cr~a.i1 Address: ~ ~ - - --- - - ---• -• D
• SEP 1 7 2007
117. I'roje~:t l:txl'ortnati.on DENR -WATER OUAUTY
1WETLAfVpg AND STOR.Mi'yATE~R BRANCH
Attach, a iricinity ntap clearly showing the location of tha property with r~spec't t.:~
local laxidrnaxlcs such as towns, rivers,'and roads. Also provide a detailed ;.itt•;
plan sl:u~wing prtoperty botuldaries, and developmzn.t plans in ral3tiou 1:_•,
surrow~ciing propelrties. You xrzay use the daagxarrr belaw~ta make a hand sketch of
~~n., i~~n~~ ~ .~ :.nark c~~au nUU awrn ronr n i n T ,. i -., ,~~.. , ~ ,

your project. Also, Sze tlra zYample below 1'or widalrco. Both the viciivCy n~a~~ ~n ~l.
site f~L3n must includa a Scala and north arrow. The footprinCS of all builcliiiE~c~
irnp~:vious surfaces, or other facilities must be included.
Loc.ahon
~~ounty:_ - - - ~~~- N'earest Town: ~"~" ~ (? ..
;i-:~bdivision name or site address (ui~lude phase/lot numbei-~,~~ ~_~ ~ ~_.~t~-~L
laixectiozas to site please include road numbers, landmarks, etc.. (This is ncp~ (~ ~' ,
n ~ ~~sary if adequate ~'ciruty neap 's inclu ): ~~ 3 ~I 3
j~V y~ ~ ~- -~-_ ..~..~....s....,......._... ~ T
,h
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2. nc,sc;ribe the exi ting lazx u e or Condit}on of the sit4 at the time c>f' t.tu
applicatYOn:..T. C ~~. ytrr'~~ ~ p~' ~ ~~i 1'1 .( C.~ C'~~V1S tc 0v'1 O
~__....._ ...~_........ _ _... _W_.
3. 1'roprrty size (acres):~.~~,=~~. ~~'
4. N~axc;sC body of vaatc~ (sti~ea.u~/~iver/souud/ocear~/iake): C~ ~:~
S. 17escribe the l.~urpose of the proposed work:_ ~~~~__~~~ ~_(~~
--- -
~ m ----- - --- - - - - -
6. L,isC ilie typ;; of equi zz~erit t~ a. ~ed to onstruct tlra project: ~ l __~ ~L(~ ~~r_~-`t U ~'
7. Axr~ouutt of irrtpact (includi.t~„ all excavation, backfill, rip ra , ret;iining w~all~
etc.) Lelow the normal pool lake level in squaxe feet or acres: ~ ~ ~ ~ ~ ~'f'
8. a. ,~uounC of unpact (includius all clearing, vack fill, excavation, 111 << P.
retai,:urlg walls, eCC.) above the uor fool lake level d SQ fzec d-~+rard. i1i
squ;~:r, feeC or acres:`~~ _~ ,_- ~`7''~ ~~,,
b. 1''le~,tse describe vegetation abova the normal pool
w~r~l to be~.~a~ted (nurn~ier of trees,. for instan~c):_
T

v~l and 'i feet lan~a-
I~~lo~l~
,
Al~l~lrcarr ;e»t's S~~nanzre Date
(.A~ertt'$ signature is valid only ifan authorization letter from the applieanC is ~~rovidc;d.)
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