20141061 Ver 1_Application_20141007

Alcoa Power Generating Inc.
Yadkin Division - SEP 3 Q 2014
PO Box 576
ALCOA Badin, NC 28009 - 05765'0
Application for Activity Permit for Reservoir and Shoreline Alteration
(Excavation, Dredge, and Fill)
Print or type all information below and return to APGI, Yadkin Division, P.O. Box 576, Highway 740, Badin, N.C. 28009
SECTION ONE – BACKGROUND INFORMATION (to be jcompleted by the applicant)
1. Full Name (adjoining property owner): !7 �s!��� fV 1 hs U�
2. Permanent Mailing Address:
3. Local Address (if different):
4. Telephone (Business):
5. Fax No
and E -mail (optional): _A //� .,a Lail UI 2 ✓ / , 5 �� �?� �. G � ►n
6. Reservoir: G 1 < 7. Township: Ci �t t Gl,�t 8. County:
9. Subdivision y/M M Ed lG G c°. 10. Section: 13 i D L I -I'
11. Lot No.: 6
12. Tax Map No.: 50 Q 3 3 C ,%
13. Directions to property (f necessary, use the enclosed drawing sheet to provide us a map to the site):
14. Is the shoreline along the property described above designated as a "High Cultural Probability Zone" in Yadkin's Shoreline
Management Plan (leave blank if you do not know): ❑ Yes ❑ No
SECTION TWO— INFORMATION 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 clearly 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 reservoir.
3. Plan for disposal of excavated material - applicant must attach 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 APGI Yadkin Datum), or on property
owned or managed by Yadkin or Alcoa.
4. Resource impacts assessment - applicant must attach a brief written description of the potential impacts of the proposed excavation
activity 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 should be noted and the areas of vegetation should be photographed, and photos
included with application.
5. Schedule for conducting the proposed excavation - applicant must 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 Application for Activity Permit for Reservoir and Shoreline Excavation):
U.S. Army Corps of Engineers
North Carolina Division of Water Quality
North Carolina Department of Cultural Resources (required in "High Cultural Probability Zones")
7. Non - refundable permitting fee -applicant must include a check or money order made payable to APGI, Yadkin Division in the amount
of $100.00
SECTION THREE (to be completed by the applicant)
I hereby apply for a permit to perform the above- described shoreline alteration at High Rock Reservoir. I agree to abide by all applicable
requirements of Yadkin's Shoreline Management Plan, the conditions of the Activity Permit for Reservoir and Shoreline Alteration
(Excavation, Dredge, and Fill) and other Yadkin procedures and requirements. I also agree that no work will begin until I receive an
Activity Permit signed by Yadkin.
Applicant's Signature Date
Page I of 2

The following is an abbreviated application form for those applying for a 401 Water Qualih
(:� rti('ication to impact FERC (Federal Energy Regulatory Commission) regulated take shore or
bottom under the U.S. Army Corps of Engineers Permit GP30. This Application cannot be used
for wetland or stream impacts. Plcs►sc )r1't►1'idc I'i%c (i) t•t►l ►ies of this application and supporling
information as well as a non - refundable application I" to the 1)i�ision of li'i ►ter Quality 01'$2.10.0[)
for impacts to lake bottom of less than i acre and $570.00 for impacts to tape bottom of greater or
equal to I acre.
Applications should be sent to:
Division of, Water Qustli($ •101 O e►sight/J."Xiwess Itevieti4• Permitting
1650 \fail Service ('enter
Raleigh, N(• 27099 -1650
I• Applicant Information
!. Owner /Applicant Information
Name: />/t'� 1 �✓ /�.'7` j' f ��
Mailing Address:
Telephone Number: %�/� j ��— j �` f Fax Number:
E -mail Address:�l�,i
2. Agent Information (A signed and dated copy of the Agent Authorization lctter 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 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.

1. Location
County: Nearest Town: ---�
Subdivision,name or site address (includwphasellot number): �y�nO�/
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:
3. [property size (acres):
4. Nearest body of water ( stream /river /sound/occan%lake) :I�il�
5. Describe the purpose of the proposed work:
J�
6. List the type of equipment to be used to construct the project: /t ��6)
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below the
normal pool lake level in, square =fect or acres: UZI
8 -a. Amount of impact (including all clearing, back fill, excavation, rip rap, retaining,walls, etc.)
above normal pool lake level'and 50 feet land -ward in square feet or acres:
8.b. Please,describe vegetation above the normal pool lake level and,50 feet landward to,be impacted
(number of trees for'instance):
Applicant/Agent's Signature Da e
(Agent's signature is valid only if an authorization letter from the applicant'is,provided.)

Square footage of area to be excavated is 1500 sq ft
Cubic yards of material to be removed is 55
A backhoe will be used to remove the material. Due to new,pier regulations.material will be remove to
same,level to allow for new pier installation. This allows the same depth of water to remain under the
floating part of'pier.
The material will be transported to 8360 pleasant meadow1n. Rockwell nc
Resource impact. There will be no resource impact due to there is no vegetation growth in °the area and
the surrounding area has already be,excavated before.
The excavation will happen the _first or second week of Nbv: when Alcoa drains the lake.

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