20141067 Ver 1_Shoreline Stabilization_20141008

PAID
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The following is an abbreviated application form for those applying fora 401 Wiitcr (1ui►lit�
(:ertificHtion 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
for wetland or stream impacts. Please pros idc fi%e (5) copies of this i be used
pplication a,ut supporting
informitt,on its well as it non- "efunditbit- application Ice to the I)i!•Ision of 1i'Hier (1uality of $2.10.00
tin- impacts to lake bottom of less thin, I acre. and $570.00 for impacts to lake bottom of greater or
equal to 1 acre.
Applications should be sent to;
I)ivision of Willer Quali(y 401 (vesiglIVExpress Review 1'ertnitting (�1
1650 11ai1 Service (:eulc�r ��� tol j Raleigh, NC 27699 -1650 OCT U —� 2014
I. Applicant Information
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Owner /Ap y licant Information
Name: f
Mailing Address:
Telephone Number: - O ' / �Fa; Num er:
E -mail Address: n�N� -lo
2. Agent Information (A signed and dated copy of the Agent Authorization letter must be attached
if the Agent has signatory authority for the ownertapplicant.)
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 (include phase /lot number):
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 sitc,at the time of this application:
3. Property siye (acres): ,
4. Nearest body of water (stream /river /sound /ocean /lake):
5.
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Describe the purpose of the proposed work:
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6. List the type of equipment to be used to construct the project: 131fc_,& 1%e5
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below the
normal pool lake level in square feet or acres: �/'� x i0 (VX4 roe exCeV4725_1>
Rio( wled 4z)
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:
8.b. Please describe, vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instance): _ r�c�s ,� Cs-k
Applicant/Agent's Signature Date
(Agent's signature is valid only if an Authorization letter from the applicant is provided.)
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Lots /Acres /Fauns (Active) Area: 2118 Mod! : 0 5
MILS #: 529367 LP: $ 75,000 Subdivision: Waters Edge
21 Waters- RD Tax Loc: Rowan
Salisbury, NC 28146 County: Rowan
Type: Lot Approx Acres: 2.7
Lot Dimensions: 215x823x30x755 Price /Acre: $ 27,777
Water /Sewer: Community Sewer Minimum SgFt to Build: 1000
Elementary: Middle: High:
Exterior Features: None
Lot Desc: Waterfront Restrictions:
m LS Restrictions: Architectual Review
DIRECTION :1 85 to Jake Alexander Blvd., rt. on Jake til it dead ends at Stokes Ferry Rd., Rt. on Stokes Ferry to left and Dunns Mtn.,
Rt. on Bringle Ferry, left on Providence Ch. Rd., Rt. into Waters Edge, property on the left.

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Alcoa Power Generating Inc.
Yadkin Division
PO Box 576
ALCOA Badtn, NC 28009 -0576 USA �
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 completed by the applicant)
1 Full Name (adjoining property owner) Ir ) 'U
2 Permanent Mailing Address"
' 3 Local Address (if different) 'y
4 Telephone (Business) (Permanent) '7n'14 W i 12. (Local)
5 Fax No and E -mail (optional)
1 --
6
Reservoir �lwl, f l 7, T ownship _�' d �*� �cl�rt- ��+_ �« ,{ 8- County
9 RSubdivision �t t! '.)` 10 Section '
11 Lot No (J i } 12 Tax Map No
13 Directions to property (f necessary, use the enclosed drawing sheet to provide us a map to the site)
*1' 14 Is the shoreline along the property described above designated as a' "High Cultural Probability Zone" in Yadkin's Shoreline
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I•hereby, apply- forra,permlt to, perform the,above- describbdwshoreline alt
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requirements' of Yadkin s:Shorehne "Managemeht,,PIan , 'the conditior
`(Excavation Dredge a`ndxFill) "rand other'�Yadkin't 'bl edures� and ;requ
Act��y /�.`,per�mit�'sigried.l L/'Ya��,c/lki� =v,',t° ,��"�• }r��r�"r.'� �-
Signature `� t
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eratlon at High Rock Reservoir �I ragree,to ,abide by ;allr5ppl able 1r�_
ty R,ermit for Reservor 'anhoreeAls=ofAhe,Aetiv ntio ,,
rp.S i t ' a• ry { rr a ,,L�r..a sir -H .
reme,nts�, Palso_agree;,thaf�no_7,wo`rk. will .beg�iniuntilf'l�receive,'ari;, v,
e J, .'r� xvr '�i� R '�.•'�Xi F _ w � �` 4:s'z .. "'�' � .> i 'l�v'.�' , r � r � �� " '�'��%rt�`�1,a,+'�
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Date
White Copy - Yadkin Canary Copy - Applicant Pink Copy - Other
Page I of 2
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 r'eservolr and'adtoming
shoreline- ro ert ;owned b' the applicant where,excavation,is proposed The ma must•clearl exhibit the area`of -the ro osed,
P P Y Y PP P, P P' Y P ,P,
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excavation and to what ;depth (contour elevation) the excavation is proposed °^
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Description of,the planned excavation - applicant must attach a written descrption of the planned excavation including an'estimate
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of the reservoir `bottom to be modified and the amount of material to be removed from the reservoir-
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3 Plan for disposal of excavated material - applicant must attach a written description of their plans for disposing of the excavated
sediment No sediment maybe disposed of within the FERC project boundary (655 foot contour APGI Yadkin Datum), or on property
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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
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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 , ,xt
5 Schedule for conducting the proposed excavation - applicarit must attach a written schedule for completing the proposed excavation
_
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Agency App"r'oval6"t applicant must "attach copie "s of,wntteri' "concurrence With'the" proposed excavation from`the' following agencies
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(refer to Instructions for,•Apphcation for Activity PgrTii,for Reservoir and Shoreline Excavation)
U S Army Corps of Engineers
North Carolina Division of Water Quality
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North Carolina Department of Cultural Resources (required in "High Cultural Probability Zones
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7 Non - refundable permitting fee - applicant must include a check or money order made payable to APGI, Yadkin Division in the amount
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of $100 00
SECTION THREE (to,be completed by theapplicant)
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I•hereby, apply- forra,permlt to, perform the,above- describbdwshoreline alt
y i
requirements' of Yadkin s:Shorehne "Managemeht,,PIan , 'the conditior
`(Excavation Dredge a`ndxFill) "rand other'�Yadkin't 'bl edures� and ;requ
Act��y /�.`,per�mit�'sigried.l L/'Ya��,c/lki� =v,',t° ,��"�• }r��r�"r.'� �-
Signature `� t
r ,
eratlon at High Rock Reservoir �I ragree,to ,abide by ;allr5ppl able 1r�_
ty R,ermit for Reservor 'anhoreeAls=ofAhe,Aetiv ntio ,,
rp.S i t ' a• ry { rr a ,,L�r..a sir -H .
reme,nts�, Palso_agree;,thaf�no_7,wo`rk. will .beg�iniuntilf'l�receive,'ari;, v,
e J, .'r� xvr '�i� R '�.•'�Xi F _ w � �` 4:s'z .. "'�' � .> i 'l�v'.�' , r � r � �� " '�'��%rt�`�1,a,+'�
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Date
White Copy - Yadkin Canary Copy - Applicant Pink Copy - Other
Page I of 2