20141214 Ver 1_Shoreline Stabilization_20141121

SEP -14 -2005 06:13 FROM:DWO- WETLANDS 9197336893 TO:918284953050 P:1 ,15
PAID
The following is an abbreviated application form for those applying for a 401 Water
Quality Certification to impact FERC (Federal Energy Regulatory Commission)
regulated Iake shore or bottom under the U.S. Army Corps of Engineers Permit
G1'30. This Application cannot be used for wetland or stye rn impacts. Please
provide seven (7) copies of this application and supporting information as well. as a
ron- refundable application fee to the Division of Water Quality of $200.00 for
impacts of to lake bottom of less than I acre and $475.00 for impacts tolf_ak�ebottom
of greater or equal to 1 acre.
Applications should be sent to:
Division of Water Quality Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699 -1650
I. Applicant Information
1. O hmer /Applicant Informal
Name: 0 U c,
Mailing Address:_
2.
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Tcicphone Number: Fax Number:
E -mail Address:
Agent Woxmation (A signed and dated copy of the Agent Authorization letter
must be attached if the Agene ri for th/e`owner /applicant.)
Name: �ccril� lTc(0t
Company Affiliation:
Mailing Address :__��F,
Telephone Number. 4o,,�/ - 3 Q -�L
E -mail Address:, a r , < C c ,
II. Project Information
0(
C) k_ Fax Number:
- C: c; . In
Attach a vicinity map clearly showing the location of the property with respect to
local landmarks such as to«+ns, 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
09 -13-2005 19:47 MARINE CONSTRUCTION CO 8284953040 PprFi

SEP -14 -2005 06:13 FROM:DWO- WETLANDS 9197336893
TO:918284953050 P :2'5
your project. Also, see the example below for guidance. Both the vicinity map and
site plan inust include a scale and north arrow. The footprints of all buildings,
impervious surfaces, or other facilities must be included.
1. Location I /
County ( /� , 7 c J 2 Nearest Town: �~� r C g ✓ `,
Subdivision name or site address (include phase/lot number): #- / 0
Directions to site please include road numbers, landmarks, etc. (This is not
necessary if an adequate vicinity map is included
2. Describe the ems g land use or condition of the site at the time of this
application:
3. Property size ( acres): c v : i
4. Nearest body of water ( strearn/river /sound/ocean/lake):
5. Desmib the p}trpose of the proposed work: / S S a "L
6. List the type of equipment to be used to construct the project: I -cl 140
7. Amount of impact (including all excavation, back-fill, rip rap, retaining wails,
etc.) below the norms pool lake level in s 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 fc t � ward i n
square feet or acres: Ann✓ - �[ 3 y u SF C U , a L ,c �/ ,.r w
b. Please describe vcgetation above the normal pool lake level and 50 feet land-
ward to be ' acted (number of trees for instance):
o /it)
AWcantl gent's Signature ' Date
(Agent's &Ignature is valid only if an authorization letter from the applicant is provided_)
09 -13 -2005 19:47 MARINE CONSTRUCTION CO 8284953040 PAGE2

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Print - Maps
Page 1 of 1
bind Maps
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V. Dor. hB9ei8deror Engineer
^----- ,- .---- �--- �---r- � - , --- - - - - -- -_ - �-_ -- -- -� -- � - -- - - - -- -- - -- - -- - - _ - - -___ - - -- --
Name/Company I M., r I on a. C, d • C".
iu+e
Address J !. f -� V u w L, le rn a o� . - Phone Number Td % Arl) 3 o v
City (, ��v v State Zip Code ago / Email
i"YlC3 (r f 'v1 u n 1.. N e t� S O< +,.,o �• C u w,
VI. it "ist of Required Documents (to include with Application Submission) -
cent Survey (stamped /signed by a professional licensed surveyor showing the location of the existing or proposed
E structure and/or survey of the existing or proposed stabilization)
Photos along property shoreline and photos of any existingstructures and /or stabilization in or near the water
Application fee (check only, payable to Duke Energy) O/S- igned,User.Agreement Letter
❑ Applicable local, state, and,federal permits " n and profile drawing showing a!f measurements and elevations
Habitat Enhancement payment (if applicable)
Y PP )
VIi. Approval Process
• Application is reviewed and determined if complete. Fields with an asterisk are required.
• If application is not - complete or does not include all items and information listed in the checklist, the
application will be returned as`incomplete.
• XDuke Energy representative will'visit the site to conduct a visual inspection.
• Applicant will be notified of approval or denial.
• Applicant 'is to have the notice, to be supplied by Duke Energy upon application approval, posted and
must be viewable from water. The notice must remain posted until a representativeJnspects•the
project,and determines the project is complete and within the application specifications.
Vlill. Directions by Road
Directions,by
Road*
_36 ` PV Z lY kf ( 1V
PI ( 3� °`('r,
IX. Application Submission - _ -- - - - -- - -- --
Please complete, print and sign this application. Then enclose all items from the checklist above in an envelope and
submit all the information to the address below.
Water Strategy, Hydro Licensing and'Lake Services
Duke Energy Print Form
PG Box 1006 / EC12Q
Charlotte, NC 28201' r�
i agree that the information contained within is accur e:

DUKE ENERdY IWERNIAL USE ONLY:
Construction n�
Date Received: FAF Paid ` ?t_ _ \,
Application
❑Application Complete version 13p
HEP Fund Permit No. Water Strategy, Hydro Licensing and Lake Services
Duke Energy
Site ID Ciose =out Date PO Box 1006/,EC12Q
Charlotte, NC 28201
(.'DATE OF APPLICATION" - - -- -- -- - - Permit(Tag
11. APPLICANT INFORMATION (applicant,mailing address and contact information)
Name* av �- a, 14 R u c a rl Q„ Primary Phone*
Address* af7 j -2 f� ve t'�. (�✓. Secondary Phone
city* State* RP Zip Code* � � Fax Number I
Email* L46 0d q @9 r0r4.1K kor awool4&cuY%,
Ill. 4ii6k (location of e– t—)
Address* � 4'i j ? f � v �� !,�/ - - - - - County*[
ty* _ C'-: OALS q
City; P , State* Zip Code* a � County Parcel ID number 31b k 0(, 4`73 S-� o
Lake-- 1 (e.g. Pin; Tax ID, TMS 1 °� S' 14 0103
rA
ova Number...)
Subdivision peen -�o �.� o LOt {5) �� oo -
- Plat B k/Page 3 R-
To enter the Latitude and Longitude of the property,
service/software to easily acquire the locatiorninformation. Values Latitude (e.g. 35.12345)*
should be provided in Decimal Degrees format'(35.1245).
example service: http:/Atduchrnap:com / ladong.htmi Longitude (e.g. - 80.12345).*
IV. PROPOSED ACTIVITY -
C New /Modification of Existing Structure C' Maintenance of Existing Structure Dock
RNew/Modifcation of Existing Shoreline Stabilization C' Maintenance of,Existing:Shoreline Stabilization Covered?
=� New /Modification of Existing Structure & Stabilization C Maintenance of Existing Structure & Stabilization # of Slips
(' Transfer of Ownership C' Other (please describe below)
# of Jetports
Area,over landw(sq ft) Area over water (sq ft) 91 J Total Square Feet 9
Shoreline Stabilizationf(feet) Length of Distance From Shoreline S '
Stabilization
Materials
Brief Description
of the Activity
cc, n 54V1 .r C " j n S �r t�� 'i�r� C 4 � � o c l d o r_ Gt n i �c1 Jc2 ,- A
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Describe Briefly the Existing
Structures Over Land and
Water (include sq fQ
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