20071662 Ver 1_Application_20071001

07-1662
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. ~~ ~ ~
Applications should be sent to:
Division of Water Quality Wetlands Unit
1650 Mail Service Center Q (~ ~ ~ ~~~
Raleigh, NC 27699-1650 p
ocj ~ ~ zoos
«~Na . ware cw~aLiw
I. Applicant Information WE~LAN0.4AN0 ST(?R!4~ATCRR BRANCH
Owner/Applicant Ir ~
Name: " l ~
Mailing Address:
Telephone Number: _ t4
E-mail Address: c1»-- ~
Number:
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:
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: d~ ~~ Nearest Town:,
Subdivision name or site address (include phase/lot number
Directions to site please include road numbers, landmark;
necessary if an adequate vicinity map is included):
2. D n e e "ex7(St~ii~andrtfse~ or irolid
not CQ
~~1~ oM.. ~~'
this
3. Property size (acres): ~ • ~~, ~,C,~P~S 1--~~ ~S~~x°
4. Nearest body of water (stream/river/sound/ocean/lake): ~d~'
.~-
5. Describe the purpose of the ~roposed~vork: ~~~P ~`~ n G l~ rc5~~/Y ti
6. List the type of equipment to be used to construct the project:~t;~~~Gl,Llf ~1~.?
7. Amount of impact (including all excavation, backfill, rip rap, retaining
etc.) below the normal pool lake level in square feet or acres:--
8. a. Amount of impact (including all clearing,
retaining walls, etc.) above the normal pool lak
square feet or acres: ~,~,~,~~~
back fill, excavation, rip rap,
e level and 50 feet land-ward in
b. Please describe vegetation above the norm~dl pool lake level and 50 feet land- ,
ward to be im acted`(numdber of trees for instance): fi•/~d ~~~ ~~: '~~_
t~ M ~ i , 1~~ hG6 ~l
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

I.~k~ Full P't~nd~
.~11id~f~liili~ ~,.~~ « / f/~A.~~G~ ~~~r~jt.~S'~ k~~.. ~~ ~~~D1.~F'
~~ 3 ~ c. ~~e ~~~ ~~ ~ - -Q ~~ n
l '-'' ~t~ ~~Pd2 "
~~~~~
Shbvel.'ne
~~ t~ ~ ~~a ~.~
`~ "~ ~-~~ Ili
~~1~~'~~s~~,~~~
~ ~ ~~~ ~~S
Please appra~~cir~~~t~G~ sl€etch tha ft~•N~~wi~g ir~U+~r~atc~o~ ~~ Ehas plan
~p~l!e~ pr~vid~ diir~e~rei+~i~~ fr~r each item, e~~h ae 'I Ei Ft. ~ 10~ ftl:
'i~ l~ctt p~rapos~ed r~eget~tian ~(~aring (provide dirri~nsu~tns~
~~ La~ca~tian cif riip rip ~~ fll t~ tfe pla~ad at~~+~e the F~e61 P'and eleuatian
~~ La~cati~n ~F rip r crr FII t+s he plea! bel~v~ the Pt~iF ~~nd ele~ati~n
d~ Tfre p~cation of art~~r~ p~r~Ra~ed str~~~t~r su~N as Ctuildit~gs, retaining
w~~BUe, dacN¢~} et:~.
~~} ~'Me la~~~ti~n ~f a~ny~ ex~wuati~n rjr dredging b~~~~ tl~e F~(I P~a~nd
ele~ataa~n.
61 L~~ati~ud~ ~fi ~r~n~,ltrn~Y:i~a~n a~~~es. ~rrrie~+~r~.

Actfon ID. 5AW-2007-02971-063 County: Moore USGS Quad: Lobelia
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Property Owners: Mrs. Thami Hamdoune
Address: 122 Mallard Cove
Vass, NC 283)4
Telephone No.: [phone]
Size and location of property (water body, road name/number, town, etc.): Property is lot #771ocated on
Castleberry Court in the Woodlake Country Club community, adjacent to Section 404 jurisdictional
waters of Woodlake (Lake Surf), in the town of Vass, Moore County, North Carolina.
Description of projects area and activity: This permit provides authorization to install bulkhead along 66 LF
of shoreline with approximately 6 feet of rip-rap placed on each end, resulting m_OA036 acre impact
below the Lake`s ordinary hi h water mark for the ur ose of reventin erosion and runoff of sediment
into Woodlake.
Applicable Law: ® Section 404 (Clean Water Act, 33 USC 1344)
^ Section 10 (Rivers and Harbors Act, 33 USC 403)
Authori-r_ation: Regional General Permit Number: 19781)0(180
Nationwide Permit Number:
Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with the attached
conditions and your submitted application and plans received 8/10/07. Any violation of the attached conditions or deviation from
your submitted plans may subject the permittee to a stop work order, a restoration order and/or appropriate legal action.
This verification will remain valid until the expiration date identified below unless the nationwide authorization is modified,
suspended or revoked. If, prior to the expiration date identified below, the nationwide permit authorization is reissued and/or
nutdil'icd, this verification will remain valid until the expiration date identified below, provided it complies with alt requirements of
the nuulil'icd nationwide permit If the nationwide permit authorization expires or is suspended, revoked, or is modified, such that the
activity would no longer comply with the terms and conditions of they ationwide permit, activities which have commenced (i.e., are
under construction) or are under contract to commence in reliance upon the nationwide permit, will remain authorized provided the
activity is completed within twelve months of the date of the nationwide permit's expiration, modification or revocation, unless
discretionary authority has been exercised on a case-by-case basis to modify, suspend or revoke the authorization.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality Certification. You
should contact the NC Division of Water Quality (telephone [phone]) to determine Section 401 requirements.
For activities occurring within the twenty coastal counties subject to regulation under the Coastal Area Management Act (CAMA),
prior to beginning work you must contact the N.C. Division of Coastal Management .
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other required Federal,
State or local approvalslpermits.
IF there are any questions regarding this verification, any of the conditions of the Permit, or the Corps of Engineers
regulatory program, please contact Emily Burton, Regulatory Specialist at 910-251-4635.
~' ~ %
'~._..
._ -,
~~ ; ,..~ , _. ;, ,~_ ---_-- Date: 9/13/07
Corps Regulatory Official
i
I-,xpiration Date of Verification: 12/31/2. 10
Kc.n Ave, itte NCDENR DWQ Fayetteville Re~ion•tl Office 225 Green St. Suite 714/Systel Bldg Fayetteville, NC 28301
Debt a C Ensmint*_er Planner County of Moore P O Box 905 Carthage, NC 28327
Page 1 of 3

I HEREBY CERTIFY THAT THE PREMISES OR A
PORTION OF THE PREMISES SHOWN AND DESCRIBED
HEREON, DO LIE IN A F.E.M.A. DESIGNATED 100 YEAR
FLOOD PLAIN AREA.
.~ '~
~'o Essi
~ ~• ~~• v
•~-
_ ~ ~,l~L SHEFFIELD, PLS N0. 1365
_ ~ N0. L-1365
'•.9 ~: ll'EFERENCE:
i~ •~ ,tiQ J~-l~' SLAT CAB. 2, SL. 212
,~, ••., SUR. • ~; MOORE COUNTY REGISTRY
~ ~ \~ ' RATIO OF PRECISION= 1/10,000+
~~'~;,,SH E F F~~~~~ ~.
ACREAGE DETERMINED
BY COORDINATE METHOD.
NOT INTENDED TO BE PREPARED
FOR RECORDATION IN ACCORDANCE
WITH G. S. 47-30 AS AMENDED.
UNLESS OTHERWISE DENOTED,
•=EXISTING IRON STAKE
^=EXISTING CONCRETE MONUMENT
~=SET CONCRETE MONUMENT
O=SET IRON STAKE
~t I =SQUARE FOOTAGE
t ~ •=POWER SERVICE STUB
tt j ©= SEWER SERVICE STUB
~ 0= T( 4~ HONE SERVICE STUB
tt ~ ~= C ETV SERVICE STUB
t i ®=WATER METER
tt i 'Q'= FIRE HYDRANT
t ~~ ~ MH
t ~ p=SANITARY SEWER MANHOLE
ttt ~ ~ UTILITY POLE ~ 74
t I ~i
t ~ ~ / i ~
70 \ ~ / ~~ \
~ -/// ,
O t
1 1 ~
TIE LINE tt _ ----- - - ,' -----
N 23'15' 01 "E * Y ~
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54.72' ~ ~; c ASTLEBERR ,
~' '
i / 4.9? E C OVRT ~~~/TIE LINE /
i C ~5. 14 56~~ ~ N51'01'06"E ~s
~g N 0 06; N86'09'19"E 91.71' i
i RP~65.32 N 57.68 \
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78
10652 SQ FT \
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WOODLAKE
SURVEY FOR
TT~aIVfT NaMTI(1TTNF
l-OCATI ON ~KETCI-i

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