20150130 Ver 1_Shoreline Stabilization_20150202

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The following is an abbreviated application form for those applying for a 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 five (5) copies of this application and supporting
information as well as a non - refundable application fee to the Division of Water Quality of
$240 00 for impacts to lake bottom of less than 1 acre and $570 00 for impacts to lake bottom of
greater or equal to 1 acre v AI
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Applications should be sent to
Division of Water Quality 401 Oversight/Express Review Permitting
1650 Mail Service Center
Raleigh, NC 27699 -1650 2 1 5 0 1 3 0
1 Applicant information
I Owner /Applicant Information a �/y
Name -- V
JOANN M, HOLTKAMP TRUSTEE ED�EN—R ® 2
2015 i
Mailing Address R k, 6 R`-1 102 29 MEADOWKNOWL DR, LOVELAND OH 45140- R PERMITTING
4904
Telephone Number Fax Number
E -mail Address
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
DOUG MOFFAT
Company Affiliation
Mailing Address 765 N ISLAND DR NW TLANTA GA 30327
Telephone Number _404- 668 -9725 Fax Number _404- 256 -0485_
E -mail Address dougmoffatncomcast net
Name
BOB MARTIN
Company Affiliation BOBS DOCKS
Mailing Address PO BOX 304 GLENVILLE NC 28736
Telephone Number _828- 226 -2047 Fax Number
E -mail Address poppaboo56 @aol com
II Project Information
_828- 743 -6260_
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 _JACKSON Nearest Town CULLOWHEE /9LENVILLE
Subdivision name or site a ress (include phase /lot number) 572 GLENSHORE DR,
(CULLOWHEE, NC 28723
Directions to site please include road numbers, landmarks, etc (This is not necessary if an
adequate vicinity map is included) _S RT107 to Pine Creek Rd(Glenville) to N Norton, 2 6 MI
TURN LEFT ON LOYD HOPPER RD, RIGHT ON GLENSHORE DR
GATECODE
2 Describe the existing land use or condition of the site at the time of this application 11 df g ,51M
3 Property size (acres) 1 16acres\
4 Nearest body of water (stream /river /sound /ocean/lake) �On Lake Glenville
5 Describe the purpose of the proposed work Stabilize shoreline
6 List the type of equipment to be used to construct the project _excavator, barge boat
7 Amount of impact (including all excavation, ackfill, rip rap, retaining walls, etc ) below the
normal pool lake level in square feet or acres 1 _400 SF of impact below normal pool
8 a Amount of impact (including all clearing, back fill, excavation, rip rap, retaining walls, etc )
t4OOve the normal pool lake level and 5 ,feet land -ward in square feet or acres
SF of impact above normal pool
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 Date
(Agent's signature is val only if an authorization letter from the applicant is provided )

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CURRENT OWNER
JOANN N HOLTKAMP

AGENT AUTHORIZATION LETTER
FOR NCDENR AND DUKE ENERGY SHORELINE STABILIZATION AND DOCKS
DECEMBER 18, 2014
THIS LETTER IS TO AUTHORIZE DOUG MOFFAT, 765 N ISLAND DR ATLANTA GA 30327
404 - 668 -9725 AND /OR BOB MARTIN, BOBS DOCKS, PO BOX 304 GLENVILLE NC 28736
828-743-0017,828,266-2047 TO ACT AS OUR AGENT(S) IN MATTERS PERTAINING TO
APPLICATIONS AND CONSTRUCTION OF SHORELINE STABILIZATION AND DOCK
PERMITS FOR
572 GLENSHORE DR, LOT 3
PIN. 7554 -85 -3391
CULLOWHEE NC 28723
OWNER(S).
G k i � DATE 2 - Z q
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PANN M. HOLTKAMP TRUSTEE
DATE,
AGENT /APPLICATION.
DATE Z-- Z- G"1.�-
DOUG M FFAT
IAP DATE.``
BOB MARTIN

Latitude and Longitude of a Point I. Page 1 of 2
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