HomeMy WebLinkAbout20071713 Ver 1_Shoreline Stabilization_2007101013
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The following is an abbreviated application form for those applying far 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 seven (7) copies of this application and supporting information as well as a
non-refundable application fee to the Division of Water Quality of $200.80 for
impacts of to lake 1lottom 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
Raleigh, NC 27699-1650
I. Applicant Information
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Owner/Applicant Information
Telephone Number:
E-mail Address: 5
Fax 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, seethe 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 (~' r
County: ~_a`~ (~.L~n Nearest Town: ~~-~~
Subdivl~ion name or site address (include phase/lot number): ~~ ~ ~~~~
Directions to site please include road numbers, landmarks, etc. (This i~s'not -
necessa~ if an adequate vicinity/reap is included):-7 '~-~ ~ 4',~rr~~C~ -fz,
~~ . /1 C7/~ 1'Yl ra'~1' n "'}'f1 l F- l1 rrv~ (~ ~ i i i I ~ ~ n vrr rn v~ `~ 1
2. Describe the existing land use or condition of the site at the time of this
application: E' 1X' I ~~A(1 ~.~ ~ ~~ i S~ h~ G~. ~.P ~ ~(( ~11Y~ e~" i ~
3. Property size (acres): C `~ ~ Cl ~~.L~
4. Nearest body of water (stream/river/sound/ocean/lake): ~ 7~'~ ~ ~ ~
5. Describe the purpose of the ropo ed work: Q ~.lu +Y l~~ ~ ~'
6. List the type of equipment to be used to construct the project:~JC ~~~ ~{'
7. Amount of impact (including all excavation, backfill, rip rap, retainin walls,
etc.) below the normal pool,,lake le~e~ in square feet or acres: I ~")J< :~~ p~ -(~-1'O
8, a. Amount of impact (including all clearing, back fill, excavation, rip rap,
retaining walls, etc.) above the normal ool la a level and 50 feet land-ward i~,
square feet or acres:. ~'-{ ~C 'a-L4 ~y, ~,~ i (1 ~ (~~ 1'1 ~ ~ (_ C
b. Please describe vegetation above the normal pool la$e level and 50 Feet land-
ward to be impacted {number of trees for instance) ~`~S`l-~«~~
ApfSlicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
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Please appraximateiy glcetch the .fiollawing nformatlvn on this plan
~piease pr+ovii~e ~#imensions for each item, sash as ~0 ft. x 100 ft}:.
~~ Ail proposeed vegetatian clearing tprovide dimensions}
~~ Location of rip rap or X11 tc- be place~t above the Full Pond elevation
3) t.ocatian ofi rip rap or fill to be placed below the Fu1! Pond elevation
~~ The location of any proposed structureffi such as but{dings, retaining
watis> docks, etc.
~~ The io~a#on afi any e~c~a~vatan c-r drudging betva~ the l=uii Pond
elevation.
6) Location of construction ace~rss corridors.
Page 1 of 1
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