20150335 Ver 1_401 Application_20150406

2 0 1 5 0 3 3 5
The following is an abbreviated application fo s fo�ItkhO�slglylng for Cefi° �l�a�tioaa to impact SRC (I ecle� -a➢ Eger gam' - a 401 Water Quality
bottom under the U.S. Army Corps of Engineers Permit G 0 ssApplicatiotae Canlake g be used
for wetland or streams impacts, please provide gave (5) copies of this application and supporting d
information as well as a non - refundable application fee to the Division of Water Quality 2
for impacts to lake bottom of less than i acre and $570.00 for impacts to lake bottom of r
equal to 1 acre. $ 4Q.QQ
greater or
ApplicatIORS ,should be sent tog
Division of Water (Quality 401 Oversight/Express Review permitting
y 6SQ rl/gail Service Center
Raleigh, NC 27699 -1650
1. Applicant hformai-iorn
owner /Applicant information
Na. me•
wiling Address
L
Telephone Number:
E -mail Address Fax Number
rAPR o s 2015
2• Agent information (A si,,ned and
if the Agent has signatory authority for dthe owner/appllii�arit.) rizatlon letter must be attached
Narr_e (v Jl r". — , / _ — I .
Company AfflIiationl:
Mailing Address. CG U
Telephone Number: �� -"7 �! - _ _ U t u ,
S ( Fax Number:
E -mail Address• ti-.v x, L I _ .
no
-U. project information
Attach a vicinity map clearly showing the location of the property with respect to local
as towns, rivers, and roads. Also provide a detailed site plan showin Pro
development plans in relation to surrounding landmarks such
hand sketch of our project. Properties. You may use the diagram below make a
b ro ernes. Y
plan must include a c ale and north arrow T_he Poo bunts, for guidance. Both the vicinity ma
facilities must be included footprints of all buildings, impervious surfaces, rl other
9'035__%

1. Location
County: l (I 1 x a ( Nearest Town.
Subdivision name or site address (include phase/lot number)- 447_3 j Cis. k d Icc L1 110_
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 site at the time of this application-
3 Property size (acres)- o i (, r r& <F,
4 Nearest body of water ( stream /river /sound/ocean/lake) _ h c Kn
5 Describe the purpose of the proposed work. PS- " ° : ,
S7 11:� ! J !fX -e,
6 List the type of equipment to be used to construct the project. "n i n! x�c�c�. tr r ���h «�
7 Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below the
normal pool lake level in square feet or acres: -Z o
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). - y e t= _
Applicant/A(gent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

Print - Maps
Page I of 2
bing Maps !My Notes
A
Mooresville, NC
B
4736 Crystal Falls Ave, Hickory, NC 28601
Route 55.3 mi, I hr 6 min
m bing com i:-,n—i
A
Mooresville, NC
A—B: 55.3 mi
1 hr 6 min
1 Depart W McLelland Ave toward S Academy St
09mi
2 Bear left onto NC -150
18mi
3 Take ramp right for 1-77 North toward Statesville
Pass Days Inn on the right in 0 1 mt
153mC
15 min'
4 At exit 5113, take ramp right for 1-40 West toward Hickory
26 0 mi,,
24 min
5 At exit 126, take ramp right toward Newton Hickory
02mi
6 Turn right onto McDonald Pkwy SE
0.9 mi
A
7 Keep straight onto McDonald Pkwy NE
0.7 mi
t
8 Road name changes to McDonald Pkwy SE
240 ft
t
9 Road name changes to McDonald Pkwy NE
1 4 m
10 Keep straight onto 24th St NE
0.4 mi
11 Bear left onto 29th Ave Dr NE
1 1 mi
(0
12. Turn right onto 16th St NE
1.3 mi
13 Bear left onto Cloninger Mill Rd NE
1 1 mi
Exxon on the comer
14 Turn right onto NC -127 / N Center St
1 7 m
Hess on the comer
4)
15 Turn left onto Rink Dam Rd
02mi
httpllwww Bing comlmapslprint.aspx?mkt--en-us&z=10&s=T&cp=35.700860,-81.077469.. 3/31/2015

Print - Maps
t 16 Keep straight onto Hubbard Rd
Y 1 Turn right to stay on Hubbard Rd
18. Road name changes to Icard Dam Rd
19 Turn left onto Crystal Falls Ave
B 20 Arrive at 4736 Crystal Falls Ave, Hickory, NC 28601
The last intersection is Rio de Luna
Page 2 of 2
06mi
1 3 mi
0 1 mi
02mi
Thesa directions are subject to the Microsoft© Service Agreement and for informational Purposes only No guarantee is made regaroing their completeness or accuracy
Construction projects traffic or other events may cause actual conditions to differ from these results Map and traffic data @ 2015 NAVTEQ-11
http• //www.bing com/maps/Pnnt.aspx?mkt--en-us&z--10&s=r&cp=35 700860,-81.077469... 3131/2015

Printing Layout Page
Caldwell Countv Mannin
tOr�i r -
19 3)'
it 11 1 5OA V S 7
� %
to 5M
6 !
1 f
1 O74�re ��
\4707, , 6646 f 1 l�l f � 12�,,>4 %
81 ` C ��.� / 7651 3.9 , z � 5i Qs t''� -��'� r
1 09A
4306\ 1\
3 :390 pl 6] �1 -G `,� �1 , 4737 `O '
t�l \ �'� 687
jjj
3 128 ` �` 4725 9264 �� kv " -- "
4 ©2 ``� �`� `' 723 \8242'
- } ��
Ifl v
:3012
i v 421°
4824110 FIB 23 /PG 1
a
� � t
4843
63 63 491
�.t
131A 5871/�r�
i 43-43 L
Page 1 of 1
I UM i - GVV LGGL
This map Is prepared for the inventory of real property found within this jurisdiction, and is compiled from recorded deeds, plats, and other public records and data Users of this map are hereby notified that the
aforementioned public primary information sources should be consulted for verification of the information contained on this map Caldwell County and its mapping and software contractors assume no legal responsibility
for the information contained on this map or in this websrte This map and information are NOT of land survey quality and are NOT suitable for such use
http•/ /gis.caldwellcountync.org/niaps /layout aspx 1/11 / ?n15

Printing. Layout Page
Page 1 of 1
This map is prepared for the inventory of real property found within this jurisdiction, and is compiled from recorded deeds, plats, and other public records and data Users ofthis map are hereby notified that the
aforementioned public primary information sources should be consulted for verification of the information contained on this map Caldwell County and its mapping and software contractors assume no legal responsibility
for the information contained on this map or in this website l his map and information are NOT of land survey quality and are NOT suitable for such use
http: / /gis caldwellcountync org /maps /layout aspx I/11 /1)n1 5

Printing: Layout Page
Page 1 of 1
I inch = 100 feet
This map is prepared for the inventory of real property found within this jurisdiction, and is compiled from recorded deeds, plats, and other public records and data. Users of this map are hereby notified that the
aforementioned public primary information sources should be consulted for verification of the information contained on this map. Caldwell County and its mapping and software contractors assume no legal responsibility
for the information contained on this map or in this website. This map and information are NOT of land survey quality and are NOT suitable for such use
http://gis.caldwellcountync.org/maps/layout.aspx
3/31/2015

R
W
� R ,
i
1.
S '