Shealy_Lot1_DWR_RESUBPages.pdf

5. Describe the existing land use or condition of the site at the time of this application (residential,
undeveloped, etc.): K61CUht1w
6. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary): OYtdk �(AVA bed fir loyar ocars. A%Ovig bardyx E
shore ly u w he I nfi d ru wC Y
7. Will work be conducted from land? ❑ From water? K
8. Total amount of impacts below the normal pool lake level / Normal Water Level
Permanent impacts (including all excavation, backfill, rip rap, retaining walls, etc.) in square feet:
4100 IF OY D TIV AfRET
Temporary impacts in square feet:
Nl A
9. Total amount of impacts above the normal pool lake level / Normal Water Level and 50 feet land-
ward
Permanent impacts (including back fill, excavation, rip rap, retaining walls, etc.) in square feet:
MIA-0
Temporary impacts (temporary clearing, construction corridor) in square feet:
+,A
10. Please describe the vegetation above the normal pool lake level/ Normal Water Level and 50 feet
landward to be impacted (number of trees, for instance): d �} - Iu0 USG lh I IKpb wd
11. Signature
By signing below, I, as the project proponent, certify to the following:
• The project proponent hereby certifies that all information contained herein is true, accurate,
and complete to the best of my knowledge and belief
• The project proponent hereby requests that the certifying authority review and take action on
this CWA 401 certific tion request ithin the applicable reasonable period of time
/ tl LpZ
Owner/Agent's Signature' [1SA NCAC 02H .0502(f)] Date
'Agent's signature is valid only if an authorization letter from the owner is provided.
12. Please approximately sketch the following information on this plan and provide dimensions for
each item:
a. All proposed vegetation clearing
b. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
c. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
d. Location of any proposed structures such as buildings, retaining walls, docks, etc.
e. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
North Carolina Department of Environmental Quality 1 Division of Water Resources
..�.D E Q25 512 North Salisbury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27690.1617
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E:North Carolina Department of Environmental Quality I Division of Water Resources
Q§512 North Salisbury Street 1 1617 Mail Service Center l Raleigh, North Carolina 27699-1617
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