20150858 Ver 1_Shoreline Stabilization_20150824

SEP -14 -2005 06:13 FROM:DWQ- WETLANDS 9197336893 TO:918284953050
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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 seven M copies of this application and supporting information as well as a
von- refundable application fee to the Iiivision of Water Quality of X200.00 for
impacts of to lake bottom of less than 1 acre and $475.00 for impacts to lake bottom
of greater or equal to I acre.
Applications should be sent to:
Division of Water Quality Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699 -1650
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Applicant Information
1. Owner /Appli cnt Information
Name: LJ,11 c 001c./ C°- 1_�1
Mailing Address:
Telephone Number 36 i - W- h .)� IS— Fax N
ym
ber:
E -mail Address: r 'cflk 1,ck k Ve c i f -- m
2. Agent Infoxnctation (A signed and dated copy of the Agent Authorization letter
must be attached if the,A.gent has signatory authority for the owner /applieaut)
Company .A.ffliation: I 'lIE! r ! 4 z- C ­ s -• LII
Mailing Address:
Z
Telephone Ntunber %- i« - L_ Fax Number: _�
E -mail Address: d� °e�`% ! r� a_ c'_ �; _ a , �c� V � a I
Project Information
Attach a vicinity map clearly showing the locatiou of the property with respect to
local landmarks such as towns, rivers, and goads. 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
P:1 /5
M- 17,-PA05 19:47 MARINE CONSTRUCTION CO 8284953040 PAGE1

SEP-14-2005 06:13 FROM. DWO-WETLRNUS I U;
your project. Also, see the *example Wow for guidance. Both the vicinity map and
site plan must include a scale, and north arrow. The footprints of all buildings,
impervious stufam, or other facilities mw be included.
1. Location
County- Nearest Town:
Subdivision name or site address (include phase/lot number)- /_31 t , ei,,4,
Directions to site please include road numbers, landmarks, etc- (This is not
ne7 cirri an ad uate map is included):
2. Describe the existing land use or condition of the site at the time of this
applicatiog: /4oug E- Q(';'t 571<-Y hl- J-
C-1
3. Property size (acres):
4. Nearest body of water (streamhiver/sound/boeaMake); I's s 4'il"—
5. Describe, the purpose of the ploposed. work: 4t k- 6,,,w -s; If4a
J
6. List the type of equipment to be used to construct the project:
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls,
etc.) below the normal pool lake level if re, fleet or acres:
6_
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8. a. Amount of impact (including all clearing, back U, excavation, rip rap,
retaining walls, etc.) above the Aprma pool I I and 50 feet land -ward
square fee or acres: ro vv, 4-4 c. t�, e-t -Clre t"f ir b-,q) "el
Q CI
b. Please'desofibe vegetation above the normal pool lake level and 50 feet land-
ward to be"impact (number of es for instance):
Applicantl gent's Signal= Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
m^ I ----nmrArz 10• '1-7 MOPTWP i-nN1;TRI ICTION CO 82e4953040 PAGE2

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