20071872 Ver 1_401 Application_20071107

DUKE POWER LAKE MANAGEMENT, EC12-Q
P. O. BOX 1006
CHARLOTTE, NC 28201-1006
704-382-1567 OR TOLL FREE 1-800-443-5193
APPLICATION FOR PERMIT TO STABILIZE THE SHORELINE IN NORTH
CAROLINA
Please type or print and fill in all blanks. If information is not applicable, so indicate by placing N/A in
blank. PLEASE SUBMIT APPLICATION AND APPROPRIATE DUKE POWER FILING FEE, PAYABLE
TO DUKE POWER, TO ABOVE ADDRESS.
1. Applicant Information
A. Name
B. Mailing Address
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C. Telephone ~a y _ ~ 7~ _ ~ CPo ~
11. Location of Proposed Project
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A. Lake
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B. Street Address
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C. County
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D. City, Town, Community or Landmark e~
E. Section Lot # Subdivision
F. Directions to property by road
5() Inf - ~ a ~f Doz.. ~. ~t 6'?~ ~e.~'n
G. Latitude and longitude for the project site ~5 , ~~~ _ l
H. Please submit a map showing the coordinates or a detailed map/ (USGS ~ d map, city map,
etc_) showing the exact location of the project site. (NOTE: Latitude/iongitude~cpo~'d' a ~
be found on Internet site, www.maosonus coin. Directions: Don't register, c Ir '"l~ ~ ~: ~ ~ r7't':~"'- i
address, draw map, select "Map Clicking Will... ", select "Lat/Long", click ma ~~`~°" ~ °~ 3 s~~~ t ~~~ ~~gg
i ~ I
111. DescrlptionofProject e C~:t~U ;'~ Z0~17
A.
B
C.
Length of wall ~ ~ 2 ~
Material
Distance from property
IV. Intended Use of Project Area

ne ~ r -
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A. Private X
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B. Commercial _ __ _ . _ __ - -
V. Applicant Signature jkA~ ~ /
Date ~U _ ~~'~
PLEASE NOTE THE FOLLOW/NG:
• A COPY OF THE COMPLETE APPLICATION WITH A ROAD MAP SHOWING LOCATION OF THE PROPERTY MUST BE SUBMITTED TO: US
ARMY CORPS OF ENGINEERS, 151 PATTON AVENUE, ROOM 208, ASHEV/LLE, NC 28801-5006
• A COPY OF THE "DUKE POWER APPLICATION FOR PERMIT TO STABILIZE THE SHORELINE IN NORTH CAROLINA" AND SEVEN (7}
COPIES OF THE COMPLETED "NC DIVISION OF WATER QUALITY PRE-CONSTRUCTION NOTIFICATION APPLICATION" MUST BE
SUBMITTED WITH THE DIVISION OF WATER QUALITY APPLICATION FEE TO: NC D/V/S/ON OF WATER QUALITY, ATTENTION: Cyndi
Karoly, PARKVIEW BLDG., 2321 CRABTREE BLVD., RALEIGH, NC 27604, PHONE: [phone]

401 WATER QUALITY CERTIFICATION APPLICATION
The following is an abbreviated application farm for those applying fora 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 we8and or stream impacts.
Please provide seven (7) copies of this application and supporting information as well as a non-
refundable applica#ion fee to the Division of Water Quality of $200.00 for impacts to lake bottom of less
than 1 acre and $475.00 for impacts to lake bottom of greater or equal #01 acre.
APPLICATIONS TO BE SENT TO:
DIVISION OF WATER QUALITY WETLANDS UNIT
1650 MAIL SERVICE CENTER
RALEIGH, NC 27699-1650
1. Applicant Information
Owner/Applicant Information
Name Robbie Tilley
Mailing Address 172 Beaverbrook Road
Statesville, NC

Telephone Number 704872-6606
Fax Number
E-mail Address

2. Agent Information {A signed and dated copy of the Agent Authorization fetter must be attached
if the Agent has signatory authority for the ownerlappiicant)
Name Mark Lancaster
Company Affiliation Lancaster Custom Dock and Sfiorelines
Mailing Address 1156 Perth Road
Troutman, NC 28165

Telephone Number 704-b28-7400
Fax Number 704-528-3400
E-mail Address docks~lancasterdock.com
11. Project Information
Attach a vicinity map clearty 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 Aiso, see the example below for guidance_ Both the vicinity
map and site plan must include a scale and north arrow. The footprints of ail buildings, impervious
surfaces, or other facilities must be included.
1. Location
County Iredell Nearest Town Moooresville
Subdivision name or site address (inGude phase/lot number): WA

Directions to site -please include road numbers, landmarks, etc. (This is not necessary
if an adequate vicinity map is included): l.r~n~ .~jy ~~~ ~,~ _ ~„ ~?aj,~- ~

2. Describe the existing land use or condition of the site at the time of this application:
(~> ~I~P ~o ~-
3. Property size (acres): 7 ~
4. Nearest body of water (stream/river/sound/ocean/lake): ~~~„la,~
5. Describe the purpose of the proposed work: ~,. )~~ f - yn
~~ ~ / 7a J ~/ 3 l/_! /!1D
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
q ~ ~ ~~3 .
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:
~ ,( 0202,3 ~
b. Please describe vegetation above the normal pool lake level and 50 feet land-ward to
be impacted (number of trees for instance):
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T-~
Applicant/Agent's Signature ,./' '
(Agent's signature is valid only if an authorization fetter from the applicant is provided)
Date
-~S O~

Lake (Full P©ndj
Full Pond
Shoreline
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a
Please approximately sketch the following information on this plan (please provide dimensions
for each item, such as 10 ft. x 100 ft.):
1) AI! proposed vegetation clearing (provide dimensions)
2) Location of rip rap or fill to be placed above the Fuil Pond elevaYwn
3) Location of rip rap or fill to be placed below the Full Pond elevation
4) The location of any proposed structures such as buildings, retaining walls, docks, etc.
5) The location of any excavation or dredging below the Full Pond elevation.
6) Location of construction access corridors.
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Name: Robbie Tilley
Mailing Address: 172 Beaverbrook Road
Town & State: Statesville, NC 28677
Lake Address: 543 Kenway Loop
Feet of shoreline and material: 223' Rip Rap
AMOUNT OF FILL ~ a ~ CUBIC YARDS
Elevation 760 ft. Full Pool
Lake Norman Summer Pool 758 ft.
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106 ;00 f00 a00

DIRECTIONS BY ROAD FORM
Lake Use Permit Applicants and Contractors: Ease of locating the proposed project
site can have a big impact on permit processing time. Please complete this form
and return it along with your completed permit application to:
DUKE POWER
C/O LAKE MANAGEMENT - EC 12 Q
P. O. BGX 1~6
CHARLOTTE, NC 28201-1006
1-800-443-5193
Applicant's Name=- Robbie Tilley
Lake Name= Norman
Subdivision Name n/a
Property Section Lot (s)~ 41
City Mooresville County Iredell
State= NC Zip= 28117
Telephone [phone]
Type of Permit
Requested
"Circle":
Private Facility
Commercial Facility
- Excavation
tabiliza
onveyance
Miscellaneous Uses
Directions (from major road or highway): 150W-turn right onto Perth Road-Left
onto Fern Hill Road-Left onto Kenway Loop
Descriptive Structure (~ on Property ~i.e. brick garage, white fence, mobile home,
etc.
543 Kenway Loop
*Note: Please use the Back of this form, if desired, to draw us a map to the site.

543 Kenway Loop, Mooresville, NC -Google Maps Page l of 1
Address 543 Kenway Loop Save trees. Go green!
._~ ~ Mooresville, NC 28117 Download Google Maps for mobile
Text maps to 46645 3
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