20160099 Ver 1_Shoreline Stabilization_20160201

rZ.
20 160099
The following is an abbreviated application form for those applying for a 4011 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 five (5) copies of this application and supporting
information as well as a non-refundable application fee to the Division of Mater Quality of $240.00
for impacts to lake bottoan of less than I acre and $570.00 for impacts to lake bottom of greater or
equal to I acre.
Applications should be sent to: D O
Dlzdsion of Water -Permitting
Y�t.alaty 441 OversgIMlat/Express Review 7�
1650 Mall 5en4ce Center 16
Raleigh, NC 27699-1650 DEQ- rER r; ;gyp;,
R N� RCF_
11?I G
1. Applicant fnformation
1. Owner/Applicant information
Name: ►La C7 1 �- �� X
Mailing Address:
oE'1 N
Telephone Number: Z Jc % - 212 Fax Number:
E-mail Address:
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: tc Co
Mailing Address: ,SL C
Telephone Number:a�-%�S�- 1Sb1 Fax Number:
E-mail Address: 2.'1 P e --I" 5 (rc{ {� O�1 q ` Cc.; y,
v J
IT. Project Wor-oration
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, see the 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 \ /
County: Bur 1 n Nearest Town: l_sJ e– f i r-) C.,
Subdivision name or site address (include phase/lot number):` �� ��G r ��� 'Lk30(,, Z§0-19d�
Directions to site please include road numbers, landmarks, etc. (This is not necessary if an adequate
vicinity map is included): D Il I 6 E X t� 1 ) 6 �� 0 r' t V, •� I n
•k C Ya r aA *s 8ar�p a'
2. Describe the existing landuseor condition of the site at the time of this application:
3. Property size (acres): l . N P,(:,
4. Nearest body of water (stream/river/sound/ocean/lake): MOAV-, ; !SS
5. Describe the purpose of the proposed work: 7 o Shore L< v�_q
6. List the type of equipment to be used to construct the project: a- S ke—e- -�YG_C_ L Vie.
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below the
normal pool lake level in square feet or acres: 1401 j 0 h_ - C ��(„�, =
8.a. Amount of impact (including all clearing, back fill, excavation, rip rap, retaining walls, etc.)
above
normal pool lake level and 50 feet land -ward in square feet or acres:
` 140
8.b. Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instance): Z � r t,bS
-
Ap . ant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

Tease approximately sketch the following information on this plan
(please provide dimensions for each item, such as 10 ft. x 100 ft):
1) All proposed vegetation clearing (provide dimensions).
2) Location of rip rap or fill to be placed above the Fug Pond -elevation
8) Location of rip rep or fill to be placed below the Full Pond elevation
4) The location of any proposed shvctures such as buildings, retaining
watts, docks, etc.
5) The location of any excavation or dredging below the Full Pond
elevation.
6) Location of construction access corridors.
SIC
abo \je--

Bing Maps Pagel of 3
tv bing rnaps
From: Mooresville 1 hr 15 min, 60.3 mi
To: aollq Dockside PI, Connellys Springs, NC Light traffic
28612 1 hr 11 min without traffic
Notes: Type your route notes here is I-77 N, I-40 W
EO'19+'�s �
(Mooresville
At exit 116, take ramp
5' right toward Icard 0.2 mi
Keep straight onto lump
6' Stillwell Rd 423 ft
http://www.bing.com/mapspreview?msnurl=http%253a%252Plo252fmapblast.com%253a8... 1/26/2016
1 Depart W McLelland Ave
0.9 mi
toward 5 Academy St
2. Bear left onto NC -150
1.8 mi
Take ramp right for I-77
3 North toward Statesville
15.3 mi 15 min
Pass Days Inn on the right in 0.1
mi
At exit 510, take ramp
right for I-40 West toward
4. ii-Ilickory
36.0 mi 33 min
Minor Congestion: At Thornburg
Dr/Exit 132 - Traffic congestion. on
the left.
At exit 116, take ramp
5' right toward Icard 0.2 mi
Keep straight onto lump
6' Stillwell Rd 423 ft
http://www.bing.com/mapspreview?msnurl=http%253a%252Plo252fmapblast.com%253a8... 1/26/2016

Bing Maps
7. Turn right onto Old NC 0.4 mi
Highway 10
$ Turn left onto US -70 / US- 21 mi
701IV
9. Turn right onto Lindsey 0.1 mi
Rd
10. Turn right onto Shady 1.0 mi
Grove Rd
Arrive at Dockside PI
15. The last intersection is
Boardwalk Dr
X-19 -Dockside PI,
Connellys Springs, IAC
28612
These directions are subject to the Microsoft® Service Agreement and are for informational purposes only. No guarantee
is made regarding their completeness or accuracy. Construction projects, traffic, or other events may cause actual
conditions to differ from these results. Map and traffic data 0 2016 HERE".
Page 2 of 3
http://www.bing. comlmapspreview?msnurl=http%253 a%252f%252fmapblast.com%253 a8... 1/26/2016
11.
Keep straight onto
0.9 mi
Tomlinson Loop
Turn right, and then
12.
immediately turn right
1.3 mi
onto E Paradise Harbor Dr
13.
Turn left onto Boardwalk
0.1 mi
Dr
14.
Turn left onto Dockside PI
446 ft
Arrive at Dockside PI
15. The last intersection is
Boardwalk Dr
X-19 -Dockside PI,
Connellys Springs, IAC
28612
These directions are subject to the Microsoft® Service Agreement and are for informational purposes only. No guarantee
is made regarding their completeness or accuracy. Construction projects, traffic, or other events may cause actual
conditions to differ from these results. Map and traffic data 0 2016 HERE".
Page 2 of 3
http://www.bing. comlmapspreview?msnurl=http%253 a%252f%252fmapblast.com%253 a8... 1/26/2016

CT.
e
i'O�®44�
.,sAas�rj4toC:e�:oeeeva:�e:^.ry�`stir /
�
7 •�`r�ae �ca�� ��� ```+' �O ` `,
11 2088
1 j
3J
.00
(312)
��
--(239
Coni i Springs
Cg i !f�
�' r 2i �3i1
�
��� 15
Q�4
(41_
307
S Q5 `� 1

January 24, 2016
Owner: FOX, JAMES E; FOX, JUDITH
13305 PENINSULA DR
AUBURN, CA 95302
Property 2079 DOCKSIDE PL
Address: CONNELLY SPRINGS 28612
PROPERTY_DESC
Burke County, NC
PIN:
PIN EXT:
REID:
Property Value:
Acreage:
Deed Book:
Deed Page:
Deed Date:
2764363304
000
0058868
$106,156
1.84
001503
00119
9/29/2005
0 110 220
t t
Feet
1:1,416
1 inch= 118 feet
Disclaimer: The information contained on this page is taken from aerial mapping,
tax mapping, and public records and is NOT to be construed or used as a survey
or'legal description' Only a licensed professional land surveyor can legally
1:00:00 AM determine precise locations, elevations. lenoth and direction of line. and areas

— Ax,
N V44
o
W, 710