20080098 Ver 1_Shoreline Stabilization_20080114

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The following is an abbreviated application form 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 wetland or stream impacts. Please
provide seven (7) copies of this application and supporting information as well as a
non-refundable application fee to the Division of Water Quality of $200.00 for
impacts of to lake bottom of less than 1 acre and $475.00 for impacts to lake bottom
of greater or equal to 1 acre.
Applications should be sent to:
Division of Water Quality Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
I. Applicant Information
1. Owner/Applicant Information
Name: ~~ t!~. ~
Mailing Address:
Telephone Number:
E-mail Address: ~
~~
9 ~ ~~
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Fax Nurrtber: S ~t.-l ~ '-~
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2. Agent Infornlation (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Company Affiliation:
Mailing Address:_
Telephone Number:
E-mail Address:
IL Project Information
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
Fax Number:

4
US Army Corps Of Engineers Field Offices and County Coverage
Asheville Regulatory Field Office Alexander Cherokee iredell Mitchell Union
US Army Corps of Engineers Avery Clay Jackson Podc Watauga
IS1 Patton Avenue Buncombe Cleveland Lincoln Rowan Yancey
Room 208 Burke Gaston Macon Rutherford
Asheville, NC 28801-5006 Cabartus Graham Madison Stanley
Telephone: [phone] Caldwdl Haywood McDowell Swain
Fax: [phone] Catawba Henderson Mecklenburg Transylvania
Raleigh Regulatory Field Office Alamartce Durham Johnston Rockingham Wilson
US Amry Corps bf Engineers Allegheny Edgecombe Lee Stokes Yadkin
6508 Falls of the Neuse Road Ashe Franklin Nash Surry
Suite 120 Caswell Forsyth NorUrarrytton Vance
Raleigh, NC 27615 Chatham Granville Otange Wake
Telephone: [phone] Davidson Guilford Person Warren
Fax: (919) 87(x5283 Davie Hahfax Randolph Wilkes
Washington Regulatory Field Office Beaufort Cuuituck Jones Pitt
US Army Craps Of Engineers Bertie Dare Lenoir Tyrrell
Post Office Box 1000 Carttden Gates Martin Was}iington
Washington, NC 27889-1000 Carteret' Green Pamlico Wayne
Telephtone: [phone] Chowan Hertford Pasquotank
Fax: [phone] Craven Hyde Perquirnans 'Craatan National Forest Only
Wilmngton Regulatory FieM Office Anson ~ Duplut Onslow
US Army Corps Of Engineers Bladen Harnett Pender
Post Office Box 1890 Bnmswick Hoke Richmond
Wilmington, NC 28402-1890 Carteret Montgomery Robeson
Telephone: (910) 251~IS1 l Columbus Moore Sampson
Fax: [phone] Cumberland New Hanover Scotland
US Fish and Wi(dl"de Service /National R9a tine Fisheries Service
US Fish and Wildlife Service US Fish and Wildlife Service National Marine Fisheries Service
Raleigh Field Office Asheville Field Office Habitat Conservation Division
Post Office Box 33726 160 Zillicoa Street Pivers lsland
Raleight, NC 27636-3726 Asheville, NC 28801 Beaufort, NC 28516
Telephone: [phone] Telephone: [phone] Telephone: (2S2) 728-5090
North Carolina State Age ncies
Division of Water Quality Division of Water Quality State Historic Preservation Office
401 Wdlands Unit Wetlands Restoration Program Departrncnt Of Cultural Resources
1650 Mail Service Center 1619 Mail Service Center 4617 Mail Service Center
Raleigh, NC 27699-1650 Raleigh, NC 27699-1619 Raleigh, NC 2 7 699136 1 7
Telephone: [phone] Telephone: [phone] Telephone: [phone]
Fax: [phone] Fax: [phone] Fax: [phone]
CAMA and NC Coastal Counties
Division ofCoastal Management Beaufort Chowan Hertford Pasquotank
1638 Mail Service Center Bertie Craven Hyde Pender
Raleigh., NC 27699-1638 Brwvswick Cumtuck New Hanover Perqu~man~
Telephone: (9l9) 733-2293 t.antden Dare Chtslow Tyrrell
Fax: [phone] Carteret Gales Yamlico Washington
NCWRC and NC Trout Counties
Western Piedmont Region Coordinator Allegltany Caldwell Watauga
38SS Idlewild Road Ashe Mitchell Wilkes
Kernersville, NC 27284-9180 Avery Stokes
Telephone: [phone] Burke Sung
Mountain Region Coordinator Buncorrrbe Herndersmt Polk
20830 Great Smoky Mtn Expressway Cherokee Jackscm Ruttnerfixd
Waynesville, NC 28786 Clay Macon Swain
'
Telephone: [phone] Graham Madison rarnsylvania
1
Fax: [phone] Haywood McDowell Yancey

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: ~L~('t-t.~t [,~ ~~~ Nearest Town: C- ~~~ r
Subdivision name or site address (include phase/lot number): it rr0 - r o~ O 1 I'1
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 c ndition of the site at the time of this
application: V~~1 Ga N ~~ ~d"~
3. Property size (acres): K ~ ~ G~~--~~ S
4. Nearest body of water (stream/river/sound/ocean/lake): ~ r?I ~,{ I~1"1 C ~~ R--~
5. Descri e the purpose of the proposed work: ~~~ ~ ~~C-~ ~~
~ ~- ~ `~~
6. List the type of equipment to be used to construct the project: ~ ~ ~tA L '~ 'd-
L PJCG.~
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls,
~~'Q ~ ~ etc.) below the normal pool lake level in square feet or acres: °~~ 3 t-0 h Gl
,R i ~ ~
~~°` ~~
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: ~ `I 3 ~ ~ ~~~ ~~ ~ 'f'~ ~
b. Please describe vegetation above the normal pool lake level and 50 feet land-
ward to be impacted (number of trees for instance): Q
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.) ,
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Please appraxirnately sketch the follar~nng information on this plan
(please provide d"tmensians far each item, such as 10 it x 1Qg ft~:
1) Ali proposed vegetation Bearing (provide dimensions}.
2) Location of rip rap a-r fill to be placed above the Fug Pond elevation
3~ Location of riR rap or fill to be placed below the Fu® Pond elevation
4) The location of any proposed stn~ctures such as buildings, retaining
walls, docks, etc.
5~ The location of any excavation or dredging below the Full Pand
eleYatlOn.
6) LOGation of CanstrUCttan aGCess Corridors.
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January 10, 2008
Ian,
Thanks so much for your help on the phone. If I made any mistakes or you need
more information, please call me at: 828-294-1944.
Sandy DiBenedetto