20080239 Ver 2_Application_20080214

The following is an abbreviated application form for those applying for a 401 Water Quality
Certit5cation 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 anon-refundable application fee to the Division of Water Quality of $240.00
for impacts of to lake bottom of less than 1 acre and $570.00 for impacts to lake bottom of greater
or equal to 1 acre.
Applications should be sent to:
Division of Water Quality 401 OversightlExpress Review Pernutting
1650 Mail Service Center
Raleigh, NC 27699-1650 D ~ ~ ~ L! V
I. Applicant Information u
FEB 1 4 ?OOg
Owner/Applicant Information
Name: W:I~Jtw. ~Ca.~~c~,~-~ ~rna.r~ wert~N~~U:Z~;~ava~Y~:~.~r„~~.s,
Mailing Address: ~~ ~~ T~~a ~~wry ~ r .
~ ~~~.o IJc, ~ 7ysS
Telephone Number: _ _33C- tisl - 4 7 ~y 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: _ /-~-~~y ~ r~ c.l~w~.a.~
Company Affiliation: ___/~i~~l,.co Co~s~~~~sc..~ .1c
Mailing Address: __~~ q~0a GG.~„~( ~.F~(( NL 7 7~Z'S
Telephone Number: c1(cl 43 3 17-1( Fax Number: ~(R 4 33 ` 4~!!a
E-mail Address: _ ~<i~ c.G,~o ~ ~,. rr . <o ~
II. 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 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 ~s ~„c,l ~ Nearest Town: Les.~~~~a
Subdivision name or site address (include phase/tot number): G r4.y s~~ Po ~~.{-
Directions to site please include road numbers, landmazks, etc. (T'his is not necessazy if an adequate
vicinity map is included): Frl""" ~5er o uL ~~ N°~'~ ~ ~-~d w~ S -~. ~~A ~'
Q-j-, ov~~-o p r ~ ~ z. ra., f 6 r 0.Y.s~-s'~c. poJ.e-~' ~. ~ gi~-3 ~,.~ e.~c(. o ~ I~c+ .
2. Describe the existing land use or condition of the site at the time of this application:
3. Property size (acres): (• 1( A~~~s
4. Neazest body of water (stream/river/sound/ocean/lake): ~.,c.v ~ ~~
5. Describe the purpose of the proposed work: /~~ ~v Q ~p ~"P ~ Stio r~e..l~ ~~
~o Q rr.veh.~' ~'c.r ~-Ler U-ac~ar~ -~+~ S~or~~Jn~
6. List the type of equipment to be used to construct the project: ~~kd~
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below the
normal pool lake level in square feet or acres: q Do sLy ~
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:
8oy sti'
8.b. Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instance): ~~N(o -}~~.~s . No-u.a ~, (a,.,, /mar ~.,r 1 "
40./1~ U L MP~La ye(Y M.~ Kr~YW.~ ~L~4R.`f'C~O /l d~STiir ~~'1C~
Applicant/Agent's Signature Dam
(Agent's signature is valid only if an authorization letter from the applicant is provided.}

Jan 31 08 03;09p
.Tarawiry 3i, 200$
~iilliam Mani Barnard
X91 S Tar>~armary :drive
Greensboro, NC 3'755
336~~45 i. -977
ItE: ~°awali Placement with ltip-Rap
Hyea Lake • Dock 1 i lA
X23 Gxavstone Point Road
I:e35burg, i~C: 27291
p.1
This ictcer is to seY~ve ~ nay authorization for Andy Krichman to serve as my agent to
build ~ ni.ew seawall constructed ©f Rip»Rap an my Lake Property noted abave. T>Sis is a
new seawall needed to prevent further erasion of earth into t~ze lake. [t w-iIl slst~ serve ~
a natural iYaErit for fish and ather wildlife.
Tlti~tllC 5'`OUy
d~~c~r :.~ `~
~%illiarn K. $anxard

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FINAL MAP
M!LTON,TWSP.
CASWELL COUNT`(, NC
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I, ~1tLLtAM CQNWAY tA43DREFfELD CERTIFY Ty
THIS PLAT WAS DRAH~t tll~E?ER 48Y SUPERV tS ~
SURt~EY 'Mt~1€ UNE)1:R ~vU~~R~~SbQN (fi7E~,
T IOE+! RECf~RDED tN 6(?tlK ~ '"",~,.PIk~E
( OTHER ): THAT TH;r 6(£DARk~~ t+~')" ~~~~„
INDICATED A3 C'l)~AN~1 F~ tNF~'f14N F
MB. I 1 X1007, PACE _______; THAT ~ t~A~'~~'~ I
IS IiIOQOO~r;TH~T TH45 P(,AT ~~ ~[~~
WITH G.S. 47-~a AS ~NIENDE~3.1~#~'r't~~`a•~ ~
S I GNATtJRE, REG I ~TR:A~ 1.0N N(•,4~~ ,rte} :~'
"~"~ DAY OF 5~~4~_, A. D. ~wa~} ~,
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ELq ( 125 ~
"0 ANY EAS€MENTS,AGREE~NTS
OR Ai'PARfN7 ON PREMISES.
WITHOUT
>SAR I L Y INDICATE
:RTY.
LEGEND
0 EXISTING IRON
0 IRON PLACED
C] STONE FOUND
X MATHEMAiICAI PT.
'~-- CREEK ,DRAIN OR RD.
OHPL OVERHEAD POWER LINE
OHTL OVERHEAD TELEPHONE U NE
P, P. POWER POLE
W. V. WATER VALVE
F, H. FIRE HYDRANT
TiM TAX MAP' 8 PAGE
TM. 139_g
LAYTON J. EV'~RITT JR.
~B: 27948-~8• I I ~ 1007
AREA BY COORDINATES
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GRAP~i4C SCALE -FEET
FILE KAM-BERN
F 1 NAI MAP