20160866 Ver 1_Shoreline Stabilization_20160902

DUKE ENERGY EXCAVATION PERMIT APPLICATION FORM
20160866
FOR DUKE ENERGY USE ONLY
Duke File No.
Application Fee $ Security Deposit $
Check 4 Date Recv'd
Date of Duke Energy Lake Services, applicant and/or contractor on-site inspections Date
Date Final Protection/Avoidance Area Markings Field - Verified
Approved to Start Work By * :
Date Completion Required
Date Passed Closeout Inspection*
(Print)
Date of Any Approved Extension
Initials
(sign)
Initials
Any Stop Work Orders or SMG Violations*? (check one) OYes ONo (If Yes, explain in PART V)
Date Deposit Refunded Initials Date Permit Database Updated Initials
* Forward copy of approved application (all pages, plus any attachments that Duke Energy changed) back to applicant
with Approval Letter and highlight any changes. File copies of Approval and Close-out Checklists and any Stop Work
Orders with application.
PART L - APPLICANT INFORMATION (Please Print) Ari
Nam.(' A A e_ . C� p,K C.'_/J V 4 M ICAA LL,L- Telephone v 0 73 5 . e� % /
Lake Address e( n /. /� Dr ' Mailing Address --Nq
(If different) r- '
2 rrzliT/J C x-86 I I © �i4sT Ii ST
i pier
Contractor Company 1[Y,
ntrA l (-rteam 5eAw.3 5&ricclLLC X381%kcri
Contractor Contact Person Cl u b -bi 1 Che- 9 Telephone
KA -Wm
S�i:11e AFL �811,'5-
5(11 t
LAKE LOT INFORMATION f
Lake ar m�/� County AT A W 6 A City 1 -- L `rreW State _ Tax Map No.
Subdivision I r Z� b 5 � r' I, PY'c P Lot / Section No. 3 Lot Size 4 4O Acres
Are there any Co -Applicants*? (check one) OYes ONo (If Yes, include names, addresses, phone nos., lot nos., lot
sizes in PART V - ADDITIONAL INFORMATION) * Co -Applicants exist when the proposed work is being done under a
single application, will be performed by a single contractor as one continuous project and is done to benefit multiple owners /
lease holders of project -front properties within a single development. The check for the application filing fee and security
deposit should be from the party shown as Applicant and not several checks from the Applicant and Co -Applicants.
Do not continue the application until an on-site inspection has been conducted between a Duke Energy Lake Services
Representative (DELSR) and the applicant and/or the excavation contractor. NOTE. Initializing this portion of the
application by a DELSR in no way constitutes approval or eminent approval of the ezeavadon or any other lake use
permitting activity. .0
Date of on-site inspection ' Initials (Duke Energy) (appheant/contractor)
Duke Energy Page 1 of 14 rev 9/19/14
Excavation Program
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application 113 10.docx

DUKE ENERGY EXCAVATION PERMIT APPLICATION FORM
PART H. - DESCRIPTION OF PROJECT
A. BASIC INFO
1. Type of excavation: (check one) .New excavation Cl Maintenance excavation
2. Purpose of excavation: (check one)Boat Access Channel O Water Intake Channel
Wastewater Discharge Channel O Other (specify):
3. Lake user category: (check one) *nvate OResidential Marina OCommercial Marina
OPublic OOther (spec):
4. Max. Excavation Area Dimensions (ft): Length 60 Width &D Depth S—
(Note: include additional area dimensions if necessary so response to 45 below equals maxarea dimensions in #4)
5. Volume of Excavated Material (TOTAL for the project): (06(. Cubic yards
Type of material removed (applicant determines by field sample if practical): I h Y D ! .5;h-
7.
5 / it
7. Excavation Site ares: Acre (s) Dispossal Site area: 0. Q 9 Acre (s)
8. Total Disturbed Area (including equipment staging area): 40,16 Acre (s)
9. Does the project meet the requirements of the applicable General Permit? (check one) P(Yes ONo
10. Do you claim title to the disposal area? (check one) ?Yes ONo
11. Do you claim title to the equipment staging area? (check one) Ayes ONo
12. Are there any water -treatment facilities within 50 feet of the proposed excavation area? (check one) Oyes 'Q O
(If Yes, specify):r'-
13. How will the excavated material be entrapped and the erosionntrolled? (e.g. ee hed erosio�ontrol pand
disposal area design): 6 G e Y
14. Type(s) of excavation equipment to be used: iT kr4 C ! 10`1 rG14' fNL�Ai-t r
15. Will waters or wetlands be crossed in transporting equipment to or from the site? (check one) Oyes XNo
(ID -S. explain)
16. Will return water re-enter the reservoir? (Check one) OYes *o ON/A (If Yes, specify points) of re-entry and
show on Excavation Area Drawing)
17. Is there an existing facility (e.& pier) that access is being maintained to by conducting the excavation?Yes ONo
(If Yes, specify the existing permit number: If No, include a scaled drawing of the proposed facility). Permit # 7
18. Total planned duration of the VVork (Include first equipment mobil&att excavation through final mitigation measures
complete): START FINISH / �o fb
nth) (Year) SL &M) (Year)
Duke Energy Page 2 of 14 rev 9/19/14
Excavation Program
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application 113 10.docx

DUKE ENERGY EXCAVATION PERMIT APPLICATION FORM
PART 1L (Continued)
B. PROTECTION / AVOIDANCE AREA DESCRIPTION
Complete the following table including all land areas within and immediately adjoining the disturbed area:
ProteWon/Avoidance Areas
(check all that apply)
ADProa.
Identification Method M
Avoid (A) or Mideste (M)
*r
Field ID
Work Area Dwa. ID
Acreage
a. Marshland, swamp, ponds, beneficial
aquatic vegetation or other potential wetlands (circle all
that apply)
J
l
b. Buffer Zones (specify width & source of
requirement)
//�F o ptc y
a Environmental Areas as identified by Duke
Energy
` 11
d. Natural Areas as identified by Duke Energy
, r
�V
e. Historic properties (specify)
L stare or threatened species (spec6)
Duke Energy Page 4 of 14 rev 9/19/14
Excavation Program
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DUKE ENERGY EXCAVATION PERMIT APPLICATION FORM
Protection/Avoidance Areas
(check all that apply)
Approx.
Acreaee
Identification Method M
Avoid (A) or Mideate (Ml
**
Fed ED
Work Area Dwe. ID
e. Buried gas, water, sewer, communications
or electric lines (circle)
lV (tT
h. Impact Minimization Zones as identified by
Duke Energy
I. Other areas requiring specific avoidance,
protection or mitigation (spec6)
* For "Field ID" column, specify entity or person that performed the identification and how it was physically marked (e.g. Duke Energy (John Doe)/Pink and purple -dotted tape,
Corps of Eng. (John Smith)/ yellow flagging). For "Work Area Dwg ID" column, show the symbol that is used on the drawings to identify the protection/avoidance area.
** List and attach mitigation plans
Duke Energy Page 5 of 14 rev 9/19/14
Excavation Program
c:\users\ann\appdata\local\microsoft\windows\temporary internet files\content.outlook\mp7eolj9\c-w excavation application 113 10.docx

DUKE ENTERGY EXCAVATION PERMIT APPLICATION FORM
C. APPLICANT'S SIGNATURES
Arjun Chatterjee and Aimee Wilkin are managing partners of Chatterjee Lake Investments, LLC
Comments:
1'744 zU /jC-
310
Applicant Name (print) Arjun B. Chatterjee—
Applicant Signature*_Z�&722�0
_
�lYi`%. Name(print) Aimee M. Wilkin
;;—.j
(20 Co -Applicant Signature*
c e
Co -Applicant Name (print)
Co -Applicant Signature*
Co -Applicant Name (print)
Co -Applicant Signature*
Co -Applicant Name (print)
Co -Applicant Signature*
Co -Applicant Name (print)
Co -Applicant Signature*
v-re k, /(C
Lot# 3
Dat _2-
Lot -3
Datj 2016 AUG 11
Lot #
Date
Lot #
Date
Lot It
Date
Lot #
Date
*Per my signature, the information provided in this application is correct to the best of my knowledge.
BEFORE YOU MAIL THE APPLICATION TO DUKE ENERGY LAKE SERVICES ENSURE YOU HAVE:
• CHECKED THE INFO THOROUGHLY
• MET ALL REQUIREMENTS FOR A COMPLETE APPLICATION (see cover letter of application package)
• INCLUDED A SINGLE CHECK TO DUKE ENERGY FOR THE APPLICATION FILING PEE AND SECURITY
DEPOSIT
• INCLUDED ALL AGENCY PERMITS OR COMMENT LETTERS AND RESOLVED ALL ISSUES RAISED
• INCLUDED ALL REQUIRED DRAWINGS (INCLUDING PROPOSED FACILTITES), PERMIT #FOR EXISTING
FACILITIES, SURVEYS AND PLANS
• INCLUDED COPIES OF DEEDS AND AUTHORIZATION LETTERS
Duke Energy Page 6 of 14 rev 9/19114
Excavation Program
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application 113 10.docx

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Division of Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SSGP 30-2013
Shoreline Stabilization Application Form
Four copies of the application (including attachments) and the application fee should be sent to:
Division of Water Resources
401 & Buffer Permitting Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
1. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Inf rmation r II
Name: r ee � 6geJi ve_gti'►'IeJ_
Mailing Address: N
g7k-s-r A4 A,%, ri
• 4Y''xA nl 73.6 A Aer ft c-
_11 Trec
Telephone Number(MI" 7;1t) • `7 �� `7 Fax N mber:
'E-mail Address: CJ iN� e- b60 w rr1
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
http://www.saw.usace.army.mil/Portals/59/docs/regulatory/repdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name:
Company Affi iation:L_i CSN _5_-j4 f3 Iox Ti GS k=Lc
Mailing Address: (3 9 O 'ri c- AV_rh W
oDrcS, i (le
Telephone Number: I f-. 660,-,5-111 Fax Number: 70J. 6 (o O.
E-mail Address: rh- !Zg u)A �J 5 P , A►4t*r � • r-)
Person to receive the Certification Approval: ckt j2 %arida c s
11. Project Information [15A NCAC 02H .0502(a) & (b)]
1. Attach a vicinity map (i.e. street map) clearly showing the location of the property with
respect to local landmarks such as towns, rivers, and roads.
2. Provide a detailed site plan showing property boundaries and proposed locations of
vegetation clearing, structures (buildings, retaining walls, docks, impervious surfaces,
FORM: SSGP 10-2013 Page 1 of 4

construction access corridors. you may use the diagram provided at the end of this
application form.
3. Attach a photograph of the shoreline/ buffer proposed to be stabilized. (Include a scale of
H
some sort- a yard stick, shovel handle, etc.)
Location of the property (where work is to be conducted)
County: C A T �"� Nearest Town:
Subdivision name or site address (include phase/lot number):.;cLI
Di ,ections t site - p ease incl de road names and numbers, landmarks, etc.:
40—
Ria-;
r 56 2 5 i Longitude (decimal degrees) eo� / 6 g 7563
Latitude (in decimal degrees) � ,� - � g
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Ye,5 `IcrJt•
6. Property size (acres):
7. Lake/ river/ ocean adjacent to property:
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): t Y O f4 f 5 5
9. Will work be conducted from land? � From water? [P,
10. Total amount of disturbance (including all excavation, backfill, rip rap, retaining walls, etc.)
below the normal pool lake level/ Normal Water Level in square feet or acres:
Cu.
11. Total amount of disturbance (including all clearing, back fill, excavation, rip rap, retaining
walls, etc.) above the normal pool lake level/ Normal Water Level and 50 feet land -ward in
square feet or acres:
12. Please describe the vegetation above the normal pool lake level/ Normal Water Level and 50
feet landward to be impacted (number of trees, for instance): r A55 ) C6u 7// -e_
�5ee DA
%Arjun Chatterjee and Aimee Wilkin for 2016 AUG 11
-�%- Chatterjee Lake Investments, LLC
Owner/Agent's Signature* Printed Name Date
115A NCAC 02H .0502(f)]
'Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 3

Ft
Normz
S
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ft x 100 ft) *:
1. All proposed vegetation clearing
2. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
3. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
4. Location of any proposed structures such as buildings, retaining walls, docks, etc.
S. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
FORM: SSGP 10-2013 Page 3 of 3

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