20080641 Ver 1_Shoreline Stabilization_20080407

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: ~is ~Ic'r• ~ /~
Mailing Address:__~c~
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APR 7 2008
DENR -WATER QUALITY
WETLANDS AND 3TDRMWATER BRANCH

Telephone Number: °7~~/-~S -~3oU Fax Number:
E-mai I Address: ~~'ti-~ ~ CI-~ G R L ar,.~ .- ~.o~
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II. Project Information
Attach a vicinity map clearly showing the location of the property with respect to
focal 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
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: __.,_._
Mailing Address: ___
Telephone Number: Fax Number:
E-mail Address:

Address 4637 River Bluff Ct
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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.
Location `A /~~
County: /VI ~CIC IC,J .~•~ Nearest Town: (_.~tR~'o~e
Subdivision name or site add ess (include phase/lot number):
Directions to site please include road numbers, landmarks, etc. (This is not
necessary if an adequate vicinity snap is included):
2. Describe the e fisting land use or condition of the site at the time of this
application: ~Jcc.~ ~ E! r~ i ' ; ~ ~ a~ b ,d ~ re A ,(~ e aw h ~s ws
///~ ~ X /6 ~ z /i ~ ~>/~s cam. ~~
3. Property size (acres): ~. g~j ~ ,/~~~eS
4. Nearest body of water (stream/river/sound/ocean/lake): L~ ~~ ~ e. ~ ~ E
5. Describe the purpose of the proposed work: J"`~~iD~~~~~+~. ~7,~~~ ~ ~ 2AY-io,J
6. List the type of equipment to be used to construct the project: o ~~ar
Amount of impact (including all excavation, backfill, rip rap, retaining walls,
etc.) below the normal pool lake level in square feet or acres: r~ ~c-. -' r_
8. a. Amount of impact (including all clearing, back fill, excavation, rip rap,
retaining walls, etc.) above t//he normal pool lake level and ~0 feet land-ward in
squ re feet o acres: /VO L.lNAr,.•~~v /DD Sa f~'"K ;o~C-,o,,c1 A ~o.~e~ ~~tarc ~,,~
1'X i Oa'
b. Please describe vegetation above the normal pool lake level and 50 feet land-
ward to be impacted (number of trees for instance): ~~~, ~~".~~~ ~,a ; ~ ~.c..,~ci/e ,,,.~ c
h ~~, ~ t. -~ ~ ~ e~ c -~~. ,.:, a / ~'a, `f h .~s ,o re . ~t/~V~.;u„ )a ~,~~ ~ ~{-~. as i ~ <<
Applicant/Agent's Signature ~ ~Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

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f'lea~e pr~sxirr~at~el~ skgt~fti the fcsllo~ing infornr-~ticsn on th"rs plat
(please presvide dire=en~icrns ft~r each item, such as 10 ft. x ~Ob ft}:
ij Al p~rc-pose~f ve~et~~ion cfearin~ tPrarride dimensicsns)
2~ Locaitio~ of rip refs ter f;fl to be pla:~eci above tf~e Fill Pond elevation
~~ Lc~cati4n df rids rap ~r Fflf to k~e fsla~e€1 belav~ the- Full fond elevation
4) The laca~tion of y prer~rased stru~tv~res such as buildings, retaining
walls, stacks, a#~.
~} The l~cation~~rf any exeavatia~ ar dr~dgin~ belo~+r the Fulf P~sn~f
elevation.
6) L~r~atcsn csf cc-ns~truoticsn access +~Qrriii~srs~