20080848 Ver 1_Shoreline Stabilization_20080520

PAYMENT o 8 --
iECERTD o8-0 84s
The following is an abbreviated application form for those applying for a 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
® . - _ D?
MAY 2 0 2008
1. Applicant Information
?1Cf'd?e VVAi ER tJUAL1 f Y ,tn?dt`ti
;rte ?i?NDS ANC's ST?^R??YVAT 8
1. Owner/Applicant Information
Name:
Mailing Address: _5790
19 IVI'b
Telephone Number: O -? - 7 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 sign ory authority for the owner/applicant.)
Name: 4 u--,-J /V
Company Affiliation: u -N N
Mailing Address:
'S? Q nnI Nr
Telephone Number:
E-mail Address: D
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: D 4qb Nearest TowJqqf ' C
Subdivision name or site ad ress (include phase/lot number): -
Directions to site please include road numbers, landmarks, etc. (This is not
n cessa if an adequate vicinity map is included):
2. Describe the existin land use or condition of the site at the time of this
application: ? c A 't
3. Property size (acres):-.* ?Z?
4. Nearest body of water (stream/river/sound/ocean/lake):
5. Describe the purpose of the proposed work: 7iesu rke n j?,0r, 141
6. L'st the type of equipment to be sed to, construct the project: &Amc_,)- AD
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, Ulk r
etc. elpw the normal 99 J 1 e level in are feel m: e ?
8. a. Amount of impact (including all clearing, back fill, excavation, rip rap,
retaining walls, etc.) above the normal pool lake level a0d 50 f fet land-war i
s uare feet or acres: i h1 r1LL C, ft- 4A'? , I- aJ C_
IAq_ .. 1
b. Please describe vegetation above the normal pool lake level and 50 feet 1 nd-
w rd to be im acted (number of trees for instance):n-hMo- _TkTL--S
MOJT L
W, M -? A ,?. *,I
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Applicant/Agent's Signaffrrf ? Datd
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
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Please approximately sketch the Wowing Wormabon on Ws plan
(please provide dimenslons for each Item, such as g ft. x 10 ft):
1) All proposed vegetation clWng (provide dimensions)
.2y Location of rip rap or fill to be placed above the Ftdl Pond elevation
3) Location of rip rap or fill to be placed below the Fug Pond elevation
d) 'Thee location of any ;proposed structures such as buildings, retaining
wails? docks, etc.
6) The Location of any excavation or dridging below the Full Pond
elevation.
6) Location of construction access corridors.
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