20080962 Ver 1_Application_20080613

08-0962
The following is an abbreviated application form .fox those applying for a 401 Water
Quality Certification to impact FERC (Federal Energy Regulatory Commission)
regulated lake shore or bottom under the U.S, Array Corps of Engineers Perzait
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 I acre and $475.00 for impacts to lake bottom
of greater or equal to I acre. ,
Applications shame--sent to:
Division of Water Quality Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-X650
L Applicant Information
1. Ownez/,Applicaut
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Mailing Address:_ b s ??? ?t G f v,i?l1 o n
S6LA (JoAr, 59?--
Telephone Number:
E-mail Address:
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Hyco t peke;
R 1 5,, seh d [phone]
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Aee'g illry Branch
e
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US Army Corps
of Engineers 6508Falls of Neuse Road
SOa 120
Wilmington District Ralogh, NC 2761 5-68 1 4
r7AX ?`!6 58 3
FJ'2?154 seAl pkF J oak fnM leytS ; CA
Fax Number:, q 3' - S 7 S'- IF ? ?
t
2. Agora 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:
CompaAy Afl`zliatiom:
Mailing Address:,
Telephone Number: Fax 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
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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.
I
Location
County: f.A S Lj l 1 Nearest Town: a ti 6 /^
Subdivision name or site address (include phaseilot number): Z(d
Directions to site please include road numbers, landmarks, etc. (This is not.
necessLary if an adequate vicini/tfyY map is included): f / o a.k L e . o ^ f ") N' +i ^^?-c F t
/l a L-+' o? d't
2. Describe the existing land use or condition of the site at the time of this
application: wc-4,E_ L-d (like
3. Property size (acres):
/h k
4. Nearest body of water (stzeam/river/sound/ocean/lake): N4 C-')
5. Describe the
6. List the typo of equipment to be used to construct the project: 4--L'4,4-
7.
Amount of impact (including all excavation, baakfill, ,rip rap, retaining walls,
etc.) below the normal pool lake level in square feet or acres: /oft ,, Z o .;' t?'7
8. a. Amount of impact (including all clearing, back fill, excavation, rap rap,
retaining walls, etc.) above the normal pool lake level and 50 feet land-ward in
square feet or acres:?.9_ f J f
b. Please describe vegetation above the normal pool lake level and 50 feet land-
wlyd to be impacted (number of trees for instance). .s

Applican Agent' .ignature 7-1 Date
(Agent's signature is valid onl n authorization letter from the applicant is provided.)
DEAN JONES CONSTRUCTION
"THE PREFERRED CHOICE"
40 S. OAK COVE DRIVE VA Class A #2705-066874A
SEMORA, NC 27343 NC Lic. #51189
Cell: 434-579-5665 ?w Building in NC and VA
Office: 336-599-0915 air including Hyco Lake,
Fax: [phone] Kerr Lake and Lake Gaston
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Please awaximately. sketch the fagomfmg trtfomaeion on Mis plan
:lease provide 4ftenslons ror .eatb Mem, sucb"10 In. x ICO ft):
1) A' proposed vege4dion -cieartn9 tprovide +dh aenstons)
2) Location cd rip cap gar fill to !be pled above the FdH Piond cleva ion
S) Lmezttom of tip rap Qrfill to be ptated belowthe Fum Pond e1eva%lon
4) The !location of + (propose stresctw.. es. suer as 1uildins, retaln)n
wa'6s, d"Iks, CU.
6) ?-he tocation of any uravation or &edging below the 'Full. Pond
elevation. .
66) Location of construction mess c.arrldors.