20161167 Ver 1_Shoreline Stabilization_20161128

20161167
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 he U.S. Army Corps of Engineers Permit GE30. This Application cannot be used
for vredand or stream impacts. Please provide Pave (S) copies of this application and supporting
information as well as a non-refundable application fee to the Division of dater Quality of $I240.00
for impacts to lake bottom of less than 1 acre and $570.00 for impacts to lake bottom of greater or
equal to k acre.
Applicatrions should he sent Otto:
division o= 701ateruali G0
� ty - Oversight/Express Review Perrraitting � (� � Q�
1650 NA-aff Service Center ?10�
Raleigh, NC 29699-1650 Applicant linformatioaa NU V g 2
Owner/Applicant information
Name: �� _►
Mailing
Tele -Phone Number: 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: � Q
Company Affiliation: Cuc c -� O (\
Mailing Address: � a , C
Telephone Number:
---�' Fax Number:
E-mail Address: rPYIP/YmI t)v\ c l' _ /- _ , _ ;
1. Project Laormation
Attach a vicinl@y 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. �'ou 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. ^r_ he footprints of all buildings, impervious surfaces, or other
facilities must be included.

1. Location
County: re— d ,eA \ Nearest Town: �) 6N 1 & 0 r)
Subdivision name or site address (include phase/lot number): Lc,+ Oa H (p MeA gn r- L,
Directions to site please include road numbers, landmarks, et.(This is no necessary if anadequate
vicinity map is included): o o [1 rp
2. Describe the existing land use or condition of the site at the time of this application: Ros % cp-n Ce,
3. Property size (acres): • 10
4. Nearest body of water (stream/river/sound/ocean/lake):
5. Describe the purpose of the proposed work:llt\ �,:� �\ "., , A
6. List the type of equipment to be used to construct the project: )Oob COA_ S Y� LA Sneer frac-
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below the
`l '
normal pool lake level in square feet or acres:
I
-111 � . -��-
8.a. Amount of impact (including all clearing, back fill, excavation, rip rap, retaining walls, etc.)
above the no al pool lake level and 50 feet land -ward ins quare feet or acres:
1 MA , 1 -, h�-AXn � i s�
8.b. Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instance): �� , ►� C� v i n Sri -�ype_s
- 1 .[Z%,,t- t'V4_"_60 1 \ -\ ' (O
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

a� = � "
J k.

Bing Maps - Directions, trip planning, traffic cameras & more
V bing .
A Mooresville
9 146 Medford Ln, Troutman, NC 28166
Harris
Page 1 of 2
32 min, 15.4 mi
Light traffic (30 min without traffic)
Via I-77 N, US -21
A Mooresville
'r
1.
Depart W McLelland Ave toward S Academy St
0.9 mi
2.
Bear left onto NC -150
1.8 mi
5.4 mi
Q
3.
Take ramp right for I-77 North toward Statesville
Pass Days Inn on the right in 0.1 mi
N
4.
Take ramp right
0.2 mi
5.
Turn left onto US -21 N / NC -115 N
2.9 mi
6. Turn left onto Wagner St
7. Road name changes to Perth Rd
8. Bear right onto State Park Rd
9. Turn left onto Morrison Farm Rd
10. Bear right onto Medford Ln
11. Arrive at Medford Ln
The last intersection is Stillwater Rd
If you reach Seekirk Dr, you've gone too far
0.8 mi
0.7 mi
1.4 mi
1.1 mi
0.2 mi _.
B 146 Medford Ln, Troutman, NC 28166
These directions are subject to the Microsoft,k Service Agreement and are for informational purposes only. No guarantee is made regarding their completeness or accuracy.
Construction projects, traffic, or other events may cause actual conditions to differ from these results. Map and traffic data ,z, 2016 HERE'".
https://www.bing.com/mapspreview?FORM=LGCYVD 11/21/2016

ConnectGIS Feature Report Page 1 of 1
Iredell4&COVV CT^ J
Printed November 21, 2016
See Below for Disclaimer
Addresses
Infrastructure
NonResidential Use
Residential Use
Streets
Interstate
Ramp
—US Hwy
State Hv- y
— Main Road
�.:
�.Local Road
-- Residential
Private
11 — Inactive
Parcels Hooks
Parcels
El
-� City Limits
�ake :,orman
r —
J ° a Iredell Countyline
c
L_,
NC Courties
N /
S 1 : 64 Feet
i'
he maps prepared for this website are generated from recorded deeds, plats, and other public records. Users of these maps are hereby notified that the information
rovided herein should be verified. Iredell County assumes no legal responsibilities for any of the information contained on this site. Users are advised that the use of an
f this information is at their own risk. All maps on this site were prepared using a 1000SE— Grid based upon the North Carolina State Plane Coordinate System from the
1983 North American Datum. The delinquent real property tax overlay is updated monthly. The information presented is not intended to be used or relied upon as official
otice of tax liens. For additional information regardinq delinquent taxes, contact the Iredell Countv Tax Collector's Office.
http://iredell.connectgis.com/DownloadFile.ashx?i=_ags_map 152576c8291498911077... 11/21/2016

JXL
7F yc ��wgT+fY ,x jf, fi'
AIN
CA, d.^ Y�dsR Ailw
���-�Y f� ',�#.y,F•'�:., �', ��-ro si'
1 i
r
%: .t� .``e1,•�� l �}`{�,h�$i��',�p/yj �lx.� m.�,s '�t�'•p'. �\ `�y�s�y � "�

r '
F