20170514 Ver 1_Shoreline Stabilization_20170426

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The following is an abbreviated application form for those applying for a 401Water
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 $240.00 for
impacts of to lake bottom of less than I acre and $475.00 for impacts to lake bottom
of greater or equq] to >� e.
FA
Applications should be sent to:
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Division of Water Quality Wetland Unit 2 0 1 7 0 5 1 4
1650 Mail Service Center APR ' 6 2017
Raleigh, NC 27699-1650 ___
I.
11.
Applicant Information
1. Owner/Applicant Information
Name: Bert Baker (Camp Baker LLC)
Mailing Address 6907 Ancient Oak Lane
Charlotte, NC 28277
Telephone Number: [phone] Alt 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:
Company Affilaition:
Mailing Address:
Telephone Number:
E-mail address:
Project Information
Fax Number
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: Stanly Nearest town: Albemarle
Subdivision name or site address(include phase/lot number)
25116 Strand Drive (Portion of Hearn Tract #2 N Albemarle #1 Township
Directions to site please include road numbers, landmarks,etc (This is not
Residential home with grass lawn and natural area ( See inc 1 Uded map)
From Albemarle Easy on 24/27
Left on River Haven Drive, continuing on straight on Strand Drive
Property on right (2.3 miles)
2. Describe the existing land use of the site at the time of this
application:
Residential home with grass lawn and natural area
3. Property size (acres): .78 acres
4. Nearest body of water(stream/river/sound/ocean/lake): Lake Tillery
5. Describe the purpose of the proposed work:
Stabilize shore line e--� '
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6. List the type of equipment to be used to construct the project:
Excavating and carpenter tools
7. Amount of impact (including all excavation, backfill, rip rap, reatining walls,
etc.) below the normal lake pool level in square feet or acres:
1500 q ft
8. a.Amount of impact (including all clearing, backfill, excavation rip rap,
reatianing walls, etc.) above the normal pool lake level and 50 feet landward in
square feet or acres:
2400 sq ft
b. Please describe vegetation above the normal pool lake level and 50 feet land-
ward to be impacted(number of trees for instance):
Natural area covered with grass and vegetation.
Applicant/Agents's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided)

Lake (Full Pond)
Remove and replace existing seawall
1500 sq ft below full pond
2700 sq ft above ' ..
4200 sq ft 1
Ft
230 feet of rip -rap to be
installed on water front
2 to 1 slope
Repair I replace 70
feet of seawall
Rip rap 2 to 1
cinnn r%n lake side
Shoreline
(Lake Tillery)
Existing pier
Please approximately sketch the following information on this plan
(please provide dimensions for each item, such as 10 ft x 100 ft)
1) All proposed vegetation clearing (provide dimensions)
2)Location of rip rap or fill to be placed above the full pond elevation
3)Location of rip rap or fill to be placed below the full pond elevation
4)The location of any proposed structures such as buildings, retaining
walls, docks, etc
5)The location of any evacuation or dredging below the Full Pond
elevation.
6)Location of construction access corriders.

Bert Baker (Camp Baker LLC)
6907 Ancient Oak Lane
Charlotte, NC 28277
16 Strand Drive (Portion of Hearn Tract #2 N Albemarle #1 Town

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[6907
ert Baker (Camp Baker LLC) From Albemarle Easy on 24/27
Ancient Oak Lane Left on River Haven Drive, continuing on straight on Strand Drive
harlotte NC 28277 Property on right (2.3 miles)