20171232 Ver 1_Shoreline Stabilization_20170927

July 20, 2017
2 p 1 T 1 2 32
Division of Water Quality Wetland Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
My signature below authorizes Sonny Tyson of Sonny's Construction to act as my agent to file the
abbreviated application form for 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 GP 30.
t '
7/20/17
Date
Dana Kesslar
3061 Eddleweiss Court
Mars, PA 16046
SEP 2 U
? 2017 10)

The following is an abbreviated application form for those applying for a 40lWater
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 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 Wetland Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
I. Applicant Information
1. Owner/Applicant Information
Name: Dana Kessler
Mailing Address 3061 Eddlweis Court
Mars, PA 16046
Telephone Number: [phone] Alt Number
E-mail address: dana.kessler(cD_arconic.com
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: Sonny Tyson
Company Affilaition: Sonny's Construction
Mailing Address: 186 Vineyard Road
Norwood, NC 28128
Telephone Number: [phone] Fax Number
E-mail address: son nyna.sonnysconstruction.com
11. 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: Stanly Nearest town:
Subdivision name or site address(include phase/lot number)
Albemarle
50023 Horseshoe Trail -Tillery Lake Estates Block 1 Unit 2 Lots 44, 45 & 46
Directions to site please include road numbers, landmarks,etc (This is not
Residential home with grass lawn and natural area (See ilICILIded ina
From Albemarle, NC, East on 24/27
Right on Lake Tillery Road - Left on Horseshoe Trail
50023 will be on the left
2. Describe the existing land use of the site at the time of this
application:
Residential home with crass lawn and natural area
3. Property size (acres): Approx .42 acres
4. Nearest body of water(stream/river/sound/ocean/lake): Lake Tille
5. Describe the purpose of the proposed work:
Replace existing seawall with large rock / rip rap
6. List the type of equipment to be used to construct the project:
Excavation equipment
7. Amount of impact (including all excavation, backfill, rip rap, reatining walls,
etc.) below the normal lake pool level in square feet or acres:
765 Square feet
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:
7,650 Square feet
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.
No veaetation to be affected.
September 18, 2017
Date
(Agent's signature is valid only if an authorization letter from the applicant is provided)

Lake (Full Pond)
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.

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Prop" Record Card
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Tax Record:
1965
PIN:
657602561650
OwnerNave: KESSLER DANA B
owner Marne 2.
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Ma4iN Address:
3061 EDELWEISS CT
Mading Address 22
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Cry:
MARS
State°
PA
ZIP:
16046
Phyrskal Address:
more 5=3 HORSESHOE TR
Results

Dana Kessler
50023 Horeshoe Trail
Albemarle NC 28001
50023 Horseshoe Trail -Tillery Lake Estates Block 1 Unit 2 Lots 44, 45 & 46

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50023 Horeshoe Trail
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n Lake Tillery Road - Left on Horseshoe Trail
Nill be on the left