20090089 Ver 1_401 Application_20090109

DUKE POWER LAKE MANAGEMENT, EC12-Q
P. 0. BOX 1006 0 9- 0 0 8 9
CHARLOTTE, NC 28201-1006
704-382-1567 OR TOLL FREE 1-800-443-5193
APPLICATION FOR PERMIT TO STABILIZE THE SHORELINE IN NORTH
CAROLINA
Please type or print and fill in all blanks. If information is not applicable, so indicate by placing N/A in
blank. PLEASE SUBMIT APPLICATION AND APPROPRIATE DUKE POWER FILING FEE, PAYABLE
TO DUKE POWER, TO ABOVE ADDRESS. Za"
1. Applicant Information ?` -
A. Name M/,e,0_
B. Mailing Address 2 pyZ ?1v??/S Rol. 0-. C Aar 1*44c ?1/G Z X20 - Z ? L?
C. Telephone 70 y - 372 - ZY07
II. Location of Proposed Project
A. Lake

B. Street Address Z092,f- 2AG0,4.11,4 C. Count svocvi
y Gb? le.- i e v-1 D. City, Town, Community or Landmark eo1,,e_ i of
E. Section Lot # 4 W Subdivision
F. Directions to property by road 77 f to ?6xi f' L8' ? o?v TD Of.*7-A",A.4
b _
e n?T? 6Tw0 [_. CH vA e-H To / O Mr-e Bi S c a ye,e6 7-0 a s?i?-to
04--4 LI . N-ei., lG
G. Latitude and longitude for the project site
H. Please submit a map showing the coordinates or a detailed map (USGS quad map, city map,
etc.) showing the exact location of the project site. (NOTE: Latitude/longitude coordinates can
be found on internet site, wvvw.m?sonus.com. Directions: Don't register, click "Maps", enter
address, draw map, select "Map Clicking Will...", select "Lat/Long", click map)
III. Description of Project '
A. Length of wall Z i a
B. Material l e, it i..,g
C. Distance from property line/shoreline
IV. Intended Use of Project Area
A. Private
B. Commercial
V. Applicant Signature Date 12 •22..,48
PLEASE NOTE THE FOLLOWING:
• A COPY OF THE COMPLETE APPLICATION WITH A ROAD MAP SHOWING LOCATION OF THE PROPERTY MUST BE SUBMITTED TO: US
ARMY CORPS OF ENGINEERS, 151 PATTON AVENUE, ROOM 208, ASHEVILLE, NC 28801-5006
• A COPY OF THE "DUKE POWER APPLICATION FOR PERMIT TO STABILIZE THE SHORELINE IN NORTH CAROLINA" AND SEVEN (7)
COPIES OF THE COMPLETED "NC DIVISION OF WATER QUALITY PRE-CONSTRUCTION NOTIFICATION APPLICATION" MUST BE
SUBMITTED WITH THE DIVISION OF WATER QUALITY APPLICATION FEE TO: NC DIVISION OF WATER QUALITY, ATTENTION: Cyndi
Karoly, PARKVIEW BLDG., 2321 CRABTREE BLVD., RALEIGH, NC 27604, PHONE. [phone]
Directions to site - please include road numbers, landmarks, etc. (This is not necessary
if an adequate vicinity map is included/): ? ? f ? ?x?•h L8 ? e?•? a
?-fF1'i>}N,B e?,rTl 66Ti,l?L C_HY/Q.L!'r ? e NT,? B/ SGA'?? _ _
2. Describe the existing land use or condition of the site at the time of this application:
r2es?dwt/a/ .Cs?' _
3. Property size (acres):
4. Nearest body of water (stream/river/sound/ocean/lake): AVAMA A"
5. Describe the purpose of the proposed work:
.57xa/z,/ z,6 .StFe,a,Ec./.vS _
??/ ??vST)t`c. /•vG R 0/ 2oes-
A141-1- 4//T7#
M,ri?TI.?C / N O,eOF?,e
?"0 GpivT?2(jL L?iQOS /??
6. List the type of equipment to be used to construct the project: 7Q y
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below
3'x 2to'
8. a. Amount of impact (including all clearing, back fill, excavation, rip rap, retaining walls,
etc.) above the normal pool lake level and 50 feet land-ward in square feet or acres:
3 'x 2-t6
b. Please describe vegetation above the normal pool lake level and 50 feet land-ward to
be impacted (number of trees for instance):
kviu
Applicant/Agent's Signature
AAWA .t mot- RFS iDE.?•7 / -a T
22-W
Date
(Agent's signature is valid only if an authorization letter from the applicant is provided)
Ma POWER DIRE, MONS 13Y ROAD FORM
Lake Vse)'ernrit Applicants and Contractors: Ease of locadAg the proposed project site can have a big
unpact oil peruatprocessing time. Please complete this form and return it along with your completed
permit application to:
DUTY PO'WBR
CIO LICE' M NAOEIYNT - UC 12 Q
VO BOX 1006
CHARLOTTE, NC 28201-1006
1-1300-443-5193 or Option 5
Applicant°s rrar> te:_ ?. M KE 14.4 6 u415-
9trect Address (a( lakc): ZD 87+1 Lf?G41tN__ L1 AJ10
r,nice Name
Subdivision Nnaw.,
Ci.ty:-C.??4?./.f.?L__vs-___ County: ?!IEGKG???.?UP6
Stag: -- -- -- Zip; ,r. -- 2- 3 ?
Tr..loplion,e: ----
Directions (from major road or hip, liw ay):
Type of Permit Requested
"Gla'de"Private facility
Commercial Facility
pxcavatiou
bilizati
Convcyaacc
MiSullaneous Usc,
7 7 So yr,i To Ex Vr 2-8 0 s^.?o tr,4?n+wd of
3 9Mf EL (?l?f f12G t-F 13 iset? Ytig
L.A-hoe ? A .
Descriptive Structure(s) On Property'(i.e. brick garage, w}site Pence, zxtobil horric, etc):
HOUSE Zs AF 6 rvo OF S1'-A,5?6T
D^L" Z i6H-F
*Nate: P1eaSe use the back of this form if desired to draw us a map to the slte_
CPAIJI AKPMGMT/WPPM/DIRECTIOM1ADOC F.frrrt;.•^ r` -• '^^
x.t?. TOTAL PAGE-01
401 WATER QUALITY CERTIFICATION APPLICATION
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 to lake bottom of less
than 1 acre and $475.00 for impacts to lake bottom of greater or equal to 1 acre.
APPLICATIONS TO BE SENT TO: A i
DIVISION OF WATER QUALITY WETLANDS UNIT
1650 MAIL SERVICE CENTER
RALEIGH, NC 27699-1650
09-0089
1. Applicant Information
. Owner/Applicant Information
Name /'h I KE rTAGU?
Mailing Address 26,q7_ GPvt S Ad. E
zff *b A -7 - z'>z?
Telephone Number 7d y 372 -eye 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 signatory authority for the owner/applicant)
Name Mark LANCAs--e2
Company Affiliation Lancaster Custom Dock & Shorelines
Mailing Address 1156 Perth Road
Troutman, NC 28166
Telephone Number 704-628-7400
Fax Number 704.628-3400
E-mail Address 1
[e-mail]
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.
Location
County l0eek [ems by Nearest Town Cd t /A e,
Subdivision name or site address (include phase/lot number):
Lake (Fula Pored)
I
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 excavation or dredging below the Full Pond elevation.
6) Location of construction access corridors.
Mecklenburg County, NC POLARIS Page 1 of 1
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Printable reap of 20825 Lagoona Drive, Cornelis, Nc 28031 - Mapsonus.com

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01/21/2009 16:00 704--358-0100 FEDEX KINKO'S 4903
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PAGE 02
THIS IS TO CERTIFY THAT ON THE'.Z7th DAY OF JORU.ar 187,E , I SURVEYED THE
PROPERTY SHOWN ON THIS PLAT, AND THAT THE PROPERTY LINES. WALLS AND BUILDINGS ARE AS SHOWN
HEREON: THAT THE BUILDINGS LOCATED ON SAID LOT DO NOT ENCROACH OR PROJECT ON ADJACENT STREETS
OR PROPERTY: AND THAT NO ADJACENT UILD.INGSi OR WALLS ENCROACH OR PROJECT ON SAID PREMISES.
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