20171483 Ver 1_Shoreline Stabilization_20171117

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dEO-WATfiR RESOURCES
Division of Water Quality Wetland Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
483
My signature below authorizes Sonny Tyson , DBA 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.
D
Herb Golden
10565 Kasieville Road
Mercerberg , PA 17236

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 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: Herb Golden Silo' address
Mailing Address 10565 Kasieville Road 421 Tranquil Bay Circle
MercerberE , PA 17236 Norwood, NC 28128
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: Sonny Tyson
Company Affilaition:
Mailing Address: 186 Vineyard Road
Norwood, NC 28128
Telephone Number: [phone] Fax Number
E-mail address: sonnvlaDsonnvsconstruction.com
II. 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)
Norwood
421 Tranquil Bay Circle-Trangil Bay Subdivision Section 1 -Lot 4 & portion of lot 3
Directions to site please include road numbers, landmarks,etc (Iiee Included lap )
In Norwood NC heading South, turn left on PeeDee Avenue
Ri ht on Allenton St, Right on Island Cove Road, Left on Harbor Road,
Right on Tranquil Bay Circle, 421 Tranquil Bay Circle will be on the right
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):
4. Nearest body of water(stream/river/sound/ocean/lake):
5. Describe the purpose of the proposed work:
362 acres
Remove seawall, dredge cove and install rip rap on shore line
6. List the type of equipment to be used to construct the project:
Excavattion e uipment
Lake Tillery
7. Amount of impact (including all excavation, backfill, rip rap, reatining walls,
etc.) below the normal lake pool level in square feet or acres:
8,900 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:
822. s are 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.
Small bushes will be removed
Applicant/AgeatVss Signal&re JIate
(Agent's signature is valid only if an authorization letter from the applicant is provided)

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.

Herb Golden
421 Tranquil Bay Circle
Norwood, NC 28128
421 Tranquil Bay Circle-Tranqil Bay Subdivision Section 1 -Lot 4 & portion of lot 3

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Herb Golden _..._.____...._..�_.�.�...
421 Tranquil Bay Circle
;Norwood NC 28128
Norwood NC heading South, turn left on PeeDee Avenue
ght on Allenton St, Right on Island Cove Road, Left on Harbor Road,
ght on Tranquil Bay Circle, 421 Tranquil Bay Circle will be on the right