20090604 Ver 1_401 Application_20090509

-09-0604
DUKE POWER LAKE MANAGEMENT, EC12-0
P. O. BOX 1006 2T-LAS TFJh
CHARLOTTE, NC 28201-1006
704-382-1567 OR TOLL FREE 1400-443-5193
APPLICATION FOR PERMIT TO STABILIZE THE SHORELINE IN NORTH
CAROLINA
Please type or print and till 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.
1. Applicant Information
A. Name _ RA D, ??l li 1Z ?r n1
B. Mailing Address 0 3 ?i? on h, 2e D 2 fn1 o?L t??? l? C ?? C a? l 1 '1
C. Telephone IL I
n"rQ
11. Location of Proposed Project MAY 2 1 2009
A. Lake a cm R ri
AS---
t3. Street Address pENR -W _ D 3 phi 2 C 1 !L _. V ow 97OR1
C. County
D. City, Town, Community or Landmark 'good ES u < < C
E. Section Lot # t43 Subdivision h d ad
F. Directions to propert/y? by road _ v) N p Et , } 3 3 ()-)-e , n
(u 1 I /q'Y?` SUl I (Cp - r` / ?' Q :1 , t`Ff? LO/n ?QLC?_ LW • -
9
G. Latitude and longitude for the project site
H. Please submit a map showing the coordinates or a detailed map (USGS quad map, city m p,
etc.) showing the exact location of the project site. (NOTE: Latitude/longitude coordinates can
be found on intemet site, www,mga§gnus.com. Directions: Don't register, click "Maps", enter
address, draw map, select "Map Clfcking Will...", select "Lat/Long", click map)
III. Description of Project
A. Length of wall Z I
B. Material II D
C. Distance from property line/shoreline oil-) C-4 i S 4 -nC S ?aE'r n -e---
IV. Intended Use of Project Area
A. Private X
B. Commercial
V. Applicant Signature
PLEASE N07E THE FOLi,OWWG.

A COPY OF THE COMPLETE APPLICATION WITH A ROAD MAP SHOWING LOCATION OF THE PROPERTY MUST
ARMY CORPS OF ENGINEERS, 151 PATTON AVENUE, ROOD 208, ASNEWL.LE NC 28804-8008
SUBMITTED TO: US
• 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
SU16MrTTED WITH THE DMSION OF WATER QUALITY APPLICATION FEE TO: NC D114SION OF WATER QUAUT1, ATTEN7M. Cyndl
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,09-0604
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:
DIVISION OF WATER QUALITY WETLANDS UNIT
1650 MAIL SERVICE CENTER
RALEIGH, NC 27699-1650
1. Applicant Information
1. Owner/Applicant Information
Name Rob D. Martin
Mailing Address 103 Sapphire Drive
Mooresville, NC 28117

Telephone Number 704-
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
Company Affiliation CBC Custom Shorelines, Inc.
Mailing Address 638 Oakridge Farm Hwy
Mooresville, NC 28115

Telephone Number 704-660-5111
Fax Number 704-660.5969
E-mail Address [e-mail]
If. Project Information
Attach a vicinity map clearly showing the location of the property with respect to kcal 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 Iredell Nearest Town Mooresville
Subdivision name or site address (include phasetlot number): Diamond Head
Directions to site - please include road numbers, landmarks, etc. (This is not necessary
if an adequate vicinity map is included):-??1 N -I v E? , F 3 3- Wsf o?_
1 E811 00 n I`
E me ?z,w l?{ LrJ - _12?' ??-1 or, Snti: 2 (rL
2, Describe the existing land use or condition of the site at the time of this application:
h Lt S e- 1, '1 44, V)
3. Property size (acres):
4. Nearest body of water (stream/river/soundtoceanflake): -_ Q2mp rJ
5. Describe the purpose of the proposed work: _u)_" k
R- I 2 v _R < - TO C o_r4 -a 2, C R U a,
6. List the type of equipment to be used to construct the project: -Ea
Loi_?_? ?
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below
5^1 X I $ 2-
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.
l ' )? 1q2_ b. Please describe vegetation above the normal pool lake level and 50 feet land-ward to
be impacted (number of trees for instance): Ln ILq?-?
p-ll"IA ? in I'U am.&sea_ a0a?? --

(Agmes signature is valid only if on *vOwisatlon MW ft m tl?e applicant Is wavid*O
9 'd 6969-099-troL wwij aiggog dET :EO 60 ZT l;i
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k30dc

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.
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REGISTER OF DEEDS
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DIRECTIONS BY ROAD FORM
Lake Use Permit Applicants and Contractors: Ease of locating the proposed project
site can have a big impact on permit processing time. Please complete this form
and return it along with your completed permit application to:
DUKE POWER
C/O LAKE MANAGEMENT - EC 12 Q
P. O. BOX 1006
CHARLOTTE, NC 28201-1006
1-800-443-5193
Applicant's Name:-Rob D. Martin
Lake Name: Norman
Subdivision Name: Diamond Head
Property Section: Lot (s)= 43
City: Mooresville County:Iredell
State: NC Zip: 28117
Telephone 704-
Type of Permit
Requested
"Circle":
Private Facility
Commercial Facility
Excavation
ion
Conveyance
Miscellaneous Uses
Directions (from major road or highway): I-77 N to Exit 33 - West on Williamson
Rd - Right on Diamond Head Dr - Left on Emerald Lane - Right on Sapphire Dr -
House on left
Descriptive Structure (s) on Property (i.e. brick garaMe white fence, mobile home
etc.
103 Sapphire Dr
"Note: Please use the back of this form, if desired, to draw us a map to the site.
103 Sapphire Drive, Mooresville, NC - Google Maps
G- 0 Address 103 Sapphire Dr
i j l l c Mooresville, NC 28117
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