20090703 Ver 1_401 Application_20090609

LCCS, Inc,
1156 Perth Road
Troutman, NC 28166
Phone [phone]
Pax: 704-528-3400
NCGCL # 49723
Contact Information:
Steve Davis
sdavis(a)lancasterdock.com E MAIL ADDRESS
LCCS
1155 Perth Road
Troutman, NC 28677
704-528-7400 Phone
704-528-3400 Fax
www.lancasterdock.com WEB SITE
PAiP
0 9- 0 7 0 3
3
? 2ko
D
JUN 17 2009
DENR • WATER QUALITY
WETLANDS AND STORMWATER BRANCH
DUKE POWER LAKE MANAGEMENT, EC12-Q
P. O. BOX 1006
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.
. 0 9 - 0 70 3
1. Applicant Information
A. Name PAY _gVS,QiI #A,V?
B. Mailing Address 4111 ,$A 164 bDeA/ . r1flew?
C. Telephone 70 rd - lao- /s l
II, Location of Proposed Project
PAII?
A. Lake Nea M.4
B. Street Address 11111 1,0.4 -y t 104AIEyvS Ale 28d3 /
C. County ?f?,Ic%„e fjaP
D. City, Town, Community or Landmark G'??•?,? /?y?_ __-_
E. Section Lot # 2 6 ? Subdivision
F. Directions to property by road 77J7 -7?v
G. Latitude and longitude for the project site .3 .3 ?? -
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,_r?rnv.l"llc4?<r' )iILIS curie. Directions: Don't register, click "Maps", enter
address, draw map, select "Map Clicking Will... ", select "Lat/Long", click map)
Ill. Description of Project
A. Length of wall 7,4 R_ Material
C. Distance from property linelshoreline Fe I low-EX -t5-s S kA6G
IV. Intended Use of Project Area
A. Private X
B. Commercial
?V. Applicant Signature Date
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, 959 PATTON AVENUE, ROOM 208, ASHEVILLE, NC 28801-5006
o 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): 77 3 - 4v rx,-`' 7Te.,l
nA 6. AMV isT/rf e QA4p, co'-'d C?'- /a-;t-)
1
3
4
2. Describe the existing land use or condition of the site at the time of this application:
tees? P? 7"/u 1 fel' w D /cJ'
Property size (acres)- D • 6 313
Nearest body of water (stream/river/soundlocean/lake):

5. Describe the purpose of the proposed work:
6 t? iN.f /?i? 7Aii.? ? ? / /' /& 'n ?p do i ?c7Sti?? ___._/??_____2L L_ '___ . _ .
6. List the type of equipment to be used to construct the project: e-
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below
Z X 70
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:
I,X 70,
V- ' Appli5pdtlAgent's Signature
(Agent's signature is valid only if an authorization letter from the applicant is provided)
b. Please describe vegetation above the normal pool lake level and 50 feet land-ward to
be. imnartari fm imhPr of trees for instanc-N-
eSlA
Lake (Full Pond)
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.
g) Location of construction access corridors.
DU POWER DIRE MONS BY ROAD FO
LaT- Use, VL'Y'HI Applicants and Contractors: Ease of locating the proposedprojcc! site can have a Jig
impact on perxnit processing time'. Please complete this form and reftm it along with your completed
permit application to:
1 uKri POWER.
CIO IL,AT MA,NAGEME, NT - VC:' 12 Q
PO BOAC 1006
CrTt4..RLOTTV, NC; 28201-1006
1-800-443-519-1 or Option 5
Applicant's Name,: -, ?._._ Type of Parrnit Requested
"Circle":
Street Address (at Iakc):
1:'i'1VatC l';tctii(y
Lake 1 ITTIC: Commercial Facility
}7XC:I YotI
Convcyancc
Property Section: -- - _ 1 of{-- Z? 1•tisc.0ll0nc0us Use",
.t County:
Ci
y: __ L,E??-----
zi D?/ -------
state: Z B j? -------?--
_?....-..dam -,-=---•---
Dimct-ions (.Groin lz1'tjor_ voadu 01, hirliv/,ay):
7 > tr ?"x t 1- Z 8 R, re 77';0' ^?? ?i ,9a o?eo,.v
?sT ?Af Oti' Q a G??itU !d 7.
Descriptive Structure(s) oc>. ProPevty (i.e. brink garage, w}line &n.cc, mobil hOITte, e(c):
*IYata: Please use the back of Phis form If destred to drat us a snap to the stye.
CPAULAKEMGMTIUAPPMMIRF-CT ONiL9-D-OC F.frrrt;.. n•._.
:v.-? TOTAL PAGE . 0

U4/ U7 / ZU(JI U0. J7 IU4/'77LL7L
Y'KUr t?51UNAL rKUI-'tN.Y
///IAA
/ I

n0,`/ / J r(
!Q- 2°,
C ?, O 1

? in
rn
l
F ,?? ?
a to r
C
q
N71 `3 so c0"TOUR
3

1
8„?
06, r
1?
00? .Sn ,
OFFS
6, /Q>
h
001-
?o

40
GRAPHIC SCALE
20 40 80
FADE 03/03
,LOS" ,266
27,507 SQ- ,F,T-
0.63 ACRES
100
( IN FEET )
1 inch = 40 ft.
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
Owner/Applicant Information
Name RAY ,-VE,k A/NA /''l
Mailing Address 11116 8121?A00®?tJ COQryELIG1 ?t?'G Z,R'03 /

Telephone Number
6
7 .0 Y- 3 `d - ire
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 Lancaster
Company Affiliation Lancaster Custom Dock $ Shorelines
Mailing Address 1156 Perth Rd
Troutman, NC 28166

Telephone Number 704528-7400
Fax Number 704528-3400
E-mail Address [e-mail]
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.
Location
County MEcK-EivB DR Nearest Town Ca
Aiv6t1vS
Subdivision name or site address (include phase/lot number):
. A
tAMMM
AIKA
-;ate
/1 r
w..
IF ,
a
6 A:
I
I �t�
I
Awl
1�
C
1
1.0

�m
t
! tl 4
i
N