HomeMy WebLinkAbout20050577 Ver 1_Complete File_20050406,e
Regulatory Division
DEPARTMENT OF THE ARI IY
WILMINGTON DISTRICT, CORPS OF ENGINEERS
P.O. BOX 1890
WILMINGTON. NORTH CAROLINA 28402-1890
Action ID No. 200500575
June 1, 2005
Mr. Doug Huggett
Division of Coastal Management
North Carolina Department of Environment
and Natural Resources
400 Commerce Avenue
Morehead City, North Carolina 28557-3421
Dear Mr. Huggett:
C) S-a?1.1
2005
SUN 7
ti`?ENd1DS Ff.D S i U;?i?Sr'rAl ?f i C? JJ+C11
Reference the application of William Branch for a Department of the Army permit to
excavate a small boat basin and construct a private pier, gazebo, boat lift and floating docks at
2501 Shandy Lane, adjacent to the south side of Bradley Creek, Wilmington, in New Hanover
County, North Carolina.
REPLY TO
ATTENTION OF:
The Federal agencies have completed review of the proposal as presented by the
application and your field investigation report.
We recommend that the following conditions be included in the State authorization:
1. All work authorized by this permit must be performed in strict compliance with the
attached plans, which are a part of this permit. Any modification to these plans must be approved
by the US Army Corps of Engineers (USACE) prior to implementation.
2. The permittee understands and agrees that, if future operations by the United States
require the removal, relocation, or other alteration, of the structure or work herein authorized, or
if, in the opinion of the Secretary of the Army or his authorized representative, said structure or
work shall cause unreasonable obstruction to the free navigation of the navigable waters, the
permittee will be required, upon due notice from the U.S. Army Corps of Engineers, to remove,
relocate, or alter the structural work or obstructions caused thereby, without expense to the
United States. No claim shall be made against the United States on account of any such removal,
relocation, or alteration. The permittee shall notify NOAA/NATIONAL OCEAN SERVICE
Chief Source Data Unit N CS261, 1315 E West HWY- RM 7316, Silver Spring, MD 20910-
3282 at least two weeks prior to beginning work and upon completion of work.
3. Except as specified in the plans attached to this permit, no excavation, fill or
mechanized land-clearing activities shall take place at any time in the construction or
r
maintenance of this project, in such a manner as to impair normal flows and circulation patterns
within waters or wetlands or to reduce the reach of waters or wetlands.
4. Except as authorized by this permit or any USACE approved modification to this permit,
no excavation, fill or mechanized land-clearing activities shall take place at any time in the
construction or maintenance of this project, within waters or wetlands. This permit does not
authorize temporary placement or double handling of excavated or fill material within waters or
wetlands outside the permitted area. This prohibition applies to all borrow and fill activities
connected with this project.
5. All mechanized equipment will be regularly inspected and maintained to prevent
contamination of waters and wetlands from fuels, lubricants, hydraulic fluids, or other toxic
materials. In the event of a spill of petroleum products or any other hazardous waste, the
permittee shall immediately report it to the N.C. Division of Water Quality at (919) 733-5083,
Ext. 526 or (800) 662-7956 and provisions of the North Carolina Oil Pollution and Hazardous
Substances Control Act will be followed.
6. The authorized structure and associated activity must not interfere with the public's right
to free navigation on all navigable waters of the United States. No attempt will be made by the
permittee to prevent the full and free use by the public of all navigable waters at or adjacent to
the authorized work for reason other than safety.
7. The permittee must install and maintain, at his expense, any signal lights and signals
prescribed by the U.S. Coast Guard, through regulations or otherwise, on authorized facilities.
For further information, the permittee should contact the U.S. Coast Guard Marine Safety Office
at (910) 772-2191.
8. In order to protect juvenile finfish resources, no excavation or filling activities will be
permitted between the dates of April 1 and September 30 of any year without the prior approval
of the North Carolina Division of Coastal Management and the U.S. Army Corps of Engineers.
9. All excavated materials will be confined landward of the mean high water level
elevation contour and any vegetated wetlands.
10. All excavated materials will be confined landward of the mean high water level
elevation contour within adequate dikes or other retaining structures to prevent spillover of
dredged materials into any vegetated wetlands or surrounding waters.
11. Flow from the diked retention area will be confined by pipe, trough, or similar device
to a point at or below the mean low water level elevation contour to prevent gully erosion and
siltation.
2
,i
12. Excavation will not exceed 4 feet below the elevation of mean low water.
13. If the permittee discovers any previously unknown historic or archeological remains
while accomplishing the authorized work, he will immediately notify the Wilmington District
Engineer who will initiate the required coordination procedures.
14. Approval of the structure was based on determinations that there would be no
obstruction to navigation. The structure may be damaged by wave wash from passing vessels.
Issuance of this permit should not be construed, as relieving the permittee of taking proper steps
to insure the structure and moored boats will not be damaged by wave wash.
15. The permittee shall advise the Corps in writing at least two weeks prior to beginning
the work authorized by this permit and again upon completion of the work authorized by this
permit.
16. The permittee shall require its contractors and/or agents to comply with the terms and
conditions of this permit in the construction and maintenance of this project, and shall provide
each of its contractors and/or agents associated with the construction or maintenance of this
project with a copy of this permit. A copy of this permit, including all conditions, shall be
available at the project site during construction and maintenance of this project.
17. The permittee shall employ all sedimentation and erosion control measures necessary to
prevent an increase in sedimentation or turbidity within waters and wetlands outside the permit
area. This shall include, but is not limited to, the immediate installation of silt fencing or similar
appropriate devices around all areas subject to soil disturbance or the movement of earthen fill,
and the immediate stabilization of all disturbed areas. Additionally, the project must remain in
full compliance with all aspects of the Sedimentation Pollution Control Act of 1973 (North
Carolina General Statutes Chapter 113A Article 4).
18. The activity will be conducted in such a manner as to prevent a significant increase in
turbidity outside the area of construction or construction-related discharge. Increases such that
the turbidity in the waterbody is 50 NTU's or less in all rivers not designated as trout waters by
the North Carolina Division of Environmental Management (NCDEM), 25 NTU's or less in all
saltwater classes and in all lakes and reservoirs, and 10 NTU's or less in trout waters, are not
considered significant.
19. The permittee, upon receipt of a notice of revocation of this permit or upon its
expiration before completion of the work will, without expense to the United States and in such
time and manner as the Secretary of the Army or his authorized representative may direct, restore
the water or wetland to its pre-project condition.
3
20. Violations of these conditions or violations of Section 404 of the Clean Water Act or
Section 10 of the Rivers and Harbors Act must be reported in writing to the Wilmington District
U.S. Army Corps of Engineers within 24 hours of the permittee's discovery of the violation.
21. The West Indian manatee (Trichecluus nianatus), which is listed as a federally
endangered species, has been reported in the waters in New Hanover County. In order to protect
the West Indian manatee all work should be done during the period from November 1 to May 31.
If work must be done during the period from June through October the enclosed guidelines,
entitled "Precautions for General Construction in Areas Which May Be Used by the West Indian
Manatee in North Carolina" must be followed.
Questions or comments may be addressed to Mr. Henry Wicker, Wilmington Field Office,
Regulatory Division, telephone (910) 251-4930.
Sincerely,
0 azn
=icker
Regulatory Project Manager
Enclosure
4
Copies Furnished (without enclosure):
Ms. Cyndi Karoly
Division of Water Quality
North Carolina Department of Environment
and Natural Resources
1650 Mail Service Center
Raleigh, North Carolina 27699-1650
Mr. Pete Benjamin
U.S. Fish and Wildlife Service
Fish and Wildlife Enhancement
Post Office Box 33726
Raleigh, North Carolina 27636-3726
Mr. Ron Sechler
National Marine Fisheries Service
Habitat Conservation Service
Pivers Island
Beaufort, North Carolina 28516
Mr. David Rackley
NMFS, Habitat Conservation Division
219 Fort Johnson Road
Charleston, South Carolina 29412-9110
Mr. Wesley Crum, Chief
Coastal Section
61 Forsyth Street, SW
Atlanta, Georgia 30303
Mr. Jim Gregson, District Manager
Wilmington Regional Office
North Carolina Division of Coastal
Management
127 Cardinal Drive Extension
Wilmington, North Carolina 28405
Commanding Officer
U.S. Coast Guard Marine Safety Office
721 Medical Center Drive, Suite 100
Wilmington, North Carolina 28401-4895
5
o?0F w ATF9QG
r
Mr. Jeff Hunt
1061 Rt. 376
Wappinger Falls, NY 12590
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek. P.E. Director
Division of Water Quality
J?
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t?
APR 2 6 2005
April 19, 2005
DWQ# 05-0577
Iredell County
DENR - WATER QUALITY
VYETMS At@ STORMWATER ERAI.CH
Subject: Lot 51, Pinnacle Shores S/D
Approval of 401 Water Quality Certification and Authorization Certificate per the Catawba River Buffer
Protection Rules (15A NCAC 2B .0243) with Additional Conditions
Dear Mr. Hunt:
You have our approval, in accordance with the attached conditions and those listed below, to place fill in
or to otherwise impact approximately 0.008 acre of waters and 0.008 acre of riparian buffer for the purpose of
stabilizing approximately 115 linear feet of shoreline on Lake Norman, as described in your application
received on April 6, 2005. After reviewing your application, we have determined that this project is covered by
Water Quality General Certification Number 3492, which can be viewed on our web site at
http://h2o.enr.state.nc.us/ncwetlands. The General Certification allows you to use Regional Permit No.
198200030 once it is issued to you by the U.S. Army Corps of Engineers (USACOE). This letter also serves
as your approved Authorization Certificate for impacts to the protected riparian buffers per 15A NCAC 2B
.0243. Please note that you should get any other federal, state or local permits before proceeding with your
project, including those required by (but not limited to) Sediment and Erosion Control, Non-Discharge, and
Water Supply Watershed regulations.
The above noted Certification will expire when the associated USACOE's 404 permit expires unless
otherwise specified in the General Certification. This approval is only valid for the purpose and design that you
described in your application. If you change your project, you must notify us in writing, and you may be
required to send us a new application for a new certification. If the property is sold, the new owner must be
given a copy of the Certification and approval letter; and is thereby responsible for complying with all
conditions. If the total wetland fill for this project (now or in the future) exceeds one acre, compensatory
mitigation may be required as described in 15A NCAC 2H .0506 (h).
In addition to the requirements of the certification, you must also comply with the following conditions:
1. All stormwater shall be directed as diffuse flow at non-erosive velocities through the protected stream buffers
so as not to re-concentrate before discharging into the stream (as identified in 15A NCAC 2B .0243 (5)).
2. No impact to the buffer shall occur, including the removal of trees.
3. Upon completion of the project, the applicant/responsible party shall complete and return the enclosed
"Certificate of Completion" form to the Division of Water Quality's 401 /Wetlands Unit.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing. You
must act within 60 days of the date that you receive this letter. To ask for a hearing, send a written petition (that
N?o,hCarolina
I'Vatirra!!if
North Carolina Division of Water Quality 610 East Center Ave., Suite 301 Mooresville, NC 28115 Phone (704) 663-1699 Customer Service
Internet h2o.enrstate.nc us FAX (704) 663-6040 1-877-623-6748
An Equal Opportunity/Affirmative Action Employer- 50% Recyded/10% Post Consumer Paper
Page 2
conforms to Chapter 1506 of the North Carolina General Statutes) to the Office of Administrative Hearings, 6714
Mail Service Center, Raleigh, N.C. 27699-6714. This certification and its conditions are final and binding unless
you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water Act.
If you have any questions, please telephone Mr. Alan Johnson in the Mooresville Regional Office at 704-663-
1699 or Ms. Cyndi Karoly in the Central Office in Raleigh at 919-733-9721.
Sincerely,
z), P dee--a?
for Alan W. Klimek, P.E.
Attachments
cc: Corps of Engineers Asheville Regulatory Field Office
Wetlands Unit- Cyndi Karoly
Central Files
Triage Check List
Date: 4/7/05 Project Name: Jeff & Colleen Hunt
DWQ#: 05-0577
County: Iredell
To: Alan Johnson, Mooresville Regional Office
r ,a
60-day Processing Time: 4/6/05 to 6/4/05 `? .
From: Cyndi Karoly Telephone : (919) 733-9721
The file attached is being forwarded to your for your evaluation.
Please call if you need assistance.
? Stream length impacted
? Stream determination
Wetland determination and distance to blue-line surface waters on USFW topo maps
? Minimization/avoidance issues
? Buffer Rules (Neuse, Tar-Pamlico, Catawba, Randleman)
? Pond fill
Mitigation Ratios
? Ditching
? Are the stream and or wetland mitigation sites available and viable?
? Check drawings for accuracy
Is the application consistent with pre-application meetings?
? Cumulative impact concern
Comments: As per our discussion regarding revision of the triage and delegation processes,
please review the attached file. Note that you are the first reviewer, so this file will need to be
reviewed for administrative as well as technical details. If you elect to place this project on hold,
please ask the applicant to provide your requested information to both the Central Office in
Raleigh as well as the Asheville Regional Office. As we discussed, this is an experimental, interim
procedure as we slowly transition to electronic applications. Please apprise me of any
complications you encounter, whether related to workload, processing times, or lack of a "second
reviewer" as the triage process in Central had previously provided. Also, if you think of ways to
improve this process, especially so that we can plan for the electronic applications, let me know.
Thanks!
PA\'itiEf"!T
RECEIVED 0 57
The following is an abbreviated application form for those applying; for it 401 N'e'ater
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 Avell as a
uou-refundable application fee to the Division of Water Qimpacts ality to lake .00 for
impacts of to lake bottom of less than 1 acre and .'""'",.••=1 bottom
of greater or equal to 1 acre.
Applications should be sent to:
I)ivisiou of Water Quality Wetlands Unit
1650 Mail Service Center
tialeigh, NC 27699-1650
1. Applicant Infornation
?s r- -, t
APR li 2005
1 cTU
"i7
? tom'
:i
Owner/Ahplic.a?t Info+nnation?,?
04
Mailing A(Idress:l?L ??-
"I'clcphonc Tltnnbc -_ K/?.L --- - - --? .--? - ?. ? -----' - ..? -
F-mail Address:_. ?4<s'.!_crl?.rrz_7 --Q?•?_L.rL s . c??-- -..
signed and dated coj,y of titc Aiicnt Atithotization letter
??+?ent Iniunuatic,t, kA
must l.+c att,tc.lted if the Agent ltas sitnatory authotlt} !or the. i?wncr/ap(?licant.) -
C;uml,att?Atltliation: _._.?_?__--------- ------------------ - _ -- -- ---- ._.-
N41ttlin}' Ad?lrc ;s: - - ---- -- - - - -- - - ---- - - - - - -
Tclcpho;tc
I?-mail
ll. project lnformahou
Attach a vicinity net{) CIcarly showint; the lot:atiMr t,i the }in+}}cri> with respect It,
local Luttlln irks s!!(;II a; town-<., rivets, tnd rc?a(ls Ako hmvidC a dctailcd site
plan ho»win; h:()p -ny l+c+uudarita :tnd dcvcl?+httt. nt }?I:uts in relation to
:1;rroulit11111! plo}tcrtie.. You way Ilse the (ial;.rttn I)Jo\? it) ntal:e a hand sl etch o;
your project. Also, see the example below for guidance. Both the vicinity map and
. ootprints of all buildings,
site plan must include e scale facilities must be included.
impervious surfaces, or ott
1. Location Nearest Town:???C?l?s
r? C- l r
County:
Subdivision name or site address Cmclude phase/lot number): ,1111, 1111 1, ?-? f -
not, 11
Directions to site please include road numbers, landmarks , i' (This is
necessary if an adequate vicinty map is inc uded): --
2. Describe the existing land use or
appl;,cation: /'lrr, nom' 0
i
of the site at the time of this
r'
e-'_
3. Property size (acres)* -2
d //
IV/
4. Nearest body of water (stream/river/sotrnd/occan/lake): f
ed work: t-
'.7-?„?a.c
5. Describe the purpose of the propos
6. List tltc type of equipment to be used to constnict tile prQlect
Amount of Impact (Illcluding all excavation, back-fill, rip rap, retaining walls
etc.) bellow file normal pool take level in square feet or acres: : ,0 l? G ??--
i
a. Amount of impact (including all
retaining walls, etc.) above the normal
square feet or acres:/sue -''-
clearing, back fill, excavation, rap rap,
nool lake level and 50 feet land-ward in
b. Please describe vegetation above the normal pool lake level and 50 fect.land- .?
ward to be impacted (number of trees for
n{?plir ,'nt's Si`:nattire
(Agent's signature is valid only if an authorization letter troni 111c applicant is provided.)
C.4t. ?7 tr .l F:4lYC?
1014 //5.? /
Please approximately sketch the foUowing information on this plan
/(please provide dimensions for each Item, such as 10 ft. x 100 ft):
I®K/I 1) All proposed vegetation clearing (provide dimensions) 2
1i.2) Location of rip rap or rill to be placed above the Full Pond elevation
3) Location of rip rap or fill to be placed below h as buildings, retaining
/
"VJ /!-,e,4) The location of any proposed structures such
walls. docks, etc.
5) The location of any excavation or dredging below the Full Pond
elevation.
6 Location of construction access corridors. 49
?- ,-
?'r:.. -? /' rx
-..
???_
EPA Kn i g`1t Rea I tu. r ax :70488 %x+661 May i 2rO4 1'.:20 F. C,I
Mai 03 04 02:51P Lance Schamback 7046620982 P•1
Lanca 0. Schomback, cert'fy that this plat was drawn tinder my supervision from on actual
& 146
144
P
survey made under my supervisian (deed description and/ oge
-
or Map Book:
That the boundaries not surveyed are clearly indicated as drown from information as shown
reocred
t was
l
t thi
survey, that the ratio of precision os calculated is 1:
t p
s p
a
'0.000+ tha
registration number
nature
inal si
ri
ness my
,n accordance with G.S. 89-C as amended. Wi ,
g
g
o
and seal this civy of t?±a?__?^ A.D. 2004. °
?
??
rr
NOt6s: `r
O?
0I11
/,(f
r
`9 /
7) This property moy bo .subject to ony Eosem@nts.
Rights-aF-wCy, and/aY Restrictive Covenants. q
?
?? .?? mot' 'A, A-
2) Boundary Information oosed on Mop Book, 25 ct mac bade, BLS
pa es: ;44 Je 746 as recordad in the Iredell County Register
f r
9J
LIC f?D
Deeds.
o +
Z
3) One hundred year Roca lire shown as located of 4-30-04.
on 4-3-04,
U
ke level at 12:20 P
f
d fr
m j ?.
.
.
ere
o
u
Eievctions trons
' G
°
Vegetative
4) 7-his survey is of in existing 30 haitWillN
parcel cr parcels of land l?eaffer
5) Arco by coordinate method. Lot 50
¢ Rcbcr
Found S67'11`3B"? ,a Rebor
Found
1BA.16
Lake Norman
Calculated ' ;f at 51 P.K. Nail Found 4
Centerline of
Point y & =4.528 Sq. ft. 1 P.
fauna pinnocle Shares Dr.,
sc
E
\\ `l?ts'
?atD °?'
% Crrcrald Point Ln.'
?
Ono Hundred Year C?
l ,qty
7001d,
Fiood Line, Elevation Al
?- -188.00
?drk`
= 760, as vacated
on April 30, 3004. 1 I Transformer
.U4 Fcehcr I Pad #4 Rebor
,
Found M ' of 52 Found RI;V
Pinnacle
24 Public Rems Sh ores Dr. 5torm
D?vlndge age Eesemsnt
45' Public R/fr
GY/R?±fNG7N RAZ:JUS d?RlNC G,'LL"+O
?Cl Sd.89 Val $521 433'W :531
L!n'E TAM'
t_VNE UVC?N sEA?vNa_?
Ll? 68.09 197737' '
L.71 4 75 JT44' T
L41 46.32 s " -W
Legend
RIVI = Right-cf-way
i.. P. S. = #4 Re-bar Set
y- _ Not to scale
irlephor o P:dekt:l
t-a, = utility Pore
C) = Gable Pedestal
r Wotar Voive '
Sanitary Sewer Monhalc
= L/ght Past
?Gl: = ReinfcrCVd Concrete POL'
Lot 59
?? ro
xr
q
P, S.
` f?„)? A i-` Q5
,4 Rebor
Found Septic Easement N
Lot 51A `-? ca I
f ?, r, 25.031 S7. Ft. r j O gyp-'
Lot 59 ?. ?U, I.P.S. U -
47
J4 Robcr $B M
Found ' 0.
Lot 45A 1 1 `^
I cot 52A
m?
04 Rebor
Found
Mog Nail SAf
Center,110 of
Pinnacle .Shares Or.
ctt Shelter- Cove in,
GRAPHIC SCALE
kUc
p so 100 NO
( IN F'EE'T' )
I inch = 100 ft,
Lot 51 sae `Vicin2ty Map
A
Boundar^ Survey SOALE; 1" = 100'
i
DUKE POWER LAKE MANAGEMENT, EC12Q,
P O BOX 1006
CHARLOTTE, NC 28201-1006
704-382-1567 or TOLL FREE 1-800-443-5193 3
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.
Applicant Information
t'"(??fN mil /7'LTN l
A. Name,.?e;t At
B. Mailing Address ?n?h / rT ?% C l 0/0
C. Telephone .? y % 7 ?
oposed Project
II. Location of P64r,
A. Lake / ? ? =? ??
B. Street Address
C. County
D. City, town, commumty or landmark Li., zXcl
E. Sectio I , I rot # S l Subdivision
F. Directions to property by road T 7 72- ; f LJr ?J" Cj
n
G. Latitude and longitude for the project site YL /5-/' ?V UK U S'-,57• Yd !?
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,
www.mansonus.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 S 57 '
B. Material r:?i.'r-mac: ?s`d??ry .-7 .; ' r Cs?•?k:./C
C. Distance from property line/shoreline ?L-Gr_, A-- l r ?rti
IV. Intended Use of Project Area
A. Private
B. Commercial
V. Applicant Signature
Date
4SE NOTE THE FOLLUIVING:
A COPY OF THE COMPLETED APPLICATION WITH A ROAD MAP SHOWING LOCATION OF THE PROPERTY
MUST BE SUBMITTED TO: VS ARMY CORPS OF ENGINEERS, 151 PATTON AVE. -ROOM 208,
ASHEVILLE, NC 28801-5006
• 2 COPIES OF THE "DUKE POWER APPLICATION FOR PERMIT TO STABILIZE THE SHORELINE IN NORTH
CAROLINA", PHOTOGRAPHS OF THE SHORELINE TO BE STABILIZED, AND FIVE (5) 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
PARKVIEJV BLDG., 2321 CRABTREE BLVD.
RALEIGH, NC 27604
919-733-1786
03/11/05 GPAL/LAKEMGNMLMPPM\STABILIZATION.G.27\STABILIZE\SHORLIN.STAB.NC.doc
DUKE POWER 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
PO BOX 1006
CIIARLOTTE, NC 28201-1006
1-800-443-5193 or Option 5
ri?
' Type of Permit Requested
s Name:
Applicant "Circle":
?/
Street Address (at lake): , Private Facility
/ f??,1 T ,?? ?1t 1 Conunercial Facility
Lake Name: Excavation
? ?, ? ? -C
t ?1'!` ?Sta? bill ion
?
S u b d i v i s i o I i l adle: / Conveyance
Property SCC1 10 Lot 11 6? _ Miscellaneous Uses
CouIlty. .-
City: Z LF-?? !'L' •!_-1_
State: / l-
Tclefflio lie:
Directions (from m:tjor read or highway):
Okescl lplive structure(s) on I'ropci-ty (i.e. prick gilwi,e, willic fCncc, n)ohil honx•, ctc):
note: Ilene uw the hack of thk`Uft)t if disircd to tint r u, a malt to Ow ,it
°tJ,9??e. iz' r r,
14 .11) -
f
?? =' ` ?
/ _`
.?
?----