20051080 Ver 1_Complete File_20050616

Certificate of Completion

DWQ Project No.: D S - I D~ 0
Applicant: tDov;/; \1&t/J Bt8ltY/J

County:

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Project Name:

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Date of Issuance of 401 Water Quality Certification:

Upon completion of all work approved within the 40 I Water Quality Certification and Buffer Rules, and
any subsequent modifications, the applicant is required to return this certificate to the 40lIWetlands Unit,
North Carolina Division of Water Quality, 1621 Mail Service Center, Raleigh, NC, 27699-1621. This form
may be returned to DWQ by the applicant, the applicant's authorized agent, or the project engineer. It is
not necessary to send certificates from all of these.

Applicant's Certification

I, D f) v ;l<;. q.L 1') Mro 11 )f} , hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the construction was observed to be
built within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the
approved plans and specifications, and other supporting materials.

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Agent's Certification

Signature:

Date: / / -- /J:;- t6'

I, , hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the construction was observed to be
built within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the
approved pI and specifications, and other supporting materials.

Date: II- 29-tfg

Signature:

If this project was designed by a Certified Professional

I, , as a duly registered Professional (Le.,
Engineer, Landscape Architect, Surveyor, etc.) in the State of North Carolina, having been authorized to
observc (periodically, weekly, full time) the construction of the project, for the Permittee hereby state that,
to the best of my abilities, due care and diligence was used in the observation of the construction such that
the construction was observed to be built within substantial compliance and intent of the 401 Water Quality
Certification and Buffer Rules, the approved plans and specifications, and other supporting materials.

Signature:

Registration No.: .

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Michael F. Easley, Governor

William G. Ross Jr.. Secretary
North Carolina Department ofEnvironmcnt W1d Natural Resources

AIW1 W. Klimek, P.E. Director

~~@~OW~ @ Divi,i,"ofW~~o.wi~
JUL 0 6 2005

July 1, 2005
DWQ# 05-1080
Catawba County

Ms. Doris Brown
9115 Clement Circle
Terrell, NC 28682

DENR - WATER QUALITY
\VETlANDS AND STORMWATER BRANCH

APPROVAL of 401 Water Quality Certification and Authorization Certificate per the Catawba River Buffer
Protection Rules (15A NCAC 2B .0243) with Additional Conditions

Dear Ms. Brown:

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 0.006 acre of riparian buffer for the purpose of
stabilizing approximately 123 linear feet of shoreline on Lake Norman, as described in your application
received on June 16, 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://h20.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 28
.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. No impacts shall occur in the buffer, including the removal of trees.
2. Mulch or pine needles (6" deep) shall be used to help reestablish the buffer upon completion of the project.

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
conforms to Chapter 150B 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.

N.?rthCarolina
/Vo/urn/llI

North Carolina Division of Water Quality 610 East Center Ave., Suite 301 Mooresville, NC 28115
Internet h2o.enr.state.nc.us
An Equal Opportunity/Affirmative Adion Employer - 5O"k Recydedl10% Post Consumer Paper

Phone [phone]
FAX [phone]

Customer Service
1-877-623-6748

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Page 2

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 Alan Johnson in the Mooresville Regional Office at 704-663-1699 or
Cyndi Karoly in the Central Office in Raleigh at 919-733-9721.

Sincerely,

~ Ik Jd'~

forAlan W. Klimek, P.E.

Attachments

cc: Corps of Engineers Asheville Regulatory Field Office
Wetlands Unit- Cyndi Karoly
Rowboat Company
Central Files

o'f WA TI2If

OW~c.
Cij nil rt"":\ \)7
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o\~ '"

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

July 1, 2005
DWQ# 05-1080
Catawba County

Ms. Doris Brown
9115 Clement Circle
Terrell, NC 28682

APPROVAL of 401 Water Quality Certification and Authorization Certificate per the Catawba River Buffer
Protection Rules (15A NCAC 2B .0243) with Additional Conditions

Dear Ms. Brown:

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 0.006 acre of riparian buffer for the purpose of
stabilizing approximately 123 linear feet of shoreline on Lake Norman, as described in your application
received on June 16, 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://h20.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. No impacts shall occur in the buffer, including the removal of trees.

2. Mulch or pine needles (6" deep) shall be used to help reestablish the buffer upon completion of the project.

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
conforms to Chapter 150B 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.

N~rhcarOlina
.AIl/llmlly

North Carolina Division of Water Quality 610 East Center Ave.. Suite 301 Mooresville. NC 28115
Intemet: h20.enr.state.nc.us
An Equal Opportunity/Affirmative Action Employer - 50% Recycled/l0% Post Consumer Paper

Phone [phone]
FAX [phone]

Customer Service
1-877-623-6748

Page 2

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 Alan Johnson in the Mooresville Regional Office at 704-663-1699 or
Cyndi Karoly in the Central Office in Raleigh at 919-733-9721.

Sincerely,

forAlan W. Klimek, P.E.

Attachments

cc: Corps of Engineers Asheville Regulatory Field Office
Wetlands Unit- Cyndi Karoly
Rowboat Company
Central Files

Triage Check List

Date:

6/21/05

Project Name: Doris Brown Lot 18
DWQ#: 05-1080
County: Catawba

To: Alan Johnson, MooresviIIe Regional Office

60-day Processing Time: 6/16/05 - 8/14/05

From: Cyndi Karoly Telephone: [phone]

The file attached is being forwarded to your for your evaluation.
Please call if you need assistance.

D Stream length impactcd
D Strcam determination
Wetland determination and distance to bIue-linc surface waters on USFW topo maps
D Minimization/avoidance issues
D Buffer Rules (Ncuse, Tar-PamIico, Catawba, Randleman)
D Pond fill
D Mitigation Ratios
Ditching
D Are the strcam and or wetland mitigation sites available and viable?
D Check drawings for accuracy
D Is the application consistent with pre-application meetings?
Cumulative impact concern
D
D
D

Comments: As pcr our discussion regarding revision of the triage and delcgation proccsscs,
please review the attached file. Note that you are the first reviewer, so this file will need to be
reviewed for administrativc as well as technical details. If you elect to place this project on hold,
please ask the applicant to providc your requested information to both the Central Office in
Raleigh as well as thc Asheville Regional Office. As we discusscd, this is an expcrimental, intcrim
procedure as we slowly transition to electronic applications. Please apprise me of any
complications you encounter, whether related to workload, processing timcs, 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 mc know.
Thanks!

,

ROWBOAT

Dock & Dredge

THE ROWBOAT COMPANY. INC.

June 14,2005

~~@~U'\ll@' ~
JUN 1 6 2GG5
OENR'~IWO ~J~x~~~rRNlCH
WEltNIOS t'l'

US Army Corps of Engineers
Regulatory Office
151 Patton Ave.
Room 208
Asheville, NC 2880 I

RE: Lake Nonnan

To Whom It May Concern:

Our firm is proccssing this application on behalf of Ms. Doris Brown to stabilize approximately
123 lincar feet of shorelinc by installing Kcystone Block (9//5 Clements Circle, Terrell, NC
28682) on Lake Norman, in Catawba County, North Carolina.

A copy of the Dukc Power Company applicatiori, pertinent drawings and a location map arc
cnclosed for your use.

To access the projcct: /-77 North to Exit 36, turn left. Proceed to Greenwood Road, hard left.
Proceed to Clement Circle, bear left.

We look forward to hearing from you at the earliest time possible.

Sincerely,

TIlE ROWBOAT COMPANY, INC.

12~

Sales Department

cc: NCDWQ (7 copies)

"

'. ."~ '.

858 Williamson Road . Mooresville, NC 28117 . 704-663-3478 . FAX [phone]
www.rowboalcompany.com... email: [e-mail]

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DUKE POWER LAKE MANA.GEMENT, EC12-Q

POBOX 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.

Plcasc typc or print and fill in all blanks. If information is not applicablc, so indicatc by placing a N/ A in blank.
PLEASE SUBMIT APPLICATION AND APPROPRIATE DUKE POWER FILING FEE, PAYABLE TO DUKE
POWER, TO ABOVE ADDRESS.

I.

III.

IV.

V.

Applicant Information
A. Namc

B.

C.

G.

Doris Brown ,

Mailing Addrcss

9115 Clement'Circle

Tcrrell, NC 28682

Tclephonc

[phone]

II. Location of Proposed Project
A.
n.
c.
D.
E.
F.

Lakc Lake Norman
Strcct Addrcss 9115 Clement Circle
County Catawba
Cityffown/Comll1unity or Landmark :
Section Lot if
Dircctions to property by road
1-77 N to Exit 36, turn left. Proceed to Greenwood Uoad, hard left.
Proceed to Clement Circle, bear left;'
Latitudc and Longitude for thc projects,ite SEE ATTACHED MAP
Please submit a map showing thc coordinates or a dctailed map (USGS quad map. city
map, ctc.) showing the cxact location of the project site. (NOTE: Latitude/Longitude
coordinates can be found on intcrnct site, WH1v.l1lllpblllst.COI1l)

18

Subdivision

~@,@@,u~@, ~

JUN 1 G 2005

Description of Project
A. Length of wall 123'
n. Matcrial Keystonc Block
C. Distance from property line/shorelinc,

Intended Use of Project Area
A. Private X
B. Comll1crcial

Applicant's Si~n:lture AfJ ~

on the 760

OENR. 'Wo :{6mA~~{E~rRAl.CH
W8WiDSN,

;
to"

~o/-)

Dalc

6-/8-66

PI,EASE NOTE TilE FOLUJWING:

111IO/OOssb

A COPY OF TIlE COMPLETED ^PPLlCATI0N \VITII'A ROAD M^P SIIOWING LOCArJON OF TIlE
PROPERTY MUST BE SUBMrrnmTO: US ARMY CORPS OF ENGINEERS, 151 PATTON AVE.-
ROOl\l208, ASHEVILLE, NC 28801-5006
A COPY OF TI IE "DUKE POWER APPLICATION Foit PERMrr TO STABILIZE TIlE SIIORELINE IN
NORTII C^ROLlN^" AND SEVEN (7) COPIES OF nm COMPLETED "NC DIVISION OF WATER
QIMLlTY PRE-CONS'IlUJC'IlON NO'IlFICA 110N ^PPLlCAIlON" MUST BE SUBMrrmD WITI I
TIlE DIVISION OF WATER QU^L1TY ^PPLICAllON'FEE TO:
NC DIVISION OF WATER QUALrry
ATrENTI0N: JOliN DORNEY
2321 CRABTREE RoAD
R^LEIGII, NC 27604-2260
(9 I 9) 733-1786

.

The following is an abb."eviated application form fo.' those applying fo.' a 401 'Vate..
Quality Ce..tification to impact FERC (Federal Energy Regulato.)' Commission)
regulated lakc shOl"c 01' bottom unde..'thc U.S. Ann)' COqls of Enginee.'s Pennit
GP30. This Application cannot be used fOl. wetland or stream impacts. Please
pl"Ovidc seven (7) copies of this application and SUPllo..ting information as well as a
non-rcfundable application fee to the Division of 'Vater Quality of $200.00 fo.'
impacts of to lal{e bottom of less than I ac.'e and $475.00 fOl' impacts to lal{e bottom
of greate.. 0.. equal to 1 acre.

Applications should be sent to:

Division of Wate.. Quality Wetlands Unit
1650 1\lail Se.vice Center
Raleigh, NC 27699-1650

I. Applicant Information

1. Owner/Applicant Information ."
Name: ~y; u Rl".D.J..illl
Mailing Address: IIV} C;l~(tvn.(- (]l'O.Je
e.-vre.1 I If'S t'! 2. 'l?~3:2,..,

. .

Tclcphone Numbcr: (S'LS) 4-(7'3 - 1ft'?&> Fax Numbcr:
E-mail Address:

Telcphon:.1::!.un er:
E-I~ldrcss:

Fax Number:

..,

Agent I formation (A signed and datcd copy of thc Agcnt Authorization lctter
must be attac . the Agcnt has signatory authority for thc owner/applicant.)
Namc: .
Company Affiliation:
Mailing Addrcss:

II. Project lnfonnation

Attach a vicinity map c1carly showing the location of thc property with rcspcct to
local landmarks such as towns, rivers, and roads. Also provide a detailed site
plan showing property boundarics and development plans in relation to
surrounding propcrtics. You may use'thc diagram below to make a hand sketch of

your projcct. Also, sce thc cxamplebelow for guidancc. Both thc vicinity map and
site plan must include a scale and' north arrow. The footprints of all buildings,
impervious surfaccs, or other faciliti~s must bc included.

I. Location /l ..,.-:- /
County: L. tJ.. r ctw ta Ncarcst Town: I erre),
Subdivision namc or sitc address (include phase/lot number): If6
Dircctions to sitc plcasc include road numbcrs, landmarks ctc.
ccessary ifan adequate vicini 'map is included): - 1
~
11ft.

2. Dcscribe the cxisting land use' or condition of the site at the time of this
application:_prt'VLt,rl/ I Y'f:sldenhi1-1

3. Property size (acrcs):~8
4. Ncarcst body ofwatcr (strcam/riv~r/sound/ocean/lake):~f f\brrrttvt

. "

5. Describc the purpose ofthc prop()~cd work:
WalL. . ,

. ;
"

6. List the typc of cquipment to bc uscd to construct thc project:
t5 J1!(LU WIlt1t 0tf-t1\1LLTI> Y'

7. Amount of impact (including al1"cxcavation, backfill, rip rap, rctaining walls,
ctc.) bclow thc normal pool lake level in squarc feet or acrcs:
2A-R ~J+t-

8. a. Amount of impact (includinfLall clcaring, back fill, excavation, rip rap,
retaining walls, etc.) above thc n.O...~~1 001 lake levcl and 50 fcet land-ward in
squarc fect or acrcs: I)~J~ ~

: J,~;

b. Please dcscribe vcgetation above thc normal pool lake Icvcl and 50 fcct land-
ward to be impacted (number ofttecs for instance):Ja..n:jsCt1.jYd la.u.5n

~~() &HAnG CL)

Applicant/Agcnt's Signaturc () ,: Datc
(Agcnt's signaturc is valid only if an authorization letter from thc applicant is proviq~PI)

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TOWNSHIP
au NTY, N. C.

IONS OF.JOHN RAYMERTR_ET.AL.

QFILE NO..849A

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9115 Clcmcnts Circle
Terrell, NC 28682
(828) .t78-2976

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9115 Clement;'Circle
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Doris Brown
9115 Clements Circle
Terrell, NC 28682
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For Recreationat Use Onty

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Doris Brown
9115 Clements Circle
Terrell, NC 28682
[phone]

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DUKE POWER DIRm'~TIONS BY ROAD FORM
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...Lal{c Usc Permit Applicants and Contnlctors:'IEasc of locating thc proposcd projcct sitc can havc a big
. inipact 0/1 pcrmit proccssing timc. Plcasc complcli/this form and return it along with your complctcd
. permit applic'ati~n to: t}. ;
:11 ~"
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I?,VKE POWER
C/O LAKE M;~N"AGEMENT - EC 12 Q
POBOX 1006
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CHARLgpE, NC 28201-1006
1~800-443-5193
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Applicant's Namc:

Doris Brown

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Strcet Address (at lake):

9115 Clcment Circle'

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Lakc Namc:

Lal{C Norman

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Subdivision Namc:

nc &: B1anchc.J Slicrrill

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Propcrty Section:

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Type of Permit Requested
"Circle":

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Private Facility

Commercial Facility

Excavation
Stabilization

Conveyance
Miscellaneous Uses

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NC

Telephone:

[phone]

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Zip: 2H6H2-9719

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ROWBOAT

Dock & Dredge

THE ROWBOAT COMPANY. INC.

June 14,2005

US Army Corps of Engineers
Regulatory Office
151 Patton Ave.
Room 208
Asheville, NC 2880 I

RE: Lake Nonnan

To Whom It May Concern:

Our firm is proccssing this application on behalf of Ms. Doris Brown to stabilize approximately
123 linear fcct of shorelinc by installing Keystone Block (9115 Clements Circle, Terrell, NC
28682) on Lake Nonnan, in Catawba County, North Carolina.

A copy of the Duke Powcr Company application, pertinent drawings and a location map arc
encloscd for YOllr lISC.

To access the project: 1-77 North to Er:it 36, turn left. Proceed to Greenwood Road, hartlleft.
Proceed to Clement Circle, bear left.

We look forward to hearing from you at the earliest time possible.

Sincerely,

THE ROWBOAT COMPANY, INC.

l;L~

Sales Dcpartmcnt

cc: NCDWQ (7 copies)

~~@~DW~@

JUN 1 6 Z005

DENR. WATER aUALllY
Vl'E1l}JjDS AND STORIAWATER BRANCH

-"'

.
':.,4~ .

858 \Nilliamson Road. Mooresville, NC 28117 . 704-663-3478 . FAX [phone]
www.rowboalcompany.com . email: [e-mail]

.,
. ~

I.

Applicant Infonnation
A. Namc

Doris Brown.

13.

Mailing Addrcss

9115 Clement Circle

Terrell, NC 28682

c.

Telephone

[phone]

II. Location of Proposed Project
A. Lakc Lal{e Norman
13. Strcct Addrcss 9115 Clement Circle
C. County Catawba
D. CityfTown/Community or Landmark
E. Scction Lot if 18 Subdivision
F. Dircctions to property by ro:ld
1-77 N to Exit 36, turn left. Proceed to Greenwood Road, hard left.
Proceed to Clement Circle, bear left.
G. Latitudc and Longitudc for thc projcct sitc SEE ATTACHED MAP
Pleasc submit a map showing thc coordin:ltcs or a dctailed m:lp (USGS quad map. city
map, ctc.) showing thc cxact location ofthc project sitc. (NOTE: Latitudc/Longitudc
coordinatcs can be found on intcrnct sitc, Hww.mapblast.com)

Ill.

Description of Project
A. Lcngth of wall 123'
B. Matcrial Kevstone Block
.
C. Distancc from property linclshorelinc

P@~
on the 76ll 'U~ 1 G 2
... I 005

IV.

Intended Use of Project Area
A. Privatc X
B. Commcrcial

Applicant's Signature A'P ~

Datc

~-18"'b6

DENR. WATER
\\'8l.ANDS N/D STORJ.!\~A~~H

~~)

V.

PI.EASE NOTE HIE FOU.OWIN(,':
A COPY OF TIlE COMPLETED APPLICATION WITl I A ROAD MAP 31 lOWING LOCATION OF TI IE
PROPERTY MUST BE SUBMITrEDTO: US ARMY CORPS OF ENGINEERS, 151 PATTON AVE.-
ROOl'tt 208, ASHEVILLE, NC 28801-5006
A COPY OF TilE "DUKE POWER APPLICATION FOR PERMIT TO STABILIZE TIlE SIIORELlNE IN
NORTII CAROLINA" AND SEVEN (7) COPIES OF '11m COMPLETED "NC DIVISION OF WATER
QUALITY PRE-CONS-m.UC'nON NmlFICA TION APPLICA'nON" MUST BE SUBMrrnm WITI I
TilE DIVISION OF WA'rER QUALITY APPLICA110NFEE TO:
NC DIVISION OF WATER QUALfl'Y
A lTENTION: JOI IN DOltNEY
2321 CRABTREE ROAD
RALEIGI I, NC 27604-2260
[phone] "

.

1 1I1O/00ssh

.....

"

The following is an abbl'eviated application foml fOI. those applying fOl' a 401 'Va tel.
Quality Certification to impact FERC (Fedel'al Energy Regulatol)' Commission)
I'egulated lal{e shore 01. bottom undel. thc U.S. Al"ll1Y COI'PS of Engineel.s Pel'mit
GP30. This Application cannot be used fOI. wetland 01. stream impacts. Please
providc seven (7) COllies of this application and supporting infol"ll1ation as well as a
non-I'efundable application fee to the Division of Water Quality of $200.00 fOI.
impacts of to lal{e bottom of less than I acre and $475.00 fOI. impacts to lal{e bottom
of greatcr 01. cqual to 1 acre.

Applications should bc scnt to:

Division of Water Quality Wetlands Unit
1650 Mail SClvice Center
Raleigh, NC 27699-1650

I. Applicant Infol"ll1ation

I. Owner/Applicant Information

~a;:;~ng Address ~~~" e~;t:;t G;fcle
&vre.-I ( I N {! 2 7J(p5~

Telephone Number: (S'LS) 4-'755'" ?fl1& Fax Numbcr:
E-mail Addrcss:

..,

Agent I formation (A signcd and dated copy of the Agent Authorization Ictter
must be attac . . the Agent has signatory authority for thc owncr/applicant.)
Name:
Company Affiliation:
Mailing Address:

Fax Numbcr:

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 providc a dctailed site
plan showing property boundaries and dcvelopment plans in relation to
surrounding properties. You may use the diagram bclow to make a hand sketch of

", ....

0.,

your projcct. Also, see thc example bclow for guidance. Both thc vicinity map and
site plan must include a scalc and north arrow. The footprints of all buildings,
impervious surfaccs, or othcr facilities must bc included.

I. Location /l '--I:' /
County: ~ara.tVb1.. Ncarest Town: ler(e.l
Subdivision name or sitc address (includc phasellot number): I~
Dircctions to site pleasc include road numbcrs, landmarks ctc.
eccssary if an adcquate vicini map is includcd): - 1
~
11ft.

2. Describe the existing land use or condition of thc sitc at the time of this
application:_prl'v'LU-I/ I 1'(1) idf:.nhiLl

3. Propcrty size (acrcs):~8
4. Nearcst body ofwatcr (strcam/rivcr/sound/ocean/lake):~f' Nr>rrruvt

5. Dcscribe the purposc ofthc proposcd work:
LJ.11L .

6. List the typc of cquipmcnt to be used to construct thc project:
i5 ThO U +r1lt1 ~ ~I1\1m Y'

7. Amount of impact (including all cxcavation, backfill, rip rap, retaining walls,
etc.) bclow thc nonnal pool lake level in square fect or acrcs:
2.iJ-R flJf'

8. a. Amount of impact (including all c1caring, back fill, cxcavation, rip rap,
retaining walls, etc.) above thc normal pool lakc level and 50 fcet land-ward in
squarc fcct or acrcs: I)~J~ 5'i J+

b. Plcase describc vcgctation abovc thc normal poollakc level and 50 fcct land-
ward to be impactcd (number oft~ees for instancc):J.an:j6MfX'd IQuSn

~~{} ~nL CL)

Applicant/Agent's Signaturc {). Datc
(Agcnt's signaturc is valid only if an authoriiation letter from thc applicant is prQviq~~.)

C:, - /3-tJb

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, . . I . . . ..

RAY C. S HER RILL PRO.
MT_ C REEK TOWNSHIP
CA TA WBA COUNTY, N. C.

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BEING. PORTIONS OF.JOHN RAYMERTR_ET.AL.

MT_ I S LAND FILE NO_. a 4 9A

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Tcrrell, NC 28682
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9115 Clement:Chrcle
Terrell, NC 28()82-9719
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Terrell, NC 28682
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Doris B
9115 Crown
lements C'
Terrell NC Ircle
(828)'478_2;~~82

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DUKE POWER DIRE€TIONS BY ROAD FORM
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~':L;ike Use Permit Applicants and Conh'actors:;'j~ase of locating the proposed project site can have a big
, inipact ori permit processing time. Please compldW this form and return it along with your completed
. . .' ,.,' ~ .
pcrmit application to: ;m~
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D:UKE POWER
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cia LAKE 1\I:AN'AGEMENT - EC 12 Q
!l,'onox 1006
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CHARLOTTE, NC 28201-1006
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Applicant's Namc:

Doris Brown

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Street Address (at lake):

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9115 Clcment CirCle',

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Type of Permit Ilequesled
"Circle":

Lake Name:

Lake Norman

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Private Facility

Commercial Facility

Excavation
Stabilization

Subdivision Name:

RC & B1anchc.J Sllci-rill

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t'Coullty: Calawha
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1-77 N 10 Exit 36, turn Icft onlo NC-ISO/Ri"cI'II}i}. Procccd 10 GI'eenwo()(1 Road, make a hanl
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Property Section:

City:

Tcn-cll

State:

NC

Telephone:

[phone]

Directions (from major road or highway):

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"Note: I'lease IIse lhe bad( of this form, if desired 10 drill\' us n mllp Iii: the sile.

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Conveyance
Miscellaneous Uses

Zip: 28682-9719

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