20090921 Ver 1_401 Application_20090809

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09-0921
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 five (5) 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 to lake bottom of less than 1 acre and $570.00 for impacts to lake bottom of greater or
equal to 1 acre.
Applications should be sent to:
Division of Water Quality 401 Oversight/Express Review Permitting D 11 L5 p
1650 Mail Service Center ?j
Raleigh, NC 27699-1650 AUG, 2 4 2009
1.
1.
2
Applicant Information
Owner/Applicant Information
DENR - WATER-QUALITY
WETLANDS AND STORMWATER MAN01
Name: &'fl 111-1('ar, J rooV% r.,he_ax)_?
Mailing Address: I Cnr) r?tCO6Ey VY, r_ 0 J 1?1 (_-
Telephone Number: {70-0 -1:57 Fax Number:
E-mail Address:
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:
Mailing Address:
Telephone Number:
E-mail Address:
H. Project Information
Fax Number:
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: Nearest Town: -t kvo
Subdivision name or site address (include phase/lot number): ib lj s I?L I Ct 4
Directions to site please include road numbers, landmarks, etc. (This is not necessary if an adequate
vicinity map is included): I LIi if r 1 Paw) M 1. q f k,l , L O t "1 Kai 1:51') 4'a r (n 1
2. Describe the existing land use or condition of the site at the time of this application: 1lar-rapf ant
3. Property size (acres): / • 'q ClCre..S
4. Nearest body of water (stream/river/sound/ocean/lake): (??. IV G?mCt??
5. Describe the purpose of the proposed work: 5h 0a I ?I 1 e- ?f7lG%r l i LE,lfi «'i' .
6. List the type of equipment to be used to construct the project: Acch
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls, etc.) below the
normal pool lake level in square feet or acres: Q? V - ??
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:
Py.
8.b. Please describe vegetation above the normal pool lake level and 50 feet landward to be impacted
(number of trees for instance): „ree5 &r at t 51Ze.. .
G -G
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Please approximately sketch the fopowing information on this plan
(please provide dimensions for each Rem, such as 10 It x 100 ft):
1) All proposed vegetation dearing (provide dimensions).
2) Location of rip rap or fill to be placed above the Full! Pond-elevation
8) Location of rip rap or fill to be placed below the Ful 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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DUKE ENERGY LAKE SERVICES
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 ENERGY FILING FEE, PAYABLE TO DUKE ENERGY,
TO ABOVE ADDRESS.
I. Applicant Information
A. Name jj(_4 I,)u l1 Ca I'1
B. Mailing Address_(_f<iC: C t" I Vl.' i !'1SfZ?7- rE? }? /?tG v?7j L'?
C. Telephone:(_7 Oq) 37 a 33 j i
II. Location of Proposed Project
A. Lake IVOCK Or7
B. Street Address jc y (n 7 I r16Cr P I ; `? Y r??.(fl ?'tCi rt 1\1C
C. County_ J7 rt d e 1 /
D. City, town, communityor landmark j?r'CrJF?Q 6? _
E. Section 1 ? Lot # '/ L_ Subdivision _ _li%V7 C'5 ? ?t 1
F. Directions to property by road 13 g/? t' [y-1 'Shift 11 ):A Aij. "fritr'1f---? [ c7? 1'1 c'/'I M drr rt.;oo f-arm 1, hl"
{i4i't? dYi 7?ri!i?r? :1mrlPCy ??-ft an lt)rildtJa I ??ltvte/?s, /Lt4iT_TlnK&- !?i rf 4f.
G. Latitude and longitude for the project site 55,651 o CJJS . -- 53
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.mapsonus.eom. 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 r,
B. Material _A/
C. Distance from property line/shoreline
IV. Intended Use of Project Area
A. Private. _ a r, if a
B. Commercial
V. Applicant Signature Vi Date 5_lq o _ 0 4
PLEASE NOTE. THE FOLLOWING:
• 2 COPIES OF THE "DUKE ENERGY 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 NAROLY
PARKVIEW BLDG., 2321 CRABTREE BLVD.
RALEIGH, NC 27604
919-733-1786
Y:ILAKEMGWRPackage InformationlNC Shoreline Stabilization ADDlication.doe
lot 46 tinker place, troutman, nc - Google Maps
Address Tinker PI
7t -? map,-- Troutman, NC 28166
Page 1 of 1
Get Goocji<?, Nyaps on your phone
J`. Text the word", MAPS" to 466453

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