20091013 Ver 1_Application_20090921

DUKE POWER LAKE MANAGEMENT, EC12-Q
P. O. BOX 1006
0 9- 1 0 1 3
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.
1. Applicant Information
A. Name D i F} n n C
B. Mailing Address O al. Q P._ 1 Y1 j 1??. Ln ` ??1C?. 2/ ??.5 0,1n
C. Telephone a g- 4q - (' g q 3
II. Location of Proposed Project PAID
SEP 2 1
' 20
'A Lake 09 ! Q R /?'? ?!?
B. Street Address I DE NR WATER QUALITY
2 l (? P ?. n. 5 ttit ?.n WETLAN AND STORMIWATER BRANCH
C. County ?1?? Y11.?? YJ??
D. City, Town, Community or Landmark S? j 1 5 Erv a?P
E. Section Lot # - Subdivision
?!{d Ad?lof ?"1o(th`C2?k 5_l-tartr5.._. .
F. Directions to property by road //??
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G Latitude and longitude for the project site
......... ......U...?.`..7'].. 3.5.....? X33
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.com. Directions: Don't register, click "Maps", enter address, draw map, select "Map
Clicking Will..." select "Lat/Long=", click map)
IV. 'Intended Use of Project Area
• A COPY OFTHE COMPLE'TF APPLICATION WITH A ROAD MAP SHOWING LOCATION OF THE. PROPERTY MUST' BE, SUBMITTED i'O: USARMYCORISOF
ENG/NF.F,RS. 151 PATTO. AVEAVE, ROO41208„1SFIEt7LLE. NC 28801-5006

s
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 . 0 9- 0 1 3
1. Applicant Information
1. Owner/Applicant Information PAID
?
Name Dianne A. Hendrix •
Mailing Address 8210 Peninsula Lane
Sherrills Ford, NC 28673
Telephone Number 828-244-0843
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 Chip Bridges
Company Affiliation CBC Custom Shorelines, Inc
Mailing Address 638 Oakridge Farm Highway
Mooresville, NC 28115
Telephone Number 704-660-5111
Fax Number 704-660-5969
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.
1. Location
County Catawba Nearest Town Sherrills Ford
Subdivision name or site address (include phase/lot number): Mountain Creek Shores

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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 ciearinq (prov de sae €a €as s;a. F
2) Location of rip racy or fill to be oiac^c
3) Location of rip rap o. f:€ &v
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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-Dianne A. Hendrix
Lake Name: Norman
Subdivision Name: Mountain Creek Shores
Property Section Lot (s): 14 & adj. lot
City: Sherrills Ford County: Catawba
State: NC Zip: 28673
Telephone: [phone]
Type of Permit
Requested
"Circle":
Private Facility
Commercial Facility
Excavation
Stabiliza
Conveyance
Miscellaneous Uses
Directions (from major road or highway): Hwy 16 N to Denver - Right on
Campground Rd - Right on Keistler's Store Rd - Left on Mountain Shore Rd Left
on Peninsula Lane - Property on left
Descriptive Structure (s) on Property (i.e. brick garage, white fence mobile home
etc.
8210 Peninsula Lane
*Note: Please use the back of this form, if desired, to draw us a map to the site.
8210 Peninsula Ln, Sherrills Ford, NC - Google Maps
G C)1?, i ??, maps Address 8210 Peninsula Ln
c,(? Sherrills Ford, NC 28673
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http://maps.google.comlmaps?f--q&source=s_q&hl=en&geocode=&q =8210+Peninsula+L... 9/18/2009
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