<table>
<colgroup>
<col style="width: 16%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 6%" />
<col style="width: 14%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 0%" />
<col style="width: 17%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 15%" />
<col style="width: 2%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="13"><p><strong>JOINT APPLICATION FORM</strong></p>
<p><strong>Department of the Army/TVA</strong></p></td>
</tr>
<tr class="even">
<td colspan="13">The Department of the Army (DA) permit program is
authorized by <strong>Section 10 of the Rivers and Harbors Act of
1899</strong> and <strong>Section 404 of the Clean Water Act (P.L.
95-217).</strong> These laws require permits authorizing structures and
work in or affecting navigable waters of the United States and the
discharge of dredged or fill material into waters of the United States.
<strong>Section 26a of the Tennessee Valley Authority Act,</strong> as
amended, prohibits the construction, operation, or maintenance of any
structure affecting navigation, flood control, or public lands or
reservations across, along, or in the Tennessee River or any of its
tributaries until plans for such construction, operation, and
maintenance have been submitted to and approved by the Tennessee Valley
Authority (TVA).</td>
</tr>
<tr class="odd">
<td colspan="13"><strong><mark>Please TAB to gray
areas</mark></strong></td>
</tr>
<tr class="even">
<td colspan="8">Name and Address of Applicant:</td>
<td colspan="5">Name, Address, and Title of Authorized Agent:</td>
</tr>
<tr class="odd">
<td colspan="8"><blockquote>
<p>     </p>
</blockquote></td>
<td colspan="5"><blockquote>
<p>     </p>
</blockquote></td>
</tr>
<tr class="even">
<td colspan="8"><blockquote>
<p>     </p>
</blockquote></td>
<td colspan="5"><blockquote>
<p>     </p>
</blockquote></td>
</tr>
<tr class="odd">
<td colspan="8"><blockquote>
<p>     </p>
</blockquote></td>
<td colspan="5"><blockquote>
<p>     </p>
</blockquote></td>
</tr>
<tr class="even">
<td colspan="8"><blockquote>
<p>     </p>
</blockquote></td>
<td colspan="5"><blockquote>
<p>     </p>
</blockquote></td>
</tr>
<tr class="odd">
<td>Telephone Number:</td>
<td colspan="2">Home</td>
<td colspan="3">     </td>
<td colspan="2"></td>
<td>Telephone Number:</td>
<td>Home</td>
<td colspan="2">     </td>
<td></td>
</tr>
<tr class="even">
<td colspan="3">Office</td>
<td colspan="3">     </td>
<td colspan="2"></td>
<td colspan="2">Office</td>
<td colspan="2">     </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="8"></td>
<td colspan="5"></td>
</tr>
<tr class="even">
<td colspan="13">Location where activity exists or will occur
<em>(include Stream Name and Mile, if known):</em></td>
</tr>
<tr class="odd">
<td colspan="13">     </td>
</tr>
<tr class="even">
<td colspan="13"></td>
</tr>
<tr class="odd">
<td colspan="13">Application submitted to DA TVA</td>
</tr>
<tr class="even">
<td colspan="13"></td>
</tr>
<tr class="odd">
<td colspan="4">Date activity is proposed to commence:</td>
<td colspan="2">     </td>
<td></td>
<td colspan="4">Date activity is proposed to be completed:</td>
<td>     </td>
<td></td>
</tr>
<tr class="even">
<td colspan="13"></td>
</tr>
<tr class="odd">
<td colspan="13"></td>
</tr>
<tr class="even">
<td colspan="13">Describe in detail the proposed activity, its purpose
and intended use <em>(private, public, commercial, or other)</em>.
Describe structures to be erected including those placed on fills,
piles, or floating platforms. Also describe the type, composition, and
quantity of materials to be discharged or placed in the water; the means
of conveyance; and the source of discharge or fill material. Please
attach additional sheets if needed.</td>
</tr>
<tr class="odd">
<td colspan="13">     </td>
</tr>
<tr class="even">
<td colspan="13"></td>
</tr>
<tr class="odd">
<td colspan="13"><blockquote>
<p>Application is hereby made for approval of the activities described
herein. I certify that I am familiar with the information contained in
this application, and that to the best of my knowledge and belief such
information is true, complete, and accurate. I further certify
that<br />
I possess the authority to undertake the proposed activities. <strong>I
agree that, if this application is approved by TVA, I will comply with
the attached terms and conditions and any special conditions that may be
imposed by TVA at the time of approval. Please note the U.S. Army Corps
of Engineers may impose additional conditions or
restrictions.</strong></p>
</blockquote></td>
</tr>
<tr class="even">
<td colspan="13"></td>
</tr>
<tr class="odd">
<td colspan="2"></td>
<td colspan="3">     </td>
<td colspan="3"></td>
<td colspan="4"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"></td>
<td colspan="3"><em>Date</em></td>
<td colspan="3"></td>
<td colspan="4"><em>Signature of Applicant</em></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="13"></td>
</tr>
<tr class="even">
<td colspan="13"><blockquote>
<p>18 U.S.C. Section 1001 provides that: Whoever, in any manner within
the jurisdiction of any department or agency of The United States
knowingly and willfully falsifies, conceals, or covers up by any trick,
scheme, or device a material fact or makes any false, fictitious or
fraudulent statements or representations or makes or uses any false
writing or document knowing same to contain any false, fictitious or
fraudulent statement or entry, shall be fined not more than $10,000 or
imprisoned not more than five years, or both. The appropriate DA fee
will be assessed when a permit is issued.</p>
</blockquote></td>
</tr>
<tr class="odd">
<td colspan="13"></td>
</tr>
<tr class="even">
<td colspan="13"></td>
</tr>
<tr class="odd">
<td colspan="13">Names, addresses, and telephone numbers of adjoining
property owners, lessees, etc., whose properties also join the
waterway:</td>
</tr>
<tr class="even">
<td colspan="13">     </td>
</tr>
</tbody>
</table>

<table style="width:100%;">
<colgroup>
<col style="width: 9%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 0%" />
<col style="width: 9%" />
<col style="width: 1%" />
<col style="width: 8%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 1%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 7%" />
<col style="width: 0%" />
<col style="width: 5%" />
<col style="width: 14%" />
<col style="width: 3%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="19"></td>
</tr>
<tr class="even">
<td colspan="6">List of previous DA/TVA permits/approvals</td>
<td> DA</td>
<td colspan="6">     </td>
<td colspan="3"> TVA</td>
<td colspan="2">     </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="6"></td>
<td></td>
<td colspan="6"><em>Permit Number</em></td>
<td colspan="3"></td>
<td colspan="2"><em>Date</em></td>
<td></td>
</tr>
<tr class="even">
<td colspan="19"></td>
</tr>
<tr class="odd">
<td colspan="19"></td>
</tr>
<tr class="even">
<td colspan="10">Is any portion of the activity for which authorization
is sought now complete?</td>
<td colspan="4"> Yes</td>
<td> No</td>
<td colspan="4"><em>(If “Yes” attach explanation)</em></td>
</tr>
<tr class="odd">
<td colspan="5">Month and year the activity was completed:</td>
<td colspan="4">     </td>
<td colspan="10">. Indicate the existing work on the drawings.</td>
</tr>
<tr class="even">
<td colspan="19"></td>
</tr>
<tr class="odd">
<td colspan="19"></td>
</tr>
<tr class="even">
<td colspan="19">List all approvals or certifications required by other
federal, interstate, state, or local agencies for any structures,
construction, discharges, deposits, or other activities described in
this application.</td>
</tr>
<tr class="odd">
<td colspan="19"></td>
</tr>
<tr class="even">
<td colspan="3"><strong>Issuing Agency</strong></td>
<td colspan="5"><strong>Type Approval</strong></td>
<td colspan="3"><strong>Identification No.</strong></td>
<td colspan="6"><strong>Date of Application</strong></td>
<td colspan="2"><strong>Date of Approval</strong></td>
</tr>
<tr class="odd">
<td colspan="3">     </td>
<td colspan="5">     </td>
<td colspan="3"><blockquote>
<p>     </p>
</blockquote></td>
<td colspan="6"><blockquote>
<p>     </p>
</blockquote></td>
<td colspan="2"><blockquote>
<p>     </p>
</blockquote></td>
</tr>
<tr class="even">
<td colspan="3">     </td>
<td colspan="5">     </td>
<td colspan="3"><blockquote>
<p>     </p>
</blockquote></td>
<td colspan="6"><blockquote>
<p>     </p>
</blockquote></td>
<td colspan="2"><blockquote>
<p>     </p>
</blockquote></td>
</tr>
<tr class="odd">
<td colspan="3">     </td>
<td colspan="5">     </td>
<td colspan="3"><blockquote>
<p>     </p>
</blockquote></td>
<td colspan="6"><blockquote>
<p>     </p>
</blockquote></td>
<td colspan="2"><blockquote>
<p>     </p>
</blockquote></td>
</tr>
<tr class="even">
<td colspan="3">     </td>
<td colspan="5">     </td>
<td colspan="3"><blockquote>
<p>     </p>
</blockquote></td>
<td colspan="6"><blockquote>
<p>     </p>
</blockquote></td>
<td colspan="2"><blockquote>
<p>     </p>
</blockquote></td>
</tr>
<tr class="odd">
<td colspan="3">     </td>
<td colspan="5">     </td>
<td colspan="3"><blockquote>
<p>     </p>
</blockquote></td>
<td colspan="6"><blockquote>
<p>     </p>
</blockquote></td>
<td colspan="2"><blockquote>
<p>     </p>
</blockquote></td>
</tr>
<tr class="even">
<td colspan="3">     </td>
<td colspan="5">     </td>
<td colspan="3"><blockquote>
<p>     </p>
</blockquote></td>
<td colspan="6"><blockquote>
<p>     </p>
</blockquote></td>
<td colspan="2"><blockquote>
<p>     </p>
</blockquote></td>
</tr>
<tr class="odd">
<td colspan="3">     </td>
<td colspan="5">     </td>
<td colspan="3"><blockquote>
<p>     </p>
</blockquote></td>
<td colspan="6"><blockquote>
<p>     </p>
</blockquote></td>
<td colspan="2"><blockquote>
<p>     </p>
</blockquote></td>
</tr>
<tr class="even">
<td colspan="19"></td>
</tr>
<tr class="odd">
<td colspan="19">Has any agency denied approval for the activity
described herein or for any activity directly related to the activity
described herein?</td>
</tr>
<tr class="even">
<td> Yes</td>
<td> No</td>
<td colspan="17"><em>(If “Yes” attach explanation)</em></td>
</tr>
<tr class="odd">
<td colspan="19"></td>
</tr>
<tr class="even">
<td colspan="19">Project plans or drawings should accompany the
application. These should be on paper suitable for reproduction no
larger than 11 x 17 inches or contained on a 3-1/2 inch floppy computer
disc in “dxf” format, and should be submitted to the appropriate TVA and
U.S. Army Corps of Engineers offices. An application that is not
complete will be returned for additional information.</td>
</tr>
<tr class="odd">
<td colspan="19"></td>
</tr>
<tr class="even">
<td colspan="12"><strong>U.S.A.C.E. Offices</strong></td>
<td colspan="7"><strong>TVA Office Location</strong></td>
</tr>
<tr class="odd">
<td colspan="4">U.S. Army Corps of Engineers</td>
<td colspan="8">U.S. Army Corps of Engineers</td>
<td colspan="7">Tennessee Valley Authority</td>
</tr>
<tr class="even">
<td colspan="4">Eastern Regulatory Field Office</td>
<td colspan="8">Savannah District</td>
<td colspan="7"></td>
</tr>
<tr class="odd">
<td colspan="4">Spring Cress Business Park</td>
<td colspan="8">The Plaza, Suite 130</td>
<td colspan="7"></td>
</tr>
<tr class="even">
<td colspan="4">501 Adessa Blvd., Suite 250</td>
<td colspan="8">1590 Adamson Parkway</td>
<td colspan="7"></td>
</tr>
<tr class="odd">
<td colspan="4">Lenoir City, Tennessee 37771</td>
<td colspan="8">Morrow, Georgia 30260-1763</td>
<td colspan="7"></td>
</tr>
<tr class="even">
<td colspan="4">(865) 986-7296</td>
<td colspan="8">(678) 422-2729</td>
<td colspan="7"></td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="8"></td>
<td colspan="7"></td>
</tr>
<tr class="even">
<td colspan="4">U.S. Army Corps of Engineers</td>
<td colspan="8">U.S. Army Corps of Engineers</td>
<td colspan="7"></td>
</tr>
<tr class="odd">
<td colspan="4">Regulatory Branch</td>
<td colspan="8">Western Regulatory Field Office</td>
<td colspan="7"></td>
</tr>
<tr class="even">
<td colspan="4">3701 Bell Road</td>
<td colspan="8">2042 Beltline Road, SW, Bldg C, Suite 415</td>
<td colspan="7"></td>
</tr>
<tr class="odd">
<td colspan="4">Nashville, Tennessee 37214</td>
<td colspan="8">Decatur, Alabama 35602</td>
<td colspan="7"></td>
</tr>
<tr class="even">
<td colspan="4">(615) 369-7500</td>
<td colspan="8">(256) 350-5620</td>
<td colspan="7"></td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="8"></td>
<td colspan="7"></td>
</tr>
<tr class="even">
<td colspan="4">U.S. Army Corps of Engineers</td>
<td colspan="8">U.S. Army Corps of Engineers</td>
<td colspan="7"></td>
</tr>
<tr class="odd">
<td colspan="4">Norfolk District</td>
<td colspan="8">Asheville Regulatory Field Office</td>
<td colspan="7"></td>
</tr>
<tr class="even">
<td colspan="4">P.O. Box 338</td>
<td colspan="8">151 Patton Avenue, Room 208</td>
<td colspan="7"></td>
</tr>
<tr class="odd">
<td colspan="4">Abingdon, Virginia 24212</td>
<td colspan="8">Asheville, North Carolina 28801-5006</td>
<td colspan="7"></td>
</tr>
<tr class="even">
<td colspan="4">(276) 623-5259</td>
<td colspan="8">(828) 271-4856</td>
<td colspan="7"></td>
</tr>
</tbody>
</table>

+-----------------------------------------------------------------------+
| **Privacy Act Statement**                                             |
|                                                                       |
| This information is being requested in accordance with Section 26a of |
| the TVA Act as cited on the front page of this form. Disclosure of    |
| the information requested is voluntary; however, failure to provide   |
| any required information or documents may result in a delay in        |
| processing your application or in your being denied a Section 26a     |
| permit. An application that is not complete will be returned for      |
| additional information. TVA uses this information to assess the       |
| impact of the proposed project on TVA programs and the environment    |
| and to determine if the project can be approved. Information in the   |
| application is made a matter of public record through issuance of a   |
| public notice if warranted. Routine uses of this information include  |
| providing to federal, state, or local agencies, and to consultants,   |
| contractors, etc., for use in program evaluations, studies, or other  |
| matters involving support services to the program; to respond to a    |
| congressional inquiry concerning the application or Section 26a       |
| program; and for oversight or similar purposes, corrective action,    |
| litigation or law enforcement.                                        |
+-----------------------------------------------------------------------+

+-----------------------------------------------------------------------+
| **Burden Estimate Statement**                                         |
|                                                                       |
| Public reporting burden for this collection of information is         |
| estimated to average 1.5 hours per response, including the time for   |
| reviewing instructions, searching existing data sources, gathering    |
| and maintaining the data needed, and completing and reviewing the     |
| collection of information. Send comments regarding this burden        |
| estimate or any other aspect of this collection of information,       |
| including suggestions for reducing this burden to Agency Clearance    |
| Officer, Tennessee Valley Authority, 1101 Market Street, Chattanooga, |
| Tennessee 37402; and to the Office of Management and Budget,          |
| Paperwork Reduction Project (3316-0060), Washington, D.C. 20503.      |
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|                                                                       |
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