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001 APPLICATION FOR CONSTRUCTING FACILITIES ON PROGRESS ENERGY S PROPERTY LAKE ROBINSON I. Date of Application: II. Applicant Information (please print) Lessee s Name(s): Lease Code (ROB0.0XXX): Billing Address: City: State: Zip: Telephone (h): Telephone (w): III. Property Information (please print) Property Address: City: State: Subdivision: Lot No.(s): Telephone (lake): Zip: County: IV. Proposed Activity Dock New Modification Seawall/Rip Rap New Modification Boat Ho.

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