20100285 Ver 2_Shoreline Stabilization_20191028

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State of North Carolina
Department of Environment and Natural Resources
DWR--", Division of Water Resources
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
Division of Water Resources FO M: SSGP 10-2013
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Shoreline Stabilization Application Form
One copy of the application (including attachments) and the application fee-, \shod Ment to:
Division of Water Resources Ix
401 & Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
1. Applicant Information [15A NCAC 02H .0502(a)]
RECElVEQ!DENROW
1. Owner Information
OCT 2:8 2019
Name: j rti V:'d t 1)CL a S
yifat'ar a=eitrt
Mailing Address: 204-2 k)C' C-E-.
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Permitting Section
Telephone Number: '1bq- . 0'1- 1533 Fax Number:
E-mail Address: +me_d.ulnr6s ®5 1010'3CmaIl.coftm
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2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
http://www.saw.usace.army.mil/PortalsIL59jdocs%regulatorylregdocq/Permits/SAMPLE
AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name:
Company Affiliation:
Mailing Address:
�u r6T'A7aRM11=iMr4W&21rt.
Telephone Number: 'i[)Lt- La(uD- 51(( Fax Number: Jog - t otp(,) - 5gC9q
E-mail Address: ctnenecuu)a.lksQ-�t,ilrtd5+Y-eo.m. ne+
Person to receive the Certification Approval: —,FRn , c ee r_5}ep
11. Project Information [15A NCAC 02H .0502(a) & (b)]
1. Attach a vicinity map (i.e. street map) clearly showing the location of the property with
respect to local landmarks such as towns, rivers, and roads.
2. Provide a detailed site plan showing property boundaries and proposed locations of
vegetation clearing, structures (buildings, retaining walls, docks, impervious surfaces,
etc.), rip rap, excavation or dredging below Full Pond/ Normal Water Level elevations,
FORM: SSGP 10-2013 Page 1 of 3

and construction access corridors. You may use the diagram provided at the end of this
application form.
3. Attach a photograph of the shoreline/ buffer proposed to be stabilized. (Include a scale
of some sort- a yard stick, shovel handle, etc.)
4. Location of the property (where work is to be conducted)
County: Nearest Town: Co rne_� ,y5
�
Subdivision name or site address (include phase/lot number): toy 2$ l%p_n eve
#'
Directions to site - please include road names and numbers, landmarks, etc.:
see 0--t+6tched
Latitude (in decimal degrees) 35,L190 Rio ( Longitude (decimal degrees) " W aE 5 s1
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): leb,l3e,4IOLA
6. Property size (acres): 2. 55P� ae_rCIS
7. Lake/ river/ ocean adjacent to property: orm_ xq
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): �iho�r�Q.. Slonp. n5 ll rna-E�� nQ and
bOew l C1 r r� ,� rn`�
9. Will work be conducted from land? ❑ From water? 0
10. Total amount of disturbance (including all excavation, backfill, rip rap, retaining walls, etc.)
below the normal pool lake level/ Normal Water Level in square feet or acres:
1,115 SV' e12 irnfl .v+)
If
11. Total amount of disturbance (including all clearing, back fill, excavation, rip rap, retaining
walls, etc.) above the normal pool lake level/ Normal Water Level and 50 feet land -ward in
square feet or acres: ( i Cll-5nve.
12. Please describe the vegetation above the normal pool lake level/ Normal Water Level and
50 feet landward to be impacted (number of trees, for instance): _cJrasS kolF�c1_r
_on (� n +rePkieA , no d;t-t,rko_nc210. oE-kr, world rhone 6+barse,.
Owner/Agent's Signature* [15A NCAC 02H .0502(f)]
lb 11-7 1 l
Date
Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 3

Full Pond/
Normal Water Level
Shoreline
Lake
(At Full Pond/Normal Water Level)
i
5 elou,�
1 0�A-3o v e
235' je,n3+h
MEMO
jyo-�'re25 rerc�o�ed
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Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ft x 100 ft) *:
1. All proposed vegetation clearing
2. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
3. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
4. Location of any proposed structures such as buildings, retaining walls, docks, etc.
5. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
Tina Edwards
20428 Deep Cove Ct.
Cornelius, NC 28031
FORM: SSGP 10-2013 Page 3 of 3

1021/2019 610 East Cerdw Averuie, Mooresville, NC to 2042E Deep Cove Ct, Corndirs, NC 26031 - Google Maps
Google Maps 610 East Center Avenue, Mooresville, NC to 20428 Deep Cove Ct, Cornelius, NC 28031 Drive 10.6 miles, 21 min
610 E Center Ave
Mooresville, NC 28115
t 1. Head south on Evergreen St toward E Center Ave
17 s (197 ft)
r► 2. Turn right onto E Center Ave
1 min (0.5 mi)
Continue on S Church St to S Main St
2 min (0.6 m)
41 3. Turn left onto S Church St
0.5 mi
r' 4. Turn right onto College St
0.1 mi
Take NC-115 S and 1-77 S/US-21 Sto Bethel Church Rd in
Cornelius
-
14 min(8.4 m)
41
5.
Turn left onto S Main St
1.2 mi
t
6.
Continue onto NC-115 S
2.1 mi
r'
7.
Turn right onto Langtree Rd
1.1 mi
8.
Usethe left 2 lanesto turn left onto
the Interstate
77 S/US 21 S ramp
0.2 mi
9.
Merge onto 1-77 S/US-21 S
29 mi
MtpsJM+ .google.conit apsldri610+Fast+Center+Avenue,+Moorestille,+NC20428+Deep+Cove+Ct,+Cornelius+NC+280311@35.5310073; 60.6663997,13rla t(data-!4ml414ml311n5!lm111sa2&13ft641c43... 12
101212019 610 East Center Avenue, Mooresville, NC to 20428 Deep Cove Ct, Cornelius, NC 28031- Google Maps
r 10. Take exit 28 for US-21
0.2 mi
11. Merge onto W Catawba Ave
0.7 mi
Continue on Bethel Church Rd. Take Walter Henderson Rd
to Deep Cove Ct
3 min (1.1 m)
r' 12. Turn right onto Bethel Church Rd
0.5 mi
r' 13. Turn right onto Walter Henderson Rd
0.4 mi
41 14. Turn left onto Deep Cove Ct
0.2 mi
20428 Deep Cove Ct
Cornelius, NC 28031
These directions are for planning purposes only.
You may find that construction projects, traffic,
weather, or other events may cause conditions to
differ from the map results, and you should plan
your route accordingly. You must obey all signs or
notices regarding your route.
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Polaris 3 G Map — Mecklenburg County, North Carolina
Date Printed: 10/21/2019 1:50:25 PAS
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This map or report is prepared for the inventory of real property within Mecklenburg County and is compiled from recorded deeds, plats, tax maps, surveys, planimetric maps, and other public records and data.
Users of this map or report are hereby notified that the aforementioned public primary information sources should be consulted for verification. Mecklenburg County and its mapping contractors assume no legal
responsibility for the information contained herein.

10/21/2019
20428 Deep Cove Ct - Google Maps
,. k [,,dap, , 20428 Deep Cove Ct
Imagery ©2019 Google, Imagery ©2019 Maxar Technologies, Orbis Inc, U.S. Geological Survey, Map data ©2019 50 ft
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20428 Deep Cove Ct - Goog le Maps
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