20200026 Ver 1_Shoreline Stabilization_20191230

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December 22, 2019
Division of Water Resources
401 & Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Dear Sir or Madam,
hPA
Please find enclosed three copies of a Shoreline Stabilization Application form and a check in the
amount of $240.00.
I am submitting the enclosed to secure permission to accomplish 2 goals:
1.) Document the existence of an existing boat house, demolish boat house structure and rebuild a
new structure on the same (or smaller) footprint, and
2.) Refresh Rip Rap on same property
The property address for both goals is:
8088 McConnell Road
Denver, NC 28037
Please feel free to contact me with any questions.
Thank you for your consideration of this request.
4�
Kurt J Koch
8069 McConnell Road
Denver, NC 28037
704-577-7354
[e-mail]
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DEC 31 2019
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State of North Carolina
Department of Environment - t 9 ' es
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Division of Water Resources
15A NCAC 02H .0500 — Water Quality Cettl6catlon, ShoreOne StabiRzation
FORM: SSGP 10-2013
Shoreline Stabilization Application Form
Three copies of the application (including attachments) and the application fee should be
sent to:
Division of Water Resources
401 & Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
1. Applicant Information [I5ANCAC 02110502(a)]
Owner Information
Name: vo—T j . b(lhA
Mailing Address:
gobs[ MLCaVJJat.L UA6
brwvl� AIL 2-8034
Telephone her : Fax Number:
i�l- S77-'7354
E-mail Address:
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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:
http1/www.saw.usace.ariny.mil/Portals/­59/docs/­`regulatQlyZI.Qg
flocs/Permits/SAMPLE AGENT AUTHORIZATION FOR
M.PdL must be attached if the Agent has signed this application form.
Name: Company Affiliation: /�i l3D jI1`_ )
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
Person to receive the Certification Approval:
11. Project Information [15ANCACo2ll0502fa1R (7)j
1. Attach a vicinity trap (i.e. street map) clearly showing the location of the property with e J` � D `lA 11
respect to local landmarks such as towns, rivers, and roads. v
2. Provide a detailed site plan showing property boundaries and proposed locations of 5 k--�-%LOS`r--IJ tt 6 11

vcgcuxuou uctuing, snucrures tomlamgs, retaining walls, docks, impervious surfaces,
etc.), rip rap, excavation or dredging below Full Pond/ Normal Water Level elevations,
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 SEE &jQ6Jo5/L.C> d Gn
of some sort- a yard stick, shovel handle, etc.)
4. Location of the property (where work is to be conducted)
County: Lit ott4 Nearest Town: NtANQk/ Mc
Subdivision name or site address (include phase/lot number):
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DuL vttL, AI(I L1?,o3l
Directions to site - please include road names and numbers, landmarks, etc.:
14 L I to TO W 2BBs it D . i rZ'C-r onl (3U T'CfQ t40 . / fZT ON W &66 S
u-IAML ; TZ-T or-1 McLos.)NkLL_ 2D / i n iu-, otJ iZ1w4r
Latitude (in decimal degrees)_ Longitude (deomai
degrees)
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.):
IZrz51 XAM/V L N&.1-J 14em2 GoN5T W( ilOA/ wl F x 1sT tJ �, t3o�4T1lou
sr►w�ry �xlsiiiJl eA 6. Property size (acres): i P-1P P
Q r $O(o /aL
%. Lake/ river/ ocean adjacent to property:
LAkr 11ozjmAnl
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): /
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9. Will work be conducted from land? Yf-- S From water? too or— 13oATI 10IJS k.F F2!_�
10. Total amount of disturbance (including all excavation, backfill, rip rap, retaining walls, /P'IP P-AP
etc.) helow the normal pool lake level/ Normal Water Level in square feet or acres:
ZLAO
1 I. 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: to +Z Z'I' (L^IO Sr-) W 00A P&MOVA-L "l6
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12. Please describe the vegetation above the normal pool lake IeveV Normal Water Level and RIP �� p, r.�j,, , . I
50 feet landward to be impacted (number of trees, for instance): AJ'; %'GA
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Owner/Agent's Sigr> Printed
Name FLU iV_ J , 140LA Date / Z - 15 j - ZO I °I
[15A NCAC 02H .0502(t)]
Agent's signature is valid only if an authorization letter from the
owner is provided.

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8088 McConnell Rd - Google Maps I IC#4ITi PAA Page 1 of 1
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-8088 McConnell Rd - Google Maps
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