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Home My WebLink About20200147 Ver 1_Shoreline Stabilization_20200127C�240020oiq -f- -r4p State of North Carolina DeparLret of Fisi®t ri Natural Resourt 1SA NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization FORM: SSGP02-2017 Shoreline Stabilization Application Forth Three copies of the application (including attachments) and the application fee should be sent to: IJsending via US Pascal Service Ifsen&ng via delivery service (UPS, FedEx, ere.) Karen Higgins Karen Higgins DWR - 401 & Buffer Permitting Branch DWR - 401 & Buffer Pemtitring Branch 1617 Mail Service Center 512 N. Salisbury Street Raleigh, NC 27699-1617 Raleigh, NC 27604 A. Appliewt Information 115A NCAC 02H .0502(a)1 1. Owner Information' Name: t.ri C'1 ��i✓ N � C.�ti J f� V I C Mailing Address: LiLLL P/Nrs GT 55 cam( LI_S Fo4 _p, Isi✓ a��-7 3 Telephone Number: Fax Number: -703- 338- l Z)J_ 5 7 E-mail Address: 1 /i,C� 1 z O t.0?E1�Sh V I C_ H V 2. Agent/ Contact Person Information A signed and dated copy of the Agent Authorization letter must be attached if the Agent has signed this application form. (A form can be downloaded here: blip:/,' w ,.saw.asaca.a y.niil%Portals/59/do !mpulato ,4 gdmc Permits/SAMPLE AGENT AUTHORIZA 110N FORM,odfl y Name: c��: 1` 10 Q (� CompanyAffihation: Mailing Address: ('M ,_trD(ZES J 1 Telephone Number: Fax Number: -70c{ LfUS- (P39 Q/ N( E-mail Address: 5za ��s c� �oc� �'-} � o O K�p� � • ��rr� B. Project Information 115A NCAC 02H 0502(a) & (b)1 l . 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. https://files.nc.gov/ncdeq/Water%200uality/Surface%20Water...%20PermiWSSGP°h2002-2017%2OShoratine%2OPorm final.docx 11/26119, 10:15 AM Page i of 6 2. Provide a detailed site plan showing property boundaries and proposed locations of vegetation clearing, buildings, retaining walls, docks, impervious surfaces, 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. L �rC�17 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,. Lake/ river/ ocean adjacent to property: L j-T,(-6 N CiZ-CY-% tPrl�i Property size (acres): !D , --I �9 n (L�s Subdivision name or site address (include phase/lot number): L-R+.x-- t" r rJ ►, 2,0 '1— 10 61?a-33 6 4)ft � . Gd- 5 KKR k'-L5 Rb�Lo, AJC- a9�(1273 �� Directions to site - please include road names and numbers, landmarks, etc.: S �^' �5 t 6/ 00 !1-T- O'a'C�fl �5 LA N ►� 1 Nz" `� 3 1n . \-� S aN C.ATAt' e') Fo 1 We 0.1 'K I C=' r+i o JJ F-'GLL�i V 1 NtS � - Latitude (in decimal degrees)_ Longitude (decimal ql 5(3 -C�- degrees) 315 . (.0 a L--Q (9 C) - S�o . 9LO(q -10 5. Describe the existing land use or condition of the site at the time of this application (residential, undeveloped, etc.): gC� i DEk (I Pf L 6. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or why it is necessary): �� S� 6 ( L- l Z P=-k t 0 l-A u"S / N G 1 `Doa � Q4 L3 �-�� SV� C� E3fr2C— -lam 7. Will work be conducted from land? From water? 8. Total amount of impacts below the normal pool lake level / Normal Water Level Permanent impacts (including all excavation, backfill, rip tap, retaining was, etc.) in square feet -� o 5q. -- Temporary impacts in square feet NY 9. Total amount of impacts above the normal pool lake level / Normal Water Level and 50 feet land- ward Permanent impacts (including back fill, excavation, rip rap, retaining walls, etc.) in square feet https://files.nc.gov/ncdeq/Water%20Quality/Sur#ace%2OWater..%20Permits/SSGP%2002-2017%20Shoreline%20Form-final.docx 11126/19, 10:15 AM Page 2 of 5 Temporary impacts (temporary clearing, construction corridor) in square feet- 0 (A(-\ 10. 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): Q N t 11. Signature Owner/Agents Signature [15A NCAC 021 .0502(fll Date w'9-0 Agent's signature is valid only if an authorization letter from the owner is provided. 12. Please approximately sketch the following information on this plan and provide &&»ions for each ite"r a. All proposed vegetation clearing b. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation C. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation d. Location of any proposed structures such as buildings, retaining walls, docks, etc. e. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation 3 R p�> Full PCno Pai https://files.nc.gov/ncdeq/Water%20Quality/Surface%20Water...%20Permits/SSGP%2002-2017%2OShoreline%20Form_final.docx 11126/19, 10:15 AM Page 3 of 5 r 4WrK - s.-n xw. ^... .. .:.:i. ..f r Plan View h biw IJ P'b vHS+� Irvnl 4 N .lan IW! PY•.E wM M.vl 1 N..4.4.YM1i� iNmirq •X rcanwy EnEs mg Oink Side hitps://files.nc.gov/ncdeq/Water%200uality/Surface%2OWater...%20Permits/SSGP%2002-2017%2OShorelina%2CForm final.docx 11/26119, 10:15 AM Page 4 of 5 IV Resources , _ F�, FM Zrqj �o pep o` Is/ahOp. . . oh c rRq � �9233 Belle Pines Ct Carolina Hideaway Luxury Vacation... 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