20200945 Ver 1_Shoreline Stabilization_20200720

`Mate of North Carolina
* Department of Environment and Natural Resources
l Division of Water Resources
Division of Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SSGP 10-2013
Shoreline Stabilization Application Form
Three copies of the application (including attachments) and the application fee should be sent
to:
If sending via US Postal Service
Karen Higgins RECEIVED
DWR — 401 & Buffer Permitting Branch
1617 Mail Service Center JUL 2 0 2020
Raleigh, NC 27699-1617
WDEWWRWNPDES
Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: Jubal Reeves LLC Scott Westbrook
Mailing Address: 6398 Green Oak Drive
Stanfield, NC 28163
Telephone Number:
Fax Number:
E-mail Address: [e-mail]
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/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
Person to receive the Certification Approval:
II. 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,
FORM: SSGP 10-2013 Pagel of 3

1. Attacn a vicinity neap (►.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,
and construction access corridors. You may use the diagram provided at the end of this
application lorm.
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 (lie property (where work is to be conducted)
County: o go►uery
Nearest Town: ML
Gilead
Subdivision name or site address (include phase/lot number):
222 Jubal Reeves Circle -
Woodrun
Directions to site - please include road names and numbers, landmarks, etc.:
I"roino NC — take 24/27 W towards Albemarle. (_,pprox. 13 miles)
Turn riglit onto River Road, tuna left onto Woodrun Drive. Turn left onto Skyland Court,
Turn left onto Skvland Drive, turn left onto Sleepy Hollow, Turd right ontg Sl_eep,." III
Lane, then turn right onto Jubal Reeves
Circle.
Latitude (in darimal degrees)_ 35.317910 Longitude (decimal
degrees) -30.076910
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): residential
developed
6. Property size (acres): .52
acre
%. Lake/ river/ ocean adjacent to property: LUJU
T►lle►v.
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary)
1�R
9. Will work be conducted from land? -
stabilize shoreline with class 2 rip
From water?
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:
10011. of shoreline x 6' below — 600
aqA
11. Total amount of disturbance (including all clearing, back fill, excavation, rip rap, retaining
walls, etc.) WIgyq the normal pool lake leveV Normal Water Level and 50 feet land -ward
in square feet or acres: 100 ft. of shoreline x 6' above - 600
4A
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): native V getative
RL
e
Owner/Agent's Signature+ [15A NC'AC 021J .0502(111 Date V7, (1, 2Z2C
Agent's signature is valid only if an authorization letter from the

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REFERENCE
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MAP BOOK A, PAGE 683
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MAP WITHOUT PRIOR WIITTEN CONSENT IS A
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SEALED WITN RED INK.
BOUNDARY SURVEY FOR
SCOTT WESTBROOK
UWHARRIE TOWNSHIP
MONTGOMERY COUNTY, N.C.
SCALE: 1'= 50'
MAY 16, 2020
FILE / 200508
BARRETT 0. EATMAN PLS L-3556
25152 CABIN RIDGE ROAD
ALBEMARLE, TIC 28001
704-953-2451 ,

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