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HomeMy WebLinkAbout20220260 Ver 1_Shoreline Stabilization_20220217 •
Shoreline Stabilization Application Form `" 'a,
NORTH CAROLINA
EnWrortmental Quaiity
15A NCAC 02H.0500—Water Quality Certification,Shoreline Stabilization
FORM:SSGP 10-2013
DRAFT-NOT FOR USE AT THIS TIME
Submission Form
I. Applicant Information [15A NCAC 02H .0502(a)]
Please note:fields marked with a red asterisk *below are required. You will not be able to submit the form until all
mandatory questions are answered.
Primary Contact Email* jasonorsick@gmail.com
Please provide an email address for payment and requests for more information here.
Owner Information:
Name:* Jason Orsick
Email:* jasonorsick@gmail.com
Phone Number: (401)743-3252
(xxx)xxx-xxxx
Mailing Address:* Street Address
2051 Brawley School Road
Address Line 2
City State/Province/Region
Mooresville NC
Postal/Zip Code Country
28117-7082 US
Is there an agent working on the project?* Yes
No
Agent/Consultant Information
Name:* Janice Estep
Company Affiliation:* CBC Stone&Recycling,LLC
Email:* info@cbcstoneandrecycling.com
Phone Number:* (704)660-5111
(xx()xxx-xxxx
Mailing Address:* Street Address
638 Oakridge Farm Hwy
Address Line 2
City State/Province/Region
Mooresville NC
Postal/Zip Code Country
28115 United States
A signed and dated copy of the Agent Authorization letter:*
Auth.Form.pdf 597.83KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC O2H .O5O2(a) & (b)]
Project Name:* Orsick Dredge
If your project has a formal name please use this.If your project does not have a formal name,please identify your project
by the owner name and proposed activity(Jones Property Access Road,Smith Guest House,etc.)List in parentheses
any other names that have been used to identify the project in the past.
1. Provide 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.*
Upload File
Look up address
Upload Map: Plat Map.pdf 1.72MB
Vicinity Maps.pdf 5.77MB
Latitude:* 35.512559 Longitude:* -80.928587
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 under
section 12.normal pool lake level/normal water level*
Site Plan.pdf 940.08KB
Buffer Form.pdf 1.03MB
Please use the diagram at the link below:
https://edocs.deq.nc.gov/WaterResou rces/0/edoc/616616/Shoreline%20Layout.docx
3.Attach a photograph of the shoreline/buffer proposed to be stabilized.(Include a scale of some sort-a yard
stick,shovel handle,etc.)
Dredge Area Pics.pdf 33.85MB
4. Location of the property(where work is to be conducted)
Nearest Town:* Mooresville
County:* Iredell
Lake/river/ocean adjacent to Norman
property:
Subdivisions name or site address:* Lot 4 Saylors Watch Subdivision
Include phase/lot number
Directions to site:*
610 E Center Ave
Mooresville,NC 28115
Head south on Evergreen St toward E Center Ave
13s(197ft)
Turn right onto E Center Ave
2 min(0.5 mi)
Continue on S Church St.Take E Catawba Ave to W Wilson Ave
3 min(0.6 mi)
Turn left onto S Church St
0.3 mi
Turn right onto E Catawba Ave
0.2 mi
Turn left onto S Academy St
0.1 mi
Take NC-1100 to Torrence Chapel Rd
18 min(10.2 mi)
Turn right onto W Wilson Ave
1.2 mi
Continue onto NC-1100Brawley School Rd
1.0 mi
Continue straight to stay on NC-1100Brawley School Rd
6.4 mi
At the traffic circle,take the 2nd exit onto NC-1100
1.6 mi
Turn left onto Torrence Chapel Rd
2 min(0.5 mi)
16938-16900 Torrence Chapel Rd
Mooresville,NC 28117
Please include road names and numbers,landmarks etc.
5. Describe the existing land use or condition of the site at the time of this application:*
Residential(new construction)
Residential,undeveloped,etc.
6.Property Size 1.122 acres
Acres
7. Describe proposed work(include discussion as to how hardening of shoreline has been avoided,or
why it is necessary):
Dredge a 94'x 50'area for new dock.Dredge by barge,haul material off
by land.
8. How will the work be done?* From Land
C� From Water
9.Total amount of disturbance below the normal pool lake level/normal water level:*
(including all clearing,back fill,excavation,rip rap,retaining walls,etc.)
696.29 cubic yards
below
square feet
10.Total amount of disturbance above the normal pool lake level/normal water level and 50 feet land-
ward:*
(including all clearing,back fill,excavation,rip rap,retaining walls,etc.)
0'above for dredge
10'x 50'access
corridor(500 sf of
temp.impact)
square feet
11.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)
Grass buffer,no trees removed,minimal disturbance to buffer.
Sketch: Dredge Application.pdf 11.5MB
Dredge Spoils Info.pdf 7.73MB
Sketches.pdf 825.53KB
Application Fee:
Once the application has been accepted. You will need to send a corresponding fee in with the appropriate DWR#.The
application fee is as follows(pursuant to G.S. 143-215.3D):
a $240.00 for impacts to lake(below normal water level)of less than 1 acre
a $570.00 for impacts to lake(below normal water level)of greater or equal to 1 acre
By digitally signing below,I certify that:
a I,the project proponent, hereby certifies that all information contained herein is true,accurate,and complete to the best
of my knowledge and belief
a I,the project proponent, hereby requests that the certifying authority review and take action on this CWA 401
certification request within the applicable reasonable period of time.
a I agree that submission of this Shoreline Stabilization online form is a"transaction"subject to Chapter 66,Article 40 of
the NC General Statutes(the"Uniform Electronic Transactions Act");
a I agree to conduct this transaction by electronic means pursuant to Chapter 66,Article 40 of the NC General Statutes
(the"Uniform Electronic Transactions Act");
a I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature;AND
o I intend to electronically sign and submit the Shoreline Stabilization online form.
Full Name:* Janice Estep
Signature:
Submittal Date: 2/14/2022
Initial Review
Is this accepted into the review process?* • Yes No
Project Number:* 20220260 Version:* 1
Select Reviewer:* Doug Perez:eads\djperez
Select Reviewing Office: Mooresville Regional Office-(704)663-1699
Has payment been received?* No Payment Needed
c_ Fee Received
C• Need Fee-send electronic notification
What amount is owed?* '• $240.00
$570.00
AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. 4 PLAN NO. PARCEL ID:
STREET ADDRESS: 11?) Sag or S 1..Vac h Ln
CYlooresv., Ite NC a 8 t1-1
Please print:
Property Owner: Jason Ors 1 CIA
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
J aYl ACC.5�-e >�
(Contractor / Agent)
of G ec, S-Vone �1eC'C�`a flc ILL(
(Name of consulting firm) j
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
ao5 ----2)r l-k ScIr,onk °Orellfa2111
Telephone: /1-10 j - 11-13- 3a5Z
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
uthorized .nature
Date:
Authorized Signature
Date: (1')
y_ vizikrwp
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113 Say
ors Watch ono Lot 4
Legend
35.512559 -80.928587
N
Full Pond/
Normal Water Level
Shoreline
Lake
(At Full Pond/ Normal Water Level)
56
1�\o ree3 reAYIO\Cd
Cr) f)'1e o.1 cV,lt-Of\ooLrice
wide
G
5
NeW
Cr
Please approximately sketch the following information on this plan, Eength of shoreline
(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
FORM: SSGP 10-2013
Page 3 of 3
Ci TAWBi RI1PARM BUFFER 6 C ` IIRCATB N FORriVil
Project Name/address:_I 13 �n�► for �� a Lam► resv "i i le County:
Owner:—_)aS'an FS: C\4 \1<'\L.
Print
Contractor/agent: CgC. cyv►e E
Print - - "ature
The approval is for the purpose and design described in your application. Impacts not indicated in the
application is a violation of the Buffer Rule. Site specific work should be provided in the application. [15A NCAC
02H .0506 and 15A NCAC 02B .0243(8)]
Trees are not allowed to be removed from Zone 1 of the Buffer (within 30 ft of the full pond elevation), unless
approved. Exception, those trees that are severely undermined along the immediate shoreline can be removed.
Minimal shaping and sloping along the immediate shoreline is allowed. [15A NCAC 02B .0243(6)]
Benching, grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 02B .0243 (6)]
Beaches, impervious patios, impervious walkways, etc. are not allowed in the buffer unless specifically approved
by the Division. There are limitation on size for decks. [15A NCAC 02B .0243(4) and (6)]
Work to be conducted from land must indicate an access and indicate any trees that are to be removed. The
work corridor should be described. The approved access corridor shall be restored. Staging, spoil, construction
material must be outside the buffer. (15A NCAC 02H .0502 and 15A NCAC 02B .0243 (4), (6), (8)]
Stormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
discharges must be at the natural elevation and discharged prior to entering the buffer directed as diffuse or
sheet flow at non -erosive velocities to the lake. [15A NCAC 02B .0243(5), (6)]
Acknowledgement of Notification
I, 0;t6n Of5-i 06 _ , hereby state that I have been informed of the Catawba
Riparian Buffer Rule. Any work conducted in the buffer, not specifically stated in the application and approved
by the Division of Water Resources (DWR), is a violation and subject to enforcement. Due diligence will be
taken such that the construction will be built within substantial compliance and intent of the 401 Water
Quality Certification and Buffer Rules, the approved plan(s) and specification(s), and other supporting
materials.
Signature
Date: �7',51Z:2
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Duke Energy Excavation Permit Application Form
FOR DUKE ENERGY IJSE ONLY
Duke File No.
Application Fee $ Security Deposit $ Check # Date Recv'd Initials ii
Date of Duke Energy Lake Services, applicant and/or contractor on -site inspections Datet 6 �' Initials t.J er✓ 11,t
Date Final Protection/Avoidance Area Markings Field - Verified Initials
Approved to Start Work By * : Date
(Print) (Sign)
Date Completion Required Date of Any Approved Extension Initials
Date Passed Closeout Inspection* Initials
Any Stop Work Orders or SMG Violations*? (check one) ❑Yes ❑No (If Yes, explain in PART V)
Date Deposit Refunded
Initials Date Permit Database Updated Initials
* Forward copy of approved application (all pages, plus any attachments that Duke Energy changed) back to applicant
with Approval Letter and highlight any changes. File copies of Approval and Close-out Checklists and any Stop Work
Orders with application.
Part I. Applicant Information (Please Print)
Name ,JGSe) Or-S tC K
Email address:
Telephone 4 0 1- 1 L-13 - 3a5 a
Jct_-1er,ors -, me 1 L corn
Lake Address Mailing Address (if different
13 lc.r5 LJ -k.- n. a,c51 rcw3'ke �Cheol 1 .
a-10xnreSVrI\-e NC. asl11 roc-esv,lte, ia1C 2.g11-)
Contractor Company 21 C_ S P c d ', n3 „ LLG
Contractor Contact Person , n lcc S - Telephone ` 104 - Cotob - 51 r
Contractor Email Address: 1 cr e bCskone_and re9C .1nq or Cr
LAKE LOT INFORMATION `1
Lake I`lorrn(r,fl County -Treekell City Innnres s't Ike. State MC Tax Map No.
Subdivision Scu jor- l ja. Lot / Section No. Lo-k- 4 Lot Size LuaAcres
Duke Energy Page 4 of 13
Excavation Program
rev 11/22/21
Duke Energy Excavation Permit Application Form
Security Deposit Refund Information
The security deposit will be refunded after the excavation permit has expired if no violations of
the approval occurred. The applicant will receive the security depost refund at the mailing
address in Part I unless an alternative recipient is identified.
Send the security deposit to an alternative recipient? (check one) ❑Yes 17&o (If Yes,
include name and mailing address below.
Name: Tax ID:
Mailing Address:
Are there any Co -Applicants*? (check one) ❑Yes E6o (If Yes, include names, street
addresses or lot numbers, pier numbers, phone numbers, and email addresses in Part V —
Additional Information)
* Co -Applicants exist when the proposed work is being done under a single application, will be
performed by a single contractor as one continuous project, and is done to benefit multiple
owners / lease holders of Project -front properties within a single development. There can be no
more than 4 co -applicants in addition to the lead applicant on any application.
Do not continue the application until an on -site inspection has been conducted between a
Duke Energy Lake Representative and the applicant and/or the excavation contractor.
NOTE: Initialling this portion of the application by a Lake Representative in no way
constitutes approval or eminent approval of the excavation or any other lake use permitting
activity.
Date of on -site inspection L. 145 ZZ.
Initials (Duke Energy) !) CV 1(1 (applicant/contractor) ` 1F
Duke Energy
Excavation Program
Page 5 of 13 rev 11/22/21
Duke Energy Excavation Permit Application Form
Part II. Description of Project
A. Basic Infoiuiation
1. Type of excavation: (check one) "New excavation 0 Maintenance excavation
2. Purpose of excavation: (check one) 0 Boat Access Channel
0 Water Intake Channel 0 Wastewater Discharge Channel
'Other (specify): ne.no cicem,
3. Lake user category: (check one) ZPrivate
❑Commercial Marina ❑Public
❑Other (specs):
❑Residential Marina
4. Max. Excavation Area Dimensions (ft): Length q 1-i Width 5(')1 Depth 1 a
(Note: include additional area dimensions if necessary so response to #5 below equals max. area
dimensions in #4)
5. Volume of Excavated Material (TOTAL for the project): (.12(21C0 Cubic yards
6. Type of material removed (applicant determines by field sample ifpractical):
-Dirq ii-
7. Excavation Site area: 0 • L131 Acre (s)
(s)
Disposal Site area: a. a. G Acre
8. Total Disturbed Area (including equipment staging area): 0 • t-{ y'a
Acre (s)
9. Does the project meet the requirements of the applicable General Permit? (check one)
Et Yes ❑No
10. Do you claim title to the disposal area? (check one) ❑Yes iilo
11. Do you claim title to the equipment staging area? (check one) Lies ❑No
12_ Are there any water -treatment facilities within 50 feet of the proposed excavation area?
(check one) ❑Yesto
(If Yes, specify):
13. How will the excavated material be entrapped and the erosion controlled? (e.g. see attached
erosion control plan and disposal area design):
-Oredse Vaarge. , ho_.ul 010L-Ver ia1 oo* b land-t-hrooS acc,eSS on
\ro r+4 avid flake els�c 1 �'�te ioec�?-eck a.}- (036 Z')Yl�,ric�eFo_rvrl�wtJ
Mooresv1Ile. t Mc aQ115
Duke Energy
Excavation Program
Page 6 of 13
rev 11/22/21
Duke Energy Excavation Permit Application Form
14. Type(s) of excavation equipment to be used:
Lo n5 r ec&c1i eX cova.+or broo eo by bc4.ro e.,
15. Will waters or wetlands be crossed in transporting equipment to or from the site?
(check one) ElYes DNo
(If yes, explain)
h5 b0 €
16. Will return water re-enter the reservoir? (Check one) :Wes 015'o
(If Yes, specify point(s) of re-entry and show on Excavation Area Drawing)
❑N/A
17. Is there an existing facility (e.g. pier) that access is being maintained to by conducting the
excavation? ❑Yes ®No
(If Yes, provide the existing permit number. IfNo, include a scaled drawing of the proposed
facility). Permit It new dcc baP?l e.ck cor
18. Total planned duration of the work (Include first equipment mobilization, excavation
through final mitigation measures complete):
START 'l / 9•2 FINISH 1 / •aa
(Month) (Year) (Month) (Year)
Duke Energy Page 7 of 13
Excavation Program
rev 11/22/21
Duke Energy Excavation Permit Application Form
Part II. (Continued)
B. Protection / Avoidance Area Description
Complete the following table including all land areas within and immediately adjoining the disturbed area:
Protection/Avoidance Areas
Auprox
Identification
Method (*)
Avoid (A) or Mitigate (M)
(check all that apply)
Acre
Field ID
Work Area Dwg. ID
a. Marshland, swamp, ponds, beneficial
NI ( A
aquatic vegetation or other potential wetlands
(circle all that apply)
✓' b. Buffer Zones (specify width & source
0,01k
I� red e �o r 2.
I-10,1/4.3 l r cn re.r l &\ oCC \:,
land
of requirement) •
► o u,� Ids, access
A--lnro09 h 50' ‘,.., F-cr
c. Environmental Areas as identified by
N I p
Duke Energy
d. Natural Areas as identified by Duke
NIA
Energy
e. Historic properties (specify)
f. Rare or threatened species (specify)
NA
g. Buried gas, water, sewer,
N i A
communications or electric lines (circle)
Duke Energy
Excavation Program
Page 8of13
rev 11/22/2021
Duke Energy Excavation Permit Application Form
Protection/Avoidance Areas
Approx
Identification
Method (*)
Avoid (A) or Mitigate (M)
(check all that apply)
Acre
Field ID
Work Area Dwg. ID
I
h. Impact Minimization Zones as
NI I_IA
identified by Duke Energy
i. Other areas requiring specific
N i 'A
avoidance, protection or mitigation (spec)
* For "Field ID" column, specify entity or person that performed the identification and how it was physically marked (e.g. Duke
Energy (John Doe)/Pink and purple -dotted tape, Corps of Eng. (John Smith)/ yellow flagging). For "Work Area Dwg ID" column,
show the symbol that is used on the drawings to identify the protection/avoidance area.
** List and attach mitigation plans
Duke Energy
Excavation Program
Page 9 of 13 rev 11/22/2021
Duke Energy Excavation Permit Application Form
C. Applicant's Signatures
Cotnments: jke191nhUrs
P'1l ue_ Paluclo act-ri C10.. -De 5ou2o.
115 S u jiors U.Sa*ch Lin.
Moores ille, NC as in
FrarlC2.5ca.. ryee-Fey
i0C1 Sn'j1oYS UJa�c1� Lr.
moCoce.5 1 1 1e, `' I i-1
Applicant Name (print) A. at*
applicant Signature*,' Date l f �2
Co -Applicant Name (print)
Co -Applicant Signature*
Co -Applicant Name (print)
Oe.„.(e.
Date \'t' 7)
Co -Applicant Signature* Date
Co -Applicant Name (print)
Co -Applicant Signature*
Date
Co -Applicant Name (print)
Co -Applicant Signature* Date
*Per my signature, the information provided in this application is correct to the best of my
knowledge.
Duke Energy Page 10 of 13
Excavation Program
rev 11/22P2021
Excavation Project User's Agreement Letter
(Please fill in the blanks. Please Print)
Date o-3-aa
TO: Duke Energy
c/o Lake Services - EC12Q
526 S. Church Street
Charlotte, NC 28202
RE: Excavation For (Subdivision and Lot #'s or Other Project Name)
L.v# Sc4or5 UJa.#c n
(Lake/County/City) rr c&x / -=rec1e11 / fnoo -esv i 11e_
(Applicant's full name) 3c.6on (Dc21C.\' hereby agrees to comply with all
recommendations, requirements and/or conditions of Duke Energy, General Peunit(s) (if
applicable) and other federal, state and local agency requirements pertaining to the application to
excavate for the purpose of a (1e.W doh '1
In addition, I/we have read and agree to comply with Duke Energy's current Shoreline
Management Plan (SMP) or other applicable guidelines, much of which is repeated herein, and
understand that written authorization must be obtained from Duke Energy prior to beginning any
activity within the Federal Energy Regulatory Commission (FERC) project boundary or on Duke
Energy property associated with a reservoir, collectively referred to as Project Boundary. The
excavation will be completed as described in the approved application and within eighteen (18)
months from the date of written approval by Duke Energy, unless specifically noted otherwise in
the application or unless I/we obtain approval for a single, time extension (maximum of one year)
in writing from Duke Energy. I/we understand that if the SMP or other applicable guidelines or
rules change during any extension period, I/we will be expected to comply with the new
requirements to the maximum extent practicable. I/we also recognize that failure to complete the
excavation within this build -out period will require the filing of a new application within the then -
current SMP or other applicable guidelines and the new application must include any applicable
fees and security deposits.
I/we attest to be the owner(s) or lease holder(s) of the land immediately adjoining the Project
Boundary where the excavation activity is to take place, or if not the owner or lease holder, I/we
have included proof of title to the property and written authorization from the owner(s) or lease
holder(s) to carry out the proposal within the Project Boundary adjacent to their land.
I/we attest to be the owner(s) or lease holder(s) of the land that will be used for equipment
staging and disposal of excavated material or if not the owner or lease holder, I/we have included
proof of title to the property and written authorization from the owner(s) or lease holder(s) to
carry out the work on their land.
Duke Energy
Page 1
Rev 4/6/2020
I/we understand that all excavation work must be done directly in front of my/our property and as
specified in Duke Energy's approval. I/we also understand that access channels must run
perpendicular to the shoreline while within the third of the cove area that is nearest my/our
property.
I/we understand that for proposed excavations, I/we must notify the appropriate local, state and
federal agencies in advance of the activity by sending them a completed copy of Duke Energy's
Excavation Permit Application Form and other required information. I/we understand that
written authorization and/or other permits may be required by some of these agencies and such
required authorizations must be obtained before I/we submit the fmal application to Duke
Energy.
At FERC-licensed reservoirs, I/we understand that except for maintenance excavations, any
excavation exceeding 2000 cubic yards of material removed or any excavation or shoreline
stabilization work needed to support an application that requires FERC review does itself require
specific review and approval by the FERC before Duke Energy can issue any approvals.
I/we agree that unless specifically approved otherwise in the application, explosives will not be
used as part of this excavation activity.
I/we understand that every reasonable effort must be made to minimize any adverse impact on
fish, wildlife and other natural resources.
I/we understand that applicants in South Carolina proposing excavations that are not covered
under the General Permit, or are greater than 150 cubic yards, must receive prior written
authorization from the South Carolina Department of Health and Environmental Control
(SCDHEC) or the US Aiury Corps of Engineers (as applicable) before submitting the completed
application to Duke Energy.
I/we agree that excavation activities will not occur during the months of March, April, May and
June because of the potential impacts to fish spawning areas.
I/we understand that trees and vegetation growing within or adjoining the lake play an important
role in its overall environmental condition, and the ecological benefit the vegetation has on fish
and wildlife habitat directly supports a sound and healthy lake enviromnent. I/we also understand
that unauthorized removal of shoreline vegetation (e.g. button bushes, willows, cattails, etc.)
and/or disturbance of the shoreline buffer may result in suspension or denial of lake use
permitting requests, forfeiture of security deposits and require re-establishment of vegetation at
my/our expense, particularly if the disturbance is found to be in violation of state or local
ordinances or impacts FERC project buffers.
I/we agree all excavated material will be placed in upland areas, landward of the Project
Boundary, and confined to prevent erosion and sedimentation back into the lake or nearby
streams.
Duke Energy
Page 2
Rev, 4/6/2020
I/we agree to adequately stabilize all excavated material and all disturbed shoreline to prevent
erosion and runoff into the lake.
I/we understand that the double handling of excavated material will not be allowed; therefore, all
excavated material must be placed above the Project Boundary in one handling.
I/we have designed the hydraulic excavation process (if any will be used) so that return water re-
enters the lake in the same general vicinity and cove as the excavation, to the maximum extent
practicable.
I/we agree that the proposed excavation will not be for the purpose of creating additional
shoreline, will not alter the Project Boundary or the full pond contour, and will not impact
threatened or endangered species, historic properties, or environmentally -important areas, unless
special public entity provisions were made in the application.
I/we recognize that it is my/our responsibility to clearly locate in the field and label on my/our
work area drawings any areas that require specific protection or avoidance during this excavation
work. Examples of these protection/avoidance areas include but are not limited to, any
Environmental Areas, Natural Areas or Impact Minimization Zones as identified by Duke
Energy; jurisdictional wetlands; historic properties; rare or threatened species; and buried gas,
water, sewer, electric or communications lines. I/we agree to provide my/our contractor with a
copy of these work area drawings showing these areas to stress the necessary protection
measures.
I/we agree that if any archaeological resources (e.g. pottery shards, Indian artifacts, etc.) are
discovered during the excavation, work shall be halted immediately. I/we will then notify Duke
Energy and the State Historic Preservation Office to determine what measures, if any, //we must
pursue to protect or salvage the archaeological resources.
I/we agree that any excavation from within the Project Boundary will not exceed the volume as
outlined in the application and will remove and disturb only what is absolutely necessary to
achieve the project's stated purpose.
I/we agree to be fully responsible for the permitted lake use and I/we understand that this
responsibility is considered to transfer automatically along with ownership and leases of the
adjoining tract.
I/we understand Duke Energy representatives may issue Stop Work Directives for violations of
the SMP or other applicable guidelines and other consequences may result from such violations,
including but not limited to suspension or cancellation of approved permits, increases in fees,
modification or removal of non -complying structures and restoration of disturbed areas at my/our
own expense or loss of any consideration for future lake use permits. I/we agree to immediately
comply with any Stop Work Directives, to fully cooperate with Duke Energy and other agencies
as necessary, and to perform the necessary remedial actions within the specified time frame.
Duke Energy
Page 3
Rev: 4/6/2020
Uwe agree to develop any required mitigation plans and to complete any required mitigation
activities at my/our own expense within the specified time frames. Uwe recognize that the
excavation work is not considered complete and deposits will not be refunded until the
mitigation requirements (if any) have been satisfactorily fulfilled.
//we agree to notify Duke Energy by phone when the excavation is initiated and to ensure that
during the excavation period, I/we will post Duke Energy's approval letter in a clear waterproof
bag at the lob site and visible from the water's edge.
Uwe agree to notify Duke Energy in writing when the excavation is completed (including any
required mitigation measures) and that the excavation was completed per the approved
application, so a close-out inspection can be performed.
Uwe recognize security deposits will not be refunded if any violations of the SMP, other
applicable guidelines, or this user's agreement occur.
Uwe understand there will be no change in hydro project operations as a result of the excavation
and/or utilization of the excavated area.
I/we agree to maintain the work area in a safe condition and to fully indemnify and save Duke
Energy harmless from any and all claims, liability, loss or damage that may arise from this
excavation project.
//we understand that this user's agreement does not, in any way, constitute the transfer of any
rights in real property and that my/our use and enjoyment of FERC project and Duke Energy
lands and waters shall not hinder the general public's lawful use and enjoyment of the same.
Sincerely,
bpi P(5i K
Applicant's Name Print) `— pplieant's gnature
14-e 4 or-S c 4'
Co -Applicant's Name (Print) Co-Appli ant's Si
Co -Applicant's Name (Print)
Co -Applicant's Name (Print)
Co -Applicant's Signature
Co -Applicant's Signature
Co -Applicant's Name (Print) Co -Applicant's Signature
Duke Energy
Page 4
Rev A/6/2020
Type: CONSOLIDATED REAL PROPERTY
Recorded: 12/3/2021 2:19:34 PM
Fee Amt: $7,626.00 Page 1 of 2
Revenue Tax: $7,600.00
Iredell County, NC
Maureen P. Purcell Register of Deeds
BK 2876 PG 1741 - 1742
NORTH CAROLINA GENERAL WARRANTY DEED
Excise Tax: $ 7,600.00
Parcel Identifier No. 4624579069 Verified by County on the day of , 20
By:
Mail/Box to: Thebeau &Associates, PA. 19600 W Catawba Ave., Bldg. A Ste. 100. Cornelius, NC 28031
This instrument was prepared by: Thebeau &Associates, PA, 19600 W. Catawba Ave , Bldg A, Ste 100, Cornelius, NC 28031
Brief description for the Index: LOT 4, Saylor's Watch
THIS DEED made this 3rd day of
December , 20 21, by and between
GRANTOR
Ra Iph Coppola and wife,
Kimberly Coppola
251 Gainswood Drive
Mooresville, NC 28117
GRAN I'i E
Jason Orsik and wife,
Heidi Orsik
113 Saylors Watch
Mooresville, NC 28117
Enter in appropriate block for each Grantor and Grantee: name, mailing address, and, if appropriate, character of entity, e.g.
corporation or partnership.
The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and shall include singular,
plural, masculine, feminine or neuter as required by context.
WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby acknowledged, has and by
these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that certain lot, parcel of land or condominium unit
situated in the City of Mooresville Township, Iredell County,
North Carolina and more particularly described as follows:
BEING all of Lot 4 of SAYLORS WATCH Subdivision, as shown on map recorded in Map Book 72 at Page 12, a revision of Map Book 53 at Page
25, Iredell County Public Registry.
Page 1 of 2
NC Bar Association Form No. 3 © 1976, Revised 01977, 2002, 2013 This standard form has been approved by:
Printed by Agreemant with tha NC Par Anon ; r; t(lo 1 .. .. .. . . . _
Submitted electronically by "Thebeau and Associates"
in compliance with worth Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Iredell county Register of Deeds.
The property hereinabove described was acquired by Grantor by instrument recorded in Book 2752 page 425
All or a portion of the property herein conveyed _ includes or _X does not include the primary residence of a Grantor.
A map showing the above described property is recorded in Plat Book 72 page 12
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in fee
simple.
And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple, has the right to convey the same in fee
simple, that title is marketable and free and clear of all encumbrances, and that Grantor will warrant and defend the title against the lawful
claims of all persons whomsoever, other than the following exceptions:
All such valid and enforceable easements and restrictions of record.
IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year first above writte
(Entity Name) Print/Type Name: Ralph Coppola
By.
Print/Type Name & Title:
By:
Print/Type Name & Title: Print/Type Name:
By:
(SEAL)
f � t:4) ^` C L (SEAL)
Print/Type faille: K.inibbrly Coppola
(SEAL)
(SEAL)
Print/Type Name & Title: Print/Type Name:
State of N efrTh Card ii .1i - County or City of • RtOVV 'ice
I, the undersigned Notary Public of the County or City of VW and State aforesaid, certify that
Ralph Coppola and wife, Kimberly Coppola personally appeared before me this day and acknowledged the
due execution of the foregoing instrument for the purposes therein expressed. Witness my h. . nd Notarial stamp or seal this 2_ day of
Decemb er , 20 2-t JENiFER MEEKS
NOTARY PUBLIC
My Commission Expires: Zf Rowan County
t • e- t e� : S Notary Public
Affix Seal)
North Caroline�—
( My Commission Expires ?j �} Notary's Printed or Typed Name
State of - County or City of
I, the undersigned Notary Public of the County or City of
and State aforesaid, certify that
personally appeared before me this day and acknowledged the
due execution of the foregoing instrument for the purposes therein expressed. Witness my hand and Notarial stamp or seal this day of
, 20 .
My Commission Expires:
Notary Public
(Affix Seal) Notary's Printed or Typed Name
State of - County or City of
I, the undersigned Notary Public of the County or City of and State aforesaid, certify that
personally came before me this day and acknowledged that
_he is the of a North Carolina or
corporation/limited liability company/general partnership/limited partnership (strike through the
inapplicable), and that by authority duly given and as the act of such entity, __he signed the foregoing instrument in its name on its
behalf as its act and deed. Witness my hand and Notarial stamp or seal, this day of 20.
My Commission Expires: _ Y Notary Public
(Affix Seal) Notary's Printed or Typed Name
Page 2 of 2
NC Bar Association Form No. 3 © 1976, Revised © 1977, 2002, 2013 This standard form has been approved by:
Printed by Agreement with the NC Bar Association — 1981 North Carolina Bar Association — NC Bar Form No. 3
[Project Nametaddress2 I I
Locabn AddressiD_
BREDGE SP IL DISPOSAL FORM
Fpgiti Jd&,,
Pamell gi,dplaq
Percerinot $1,p1 „ LtC),
/I tr.set
Okacosa area reepAred (scj andlior acreage) I no' -
Acknowiedgegysepn Nod/lotion
n
eS r. , am aware that the site must adhere to all state regulations
and rules regarcilng sedi nt a d erosion control and water quality. And give permission for
060‘11
Name of individual and Company
to dispose of their dredge material at the above stated location
Outrnerg \c-'1 ciaeS
Print
Date:
eSu'l ',te_Countyg
ft hic a HT
Along with form, please provide: •
Aerial of parcel/lot (County GIS)
Photo of proposed spoil site
Identified proposed spoil site
5/24/2021
Iredell.ConnectGIS
CONNECGiS
Wct, HOSTING
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httos://iredell.connectois.com/Map.aspx
111
STATE OF NORTH CAROLINA
IREDELL COUNTY
I certify that this map was drawn from an actual survey made under my
supervision The unadjusted rotio of precision as calculated is 1': 10,000±
Boundaries not surveyed, 11 ony, ore noted. Deed descriptions are recorded in Book as
Page shown .Witness my hand and seal this 4th day of JUNE , 2019.
Professional Land Surveyor
L-3703
® PROPERTY SUBJECT TO ANY VALID & ENFORCEABLE
EASEMENTS, RESTRICTIONS & RIGHTS OF WAY OF RECORD.
• SURVEY IS BASED ON PHYSICAL ENDENCE AND EXISTING
MONUMENT FOUND DURING THE SURVEY.
• PROPERTY CORNER PIPE SIZES AS SHOWN ARE NOMINAL
INSIDE DIAMETER.
LEGEND
NOTES:
• ALL DISTANCES ARE HORIZONTAL GROUND DISTANCES
UNLESS OTHERWISE NOTED.
• AREA 8Y COORDINATE COMPUTATION. I LOCATION MAP
UNES SURVEYED
LINES NOT SURVEYED
11E ONESOVHD DISTRIBUTION UNE — • —
(OVERHEAD)
R/W LIMITS — - - — - -
C'Q, TRANSMISSION O NO MONUMENTA11ON
POWER POLE UNLESS OTHERWISE
CL CENTERLINE NOTED
PROPERTY LINE
(F) DENOTES °FOUND„
(S) DENOTES °SET"
NTS DENOTES °NOT TO SCALE"
BENT #4
/REBAR (F)
/ DUKE ENERGY
1RANSMISSION UNE
NOT TO SCALE
UNE TABLE
LINE I BEARING
DISTANCE
60.30
24.31
40.80
95.21
46.53
170.16
82.82
PIN 4668-20-8185
BRIDGES PROPERTIES, LLC
D.B. 1602 PG. 1912
LOT ff1-P.111. 36 PG. 150
/
GRAPHIC SCALE
0 75 150
1
( IN FEET )
1 inch = 150 ft.
- LINE R/14,
PIN 4667-29-6642
BRIDGES
PROPERTIES, LLC
D.B. 1602 PG. 1912
STAGING AREA
0.227 ACRE-7
yam•-64C3 / l L7-(7IE
LINE ONLY)
571.73'
TRANSMISSrGN
I
PIN 4667-29-5304
PCM'ORLESS HOLDIlIGS, LLC
D.B. 2160 PG. 1029
LOT #2-P.B. 26 PG. 73
TAX ID: 4667-29-6642
FOR SOURCE OF TITLE REFER TO D.BK. 1602 PG. 1912
PROPERTY OWNED BY
BRIDGES PROPERTIES, LLC
SURVEY SHOWING LOCATION OF
STAGING AREA
CODDLE CREEK TOWNSHIP IREDELL COUNTY, N.C.
SCALE: 1" = 150'
BOOK: NA
DATE OF SURVEY: JUNE 3, 3019
DATE OF MAPPING: JUNE 3, 2019
L1
I N14'58'43"E
L2 I N64'57'57"E
L3 ! S71'07`33"E
L4 i S63'06'35"E
L5 I S06'55'28"E
L6 N78`30'12"W
L7 I 354'19'38"E
PIN 4668-30-1353
OARPIDGE STORAGE, LLC
0.6, 2521 PG. 2033 /
/
I /
CONCRETE
NU
NMO679940.48MENT(F) F'
E 1462951.44 FT
NAD 83(2011)
m
/
yY
6n
vf
PIN 4667-39-0000
ARGOS USA LLC
D.B. 2016 PG. 4981(CD)
NAIL (F) AT BENT
"4 REBAR (F)
679337.77 FT
E 1462830.56 FT
NAD 83(2011)
LNS FILE NO.:
S190507
DWG NO.:
S190507
SURVEYED BY: N.D. WHITLEY
DRAWN BY:
N.D. WHITLEY
CHECKED BY:
J.R. HOBBS
SURVEY AND MAP PREPARED BY:
LAKE NORMAN SURVEYING
& MAPPING PLT,C #P-0790
137 Jennings Road, Suite C
Statesville, North Carolina 28625
(704) 876-4450 Fax (704) 876-4451
11111111 l 11I111III1111111 Il II
Doc ID: 00E1889990003 Tvoe CRP
Recorded: 1i/23/2004 at 01:2B 00 PH
Fee Amt: $674.00 Page 1 of 3
Excise Tax: $854.00
Iredell County_ NC
Brenda D. Bell Register of Deeds
BK 1602 PG 1912-1914
Excise Tax $654.00
Tax Lot No.
Verified by County on the day of
by
Parcel Identifier No 4667-29-6642 and 4668-20-8185-4.34
Mail after recording to: Grantee
This instrument prepared by: Lutzel, Gandy Broadway, PLLC
Brief Description for the Index
NORTH CAROLINA GENERAL WARRANTY DEED
THIS DEED made this 22nd.... day of November 2004, by and between
GRANTOR
Donald Ray Snyder and wife,
Victoria A. Snyder,
a/k/a
Vicotira A, Snyder
GRANTEE
Bridges Properties, LLC
628 Oak Ridge Farm Hwy
Mooresville, NC 28115
Enter in appropriate block for each party; name, address, and, if appropriate, character of entity,
e.q. corporation or partnership.
The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns
and shall include singular, plural, masculine, feminine or neuter as required by context.
WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby
acknowledged, has and by these presents does, grant, bargain, sell and convey unto the Grantee in fee simple, all
that certain lot or parcel of land situated in the City of , ... Township, Iredell County,
North Carolina and more particularly described as follows:
See Exhibit "A" attached hereto and made a part hereof
:t
The property hereinabove described was acquired by Grantor by instrument recorded in Book , Page
A map showing the above described property is recorded in Plat Book , Page
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the
Grantee in fee simple.
And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple, has the right to convey the same
in fee simple, that title is marketable and free and clear of all encumbrances, and that Grantor will warrant and defend the title
against the lawful claims of all persons whomsoever except for the exceptions hereinafter stated, Title to the property herein -
above described is subject to the following exceptions:
All easements, restrictions and rights of way of record.
Ad valorem taxes for the year 2005 and subsequent years not yet due and payable.
All matters revealed by and accurate survey of the property.
IN WITNESS WHEREOF, the Grantor has hereunto set his hand and seal, or if corporate, has caused this instrument to be signed
in its corporate name by its duly authorized officer(s) by authority of its Board of Directors, the day and year first above written.
(Corporate Name)
By:
President
Attest:
Secretary
(SEAL)
• Donald Ray Snyder
o (/
Victoria A. Snyder
to (SEAL)
w
co
ors �Y. • (SEAL)
NORTH CAROLINA � , 4I G -- COUNT
I, a Notary Public of the County and State aforesaid, certify.:..
Snyder and Victoria A.
SNyder, Grantor, personally appeared before - u s �trd acknowledged •e executi.n of the
foregoing instrument. Witness my hand and o ial s' inp o cal this 2Znd...y - 004.
My Commission Expires:.t;7.'4/Q/.4 Notary lie
(SEAL)
NORTH CAROLINA, COUNTY,
I, a Notary Public of the County and State aforesaid, certify that
Grantor, personally appeared
before me this day and acknowledged that he/she is of
.a
corporation, and that he/she as ., being authorized to do so, exe-
cuted the foregoing instrument on behalf of the corporation. Witness my hand and official stamp or
seal this day of , 2004.
My Commission Expires:
The foregoing Certificate(s) of .
is/are certified to be correct. This instrument and this certificate are duly
�efirst p
Notary Public
gistered at thand time and in the Book and Page
Deeds for4 aunty
Deputy/Aaaictoet—Register of Deeds
EXHIBIT "A"
TRACT II: BEING all of that certain 6.49 acre tract located in Coddle Creek Township, Iredell
County, North Carolina on NC Hwy 150 By-pass; being more particularly described as follows:
BEGINNING at a point in the centerline of the 100 ft. right of way for NC Hwy 150 By-pass,
said point being located North 36-17-36 East 2,458.39 ft. (Ground) from NCGS Monument "Run
In" N; 206,469.354 meters E: 445,280.693 meters Dated: 1991 NAD 83; thence continuing from
said point of Beginning and along the centerline of the right of way for NC Hwy 150, North 36-
22- 16 East 561.58 ft. to a point, thence leaving said right of way and running with the line of
Whitman property (now or formerly) South 64-06-48 East 49,80 ft. to an existing #4 rebar in the
eastern margin of the right of way for NC Hwy 150; thence South 64-06-48 East 246.91 t_ to an
existing 1 1/2" pipe; thence continuing with another line of Whitman property North 40-19-43
East 305.82 ft. to an existing 1" pipe; thence North 71-18-07 East 121.51 A. to an existing angle
iron in the line of Evelyn Brown (See Deed Book 308, Page 337, IredelI County Registry);
thence a new line of John W. Caffey, et al (see Deed Book 601, Page 538, lredell County
Registry) South 42- 31-26 West 221.12 ft. to an existing concrete monument; thence another new
line of Caffey, et al South 15-00-41 West 614.81 ft. to an existing #2 rebar; thence with the
northern line of Lot 2, Scott D. Burton Property (see PIat Book 26, Page 73, Iredell County
Registry) North 74-59-17 West 572.00 ft. to an existing #2 rebar in the eastern margin of the
right of way for NC Hwy 150; thence North 74-59-17 West 53.64 ft. to the point and place of
Beginning.
TRACT II: BEING all and the full contents of Lot No. 1 as shown on plat of Minor
Subdivision for William Wallace Whitman Estate and recorded in Plat Book 36, Page 150,
Iredell County Registry, to which plat reference is made for a more full and complete description
of said lot by metes and bounds,
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SN3Id'8 S31000 301SH31VM