20140410 Ver 1_401 Application_20140414

,l PLEASE SEND, EMAIL OR FAX APPROVALS TO:
LANCASTER DOCK
1156 PERTH ROAD, TROVTMAN, :.NC 28166
Steve Davis
aspireconcepts@aol . corn
Fax: [phone]
Cell: 704- 516 -8342

DUKE POWER LAKE MANAGEMENT, EC12 -0 2 0 1 40 4 10
P. O. BOX 1006
CHARLOTTE, NC 28201 -1006
704-382 -1567 OR TOLL FREE 1- 800 - 443 -5193
APPLICATION FOR PERMIT TO STABILIZE THE SHORELINE IN NORTH
CAROLINA
Please type or print and fill in all blanks. If information is not applicable, so indicate by placing N/A in
blank. PLEASE SUBMIT APPLICATION AND APPROPRIATE DUKE POWER FILING FEE, PAYABLE
TO DUKE POWER, TO ABOVE ADDRESS. $_!PAAIIUD
I. Applicant Information
A. Name IW4A V D. EV4E-R_e114 "t
B. Mailing Address 2 t b Z I Y HeX—XS Dki V4e- IPS .A16
C. Telephone Toy - 25Z - 1,7 65
II. Location of Proposed Project
A. Lake /VaP —/n A ,t/
B. Street Address 21,621 NOR nf,,V .5_,t0,QES Ae7v66 r v,v�✓6�ivs NC z8o,3 /
C. County Mc��vBL /QG
D. City, Town, Community or Landmark
E. Section Lot # 17 Subdivision
F. Directions to property by road ?7 J' -6 Ex, t A1- i.vt o 7 eM��
1►♦ �,�, fe /�d/ Mme- �iiircS ��' IY�
G. Latitude and longitude for the project site 3S. SoEp�// I - ,�; d . /,r'Q ( /
H. Please submit a map showing the coordinates or a detail d map (USGS quad map, city map,
etc.) showing the exact location of the project site. (NOTE: Latitude /longitude coordinates can
be found on internet site, www.mapsonus.com. Directions: Don't register, click "Maps ", enter
address, draw map, select "Map Clicking Will... ", select "Lat/Long ", click map)
III. Description of Project
A. Length of wall Z 71
1
Material Rl p 9/+,,0 W17-A4 1+1 A 7T /.-vG
Distance from property line /shoreline
IV. Intended Use of Project Area
A. Private X
B. Commercial
V. Applicant Signature l
ltu�
PLEASE NOTE THE FOLLOWING: I
A COPY OF THE COMPLETE APPLICATION WITH A ROAD MAP SHOWING LOCATION OF THE PROPERTY MUST BE SUBMITTED TO: US
ARMY CORPS OF ENGINEERS, 151 PATTON AVENUE, ROOM 208, ASHEVILLE, PIC 28801 -5006
A COPY OF THE "DUKE POWER APPLICATION FOR PERMIT TO STABILIZE THE SHORELINE IN NORTH CAROLINA" AND SEVEN (7)
COPIES OF THE COMPLETED "NC DIVISION OF WATER QUALITY PRE - CONSTRUCTION NOTIFICATION APPLICATION" MUST BE
SUBMITTED WITH THE DIVISION OF WATER QUALITY APPLICATION FEE TO: NC DIVISION OF WATER QUALITY, ATTENTION: Cyndi
Karoly, PARKWEW BLDG., 2321 CRABTREE BLVD., RALEIGH, NC 27604, PHONE: 919 - 733 -1786

Directions to site — please include road numbers, landmarks, etc (This �is not necessary
if an adequate vicinity map is included)
7 7 5 +a E.A-L+ 2�F . R LG H T G,-r o
R 0 M-T "TO 111akn*vy _5,; / 2gss 95e i IAE Z ! Z
2 Describe the existing land use or condition of the site at the time of this application
��S iDEn�T /R2- ZoT
3 Property size (acres)
A Nearest body of water (stream /river /sound /ocean /lake) „LAKE - it/GRNt 11-1-/
5 Describe the purpose of the proposed work STA81L, /Z />YG - �}i'e.�EL/ti�
$Y _D T.Q
i ^'9s l� t i�/l /yl,g Ti /�/G I ND �I P IRA T C_tiO4
6, `List -the type of equipment to be used to construct,the project
7 Amount of impact (including all excavation, backfdl, rip rap, retaining walls, etc ) below
X zj!
8 a Amount oflimpact,(mcluding all clearing, back fill-, excavation, rip rap, retaining walls,
etc ) above the normal pool lake level and 50 feet land -ward ih square feet or acres
6`X2- 71
b Please` describe, vegetation above the normal pool lake level and 50,feet land -ward to
be impacted (number of trees for instance)
/AppftandAgenWls ffiganatuve Date
(Agent's signatur,�9s vadidAoniy'dan au horizadon letl ' froird Me appiBCani10s provided)

DUKE LNLRGY DIRECTIONS BY ROAI) DORM
Lake (Ise Perntit,Appheants and Contractors Luse of locating the proposed project site can have a bib
unpact on permit pioc.essmg time Please complete. this form and tetutn it along with your completed permit
application to
DUKE ENERGY
C /C) LA=KE SI-AIVICLS - EC 12 Q
PO BOX 1'006
CHARLOTTE,,NC 28201 -1006
1-800- 443 =5193 and select Option S
App'licant's Name
Street Address (a( lake) _ Z l6 2-[__ 1)! � S}!p2 S_�Ri y,=7-
Lake Name
Subdivision Name
rax Parcel ID (if known) D� �Y 3 J L ( Lot 11
City /LvL J /%S County
State _ '. Zip - - - --- �8 e2
Latitude Longitude
Telephone
Directionss�(from mayor road or highway) /J 7 7 S � �x 17—�
DiYTO / 0 RQ N« C�ApEL /kC 16 t7,7—
-14r Z 1,0 2- Z-e PT ,
Descriptive Structure(s) on Property (i e brick garage, white fence, mobile home, etc)
gpal /LAK[:MGM r /Package Intomation /Directions "by Road ronn doc E /20/09

I
Lake (Full Pond)
Full Pond
Shoreline
'Please approximately sketch the folioweieng irnforrvnetiorn on this pslern,(pleese provide dimensions
for each Rem, such as, 16 ft.�x 100 ft.): J
1) All oroposed vogeta$ ion clearing (provide dimensions)
2) Location of rip ragor,feal to be placed above,the Full Pond, elevation
3) Location of rap rep or fill to the placed below the,Full Pond elevation
4) The location of any proposed stmctum such as buildings, retaining walls, docks, etc.
5) Thejocation of any excavabon or dredging below the Full pound elevation.
6) Location of construction access corrldors.

401 INATER QaBALrTY CERTIFICATION APPLO CATION
The following 4s an abbreviated application form for those applying for a 401 Water Quality Certification to
impacg I,ERC (Federal Energy Regulatory Commission) regulated lake shore or bottom under the U S.
Army'Corps of Engineers Permit GP30. This Application cannot be used for wetland or stream impacts
Please provide seven (7) copies of this application and supporting information as well as a non -
refundable application fee to the Division of Water Quality of $200.00 for impacts to lake bottom of less
than 1 acre and $475.00 for impacts to lake bottom of greater or equal to 1 acre.
APPLICATIONS TO BE SENT TO.
DIVISION OF WATER QUALITY WETLANDS UNIT
1650 MAIL SERVICE CENTER
RALEIGH, NC 27699 -1650
Owner /Applicant Information
Name It'Ig,Q F ✓�lL�vti�M
Mauling Address 2-1,6 21
Telephone�Number ?o _2 S2 - / 9 6-
Fax Number
E- mailAddress R D E M D E @' A o /-'. c ors _
2. Agent Information (A signed and dated copy of the Agent Authori: �on j%t:,er must be attached
if the Agent has signatory authority for the ownerlapplicant-)
Name :5�v Vg I)*VS.f
Company Affiliation Lancaster C 'Dock iota ShoMhuz
Mailing Address 1156 Perth Road
Trouhst n, NC 28166
Telephone Number 70"28.7400 j C E L 1, : 7 o 4 • 5"1$ - J",3 ,Y 2
Fax Number 7
E-mail Address ASPIRE CdwcEP 7-9 6P' 4qZ - com
18, Pfflject Infomation
Attach a v §clnky imp clearly shovAng tine - location of the property wM respect to local landmarks
such as tmvns, rivers, and roads Also provide a detailed sfte pbua showing property boundaries
and development plarm in relates to surrounding properties. Yoi4 rnay use the diagram balowto
make a hand sketch of your project Also, see the example below for guidance. Both the vicinity
map and site plan must include a scale and north arrow The footprints of all buildings, impervious
surfaces, or other facilities Faust be included.
Locaton
County /Yl�C��Neg Gre6 Nears# rowri —, --
Sub&Asion name or sis address (include phasaAot numb),
Z ` 2-1 'l aRAI/ -�� Stto. S Ole I VET �6Qrv�� r �'S� /UG Z�03
L.d T :t-

MECKLENBURG COUNTY, North Carolina
POLARIS 3G PARCEL OWNERSHIP AND GIS SUMMARY
Date Pnnted-
Identity
Parcel 16 dl'S ID
00143121 00143121
Property Characteristics
Legal desc
L9 M13- 271&L9 -A U/M
Land Area
0 95 AC
Fire District
CORNELIUS
Special District
FIRE SERVICE B
Account Type
;INDIVIDUAL
Municipality
CORNELIUS
Property Use
SINGLE FAMILY
RESIDENTIAL -
WATERFRONT
Zoning
Contact appropnate Planning Department or see Map
Water Quality Buffer
Parcel Inside Water Quality Buffer I Yes
FEMA and Community Fioodplain
FEMA Panel#
3710464400K
FEMA Panel Date
03/02/2009
FEMA Flood, Zone,
IN VIEW FEMA FLOODPLAIN TO VERIFY
Community Flood
Zone
OUT.VIEW COMMUNITY "FLOODPLAIN
I TO VERIFY
Situs Addresses Tied to Parcel
21621 NORMAN SHORES DR CORNELIUS
04/12/2014
Ownership
Owner Name 11,
'Mailing,Address
MARY DOWENS EVERNHAM
21621 NORMAN SHORES DR
CORNELIUS NC 28031
Deed Reference(s) and Sale Price
Deed
Sale Date
Sale Price
24204 -316
10/20/2008
Charlotte 6/30/2011 Annexation Area
07160 -608
01/04/1993,
'$220;000'00
Site Location
ET_J Area
Cornelius
Charlotte Histroic District
No
Charlotte 6/30/2011 Annexation Area
No
Census Tract #
6203
Post Construction District
Jurisdiction
Comehus
District
Comelws
Watershed Districts
Watershed Name LAKE NORMAN
Watershed Class CA
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, planrmetnc maps, and other public records and data Users of this map or report are hereby notified that the aforementioned public pnmary
information sources should be consulted for verification Mecklenburg County and its mapping contractors assume no legal responsibility for the
information contained herein
Page 1/1

6Q " • tia Irr +_'
1156 Perth Road
Troutman, NC 28166
NC'Ceneral LicensvOintractor # 49723
704 - 528 -7400 Phone
704 - 528 -3400 Fax
Mary Evernham
21621 Norman Shores
Cornelius, NC 28031
Description
1. Shoreline Management — Hammered Rip Rap
A. Shape & slope approximately 271' of shoreline
Bi Pull back existing rock
C. Install matting
®NT CT
Shoreline Management
D. Pant existing rock back in place as a base coat
E. Install Hammered Rip Rap (approx 195 tons) for a compact
finish send heavy border
F. Work to be performed by barge or land
3 -26 -14
Hammered Rip Rap ** *Due to constant changes in state and federal Code regulations, if we
are notified by the county inspector or any agency of any required changes after this
contract is signed the homeowner shall be responsible for any additional costs that may be
incurred to comply with these changes. Every effort is made to stay current with the Code
requirements.
Lancaster's Custom Dock & Lift Systems, Inc. hereby proposes to furnish material & labor
to complete in accordance with the above and attached Material is guaranteed as' specified.,
All work to be completed in a workmanlike manner according „to standard practices. Any
alteration or deviation front the above ispecifications involving extra cost will be executed
only upon written orders and will be an extra charge not included in estimate. All
agreements are contingent upon strikes, accidents /delays beyond our control.
Lancaster's Custom Dock & Lift Systems, Inc. is fully covered for Workman's
Compensation and Liability. Homeowner is responsible for fire, theft, tornado and other
necessary insurance. The above prices, specifications and conditions are satisfactory and
hereby accepted. By signing below, I authorize you to do the work specified. Payment will
be made as outlined. Contract price is valid for a period of 10 days from contract date.
We look forward to doing business with you.

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