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20141062 Ver 1_Shoreline Stabilization_20141007
2 0 1 4 1 0 6 2 State of North Carolina Demsht 2,f Environment and Natural Resources DWR 160 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: Division of Water Resources 401 & Buffer Permitting Unit 1617 Mail Service Center Raleigh, NC 27699 -1617 I. Applicant Information [15A NCAC 02H .0502(a)] 1. Owner Information Name: -teeS�I e lcine- LL-C_ Mailing Address: � k93Ti rasf _ Ln l7enye'-r, Kl 's�Sy3`7 Telephone Number: Fax Number: E -mail Address: 61(1nf1e_F(!' ke�+1, �3,t o�rlt��t _ l+,anA- 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 /dots /regulatory /regdocs /Permits /SAMPLE AGENT AUTH ORIZATION FORM.pdf) must be attached if the Agent has signed this application form. Name: f� Company Affiliation: LCD r_ C+tY%c O �� �n-, hc) l 4 Mailing Address: l [ 5b -%Y 4-� VJ Telephone Number: rj o4. sa6 • `74o[) Fax Number: !] Q4. Ste- -_�L}-OD E -mail Address: I.AN Asa-al)ucJ & kAe. et, 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 Page 1 of 3 �S SSA S 93 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 of some sort- a yard stick, shovel handle, etc.) 4. Location of the property (where work is to be conducted) County: L ir1cctr-, Nearest Town: TY�Vc,— Subdivision name or site address (include phase /lot number): Directions to site - please include road names and numbers, landmarks, etc.: Latitude (in decimal degrees) 35. 5(elI ( 1 Longitude (decimal degrees) — 0 U. `��l O5k 5. Describe the existing land use or condition of the site at the time of this application (residential, undeveloped, etc.): �P �J�,a, a 6. Property size (acres): 7. Lake/ river/ ocean adjacent to property: Lake_ fi0 rrnp n 8. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or why it is necessary): na S-, hsrr 1, d ,ns. It, T - 9. Will wor e conducted from land? ❑ From water? LES 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: 11. 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: ( r X 300 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): Owner /Agen 15A NCAC 02H .0 Printed Name t_C, Agent's signature is valid only if an authorization letter from the owner is provided. Date FORM: SSGP 10 -2013 Page 2 of 3 I Nora Please approximately sketch the following information on this plan (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 10/2/2014 tau 4883 Trestle Ln Denver, "if,' 28031 Street View Search nearby yq LEE iao' znt �F� s Ytii s tno isse taix3 td� Marten �~ i� w iwY 1N7 F � AO FVAaen ad 9C is 4883 Trestle Ln - Google Maps L 41►4 iso` ian 11349 R i i ' ts, IaoS. - iiii tm. J20 r • � i iio � 1 . 1N. rn https: / /www.google.com /maps /place /4883 +Trestle +Ln,+ Denver, +NC +28037/ @35. 5595652 ,- 81.0010934,12z/data= !4m2!3m1 ! 1 sOx8856b2bda934ab79... 1 /1 10/2/2014 4883 Trestle Ln. Denver, N Street Vlew Search nearby 5 t�e �y pt people BaY Dr Y 4 F-1. p Q C 6 11852 C�`SP A� 4 �a Sa�C'tUyyaY � of Watt'Y Oaks Dt C Aapen Ct 4883 Trestle Ln - Google Maps ,hes CGU" 91 1 7 tam SIM DOrC k'p Map data ©2014 Goog https: / /www.google.com /maps /place /4883 +Trestle +Ln,+ Denver, +NC+ 28037/ @35. 559635 ,- 81.0090327,16z/data= !4m2!3m 1 ! 1 sOx8856b2bda934ab79:. . . 111 I 4 Goo- ze as it T R Bit 7- ".Ulz SIR z lift 4� X, 1A 17 ip, t~ _ �1 tom- ,. ...1'�A �r�. • .� � .� � ` � � .� .•+e'` � ~� • Jam'' � � i - a a1M-. ''� �v R4 a 1 .y A/ . —� _ � • ,�. Ii/` ��`e+7 dJ ��� eft: .�.. lwy '' � _ r i� t � � �• �# '�-[ t` 'r � .. ,{ � rr'- 'mot t.. �` .� r Om. jell Amt All+ T ' .. - _ •�,rt . Lam..- -^ CAT_AWBA Geospatial Information Services Real Estate Search 1 in =300ft Parcel: 460604543806, 4883 TRESTLE LN DENVER, 28037 Owners: TRESTLE LANE LLC, Owner Address: 617 N MAIN ST Values - Building(s): $0, Land: $57,600, Total: $57,600 This map /report product was prepared from the Catawba County, NC Geospatial Information Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report. Catawba County promotes and recommends the independent verification of any data contained on this map /report product by the user. The County of Catawba, its employees. agents, and personnel, disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or may arise from this map /report product or the use thereof by any person or entity. Copyright 2014 Catawba County NC 09/25/2014