20141330 Ver 1_Shoreline Stabilization_20141230

Apartment State of North Carolina
2 0 1 4 1 3 3 department of Environment and Natural Resources
Dw�� Divisionn of Water Resources
~ - - � 15A NCAC 02H .0500 — Water Quality Certification; Shoreline Stabilization
Division of Water Resources
—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: MAG Bear Lake. LLC
Mailing Address: 5001 Spring Valley rd.
Suite 50OW
Dallas TX 75244
Telephone Number: 972 - 715 -6421 Fax Number:
E -mail Address:
[e-mail]
2. Agent/ Contact Person Information
,3
DEC 3 0 2014
DENR - WATER RESOURCES
401 & BUFFER PERM1lITTING
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
http:Hwww.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: Chad Ensley, Ensley Properties and Excavating, LLC
Company Affiliation: Owner
Mailing Address: 6327 Hwy 107
Cullowhee NC 28723
FORM: SSGP 10 -2013
Page 1 of 3

Telephone Number: 828 - 421 -2025 Fax Number:
E -mail Address: censley23 @aol.com
Person to receive the Certification Approval: Chad Ensley
II. Project Information [15A NCAC 02H .0502(a) & (b)j
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,
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: Jackson Nearest Town: Tuckasegee
Subdivision name or site address (include phase /lot number): Bear Lake Reserve 503
Harbor Ridge Drive, Tuckasegee, NC 28783
Directions to site - please include road names and numbers, landmarks, etc.: Turn off Hwy
107 onto Shook Cove Rd., turn right into Bear Lake Reserve (Lake Forest Dr.) go 4.5 miles
and turn left onto Harbor Ridge Dr., go '% mile to the end.
Latitude (in decimal degrees) 35.232780 Longitude (decimal degrees)
83.054289
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): undeveloped recreation area.
6. Property size (acres): 1 ac. +/-
FORM: SSGP 10 -2013
Page 2 of 4

7. Lake/ river/ ocean adjacent to property: Bear Creek Lake
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Shoreline stabilization- trees, roots, soil eroding away._
9. Will work be conducted from land? x[] 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:
3500 square feet
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: 9100 square feet
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): Approximately 10 -12
trees that have been eroded under
Owner /Agent's Signature` [15A NCAC .0502 Date
'Agent's signature is valid only if an authorization letter from the owner is provided.
FORM. SSGP 10 -2013 Page 3 of 4

SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. L.AX6 LLO PLAN NO. PARCEL ID: 7285' 91 " & �9I
STREETADDRESS: S03 i -IM9on &W &,
j+C1CL1 .NG 7-1783
Please print: /
Property Owner: .MAr ��,/14 L-AK �. LLC (, ALLf nl :Ton/6S
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
r
61*0 ENJLAY , of &-i C6Y AOP6/iM-0 3 EXeA✓47W6
(Contractor j Agent) (Name of consulting firm)
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):
U01 Sli(fr/G VRLl Y ,CD , Suz�Tl= Sa11 �, /69 1� 752 -rf�
Telephone: 971-7/!5-&q-L1
We hereby certify the above information submitted In this application is true and accurate to the
best of our knowledge.
— J4/�?�
Authoriz d Slgnat
Date:
17
Authorized Signature
Date: ! 9! J �c // /

Lake
(At Full Pond/ Normal Water Level)
-I/ kV AAP S �J
Full Pond/ �! (�;oL nu���
Normal Water Level ����� ' �� N�47ti+
Shoreline
A(-c EIS
CoR�i
1,4K6 CL..vt.>'
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 4 of 4

Bear Lake Reserve
This map is prepared for inventory of real property within Jackson County. It is compiled from recorded deeds, plats. and public data records.
Users of this map are hereby notified that the aforementioned public information sources should be consulted for verification. Jackson County o
any County representative assumes no legal responsibility for the contents of this map. Printed-Dec 10, 2014 i 4

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NOTE
* This is a topographic survey only, boundUcy information obtained from plat
recorded in Plat Book 14, Page 859.
* This survey was prepared without benefit: ,of abstract title and matters of title
should be referred to an attorney-at-law.
* This survey may be subject to all rights-cf-sway, easements, reservations and
restrictions, written and unwritten, recorded and unrecorded.
* The certification shown hereon is not a cc-:rtification of title, zoning or
freedom from encumbrances.
" No underground utilities were located. Caill 1-800-632-4949 before digging.
* This property is oriented to the North Carc4ina Grid (North American Datum
of 1983) by global positioning system meth-Dds and utilizing North Carolina
Geodetic Monuments: "Big Ridge" and "Tucikasegee".
* All distances shown hereon are North Ca;-Dlina Grid distances.
* All elevations shown hereon are approximiate NGVD 1929 elevations.
* The combined grid factor used is: 0.9997:;00.
* Contour interval is 2'.
I, Robert C. Brown, certify that this map was drawn under my supervision from an
actual survey made under my supervision using traditional field procedures; that the
boundaries not surveyed are clearly indicated by dashed lines as drawn from
information found in deed books as shown; that the topographic survey was
performed at the 95 percent confidence level to meet Federal Geographic Data
Committee Standards [(21 NCAC 56.1606 (3)9b))].
Witness my signature, License Number, and Seal
this 24th Day of November. A.D., 2014 _,illean
N.C. Professional Land Surveyor�m,p
Robert C. Brown, PLS
License # 2748L 274
S'
C.
®.bo
CEDAR
CLIFF
LAKE BEAR
LAKE
LAT. & LON.35,23956' N
83.08259'W
VICINITY MAP SITrE
(NOT TO SCALE)
W
:E
r -i
N Ff I
Topographic Survey for
BENCHMARK
"EHA"
TOP OF #5 REBAR FOUND WITH CAP
LAKEELEV.=
(\G
2,569.82' (APPROXIMATE NGVD 1929)
0 LADE CLUB SHORE STABILIZATION
Being on a portion of PIN 7586-91-6329
as described in Deed Book 1982, Page 444
Juland shown in Plat Book 14, Page 859
River Township, Jackson County, N.C.
.0 Date: 11-24-2014 Drawn By: M. Edgerton
Job#: 13171 Checked By: B. Brown
f
Robert C. Brown, PLS
.0
n Ed Holmes & Associates Land Surveyors, PA
TREE
LEGEND:
r-4200 Ridgefield Court, Suite 215, Asheville, NC 28806
HIC
SW
= HICKORY
= SOURWOOD
#5 REBAR
+
828.225.6562 Company# C-2806
MAP
BIR
=MAPLE
=BIRCH
FOUND
WCAP
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HOLMES
40' 0' 40' 80'
LOC
POP
= LOCUST
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---
HEM
=HEMLOCK
SCALE 1" = 40' DWG#: C14-119
WAL
PN
= WALNUT
= PINE
/
i A N D s u x v E Y 0 R;,