HomeMy WebLinkAbout20151096 Ver 1_Shoreline Stabilization_20151021Shoreline Stabilization Apolicat on' Form
201ST
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 ICI 1!
Raleigh, NC 27699 -1617 D
OCT 2 1 2015
o Applicant Information f15A NCAC 02H .0502(a)]
1. Owner Information rr
Name: o ran 15
Mailing Address:
Chaylofl-& At
DENR - WATER RESOURCES
401 8 BUFFER PERMITTING
wa'6v �6 (2&'
mqf
Telephone Number: _j_a4-90 0- 1 Ileg Fax Number:
E -mail Address: �n In �G V115 .A,l< 1'e ►�� C'm
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be
downloaded here:
httr): / /www.saw.usace.armv.miI /Portals /59 /docs /regulatory /regdocs /Permits /SAM PL
E AGENT AUTHORIZATION FORM.pdf) must be attached if the Agent has signed
this application form.
Name: : r,, 11 a p,ll C,1 5:56))
Company Affiliation: 5 S Pdr
Ui�►Vl�la S (��� c.
Mailing Address: ��0 h r r 1 eSlff
Lo(.01
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se, 01a110
Telephone Number: 0 IA I -91110 Fax Number: gn - gal -5656
E -mail Address: �)5 3J� I<tJ P�II�1K
Person to receive the Certification Approval: rla vs-ns fi'le_ Dh',j,.Uc
• Project Information j15A NCAC 02H .0502(a) & (b)l
• 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.
• 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.
• Attach a photograph of the shoreline/ buffer proposed to be stabilized.
(Include a scale of some sort- a yard stick, shovel handle, etc.)
• Location of the property (where work is to be conducted)
County: MttAkt& Nearest Town: �,hfirl °}{�
Subdivision name or site address (include phase /lot number):
Directions to site - please include road names and numbers, landmarks, etc.:
IyAD
i
Latitude (in decimal degrees) 350 17. oll 8$" Longitude (decimal degrees)IL oa ! TA
• Describe the existing land use or condition of the site at the time of this
application (residential, undeveloped, etc.): �.e S� - -,�o<_ /
• Property size (acres):
• Lake/ river/ ocean adjacent to property: -LA t �A)6I It
2
• Describe proposed work (include discussion as to how hardening of shoreline
has been avoided, or why it is necessary): S7a b, Ir'Z aorox
r� �.l, 4n �(. ✓ten �' �aa r✓_ate/- $ G/�t f�!
Aa
o Will work be conducted from land? A,/s From water?
s 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: �p�x�,2S _ r. f�oc�% ) C_e . /I/
11. Total amount of disturbance (includin4 all clearing, back fill, excavation, rip
rap retaining walls etc ) above the normal p ool lake level/ Normal Water
Level and 50 feet Ian -ward in square feet or acres:
C es-tL C e� .
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
in tance): D ,j; a - `f %eS *> R
r
Owner /Agent's Signature` j15A NCAC 02H .0502(f)1 Date
'Agent's signature is valid only if an authorization letter from the owner is provided.
3
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•
Slide 4 014 'Office Theme'
., � ,r.•rxc_.. -ups __
Please approximately sketch the following information on this plan (provide
dimensions for each item, such as 10 ft x 100 ft) *:
• All proposed vegetation clearing
• Location of rip rap or fill to be placed above the Full Pond / Normal Water Level
elevation
• Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level
elevation
• Location of any proposed structures such as buildings, retaining walls, docks, etc.
• Location of any excavation or dredging below the Full Pond/ Normal Water Level
elevation
4
-' Home s Insert
Design Animations Slide Short
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Lake
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(At Full Pond/ Normal Water Level)
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Full Pond/
;^
Normal Water Level
�
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Shoreline
�n
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•
Slide 4 014 'Office Theme'
., � ,r.•rxc_.. -ups __
Please approximately sketch the following information on this plan (provide
dimensions for each item, such as 10 ft x 100 ft) *:
• All proposed vegetation clearing
• Location of rip rap or fill to be placed above the Full Pond / Normal Water Level
elevation
• Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level
elevation
• Location of any proposed structures such as buildings, retaining walls, docks, etc.
• Location of any excavation or dredging below the Full Pond/ Normal Water Level
elevation
4
O Location of construction access corridors
SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. PLAN NO. PARCEL ID:
STREETADDRESS:
i
Please print:
Properly Owner:
-- Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
, of &A)5015 &A(iv L E &WSfr.UA4'
(Contract / Agent) (Name of consulting firm) qt
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):
Telephone: 104- fte — 110
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Guth ized i ure
NV � Authorized Signature
Date: NV �� � � � � Date: /O // % /3
/ 4 mapquest
Trip to:
16409 Bunch Walnuts Rd
Charlotte, NC 28278 -8992
1.43 miles / 3 minutes
Notes
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1. Start out going northwest on Charlotte Hwy / SC-49 toward Blucher 0.04 Mi
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2. Make a U -turn at Blucher Cir onto Charlotte Hwy / SC -49 (Crossing 0.4 Mi
'9 into North Carolina). Map 0.4 Mi Total
If you reach Executive Ct you've gone about 0.2 miles too far
3. Charlotte Hwy / SC-49 becomes NC-49 / York Rd. Map 0.4 Mi
0.9 Mi Total
4. Turn right onto Red Fez Club Rd. Map 0.2 Mi
If you reach Riverpointe Dr you've gone about 0.4 miles too far 1.0 Mi Total
5. Stay straight to go onto Walnut Hill Dr. Map 0.02 Mi
1.1 Mi Total
6. Take the 1st right onto Tulloch Rd. Map 0.03 Mi
If you reach Boyd Cove Ln you've gone about 0.2 miles too far 1.1 Mi Total
,, 7. Take the 1st left onto Bunch Walnuts Dr. Map 0.3 Mi
If you reach Chatfield Dr you've gone about 0.1 miles too far 1.4 Mi Total
8. Take the 1st left onto Bunch Walnuts Rd. Map 0.02 Mi
1.4 Mi Total
®
9.16409 BUNCH WALNUTS RD is on the left. Map
If you reach the end of Bunch Walnuts Rd you've gone a little too far
16409 Bunch Walnuts Rd, Charlotte, NC 28278 -8992
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