20240995 Ver 1_Site Plan_20240725

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State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Water Resources 1SA NCAC 02H .0500 - Water Quality Certification, Shoreline Stabilization
ENVIRONMENTAL DUALITY FORM: SSGP 02-2017
Shoreline Stabilization Application Form
Three copies of the application (including attachments) and the application fee should be sent to:
If sending via US Postal Service If sending via delivery service (UPS, FedEx, etc.)
Paul Wojoski Pahl Wojoski
DWR - 401 & Buffer Permitting Branch DWR -401 & Buffer Permitting Branch
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699-1617 Raleigh, NC 27604
A. Applicant Information [ISA NCACO2H .05O2(a)]
1. Owner Information
Name: Gary Schrock
Mailing Address: 1456 Sunset Paint Or
ConnellV_5prings, NC 2861 - - - —
Telephone Number: _(404) 277-3102 Fax Number: NIA
E-mail Address: [e-mail]
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter must be attached if the Agent has
signed this application form. (A form can be downloaded here:
http:ILwww.saw. usace.army.milLPorfals/59/dots/reguiatorv/regdocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM. ad
Name: Charlie Washburn
Company Affiliation: Marine Construction LLC
Mailing Address: P❑ Box 6400
Hickory, NC 28603
Telephone Number: 828-495-3040 Fax Number: N/A --
E-mail Address. office@marineconstruction[1c.com
B. 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, buildings, retaining walls, docks, impervious surfaces, 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.
FORM: SSGP 02-2017

I 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: __3urke nearest Town: -CoUn l rite _no- _-
Lake/ river/ ocean adjacent to property. Lake Ahodhiss
Property size (acres): _ ----• �_.
Subdivision name or site address (include phase/lot number): Paradise Har r hase 2
Directions to site - please include road names and numbers, landmarks, etc.:
Included in acket
Latitude (in decimal degrees) 35.779 Longitude (decimal degrees)
_��f
Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): residential
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
7. Will work be conducted from land? From water? x
8. Total amount of impacts below the normal pool lake level / Normal dater Level
Permanent impacts (including all excavation, backfil€, rip rap, retaining walls, etc.) in square feet:
230 salt
Temporary impacts in square feet:
9. Total amount of impacts above the normal pool lake level / Normal Water Level and 50 feet
land -ward
Permanent impacts (including back fill, excavation, rip rap, retaining walls, etc.) in square feet:
�30 s ft
Temporary impacts (temporary clearing, construction corridor) in square feet:
construction corridor= ,_ 0 sgft
10. 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): Wooded Backuartl.. Ve titan to
remove 3 trees but will re iar;t them one for one. Any rernainin disturtaed area will hive mulch a lied to it.
11.5ignat e
7
Owner/Ag4PA Signature' j3T5A NCAC 02. -i_3502(f)l Da e
'Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 02-2017

12. Please approximately sketch the following informations on this plan and provide dimensions for
each item:
a. All proposed vegetation clearing
b. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
c. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
d. Location of any proposed structures such as buildings, retaining walls, docks, etc.
e. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
Full Pond/ Normal Water Level
Shoreline
Plan View
Full Pondl Norm�aI Water Ley
�hora Ine
2 fLXMft.
eddl[lonel nearing w
.8 neoewrg
Plan View
La ke
(At Full Pond/ Normal Water Level)
N o COM Nch m C O (Moc
NO I mppi Maa5
I ll m AkA o.l
Lake
[At iWR Pond/ Normal Water Level) Existing Dock
/ 30MR7ft
3 hz IW fs
" Mowfull pond) NWL
4f xI Tft
Abode fLAl pmdl NYV4
a' X M ` koW
Wlk V4 L
17 11'%115'Mom
�M VOnd NwL-
FORM: SSGP 02-2017 Page 3 of 4

r— Lake
(At Full Pond/ Normal Water
Side View
10 ft. bank
height
Side Vi _r
pa conMOf O() COMa6'
�j 6 jWnp-" 1 nn F60-s
in b� Gaf�t
64 (
3 ft. below full and water level 4 ft. above full and water level 2 ft. additional clearing
P p If necessary
Existing hank
. r r
AMI tLkfl Z M
FORM: SSGP 02-2017 Page 4 of 4

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CABS RIPARIAN BUf FER NOTIFICATION FORM
Protect Nameladdress; __$� e k argdi&i orb L ?4 County: Aljr a
Owner:
Print 5ign�&re
Contractor/agent. Charlie Washburn - Marine Construction ______4�
PHnt Signature
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)1
Trees are not allowed to be removed from Zane 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 M43{6)]
Benching and grading in the buffer is not allowed. Excessive disturbance of ground cover. 115A NCAC. 02B .0243
(6)]
Beaches, impervious patios, impervious walkways, etc, are not allowed in the buffer unless specifically approved
by the Division. Where are limitation on size for decks. [15A NCAC 02B .0243(4) aid (6)]
Work to be conducted from land must indicate are access and indicate any trees that are to be removed. The
work corridor should be described. The approved access corridor small he restored. Staging, spoil, construction
material roast be outside the buffer. [15A NCAC 02H .0502 and 15A NCAC 02B .0243 (4), (6), (8)1
5tor€nwater 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 0213 .0243(5), (6)]
Acknowledgement of Notification
i, - -GaU __, hereby state that E 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 plater quality Certification and
Buffer Rules, the approved plan(s) and specification(s), and other supporting materials.
7
Signature (owner): � _ 13at2: ��

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1-40 This route has restricted usage or private roads.
Hickory,
NC
28602
Take 1-40 and US-70 W to Lindsey Rd in Connelly Springs
7 min {6.0 mi}
1. Head west on 1-40
3.3 mi
e 2. Take exit 116 toward Icard
0.3 mi
& 3. Turn right onto Old N C Hwy 1 o
0.4 mi
4-1 4. Turn left onto US-70 W
2.1 mi
Take Shady Grove Rd, Tomlinson Loop and W Paradise
Harbor Dr to Sunset Point Dr
7 min (3.1 mi)
r* 5. Turn right onto Lindsey Rd
0.1 mi
& 6. Turn right onto Shady Grove Rd
1.0 mi
rN 7. Shady Grove Rd turns slightly left and becomes
Tomlinson Loop
r } 8. Turn right onto W Paradise Harbor Dr
Restricted usage road
'(-1 9. Turn left to stay on W Paradise Harbor Dr
Restricted usage road
4"1 10. Turn left onto Sunset Paint ❑r
Restricted usage road
Destination will be on the right
1456 Sunset Point Dr
Connelly Springs, NC 28612
0.9 mi
14s fi:
Col
0.4 mi

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AGENT AUTHORUATION FORM
Please note that multiple forms may be necessary if there are more than two owners of the property.
PROPERTY LEGAL DESCRIPTION:
STREET ADDRESS OF EXISTING HOME or LATITUDE/LONGITUDE OF NEW CONSTRUCTION:
1456 Sunset Point Dr, Connelly Springs, NC 28612
35.7791-81.499
Parcel ID: 2754878803
Property Owner Name(s) -- please print:
Property Owner: Gary Schreck
Property Owner:
The undersigned, registered property owners of the above noted property, do herebyauthorize
Charlie Washburn of Marine Construction LLC
(Cvntrador/Agent) (Name of company) -
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 Owners Mailing Address (if different than property address above):
Same as Above
Property Owner(s) Telephone: [phone]
We hereby certify that the above information submitted in this application is true and accurate to the
iur knowledge.
Authorized Signatur
5 24
Date