20161084 Ver 1_Shoreline Stabilization_20161107

DUKE ENERGY INTERNAL USE ONLY:
Construction
Date Received: FAF Paid Application
Application Complete version 14p
Permit No. Duke Energy Lake
HEP Fund Mail Code EC12Q
526 S. Church St.
Site ID Close -Out Date Charlotte, NC 2820:
I. DATE OF APPLICATION*i Permit/Tag #.:
II. APPLICANT INFORMATION (applicant mailing address and contact information)
_.._... C1 M 1 I _', i i� _c _ .. �. .
Name* IPi--IU1'AA4/6.PrlbDer -kf 0
Address* T31V (�
City* G 0- State* Zip Code'
Email* c��-5 Com- h6w Ly oy-tie-,mam:� ce,i
Primary Phone*
Secondary Phone
Fax Number
�.. DUKE
' ENERGY.
III. PROPERTY INFORMATION (location of pe it)
Address* e foi ti5l,Q 1 &) DC I County CGI .rX
City* rge i q's I State* t - `I Zip Code* County Parcel ID number
(e.g. Pin, Tax ID, TMS�5 ��
Lake*: r M AA/ Number...)
Subdivision h-�t aejj 'i,js ju,, Lot(s) Plat Book/Page
To enter the Latitude and Longitude of the property, please use a Latitude (e.g. 35.12345)* 3Y72- 8
service/software to easily acquire the location information. Values
should be provided in Decimal Degrees format (35.1245).
Longitude (e.g. -80.12345)*
example service: http://itouchmap.com/lationg.htmi
IV. PROPOSED ACTIVITY
(' New/Modification of Existing Structure C Maintenance of Existing StructureIs Dock
0 Covered?
(New/Modification of Existing Shoreline Stabilization ( Maintenance of Existing Shoreline Stabilization ❑
`New/Modification of Existing Structure & Stabilization ( Maintenance of Existing Structure & Stabilization # of Slips
(' Transfer of Ownership (' Other (please describe below) # of Jetports
Area over land (sq ft) Area over water (sq ft) Total Square Feet
Shoreline Stabilization (feet) Length of Distance From Shoreline �� . Gia �'� '�j 1; Ne_
Stabilization I
Materials r, 3 Y-' p
Brief Description I/'['_tj � eYb 5 [ D
of the Activity
Describe Briefly the Existing
Structures Over Land and
Water (include sq ft)
T�j �6)&6 ,p kc -e --s6 l of

V. Dods Builder or Engineer
Name/CompanyK r�e e'!J J`Cl't y'r Y Ices; �- �-L 1
Address %3 l K v- u w t r trr M if Phone Number 70 4-6
41
City Map Sv) { StateJ►�C Zip Code ygj I S Email 5 i � 5 AM, A -IJ
u
VI. Cheddist of Required Documents (to include with Applkation Submission)
ecent Survey (stamped/signed by a professional licensed surveyor showing the location of the existing or proposed
structure and/or survey of the existing or proposed stabilization)
B"Photos along property shoreline and photos of any existing structures and/or stabilization in or near the water
Ev 'Application fee (check only, payable to Duke Energy) Signed User Agreement Letter
[ Applicable local, state, and federal permits ❑ Plan and profile drawing showing all measurements and elevations
[] Habitat Enhancement payment (if applicable)
VII. Approval Process
• Application is reviewed and determined if complete. Fields with an asterisk are required.
• If application is not complete or does not include all items and information listed in the checklist, the
application will be returned as incomplete.
• A Duke Energy representative will visit the site to conduct a visual inspection.
e Applicant will be notified of approval or denial.
• Applicant is to have the notice, to be supplied by Duke Energy upon application approval, posted and
must be viewable from water. The notice must remain posted until a representative inspects the
project and determines the project is complete and within the application specifications.
VBI. Directions by Road
L 71
Directions by f
Road*
IX. AppBcation Submission
1, e p f- dC ff yV b N (A T-trwr-Irr
ON PPt,iNS►� rJ'f"� .
•1
Please complete, print and sign this application. Then enclose all items from the checklist above in an envelope and
submit all the information to the address below.
Duke Energy Lake Services I Print Form I
Mall Code EC12Q
Cha Church
Cha28202
rll otte, NC 288 202
I agree that the information contained within Is
1,01V
A

State of North Carolina
Department of Environment and Natural Resources
D -W,- R Division 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 2 0 1 6 1 0 8 4
Raleigh, NC 27699-1617
I. Applicant Information [15A NCAC 02H .0502(a)1
1. Owner Information
Name: -�-7AM i� x CK5PC'Q i rel S11kPE
Mailing Address: C> I Cs ) (q L
r h (o ac -
'C t',
c
tty a'JAle,rs A-5 S a I A a0.4
g�_ �Lz
Telephone Number: 70- -3-77- a/ 4- Fax Number:
E-mail Address: 5hi(_K5 r %AW+ 1601'5- M9M` C.oM
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/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTHO
RIZATION FORM.pdf) must be attached if the Agent has signed this application form.
, .,r
Name: Ul 17Jr,Ac f S
Company Affiliation: Y� e
Mailing Address: Dl4-Kri
MAU're5v� I
Telephone Number: M W- -6/"
E-mail Address: 6&3-e�0,4Giy
Person to receive the Certification Approval
LL--�—
t Fir ►M .� � �
Fax N71rreA,01
ber: 0
t);A J. Asc-
i %3k
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, etc.),
rip rap, excavation or dredging below Full Pond/ Normal Water Level elevations, and
FORM: SSGP 10-2013 Page 1 of 3

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: t Nearest Town: r C K s
Subdivision name or site a dress (include phase/lot number) --TX t f P�/���
Latitude (in dedmoidegrms)35 •TTS Longitude (dedmoidegrees) 90.9 L
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.):c+,a-�� �fftSS�b�
6. Property size (acres): A dU 4'1'-
7. Lake/ river/ ocean adjacent to property: o4-41<cNO r1n'*AJ
r
8. Describe proposed work (include disc sspi n to how harde ing oT'OtrAC-Alrenvia oreline haspeen
avoided, or why it is necessary): 5 O i /' �% %V�/✓
9.Will work be conducted from land? ❑ From water? rVIYN
10. Total amount of disturbance (including all excavation, backfill, rip rap, retaining walls, etc.)
below the normal yool lakeilevel/ Normal Water Level In square feet or acres:
ov x �
11. Total amount of disturbance (including all clearing, backfill, 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: /D0 X l
12. Please describe the vegetation above the normal pool lake level/ Normal Water Level an?0
feet landward to be impacted (number of trees, for instance): f -e s Sc e /� S)
caner ent's Signature* Printed Name ate
115A NCAC 02H .0502(f)]
'Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 3

Full Pond/
Normal Watery evel
'
Shoreline
Lake
(At Full Pond/ Normal Water level)
cf)
A c �aaar� �nU
M•
/L
(t&- Jd5
/l 1
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

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PRIVATE FACILITES USER'S
AGREEMENT LETTER
(You may use this letter and fill in the requested information. Please Print)
Date /0 • -2-4 - a-LO%fo
TO: Duke Energy
c/o Lake Services - EC 12Q
PO Box 1006
Charlotte, NC 28201-1006
RE: (Project Name) 5AM k(-e5/PI-IJ;Af-5u IJPrope y 6Gvl/e v-5 A5 see-
(Lake
Oc(Lake Address) ICI 0 09 pe rJJ * r :5 kL PD i /JI
Cpr-gel ,w-,. NC ;-go
(Applicant's full name) etWil ey agrees to comply
with all requirements and conditions set forth a Energy's Lake Services' office, or
any federal, state or local agencies pertlunmg to $rivate Facilities application to
constructd/or m' fain a 5 /t p ,,�c,,((; W C.
on Lake b r . In addition, 1/we have read and agree to comply with Duke
Energy's Shoreline Management Guidelines (SMG) and understand that written
authorization must be obtained from Duke's Lake Services' office prior to beginning any
activity/construction within the Project boundary. The construction will be completed as
described in the approved private facilities program application and within twelve (12)
months following the date of approval by Lake Services. Failure to complete construction
within the twelve-month build -out period will require the applicant to file a new
application within the then -current guidelines. The filing will include any applicable fees
and security deposits.
Uwe attest to be the owner or lease holder of the had of land immediately adjoining the
Project boundary where the proposed private facility is to be constructed.
Uwe understand that the structures to be installed and/or maintained are my/our property
and Uwe therefore agree to be fully responsible for the permitted reservoir use including
maintaining structures in good repair. If the private facility is deemed unsafe by a Lake
Services Representative, Uwe agree to repair or remove the private facility at my/our own
Pagel of S
146 IdwnvAb=Arm=mdUPdv&Wffnv&W radIbm thm Apemel cw Kr rml 112 08 A mv.doc Aav x-21-10

expense and within the specified timeframe set by Lake Services. This responsibility is
considered to transfer automatically along with ownership and leases of the adjoining
tract.
Uwe agree to fully disclose all information regarding the approved private facility to any
prospective buyer/leaseholder of the property and any new owner/leaseholder. Llwe agree
to notify Duke Energy Lake Services immediately of any saleltransfer of the property,
including the name and address of the new owner and to transfer the permit to the new
owner/leaseholder.
Uwe understand that unless the private facility was permitted by Lake Services before
June 1, 1996, no more than (1) pier/dock or one Common Use boat slip per waterfront lot
will be considered for approval. Ownership/interest in a Common Use Facility or
residential marina eliminates the option of having a separate private facility on any other
owned or leased lot within the affected subdivision.
Uwe understand that Lake Services' approval of the requested reservoir use in no way
constitutes assignment of an interest in real property (i.e. land rights). The approval is
granted and maintained solely at Duke's discretion. Uwe also understand that the
permitted use may be revoked at any time by Duke Energy or its successors for any
reason whatsoever. If the approval is revoked, Ilwe agree to remove the facility at my/our
own expense within the specified timeframe set by Lake Services.
Uwe specifically waive any claim for consequential damages arising out of or relating to
this application, Duke's approval or denial of it, or Duke's subsequent revocation of
approval, and Uwe specifically understand and acknowledge that, because Duke Energy
can revoke the permitted use at any time, Uwe are not entitled to reliance damages.
Uwe understand during drought conditions Duke Energy may request reduced usage or
discontinued usage of any water withdrawal or related systems, until such drought
conditions improve. Failure to do so may cause possible removal of the system and/or
any other permitted facilities that Uwe may have, and any costs associated with removal
of the facilities will be assessed to the lot owner.
Uwe understand that this lake was constructed as a working hydropower reservoir for the
primary purpose of producing cost-effective electric energy and that this remains as the
lake's primary purpose. Uwe understand that the lake and its associated hydropower
station are operated by Duke Energy Lake Services under the terms of a license issued by
the Federal Energy Regulatory Commission (FERC) and that there will be no change in
hydro project operations as a result of the construction and/or use of any facilities that
Uwe may be allowed to place within the FERC Project boundary or on Duke Energy Lake
Services -owned property.
Ave understand that the proposed private facility will be used only for the purposes
descn'bed in the information submitted for approval by Lake Services and other
appropriate governing bodies.
Page 2 of 5
HY&OW esvdU ForiWw Um ASMOMM CW KT Lod 1 1208 joh NVADC Bev 3.11.16

Uwe understand that this lake is open for use by the general public and that maintaining
safe and lawful public use is one of the primary lake management objectives of Duke
Energy Lake Services.
Uwe understand that the use for which we are applying is a private use and it should not
interfere with the general public's safe and lawful use of the lake.
Uwe understand that every reasonable effort must be made to minimize any adverse
impact on fish, wildlife, and other natural resources.
Uwe understand that trees and vegetation growing within the Project boundary play an
important role in the overall environmental condition of the lake. The ecological impact
the vegetation has on the fish and wildlife habitat is necessary to ensure a sound and
healthy lake environment. Uwe also understand that unauthorized removal of shoreline
vegetation (i.e. button bushes, willows, cattails, etc.) and/or disturbance of the shoreline
buffer may result in suspension or denial of lake use permitting requests and require
me/us to re-establish the vegetation if the disturbance is found to be in violation of the
state or county watershed buffer regulations or Duke Energy's Vegetation Management
Requirements.
(For construction on Lake Keowee) Uwe agree that if land disturbing activities are to
occur within the Project boundary prior review/approval from Duke Energy Lake
Services, the State Historic Preservation Office and the Eastern Band of the Cherokee
Indians is required prior to work beginning.
L'we agree that if any historic or archaeological resources are discovered during
construction of an approved activity the applicant must stop work immediately and
contact Duke Energy Lake Services. Ihve understand that in the event that anyone
discovers a potential site of archaeological or historic significance including any
gravesite within the Project, the individual must immediately notify Duke Energy Lake
Services.
Uwe agree to notify Lake Services when construction is completed. During the
construction period, the weather-proof "Duke Energy Approved Lake Use Activity" sign
(to be provided by Duke Energy) must be posted at the job site, visible from the water's
edge.
Uwe have included a check for any applicable filing fees, security deposits and copies of
all other necessary permits.
Uwe agree that if any action is taken by Duke Energy to enforce any provision, covenant
or agreement contained in this user agreement or Duke Energy Lake Services SMG or if
Duke Energy is required to retain an attorney to enforce any provision, covenant or
agreement contained in this user agreement or SMG (including, without limitation, the
payment of fees due hereunder or the removal of an encroachment constructed in
violation of this user agreement or SMG), then Duke Energy shall be entitled to recover
all of its reasonable costs associated with such an action, including but not limited to,
attorneys' fees and court costs incurred in such action and/or enforcement.
Page 3 of 5
Faeilifim Ua Apeemmt CW KT 8m1 l 12 O8ph mv.doe Rev 3.11.16

Ave understand that Lake Services' representatives may issue Stop Work Directives for
any violations of the SMG or engagement in prohibited acts or activities on Duke Energy
Lake Services' property as specifically identified in the SMG. Uwe understand that
persons found to be in violation will be subject to Duke Energy Lake Services sanctions
which can include: 1) restoration of the impacted area at the person's expense; 2) loss of
consideration of any future lake use permitting activities for up to five years for improper
vegetation removal or until vegetation is satisfactorily re-established (even if there is a
change in property ownership); 3) revocation of a previously issued permit and loss of
consideration of any future lake use permitting activities and/or reinstatement of the
revoked permit; 4) increases in fees; 5) modification or removal of non -complying
structures; and/or 6) further legal action being taken by Duke Energy Lake Services .
Ave understand that certain activities specified in the SMG are prohibited because of
environmental concerns, boating capacity limitations, safety considerations and other
reasons.
Uwe understand that ownership/interest in a Common Use Facility eliminates the option
for me/us to also have a separate facility on any other lot within the affected subdivision
that Ave own or lease.
Uwe understand that this lake is open for use by the general public and that maintaining
safe and lawful public use is one of the primary lake management objectives of Duke
Energy Lake Services.
Uwe understand lake use permit holders have the authority to prevent others from
trespassing on the structures they have built. Uwe also understand that Uwe, however, do
not have any authority to impede anyone from pursuit of the lawful public recreation
enjoyment of FERC Project lands and waters. Except as specified otherwise in the SMG
or other Duke Energy Lake Services documents (e.g. Public Safety Plans), anyone may
fish around/under structures built by others, may walk/wade/fish within the FERC Project
boundary or any Duke Energy Lake Services -owned peripheral strip, boat in the lake's
waters, etc. without having to get anyone's permission to do so. Boaters may not block
ingresslegress to piers/docks.
Uwe agree to exercise all care and due diligence to preserve and maintain the character of
the Duke Energy Lake Services's adjacent property. Uwe agree to comply with the Duke
Energy Lake Services Vegetation Management Requirements. Ilwe agree fiuther to not
allow sewage, including discharge from septic tanks (or similar facilities) or boat holding
tanks, garbage, trash, or other waste material to be discharged or dumped into the
reservoir, tributaries or adjacent property.
Ave understand that as an adjoining property owner Uwe can make no change in land
form of land within the FERC Project boundary or land owned by Duke Energy Lake
Services , such as grading, excavation or filling without prior written approval by Lake
Services.
Uwe agree for myself/ourselves, members of my/our family, guests and invitees that Uwe
Page 4 of 5
Hy&ol*Asvar/Usmsfteom@nM&dva&ldvm FawaWa Uses Ag r r = CW KT Sod 112 08Jih sev doc Rev 3.11.16

assume all risks of personal injury or property damage incident to my/our occupancy and
use of the premises; including but not limited to any personal injury or property damage
which may be sustained as a result of flood waters or in connection with the rise and fall
of water in the reservoir as a result of floods or of the operation of Duke Energy's hydro
electric facilities. II'we as the adjoining property owner further agree that Uwe will
indemnify, protect, defend, and save harmless Duke Energy from any and all loss, cost,
claims damages, expenses, judgments and causes of action for all injuries and damages
sustained by the members of my/our family, guests, and invitees arising or claimed to
have arisen in connection with their occupancy or use of the Duke Energy Lake Services
-permitted facility(s).
Uwe acimowledge that Duke Energy Lake Services has the right to charge reasonable
user's fees for private use of its property and that failure to pay any applicable user's fees
in a timely manner can result in the suspension or cancellation of any previously
approved lake use permit.
Ave recognize that Uwe have the continuing responsibility to ensure that the constructed
structures are maintained in good repair, including, but not limited to maintenance of the
dock and boat slips, and proper erosion control within the permit area and along the
shoreline, and agree to take all reasonable steps necessary to meet this responsibility. Uwe
agree to maintain all structures within the Project boundary on Duke Energy Lake
Services - owned property in a sound condition and in a neat appearance and pay all costs
for said maintenance.
Sincerely,
�f� � u5+�la`p�pc.-� QwN'Cr9 iQ-SSoC .
(Appli s Nai e)
190x9 T61%M54- 1144 Dr
Lake Street Address
Cb rti e (�ws,l�fC dLsi 3 l _
City/State&ip Code
Lake Phone Number
(Designated Duke Energy Agent)
AAW&Wt's S
`� D 'f30� i i `I o6,
Home Street Address
c6A 4140 g8;t-s-o
City/Stotetzip Code
.704. 3 77 0114-
Honit, Phone Number
Page 5 of 5
Date:
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