20081519 Ver 1_Shoreline Stabilization_20081002

FRED BAIRD BLACKLEY, ASLA
LANDSCAPE ARCHITECT
504 SOUTH DEKALB STREET
SHELBY, NORTH CAROLINA 28150
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[phone]
Transmittal 0 8-, 5 9
To:

??,Atttn:
(40ject:
Project No:
Date:
Copies Item Description
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For: APPROVAL INFORMATION RECORD.
REQUEST REVIEW COMMENT- USE
Remarks:
0 C T 2 2008
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Copy To: By:
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Via: US MAIL AIRBORNE _i PICK UP UPS FAX HAND DELIVER OTHER

The following is an abbreviated application form for those applying for a 401 Water
Quality Certification to impact FERC (Federal Energy Regulatory Commission)
regulated lake shore or bottom under the U.S. Army Corps of Engineers Permit
GP30. This Application cannot be used for wetland or stream impacts. Please
provide seven (7) copies of this application and supporting information as wel as a
non-refundable application fee to the Division of Water Quality of $2 . 0 ford` °
impacts of to lake bottom of less than 1 acre and $475.00 for impacts to lake bottom
of greater or equal to 1 acre.
Applications should be sent to:
Division of Water Quality Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
08- 1 5 1 9
1. Applicant Information
Owner/App
Name:
Mailing
2.
LS
? C ? ? 2008
DDS p,ND STORM?A??CI?
Telephone Number: `I MA Fax Number:
E-mail Address:
Agent Information (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
II. Project Information
Attach a vicinity map clearly showing the location of the property with respect to
local landmarks such as towns, rivers, and roads. Also provide a detailed site
plan showing property boundaries and development plans in relation to
surrounding properties. You may use the diagram below to make a hand sketch of
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your project. Also, see the example below for guidance. Both the vicinity map and
site plan must include a scale and north arrow. The footprints of all buildings,
impervious surfaces, or other facilities must be included.
1. Location , A JA U4
C Nearest Town:
County: l
Subdivision name or site address (include phase/lot number):
Directions to site please include road numbers, landmarks, etc. (This is not L ' tiVI
necessary,if an adequgt_% vicinity, map is included):
2. Describe the xistin land use or condition of t e site at th ti%e of this
application:
3. Property size (acres):
4. Nearest body of water (stream/river/sound/ocean/lake): MfjS?. L/ Vk-
5. Des ribe the purpose of the roposed wo k: 61 e UIVVJ al?_A
V\?S G ?
6. List t e type o equipment to be used to construct the project: ?? a S r I © ` ks-
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls,
etc.) bgla4v the normal pool lake le el in square feet or acres:
8. a. Amount of impact (including all clearing, back fill, excavation, rip rap,
retaining walls, etc.) above the normal pool lake level and 50 fe t land-ward in
square feet or acres: 1? I ?C I k !fC 1 .4 -1
b. Please describe vegetation above the normal pool lake level and 50 feet lan -
ward to be impacted number of trees for instance): 'l ( -Y O1-P'U
s ? 6 ?- tie-.- G
I VI
Applicant/Agent's Signature.: r Date --?
(Agent's signature is valid o if an auth 21.;;? n letter from the applicant is provided.)
pg -r
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Lake (Full Pond)
Full Pond
Shoreline

Ply approximately sketch the following information on this plan
?please provide tensions for each Item, such as 10 ft. x 100 ft)
?1) All proposed ve etattion cleating (provide dimensions) _ 5C,-?
t . vocation of rip rap or fill to be placed a+e the Full Pond eleartion.
rt 3) Location of rip rap or fill to be pled low the P Pond elevation
,/4) The location of any proposed structures such buildings, retaining
wallso docks, etc.
The location of any a ca i n or ri?dging b 4ow Te Full Rend
elevation. -ac(
U} Location of' c onstrucl on access-corridors.
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APPI.I C19,3'li ??]C? _F'Qd: 1?1G]EYO'O<I TQ C®NST?JQT' C7R A]LI['Elt
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pau. J[ E QlF Hl 11 moss 1CSIERVO « ARJEA
DATE OF APPLICATION: 05
APPLICANT(s) : vh
OWNER (s) : 1 In O CT 2006
OWNER (s) SIGNATURE.: P aRM
ADDRESS OF PROPER
W
(Include Lot Number -sand Subdivision Name if Applicable)
TELEPHONE NUMBER FOR CONTACT:
i
WIDTH OF LOT AT SHORELlP7E: ? !TZ
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PROPOSED CONSTRUCTION AND/OR ALTERATION OF SHORELINE:
INSTRUCTIONS FOR SUBMISSION OF APPLICATION
SEC.14-74. PERMIT TO CONSTRUCT.
All structures, including stationary and floating docks, launching ramps, and
mooring facilities, which are proposed for construction' either on or in the
waters of Moss Lake, or upon or over the city's control strip of land,
adjacent to the lake (generally between the 736.0' and '744.0' above mean sea
level elevations), must be approved and inspected by the city's building
inspector. Permit approval is required before construction can begin on
structures or dredging. Application for such permits may be obtained either
from the park ranger's office or the building inspector's office.
Structure permits shall :be submitted with a complete set of plans, signed and
sealed by the registered Engineer, Architect, or Landscape Architect, showing
the proposed stationary pier, floating structure, launching ramp, cluster
mooring facility or seawall. The plans shall show the 'relationship of the
structure to the property lines, the projection of the property corners (see
Figure 1) and the materials of construction. The permit fee for structures,
shall be recommended by 'the Lake Commission and approved by resolution of the
city Council.
Dredging permits shall be submitted with a complete set of plans showing all
elevation changes and required erosion protection (i.e. rip-rap, seawall, or
similar measures). Documenta-lion must be submitted for; any- required permits
from the U.S. Army Corps of Engineers, kind the N.C. Department of
Environment:, Health, and Natural Resources, Division of Land Resources., Land
Quality Section. The permit fee for dredging shall. be recommended by the
L ke Commission and approved by resolution of the City Council. A deposit
sal.l be collected prior' to issuance of to dredging permit, as required by
Sec. 14-75 (a) of this Code.
Shbre Improvements
Check List
Building Plan and Site Plan
1. Property Boundaries (all)
V 2. Existing Structures (all)
3. 744 MSL contour
4. Existing 736 MSL contour
5. Property corners
6. Limits of projection
11/7. Location of proposed structures (to scale)
V 8. Depth of water (at full pond) around proposed structure
9. Sealed design and construction details
A. Seawalls r
1. Footers
2. Depth of wall below full pond
3. Full pond level
4. Weep holes
5. Excavation area
6. Fill area
7. Existing slope of control strip
8. Proposed slope of control strip
9. Drainage fill and rip rap
10. Tie into existing structures
11. Soil erosion and sedimentation control
12. Construction plan details
13. Shoreline erosion.control measures
B. P;
`-*' 1.
2
./ '
3.
e4.
1Z.
ers/Quays
e
Depth of water
Width of cove ,VY?,"
Existing structures
Construction plan details
Shoreline erosion control measures
10. Physical address of lot
17 tt+
t
12.
X13.
c?'° `??.
Property Inventory Tag No.
Tax Map, Block and Lot Number of the private property
A IU ; 1, I
Architect's or Engineer's Seal
Verification of permits from Army Corp of Engineers or NC Department of
Envirorunent and Natural Resources.
Shore Improvements
Check List
As-Constructed Certification
1.
Information listed. as 1 - 14 on Building and Site Plan certified by Architect or
Engineer on letterhead as having been built accordingly.

Shore Improvements
Check List
Building Plan and Site Plan
\/ 1. Property Boundaries (all)
V2. Existing Structures (all)
3, 744 MSL contour
4. Existing 736 MSL contour
u 5. Property corners
6. Limits of projection
7. Location of proposed structures (to scale)
8, Depth of water (at full pond) around proposed structure -l' 7' A,+ ?-f•?
9. Sealed design and construction details
A. Seawalls
1. Footers
2. Depth of wall below full pond
3. Full pond level
4. Weep holes ?/ j -
5. Excavation area
6. Fill area
7. Existing slope of control strip
J 8. Proposed slope of control strip
9. Drainage fill and rip rap
10. Tie into existing structures
11. Soil erosion and sedimentation control
12. Construction plan details
13. Shoreline erosion. control measures
B. Piers/Quays e
I. Depth of water,l
/2. Width of cove Pte.
3. Existing structures
/4. Construction plan details
Shoreline erosion control measures
10. Physical address of lot
ci

12.
X13.
Property Inventory Tag No. C}?
Tax Map, Block and Lot Number of the private property
A lU f I
Architect's or Engineer's Seal
Verification of permits from Army Corp of Engineers or NC Department of
Environment and Natural Resources.
Shore Improvements
Check List
As-Constructed Certification
1. Information listed as 1 - 14 on Building and Site Plan certified by Architect or
Engineer on letterhead as having been built accordingly.
s;el.doc