20171246 Ver 1_Shoreline Stabilization_20171003

FOR
Duke Energy k.xcayatinn Permit nplicati©, VAellr
.. Duke Fide No.
71246
Applitution Fce Security t7enosit S i Itcck it
Date Rcc.'d Initials
Datoof Duku snerti� sake Semiccs, appiieazi ant3,'or contractor on-site insprtitiutrs Date
Initials
Date Final t'ratcction/Avoidance Arca,vfarkinp Field- Vcrilied zR
Initials
Approved to start Work 8y :
(E'rint)Date
Dote Completion Rewired
Date of Any Approved Extension initials
Date Passed Closeout inspcctitm`- Init6is
AUY Stop WOA Orders or SAtG Viutatiuns*? (check one) [3 cs ONO (tf Yes, C-IrP uia in PART V)
Bate Deposit Refunded Initials — Date Permit Database CI. dated
P initials
Forward copy of approved application (all pages, pins any attachments that puke Energy changed) back to applicant
with Approval Letter and highlight any changes. pile copies of Approval and Close-out Checklists and any Stop Work
Orders with application.
Y -w P UC211: Ilti!4?t'mation (Plet1se Mint)
Name h
W`'
ifl e -u Telephone
Email address: Ott*
L ake Address
Contractor Company,
Contractor Contact Person
Contractor EtSiall, hiltless:
e-3
Iviailing Andress (if dijferent)
Lf te-A r r :.t✓k, L (_iL. i
e-NOi PIGI
al byi do�
u
LAKE LOT RNFORMATION
Lake No"cu-)County Iy?d2t 1 City i1cG1' State N( -Tax Map No. L—W VA 2(';'C133 ?)
Su adwision Vic, ISI � Lot / Section No. I�� Lot Size :acres
o� D
Duke Energy Page 3 of 14
Excavation Program

Duke Energy Excavation Permit Application Form
Are there any Co -Applicants*? (check one) Oyes ONo (tf Yes, include names, addresses or
lot numbers, phone numbers, lot sizes in PART V — ADDITIONAL INFORMATION)
* Co -Applicants exist when the proposed work is being done under a single application, will be
performed by a single -contractor as one continuous project, and is done to benefit multiple
owners / lease holders of Project -front properties within a single development. The check for the
application filing fee and securitydeposit should be from the party shown as Applicant and not
several checks from the Applicant and Co -Applicants.
Do not continue the application until an on-site inspection has been conducted between a
Duke Energy Lake Representative and the applicant and/or the excavation contractor.
NOTE: Initializing this portion of the application by a Lake Representative in no way
constitutes approval or eminent approval of the excavation or any other lake use permitting
activity.
Date of on-site inspection 1 Lb_
Initials (Duke Energy)
(applicant/contractor)
Duke Energy Page 5 of 14 rev 2/61 P
Excavation Program

Duke Energy Excavation Permit Application Farm
Part It. Description of Project
A. BASIC INFO
1. Type of excavation: (check one) O New excavation ❑ Maintenance excavation
2. Purpose of excavation: (check one) M Boat Access Channel
❑ Water Intake Channel ❑ Wastewater Discharge Channel
❑ Other (specify):
3. Lake user category: (check one) 124rivate ❑Residential Marina
❑Commercial Marina ❑Public
00ther (specify):
?J�
4. Max. Exec Mari (
on Area Dimensions ft): Length Width
_
Depth S
(Note: include additional area dimensions if necessary so response to #S below equals max. area
dimensions in #4)
5. Volume of Excavated Material (TOTAL for the project): ✓ Cubic yards
6. Type of inaterial removed (applicant determines by field sample if practical): Si
7. Excavation Site area:_ ei-�Z, Acre (s) Disposal Site area: n . 4 Acre
(s)
8. Total Disturbed Area (including equipment staging area)'%. Acre (s)
9. Does a project meet the requirements of the applicable General Permit? (check one)
Yes ❑No
10. Do you claim title to the disposal area? (check one) MdYes [No
11. Do you claim title to the equipment staging area? (check one) 'Yes ❑No
12. Are there any water- eatment facilities within 50 feet of the proposed excavation area?
(check one) ❑Yes io
(If Yes. specify):
13. How will the excavated material be entrapped and the erosion
erosion control plan 9nd disposal area design): VV Z i- W l 1
(e.g. see attached
Duke Energy Page 6 of 14 rev 216117
Excavation Program

Duke Enemy Excavation Permit ADnucadon Form
14. TypefaN of excavation equipment to be used: Luno) Yta. u bw� aM
15. Will waters or wetls be crossed in transporting equipment to or from the.site?
(check one) OYes o
(If yes, explain)
16. Will return water re-enter the reservoir? (Check one) OYes G4 ON/A (If Yes, sped
point(s) of re-entry and show on Excavation Area Drawing)
17. is there an VIng facility (e.g. pier) that access is being maintained to by conducting the
excavation?s ONO
(If Yes, specify the existingpermit number.. If No, include a scaled drawing of the proposed
facility). Permit #_��._
18. Total planned duration of the work (Include first equipment mobilization, excavation
through final mitigation measures -complete):
START / FINISH /
(Month) (Year) (Month) (Year)
Duke Energy Page 7 of 14 rev 2/6/17
Excavation Program

Duke Energy Excavation Permit Apal estion Form
PART 1I. (Continued)
B. PROTECTION / AVOIDANCE AREA DESCRIPTION
Complete the following table including all land areas within and immediately adjoining the disturbed area:
Protection/Avoidance Are
(check all that apply)
Auurox
Identif ton
a od
Avoid (A,� or NIitivate (M)
Acre
e d ID
Wo k AM w. ID
a. Marshland, swamp, ponds, beneficial
aquatic vegetation or other potential wetlands
(circle all that apply)
b. Buffer Zones (specify width & source
of requirem ent/)(/
of
, AV I) V Vl O I + 19t COM -
—
F- 1�t/` ^ (t
il'1Gt • V'
_c. Environmental Areas as identified by
Energy
1p,Duke
d. Natural Areas as identified by Duke
Energy
e. Historic properties (.specify)
f. Rare or threatened species (specify)
Doke Energy Page 8 of 14 rev 2/6/17
Excavation Program

Duke Energy Excavation Permit Application Form
Protection/Avoidance Areas
(check all that apply)
Aptwox
Acre
Identifcatio
aod *
Avoid (A) or Mites tete (M)
a
WKk &W D
(**I
�I w'
it. Buried gas, water, sewer,
communications or electric lines (circle)
NJ Pf
h. Impact Minimization Zones as
identified by Duke Energy
Nj
b
L Other areas requiring specific
avoidance, protection or mitigation (spec)
Ivy
* For "Field ID" column, specify entity or person that performed the identification and how it was physically marked (e.g. Duke
Energy (John Doe)/Pink and purple -dotted tape, Corps of Eng. (John Smith)/ yellow flagging). For "Work .Area Dwg ID" column,
show the symbol that is used on the drawings to identify the protection/avoidance area.
** List and attach mitigation plans
Duke Energy Page 9 of 14 rev 214r17
Excavation Program

Duke Ener ry Excavating PPrn,*r* A --ification Form
-,kPPLIQANT'S'-IGNA'j:LRF-;$
Comments:
A A
Applicant Name (Prini)
Ot
4
Applicant Signature* ✓ Date
Ccs -Applicant Name (print) Lot #
Co -Applicant Sigilatuye* Date
Co -Applicant Name (print) Lot #
Co -Applicant Signature* Date
Co -Applicant Name
Lot
Co -Applicant Signature* Date
CAo-Applicant Name (print) Lot #
Co -Applicant Signature* Date
Cry -Applicant Name (print) Lot
Co -Applicant Signature* Date
.,,.Per my signature, the information p-10-vided ir, this application is ck�rreet t�, LIle best of illy
knot/ [ed
Duke Eaergy Page 10 of 14 rev 2/6117
Excavatimt Program

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
15A NCAC 02H .0500— Water Quality Certification, Shoreline Stabilization
NVISIM of Witter Resources FORM: SSGP 10-2013
Shorefine Stabifization Application Form
Three copies of the application (including attachments) and the application fee should be sent to:
Division of Water Resources
401 &,Wer �'eraaitt�arg Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
4. Applicant information 115A NCAC 02H .0502(a))
1. Owner Information
Name:
Maifing
Telephone Number: Fax Number:
E-mail Address:
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
hU2Wwwwsaw usace arm rnil/Portals/59/docs/reeuI atoryr(rei docs/Perrnits/SAMPLE AGENT AUTHO
RIZATION.FORM.adf} must be attached if the Agent has signed this application form.
Name: kLI
Company Affiliation: 3 NCttvi
Mailing Address: t
Telephone Number: Fax Number:
Y
E-mail Address:
Person to receive the Certification Approval. I"f
11. Project Information 115A NCAC 02H .0502(a) & (b}i
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)
Wei I
�
County: r� Nearest Town: m UD r`K�
Subdivision name or site address (include phase/lot number): rhf
Directions to site - please include road names and numbers, landmarks, etc.:
Ili N tD J.-KIl +' �3�V494- (ftA 1 11 i am <IPA 2d ,
Latitude (in decimal degrees) 7S. S1 uy Longitude (decimal degrees)-qLA
Describe the existing (and use or condition of the site at the time of this application
(residential, undeveloped, etc.): Va(w_ tot Oct w
6. Property size (acres): 1. YX9J
7. Lake/ river/ ocean adjacent to property:
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): 1A 1:::,ki lexataa`�
9. Will work be conducted from land?
From water?
10. Total amount of disturbance (including all excavation, backfill, rip rap, retaining walls, etc.)
below the normal pool l9ke level/ Normal Water Level in square feet or acres:
2A, Un V <, � '777 (A,01 I- Vd .
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:
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): �Vte5
/Agent's Signature Printed Name Date
115A NCAC 02H .0502(f2
'Agent -s sigrwture is vQfid onty if an alt WriZa6OR letter frOm the owner is provided.
FORM: SSCP 10-2013 Page 2 of 3

Lake
Fu# Pond/ftrnW Level]
3
Full Pond/
NormakW
pop
Shoreline
SUv CO fid•
131 PA"n k,r way
moore�U i1e, �- 2P�e 11
Please approximately sketch the following information on this plan (provide dimensions for each
Item, such os loft x loo 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 wraps, docks, etc.
S. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
FORM: SSGP 20-2413 Page 3 of 3

D DON ALLEN & ASSO C IATES, P. A
'Since 1971"
Commercial * Residential * Mortgage Surveys * Multi—Family
Construction Staking * Subdivision Design * Topographical
131 Crosslake Park Drive — Suite 102 * Mooresville * NC * 28117
[phone] [phone] Fax
I, certify that this map was drawn under my supervision from an actual
survey made under my supervision recorded in deed book_ , page--_, and/or
plat book — page_ , that the ratio of precision is 1':10,000, that this map
was prepared in accordance with the General Statutes of North Carolina Chapter 89C.
my hand and seal on the ?t _ day of JULY
A.D. 20_ 17
CURVE TABLE
CURVE
RADIUS I LENGTH
BEARING
CHORD
C1
82.00' 75.82'
N 6738'32' E
73.15'
LOT 1008
WILLIAM M.
I / LOT 1007
{ / 1.86 AC.
I
bI e
b�
41.2 "O• m •. /�
It 4"1.5.'10 /moi
I
1 r
f
BUNKER WAY
(PUBLIC R\ W)
i
1y �e
VS
i
i
i
=O� •FESS/p,�; �Z
SEAL
L-349
SUR\j
..........
D' 30' so' 100' BOUNDARYSURVEY
SCALE IN FEET OF
LOT 1007 THE POINT PHASE 10
SCALE 1" —6d' _ DAVIDSON TWSP., IREDELL CO., N.C.
ACQUIRED BY: JOHN WHITLEY
FIELD BOOK:
FILE POINT 1007
DC FIl E;
TAX MAP NO,
LINE TABLE
LINE
BEARING
LENGTH
Lt
N '2325" W
42.97-
2. 7'L2
L2
N 7935'55" W
36.72'
L3
N 7248'02' W
57.87'
L4
N 4535'41" W
49.26'
L5
N 64"17'13' W
29.71'
!6
N 8'06'40" W
32.54'
L7
S 41'14'07" W
44.09'
L8
N 7470'13" W
25.68'
LOT 1008
WILLIAM M.
I / LOT 1007
{ / 1.86 AC.
I
bI e
b�
41.2 "O• m •. /�
It 4"1.5.'10 /moi
I
1 r
f
BUNKER WAY
(PUBLIC R\ W)
i
1y �e
VS
i
i
i
=O� •FESS/p,�; �Z
SEAL
L-349
SUR\j
..........
D' 30' so' 100' BOUNDARYSURVEY
SCALE IN FEET OF
LOT 1007 THE POINT PHASE 10
SCALE 1" —6d' _ DAVIDSON TWSP., IREDELL CO., N.C.
ACQUIRED BY: JOHN WHITLEY
FIELD BOOK:
FILE POINT 1007
DC FIl E;
TAX MAP NO,

Google Maps
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9/19/2017
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