20171278 Ver 1_Shoreline Stabilization_20171009

Shoreline Stabilization Application Form 2 1 7 1
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
Raleigh, NC 27699-1617 r'1 W% fg
OCT 0 2017
• Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information 40E& BUFFER PERM1T71ES
Name: A6 Zb_a.e.( (-A[i e,
Mailing Address: as s �nop �.,�+ Y -1 •—&e,1-tio�,_ AJ -c
aD2 GL
Telephone Number: 160 -(Aa -9153 Fax Number:
E-mail Address: *V_V rists e T c,lou.d • C-C)ru
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.rnii/Portals/59/docs/regulatory/regdocs/Permits SAMPL
E AGENT AUTHORIZATION FORM.pdf) must be attached if the Agent has signed
this application form.
Name: 12..L jy I ,�n�(SaH l ��a.�.ItnN� Lai 11f3v�►.d d- i'�...
Company Affiliation:
Mailing Address: S$_65 s 720. Qove-,r, S -C - 99-I1 0
1

Telephone Number: $03-831- "IG Fax Number: _st]3- 831-
5-G s5
E-mail Address: a,(wA[s 35 (Vrmff4-h A r ,-A L�k-
Person to receive the Certification Approval: Ra-dy C .wc-cn
• Project Information (ISA NCAC 02H .0502(a) & (b)]
• 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: 6cas4-On Nearest Town: Jam[ an
Subdivision name or site address (include phase/lot number):
ud
So % S4vcC&S P i S e ALqu i- --p[
Umn,4-` AIX. a/ --X
Directions to site - please include road names and numbers, landmarks, etc.:
64a0- i(�aAJV� l�ci►�e. �iit,h 15;choOI — +ate gri W- e►40 Se,,44i PMnk
1� - i Lai m=will6won tA-4
Latitude (in decimaidegrees) 3S•15 73 Longitude (decimaidegrees)
-V- 03(g.144
• Describe the existing land use or condition of the site at the time of this
application (residential, undeveloped, etc.):
• Property size (acres): 1/D_ D
• Lake/ river/ ocean adjacent to property: ('ak��3),m-
2

• Describe proposed work (include discussion as to ow hardening of shoreline
as been avoided, or by it is necessary): i3 f' row -a
t. Z P— - 04 n._ 11 —4 1n_ M.-
Will work be conducted from land?,�,k From water?
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: 2 /_ -t-A it x 102 / 4 PLO x 3 fk k -
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: � 0 2' �a /Z X X 0.2
= a4ervx <_?6 s&CR'><�Ja1i�'� x /0.? %n9 aeecsSR�..L $/C s('�{
12. Please describe the vegetation above the normal pool lake level/ Normal% �„ / /3-5-;2
Water Level and 50 feet landward to be impacted (number of trees, for st �t
instance): F•et.) cbia// sail;,�c r
,A" I l o A', r• w; N n 0-t
6'r- c�QI t
Owner/Agent's Signature' [15A NCAC 02H .0502(f)]
Date
`Agent's signature is valid only if an authorization letter from the owner is provided.

i
Home 1n5'tt thstgit :.nBnattons SrWe Srro1 Rtrtri Vift. L3strtirht
Ji.
Pszte-
6
- chCe' ..J Delett
Lake
(At Ful I Pond/ Normal water Level J•
Full Pond/
Normal Water Level
T: � � r �
- Shoreline
I
f -
Slde4 oro '011ite
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/ formal 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
lI
Pa

• Location of construction access corridors

SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. 9A PLAN NO. J24 I'S l PARCEL ID:
STREETADDR. .. •
Please print:
Property Owner: M � r k -s oLeA (� ►�
PropertyOwner: Ci �.i (A/ i S
The undersigned, registered property owners of the above noted property, do hereby authorize
/gvJ'1 i�.lawso^ ofMud ay � Lt- �l.i tr 4-- Co
.
(Contractor Agent) (Name of consulting firm)
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: Vo 0 - ( Q'al — u 1<:5
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
AuthorizedSignatureAuthorized Signature
Date:/ f 27 1 7 Date:

SHIMMERLAKELN
SURVEY NOTES:
_
1. AREA COMPUTED BY THE COORDINATE METHOD.
A
2. PROPERTY SUBJECT TO ANY 8 ALL EASEMENTS AND RESTRICTIONS OF RECORD.
®
3. NO NGS OR NCGS CONTROL WAS FOUND WITHIN 2000' OF SUBJECT PROPERTY.
SO
4. A PORTION OF THIS PROPERTY IS LOCATED IN A SPECIAL FLOOD HAZZARD AREA, ACCORDING
CAPE
TO FIRM MAP NUMBER 3710359100L, PANEL 3591, EFFECTIVE DATE SEPTEMBER 2, 2015.
pl��NG AUGUST PL
5. PROPERTY ZONED AS GR (CD) ACCORDING TO MB 84 PG 39.
6. THIS SURVEY WAS DONE WITHOUT BENEFIT OF A TITLE REPORT AND DOES NOT PURPORT TO
U' SITE
SHOW ALL MATTERS OF TITLE WHETHER OF RECORD OR NOT.
uy
7. REFERENCE NOTES FROM MB 84 PG 39.
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p
'P
UNE TABLE
LINE LENGM dEAMNG
Li 6.10 rf,56'D'
LAKE WYLIE
L2 134 S12'40'tJELINE LEGEND
L5 M51 S30W29t
u lass PROPERTY LINE
L5 lR99 ' 'f PL NOT SURVEYED
L6 19.01 ' `E
VICINITY MAP (NOT TO SCALE)L7 11.26 _ ` _ RIGHT OF WAY LINE
B a97 :1r1 — —SETBACK
DUKE ENERGY
PROJECT BOUNDARY ----,LAKE WYLIE
ELEVATION=569.4' MSL L 1L8
(SCALED FROM MB 84 PG 39) 10- J� Q IRF
-" 14 REBAR
ABBREVIATIONS
M8 MAPBOOK '
PG PAGE
DB DEED BOOK
NIF NOW OR FORMERLY
SB SETBACK
IRF IRON ROD FOUND
CONC CONCRETE
COV COVERED
RNV RIGHT OF WAY
SF SQUARE FEET
-L BEARINGS, DISTANCES ANDI
3ORDINATES SHOWN HEREON ARE
)CALIZED (GROUND) NAD 83 (2011),
iSED UPON THE NC STATE PLANE
DORDINATE SYSTEM, PER A GPS SURVEY
_RFORMED UNDER MY SUPERVISION ON
_PTEMBER 14, 2017. THE NC STATE
ANE COORDINATES FOR THE PROPERTY
ORNERS, SHOWN HEREON, WERE
'TABUSHED BY REAL TIME KINEMATIC
FFERENTIAL GPS OBSERVATIONS USING
TOPCON GRS-1 RECEIVER IN
INJUNCTION WITH THE NC GEODETIC
JRVEY'S VIRTUAL REFERENCE SYSTEM
RS), WHICH IS BASED UPON THE
DNTINUALLY OPERATING REFERENCE
fATIONS(CORS). ALL MEASUREMENTS
TOWN HEREON ARE REPORTED IN U.S.
JRVEY FEET.
— R/W
101. �NLy
IRF
14 REBAR .r'(IE EIN / 100' YFEMA EAR
�• BUFFER 2 I (SCALED FROM I
R lipp�\P20 ZONPG 3g1) MB 84 PG 39)
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I ARH MODELS, LLC I
PN 224157 I I
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138 4823 PG 733
I( MB 84 PG 39 COV I
III ((e SS LOT 22 DECK I
I 40,057 SF
I}11.7'
015.9 1`*I� M^15.9 16.6' s "V
a 2 -STORY 1.6
I `w HOUSE I
.4' X225 6
1, 14,:-g.7) c5
ICONC n
IDM 24.1 ' I 3
GOV �0 I
11J I 1 GONC WALK PORCI �r)
�N O
oI'1 �I U)
Z
N/F
N/F I l J BARWICK
PULTE HOME I ( I CONSTRUCTION, LLC I
CORPORATION ( I PN 224996
PN 224156 I , DB 4925 PG 423
DB 4827 PG 702 I I MB 85 PG 16
MB 84 PG 39 I LOT 23
LOT 21 I
L 20'SB
RF
4 6 'E FT -1 114 REBAR
RE,
0.
61 4 30 610 1i0
GRAPHIC SCALE
I HEREBY CERTIFY THAT THIS MAP WAS DRAWN UNDER MY SUPERVISION,
FROM A SURVEY PERFORMED UNDER MY SUPERVISION, THAT
THE RATIO OF PRECISION EXCEEDS 1:10,000. ALL BUILDINGS
SHOWN LIE WHOLLY ON THE LOT, THERE ARE NO „s/llRfENCROA�,
ENTS EXCEPT AS SHOWN.
WITNESS CMY^ORIGINAL SIGNATURE, ��� C AR���/Oj
REGISTRATION NUMBER AND SEAL THIS 14th •�,,"*Ms
I o OC
DAY OF SEPTEMBER, A. D • D. 2017. O0
•
SYMBOL LEGEND
_
PROPERTY CORNER FOUND
A
COMPLIED POINT
®
IRRIGATION BOX
SO
PUMP STATION
PRESSURE SEWER
❑f
ELECTRIC TRANSFORMER
TELEPHONE RISER
0
WATER METER
ELECTRIC METER
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©
GAS METER
TELEPHONE BOX (AT&T)
-L BEARINGS, DISTANCES ANDI
3ORDINATES SHOWN HEREON ARE
)CALIZED (GROUND) NAD 83 (2011),
iSED UPON THE NC STATE PLANE
DORDINATE SYSTEM, PER A GPS SURVEY
_RFORMED UNDER MY SUPERVISION ON
_PTEMBER 14, 2017. THE NC STATE
ANE COORDINATES FOR THE PROPERTY
ORNERS, SHOWN HEREON, WERE
'TABUSHED BY REAL TIME KINEMATIC
FFERENTIAL GPS OBSERVATIONS USING
TOPCON GRS-1 RECEIVER IN
INJUNCTION WITH THE NC GEODETIC
JRVEY'S VIRTUAL REFERENCE SYSTEM
RS), WHICH IS BASED UPON THE
DNTINUALLY OPERATING REFERENCE
fATIONS(CORS). ALL MEASUREMENTS
TOWN HEREON ARE REPORTED IN U.S.
JRVEY FEET.
— R/W
101. �NLy
IRF
14 REBAR .r'(IE EIN / 100' YFEMA EAR
�• BUFFER 2 I (SCALED FROM I
R lipp�\P20 ZONPG 3g1) MB 84 PG 39)
.� o ios,E N MB 6A 1
I �p-0) FR N/F I
I ARH MODELS, LLC I
PN 224157 I I
I (
138 4823 PG 733
I( MB 84 PG 39 COV I
III ((e SS LOT 22 DECK I
I 40,057 SF
I}11.7'
015.9 1`*I� M^15.9 16.6' s "V
a 2 -STORY 1.6
I `w HOUSE I
.4' X225 6
1, 14,:-g.7) c5
ICONC n
IDM 24.1 ' I 3
GOV �0 I
11J I 1 GONC WALK PORCI �r)
�N O
oI'1 �I U)
Z
N/F
N/F I l J BARWICK
PULTE HOME I ( I CONSTRUCTION, LLC I
CORPORATION ( I PN 224996
PN 224156 I , DB 4925 PG 423
DB 4827 PG 702 I I MB 85 PG 16
MB 84 PG 39 I LOT 23
LOT 21 I
L 20'SB
RF
4 6 'E FT -1 114 REBAR
RE,
0.
61 4 30 610 1i0
GRAPHIC SCALE
I HEREBY CERTIFY THAT THIS MAP WAS DRAWN UNDER MY SUPERVISION,
FROM A SURVEY PERFORMED UNDER MY SUPERVISION, THAT
THE RATIO OF PRECISION EXCEEDS 1:10,000. ALL BUILDINGS
SHOWN LIE WHOLLY ON THE LOT, THERE ARE NO „s/llRfENCROA�,
ENTS EXCEPT AS SHOWN.
WITNESS CMY^ORIGINAL SIGNATURE, ��� C AR���/Oj
REGISTRATION NUMBER AND SEAL THIS 14th •�,,"*Ms
I o OC
DAY OF SEPTEMBER, A. D • D. 2017. O0
•
9°L
boy
_
SEAL
L-3412 °
_ 4
CAPE AUGUST PLACE
50' WIDE PUBLIC RNV
MB 84 PG 39
DEED BOOK 4823 PAGE 733
BOUNDARY SURVEY for. --
MICHAEL R. WISE & CYNTHIA A. WISE
225 CAPE AUGUST PLACE
LOT 22, McCLEAN- SOUTH SHORE PHASE 1, MAP 1
BELMONT, GASTON COUNTY. NC
7422 DOVER MILL DRIVE SW
CONCORD, NC 28025
I NORTH CAROLINA REGISTRATION NUMBER L-3412 SCALE. I"=60' DATE: SEPTEMBER 14.2017 FILE: 17-047
JACKIE G. DUNCAN DRAWN BY JGD CHEOLEDBY: , D SHEET 1v

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