20171508 Ver 1_Shoreline Stabilization_20171127

2 1 7 1 5 0 8
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
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.)
Karen Higgins Karen Higgins
DWR — 401 & Buffer Permitting Branch DWR — 401 & Buffer Permits
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699-1617 Raleigh, NC 27604
A. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: Kevin Hogsed Project address: 211 Hardy Hollow Rd, Semora, NC 27343
Mailing Address: 6193 Tri County Dr
Telephone Number
E-mail Address:
Gibsonville, NC 27249
336-549-4868
[e-mail]
2. Agent/ Contact Person Information
Fax Number:
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://www.saw.usace.army.miI/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf)
Name: Same - as exb0Ve,
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
B. 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, 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 Page 1 of 3

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: Person
Nearest Town: Semora
Lake/ river/ ocean adjacent to property: Hyco Lake
Property size (acres): 1.69 acres
Subdivision name or site address (include phase/lot number):
211 Hardy Hollow Rd, Semora INC 27343
Directions to site - please include road names and numbers, landmarks, etc.: Take Hwy 57 to
Zion Level Church Rd. Take Zion Level Church Rd to left on Pinesborough Estates Rd. Then
left on Hardy Hollow Rd to 1' Singlewide on left at curve.
Latitude (in decimal degrees) 36.503962 Longitude (decimal degrees) -79.088184
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Residential Singlewide with existing single slip dock. No
erosion control currently exists at shoreline.
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Add filter cloth and rip rap along 50' of shoreline to stabilize
shoreline and control erosion. No efforts have been attempted to stabilize the shore by
previous property owners.
7. Will work be conducted from land? ® From water? ❑
8. Total amount of impacts below the normal pool lake level/ Normal Water Level
Permanent impacts (including all excavation, backfill, rip rap, retaining walls, etc.) in square feet:
50 linear feet of filter cloth and rip rap proposed at 1' below normal pool for a total of
50sgft
Temporary impacts in square feet:
N/;+
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:
50 linear feet of filter cloth and rip rap proposed at 4' above normal pool for a total
of 200sgft
Temporary impacts (temporary clearing, construction corridor) in square feet:
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): No vegetation to be impacted.
FORM: SSGP 02-2017 Page 2 of 5

11. Signature
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.
12. Please approximately sketch the following information 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
0
Full Pond, Normal Water Level
Hzq INM wn.
Shoreline
q ,x 0 .
Plan View
La ke
(At Full Pond/ Normal Water Level)
FORM: SSGP 02-2017 Page 3 of 5

_ LI
Lake
(at Full Pond( No�mai Water Level t Existing Dock
30 fta 7ft
I
{
3h ISOR
po
Full Pond/ Normal Water Level" � � �,Belay full .dl NWL
hore'ine 4hx10r,
Rlprap . Aw.refulipend/N`NL
2 h . 150 4. �g'��w� T A.�.. _x -
di,
additionalde d.l. -C,
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TIMM PLE
Plan View
FORM: SSGP 02-2017
Page 4 of 5

3 ft, below full pond water level 4 ft. above full pond water level 2 ft. additional clearing
"if necessary
Existing bank
10 ft. bank
IrANiam,110 MZ
FORM: SSGP 02-2017 Page 5 of 5

Shoreline stabilization - RIP RAP proposal
Property Owner: Kevin Hogsed
Project Address: 211 Hardy Hollow Rd
Semora, NC 27343
Mailing Address: 6193 Tri County Dr
Gibsonville, NC 27249
Contact # and email: 336-549-4868. 03217CDatt.com
Proposed Construction will take place at 211 Hardy Hollow Rd, Semora, on Hyco Lake in Person County,
NC.
The property is 50' wide along the shoreline and I would like to add Rip Rap for the entire distance.
Rip Rip and filter cloth is proposed at 4' above the average water level and 1' below the average water
level for a total of 250sgft.
Please see pictures below.

211 Rxr y 4011OL-0 2d-
lA W1 S 7 4-o Zi'on Leve-( ChtA,c-k 12-4
Ta k
-7-,'on Level C kw rck (Z4 a l nz o s +- 4-o U �e..
n A n d +tA r n L C -f -f o n ? 1'n e_ s b o r o ",9 k E s fa -+e
�itirn le. P+- on 9a'' JI 140"&w 1" (5rave-).

Picture #1 shows East side of the dock
ict 're #2 shows Lest side of the dock

Picture #£ Elude of the dock. ~27 to center of dock from east property line
. . , . .. > . .,.:.. .
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.
t< ?

Picture #2. West side of the dock. —30' to center of dock from west property line.
Picture taken from neighbors dock looking at East side of my property.

Areas where proposed rip rap and filter cloth will cover.