HomeMy WebLinkAbout20180762 Ver 1_Shoreline Stabilization_20180604201 80762
State of North Carolina
�� Department of Environment and Natural Resources
DWR Division of Water Resources
1 A 2H. —W
Division of Water Resources 5 NCAC 0 0500 ater Quality Certification, Shoreline Stabilization
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 d , @ " i
1617 Mail Service Center
D
Raleigh, NC 27699-1617 ,JUN 'Q 4 2018
I. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: Christof Heisser and Vicki Jarvis
Mailing Address: 4076 Windflower Ln
Denver NC 28037
Telephone Number: 7049664358
Fax Number:
E-mail Address: viarvis50CEDhotrnail.com
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 AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: Dean Fisher
Company Affiliation: President, Lake Norman Custom Dock & Pile Driving, Inc.
Mailing Address: PO Box 1439
Denver NC 28037
Telephone Number: 7044832144 Fax Number:
E-mail Address: Ikndock0mmail.com
Person to receive the Certification Approval: Dean Fisher
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,
FORM: SSGP 10-2013 Page 1 of 3
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.)
4. Location of the property (where work is to be conducted)
County: Lincoln Nearest Town: Denver
Subdivision name or site address (include phase/lot number): Eastwind Cove
pba_,,5�_, 1 0 1's -F 35
Directions to site - please include road names and numbers, landmarks, etc.:
From Hwy 73 take Hwy 16 Bus N. Turn right onto Webbs Rd. Turn left onto Cindy Ln. Turn right onto Sellers Way.
Turn left onto Windflower Ln. Home is 472 ft.
Latitude (in decimal degrees) 35.5265548 Longitude (decimal degrees) -80.9970044
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): residental
6. Property size (acres): 0.54
7. Lake/ river/ ocean adjacent to property: Lake Norman
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Stabilize shoreline using filter fabric and rip rap to prevent further
bank errosion.
9. Will work be conducted from land? X❑ From water? ❑
10. 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:
100 ft x 5 ft wide = 500 soft
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: 100 ft x 10 ft = 1,000 sg ft + 50x 10 ft access corridor= 500 sq ft (1,500 sq ft total)
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): Existing trees shrubs with
mulch/pine needles. All trees and shrubs less than 3 in removed within 10 ft of shoreline
-�M iV
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.
FORM: SSGP 10-2013 Page 2 of 3
SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. .P* S� PLAN NO.
PARCEL ID: Is t -i 11-1 1 C"
STREET ADDRESS:
,L 1prl
Please print:
Property Owner:
Property Owner:
�C
The undersigned, registered property owners of the above noted property, do hereby authorize
Dean Fisher, President of Lake Norman Custom Dock & Pile Driving, Inc
(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:(:�Ula — y�s
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
fs
Date: \�`\ \�
A orized Si nature
Date:
5/30/2018 NC -16 Business, Denver, NC to 4076 Windflower Ln, Denver, NC 28037 - Google Maps
Go gle Maps NC -16 Business, Denver, NC to 4076 Windflower Ln, Denver, NC 28037
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Existing site picture
4076 Windflower Ln. Denver, NC 28037
Christof Heisser
Existing site picture
4076 Windflower Ln. Denver, NC 28037
Christof Heisser
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