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Home My WebLink About20181279 Ver 1_Shoreline Stabilization_2018091720181279 State of North Carolina Department of Environment and Natural Resources Division of Water Resources Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization ENVIRONMENTAL QUAUTY FORM: SSGP 02-2017 Shoreline Stabiliz NVIcation Form I seman,.. Three copies of the application (including att ch a ts) d 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 Permitting Branch 1617 Mail Service Center 512 N. Salisbury Street Raleigh, NC 27699-1617 Raleigh, NC 27604�� cr A. Applicant Information [15A NCAC 02H .0502(a)]� 1. Owner Information Name:�j(�W �0() uuar� Mailing Address: 15 ( boAam Circle ROY NC 2D U 1 Telephone Number: _M — q00 0'? Fax Number: E-mail Address: L CC.I SIC 6 04,1'14 2. Agent/ Contact Person Information 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: htto://www.saw.usace.armv.mil/Portals/59/docs/reRulatory/re2docs/Permits/SAMPLE AGENT AUTHORIZ ATION FORM.pdf) Name: 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 y�lithe property (where work is to be conducted) County: 10nL90(r)ei_Y Nearest Town: T fo Lake/ river/ ocean adjacent to property: ) (I ei Y Property size (acres): Subdivision name orsite address (include phase/lot number): CCtrOl1ha FVeS t- - - Lo+ � �l //n�3 / "1 Directions to site - please include road names and numbers, landmarks, etc.: [3a►yi Cd( I, In (Ot(c I i rA i-OrQsk Latitude (in decimal degrees) Longitude (decimal degrees) 5. Describe the existing land use or condition of the site at the time of this application (residential, undeveloped, etc.): resi J ti, } Ci I 6. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or why it is necessary): R 4 P X0 S120//,h,e Coca 5i -wit ii'ne s eroj ins) as va y 7. Will work be conducted from land? 2� 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: Temporary impacts in square feet: . 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: Z i") c,, r -'T Temporary impacts (temporary clearing, constrq, tion corridor) in square feet: 10. Please describe the vegetation above the normal pool lake level/ Nrmal Water Level and 50 feet landward to be impacted (number of trees, for instance): %✓ec g EfVu4S 11.Signat e Owner/Agent's Signature' [15A NCAC 02H .0502(f)l �- S- 20 I$ Date *Agent's signature is valid only if an authorization letter from the owner is provided. FORM: SSGP 02-2017 Page 2 of 4 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 Full Pond, Normal Water am . Shoreline Plan View La ke (At Full Pond/ Normal Water Level) Air Lake At Rdl Fond/ Normal Water le. PI) Existing Dock ,/30 ft x7 ft 3ftxi50ft 6. — Ul pond/ NWL Y r � •F Full Pond/ Normal Water Level . aftxisoR ; atv U1p—d/NWL 2ft. x150 k. X X_1 1 • - .additional clearing ;ImRiprap 'if necessary (�@ Plan View i `fit /is, FORM: SSGP 02-2017 Page 3 of 4 10 ft. bank height Side View FORM: SSGP 02-2017 3 ft, below full pond water level 4 ft, above full pond water level ft. additional clearing f necessary Existing bank Page 4 of 4 /6-/9-017 a. 3;- Pm #,al-oo pd F- /02 •B Survey of the New Allocation Lines for ,R -gin 's �\. `\ ` Lot No. 433, Lot No. 434, and the a/..n � Carolina Forest Community Area of the Beb°r Carolina Forest Subdivision Deed Oaaw 472 Pope / g sY �� % Y' Uwhurrie Township, Montgomery County, North Carolina \/O y ,. p. Deed Reference Book 546 Page 1.65 and Book 472 Page 1; Plat Cabinet A Slide 601. Surveyed by Thomas J. Fields, PIS -2906. and Associates, on November 14th, 2005 and /r. on September 14th, 2007. S• `\, a Q,\ S //r / 50 0 so \ \\ S.d. la M Foot t . 50' / \ From th. fs- of NN14C de FIELDS LAND SURVEMG Tillery a . Pro ress 9 Energr •�•+� Property \ moi \ / F 13310 Albemad* Road, Suit. C T y. N.C. 27371 •� e. t w i IC lipC-r t \ i K• `1 �s Progress energy '`:w F—n J I// Property { f sa \ Community Area N •� Lot No. 432 Lake .. �- Tillery y... '?'`/` . : a � i/ aadd N. uw-d ��` n.ed Boer 36T S Pap. 151 y a Lot No. 435 Beew I Lake Tillery Cbwd- W. F mplan & H!q 1 I eortlfy Nat lhle plat repr...nt. a w f anle.4ots pored e4 w change enrol l*tNg atr..L lit Surv. NORTH CAROLINA MONTGOMERY COUNTY F Them.. J. FlNdq certify thol thl. plat wos pr.psed Iran a7 octad —y done by ma h Nov Oro5e.t 07 frau hlarm.tlon found In p. dead* ferm:ed on this plot and is M oe reapecls car.ct to th. bm eat of y kno, .dge and b,110. The roll, o/ pr.el.l- o. ed -Wt d by Ialllud- — deporturee N 1:15.000'+ - that W. plot Ins prpw.a ti aeewdonu with C.S. 47-30 a. omande,L etln.0 my anglM .".tor. end .f tell .tang w aed NI. the 17N day of Srolembs 2007 No harfxmti control within 2000 feel Progress Energy Property Z �yUq,6EAL =i:r L•:.. s i9S•>, Q$i qg .yds JEY f„ f J� Cul Na 4JI STATE OF NORTH CARGUNA MONTGOMERY COUNTY Filed for registration at��o'Uoek LM er �V , 2007 and recorded in Plat Cabinet S1ids.Z02-B Keys G. Norris. Register of Deeds by..L'a-4Y77i%udtca.wx.on Qedee�a.. Communily- Areo f i for Nq u7 1 I 1 I —ury Nat Ne plot .hown hreon I. not SINN the Natw.hed Prol.elkn Dl.trkl w eompll- Mlh the w.teran.d proteetkn DI.W t for Menlgamery County and k oppro—1 by th. R,ming e_M for —,,1.9 H Na Re titer al D.ed. Is 10 I D'1 '�y r;,ATfl.�om�Drm oat. wata.h.d Adminl.wlw Monlg_y Co., N.C. State of North Carolina County of Montgomery t. o *dew Offl— of M, t,—." County. . tify ap et th. mpot to whkh thi. atino tion 1. ' .1fia.d. meet. ed .t.l.to,y reguk.manta lor reed td Dols vNw Oilks lob No. 2006-322. ,R -gin 's �\. `\ ` i Baba Lot No. 433 \ hme. f. C'a.ine.. B R//q \ a/..n � Progress Energy cTnuri K Co,w,e.s ,� Beb°r Property Deed Oaaw 472 Pope / g sY �� % Y' \/O y ,. p. � /r. ar? ` S• `\, a Q,\ S //r / �!T 9 Lot No. 434 / Robert e95,m W dnvrd •� Cour# ✓6MeM Oed Boat 5.6 P,ps 165 / _ Community Area N •� /-M. I d % Lot No. 435 Beew I Cbwd- W. F mplan & H!q 1 Bann/. A F—m-kplon Legend Deed book 157 Pop• 475 % dn.tt M ea notedenee qe a%tIrvn IBwroi°a1 Bees w^r A denote. mwanad Pohl. dwp right -of- of H. _ , sg --- rwnd a n.es n CURVE TABLE Lot Na 436 NRVE1 1-.— FNGMt t:R -&d C // k. C1 ern R 271.43 da.e1 FT �- $ D..e Boort 167 Pope 2e # d cz e] ease FI z7 .b r 35.97 R 271..6 fT SS.e7 FT Communily- Areo f i for Nq u7 1 I 1 I —ury Nat Ne plot .hown hreon I. not SINN the Natw.hed Prol.elkn Dl.trkl w eompll- Mlh the w.teran.d proteetkn DI.W t for Menlgamery County and k oppro—1 by th. R,ming e_M for —,,1.9 H Na Re titer al D.ed. Is 10 I D'1 '�y r;,ATfl.�om�Drm oat. wata.h.d Adminl.wlw Monlg_y Co., N.C. State of North Carolina County of Montgomery t. o *dew Offl— of M, t,—." County. . tify ap et th. mpot to whkh thi. atino tion 1. ' .1fia.d. meet. ed .t.l.to,y reguk.manta lor reed td Dols vNw Oilks lob No. 2006-322.