20100293 Ver 2_Shoreline Stabilization_20190930

State of North Carolina
Department of Environment and Natural Resources
DWR Division of Water Resources
Division of Water Resources
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SSGP 10-2013
Shoreline Stabilization Application Form
One copy 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
I. Applicant Information [15A NCAC 02H .0502(a)] RECEi,fEN" t`
1. Owner Information SEP 3 0 2019
Name: GAeoraR oye.S.l Ftn;*6tiFGGG
Mailing Address: x.11 Oy o,l!+,y i r , iQrr,tit;in Secti`-,;,
eoirnel',gs. tW_ a8n�
Telephone Number: '104- (a51- ` R36 Fax Number:
E-mail Address: nhc>ve-Lba) II_-', 1',-'IiV-%PC'- 0„
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:
Company Affiliation:
Mailing Address:
Telephone Number: goLj- "141 5111 Fax Number: '10c( -1fl140 .- Sq�G
E-mail Address: 0 -kc I lci lkn a-) Lu c6n+reckm ne+
Person to receive the Certification Approval: :Tci,n i e �_ _ -lin
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,
etc.), rip rap, excavation or dredging below Full Pond/ Normal Water Level elevations,
FORM: SSGP 10-2013 Page 1 of 3

and 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)
County: ��� le_n Nearest Town: Onr.ne ; o s
Subdivision name or site address (include phase/lot number): -IuoL1
Directions to site - please include road names and numbers, landmarks, etc.:
Latitude (in decimal degrees) 355_ 5bb 3C)%_ Longitude (decimal degrees)— Rp , gQr 1
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Iles %cue n -V LLI
6. Property size (acres): O. 1v51 a►creS
7. Lake/ river/ ocean adjacent to property: 1',r -,man
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Anc
9. Will work be conducted from land? 0 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:
a. 5 htIC*.,
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: k' alov
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):
an Are eS remov ed , M's ri ► yy)QA Al 6k, 4 --an c.e 4rn
ql;z3kq
Date
*Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 3

Lake
(At Full Pond/Normal Water Level)
I)bcK 2.5 6e1ow
Full Pond/
Normal Water Level
Shoreline �
a-bave INO --Tees removed
fn i n'i n -\c .� d i S� vrl aYtc�
IRe pk-ce e X
steps
t0'
ho�52 LUID?_
ACCESS
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ft x 100 ft)*:
1. All proposed vegetation clearing
2. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
I 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 walls, docks, etc.
5. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
George Hovey
21104 Lakeview Cr.
Comelius, INC 28031
FORM: 5sGP 10-2013 Page 3 of 3

Google Maps 610 East Center Avenue, Mooresville, NC to 21104 Lakeview Cir, Cornelius, NC 28031 Drive 10.7 miles, 22 min
610 E Center Ave
Mooresville, NC 28115
t 1. Head south on Evergreen St toward E Center Ave
14 s (197 ft)
Take S Main St, NC -115 % Langtree Rd and 1-77 S/t1S-21 S
to Torrence Chapel Rd in Cornelius
17 min (8,9 m)
N 2. Tum right onto E Center Ave
0.6 mi
01 3. Turn left onto S Main St
1.6 mi
t 4. Continue onto NC•115 S
2.1 mi
N S. Turn right onto Langtree Rd
1 1 mi
6. Use the left 2 lanes to turn left onto the interstate
77 S/US 21 S ramp
0.2 mi
7. Merge onto 1-77 S/US•21 S
2.9 mi
N 8. Take exit 28 for US -21
0.2 mi
9. Merge onto W Catawba Ave
456 It
Follow Torrence Chapel Rd to Lakeview Or
4 min (1.8 m)
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9zM9 910 East Carder Marm MoaesNUe, NC to 21104 LalefawOr. Comellus, NC 79«31- Google Maps
r 10. Turn right onto Torrence Chapel Rd
1.7 mi
41 11. Turn left onto Lakeview Cir
0.1 mi
t 12. Continue straight to stay on Lakeview Cir
151 It
21104 Lakeview Cir
Cornelius, NC 28031
These directions are for planning purposes only.
You may find that construction projects, traffic,
weather, or other events may cause conditions to
differ from the map results, and you should pian
your route accordingly You must obey all signs or
notices regarding your route.
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UNSURVEYED LINE
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--------------------------- BACK OF CURB. PAVEMENT
d CPO COMPUTED POINT
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0.56 AC.
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L BARBARA B. POWELL
oar W I' tvE 10668-466
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PYRAMID
NOTES:
I. This properly S£E NOT£ 7 located in a designated flood zone.
2. Area determined by coordinate Computation.
3. CP denotes computed point, no monument found or set.
LAND SURVEYING 4. All it are horizontal ground distances.
jam 4%CKSOR LOVE 5. Property Is subject to any right-of-ways and eosemenis of record.
nrowaLNG rwrna a-Nw
P.D. 6w tt 6. Underground utilities not located as of this dote.
9601-Ow
e0l O 7. House Is above 751 Contour as reRWred by Mecklenburg County.
BOUNDARY/ PHYSICAL SURVEY
PROPERTY OF
GEORGE D. HOVEY 81 WF., KAY 0.
21 104 LAKEVIEW CIRCLE
LOT 13, BLOCK A, COUNTRY CLUB SHORES, MB 12•"329
TAX CODE 001-151-27; DEED 9759-197
LEMLEY TOWNSHIP, MECKLENBURG COUNTY
CORNELIUS, NORTH CAROLINA
JANUARY 16, 2006
FILE - 1t0VEY
40 0 40 80 120
GRAPHIC SCALE - FEET SCALE 1 40'

Polaris 3G Map — Mecklenburg County, North Carolina
Miles
Date Printed: 9/24/2019 10:32:04 AM
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This map or report is prepared for the inventory of real property within Mecklenburg County and is compiled from recorded deeds, plats, tax maps, surveys, planimetric maps, and other public records and data.
Users of this map or report are hereby notified that the aforementioned public primary information sources should be consulted for verification. Mecklenburg County and its mapping contractors assume no legal
responsibility for the information contained herein.

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George Hovey
21104 Lakeview Cr.
Cornelius, NC 28031
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CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address:
Owner:
Contractor/agent:
Print
The approval is for the purpose and design described in your appWation. Impacts not indicated in the
application is a violation of the Buffer Rule. Site specific work should be provided in the application. [15A NCAC
02H.0506 and 15A NCAC 02B.0243(8)]
Trees are not allowed to be removed from Zone 1 of the Buffer (within 30 ft of the full pond elevation), unless
approved. Exception, those trees that are severely undermined along the immediate shoreline can be removed.
Minimal shaping and sloping along the immediate shoreline is allowed. [15A NCAC 02B.0243(6)]
Benching, grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 0213.0243 (6)]
Beaches, impervious patios, impervious walkways, etc. are not allowed in the buffer unless specifically approved
by the Division. There are limitation on size for decks. [15A NCAC 02B.0243(4) and (6)]
Work to be conducted from land must indicate an access and indicate any trees that are to be removed. The
work corridor should be described. The approved access corridor shall be restored. Staging, spoil, construction
material must be outside the buffer. [15A NCAC 02H .0502 and 15A NCAC 02B.0243 (4), (6), (8)]
Stormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
discharges must be at the natural elevation and discharged prior to entering the buffer directed as diffuse or
sheet flow at non-erosive velocities to the lake. [15A NCAC 02B.0243(5), (6)]
Acknowledgement of Notification
I, _ C me-orap- `�\Iftu hereby state that I have been informed of the Catawba
Riparian Buffer- ule. Any wcacl conducted in the buffer, not specifically stated in the application and approved
by the Division of Water Resources (DWR), is a violation and subject to enforcement. Due diligence will be
taken such that the construction will be built within substantial compliance and intent of the 401 Water
Quality Certification and B ffer Rules, the approved plan(s) and specification (s), and other supporting
materials.
Signature (owner): Date:
State of North Carolina I Environmental Quality I Water Resources
512 N. Salisbury Street 1 1611 Mail Service Center I Raleigh. NC 27699-1611
919.707.9000