20191360 Ver 1_Shoreline Stabilization_20191007

1C_ 2 0 1 9 1 3 6 0 State of North Carolina
Department of Environment and Natural Resources
Division c&at r Resources
Water Resources 15A NCAC 02H .0500 —Water Quality Certification, Sh elin Ii ation
ENVIRONMENTAL OUAL!TY FOR . SSG 7
Shoreline Stabilization Application Form l `
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 Permitting Branch
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699-1617 Raleigh, NC 27604
A. Applicant Information [15A NCAC 02H .0502(a)] REC8VEUDEf RJDWF
1. Owner Information
Name: Richard and Mary Hinson OCT 0 7 2019
Mailing Address: 110 Timber In VA"flesouries
Matthews, NC 28104 Mm*wg Section
Telephone Number: 704-516-5600 Fax Number:
E-mail Address: [e-mail]
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorisation letter must be attached if the Agent has
signed this application form. (A form can be downloaded here:
httr)://www.saw.usace.armv.miI/Portals/59/docs/reeulatory/reedocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf)
Name:
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Address:
Fax Number:
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: Iredell Nearest Town: Mooresville
Lake/ river/ ocean adjacent to property: Norman
Property size (acres): 0.6 acres
Subdivision name or site address (include phase/lot number): 524 Canvasback Rd
Directions to site - please include road names and numbers, landmarks, etc.: Brawley School
Rd. Right on Canvasback rd
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.): residential
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): put down rip rap/rock along shoreline to mitigate erosion
7. Will work be conducted from land? Elyes 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:
119 ft of shoreline with rip rap 3 ft below waterline = 357 sq ft
Temporary impacts in square feet:
N/A
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:
119 ft of shoreline with rip rap 3 ft above waterline = 357 sq ft. Will also include 4 ft of stone
steps
Temporary impacts (temporary clearing, construction corridor) in square feet:
N/A
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): grass and natural area; no trees
to be affecte
11. Signatures
Owner/Agent's Signature' [15A NCAC 02H .0502(f)l Date
'Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 02-2017 Page 2 of 6

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 Level i'v.1,f--
Shoreline 1,1/70
Plan View
La ke
(At Full Pond/ Normal Water Level)
5
v
i Or p % 47yi/i
ys C ss
Lake
(At Full Porti/ Normal water Level(
Existing Dock
/30hx7h
E AMP E
Plan View
i-{
- Y'k
7
FORM: SSGP 02-2017 Page 3 of 6
2ft . 150 fl
do . .
E AMP E
Plan View
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7
FORM: SSGP 02-2017 Page 3 of 6

�I
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 a
height age'
ow
f
"
•- = _=rte'
FORM: SSGP 02-2017 Page 4 of 6

United States NC Iredell Co. Mooresville
524 Canvasback Rd, 21
Mooresville, NC 28117 low --
0 2010 HERE 9 0 -St -
FORM: SSGP 02-2017 Page 6 of 6