20191318 Ver 1_Shoreline Stabilization_20190930

o
3
; I
Shoreline Stabilization Applic,al F drm
Three copies of the application (including attachments) and th p z Iiica tion fee
_�p
should be sent to:
Division of Water Resources $ PX1 401 & Buffer Permitting Unit rum"',
1617 Mail Service Center
Raleigh, NC 27699-1617
J)
•
Applicant Information [15A NCAC QZU .0502ja
1. Owner Information
Name:
Mailing Address:
Telephone Number: Fax Number: - AIIA
I /
E-mail Address: OL14L)k,
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be
downloaded here:
httr)://www.saw.usace.army.miI/PortaIs/S9/docs/reg!jlatoryLregdocs/Permits/SAMPLE
AGENT AUTHOR IZATIO NEg3M, pdf) must be attached if the Agent has signed
this application form.
Name:
Company Affiliation:
Mailing Address:
1

Telephone Number: Fax Number:
E-mail Address:
Person to receive the Certification Approval:
• Project Information [15A NCAC 02H .0502(a) & (b)]
• 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.
• 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, 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.)
• Location of the property (where work is to be conducted) /�
County: . Ye de_ / l Nearest Town: CiLC/�,c(,{)(JG�
Su
Directions to site - please include road names
names and number� landmarks, etc.: _
e, _ /) e r n/a. 1 \ . ✓}_/ LL G-., ) A hJ_ — , J ) / . _ i
V
UL ,LLLG�icae �r7 • /Za ir i1"VW1�—v` a
Latitude (in decimal degrees) ,35. 7,2, p,t Longitude (decimal degrees)'
• Describe the existing land use or condition of the site at the time of this
application (residential, undeveloped, etc.): � iW 6X-f;'q
• Property size (acres): 17- 5_� 7 &d 57
• Lake/ river/ ocean adjacent to property: 6IZII_LIA klit y-
2

• Describe proposed work (include discussion as to how hardening of shoreline
has been avoided, or why it is necessary): r, j�2t6yt,x
• Will work be conducted from land? From water?
• 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
11. Total ar6unt of distu bance (including all clearing, back fill, excavation, rip rap,
retaining walls, etc.) above the normal pool lake, lev�ell/ JNorm I Water Level and
50 feet land -ward in square feet or acres:
12. Pleased scribe the vegetation above the normal pool lake level/ Normal Water
Level and 50 feet landw fd to be impacted (number of trees, for instance):
. Z_ ), A. r , n
Owner/Agent's Signature* [15A NCAC 02H .0502(f)1 Date
Agent's signature is valid only if an authorization letter from the owner is provided.
3

0
NoTtF-� fink- wh6vt 1 evt]s Alt yts 1pq(l

L)
m,an .G a tan,ans s�vae snn gee Po•. F.r
J
Lake /'
(At Full Pond/ Normal WaterLevel)
r��
Full Pond/
Normal Water Level & � ` .�
Shoreline � V ' ',,{/� 0IJ
'1
lot &'/
i 5
Please approximately sketch the following information on this plan (provide dimensions
for each item, such as 10 ft x 100 ft)*:
• All proposed vegetation clearing
• Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level
elevation
• Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level
elevation
• Location of any proposed structures such as buildings, retaining walls, docks, etc.
• Location of any excavation or dredging below the Full Pond/ Normal Water Level
elevation
• Location of construction access corridors
Ld

CP
/Exist. ier
� _2>
WA 50'
Proposed Rip Rape R 6
Approx. 2' Hig, D
b 40' Loncy,
Y
J)
ic
nail
CP
uklry 44r 1,5,
Remove SHt Pond and retum to odginal
,--30' Buffer Line
VU771L/ry
T
MA Y12019
ON PA 770
N 24395,
bosom
C�_.�ve Rodius i
Chord Beoring and Distcnce Arc Length n 9 (7-)
10i4­50' S IS* 27 25 W 0 33. 1 ,3, '00. 17'
LjAne Bearing Distance
1 N 14' 45 29" E 9.62'
L 6' 13, 7 56 02" E
N 7' 15' 15" W 30,00,
L4 N 29' 46' _5 11 " W 17.3 3'
a -mot Jea-rmie L. McNeil
PM GROL9 MM A ./M7
SASE FLM aZY. (WE) z M9
i # ill
/DOCKSIDE LANE
LOCATION: MAY/2019
E)(IS r
—__DRILZ
mote:
Ajl exposed soil to be
Sown orprtoper ground
cover t,,,S cited
W_
A
7P41VS. i
PAD �—/be'.p.,3/4'
Srn
AfANki
Qh)
loc.
SET"MAG"
54 nail Elev.: 809.47
by GPS reading
-,j
36.0.
e.i.p.,3