20191478 Ver 1_Shoreline Stabilization_20191028

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State of North Carolina
Department of Environment and Natural resources
Division of Water Resources
Wo ter Resources 15iA NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
ENVIRONMENTAL GUALITY
FORM: SSGP 02-2017
Shoreline Stabilization Application Form
Three COPies of the application (including attachments) and the application fee sho d nt to:
If sending via US Postal Service Ifsending via delivery service (UPS, FedEx; etc) Karen 11iggins Karen Higgins
D WR — 401 & Buffer Permitting Branch D WR — 401 & Buffer Permitting Branch
161-7 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699-1617 Raleigh, NC 27604
©c�% B 2019
A. Applicant Information [15A NCAC (121i 0502(a)] tNst�� Rgsouro s
1. Owner Information sectfoil
Name:
Mailing Address: g ��
Telephone Number: _31IC 333r C�fkq 3 Fax Number:
E-mail Address: - "rb�2 �dS �D
2- AgenV 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 four, can be downloaded here:
_ TION FORiVIgdf)
Name: �� OUINS
Company Affiliation:°
®v�`rv, e-.
Mailing Address: i! \
a8 b o t
Telephone Number: ��8 `�q5-3 Fax Number:
E-mail Address:0.�\
g- project Information 115A NCAC C12H [35p2(a) & (b)j
L 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. 9MVide a detai4ed 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 fo rn
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: U-6A .>Ve— Nearest Town:
Lake/ river/ ocean adjacent to property: L.o.�_ V\
Property size (acres):
(o
Subdivision name oradp—address (include phase/lot number): 01 Sy" Jl. Nk- t(0
a7 btu
Directions to site - please include road names and numbers, landmarks, etc.:
S4.0.
Latitude (in decimal degrees) 35 .' U at d. Longitude (decimal degrees) - V t • 33aU3
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.):
6. Describe proposed work (include disc
avoided, or why it is necessary)
Qi' In f?c-" 4u AVo i' c(
on as to how hardening of shoreline has been
Ore- e V a I &, . Y i'J.�a< f 'X4",/ —
7. Will work be conducted from land? 91 From water? ❑
8. Total amount of impacts below the normal pool lake level / Normal Water Level
91
Permanent impacts (including all excavation, backfill, rip r ,retaining walls, etc.) in square feet:
SF f3�I�� F�1i ���
Temporary impacts in square feet:
Total amount of impacts above the normal pool lake level / Normal Water Level and 50 feet
land -ward #rtYcd -)'ao sr —
Permanent impacts (including backr�S fill, excavation rip rap, retaining walls, etc.) in square feet:
cln
Temporary impacts (temporpry clearing, construction corridor) in square feet:
Q'-/' re-7)0
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): f�o I V e e s � Qe
PC'Y�UyPCI e" VPVeC 1 �ee S iNc� CCS4c,
11. Signature
nt's Signature* [15A NCAC 02H .0502(f)]
Iv%a //9
Date
signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 02-2017 Page 2 of 4

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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
Lake
{At Full Pond/ Normal Water Level}
Full Pond/ t' rmal Water LeveAM Um am
Shoreline
Lake
(At Full Pond/ Normal Water Level)
Existing Dock
30 ft x7 ft
3 It x 150 ft
Belowfult.PomV NWL
Full Pond/ Normal Water Level
n err
ho
tel lne 4 ft x 150 It
Riprap Above full pond/ NWL
2 ft.x 150 ft. -
additional clearing
necessary
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M P L E
Plan View
FORM: SSGP 02-2017 Page 3 of 4

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Side View
3
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FORM: SSGP 02-2017 Page 4 of 4

YOUR TRIP TO: MZDQJQW
4101 5th St NW
7 MIN 1 3.9 MI
Est. fuel cost: $0.36
Trip time based on traffic conditions as of 12:25 PM on September Print a full health report of your car with HUM
4, 2019. current Traffic: Light vehicle diagnostics (So ) 906-2501
�.. 1. Start out going northeast on Shiloh Church Rd toward Lynwood Ln.
------Then 0:16 miles ----------------------------------------------- ._.___._..---------------- ..------ .---------
---- 0:16-total-miles
y. 2. Turn right onto NC Highway 1271NC-127. Continue to follow NC-127.
.1.-._---Them2:84 miles -- ..................._... ----------------__------_........... .... .._--- .------
.3.004otal-miles
3. Turn right onto 39th Avenue Dr.
39th Avenue Dr is just past 39th Avenue Cf.
If you reach Jenkins Elementary School you've gone a little too far.
-----Then 0:50-miles ---................ _. ---- .----- ,.. - ...------- .--------- ,---- .............-----
..-3.50 total -miles
,r 4. Stay straight to go onto 4th Street Ct.
..-..-.Then-0.08 miles ---- ------- .-,_....._..-..._-_-.__....-_....__..-.--._.._..........__...,...-_..
3.58total-miles
S. Take the Ist left onto 4th Street Ln.
0.2 too far.
If you reach the end of 4th Street Cl you've gone about miles
-_----- Then 0:25 miles ....-.------------------------------------- ..___--_....... .------ .--- ..-------------- ....
_... 3.83-total-miles
6. Take the 1st left onto 41st Ave.
If you reach the end of 4th Street Ln you've gone about 0.2 miles too far.
.__.---- Then 0:08 miles ----------- _-------------------- _.._.._...................-..-._.._-___,__._.._..._.._-.._........
3:91-total miles
a 7. Turn right onto 5th St.
.,..----- Then 0.01 miles --- ..--- ...._-....--------- ...._..-._.......... .._,.--- - --.—.. _.............._-----------
3.92-total-miles
8. 4101 5th St NW, Hickory, NC 28601-9015, 4101 5TH ST NW is on the left.
If you reach the end of 5th St you've gone a little too far.
Use of directions and maps is subject to our Terms of Use. We don't guarantee accuracy, route conditions or usability. You assume ell
risk of use.

_Acatawba Count Geospatial
k,�. nvi„�. ��f=Fy Information Services Real Estate Search
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Parcel: 370520813033, 4101 5TH ST NW HICKORY, 28601
Owners: STRUVE THOMAS J, STRUVE PATRICIA L
Owner Address: 2588 SUGAR BOTTOM RD NE
Values - Building(s): $1,000, Land: $184,800, Total: $185,800
1 in=60ft
8l . 33A��'3
�5.'latar2.
to 3 A crze.
This map/report product was prepared from the Catawba County, NC Geospatial Information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and labeling information contained on this map or data on this report. Catawba County promotes and recommends
the independent verification of any data contained on this map/report product by the user. The County of Catawba, its employees, agents, and
personnel, disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or may
arise from this map/report product or the use thereof by any person or entity.
Copyright 2014 Catawba County NC
08/15/2019

4W.C:8)catawba county Geospatial Real Estate Search
arexixc. urixe. sarrea. Information Services
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W+E
5
Parcel: 370520813033, 4101 5TH ST NW HICKORY, 28601
Owners: STRUVE THOMAS J, STRUVE PATRICIA L
Owner Address: 2588 SUGAR BOTTOM RD NE
Values - Building(s): $1,000, Land: $184,800, Total: $185,800
1 in=400ft
This map/report product was prepared from the Catawba County, NC Geospatial Information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and labeling information contained on this map or data on this report. Catawba County promotes and recommends
the independent verification of any data contained on this map/report product by the user. The County of Catawba, its employees, agents, and
personnel, disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or may
arise from this map/report product or the use thereof by any person or entity.
Copyright 2014 Catawba County NC
09/04/2019

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CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: i\kko V-g60 1
Owner: Y1v Jr
Print
Contractor/agent..
Print
Signature
CM
The approval is for the purpose and design described in your application. 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 isnot Excessive disturbance of ground cover. [15A NCAC 02B .0243
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
hereby state that I have been informed of the Catawba
Riparian Buffer Rule. Any work 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 enforcemept;Tpue diligence will be
taken such that the construction will be built within substantial compliance and intent of the 401 Water
Quality Certification and Buffer Rules, the approved plan(s) and specification(s), and other supporting
materials.
Signature (owner): Date: / U d )