20191615 Ver 1_Shoreline Stabilization_20191125

NI-
; State of North Carolina
1 a
Department of Environment and Natural Resources
Division of Water Resources
Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabiliion
ENVIRONMENTAL QUALITY FORM: SSGP Oi:: b17
Shoreline Stabilization Application Form
Three copies of the application (including attachments) and the application fee should be sent to:
If sending via US Postal Service
Karen Higgins
DWR - 401 & Buffer Permitting Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
A. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name:
If sending via delivery service (UPS, FedEx, etc.)
Karen Higgins
DWR - 401 & Buffer Permitting Branch
512 N. Salisbury Street
Raleigh, NC 27604
Mailing Address: bI y I?Iea.5ain+ 14 i I I TL r. E
LKNCord . RC_ 28025
Telephone Number: 8bZ- 233-0'1100 Fax Number:
E-mail Address: rohj�Sherg2?_'!)Q a'�.Com
2. Agent/ Contact Person Information
FAEGEJVE0/DENNDVVR
NOV 2 5 2019
V.atsr Resources
Pertnig. iIng SQCiiOn
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:
httr)://www.saw.usace.armv.mil/Portals/59/docs/regulatorv/reedocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf)
Name:
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Address:
V •. \C3�iirl•4:�1�.
• .- • ,0.•
'I n
•es • s .�,
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: _ 7.re.clel\ Nearest Town: 9�aA-cSv
Lake/ river/ ocean adjacent to property: t�ocman
Property size (acres): (0- 4F3
Subdivision name or site address (include phase/lot number): Lo+ # 1 © Ln.
(sD Sun n �_A CL- tl l s` fS' Qlde , N C 28L.
Directions to site - please include road names and numbers, landmarks, etc.:
e2 o_A4ox he d
Latitude (in decimal degrees) 35,613 0 ii.-1 Longitude (decimal degrees) - 8b. 9Cow l 2_J
Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): U n deve Iaj _Lo j-
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
n l !' i7 "
91
7. Will work be conducted from land? ❑ From water? 0
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:
I aAnoy e_ '15 SG of i rn , �' 3 - q o � m ulCh 2 lay��
Temporary impacts (temporary clearing, construction corridor) in square feet:
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): ncieve 1nped jo-_
OMSS kkceny�\Je_ and Pn �)en -4 r PS to 5 �,2 Shpre� `�r1Z
Frees fo 1ae removed orb olonc�immedlct�e 5horel;r�Z.
11. Signature
I (�15�►9
Owner/Agent's Signature* 5A NCAC 02H .0502 f Date
'Agent's signature is valid only if an authorization fetter 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 Level
Shoreline
31 - y/
cil� mulch
above 6P ro f
Plan View
Lake
(At Full Pond/ Normal Water Level)
9s, l e nc +k
u nc�ev elo�eci
Lot O
Lake
(At Full Pond/ Normal Water
Leveq
Existing Dock
30ftx 7ft
3 ft x 150It
Below fug Pono NWL
Full Pond/ Normal Water Level
r_—horei'ne __
-(-50ft
Riprap
-
Above fill pond/ NWL
1ft.xi50ft.
addltlanal clearing
ifnecessary
Ej'<AMPLE
Plan View
3' X '7rj �elouJ
�i x above -
FORM: SSGP 02-2017 Page 3 of 4

La ke a�
(At Full Pond/ Normal Water Level) (10
3 ' 6—louj
r► l rq
C
Side View
U-
10 ft. bank
'Side Vi
3'
r r��
o.b0 \jf- r ') � ro..P
v
0
C-
V)
3 ft. below full pond water level 4 ft. above full pond water level 2 ft. additional clearing
f necessary
Existing bank
mmo
FORM: SSGP 02-2017 Page 4 of 4

111222019 610 Fast Carta Aenue, Mooresvl!e, NC to 260 Sun y Path, Statesville, NC 28677 - Google Maps
Go _.gle Maps 610 East Center Avenue, Mooresville, NC to 260 Sunny Path, Statesville, NC 28677 Drive 15.8 miles, 31 min
610 E Center Ave
t 1. Head south on Evergreen St toward E Center Ave
15 s (197 ft)
Take NC-115 N to Talley St in Troutman
22 min (10.7 mi)
r' 2. Turn right onto E Center Ave
381 ft
r 3. Turn right onto E Statesville Ave
1.2 mi
rr 4. Slight right onto NC-115 N/N Broad St
O Continue to follow NC-115 N
8 Pass by Fifth Third Bank & ATM (on the left in 9.3 mi)
9.4 mi
«� 5. Turn left onto Talley St
3 min (21 mi)
Follow E Monbo Rd to Sunny Path
3 min (2.3 mi)
47 6. Turn left onto E Monbo Rd
f 7. Turn right onto Pineville Rd
•t 8. Turn left onto Sunny Path
2.1 mi
02mi
2 min (0.6 mi)
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11/22r2019 610 East Cella Avenue, Mooresville, NC to 260 SunnyPath, Statesville, NC 28677 - Google Maps
260 Sunny Path
Statesville, NC 28677
These directions are for planning purposes ony.
You may find that construction projects, traffic.
weather, or other events may cause conditions to
differ from the map results, and you should plan
your route accordingly. You must obey all signs or
notices regarding your route.
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/ PJN 4710 — 65 — 6457 n
Drawn Fror^ Deed Dcscr;pt;o9 �510
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Calculated From Dead COIIS
Legend
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t i �ZIO- /GJ 61P.............Existing Iron Pipe
po, E1R..............Existing Iron Rod
NIR...................Now Iron Rod
C.M......... Concrete Monument
R/w..................Right of Way
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roetit . onors Boundary and Physical Survey Plot For
Scale
)Ilstown Township
Scale i "= 40'
All of Lot # 11 & 10 of
Iredell County
August
R. T. Setzer Estates
North Carolina
27, 2015
Unrecorded
Reference
Deed Book 1898 Page
2389 PIN 4710 —
65 — 6684
Deed Book 2198 Page
1388 PIN 4710 —
65 — 6457
DALEB.
HILD_E BRAN.
PLS.
LANDSURVEYING
and SUBDMSION
PLANNING
2389 Kens Drive
Sherrilis Ford N,
C. 28673
Phone [phone] Mobile (980)
721-5025

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11/20/2019
Sunny Path - Goog le Maps
gl;- Maps Sunny Path
Imagery ©2019 Google, Imagery ©2019 MaxarTechnologies, Orbis Inc, Map data ©2019 50 ft
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11/20/2019
Sunny Path - Goog le Maps
G4 gle Maps Sunny Path
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Map data @2019 50 ft
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Lot #10
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Sunny Path • 'Statesville, NC R
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CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
i�-f-
Project Name/address:_ 410
Owner:
Print Signature
Contractor/agent: 0_ R S-6r►e E e cwcp ► nQ , LLc OaAU
Print ` " / I Signature
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 is not allowed. Excessive disturbance of ground cover. [15A NCAC 02B .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, _7�� �i�hP_r , 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 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 Buffer Rules, the approved plan(s) and specification(s), and other supporting
materials.
) (owner Signature : Date: 1
g