20191616 Ver 1_Shoreline Stabilization_20191125

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
K'ater Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
ENVIRONMENTAL DUAL} T Y
FORM: SSGP 02-2011
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 If sending via delivery service (UPS, FedF,, etc.)
Karen Higgins 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
RECEiVED/DENR t
A.
Applicant Information [15A NCAC 02H 0502(a)J
I. Owner Information
Name: :S'oo, ?�� �- L.feR�
Mailing Address: t4L 5.Pa o k rer
Telephone Number: `a�- 61 a — p a, j �i Fax Number:
E-mail Address:
J J
NOV 2 5 2019
Wow Resources
ftrmitItIng Section
2. Agent/ 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 form can be downloaded here:
ZATION FORM pdf)
Name:
Company Affiliation:
Mailing Address:"<o
Telephone Number: Fax Number:
E-mail Address:
`cu \ • C-ow`
B. Project Information [L5A NCAC 02H 0502(a) & (b)]
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. Prtzvide a detai4ed site pian showing property boundaries and proposed locations of
vegetation clearing, buildings, retaining wails, 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)
pQ�
County: C`��a, Nearest Town:\VKI�
Lak fiver/ ocean adjacent to property: A—\ IC 1K.
Property size (acres):
Su division name r site address (include phase/lot number): 4 45 2 ?j R4
k,c "Z:' _ ftQ' agez'�
Directions to site
- please include road names and numbers, landmarks, etc.:
�\_a a.
Latitude (in decimal degrees) 3S.'14 662 Longitude (decimal degrees) -41, 3.-, S1,g
5_ Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): a u_
6. Describe proposed work (include discussion as to how hardening of shoreline has
been avoided, or why it is necessary): -OCA,1 C� i-n ,f,l �' /_ �,•
e- (2Ya
7. Will work be conducted from land? O
From water?
�'� � t-i� i✓ W� � l
8. Total amount of impacts below the normal pool lake level / Normal Water Level
Permanent impacts (including ail excavation, backfill, rip rap, retaining walls, etc.) in square
feet: a asr
Temporary impacts in square feet:
0. Total amount of impacts above the normal pool lake level / Normal Water Level and
50 feet land -ward 0
Permanent impacts (including back fill, excavation, rip rap, retaining walls, etc) in square
feet: S7a -1
Temporary impacts (temporary clearing, construction corridor) in square feet:
11
10. Please describe the vegetation above the normal pool lake level/ Normal Water level
and 50 feet landward to be/impact%edd (number of trees,, for instance) : 1
C"7C+ST+n^ C-C,6 ,l(, %�IcIN�r-1l&J I'(' Jc %�d irr()o:TG�u✓z
11. Signature
FORM: SSGP 02-2017
Page 2 of 3

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
La ke
(At Full Pond/ Normal Water Level)
iS�(oiN i'os' i
Full Pond/ Normal Water Leve
Shoreline
FX S k.-
sc�► o►�� N 0 4-� i nJ -To
tCAVIA) Rocv,
Plan View
EF•r d k n j
�ptK
w1,11 6le
CNd Cle,�r�„'
Lake
(At FWI Pond/ NorMI water Le,ml(
Existing Dock
/ 30 ftx 7ft
Shoreline
�� any rii�
If necessary
Plan View
34x 179 4�}
RN r:4P
�ZAlerr% -,r pd,
=. � . Un
ire o,5 �;
J
�co, WC I
FORM: SSGP 02-2017
Page 3 of 4

Lake
(At FLIN Pond/ Normal h/al
i�l �. U; i 1
�"t ;"
Side view
Level)
10 ft. bank
aide Vi
FORM: SSGP 02-2017
5eQl Wa lA
a�
R;f
He'
Ih�-
3 f�
0
l-
3 ft. below full pond water level
Existing bank
4 ft. above full pond water level 2 ft. additional clearing
`if necessary
Page 4 of 4

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
SUX U).
Project Name/address: 3- �� �;-1� ,(C County: A
Gt l�1 ty: ���\Dw
Owner: t�e-an ti
Print_ �
Contractor/agent: \ p ; S atur
Print
y — bignature
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 specificall
approved by the Division. There are limitation on size for decks. [15A NCAC 02B .0243(4) and (6)] y
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 or
discharges must be at the natural elevation and discharged prior to entering the buffer directed as diffuse
sheet flow at non -erosive velocities to the lake. [15A NCAC 02B .0243(5), (6)]
Acknowledgement of Notification
hereby state that I have been
Riparian Buffer Rule. Any work conducted in the buffer, not specifically stated in the application d of the Catawba
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
be
Quality Certification and Buffer Rules, the approved plan(s) and specification(s), and other Supporting
materials. pp g
Signature (owner):
:le J , Date:VV

6 Catawba county Geospatial^ cp Real Estate Search
MBXtXG. HYING. BETTER. Information Services
N
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Parcel: 371517121077, 4452 3RD ST LN NW HICKORY, 28601
Owners: EVERETT MARVIN H JR, EVERETT JOAN K
Owner Address: 4452 3RD STREET LN NW
Values - Building(s): $667,200, Land: $262,100, Total: $929,300
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
08/27/2019

catawba county Geospatial Real Estate Search
MAKING. LIVING. WTH. Information Services
N
w + E
5
Parcel: 371517121077, 4452 3RD ST LN NW HICKORY, 28601
Owners: EVERETT MARVIN H JR, EVERETT JOAN K
Values - Building(s): $667,200, Land: $262,100, Total: $929,300
1 in=60ft
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
08/27/2019

YOUR TRIP TO:
4452 3rd St NW
7 MIN I 3.3 MI
Est. fuel cost: $0.31
Trip time based on traffic conditions as of 2:06 PM on August 27, Print a full heatth report of your car with HUM
2019. Current Traffic: Light vehicle diagnostics [phone]
Ina 1. Start out going northeast on Shiloh Church Rd toward Lynwood Ln.
Then 0.16 miles 0.16 total miles
1 " 2. Turn right onto NC Highway 1271NC-127. Continue to follow NC-127.
Then 2.23 miles 2.39 total miles
3. Turn right onto 42nd Avenue Dr.
42nd Avenue Dr is 0.2 miles past 44th Avenue Pl.
If you reach Falling Creek Rd you've pone about 0.3 miles too far.
Then 0.19 miles 2.58 total miles
4. Take the 1 st left to stay on 42nd Avenue Dr.
If you reach the end of 42nd Avenue Ct you've gone a little too far.
Then 0.37 miles 2.95 total miles
a 5. Turn right onto 3rd St.
- Then 0.30 miles 3.25 total miles
®. 6. 4452 3rd St NW, Hickory, NC 28601-9006, 4452 3RD ST NW is on the right.
Your destination is 0.2 miles past 3rd Street PI.
If you reach 44th Avenue Cir 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 all risk of use.
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