HomeMy WebLinkAbout20191698 Ver 1_Shoreline Stabilization_20191211j::.
Y
q• State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline StabiilizatO
ENVIRONMLNTAL QUALITY FORM: SSGP 02-2117
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
1. Owner Information
If sending via delivery service (UPS, FedEx, etc.)
Karen Higgins t� �1
DWR — 401 & Buffer Permitting BC�ti�*WD;rA;;
512 N. Salisbury Street
Raleigh, NC 27604or
DEC 1 i19
��Alttt*V"'urn
Name: TAMMY WILLCOX AND ELIZABETH CHILDRESS
Mailing Address:
Telephone Number:
E-mail Address:
4676 BOYD MOORE AVE
MORGANTON NC 28655
828-448-7248 Fax Number:
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:
http://www.saw.usace.army.mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf)
Name: CARISSA PARKER
Company Affiliation: BENNICK ENTERPRISES LLC.
Mailing Address: 7836 HWY 70 EAST
NEBO NC 28761
Telephone Number: 828-659-1000 Fax Number: 828-659-1001
E-mail Address: CARISSA(@BENNICKGRADING COM
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.
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
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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: BURKE Nearest Town: MORGANTON
Lake/ river/ ocean adjacent to property: JAMES
Property size (acres): .5
Subdivision name or site address (include phase/lot number):
BOYD MOORE AVE
Directions to site - please include road names and numbers, landmarks, etc.:
FROM MORGANTON TAKW HWY 126 / TL ONTO N POWERHOUSE RD / TR ONTO BOYD
MOORE AVE TO PROPERTY
Latitude (in decimal degrees) 35.76717 Longitude (decimal degrees) 81.82169
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): VACANT WOODED LOT
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): 300' SHORELINE STABILIZATION BY BARGE
HEIGHT WILL BE 4'
7. Will work be conducted from land? ❑ 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:
3' X 300' = 900 SQ FT
Temporary impacts in square feet:
NO TEMP IMPACT
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:
1' X 300' = 300 SQ FT
Temporary impacts (temporary clearing, construction corridor) in square feet:
NO TEMP IMPACT
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): NO TREE REMOVAL
FORM: SSGP 02-2017 Page 2 of 3
7�VrVA�'roi 4 (max
11. Sig
/ �Z
O gent's Sign ure 0502(f)1 ate
Agent's signature is valid only if an authorization letter from the owner is provided.
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 �Gtrv�1S
(At Full Pond/ Normat Water Level)
Full Pond/ Normal Water Level
S,^orel ne ,
jo� a AN-e-
Plan View
X30D��
I x -5 Do,
FORM: SSGP 02-2017 Page 3 of 3
Tammy Wtox , Elizabeth Childress
LAKE JAMES
Boyd Moore Ave.
TO: NORTH CAROLINA DIVISION OF WATER RESOURCES
I GIVE CARISSA PARKER, OF BENNICK ENTERPRISES, LLC.,
PERMISSION TO SIGN AS MY AGENT ON MY APPLICATION FOR
SHORELINE STABILIZATION.
SIGNATURE (S) w6t �-
DATE 7
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Wilcox, Childress
Boyd Moore Avenue
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t �{ "Co Longitude:81.82169W
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Tammy Willcox / Elizabeth Childress
Boyd Moore Avenue