20200041 Ver 1_Shoreline Stabilization_20200107

VL
LA bA0 MY/
State of North Carolina
DWR Department of Environment and Natural Resources
Division of Water Resources
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
Division of Water Resources FORM: SSGP 10-2013
Shoreline Stabilization Application Form
Three copies of the application (including attachments) and the application fee should be sen
to:
Division of Water Resources
401 & Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information ; j 1 -
Name: i 1e�YN, 5 1JQC Illy
Mailing Address:
t
Telephone Number: A5..) 610 USA\ Fax Number:
E-mail Address: & 20\a3C4D QMG%to1M
2. Agent/Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
http://www saw.usace.army.mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.odf) must be attached if the Agent has signed this application form.
Name:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number
E-mail Address:
Person to receive the Certification Approval
II. 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, structures (buildings, retaining walls, docks, impervious surfaces,
FORM: SSGP 10-2013 Page 1 of 3

a.
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.
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: ,�)G3L C.6y-, Nearest Town: 0QC1%\e 5.
Subdivision name or site address (include phase/lot number): \r�k
0)n0,\a 5V,00-c5
Directions to siV - please include road names and numbers, landmarks, etc.:
Latitude (in decimal degrees) 3S. o N S a Longitude (decimal degrees) -'93 • Wk TS16
5. Describe the existing land use or condition of the site The time of this application
(residential, undeveloped, etc.): uLf\&_VtI09C
6. Property size (acres):
7. Lake/ river/ ocean adjacent to property: \-kV-4—
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): 35 4 �C , to WQ k\ 15 �-k ! V y
9. Will work be conducted from land? ❑ From water? ❑
10. 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 or acres:
11. Total amount of disturbance (including all clearing, back fill, excavation, rip rap, retaining
walls, etc.) above the normal pool lake level/ Normal Water Level and 50 feet land -ward in
square feet or acres:
12. Please describe the vegetation above the normal pool lake level/ Normal Water Level nd
50 feet landward to be impacted (number of trees, for instance):�� 0.►1�
�� VPL4iQ or',
, - 6 - Z� %z/L<,1/9
Owner/Agent's Signature* [15A NCAC 02H .0502(f)] Date
-Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013
Page 2 of 3

FullPond/
Normal Water Level
rri�a�
Shoreline
Lake
(At Full Pond/Normal Water Lever
35 tk
\dear kX*A
3kk be.\*%-0
3�-t <<QYaQ
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ft x 100 ft) *:
1. All proposed vegetation clearing
2. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
3. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
4. Location of any proposed structures such as buildings, retaining walls, docks, etc.
5. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
FORM: SSG 10-2013 Page 3 of 3

Peoa 1 of 1
hn nio l I r_rs
z TnD1EM s. men wv®miy, u�a ewnw io. �-.ue mrtnr m w: w
la¢ OP M I6ta1DB a DNC lCe Tr6 • i •
Ow nar nee war a m A eiwreT v A ueom� ao tWD rmmi M Aea w
M RMIT T1aT 11„ W ORWI� 11aT IFA4Ti4 Fam6 OP WT.
[7Ls TM,T nas ruT n v a awrir TwT a ,nrnn n era rwrmi or a mwir
w aernrm mr a wmurm As m W er0aa¢ TYT enrums
rAgeas a urm.
C TNa M LreT a DI W OROfDo ram w raazi � WD aT ovs er
OE 1! i Id efl@r WYW A 041¢ W FASfDC eil@r aWMm.
17C Tar Tor R1i a De A e1,0S1 O AlDlia tllaalT. COI W M f�aflar=n
of M=W raml • alwl a®m eUiYlT w DO61 EI®r=T6 m M
O6LOT=q W atoframi.
Oe nor rx Twmrrtax ArATsaas m nor �nrpeA a emr nor , W
uwne m Moa A D,�araa,a m M m OP Nr wunaoar.
AraTY u ro wonTOaB maATep 1r a fwmuNr a mre
--m
z are.nr e. Fmren o'rrvr nar T08 war Na orow iT a na W Acme
nr0tr ex ere ®r®mm n smc._ ER—r ris
Tar M armim rm swre,Ta a! usAv mm�rm a; LTaw Fla
emo eraarin rwr M wm0 or rwana u wmarm u f : r.5oq_
Twr naa war a wvam n Amroaos en es, nbo As Aae®. ones
Nr aGeDUL BIWa1rC IfTITIaTmr IT. rlT @a. 3Z ...
swvao ro. A.ere
■TiN MY
EX I9TIN6
ifirkm2onam orraai
mRYT 1WT M W w waT m aaa. Tor raa a arT® ems
em orrrml
IDXI>HlIIt 012�D8:
IgTM fi1lYLll
JOtICSOfI mwrr
Tor varwrort m wmnm roe eramuTw m wsa®n war
c roaT afa m rsc w caor=
m 19.T_ �N-
semnfn u �
JOE
NA O.Tca
GRAPHIC SCALE 1-30'
0 30 GO 90
mia
DUOS ENER
r �nc PAPAXEL
ra•'E K'rTe
D7.17 O6'M
a. ee• 567?3'51-E' 21.33
um• m
sf-N J�0
hTN 3A.2:
LOT 2
WILLIIAiw S. WAIAE
D.B. lg6 PS. 6f3)
P.C. S SL. 976
PARCEL • 1-9?a9
r6 1aFIN Wip.rNA COai101. MaNF]IT lOCaIED MITMn a.am FEET
W E
rioo0 ITT AMM HMM n r6i LOCATED WMN ANT DFSIOtuTED
/ Fwome IS U6ECf m All. AlGW m MAT EASBi M Aa) n69T=Tj0W
S
N30'f9•a6-N ,ryap
O.TB'
m-eDme n0sroo DOr en
-V -tome far Da m aR
a'ef mi. �w..-mores uoEre ■i..aNr
�.•-Door® urafn of
N9-E 13.52* ar-mmu YTG ern
5o LLC
L932 eNn-mmc eAmWr eaoi NWT�e
eow-mDio aaw aun sDeue
a0 � m ®--mega utw imx
N•-D901Es m61 as�a Dur
o'-mmss maunra ern vae
TAHIILLOATSHOIF.S
'P> SEMISE*. QVJqM ILL
D.B. 2051�gP�6, r71
LOT 3
O.S. TAP% Pg. 739
P.C. 1 SL. 32
PANCFL,f •��p7p765
1 ml
0.45 siaeE$
i
� �A.t-T 1 Tie ane T i L.
E 5D.04'
iE �. � �• /�21.2
/ MOWS�IIOIM�TALIFTAIIIL
/ (BO' PAIYATE R/ q
/ r.Ts eeame ru0 m
n a,.a• sTe oe•N a. w.m•
SURVEY FOR:
QUINN ISLAND, LLC.
"TmmCWVMT2W.*M.L A NORTH CAROLINA
i ot"-.rL�1�rRoby�rnMeraw6 LIMITED LIABILITY COMPANYeI'visNis°fjew.
_
... cuwo T owat
weft TNfi orODT'1T J. foe.Tie .,wn . rmae ester LISA DAW.% TRUSTEE
.wr r nrmawe. TrreTeiaenc reaa,0lfm. rr sa01r.
_ LtIT 3. _ TAHALA S 01M - THE POINT -
e0Tl QTI1TLE AfFTfTr NAS rmYaEa Fes TQS weG�.z50eIFLWFAT9MLNpil�flt2�tTpnfFm
A/Om969�CE "r�FMM
w 8 S =16fALLTTIO[f �0'a1
SoDf: 23 Page: S65 Seq:•

F•
I i<<
1
r ,
1

FULI. POND
NCIi'i IAL SUMMERTIME
fq
T]
0
END OF LACE 13ED
zw
C7 �
xU3
2a
ace
mw
5'
}�lune�'�hp,raf+v.e.
TOE OF BANK
1K HEIGHT DETERMINATION -
FM SHOREf.1HE STAB UT TIA ON TMg
MAY, Im
e
5'tw-
i

NORMAL SUMMERTIME
,��
J
TOP F-RODED ESCARPMENT
qr-"
w
EW OF LAKE aEo-, pIo TOE OF BANK
A NK NEIGHT iiETER�i1td�►� olt
MR SHOREUNE ST ASIUTAT1®M ACT- M nn
MAY, 1999

Jackson County, NC - GoMaps
`'
Select Map General
r"10,
k%Sf#}y7
i
ff,bl eteyet TrlxPam(*I
quv.e HrCII)t
t`
F
¢
1C .� •
_ F•
_
4,
z

w
UN
3 4 Lx low
a0-a6K
IE
I

• w r.
L3 ',
14
t jy