20200040 Ver 1_Shoreline Stabilization_20200107

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
ENVIRONMENTAL GUALITV FORM: SSGP 02-2017
Shoreline Stabilization Application Form w
Three copies of the application (including attachments) and the application fee should be sen totio
If sending via US Postal Service If sending via delivery service (UPS, FedEx, e ) ��
Karen Higgins Karen Higgins
DWR - 401 & Buffer Permitting Branch DWR - 401 & Buffer Permitting Branch
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699-1617
A. Applicant Information 115A NCAC 02H .0502(a)]
1. Owner Information
Raleigh, NC 27604
Name: 4dQU C-OOMN
Mailing Address: Deegwpv ea LN
DeN vex N L
Telephone Number: 7D4-604 — Oq QJ__ Fax Number:
E-mail Address: CIemsoNdeb IW b2-]]sQdkh. IJe.T
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
Name: !E-,tede tjiNC.AAT(,
Company Affiliation: 0 Lmxyr-
Mailing Address: 1-1541 UI'
Telephone Number:
E-mail Address:
Fax
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.
`4: 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: Nearest Town:
Lake/ river/ ocean adjacent to property:. s�Ke d P m
Property size (acres): 0,913
Subdivision name or site address (include phase/lot number): �eed
Lmme Newer' N. C, 2-8037
Directions to site - please include road names and numbers, landmarks, etc.:
Latitude (in decimal degrees)-35.12 6 Longitude (decimal degrees) 80, 7
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): f e5 t denU�i°a I
6. Describe proposed work (include discussion� as to how hardenin of shoreline has been
avo/idgd, or why it is necessary): Il ` to oJ,' -�)
7. Will work be conducted from land? [► From water? ❑
8. Total amount of impacts below the normal pool lake level / Normal Water Level
Z X 1 Permanent impacts (including II excavation, backfill,Irip rap, retaining /walls, etc.) in square feet:
U
v�.�(s 5 / .% Ee ' /aloe, ZGo��sQs fe a.. Ar 6 f`'olie w #S'7 s'�v�•t�
Te ora`'f y impact n square feet: 3) I I 0
9. Total amount of impacts above the normal pool lake level / Normal Water Level and 50 feet
land -ward '36 A 5ft
Permanent impacts (including back fill, excavation, rip rap, retaining walls, etc.) in square feet:
s.1
Temporary impacts (temporary clearing, construction corridor) in square feet:
10. Please describe the vegetation above the normal pool lake level/ Normal Water Lev/el and 50
feet landward to be impacted (number of trees, for instance):
Few 4-reps off- to L oMo.ele-d
11. Signatur
Owner/Agent's Signature` [15A NCAC 02H .0502(f)l Date
*Agent's signature is valid only if an authorization letter from the owner is provided.
'� SSGP 02-2017 Page 2 of 4

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IOw level mw.rk J
o � r� J
f a
(At Full Pond/ Normal Water Level)
L,D W wa+f r
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. F rap rp
Prtvc.I Pros Io u
Side View-
10 ft. bank
I.r,
ZN FILL SOIL-'
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Ptlr:t 4-0 1f F"J de}une4
I toi! 0.t,;1 W,11 rock,
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3 ft. below full pond water level 4 ft. above full pond water level 2 ft. additional clearing
Ir "If necessary
Existing bank
low r
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-ORM: SSGP 02-2017
Page 4 of 4

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: O 133 DU12 VVeJer ". County:
Owner:
Contract
Print 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
z4),6DA ckWilln , herebv 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.
Signature (owner): /��ln� 1 Date:

12/17/2019
9:05 PM
Mon Dec 16
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Tax Pence! to:
32519
PIN:
4613176880
Md.
8133 DEEP WATER LN
Sub or Cando:
CRESCENT LAND B TIMBER CORP
Township:
CATAWBA SPRINGS
Not Book -Page:
L-61
Dead Book -Page:
2379-264
Historical Deed(s(:
View
Tex District:
EAST LINCOLN
Legal Deacripaon:
ON SEC 38 CRESCENT
Lots:
68
Neighborhood:
0613F
Prevbus Parcel ID:
Owner
CONKLIN DEBORAH ANN
Melling Addr9es:
6133 DEEP WATER LANE
Mailing City, State Zip: DENVER NC 28037
Acres:
0.873
Land Value:
$320,653
Improved Value:
$1,414,124
Total Value:
$1.734,777
Last Recorded Date:
02/282013
Zoning.
R-SF
Regal, I ofos;
None
Summary Property Record Card
Directions Googl
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8133 Deep Water Ln
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ALLAN
UNIT
HORIZONTAL LAYER OF
CUTNOTCHINALLAN FILTER FABRK TO BE
: e
BLOCK TD ALLOW FOR '
DRAIN PIPE �INFILL SOD INPLACED
FILL SOILS AND WAIL
q,... ",.'
ROCK
•' r • INSTALL. EMBANKMENT
'' t ' PROTECTION FABRICTO
HIGH WATER A MINIMUM OF I R (30 an)
••
' { ABOVE HIGH WATER LINE
'
ELEVATION '/ • �.•• .;
>
4In(10
cm) BRAIN PIPE PLACED ALONG
(1)
BACKOFBLOCK
AND VENTED THROUGH — `%•`=`.= WELL iADED,11n-21n
• •
J
THEM
• • •4 ,:'; (2.Sco-5an) COMPACTED
WATER ELEVATION. OUTLETS ON 30 R • + . , , • GRANULAR WALL ROCK
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,..
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(10
m) CENTERS MAXIMUM. RODENT ; e * ; . t. 04 WITH NO FINES
mil.
SCREEN
AS REQUIRED •r.- .. ��'--�.' ,
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LOW WATER • .'• INSTALL OEOGRID LAYERS PER
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FORM: SSGP 0272017 Page 4 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
j
Plan View
Lake
(At Full Pond/ Normal Water
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('reposed�p roPrrf.
4"1
199 Ota n wa.ter f:aN f
Lake
(At Full Paam Normal Water Laval)
Existing Dock
30hx7h
3hv 150A
Fell full Forest Nw1
Full Pond/ Nornrall Water Level
�_�horeline
1 anv 60h
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P P
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r
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Plan View
FORM: SSGP 02-2017 Page 3 of 4

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