20200072 Ver 1_Shoreline Stabilization_20200113

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SSGP02-2017 /\
Shoreline Stabilization Application Form
Three copies of the application (including attachments) and the application fee should be sent
If sending via US Postal Service
Karen Higgins
DWR — 401 & Buffer Permitting Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
If sending via delivery service (UPS,
Karen Higgins
DWR-401 & Buffer Pe
512 N. Salisbury Street
Raleigh, NC 27604
A. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Informati
Name: l
Mailing Address:
Telephone Number: U c i' l I Fax Number:
1
E-mail Address: 55 yU �Il1 affA-C
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:
httD://www.saw.usace.armv.mil/Portals/59/dots/reeulatorv/readocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf)
Name:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
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: 'O M Nearest Town: 1 \ 1(y cllt IPQ U
Lake/ river/ ocean adjacent to roperty: Qt-I i) - fU
Property size (acres):
Subdivision name or site address (include phase/lot number):
Directions to site - please include road names and numbers, landmarks, etc.:
Latitude (in decimal degrees)36• Wla.$" Longitude (decimal degrees)-i(j, j _'36•n
5. Describe the existing land use or condition\ of the site at the time of this application
(residential, undeveloped, etc.):
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): P�Ckltna &VN$Xf `tN _ A-r' prrvexs4 r cas%on
(and CL11-rn of ban�—
7. Will work be conducted from land? Z 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:
�i-
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:
4 )� 100 = i-Fl� S �" C 4-
Temporary impacts (temporary clearing, construction corridor) in square feet:
"IA
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): beat .L u rA" brltiil 1
11.
Signature* [15A NCAC 02H .O502(f)l
Date
Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 02-2017 Page 2 of 4

Charlotte, NC to Cove Point, Pee Dee, NC 27306 - Google Maps https://www.google.com/maps/dir/Charlotte,+NC/Cove+Point,+P...
Go gle Map: Charlotte, NC to Cove Point, Pee Dee, NC Drive 53.3 miles, 1 h 16 min
27306
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Map data 02019 5 mi �
Charlotte
North Carolh-a
Get on US-74 E
6 min (1.1 mi)
T 1. Head northeast on S Tryon St toward W Trade St
A Parts of this road may be closed at certain times or
days
482 ft
1" 2. Turn right onto E 5th St
0.7 mi
3. Use the middle 2 lanes to merge onto US-74 E via
the ramp to NC-27 E
0.3 mi
Follow NC-27 E to NC-73 E in Pee Dee
1 h 4 min (47.7 mi)
A 4. Merge onto US-74 E
2.7 mi
41 5. Keep left to continue on E Independence Blvd/E
Independence Expy
0.8 mi
1 of 2 12/20/19, 11:26 AM

Charlotte, NC to Cove Point, Pee Dee, NC 27306 - Google Maps https://www.google.com/maps/dir/Charlotte,+NC/Cove+Point,+P...
*1 6. Use the left 2 lanes to turn slightly left onto NC-27
E/Albemarle Rd
0 Continue to follow NC-27 E
0 Pass by Pizza Hut (on the right in 2.0 mi)
38.0 mi
IN 7. Turn right onto NC-24 E/NC-27 W/NC-73 WE Main
St
0 Continue to follow NC-24 E/NC-27 W/NC-73 W
6.2 mi
Take Lillys Bridge Rd to Landing Trail
N 8. Turn right onto NC-73 E
10 9. Turn right onto Lillys Bridge Rd
r 10. Turn right onto Livingston Point
r' 11. Turn right onto Landing Trail
A Restricted usage road
Cove Point
Pee Dee, NC 27306
These directions are for planning purposes only.
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.
7 min (4.5 mi)
1.1 mi
2.2 mi
1.0 mi
0.2 mi
2 of 2 12/20/19, 11:26 AM

Google Maps
https://www.google.com/maps/@35.2589227,80.0917105,31 I m/d...
Go gle Maps
Imagery @2019 Maxar Technologies, USDA Farm Service Agency, Map data ©2019 100 ft
l of 1 12/20/19. 11:20 AM

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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
=ull Pond/ Normal Water
Shoreline
Plan View
Full
Lake
(At Full Pond/ Normal Water Level)
Lake
M WII PoM/ wuuuli Wrter LevNl
Riprap
Existing Dock
,/ M1u ]h
3 h•i50h
• &bvM PTa/NWL
_ ah 60h
Pbax lull piny NM
FORM: SSGP 02-2017 plan Vie E A I� E
Page 3 of 4

'1
Lake
Y
(At Full Pond/ Normal Water Level)
ai
0
Side View
3 ft. below full pond water level 4 ft. above full pond water level 2 ft. additional clearing
'if necessary
10 ft. bank
height
SideViEW
FORM: 55GP 02-2017 Page 4 of 4

Survey for
Subdivision
CAM DEVELOPMENT PROPERTIES, INC.
THE LANDING
Lot(s) 9 PLAT CAB. F SLIDE 48—D
Tax Parcel 6575-18-31-6084 DB 805 PG 517
Street Address 110 COVE POINT
Township PEE DEE
This Survey Is of an existing parcel
or parcels of land.
This plat Is subject to any facts
that may be disclosed by a full 6
accurate Ode search.
Survey Based on Existing Comers
Found on Site.
No Published Horizontal Control
Within 2000' of this Survey.
County MONTGOMERY State NC
518" EIR
TALL.
DUKE ENERGY
PROGRESSING
2/ 1
w
r �
LARGE STONES �I CN
ALONG SHORELINE cA
. CP. 2 I
314" EIR
LEGEND
EIP- EXISTING IRON PIPE
EIR - EXISTING IRON ROD
EIRF- 12'EXISTING IRON ROD FLUSH
EMAG - EXISTING MAGNAIL
EP -EDGE OF PAVEMENT
ICV . IRRIGATION BOX
RAN-RIOHTOFWAY
WM .WATER METER
MBL -MINIMUM BUILDING LINE
FBI -POWER BOYMRANSFORMER
CP - COMPUTED POINT
NTS-NOTTOSCALE
LINE
TABLE — TIE LINES
ONLY
LINE
BEARING
DISTANCE
L5
W S57'0840
TIE 50.00
LB
N8545J1 E
I TIE 37.J2
LINE LEGEND
PROPERTY LINE SURVEYED
r— FENCE LINE
P — OVERHEAD POWER LINE
— — — ADJOINER PROPERTY LINE
— — — RIGHT OF WAY
MINIMUM BUILDING LINE
—•—•—•— LEASE LINE
EIRF N/F RAWLEY R. McBRIDE, Jr. \
S�3ps3ga DB. 805, PG. 634 EIRF
TELCI
f TAX REF. 6575-18-31-7127 9°E� n�
10,MB� �51.82. 0a9 6g EIRF
EIRF
LOT 9 �0//� STREET
DB 805 PG
1.5" EIP(CP&L)
3" TALL
70•
This Easemlat enits,Agfect to reements or FLUSH �8 �6� RIP RAP
Right-0f-wayofrecordprior to N/F WILLIAM W. GRISWOLD \\ DITCH
date of this plat, which was not
visible at the time ofmy Inspection. DB. 804, PG. 155
No attempt has been made as a part of this TAX REF. 6575-18-30-5954
Boundary Survey to obtain or show data concerning CONC. DR.
existence, size, depth, condition, capacity, or OVER P/L 1.8't
location of any utility or municlpaVpubiic service faGllty.
For Information regarding these utilities or 13I /rvM
facilities, please contact the appropriate agency.
EIRF
V ,
Surveyed by
GARY KENNEDY
PROFESSIONAL LAND SURVEYOR
[phone] - [phone]
[e-mail]
703 Page Street
Troy, N.C. 27371
Scale: 1"=50' I Date: 8/26/2019 1 Precislon 1:10,000+
Drawn: JGK I Checked: gk I Job: S-06119
_L6 —A
tF EMAG
VICINITY MAP
L RiW
20,703fSq. Feet
0.475f Acres
(D.M.D.) R
BICV
CURVE
TABLE
CURVE
RADIUS
ARC LENGTH
CHORD LENGTH
CHORD BEARING
Ci
240.00
1314
13.14
S46 28 44 E
C2
282.88
10.75
10.75
S4910W E
(NTS)
tgo
30
°zLC
C
2C
> �/' BEENS MAP MAY NOT BEA REVEWEDBYALOCALGOVERNMENTAGENCYFOR
TIFIED SURVEYAND HAS NOT
LOT 6 COMPLIANCE WITH ANYAPPLICABLE LAND DEVELOPMENT
PLAT CABINET F, SLIDE 48-D
05, REGULATIONS AND HAS NOT BEEN REVIEWED FOR
COMPLIANCE WITH RECORDING REQUIREMENTS FOR PLATS."
aagas�a�ssHs�i I cartify that this map was drawn under my supervision from an actual
LINE TABLE ♦♦♦♦♦'(N C'A/�O<++�, 8n °y meda under my supervWon (deed desap�UTCrecorded
In Book 1;
♦ +� page 546 or other reference source
LINE BEARING DISTANCE ♦♦♦ C• FESS/D ?i �i that the boundaries not surveyed are Indicated as drawn from information
L1 S48U250 E 17.50 2 QQO tiy� 9 �: Book page or other reference source
L2 N57'19 51 E 17.90 1:10,000+
L3 N7273'24'W 33.24 = SEAL that the raft. of precision or positional accuracy Is
L4 N73 f445'W 18.20 r L-3883 and that this map meets the requirements of The Standard of Practice
%' for Surveying fn North Caroline (E1 NCAC fib, 1000).
0' 50' 100' 150' %�� 9tic Eyc ' T� 2stn nay .f August Bo 19.
♦
,•�++� (�' ��l.�O♦♦, /S��` `�I f L-3883
MOW�4'� Nor ... aaaaa fenlonal Land Survey Reg. No.
GRAPHIC SCALE Thls map does not meet N.C.G.S. standards 47-30 and Is not for Recording