20200071 Ver 1_Shoreline Stabilization_20200113

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State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
15A NCAC 02H .0500 - Water Quality Certification, Shoreline Stabilization
FORM: SSGP 02.201 "
Shoreline Stabilization Application Form 76
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, FedEx, etc.)
Karen Higgins Karen Higgins JF�
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DWR - 401 & Buffer Permitting Branch DWR - 401 & Buffer Permitting B7
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699-1617 Raleigh, NC 27604 3 2p20
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A. Applicant Information 115A NCAC 02H .0502(a)]
1. Owner Information
Name: l I
Mailing Address:
Telephone Number:
E-mail Address:
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/regulatofylregdocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.odf)
Name: L.—
Company Affiliation:
Mailing Address:
Telephone Number: qIJ q"A-ot"1S' Fax Number:
E-mail Address: _Sc- }4 Lk @ e-rnbQr4nn• 1 • w"1
B. Project Information 115A NCAC 02H .0502(a) & (b)1
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

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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) 1 -
County: _ Nearest Town:
Lake/ river/ ocean adjacentto prop
Property size (acres):
Subdivision name or site address (include phase/lot number
-�n ,. ` r, h - 1 nA-
Directions to site - please include road names and numbers, landmarks, etc.:
SQA
Latitude (in decimal degrees)3&A5 ` c' L9.s " Longitude (decimal degrees)-- 8D , 05.13a.9
1
5. Describe the existing land use or condition of the site ,at++th time of this
(residential, undeveloped, etc.): '�•e��A0 'L'z_J �l1R
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
nod a bi�k
7. Will work be conducted from land? 14 From water? ❑
8. Total amount of impacts below the normal pool lake level / Normal Water Level
Permanent impacts (including all excavation, backfiil, rip rap, retaining walls, etc.) in square feet:
a1 Yr wo = —up Sq .
Temporary impacts in square
9. Total amount of impacts above the normal pool lake level / Normal Water level and.50 feet
land -ward
Permanent impacts
back fill, excavation, rip rap, retaining.walls, etc.) in square feet:
Temporary impacts (temporary clearing, fppstruction corridor) in square feet:
10. Pleasedescribe the, vegetation abovethe;normal pool- lake level/Normal Water Level and 50
feet landvygrd-to be impacted;(number of trees, for instance): gee&, 4_UeA= bx&
11.
Ow Agerit's signature* 115A NCAC 02H..0502(fll Date
Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 62-2017 Page 2 of 4

Charlotte, NC to landing Trail, Mount Gilead, NC - Google Maps https://www.google.com/maps/dir/Charlotte,+NC/Landing+Trail,...
Google Maps Charlotte, NC to Landing Trail, Mount Drive 53.5 miles, 1 h 16 min
Gilead, NC
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Map data ©2019 5 mi t____
Charlotte
North Carolina
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
r 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
l of 2 12/20/19, 11:37 AM

Charlotte, INC to Landing Trail, Mount Gilead, INC - Google Maps https://www.google.com/maps/dir/Charlotte,+NC/Landing+Trail,...
"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
f"7. Turn right onto NC-24 E/NC-27 W/NC-73 WE Main
St
fa Continue to follow NC-24 E/NC-27 W/NC-73 W
6.2 mi
Take Lillys Bridge Rd to Landing Trail
11 8. Turn right onto NC-73 E
f 9. Turn right onto Lillys Bridge Rd
t' 10. Turn right onto Livingston Point
t' 11. Turn right onto Landing Trail
A Restricted usage road
Landing Trail
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.
8 min (4.7 mi)
1.1 mi
2.2 mi
1.0 mi
0.4 mi
2 of 2 12/20/19, 11:37 AM

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Google

Landing Trail - Google Maps
https://www.google.com/maps/place/Landing+Trail,+Pee+Dee,+...
Go gle Maps Landing Trail
Imagery ©2019 Mazar Technologies, USDA Farm Service Agency, Map data 02019 100 h
I of 1 12/20/19. 10:52AM

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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
In. 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.
P i nrntinn of anv PYravatinn or dredginE below the Full Pond/ Normal Water Level elevation
FORM: SSGP 02-2017
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Plan View
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Page 3 of 4

3 ftbelow full pond water level 4 ft. above full pond water level 2 ft. additional clearing
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FORM: SSGP 02-2017
Page 4 of 4

Surveytor CAM DEVELOPMENT PROPERTIES, INC.
Subdivision THE LANDING
Lot(s) 3 PLAT CAB. F SLIDE 48-D
Tax Parcel 6575-18-30-9873 DB 811 PG 608
Street Address 157 LANDING TRAIL
Township PEE DEE County MONTGOMERY She NC
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