20200243 Ver 1_Shoreline Stabilization_20200213

r1a State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
It ,lt; r Resom , (.5 15A NCAC 02H .0S0o — Water Quality Certification, Shoreline Stabilization
iv.'u;oar,u+i.«FORM: SSGP02-2017
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 if sending via delivery service (UPS, FedEx,
etc.)
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 Raleigh, NC 27604
A. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: Samuel Young —
Mailing Address: 7224 Lancer Drive Charlotte, NC 28226
Telephone Number: 704-560-3138 Fax Number:
E-mail Address: svounR240Patt net -
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. (Aform can be downloaded here:
http://www.saw.usace.armv.mil/portaiz/c;q/rlr)t-,./rf ------ E AGENT AUTHORIZ
ATION FORM.pdf)
Name:
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Address:
Fax Number:
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: SSGP02-2017
Page 1 of 3
Scanned by CamScanner

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: Catawba Nearest Town: Terrell
Lake/ river/ ocean adjacent to property: Lake Norman
Property size (acres): 0.48 Acres
Subdivision name or site address (include phase/lot number): 5006 Kiser Island Road,
Terrell NC 28682
Directions to site - please include road names and numbers, landmarks, etc.: -r/aW Ca '-&t_
ICn T_ fiJr ..- n L ..rvnK Jerrwa w W ONFn J<Cv,-.15&K,d , c+.itl be-c- i
Latitude (in decimal degrees)35•S551530 Longitude (decimal degrees)"80,55q 4JI
S. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Residential
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Repair and stabilize shoreline erosion caused by high
lake levels combined with waves from boating activity and wind. Add erosion control blankets
and rock to shoreline -
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
impacts in quare feet:
backfill, rip rap, retaining walls, etc.) in
rrtr - _t 4d4 I ,,,.e 4"` &,,,LGC1�.
Oe-G_ [h1L �_� tit'
9. Total amount of impacts above the normal pool lake level/ Normal Water Level and 50 feet
land -ward
Permanent impacts
Temgyrary impacts (tempora
back fill, excavation, rip rap, re aining
& __ S' 4i fv _ sa.i c (tea cu
construction
re feet:
in square feet:
It 1 GH CXIS
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): Lawn grass to be
disturbed. No trees or other vegetation to be impacted.
11. Signatures--
FORM: SSGP02-2017 Page 2 of 4
Scanned by CarnScanner

acY 10-�a.l.f'
z- � ve �- e (�`,v
& ( Ci
Ccw
f� CA cve- v `ass ��`� e

j jqp�
-tt-h
jr
III _-w
o-h
1 t q �!
_3no 6
/-n -?� n -�-05

2/3/2020 20201]110_112235.jpg
Geo
G V-t�
r �
https:Hmail.google.com/mail/u/1 /#inbox?projector-1

2/3/2020 20200110_112239.jp9
https:Hmail-google.com/mail/u/i /#inbox?projector= l

'1d
� I r
y^� tr r
K"5 �" i p t a 'r� • pp��rjj J

2/3/2020 20200110_112225.jpg
https //mail.google.com/mail/u/1/#inbox?projector=l

2/3/2020 20200110_112219.jpg
https://maiI-google.Com/mail/u/1 /#inbox?projector=1