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Home My WebLink About20200296 Ver 1_Shoreline Stabilization_20200225State of North Carolina Department of Faivi omment and Natural Resources Division of Water Resources 15A NCAC 02H .0500 - Water Quality Certification, Shoreline Stabilization FORM: SSGP 02-2017 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 115A NCAC 02H .0502(ja Owner Information Name: 0ya�/'31aL � 5 ZKvL-�'+�—Z Mailing Address: O ` JQ v� � Telephone Number: Fax Number: -7 l Cg - TS ~ to _ oc) N/� E-mail Address: D4 �1 � L L 0 L,) I 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: httry wuw.saw. usace.amit.nul Portals'?9 does'reaulatorv-reedocs'Pemits'S,"IPLE AGENT AUTHORIZA TION FORDI.odf) Name:,"--- ('Z-D t I� (�(�. _ Company Affiliation: L�� /J0JLeY_ 1 Mailing Address: (Y1 C)O v �i l lAJ C- Telephone Number: Fax Number: 7a--f L40 <� - G 3` 9 E-mail Address: Sfq-& B. Project Information 115A NCAC 02H .0502(a) & (hA 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. 9�0 httpsy/files.nc.gov/ncdeq/Water%20Quality/Surface%20Water%...%20Permits/SSGP%2002-2017%20Shoreline%20Form_final.docx 10/3/19, 11:25 AM Page 1 of 5 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. 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 L(,� Nearest Town: Lake/ river/ ocean adjacent to property: L44i-, O� r1(1 �►� Property size (acres): 0.151 Iq Subdivision name or site address (include phase/lot number): 13-1 o T3t-k0 I- ffl-4 —FgjZ> A to j /J (�— Directions to site - please include road names and numbers, landmarks, etc.: jl-7 E-X rT 3lo NL 15O 't-0' S Li N LdLNT dry �.3 m.�5 �-�� o N mom•-�-�s� r� �� ern a. S nn- les �,t G.i tT o N +4 �.cn' 4+Prc.L Latitude (in decimal degrees)- Longitude (decimal degrees) 35 • (0'S() 3 ) L� — 1116b ` ! l;z5 6 O O 5. Describe the existing land use or condition of the site at the time of this application (residential, undeveloped, etc.):S ` o 6. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or why it is necessary): i- cz) ev- k � use nl I�H �G>✓ %. 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 excavation, backfill, rip rap, retaining walls, etc.) in square feet: — 3qO si � 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: IIIA https://files.nc.gov/ncdeq/Water%20Quality/Surface%20Water`/`%20Permit s/SSGP%2002-2017%20Shoreline%20Form_ final. docx 10/3/19, 11:25 AM Page 2 of 5 Temporary impacts (temporary clearing, construction corridor) in square feet: P I +v 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): 11. Signature Owner/Agent's Signature A N 0 .050 l Date , Agent's signatur alid only if an authorization lette from the owner is provided. 12. Please approximately sketch the following information on this plan and provide drmemiom 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 V71 Full Pond/ j� �&P --7 Plan View izi�' ?AW https://files.nc.gov/ncdeq/Water%20Quality/Surface%20Water%...%20Permits/SSGP%2002-2017%20Shoreline%20Form_final.docx 10/3/19, 11:25 AM Page 3 of 5 Lake iu wu wmr-wan l�f Existing Dock ww adw ho Noa�Y wWl Full Pond/ Normal Water Lrevel`' �. m �ihore�rne yy a �+h.lwk Row :,,'S fw.e wrW rwK t h,F150 fG adNtiwbl ckarNy •if �rcessary , EIf % �' Plan View c Side View U- 3 ft. below fill 2 ft. additional clearing pond water level 4 ft. above full pond water level •if necessary Existing bank 10 ft. bank height Side Vi https://files.nc.gov/ncdeq/Water%20Quality/Surface%20Water'?...;�20Permit s/SSGP%2062-2017%20Shofeline,620Form _final.docx 10/3/19, 11:25 AM Page 4 of 5 Lake Norman State Park 1322 State Pall"'" 1447 1321 1401 1400 1137 Redbud Ln 1, I'I � � � '��a� �' ;_ •' - � w'`.� 7 1= 4 - _ - V a . � r;` � a � �' � .. mot-' w� _ -_.: L- . ` .��,� 1 �� ? � `...� •�'« � a