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Home My WebLink About20200325 Ver 1_Shoreline Stabilization_20200302State of North Carolina Depara ent of Fnviraumeet ar Natond Resources Division of Water Resources A 47 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization I FORM: SSGP 02-2017 ASV[ 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 dehvery 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 [15ANCAC 02H .0502(a) Owner Information Mailing Address: IOq T'>R'YE MooP�SV 1 L4-c 0(L l l7 - g'{D% Telephone Number., Fax Number: - I DLf � b� .. -'K Ll p- E-mail Address: 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: hum' www.saw.usace.armv.mil-Poruk 59idoes/reeulatory reedocsiPermits,SANNIPLE AGENT AUTHORUA TUONFORM.Pdf) Name: YL 1 iJ VD L" Company Affiliation: Mailing Address: P.(D. (71, o0 2S l L-L / / 7 Telephone Number. Fax Number: /1 p E-mail Address: B. Project Information [ 15A NCAC 02H .0502(a) & " 1 . Attach a vicinity map (i.e. street map) clearly showing the location of the property with respect to local landmarks such as tons, rivers, and roads. https://files.nc.gov/ncdeq/Water%20Quality/Surface%2OWat...OPermits/SSGP%2002-2017%2OShoreline%2OForm_final.docx 2/18120, 4:32 PM 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 Pondf Normal Water Level elevation, 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: Nearest Town: C L c__ —ITS�' �11� Lake/ river/ ocean adjacent to property. O Q_ r'\ Property size (acres): Subdivision name or site address (include phase/lot number): I oa kEEP�J tvt's D P-k V E m�Cz�sJ % U_L_- , A)C_ 69s) l ti Directions to site - please include road names and numbers, landmarks, etc.: _4�--7-7 E1-I T 3(O N L 15a (1)1"dPry 121 C't-E 0*3 VIr_-K-CH ?�P. o . 9 ✓YNt'_c s L8F oP por.m ft,3 o'i rri,1- _k ( E' --T o p Latitude (in decimal degrees)_ ( Longitude(decimal (� degrees) )6 , C9 1 `- `J `L 0 �— 2S V � � C) ` � C) 0 5. Describe the existing land use or condition of the site at the time of this application (residential, undeveloped, etc.): '�? If--<,` —L 6. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or why it is necessary): eR L� �) 1�/ %� L � LOO?' %. 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, baekfill, rip rap, retaining walls, etc.) in square feet: 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: NJ P https://files.nc.gov/ncdeq/Water%,2OQuality/Surfacel2OWat...OPermits/SSGP%2002-2017%2OShoreline%20Form_final.docx 2/18/20, 4:32 PM Page 2 of 5 Temporary impacts (temporary clearing, construction corridor) in square feet: 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): �j C)OS � 11. signature GIlg 'Oe -�;� Owner/Agent's Signaturew F 15A NCAC 02H .0502(fll Agent's signature is valid only if an authorization lette from the owner is provided. 12. Please approximately sketch the following information on this plan and provide dimmions 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 Lake J�k` tat NO Pond/ Nw#W Mi± W LeveQ prep Full Pond/ Normal Water Level Re P L-V=� CA 14 Qz V, N Plan View https://files.ne.gov/ncdeq/Water%20Quality/Surface%2OWat...0Permits/SSGP%2002-2017%2OShoreline%20Form_final.docx 2/18/20, 4:34 PM Page 3 of 5 Lake xrwfar�nw.—s existing Dock /]up.)k 4fi�i�!••i�tiiL_j� WOMEN - EXAMPLE _ •rr�••i �••rPlan View C Side View f° 3 ft below full pond rater level 4 ftabove full pond v:ater level 2 ft. additional clearing 'if necessary Existing bank 10 ft. bank i7 height Q https://files.ne.govincdeq/Water%200uality/Surface%2OWat... 0Perm its/SSGPl2002-2017%20Shoreline°l20Form_final.docx 2/18/20, 4:32 PM Page 4 of 5 �e Or 109 Keenan Dr 1? 0 Lake Norman Airpark