20200353 Ver 1_Shoreline Stabilization_20200305

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"'Al"'R8 Ip"IAP"; "' LPFER NOTIFICATION FORM
Project Nance/ad
Owner: 1(l Yl
Print
Contractor/agent: _
Print
ZOO aW% County: IrPAP.�t �
C
The approval is for the purpose and design described in your application. Impacts not indicated in the
application is a violation of the Buffer Rule. Site specific work should be provided in the application. [15A NCAC
02H .0506 and 15A NCAC 02B .0243(8)]
Signature
Trees are not allowed to be removed from Zone 1 of the Buffer (within 30 ft of the full pond elevation), unless
approved_ Exception, those trees that are severely undermined along the immediate shoreline can be removed.
Minimal shaping and sloping along the immediate shoreline is allowed. [15A NCAC 02B .0243(6)]
Benching, grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 02B .0243 (6)]
Beaches, impervious patios, impervious walkways, etc. are not allowed in the buffer unless specifically approved
by the Division. There are limitation on size for decks. [15A NCAC 02B .0243(4) and (6)]
Work to be conducted from land must indicate an access and indicate any trees that are to be removed. The
work corridor should be described. The approved access corridor shall be restored. Staging, spoil, construction
material must be outside the buffer. [15A NCAC 02H .0502 and 15A NCAC 02B .0243 (4), (6), (8)]
Stormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
discharges must be at the natural elevation and discharged prior to entering the buffer directed as diffuse or
sheet flow at non -erosive velocities to the lake. [15A NCAC 02B .0243(5), (6)]
C nowledger en-6- of NoLflrcaiior?
�WC`ra S hereby state that I have been i =
Riparian Buffer Rule. Any work conducted in the buffer, not specifically stated irl'the ad of the i cat anand Catawba a
by the Division of Water Resources (DWR) is a violation and subject to enforcement. Due diligence willpbeoved
taken such that the construction will be built within substantial compliance and intent of the 401 Water
Quality Certification and Buffer Rules, the approved Plan(s) and specification(s), and other supporting
materials.
Signature (owner):_AJc
V Date: J/;Z 21 �20
Stateoi "10rth Carolina Emircnmmml Qualir, ; \Voter Resottrces
�12 ti. SaiisEurgStreet Jail tvlaii Scraee Center c Raleigh N*C 27699-1611
'719'707.9000

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 02-2017
Shoreline Stabilization Application Fore
Three copies of the application (including attachments) and the � sF l; : _ _ should be sent to:
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, FedEx,
etc.)
Karen Higgins
DWR-401 & Buffer Permitting Branch
512 N. Salisbury Street
Raleigh, NC 27604
A. Applicant Information [15:1 NCAC 02H .0502(a)]
1. Owner Information
Name: Jbhn �.c�w�r�S
Mailing Address: _a 00 1S i ye rwa \ 1�,
Telephone Number:-1S-)—`1(,,3 V(o1-7 Fax Number:
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:
I .. f i
(�!_»�� jtt,,�yLrt:L;SuI�`J.11SaC�.�al�rtl�j iTlllj!'OI lcl5 r5`'�i `O'S/!-a •-
/ UlatOi'Vile C'ocsI errnil s S iVIPLE ,,GJCi f U' U i7�T r Z
/ riU i IL 1.01,E _FGRINALQdf )
Name:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
B. Project Information [1 SA NC,,C 02i { .0502( j
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: `w e- &d 1 Nearest Town:
Lake/ river/ ocean adjacent to property: Lo D
Property size (acres):
Subdivision name or site address (include phase/lot number): -mil i UP_rw 0 i K h..4 11
Directions to site - please include road names and numbers, landmarks, etc.:
- S G car.?
Latitude (in decimal degrees)35,1, q L 0 3 Longitude (decimal degrees) 03 C71
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): U y,\ cJry >!I a hQ d, _ ,P -nq���-
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): P' 1 r' p ra-U) 4p so, S l r.e_ Ana -F -i5
_2rv�cna -kk"..k A4 Y.ok a '2W b«.:(� C.V. ijr
7. Will work be conducted from land?] From water?
3. 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:
Sol be_,_ a r-23 sue-'E- A— I I
Temporary impacts in square feet: V
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:
- 5u ' I0hc1 X above 1�D <o .0 -
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): n p ri p
11. Signature
O er/Agent's Signature' [i,_SA 02;, .(? Q?( )i Date
'Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 02-2017
Page 2 of 4

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
iFull Pond/ Normal Water
Shoreline
La ke
(At Full Pond/ Normal Water Level)
5 01 DIP- V-
rc` P
�r4'
A \�
"Full Pond/ Normal Water
r
Shoreline
2 ft. a SO ft
addrtwnal dearin
' If necessary
Lake
(Ft Ful Pond/ timmal lWater keel)
Existing Dock
3 ft :15o ft
80m, fu➢pond/ tn;rL
ftx 150 ft
Ab-- fidt P-d! UNI.
( i
Plan View
FORM: SSGP 02-2017
Page 3 of 4

5
- --- _.; La sir
(At Full Pond/ Normal Water Le
I
Side Vie LL-
-�
i J
3 ft below full pond water level
QW1
I
4 ft. above full pond water le•✓el Z ft. additional clearing
if necessary
Existing bank
e' f
}
I
10 ft bank
height ( a
sr' de <
Side V� _
FORM: SSGP 02-2017
Page 4 of 4

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Addresses
A, Infrastructure
NonResidential Use
` Residential Use
Streets
Interstate
Ramp
US H%vy
State Hvey
— Main Road
Local Road
Residential
Private
Inactive
Parcels Hooks
Parcels
El
City Limits
Lake Norman
Iredell Countyline
t.. °r
NC Counties

bing maps
A Mooresville 53 min , 35.5 miles
B 200 Riverwalk Rd, Stony Point, NC 28678 Light traffic (6 min delay)
Via 1-77 N, 1-40 W
I `
A Mooresville
i
'(' 1 Head northwest on W McLelland Ave toward S Academy St 0.9 mi
2 Bear left onto NC-150 1.8 mi
Take ramp right for 1-77 North toward Statesville i
3, ♦ Construction: At 1-40/Exit 51 - Construction work. Narrow lanes. 14.9 mi, 14 min j
f I
i ♦ Minor Congestion
� Atexit5l-,���.-..
4 ake ramp right for US-21 toward Statesville 12.2 mi, 12 min
jA 5. At exit 141, take ramp right and follow signs for Sharon School Rd 0.1 mi
(% 6 Turn right onto Sharon School Rd 1.4 mi
i
rf 7 Turn left to stay on Sharon School Rd 2.3 mi
i
8 Road name changes to Paul Payne Store Rd 85 ft
9 Bear left onto Stewart Rock Rd 1.1 mi
Road name changes to Ste �
i a
10 9 wart Rock Dr 0.3 mi
I
f
11 Turn left onto Riverwalk Rd 0.4 mi
Arrive at Riverwalk Rd
I 12.The last intersection is Stewart Rock Dr
..... .....
B 200 Riverwalk Rd, Stony Point, NC 28678
These directions are subject to the Microsofty Service Agreement and are for informational purposes only. No guarantee is made regarding their completeness or accuracy.
Construction projects, traffic, or other events may cause actual conditions to differ from these results. Map and traffic data © 2020 HERE'".

7IDrojeCt
Owner: Yin
Print
'i antrcactar/'agent:
Print
�C,
bound-: 1�-ea��11 A
re
Signature
The approval is for the purpose and design described in your application. Impacts not indicated in the
application is a violation of the Buffer Rule. Sire specific work should be provided in the application. [15A NCAC
02H .0506 and 15A NCAC 02B .0243(8)]
Trees are not allowed to be removed from Zone 1 of the But rer (within 30 ft of the full pond elevation), unless
approved_ Exception, those trees that are severely undermined along the immediate shoreline can be removed.
Minimal shaping and sloping along the immediate shoreline is allowed. [15A NCAC 02B .0243(6)]
Benching, grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 02B .0243 (6)]
Beaches, impervious patios, impervious %ralkways, erc. are not allowed in the buffer unless specifically approved
by the Division. There are limitation on size for decks. [15A NCAC 02B .02L'.3(4) and (6)]
Work to be conducted from land must indicate an access and indicate any trees that are to be removed. The
work corridor should be described. The approved access corridor shall be restored. Staging,spoil, construction
material must be outside the buf ter. 1`15A NCAC 02H .0502 and 15A NCAC 02B .0243 (4), (6), (8)]
Stormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
discharges must be at the natural elevation and discharged prior to entering the buffer directed as diffuse or
sheet flow at non -erosive velocitiesco the lalce. [15A NCAC 02B .0243(5), (6)]
F4C;mawledgeraenis O1 mEatlifcCrtion
1r\h 1� tiJ�rd S hereby state that i have been informed
of the
Riparian Buffer Rule. Any work conducted in the buffer, not specifically stated in the alicat on and approved
by the Division of Water Resources (DWR), is a violation and subject to enforcement. Due diligence willpbe
talcen such that the construcrion will be built within substantial compliance and intent of the 402 W2-cer
Quality Certification and Buffer Rules, the approved Plan(s) and specification(s), and othersuppor-Ling
materials.
.� Signature (owner):
Date:
Starr oriqortir Carorma - Errvirenrrental Quality ; ;Vatcr I US CeS SL v.se{isEorrStrc.`' Ic111iailScrviecCCntCr RaleioSttiC?764q-16ll
nte.FOi 4000