20200352 Ver 1_Shoreline Stabilization_20200305

Dhlhdon of Water Resources
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
15A NCAC 02H .0500— Water Quality Certification, Shoreline Stabilization r
FORM: SSGP 10-2013 t
Three copies of the application (including attachments) and the application fee should be sent
to:
Division of Water Resources
,�2 f
401 &Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617 (,a
I. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: Josh Cohn
Mailing Address: 21449 Country Club Dr.
Cornelius NC 28031
Shoreline Stabilization Application Form
Telephone Number: Fax Number:
E-mail Address: -:10<_0 C OHN -I: ���4SL• Cu.AA
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
http://www.saw.usace.army.mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTH_
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: ,�y_S N (. , H 0
Company Affiliation: tic t6i (Zovj',' ,{
Mailing Address: ;Ltk`tc1 CV VV-n`f C�v� fl�
CDIR_t�ZU0S 14C2-10� �
Telephone Number: Fax Number:
E-mail Address: `j 0S11 i.i5°tIN' e
Person to receive the Certification Approval: J s 5 it C. 1� tj
II. 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, structures (buildings, retaining walls, docks, impervious surfaces,
FORM: SSGP 10-2013 Page 1 of 3

etc.), 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: �/ A CCK( b �<.(i Nearest Town: C1 p 1t��'��
Subdivision name or side address (include phase/lot number):
CU.%r%t4 C\ub SY`DizS
Directions to site - please include road names and numbers, landmarks, etc.:
.iuwbG� pot CIA-*( �\A f 1Jrkyc l_fy,LaI
Latitude (in decimal degrees) 3 > <
Longitude (decimaidegrees) L t 1 O S 'J II I 7
5. Describe the existing land use or condition of the_site at the time of this application
(residential, undeveloped, etc.): �i� y then
6. Property size (acres): > U�
7. Lake/ river/ ocean adjacent to property: L p1 r Qo P&A ti
S. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): &\ 6 2 j ��,� �1c}� ``s �� 1���� �(�'�5 ✓c
(✓{�O�<u fn (U e bZ l0 4c`�fJfram- o�.Itlti1' <zpq "h
9. Will work be conducted from land? From water? ❑
10. Total amount of disturbance (including all excavation, backfill, rip rap, retaining walls, etc.)
below the normal pool lake level/ Normal Water Level in square feet or acres:
11. Total amount of disturbance (including all clearing, back fill, excavation, rip rap, retaining
walls, etc.) above the normal pool lake level/ Normal Water Level and 50 feet land -ward in
square feet or acres: 4 U K f ",
12. 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): 140 NC
Owner/Agent's Signature" [15A NCAC 02H .0502(f))
d Zip `L1
Date
Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 3

2ro,
jee--ee-d
ft)-(4-
Please approximately sketch the following information • this • (provide dimensionsfor each
item, such as 10ft x 100ft) *:
1. All proposed vegetation clearing r,4 (,J
2. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
3. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
4. Location • any proposed structures such as buildings, retaining walls, docks,
5. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location • construction access corridors LA�
FORM: SSGP 10-2013 Page 3 of 3

-,,., v> •�,—_' - mow', /+��p f
�70" Zi°TT-+
-71
�✓'.:z'
- _ _ _ a a>" t��a,��• J� r"�, '.m,�. ^' � ,.,, i � ii�;,'�r. I tM1l 1 i�� � ��i�l�r5} � i t '1" ,Y��� itf P: ���.
r�
N" R�
I � `
- a
Y
I
y
� l
1, +
� y
r. a
k.

lake
fp
$RIAiV K SOLE, F.L.S.
�
18335 OLD STATESVILLE ROAD
5
SIATE A
A
COItI+IELIl1S, A1.C. 28031
�r
{704) 765-5134
I NO NCGS MONUMENTFOUND
WITHIN2w
2. PROPERTY MAY BE SUgIF.CT TO
OTHMCOVENANTS,
RESTRICTIONS,EASEMENTS OR
RIGHTS -OF -WAY THAT MAY BE OF
RECORD
3, SETBACKS PROVIDED FROM
TOWN OF CORNELIUS PLANNING
DZPARTME111'.
TONING FOR SUBJECT TRACT IS
GP- CTO.C)
4.NOIMPROVEMENTSSHOWN FOR
PURPOSEOF THIS SURVEY AT
OWNERS REOUPST DUE TOTOTAL
NORTH PER D.B. 7348, PG. 200
5 CONSULT WIM GOVERNING
AGENCY FOR PREVAHMG LAND \
DEVELOPMENTANDZONING
REQUIRPMENTS PRIOR TO
DESIGN OR CONSTRUCTION OF
ANYIMPROVENWrM.
('FIE ONLY)
1403'3315'W _120.21'
001-164-21
PHILIP A. MSSER
ANDREA M. MSSER
08. 9985, PG. 784
OB. 8362, PG. 703
PO %k G ttii� yiy
:<t 6EAL t S
w -40' Voy'4'
%/'N
TABLE
CURVE
__CURVE
LENQTH
RADIUS I
CHORD
_
CHi1RD BRG
C11
36.241
50.00
35.45
'OQ' 7"
C21
77.58
50-001
70.03
't9' Nt
rAK- i • ORAfAIV
.o
—2111D LOCA SO' C�
N01'SO 94.35
1
2S`REAR skIaaex texoan PRop�1Y LINeI �
3Q' 1 UFR tFROIdI FE!&Q� r.ONTQ-G 1!'��'
AORffIONAI AREA f1iONA DUKE EiBRGY p
PERIIB.7348,PG. 200
L5 OR
zt7T 12
f
3S•pR0 � .1 �Dti
1TIE ONLY)
NO2,10'415"W _ 125,5$' C7 AD101NER'S V
0U 0u OU $RICK WALL
COOSSES LINE
ar U.1VTR Y ew 0.7'
CLUB .D.t I VB \'O x,
60' PUBLIC RAW
(108. 12, PG, 21) 8 z
18'EPTOEP o
LEGEND:-
AREA TABLE.
.5 RESAR FOUND
o
DUKt TRACT
I IRON PIPEND
®
8.694 SOFT
ETi INOT
0 ACRES
PUNCH HOLE SET IN WALL
A
LOT 12
LOT
UTILITY POLE
0
10,051 SQ.FT
SUBJECT PROPERTY LINE
0.230 ACRES
AD DINER PROPERTY LLNE
—
TOTAL AREA
BUILDING SETBACK
30' i_AKESIDE SUFFER
18 745 Sfl.FT
.
AUCOUCAP, tt7II171CC
AIA-.---.a-
Q 430 ACRES
OD1-164-23
MARK W. ARMSTRONG
KELLY ARMSTRONG
D8. 16W. PG. 429
LINE TA€3LE
LINE
BEARING
L1
-LENGTH
-9-09
1425.14W
12
27.95
Nt0625 "Yi
L3
11,94
N2 '49"40'W
L4
46.
E
LS
32.90
NO3'32' 81W
Gmphie Selo
50 25 0 50
bmzi
Seale otllydWing t Inch= 50 Feet
01
Physical, Survey of Lot 12 Country Club Shores No. 2 & Additional Strip leer DB, 7348, Pg 200
Professiyonal
I Inc.
�4 °f
As lie o*A in -
Deed 27821, P& 493
Site Address:
21449 Country Gluir Drive
� iuueY I
Book
183.15 Old Statesville Road
Josh K. Cohn.
Deed Book 7348, pg, 200
Cornelius, NC 28081
Ste. A. Cornelius, PLC. 28031
704-765-5134 Phone/Fax
Blaire C. Cohn
M Book 12, 21
Mecklenburg
bg County
Fim{ Liscem C-3666
1(441"3
dob ilo.--
1 R&IJE C
L Y10
i
WI-164-22 21447COOMY
aII Parceitmw LFki;v..f
i ox t
tol3lnol
Viand Sy
Ormr�osum
a—m— Safe
Shea
f

Polaris 3G Map — Mecklenburg County, North Carolina
Cohn
Date Printed: 3/2/2020 12:18:07 PM