20200416 Ver 1_Shoreline Stabilization_20200326

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
ENVIRONMENTAL QUALITY 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 [15A NCAC 02H .0502(a)]
Da U W R
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1. Owner Information MAR f 11) to
Name: Skipping Stones, LLC (Manager: Mike Johnson) DENR -WATER RESOURCES
Mailing Address:
531 Brentwood Road, PMB 127 eRfAW0WPMMTTtNG UNIT
Telephone Number:
E-mail Address:
Denver, NC 28037
704-905-0269 Fax Number:
[e-mail]
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:
http://www.saw.usace.army.mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT ALITHORIZ
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: 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: Lincoln Nearest Town: Denver
Lake/ river/ ocean adjacent to property: Norman
Property size (acres):
1.3
Subdivision name or site address (include phase/lot number): DR PRESTON R TAYLOR EST Lot C
End of Harbor Lane, Denver NC 28037 PID# HARBOR LN
Directions to site - please include road names and numbers, landmarks, etc.:
take HWY16 Bus N, Right on Webbs Road go to end, Left on Burton Lane, Take first Right on Webbs Chapel Church Road, take
�_nd right on M - :onnell Road_ Follow until end it becomes Harbor Lane. Continue on Harbor lane to ind. take gravel driveway at
the end
Latitude (in decimal degrees) 35.536804
Longitude (decimal degrees)-80.954594
Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.):
Undeveloped Residential Lot
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Stop Bank erosion by cutting bank to 45 degree angle and installing
rip rap 3 feet below full lake level and continuing 1 foot above. Current vegetation on bank has been insufficient
and bank is eroding out beneath it.
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 excavation, backfill, rip rap, retaining walls, etc.) in square feet:
Approximately 315 Square feet of rip rap
Temporary impacts in square feet:
WA
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:
approximately 105 Square feet of rip rap
Temporary impacts (temporary clearing, construction corridor) in square feet:
WA
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): Minimal vegetation impact,
Removal of approximately 13 small trees along bank to grade back to 45 degrees and install rip
rap. Most trees well under 6 inches in diameter.
11. Signature
Owner/Agent's Signature* [15A NCAC 02H .0502(f)] 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
Lake
(At Full Pond/ Normal Water Level)
IFull Pond/ Normal Water Level
Lake
(At Full Pond/ N-1 Water
Level(
Existing Dock
3ftx150k
Below full pond/ NWL
Full Pond/ Normal Water LevS"311
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�horenea
5-
ft x 1s0 ft
Anove fullpond! NWL
2ft x150fadditional
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Plan View
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FORM: SSGP 02-2017 Page 3 of 4

N
Lake
(At Full Pond/ Normal Water Level) M
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E
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C-
Side View
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3 ft. below full pond water level 4 ft. above full pond water level 2 ft. additional clearing
"if necessary
Existing bank
10 ft. bank a
height D�Q
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FORM: SSGP 02-2017 Page 4 of 4

Top View
f
(Proposed)
S
s
w
Full Pond
Lake Level

Side View
(Proposed)
3 ff Below 1 ft above
full pond full pond
Existing Bank
Lak
at full Fond
It
Bank
height

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