20200468 Ver 1_Shoreline Stabilization_20200331

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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
LNVIRONMENTAL QUAi.-v 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 RECEIVED
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A. Applicant Information [15A NCAC 02H .0502(a
1. Owner Information
Name: Chad Colby
Mailing Address: 10292 Sycamore Rd.
Norwood, NC 28128
Telephone Number: [phone] Fax Number:
E-mail Address: [e-mail]
2. Agent/ Contact Person Information
MAR 3 1 2020
KDEQIDWPCINPDES
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:
httD://www.saw.usace.armv.mil/Portals/59/dots/regulatory/regdocs/Permits/SAMPLE AGENT_A_UTHORIZ
ATION FORM.pdf)
Name: Nathan Almond
Company Affiliation: Nathan Almond Construction
Mailing Address: 567 Harbor Rd
Norwood. NC 28128
Telephone Number:
E-mail Address:
704-985-6852 Fax Number:
[e-mail]
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. Done.
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.
See diagram at the end of the application form. Done.
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.) Done.
4. Location of the property (where work is to be conducted)
County: Stanly Nearest Town: Norwood
Lake/ river/ ocean adjacent to property: Lake Tille
Property size (acres): .46
Subdivision name or site address (include phase/lot number): Piney Point, 1092 Sycamore Rd,
Norwood, NC 28128 (part of lot nos. 83, 84, and 115 of Country Club Estates (Plat Book 5, page
146, Stanly Cunty Registry)).
Directions to site - please include road names and numbers, landmarks, etc.: Piney
Point. Make a left onto Pine Tree from Pinev Point. follow Pine Tree till it intersects with
Sycamore and make a right onto Sycamore. It is the last house on the left with a 3 car garage.
Latitude (in decimal degrees) 35.220137 Longitude (decimal degrees)-80.093672
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): residential
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Decreasing slope of shoreline, landscape fabric, and rip
rap. We have had muskrats digging into the shore and the drop from the yard is about 3 foot
down to the water. The shoreline keeps eroding into the water. Some minor dredging below
the water line at the boat slips and near the dock.
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:
Excavation to decrease slope, landscape fabric, some minor dredging at the proposed boat slips
and around the dock. 137 foot of shoreline, approximately 1 foot of rip rap below the water
level, would equal approximately 137 sq ft.
Temporary impacts in square feet:
Negligible?
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:
Using existing dirt to decrease slope, landscape fabric, and rip rap. 137 foot of shoreline,
approximately 3 feet of rip rap above the normal pool lake level, would equal approximately
411 sq ft. Cutting down two small trees with a trunk diameter of approximately 4-6 inches.
Temporary impacts (temporary clearing, construction corridor) in square feet:
FORM: SSGP 02-2017 Page 2 of 5

There already is an established lawn so there will be no temporary clearing or construction
corridor needed.
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): Cutting down 2 small trees
(trunk diameter 4-6 inches), grass. There is already an established lawn.
11. Signat r
hz,)
Owner/Agent's Signatu ' [15A NCAC 02H .0502(f)] Date
'Agent's signature is valid only if an authorization letter from the owner is provided.
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
Full Pond/ Normal Water
sm mu TM IS
Shoreline
Plan View
Lake
(At Full Pond/ Normal Water Level)
Proposed dock Proposed mild dredging area.
38' by 24'
- Existing dock
(� 34' by 16'
I I ',I Rip rap I I i I I
Rip rap
1' by 137' below full pond
3' by 137' above full pond
FORM: SSGP 02-2017 Page 3 of 5

5-6 foot back from full pond.
Existing
Shore
oa
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lake
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4# i�UP-
I _fib /-Normal Water have
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1 ft below full pond
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View
View
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,. Decrease current slope of shore.
Install landscape fabric and rip rap.
Lake
(At Full Pond/ Normal Water Level)
Existing Dock
30ftx7ft
3ftx 150ft
Below Full pond/ NWL
Full Pond/ Normal Water Level
x rorellne ® ar _aft. 15oft
Rl p ra p Above full pond/ NWL
2 f, x 150 ft. �L _
additlonal clearing +
" if necessary
E, AMPLE
Plan View
FORM: SSGP 02-2017 Page 4 of 5

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
Q�Oq
Side Vi
FORM: SSGP 02-2017 Page 5 of 5

10292 Sycamore Rd - Google Maps Page 1 of 1
o ,-gle Maps 10292 Sycamore Rd lull
Turn onto Pine Tree to come to Sycamore from Piney Point. Do not take Sycamore from Piney Point-mudholes.
Imagery 02020 Maxar Technologies, USDA Farm Service Agency, Map data ©2020 1000 ft
https://www.google.comlmaps/place/10292+Sycamore+Rd,+Norwood,+NC+28128/@35.2156571,-80.1043757,2370mldata=! ... 03/24/2020

10292 Sycamore Rd - Google Maps Page 1 of 1
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Go,, gle Maps 10292 Sycamore Rd
When you come to the douse, turn onto Pine Tree Rd at the golf course. Do not take Sycamore from Piney Point-
mudholes.
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https://www.google.com/maps/place/10292+Sycamore+Rd,+Norwood,+NC+28128/@35.2156571,-80.1043757,15zldata=!4m... 03/24/2020

SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION: 6�t#Ng{ i-j C[14.�-ES6feS No hroK 5 111 1
LOT N0. S 2 P261 94 (41-AN N0. PARCEL ID;
STREET ADDRESS: J�2 % �,vl,1140rla gd
Please print:
Property Owner:
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
� of �7 Ia n A `m J l oL4 �I ru �1 t D►j
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
Telephone: 91-6I i' — q
4 4
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
_Sdn isa
Authorized Signat Authorized Sign ture
Date: 3 Date:
COw,
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Chad ColbY
10292 Sycamore Road
Norwood. NC 26128

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State of North Carolina
Health Service Regulation
Nursing Home Licensure & Certification Section
2711 Mail Service Center
Raleigh, NC 27699-2711
CHAD COLBY, RBALNHA
Nurse Consultant
919 909 2028 O
919 733 8274 F
[e-mail]
Health & Human
Services