HomeMy WebLinkAbout20200680 Ver 1_Shoreline Stabilization_20200518DECEIVE
MAY 18 2020
NCDEQ/DWR/NPD
SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. 3 S PLAN NO. PARCEL ID:
STREET ADDRESS: / L/ Lt i O fi 1`l 1 L-L- ►" t
Please print
PM" Owner.
Property Owner
The tetdnrskjned, ri ertY omnias of the above noW pgDerty, do hereby authorize
•fit . of -Ma � � CTt i �,� T'r'x—
(Contract0r / Agent) (Name of aortsulUrtg )
to act on my behalf and take aH actions nea MMY for the prooessM bmance and aaWtanoe of
Ws permit or certification and any and aA standard and special mmWons attached.
Property Owner's Address (if cliffert, ):nl� zS2��
�Zo2
Tdleplww ?o 0 3
We hereby oariify the above mfomnat,on s knated in this application is true and aoourate to the
best of our knowledge.
r
Date Vj:kDate: `a4a n
State of North Carolina
Department of Environment and Natural Resources
DWR
Division of Water Resources
Division of Waver Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SSGP 10-2013
Shoreline Stabilization Application Form
Three copies of the application (including attachments) and the application fee should be sent
to:
Division of Water Resources
401 & Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
1. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
elrl Name: l � �Y t 15 v/ ee2
Mailing Address: ZZO g > ke_- P,4--W 47,Ae--
��-I r_�' Or-1- z�z 70
Telephone Number: — OK— Fax Number: 70 Y- '//— 82� %/
E-mail Address: pw'+ • 4 i '�✓FBI-IJS
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
httpl/www saw usace army mil/Portals/59Ldocslregulatory/rep,docs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: Da N i -,,- - bu�C(L - -
Company Affiliation: `r R C_�—
Mailing Address: / -' —i 31- 44 V , % 3
9t<'rfic-tt-s Ui'u-f- f-:_.
Telephone Number: r c
p 7C.Y- '�/-5 7V I Fax Number:
E-mail Address: 7� 1�s�.r217 f %�� L< <C �'T� • N
Person to receive the Certification Approval: 1DA tJ) tic- /'J C V'rE'YL
11. 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: J_R.F PNE ( Nearest Town: iT) C1 L'(� ✓ LLB
Subdivision name or site address (include phase/lot number): 3 S~
)`t't 6 , ►iLl jlt
Directions to site - please include road names and numbers, landmarks, etc.:
Latitude (!n decimal degrees) l 03 7 'J� r I r Longitude (decimal degrees) �y s a J�
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): W 7OJ u' 141 ISE&_�111
6. Property size (acres): (, CAL
7. Lake/ river/ ocean adjacent to property: L
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): 07: �—_ X 1 Stlhy' ri, r p /Lli p
j
9. Will work be conducted from land? 2 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:
j0t�_-, Sr
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:
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 in tance): ` eni J a d--
(V- t�Ltj,,u
Owner/Agent's ignature* [15A NCAC 02H .0502(f)l Date
Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 3
Lake
(At Full Pond/Normal Water Level)
Nor
OCI'--
�� a)ry r
2- P7- X -o,8,pT
\.1�vtj,
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ft x 100 ft)*:
1. All proposed vegetation clearing
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 of any proposed structures such as buildings, retaining walls, docks, etc.
S. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
�s A rq r S '� P>z� bs
10pr cic
�IFL"' lj Pat-ty
141�i
FORM: SSGP 10-2013 I
i ,', f air
Page 3 of 3
5I5r2m CortrtedGlS Feature Report
APICONNEOGIS
WEB HOSTING
Iredell
Printed May OS, 20 .01
See Below for Disclaimer
TRH '!!-MrIAN, Streets
— Interstate
Ramp
US Hwy
ti State H,v;
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— hllain Road
Local Road
i Residential
Private
r s r tir'; i Inactive
jtr; f t City Limi-5
Catawba County =i- I I lake Norman
' 1 Iredell Countylir.e
J NC Counties
IT
` I County
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maps prepared for this website are generated from recorded deeds, plats, and other public records Users of these maps are hereby ratified that the informatior
resided herein should be verified Iredell County assumes no legal responsiblities for any of the information contained on this site. Users are advised that the use o
rry of this information is at their own risk All maps on this site were prepared using a 10005E^• Grid based upon the North Carolina State Plane Coordinate System fron
he 1983 North American Datum. The delinquent real property tax overlay is updated monthly. The information presented is not intended to be used or relied upon a
fficial notice of tax bens. For additional information regarding delinquent taxes, contact the Iredell County Tax Collector's Office.
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144 Goathill Rd
Mooresville, NC 28117
These dinmadons are for planning Purposes orlly,
You may find that constriction projects, traflb,
weather, or other evens may cause oonditions to
differ from the map results, and you should plan
your route socordin*. You must obey all signs or
not kxa regarding your route.
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13 min (8.1 nit)
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273 ft
6. Turn left onto the Interstate 77 N ramp
it 2 mi
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1 � m,
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School Rd W W and merge onto NC-1100/Brawley
School Rd
43m,
Continue on McKendree Rd. Drive to 1456/Goathill Rd
5 min (25nit)
r► 10. Turn right onto McKendree Rd
1.6 mi
r► 11. Turn right onto Lakeview Shores Loop
07
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® Destination will be on the right
07mi
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Maps Mooresville, North Carolina 28117 to 144 Goathill Rd, Mooresville, NC 28117 Drive 10.6 miles,17 min
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tMe maps prepared for this weWte are generated from recorded deeds, plats, and other public records. Users of these maps are hereby notified that the information provided herein she
legal responsibilities for any of the information contained on this site. Users are advised that the use of any of this Informations at their own risk. All maps on this site were prepared us
144 Goathiii Rd
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