20200354 Ver 2_Shoreline Stabilization_20200624

Owner: nK``i L _ I`
Print Signature
Contractor/agent: LA'J �i ScIVIG C)�- L�-Vv' —
N
Print Signature
The approval is for 'the purpose and design described in your application. Impacts not inTiuxaed 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)]
Trees are not allowed to be removed f m Zone I 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.
Ali; mmm s'sap atd SWM9 a's t*t lxt etls c stwaetDe n Wkme& �15A NCAC M M 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. f 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. [I5ANCAC 02H .0502 and 15A NCAC 02B .0243 (4), (6), (8))
Stormwater cannot be piped or channeled for direct discharge to the lake. AU constructed stormwater
discharges must be at the h ekvaum mad wed pax w , the buffer dweetcd as effuse or
sheet glow at non -erosive velocities iv the lake. (;SA,�AC. f3i4?, t6;r,
Acknowledgement of Notification
1, M ff� V k1" bZ, , Hereby state that I have been informed of the Catawba
Riparian Buffer Rule. Any work conducted in the buffer, not specifically stated in the application and approved
by the Division of Water Resowces (DWR), is a violation and subject to enforcemeot. Due diligence will be
taken such that the construction will be built within substa anal comp;sa"cc and intent of the 401 Water Quality
CCMFA= ass 'ftTer &,ex, &- qproved pt*s`) wd spwftMn(s), amd pother sWoamg ials.
Signature owner): Date:
D L9 0 ��
UN Z 4 �010 D
DENR • WATER RESOURCES
rRANSPOMA-noN PERMIMNG UNIT

ti
State of North Carolina
nWR
Department of Environment and Natural Resources
Division of Water Resources
[livislon of Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SSGP 10-2013
Shoreffne Stabilization Application Form
Three copies of the application (including attachments) and the application fee should be sent to:
Division of Water Resources
401 & $ufferPern;ltMg Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Applicant Information f1SA NCAC 02H 0502(a)1
1. Owner Information
Name: 0f4j.`J L - V
Mailing Address: 1-41
Telephone Number: 1 O - Fax Number:
E-mail Address: ryynar) fire a
2. Agent/ Contact Person information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
htti):&W.—Am.saw-usace,army.mil/Porritais/59/docs/reaulatoENT AUTi•10
iUiATION FORM nM must be attached if the Agent has signed this application form.
Name: Ptl`i .So tii Co
Company Affiliation: LPtw C>
LN7y� p� �� (j�/t �Ar-
Mailing Address: 90 7
Telephone Number: i % - 313 Fax Number: , 70� CC 3 - 1
E-mail Address: LT"
Person to receive the Certification Approval:
Ii. Project Information f15A NCAC 02H .0502(a) & (b)1
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, etc.),
rip rap, excavation or dredging below Full Pond/ Normal Water Level elevations, and
FORM: SSGP 10-2013 Page 1 of 3

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 roperty (where work is to be conducted)
County:��.� Nearest Town: J`� �e5� ��—
Subdivisi n name or site address include phase/lot number):
Directions to site - please include road names and numbers, landmarks, etc.:
®w1e-) S(a-221 5 t_ , (ogre �
Latitude (in derlmal dvrees)-3 S • S 33 S Longitude (dedmal deprres) --� i] • y �0 7 e; f
S. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): tLowed
6. Property size (acres): , 41
7. Lake/ river/ ocean adjacent to property: (4]
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
9. Will work be conducted from land? From water? .0
10. Total amount of disturbance (including all excavation, backfill, rip rap, retaining wails, etc.)
be_ low the ryormal pool Ile 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 nor9rai pool take level/ Normal Water Level and 50 feet land -ward in
square feet or acres: i X leA/
12. Please describe the vegetation above the normal pool lake leve N rm;��eter Level and 50
feet landward to be impacted (number of trees, for Instance): /Ir0 3 k�r Z
Owner/Agent's-fignature* Printed Name
Date
MA NCAC 02H _05021fii
'Agent's signature is valid only ifan authorization latter from the owner is provided
FORM: SSGP ID-2M3
Page 2 of 3'

Lake
(At Full Pond/NormalWalarLevel)
Full Pond/
Norm re In C)
64 Saw a&% WW 0M
l
(CC 557S
V
Please approximately sketch the following information on this plan 1provide dimensions for each
item, such 0Sj0ftx.,00ft)*:
1. All Proposed vegetation clearing
Z. Location Of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
I 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 buildiniss, retaining walls, docks, etc.
S. Location Of MY excavation or dredging below the Full Pond/ Normal Water Level elevation
6- Location of construction access corridors
FORM, SSGP 10-ZD13
Page 3 Of 3

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SU'? Yf�AND IYAP\�PJR(IAEP�A\R]J\E)D BY.
LAKE NORhIAN SURVEYING
& MAPPING PLLC UP-olao
137 Jennings Rood, Suite C
T Er raNUARr zz. zo)J StOte3ltille. North Carolina 28625
Pwc eA, Tt. zD13 [phone] Fax (704j 876-4451

)v i,4orm 134 Liondola Rd Mooreville. NC - Google Maps
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Maps 130 North 134 Gondola Rd Mooreville. NC
134 Cmdoilu RvA-
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