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Home My WebLink About20200984 Ver 1_Shoreline Stabilization_20200801Action History (UTC-05:00) Eastern Time (US & Canada) Submit by Anonymous User 7/30/2020 8:35:42 PM (Submittal) Approve by Montalvo, Sheri A 8/1/2020 8:59:36 AM (Non -DOT - Approver) • The task was assigned to Montalvo, Sheri A 7/30/2020 8:35 PM Submission Form I. Applicant Information [15A NCAC 02H .0502(a)] Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all mandatory questions are answered. Primary Contact Email * Owner Information: Name: * Email: * Phone Number:* Mailing Address:* Is there an agent working on the project?* Agent/Consultant Information ................................................................................................................. Name: Company Affiliation: Email:* Phone Number:* Theresa Scipioni Rease provide an email address for payment and requests for pore information here. Theresa Scipioni theresascipioni@gmail.com (914)755-1586 (xxx)xxx-xxxx Street Address 1360 Lake Royale Address Line 2 city Louisburg Fbstal / Zip Code 27549-7459 r Yes r No Harry Lee Harry Lee's Landscaping leecarpenter66@icloud. corn (252)885-2861 (xxx)xxx-xxxx State / Frovince / Region NC Country US Mailing Address:* Street Address 986 Lindsay Road Address Line 2 city Nashville Fbstal / Zip Code 27856-8500 Asigned and dated copy of the Agent Authorization letter:* Agent Letter.pdf 208.73KB Link to: Sample Agent Authorization Form Project Information [15A NCAC 02H .0502(a) & (b)] Project Name:* Rip Rap extension State / Province / Fegion NC Country US If your project has a formal name please use this. If your project does not have a formal name, please identify your project by the owner name and proposed activity (Jones Property Access Road, Smith Guest House, etc.) List in parentheses any other names that have been used to identify the project in the past. 1. Provide 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. r Upload File r Look up address Property Address Lookup:* Street Address 1251 Sagamore Drive Address Line 2 City Louisburg Fbstal / Zip Code 27549-7449 Latitude:* 35.971128 State / Province / Fbgion NC Country US Longitude:*-78.194935 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 construction access corridors. You may use the diagram under section 12.normal pool lake level/normal water level* Rip Rap (1).pdf 1MB Please use the diagram at the link below: https://edocs.deq.nc.gov/WaterResources/0/edoc/616616/Shoreline%2OLayout.docx 3. Attach a photograph of the shoreline/ buffer proposed to be stabilized. (Include a scale of some sort- a yard stick, shovel handle, etc.)* Rip Rap (1) (1).pdf 1MB 4. Location of the property (where work is to be conducted) Nearest Town:* Bunn County:* Franklin Lake/ river/ ocean adjacent to Lake Royale property: Subdivisions name or site address:* 1251 Sagamore Drive Lot # 2829 Include phase/lot nunber Directions to site:* hwy 98 to Bunn to Baptist Church road Right on Sledge and Left on Cheyenne Drive Rease include road naves and nunbers, landnarks etc. 5. Describe the existing land use or condition of the site at the time of this application:* Undeveloped Residential, undeveloped, etc. 6. Property Size .396 Acres 7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or why it is necessary): Install rip rap 35 ft to the existing approval of the 40 ft The ID number for that project is 20200467, Version 1. Scipioni 2829 Lake Royale 8. How will the work be done? * I7 From Land r' From Water 9. Total amount of disturbance below the normal pool lake level/ normal water level:* (including all clearing, backfill, excavation, rip rap, retaining walls, etc.) 70 square feet 10. Total amount of disturbance above the normal pool lake level/ normal water level and 50 feet land -ward:* (including all clearing, back fill, excavation, rip rap, retaining w alls, etc.) 70 square feet 11. Please describe the vegetation above the normal pool lake level/ normal water level and 50 feet landward to be impacted:* (nunber of trees, for instance) 350 Sq feet Sketch: Application Fee: Once the application has been accepted. You will need to send a corresponding fee in with the appropriate DWR#. The application fee is as follows (pursuant to G.S. 143-215.3D): o $240.00 for impacts to lake (below normal water level) of less than 1 acre $570.00 for impacts to lake (below normal water level) of greater or equal to 1 acre By digitally signing below, I certify that: • I have given true, accurate, and complete information on this form; • I agree that submission of this form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act") • I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act'); • I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND o I intend to electronically sign and submit this form. Full Name:* Theresa Scipioni Signature: Initial Review Is this accepted into the review process?* Project Number:* 20200984 Select Reviewer:* Select Reviewing Office Has payment been received?* What amount is owed?* rYes allo Version:* 1 Stephanie Goss:eads\szgoss Raleigh Regional Office - (919) 791-4200 r No Payment Needed r Fee Received r Need Fee - send electronic notification r $240.00 f $570.00 AGENT AUTHORIZATION FORM PROPERTY LEGAL DESCRIPTION: LOT NO: 2829 PLAN NO: STREET ADDRESS: 1251 Sagamore Drive Louisburg, NC 27549 Please print: Property Owner: Theresa Sdpioni Property Owner: PARCELID: The undersigned, registered property owners of the above noted property, do herebyauthorize Lee Carpenter , of Harry Lee's Landscaping (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 Owners Address (if different than property above): 1253 Sagamore Drive Louisburg, NC 27549 Telephone: 914-755-1586 We hereby certify the above information submitted in this application is true and accurate tothe best of our knowled e. Authorized Signa re Date Authorized Signature Date i 7. De i 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 (Ai Full Pond Normal !,.Va`er Level) Full Pond/ Normal Water Level ,a ° Joao �oo� Shoreline dQ�00000 Part View Lakz Existing Dock ,, 1 iIj :J Pond/ Normal Water Lawl shoreline Plan View FORM: SSGP 02-2017 Page 3 of 4 L ! N m =Q) �c:_ � • L O i11 67 v m f� a- v O a 0 +' Q bA O a a a vi a a a r O G1 Q cm y a a SURVEY FOR G� I La THERESA SCIPIO[gl LOT 2829, LAKE ROYAL E 1251 SAGAMORE DRIVE PINS 2330-89-2305 D_S_ 1524, PAGE 137 P_R.F. 1, SLIDE 102A CYPRESS CREEK TOWNSHIP FRCANKLIN COUNTY, NORTH, CAROLINA APRIL M. 20 i g 0 20 0 0 a SCALE 1 n=40' 2828 c- 100 cFR :.!'. --Loot PLAIN PER FlMA FlRm PAN-9 37207230-ZIox E)A_-� "AFML IE. M13 EKE ',250 sq.ft. 0.396 AC. LP GAS TANX Is --s- uc m o- FROPCRTT LINE PJMLITE eLISil j 1_ 5,6' tiG:7iN CF FFtL�r.1iT;' a � , CAM'HORyE, MOSS F4 PANCIERA. F_C- Proress€onal !and Surveyors C 1525 333 S. Wh€te StresL Post Office Box 1253 Wake Forest. N.C. 27588 (9io]556-3148 283Q I[, VICINITY MAP LEGEND: EIP — EXISTING IRON PIPE E€9 — EXISTING IRON BAR 3,€P — 6EWT IRON PIPE 9 — SENT IRON BAR CM, — M14CRUE MONUMW =PK -- EXISTjING PK NAIL SPK — SET PK ,MAIL NIP — NEW IRON PIPE SET RIGHT OF WAY CATV — CABLE TV BOX E3 — ELECTRIC 9OX IE — TELEPHONE PEDESTAL P? — POINER POLE OHL — OVERHEAD LINE LP — LIGHT POLE VIM — WATER METER tits! — WATER VALVE CG — 5E19f EE CLEAN —OUT I To AK UK IN sr w7u.sEcIlorl EIF -K d xwnays cave N Q m L7 NCR Tri C n Q E} 8 i Zo'5=' Pa Qe C7 O t GEC7LARE THAT i-15 SURVEY ComPLIES '51TH Tl-iE NORTH CAROLINA STANDARDS OF PIRACICE FOR 5URVEYING, (_ECTION 1150C9 FOR CLASS A SURVEYS AND 'r-.AT T'-iE CALCULATED RATIO Ce= FRECISIUN BEFORE 7DJUSTFAEN TS IS 1_I0,90134- =LIR-5-4M ME PROPERTY CGiNERS SiOYrN ART PRIIA v CCViS2f3F !AQx11Ai�UThi10N FOB TT?E RE— Esin3 1 i aF P--Ri♦JPMRl'Y CORNERS Jr, TFE "BSFYCE t?� C , HMO,• ,y TS AND OTrjZR SUSMVi510M PRopr rr cv31;�E�s. r s�RVEY €S NOT To 13C RZC;OR0ED WIT-r1— 6JjT THE L 1TTGii AUTrJG91Z.ATION, OF TrlE SDRVEYOR_ i 7. De i 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 (Ai Full Pond Normal !,.Va`er Level) Full Pond/ Normal Water Level ,a ° Joao �oo� Shoreline dQ�00000 Part View Lakz Existing Dock ,, 1 iIj :J Pond/ Normal Water Lawl shoreline Plan View FORM: SSGP 02-2017 Page 3 of 4 L ! N m =Q) �c:_ � • L O i11 67 v m f� a- v O a 0 +' Q bA O a a a vi a a a r O G1 Q cm y a a SURVEY FOR G� I La THERESA SCIPIO[gl LOT 2829, LAKE ROYAL E 1251 SAGAMORE DRIVE PINS 2330-89-2305 D_S_ 1524, PAGE 137 P_R.F. 1, SLIDE 102A CYPRESS CREEK TOWNSHIP FRCANKLIN COUNTY, NORTH, CAROLINA APRIL M. 20 i g 0 20 0 0 a SCALE 1 n=40' 2828 c- 100 cFR :.!'. --Loot PLAIN PER FlMA FlRm PAN-9 37207230-ZIox E)A_-� "AFML IE. M13 EKE ',250 sq.ft. 0.396 AC. LP GAS TANX Is --s- uc m o- FROPCRTT LINE PJMLITE eLISil j 1_ 5,6' tiG:7iN CF FFtL�r.1iT;' a � , CAM'HORyE, MOSS F4 PANCIERA. F_C- Proress€onal !and Surveyors C 1525 333 S. Wh€te StresL Post Office Box 1253 Wake Forest. N.C. 27588 (9io]556-3148 283Q I[, VICINITY MAP LEGEND: EIP — EXISTING IRON PIPE E€9 — EXISTING IRON BAR 3,€P — 6EWT IRON PIPE 9 — SENT IRON BAR CM, — M14CRUE MONUMW =PK -- EXISTjING PK NAIL SPK — SET PK ,MAIL NIP — NEW IRON PIPE SET RIGHT OF WAY CATV — CABLE TV BOX E3 — ELECTRIC 9OX IE — TELEPHONE PEDESTAL P? — POINER POLE OHL — OVERHEAD LINE LP — LIGHT POLE VIM — WATER METER tits! — WATER VALVE CG — 5E19f EE CLEAN —OUT I To AK UK IN sr w7u.sEcIlorl EIF -K d xwnays cave N Q m L7 NCR Tri C n Q E} 8 i Zo'5=' Pa Qe C7 O t GEC7LARE THAT i-15 SURVEY ComPLIES '51TH Tl-iE NORTH CAROLINA STANDARDS OF PIRACICE FOR 5URVEYING, (_ECTION 1150C9 FOR CLASS A SURVEYS AND 'r-.AT T'-iE CALCULATED RATIO Ce= FRECISIUN BEFORE 7DJUSTFAEN TS IS 1_I0,90134- =LIR-5-4M ME PROPERTY CGiNERS SiOYrN ART PRIIA v CCViS2f3F !AQx11Ai�UThi10N FOB TT?E RE— Esin3 1 i aF P--Ri♦JPMRl'Y CORNERS Jr, TFE "BSFYCE t?� C , HMO,• ,y TS AND OTrjZR SUSMVi510M PRopr rr cv31;�E�s. r s�RVEY €S NOT To 13C RZC;OR0ED WIT-r1— 6JjT THE L 1TTGii AUTrJG91Z.ATION, OF TrlE SDRVEYOR_