20201120 Ver 1_Shoreline Stabilization_20200831

State of North Carolinapweet
Department of Environment and Natural Resources
DWR Division of Water Resources
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
Division of Water Resources 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 RECEIVED
401 & Buffer Permitting Unit
1617 Mail Service Center AUG 31 2020
Raleigh, NC 27699-1617
NCDEQIDWRINPDES
I. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: Mark and Colette Bessette
Mailing Address: 240 West 7th Street, Chuluota Florida 32766
Telephone Number: (407-466-6643 Fax Number: [phone]
E-mail Address:
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
httt)://www.saw.usace.armv.mil/Portals/59/docs/regulatory/regdocslPermits/SAMPLE AGENT AUTH
CREATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: Bob's Dock and Seawall Co
Company Affiliation: Contractor
Mailing Address: P.O. box 304
Glenville, NC 28736
Telephone Number: [phone] Fax Number:
E-mail Address: [e-mail]
Person to receive the Certification Approval: Bob Martin
II. Project Information i15A 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.
FORM: SSGP 10-2013 Page 1 of 3

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 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: Jackson County Nearest Town: Glenville
Subdivision name or site address (include phase/lot number): 59 Knob hill Road
Glenville NC
Directions to site - please include road names and numbers, landmarks, etc.:
From SR 107 turn right on Knob hill road , 1st house on left next to Signal Ridge
Marina
Latitude (in decimal degrees) 35.16417 Longitude (decimal degrees)-83.12951
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Lake front Residential Home
6. Property size (acres):
7. Lake/ river/ ocean adjacent to property: Lake Glenville
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Repair- Replacement of existing seawall that has
collapsed
9. Will work be conducted from land? ❑ From water? X
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:
%5-P So,' ,,� 134" c-0
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: 7JZ _SQ A66 V�
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 instance): ^/0)fiSf�LS
D/? 7/2/ S T /N IAI/lPz�-dr�� ,
FORM: SSGP 10-2013 Page 2 of 3

k C25" i2Z l Z�Zd
Owner/Agent's Signature* [15A NCAC 02H .0502(f)l Date
*Agent's signature is valid only if an authorization letter from the owner is provided.
La ke
(At Full Pond/Normal Water Level)
91-)�e#ejf
Full Pond/
Normal Water Level
SI
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ftx 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.
5. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
FORM: SSGP 10-2013 Page 3 of 3

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NOTES:
1. RECORD OWNER: NOW OR FORMERLY N.C. VACATION RENTALS, LLC
2. ME BELOW REFERENCED DOCUMENTS WERE ACQUIRED, RENENED AND CONSIDERED
IN ME PREPARATION OF THIS PLAT. ADDITIONAL DOCUMENTS MAY EXIST, AND IF
PRONDED. COULD AFFECT THE RESULTS DF THIS PLAT
5. REFERENCE DEED. OEM BOOK 1876. PAGE 448 (PORTION 01)
4. REFERENCE PLAT, PLAT CABINET 18, SUDE 857 (PORTION 6)
5. PIN: 7564-60-6821
LOCA77ON SURVEY
FOR
MARK A. BESSETTE &
COLLETTE L BESSETTE
OF
TRACT A'
IN
NORTH CAROLINA
DATE SEPTEMBER 27, 2076
ORAMNG NWBER: 5952
RECISIONS
PREPARED BY
SYLVESTER & COMPANY, PA
SURVEYING • PLANNING
W
P.O. BOX 1596 • 8 CHESTNUT SQUARE TEL [phone]
N
CASHIERS. NORTH CAROLINA 28717 FAY 828-743-87D0

PROPERTY LEGAL DESCRIPTION:
LOT NO. Tract "A"
AGENT AUTHORIZATION FORM
PLAN N0. 5952 PARCEL ID:
STREET ADDRESS: 59 Knob Hill Road , Glenville NC 28736
Please print:
Property Owner: Mark and Colette Bessette
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Bob Martin
(Contractor / Agent)
of Bob's Dock and Seawall Co.
(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: office [phone] cell [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized Signature
Date: Sr-� / �� �c)-ZC
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Authorized Signature
Date: �5/0,2 0

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