20201160 Ver 1_Shoreline Stabilization_20200904

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i� State of North Carolina
Department of Environment and Natural Resources
ra.
Division of Water Resources
Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
ENVIRONMENTAL QUALITY 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 RECEIVED
Raleigh, NC 27699-1617 Raleigh, NC 27604
S E P 0 4 2020
A. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
NCDEQ/DWR/NPDES
Name: REED & SARA POTECHA
Mailing Address: 213 ERWIN ST
MORGANTON NC 286SS
Telephone Number: 804-393-8572 Fax Number:
E-mail Address:
2. Agent/ Contact Person Information
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:
httP://www.saw.usace.army.mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf)
Name: CARISSA PARKER
Company Affiliation: BENNICK ENTERPRISES, LLC.
Mailing Address: 7836 HWY 70 EAST
NEBO NC 28761
Telephone Number: 828-659-1000 Fax Number: 828-659-1001
E-mail Address: [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.
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.
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.)
4. Location of the property (where work is to be conducted)
County: BURKE Nearest Town: NEBO
Lake/ river/ ocean adjacent to property: JAMES
Property size (acres): 1.8
Subdivision name or site address (include phase/lot number): 1780 LOT 10
2236 OLD NEBO BRIDGE RD
Directions to site - please include road names and numbers, landmarks, etc.:
FROM MORGANTON TAKE HWY 126 / TL ONTO CAMPBELLS TRACE / TL ONTO OLD
NEBO BRIDGE RD TO PROPERTY
Latitude (in decimal degrees) 35.75372 Longitude (decimal degrees) 81.90938
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): VACANT WOODED LOT
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): 165' SHORELINE STABILIZATION BY BARGE,
HEIGHT WILL BE 4'
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:
3' X 165' = 495 SQ FT
Temporary impacts in square feet:
NO TEMP IMPACT
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:
1'X 165'= 165SQFT
Temporary impacts (temporary clearing, construction corridor) in square feet:
NO TEMP IMPACT
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): 3 TREES LESS THAN 6" AND
1 TREE GREATER THAN 6" WILL BE REMOVED TO COMPLETE THIS PROJECT. THEY WILL BE
REPLACED INCH FOR INCH, WITH TREES TOTALING THE SAME DIAMETER ANY REMAINING
DISTURBED AREA WILL HAVE MULCH APPLIED TO IT
FORM: SSGP 02-2017 Page 2 of 3

11. Sig
F!�- 2"1-70
Owner Agent's Signature* [15A,1 CAC 02l .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
La ke
(At Fell Pond/ Normal Water Level)
1 {
Full Pond/ Normal Water Level
Shoreline
"D
e0
Plan Vie
FORM: SSGP 02-2017 Page 3 of 3

i
REED POTECHA ,5�'✓aUfPG`��
LAKE JAMES
1780 LOT 10
TO: NORTH CAROLINA DIVISION OF WATER RESOURCES
I GIVE CARISSA PARKER, OF BENNICK ENTERPRISES, LLC.,
PERMISSION TO SIGN AS MY AGENT ON MY APPLICATION FOR
SHORELINE STABILIZATION.
SIGNATURE (S)
DATE � I/.51oZ 0

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Reed & Sara Potecha
1780 lot 10

Potecha - 1780 10
1780 lot 10
2236 Old Nebo BridgeRd
Latitude: 35.75372 N
Lon itg ude: 81.90938 W
Pisgah National Forest
126
Lake James
Nc 1
wy 126
n
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