20060201 Ver 5_Shoreline Stabilization Form_20200910

State of North Carolina
Department of Environment and Natural Resources
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
Raleigh, NC 27699-1617 Raleigh, NC 27604
A. Applicant Information [15A NCAC 02H .0502(a
1. Owner Information
Name: CAMP LAKE JAMES MASTER RECREATIONAL ASSOCIATION INC
Mailing Address: 3100 CAMPBELL'S TRACE
NEBO NC 28761
Telephone Number: 828-391-6866 Fax Number:
E-mail Address:
Chamberlain4l(@msn.com
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:
Company Affiliation
Mailing Address:
Telephone Number
E-mail Address:
CARISSA PARKER
BENNICK ENTERPRISES, LLC.
7836 HWY 70 EAST
NEBO NC 28761
828-659-1000 Fax Number: 828-659-1001
CARISSA(@BEN NICKGRADING.COM
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)
5
County: BURKE/MCDOWELL Nearest Town: NEBO
Lake/ river/ ocean adjacent to property: JAMES
Property size (acres)
..R
Subdivision name or site address (include phase/lot number)
1780 CAMP LAKE JAMES
3100 CAMPBELL'S TRACE
Directions to site - please include road names and numbers, landmarks, etc.:
FROM MORGANTON TAKE HWY 126 TO CAMPBELL'S TRACE TO PROPERTY
Latitude (in decimal degrees) 35.75628 Longitude (decimal degrees) 81.91811
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): 900' SHORELINE STABILIZATION BY BARG
HEIGHT WILL BE 10'
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:
7' X 900 ' = 6300 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:
3' X 900 ' = 2700 SQ FT
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): 4 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
11. Signature
FORM: SSGP 02-2017 Page 2 of 3

9-10-2020
Owner/Agent's Signature* [15A NCAC 02H .0502(f)] Date
Agent's signature is valid only if on 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 Full Pond/ Normal Water Level[
Full Pond/ Normal Water Level
Plan
Tx 900' Rip
FORM: SSGP 02-2017 Page 3 of 3