20201494 Ver 1_Shoreline Stabilization_20201125

Submission Form
Pre -Filing Meeting Information
Before submitting this form please ensure you have submitted the Pre -Filing Meeting Request Form as we will not be able
to accept your application without this important first step. The Pre -Filing Meeting Request Form is used in accordance
with 40 C.F.R. Section 121.4(a) "At least 30 days prior to submitting a certification request, the project proponent shall
request a pre -filing meeting with the certifying agency" and in accordance with 40 C.F.R. Section 121.5(b)(7), and (c)(5)
all certification requests shall include documentation that a pre -filing meeting request was submitted to the certifying
authority at least 30 days prior to submitting the certification request. Click here to read more information on when this
form is needed prior to application submission or here to viewthe form.
Attach documentation of Pre -Filing Meeting Request here:
Irlando DWR Pre -Filing Meeting Request
51.44KB
Form.pdf
Pre -fling Meeting or Request Date 10/19/2020
ID# 20201494 Version 1
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:*
[e-mail]
Rease provide an er ail address for payment and requests for more infornation here.
Andres Irlando
airlando@yahoo. com
[phone]
(xxx)xxx-xxxx
Street Address
1646 Friar Tuck Road Northeast
Address Line 2
City
Atlanta
Rbstal / Zip Code
30309-2612
State / Frovince / Region
GA
Country
Us

Is there an agent working on the F Yes
project?* r No
Agent/Consultant Information
Name: * Donna P. Hrko
Company Affiliation:* Lancaster Custom Dock and Lift Systems, Inc.
Email:* donna. lancasterdocks@gmaiL corn
Phone Number:* [phone]
(XXX)XXX-XXXX
Address:* Street Address
1156 Perth Road
Address Line 2
City
State / Province / Region
Troutman
NC
Fbstal / Zip Code
Country
28166-8640
US
Asigned and dated copy of the Agent Authorization letter:*
Irlando Signed Agent Authorization Form.pdf 147.87KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* Irlando Dock Dredge
If your project has a formal name please use this. If your project does not hake 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 Lookup address
Property Address Lookup:* Street Address
108 Teakwood Lane
Address Line 2
city
Mooresville
Fbstal / Zip Code
28117-7565
Latitude:* 35.520518
State / Province / Region
NC
Country
US
Longitude:*-80.894307
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*
Irlando Dredge Application Packet.pdf 6.59MB
Please use the diagram at the link below:

https://edocs.deq.nc.gov/WaterResources/0/edoc/616616/Shoreline%20Layout.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.)*
Irlando Shoreline Photos.pdf 532.98KB
4. Location of the property (where work is to be conducted)
Nearest Town:* Mooresville
County:* Iredell
Lake/ river/ ocean adjacent to Norman
property:
Subdivisions name or site address:* Sailors Lair Lot #12
Include phasellot number
Directions to site:*
From I-77 NB, Exit 31, Left onto Langtree Road, Take 2nd right in traffic
circle and proceed straight on Langtree Road, Right onto Schooner Rd,
Right onto Teakwood Lane. Property is on the left immediately adjacent
to Sailors Bay Court (on right side of property looking toward the lake).
Rease include road nacres and numbers, landmarks etc.
5. Describe the existing land use or condition of the site at the time of this application:*
Residential
Residential, undeveloped, etc.
6. Pro pertySize .690
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
Remove existing dock. Dredge area for boating access. Construct a new
fixed pier and covered dock.
NOTE: Shoreline refresh was erroneously included in the prefiling
meeting project scope and title however this work will not be performed
under this contract. Shoreline stabilization approval is NOT being sought
at this time.
8. How will the work be done? * I7 From Land
V From Water
9. Total amount of disturbance below the normal pool lake level/ normal water level:*
(including all clearing, back fill, excavation, rip rap, retaining walls, etc.)
1,680 sf
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 walls, etc.)
500 sf
square feet
11. 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)
None

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):
0 $240.00 for impacts to lake (below normal water level) of less than 1 acre
0 $570.00 for impacts to lake (below normal water level) of greater or equal to 1 acre
By digitally signing below, I certify that:
o I, the project proponent, hereby certifies that all information contained herein is true, accurate, and complete to the
best of my knowledge and belief
o I, the project proponent, hereby requests that the certifying authority review and take action on this CWA 401
certification request within the applicable reasonable period of time.
o I agree that submission of this Shoreline Stabilization online form is a "transaction" subject to Chapter 66, Article 40 of
the NC General Statutes (the "Uniform Electronic Transactions Act');
o 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');
0 1 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 the Shoreline Stabilization online form.
Full Name:* DonnaP. Hrko
Signature:}7

Initial Review
Is this accepted into the review
process?*
Project Number:* 20201494
Select Reviewer:*
Select Reviewing Office
Has payment been received?*
What amount is owed?*
rYes allo
Version:* 1
Alan Johnsomeads\adjohnsonl
Mooresville Regional Office - [phone]
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: 12 PLAN NO:
STREET ADDRESS:
108 Teakwood Lane
Mooresville, NC 28117
Please print:
Owner: Andres Irlando
Property Owner:
PARCEL ID: 4634693777
The undersigned, registered property owners of the above noted property, do herebyauthorize
Donna P. Hrko of Lancaster Custom Dock and Lift Systems, Inc.
(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):
1646 Friar Tuck Road NE
Atlanta, GA 30309
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate tothe
best of our knowledge.
A/�
Authorized Sign ture
11-6-2020
Authorized Signature
Date Date

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: IV,
Owner: / - ky i ci +re 5 i r
Print
Contractor/agent: —
Print
ty: ire
Z8117
The approval is for the purpose and design described in your application. Impacts not indicated 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 from Zone 1 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. Minimal shaping and sloping along the immediate shoreline is allowed. [15A NCAC 02B .0243(6)]
Benching, grading in the buffer is not allowed. Excessive disturbance of ground cover. 115A 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. [15A NCAC 028 .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. [15A NCAC 02H .0502 and 15A NCAC 02B .0243 (4), (6), (8)]
5tormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
discharges must be at the natural elevation and discharged prior to entering the buffer directed as diffuse or
sheet flow at non -erosive velocities to the lake. 115A NCAC 02B .0243(5), (6)]
Acknowledgement of Notification
I, Andy-C S .1 r L Q n d n , 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 Resources (DWR), is a violation and subject to enforcement. Due diligence will be
taken such that the construction will be built within substantial compliance and intent of the 401 Water
Quality Certification and Buffer Rules, the approved plan(s) and specification(s), and other supporting
materials.
Signature (owner): Date:

�w
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabiiization
ENVIRONMENTAL QUALITY FORM: SSGP 02-2017
Please approximately sketch the following information on this plan and provide dimensions far
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
Full Pond/ Normal Water
Shoreline
Plan View
FORM: SSGP 02-2017
La ke
(At Full Pond/ Normal Water
10
Lake
Iu cuu Pond/N—.1 wager L-1q Existing Dock
/3a ha7 It
rrrrr..wr...�
rr�r r�i
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Plan View
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Page 1 of 3

Duke Energy Lake Services
Guidance for Completing an Excavation Permit Application
Notre: If you are proposing excavation in association with the permitting of a new
or expanded facility under the Marina or Conveyance Programs, you do not need
to complete this application. Instead, you should incorporate the excavation
request into the permit application for the marina/conveyance using the
appropriate application.
Step 1: Contact Duke Energy Lake Services
Complete "Part r' of the application and develop a drawing of the proposed excavation area.
Contact Duke Energy Lake Services to schedule a site visit. Lake Services will conduct a site
visit to determine if Duke Energy will accept an excavation permit application for the proposed
work. If the Lake Services representative determines the application process may proceed,
he/she will initial Part I of the application.
Step 2: Draft Application Development
Complete Parts II-III.A-G and Part V of the Excavation Permit Application.
Step 3: Agency Consultation
Send the draft application developed during Step 2 to the agencies for review and comment on
the proposed activity. Refer to the Agency / Organization List available from Duke Energy to
determine which federal, state, regional, and local agencies and organizations require
consultation or review.
Note: Dube Energy reserves the right to require consultation with additional organizations
beyond those included in the Agency / Organization List.
Each agency / organization must be provided at least 30 days prior notification. Evidence must
be provided (e.g., response letter or Certified Mail receipt) in the complete application to show
each agency / organization was given the opportunity to review the proposal.
Consultation letters must be dated within the two years preceding Duke Energy's receipt of the
application. All permits must be valid at time of application and have a term longer than the
projected schedule for completing the permitted project.
What to EAMt During Agency Review and Comment:
• You will typically receive a letter from each agency / organization either documenting its
concurrence with your proposal, requiring additional information, recommending
modifications, or offering no continent. You must address each agency's / organization's
comments with a follow-up letter and in your final application as described in part W.
• If you do not receive any documentation from an agency / organization within 30 days of its
receipt of your proposal, you must provide the agency / organization with a follow-up letter
requesting comment on your proposal within 15 days from the date of the follow-up letter. If
you still do not receive any response as a result of the second letter, type "NO RESPONSE"
Duke Energy Page I of 13 rev 10/12019
Excavation Program

at the top of the follow-up letter and include it in the application along with proof of the
agency's / organization's receipt of the letter (e.g., Certified Mail receipt). You may proceed
with the application process recognizing, however, that if its comments come later in the
application process, you will be required to address them.
From the United States Army Corps of Engineers (Corps): (* * Note — The Corps may have
additional forms to submit for your proposal and an additional fee.) If the excavation can be
done under the requirements of the General Permit (GP) or a Nationwide Permit (NWP), you
will typically receive a copy of the Corps' tear sheet documenting authorization and
providing any additional instructions. If the excavation isn't covered under the GP or a
NWP, you'll be required to obtain an individual 404 Dredge and Fill permit from the Corps.
You must receive written documentation from the Corps that your application either (1)
meets the requirements of the GP or a NWP or (2) the proper 404 Dredge and Fill permit has
been received before Duke Energy can process your application.
From the North Carolina Department of Environmental Quality (NCDEQ), Division of
Water Resources: (Note NCDEQ may have additional forms to submit for your proposal
and an additional fee.) If the proposal meets the requirements of the Clean Water Act Sect.
401 Water Quality Certification, you will typically receive a letter from the NCDEQ Division
of Water Resources documenting Sect. 401 Certification and providing any additional
instructions. You may also receive a letter requiring additional information or
recommending modifications. You must receive written documentation from NCDEQ
noting any required Sect. 401 Certification has been received before Duke Energy can
process your application.
• From the North Carolina Wildlife Resources Commission (NCWRC): If you do not receive
any documentation from the NCWRC within 30 days of their receipt of your application, you
may proceed with the application process without submitting a follow-up request,
recognizing however if comments come in later in the application process, you will be
required to address them.
From the South Carolina Department of Health and Environmental Control (SCDHEC):
(Note — SCDHEC may have additional forms to submit for your proposal and an additional
fee) The SCDHEC conducts a joint application process with the USACOE in S.C. If the
proposal meets any applicable requirements of the Clean Water Act Sect. 401 Water Quality
Certification, you will typically receive a letter from SCDHEC documenting Sect. 401
Certification and providing any additional instructions. You may also receive a letter from
USACOE requiring additional information for the agencies participating in the joint
application process. You must receive written documentation from SCDHEC noting Sect.
401 Certification has been received if required before Duke Energy can process your
application.
• From the South Carolina Institute of Archaeology and Anthropology (SCIAA): The applicant
must wait 30 days after receiving the signed postal returned receipt. If a response from
SCIAA has not been received by this time you may proceed with the application process
without submitting a follow-up request, recognizing however if comments come in later in
the application review process, you will also be required to address them.
Duke Energy Page 2 of 13 rev 10/1/2019
Excavation Program

Step 4: Final Application & Submittal to Duke Energy
Following the consultation process, finalize the application. The final application submitted to
Duke Energy should incorporate all comments and recommendations provided by agencies and
organizations during the agency consultation process as well as copies of all permits received In
addition to the fmal application include the following:
• One check payable to Duke Energy for the application fee and security deposit
• If applicable, a separate check payable to the appropriate Habitat Enhancement Program fund
• Signed Excavation Program Applicant's Agreement
Note: Co -applicants must also submit the application fees and applicable HEP fees with the
application.
Duke Energy Page 3 of 13 rev 10nY2019
Excavation Program

Duke EneM Excavation Permit Application Form
FOR DUKE ENERGY USE ONLY
Duke File No.
Application Fee $ Security Deposit $ Check 4 Date Recv'd Initials
Date of Duke Energy Lake Services, applicant and/or contractor on -site inspections Date l0 car Z42itialsC.1.{
Date Final Protection/Avoidance Area Markings Field - Verified Initials
Approved to Start Work By * :
(Prim)
Date Completion Required Date of Any Approved Extension
Date Passed Closeout Inspection* Initials
(.Senn)
Initials
Date
Any Stop Work Orders or SMG Violations*? (check one) ❑Yes ❑No (if Yes. explain in PART V )
Date Deposit Refunded Initials Date Permit Database Updated Initials
* Forward copy of approved application (all pages, plus any attachments that puke Energy changed) back to applicant
with Approval Letter and highlight any changes. File copies of Approval and Close-out Checklists and any Stop Woric
Orders with application.
Part 1. Applicant Information (Please Print)
Name n5 ly-lando
_I Telephone Zt 3 - 505 - 7810
Email address: 1 r 1 [ Irj Ci Q t `� `f Q + J QQ , r cm
L e Address Madin Address,(ifdifferent
_reo wood Ln _ I ( Lo t- � ar iu� 96 _ NP
M oore6vj I i e. NE ZS 117 o 0
Contractor Company
Contractor Contact Person
Contractor Email Address:
LAKE LOT INFORMATION
FiN pp
Lake�bsrlY '1County Ire—dell.City r i� State Tax Map No. 3777
Subdivision Sal lor5 Loll r Lot / Section No. 12, Lot Size ZAcres
Duke Energy Page 4 of 13 rev 10/l/2019
Excavation Program

Duke Enemy Excavation Permit Application Form
Are there any Co -Applicants*? (check one) ❑Yes QNo (If Yes, include names, street
addresses or lot numbers, pier numbers, phone numbers, and email addresses in Part V —
Additional information)
* Co -Applicants exist when the proposed work is being done under a single application, will be
performed by a single contractor as one continuous project, and is done to benefit multiple
owners / lease holders of Project -front properties within a single development. There can be no
more than 4 co -applicants in addition to the lead applicant on any application.
Do not continue the application until an on -site inspection has been conducted between a
Duke Energy Lake Representative and the applicant and/or the excavation contractor.
NOTE: Initialling this portion of the application by a Lake Representative in no way
constitutes approval or eminent approval of the excavation or any other lake use permitting
activity.
Date of on -site inspection to 7-0 Z '
Initials (Duke Energy) 4W -
(applicant/contractor) C)e
Duke Energy Page S of 13 rev 10l1C2019
Excavation Program

D_uke_Eneray_ Excavation Permit Aunlication Form
Part IL Description of Project
A. Basic Information
1. Type of excavation: (check one) Plfgew excavation ❑ Maintenance excavation
2. Purpose of excavation: (check one) Ptoat Access Channel
❑ Water Intake Channel ❑ Wastewater Discharge Channel
❑ Other (spec):
3. Lake user category: (check one) OPrivate ❑Residential Marina
[Commercial Marina ❑Public
❑Other (specify):
4. Max. Excavation Area Dimensions (ft): Length -V4* Width Depth L6
(Note: include additional area dimensions if necessary so response to #5 below equals max. area
dimensions in 44)
5. VoIume of Excavated Material (TOTAL for the project): 07- `C,ubiic�yards
6. Type of material removed (applicant determines hyfeld sample ifpractical): Gann f
7. Excavation Site area: . L138 Acre (s) Disposal Site area: • 1038 Acre(s)
8. Total Disturbed Area (including equipment staging area): • 6 Z�2 Acre (s)
9. Does theproject meet the requirements of the applicable General Permit? (check one)
Ues Vo
10. Do you claim title to the disposal area? (check one) ❑Yes ZNo
11. Do you claim title to the equipment staging area? (check one) 04'Yes �o
12. Are there any water-treatme facilities within 50 feet of the proposed excavation area?
(check one) Yes Jo
(If Yes, specify):
13. How will the excavated material be entrapped and the erosion controlled? (e.g. see attached
Verosian control plan and disposal area design): —b*"ed�9e- W ►+v% lorn regc h P�CC x.V Or
i'Q Mccke.+rigl in hopper- bcLr- es. Aout away e `n off lmd
onty duM -h-LV- 'b Quad:=por4-ed +odi5po5a1Sl .
Duke Energy Page 6 of 13 rev 10/112019
Excavation Program

Duke EnerLyy Excavation Permit Application Form
14. Type(s) of excavation equipment to be used: LC r, �eaclh 5-xCa:ga+ y., 6j 10r+ React \
E-xcava+ow bame-S, dl�rnptr s
15. Will waters or wetlands he crossed in transporting equipment to or from the site?
(check one) Yes ❑No
(1 yes, explain)
inc, equipmen+ i S hYiytS�pr vi a
lraOw L �n Ja1cusf e-4- eus{�m oc.Vi 5 in
D
514-e on L,C>LV,e Morm.ah ,
16. Will return water re-enter the reservoir? (Check one) ❑Yes
(If Yes, specify point(s) of re-entry and show on Excavation Area Drawing)
P locthn P lanf w i h
area �Pm-,-
❑No )OII/A
17. Is there an existing facility (e.g. pier) that access is being aintained to by colducting the 1
excavation? ❑Yes JONO a ''nQ dlaG��?�rej-rlaveC� y're�7/ctCea
(If Yes, provide the exi i ermit nu be .�If No, inc d''ejja--s--c11a__led rawing of the proposed
facility). Permit # G ee Ti `Oj EnQ r]eCfJ #
18. Total planned duration of the work (Include first equipment mobilization, excavation
through final mitigation meas r s complete):
START / FINISH
(Month) (Year) (Month) (Year)
Duke Energy Page 7 of 13 rev 1 a/ 1 no 19
Excavation Program

Duke Energy Excavation Permit Application Form
Part H. (Continued)
B. Protection / Avoidance Area Description
Complete the following table including all land areas within and immediately adjoining the disturbed area:
Protection/Avoidance Areas
Approx
Identification
Method *
Avoid (A) or Mitigate (M)
Acre
Field ID
Work Area Dw . ID
(check all that apply)
a. Marshland, swamp, ponds, beneficial
/�
aquatic vegetation or other potential wetlands
circle allthat a !
`/
b. Buffer Zones (specify width & source
of requirement)
Dr W�11 �QZGD �Ied
From YID piQi1} W51
w�ttl Ioe loadeda r.LclurxP
owl
I P�Q tcLLSWtE
c. Environmental Areas as identified by
Duke Energy
d. Natural Areas as identified by Duke
Energy
e. Historic properties (specify)
f. Rare or threatened species (spec)
v A
Duke Energy Page 8 of 13 Teti10.1 101y
Excavation Program

Duke Energy Excavation Permit Application Form
Protection/Avoidanee Areas
(check all that apply)
Approx
Identification
Method
Avoid (A) or Mitigate (M)
Acre
Field ID
Work Area Dw,g. ID
iz. Buried gas, water, sewer,
communications or electric lines circle
� yJ/A
h. Impact Minimization Zones as
identified by Duke EnergyV
r
i. Other areas requiring specific
avoidance, protection or mitigation (spec)
A f/A
* For "Field ID" column, specify entity or person that performed the identification and how it was physically marked (e.g. Duke
Energy (John Doe)/Pink and purple -dotted tape, Corps of Eng. (John Smith)/ yellow flagging). For "Work Area Dwg ID" column,
show the symbol that is used on the drawings to identify the protection/avoidance area.
** List and attach mitigation plans
Duke Energy Page 9 of 13 rev 10nn019
Excavation Program

Duke Enerev Excavation Permit Application Form
C. Applicant's Signatures
Comments:
Applicant Name (print) ft
j
Applicant Signature* Date i y r (o-2o2o
Co -Applicant Name (print)
Co -Applicant Signature* Date
Co -Applicant Name (print)
Co -Applicant Signature* Date
Co -Applicant Name (print)
Co -Applicant Signature* Date
Co -Applicant Name (print)
Co -Applicant Signature*
Date
*Per my signature, the information provided in this application is correct to the best of my
knowledge.
Duke Energy Page 10 of 13 rev 10/1/2019
Excavation Program

Duke Enerev Excavation Permit Application Form
Part III. Additional Information
Deed and Survey Plat: A copy of the deed and registered survey plat or other instrument
under which each applicant and co -applicant claims title to the affected property (the
shoreline adjoining the excavation area, equipment staging area, area crossed by any spoil
and return water lines, and the disposal area). If the applicant(s) is(are) not the owner(s) of
said property, then forward a copy of the deed and registered survey plat or other instrument
under which the owner(s) claim title plus written authorization from the owner(s) to carry
out the project on their land.
131"l Excavation Area Drawing: An accurate drawing of the area to be excavated. The drawing
must show at a minimum, a North arrow; the boundaries and acreage of the proposed
excavation area and equipment staging areas; lake, county, city, cove, tributary, road and
subdivision names and lot numbers (as applicable); property comers for project front lots;
the full pond elevation contour and lines dividing the cove width into equal thirds (as
applicable); approximate volume in cubic yards of the material to be excavated; point(s) of
return water re-entry; the boundaries of any adjoining areas that are to be specifically
avoided or protected during the work and the location (address) of the disposal area for the
excavated material. [NOTE: A copy of this drawing must also be provided to the
excavation contractor to ensure restricted areas are not impacted.]
Disposal Area Drawing: An accurate drawing, of the proposed design for the disposal area.
The drawing must show at a minimum, a North arrow; the boundaries and acreage of the
proposed disposal area; lake, county, city, cove, tributary, road and subdivision names and
lot numbers (as applicable); the full pond elevation contour (unless disposal is well away
from the lake); the boundaries of any adjoining areas that are to be specifically avoided or
protected during the work; the location (address) of the excavation area from which the
material came and a statement of the disposal area's capacity with all dimensions labeled
that were used in the volume calculation. [NOTE: A copy of this drawing must also be
provided to the excavation contractor to ensure restricted areas are not impacted.]
Also note for projects larger than one (1) acre in North Carolina, including excavated,
equipment staging, and disposal areas, you must submit an erosion control plan. For
projects larger than two (2) acres in South Carolina, including excavated, equipment staging
and disposal areas, you must submit an erosion control plan. For projects < two (2) acres in
South Carolina, you must submit a completed standard reportingform orm for construction sites
disturbing two (2) acres or less to the South Carolina Dept. of Health and Environmental
Control (SCDHEC) - Stormwater Management
Vicinity Map and Driving Directions: A vicinity map and directions by road showing
directions to both the excavation area and disposal area. Include the latitude and longitude of
both the excavation area and the disposal area.
Part IV. Agency Reviews and Approvals
Begin this section with a summary table of all agencies consulted and applicant response to
agency comments as shown in the example table below. Agencies should be listed in the order
Duke Energy Page 11 of 13 rev 1041/2019
Excavation Program

Duke Enerey Excavation Permit Application Form
shown in the Agency/Organization List. Consultation letters must be dated within the two years
preceding Duke Energy's receipt of the application.
Table IV-1. Sample Agency Comment and Response Table
Agency Comment
Applicant Response
Agency 1
The activi is a roved as proposed. NA
y2
Agenc
The on -site well provides drinking water to the
Contacted Mr. Smith on 1/1/20xx. No
public. Please contact Mr. Smith to discuss the
further action needed.
proposed changes and potential issues
associated with youpipposal.
You must contact us immediately if
Applicant will contact Agency 2 if
endangered species are located during the
endangered species are located during
course of construction.
construction
Azencv 3
Requested agency comments on 1/l/20xx and
NA
again on 2/1/20xx. No response as of
2/I 6/20xx.
Agency 4
Section 401 Water Quality Certification
Applicant will comply with the conditions of
the 401 Water Quality Certification
Following the table of agency comments and applicant responses, include a table of permits and
certifications issued by the reviewing agencies. As with the table of agency comments and
applicant responses, agencies should be listed in the same order as they are listed in the
Agency/Organization List.
Table IV-2. Sample Agency Permits and Certifications Table
Agency
Permit/Certification Name
Date of
Date of
Issuance
Expiration
Agency 1
Surface Water Withdrawal Permit
Agency 2
Section 401 Water Quality Certification
Following the two summary tables, include a copy of all correspondence to and from any local,
regional, state and federal agencies or other organizations with which you are required to consult,
including any required permits (e.g., Section 401 water duality certifications, Section 404
dredge/fill permits, building permits, etc.) or other approvals or comments which have been
obtained from these organizations regarding this activity. Include a copy of any local, regional,
state or federal regulations or guidelines that will be followed. All permitting issues must be
resolved and clearly documented. Correspondence should be organized in the order the agencies
are listed on the Agency/Organization list with the applicant's request for comments followed by
additional correspondence in chronological order. All permits must be valid at time of
Duke Energy Page 12 of 13 rev 10/1/2019
Excavation Program

Duke Enersv Excavation Permit Application Form
application and have a term longer than the projected schedule for completing the permitted
project.
Part V. Additional Information
Provide relevant additional information. Reference previous parts as applicable. Include the
FERC-required Environmental Assessment if you were directed to do so during the initial site
visit. if there are co -applicants, this is where their information would be provided (see Part I).
Duke Energy Page 13 of 13 rev 1011/201
Excavation Program

Type: CONSOLIDATED REAL PROPERTY
Recorded: 8/7/2020 12:43:58 PM
Fee Amt: $2,616.00 Page 1 of 4
Revenue Tax: $2,590.00
Iredell County, NC
Ronald N. Wyatt Register of Deeds
B K 2722 PG 1532 - 1535
NORTH CAROLINA GENERAL WARRANTY DEED
Excise Tax: $ 2,590.00
Parcel Identifier No. 463469377 Verified by County on the day of , 20
By:
Mail/Box to: GRANTEE
This instrument was prepared by: KIMBERLY E. FOX PLLC 21031 Catawba Ave. Ste 104, Cometius, NC 28031
Brief description for the Index: LOT 12 SAILORS LAIR,
THIS DEED made this _r,t'd-a-y of August , 2020 , by and between
GRANTOR
CECIL N. SMITH III and spouse, ANNE M. SMITH
Co
GRANTEE
ANDRES FEDERICO IRLANDO and spouse, OLIVIA IRLANDO
1646 FRIAR TUCK RD NE
ATLANTA, GA 30309
Enter in appropriate block for each Grantor and Grantee: name, mailing address, and, if appropriate, character of entity, e.g.
corporation or partnership.
The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and shall include singular,
plural, masculine, feminine or neuter as required by context.
WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby acknowledged, has and by
these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that certain lot, parcel of land or condominium unit
situated in the City of MOORESVILLE Township, IREDELL County,
North Carolina and more particularly described as follows:
SEE ATTACHED EXHIBIT "A"
The property hereinabove described was acquired by Grantor by instrument recorded in Book 2386 page 787
All or a portion of the property herein conveyed X includes or _ does not include the primary residence of a Grantor.
A map showing the above described property is recorded in Plat Book 14
Page 1 of 2
NC Bar Association Form No. 3 C9 1976, Revised @ 1977, 2002, 2013
Printed by Agreement with the NC Bar Association — 1981
page 90
This standard form has been approved by:
North Carolina Bar Association — NC Bar Form No. 3
Page Count q ROTC
NS PQ St

TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in
fee simple.
And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple, has the right to convey the same in fee
simple, that title is marketable and free and clear of all encumbrances, and that Grantor will warrant and defend the title against the
IawfuI claims of all persons whomsoever, other than the following exceptions: Easements, Restriction and Rights of way ofmcord
and the lien of ad valorem taxes which the Grantee hereby assumes and agrees to pay.
IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year first above written.
r (SEAL)
(Entity Name) Prin ype N me: CECIL N. SMITH M
By:
�- ^'k�" � SEAL
PrintiType Name & Title: Prin yp Name: ANNE M. SMITH
By:
PrintiType Name & Title:
By:
PrintiType Name & Title:
(SEAL)
Print/Type Name:
SEAL
Print/Type Name:
State of North Carolina - County or City of IREDELL
XI, the unders' ed Notary Public of the County or City of IREDELL and State aforesaid, certify that
CE N. SNUTH n d s ouse ANNE M. SMITH personally appeared before me this day and
ackno edged th ue execution of the foregoing instrument for the purposes therein expressed. Witness my hand and Notarial stamp or
seal this th ay of Aup�Bt , 20 20 .
My/CossiN
res: Notary Public
(Af) Notary's Printed or Typed Name
tate of - County or City of
I, the unders' ed Notary Public of the County or City of and State aforesaid, certify that
personally came before me this day and acknowledged that _he is the
of , a North Carolina or
corpora 'on/li d liability company/general partnership/limited partnership (strike through the inapplicable), and that by authority
duly give an the act of such entity, _he signed the foregoing instrument in its name on its behalf as its act and deed. Witness
my hand an otarial stamp or seal, this day of , 20—•
My C ssion ires: Notary Public
(A Seal) Notary's Printed or Typed Name
to of - County or City of
1, the un igned Notary Public of the County or City of and State aforesaid, certify that
Witness d and Notarial stamp or seal, this day of , 20
M onunission E ires: Notary Public
ffix Seal) Notary's Printed or Typed Name
NC Bar Association Form No. 3 C 1976, Revised © 111/2010
Printed by Agreement with the NC Bar Association

NOTARY ACKNOWLEDGEMENT FOR NORTH CAROLINA GENERAL
WARRANTY DEED FROM CECIL N. SMITH III and ANNE M. SMITH (GRANTOR)
to ANDRES FEDERICO IRLANDO and OLIVIA IRLANDO (GRANTEE)
STATE OF N C/
COUNTY OF MQCkty�V C
I, certify that the following person appeared before me this day, acknowledging to
me that he or she voluntarily signed the foregoing document for the purpose stated
therein and in the capacity indicated.
CECIL N. SMITH III and ANNE M. SMITH
(Name of Principal(s) (person(s) appe ' bore you)
Witness my hand and official sea , thise'A day of
Notary Public J
Type or Print Name: 7
My Commission Expires:
3 uv�'z 2S ljti'�
KIMBERLY E. FOX
NOTARY PUBLIC
Mecklenburg County, NO
hly commission Expires June 25, 2023
(Notary Seal)

EXHIBIT A
ALL THAT CERTAIN LOT OR PARCEL OF LAND SITUATED IN IREDELL COUNTY, NORTH CAROL.INA AND
MORE PARTICULARLY DESCRIBED AS FOLLOWS:
TRACT ONE:
BEING ALL OF LOT 12 OF THE SAILORS LAIR SUBDIVISION, AS SAME AS SHOWN ON A MAP OR PLAT
THEREOF WHICH IS RECORDED 1N THE IREDELL COUNTY PUBLIC REGISTRY 1N BOOK 14, PAGE 90.
TRACT TWO:
THAT CERTAIN TRACT OF LAND CONTAINING 0.0260 ACRE BOUND ON THE EAST BY OTHER LANDS OF
GRANTOR IN DEED BOOK 1545 PAGES 182 AND ON THE WEST BY DUKE POWER'S COWANS FORD
HYDROELECTRIC PROJECT (LAKE NORMAN), AS SHOWN ON PLAT OF SURVEY ATTACHED TO DEED
RECORDED IN BOOK 823, PAGE 029, IREDELL COUNTY REGISTRY,
TRACT THREE:
THAT CERTAIN TRACT OF LAIC❑ CONTAINING 0.0040 ACRE BOUND ON THE SOUTHEAST LANDS OF
GRANTOR IN DEED BOOK 1545, PAGE 182 AND ON THE NORTHWEST BY DUKE POWER'S COWANS
FORD HYDROELECTRIC PROJECT (LAKE NORMAN), AS SHOWN ON PLAT OF SURVEY ATTACHED TO
DEED RECORDED IN BOOK 823, PAGE 29, IREDELL COUNTY REGISTRY.
BEING THE SAME PREMISES CONVEYED BY DEED RECORDED IN IREDELL COUNTY IN BOOK 2386,
PAGE 787.
PIN: 4634693777.000

NOTES
• PROPERTY wAy of susiv;F TD RECORDED oR
INSIECORDED RIGHTS OF WAYS OR EASDA NTS
NOT OBSFRIQD
• OWNER TO VWFY All. SETBACKS AND ZONING
RAULATIONS PRIOR TO ANY PLANNING OR
CONSTRUCTION.
• CIMDESONR OF ALL IMPRVANIENTS SHOWN ON
THIS PLAT SHOULD NOT BE SCALED OR RLTIEO
UPON FOR nFSGN OR CONSIRLIORON WRHOUT
A MELD VE iIFMF10N OF AU DNENSION9.
• DKGRAL COPIES OF THIS ALE ARE FOR REFEAD40E
ONLY AND ANY NOT BE USED FOR DESIGN WORK
• NO PORRON OF THE RO ODITUL STRUCTURE
19 LOCATED IN THE 100 YEAR FLOOD PLAI1.
• A PORTION OF YEAS PROPFRT' 9 LCOATM R A
100 YEAR Flom PLAIN,
Courm
Rearing
Distance
L1
N 2T01 01 E
25.94
N 34'05 05 E
1 .
L3
N 3751 31 W
10.32
L
N 7U 12 20 E
22.79
L5
N 3542 28 E
B 88
L8
N 473156 E
32. 2
L7
N 14 39 15 E
4.59
S 2732 00 E
7.12
10
PB 14-90 \ \
OF 10000OYEAR F1A UNE P8 14-90 �
REHAB TRACT 2 0.690 AC
I)B 2362-2407 TOTAL S� t
a4
FENCE I
t F
WµL!
R I
_ 4
OB 23eY10 -27
TRACT 3 !- '-
`A i4 aEaw
DOCK 1 \
1
APPROXHATE 780' CONTWR GNE
PHYSICAL SURVEY
FOR
40 a 40 90 120 ANDRES & OLrv"
CR"EEC SCALE - FEET IRLANDO
108 TE/KNDOO LANE - MOORMWILLE, ND
LOT #12. SAILORS ENR • 7 ACOMOINL PARCELS
DAVIDSON 7OWaW. REDELk DDUNY, MC
i DEDMON SURVEYS
OCHUCK POOVEY, PLS 03762
FIB 14-90 ' 37a4 NC HIGHWAY fi NORTH
1 P.O. BOX 494 - DENVER, NC 28037
iASPYALT DRNRYrAY PHONE: [phone]
AWL IN DRPAWAY FAX:[phone]
r-__ _---__-_ --- I YWYW.DEDMONsURVEYi
01'S533 E. NAEL IN DWIVEWAr j 14!! tlllr�
:r
Sm _
\ f�
.l ^'QJL 1 �Ap'sy4
Yq
\\� 0a 4, \ � 'iMiiin",
\ L ROBERT J. DEDMON, COMFY THAT THIS PLAT WAS
DRAWN FROM AN AC7114 SURVEY LODE UNVER MY
SWERMION (139 s3ee. Pa 737XM 14. PC 90):
l* THAT THE RATIO OF PRECISION AS CALCUTATED
WELL ., \. V' \ EXCEEDS 1n D.000% TENT THIS PUT WAS PREPARED
_U •.• qA IN ACODRCANCE WnM OS 47-30 AS AYENOEO.
WITNESS MY ODOINAL SIGNATURE, JULY TO, 7020.
277.7V Z- (�coEern ,1r. AC.d' 3899
30 .3B TOTAL '\ F-FE55ION& LAP40 SUMEYOR LCOME N0.
OUTDOOR SHOWER \ SURV. FN: MP DRAWN: RD JOB% WSL12
ti VICINITY NAP
SITE
P814-90
¢4
04 RERAR
PLAT BOON ih90

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Y NI alMV) & ALiddONd S. Jo Nwaod Y .
'NNW OOP•! W3k OOL 3NL N a3L1Um 9
3aNLYRO TNN[3atM 3M d0 NOUMOd ON .
71du NOMM Wad am 38 IN AM Ow Jlw
3YnVL-M V(W 3W PW SNa i0 0" ' NW .
'SNOaNf3R0 T% 30 NMVDLMW TUTA Y
JMK M NBILMUSN00 1I0 NOIS30 URA NOT
a3raw 00 a3lYW 30 ION aTa6 lYld SNa
NO NMDaS Slh31Si1101" TW AO ANMSOORIO .
'NOaa11y1SNW
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SU131+OSY3 90 SM to SWOIa G30tlO33WM
NO 93aWOOM M JZ3Bn5 30 Am AXIdOad .
:s3LON

108 `T'ecAwood Ln.
�*rebv r ! le.
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i
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1
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'
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DUKE ENERGY DIRECTIONS BY ROAD FORM
Lake Use Permit Applicants and Contractors: Ease of locating the proposed project
site canhaveabig impact on permitting processing time. Please complete this form and
return it along with your completed application to:
1618J_3210121:t�'f•1
CIO LAKE SERVICES — EC 12 Q
526 SOUTH CHURCH STREET
CHARLOTTE, NC 28202
Applicant's Name: Andres lrlando
Street Address (at lake): 108 Teakwood Lane
Lake Name: Norman
Subdivision Name: Sailors Lair
Property Section:
Lot #: 12
City: Mooresville County: Iredell
State: NC I Zip: 28117
Telephone: [phone]
Directions (from major road or highway):
From I-77 NB Exit 31, Left onto Langtree Road, Take 2nd Right in round about
and proceed straight on Langtree Road, Right onto Schooner Road, Right onto
Teakwood Lane, Property is on the left immediately adjacent to Sailors Bay Ct
(on the right side of property looking toward the lake). Descriptive Structure(s)
on Property (i.e. brick garage, white fence, mobile home, etc.)
*Note: Please use the back of this form if desired to draw us a map to the site.

Google Earth
«2020 Googie

iTouchMap.com
Home a Find Latitude and Longitude
tMaps
CRM
Address or Place GO
108 Teakwood Lane Mooresville, NC 28117
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35.520650,-80.894316
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•
♦ Deg ♦ DMS
Decimal Degrees Latitude: 35.520650
Decimal Degrees Longitude:-80.894316
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Tahle 31
21
I
Help
LUA — +

DUKE ENERGY DIRECTIONS BY ROAD FORM
LANCASTER CUSTOM DOCKS DISPOSAL SITE
Lake Use Permit Applicants and Contractors: Ease of locating the proposed project
site can have a big impact on permitting processing time. Please complete this form and
return it along with your completed application to:
DUKE ENERGY
C/O LAKE SERVICES — EC 12 Q
526 SOUTH CHURCH STREET
CHARLOTTE, NC 28202
Applicant's Name: Lancaster Custom Dock Disposal Site
Street Address (at lake): 1162 River Highway Mooresville, NC 28117
Lake Name: Norman
Subdivision Name: Big Daddy's of Lake Norman
Property Section: Lot 4:
City: Mooresville County: Iredell
State: NC Zip: 28117
Telephone: [phone]
Directions (from major road or highway): From I-77 NB, Exit 36, Left onto NC-
150 WB, Disposal Area is on the right behind Big Daddy's Restaurant
Complex.
Descriptive Structure(s) on Property (i.e. brick garage, white fence, mobile
home, etc.)
*Note: Please use the back of this form if desired to draw us a map to the site.

C oo(Slc earth

17
!�ff
� �■ h

ID#* 20201494
Version* 1
Regional Office * Mooresville Regional Office - [phone]
Reviewer List* Alan Johnson
Pre -Filing Meeting Request submitted 10/19/2020
Contact Name* Donna P. Hrko
Contact Email Address* donna. [e-mail]
Project Name* Irlando Dock/Dredge/Shoreline Refresh
Project Owner* Andres Irlando
Project County* Iredell
Owner Address: Street Address
108 Teakwood Lane
Address Line 2
aty State / Province / Pegion
Mooresville NC
Postal / Zip axle Country
28117 United States
Is this a transportation project?* r Yes (' No
Type(s) of approval sought from the DWR:
F 401 Water Quality Certification - F 401 Water Quality Certification -
Regular Express
F- Individual Permit F- Modification
W Shoreline Stabilization
Does this project have an existing project ID#?*
C Yes (-- No
Do you know the name of the staff member you would like to request a meeting with?
Please give a brief project description below.*
Remove and replace e)asting dock. DREDGE for boating access.
SHORELINE REFRESH.
Please give a couple of dates you are available for a meeting.

Please attach the documentation you would like to have the meeting about.
pdf only
By digitally signing below, I certify that I have read and understood that per the Federal Clean Water Act Section
401 Certification Rule the following statements:
This form completes the requirement of the Pre -Filing Meeting Request in the Clean Water Act Section 401 Certification
Rule.
1 understand by signing this form that I cannot submit my application until 30 calendar days after this pre -filing
meeting request.
1 also understand that DWR is not required to respond or grant the meeting request.
Your project's thirty -day clock started upon receipt of this application. You will receive notification regarding meeting location
and time if a meeting is necessary. You will receive notification when the thirty -day clock has expired, and you can submit an
application.
Signature
Submittal Date 10/19/2020