20201688 Ver 1_Shoreline Stabilization_20201214

r�a.
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Water- Resources
ENVIRONMENTAL. QUALITY
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
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 .OS02(a)]
1. Owner Information
Name: HEATHWOOD FRAMILY LAKE HOLDINGS - JASON STRIFE
Mailing Address: 228 HEATHWOOD RD
CHARLOTTE NC 28211
Telephone Number: 704-840-3219 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/regulatorv/reRdocs/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: MCDOWELL Nearest Town: NEBO
Lake/ river/ ocean adjacent to property: JAMES
Property size (acres): 13
Subdivision name or site address (include phase/lot number): OLD WILDLIFE CLUB 99
163 BIG GAME DR
Directions to site - please include road names and numbers, landmarks, etc.:
FROM MORGANTON TAKE HWY 126 / TR ONTO WILDLIFE RD / TR ONTO OLD WILDLIFE
CLUB DR / TR ONTO BIG GAME DR TO PROPERTY
Latitude (in decimal degrees) 35.73456 Longitude (decimal degrees) 81.92359
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): 110' 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:
2' X 110' = 220 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:
2' X 110' = 220 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): 3 TREES LESS THAN 6" AND
5 TREES 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. Signat r
l;� ---' --
Ao'lt� 11 o-l?
Owner/Agent's Signature J A NCAC 2H .0502(f)) ate
{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
Full Fond/ Normal Water Level ?`
Shoreline
Plan View
La ke
(At Full Pond/ Normal Water Level)
�"W
i
� x 110,
�p
FORM: SSGP 02-2017 Page 3 of 3

A
IFE, HEATHWOOD FAMILY LAKE HOLDINGS LLC
LAKE JAMES
OLD WILDLIFE CLUB LOT 99
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 STABILI7-ATIO
Jv31iv" 0, &7
DATE %l-/0 -)czc>

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2019005255
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Heathwood Framily Lake Holdings LLC
Old Wildlife Club lot 99

Strife - Heathwood Ramily Lake Holdings OWC99
Old Wildlife Club 1ot99
163 Big Game Dr
Latitude: 35.73456 N
Longitude: 81.92359 W m e S
l Rd
0 mi 0.2 0.4 0.6
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ID#' 20201274
Regional Office
Reviewer List„
Version* 1
Asheville Regional Office - [phone]
Amy Annino
Pre -Filing Meeting Request submitted 11/4/2020
Contact Name'Stefan
Contact Email Address*
Project Name "
Project Owner'
Project County'
Owner Address:
[e-mail]
OWC 99
Jason Strife - Heathwood Family Lake Holdings LLC
McDowell
Street Address
228 Heathwood Rd
Address Line 2
city
Charlotte
Fbstal / Tip Code
28211
Is this a transportation project? (" Yes r No
State / Province / Pegion
NC
USA
Type(s) of approval sought from the DWR:
F 401 Water Quality Certification - P 401 Water Quality Certification -
Regular Express
I— Individual Permit F Modification
W Shoreline Stabilization
Does this project have an existing project ID#?
(' Yes 7 No
Do you know the name of the staff member you would like to request a meeting with?
Amy Annino
Please give a brief project description below.
110' Shoreline stabilization by barge
Please give a couple of dates you are available for a meeting.

F +
Please attach the documentation you would like to have the meeting about.
pdf orly
By digitally signing below, I certify that 1 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 11/4/2020