20211778 Ver 1_Shoreline Stabilization_20211209

Shoreline Stabilization Application Form
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SSGP 10-2013
DRAFT -NOT FOR USE AT THIS TIME
Submission Form
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]
Please provide an email address for payment and requests for more information here.
john
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
2026 Sharon Road
Address Line 2
City
Charlotte
Postal / Zip Code
28207-2642
Is there an agent working on the project?*
Yes
No
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name: * 93 Rusty Hook Shoreline
State / Province / Region
NC
Country
US
If your project has a formal name please use this. If your project does not have 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. *
Upload File
Look up address

Property Address Lookup: *
Latitude:*
35.740812
Street Address
93 Rusty Hook Drive
Address Line 2
City State / Province / Region
Nebo NC
Postal / Zip Code Country
28761 US
Longitude: *-81.920365
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*
topo lake james .pdf 735.23KB
water resource sketch.pdf 2.12MB
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.)*
topo lake james .pdf 735.23KB
4. Location of the property (where work is to be conducted)
Nearest Town:* Marion
County: * McDowell
Lake/ river/ ocean adjacent to lake james
property:
Subdivisions name or site address: *
Old Wildlife
Include phase/lot number
Directions to site: *
Once you enter into old wildlife take it all the way down till you hit :
Rusty Hook Drive- then turn right, keep going pass the field and turn into
the first driveway on the left side right after the small filed. about 300
yards down.
Please include road names and numbers, landmarks etc.
5. Describe the existing land use or condition of the site at the time of this application: *
This residential site is bare with a road on it with min. utilities. I would
like to stabilize the shoreline asap. approx. 250 feet will be work on. Most
of the land is slightly sloping so there will be less work here than most
lake lots on lake james.
Residential, undeveloped, etc.
6. Property Size 4 acres
Acres

7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
Will use machinery to clean the shoreline up and grade properly and create
a boulder shoreline with footing and proper geo tech. Will be mindful of
the environment around us.
8. How will the work be done?*
From Land
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.)
1800
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
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)
We will keep all large healthy trees and even most smaller ones. We will
have single area routes to help with less disturbance.
Sketch: topo lake james marking copy.pdf 856.67KB
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):
o $240.00 for impacts to lake (below normal water level) of less than 1 acre
a $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
• 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.
a 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");
a 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");
a I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
a I intend to electronically sign and submit the Shoreline Stabilization online form.
Full Name:* John Jackovich
Signature:
Submittal Date: 12/6/2021

Initial Review
Is this accepted into the review process?* Yes No
Project Number:* 20211778 Version:* 1
Select Reviewer: * Mitchell Anderson:eads\mlanderson
Select Reviewing Office: Asheville Regional Office - [phone]
Has payment been received? * No Payment Needed
Fee Received
• Need Fee - send electronic notification
What amount is owed?*
• $240.00
$570.00

DocuSign Envelope ID: 5AE90C1 D-B81 D-431A-8DF4-8B4E810874A8
OLD WILDLIFE CLUB DR.
SURVEYOR'S NOTES
1. This survey was performed without the benefit of a title report and
therefore all encumbrances upon the property may not be shown. The
property is subject to all easements and right of ways of record shown
hereon or otherwise. The results of this survey are a matter of
professional opinion, and are not intended to be a guarantee of title.
This survey is only to be used by the parties named in the title block.
2. All distances shown are horizontal ground distances measured in US
feet, unless otherwise noted.
3. The area was computed by coordinate geometry.
4. Utilities shown are based on above —ground visible evidence.
Underground utilities may exist that are not shown on map.
5. FLOOD NOTE: A portion of the subject property lies within a flood
hazard area according to FEMA FIRM #3710173300K, which has an
effective date of 10/2/08.
6. Site Address: 93 Rusty Hook Dr.
SETBACKS
30' FRONT
15' SIDE
100' WATERFRONT
110' WATERFRONT BUILDING
ALL STRUCTURES TO BE BUILT
WITHIN REQUIRED BUILDING ENVELOPE
SURVEYOR'S CERTIFICATE
I, Benjamin T. Patton, PLS, certify that this map
was drawn under my supervision from an actual
survey made under my supervision (DB 1362, Pg.
312); that the boundaries not surveyed are clearly
indicated as drawn from information referenced
hereon; that the ratio of precision as calculated
exceeds 1:7,500; and that this plat was prepared
in accordance with The Standards of Practice for
Land Surveying in North Carolina. The topographic
survey meets Federal Geographic Data Committee
Standards. Elevations are based on NAVD88 and
are shown in one foot intervals. Witness my hand
and seal this 21 st day of July, 2021.
I, Benjamin T. Patton, PLS certify that this map
was drawn under my supervision from an actual
GPS survey made under my supervision and the
following information was used to perform the
survey:
1) Class of survey: B
2) Positional accuracy: 0.10'
3) Type of GPS field procedure: VRS
4) Date of survey: 7/22/20 (BPLS #20169)
5) Datum: NAD 83 (2011)
6) Published/Fixed—control used: NGS LINVIEW
7) Geoid model: 12B
8) Combined scale factor: 0.99984778
9) Units: US survey feet
LDocuSigned by
c In awliln, I OLA.
54C11D25DDC0457...
7/21/2021
Benjamin T. Patton, PLS #4904 Date
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OLD WILDLIFE CLUB
PLAT BOOK 13, PAGE 35
PHASE 1
NC GRID TIE
N:736900.74
E:1 133586.24
Al 18 0°
2�9 ,427"
3 iTle�
7687.53' Grid (Tie)
7688.70' Ground (Tie) —
NOT A BOUNDARY
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N:729285.39 N 07'51'27" W
E:1 134637.19 :°
co
BPLS
Ben Patton Land Surveying, PLLC
PHONE: [phone]
931 N. MAIN ST. SUITE 5, MARION, NC 28752
SERVING NC, SC, & TN FIRM LICENSE NO. P-0907
WEB: BPSURVEYING.COM EMAIL: BEN®BPSURVEYING.COM
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stabilization
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60.7g ,
BOUNDARY FOLLOWS UNMARKED
POINTS ALONG DUKE ENERGY
BOUNDARY (1200')
LAKE DAMES
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ENVELOPE (RBE)
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BASE FLOOD ELEVATION
(1207.3')
51.82'
05' 24' 40"
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31�
3.99 ACRES
DUKE ENERGY FLOOD
EASEMENT (1210')
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COS-9
REVISIONS:
7/21/21 UPDATED OWNER INFO
30 60 90
1.3
LAKE
VICINITY MAP
(Not to scale)
LEGEND
Unmarked point
flo 5/8" Iron rebar set
® 5/8" Iron rebar found
® Utility (type noted)
Ci National Geodetic monument
Tall wood stake set
Boundary line (surveyed)
Tie line
Adjoiner line (not surveyed)
Private right of way
Building envelope
— — Contour scaled from plat
Existing major contour
Existing minor contour
FH — Fire Hydrant
WM — Water Meter
WV — Water Valve
BOUNDARY & TOPOGRAPHIC FOR OWNER:
PIN 1733-00-37-4235
PB 13, PG. 35
DB 1362, PG. 312
NEBO TOWNSHIP
11/13/20
DRAWN By:
MCDOWELL COUNTY
BTP
7/21/21
NORTH CAROLINA
SHEET:
SCALE:
PROJECT # 20288 R1

Water Resources
ENVIRONMENTAL QUALITY
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SSGP 02-2017
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 Pond/ Normal Water Leve
- OM NM - =
Shoreline
i/ ?co'?
Plan View
Lake
(At Full Pond/ Normal Water Level)
ZipTiTg:t4;1;11/471:41;t4.111: r0;0710;117
No \vtW
DOC k-c.,�.1
fUo bode-
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42rcaw Z
FORM: SSGP 02-2017
Page 1 of 3

Full Pond" Normal Water Level
1r"ngh-e-ne r-
2 ft. x15oft.
additional clearing
if necessary
E
Plan View
FORM: SSGP 02-2017
Lake
fat Full Pond/ Normal Water level)
irf...r��
rrWrr�!
te^*��*C*S„�ORiprap"0A awe
Existing Dock
30 fta 7ft
3ftx150ft
Below full pond/ NWL
MI M9 fc 150 ft
Above full pond/ NWL
E
Page 2 of 3

DocuSign Envelope ID: 5AE90C1 D-B81 D-431A-8DF4-8B4E810874A8
OLD WILDLIFE CLUB DR.
SURVEYOR'S NOTES
1. This survey was performed without the benefit of a title report and
therefore all encumbrances upon the property may not be shown. The
property is subject to all easements and right of ways of record shown
hereon or otherwise. The results of this survey are a matter of
professional opinion, and are not intended to be a guarantee of title.
This survey is only to be used by the parties named in the title block.
2. All distances shown are horizontal ground distances measured in US
feet, unless otherwise noted.
3. The area was computed by coordinate geometry.
4. Utilities shown are based on above —ground visible evidence.
Underground utilities may exist that are not shown on map.
5. FLOOD NOTE: A portion of the subject property lies within a flood
hazard area according to FEMA FIRM #3710173300K, which has an
effective date of 10/2/08.
6. Site Address: 93 Rusty Hook Dr.
SETBACKS
30' FRONT
15' SIDE
100' WATERFRONT
110' WATERFRONT BUILDING
ALL STRUCTURES TO BE BUILT
WITHIN REQUIRED BUILDING ENVELOPE
SURVEYOR'S CERTIFICATE
I, Benjamin T. Patton, PLS, certify that this map
was drawn under my supervision from an actual
survey made under my supervision (DB 1362, Pg.
312); that the boundaries not surveyed are clearly
indicated as drawn from information referenced
hereon; that the ratio of precision as calculated
exceeds 1:7,500; and that this plat was prepared
in accordance with The Standards of Practice for
Land Surveying in North Carolina. The topographic
survey meets Federal Geographic Data Committee
Standards. Elevations are based on NAVD88 and
are shown in one foot intervals. Witness my hand
and seal this 21 st day of July, 2021.
I, Benjamin T. Patton, PLS certify that this map
was drawn under my supervision from an actual
GPS survey made under my supervision and the
following information was used to perform the
survey:
1) Class of survey: B
2) Positional accuracy: 0.10'
3) Type of GPS field procedure: VRS
4) Date of survey: 7/22/20 (BPLS #20169)
5) Datum: NAD 83 (2011)
6) Published/Fixed—control used: NGS LINVIEW
7) Geoid model: 12B
8) Combined scale factor: 0.99984778
9) Units: US survey feet
LDocuSigned by
c In awliln, I OLA.
54C11D25DDC0457...
7/21/2021
Benjamin T. Patton, PLS #4904 Date
ICARO�� ////
/t-�F(�SS/p• �s�
_ '4 SEAL e'
.<
• L-4904 •=
imF �� SURv�y0:&
'I1111'
OLD WILDLIFE CLUB
PLAT BOOK 13, PAGE 35
PHASE 1
NC GRID TIE
N:736900.74
E:1 133586.24
Al 18 0°
2�9 ,427"
3 iTle�
7687.53' Grid (Tie)
7688.70' Ground (Tie) —
NOT A BOUNDARY
NGS LINVIEW (Not to scale)
N:729285.39 N 07'51'27" W
E:1 134637.19 :°
co
BPLS
Ben Patton Land Surveying, PLLC
PHONE: [phone]
931 N. MAIN ST. SUITE 5, MARION, NC 28752
SERVING NC, SC, & TN FIRM LICENSE NO. P-0907
WEB: BPSURVEYING.COM EMAIL: BEN®BPSURVEYING.COM
/
•
•
S 58'31'06" W \ \ \
19.75'
•
S 30°06'29" W
26.99' /(
40 07,
46.32,
\
\
•
•
•
•
•
W
14.40'0j
29 95,
NC GRID NORTH
NAD 83 (2011)
\
•
ti
(0.
F
7
155.4g,
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, 1:14 1: ,,N,: ,,,,\ NI 11:1•: ,`..- . : :, -----........
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COS-9
REVISIONS:
7/21/21 UPDATED OWNER INFO
30 60 90
1.3
LAKE
VICINITY MAP
(Not to scale)
LEGEND
Unmarked point
flo 5/8" Iron rebar set
® 5/8" Iron rebar found
® Utility (type noted)
Ci National Geodetic monument
Tall wood stake set
Boundary line (surveyed)
Tie line
Adjoiner line (not surveyed)
Private right of way
Building envelope
— — Contour scaled from plat
Existing major contour
Existing minor contour
FH — Fire Hydrant
WM — Water Meter
WV — Water Valve
BOUNDARY & TOPOGRAPHIC FOR OWNER:
PIN 1733-00-37-4235
PB 13, PG. 35
DB 1362, PG. 312
NEBO TOWNSHIP
11/13/20
DRAWN By:
MCDOWELL COUNTY
BTP
7/21/21
NORTH CAROLINA
SHEET:
SCALE:
PROJECT # 20288 R1

DocuSign Envelope ID: 5AE90C1 D-B81 D-431A-8DF4-8B4E810874A8
OLD WILDLIFE CLUB DR.
SURVEYOR'S NOTES
1. This survey was performed without the benefit of a title report and
therefore all encumbrances upon the property may not be shown. The
property is subject to all easements and right of ways of record shown
hereon or otherwise. The results of this survey are a matter of
professional opinion, and are not intended to be a guarantee of title.
This survey is only to be used by the parties named in the title block.
2. All distances shown are horizontal ground distances measured in US
feet, unless otherwise noted.
3. The area was computed by coordinate geometry.
4. Utilities shown are based on above —ground visible evidence.
Underground utilities may exist that are not shown on map.
5. FLOOD NOTE: A portion of the subject property lies within a flood
hazard area according to FEMA FIRM #3710173300K, which has an
effective date of 10/2/08.
6. Site Address: 93 Rusty Hook Dr.
SETBACKS
30' FRONT
15' SIDE
100' WATERFRONT
110' WATERFRONT BUILDING
ALL STRUCTURES TO BE BUILT
WITHIN REQUIRED BUILDING ENVELOPE
SURVEYOR'S CERTIFICATE
I, Benjamin T. Patton, PLS, certify that this map
was drawn under my supervision from an actual
survey made under my supervision (DB 1362, Pg.
312); that the boundaries not surveyed are clearly
indicated as drawn from information referenced
hereon; that the ratio of precision as calculated
exceeds 1:7,500; and that this plat was prepared
in accordance with The Standards of Practice for
Land Surveying in North Carolina. The topographic
survey meets Federal Geographic Data Committee
Standards. Elevations are based on NAVD88 and
are shown in one foot intervals. Witness my hand
and seal this 21 st day of July, 2021.
I, Benjamin T. Patton, PLS certify that this map
was drawn under my supervision from an actual
GPS survey made under my supervision and the
following information was used to perform the
survey:
2)
3)
4)
5)
6) 7
8)
9)
Class of survey: B
Positional accuracy: 0.10'
Type of GPS field procedure: VRS
Date of survey: 7/22/20 (BPLS #20169)
Datum: NAD 83 (2011)
Published/Fixed—control used: NGS LINVIEW
Geoid model: 12B
Combined scale factor: 0.99984778
Units: US survey feet
DocuSigned by
L
t to 00/146A. W aif OLA.
54C11D25DDC0457...
7/21/2021
Benjamin T. Patton, PLS #4904 Date
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OLD WILDLIFE CLUB
PLAT BOOK 13, PAGE 35
PHASE 1
NC GRID TIE
N:736900.74
E:1 133586.24
N 7$ 0°
2�9 ,427"
3 iTle�
7687.53' Grid (Tie)
7688.70' Ground (Tie) —
NOT A BOUNDARY
NGS LINVIEW (Not to scale)
N:729285.39 N 07'51'27" W
E:1 134637.19 :°
co
BPLS
Ben Patton Land Surveying, PLLC
PHONE: [phone]
931 N. MAIN ST. SUITE 5, MARION, NC 28752
SERVING NC, SC, & TN FIRM LICENSE NO. P-0907
WEB: BPSURVEYING.COM EMAIL: BEN®BPSURVEYING.COM
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S 09°25,07" W
51,89'
proposed shoreline
stabilization
S 05.57'37.. w
58.16'
60.79 ,
BOUNDARY FOLLOWS UNMARKED
POINTS ALONG DUKE ENERGY
BOUNDARY (1200')
LAKE DAMES
-
\
•
•
•
•
•
100' BUFFER
•
•
•
\
•
REQUIRED BUILDING
ENVELOPE (RBE)
•
•
•
•
•5
100' BUFFER
BASE FLOOD ELEVATION
(1207.3')
51.82'
05' 24' 40"
FH
0
3.99 ACRES
DUKE ENERGY FLOOD
EASEMENT (1210')
/
COS-9
REVISIONS:
7/21/21 UPDATED OWNER INFO
BAR SCALE: 1'1=30'
30 60 90
LAKE
VICINITY MAP
(Not to scale)
LEGEND
Unmarked point
® 5/8" Iron rebar found
® Utility (type noted)
Ci National Geodetic monument
Tall wood stake set
Boundary line (surveyed)
Tie line
Adjoiner line (not surveyed)
Private right of way
Building envelope
— — Contour scaled from plat
Existing major contour
Existing minor contour
FH — Fire Hydrant
WM — Water Meter
WV — Water Valve
BOUNDARY & TOPOGRAPHIC FOR OWNER:
PIN 1733-00-37-4235
PB 13, PG. 35
DB 1362, PG. 312
NEBO TOWNSHIP
11/13/20
DRAWN By:
MCDOWELL COUNTY
BTP
7/21/21
NORTH CAROLINA
SHEET:
SCALE:
PROJECT # 20288 R1