20140025 Ver 1_Shoreline Stabilization_20140107

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Division of Water Resources 1SA NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SSGP 10 -2013
Shoreline Stabilization Application Form
Four copies of the application (including attachments) and the application fee should be sent to:
Division of Water Resources
401 & Buffer Permitting Unit
1650 Mail Service Center
Raleigh, NC 27699 -1650
I. Applicant Information [15A NCAC 02H .0502(a))
1. Owner Information
Name: J rh a n Eliu*' "(� )►r+un .%: CuAOke ro 16� _4D SP �� '�D Srh 6D
Mailing Address: _319b /Vw1ty Cgek 9
A�IG•, GA' 303a7
Telephone Number: 04 9 88x0 Fax Number: � D 326 'f16
E -mail Address: tip► 01 sfi/awl G �v !q h' m
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
htto: //www.saw.usace.army.mil/ Portals /59 /docs /reeulatory /reedocs /Permits /SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: Sz+k 6uid5vali
Company Affiliation: 5t---+k
Mailing Address: Ceyek
All, 1A �_A 303a-7
Telephone Number:
E -mail Address:
40 t0 q g CIO Fax Number: 4 04 337 3116
Person to receive the Certification Approval:
11. Project Information [15A NCAC 02H .0502(a) & (b)l
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, structures (buildings, retaining walls, docks, impervious surfaces,
FORM: SSGP 10 -2013 Page 1 of 4

etc.), 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.
3. Attach a photograph of the shoreline/ buffer proposed to be stabilized. (Include a scale �.
of some sort- a yard stick, shovel handle, etc.)TwvQ66, ft wW/e riPruQg/ol in —�pIP) �' 01
4. Location of the property (where work is to be conducted) &Ck, Sercmd wkue 6ovU1/ `)( (n9
County: Jackson Nearest Town: Glenville
I �6 J �-
Subdivision name or site address (include phase /lot number): Lot 14,
Stillpoint Subdivision
Directions to site - please include road names and numbers, landmarks, etc.: from
Cashiers, take Hwy 107 North to Glenville, turn left onto Glenville School Road, turn
right onto Lakeside Circle Drive, turn left at gate to Stillpoint, lot 14 on right
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): undeveloped residential lot
6. Property size (acres): .98 acres
7. Lake/ river/ ocean adjacent to property: Lake Glenville (Thorpe Reservoir)
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): To apply dry stack stone boulders and rip rap
to help stabilize shoreline and prevent further erosion
9. Will work be conducted from land? ❑N From water? ❑
10. Total amount of disturbance (including all excavation, backfill, rip rap, retaining walls,
etc.) below the normal pool lake level/ Normal Water Level in square feet or acres:
7'x 140' total = 980 square feet
11. Total amount of disturbance (including all clearing, back fill, excavation, rip rap, retaining
walls, etc.) above the normal pool lake level/ Normal Water Level and 50 feet land -ward in
square feet or acres: V x 140' total = 700 square feet
12. 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):
6 dead trees
0itkP D Vsx/y
Owner /Agent's Signature' [15A NCAC 02H .0502(fll Date
Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10 -2013 Page 2 of 3

2 0 1 40 0 2 5
SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIMON:
Lar No. PLAN NO. PARCEL ID: `� 5 b� -'� 3 - NO(
STREET ADDRESS:
Please print. S �' ` In A ►�I,`' -�_
Property owner: ��P►vrc, , q m
Property Owner: il. .% 4.obt,� �,'" \ahnnp.rj
The undersigned, registered Propelty owners of the above noted property, do hereby authortm
�e-Ri GolXho m of " ` tV o w4er
(Contractor /fit) (Name of consulting firm)
to act on my behalf and take all actions necessary for the proofing, issuance and acceptance of
this permit or certification and any and all sWidard and special conditions alladmd.
Properly Owner's Address (if difiierent than property above):
19
Telephone: 1)1? 7 h1 o
We hereby above information submitted In this application Is true and accurate to the
best of our

La ke
80'
Native Boulder Stacked Wall
5'x80' Rip Rap below full pond
Full Pond/
Normal Water Level
Shoreline
2'x80' Rip Rap above full pond
Tx 140'
60'
Large Native Rip Rap on Filter Fabric
3'x60' Rip Rap below full pond
Construction
Access
Pathway
8'x70'
2'x60' Rip Rap above full pond
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ft x 100 ft) *:
1. All proposed vegetation clearing
2. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
3. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
4. Location of any proposed structures such as buildings, retaining walls, docks, etc.
5. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
140' Seawall constructed to Army Corps standards, with 8oz fabric liner, 5' surge
backfill and 5' surge in front of wall.
80' Stacked Native Stone approximately 3'x4'x2' in size. Approximately 5' below full pond.
60' Native Rip Rap approximately 5 "x15" - Class B size. Approximately 3' below full pool
and 2' above full pond.
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