20220017 Ver 1_Site Plan_20220104

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: _ Burke - Nearest Town: (card
Lake/ river/ ocean adjacent to property: Rhodhiss
Property size (acres): 3.79 acres
Subdivision name or site address (include phase/lot number):
1101enialo Dr. Hickory NC 29601
Directions to site - please include road names and numbers, landmarks, etc.:
Printed directions included in this packet _
Latitude (in decimal degrees) 35.768 Longitude (decimal degrees)-81.440
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Residential
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
�< is r
7. Will work be conducted from land? L From water? ❑
3. 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:
1 Crd 54 H (9a,"? il C_n)
Temporary impacts in square feet:
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:
a r 4 4p) —
Temporary impacts (temporary clearing, constru tion corridor) in square feet:
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):
XIS f V 'e
11. Signatur
Owner gent's Sign u A NCAC 02H .0502(f)j to
'Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 02-2017 Page 2 of 4

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
Lake
4-2 Full Pond/ Normal ulster Levelus sm am
Um 'Tw
Shoreline j
Plan View
A4
FORM: SSGP 02-2017 Page 3 of 4

Lake
i At �-ull PondiNormal Water Le
Side View
U-
l
1
4i ?
Z �1 c; t u �� Vc
FORM: SSGP 02-2017 Page 4 of 4