20140160 Ver 1_Shoreline Stabilization_20140218

February 14, 2014
NC DWR, Transportation Permitting Unit
512 North Salisbury Street
Raleigh, NC 27604 2 Q 1 4 0 1 6 0
Please find enclosed requested copies of my DWR Application and supporting drawings and
pictures along with my check number 819 dated 21112014 in the amount of $240.00. If possible
please email me a receipt to alabamouso @comcast.net /check my email several times a day.
If there are any questions and you can contact me via email "please" do so. That would be most
helpful.
My application is for rip rap to be installed along the shore line of lot #11 located in Hayes Mill
Landing — Phase 2.
1 am Earl W. Hindman and can be contacted as follows.
Home Phone [phone] Cell Phone — 904 - 707 -5141
i
Earl W. Hindman
4391 Sidewinder Trail
Middleburg, FL 32068

State of North Carolina
DWR Department of Environment and Natural Resources
Division of Water Resources
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
Division of Water Resources 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 11l
Name: ( c+, VJ. �)i ► n rn L `1 I n rn A
Mailing Address: L-% 3 91 S I e W i rl (A ti- fi
r - -L
Telephone Number: 04 — "L�;L— i�� Fax Number: n e
E -mail Address: 0.i c'\0 C, r^ ck'A "C'_ M c- cl'_ S
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
http: / /www.saw.usace. army. mil / Portals /59 /docs /regulatory /regdocs /Permits /SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name:
Company Affiliation:
Mailing Address:
Telephone Number:
Fax Number:
E -mail Address:
Person to receive the Certification Approval: V)
II. Project Information [15A NCAC 02H .0502(a) & (b)] m c t� (�� y i qh I (� �- j� 4 6�
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.)
4. Location of the property where work is to be conducted)
County Nearest Town-
Subdivision name or site address (include phase /lot number):
Directions to site - please include
names and numbers, landmarks, etc.. I -A LT
5. Describe the existing land use b� condition of the site at the time of this application
(residential, undeveloped, etc.): NA9,S I AQ.te e, LAA A a Lk
6. Property size (acres)
7. Lake/ river/ ocean adj
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): AA ► e Sho C-9- � i A e✓
an-6
r
P
U�
9. Will work be conducted from land? rX From water? ❑
P.
10. Total amount of disturbance (including II excavation, backfill, rip rap, retaining walls, etc.)
below the normal pool lake level/ Normal Water Level in square feet or acres-
11.
Total amount Isturbance (incliNding all clearing, back fill excavation rip ra p
c, � retaining �
�
walls, etc. ) above the normal pool lake leveyl rma Wa r eve l and 50 feet land-ward in
square feet or acres r ,p
�
12. Please describe the vegetation above the normal pool lake level/ Normal Water Level and
3
50 feet landward to be impacted (number of trees, for instance): a
No underbrush or low growth vegetation exists Approximately 20 trees, consisting of mostly small (less than 6" @ 3ft —
hardwoods with larger hardwoods All trees that need to remove for access are less than 6' with the exception of one large oak
which is 8" and it is leaning towards dock that needs to be removed There area total of 10 trees that need to be removed
Also attached is a dewing prepared by Mr Kris Williams, Of Kris Williams Grading Inc, who asks to be contacted with any 7
questions His number is 828 - 312 -4566
71
0 er /Agent's Signature; [15A NCAC 02H 0502(f)1 Dale
*Agent's signature is valid only if an authorization letter from the owner is provided
x
FORM. SSGP 10 -2013 Page 2 of 3 f
P
e
r

Full Pond/
Normal Water Level
S
La ke
(At Full Pond/ Normal Water Level)
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
FORM: SSGP 10 -2013 Page 3 of 3

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