20140178 Ver 1_Shoreline Stabilization_20140224

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State of North Carolina
DWKw". Department of Environment and Natural Resources
Division of Water Resources
Division of Water Resources 15A 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: JOSEPH & KIMBERLY SANTUCCI
Mailing Address: 13655 SMOKEY RIDGE PLACE
CARMEL IN 46033
Telephone Number: 317 - 566 -1641 Fax Number:
E -mail Address:
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 /59l dots / regulatory Z -egdocs %Perniits /SAMPi t AGENT Aij
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: CARISSA PARKER
Company Affiliation: BENNICK ENTERPRISES LLC
Mailing Address: 7836 HWY 70 E
NEBO NC 28761
Telephone Number: 828- 659 -1000 Fax Number: 828- 659 -1001
E -mail Address: CARISSA @BENNICKGRADING.COM
Person to receive the Certification Approval: CARISSA PARKER
II. Project Information [15A NCAC 02H .0502(x) & (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, structures (buildings, retaining walls, docks, impervious surfaces,
etc.), rip rap, excavation or dredging F. } �,tiQffft_a�Water Level elevations,
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FORM: SSGP 10 -2013 FFE 2 4 2015
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Page 1 of 4

3.sqpk 4- Ki mb." !ty Sa-h. _, ,
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 BURKE Nearest Town NEBO
Subdivision name or site address (include phase /lot number) _ 1780 / 175
2087 FIRESTONE TRAIL NEBO NC 28761
Directions to site - please include road names and numbers, landmarks, etc
FRM MORGANTON TAKE HWY 126 / TL ONTO CARSON DR / TL ONTO YELLOW FORK TRAIL
/ TL ONTO FIRESTONE TRAIL TO PROPERTY
5 Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc) VACANT WOODED LOT AREA
6 Property size (acres) 2
7 Lake/ river/ ocean adjacent to property LAKE JAMES
8 Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary) 200' OF SHORELINE STABILIZATION BY BARGE
HEIGHT WILL BE 2 -3'
9 Will work be conducted from land? 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
1' X 200'= 200 SQ FT
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 1' X 200'= 200 SQ FT
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) NO TREE REMOVAL
Owner /Agent's Signature* [15A PkAC 02H 0502(f)] Date
YAgent's signature is valid only if an authorization letter from the owner is provided
FORM SSGP 10 -2013 Page 2 of 3

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Full Pond/
Normal Water Level • , •
Em
Shoreline • •
La ke
(At Full Pond/ Normal Water Level)
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on,
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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

JOSEPH & KIMBERLY SANTUCCI
LAKE JAMES
1780 LOT 175
To: North Carolina Division of Water Quality
I give Carissa Parker, of Rennick Enterprises, LLC., permission to sign
as my agent on my application for shoreline stabilization.
Signature (s)
Date t

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107 -A Alica Ave 1780 Lot 175 Shoreline
A � Morganton, NC 28655 Stabilization Areas
Phone [phone] PRELIMINARY MAP ONLY NOT TO BE
Fax [phone] USED FOR RECORDATION, SALES OR
Abernathy & E-mail aapc @bellsouth net CONVEYANCE 09/10/2007
The pur you of lhi5 rnop S to Show pole nliol Shore hric, Slabdiialion ore•C)S
Associates. P.C. r,,.,, , ,, —f E.,.,,...., -_....,-._- - - - -- -- - - - -
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Legend of shoreline areas are
from developer's FERC Dian
= POTENTIAL SHORELINE
STABILIZATION AREA
® = ENVIRONMENTAL AREA
Note Refer to recorded
plat book for relative
survey information
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176

Joseph & Kimberly Santucci
1780 lot 175

Joseph & Kim Santucci - 1780 175
Pisgah National Forest 2�
Joseph & Kim Santucci
1780 lot 175
2087 Firestone Trail
Latitude: 35.74346 N
Longitude: 81.89102 W
126
Lake
James
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