20140299 Ver 1_401 Application_20140314

DUKE POWER LAKE MANAGEMENT, EC12 -Q JNR
P. O. BOX 1006 D
CHARLOTTE, NC 28201 -1006 R 2 0 Zp;4
704 - 382 -1567 OR TOLL FREE 1- 800 -443 -5193
APPLICATION FOR PERMIT TO STABILIZE THE SHORELINE I A ac, a Irr
rte,
CAROLINA
Please type or print and fill in all blanks. If information is not applicable, so indicate by placing N/A in
blank. PLEASE SUBMIT APPLICATION AND APPROPRIATE DUKE POWER FILING FEE, PAYABLE
TO DUKE POWER, TO ABOVE ADDRESS.
I. Applicant Information
A.
Name X4!57
1
iiV DWVI �
B.
Mailing Address ISI
5Ay ,5hore koop /\Ao
o resy ;11 ,t, 74 C e2 o?/1
C.
Telephone
57Y A� 76
II. Location of Proposed Project
A.
Lake
0Y-MA, Al
B.
Street Address
/31 D,4V JADrC- pn
C.
County
�Z Q
D.
City, Town, Community or Landmark Kd 0,(r> / , �[ r/
f1
4L gkI 17
E.
Section
Lot# Z Subdivision 15Ay ( P'0 55;Alq
F.
Directions to property by road _ ; 3
W oA/ 4,, o
0 f Per Rol
o i �_ I v,+ LiV,
,1 v /3 ir r-o SS iN
+ /1/ 4 5A o ►' Da w� t Diti
G. Latitude and longitude for the project site J5.6 -3 5 3 Yo. $g IL -
H. Please submit a map showing the coordinates or a detailed map (USGS quad map, city map,
etc.) showing the exact location of the project site. (NOTE: Latitude /longitude coordinates can
be found on internet site, www.mapsonus.com. Directions: Don't register, click "Maps ", enter
address, draw map, select "Map Clicking Will... ", select "LaULong ", click map)
III. Description of Project
A. Length of wall
B. Material _7 tO Ate- 5SCe- R'►/Lr R°",-
C. Distance from property line /shoreline �� I� Co dbod gyp, fi Nq S k re- 1-W r­
IV. Intended Use of Project Area
A. Private X
B. Commercial
V. Applicant Signature `L . Da
PLEASE NOTE THE FOLLOWING:
.l
• A COPY OF THE COMPLETE APPLICATION WITH A ROAD MAP SHOWING LOCATION OF THE PROPERTY MUST BE SUBMITTED TO: US
ARMY CORPS OF ENGINEERS, 151 PATTON AVENUE, ROOM 208, ASHEVILLE, NC 28801 -5006
• A COPY OF THE "DUKE POWER APPLICATION FOR PERMIT TO STABILIZE THE SHORELINE IN NORTH CAROLINA" AND SEVEN (7)
COPIES OF THE COMPLETED "NC DIVISION OF WATER QUALITY PRE - CONSTRUCTION NOTIFICATION APPLICATION" MUST BE
SUBMITTED WITH THE DIVISION OF WATER QUALITY APPLICATION FEE TO: NC DIVISION OF WATER QUALITY, ATTENTION: Cyndi
Karoly, PARKVIEW BLDG., 2321 CRABTREE BLVD., RALEIGH, NC 27604, PHONE: [phone]

DWR
State of North Carolina
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 2 0, 1 4 0 2 9 9
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: kr-; s ; Al L . De. b c v-pr r f>41 o s
Mailing Address: 13k ­1�)" 5karc.- Loop
f�ao rre,,g -) : I , Al L a-% 117
Telephone Number: 610-_671-1476 Fax Number:
E -mail Address: 0- 4 mo- l -cam
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.
c__h
Name: r,r3 (_ - t b T�wic�gc -S
Company Affiliation: CT?,L
Mailing Address: 6,38 CR K R 1 DG-E- i'- `1Y11 w4
Telephone Number: 70 � -6 O Fax Number: 704-660- 5 610
E -mail Address: C_6C,5ei4 -c A415 (=* v LJiAJJ5 +rem . Ne-t
Person to receive the Certification Approval: J-, i h 7L:? ' 3c, s
I1. Project Information [15A NCAC 02H .0502(a) & (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,
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=]fa yard stick, shovel handle, etc.)
4. Location of the property (where work is to be conducted)
County! ire -JeA Nearest Town: MaigrGSU�; fle.,,4 C=
Subdivision name -or site address (include phase /lot number),
DAyC-o55f4MR k3y 131 T pP )
Directions to site,- please include road�names and numbers, landmarks, etc::
e,P4" 3,41 V em 4w1 / 56 P� V_O Rd) �
r� t ,
R'- onl �JRM Cro s g i �q • Lt 73A--y -5 A.oY. _4L_ ko op,
5. Describe the existing land use or condition of the site at-the time of this application
(residential, undeveloped, eta): v-es%Ae.al ri'AJ hOr,% _;I Ilam
6. Property size (acres): 1.01(d
7. Lake/ river/ ocean adjacent to property: LA-Kc- Jt(ore+1�+�1
8. Describe proposed,work (includeAiscussion as,to,how hardening of shoreline has been
avoided, or why it is necessary): s1ol2e.. 5A,-- *p cif ivq �or
�iJ�fCSSc� ��vt.I %�OGIL
,9. Will work be�conducted from land? R✓ From water? R
10. Total,amount of disturbance (including all excavation,_backfill, rip rap, retaining•walls, etc.)
below the normal pool lake level/ Normal WaterIevel in square feet or acres:
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 14 S �
12. Please describe the vegetation above the normal pool lake level/ Normal Water Level and
50°feet landward to be ii/mpacted,(nurriber ,-oftrees, for instance):- '�` �`� � ""e-e
cv -A4 5 -1. ill Cl 4 6_W-U4 -S ( ✓ G't - P (.o to 5 , - -
S4 -�
Owner/ . ent's Signature* [15A NCAC 02H .0502(fll Date
`Agent's signature is valid only,if an authorizatiom,letter from the owner is provided.
FORM: SSGP 10 -2013 Page 2�of 3

FL
Norma
SI
Lake
(At Full Pond /Normal Water Level)
�-j
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

DUKE ENERGY DIRECTIONS BY ROAD FORM
Lake Use Permit Applicants and Contractors: Ease of locating the proposed project site
can have a.big impact on,permit processing_ time. Please complete .this form and return it along
with _your completed permit application to:
Duke Energy
CIO LAKE SERVICES - EC 12Q
POI BOX 1006
CHARLOTTE, NC 28201 -1006
1- 800 -443 -5193 and select Option 5
Applicant's Name: Kristin Deberardinis
Street Address (at Lake)_131 Bay Shore Loop.
Lake Name: Norman
Subdivision Name: Bay,Crosing Lot 32
City:_ Mooresville.
State: NC
'Latitude-;-35.6353
Telephone: _610- 574 -1676
County: - Iredell
Zip: 28117
Longitude:_ 80.8984
Directions (from, major "road or highway)i
I -77 North to ezit,36- West on Hwy 150 - right onTerth Rd - Lefton Liva Lane - Rig_ ht on
Bay Crossing Dr - Left,on Bay Shore Loop.
Descriptive Structure (s) on Property (i.e. brick garage, white fence, mobile home, ete.):
131 Bay Shore Loop

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