20140357 Ver 1_Shoreline Stabilization_20140410

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State of North Carolina
DWR 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
Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: GERALD GIGON
Mailing Address: 6259 HARD BARGAIN CIRCLE
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APR 1 0 2014
LNR - WATEP. 15UALITY
INDIAN HEAD, MD 20640
Telephone Number: 240- 505 -0594 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 /59/ dots /regulatory /regdocs /Permits /SAMPLE AGENT AUTH
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
EBO NC 28761
Telephone Number: 828- 659 -1000 Fax Number: 828 - 659 -1001
E -mail Address: [e-mail]
Person to receive the Certification Approval: CARISSA PARKER
II. 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,
etc.), rip rap, excavation or dredging below Full Pond/ Normal Water Level elevations,
FORM: SSGP 10 -2013 Page 1 of 4

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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: MORGANTON
Subdivision name or site address, (include phase /lot number): DRY CREEK / 15
1595 OLD DRY CREEK RD
Directions to site - please'include road names and numbers, landmarks, etc.-
FROM MORGANTON TAKE HWY 126 / TL ONTO SOUTH POINTE DR / TR ONTO OLD
DRY CREEK RD 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) 2.16
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) 100' 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'X100' =100SQ 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- 2'X1,00'= 200 SQ FT
12'. Please describe the vegetation above the normal pool fake level/ Normal Water Level and
50 feet landward to be impacted' (number of trees, for instance,): 1 TREE LESS THAN 6,"
AND 1 TREE GREATER THAN 6" WILL BE REMOVED TO COMPLETE THIS PROJECT,. THEY
WILL BE REPLACED INCH FOR INCH, WITH TREES TOTALING THE SAME DIAMETER ANY'
REMAINING DISTURBED AREA'WILL HAVE MULCH APPLIED TO IT
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Owner /Agent's Signature* [15A NCA 02H 0502(f)] Da /e
Agents signature is valid only if an authorization letter from the owner is provided
FORM- SSGP 10 -2013 Page 2 ofT3

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Shore
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 Fall 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

GERALD GIGON
LAKE JAMES_
DRY CREEK-LOT 15
To: North Carofina Division of Water Quality
I give Carissa Parker, of Benni,ck Enterprises, LLC., permission to sign
as my agent on my application for shoreline stabilization.
Si' natures
Date 2.7, /?7 41L / V

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Dry Creek lot 15
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Pisgah Latitude: 35.76245 N
National Longitude: 81.83980 W
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reserved. Tele Atlas and TeleAtlas North America are trademarks of Tele Atlas, Inc. © 2012 by Applied Geographic Solutions. All rights reserved. Portions O Copyright 2012 by Woodall
Publications Corp. All rights reserved.
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Copyright © and (P) 1988 -2012 Microsoft Corporation and /or its suppliers. All rights reserved. http. //www.microsoft com/streets/
Certain mapping and direction data © 2012 NAVTEQ. All rights reserved. The Data for areas of Canada includes Information taken with permission from Canadian authorities, including.
Her Majesty the Queen in Right of Canada, O Queen's Printer for Ontario. NAVTEO and NAVTEQ ON BOARD are trademarks of NAVTEQ. © 2012 Tele Atlas North America, Inc. All rights
reserved. Tele Atlas and TeleAtlas North America are trademarks of Tele Atlas, Inc. © 2012 by Applied Geographic Solutions. All rights reserved. Portions O Copyright 2012 by Woodall
Publications Corp. All rights reserved.