20140464 Ver 1_More Info Received_20140521

State of North Carolina
V 11W& Department of Environment and Natural Resources
DWKDivision 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 vv
1650 Mail Service Center MAY 2 1 2W4
Raleigh, NC 27699 -1650
I. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
2.
11.
1.
2.
Name: Stephen Locke
Mailing Address: 8237 Brightwater Lane
Denver NC 28037
Telephone Number: 252 - 940 -9007 Fax Number: N/A
E -mail Address: [e-mail]
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 /S9 /does /regulatory /regdocs /Permits /SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: Shannon Miller
Company Affiliation: Owner LAKE NORMAN DREDGING
Mailing Address: PO BOX 3156
Mooresville NC 28117
Telephone Number: 704 - 664 -1010 Fax Number: 704 - 664 -6232
E -mail Address: geodredgelarson(@gmaii.com
Person to receive the Certification Approval: Mickey Larson/ Office Manager
Project Information [15A NCAC 02H .0502(a) & (b)]
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.
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,
Page 1 of 4
FQRM: 55GP 10-2013

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: Lincoln Nearest Town: Denver
Subdivision name or site address (include phase /lot number): 8237 Brightwater Lane
Denver NC 28037
Directions to site - please include road names and numbers, landmarks, etc.:
see map included
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Residential Refresh Rip /Rap fill in areas that are bare
and thin
6. Property size (acres): 0.69
7. Lake/ river/ ocean adjacent to property: Lake Norman
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Refresh Rip Rap due to bare spots high traffic area
prone to scour from wind and wave driven swell.
9. Will work be conducted from land? ❑From water? PI WORK DONE BY BARGE
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:
525 sq feet
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: 350 -sq feet
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): Zero since all work done
by barge
L 4/18/14
Owner /Agent s Signature` [15A NCAC 02H .0502(f)] Date
'Agent's signature is valid only if an authorization letter from the owner is provided.
Page 2 of 3
FORM: SSGP 10 -2013

Sullivan, Shelton
Subject: FW: shoreline info
From: Mickey Larson [mailto:geodredgelarson (cbgmail.com]
Sent: Wednesday, May 07, 2014 4:03 PM
To: Sullivan, Shelton
Subject: Re: shoreline info
Thanks SO much! I look forward to workifig with you! :) Attatched is a picture for Locke
On Wed, May 7, 2014 at 4:00 PM, Sullivan, Shelton <[e-mail]> wrote:
Mickey,

Full Pond/
Normal Water Level
Shoreline
La ke
(At Full Pond/ Normal water Level)
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�,qve � -iilin Ql'eaS
Iym 'ti1 iii
ref-re sheck
I I q5I .
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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 paced above the Full Pond/ Norma! 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.
S. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
Lo � Page 3 of 3
FORM: SSGP 10 -2013

Four copies of complete applications (with attachments) needed. See
http: / /portal.ncdenr.or /g6yeb /wq /swp /ws /401 /certsandpennits /apply /forms for information. Send any additional
pictures on projects we may have in house via email.
My contact info below.
Thanks
Shelton Sullivan
401 & Buffer Permitting Unit
NCDENR I Division of Water Resources I Water Quality Permitting Section
1650 Mail Service Center, Raleigh, NC 27699 -1650
Phone: [phone] Fax: [phone]
Email: shelton.sullivan @n.cdenr.gov
Website: http: / /portal.ncdenr.org/web /wq /swp /ws /webscape
E -mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to
third parties
`A Please consider the environment before printing this email.