20140522 Ver 1_Shoreline Stabilization_20140527

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State of North Carolina
'DWR Department of Environment and Natural Resources
Division of Water Resources
Division of Water Resources 1SA NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SSGP 10 -2013
Shoreline Stabilization Application Form
Four copies of the application (including
Division of Water Resources
401 & Buffer Permitting Unit
1650 Mail Service Center
Raleigh, NC 27699 -1650
fee should be sent to:
Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: GEORGE RETTER
Mailing Address. _ 5077 LIGHTHOUSE CT
MORGANTON NC 28655
Telephone Number: 828 - 584 -7680 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 /docs /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
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(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,
PA I D
FORM: SSGP 10 -2013 Page 1 of 4

cl,w��t )��4tK
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) 'SOUTH PC=INTE LOT 91
5077 LIGHTHOUSE CT
Directions to site- please include road names and numbers, landmarks, etc
FROM MORGANTON TAKE HWY 126 / TL ONTO SOUTH POINTE DR /'TR ONTO LIGHTHOUSE
CT / PROPERTY ON THE LEFT
S 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) .74
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)- 95' OF SHORELINE STABILIZATION BY BARGE HEIGHT
WILL BE 2'
9. Will work be conducted from land? ❑ From water? rq
10 Total amount of disturbance (including all excavation „backfill, rip rap, retaining walls, etc F)
below the normal pool lake level/ Normal Water Level in square feet or acres*
V X 95' = 95 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 1' = 95 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
D, A A Auo4 'S
/,2/
0 r /Agent's Signature* [1 -5A CAC 02 0502(f)] Da /e
Agent's signature Is voted only if n of thonzatlon letter from the owner /s provided
FORM SSGP 10 -2013 Page 2 of 3

C1, "Kk�-e�
Lake, 2
At,FuILPond
Full ZPond'
MN EM ME
Shoreline
19� ql
Please approximately sketch the following information on this plan (prov1de d1mensions 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 Page3 of 3

GEORGE & DALE RETTER
_LAKE JAMES
SOUTH POINTE / 91_
To: North Carolina Division of Water Quality
I give Carissa Parker, of Bennick Enterprises,, LLC., permission to sign
as my agent ,on my application for shoreline stabil'i'zation.
Signature (s) ` p bk—,
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George Retter
South Pointe / 91

Lake James
Pisgah National
Forest
George & Dale Retter
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