20140533 Ver 1_Shoreline Stabilization_20140527

DUKE POWER LAKE MANAGEMENT, EC12 -Q 4 t1
CHARLOTTE, NC 28201 -1006 40 13 8
704 - 382 -1567 OR TOLL FREE 1- 800 - 443 -5193
APPLICATION FOR PERMIT TO STABILIZE THE SHORELINE IN NORTH
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 j� n 1 1 l- n/ SAM -�f
A. Name) 0.h 1" 1 � 11 c c 5L ,� lYC,'rn'll�D/42 I
B. Mailing Address d 9 -05 rn 00 t �5y , 11t _ \L a16 X"1
C. Telephone '� "alp t a1 CU$
Fc>—x p X11 "3j `T <�b5 0
II. Location of Proposed Project h�AY 2 7 %�)'j
A. Lake
UALITy
B. Street Address > O$ P n�o �� . &n
nch
C. County oo
D. City, Town, Community or Landmark
E. Section A-Se 3 Lot# 59- Subdivision
F. Directions to property by road _1--777 36, W o�J ISO
G. Latitude and longitude for the project site 35.4 2-.7--s 196-9666
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 "Lat/Long ", click map)
III. Description of Project $ PAID
A. Length of wall
B. Material S Ne-
C. Distance from property line /shoreline �� `�oW {,ri.5 ,'nry 5 r .m
IV. Intended Use of Project Area
A. Private X
B. Commercial
V. Applicant Signature Date
PLEASE NOTE THE FOLLOWING:
• 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: 919 - 733 -1786

Lb't �c r add
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
1SA.NCAC 02HAS0&— Water Quality Certification,aShoreline °Stabilization
Division of Water Resources FORM: SSGP 30 -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 Pertnitting Unit
1650 Mail Service Center
Raleigh, NC 27699 -1650
I. Applicant Information 15A NCAC 02H .0502 a ]
V_0^_ a 1. Owner Information R AN M (tV__,,:5 Name: 5�F ff NIL. Mc3_nY-\CA *1C-.. ,.N LL
Mailing Address: V, U . 'no-;t, q lPj
NC_ a$t \1
Telephone Number: -104 301.- al 0$ Fax Number: -I oLk -
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-Hwww.saw.usace.armV. mil / Portals /59 /docs /regulatory /reedocs /Permits /SAMPLE AGENT AUTH
ORIZATION FORM pdf) must be attached if the Agent has signed this application form.
Name: M\ \Vc-r
Company Affiliation:
Mailing Address:
Telephone Number:
E -mail Address:
704 0_'0► -a-10$ Fax Number: 1U4 9-13 -116S
Person to receive the Certification Approval:
II. Project'Information [15A NCAC 02H 0502(aj & (b)]
t
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 toads.
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 scats
of some sort- a yard stick, shovel handle, etc.)
4. Location of the property (where work is to be conducted)
County: -- D- e.66 Nearest Town: �' \ ao Ce'SpV ►lte
Subdivision name or site address (include phase /loft number): 1 fig �1 � r. o a.
(`000 rc K' J � lkc,. 0(- a %(Il �.t27S��S� 5 firs 6 ve-1 ,+sc 3
Directions to site,- please include road names,an numnela n mar s, t .: i.L
- 3 (o W o-ti, r s—o ,� oa/ / modA/
rAf •tisW . , L ®' ;qA"' f9/-
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): deuZAb- 1d 100p►
6. Property size (acres):
7. Lake/ river/ ocean adjacent to property:
B. Describe proposed work (include discussion as to'ho,w hardening of shoreline has been
avoided, or why it is necessary): SAbl�.�e✓SNO�i�% •�!� � bslo
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 levell Normal Water Level in square feet or acres:
Za4 /X :?,- �
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: / �X
12. Please describethe vegetation above the normal pool lake level/ Normal Water Level and
50 feet landward, o be impacted (number of trees, for instance): rtr5s
(',5 ce p.
Signature
'Agen
Date
if an authorization letter from the owner is provided.
FORM SSGP 10 -2013 Page 2 of 3

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Please approximately sketch'the following information on this plan (provide dimensions foreach
item, such as 10 ftx 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

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DUKE ENERGY DIRECTIONS BY ROAD
Lake Use Permit Appicants and contractors: Ease of locating the proposed project site can
have a big impact on permit processing time. Please complete this form and return in along with your
completed permit application to:
Duke Energy
C/O Lake Services — EC12Q
P O Box 1006
Charlotte, NC 28201 -1006
1- 800 -443 -5193 and select Option 5
Applicant's Name: SLFII NC Magnolia Bays JV I.I.C.
Street Address (at Lake)
Lake Name• v
Subdivision, Name:
Tax Parcel ID (if known):
City: Mooresville_
State: NC_
Latitude: 35.11
104 Pinto Rd
_Norman
_Sisters Cove _ Lot-52—
4648576822
County Iredell
Zip: 28117_
1225 Longitude: 80.8666
Telephone: 7,,4-704-530-4607
Directions (tom major road or highway):,
1 -77 North to Exit 36 – West on Hwy 150 - Right on Bluefield Rd - Left on Cornelius Rd –
Left on Pinto Rd - second lot on left.
Descriptive Structures (s) on Property ( i.e. brick garage, white fence, mobile home, etc.):
108 "Pinto Rd

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Directions
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5/22/2014

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