20140536 Ver 1_Shoreline Stabilization_20140527

DUKE POWER LAKE MANAGEMENT, EC12 -Q
P O BOX 1006 2 0 1 4 0 5 3 6
CHARLOTTE, NC 28201 -1006
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
A Name
B Mailing Address
C Telephone
Location of Proposed P
A Lake
B
C
D
Street Address
I v w I l r %\ U \Gl
County �rc cic G�
City, Town, Community or Landmark
E Section A prSe 3 Lot # (p ` Subdivision Si, ,S 6 V-e—
F Directions to property by road —=7 7 7 /4, ex;k Wo ,j row, /I So.,
9 �- /
e l� 8 (cc c ri c V p.. L--+( .a YW C,b ws V. L1-o At
Vic- ol' LKH
G Latitude and longitude for the project site 35.612 -a5 1 000. g 6 6 b
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
A Length of wall
B Material
f
15
�Q F7i t-1 J S -'o rJ
C Distance from property line /shoreline Uq -, C( .9 f to ci ex i 5 T.%,vq 3 k V, C_ hPJ t.
IV Intended Use of Project Area
A Private X
B Commercial
V. Applicant Signature _ Date "5—�_ 1- I
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 Cyndt
Karoly, PARKVIEW BLDG, 2321 CRABTREE BLVD, RALEIGH, NC 17604, PHONE 919 - 733 -1786

M
State of North Carolina
Department of Environment and Natural Resources
Division 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
1650 Mail Service Center
Raleigh, NC 27699 -1650
I. Applicant Information [15A NCAC 02H 0502(a)]
1 Owner Information IR A ti f Al 4 ev—
Name S i 54 e.r�j (Lo-'►e' OJ� i \J, W
Mailing Address: '? n —6n X %(DE)
Telephone Number 10 o I - c -10 Fax / N// umber: 7OE 973 - '786.5
E -mail Address lr /Y,f, l-A6u1e- 5 - C6
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
Name- }
Company Affiliation:
must be attached if the Agent has signed this application form
m e-s
Mailing Address. PO /3 ox ,39(.S
00 re--s v 1/e, At C .2-9/17
Telephone Number 7c#-a'W -;-70F1 Fax Number. -7O5r-- `j7j - 7 65
E -mail Address I?M;IlGre Ke541i o m e s . for►.
Person to receive the Certification Approval RYAd %Ki 11 c v-
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,
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- a yard stick, shovel handle, etc.)
4 Location of the property (where work is to be conducted)!
County � Cc4 �A e.(( Nearest Town. I �t ODY'cS ,
✓ c <� /v L
Subdivision name or site address (include phase /lot number): S;57�rs nry,
�-o X01 d as-c 3
Directions to site - please include road names and numbers, landmarks, etc -T-7%
e-A f./ o^l �w / So f<7- o&! /�lw
5 Describe the existing land use or condition of th site at the time of this application
(residential, undeveloped, etc.): Y65;dc.471*
6 Property size (acres)
7. ke iver/ ocean adjacent to property.
orM 4 A
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): 541-�'Are. A,0,rc✓cA(171_ C,rosi onl
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
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. /l.51 X /
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): ►" �3S
Owne /Agent's Signature'
`Agent's re is valid
1 �!r A 1 �j 'ao►y
Date
an authorization letter from the owner is provided
FORM SSGP 10 -2013 Page 2 of 3

Full Pond/
Normal Water Level
= I= I= am s
Shoreline
I ( 6-6oJe_
Lake
(At Full Pond/ Normal Water Level)
t
•e s e� P O o o �• 9 �'' o•
0
m C O Q iii ! e e C o % o 0
Uzz KIM III
qCU'�5
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
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: Sisters Cove of LKN LLC_(Ryan Miller)
Street Address (at Lake) 156 Pinto Rd
Lake Name: Norman
Subdivision Name: Sisters Cove Lot 61
Tax Parcel ID (if known): 4648562727
City: Mooresville County Iredell
State: NC Zip: 28117,
Latitude: 35.6225 Longitude: 80.8666
Telephone: 704 -- 530 -4607
Directions from 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 -11th lot on left.
Descriptive Structures (s) on Property ( i.e. brick garage, white fence, mobile home, etc.):
156 Pinto Rd

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