20220848 Ver 1_Shoreline Stabilization_20220627

Shoreline Stabilization Application Form
NORTH CAROLINA
Environmental Quality
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SSGP 10-2013
DRAFT -NOT FOR USE AT THIS TIME
Submission Form
I. Applicant Information [15A NCAC 02H .0502(a)]
Please note: fields marked with a red asterisk * below are required. You will not be able to submit the form until all
mandatory questions are answered.
Primary Contact Email *
[e-mail]
Please provide an email address for payment and requests for more information here.
Pre -Filing Meeting Date Request was 5/20/2022
submitted on: *
Owner Information:
Name: * Scott Palmer
Email: * [e-mail]
Phone Number: [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
9121 Blackstone Drive
Address Line 2
City
Hickory
Postal / Zip Code
76227-1315
State / Province / Region
TX
Country
US
Is there an agent working on the project?* Yes
No
Agent/Consultant Information
Name: * Charlie Washburn
Company Affiliation: * Marine Construction LLC
Email: * [e-mail]

Phone Number:*
Mailing Address:*
[phone]
(xxx)xxx-xxxx
Street Address
PO BOX 6400
Address Line 2
City State / Province / Region
Hickory NC
Postal / Zip Code Country
28603 USA
A signed and dated copy of the Agent Authorization letter:*
Palmer- Agent Authorization Form.pdf 700.06KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name: *
Palmer- Granite Falls
If your project has a formal name please use this. If your project does not have a formal name, please identify your project
by the owner name and proposed activity (Jones Property Access Road, Smith Guest House, etc.) List in parentheses
any other names that have been used to identify the project in the past.
1. Provide 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.*
Upload File
Look up address
Upload Map: Palmer- Directions and GIS.pdf 2.61MB
Latitude:*
35.798000
Longitude: *-81.340000
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, and construction access corridors. You may use the diagram under
section 12.normal pool lake level/normal water level*
Palmer- Scope of Work.pdf 4.7M13
Please use the diagram at the link below:
https://edocs.deq.nc.gov/WaterResources/0/edoc/616616/Shoreline%20Layout.docx
3. Attach a photograph of the shoreline/ buffer proposed to be stabilized. (Include a scale of some sort- a yard
stick, shovel handle, etc.)
Palmer- Property Picture, Survey, and Buffer
Form.pdf
7.79MB
4. Location of the property (where work is to be conducted)
Nearest Town: * Granite Falls
County: * Caldwell
Lake/ river/ ocean adjacent to Lake Hickory
property:

Subdivisions name or site address: *
6151 Plantation Pointe Dr- Plantation Pointe Lot 15
Include phase/lot number
Directions to site: *
Included above.
Please include road names and numbers, landmarks etc.
5. Describe the existing land use or condition of the site at the time of this application: *
residential/ undeveloped
Residential, undeveloped, etc.
6. Property Size 1.01 Acres
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
We plan to stabilize the existing shoreline with riprap due to the current
erosion problem.
8. How will the work be done? *
From Land
From Water
9. Total amount of disturbance below the normal pool lake level/ normal water level: *
(including all clearing, back fill, excavation, rip rap, retaining walls, etc.)
411 sqft
square feet
10. Total amount of disturbance above the normal pool lake level/ normal water level and 50 feet land-
ward: *
(including all clearing, back fill, excavation, rip rap, retaining walls, etc.)
411 sqft
square feet
11. 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)
Scrappy brush and tress. Fourteen trees will be removed but replanted one
for one with native hardwood and will be maintained till maturity.
Sketch:
Application Fee:
Once the application has been accepted. You will need to send a corresponding fee in with the appropriate DWR#. The
application fee is as follows (pursuant to G.S. 143-215.3D):
o $240.00 for impacts to lake (below normal water level) of less than 1 acre
o $570.00 for impacts to lake (below normal water level) of greater or equal to 1 acre
By digitally signing below, I certify that:
o I, the project proponent, hereby certifies that all information contained herein is true, accurate, and complete to the best
of my knowledge and belief
o I, the project proponent, hereby requests that the certifying authority review and take action on this CWA 401
certification request within the applicable reasonable period of time.
o I agree that submission of this Shoreline Stabilization online form is a "transaction" subject to Chapter 66, Article 40 of
the NC General Statutes (the "Uniform Electronic Transactions Act");
o I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes
(the "Uniform Electronic Transactions Act");
o I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
o I intend to electronically sign and submit the Shoreline Stabilization online form.

Full Name:*
Charlie Washburn
Signature:
Submittal Date: 6/22/2022

Initial Review
Is this accepted into the review process?* Yes No
Project Number:* 20220848 Version:* 1
Select Reviewer: * Mitchell Anderson:eads\mlanderson
Select Reviewing Office: Asheville Regional Office - [phone]
Has payment been received?* ( No Payment Needed
C Fee Received
C• Need Fee - send electronic notification
What amount is owed?*
C• $240.00
C $570.00

AGENT AUTHORIZATION FOR
PROPERTY LEGAL DESCRIPTION:
LOT NO: PLAN NO:
PARCEL ID: 1M
STREET ADDRESS:
L0151 PI 'anion Palnle, D(
i tt F Its I^ 9 ra p
Please print:
Property Owner:
Property Owner:
The undersigned, registered property owners of the above noted property,do herebyauthorize
Charlie Washburn ,of Marine Construction LLC
(Contractor/Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of this
permit or certification and any and all standard and special conditions attached.
Property Owners Address(if different than property above):
(Mailing) Ck12. Sktne, DR
Pf fictenc.x, �ti���t � -C)( l(DIL'1
Telephone: (1O ) 12.5-
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Client Signature C�2/
Charlie Washburn
‘//1/e02 2 Qb - 1y a 202Z
Date
Date

1117 Shiloh Church Road,Hickory,NC to 6151 Plantation Pointe Dr-Google Maps 6/14/22,4:29 PM
1117 Shiloh Church Rd
Hickory, NC 28601
t 1. Head southeast toward Shiloh Church Rd
6 s(92 ft)
Take Hubbard Rd and (card Dam Rd to Rocky Mt Rd in
Caldwell County
8 min(4.3 mi)
I"+ 2. Turn right onto Shiloh Church Rd
253 ft
t 3. Continue straight onto Hubbard Rd
1.9 mi
f 4. Continue onto Icard Dam Rd
1.4 mi
E1 5. Turn left onto Petra Mill Rd
0.9 mi
Continue on Rocky Mt Rd. Drive to Plantation Pointe Dr
4 min (1.6 mi)
+1 6. Turn left onto Rocky Mt Rd
1.1 mi
41 7. Turn left onto Lovelady Dr
427 ft
r" 8. Turn right onto Plantation Pointe Dr
8 Destination will be on the right
0.4 mi
6151 Plantation Pointe Dr
Granite Fails, NC 28630
These directions are for planning purposes
only.You may find that construction projects,
traffic,weather,or other events may cause
conditions to differ from the map results,and
you should plan your route accordingly.You
must obey all signs or notices regarding your
route.
https://www.google.com/maps/dir/1117+Shiloh+Church+Road,+Hickory...8851254aac5790c7:Oxb7fb6ab1bd3b747f!2m2!1d-81.340121!2d35.798375 Page 2 of 2

1117 Shiloh Church Road,Hickory,NC to 6151 Plantation Pointe Dr-Google Maps 6/14/22,4:28 PM
e— - -, , t.A——, 1117 Shiloh Church Rd, Hickory, NC 28601 to 6151 Drive 5.9 miles, 11 min
,,,,c) ytk,
Plantation Pointe Dr, Granite Falls, NC 28630
I
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Granada Golf Course e '...
'.' .., Wanhurg Access Area
A
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Players Ridge Golf 9
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biti .4*(10,;'6151 Plantation
Pointe Drive
Loyelady Access Area
Gunpowder Boat Kamp
-11.3irt Gilley Seat,.,,c
,R. Market Basket 9
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LRL
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k nail
gie '
RIVERBEND ta?, '' ' ''..-
Map data©2022 2000 ft 1.- .1
Ia via Hubbard Rd 11 min
1 1 Fastest route now due to traffic 5.9 miles
conditions
Explore 6151 Plantation Pointe Dr
Restaurants Hotels Gas stations Parking Lots More
https://www.google.cornirnaps/dir/1117+Shiloh+Church+Road,+Hickory,...8851254aac5790c7:Oxb7fb6ab1bd3b747f!2m2r1d-81.340121!2d35.798375 Page 1 of 1

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This map is NOT of land survey quality and is NOT suits his for such use.
Owner PALMER SCOTTM Deferred Val $ Caldwell County
PALMER REBECCA R Assessed Val $177,200
9121 BLACKSTONE DR 651
1.5
PROVIDNCE VLG,TX 76227 Ca lc Acreage 1.01045514 0 0.047e 1:5,Q095 0.19 is'
Land Units 1(LT) I r t ! / i r e
Acet Number 174067 Legal Desc BK 2049 PG 1761 YR 2022 ST 414.00 0 0075 o.is 0.3 km
Parcel ID 08147115
NCPIN 3705631604 Plat Ref 00019100415 June 21,2022
Property Addr 6151 PLANTATION POINiE DR

r
State of North Carolina
Department of Environment and Natural Resources
" Division of Water Resources
Water Resources 15A NCAC 02H.0500—Water Quality Certification,Shoreline Stabilization
ENYIRONP!ENTAL QUALITY
FORM: SSGP02-2017
Shoreline Stabilization Application Form
Three copies of the application(including attachments)and the application fee should be sent to:
If sending via US Postal Service If sending via delivery service(UPS,FedEx,etc.)
Paul Wojoski Paul Wojoski
DWR—401&Buffer Permitting Branch DWR—401&Buffer Permitting Branch
1617 Mail Service Center 512 N.Salisbury Street
Raleigh,NC 27699-1617 Raleigh, NC 27604
A. Applicant Information [15A NCAC 02H .0502(a)1
1. Owner Information
Name: SCQ44 P met
Mailing Address: G\21 61aG(sttne DR
Prot/io1ena, \fLC,TX 16721
Telephone Number: 15-725-y33L{Fax Number: Q/A
E-mail Address: pay(Y 2A sr v'\@ c(\o \. Corn
2. Agent/Contact Person Information
A signed and dated copy of the Agent Authorization letter must be attached if the Agent has
signed this application form.(A form can be downloaded here:
http://www.saw.usace.army.mil/Portals/59/docs/regulatoryjregdocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf)
Name: Charlie Washburn
Company Affiliation: Marine Construction LLC
Mailing Address: PO Box 6400
Hickory,NC 28603
Telephone Number: 828-495-3040 Fax Number: N/A
E-mail Address: [e-mail]
B. Project Information [15A NCAC 02i-1.0502(a)&(b)1
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,buildings,retaining walls,docks, impervious surfaces,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.
FORM:SSGP 02-2017 Page 1 of 3

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: COAd.44.AS, Nearest Town: Gsa. t le. Fa115
Lake/river/ocean adjacent to property: Le(ke. H i eko�
Property size(acres): 1. (Q 1
Subdivision name or site address(include phasejlot number):
PIS aio(\ ?cinlre, 1,ok 15
Directions to site-please include road names and numbers,landmarks,etc.:
Included in packet
Latitude(in decimal degrees) .'198 Longitude(decimal degrees)* Ej 1. 340
5. Describe the existing land use or condition of the site at the time of this application
(residential,undeveloped,etc.): Residential t Un lop
sti
6. Describe proposed work(include discussion as to how hardening of shoreline has been
avoided,or why it is necessary): IRK, plan 3 Sk ailez . We, €Xisk nl
,tif\Q, hh" {Trove be T c.0 m. €AOS+on QrObILw
7. Will work be conducted from land? ( From water?
8. Total amount of impacts below the normal pool lake level/Normal Water Level
Permanent impacts(including all excavation,backfill,rip rap,retaining walls,etc.)in square feet:
n sqft
Temporary impacts in square feet:
0 sqft
9. Total amount of impacts above the normal pool lake level/Normal Water Level and 50 feet
land-ward
Permanent imnacts(including back fill,excavation,rip rap,retaining walls,etc.) in square feet:
1,01 1 .5,cgft ..._..�
Temporary impacts(temporary clearing,construction corridor)in square feet:
(Construction corridor= t,gtiLI sqft)
10. 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):
3Cd M hIN,ash and /.5 Pt 4+\Q,n wiU he re)rna\r A huN iwom,kd .
For iLrn Y
cairn no& uooc1s and matn}rnired h<< mc�f-u+ifs
11. Signature JJ
4r T (I) 1114. I742i
Owner/Agent's Signature`j15A NCACO2H.0502(f 1 Date
'Agent's signature is valid only if an authorization letter from the owner is provided.
FORM:SSGP 02-2017 Page 2 of 4

12. Please approximately sketch the following information on this plan and provide dimensions for
each item:
a. All proposed vegetation clearing
b. Location of rip rap or fill to be placed above the Full Pond/Normal Water Level elevation
c. Location of rip rap or fill to be placed below the Full Pond/Normal Water Level elevation
d. Location of any proposed structures such as buildings, retaining walls,docks,etc.
e. Location of any excavation or dredging below the Full Pond/Normal Water Level elevation
Lake
(At Full Pond/Normal Water Level)
i
V51 a
t E �`\ sq,44. &e loit/ANNJL
3f.OP (R`4(my) Sx IN) Kra
s iri+i r .r t• rI xs
�-
Full Pond/ Normal Water a0141,(0(A)"oi rINN40.4/crl�ufsrw,jah,;, aa.4 ,11., i — — M. —
NM
Shoreline / , / 4 / f 4lk Sle#4 4* A/14•
/1'4: X %3 Co�!{.rvG�-�Or.
44., ciAp ' 3 x t37' Arm
X /
bu4. `47[44ff01 W1. /
Plan View Ne..}t(,e- {-(ardVDads a'
Iw4.1.urtl-1r 4
Lake
(At full Pond/Normal Water Level)
Existing Dock
G////30 ft x7 ft
I
ILke�,S.•..,�,����� �.�. 3ftx35oft
r�verk t.�r 8elovfud rood!vioL
( Full Pond/Normalx�Water Level l M*��y t�� _
x "Si reline ESSMWS arts Aso ft
���;�A�� Above full Pond/NWL
2 ft.x150 it ••�SWW •r
additional clearing I
t.if necessary
E .. AM P
Plan View3
FORM:SSGP 02-2017 Page 3 of 4

No cl ,
,......� .� .r ,.i. - ...i ...1.4 r ....... �.-- .... — r..+
t I �er,rttorary 012:x 13.7i,
3Ix131 12"frc
�
e� C,onSF o -
�Jc�-� . Corr,dor
NOUG A1tJL ;�pliN r -rcct- ?hi. or, ?ale, 3 "IF LA A
1•oT.
�4y
w a.Tarit/,..1
r ---v.:A
La •����1r+�;n
Lpondj Norm I Wate`i! '����5%y
'x137 fl-irt ti i��1 • t;� c
oweli•log_ .
NUJ NwL NNip /1 4 f:,, a
c
Side View o
3 ft.below full pond water level 4 ft.above full pond water level 2 ft,additional clearing
if necessary
I I I
- •.
Existing bank ,��
4 y1111
10 ft,bank ��%
height %, 46a
V A
o
Side Vi= ' -f,
�•,
FORM:SSGP 02-2017 Page 4 of 4

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LINE TABLE
LDs
LENGOI
4169
TEARING
CURVE TALC
WSW RAMS
ARC POND 1Ya CHORD
C1
274
2112041.314
574
IF
LIO
w
622
113
1.64
666
61416
00.67
N>9,2004,
55764852
101041150
9996v2
119402290E
4.90436202
N"96902
60.6
6804058964
109.49272
N61„99 E
617
1.18
649
LSO
L21
LC2
L23
31,75
70.74
69.47
6115
SLY
6876
IAt9
1010
ncaNVE
3.,99.E
rrry
104.592
0.40.5,22
5194.141
2.9s.9Y
89.2-52892
247.4.48
Les
LP
L31
La
L33
LSE
.058
24.76
147016172
n99999'E
Nsrrss2
637
La
L"
tce
6.15
21.6
1 40
649
La
LSI
LP
651
213
656
Ls
L.
2.10
6.61
LKz
L60
6.67
4.60
P,
1.73
1.0
1763
6632
EA"
71.4
.114
sus
1.4
66.94
1.19
10.
Rio
6017
229.
06.6
,449
.47
VC SI
494
9067.1
,649
4.9
51.5
1264
a.70
47.44
4507
1.03
69.1,114462
N9y 992
947436-341
.61,,4E
64005.402
N6�96vK
143129.E
5.1027E
67941.4746
57690660
20011617
a6w992
20.494,
81046.20.2
602620502
$0613.372.
1631.690448
0606.00/
mrn56N"
.08056,
9019620.64
64.3409402
TOSteTery
20999809
00696.9E
,rWw
a296v9
Wessever
6.1.6936,
9099E
ca
CO
q
CI0
Cif
C12
C13
CIS
CIO
nt
230.R9
23600
23000
200A0
20000
310.W
aT0.00
40.00
2100
G0.00
e0.0O
6600
60.00
50.0O
25.00
PLANTATION POINTE DRIVE
80VW
.35.76
53627
T20.51
61666
61.02
50.90
� 9S
36650
50.73
V.68
10272
3152
3571
3025
63.32
21.68
sars':sw
5ee90308
STS33.26.81
Ns59'3rw
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smr23w
6702410.8
es xee'2ew
55tsr23w
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s1'sr3rw
smraw
fennel,
N31]4Oew,
N220.T34 0
S3t9P0.r,t
5173
11610
51.55
5676
51.9
8155
38.
scow
21.0E
8063
38.00
35.,9
31213
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11.00
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6p`O� \ � .. ` • LOT 28 I i
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BOOK 19 6-}wd:v..e2DDwa.2fs
PAGES 417 a 417 1353-8°D
:711 :, /3S3.9D7
I
FINAL SUBDNISIDN PUT FOR
PLANTATION POINTE
GRAPHIC SCALE
ai 1 A ..Oq
o •CaLr�, \
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NOTES:
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o
N 1 N 163 0 AN. NE0 RE POKER FS NI 8E PULED 1600020.660.
1.0
W ' Y lT IRON PR1S Al.SET Al ALL PRMGry COOQS
(u POT)
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YR a 08Y89Y612Yws
saw
LOT 40
SEE SHEET 7 OF e
LOT 39
m
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LEGEND:
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07_12-01
REVISED LOR
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NO.
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P.O. BOX 288
STATMALE• NC 28687
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FINAL SUBDIVISION PLAT OF
LOVELADY TOWNSHIP CALDWELL COUNTY NORTH CAROLINA
NCPIN REFERENCE: 3705535816
4
DATE OF SURVEY: MAOVEED 25th,E2000NCE: 10 E 0 F PLAT: MAY 30th, 2001
DRAWN 8Y: SMS DRAWING NUMBER: 00023
PRESENT OWNER:
J P PROPERTY, INC.
OWNERS UNDER CONTRACT:
AFT 10,800 5 KESNTPLACE, SUITTEN 50
CHARLOTTE, NC 28277
( 704 ) 847-6006
SURVEYOR:
GERALD V. GRANT & ASSOCIATES
P.O. BOX 268
STATESVILLE, N.C. 28687
PHONE: [phone]
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PRIVATE ROAD DISCLOSURE STATEMENT
FOR I0 PRIVATE
1. PURPOSES, A.Ad9S Di DOS SUMOVITICH. ARE AMERY
DECLAREDDECLAREDPRNAIE ND SAIL. NOT K AANTA1AED DY THE NC DELT.. TK
NADRTEAPICE CC ILL STREETS AND RODS 0 IRIS SU:6MS. SANA SE
A1SPC ISDITYOTOYw6047 1 ROADSPROPERTY INE 1 70 THE STAAND NDARDS OF Nc@
DDT. SECONDARY ROADS OINCIL IM E ANY PRNATE STREETS DR RINDS
ON RAT IRE INCLUDED DVAL
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REF, aNremme 3SSA FNt
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I, MAID V. GRANT. PROFESSIONAL LAND SURVEYOR. N0. 1593
CERTIFY THAT THIS PUT IS OF A SURVEY THAT CREATES A
SURDMSION OF LAND WITNIN THE AREA OF A COUNTY OR
MUNICIPALITY THAT HAS AN ORDINANCE THAT REGULATES
PARCELS OF LAND.
6I-EL-tmA
GERALD V. G
REGISTERED LAND SURVEYOR N0. 1593
INF�LVIs N TITS SURD.. WILL BE SUMO I1 .0411'. SEPTIC
515106 AND CAMWO. COUNTY WARM SW.
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ALL NEB PORM L06 WILL BE 59240 LINDERRO0.
SW MS ARE SET AT ALL AGPERIY C01005
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SHEET ONE OF EIGHT SHEETS

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: PalCner Cant .. ,IA5 County: Caidwe
Owner: Pat
Print •
Signature
Contractor/agent:Charlie Washburn—Marine Construction LLC L7(4/
Print Signature
The approval is for the purpose and design described in your application. Impacts not indicated in the
application is a violation of the Buffer Rule.Site specific work should be provided in the application.[15A NCAC
02H.0506 and 15A NCAC 02B.0243(8)]
Trees are not allowed to be removed from Zone 1 of the Buffer(within 30 ft of the full pond elevation), unless
approved.Exception,those trees that are severely undermined along the immediate shoreline can be removed.
Minimal shaping and sloping along the immediate shoreline is allowed. [15A NCAC 02B.0243(6)]
Benching and grading in the buffer is not allowed.Excessive disturbance of ground cover. [15A NCAC 02B.0243
(6)]
Beaches,impervious patios,impervious walkways,etc.are not allowed in the buffer unless specifically approved
by the Division. There are limitation on size for decks.[15A NCAC 0213.0243(4)and(6)]
Work to be conducted from land must indicate an access and indicate any trees that are to be removed. The
work corridor should be described.The approved access corridor shall be restored. Staging,spoil,construction
material must be outside the buffer. [15A NCAC 02H.0502 and 15A NCAC 02B.0243 (4),(6), (8)]
Stormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
discharges must be at the natural elevation and discharged prior to entering the buffer directed as diffuse or
sheet flow at non-erosive velocities to the lake, [15A NCAC 02B.0243(5), (6)]
Acknowledgement of Notification
i, paw hereby state that I have been informed of the Catawba Riparian Buffer Rule.
Any work conducted in the buffer, not specifically stated in the application and approved by the Division of
Water Resources (DWR), is a violation and subject to enforcement. Due diligence will be taken such that the
construction will be built within substantial compliance and intent of the 401 Water Quality Certification and
Buffer Rules,the approved plan(s)and specification(s),and other supporting materials.
Signature(owner): -�'�_._.�---_.__� Da#e: 60Y/2,92 2