20140746 Ver 1_Shoreline Stabilization_20140721

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State of North Carolina
2 0 1 4 0 7 4 6 Ionment and Natural Resources
Division of Water
Resources
Division of Water Resourcl!M NCAC 02H .0500 - Water Quality Certification, Shoreline Stabilization
FORM: SSGP 10 -2013
Shoreline Stabilization Application Form
Three copies of the application (including attachments) and the application fee
should be sent to: - -
Division of Water Resources
401 Et Buffer Permitting Unit 2 1 2614
1617 Mail Service Center JUL
Raleigh, NC 27699 -1617 �vA QuALitY
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1. Applicant Information [_� 5h `02.!'
1. Owner Information
Name: Jeremy Purbrick
Mailing Address: 1950 Yellow Fork Trait
Nebo, NC 28761
Telephone Number: 919 740 2961 Fax Number:
E -mail Address: jcpurbrickCgmail.com
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be
downloaded here: httn.;
clrc = 'A^,' F 4CrtJT 4A r rr� �`s ,yam =�.. ) must be attached if
the Agent has signed this application form.
Name:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E -mail Address:
Person to receive the Certification Approval:
I. Project Information
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/
FORM: SSGP 10 -2013
4
Page 1 of

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: Burke Nearest Town: Morganton
Subdivision name or site address (include phase /lot number): 1780 phase 3
Directions to site - please include road names and numbers, landmarks, etc.: _
K 126 to Carson Drive Left onto Yellow Fork Trail Our home, 1950 is 1 mile,
on the right
Latitude (in dedmat degrees) 35° 44' 28.4"_ Longitude (dedmw degrees) 81 ° 53' 59.1-
5. Describe the existing land use or condition of the site at the time of this
application (residential, undeveloped, etc.): Residential
'6. Property size (acres): 5
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): Shoreline stabilization with rip rap, to
limit erosion from boat traffic.
9: Witt work be conducted from land? No From water? Yes
1D.Totat amount of disturbance (including all excavation, backfitt, rip rap,
retaining walls, etc.) below the normal pool lake level / Normal Water Level in
square feet or acres: 660 To ft
11. Total amount of disturbance (including all clearing, back fil(, excavation, rip
rap, retaining watts, etc.) above the normal pool take level/ Normal Water
Level and 50 feet land -ward in square feet or acres: 660 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): Mixed-pine/deciduous forest. Vegetation to be removed is mostly
leaning second growth pines. We are hoping to preserve two maules at the
water's edee.
Owner Signature [15A N_Q-AC 02H .0502MI Date
FORM: 55GP 10 -2013 Page 2 of

Lake
(At,Fa11,Pond/Norarai plater level)
Full Pond/
Normal Water_ Level I / / / / -- F' x ( 6 S F
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Shoreline
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Please approximately sketch the fottowing -information on this plan (provide
dimensions for each item, such as 10 ft x 100 ft) *:
1. Alt proposed vegetation clearing
2. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Levet
elevation
3. Location of rip rap or fill to be placed below the Futt Pond/ 'Normal Water Level
elevation
4. Location of any;proposed structures such as buildings; retaining watts, docks, etc.
5. Location of any excavation or dredging below the Futt Pond/ Normal Water Level
elevation
6. Location of construction access corridors
FORM: SSGP 10 -2013 Page 3 of
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J. LEE GfzAGG LAKE JAMES CUSTOM HOMES, LLC
CIVIL ENGINEERING AND LAND 5UKVLYING 6793 NC 12G NEDO, NC 28761
1799 WATERFORD WAV VORtANTON, NC 28655
828-438-W47
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