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Home My WebLink About20221041 Ver 1_Riparian Buffer Authorization_20220728 (2) ./ ' NA' D 2@goygo ROY COOPER iiiiit° \€.Governor ELIZABETH S.BISER ` '" a JUL 2022 � Secretary *e,k o!„ ' DENR•WATER RESOURCES • TRANSPORTATION PERMITTING UNIT RICHARD E.ROGERS,JR. Director NORTH CAROLINA Environmental Quality State of North Carolina Department of Environment Quality Division of Water Resources 15A NCAC 02H.0500—Water Quality Certification,Shoreline Stabilization FORM: SSGP 04-2022 Shoreline Stabilization Application Form complete copy *��'op A 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 For electronic submittals, please see the Shoreline Stabilization Application Form. For GP80 Applicants Only: Additional requirements for 401 Certification Applications have resulted from the reinstatement of the Trump Administration's Clean Water Act Section 401 Certification Rule [40 C.F.R.Section 121.4(a)and 121.5(b)(7), and (c)(5)].This rule requires that 401 applicants request a pre-filing meeting at least 30 days prior to submitting their 401 application. In turn,the Federal Rule requires that applicants include documentation of their pre-filing meeting request in their 401 Certification application. DWR has developed a Pre-Filing Meeting Request email address to accept the federally required pre-filing meeting request. Click here:401PreFile@ncdenr.gov to send your request. In response, you will be emailed a confirmation receipt of submittal.This confirmation receipt email must then be submitted with your PCN application. All 401 applications received after April 6, 2022 that do not have documentation that a pre-filing meeting request was submitted at least 30 days prior to submittal of a 401 Certification application will be returned as incomplete.Additional information regarding the pre-filing meeting requirement may be found here: https://deq,nc.gov/about/divisions/water-resources/water- quality-permitting/401-buffer-permitting/application-forms-help-documents.The EPA has also posted a Q&A document on their CWA Section 401 Certification webpage for more information Attach documentation of Pre-Filing Meeting Request to this application. Date of Pre-Filing Meeting Request: / / (required) DWR ID# Version (if applicable) North Carolina Department ol'linvironmental Quality I Division or Water Resources 512 North Salisbun Street 11617 Mail Sen ice Center I Raleigh,North Carolina 277699-1617 — 91 o.7immoo n',:,,I,;6.nrof Emlrtrm<nsi rwk% /1 A. Applicant Information [15A NCAC 02H .0502(a)] 1. Owner Information Name: havS1eL i QVINC B Mailing Address: )-100Fj IsLaWC. T`NRive Co le-L.1os k 1,tc D.4b031 Telephone Number: 315.3fl-04d0- Fax Number: — E-mail Address: date i,e( .-e -^a(aq i 1 ,(Am ) cill..i.a tde@ 3rn 1 •C,o l 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.armv.mil/Portals/59/docs/rel;ulatory/regdocs/Permits/SAMPLE AGENT AUTH ORIZATION FORM.pdf) Name: Company Affiliation: Mailing Address: Telephone Number: Fax Number: E-mail Address: B. 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, 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. 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: Meck.Le1.031)i.G Nearest Town: Ct)lZNet.11,S Lake/river/ocean adjacent to property: 141D2L4aKi Property size (acres): .220 Acxze Subdivision name or site address(include phase/lot number): A.(OOFj i'Las4D Qp- lRiVe,Ol)Fzl le-L 1 tic - Ltd- �z I Dirgget�t''oz,�n to site�l,e,r�ase incl der d names and numbers landmar, etc.: ,tVv1 i } SI�;-^� _{ 1 eJ to 1 yk t.41 c�T6 irw-c4 to t2s--r,keep�" � `o kiro t3l..3Nb f'v eQ-r 1)9. U U 11( LzpT'. Latitude(in decimal degrees)3 .0195D-0 Longitude(decimal degrees)D.. ':15-1D-10 North Carolina Department of Guvironmental Quality I Division of Water Resources DQ1 512 NorthaUSi Salisbury Strut 1161 7 Mail Service Center I Raleigh.North Carolina 2 7699-1 6 1 7_E 919 7Q OsvaNnunt of Em^awarsnta!Itu.'\ 5. Describe the existing land use or condition of the site at the time of this application(residential, undeveloped, etc.): , -[' _- 1 x i TI 4G HT>me 6. Describe proposed work(include discussion as to how hardening of shoreline has been avoided,or `why it is necessary): 'CDKISIR)CT b VI/Cb►„ p /4 ) w I L-t_. CoV CIA ' —PC ams wl I u�toc LJJ� Ti ,-� w I 1 1,1 `RA) Lt se. —see 4TTAcQe0��c`TK. . 7. Will work be conducted from land? IY1 From water? 0 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: 1pO : _ _ . _.--- - Temporary impacts in square feet: Dr) •=3FTetA?OI1Z4 9. Total amount of impacts above the normal pool lake level/Normal Water Level and 50 feet land- ward Permanent irripacts(including back fill,excavation, rip rap, retaining walls,etc.) in square feet: 100 SF. OFTe2AakS-eis r Temporary impacts(temporary clearing,construction corridor) in square feet: C)t) SF T Pap :t 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): .1-1t4e Needles I GC Re—Re-ri bs1 I kIG• \a 1-L- ` 121/7.2a1712.1YeeiZriciL 11. Signature By signing below, I,as the project proponent,certify to the following: • The project proponent hereby certifies that all information contained herein is true, accurate, and complete to the best of my knowledge and belief • 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 (C-D1.-----q 7 /22/ 2a Owner/Agent's Signature" [15A NCAC 02 . 2(f)] Date *Agent's signature is valid only if an authorization letter from the owner is provided. 12. Please approximately sketch the following information on this plan and provide dimensions for each item: a. All proposed vegetation clearing North Carolina Department of Environmental Quality 1 Division of Water Resources Q� 512 North71179�si(t Salisbury Street I 1617 Mail Service Center I Raleigh.North Carolina 27699-1617_E d 919 a�oxonuilm fnnmmxoW ew;\ /✓ 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) IDS gx6r114(I 1 Full Pond/ Normal Water Level _ ammNMIMN1® 1! NMI MIN Shoreline 4 `"`, - i_ i.D\lee try, Com*F0T--re ''CIC.-► iErALDO& WJ -It VVia Ex is rota(-^ •r X_S1- ;4kaif. fir 1klTD.1=ic Plan View Lake IAt full Pond/Normal Water Level) Existing Dock 30 ftx 7 ft •s••••::••••:•1 a e.� Betowfull pond/Null. Full Pond/Normal Water Level•0•�.o.P..��.�./ 1� a .r a.r ar r•aar f`�1t..�.r r r 'f—s`• -^►'fit. �horerne Lai�r`_ik ••. an;15 fc 2 ft.a 150 R t�'ttg a 'r� Fa: .; Above full Pond/NM etddttooalclearing ' •if necessary Amp E r E Plan View North Carolina Department of Environmental Quality I Division of Water Resources DE Q'J 512 North Salisbury Street 11617 Mail Service Center I Raleigh,North Carolina 27699-1617 , 919.707.9000 N Lake L„ (At Full Pond/Normal Water Level) 03 ?V) TS c Side View \ 1 /A_____ tL North Carolina Department of Environmental Quality I Division of Water Resources 512 North Salisbury Street 11617 Mail Service Center I Raleigh,North Carolina 2 7699-1 6 1 7 919.7079000 neorm.mt a Enwarown.1 4us.\ /"" it � � 1 East - Point Dr. Island Fo Drive VICINITY MAP (not to LEGEND RAN- OF SB-SETBACK CP - CALCULATED POINT AC -AIR CONDITIONER The 760' Elevation Lake Contour Follows Seawal 100+1 Froadnne Per FEMA Panel #3710483400 K, Dated: March 2, 2009 Curve C1 Lake Norman Radius 50.00' Additional Tract Conveyed In Deed Bk. 7063, pg. 121 N 59'59'24" E 70.61' NOW OR FORMERLY Philip M. Sobo *at Deed Bk. 6914, Pg. 770 Parcel ID #00111101 Mecklenburg Co. Registry N tift — — CP Cp • r - -"Lot #42 • — --Parcel ID *00111102 9595.08 30' Lake Buifer-. 0.220 ACf Cov. Timber Arc 64.46' I De Well Island Forest Drive 50' Pubtc RW L R. Sun Dyer, certify that this Nat was damn Linde-myeupervisloa San an actual survey made under my supervision (deed description recorded In Boor 32912, papa 89, Ma): that Ind boundaries not eutvsyed ore Beady ia:waled m drawn from in i:m lan found in Soo( Na, page Nq Mel 0e ratio of predslon an wkldated exceeds 1:10,000: end met this map meets the requirements for The Meseaids of Practice for. Land Surveying in North Carolina (21 NCAC 58.1800). 1Mtrless my original signatse, registration number and seal this 8th day ofApril, AD. 0. R. ScotDyer, PLS A4444 DRAWN BY: 5. Kinsey DATE: April 3. 2020 NLS NO.: 19046 SCALE: 1' = 30' HAG 773.2 Chord Beadna 83'2927" W IAA L)a)C—Avf `cs 11 ?ekiT 1-a v/I N ipo Lowe -s $1L_Ly :,`t CJ4-e-l9 CP '\Y '1 Ile k p 2' PIPE ERLY Renee C.NOW OR Kosofsky & Husband Damon K. Deed Bk. 32046, Pg. 430 Parcel ID #00111103 Mecklenburg Co. Registry Impervious Area House - 2669.47 of Concrete - 897.00 sf Mechanical - 24.79 sf Stucco wall - 22.49 sf Sea Wall -132.34 sf TOTAL - 3746.09 sf Max. Allowable Impervious Area = 7676.06 sf NOTES: 'Deed Reference - Deed Bk. 32912 Pg. 85 Daniel Emcee 8 Spouse Quincy Sena Dated August 17, 2018 Recorded in Mecklenburg Co. Registry Map Reference - Island Forest Dated October, 1885 Map Sk. 12, Pg, 341 Recorded In Mecklenburg Co. Registry Performed by Keith R. Moen, Surveyor • Property subject to recorded and unrecorded right of ways. easements end agreements as may appear. NORSTAR LAND SURVEYING, INC 552-8 Newell Street NW Concord, NC 28025 Ph 704 721 6651 Fax 704 721 6653 Firm Lie # C-2294 Daniel & Quincy Eassa 21005 Island Forest Drive Cfty of Cornelius Mecklenburg County, NC Polaris 3G Map — Mecklenburg County, North Carolina 21005 Island Forest Drive Date Printed: 7/21/2022 12:03:34 PM •—• . ............... ................... ........ ....... ........ 60 ,•••...... ......... 758 is? 0 0.003).006 0.012 [flit IVIc•ckle u • .r; 762 .• „"/ ; • . • • • , 72 • ' ,.••. ..... 758 754 '^ .......................................... . • , ••• •• •" •••'. 774 ................... 66 ....................... ....• • ........ ..... ..... -760 ........ —772- This map or report is prepared for the inventory of real property within Mecklenburg County and is compiled from recorded deeds, plats, tax maps, surveys, planirnetric maps, and other public records and data. Users of this map or report am hereby notified that the ahrementIoned public primary information sources should be consulted for verification. Mecklenburg County and its mapping contractors assume no legal responsibifity for he Information contained herein. Polaris 3G Map — Mecklenburg County, North Carolina 21005 Island Forest Drive Date Printed: 7/21/2022 12:22:23 PM This map or report is prepared for the inventoryof realproperty within Mecklenburg County and is compiled from recorded deeds, plats, tax maps, surveys, planimetric maps, and other public records and data. Users of this map or report are hereby notified that the aforementioned public primary information sources should be consulted for verification. Mecklenburg County and its mapping contractors assume no legal responsibility for the information contained herein.