20140967 Ver 1_401 Application_20140914

DUKE POWER LAKE MANAGEMENT, EC12 -Q
P. O. BOX 1006 !1�1 1
CHARLOTTE, NC 28201 -1006 ��oo�L /�I ` 1
704- 382 -1567 OR TOLL FREE 1- 800 - 443 -5193 �1
�_)Wt
APPLICATION FOR PERMIT TO STABILIZE THE SHORELINE IN NORTH
CAROLINA
Please type or print and fill in all blanks. If information i§ o a able, so indicate by placing NIA in
blank. PLEASE SUBMIT APPLICATION AND APPROPRIW POWER FILING FEE, PAYABLE
TO DUKE POWER, TO ABOVE ADDRESS.
. 2 0 1 4 0 9 6 7
I. Applicant Information (I 1 / �/
A. Name R �� t e_v- cl , 151- v-S 6 ✓t o f Li°t /�, LL-C-
0'
B. Mailing Address P o 3 ux �j �+~ 5 Al U pYe SV t E / /� [ �L�( / %
C. Telephone 76- 11 _ -P-0 - 2- 76 9
II. Location of Proposed Project
A. Lake ►�DY VYl fill
B. Street Address 1 {`j f S 5 4,3 R4
C. County e
D. City, Town, Community or Landmark -(- E I l\J L
E. Section dl"c- `j Lot # S Subdivision 5 I S C r5 CO V, c-,
F. Directions to property by road —r—r -7 Il , f W Ohl yV 5 D
+ + cAf L+c,v Pier
G. Latitude and longitude for the project site � 5, (1)4z 5 I gG , 5� 4,4
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 "LaULong ", click map)
III. Description of Project
A. Length of wall
B. Material
I` f [A S>*' 1%1 C
C. Distance from property line /shoreline Lo U (-
IV. Intended Use of Project Area
A. Private X
B. Commercial
V. Applicant Signature
PLEASE NOTE THE FOLLOWING:
iS T e��v'q �P1.d1��rN�
Date - a-0 1q_
• 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

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Division of Water Resources 15A.NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
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
Name: R g A-,y 1\4 11, Ley- � D ::St5 ✓-5 6 ✓'G 0
Mailing Address:
r%ko oY-C s \I � Lite Al C ill 7
9,A/ LL-e-
Telephone, Number: 74 Fax, Number:,-7y�- r `�73— M65
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 / /www saw usace army.mil/ Portals /59 /dots /regulatory /regdocs /Permits /SAMPLE AGENT AUTH
ORIZATION FORM pd f) must be attached if the Agent has signed this application form.
Name: rhits RY -M9t4
Company Affiliatio .
Mailing Address:
CrS C
-239 O/]- rl'Clq c Ft+--o-x 14!:�j
M Do resvi l /e N f .28'115
Telephone Number: �D ©5111
E -mail Address: C SPA
Person to receive the Certification Approval
FaxNumber:
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: � cje__C Nearest Town: Moo,r -e5 yi 1 �c r�L
Subdivision name or site address (incl de phase /lot number):
S =5I rs
Directions to site - please include road names and numbers, landmarks, etc.:
_�r-77 ri i 3 6 IA o -Al 4wi 150 fie#v 8f ut c f-el
L'(-,D N (-a r-nre__ f-;_Lt_5 _ . , Leo Al ` / i'•/ .; !W
5. Describe the existing land use or condition of'th�(site at the tij, �ne of this a placation
(residential, undeveloped, etc.): V e5 �� e-riT, i l.C.i�IXe�e'�'
6. Property size (acres): Q 1 S 79
7. Lake/ river/ ocean adjacent,to property: e- Nov-m,+,&1
8. Describe proposed work (include discussion as to how hardening of s horeline has been
avoided, or why it is necessary): 57(AhkI'j -Ze-- 4 rT ye>✓I-fX @S io Al
9. Will work be conducted from land? 101" From water? R
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'50feet land -ward in
square feet or acres: 1 i x / 1�1 _5
12. Please describe the vegetation above the normal pool lake level/ Normal Water Level and
'50 feet landward to be impacted (number of tree ,for instance):
Aeby- -4c
Owner /Agent's Signature* [15A NCAC 02H .0502(f)l Date
Agent's signature is valid only if an authorization letter from the owner is provided.
FORM SSGP 10 -2013 Page 2 of 3

No
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ft x 1 00, t) *a
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 Applicants arid 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 — EC-12Q
P O Box 1006
Charlotte, NC 28201 -1006
1- 800 -443 -5193 and select Option 5
Applicant's Name :_Ryan Miller — Sisters Cove
Street Address (at Lake) 114 Pinto Rd (Twin,,Sisters Lane)
Lake �Narne: Norman
Subdivision ,Name:_Sisters Cove Lot -53
Tax Parcel ID (if known): 4648575699
City:_Mooresville County Iredell,
State: NC Zip: 28117
Latitude: 35.6225 Longitude: 80.8666
Telephone:, 704- 201 -2708
Directions from major road or highway):
177 North to EXIT 36 — West on Hwy 150 right on Bluefield Rd — Left on Cornelius Rd — Left on
Pinto Rd
Desciptive Structures (s) on Property (i.e. brick garage, white fence, mobile home, etc.):
Vacant lot

114 Pinto Rd - Google Maps
114 Pinto Rd
Mooresville, NC 28117 Directions Save
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