20221373 Ver 1_401 Application_20221005

6)--- 01- 1
Division of Water Resources
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
15A 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 & Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
I. Applicant Information 115A NCAC 02H .0502(a)]
1. Owner Information
Name: --etzu v i Cv'otik
Mailing Address: 30 (( LocA.kv- (2oS c e. P 12.4.
RECEIVED
OCT - 5 2022
DEQ-WATER RESOURCES
=hit-2 derrt-t!i PERMITTiNO
Telephone Number: 4g-323-70Z I Fax Number: 0JJA
E-mail Address: , 3&C BLOC e, IPA l d kb-
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; Peml is/SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application forrn.
Narne:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
Person to receive the Certification Approval:
Il. 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,
7-2ovide a detailed site plan showing property boundaries and proposed locations of
vegetation clearing, structures (buildings, retaining walls, docks, impervious surfaces,
FORM: SSGP 10-2013 (.t- ep(,..414-0)
Page 1 of 3

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 graph 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) 512 L et h„e h eye- D r
sty: /Y1Q Lp n NearestTown:
Subdivision name or site address (include phase/lot number):. A%d.n -/a- hiea.-
/a»d.s fshf15 Lo/ /0
Dire+c`I!ions to site - please include road names and numbers, landmarks, etc.: Cu ia i dw
G « Tram /r 4 Loa, a ti Rei/JO 4/0"rni/ /6 nc.t,
�
/4. Ri l e ,2I , Be Li-. ah lh oic fir,
59
Latitude PJadecimal degrees) 'Pa -ail kRvtrM Longitude tde deg eesi
S. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): 1 e4 te�lin ��i.c1/
6. Property size (acres): s ,53 AG
7. Lake/ river/ ocean adjacent to property: L 4 tG %`%2 n
Describe proposed work (include discussion as to how hardening of shoreline has been
voided, or why it is necessary):44b L I r zG i .Gini-tr frrvi ,vim 5h 14-0,041.
rip 4-1-6r441 host-WA/6 ^-s' h k. Scru
N 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:
10 2D S f4 o b 61,47 54-L R.4.110• -
1.1. Total amount of disturbance (iluding ail clearing, back tiff, excavation, rip rap, retaining
wails, etc.) above the normal pool lake level/ Normal Water Level and 5O feet land -ward in
square feet or acres: / S-v 0 10 0 0 5 Q P+ -
i2. Please describe the vegetation above the normal pool lake level/ Normal Water Level and
S4 feet landward to be impacted (number of trees, for instance): 7(illdl. lY—ezo 5cm 4�
4-f a4tevpl, h u. tvn r m r it 14 au�rz15 Idwz alre4.1lid /f
fin W et e i c v e-rai /1 t v.e 6 h /445 Q.tin/ 5 h tire_-4�,�
. r am Gv {1.i� 1-6 n-ecI $5 6.01? P Zi`1 f 4J Gr�t'., ?0 J ems.
.$v 007
nes Signature* 1. Date
Agent's signature is valid onty ij an authorization letter from the owner is provided.
FORM: SSGP 10-20t3
02H .0502
Page 2 of 3
w
t YIs1C.- ir4

•
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ft x 100 ft)*: 5--8 FTh( 17 O L Wiest-'i'
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
b. Location of construction access corridors
FORM: SSGP 10-2013 Page 3 of 3

:on County Parcel Information
)USE, BRUCE W
1 LOWER ROSWELL RD
3I ETTA GA 30068
perty Address
LAKE SHORE DR
- 10 NANTAHALA HIGHLANDS ESTATE
Tax ID: TaxID
PIN: 6505804095
Acreage: 0.44
levation: 3041
po Desc: ROLLING
Utilities: W,S
)eed Ref: Y-21/606
ecorded: DATE_RECORDED_STRIt�I�
Ile Price: 360,000
ng Value: $363,270
id Value: $225.000
!ferment: $0
emption:
ed Value: $589,270
ppraisal: 7/26/2017
District: NANTAHALA FIRE DISTRICT
.ownship: NANTAHALA
Zoning:
3division:
borhood: 09020
Disclaimer: The information contained on this page is
taken from aerial mapping, tax mapping,
and public records and is NOT to be
construed or used as a survey or
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I.P.S.
N 445349- E
13.95'
I P.S
N 1423'00' W
22.13
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LEGEND:
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1P.5.. Iron Pln Set
o Fence
-
-FH- o Railroad
o - Iran Pin
O Point
• : Concrete Monument
N/F . Now or Farnnaly
O-MD- Double Meridian Distance.
qwN• er eMMeM
S. 11- I
L Kenneth R. Moore. certify that this
Pled was drawn under my sup.rvNion from
on that athee ratiol preere.an al survey mode under caattedSupervision:
by latitudes and departures 1x '?A.r
that the boundaries not surveyed ore
information contaidicated ned
nBookm
Page _i that this plat .as prep/wed
in accordance with O.S 47-30 as amended.
YRness my aictimol signature.
registration number and seal this ',C^"`"
day Of 1.1.,.i AD 19 4f"
3 : SEK
s L-2739
,t:4a sn,f..i
--
North t..7 Po 111 of t e Co ntY
L o Notary PlBiy that
Ne County RYand State
aforesaid, d L Y that Kenneth Mode.
a Registered L Surveyor. personally
me this day and o ..
the execution the 0' 0na f*f6 Id q instrument.
this s hl1 w and o slang d sod
I. P.F
2900 Contour
This surrey creates a subdio..On of land that is located in a portion or the county that is
unregulated as to ordLwnces thot regulote po.cels of land.
This property Is ncl located within a designoted Rood plain.
This plot is subject to all existing easements and rights -of -ray.
20 fool rood currently under construction.
'2900' cant,. Ines established usner surrey by G.L. Sprnkle on plot recorded in
Register of Deed: Plat Cord 419.
h C Crid Nod, estoaished by saor observations
All distances ore grid
Combined grid factor: 0.999768
Revision 1. 12/3/96 Change Plot Name
9,
IPS.
N
S 84'41'52" W
N.P.& L Co. xis 851302- W
34.61'
Rood Currently
Under Construction
LP
d•
f0 LP S.
8059 75' E
(Nantahala Lake)
N 2612'55" W
13.52'
Qrci.
23O3
Centerline 20' Right-of-way
NUMBER
OIREC110N
DISTANCE
1.36
5 891323- W
16.37'
L37
L38
N 63'32'04" W
N 4208 07" W
20.12'
27.78'
L39
N 442310" W
15.28'
1.40
N 2907'42" W
103.30'
L41
N 4926'00- W
28.95-
L42
N 883349" W
20.99'
L43
N 89'44'13" W
20.86'
L44
N 89'44'13- W
1543
145
N 7025'06" W
24.97'
146
N 515325" W
26.36'
L47
N 31'45'45" W
31258'
1.48
N 1829'34" W
3394'
149
N 132854- W
180.94'
L50
N 1459'44" W
34.04'
L51
N 1216'49" W
28.91'
L52
N 3152'36' W
29.29'
153
N 69'28'28" W
27.47'
L54
N 775228" W
60.84'
L55
N 5322'23' W
36.07'
U.S.A. Tract
200B
9'25" E
N
5 5224'18" E
17 92'
I.P.S.
$ 5218.06- E
44.93
5 8541'S3- W
7598' IPF
NC Grd
I P.S.
S 3708'23' E
10.00'
Lot 5
f
Nantahala Highlands Estates
A Subdivision
Lots 6-10
Nantahala Township....Macon County, N.C.
Deed Book 0-21, Page 135
November 18, 1996
50 0 50 100 150
Scale 1" = 50'
S1uoey and plat by Kenneth R. Moore
Rt. 1 Res 19 Crow Creek Cow
Andrews. N.C. 28001
P S.

Macon County Parcel Information
CROUSE, BRUCE W
3011 LOWER ROSWELL RD
MARIETTA GA 30068
Property Address
592 LAKE SHORE DR
LOT 10 NANTAHALA HIGHLANDS ESTATE
Tax ID: TaxID
PIN: 6505804095
Acreage: 0.44
Elevation: 3041
Topo Desc: ROLLING
Utilities: W,S
Deed Ref: Y-21/606
)ate Recorded: DATE RECORDED_STRING
Sale Price: $60.000
3uilding Value: $363,270
Land Value: $225,000
Deferment: $0
Exemption:
;sessed Value: $589,270
_ast Appraisal: 7/26/2017
Fire District: NANTAHALA FIRE DISTRICT
Township: NANTAHALA
Zoning:
Subdivision:
Neigh borhood: 09020
Disclaimer:
The information contained on this page is
taken from aerial mapping, tax mapping,
and public records and is NOT to be
construed or used as a survey or
'legal description'. Only a licensed
professional land surveyor can legally
determine precise locations,
elevations. length and direction
of a line. and areas.
Orf
1:613
0 0.005 0.01 0.02 mi
t 1 i
i
0 0.0075 0.015 0.03 km
July 18, 2022

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