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r-0- State of North Carolina
Department of Environmen and Natural Resources
M0 ion of Water Resources
Water Resources 15A NCAC 02H .0500 — Water Quality Certification; Shoreline Stabilization
ENVFRpNMENTAi QUALITY FORM: SSGP 02-2017
Please approximately sketch the following information on this plan andlprovide dimensions for
ranch item:
a. All pra
used vegetation clearing
b. Location
of rip rap or fill to be placed above the Full Pond/ NormaI
Water Level elevation
c. Location
of rip rap or fill to be placed below the Full Pond/ Normal
Water Level elevation
d. Lccati
n of any proposed structures such as buildings, retaining w
Ils, docks, etc.
e. Locati
n of any excavation or dredging below the Full Pond/ Nor
al Water Level elevation
Lake
(At Full Pond/ Normal Water Level)
rMlMI,
40
Full Pond/ ftormalrRV
Shoreline
PIanlVie
75-/
FORM: 55GP 02-20171 1 Page 1 of 3

71 1
ZKd �I
ex b� U e "U
Fa iR
(At Full A01
w -
Side Vi%-=- V
Full Pon di yNorm aI Water evvel
2 ft. x 15L1 R.
gddl(lonel dering
' H necessary
1
E
Plan View
L-
Lake
(At Full Pond/ H«,nai werer u I) Existing Dock
i Xn%7n
Riprap
3nxlso
'g�ipW iWl HWC �
4R%150
A—hlly HWC
AMPLE
FORM: 5SGP 02-20�7 1 Page 2 of 3