20141299 Ver 1_Shoreline Stabilization_20141218

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
DEC 1 8 2014
i d
DENT. - , "u" - m. ,ES 1
L Applicant Information [15A NCAC 02H 0502(a)]
1 Owner Information
Name The Kathleen L Halldin Trust, agreement dated October 4, 2007, (Kathleen L Halldin
Trustee )
Mailing Address 1116 Eastin Ave _
urlando, FI 32804
Telephone Number J407) 492 -0383 Fax Number (321- 732 -3294)
E -mail Address i` athall9(c Aol corn
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 pdf) roust be attached if the Agent has signed this application form
Name Mark Cassels
Company Affiliation None
Mailing Address 826 Lo\\er< Lane
Frruiklrn_ NC 28732
Telephone Number J328)342 -4706 Fax Number None
L -frail Address casselsl @hotmail com
Person to receive the certification Approval Mark Cassels
H. Project Information [15A NCAC 02H 0502(a) & (b)]
I 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 cleat ing, strop cures (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 Jackson Nearest Town Cashiers
Subdivision name or site address (include phase /lot number)
108 Gunpoint Road, C1,1110Rhee. NC 28723. Lot 7A
Deed recorded in Book 944 Page 609 Jackson County Registry
Directions to site - please include road names and numbers, landmarks, etc From 107/04
intersection head north , +­, ards SN Ira Turn left on North Norton at Blue ROW HS Turn
rraht on FiPA Forest Road and ! o approN 2 rrules Afier see siM for Mountam Too's Lake
Club the load cur Nes left Almost immediately see atree with the Gunpoint sign on it Turn
right dowii this dirt road Address #108 is last house at the bottom on nght
Latitude (in decimal degrees) N 89 °08'00" E Longitude (decimal degrees) S 34'25'13 "" W
5 Describe the existing la id use or condition of Lhe site at the time of this application
(residential, undeveloped, etc ) Residential
6 Property size (acres) 99 Acres
7 Lake / river/ ocean adjacent to property Lake Glenville
R Describe proposed wort: (include discussion as to how hardening of shoreline has been.
avoided, or why it is necessary) Sea Wall addition to stop drastic erosion on site
9 Will tnrorf, be conductec: from land? V/ From water? ❑
10 Total amount of disturt ante (including all excavation, backfill, rip rap, retaining walls, etc )
below the normal poop lake level/ Normal Water Level in square feet or acres
11 Total amount of disturbance (including all clearing, backfill, excavation, rip rap, retaining
walls, etc ) above the normal pool lake level/ Normal Water Level and 50 feet land -ward in
S j-
square feet or acres _A55
i2 Please describe the ver r, -ation above the normal pool lake level/ Normal Water Level and
50 feet landward to be impacted (number of trees, for instance) lac , �J e--
%;\r\, w r a.��— 09/25/2014
Owner /Agent's Signature` j15A. NCAC 02H 0502(f)l Date
Page 2 of 3
FORM SSGP 10 -201? g

'Agent's signature Is valid only if an authorization letterfrom the owner is provided
-_ Lake -
(At roll Pond /Normal Water Level)
�� iZae 0)4" sj } p pit "045
Full Pond]�..„��km��.r
Normal Water Level -"
Shoreline
I
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ftx 100 jt)*
MOMS —1 All proposed vegetation clearing
Ho o r.. —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
Not4F - 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

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION
LOT NO 7A
REFERENCE DEED Deed Book 944,Page 609
PIN # 7564 -20 -7226
STREET ADDRESS 108 Gunpoint Road
Cullowhee, NC 28723
PLEASE PRINT
Property Owner Kathleen L HalldmTrust, (Kathleen L Halldm, Trustee)
The undersigned, registered property owners of the above noted property, do hereby authorize
roll
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached
Property Owner's Mailing Address (if different than property above)
1116 Eastin Ave
Orlando, F132804
Telephone [phone]
We hereby certify the above information submitted in this application is true and accurate
Kathleen L Halldm, Trustee

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