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Home My WebLink About20150102 Ver 1_Shoreline Stabilization_20150126State of North Carolina Department of Environment and Natural Resources DWRDivision of Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization Division of Water Resources 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 PAS 401 & Buffer Permitting Unit 2 0 1 5 0 1 02 1617 Mail Service Center Raleigh, NC 27699 -1617 0 I. Applicant Information [15A NCAC 02H 0502(a1] JAN 2 6 2015 � 1 Owner Information DENR.yygrER Name. Bobby & Susan Miller 4p� & BUFF ERPEM,NG Mailing Address: 1200 Clodfelter Road Winston Salem, NC 27107 -8836 Telephone Number: 336- 362 -3342 Fax Number: E -mail Address rtmiller44 @aol.com, slcmillerl2 @aol.com 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 /Permits /SAMPLE AGENT AUTH ORIZATION FORM pdf) must be attached if the Agent has signed this application form. Name: Company Affiliation Mailing Address- Telephone Number, Fax Number: E -mail Address. Person to receive the Certification Approval: 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 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 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 66/2! Nearest Town. /Vol wz) Subdivision name or site address (include phase /lot number)- Directions to site - please include road name/and numbers, landmarks, etc ka 1A o;W/ 1/r� l " hf AWAId &A B /,v o QDqe 7eIC �i LaiSe J /ems Latitude i I et erees) LJ5. 27.375 degrees) p , 697178 3 5 Describe the existing land use or co dition ole site at the ti %e of this applica�t/ipn (residential, undeveloped, etc.): T7� lC/�Ui /v 6. Property size (acres)- %/ ACR63 7 Lake/ river/ ocean adjacent to property• 8. Describe proposed work (include discussion as to how hardening of shoreli e has been avoided, or why it is necessary) ts�d �>�f�� /N� / (��11 /d�l 9 Will work be conducted from land? [d 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. 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 50 feet land -ward in square feet or acres 12. 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) Owner /Agent's Signature* [15A NCAC 02H 0502(f)] Date *Agent's signature Is valid only If an authorization letter from the owner Is provided FORM SSGP 10 -2013 Page 2 of 3 M cl 9 r\j 0 rt Ptb A n I OA, fi W 0 01 , OV, C) C-) ox IV rn vi 0) C) ut r.f. j-n 100, 4-12 C31- Suzanne W I owdei, Register of Deeds Stanly County,, N'C,, REAL. EsrAl I- EXCISE TAX $594 00 tll lllllllllllltllllllllkt.l l NORTH CAROLINA :b0.1.Dj`1-100 XV.L GENERAL WARRAN f Y DEED Ae Excise 1 ax %S91 Recording rune, l3ool< and Page Tax Map No 651501266524 Parcel Identifier No 37937 Mail after recoi<hng to Robett and Susan Millet, 1200 Clodfelter Rd , Winston - Salem, NC 27107 This instrument was prepared by Robett W Odom, Attoiney at Law, P0 Box 159, Albemarle, NC 28002 -0159 I I IIS DEED made this 5 clay of —September_, 2014 by and between – -- GRANIOR EUGCWA7 ER DEVEA,01'hRS, INC. A Not th Car olnia Cot pot atiou P O. llo\ 4127, Wil,imgum, NC 28403 - - -- -- - - - - - -- GRAN I'0C ROBLR1 I' MILLLR and wife, SUSAN C MILLER 1200 Ciodfeiter Rd., Wnistoa- Salem, NC 27107 The designation Gi,intot and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and shall include singular, pII-Rol, masculine, fominine or neuter as required by context WI1 NESSETI I, th,it the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby acknowledged, liw, and by these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that certain lot or parcel of bind and more particularly described as follows Being all of Lot 40 of Edgewater on Lake Tillery, as shown In Plat Book 20, page 236, Stanly County Registry, to which reference is made for a more completo legal description. The above•desciibod lot Is subject to rostrictive covenants as shown in Master Declaration of Covenants, ConchUons and Restrictions for Edgewater on Lake Tillery, recorded in Book 1250, page 81, Stanly County Registry The abovo- des<,ribod lot is also subject to easement to Time Warner Entertainment for installation and maintenance of service for video, Internet and tolophone service as shown in Book 1259, page 344, Stanly County Registry. f Rt�fR,rf` 1' 7i r' 717.� ti 717.� ti • R.R. S : ............... A7 Rse Le_ St ............. B8 R -leigh Ct ............. F2 Randeils Church Rd ....... B6 Randalls Ferry Rd ......... B6 Ravenwood Rd .......... B5 Red Oak Ct ............. 04 Reid Or ............... 04 Richardson Rd ........... E8 River Loop ............. C4 River Ed ........ D4. D5, F2 C r Riverside Rd .......... C4 Riverview Tr . .......... C6 Riverview L7 .......... D7 .......... AB ......... C4 ......... 04 -__._ :.. ........... C6 Roxboro u; .......... 0� Roy Or ...............: _ Rush Loco ........ . Russe0s Viav ............ v i Samantha St ............ CS Sapona Trace ........... A6 Scenic Or .............. A2 Seven Oaks Or ........... 05 Shagbark Ct ............ C5 Shelby Ct .............. E2 Shinn St .............. A7 Shore Farm Or ........... B5 Singlewood Rd ........... B5 Skyland Ct ............. C4 Skyland Or ............. D4 Sleepy Hollow Ln ......... 04 Snuggs Rd ............. A6 South Strand Or .......... B7 Southmcuit Or .......... C7 Spri- . ;Nr;d ?d .......... D7 Stony Hill Rd ........ A3, 63 Stony Mountain Rd ........ B3 Story St ............... A7 Sugar Loaf Shores Or ...... 02 Summit Ct ............. E2 Summit Rd ............. A7 01 Sunset Ct .............. C5 C8 Sunset St .............. A8 C7 Swanee Rd ............. E2 B7 Swift Island Rd .......... C4 D3 Sycamore Rd ............ CB 03 C3 r F6 A7 E2 k. LAM'ii i ,3 t �TOWIV 9 X10 -J OCR' cia N F-- � SC DR. Rp v SWGC C i CLODFEI �� Z J '¢ G ;RROWIHEgO \ C � r 18 RgNDAL cc D N �d CH& CT '•, , (1 III 141, �a Y= OV O w0 , \ D A �b u - i Jy, o 2)) 0890 Fr f i .."Y ^ w \ \ O M8 Il ✓ Z i l . m C. I 1 0, ;00 04 �l p? �� Dp czm 40� 1 rDno I oN" A mil_ l ' -s Z j ^NZ cnrn Nv _ \ 0- (;:d �1 D W 0 T O Y ti \.. I D rm DO Z nm� NC \\ �sA A A p m N O O 0 O �\ \\ r D \ 2 s Z m 7\ r D Z0 O U O D _H Z FRE:LIMINARY 0 FU' CONSTRUCnCN Scale: I•• =30• '` Chambers Engineering, PA u6 N:,:m E;,n s. m. —w.-U.— Q, N-EL66M,.. L-1. N 0:660 Lot 40 Proposed Boat House Edgewater onlake Tillery Slanly County, North Carolina Sheet 1 Dale: JAN 15 Drawn By: ss Checked By: 7m