20150098 Ver 1_Shoreline Stabilization_20150123

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
— � 1SA NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
Division of Water Resources FORM: SSGP 10 -2013
Shoreline Stabilization Application Form
` ,A PW
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 2 0 1 5 0 0 9 8
I. Applicant Information 115A NCAC 02H .0502(a))
1. Owner Information
Name: Gary Gamble - War Horse Ranch, LLC
Mailing Address: 462 Mangrove Court
Lake Mary, FL 32746
Telephone Number: 407 - 333 -1602 Fax Number: NA
E -mail Address: aary @worhorseranch.net
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: William L. Owen
Company Affiliation: Owen Grading
Mailing Address: 1407 Wolf Mountain Road RECEIVED
Tuckasegee, NC 28783
Telephone Number: 828 -507 -0655 Fax Number: NA JAN 2 3 2015
E -mail Address: owengrading @gmail.com DENR -LAND QUALITY
Person to receive the Certification Approval: William L Owen STORMWATER PERiVIITTING
11. Project Information [15A NCAC 02H .0502(a) & (b)J
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,
etc.), rip rap, excavation or dredging below Full Pond/ Normal Water Level elevations,
FORM- SSGP 10 -2013 Page 1 of 3

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, NC
Subdivision name or site address (include phase /lot number): Pin no. 7564 -22 -0497 &
7564 -22 -2493
Directions to site - please include road names and numbers, landmarks, etc.: From Cashiers
north on Hwy. 107, turn left onto Norton Road at Blue Ridge School. Continue on Norton
Road approx. 2 miles Turn right onto Fenley forest Road. Continue for approx. 3 miles until
you come to the end of the state - maintained road. Turn right onto Fenley Road. Continue
approx. 1 mile until you come to Highhala Subdivision. Lots 68 and 6C are on the right.
Latitude (in decimal degrees) 35.169854 Longitude (decimal degrees) - 83.142737
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): residential
6. Property size (acres): 1.90
7. Lake/ river/ ocean adjacent to property: Lake Glenville
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Shoreline stabilization because shoreline is eroding.
9. Will work be conducted from land? X❑ 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: 2400 sq. ft.
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: 5500 sq. ft.
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): Cleared lot with
pproximately 5 trees.
Owner /Agent's Signature* [15A NCAC 02H .0502(f)]
January 17, 2015
Date
FORM: SSGP 10 -2013 Page 2 of 3

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To William Owen. Owen Grading
From: Gary Gamble
Date: January 15, 201
Subject- Agent Authorization Letter
William. you have my approval to act as my agent regarding.
• Signing application materials related to Duke Energy's shoreline stabilization permits
• Signing application materials related to DEN -R's Division of Water Qualit, permits for
lake and reservoir activities.
L
Oary Gamble