20150099 Ver 1_Shoreline Stabilization_20150123

* State of North Carolina
D,W--- R Department of Environment and Natural Resources
PAIDDivision 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
401 & Buffer Permitting Unit 2 1 5 0 0 9 9
1617 Mail Service Center
Raleigh, NC 27699 -1617 RECEIVED
I.Applicant Information [15A NCAC 02H .0502(a)] JAN 23 2015
1. Owner Information DENR -LAND QUALITY
Name: STORMWATER PERNII T TING
U/d
Mailing Address:
��71 N l3�ckl��d
_.42
Telephone Number: 4_L L l %_ S5 Fax Number:
E -mail Address:
b, 1, 0
@ Corr► af-_S t, / V �-
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/
readocs /Permits /SAMPLE AGENT AUTHORIZATION FORM.pddf) must be
attached if the Agent has signed this application form.
Name:
Company Affiliation:
Mailing Address:
FORM SSGP 10 -2013 Page 1 of 3

r
Telephone Number:
E -mail Address:
Person to receive the Certification Approval:
Fax Number:
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, 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: J-0c k-'�oYl Nearest Town: b l owhlel M�
Subdivision name or site address (include phase /lot number):
to Po) rot 6A7d i V161 M
Inky bVitte I wf' CuIlowhle-, AJC_ ZS-7Z3
Directions to site - please include road names and numbers, landmarks,
etc.: r U al W avrp {wkd S i'n Cash l e 6, NO-, ±(A4 I 0 m
W11 N6) 1n
mdes
CVDSSInC� over
n2 [a W Wddl ,qtr qW bad 6 e P d J m) I I-or
Latitude (in decimal degrees) 53.148145_ Longitude (decimal
degrees) �� (�� d f r Y' I
� ►�� d I rr road � I o ey '��y�� � ►�► , . �(
FORM SSGP 0 -2013 lot t [rib Page 2 of 4
�f� S�I�d�v�SiDn 60 q1V)�vv6h oho

of gcnm,; <<rnhn u�d --� FbI(m �mt Yoo -rD -n►e wf of �re,
m061,5 (o -v-r, Tow r[�hr Wo L_ &e 13rf ae_ Dk W6
5. Describe the existing land use or condition of the site at the time of this
application (residential, undeveloped, etc.):
w oY6 v1A1H,, 1 S C 1mrwnu uo d ow-1 opeA A-- 0 (me is 40 '1
6. Property size (acres):
1015 Acas
be �u, I+ PyDPu"�
7. Lake/ river/ ocean adjacent to property:
Goy lc e- F Ian vi l e t
8. Describe proposed work (include discussion as to how hardening of
shoreline has been avoided, or why it is necessary):
�t WW4 f i Ve b 1d Cod f hep wad I a Ind jps D(z�,
�� ��� -way ► y✓�u lal h,� l � � s! -�b)1 � ze -rv�e s��Y� i � i�
9. Will work be conducted from land? From water? IA/ CGS
0Ur 0l6 VI 117 f0 C01 6� apt Corn S�c�100 7nYl1YYl 0 nab
1 ota mount o destur anc (inc ud ng alIY'erxck'vtaItfiA &kfill, rep rap,
retaining walls, etc.) below the normal pool lake level/ Normal Water Level
in square feet or acres: f
l-i d e S M.- 2 6 os,+L
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:
�a\�IMGr,bP 4 )D' X CAS / = 650 S23t
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): ,
. J)
lr)
0A
oylt oleo IL)W ( 1 c o«vv-,,4Y�) 7Ytv- .
&A— /- 14�1 - /5--
U
Owner /Agent's Signature* [15A NCAC 02H .0502(f)l Date
Lake
(At Full Pond/ Normal Water Level)

q(o k u
L PDwn2) ��k
L lei. re� ate. llo 6J
LD1
bay
I�?�
m
�LSt✓v
/V i c

`,t_Z0,

vP � I��'tPX.� C r �rD�3PJ SL's- �.►0 -1 � (07 TAT W I �G
- friar, w� helyt�t 7 8 - F'ee.�
GENERAL NOTE V \\
BOUNDARY INFORMATION SHOWN IS FROM RECORDED PLAT
LAKE GLENVILLE
LEGEND
36 "pine size & type tree
tb top of bank a ° ''o\
bb bottom of bank \
dl ditch line
gs spot elevation
epr edge paved road y w \ ­PROJECT ENCHMARK — TOP OF NPL MONUMENT 2673
03� ��ND y \ o\ ��ELEVATION 31 10 00' NPL DATUM
(L� T(L3GTt Prtc r S 1
�.e U
o
\ \\
\ \ \ �°' \ � •Ira �
\
i
\�
_ TOPOGRAPHIC MAP
/ 346A ft .a� S5 a
" di �,�e -y — BILL OLSEN
f
v 1 JENNA OLSEN
LOT 7, GLEN POINTE
HAMBURG TOWNSHIP, JACKSON COUNTY NORTH CAROLINA
o \ \ '<{\ I�� JULY 3D, 2013 SCALE 1' - 20•
\, ®3422 -DATE OF SURVEY - JULY 2073
f, x "9 PREPARED BY
W. EDWARD HALL L
\ e \ o MAILING ADDRESS OFFICE LOCATION
a4av_� I �`�� � O P O BOX 2004 13 yyE�I1L��LLIG,pHTNIMMNppGLU� LTTAgqNI���E
CASHIERS, NORTH CAROLINA OFF ('%%rCOMMUNITY ROAD
• ,lie�w \ \tea `v1 9faaa 28717 TEL - 828 - 743 -9836
EMAIL - edhailplsOgma lcom
REVISED - 7 -31 -2013 -ADD BENCHMARK d: LEGEND
"P 0 ECT BENCHMARK — TOP OF # 4 REBAR FOUND
ELEVATION — 3204 36' NPL DATUM ��N CA R04,,
20 0 20 40 80 L -Me
\ GRAPHIC BCALS - FM
3422REV

All
IV row
4f 1 8 .... I .
64
-Mad
. .. ...... ...
Q�05;7,
Elk-\

1/14/2015 1261 - 2791 Lake Breeze Dr, Cullowhee, NC 28723 Directions, Location and Map I MapQuest
Notes
mapquest'
Map of:
[261 - 279] Lake Breeze Dr
Cullowhee, NC 28723 -6676
Mountain
O
4
J
0
NortOrt
p
� �� Gashiars• r_
11n il�pquast ' o r
2000m
62015 MapOuest - Portions 02015 TofllTom I IELmfl 1 ftA
4=5 MapQuest, Inc. Use of directions and maps is subject b the MapQuest Terms of Use. We make no guarantee of the accuracy of their content, road conditions or route usability.
YOU spume alt risk of use. View Terms of Use
4,
http: / /www.mapquest.corr/ print ?a=app.core.b 17469dc51 d6799ac02bff32 1/1

1/14/2015
Lake Qleeze Dr
Cullowhee, NC 28723
Explore this area
Search nearby
f Tiaffic.Dicycliny.Terram
C
fi iaS
.14S
rj
r
Directions Save
Lake Breeze Dr - Google Maps
p4(
Norton Creek
noevil Media O ,
Fi—I en
IniS Map data 02015Google
RECEIVED
JAN 2 3 2015
DENR -LAND QUALITY
STORMWKFER PERMITTING
11�
b
Q
https:llwww.google.com / mapslpiace/ Lake +Breeze+Dr,+Cullowhee, +NC+ 28713 / @35 .159304,- 83.15038,16zldata =!4m2 !3m 1 ! 1 sOx88591 a31660dcO25:Ox... 1/1

till' ►
, �
/*
-Will
• }�� ;� �'
t,
�-
� �•� � "fir la�
1 df.
K _ r
s 4