20150123 Ver 1_Shoreline Stabilization_20150129

2 0 1 5 0 1 2 3
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
Division of Water Resources FORM: SSGP 10 -2013
Shoreline Stabilization Application Form
Four copies of the application (including attachments) and the application fee should be sent to:
Division of Water Resources
401 & Buffer Permitting Unit
1650 Mail Service Center � D
Raleigh, NC 27699 -1650 .JAN 2 9'2Y015 I i
I. Applicant Information [15A NCAC 02H .0502(a)]
1 Owner Information
Name Sclry-, 7 Mailing Address- 0 1,2i0 4 1L-1-1 r- 0rne1 ;v5, N
Telephone Number 704 90� 0335 Fax Number.
E -mail Address �rAr�niP c c•{,�rr,l�4. r� •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 pd f) must be attached if the Agent has signed this application form.
Name ('h,n gc,'J LS - (✓ �` 5 +00Q 4- RECVC(ee
Company Affiliation 011) n p r
Mailing Address (g X Ong r" r Ip.rnn y t/
Clef PS \1 1 (P /UL 1 /C5
Telephone Number 701/ -lVo 0 - 61 I I Fax Number
E -mail Address C.h P se of t,-)ex Is a tAj, a J Is + tea ri e-+
Person to receive the Certification Approval kelp
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 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 /' lec Ue- n�yrn Nearest Town
Subdivision name or site address (include phase /lot number) the Pen <�I rn
19,205 J uin 1Ja (h,)u(- Rd . Lo o- & 13
Directions to site - please include road names and numbers, landmarks, etc I� +. v✓1� -o
nn +o SQ 0QAYC. S I_A 1 . R4 o n 4-o
Le n4o LaLL)LZ Q1
5 Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc) P � ; d en ,J
6. Property size (acres)* C Ll �-) 5 re-,
7. Lake/ river/ ocean adjacent to property Mof rq-" o. C\
8 Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary) �?00 ' C .0/iU n C P d horA.04 r' C', P Co, p
9. Will work be conducted from land? ❑ From water? 21,
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
,.ADO ' X Z
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)
Some J ea �Ack4 -, v ,-t
�7
Owner /Agent's Signature* [15 NCAC 02H .0502(f)l D to
Agent's signature is valid only ►f an authorization letter from the owner is provided
FORM SSGP 10 -2013 Page 2 of 3

DON ALLEN & ASSOCIATES , P A
D#S
"Since 1971"
Commercial * Residential * Mortgage Surveys * Multi —Family
Construction Staking * Subdivision Design * Topographical
131 Crosslake Park Drive — Suite 102 * Mooresville * NC * 28117
(704) 664 -7029 (704) 664 -8041 Fax
I, certify that this map was drawn under my supervision from an actual
survey made under my supervision recorded in deed book 24030 , page 285 and /or
plat book 51 , page 655 , that the ratio of precision is 1' 10,000, that this map
was prepared in accordance with the General Statutes of North Carolina Chapter 89C
my hand and seal on the _ 18 day of DECEMBER A D 20, 14Lti1�1�
FLAT SHOALS Qr WILLIAA M a$LL I f �
DRIVE o A. 1_3409
SITE = o
�
O'
N C HWY 73
VICINITY MAP NO SCALE LAKE
NORdfAN
0 n 1_2 go
760 CONTOUR
LINE
�J�E `761 CONTOUR \ \�
LOT 618 (FLOOD LING) +\
�� 0 4458 AC
OF 50 SETBACK
j� I i�FROM PROPERTY LINE
n SATEUTE DISH \
11 ENCROACHES \�\
WALL -j
ENCROACHES \
LOT 617
CHRISTOPHER C BENNETT 6 mti�
23156 \471 7�
01 °I PROP Pm
m m
v V) 8.0 y4'C0 �Q'j $p
1
17'
� 3
S
/h �B
al LagR C2 oa REBAR LOT 619
HWAI —JIUAN LAI
10035 \246
POWER Box O
10 9 5 aR A)
S Z 4 REBAR #4 REBAR
TOWN HARBOUR RD
(50' PUBLIC R \W)
1� \
PK NAIL r -� �� £ \���
NOTES F
1) THIS PROPERTY MAY BE SUBJECT TO
ANY EASEMENT AND /OR RIGHTS —OF —WAY \ 0' 20' 40 100'
OF RECORD
2) AREA COMPUTED BY THE COORDINATE
METHOD \
3) EXISTING 760 & 761' CONTOUR ELEV— SCALE IN FEET
ATION BASED ON LAKE NORMAN LAKE
LEVEL AT COWAN S FORD DAM (READING LEGEND
ON 11/13/14 ) ELEVATION- 7571' 4 REBAR
4) UNDERGROUND POWER E] = POWER TRANS
5 NO 0 FE MONUMENT FOUND WITHIN BOUNDARY f PLOT PLAN SURVEY
2000 FEET E I P = EXISTING IRON FOUND
6) SETBACKS PER PLAT VERIFY SETBACKS I P S = &4 REBAR SET
BEFORE CONSTRUCTION OF
18205 TOWN HARBOR ROAD R/W = RIGHT —OF —WAY
LOT 618 THE PENINSULA PHASE XVII CP = COMPUTED POINT
SCALE 1„ — 40' LEMLEY TWSP , MECKLENBURG CO., N C FILE. PENININSULALA 618
ACQUIRED BY JMR PROPERTIES, LLC TAX TAX MAP NO- 00I81130
CURVE TABLE
CURVE
RADIUS
LENGTH
BEARING
CHORD
C1
55 00'
10 03'
S 28'57'18" E
10 01'
C2
55 DO'
45 33'
S 57'47'16" E
44 06'
LINE TABLE
LINE
BEARING
LENGTH
1_1
S 72'53'50" E
28 60'
1_2
N 82 47'27" W
38 25'
1_3
S 77'01'04° W
14 25'
1_4
N 66'09'18" W
37 44'
1_5
N 34'03'53" W
59 28'
1_6
N 15'50'10" E
22 87'

Ft
Norma
SI
Lake
(At Full Pond/ Normal Water Level)
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ft x 100 ft) *:
1. All proposed vegetation clearing
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.
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