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Home My WebLink About20150241 Ver 1_Shoreline Stabilization_2015030320150241 Shoreline Stabilization Application Form Three copies of the application (including attachments) and the applieatioPfee�k should be sent to: Division of Water Resources 401 & Buffer Permitting Unit a INAU 1617 Mail Service Center D Raleigh, NC 27699 -1617 MAR 0 3 2015 DENR -WATER RESOURCES • Applicant Information [15A NCAC 02H .0502(a)] 401 & BUFFER PERMITTING 1. Owner Information Name: O,\ 7V1)a/�t�� Mailing Address: 323 Od ]-Reba on ICJ - CAiacloik ! A/.( 2.!&2 ?3 Telephone Number: 704 -309- 25,59 Fax Number. E -mail Address d0vl (? CI'lo,004e. corv\ 2 Agent/ Contact Person Information A signed and dated copy of the Agent Authorization letter (a form can be downloaded here htt) / /www saw usace armv mil/ Portals /59 /docs /reculatory /re2docs /Permits /SAMPL E AGENT AUTHORIZATION FORM pdf) must be attached if the Agent has signed this application form. Name IZant.Q y C1 a -is o✓1 Company Affiliation- �(tu,)srNYS 11,e a'V �i E 0-M41-at LM 1j I Mailing Address: 5-605 ZJ - Cooed $.0 2q -j 10 1 V Telephone Number: X03 - �s3 i - fs31 to Fax Number 'S-c-3- fs3 ►- S�SS E -mail Address Person to receive the Certification Approval. 0 V1 Tr1cLy4san • 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. • 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. • Attach a photograph of the shoreline/ buffer proposed to be stabilized. (Include a scale of some sort- a yard stick, shovel handle, etc.) • Location of the property (where work is to be conducted) County- 4-,^ Nearest Town: Subdivision name ude phase /lot number): I /VC Directions to site - please include road names and numbers, landmarks, etc.: Latitude (in deamol degrees)_3 S L I Q /1 0 . Jrg w f4 Longitude (deamol degrees) I ° nail +, Q�� I/V • Describe the existing land use or condition of the site at the time of this application (residential, undeveloped, etc ). f e ri • Property size (acres): . 6-%G I`l C f eS • Lake/ river/ ocean adjacent to property: k e- 2 • Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or why it is necessary) 6 s«„ ; n je, c -/ r &s ZAP._ W% l/1 t l'QLISr 19 rod-e- A �/ ✓ • Will work be conducted from land? ys From water? • Total amount of disturbance (including all excavation, backfill, rip rap, retaining walls, etc.) below the normal pool lake level/ Normal Water Level i 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: ¢xca✓at"Rj =7 . 0` /sf,f/. 12 Please describe the vegetation abov the normal pool lake level/ ormal Water Level and 50 feet landward to be impacted (number of trees, for Instance): /lyc� /2 -i-r�5 /d'� fo 1y �'n �:w.s,ct•.d — %yNe t�. i'� S /b� Ask V _ l��►" Owner /Agent's Signature` [15A NCAC 02H 0502(f)l Date ;Agent's signature is valid only if an authorization letter from the owner is provided 01 �P a Ij 3 r g,) &) OL I( Vt"'CK_ 3' Shde 3 df 4 � Office Theme v - Please approximately sketch the following information on this plan (provide dimensions for each item, such as 10 ft x 100 ft) *: • All proposed vegetation clearing • Location of rip rap or fill to be placed above the Full Pond / Normal Water Level elevation • Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation • Location of any proposed structures such as buildings, retaining walls, docks, etc. • Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation 3" - Home Insert - Design «nwtaUans _ Slide Show Renew View Lasertiche i J Lai out - ri it P3S.e ^� ijtw slide- 7 Delete "` : - �•. _r .4_ u- '� -� ,z r- y 1 1 i } G i. `1o3fd PI ag-BVR 'Q a� - ` Lake (At Full Pond/ Normal Water Level) �P a Ij 3 r g,) &) OL I( Vt"'CK_ 3' Shde 3 df 4 � Office Theme v - Please approximately sketch the following information on this plan (provide dimensions for each item, such as 10 ft x 100 ft) *: • All proposed vegetation clearing • Location of rip rap or fill to be placed above the Full Pond / Normal Water Level elevation • Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation • Location of any proposed structures such as buildings, retaining walls, docks, etc. • Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation • Location of construction access corridors SAMPLE AGENT AUTHORIZATION FORM PROPERTY LEGAL DESCRIPTION: LOT NO. I ) PLAN NO. PARCEL ID: 111 ' / • / Please print: Property Owner: Property Owner: The undersigned, registered property owners of the above noted property, do hereby authorize / , 4- , , (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 Address (if different than property above): Telephone: 7v y - 0 9 - 09- 5 5g We hereby certify the above information submitted in this application is true and accurate to the best of our knowledge. AFAho zed Signatur,6 Authorized Signature Date: I - a - / 5 Date: Drivmg Directions from 3990 Charlotte Hwy, Clover, South Carolina 29710 to 1041 Peninsula Dr, Belmont, .. Pagel of 2 }4 I T map rV Trip to. 1041 Peninsula Dr Belmont, NC 28012 -8678 7.84 miles / 11 minutes Estimated Fuel Cost $.64 Notes OYL buy (9 3990 Charlotte Hwy, Clover, SC 29710 -8083 1 Start out going northwest on Charlotte Hwy / SC-49 toward Blucher Cir. g2 7 1 2 Turn right onto Highway 274 / SC -274 i�,1aa 2 7 $j 7 3. Tum slight right onto Pole Branch Rd / SC -279 (Crossing into North Carolina) Map 79 4 Pole Branch Rd / SC -279 becomes NC -279 / S New Hope Rd. Mlap 73 5. Tum right onto Lower Armstrong Rd / NC -273 � q 41 6 Turn left onto Peninsula Dr ftra,n 7 1041 PENINSULA DR is on the left Ma 1041 Peninsula Dr, Belmont, NC 28012 -8678 http- / /www mapquest.com/prmt ?a =app core cafccb4eObcf8062526563e4 Download Free App 2.6 Mi 0.9 Mi 1.9 Mi 0.9 Mi 1.2 Mi 0.2 Mi ? /l ?nnl5 THIS IS TO CERTIFY THAT ON THE 21 DAY OF November 20_ 4 AN ACTUAL SURVEY WAS DONE UNDER MY SUPERVISION OF THE PROPERTY SHOWN HEREON- THIS MAP IS NOT KFMDED TO MEET GS 4750 RECORDING REQUIREMENTS. 1-85 E»aT SIGNED Bishop Land Surveying, inc_ 10719 Trolley Run Dr. z Comefius. N.C_ 25031 �, Phone: (704) 634 -9356 E;�� 9 Business License #: G2674 vlamry map 1 s s�vtf�� LEGEND /j� j,� �.I�,. n 50 Ell E147M lONM 1 j : n W L:u r<at�oC 1ApwMLKpRAWR .V c ^c n,TF Fio n +-,,G k G d�l ��- RaAIEFSr.{{rtSY LGEicrcc �IfSiT ` rSDE ILEnGSTORNp4Na EAWWW \f1, PA07ERTYLliE6 CtO:E EtU ny CO:FOi1ATE 9fX'NOI"m L' -D.USI Exems :. mw C' MmAPP9OMMATE FULL POW OONTOUR OF 5794i Y FU= OONTOMI FRE -WL4 M FAE. FU= G1EMN 8XV,V, % +l (FeMA PANEL F37103WWJ QA7E¢SMIKWn .a VDM81.D t �a\ ,ir o ' L o 7 f4; lam. Le � nr" _ L8 I UNE TABLE I LINE I LENGTH I BEARING I Ll 23.12 -43.3 -E L2 65 4 Ns3ISWE L3 1 31.03 N41WI3 -E LOT 10 wa.awr9E,nA"jw GLu . mCwfus* E LOT 11 2U74 SO- FT. 0.576 ACRES I :I I "1 rvld Ddif '�z. I �• 9e 19.9 I I I I n'05 �:1] P01161 iq0 29.E I 11 I- --- - - - - - -_ . 7 5ca,r� .s op C�w1,�lca Qom �CCGsS Qi LOT 12 wetrn+rtDErE�Tirtma mcs. PDSu PENINSULA DRIVE —Illy, V-) .Pa1AEC w Ate, Plot Plan SURVEY OF Lot 11, Lakepoint Subdivision SCALE 1". 40' Southpoint Twsp., Gaston County, N.C. THE PROPERTY OF Spain Construction, Inc. MAP RECORDED IN BOOK 77 AT PAGE 35 DEED RECORDED IN BOOK 43664 PAGES 512 FIIEC:"nd Proje=Zaston COurdyldwg'JJlkgU&u LB.Wg Drawn By: RGS prof ;i4R7 umow G- ; Ar S C xi- �101 N ri opilillill T f� k 1 1t a C T Ar S C xi- �101 N ri opilillill T f� k 1 1t a C ti - -- - -4 Tg tw 4k QL WA IjLn' 2 'o ^4g% lops ✓ Al� jwikq Uhl ;0&; LQ1. oil. IL pool Ad tw. Pift S& Ps LQ1. oil. IL pool Ad tw. This area is 7' to 8' tall and undermined soil QQ: R 41 Ly A,4 Wwa Nm Sv� vs . . . . . . . . . . . . . . . '"!S-14WR9 : 17 k%Q*hxvqv_m M, FT:r-t �-- � - -r :aw q u A 17 7W V ipj q u A 17 • •� .epi 3' . �, ai'1S -� ' . , ,r ' ••� _ _ •—� 4 • • LL__xYyy�Y '� t_ . t ;; 'P` •�, lbw` ••.� i O .Q .. - :i.:- i�' - �- � Y}�F.. kms.-• IA! al N I 46 -c AWS IA! al N I 46 N I 46 —.. qy,•a .5 �..� �- �—�.,,,��'- rsl �. `,---� \`y` -r rr�.i..¢..... 1 �!*,�?��•�y�r,�>,l$sZ �-' �. � �. itJ Of44 1�r `OAK ._ _ .- - a• + � � ,r �a � iii '•!r = ✓-� %u A� At. z�.�• f,f Jit 7.Li . ,�; c 71. VO - SFR r � � � _ ' � � � - '�.� �'^�-�' - � •.. i• i i` �tr/��'_ � "� � ''� -p • `� � i• �� ,Rif ,� x - • - . _k ,`• -� i f ..� frb Fr� 1 e , v 4� o Y k. U ►6 '4 � : ��; ':. arM } - 4io, 3 r U kip D FjL