20230427 Ver 1_Sketch_20230323

Duke Energy Excavation Permit Application Form
FOR DUKE ENERGY USE ONLY
Duke File No.
Application Fee $ Security Deposit $ Check # Date Recv'd Initial'si
Date of Duke Energy Lake Services, applicant and/or contractor on -site inspections Date 3lnitials " e`
Date Final Protection/Avoidance Area Markings Field - Verified
Initials
Approved to Start Work By * : Date
(Print) (Sign)
Date Completion Required Date of Any Approved Extension Initials _
Date Passed Closeout Inspection*
Initials
Any Stop Work Orders or SMG Violations*? (check one) ❑Yes ❑No (If Yes, explain in PART V)
Date Deposit Refunded Initials Date Permit Database Updated Initials
* Forward copy of approved application (all pages, plus any attachments that Duke Energy changed) back to applicant
with Approval Letter and highlight any changes. File copies of Approval and Close-out Checklists and any Stop Work
Orders with application.
Part I. Applicant Information (Please Print)
Name Mathias Jonsson Telephone [phone]
Email address: mionsson500a_gmail.com
Lake Address
234 Clark Cove Rd.
Statesville, NC 28677
Mailing Address (f different)
same as lake address
Contractor Company CBC Stone & Recycling, LLC
Contractor Contact Person Janice Estep
Telephone [phone]
Contractor Email Address: [e-mail]
LAKE LOT INFORMATION
Lake Norman County Iredell City Statesville State .l_ Tax Map No.
Subdivision Old Homestead 1 Lot / Section No. 3 Lot Size o.sos Acres
Duke Energy Page 4 of 13 rev 11/22/21
Excavation Program

Duke Energy Excavation Permit Application Form
Security Deposit Refund Information
The security deposit will be refunded after the excavation permit has expired if no violations of
the approval occurred. The applicant will receive the security depost refund at the mailing
address in Part I unless an alternative recipient is identified.
Send the security deposit to an alternative recipient? (check one) ❑Yes ONo (If Yes,
include name and mailing address below.
Name:
Mailing Address:
Tax ID:
Are there any Co -Applicants*? (check one) ❑Yes Olo (If Yes, include names, street
addresses or lot numbers, pier numbers, phone numbers, and email addresses in Part V —
Additional Information)
* Co -Applicants exist when the proposed work is being done under a single application, will be
performed by a single contractor as one continuous project, and is done to benefit multiple
owners / lease holders of Project -front properties within a single development. There can be no
more than 4 co -applicants in addition to the lead applicant on any application.
Do not continue the application until an on -site inspection has been conducted between a
Duke Energy Lake Representative and the applicant and/or the excavation contractor.
NOTE: Initialling this portion of the application by a Lake Representative in no way
constitutes approval or eminent approval of the excavation or any other lake use permitting
activity.
Date of on -site inspection 5 '7—Z
Initials (Duke Energy) J 12' t (applicant/contractor)
Duke Energy Page 5 of 13 rev I1/22/21
Excavation Program

Duke Energy Excavation Permit Application Form
Part II. Description of Project
A. Basic Information
1. Type of excavation: (check one)
2. Purpose of excavation: (check one)
❑ Water Intake Channel
❑ Other (spec):
3. Lake user category: (check one)
❑Commercial Marina
❑Other (spec):
❑ New excavation 0 Maintenance excavation
® Boat Access Channel
❑ Wastewater Discharge Channel
®Private ❑Residential Marina
❑Public
4. Max. Excavation Area Dimensions (ft): Length 40' Width 20' Depth 4'
(Note: include additional area dimensions if necessary so response to #5 below equals max. area
dimensions in 94)
5. Volume of Excavated Material (TOTAL for the project): 118.51 Cubic yards
6. Type of material removed (applicant determines by field sample it practical):
Dirt/Silt
7. Excavation Site area: 0.073 Acre (s) Disposal Site area: 2.29 Acre
(s)
8. Total Disturbed Area (including equipment staging area): 0.084 Acre (s)
9. Does the project meet the requirements of the applicable General Permit? (check one)
OYes ❑No
10. Do you claim title to the disposal area? (check one) ❑Yes Iallo
11. Do you claim title to the equipment staging area? (check one) OYes ❑No
12. Are there any water -treatment facilities within 50 feet of the proposed excavation area?
(check one) ❑Yes IZNo
(If Yes, spec):
13. How will the excavated material be entrapped and the erosion controlled? (e.g. see attached
erosion control plan and disposal area design):
Dredge by barge, haul material out by land and take by dump truck to disposal site located at 638 Oakridge Farm Hwy. Mooresville, NC 28115
Duke Energy Page 6 of 13 rev 11/22/21
Excavation Program

Duke Energy Excavation Permit Application Form
14. Type(s) of excavation equipment to be used:
Long Reach Excavator, Dump Truck
15. Will waters or wetlands be crossed in transporting equipment to or from the site?
(check one) OYes ❑No
(If yes, explain)
By barge
16. Will return water re-enter the reservoir? (Check one) ❑Yes ONo ❑N/A
(If'Yes, sped point(s) of re-entry and show on Excavation Area Drawing)
17. Is there an existing facility (e.g. pier) that access is being maintained to by conducting the
excavation? 1ZYes ❑No
(If Yes, provide the existing permit number. If No, include a scaled drawing of the proposed
facility). Permit 4 13411
18. Total planned duration of the work (Include first equipment mobilization, excavation
through final mitigation measures complete):
START 7 / 23 FINISH 7 / 23
(Month) (Year) (Month) (Year)
Duke Energy Page 7 of 13 rev 11/22/21
Excavation Program

R
It
a
a
00
0
�-n
w
�y
t7
o x
w
x
m
N
�
CD
"
�o.CDeD
�
CD
CD
Q�
CD
���
0�
m �
a
_
� "
CD-
� .0
. c�
�
CD
°
^*i
oc
Y
�
p
a
Q R
°'
a'
b
CD
¢CD
CD
�.
IA
�
O
o v
a
(D
"
C
o =)
d
9
o
((D
lD
-s
x
t
fD
d
�
x
i.r
d
O
ow
i
rO
.7.
eb
It
19
A
`3
fD
m

r
o CD
qQ
°
CD
CA o
o C7
CD
Es
cl' ¢
CD
1 CD
C
O
�s
O
CD
p'i ~
� � o
CD
o
w
�
o �
�
C o
cra o
� o-
o
�
K
�
o
x
a
C�
dPD
CD
e�
�d
�
N
N
O
N
�
c
Q-
a:
O
�
b
o EP
C-D CD
CD0
CD
0
CD
fl
C
UQ
3
ro
'� ro
`O
r^ �
2f
`t
CD
Z
I� ro
D
D
c
ro
ro
�;
m
d
°o
x
Y
C
0
0
M
A
m
9

6/ 6
l _aoloafoad4xoq u l##/p/n/llew/woo-alboo6• l lew/l: sduU
Duke Energy Excavation Permit Application Form
C. Applicant's `Sicnarures
Commcnis: 1AP-4N6 rs ,
`ale.\ G_Y � e- Jo n sso r)
3•av C w-VI Cove c1
1- 1 otick E \I� '
• c k'\ -P- w\ 11 yams j
a 38 C.k r\'. Cave. 1� .
.pplirattt Name fprinti
Date
r
Co -Applicant Name (print)
Co -Applicant Signature' __ Date
Co -Applicant Name (print)
Co -Applicant Signature*
Co -Applicant Name (print
Co -Applicant Signature*
Batt
Date
Co -Applicant Name
Co -Applicant Signature* Datc
`per my signarure. the information provided in this application is correct to tha best orniv
#:n:�wletiac.
Duke Energy
Y:xeUvaLiun Progf-w:
pai-e iU of i
«v ! ? 21' n1"
6adf•g ueag
Nv 9ti:9 `EZ/£ 6/Z

Excavation Project User's Agreement Letter
(Please fill in the blanks. Please Print)
Date 1/29/2023
TO: Duke Energy
c/o Lake Services - EC12Q
526 S. Church Street
Charlotte, NC 28202
RE: Excavation For (Subdivision and Lot #'s or Other Project Name)
Lot 3 Old Homestead 1
(Lake/County/City) Norman / Iredell / Statesville
(Applicant's full name) Mathias Jonsson hereby agrees to comply with all
recommendations, requirements and/or conditions of Duke Energy, General Permit(s) (if
applicable) and other federal, state and local agency requirements pertaining to the application to
excavate for the purpose of a boat access for dock
In addition, Uwe have read and agree to comply with Duke Energy's current Shoreline
Management Plan (SMP) or other applicable guidelines, much of which is repeated herein, and
understand that written authorization must be obtained from Duke Energy prior to beginning any
activity within the Federal Energy Regulatory Commission (FERC) project boundary or on Duke
Energy property associated with a reservoir, collectively referred to as Project Boundary. The
excavation will be completed as described in the approved application and within eighteen (18)
months from the date of written approval by Duke Energy, unless specifically noted otherwise in
the application or unless I/we obtain approval for a single, time extension (maximum of one year)
in writing from Duke Energy. 1/we understand that if the SMP or other applicable guidelines or
rules change during any extension period, I/we will be expected to comply with the new
requirements to the maximum extent practicable. Uwe also recognize that failure to complete the
excavation within this build -out period will require the filing of a new application within the then -
current SNIP or other applicable guidelines and the new application must include any applicable
fees and security deposits.
I/we attest to be the owner(s) or lease holder(s) of the land immediately adjoining the Project
Boundary where the excavation activity is to take place, or if not the owner or lease holder, _1/we
have included proof of title to the property and written authorization from the owner(s) or lease
holder(s) to carry out the proposal within the Project Boundary adjacent to their land.
1/we attest to be the owner(s) or lease holder(s) of the land that will be used for equipment
staging and disposal of excavated material or if not the owner or lease holder, I/we have included
proof of title to the property and written authorization from the owner(s) or lease holder(s) to
carry out the work on their land.
Duke Energy Page 1 Rev: 4/6/2020

I/we understand that all excavation work must be done directly in front of my/our property and as
specified in Duke Energy's approval. I/we also understand that access channels must run
perpendicular to the shoreline while within the third of the cove area that is nearest my/our
property.
I/we understand that for proposed excavations, Uwe must notify the appropriate local, state and
federal agencies in advance of the activity by sending them a completed copy of Duke Energy's
Excavation Permit Application Form and other required information. Uwe understand that
written authorization and/or other permits may be required by some of these agencies and such
required authorizations must be obtained before Uwe submit the final application to Duke
Energy.
At FERC-licensed reservoirs, Uwe understand that except for maintenance excavations, any
excavation exceeding 2000 cubic yards of material removed or any excavation or shoreline
stabilization work needed to support an application that requires FERC review does itself require
specific review and approval by the FERC before Duke Energy can issue any approvals.
I/we agree that unless specifically approved otherwise in the application, explosives will not be
used as part of this excavation activity.
I/we understand that every reasonable effort must be made to minimize any adverse impact on
fish, wildlife and other natural resources.
1/we understand that applicants in South Carolina proposing excavations that are not covered
under the General Permit, or are greater than 150 cubic yards, must receive prior written
authorization from the South Carolina Department of Health and Environmental Control
(SCDHEC) or the US Army Corps of Engineers (as applicable) before submitting the completed
application to Duke Energy.
I/we agree that excavation activities will not occur during the months of March, April, May and
June because of the potential impacts to fish spawning areas.
I/we understand that trees and vegetation growing within or adjoining the lake play an important
role in its overall environmental condition, and the ecological benefit the vegetation has on fish
and wildlife habitat directly supports a sound and healthy lake environment. I/we also understand
that unauthorized removal of shoreline vegetation (e.g. button bushes, willows, cattails, etc.)
and/or disturbance of the shoreline buffer may result in suspension or denial of lake use
permitting requests, forfeiture of security deposits and require re-establishment of vegetation at
my/our expense, particularly if the disturbance is found to be in violation of state or local
ordinances or impacts FERC project buffers.
I/we agree all excavated material will be placed in upland areas, landward of the Project
Boundary, and confined to prevent erosion and sedimentation back into the lake or nearby
streams.
Duke Energy Page 2 Rev: 4/6/2020

I/we agree to adequately stabilize all excavated material and all disturbed shoreline to prevent
erosion and runoff into the lake.
I/we understand that the double handling of excavated material will not be allowed; therefore, all
excavated material must be placed above the Project Boundary in one handling.
I/we have designed the hydraulic excavation process (if any will be used) so that return water re-
enters the lake in the same general vicinity and cove as the excavation, to the maximum extent
practicable.
I/we agree that the proposed excavation will not be for the purpose of creating additional
shoreline, will not alter the Project Boundary or the full pond contour, and will not impact
threatened or endangered species, historic properties, or environmentally -important areas, unless
special public entity provisions were made in the application.
I/we recognize that it is my/our responsibility to clearly locate in the field and label on my/our
work area drawings any areas that require specific protection or avoidance during this excavation
work. Examples of these protection/avoidance areas include but are not limited to, any
Environmental Areas, Natural Areas or Impact Minimization Zones as identified by Duke
Energy; jurisdictional wetlands; historic properties; rare or threatened species; and buried gas,
water, sewer, electric or communications lines. I/we agree to provide my/our contractor with a
copy of these work area drawings showing these areas to stress the necessary protection
measures.
I/we agree that if any archaeological resources (e.g. pottery shards, Indian artifacts, etc.) are
discovered during the excavation, work shall be halted immediately. I/we will then notify Duke
Energy and the State Historic Preservation Office to determine what measures, if any, I/we must
pursue to protect or salvage the archaeological resources.
I/we agree that any excavation from within the Project Boundary will not exceed the volume as
outlined in the application and will remove and disturb only what is absolutely necessary to
achieve the project's stated purpose.
I/we agree to be fully responsible for the permitted lake use and Fwe understand that this
responsibility is considered to transfer automatically along with ownership and leases of the
adjoining tract.
Uwe understand Duke Energy representatives may issue Stop Work Directives for violations of
the SMP or other applicable guidelines and other consequences may result from such violations,
including but not limited to suspension or cancellation of approved permits, increases in fees,
modification or removal of non -complying structures and restoration of disturbed areas at my/our
own expense or loss of any consideration for future lake use permits. I/we agree to immediately
comply with any Stop Work Directives, to fully cooperate with Duke Energy and other agencies
as necessary, and to perform the necessary remedial actions within the specified time frame.
Duke Energy Page 3 Rev: 4/6/2020

2/13123, 6:46 AM
Scan 4.jpeg
lAve agree to develop any required mitigation plans and to complete any required mitigation
activities at my/our own expense within the specified time frames, Ywe recognize that the
excavation work is not considered complete: and deposits will not be refunded until the
mitigation requirements (if any) have been satisfactorily fulfilled.
I`ve auree to_notif�, Duke Energy by phone when the excavat"ton i initiated and to ensure that
during the excavation Period, Ave vzli Rost Dub Enter 's_approval letter in a clearwatcrttroof
lam; at thu job site an i visible from the water's ed�*e.
L'we as to notify Duke Energy in writint= when the excavation is completed (including any
required mitigation measures) and that the excavation was completed per the approved
application, so a close-out inspection can be performed.
1/we recognize security deposits will not be refunded if any violations of the SNIP. other
applicable guidelines, or this user's agreement occur.
I/we understand there will be no change in hydro project operations as a result of the excavation
and/or utilization of the excavated area.
Ave agree to maintain the work area in a safe condition and to fully indemnify and save Duke
Energy harmless from any and all claims, liability, loss or damage that may arise from this
excavation proiect.
understand that this user's agreement sloes not, in any way, constitute the transfer of any
rights in real property and that mv/tiur use and enjoyment of FERRC project and Duke Energy
lands and waters shall not hinder the general public's lawful use and enjoyment of the same.
Sinccrc:lt.
I
d!! applicant's'swrte (Prmt)y
Cc -Applicant's Name (Print) CrIApplicant's Signature
Co -Applicant's Name (Prim) t:ir Appiica Iv signature
Co-Applicum's Natne ('Print) Co -Applicants Signature
— Co -Applicant's ape (Ptitit) CcrAppli"nt's Signature
il-a, I+ a
Pw *61=
https:/Imail.google.com/mail/u/0/#inbox?projector=1 1/1

Type: CONSOLIDATED REAL PROPERTY
Recorded: 9/22/2016 8:06:25 AM
Fee Amt: $26.00 Page 1 of 2
Revenue Tax: $0.00
Iredell County, NC
Ronald N. Wyatt Register of Deeds
NORTH CAROlLEI�A GENERAL WARRANTY DEED
Excise Tax: $0 *This is an exempt transfer for estate planning purposes. There was no consideration paid by transferee to transferor.
NO TITLE OPINION RENDERED. NO CLOSING HELD BY PREPARING ATTORNEY.
Parcel Identifier No. 4720 02 0406 & 4720 02 1339 Verified by County on the _ day of , 20_
By:
Mail after recording to: Grantees
This instrument was prepared by: Regina M. Mahoney, PLLC. P.O. Box 3622, Mooresville, NC 28117
Brief description for the Index: 234 Clark Cove Road Statesville NC 28677 91 acres more or less
THIS DEED made this 21 st day of September 2016 by and between
GRANTOR
Mathias B. Jonsson
GRANTEES
Mathias B. Jonsson and Melanie B. Jonsson,
Husband and Wife
234 Clark Cove Road 234 Clark Cove Road
Statesville, NC 28677 Statesville, NC 28677
Enter in appropriate block for each Grantor and Grantee: name, mailing address, and, f appropriate, character of entity, e
The designation Grantor and Grantees as used herein shall include said parties, their heirs, successors, and assigns, and shall include
singular, plural, masculine, feminine or neuter as required by context.
WITNESSETH, that the Grantor conveys this property to the Grantees in fee simple for the purposes of establishing a Tenancy by the
Entirety ownership as a Married Couple pursuant to N.C.G.S. §39-13.6. The conveyance includes the certain lots or parcels of land
situated in Iredell County, North Carolina and more particularly described as follows:
Tract One: Being all of Lot No. 3 of the "Old Homestead No. I subdivision revised, as platted, planned and recorded in Plat
Book 19, Page 41, in the Office of the Register of Deeds of Iredell County.
Page I of
NC Bar Association Form No. 3 (0 Revised 712013 This standard form has been approved jointly by:
Printed by Agreement with the NC Bar Association North Carolina Bar Association — NC Bar Form No. 3
North Carolina Association of Realtors, Inc. — Standard Form 3
Book: 2446 Page: 1444 Page 1 of 2

Tract Two: Being all of Lot No. 3 of the "Old Homestead No. I subdivision revised, as platted, planned and recorded in Plat
Book 25, Page 125, Iredell County Registry, and being more particularly described as follows:
Beginning at an existing iron pin in the southeastern comer of Donn C. Hansen (Deed Book 749, Page 389) and running thence
with the line of Hansen North 21 deg. 15 min. 00 sec. east 118.04 feet to a concrete monument in the line of a 3.295 acre tract;
running thence south 47 deg. 25 min. 33 sec. east 163.52 feet to a point in Clark Cove Road (State Road 1331), having passed
through an existing iron pin located north 47 deg. 25 min 33 sec, east 33.06 feet from the point in Clark Cove Road; and
running thence with Clark Cove Road south 69 deg. 54 min. 17 sec. west 35.50 feet to a point in the road; running thence south
65 deg. 19 min. 25 sec. west 41.43 feet to a point in the road; running thence south 57 deg. 18 min. 47 sec. west 46.96 feet to a
point in the road; running thence north 43 deg. 32 min. 05 sec. west 76.51 feet to the point of beginning, containing 0.301 acres
more or less according to a survey by Gerald V. Grant, registered land surveyor, dated May 26, 1995, and being a
resubdivision of Lot No. 3 of Old Homestead No. 1 as recorded in Plat Book 19, Page 41.
The above described property is subject to right of way of Clark Cove Road (State Road 1331) and also subject to a 35 foot
building setback line.
The property hereinabove described was acquired by Grantor by instrument recorded in Book 1772 Pages 1295-1297.
All or a portion of the property herein conveyed X includes or _ does not include the primary residence of a Grantor.
A map showing the above described property is recorded in Plat Book 28, Page 56, Iredell County Registry.
TO HAVE AND TO HOLD the aforesaid lots or parcels of land and all privileges and appurtenances thereto belonging to the Grantees
in fee simple.
And the Grantor covenants with the Grantees, that Grantor is seized ofthe premises in fee simple, has the right to convey the same in fee
simple, that title is marketable and free and clear of all encumbrances, and that Grantor will warrant and defend the title against the
lawful claims of all persons whomsoever except for the exceptions hereinafter stated.
Title to the property hereinabove described is subject to the following exceptions:
Subject to easements and rights of ways, over, along and across subject property, if any.
IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as ofthe day and year first above written.
By:
Print/Type Nam e: Mathias B. Jonsson. Grantor
State of North Carolina - County of Iredell
I, the undersigned Notary Public of the County and State aforesaid, certify that Mathias B. Jonsson personally appeared
before me this day and acknowledged the due execution of the foregoing instrument for the purposes therein expressed. Witness my
hand and Notarial stamp or seal this 2151 day of SeSe tem�er2016.
`,,�`�,P M
My Commission Expires: December 8 2018 ��li �� Regina M. Mahoney T46tary Public
(Affix Seal) — 0 T'q'Q L �.Z Notary's Printed or Typed Name
NC Bar Association Form No. 3 © Revised 7/2013 This standard form has been approved jointly by:
Printed by Agreement with the NC Bar Association North Carolina Bar Association —NC Bar Form No. 3
North Carolina Association of Realtors, Inc. — Standard Form 3
Book: 2446 Page: 1444 Page 2 of 2