20150626 Ver 1_Application_20150623

2 0 1 5 0 6 2 6 State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Division of Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SS6P 10 -2013
-
Shoreline Stabilization ANpii ac Lion Form
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
I. Applicant Information (15A NCAC 02H .0502(a)j
1. Owner Information
Name: A�eL VY
Mailing Address:
Telephone Number:
E -mail Address:
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33 � 5,1'1erc1 �w
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JUN 2 3 2015 i
DENR - wATEFi R SUU,- CJ
401 & BUFFER PERIOTFING
ISO. LJ-15- 2928 Fax Number: 800-° &19 - S7U 3
& WL-W i Z -7 Z Q a® 0 - C.o W1
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
httD: / /www.saw.usace.armv. mil / Portals /59 /docs /reizulatory /regdocs /Permits /SAMPLE AGENT AUTH
ORIZATION FORM.odf) must be attached if the Agent has signed this application form.
Name:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E -mail Address:
Person to receive the Certification Approval:
II. Project Information j15A 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 3

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: Nearest Town: M c UA+ Alit%
Subdivision name or site address (include phase /lot number):
S-A-* vja�°ev 10�031(0 !9C C44 -tom 2-8
Directions to site - please include road names and numbers, landmarks, etc.:
Hoar y Ito 4-ID &4cree'r. b16&- PUMA a act RJ% m 914h -� ®f
.11� ewe CAV a fZ!Vh+6VJ C's l`vereil PC br— all 4-he_ Vmy.
°0 evict or S�Vec+-
Latitude (in decimal degrees) 3 5.36tvZ 6 9 Longitude (decimal degrees) 80 . q `8 4®3
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): resiclayiA.'aaa I ° iVVJC ''f
1J
6. Property size (acres): 1.241
7. Lake /river /ocean adjacent to property: Mau-J.-in Lae.,
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Re4n7onSK&I w« 11 &4- ska 6 14-G
- o
9. Will work be conducted from land? 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:
- 0
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: Ies S ° S 4cv& — mdduidaP 191ackwa ll I zo' , � uv�.q�/s A �U
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): M bAv
Owner /Agent's Signature` (15A NCAC 02H .0502(f)] Date
'Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10 -2013 Page 2 of 3

MQNil's liAP
LEGEND
0 PROPERTY CORNER
FOUND
S
SET
No. 4 REBAR
No. 5 REBAR
N)AFS NO MONUMENT FOUND OR SET
RP RADIUS POW
CDS CUL -DE -SAC
R/V F %YA-
CL CENTERLINE
P.D.E. PUBLIC DMNAZE EASEMENT
MAG SURVEY NAIL
Rom SURVEY NAIL
LOT. SETBACKS
Immo
12
ME u-sw ZA:'41Z_—A.—A-0-cA_ LW
I REM YARD 100
SETBACK WL Wp
Pb
Ejj,,Ab
to
fl.: N
C14 54.320 SF
1.247 Ac.
ifL_RIVER8 END TO-MNSHIP, GASTON COUNTY, N.C.
CO
plann--ing Engineering'
CURVE TABLE
WAPBOOK 67- - PAGE 61
, It
6FZONLY
SUBDIVISION
! 4= i 35.04 ' 34.43 IS
is
LINE
av,
LINE
REAF Nc_ I
t E-:, _1111 i
LI
N38!37'3,3'F
3.18
L2
N67-49'54'E
14.19
L3
S1676 Q3' E
20.15
L4
q65r�0r24 E,j
28.52
L5
j S_372,4�27'F r_28v3i
Cove Pointe
L6
17
S52'17- f
31.18
L7
S5143'_5eF
39.25
La
SO4*32*36*E I
32.46
MQNil's liAP
LEGEND
0 PROPERTY CORNER
FOUND
S
SET
No. 4 REBAR
No. 5 REBAR
N)AFS NO MONUMENT FOUND OR SET
RP RADIUS POW
CDS CUL -DE -SAC
R/V F %YA-
CL CENTERLINE
P.D.E. PUBLIC DMNAZE EASEMENT
MAG SURVEY NAIL
Rom SURVEY NAIL
LOT. SETBACKS
Immo
12
ME u-sw ZA:'41Z_—A.—A-0-cA_ LW
I REM YARD 100
SETBACK WL Wp
Pb
Ejj,,Ab
to
fl.: N
C14 54.320 SF
1.247 Ac.
(F)
41k/r :---,
QL_
OF Po
SCALE: 1" — 60 A SEX.
S
P H Y1 Sd " 0 L , U RVE Y
Mqjzeig Lucas-Forman of
A
f0 Incornorated -332 SILVERCUFF IVE ft
(F)
DUKE POWER COMPANY
RIVERSEND STEAM STATION
D-214(A). DB259—PG352
ifL_RIVER8 END TO-MNSHIP, GASTON COUNTY, N.C.
CO
plann--ing Engineering'
-
1Zzf_:r,"6 CK
WAPBOOK 67- - PAGE 61
, It
6FZONLY
SUBDIVISION
LOT 3*7 OUNDAMON
is
DEED REFERENCE:
av,
S
. •1 8 U RN
A
_j
[phone] Fox 527-9640
SURVEYED: FMF/8LT
DATE: 3-13-06 1 REV. 0
. I F .
3:0.
D&yN*.
I IPPATF•
MAG
0
Cove Pointe
f5b
(F)
41k/r :---,
QL_
OF Po
SCALE: 1" — 60 A SEX.
S
P H Y1 Sd " 0 L , U RVE Y
Mqjzeig Lucas-Forman of
A
f0 Incornorated -332 SILVERCUFF IVE ft
(F)
DUKE POWER COMPANY
RIVERSEND STEAM STATION
D-214(A). DB259—PG352
ifL_RIVER8 END TO-MNSHIP, GASTON COUNTY, N.C.
CO
plann--ing Engineering'
-
1Zzf_:r,"6 CK
WAPBOOK 67- - PAGE 61
L
41
p_x15V,,
SUBDIVISION
STONEWATER PHASE 2B
4000 Stuart Andrew Boulevard
North Carolina 28217
ChariotteBo,
DEED REFERENCE:
av,
S
. •1 8 U RN
LL
_j
[phone] Fox 527-9640
SURVEYED: FMF/8LT
DATE: 3-13-06 1 REV. 0
. I F .
3:0.
D&yN*.
I IPPATF•
MAG
Cove Pointe
f5b
(F)
41k/r :---,
QL_
OF Po
SCALE: 1" — 60 A SEX.
S
P H Y1 Sd " 0 L , U RVE Y
Mqjzeig Lucas-Forman of
A
f0 Incornorated -332 SILVERCUFF IVE ft
(F)
DUKE POWER COMPANY
RIVERSEND STEAM STATION
D-214(A). DB259—PG352
ifL_RIVER8 END TO-MNSHIP, GASTON COUNTY, N.C.
Qb -,(, -- - %.
plann--ing Engineering'
-
1Zzf_:r,"6 CK
WAPBOOK 67- - PAGE 61
L
41
p_x15V,,
SUBDIVISION
STONEWATER PHASE 2B
4000 Stuart Andrew Boulevard
North Carolina 28217
ChariotteBo,
DEED REFERENCE:
for
HELMS BUILDERS
S
. •1 8 U RN
P.O. x 11386 26220—I386
[phone] Fox 527-9640
SURVEYED: FMF/8LT
DATE: 3-13-06 1 REV. 0
. I F .
D&yN*.
I IPPATF•
JOB# FILE;9 GAS

La ke
(At Full Pond/ Normal Water Level)
Exi s+i A'� 1)0�
!q 00
Full Pond/
Normal Water Level
Shoreline
4C Area -
t tarn yu� X X, - �-- � (0.15 ,pr. 74, 12-0 C+
Vial i
��avers)
Apf oy— (,iS�iA P
� +��s�
11:4. A( gwtss
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ft x 100 f t) *:
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.
S. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation - f
6. Location of construction access corridors _ �XI�}IN� ?A-H4 lzzt. Nlo
FORM: SSGP 10 -2013 Page 3 of 3

www.duke-energy.com/pdfs/JointAppVl 3p. pdf
Page 1 of 1
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