20231115 Ver 1_Site Plan_20230814

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Water- Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
ENVIRONMENTAL QUALITY FORM: SSGP 02-2017
Shoreline Stabilization Application Form
Three copies of the application (including attachments) and the application fee should be sent to:
If sending via US Postal Service
Paul Wojoski
DWR — 401 & Buffer Permitting Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
A. Applicant Information [15A NCAC 02H .0502(a)1
1. Owner Information
Name: Stephen and Cors
Mailing Address: 3846 St, Kitts Court
If sending via delivery service (UPS, FedEx, etc.)
Paul Wojoski
DWR-401 & Buffer Permitting Branch
512 N. Salisbury Street
Raleigh, NC 27604
Punta Gorda, FL 33950
Telephone Number: [phone] Fax Number: N/A
E-mail Address: [e-mail]
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter must be attached if the Agent has
signed this application form. (A form can be downloaded here:
http://www.saw.usace.army.mil/Portals/59/dots/regulatory/regdocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf)
Name: Charlie Washburn
Company Affiliation: Marine Construction LLC
Mailing Address: PO Box 6400
Hickory, NC 28603
Telephone Number: 828-495-3040 Fax Number: N/A
E-mail Address: office ma rineconstructionllc.com
B. Project Information [15A NCAC 02H .0502(a) & (b)]
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, buildings, retaining walls, docks, impervious surfaces, 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.
FORM: SSGP 02-2017
Page 1 of 3

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: Alexander Nearest Town: Ta)+lorsville
Lake/ river/ ocean adjacent to property: Hickory
Property size (acres): 0.497
Subdivision name or site address (include phase/lot number):
Lot 15,_ Harbor Town Subdivision Section 1 280 Harbortown Dr. Taylorsville NC 28681
Directions to site - please include road names and numbers, landmarks, etc.:
Included in packet
Latitude (in decimal degrees) a5.810 Longitude (decimal degrees) •81.258
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Residential. Developed
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): We plan to haul and place riprap by barge along the existing
seawall to prevent erosion.
7. Will work be conducted from land?
From water? x
8. Total amount of impacts below the normal pool lake level / Normal Water Level
Permanent impacts (including all excavation, backfill, rip rap, retaining walls, etc.) in square feet:
184 sgft
Temporary impacts in square feet:
0 sgft
Total amount of impacts above the normal pool lake level / Normal Water Level and 50 feet
land -ward
Permanent impacts (including back fill, excavation, rip rap, retaining walls, etc.) in square feet:
184 sgft
Temporary impacts (temporary clearing, construction corridor) in square feet:
(Construction corridor= 0 sgft)
10. 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): We plan to remove b trees,
The lot is d v loped with a house grassy yard, and existing seawall
11_ Sig -ure
r 2' / Z
wner/Agent's Signature` [15A NCAC 02FI .0502(f)1 Date
*Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 02-2017 Page 2 of 4

12. Please approximately sketch the following information on this plan and provide dimensions for
each item:
a. All proposed vegetation clearing
b. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
c. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
d. Location of any proposed structures such as buildings, retaining walls, docks, etc.
e. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
Lake
(At Full Pond/ Normal Water Level)
Y, UAW
uill Pond/ Normal Water Level
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Plan View
Lake
(At F-11 Pond/ N—I Wabr
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Existing Dock
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Plan View
FORM: SSGP 02-2017 Page 3 of 4

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Side View
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3 ft. below full pond water level 4 ft. above full pond water level 2 ft. additional clearing
*if necessary
Existing bank
10 ft. bank a
height he'
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Side View
FORM: SSGP 02-2017 Page 4 of 4

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CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: Cors- Lot 15 Harbor Town Sub. County: Alexander
Owner: Stephr
Print Siat re
Contractor/aeent: Charlie Washhnrn _ Merino
Print Signature
The approval is for the purpose and design described in your application. Impacts not indicated in the
application is a violation of the Buffer Rule. Site specific work should be provided in the application. [15A NCAC
02H .0506 and 15A NCAC 02B .0243(8)]
Trees are not allowed to be removed from Zone 1 of the Buffer (within 30 ft of the full pond elevation), unless
approved. Exception, those trees that are severely undermined along the immediate shoreline can be removed.
Minimal shaping and sloping along the immediate shoreline is allowed. [15A NCAC 02B .0243(6)]
Benching and grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 02B .0243
(6)]
Beaches, impervious patios, impervious walkways, etc. are not allowed in the buffer unless specifically approved
by the Division. There are limitation on size for decks. [15A NCAC 02B .0243(4) and (6)]
Work to be conducted from land must indicate an access and indicate any trees that are to be removed. The
work corridor should be described. The approved access corridor shall be restored. Staging, spoil, construction
material must be outside the buffer. [15A NCAC 02H .0502 and 15A NCAC 02B .0243 (4), (6), (8)]
Stormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
discharges must be at the natural elevation and discharged prior to entering the buffer directed as diffuse or
sheet flow at non -erosive velocities to the lake. [15A NCAC 02B .0243(5), (6)]
Acknowledgement of Notification
1, Step' and Shtlleia COrs hereby state that I have been informed of the Catawba Riparian Buffer Rule.
Any work conducted in the buffer, not specifically stated in the application and approved by the Division of
Water Resources (DWR), is a violation and subject to enforcement. Due diligence will be taken such that the
construction will be built within substantial compliance and intent of the 401 Water Quality Certification and
Buffer Rules, the approved plan(s) and specification(s), and other supporting materials.
- � f
Signature (owner):
ti` /

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AGENT AUTHORIZATI0N F0RM
Please note that multiple forms may be necessary if there are more than two owners of the property.
PROPERTY LEGAL DESCRIPTION:
STREET ADDRESS OF EXISTING HOME or LATITUDE/LONGITUDE OF NEW CONSTRUCTION:
280 Harbortown Dr. Ta lorsville NC 28681
35.810/-81.258
Parcel ID: 0014291
Property Owner Name(s) — please print:
Property Owner: Stephen Cors
Property Owner:
The undersigned, registered property owners of the above noted property, do herebyauthorize
Charlie Washburn
(Contractor/Agent)
Of Marine Construction LLC
(Name of company)
to act on my behalf and take all actions necessary for the processing, issuance and acceptanceof this
permit or certification and any and all standard and special conditions attached.
Property Owners Mailing Address (if different than property address above):
3846 St. Kitts Court, Punta Gorda FL 33950
3846 St. Kitts Court, Punta Gorda FL 33950
Property Owner(s) Telephone: [phone]
We hereby certify that the above information submitted in this application is true and accurate tothe
best of our knowledge.
AA orized Signature CantraMY Agent
2Z g�g�a3
Date �' Date