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(At Full Pond/ Normal Water Level)
Side View
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3 1t below full pond water level 4 ft. above Full pond water level 2 ft, additional clearing
'if necessary
Existing bank
AMPLE
FORM: 55GP 02-2017 Page 4 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 dredginp, below the Full Pond/ Normal water Levpl plauarinn
Full Pond/ Normal Water Le
�''''
Shorelinee
Plan View
Lake
(At Full Pond/ Normal Water Level)
Lake
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FORM: SSGP 02-2017 Page 3 of 4

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
V/ c.LA-G E" LN
Project Narn1e/address:�sW -Srr&u.2a� 7��ryl ngnJ CourtyL41 — -,J �a,?,
Owner: C�/-�y1 Y_ rnJ,�,-iL .r fQ7;4 iLFA
Pri —signature
Contractor/agen
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 026 .0243(6)]
Benching, 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
I,rA#-c�i5-r,b.R4r ti _—T• fi�i 0, 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.
Signature (owner ]/' Date: e 13 �3