20150700 Ver 1_Shoreline Stabilization_20150715

Three copies of the application (including attachments) and the application fee should be sent
to:
Division of Water Resources
401 &Buffer Permitting Unit -�
p
1617 Mail Service Center ` r
Raleigh, NC 27699 -1617 JUL 5 ti,
,
I. Applicant Information (15A NCAC 02H .0502(a)] DENR wNfEir �7G
401 F BUFFER -Rtvlf r °Tlm� tS
1. Owner Information - -
Name: William E Routh, Jr.
Mailing Address: 206 Balsam Cir
Troy, NC 27371
Telephone Number: (336) 692 -0241 Fax Number:
E -mail Address: routh.chuck (@gmail.com
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
httr): / /www.saw.usace.armv. mil / Portals /59 /docs /reeuIatory /readocs /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: William E Routh, Jr.
II. 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.
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: Montgomery Nearest Town: Trov, NC
Subdivision name or site address (include phase /lot number):
Carolina Forest, 206 Balsam Cir, Trov, NC
Directions to site - please include road names and numbers, landmarks, etc.:
North on River Bend Rd off of Hwv 24/27. Left at Carolina Forest entrance.
Left on Pinecrest Cir, Left on Chinkapin Rd, Left on Basswood Rd,
Right on Balsam Rd, Right on Balsam Cir. Arrive at 206
Latitude (in decimal degrees) 35.362129 Longitude (decimal degrees) - 80.054038
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Residental
6. Property size (acres): 0.55 acres
7. Lake/ river/ ocean adjacent to property: Lake Tillery
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Existing Shoreline Stabilization wall has deteriorated
due to age and has several penetration points that are experiencing erosion
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:
2'x 170' = 340 so ft backfill all behind the new stabilization wall
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: 6'x 170' = 1020 so ft removal of old wall and backfill and rip
rap above water in front of new wall
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): mostly grass with a few
plants near current wall — plants will be relocated to around the house. There are some,
FORM: SSGP 10 -2013 Page 2 of 4

trees at the outer boundary of the 50 feet that will not be disturbed.
y�
Owner /Agent's Signature; 115kl / CAC 02H .0502(f)l Date
`Agent's signature is valid only if an authorization letter from the owner is provided.
Lake
(At Full Pond/ Normal Water Level)
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Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ft x 100 ft) *:
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.
5. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
FORM: SSGP 10 -2013 Page 3 of 4

6. Location of construction access corridors Most of the work will be accomplished from the
water using the Carolina Forest boat ramp (approximately 600 feet away) to bring in
materials and remove materials. As indicated above, some access will be down the side of
lot to add back fill material.
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FORM: SSGP 10 -2013 Page 4 of 4

Project. Name:
William Routh Shoreline Stabilization Repair
Project Location:
206 Balsam Cir
Troy, NC 27371
Montgomery County
Project Contact Information:
Owner
William Routh
206 Balsam Cir
Troy, NC 27371
336- 692 -0241 Routh.chuckQ�-,mail.com
Project Description:
This project will be replacing an existing shoreline retention wall that has fallen into disrepair
and has several penetrations through the wall that are causing wash and shoreline loss due to
boat traffic. Existing shoreline retention wall is approximately 40 years old and is about 160'
long and about 4' high. Additional wall length will be required to tie new wall back into
bordering walls, as new wall will be built out from existing wall, approximately 18 to 24 ".
Small fixed dock (10'x10') on West end of property will be removed. Existing boardwalk over
the water will be removed.
Install a new shoreline stabilization wall constructed of v -cut 2X8 #1 direct burial lumber with
rip rap at the water base. Wall to be installed in front of existing wall and lined with Army
Corp approved matting on ground side of wall. Wall cap to be constructed of 2X10 #2. Once
new stabilization wall is installed, existing wall will be removed and back filled void with
gravel against the wall and dirt behind the gravel.
Vegatation disruption will be minimal. Several bushes will be removed by hand prior to
construction beginning and relocated on property up near the house. Bed area border adjacent
to existing wall will be removed. Grass will be seeded up to gravel area behind new
stabilzation wall. No trees are in the vicnity of the wall.

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Survey for
WILLIAM E. ROUTH, JR. & WIFE, SUSANNA
Lot No. 425 of the Carolina Forest Subdivision
Uwharrie Township, Montgomery County, North Carolina
Deed Reference Book 699 Page 542; Plat Cabinet A Slide 601
Surveyed by Thomas J. Fields, PLS -2906, on February 8, 2013
60 0 60
Sale is in Feet
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Found:
3/4" Iron
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CURVE DATA
Radius = 230.00 FT
Arc = 68.47 FT
Chord = 68.22 FT
Chord Bearing
S 60'55'56" W
NORTH CAROLINA
MONTGOMERY COUNTY
G. ROUTH
From the office of
WRIGHT & FIELDS LAND SURVEYING
1340 Albemarle Road, Suite C
Troy, N.C. 27371
-/10 ?)� R�rn v 40
I, Thomas J. Fields, certify that this plat was
prepared from an actual survey done by me in
February 2013 and is in all respects correct
to the best of my knowledge and belief. The
ratio of precision as calculated by latitudes and
departures is 1:15,000'+ . This plat was
prepared in accordance with Board Rule .1600
Witness my original signature and official stamp
this the 13th day of February 2013
I- J'!� -PJ' y ice) ) � "'J'kv o
SURVEYOR 5 -2906 (, Firm o. -1055
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VICINITY
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No horizontal control within 2000 feet.
NOTE: This property is not located in any FEMA special flood hazard area. Job No. 2013 -16
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Routh Shoreline Stabilization Repair
Vicinty Map of 206 Balsam Cir, Troy, NC 27371
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William Routh
206 Balsam Cir, Troy, NC 27371
Shoreline stablization repair
Existing dock adjacent to boat slip (10'x30') will be enlarge to 20'x30'
Border inside of shoreline stabilzation will also be removed and grass planted. All existing
vegatation in bed areas will be removed.

Damaged area 4 - to below full pond
Damaged area 5 - to below full pond

Damage area 2 - previous owner attempted to fill

William Routh
206 Balsam Cir, Troy, NC 27371
Shoreline stablization repair & dock expansion
Proiect overview picture (looking North)
Damaged area to below full pond
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