20150741 Ver 1_Shoreline Stabilization_20150724

a
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
D�W__R 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
Division of Water Resources FORM: SSGP 10 -2013
Shoreline Stabilization Application Form 2 0' 5 0 7 4 1
Three copies of the application (including attachments) and the application fee should be sent
to:
Division of Water Resources I
401 & Buffer Permitting Unit
1617 Mail Service Center -
Raleigh, NC 27699 -1617
I. Applicant Information 115A NCAC 02H .0502(a)l
1 Owner Information
2.
II.
1.
2.
Name: LCEON Ag eo L61F-11,14
Mailing Address: Z0 -71" to O20
CG2wl IG L 1. . /J C_
� � 1
JUL 2015
WATER RESOURCES
40N � eaRMi'fi!fl� --
Drz.
2$031
Telephone Number "1 o4 - 4-S c" -- 0243 Fax Number: N/
E -mail Address: 10 -P I i &l t s (a—> Yin — eap)ore_ -n 0%) . cc) W"
Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
http: / /www. saw.usace.armv.mil / Portals /59 /docs /regulatory /regdocs /Permits /SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must b attached if the Agent has signed this application form.
Name: LJUJKLe[ — ►4><ivUtrz 1
Company Affiliation:
Mailing Address:
Telephone Number:
E -mail Address:
Person to receive the Certification Approval:
Fax Number:
At
"Lf� 0 � /�YL 1p � • ��C• -r n1
Project Information [15A NCAC 02H .0502(a) & NJ
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, 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) W
County: Wane-1-L LeAJ i3k" Nearest Town: CGewre- L itd,S
Subdivision name or site address (include phase /lot number):
lb4 ,*iA 634y Car 422 — 2(S717 R-,o Oto T-W.
I
Directions to site - please include road names and numbers, landmarks, etc.:
� 7 % TA" E)q--tT- Z°c) > C, a t,Jnr CGrJ Coh,; rl+ ISA, X U E. TU rl ifr r-
Si,� i I, aiT ciJ 1 C RFAIP�_
d � '060- v O
Latitude (in decimal degrees), c�- 74'7cO Longitude (decimal degrees) '- 0 099W
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): J SI Affigjr -xt I-k6l xt Fuv- 'J 4-?_ 1 Fxmt
6. Property size (acres): A-) D -V Ac-P.*S
7. Lake/ river/ ocean adjacent to property: Chl-,& Iq6kt4k d
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): 144"e,3 SH Or-er o ve W I C-v\ (2t P R_It�.h -M SToE'
Ace -tile .t4na6 Ew4za%ioi) WA4t. Ntmod A✓r3 LAlc* Let)EL sul10-16s
9. Will work be conducted from land? From water? 0-- 15-ru A,t e(mAt/s
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:
W%r Ajtwl44- /0/STz4o_4d.✓Crc — 6oc.4.t_. Cvu -re uRI,J6 A3 /Ao�oirb rb Z06,74-4L_
(::j�ao zrcv- ciorH P1*4 RI pRAp-
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:
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):
A4VAJ&W-
wt �✓/ V ' /ZZ Za
Owner /Agent's Signature* [15A NCAC H .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

Lake
(At Full Pond / Normal Water Level)
A. I&t4M K P't V r?"
V tf " C-A-L T-o I W t tt+ Z t/&VZ Tt c /-L
r
Full Pond/
Normal Water Level
© o 0 0 0
Shoreline
I Al s-A -Ct' ($ Y)
3 ` t- Etit�t�o
Urtr2r ( ,&L -M Fu.l-L
Y-400 'j 2 ter.
Lt,p CLA-trD
N I FT A VZ,0 dt4
PJw0
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
6. Location of construction access corridors
FORM: SSGP 10 -2013 Page 3 of 3

0
TH16 16 TO CERTIFY THAT ON TH- /j '")AY OF �GT��er iH CZ .1 SURVEYED THE PROPERTY
SHOWN ON THIS PLAT. AND THAT THE TITLE LINES. AND THE WALLS OF THE BUILDINGS IF ANY. ARE AS SHOWN HEREON.
BY L
/�� REGISTERED SURVEYOR,--STATE OF NORT� 4%^"LINA
0 12 6ir(c �• A l % '� • !t+
�0 E� fled° / i (J �`�� ••
ltzl
oip r.,•
0
(Alo f • A,
0 ORO D�
250.97 Q = 7/. 70
p µJC/
• � aO.o = OO
o 1511X11 ✓cntc/ N
Q �G,S1dc�ce
N w Bsm,2oof rU �b�419c (�
O t7ect CDCI�
E � �
m ZOO- 2 u
_o
0o-
�2 =,,I old rron

x.15
72-1 y:J
rv-
i3 4��TF0 �
r-
KV-
J J�
c� \y9 � gtiy s
��O a Lit ji 1A
o � yG P3 t¢Q t
Alf
SAP t•
a � .
2fl X40
>�, w gis is
e4 moo. - t v0�0 S O 07,p t•99 �3 O -.�� .sra�js) /1� h � cL
C,
ORO � % �� 2 \ �uti�� ` � t u� „ �� ` h •'' h � �o . 4 ` Ott
i 99 q � � y 0 i� L� 1� � a � ,� �0 � p• �7 lgrl �i {�'
s � : C,d tes, � um • ,.�8 � ,^ Rt A9a,,' c9e, � !+ i � ,ti
�" IG4. 'V 9�) 31 0 / I r • Q` !?A 72` /P4. f/ s v PL
VCRANO
GSZ
Z9 Zpao J9� 18% a
,e Q ..J33.0! 1 7 p�w,0�j r=n, �t.,� (R,� �ts�• o7d J�0 lh
10 �.� 3t pG1 fttl 34 J r e =i Q< 90 714 V —(f 39,
SLR ,� A 2 � 7i2> • I� Ta ! rte° �Ga.
�int� � � i t9 b �� � ` ' rr�i rGa, Q (�sv r�s, �� iJ V•
X09
rtso j,s� � t' 3iJJ '27 � �o ro r9
a �?" (27 t 99 - ?/ too 5 St
NORM N ,� , rep, 2,0 "P11% "P11% R 240 2J Z�
A E l� '�' 0 ' `1
L"
CArA wP' �D.s
t G,
PG.

I'onK
�wDOO ao
Camp
E �e
Ch b T RE EliVE S +p r
h p4g0 s
A,
O RETEA C J ! 41. t,(•r Y� ' �Si �GS711A1 4G �! r1D f 'J i
F4fSf ci— AcE q°
is QQ s r . s: [Ir� %scn
�,fa•r � rouc E l` - EM
fi LNDD tET,R E 10 DEP7
AM A ►< EEt Ft LO "I
1M N C
.. S/t / C
TALES ® XtN %I G y �
MAR
ESTS
� .,.� I MAGNOItA�' 1 � � '- I� - �•ssr.D.ef,� -r._ 4
q .fT 1`CDA:>t AX7 i '` t i
pR COMMODORE LNOG
ADMIH ALS
OVAPTERS W
ELliLE'
NA9rlr,; �Iv�Jt �Rfp< <p�
4 r 4
N� q,A L TESTMOREl -o
pV KIY• "u5 Ri D Jam, 1 r 9,�
tAARINw
r L
73
` RD 0.V 74
VINEYARD °T ®1 Y
K IN MARINA \ P 7�7 J�l `V • ?� k9
a ` �" 8031
rASil cf 19YA _�,-
_ 2CXARDDRRA;rt _..

0
6' �

�` °�
���
^'
r{ -;' ,
'�`,:
��.�.
,,
�. ;�,��
3�
.' ��
�, ��
rfx�,
;�t���i
sia
. � r{
:�''

��.� -
_ � �
��� � � � '�
f
.*' _Y j.�.. .�
r s ♦ H'y1 � �+j
�� 4 �
�� �� ����
�:'
,� {"
/1 11, ♦c
-:
�' �'�� "�
�';;�
,.�,, ,
� �
,.

ir.
ice: r�i
+� 16N
MEr
• 1

tF

ti lit
lk"
-1 -
Nz
-1 -

'RIF
Ps,
op
0.
p v

�,. H
Orr
- =t-14
�.� <... ,Zrra E-tii ,3
i t
* 6
HIV-"