The URL can be used to link to this page

Home My WebLink About20150763 Ver 1_Shoreline Stabilization_201508051ygOPP3OF�a . 11 2 0 1 5 0 7 6 a Abbreviated Application Form For Regional General Permit 80 (Bulkheads O and Riprap) For Section 404 Regional General Permits, Section 401 General Water Quality Certifications, and Riparian Buffer and Watershed Buffer Rules This application cannot be used for wetland or stream impacts. This form is to be used for projects qualifying for the U.S. Army Corps of Engineers' (USACE) Regional General Permits 80 (General Permit No. 197800080) as required by Section 404 of the Clean Water Act and for the North Carolina Division of Water Quality's (DWQ) associated General 401 Water Quality Certification. This form is also to be used for any project requiring approval under any Riparian Buffer Rules implemented by the N.C. Division of Water Quality. This form should not be used if you are requesting an Individual 404 Permit or Individual 401 Water Quality Certification. The USACE is the lead regulatory agency. To review the requirements for the use of General permits, and to determine if general permit 80 applies to your project, please go to the USACE vvebsite at Nkwvv.savv.usace.armv.mil /wetlands /index.html, or contact one of the field offices listed on page 4 of this application. The website also lists the responsible project manager for each county in North Carolina and provides additional information regarding the identification and regulation of wetlands and waters of the U.S. The DWQ issues a corresponding Certification (General or Individual), and cannot tell the applicant which 401 Certification will apply until the 404 Permit type has been determined by the USACE. Applicants are encouraged to visit DWQ's 401 /Wetlands Unit website at http:/ /h2o.enr.state.nc.us /newetlands to read about current requirements for the 401 Water Quality Certification Program and to determine whether or not Riparian Buffer Rules are applicable. The applicant is also advised to read the full text of the Gcneral Certification (GC) matching the specific 404 Permit requested. Applicants lacking access to the internet should contact DWQ's Central Office in Raleigh at (919) 733 -1786. USACE Permits - Submit one copy of this form, along with supporting narratives, maps, data forms. photos. etc. to the appiicable USACE Regulatory Field Office. 401 Water Quality Certification or Buffer Rules - All information is required unless otherwise stated as optional. Incomplete applications will be returned. Submit seven collated copies of all USACE Pcnnit materials to the Division of Water Quality, 401 /Wetlands Unit, 1650 Mail Service Center, Raleigh. NC. 27699- 1650. If written approval is required or specifically requested for a 401 Certification, then a non - refundable application fee is required. In brief, if project impacts include less than one acre of cumulative wetland /water impacts and less than 150 feet cumulative impacts to streams, then a fee of $200 is required. If either of these thresholds is exceeded, then a fee of $475 is required. A check made out to the North Carolina Division of Water Quality, with the specific name of the project or applicant identified, should be stapled to the front of the application package. For more information, see the DWQ website at httr)://h2o.ehnr.state.nc.us/ncwetiands/fees.html. Page t of 4 Office Use Only: USACE Action ID No. I. Form Version August 2006 DWQ No. (If any particular item is not applicable to this project, please enter "Not Applicable" or "N /A ".) Applicant Information Owner /Applicant Information Name: nJ 0 -4 c iF_ Mailing Address: ,, t2 a c `'� + o F rt > iZl= - 4-E> _J s13 .) A/ C_ 2-7-! `9� Telephone Number: C//l - -22-y- ' �3 -31 Fax Number: E -mail Address:_ & j c A N; AA (P— A C L, C-0,11-4 2. Agent/Consultant Information (A signed and dated copy of the Agent Authorization letter must be attached if the Agent has signatory authority for the owner /applicant.) Name: 9 F4 J L i (�,L � Company Affiliation: c° ,AJ00e-F —A<__7 -' O 7 Es t 6/J Mailing Address: 4- i -,w7- C _s0u.2cz, /VC Telephone Number: G%/ vii - L & i c`� Fax Number: 'as j2 E -mail Address: ��i ice., C� C��..�.��t_ II. Project Information Attach a vicinity map clearly showing the location of the property with respect to local landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property boundaries and development plans in relation to surrounding properties. Both the vicinity map and site plan must include a scale and north arrow. The specific footprints of all buildings, impervious surfaces, or other facilities must be included. If possible, the maps and plans should include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion, so long as the property is clearly defined. For administrative and distribution purposes, the USACE requires information to be submitted on sheets no larger than 11 by 17 -inch format; however, DWQ may accept paperwork of any size. DWQ prefers full -size construction drawings rather than a sequential sheet version of the full -size plans. If full -size plans are reduced to a small scale such that the final version is illegible, the applicant will be informed that the project has been placed on hold until decipherable maps are provided. 1. Location _ County: Nearest Town:ci /�� Subdivision name (include phase /lot number): /— /Oc- 'r ,A &-e-L Site coordinates: Decimal Degrees (6 digits minimum): °N °W Directions to site (include road numbers /names, landmarks, etc):5Lex��►Z =`/1I- E_ ,vr,¢y.j TE- ) zziv/vT vim) }fAi,c ,— 1ZI it N t 1 Lo T JGy-J 1_G- iJ. C � � 1 7 Page 2 of 4 I Property size (acres): 4. Name of nearest named receiving body of water(stream/river /lake): 5. Describe the purpose of the proposed work:_, nx 00 10C —_42e- 04-- 6. List the type of equipment to be used to construct the project: Zb r„ " exe,, /3a6 7. Type and amount of impact (including all back fill, excavation, riprap, retaining walls, other fill, etc.) below the normal pool lake level in square feet or acres, and distance from shoreline: /yv q 8. a. Type and amount of impact (including all clearing, back fill, excavation, riprap, retaining walls, other fill, etc.) above the normal pool lake level and 50 feet land -ward in square feet or acres: !�;o x Z2 = 3a 00 S te' b. Please describe the vegetation above the normal pool lake level and 50 feet land -ward to be impacted (number of trees for instance): r lO �n.a S G�- / lCer ire -eS lcs q Y 1 ' un. "r 6/WS .s `��Applicant/Agent' Si ature Date ent's signature is v �d only if an authorization letter from the applicant is provided.) Page 3 of 4 US Army Corps Of Engineers Field Offices and County Coverage Asheville Regulatory Field Office Alexander Caldwell Haywood McDowell Swain US Army Corps of End neers Alleghany Catawba Henderson Mecklenburg Transylvania 151 Patton Avenue Ashe Cherokee Iredell Mitchell Union Room 208 Avery Clay Jackson Polk Watauga Asheville, NC 28801 -5006 Buncombe Cleveland Lincoln Rowan Yancey Telephone: (828) 271 -7980 Burke Gaston Macon Rutherford Fax: (828) 281 -8120 CabarT s Graham Madison Stanley Raleigh Regulatory Field Office Alamance Franklin Nash Surry I S Armv Corps Of Engineers Caswell Forsyth Northampton Vance 333 f'rri� %(� Q� I Chatham Granville Orange Waite 5. i le %o,f Davidson Guilford Person Warren Davie Halifax Randolph Wilkes Durham Johnston Rockingham Wilson Edgecombe Lee Stokes Yadkin b. _._D_.�.., ... ,.rice Beaufort Currituck Jones Pitt US Army Corps Of Engineers Bertie Dare Lenoir Tyrrell Post Office Box 1000 Camden Gates Martin Washington Washington, NC 27889 -1000 Carteret* Green Pamlico Wayne Telephone: (252) 975 -1616 Chowan Hertford Pasquotank Fax: (252) 975 -1399 Craven Hyde Perquimans *Croatan National Forest Only Wilmington Regulatory Field Office Anson Duplin Onslow US Army Corps Of Engineers Bladen Harnett Pender Post Office Box 1890 Brunswick Hoke Richmond Wilmington, NC 28402 -1890 Carteret Montgomery Robeson Telephone: (910) 251 -4511 Columbus Moore Sampson Fax: (910) 251 -4025 Cumberland New Hanover Scotland Division of Water Quality 401 Wetlands Unit 1650 Mail Service Center Raleigh, NC 27699 -1650 Telephone: (919) 733 -1786 Fax: (919) 733-6893 North Carolina State Division of Water Quality (Does not need to be submitted) Page 4 of Full Pond Sho're4ine Lake (Fulf Pond) 2 AF I� I Please approximately sketch the folfowing information on this plan (please provide dimensions for each item, such as 10 €t. x 100 ft): 'f) All proposed vegetation clearing (provide dim- ensia-ns� _2) Location of rip rap or till to he placed above the Full Pond elevation 3) Location of rip rap or fill to fie placed below the Full Pond elevation 4) The location of any proposed structures such as buildings, retaining vtaffs. docks, etc. �} The location of any excavation or dredging t)elow the Full Pond elevation. 6) Location of construction access corridors. SURVEY FOR FREDDE JOYCE SLOANIM < LOT 2088, LAKE ROYALE SUBDIVISION 1193 SAGAMORE DRIVE o PIN,# 2830 -87 -4294 J P.B. PRF 1, PAGE SL -104A D.B. 1926, PAGE 315 CL CYPRESS CREEK TOWNSHIP FRANKLIN COUNTY, NORTH CAROLINA NOVEMBER 21, 2014 I- j a- 0 50 25 0 50 100 wmmmg �� SCALE 1"=50' TIE TO THE INTERSECTION DP SAGAMORE DRIVE & MAYAN DRIVE PP 2089 t.9 w,�,flr' BD e VICINITY MAP LEGEND: EIP — EXISTING IRON PIPE EIB — EXISTING IRON BAR EPK — EXISTING PK NAIL NIP — NEW IRON PIPE SET R/W — RIGHT OF WAY CAN — CABLE TV BOX EB — ELECTRIC BOX TEL — TELEPHONE PEDESTAL PP — POWER POLE OHL — OVERHEAD LINE LP — LIGHT POLE WM — WATER METER WV — WATER VALVE CO — SEWER CLEAN —OUT \ r 4r EIP �o N m E 2088;` 6 °D w 17.487 sA.- ft:�-0�- ac- 7 7 \ m 0. tto na t \� \ E r5 2087 o O� ^OFD S /4- \ : Q: ti� • e 1 9 SEAL APPROXIMATE 100 YEAR V FEMA FLOODUNE PER FIRM e L -3835 PANEL 3720 2830 OOK LAKE ROYALE DATED APRIL 16, 2013 a� a \ r+ LINE TABLE I` I LINE LENGTH I BEARING 3 t + L-1 I 245.67 I S 1233'43- E i N CAWTHORNE, MOSS CAROLINA ES THAT THIS TANDARDS 0 SURVEY PRACTICE FIOR SURVEYING, ORTH & P AN CI ER A, P.C. (SECTION 1600) FOR CLASS I SURVEYS E A THAT THE CALCULATED RATIO OF PRECISION BEFORE ADJUSTMENTS IS 1:10,D00+ FURTHERMORE, PROPERTY CORNERS SHOWN Professional Land Surveyors ARE PRJ7.4fR Y CONTROL MONUMENTA71ON FOR THE RE- Professional SC1 HMENT OF PROPERTY CORNERS IN THE ABSENCE C -1525 OF GRID NUMENTS AND OTHER SUBDIVISION PROPERTY 333 S. White Street CgF27PROFESSIONAL S SURVEY IS NOT TO BE RECORDED WITH - QUUT AU RIZAT[ON OF THE SURVEYOR. Post Office Box 1253 Wake Forest, N.C. 27588 S (919)556 -3148 LAND SURVEYOR L- 5� SAMPLE AGENT AUTHORIZATION FORM PROPERTY LEGAL DESCRIPTION: LOT NO. PLAN N0. PARCEL ID: b STREET ADDRESS:1 Please print: Property Owner: v Property Owner: The undersigned, registered property owners of the above noted property, do hereby authorize c (Contractor / Agent) (Name of consulting firm) to act on my behalf and take all actions necessary for the processing, issuance and acceptance of this permit or certification and any and all standard and special conditions attached. Property Owner's Address (if diffecsnt tl�an property above): r t iCF i G Telephone: We hereby certify the above informatics submitted in this application is true and accurate to the best of our knowledge. < Lc�.a. Authorized S,T7ture Date: � ti Authorize ignature / Date: %Z. % 5 4 .N , State of North Carolina Department of Environment and Natural Resources Division of Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization Division of Water Resources FORM: SSGP 10 -2013 Shoreline Stabilization Application Form Four 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 1. Applicant Information (15A NCAC 02H .0502(a)j 1. Owner Information Name: ,J 6 (4 C-V—; S L l M Mailing Address: 153 o 12 a " -l—Y /_oJIsn 0 re- (;, U� 1 JUt, 2 9 2015 1 t DENR . 401,& 8U FER PAR OU�r5 m c Telephone Number: 97 q - 229. 4 3'1_ Fax Number: E -mail Address: JXJ_o ,4 ^'1^'' e A o L. C -o," 2. Agent/ Contact Person Information A signed and dated copy of the Agent Authorization letter (a form can be downloaded here: http: / /www.saw.usace. army.mil/ Portals /59 /docs /regulatory /regdocs /Permits /SAMPLE AGENT AUTH ORIZATION FORM.pdf) must be attached if the Agent has signed this application form. Name: SHAv,&J L!(EpE7E--TT- Company Affiliation: Ce>'J C-f—:; t Mailing Address: / mac' s L.) J HT 6-c3 ulsi3v R-6 lKCG Telephone Number: / Cos 619Fax Number: 25-2 ~ 5 76 E -mail Address: -Des, G^f e -cgAA4-rc cs•� Person to receive the Certification Approval: S gAvI-J L G6 E,77-- II. Project Information j15A NCAC 02H .0502(a) & (b)j 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 4 s t ,t 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: Fp0A k-L-t'`3 Nearest Town: 3unt� Subdivision name or site address (include phase /lot number): L _AI.Z'C-- �b�fAL Directions to site - please include road names and numbers, landmarks, etc.: 5k,,ax, Cs a - • r 9/G *-I— 6A.'I Ch1r-- Y6-JAFd-_ q,2_ ( k �1T� i2- LAIC f� �Az E .D k a- t t-1 t_—? x4tE- � . P-1 �=, Wr 25 rJ S (�A ej 4 t4c_ t:; Z , P_ I b 4-z' a of 5'Ac6. AM0�, t> i�_' , Lo-r- c�,j Ltz-r—T - 5. Describe the existing land use or condition of the site at the time of this application (residential, undeveloped, etc.): F 5 ` t3-TI A L i ,O-C CL,CA-IZEto 6. Property size (acres): . 2/o/ 7. Lake/ river/ ocean adjacent to property: I?-C3 -( AL- 8. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or why it is necessary): &c_ 7-o slia rrnh �__, Ay-- al= cras .'c)^ 4je - 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 �x y ? �= /1 -S, - 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: S u 7 ') = 3Gnn ""S' "' 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): Aa.,W 0 Agent's Sig atu ` /(lSANCAC 02H .0502(fll Date 'Agent's signature is valid only if an authorization letter from the owner is provided. FORM: SSGP 10 -2013 Page 2of3 SURVEY FOR TIE TO THE INTERSECTION OF SAGAMORE DRIVE do MAYAN DRIVE PP 2089 2088 \� � SDI 17,487 s � AMUCO 1 ac FREDDE JOYCE SLOANIM < LOT 2088, LAKE ROYALE SUBDIVISION ° 1193 SAGAMORE DRIVE o PIN# 2830 -87 -4294 in P.B. PRF 1, PAGE SL -104A D.B. 1926, PAGE 315 D! ° CYPRESS CREEK TOWNSHIP 0 FRANKLIN COUNTY, NORTH CAROLINA N CAWTHORNE, MOSS NOVEMBER 21, 2014 in Professional Land Surveyors D_ 0 50 25 0 50 100 0 1 a 333 S. White Street SCALE 1"=50' TIE TO THE INTERSECTION OF SAGAMORE DRIVE do MAYAN DRIVE PP 2089 2088 \� � SDI 17,487 s � AMUCO 1 ac 2087 VICINITY MAP LEGEND: EIP — EXISTING IRON PIPE EIB — EXISTING IRON BAR EPK — EXISTING PK NAIL NIP — NEW, IRON PIPE SET R/W — RIGHT OF WAY CAN — CABLE TV BOX EB — ELECTRIC BOX TEL — TELEPHONE PEDESTAL PP POWER POLE OHL — OVERHEAD LINE LP — LIGHT POLE WM — WATER METER WV — WATER VALVE ' CO — SEWER CLEAN —OUT S \ r A\ f EIP i010 V• QQ �Ci% -0Ic m� r 0 a a � PP °o f t� lK \ CA .tssipN.% Trl SEAL L -3035 LINE TABLE I LINE I LENGTH I BEARING I I L -1 246.67 S 1233'43' E I I DECLARE THAT THIS SURVEY COMPLIES WITH THE NORTH CAROLINA STANDARDS OF PRACTICE FOR SURVEYING, (SECTION 1600) FOR CLASS A SURVEYS AND THAT THE CALCULATED RATIO OF PRECISION BEFORE ADJUSTMENTS IS 1:10,000 +. FURTHERMORE, PROPERTY CORNERS SHOWN ARE PR Y CONTROL MONUMENTATION FOR THE RE- ESTAB SH T OF PROPERTY CORNERS IN THE ABSENCE OF RID OINUMENTS AND OTHER SUBDIVISION PROPERTY C T NERS. IS SURVEY IS NOT TO BE RECORDED WITH - 0 TH IT3FM AUTF16RIZA11ON OF THE SURVEYOR. PROFESSIONAL LAND SURVEYOR L— ?�T�f' APPROXIMATE 100 YEAR FEMA FLOODLINE PER FIRM LAKE ROYALE PANEL 3720 2630 OOK DATED APRIL 16, 2013 \ `Z \ 1V 3 N CAWTHORNE, MOSS & PANCIERA, P.C. Professional Land Surveyors C -1525 \ 333 S. White Street Post Office Box 1253 Wake Forest, N.C. 27588 S (919)556 -3148 2087 VICINITY MAP LEGEND: EIP — EXISTING IRON PIPE EIB — EXISTING IRON BAR EPK — EXISTING PK NAIL NIP — NEW, IRON PIPE SET R/W — RIGHT OF WAY CAN — CABLE TV BOX EB — ELECTRIC BOX TEL — TELEPHONE PEDESTAL PP POWER POLE OHL — OVERHEAD LINE LP — LIGHT POLE WM — WATER METER WV — WATER VALVE ' CO — SEWER CLEAN —OUT S \ r A\ f EIP i010 V• QQ �Ci% -0Ic m� r 0 a a � PP °o f t� lK \ CA .tssipN.% Trl SEAL L -3035 LINE TABLE I LINE I LENGTH I BEARING I I L -1 246.67 S 1233'43' E I I DECLARE THAT THIS SURVEY COMPLIES WITH THE NORTH CAROLINA STANDARDS OF PRACTICE FOR SURVEYING, (SECTION 1600) FOR CLASS A SURVEYS AND THAT THE CALCULATED RATIO OF PRECISION BEFORE ADJUSTMENTS IS 1:10,000 +. FURTHERMORE, PROPERTY CORNERS SHOWN ARE PR Y CONTROL MONUMENTATION FOR THE RE- ESTAB SH T OF PROPERTY CORNERS IN THE ABSENCE OF RID OINUMENTS AND OTHER SUBDIVISION PROPERTY C T NERS. IS SURVEY IS NOT TO BE RECORDED WITH - 0 TH IT3FM AUTF16RIZA11ON OF THE SURVEYOR. PROFESSIONAL LAND SURVEYOR L— ?�T�f' SAMPLE AGENT AUTHORIZATION FORM PROPERTY LEGAL DESCRIPTION: LOT N0. ' � � 9 PLAN NO. PARCEL ID: ( (6 4 STREET ADDRESS: 1' `� ✓ n /" / '�� iC% l 1 r Please print: •f Property Owner: I �`7 ( f ' v %'L Property Owner: The undersigned, registered property owners of the a ove noted property, do hereby authorize of (Contractor / Agent) ` (Name of consulting firm) to act on my behalf and take all actions necessary for the processing, issuance and acceptance of this permit or certification and any and all standard and special conditions attached. iro � Property Owner's Address (if d'ff nt t I n property abo e): � o 2-7S Telephone: -( r 7� J�Z We hereby certify the above information submitted in this application is true and accurate to the best of our knowledge. lJU AuthorilAS,' ture Date: / �, 10/ Au orize ignature Date: , ACv 6 J r- ! , Full Pond/ Normal Water Level Shoreline La ke (At Full Pond/ Normal Water Level) 0 irm _ :34!> i F-F-cw%-.- woecr IL- f'�- cte-5< 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