20201249 Ver 2_dukedredgeapp_20230912

Duke Energy Excavation Permit Application Form
I FOR DUKE ENERGY USE ONLY
Duke File No.
Application Fee $ Security Deposit $ Check # Date Recv'd Initials
Date of Duke Energy Lake Services, applicant and/or contractor on -site inspections Dat� �%� �'rfitials 11�
Date Final Protection/Avoidance Area Markings Field - Verified
Initials
Approved to Start Work By * : Date
(Print) (sign)
Date Completion Required Date of Any Approved Extension Initials
Date Passed Closeout Inspection*
Initials
Any Stop Work Orders or SMG Violations*? (check one) []Yes ONo (If Yes, explain in PART V)
Date Deposit Refunded Initials Date Permit Database Updated Initials
* Forward copy of approved application (all pages, plus any attachments that Duke Energy changed) back to applicant
with Approval Letter and highlight any changes. File copies of Approval and Close-out Checklists and any Stop Work
Orders with application.
Part I. Applicant Information (Please Print)
Name Stephen A. Ford & Jennifer E. Ford Telephone [phone]
Email address: [e-mail]
Lake Address
131 Misty Cove Ln.
Mooresville, NC 28117
Contractor Company CTC grading
Contractor Contact Person Tina Little
Mailing Address (f different)
9804 Sandy Rock Place APT.202
Charlotte, NC 28277
Contractor Email Address: tinalittle1117(aD-gmail.com
Telephone [phone]
LAKE LOT INFORMATION
Lake Norman County Iredell City Mooresville State NC Tax Map No.
Subdivision Crescent Land & Timber Lot / Section No. 192 Lot Size .74 Acres
Duke Energy Page 4 of 13 rev 11/22/21
Excavation Program

Duke Energy Excavation Permit Application Form
Security Deposit Refund Information
The security deposit will be refunded after the excavation permit has expired if no violations of
the approval occurred. The applicant will receive the security depost refund at the mailing
address in Part I unless an alternative recipient is identified.
Send the security deposit to an alternative recipient? (check one) ❑Yes iNo (If Yes,
include name and mailing address below.
Name:
Mailing Address:
Tax ID:
Are there any Co -Applicants*? (check one) ❑Yes ❑No (If Yes, include names, street
addresses or lot numbers, pier numbers, phone numbers, and email addresses in Part V —
Additional Information)
* Co -Applicants exist when the proposed work is being done under a single application, will be
performed by a single contractor as one continuous project, and is done to benefit multiple
owners / lease holders of Project -front properties within a single development. There can be no
more than 4 co -applicants in addition to the lead applicant on any application.
Do not continue the application until an on -site inspection has been conducted between a
Duke Energy Lake Representative and the applicant and/or the excavation contractor.
NOTE: Initialling this portion of the application by a Lake Representative in no way
constitutes approval or eminent approval of the excavation or any other lake use permitting
activity.
Date of on -site inspection ("-4
Initials (Duke Energy)
(applicant/contractor)lL /
Duke Energy Page 5 of 13 rov 11/22/21
Excavation Program

Duke Energy Excavation Permit Application Form
Part II. Description of Project
A. Basic Information
1. Type of excavation: (check one) ® New excavation ❑ Maintenance excavation
2. Purpose of excavation: (check one) ❑ Boat Access Channel
❑ Water Intake Channel ❑ Wastewater Discharge Channel
® Other (specify): New dock construction
3. Lake user category: (check one)
❑Commercial Marina
❑Other (specify):
®Private ❑Residential Marina
❑Public
4. Max. Excavation Area Dimensions (ft): Length 52' Width 51' Depth 3'
(Note: include additional area dimensions if necessary so response to #5 below equals max. area
dimensions in 44)
5. Volume of Excavated Material (TOTAL for the project): 294.66
6. Type of material removed (applicant determines by field sample ifpracticaO:
Red Clay/ silt
Cubic yards
7. Excavation Site area: 0.06 Acre (s) Disposal Site area: 3.0 Acre
(s)
8. Total Disturbed Area (including equipment staging area): 0.06 Acre (s)
9. Does the project meet the requirements of the applicable General Permit? (check one)
®Yes ONO
10.
Do you claim
title to the disposal area? (check one) ❑Yes
®No
11.
Do you claim
title to the equipment sta2inQ area? (check one)
❑Yes ®No
12. Are there any water -treatment facilities within 50 feet of the proposed excavation area?
(check one) ❑Yes ®No
(If Yes, specify):
13. How will the excavated material be entrapped and the erosion controlled? (e.g. see attached
erosion control plan and disposal area design):
Dredged by barge , material will be hauled out through owners land and taken to 3776 Amity Hill rd,
Statesville NC 28677
Duke Energy Page 6 of 13 rev 11/22/21
Excavation Program

Duke Energy Excavation Permit Application Form
14. Type(s) of excavation equipment to be used:
Long reach Excavator and Dump truck
15. Will waters or wetlands be crossed in transporting equipment to or from the site?
(check one) ®Yes ❑No
(If yes, explain)
By Barge
16. Will return water re-enter the reservoir? (Check one) ❑Yes ®No ❑N/A
(If Yes, specify point(s) of re-entry and show on Excavation Area Drawing)
17. Is there an existing facility (e.g. pier) that access is being maintained to by conducting the
excavation? ❑Yes ®No
(If Yes, provide the existing permit number. If No, include a scaled drawing of the proposed
facility). Permit # LKN custom Dock has submitted dock application.
18. Total planned duration of the work (Include first equipment mobilization, excavation
through final mitigation measures complete):
START 12 / 2023 FINISH 12 / 2023
(Month) (Year) (Month) (Year)
Duke Energy Page 7 of 13 rev 11/22/21
Excavation Program

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Duke Energy Excavation Permit Application Form
C. Applicant's Signatures
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Applicant Name (print)
Applicant Signature* Date lzyLX)O-3
Co -Applicant Name (print)
Co -Applicant Signature*
Co -Applicant Name (print)
Co -Applicant Signature*
Co -Applicant Name (print)
Co -Applicant Signature*
Co -Applicant Name (print)
Co -Applicant Signature*
Date
Date
Date
Date
*Per my signature, the information provided in this application is correct to the best of my
knowledge.
Duke Energy Page 10 or 13 rev 11/22%2UZ1
Excavation Program

Type: CONSOLIDATED REAL PROPERTY
Recorded: 4/4/2023 2:27:22 PM
Fee Amt: $2,926.00 Page 1 of 2
Revenue Tax: $2,900.00
Iredell County, NC
Renee L. Holland Register of Deeds
BK 2984 PG 1254 - 1255
NORTH CAROLINA GENERAL WARRANTY DEED
Excise Tax:
$2,900.00
�Parcel ID:
4624-17-1660.000
MaiUBox to:
Ralston, Benton, Byerley & Moore, PLLC, 335 North Center Street, Statesville, NC 28677
Prepared by:
Ralston, Benton, Byerley & Moore, PLLC, 335 North Center Street, Statesville, NC 28677
Brief description
LOT 192
for the index:
J
THIS GENERAL WARRANTY DEED ("Deed") is made on the 23rd_ day of March , 20 23 , by and between:
GRANTOR GRANTEE
Jason Knee and wife, Sandra Knee Stephen A. Ford and spouse Jennifer E. Ford
2001 Purcell Lane 7914 Skye Lochs Drive
Daniel Island, SC 29492 Waxhaw, NC 28173
Enter in the appropriate block for each Grantor and Grantee their name, mailing address, and, if appropriate, state of organization
and character of entity, e.g. North Carolina or other corporation, LLC, or partnership. Grantor and Grantee includes the above
parties and their respective heirs, successors, and assigns, whether singular, plural, masculine, feminine or neuter, as required by
context.
FOR VALUABLE CONSIDERATION paid by Grantee, the receipt and legal sufficiency of which is acknowledged, Grantor by this
Deed does hereby grant, bargain., sell and convey to Grantee, in fee simple, all that certain Iot, parcel of land or condominium unit in
the City of Mooresville, Mooresville City, Iredell County, North Carolina and more particularly described as follows (the "Property"):
Being known and designated as Lot 192, Section 6, as shown on map entitled 'Revised: Crescent Land & Timber Corp. Lake Norman,
Map of Recreation Lots," recorded in Map Book 34, Page 35, Iredell County Registry. See also maps recorded in Map Book 1.7, Page
629. Map Book 18, Page 88 and Man Book 18. Page 193_ Mecklenburg Countv Registry
Property Address: 131 Misty Cove Lane, Mooresville, NC 28117
Parcel ID No.: 4624-17-1660.000
All or a portion of the Property was acquired by Grantor by instrument recorded in Book 2647 Page 1508.
All or a portion of the Property 0 includes or 0 does not include the primary residence of a Grantor.
A map showing the Property is recorded in Book 34 Page 35.
NC Bar Association Real Property Section Form No. 3 rcc Revised 02/2021
Printed by Agreement with the NC Bar Association
submitted electronically by "Ralston Benton Byerley & Moore, PLLC'
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Iredell county Register of Deeds.
Book: 2984 Page: 1254 Page 1 of 2

TO HAVE AND TO HOLD the Property and all privileges and appurtenances thereto belonging to Grantee in fee simple. Grantor
covenants with Grantee that Grantor is seized of the Property in fee simple, Grantor has the right to convey the Property in fee simple,
title to the Property is marketable and free and clear of all encumbrances, and Grantor shall warrant and defend the title against the
lawful claims of all persons whomsoever, other than the following exceptions:
IN WITNESS WHEREOF, the Grantor has duly executed this North Carolina General Warranty Deed, if an entity by its duly
authorized representative.
Name:
Name:
STATE OF SOUTH CAROLINA, COUNTY OF
Entity Name
By:
Name:
Title:
By:
Name:
Title:
i1tA u ,i. , a Notary of the above state and county, certify that the following person(s)
personally appeared before me on the 73 day of �r`��t_�.�_ 20 each acknowledging to
me that he/she/they signed the foregoing document, in the capacity represented and identified therein (if any):
Jason Knee and Sandra Knee
Affix Notary Seal/Stamp
----------
JAMES H. MCKENRICK JR.
Notary Public
State of South Carolina
My Commission Expires Nov 18, 2029
NC Bar Association Real Property Section Form No. 3 0 Revised 02/2021
Printed by Agreement with the NC Bar Association
Notary Pub c ( fficial Si nature)
My comm',` siexpires: i
Book: 2984 Page: 1254 Page 2 of 2

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131 Misty Coll
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(Plan View)
Full Pond/ Normal Water Level
mm MW No am
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y Riprap above full vond/ NWL
2 ft' r. 150 ft.
additional dearing if
11j M02
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