20231262 Ver 1_Site Plan_20230915

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
a-
Klater'Res 15A NCAC 02H .0500 - Water Quality Certification, Shoreline Stabilization
EN%' S0NV,ENTA- FORM: SSGP 02-2017
Shoreline Stabilization Application Form
Three copies of the application (including attachments) and the i si bi ue should be sent to:
If sending via US Postal Service if sending via delivery service (UPS, Fed Ex, etc.)
Paul Wojoski Paul Wojoski
DWR - 401 & Buffer Permitting Branch DWR - 401 & Buffer Permitting Branch
1617 Mail Service Center _ 512 N. Salisbury Street
Raleigh, NC 27699-1617 Raleigh, NC 27604
A. Applicant Information [35A NCAC 02H .0502(a)I
1. Owner Information
Name: James Tobias
Mailing Address: 822 N. Shore Dr.
Hickory, NC 28601
Telephone Number: [phone] Fax Number: NIA
E-mail Address:
.IM, , .e� ,
A signed and dated copy of the Agent Authorization letter must be attached if the Agent has
signed this application form. (A form can be downloaded here:
htto://w,uvw.sa�j.usace.armv.rail/Portals/59/docs/reFtilatof-r/re-pdocs/`Permiits/`5`5 f LE AGENT AUTHORIZ
A T ION FORM.odf)
Name: Charlie Washburn
Company Affiliation: Marine Construction LLC
Mailing Address: PO Box 6400
Hickory, NC 28603
Telephone Number: 828-495-3040 Fax Number: N/A
E-mail Address: [e-mail]
B. Project information (15A NCAC 02H .0502(a) & (b)]
1. Attach a vicinity reap (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, buildings, retaining walls, docks, impervious surfaces, 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.
FORM: SSGP 02-2017 Pagel of 3

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: Alexander Nearest Town
Lake/ river/ ocean adjacent to property: Hickory
Property size (acres): 1.58 Acres
Subdivision name or site address (include phase/lot number):
Hickory
Lot 22-24 ®livers Landing Phase 822 N. Shore ®r. Hickory NG 28601
Directions to site - please include road names and numbers, landmarks, etc.: _
included in packet
Latitude (in decimal degrees) 35.803 Longitude (decimal degrees) -81.331
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Residential . Developed
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): WPnj;ioto hin and pjare Riprraap along the shoreline
to prevent forthpr erosion
7. Will work be conducted from land? _ From water? x
8. Total amount of impacts below the normal pool lake level / Normal Water Level
Permanent impacts (including all excavation, backfill, rip rap, retaining walls, etc.) in square feet:
too sgft
Temporary impacts in square feet:
9. Total amount of impacts above the normal pool lake level%Normal Water Level and 50 feet
land -ward
Permanent impacts (including back fill, excavation, rip rap, retaining walls, etc.) in square feet:
1 r)() sgft
Temporary impacts (temporary clearing, construction corridor) in square feet:
(Construction corridor= D sgft)
10. Please describe the vegetation above the normal pool lake level/ Normal Water Level and SO
feet landward to be impacted (number of trees, for instance): VVe plan to remove R trees
We will replant them one for one with Native Hardwoods. The lot has a wooded backyard.
11. Signature
owne�%/Agent's Signature` [15A NCAC 02H .0502(f)) Date
*Agent s signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 02-2017 Page 2 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 dredging below the Full Pond/ Normal Water Level elevation
Lake
(At Full Pond/ Normal Water Level)
ull Pond/ Normal Water Level 6 C'
Shoreline two
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C-0i %ddo( N6 " 01
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ba�o�e
Plan View
Lake
(At full Pondl Normal Water L-1) Existing Dock j
30 ftx7ft j
F t
3x350ft
Bel—LI pond] MIA
Full Pond/ Normal Water Le¢e)
'I ore'Me s 4ftx350ft
ii -- Riprap Abova V1 pond/NN.�L
j 2fr.x'sof.
!(i addiiionaf dearfrg ( t
X AAL M PRN%
'If necessary e
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Plan View
FORM: SSGP 02-2017 Page 3 of 4

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/NWT
Lake
(At Full Pond/ Normal Water
g�ic� fvt t
fond [Nw�
C
Side View
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No Tampa" tmVu0 �, b6"z6aled `►� �,
ewe, plan f-o rwove U s .
L,* w l t( i�z?,planf- r� w-
trees or
a+�e, WhiG�i WI7,1 �e a.5 h rn
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succ-e .ss,
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3 ft. below full pond water level 4 ft. above full pond water level 2 ft. additional clearing
a *if necessary
i
Existing bank
10 ft. bank
height ;aQ'
Q�
L E
Side View
I
FORM: SSGP 02-2017 Page 4 of 4

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address:_ Tobias- 822 Ni Shore Dr. /County: Alexander
Owner: James Tohia.q r /%
Print V Signature
Contractor/agent: Charlie Washburn — Marine Construction
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 02B .0243(6)]
Benching and 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, James Tobias , 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 p'lan(s) and specification(s), and other supporting materials.
Signature (owner): `�<_,�-- Date:

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Map data ©2023 1000 ft ■ ■
1117 Shiloh Church Rd
Hickory, NC 28601
1. Head southeast toward Shiloh Church Rd
92 ft
t-3 2. Turn right onto Shiloh Church Rd
253 ft
T 3. Continue straight onto Hubbard Rd
0.6 mi
K. 4. Slight left onto Cemetery Loop
0.7 mi
r4 5. Turn right onto N Shore Dr
Destination will be on the right
0.8 mi
822 N Shore Dr
Hickory, NC 28601

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AGENT AUTHORIZATION FORM
Please note that multiple forms may be necessary if there are more than two owners of the property.
PROPERTY LEGAL DESCRIPTION:
STREET ADDRESS OF EXISTING HOME or LATITUDE/LONGITUDE OF NEW CONSTRUCTION:
822 N. Shore [fir. Hickorv, NC 28601
35.803/-81.331
Parcel ID: 0019982
Property Owner Name(s) — please print:
Property Owner: James Tobias
Property Owner:
The undersigned, registered property owners of the above noted property, do herebyauthorize
Charlie Washburn , of Marine Construction LLC
(Contractor/Agent)
(Name of company)
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 Owners Mailing Address (if different than property address above):
Same as Above
Same as Above
Property Owner(s) Telephone: [phone]
We hereby certify that the above information submitted in this application is true and ccurate to the
best of our knowledge.
i
Autho ze`d Signature Contractor/ Agent
Date Date