20231469 Ver 1_Site Plan_20231031

Full Pond,
Normal Water Level
Shoreline
La €ce
(At Full Pond/ Normal Water Level)
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Please approximately sketch the following information on this plan, length of Shoreline
(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

PFOjeCCtN@Me/address._l. CCJt 9ArJ4eL / 224.20 60t4A M,,,V CL'ija F,14 County:
C:OWEW W,r 1 NC z,VC 3
Oman PAJ416L R. Uk
Print Signature .
Contrractorrsagent: CIM ST-nr4r; AAIP O:cy'eWA ce.e elnrnini. f�.1i nD7
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 1SA NCAC 02B .0243(8)1
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, 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)]
Acknowledgemene of Afdtiflcotion
1, . 'DA,416L 2 . C.,.t_ , 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
t7uality Certification and Buffer Rules, the approved plan(s) and specification(s), and other supporting
materials.
Signati.ire (C�Wrer}: _�.__ �� � �� _ __ Date: 1011912QZ5

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DON ALLEN & ASSOCIATES,P. A.
"Since 1971"
D Commercial * Residential * Mortgage Surveys * Multi —Family
Construction Staking * Subdivision Design * Topogrgphkmt
111-8 Raceway Drive * Mooresville * NC * 28117
[phone] [phone] Fax
I, certify that this map was drawn under my supervision from an actual
survey made under my supervision recorded in deed book_ -j186L __, page_ AIL __, and/or
plat book__!2 ___, page__ 21 ___, that the ratio of precision is 1':10,000, that this map
was prepared in accordance with the General Statutes of North Carg0h`. `K "t�bPter 89C.
my hand and seal on the __19TH day of _FEBRUARY __`, A,p,,.
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AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. -21 h'1/Z - 11 PLAN NO. PARCEL ID: ©o //'6 z3
TRAi;T
STREETADDRESS:1-2/20 Cottae`7'ftj% c-loB Cia
C�ir2FlrL�GtSr /✓'G 2f;u'4i
Please print:
Property Owner: 1>4141CL %?. C,-vk
Property Owner: Ki,489/;i-y A, Ccol-
The undersigned, registered property owners of the above noted property, do hereby authorize
- anice , of e A LLG
(Contractor / Agent) ' (Name of constjlting
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 different than property above):
S -A-W Ai A B Wti'C,
Telephone: 'y`'ji -->n05 4-9e
70q - 291 - iZ3?
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized Signature Owner
Date: iC1011c 3 'cL9 2c:
Authoo2ed Signature Ag nt
Date: IQ