20150889 Ver 1_Shoreline Stabilization_20150831

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T
DUKE iNERGY INTERNAL USIE ONLY- Construction
Date Received: ; FAF Paid Application ' ,.E
=- _
E] Application Complete v*Wcn 13p ENERGY,
HEP Fund Permit No � � WaterEnergy Strategy, Hydro Licensing and Lake Services
Duke
PO Box 10051 EC12Q
Site ID Cfose -i�ut Date _ w_ Charlotte t�lC 2;3243
1. DATE OF APPLICATION' � �- � �— / 5 � Permit/Tag
It. APPLICANT INFORMATION (applicant malling address and contact Information)
Primary Phone* ; S,4�✓A PA & X I Gy 14i,45©A/ lP6;L • 4-op
Address' � f 3 % S11, 4A(Ale Al Z)r- � Secondary Phone
Cites eNc�% &J, State= Zip Code,, 6 761 Fax number
Email*
Ill. PROPERTY INFORMATION (location of permit)
Address" er- fyKe Pi,- . I County° �►''�1�`%
City- -�—,-ott-�n 64n/' Stateg Zip Code- [,�8'/66 County Parcel ID number
/ V 1i I A,44
(e.g. Number—) Tai, ID, Tt�'Li � 7 1
Lake-; � Numbtar...)
Subcltvisfion ad-s cha rcA Lot(s) Flat Book/Page b 316 30
To enter the latitude and Longitude of the property, please use a Latitude (e.g. 35.12345)° X5.6 599 P
servicelsoftware to easily acquire the location information. Values
should be provided in Decimal Degrees format (35.1245).
example service: http ; / /Itourhniap.com/iatlong.htmi � Longitude (e.g. - 80.12345)�� CIA �d 8� 1
til. f"t3Fi7SEl3 A,CTlir1T�'
i New /Modification of Existing Structure � Maintenance of Existing Structure is Dock
�,/ ❑ Covered?
;_ New /Modification of Existing Shoreline Stabilization {' Maintenance of Existing Shoreline Stabilization
r New/Modification of Existing Structure & Stabilization i Maintenance of Existing Structure & Stabilization � of Slips
r Transfer ofOwnership {' Other (please describe below) # of Jetports ❑
Area over iaand (sq ft) � � area over water 1:;q ft) Total Square Feet
Shoreline Stabilization (feet) Length of / Distance From Shoreline ,,/`� -41le J e )0i s &f j
Stabilization 16 0
j Materials
Brief Description 194,411 VA- - Fi &SMv k t✓ S +PrCY-eN v*l
of the Activity �l
Describe Briefly the Existing
Structures Over Land and
Water (include sq ft)

V, Dock Builder or Eng-ineev
Name/Company C r3
Address �p'�/r,d PhoneNumber 170
City to
State Zip Code r:Mail
-61C
V1. Check1w of Required Documents (to include with Application Submission)
,--/Recent Survey (stamped/signed by a professional licensed surveyor showing the location of the existing or proposed
M structure and /or surrey of the existing or proposed stabilization)
9"Photos along property shoreline and photos of any existing structures and/or stabilization in or near the water
[?/Application fee (check only, payable to Duke Energy) n Signed User Agreement Letter
applicable local, state, and federal permits M Plan and profile drawing showing all measurements and elevations
[] Habitat Enhancement payment (if applicable)
V11. Approval Process
a Application is reviewed and determined if complete. Fields with an asterisk are required.
o If application is not complete or does not include all items and information listed in the checklist, the
application will be returned as incomplete.
0 A Duke Energy representative will visit the site to conduct a visual inspection.
0 Applicant will be notified of approval or denial.
a Applicant is to have the notice, to be supplied by Duke Energy upon application approval, posted and
must be viewable from water. The notice must remain posted until a representative inspects the
project and determines the project is complete and within the application specifications.
Vift, Directions by Road
r- -7 7 F,j. 4-0 6X 3 (0, \A cw Av,;j 15 dl R4 r4 PCy-tin JJ-6rJ
Directions by n�-r A--fc- -PA- 4-P-0' JJ-� Et%e-YA44
Road' rl-q
K— t-toou -7't LAKe TV
IX. Application Submission
Please complete, print and sign this application. Then enclose all items from the checklist above in an envelope and
submit all the information to the address below.
Water Strategy, Hydro Licensing and Lake Services
Duke Energy PrintFcirm
PO Box 1006/ ECI ZQ
Charlotte, MC 26201
I agree that the information contained within is accurate:
-
Signed By

State of North Carolina
Four copies of the application (including attachments) and the application fee should be sent to:
Division of Water Resources 2 0, 5 0 8 8 9
401 & Buffer Permitting Unit
1650 Mail Service Center
Raleigh, NC 27699 -3650
ALIG
1. Applicant Information [15A NCAC 02H .0502 (a){ 31 2015
1. Owner Information 401 FATS �S
Name: < -S� �AK l L%ilYl FfRP AP ;vc
Mailing Address: 13 y SXC,(n AiM ib-l' i d'Q„
p
4p,rnd Lao Y\ , �3C 6'(o-1 7
Telephone Number: -�� i • �ofo� . fv Fax Number:
E -mail Address:
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
http : / /wv+;w.saw.usace.armv. rail/ Portals/ 59/ docs/ regulatory /rep,docs /Perm*its /SAMPLE AGENT AUTH
OltiZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: r.' k i P F'), -tG�j� -�
Company Affiliation: CPC
Mailing Address: _6 AA nY9-K,r;,A e.- 1-7AYm ik 4
Al oore-s1-, I(eI AV_ J9115'
Telephone Number: 7 Fax Number: 70(--
E -mail Address: r.ACSc,4kmile 0 AJ /Afi 4r4 �► . riC,7�
Person to receive the Certification Approval: �
�r6 /5v-;dq cs
II. Project Information t15A NCAC 02H .0502 (a) & iblj
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

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: :7 cot I Nearest Town: \ YoL&7V YV\ A n%
Subdivision name or site address (include phase /lot number): ►414 g rkLky-J\
) 4 615
Directions to site - please include road names and numbers, landmarks, etc.:�77 ->�o r_43(0j
on /two is o. P+o,,j B_-T'4�\ U J_+ooi 5W e_ Fr+,-m Rd ,
A IV D v^ri 5e 0j �q v^ w� ��i• , Dl\l (r t e K L can/
S. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Y�C'3 ie. crJ�J,A 1 L400Je4_ ) v-i—
&. Property size (acres); ©° 91:a / � Ale,
7. Lake/ river/ ocean adjacent to property: �q�< /Vr m Anl
8. Describe proposed work (include discussion as to how hardening o shoreline has been
avoided or why t is necessary): 57'i4,�ji�li_ S�k�Y�1, Afc- 1 fJ ✓'e %r✓r eros G�
Y Y,
9. Will work be conducted from land? From water? ❑
10. Total amount of disturbance (including all excavation, backfili, rip rap, retaining walls, etc.)
( g P
below the normal pool lake level/ Normal Water Level in square feet or acres:
`x 3'
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: 1601 X I i
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): 1060.1Jel Aa
g/,7- -7JJ
Owner /Agent's Signature, i1S�U AC 02F; .0502 (f)i Date r
+Agent's signature is valid only if on authorization letter from the owner is provided.
FORM: SSGP 10 -2013 Page 2 of 3

Full Pond/
Normal Water Level
Shoreline
\-11,
Lame
(At Full Pond/ Normal Water Level)
� 1 k'j"-)
p
r
m FEU Z1
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ft x ZOO 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.
S. 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

VICINITY MAP (NTS)
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1 1
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- PROPERTY BMWARY
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/
SETBACK INE
EA3T1aNT INE
LOT 624
KENNETH E. SPATZ
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DB 1947 PO 35-36
PID 4839390685
LOT 526
PO 52 PC 43-45
TITLE REFERENCE
MCA AND AN= IMY
DEW BOOK I004 PACE 1611
YAP BOOK 62. PACE 47--46
TAX PARCa 146Ji390785
SURVEY NOTES -
Q NORTK DFLUO ION IS BASH ON PLAT
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nes PROPERTY MAY BE SUBJECT 10
T�OIY? AND EASEM M OF RECORD.
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PHASE 6, MAP 1
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LOCATED IN THE FALLS TOWN TOWNSHIP
IREDELL COUNTY' TROUTMAN,NORTHCAROLINA
JULY2.2014 SCALE:14W
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