20150893 Ver 1_Shoreline Stabilization_20150831

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
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Division of water Resources iSA NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SSGP 10 -2013
Shoreline Stabilization Application Form 2 0
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Three copies of the application (including attachments) and the application fee should be sent
$ 93
to:
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Division of Water Resources
401 & Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699 -1617
1. Applicant Information [15A NCAC 02H .0502(a))
1. Owner Information
Name: Steve Nicholson
Mailing Address: 116 Kestrel Court
Mt Holly, NC 28120
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Telephone Number: 9732195999 Fax Number:
E -mail Address:
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter must be attached if the Agent has
signed this application form.
Name: Dean Fisher
Company Affiliation: Lake Norman Custom Dock
Mailing Address: PO Box 1439
Denver, NC 28037
Telephone Number: 7044832144 Fax Number: 8665794539
E -mail Address: Ikndock @email.com
Person to receive the Certification Approval: Dean Fisher
II. Project Information f 15 NCAC 02H .0502(a) & (b)]
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,
etc.), rip rap, excavation or dredging below Full Pond/ Normal Water Level elevations,
FORM: SSGP 10 -2013 Page 1 of 3

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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: Gaston Nearest Town: Mt Holiv
Subdivision name or site address (include phase /lot number):
116 Kestrel Court Mt Holly, NC 28120
Directions to site - please include road names and numbers, landmarks, etc.:
Hwv 16N to (RT) at Horseshoe bend beach to RT Stonewater bav to LT Woodward to
RT Beach bluff to LT Waterford to RT kestrel
Latitude (in decimal degrees) 35.355636 Longitude (decimal degrees) - 80.957422
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Established residential lakefront lot with house and
vard and pine trees in buffer
6. Property size (acres): 0.82ac.
7. Lake/ river/ ocean adjacent to property: Mt Island Lake
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Installation by land with Bobcat of ripran with fabric to
stop erosion of3-4ft bank at shoreline. Removal of small underbrush and undermined trees
as needed
9. Will work be conducted from land? XQ YES From water? ❑NO
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:
Approx 4x150ft or total 600sgft along shoreline
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: Approx 10x100ft access path thru buffer with
10x150ftgrading /access alone shoreline or 2500saft total impacted
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): Existing large nines with
small trees and grasses at shoreline
Dean Fisher
Owner /Agent's Signature' [15A NCAC 02H .0502(f)l
8/20/15
Date
FORM: SSGP 10 -2013 Page 2 of 3

FORM: SSGP 10 -2013 Page 3 of 3

3712 Mt Holly- Huntersville Rd, Charlotte, NC Drive 5.7 miles, 11 min
` 28216 to 116 Kestrel Ct, Mt Holly, NC 28120
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Map data 02015 boogie 2000 ft i t
via NC -16 N 11 min
10 min without traffic 53 miles
Details

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