20231598 Ver 1_Site Plan_20231122

Proposed
(Plan View) ,' slopes Z7�
+ 5` La ke -4
J(Full Pond/ Normal Water Level)
Full Pond/ Normal Watervvel
Shoreline
150,
.5o x I 5C0 s�
ll C`rl`x�
Lake
(At Full Pond/ Noftnal Water Uvel) Existing Deck
3U ft x' ff
3ftx350ft
Full Pon dj Normal Water Level Below full twndl NWL
Rio etiine afcxisan
Rlprap Above full Pond/ NWL
2 ft.x150 ft.
additional clearing
• If necessary
E AMPLE
Plan View

Proposed
(Side View)
La ke
t,
(At,l ull Pond/ Normal ter Level)
i
3
3 f[. below full pond waterlevel 4 ft. above full pond water level 2 ft. additional clearing
•if ne[emry
Existing bank
iD W hank a
height Qc�e
Q
Side ViEw MPLE

Duke Energy Lake Services
Guidance for Completing an Excavation Permit Application
Note: If you are proposing excavation in association with the permitting of a new
or expanded facility under the Marina or Conveyance Programs, you do not need
to complete this application. Instead, you should incorporate the excavation
request into the permit application for the marina/conveyance using the
appropriate application.
Step 1: Contact Duke Energy Lake Services
Complete "Part I" of the application and develop a drawing of the proposed excavation area.
Contact Duke Energy Lake Services to schedule a site visit. Lake Services will conduct a site
visit to determine if Duke Energy will accept an excavation permit application for the proposed
work. If the Lake Services representative determines the application process may proceed,
he/she will initial Part I of the application.
Step 2: Draft Application Development
Complete Parts II-HI.A-G and Part V of the Excavation Permit Application,
Step 3: Agency Consultation
Send the draft application developed during Step 2 to the agencies for review and comment on
the proposed activity. Refer to the Agency / Organization List available from Duke Energy to
determine which federal, state, regional, and local agencies and organizations require
consultation or review,
Note. Duke Energy reserves the right to require consultation with additional organizations
beyond those included in the Agency / Organization List.
Each agency / organization must be provided at least 30 days prior notification. Evidence must
be provided (e.g., response letter or Certified Mail receipt) in the complete application to show
each agency / organization was given the opportunity to review the proposal.
Consultation letters must be dated within the two years preceding Duke Energy's receipt of the
application. All permits must be valid at time of application and have a term longer than the
projected schedule for completing the permitted project.
What to Expect During Agency Review and Comment:
• You will typically receive a letter from each agency / organization either documenting its
concurrence with your proposal, requiring additional information, recommending
modifications, or offering no comment, You must address each agency's / organization's
comments with a follow-up letter and in your final application as described in part IV.
• If you do not receive any documentation from an agency / organization within 30 days of its
receipt of your proposal, you must provide the agency / organization with a follow-up letter
requesting comment on your proposal within 15 days from the date of the follow-up letter. If
you still do not receive any response as a result of the second letter, type "NO RESPONSE"
Duke Energy Page 1 of 13 rev 1 ]raarai
Ueavation Program

at the top of the follow-up letter and include it in the application along with proof of the
agency's 1 organization's receipt of the letter (e.g,, Certified Mail receipt). You may proceed
with the application process recognizing, however, that if its comments come later in the
application process, you will be required to address them.
From the United States Army Corps of Engineers (Corps): (** Note — The Corps may have
additional forms to submit for your proposal and an additional fee.) If the excavation can be
done under the requirements of the General Permit (GP) or a Nationwide Permit (NWP), you
will typically receive a copy of the Corps' tear sheet documenting authorization and
providing any additional instructions. If the excavation isn't covered under the GP or a
NWP, you'll be required to obtain an individual 404 Dredge and Fill permit from the Corps.
You roust receive written documentation from the Corps that your application either (1)
meets the requirements of the GP or a NWP or (2) the proper 404 Dredge and Fill permit has
been received before Duke Energy can process your application.
From the North Carolina Department of Environmental Quality (1VCDEQ), Division of
Water Resources: (Note NCDEQ may have additional forms to submit for your proposal
and an additional fee.) If the proposal meets the requirements of the Clean Water Act Sect.
401 Water Quality Certification, you will typically receive a letter from the NCDEQ Division
of Water Resources documenting Sect. 401 Certification and providing any additional
instructions. You may also receive a letter requiring additional information or
recommending modifications. You must receive written documentation from NCDEQ
noting any required Sect. 401 Certification has been received before Duke Energy can
process your application.
■ From the North Carolina Wildlife Resources Commission (NCWRC): If you do not receive
any documentation from the NCWRC within 30 days of their receipt of your application, you
may proceed with the application process without submitting a follow-up request,
recognizing however if comments come in later in the application process, you will be
required to address them.
From the South Carolina Department of Health and Environmental Control (SCDHEC):
(Note — SCDHEC may have additional forms to submit for your proposal and an additional
fee) The SCDHEC conducts a joint application process with the USACOE in S.C. If the
proposal meets any applicable requirements of the Clean Water Act Sect. 401 Water Quality
Certification, you will typically receive a letter from SCDHEC documenting Sect. 401
Certification and providing any additional instructions. You may also receive a letter from
USACOE requiring additional information for the agencies participating in the joint
application process, You must receive written documentation from SCDHEC noting Sect.
401 Certification has been received if required before Duke Energy can process your
application.
■ From the South Carolina Institute of Archaeology and Anthropology (SCIAA): The applicant
must wait 30 days after receiving the signed postal returned receipt. If a response from
SCIAA has not been received by this time you may proceed with the application process
without submitting a follow-up request, recognizing however if comments come in later in
the application review process, you will also be required to address them.
Duke Energy Page 2 of 13 rev 1 i12M t
Excavation Program

Step 4: Final Application & Submittal to Duke Energy
Following the consultation process, finalize the application. The final application submitted to
Duke Energy should incorporate all comments and recommendations provided by agencies and
organizations during the agency consultation process as well as copies of all permits received. In
addition to the final application include the following;
■ One check payable to duke Energy for the application fee and security deposit
• If applicable, a separate check payable to the appropriate Habitat Enhancement Program fund
• Signed Excavation Program Applicant's Agreement
Note. Co -applicants must also submit the application fees and applicable HEP fees with the
application.
Nke Energy Page 3 of 13 rev t Il2212I
Excavation Program

Duke Energy Excavation Permit AnIllfcation Form
FOR DUKE ENERGY usE ONLY
Duke File No.
Application Fee S Security Deposit $ Check # Date Recv'd Initials
Date of Duke Energy Lake Services, applicant and/or contractor on -site inspections Datet -t 7 lnitials
Date Final Protection/Avoidance Area Markings Field - Verified
Approved to Start Work By *
{Print)
Date Completion Required Date of Any Approved Extension
Date Passed Closeout Inspection*
Initials
Initials
Date
(sign)
Initials
Any Stop Work Orders or SMG Violations*? (check one) ClYes ❑No (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 better 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 r Telephone -&1
Email address: W 1 �r 31 ro di 1. CO YY]_
Ll o R
ire
rywaVEA n ��
Contractor Company
Contractor Contact Person
Contractor Email Address:
Mailing Address (if different)
1k11■ . i Telephone i ' .■9.
8f \ f — ■ ■ CAP CWz b ■■+ it •i
LAKE LOT INFORMATION
Lake �rr � County htmb�ity li State Tax Map No, QQ /
Subdivision r Lot 1 Section No. % Lot Size / % Acres
Duke Energy Page 4 of 13 rev I V22/2I
Excavation Program

Dune Enerav 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) Tdyes ONO (If Yes,
include name and mailing address below.
Name: Y' �e�d Tax ID: 6 + ?J
Mailing Address: _zLf rM17a
�ou�-Yrr�rr , f11 C 2B�lflla
Are there any Co -Applicants*? (check one) Oyes ZKo (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 I 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 Q 7--1 Z a
Initials (Duke Energy) '%_
(applicant/contractor)
C�
Duke Energy Page 5 of 13 re„ I1i2MI
Excavation Program

Duke Enerizv Excavation Permit Application Farm
Part II. Description of PrNect
A. Basic Information
1. Type of excavation: (check one) ❑ New excavation O'Maintenance excavation
2. Purpose of excavation: (check one)
❑ Water Intake Channel
❑ Other (sped):
3. Lake user category: (check one)
❑Commercial Marina
❑Other (spec):
Otoat Access Channel
❑ Wastewater Discharge Channel
A frivate ❑Residential Marina
❑Public
� 1 �
4. Max. Excavation Area Dimensions (ft): Length Width 5-1 Depth I�
(Note: include additional area dimensions if necessary so response to #5 below equals max. area
dimensions in #4)
5. Volume of Excavated Material (TOTAL for the project): r, L9 _Cubic yards
6. Type of material removed Capplicant determines by.fteld sample iractica :
7. Excavation Site area: Acre (s) Disposal Site area: s6G Acre
(s)
S. Total Disturbed Area (including equipment staging urea): ,� Acre (s)
9. Does the project meet the requirements of the applicable General Permit? (check one)
,dyes ONO
10. Do you claim title to the disposal area? (check one) ❑Yes J:2No
11. Do you claim title to the equipment staging area? (check one) ,OYes ❑No
12. Are there any water -treatment facilities within 50 feet of the proposed excavation area?
(check one) ❑Yes '0�io
(If Yes, spec):
13, How will the excavated material be entrapped and the erosion controlled? (e.g. see attached
erosion controlplan and disposal area design):
�-ed e. w l+lrl bi reach eaCm� r Iacp— ynq}er i cc 1s in h o p � ba es
1,�►LL40mcq b�`� e� - po loo�d ��taciux,�p *Ut��s and ct for { fS d'k -, - -, n ---,o I C-, 1 U2
Duke Energy Page 6 of 13 rev 11127J21
Excavation Program

Duke Energy Excavation Permit Application Form
14. Type(s) of excavation equipment to be used:
Lo-�qq r cox_Vl ejca\jix mv-, Short r ea c11 excrcvaj-or',
�nru V,5.
rgea 'k Puyn P
15. Will waters or wetlands be crossed in transporting equipment to or from the site?
(check one) X'es ❑No
I es, explain)
bred In equlpmevi%r' C'.t-will be, rc�� �
ore via Imfin4 pignf'
t., .
m CaS+rm 1bocv� o� ce E6+g3jA GLY',eCx rds5
r �r t
16. Will return water re-enter the reservoir? (Check one) ❑Yes ❑No .b�4/A
(If Yes, vecifY point(s)of re-entry and show on Excavation Area Drawirr) %
17. Is there an existing facility (e.g. pier) that access is being maintained to by conducting the
excavation? ❑Yes UNO New L�c�S �a �e eons i-u c�cd
(If Yes, provide the existing permit number. If No, include a scaled drawing of the proposed
facility). Permit #
18. Total planned duration of the work (Include f rst equipment mobilization, excavation
through final mitigation measures complete):
START �1 04 FINISH 1 �v
(Month) (Year) (Month) (Year)
Duke Energy Page 7 of 13 rev t tr22l21
Excavation Program

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Duke Enenzy Excavation Permit Alpolication Form
C. Applicant's Signatures
Comments:
Applicant Name (print) �y
Applicant Signature*iag, Date 7
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 of 13 rev 11/22/2021
Excavation Program

Duke Eneruv Excavation Permit Application Form
Part III. Additional Information
A. Deed and Survey Plat: A copy of the deed and registered survey plat or other instrument
under which each applicant and co -applicant claims title to the affected property (the
shoreline adjoining the excavation area, equipment staging area, area crossed by any spoil
and return water lines, and the disposal area). if the applicant(s) is(are) not the owner(s) of
said property, then forward a copy of the deed and registered survey plat or other instrument
under which the owner(s) claim title plus written authorization from the owner(s) to carry
out the project on their land.
S. Excavation Area Drawing: An accurate drawing of the area to be excavated. The drawing
must show at a minimum, a North arrow; the boundaries and acreage of the proposed
excavation area and equipment staging areas; lake, county, city, cove, tributary, road and
subdivision names and lot numbers (as applicable); property corners for project front lots;
the full pond elevation contour and lines dividing the cove width into equal thirds (as
applicable); approximate volume in cubic yards of the material to be excavated; point(s) of
return water re-entry; the boundaries of any adjoining areas that are to be specifically
avoided or protected during the work and the location (address) of the disposal area for the
excavated material. [NOTE: A copy of this drawing must also be provided to the
excavation contractor to ensure restricted areas are not impacted.]
C. Disposal Area Drawing: An accurate drawing of the proposed design for the disposal area.
The drawing must show at a minimum, a North arrow; the boundaries and acreage of the
proposed disposal area; lake, county, city, cove, tributary, road and subdivision names and
lot numbers (as applicable); the full pond elevation contour (unless disposal is well away
from the lake); the boundaries of any adjoining areas that are to be specifically avoided or
protected during the work; the location (address) of the excavation area from which the
material came and a statement of the disposal area's capacity with all dimensions labeled
that were used in the volume calculation. [NOTE: A copy of this drawing must also be
provided to the excavation contractor to ensure restricted areas are not impacted.]
Also note for projects larger than one (1) acre in North Carolina, including excavated,
equipment staging, and disposal areas, you must submit an erosion control plan. For
projects larger than two (2) acres in South Carolina, including excavated, equipment staging
and disposal areas, you must submit an erosion control plan. For projects < two (2) acres in
South Carolina, you must submit a completed standard reportingform for construction sites
disturbing two (2) acres or less to the South Carolina Dept. of Health and Environmental
Control (SCDHEC) - Stormwater Management
D. Vicinity Map and Driving Directions- A vicinity neap and directions by road showing
directions to both the excavation area and disposal area. Include the latitude and longitude of
both the excavation area and the disposal area.
Part IV. Agency Reviews and Approvals
Begin this section with a summary table of all agencies consulted and applicant response to
agency comments as shown in the example table below. Agencies should be listed in the order
Duke Energy Page 11 of 13 rev 11/22/2021
Excavation Program

Duke Enera Excavation Permit Application Form
shown in the Agency/Organization List. Consultation letters must be dated within the two years
preceding Duke Energy's receipt of the application.
Table IV-1. Sample Agencv Comment and Res onse Table
A2ency Comment Applicant Response
Agency 1
The activity is approved as proposed. INA
A&Lncy 2
The on -site well provides drinking water to the
Contacted Mr. Smith on 111120xx. No
public. Please contact Mr. Smith to discuss the
further action needed.
proposed changes and potential issues
associated with Your prrosal.
You must contact us immediately if
Applicant will contact Agency 2 if
endangered species are located during the
endangered species are located during
course of construction,
construction
Azencv 3
Requested agency comments on 111120xx and
NA
again on 211120xx. No response as of
2116120xx.
Azenev 4
Section 401 Water Quality Certification
Applicant will comply with the conditions of
the 401 Water Quality Certification
Following the table of agency comments and applicant responses, include a table of permits and
certifications issued by the reviewing agencies. As with the table of agency comments and
applicant responses, agencies should be listed in the same order as they are listed in the
Agency/Organization List.
Table 1V-2. Sample A2enev Permits and Certifications Table
Agency
Permit/Certification Name
Date of
Date of
Issuance
Expiration
Agency 1
Surface Water Withdrawal Permit
Agency 2
Section 401 Water Quality Certification
Following the two summary tables, include a copy of all correspondence to and from any local,
regional, state and federal agencies or other organizations with which you are required to consult,
including any required permits (e.g., Section 401 water quality certifications, Section 404
dredge/fill permits, building permits, etc.) or other approvals or comments which have been
obtained from these organizations regarding this activity. Include a copy of any local, regional,
state or federal regulations or guidelines that will be followed. All permitting issues must be
resolved and clearly documented. Correspondence should be organized in the order the agencies
are listed on the Agency/Organization list with the applicant's request for comments followed by
additional correspondence in chronological order. All permits must be valid at time of
DAe Energy Page 12 of 13 rev 11/22/2021
Excavation Program

Duke Energy Excavation Permit Amfication Form
application and have a term longer than the projected schedule for completing the permitted
project.
Part V. Additional Information
Provide relevant additional information. Reference previous parts as applicable. Include the
FERC-required Environmental Assessment if you were directed to do so during the initial site
visit. If there are co -applicants, this is where their information would be provided (see Part I).
Duke Energy Page 13 of 13 rev 11I2212021
Excavation Program

B37364 - P 491
For Registration
Fredrick Smith
Register of Deeds
Mecklenburg County, NC
Electronically Recorded
2022 May 24 11:42 AM RE Excise Tax: $ 3500,00
Book: 37364 Page: 491 - 493 Fee: $ 26.00
Instrument Number: 2022078662
NORTH CAROLINA GENERAL WARRANTY DEED
Excise Tax: $3,500.00
Parcel Identifier No. 078-017-12
Mail after recording to: Grantee
This instrument was prepared by: David W. Smith, III Attorney — Gray, Layton, Kersh, Et Al
Brief description for the Index: Lots 122 & 123 Crown Harbor North Subdivision
THIS DEED made this 19th day of May, 2022, by and between
GRANTOR:
CHIN JEN and wife,
I-MEI JEN
Address: 4717 Castle Ford Road Boone, NC 28607
and
GRANTEE:
WILLIAM JAMES GRANT and wife,
KELSIE HOWE GRANT
Property & Mailing Address: 20107 Bascom Ridge Drive, Cornelius, NC 28031
The designation Grantor and Grantee as used herein shall include said parties, their heirs,
successors, and assigns, and shall include singular, plural, masculine, feminine or neuter as
required by context.
WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt
of which is hereby acknowledged, has and by these presents does grant, bargain, sell and convey
unto the Grantee in fee simple, all that certain lot or parcel of land situated in the City of
Cornelius, Mecklenburg County, North Carolina and more particularly described as foil ows (the
"Property"):
Submitted electronically by "Gray, Layton, Kersh, Solomon, Furr & Smith PA"
in compliance with North carolina statutes governing recordable documents
and the terns of the submitter agreement with the Mecklenburg county Register of Deeds.

B37364 - P 492
SEE EXHIBIT "A" ATTACHED HERETO;
The subject property IS NOT the primary residence of the Grantor.
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all priviicges and
appurtenances thereto belonging to the Grantee in fee simple.
And the Grantor covenants with Grantee, that Grantor is seized of the premises in fee simple, has
the right to convey the same in fee simple, that title is marketable and free and clear of all
encumbrances and that Grantor will warrant and defend the title against the lawful clairns ofall
persons whomsoever except for the following exceptions:
I . Ad valorem taxes for the year 2022 and subsequent years, not yet due and payable; and
2. Utility easements and unviolated covenants, conditions or restrictions that do not
materially affect the value of the property.
IN WITNESS WHEREOF, the Grantor has caused this General Warranty Deed to be duly
executed as of the day and year first above written.
GRA OR:
(SEAL)
CHI EN
STATE OF NORTH CAROLINA
COUNTY OF Alp, 1(Ijo,, lw,,
(SEAL)
I-MEI JEN
11 u , a Notary Public of the County and State aforesaid, do
hereby certify that CHIH JEN AND WIFE, 1-ME1 JEN, Grantor(s) either being personally
known to me or proven by satisfactory evidence (said evidence being
Ne ), personally appeared before me this day and acknowledged the
execution of the foregoing instrument.
Witness my hand and official seal, this 70 day of May, 2022.
Notary Public /]
Print Name:
My commission expires:
Official Seal (must be legible)
=WILLIAMDES II
h Carolina
nty
s Sep 8, 2026

B37364 - P 493
Mgt 1 fParcef No. 001762261
BEING all of Lots 122 and 123 of CROWN HARBOR NORTH SUBDIVISION, PHASE 1, MAP 6 as shown on map thereof
recorded in Map Book 27 al Page 151 in the Mecklenburg County Reg isler of Deeds Office.
And also including that certain .037 acre. more or less, parcel as shown on the revision of Crown Harbor North Subdivision
as found in Map Book 31 at Page 339 of the Mecklenburg County, North Carolina Public Registry and beginning at an
existing iron pn as shown on said map, said existing iron pin located at the intersection of Line 4 and Line 5, also as shown
on said map, and running thence with Line 4 as shown on said map, said Line 4 being also one of the lines of Lot 123 as
shown on said map. N 75.14-33 E. 40.57 feet to a nail set; thence leaving the line of said Lot 123 and running with Line 12
as shown on said map, S 18-46-02.2 E 5.27 feet in Line 7 as shown on said map, S 46.16.27 E 37,88 feet to a nail set, said
nail being also in one of the Was of said Lot 123; thence with Line 6 as shown on said map and one of the lines of said Lot
123, S 80- 51.33 W 37,62 feet to a new iron pin; thence with Line 5 as shown on said map N 21.16.27 W 39.70 feet td the
point and place of beginning, and containing .037 acre, mre or less, all as per survey of Graylon W. Pippin, N.C.P.L.S.
And also including that certain .105 acre, more or less, of land designated as "Area to Lot 122' as found on the map of the
Revision of Crown Harbor North Subdivision as found in Map Book 31 at Page 339. said tract adjoining Lot 122 on two
sides, Lot 123 on one side, and that certain properly designated as "Area to Lot 129' on one side, and with "side
designated Line 14 on said map being very dose if not on the borders of Lake Norman.
And also including that certain property shown on the final subdivision plat of Phase I Me 6 Crown Harbor North Subdivision
recorded in Map Book 27 at Page 151 of the Mecklenburg County Public Registry and more particularly described
as BEGINNING at a point located in the right of way of Bascom Ridge Drive said point" the northwest corner
of Lot 123 as shown on said map; and thence from said point and place of Beginning. North 23-43-31 West with the arc of a
curve to the left having an arc radius of 45 feet and a chord of 26.12 feet, a distance of 26.51 feet to a 0 n I located in line
margin of the public right of way of Bascom Ridge Drive; thence North 49-24-01 East 15,27 feet to a point; thence South 40-
35-59 East 25 feel to a point; thence South 4W24.01 West 22,65 feet to said point and place of Beginning.
Title Reference' See Deed Book 9436, Page 609 in the Mecklenburg County Public Registry.
"t 2 Warcal bl on17s22a',
All that cenain tract of land being oesignated as "TOTAL AREA = 0.490 ACRE, more or Iess' as shown on Duke Energy
Corporation survey entilled.'Property Owned by Crescent Resources, Inc„ Cowans Ford Deve"ent. Being Portion of
Mary Gordon Kelly Tract, UM1.973. Lemley Township, Mecklenburg County, N,C.," dated April28. 1998, revised May 2,
2000. and recorded as an attachment to that Special Warranty Deed recorded in Deed Book 11543 at Page 532 in the
Mecklenburg County Register of Deeds Office.
Title Reference: See Deed Book 11543, Page 532 in the Mecklenburg County Public Registry -
BEG INNI NO at a point said point being the Northeast corner of Lot 44 of Phase I, Map 3 Crown Harbor Subdivision as
shown on Map recorded in Map Book 26 at Page 739 of the Mecklenburg Caunlyy Public Registry and from said point and
place of BEGINNING; thence N .72-33-32 W. 40,92 feet to a new pin Set; thence N. 57-41-32 W. 139,30 feel to a new pin
set; thence S. 71-14.28 W. 104.90 feet to a now pin set; thence S- 62.54-28 W. 47.70 feet to a new pin set; thence N- 73-
25-32 W. 56.00 feet to a new pin set; thence, S. 44.25-28 W, 47.00 feet to a new pin set thence N. 11-07-32 W. 66,30 feet
to a new pin set; thence N. 42-14-32 W. 92.60 feet to a new pin set; thence S. 7W1-28 W. 95.00 feel to a new pin set;
thence N. 89-40.32 W. 73.00 feet to a new pin set the N. 12-21-28 E, 102.40 feat to a new pin set; thence N. 66-53-28
E. 41,20 feet to a new pin set; thence S. 88-01-32 E. 58.40 feet to a new pin set; N. 04.45.28 E. 63.80 feet to a new pin set;
thence N. 14-22-32 W. 73.60 feet to a new pin set; thence S. 80-53.28 W. 41.10 feet to a new pin set thence N. 21.14-32
W. 39.70 feet to a new pin set. thence N- 76-16-28 E. 47.80 feet to a new pin set; thence N. 16.39.32 W. 40.40 feet to a new
pin set; thence N. 54.17-32 W- 10,80 feet to a new pin set; thence S. 89-16-28 W. 69.10 feet to a new pin set. thence S. 86-
36.28 W. 117.40 feet to a new pin Sol; thence S. 79.20-28 W. 146,50 fees to a new pin set; thence N- 30-13.001-. 273,60
feet fa a new pin set; thence N. 30-25-00 F= 377.40 feet to a new pin set thence S. 53-47-00 E. 921.60 feet to a new pin set
thence S. 69-19-00 E. 85.17 feet to a new pin set; thence S. 23-24-35 W. 537.89 feel to the point and place of BEGINNING
and containing 13.69 acres, more or less.
LESS AND EXCEPT 1.904 ACRES which is a poti ion of the property mnveyed in deed recorded in deed look 8241 at
page 142 in the Mecklenburg County Public Registry and more particularly described as follows BEGINNING at a point said
point being the Northeast corner of Lot 44 of Phase 1, Map 3 Clown Harbor North Subdivision as shown on Map recorded in
Map Book 26 at Page 739, of the Mecklenburg County Public Registry and from said point and place of BEGINNING;
thence N. 72.33.32 W. 40,92 feet to a new pin set; thence N. 57.41-32 W. 139.30 reef to a new pin set; thence N. 21-39.16
E. 539.59 feet to a point; thence S. 53-49-W E. 79.85 feet to a point; thence S. 6941-08 E. 85.17 reel to a point; and
thence S. 23-72.27 W, 537.69 fees to the point and place of BECANNIING.
Grantors herein reserves an exclusive perpetual easement, appurtenant to Lot 124, to erect, maintain and ulilize a private
pier and gazebo Over and across the property being conveyed by this Warranty Deers. This easement shall benefit the
successors in title of the property being conveyed by this Werra nty0eed end Shalt tre binding upon Iha successors in title of
Grantee. The pier and gazebo referred to herein shall be located contiguous to the northern boundary line of Lot 124 as
shown on the final Subdivision plat of Phase 1, Map 6 Crown Harbor North Subdivision recorded in Map Book 27 at Page
151 (hereinafterreferred to as "Lot 124') and further shall be located between the northwest comer of Lot 124 and the
northeast comer of Lot 124 and shall extend a distance of no more than 100 feet north into the property being conveyed by
this Warranty Deed and shall have a width of no more than 30 feet t"Easement Area).

LAKE NOR11dAN �$` p{N1HIyM,
f 6 DA Y W.LONG.P.
.w 01 d , 16335 OLD STAT86ViLLE OAP s* 2 " g
WE— A �i O
I7 g CORN&IUS,IN.C. 26031 Oq SLf Y; ►Z`
[phone] iy Yi �W •LINE L
w-
v1cIx�f u+uP WARM., DISTANCE ADDITIONAL REFERENCES:
Li s 49,33,05,S
La N awes 6 It 2zeelMAP BOOK 31, PG 39
I. xn xoDs MpNnMENr ,,,,,41„1L 3 s 5 9 2 E {O, } MAP BOOK 27, PG 151
FOUND W1TH1N 2(w. serore ea.now 6 g DEED BOOK 24281, PG 566
s rcerORE DEED BOOK 11127. P6234
1PROPERTY MAY BE, I@ SUSLT 19'38 23 E 5.27
TO OTH ER COVENANTS, L 31 448 37411 _
N E 46
RESTRICT IONS, FJ�5Rh4Ei+'1'S ` �4 L9 q}7 43 75.80
OR RTOHT"F-WAY THAT 5 03� 6 Yf 6a4t F ADJOI B 5PI G 88 ELOPE
MAY BE OF TIECORD- � {l
3. SETBACKS SHOWN ARE PER EEO 002.762-99 V
.LSB. 13. Pa. W. "UNDERWATER' t
' CNIKJEW
4, A PORTION OFTHE TPRf I•LAEI 7EN
PROPERTY LIES IN A SPECIAL . _
ruii lax.S8 DB 1k143, PG 037
FLOOD HA7.ARDAi FA 1
ACCORDSNOToFEMAFLOOD 4Lr 1
PANEL MAPS, HOW BVERTI1E
PRTNCtPAL S•fRUCTURR Is HELD LOCATED
ABOVE AND BEYOND THE ~ 760' LAKE CONTOUR
SPECIAL FLOOD HAZARD] So,[e� DATUM: NVGD 29
AREA PER FF.MA PANE MAP
37104MO0K; DATED 3RI2009,
5. CONSULT WITH GOVMN1NG w _
AOENCY FOR PRFVAILTNO� 'S
(•�j:
LA100 DEVELOMiENT AND �2• ¢�j�7N��'
c ZONING REQU I RF.MENTS [em ' C�
PRIOR TO N OR
CONS'YC!nQNOF ANY • �• 'r rerwwrieeeuNerEx ��^
I1.tPROVF.JrVEMU 1IINTS35, Epp �� � a Nnim.atsAxrn
C . It_ FIELDGiW
EY
OOI-782-24 x ar �Y�r
DB 11543, PG 532 � • �
L L3- 1
001.762.23
ROSIN E. SURANE m y C¢
06 1161L PG 895
TOTAL j
AREA I `
l , FT. 4906 I
49062ACAC RE5
001.762.28
iryrl jl ` �� MY WENDYRILEY
D5 3528, PCt 534
U �Ni , Graphic sc+lc
� � , 40 20 ❑ aD
n V Saaic of 3lgg I ].eh ado Foes
O6 001-762.27
COPY BARTER LE:OEND:
SARA BA%TER
.per DB 35655, PG 997 FOUND
$AR
`5COMPUTED PON7
a�RHVAC
�B 11GNT POLE i}
a6 i 4 ' ELECTRIC BOX �1
} , 2 37 s 'a it E SUBJECT PROPERTY LINE — —
.5 45.00 i. N 591333 E ADJDENER PROPERTY LINE
43 0 5 1 RUILDING SETBACK
erkjA nnnn k—
�p IPhysical Survey of Lot 122 & 123 of Crown Harbor, Phase 1, Map 6 (Revised)
Professional
Prorpe
Recordcd in:
site Address.
► o s, Inc.As
Inc.Road
Property of-
Map Book 33, Pg 365
20107 Bascom Ridge Drive
18333 pld Statesville Ste. A
Will Gmnt
Deed Book 8998, Pg 460
Cornelius, NC 280S1
Cornelius, N.C.28031
704-765-5134 Phone/Fax
Deed Book 9436, Pg 609
Mecklenburg County
Firm Liomsc C•3656
M2522-01
5ML
x 131.0 010
1"a40'
001-752-26 File Name
1 of I 4l28l2022
]n17N°.
�-
Ett°r of Closure
Drawl Seale
Tax i'ercei?dumlra t]rawin Flier N,i ,
umber Dma

KE NOR.hf.AN
Graphic Soak
su as o so
Scale of Draving i inch - 50 Fat
►.1i �F��164iSh
I i i�:�:�
�]I1��[+7'b:
1•)■
�d:t+i W-1 tl:Z�i�
s� bd
MAGNAIL
SEr ON !RANGY
SA'ONLINE
'2!
&FIER
Dk h;[Iy 5lgned by D- _ .J. LDrq 11NM11
H CARll
Prok"onel Property Surveyors• Ir1a. B1 OM O¢{K`
2 aWi
DARYTW" LOt3O, P.
k8335OLD STATESVILLP.ROAD S yea
SUrIE A
CORNBUUS, N.C. 2801 4q
[phone] pry yy • V
11141114
ADDITIONAL REFEREAiCES:
MAP BOUTT79U
ass MAP BOOK31, PG 39
MAP BOOK 27, PG 151
DEED BOOK 24221, PG 566
a + DEED BOOK 11127, PG 234
sj xr 4 x �d►
"UNDER WA
WiLUAM J. GRANT _
NELSIE H. GRANT AT7}'�7fFR'S PIER ENVELOPE
06M64,PG491 {� MB51,Pr. as
fed. `� "�� � � • �,�� _ � ��
FIELD LOCATED
760' LAKE CONTOUR
DATUM: NVGD 29 f ` "oi -- \�. `� \' '•�7 �
FIELD LOCATED
760' LAKE CONTOUR
DATUM: WGD 29
. i 1' / rl ' OEM--\� �r.. ,i'�R'J•� a .Y
ROBIN E. RIRANC ��
DID 116111 M 995 � +1 ! ! � - M1 � C• MA F1r1RPUNE PER
�s -?IDAi1�WlJ-q7'62.24 M
him eaio�cwTSEo
% 2I,8 7S]'k'!.'�f•_gpE� � ~`� i 1 't t, �tONf'AP
R, 01 ACRES 'AySq�
us
d
"i a / M=� � r � -- f ...ldS� ��•'.\:. ➢➢1-762.26
N • e _ MICHAEL P. RILEY
WENDY RILEY
i, f{ ,f •ql.• - 053528, PG 534
.N4 f _.
' ' y
•5
V , , 1.NONCORMONUMENT FOUND WITHIN VWD VFRTICA1.INFORMATION
FM TM PROIBCr WME POROUCFA WTH VRS GPS CEISERVATME ANC
PROQBSa '6!t , AACCURACYY ED OF TUC rrH VRs DERIV ➢YOsl1.71O AI, nl¢A4 �'OR TS OKTS GAP NETWORK rAN
001 762.27 St RV aY CI.AM WEST8 OR RXCEF.D CLASS C. VEIVnCAL DATUM USAI
CORY BAXTER NAVDBR.
SARA BAITER
DR "655, PG 897 L PROPERTY MAY BE SU&fECT TO OmR COVENANTS. RFmRIC MHS,
TBMI EASEMENTS OR RIOIIP15-0E-WAY TKAT MAY BE OP RECORD
601) MAGRAIL
ELEV•7188 35' 3" SETBACKS SHOWN ARE FFRMB.33, M S65.
LEGEND:
FOUND
RREEBBAR
OI PUTEO POINT
® ,
•
LLIIGHT POLE
ELECTRIC BOX
SUBJECT PROPERTY LINE
ADJDINER PROPERTY LINE
BUWNG SETBACK —
— -
FEMA FS.000 UNE---
SEWER EASEMENT
C A PORTION OF THE PROPERTY LM IN A FA-ECIAi. FLOOD HAM" AklL
ACCORTDNLI TO FEMA FTAOD PANEL MAPS- HOWEVER THLET%OICMAL
STRZMTLME IS ABOVE A140 BRYOMD THE SPRtiIAI. FLOODTIALARD ARIi
PER FEMA PAN- LEAP 371046U05K: ELATED 3+92f2U04.
3. NO RESIDRNTW, STRIJCrUk]' PERMANENT OR TO&CRARY MAY BE
CONSTRUCTED OR 3R=ED ON PID M-362.24. K RAB 1154%1G 531.
6. PID M]-762-24 MAY NOT BE DIVIDED TO CREATE AMMONAL LOTS(
PARCELS PERM 11543.PO 351.
7, CONSSJLT Wrlli OOVPRNRIO AG1ti1 O FCR-PRHVAU,1NO LAND
DRVEL08b4@7C AND Y.O DREQUIRF]MI-IiB PRIOR70 DESIGN OR
CONSTRUCTION OF ANY MVAOVtir1EP7CS.
Topographical Survey of Lot 122 & 123 of Crown Harbor, Phase 1, Map f (Revised)
& PID # 001-762-24 Former Crescent Resources Inc. Tract
professional
mperty Property of: As Recorded in: Site Address:
► Surveyors, Inc. p ' Map Book 33, Pg 365 20107 Bascom Ridge Drive
18335 Old Statesville Road Ste. A William & Kelsie Deed Book 8988, Pg 460 Cornelius, NC 28031
Cosnetius, N.C. 28031 Grant heed Book 37364, Pg 491 Mecklenburg County
704-765-5134 Phone/Fax
Firm License: C•36M
042522-01 JA+C 1:10 U00 1"=50' 001.762.26 TOP0 1 of 1 6�0/2022
naror 5rroriasure IhAwina 3caln Tax cell NLLv-oer Drawiie HumC net Nulnba ��

THE INFORMATION CONTAINED IN THIS DRAWING fS THE SOLE PROPERTY OF LANCASTER'S DOCK& LIFTS SYSTEM INC.
ANY REPRODUCTION W PART OR AS A WHOLE MTHOUT THE WRITTEN PERMISSION OF LANCASTERS DOCK & LIFTS SYSTEM INC. IS PROHIBITED.
ALL DIMENSIONS USED IN THIS DRAWING ARE NOMINAL
c
49-0" 20'-o'Fb
C2
N 4' 0" —
34'•0'
\N' -1l ,r-P-9uiVT 8 61 apes
ISSUE CLIENT
10-16-23 William and Kelsie Grant
Q Lancaster Custom Dock and Lifts
u DRAWN 9Y 20107 Bascom Ridge Drive 1156 Perth Road Troutman
r M.H North Carolina
Cornelius, N.C. 28031
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DUKE ENERGY DIRECTIONS BY ROAD FORM
Lake Use Permit Applications and Contractors: Ease of locating a proposed project
site can have a big impact on permitting processing time. Please complete this form
and return it along with your completed application to:
DUKE ENERGY
CIO LAKE SERVICES — EC 12Q
526 SOUTH CHURCH STREET
CHARLOTTE, NC 28202
Applicant's Name: William Grant
Street Address tat lake): 20107 Bascom Ridge Road
Lake Name: Norman
Subdivision Name: Crown Harbor North Phase 1
Property Section: Map Section 6
City: Cornelius
State: NC
Directions (from major road or highway):
Lot #: 122
County: Mecklenburg
Zip Code: 28031
From 1-77 NB, Exit 28, Turn left onto Catawba Ave. WB, Turn right on Torrence
Chapel Road, Turn right on Schooner Dr., Turn Left onto Crown Lake Drive, Turn left
onto Bascom Ridge Road. Property is at the end of the cul-de-sac to the right.
Descriptive Structure(s) on Property (i.e. brick garage, white fence, mobile home,
etc.)
Note: Please use the back of this form if desired to draw us a map to the site.

20107 Bascom Ridge Road Cornelius, NC 28031
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D UKE IENERGY DIRFCTIGNS BY ROAD FORM
LANCAanR CUSTOM DOC= DrsP.,, S,,.
Lake Ilse Permit Applicants and Contractors: Ease of lacatin the r
site csnhawa big imps as proposed l�roj ect
return it along with your compllee�ted applicatioMcen to..ing Lime. Please eaMpleie this farm and
DUKE ENERGY
C/o LADE SERVICES — EC 12 Q
526 SOUTH CHURCH si'i iir
CHARLOTTE, NC 28202
Applicant's Name:
IkW Address (at lake): 1162 ltiv ' hwa M
N 28117
Lake Name:
Subdivision Name: Bi
Prop" Section: Lot #:
City: o Mile County:
State:
--�� 71p: Z
Telephone _ OS
Directions (fmm major road or highway): From 1-77 NT3, Exit 36, Lett onto NC-
150 WE, Disposal Area is an the right behind Big Daddy's Restaurant
Complex.
Descriptive Structure(s) an Property (i.e. brick garage, white fence, mobile
home, etc.)
*Note: Please use the back of this form it dent and to draw as a map to the site.

1162 River Highway Mooresville,NC 28117
0 250 5o0 750 ft�
mmmb� ms .
€ USTIC WAY LN
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3 5.604043, - 80.99 0 286
Drag Me!
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World
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Foothills Marine
d Maps legal of Lake Norman
Performance
Hitch and Trucl
Accessories
CRM ■ Deg ■ DIMS Help
Decimal Degrees Latitude: 35.604043
Decimal Degrees Longitude:-80-910286
Clear Show Point

DUKE Lake Services
ENERGY® Duke Energy
EC120 1 526 South Church Street
Charlotte, NC 28202
Mailing Address:
EC12Q j PO Box 1006
Charlotte, NC 26201-1005
Pro' ected PrODerty Line AnDroval Letter
L i (Print Name) ^` ► owner of Lot # j in Subdivision
HA :iS'Cr,- give approval to W I W - _ -�y r )7 ,
(Print Name)
owner of adjacent Lot # in Subdivision -O CD vAN f'a, - to
encroach over the projected property line between our lots for uses that are
checked below:
0//Dock
❑ Dock Cable Anchor
Dredge
WAWRA�
arlu-2O
(DM)
()PaVLAK9MGMTlf2ekage iarmMionlProiWed Pmperry Line Approval Letter dae
www.duke-enerFy.com

Project N2rne/address.,
.
q �, NL
laeat o R dress: re i t wb
V r
Parcel #. 4 �,p,3g
Parcel/lot size
rc
Disposal area required (sq ft Omd/or acreage)
,4ck 7 r-, pe►nent of N00f cation
r files bu �P
—1 V�County: �re C-54 !
P
r S4 y.-
and rules regarding sedl ent and erosio ❑ntrol and wateram 1"Ware hauality51And g Ve pete rn
ere to ali $
state regulations
r
Name of Individual and Company
to dispose of their dredge material at the above stated location
Owner: ►. � , f Ir a v 1 �s _ n _� _ A rZ x O�
Print
Date: Jam- �JS18n�aure
Along with form, please provide:
Aerial of parcel/lot (County G15)
Photo of proposed spoil site
Identified proposed spoil site

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THE INFORMATION CONTAINED IN THIS DRAWING IS THE SOLE PROPERTY OF LANCASTER'S DOCK & LIFTS SYSTEM INC.
ANY REPRODUCTION IN PART OR AS A WHOLE WITHQUT THE WRITTEN PERMISSION OF LANCASTERS DOCK & LIFTS SYSTEM INC. IS PROHIBITED.
ALL DIMENSIONS USED IN THIS DRA WIN(: ARF MOMIM AI
ISSUE CLIENT
10-18-23 William and Keisie Grant
DRAWN BY 20107 Bascom Ridge Drive
M.H.
Cornelius, N.C, 28031
Lancaster Custom Dock and Lifts
1156 Perth Road Troutman
North Carolina
ti

THE INFORMATION CONTA fNED IN THIS DRAWING IS THE SOLE PROPERTY OF LANCASTERS DOCK& LIFTS SYSTEM INC.
ANY REPRODUCTION IN PART OR AS A WHOLE WITHOUT THE WRITTEN PERMISSION OF LANCA STEPS DOCK & LIFTS S YSTEM INC. IS PROHIBITED.
ALL DIMENSIONS USED IN THIS 6RAWAG ARE NOMINAL
issue CLIENT
D 10-18-23 William and Kelsie Grant Lancaster Custom Dock and Lifts
IjDRAW
MA. N BY 20107 Bascom Ridge Drive 1156 Perth Road Troutman
J 'HCornelius, N.C. 28031 North Carolina CUSTOM DOCK & Ll

THE INFORMA TION CONTAINED IN THIS DRAWING IS THE SOLE PROPER TY OF LANCAS TER IS DOCK& LIFTS SYSTFIN INC.
ANY REPRODUCTION IN PA RT OR A A WHOLE WITHOUT THE WRITTEN PERMISSION OF LANCASTER'S DOCK & LIFTS SYSTEM INC. IS PROHIBITED.
A LL DIMENSIONS USED IN THIS DRA WING ARE NOMINAL
. . 1 �
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• �.
II'�_AT �' i
er
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411
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�i ISSUE CLIENT
■ 1 i}18-23
William and Kelsie Grant Lancaster Custom Dock and Ufts
{� DRAWN BY 2-0107 Bascom Ridge Drive 1156 Perth Road Troutman
r M.H. North Carolina
Cornelius, N.C. 28031
W,
N

1
THE INFORMATION CONTAINED IN THIS DRAWING IS THE SOLE PROPERTYOF LANCASTER'S DOCK& LIFTS SYSTEM INC.
ANYREPRODUCTION IN PART OR AS A WHOLE WITHOUT THE WRITTEN PERMISSION OF EANOASTERS DOCX & LIFTS SYSTEM INC. IS PROHIDITED.
ALL DIMENSIONS USED IN THIS ORA WING ARE NOMINAL
a issue CLI ENT
0 23 William and Kelsie Grant Lancaster Custom Dock and Dfts
F+ °RAIIN BY 20107 Bascom Ridge Drive 1156 Perth Road Trautman
M.H. North Carolina
Cornelius, N,C, 28031
W
TV
W
fV
fV

THE INFORMATION CONTAINED IN THIS DRAWING IS THE SOLE PROPER T Y OF LANCA S TER'S DO( ►A& LIFTS SYSTEM INC.
ANYREPRODUCTION IN PART OR AS A WHOLE UVITHOUT THE WRITTEN PERMISSION OF LAN CASTER'S DDCIC & LIFTS SYSTEM INC. IS PROHIBITED.
ALL DIMENSIONS USED IN THIS DRAWA;G ARE NOMINAL
ISSUE CLIENT
10-1&23 William and Kelsie Grant
DRAWN 6Y 20107 Bascom Ridge Drlve
M.H.
Cornellus, N.C. 28031
Lancaster Custom Dock and Lifts
1156 Perth Road Troutman
North Carolina
M1]

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AGENT AUTHORIZATIrON FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. _ 122 PLAN NO. PARCEL ID. 00176224
STREET ADDRESS: 20107 Bascom Ri a Drive
Cornelius. NC 28031
Please print:
Property Owner: _1Nilliam Grant
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Donna P. Hrko
of
(Contractor J Agent)
Lancaster's Custom Dock and Lift Systems, Inc.
(Dame of consulting firm)
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):
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized SignatKY
Authorized Signature
9/25/23
Date: Date:

Project Namefaddress:
Owner: t 1 1
Print
Contractor/agent:
TAWBR RIPARIAN BUFFER NOTIFICATION FOR
Print
jj nZU,07&5co►r, Rid
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 028 ,0243(8)j
Trees are not allowed to be removed from Zone 1 of the Suffer (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 028.0243(6)1
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 028.0243(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 028.0243(5), (5)]
Acknowledgement of Notification f
vIl 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
Quality Certification and Buffer Rules, the approved plan(s) and specification(s), and other supporting
materials.
Signature (owner): Date.

Proposed
(Plan View) ,' slopes Z7�
+ 5` La ke -4
J(Full Pond/ Normal Water Level)
Full Pond/ Normal Watervvel
Shoreline
150,
.5o x I 5C0 s�
ll C`rl`x�
Lake
(At Full Pond/ Noftnal Water Uvel) Existing Deck
3U ft x' ff
3ftx350ft
Full Pon dj Normal Water Level Below full twndl NWL
Rio etiine afcxisan
Rlprap Above full Pond/ NWL
2 ft.x150 ft.
additional clearing
• If necessary
E AMPLE
Plan View

Proposed
(Side View)
La ke
t,
(At,l ull Pond/ Normal ter Level)
i
3
3 f[. below full pond waterlevel 4 ft. above full pond water level 2 ft. additional clearing
•if ne[emry
Existing bank
iD W hank a
height Qc�e
Q
Side ViEw MPLE

Duke Energy Lake Services
Guidance for Completing an Excavation Permit Application
Note: If you are proposing excavation in association with the permitting of a new
or expanded facility under the Marina or Conveyance Programs, you do not need
to complete this application. Instead, you should incorporate the excavation
request into the permit application for the marina/conveyance using the
appropriate application.
Step 1: Contact Duke Energy Lake Services
Complete "Part I" of the application and develop a drawing of the proposed excavation area.
Contact Duke Energy Lake Services to schedule a site visit. Lake Services will conduct a site
visit to determine if Duke Energy will accept an excavation permit application for the proposed
work. If the Lake Services representative determines the application process may proceed,
he/she will initial Part I of the application.
Step 2: Draft Application Development
Complete Parts II-HI.A-G and Part V of the Excavation Permit Application,
Step 3: Agency Consultation
Send the draft application developed during Step 2 to the agencies for review and comment on
the proposed activity. Refer to the Agency / Organization List available from Duke Energy to
determine which federal, state, regional, and local agencies and organizations require
consultation or review,
Note. Duke Energy reserves the right to require consultation with additional organizations
beyond those included in the Agency / Organization List.
Each agency / organization must be provided at least 30 days prior notification. Evidence must
be provided (e.g., response letter or Certified Mail receipt) in the complete application to show
each agency / organization was given the opportunity to review the proposal.
Consultation letters must be dated within the two years preceding Duke Energy's receipt of the
application. All permits must be valid at time of application and have a term longer than the
projected schedule for completing the permitted project.
What to Expect During Agency Review and Comment:
• You will typically receive a letter from each agency / organization either documenting its
concurrence with your proposal, requiring additional information, recommending
modifications, or offering no comment, You must address each agency's / organization's
comments with a follow-up letter and in your final application as described in part IV.
• If you do not receive any documentation from an agency / organization within 30 days of its
receipt of your proposal, you must provide the agency / organization with a follow-up letter
requesting comment on your proposal within 15 days from the date of the follow-up letter. If
you still do not receive any response as a result of the second letter, type "NO RESPONSE"
Duke Energy Page 1 of 13 rev 1 ]raarai
Ueavation Program

at the top of the follow-up letter and include it in the application along with proof of the
agency's 1 organization's receipt of the letter (e.g,, Certified Mail receipt). You may proceed
with the application process recognizing, however, that if its comments come later in the
application process, you will be required to address them.
From the United States Army Corps of Engineers (Corps): (** Note — The Corps may have
additional forms to submit for your proposal and an additional fee.) If the excavation can be
done under the requirements of the General Permit (GP) or a Nationwide Permit (NWP), you
will typically receive a copy of the Corps' tear sheet documenting authorization and
providing any additional instructions. If the excavation isn't covered under the GP or a
NWP, you'll be required to obtain an individual 404 Dredge and Fill permit from the Corps.
You roust receive written documentation from the Corps that your application either (1)
meets the requirements of the GP or a NWP or (2) the proper 404 Dredge and Fill permit has
been received before Duke Energy can process your application.
From the North Carolina Department of Environmental Quality (1VCDEQ), Division of
Water Resources: (Note NCDEQ may have additional forms to submit for your proposal
and an additional fee.) If the proposal meets the requirements of the Clean Water Act Sect.
401 Water Quality Certification, you will typically receive a letter from the NCDEQ Division
of Water Resources documenting Sect. 401 Certification and providing any additional
instructions. You may also receive a letter requiring additional information or
recommending modifications. You must receive written documentation from NCDEQ
noting any required Sect. 401 Certification has been received before Duke Energy can
process your application.
■ From the North Carolina Wildlife Resources Commission (NCWRC): If you do not receive
any documentation from the NCWRC within 30 days of their receipt of your application, you
may proceed with the application process without submitting a follow-up request,
recognizing however if comments come in later in the application process, you will be
required to address them.
From the South Carolina Department of Health and Environmental Control (SCDHEC):
(Note — SCDHEC may have additional forms to submit for your proposal and an additional
fee) The SCDHEC conducts a joint application process with the USACOE in S.C. If the
proposal meets any applicable requirements of the Clean Water Act Sect. 401 Water Quality
Certification, you will typically receive a letter from SCDHEC documenting Sect. 401
Certification and providing any additional instructions. You may also receive a letter from
USACOE requiring additional information for the agencies participating in the joint
application process, You must receive written documentation from SCDHEC noting Sect.
401 Certification has been received if required before Duke Energy can process your
application.
■ From the South Carolina Institute of Archaeology and Anthropology (SCIAA): The applicant
must wait 30 days after receiving the signed postal returned receipt. If a response from
SCIAA has not been received by this time you may proceed with the application process
without submitting a follow-up request, recognizing however if comments come in later in
the application review process, you will also be required to address them.
Duke Energy Page 2 of 13 rev 1 i12M t
Excavation Program

Step 4: Final Application & Submittal to Duke Energy
Following the consultation process, finalize the application. The final application submitted to
Duke Energy should incorporate all comments and recommendations provided by agencies and
organizations during the agency consultation process as well as copies of all permits received. In
addition to the final application include the following;
■ One check payable to duke Energy for the application fee and security deposit
• If applicable, a separate check payable to the appropriate Habitat Enhancement Program fund
• Signed Excavation Program Applicant's Agreement
Note. Co -applicants must also submit the application fees and applicable HEP fees with the
application.
Nke Energy Page 3 of 13 rev t Il2212I
Excavation Program

Duke Energy Excavation Permit AnIllfcation Form
FOR DUKE ENERGY usE ONLY
Duke File No.
Application Fee S Security Deposit $ Check # Date Recv'd Initials
Date of Duke Energy Lake Services, applicant and/or contractor on -site inspections Datet -t 7 lnitials
Date Final Protection/Avoidance Area Markings Field - Verified
Approved to Start Work By *
{Print)
Date Completion Required Date of Any Approved Extension
Date Passed Closeout Inspection*
Initials
Initials
Date
(sign)
Initials
Any Stop Work Orders or SMG Violations*? (check one) ClYes ❑No (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 better 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 r Telephone -&1
Email address: W 1 �r 31 ro di 1. CO YY]_
Ll o R
ire
rywaVEA n ��
Contractor Company
Contractor Contact Person
Contractor Email Address:
Mailing Address (if different)
1k11■ . i Telephone i ' .■9.
8f \ f — ■ ■ CAP CWz b ■■+ it •i
LAKE LOT INFORMATION
Lake �rr � County htmb�ity li State Tax Map No, QQ /
Subdivision r Lot 1 Section No. % Lot Size / % Acres
Duke Energy Page 4 of 13 rev I V22/2I
Excavation Program

Dune Enerav 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) Tdyes ONO (If Yes,
include name and mailing address below.
Name: Y' �e�d Tax ID: 6 + ?J
Mailing Address: _zLf rM17a
�ou�-Yrr�rr , f11 C 2B�lflla
Are there any Co -Applicants*? (check one) Oyes ZKo (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 I 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 Q 7--1 Z a
Initials (Duke Energy) '%_
(applicant/contractor)
C�
Duke Energy Page 5 of 13 re„ I1i2MI
Excavation Program

Duke Enerizv Excavation Permit Application Farm
Part II. Description of PrNect
A. Basic Information
1. Type of excavation: (check one) ❑ New excavation O'Maintenance excavation
2. Purpose of excavation: (check one)
❑ Water Intake Channel
❑ Other (sped):
3. Lake user category: (check one)
❑Commercial Marina
❑Other (spec):
Otoat Access Channel
❑ Wastewater Discharge Channel
A frivate ❑Residential Marina
❑Public
� 1 �
4. Max. Excavation Area Dimensions (ft): Length Width 5-1 Depth I�
(Note: include additional area dimensions if necessary so response to #5 below equals max. area
dimensions in #4)
5. Volume of Excavated Material (TOTAL for the project): r, L9 _Cubic yards
6. Type of material removed Capplicant determines by.fteld sample iractica :
7. Excavation Site area: Acre (s) Disposal Site area: s6G Acre
(s)
S. Total Disturbed Area (including equipment staging urea): ,� Acre (s)
9. Does the project meet the requirements of the applicable General Permit? (check one)
,dyes ONO
10. Do you claim title to the disposal area? (check one) ❑Yes J:2No
11. Do you claim title to the equipment staging area? (check one) ,OYes ❑No
12. Are there any water -treatment facilities within 50 feet of the proposed excavation area?
(check one) ❑Yes '0�io
(If Yes, spec):
13, How will the excavated material be entrapped and the erosion controlled? (e.g. see attached
erosion controlplan and disposal area design):
�-ed e. w l+lrl bi reach eaCm� r Iacp— ynq}er i cc 1s in h o p � ba es
1,�►LL40mcq b�`� e� - po loo�d ��taciux,�p *Ut��s and ct for { fS d'k -, - -, n ---,o I C-, 1 U2
Duke Energy Page 6 of 13 rev 11127J21
Excavation Program

Duke Energy Excavation Permit Application Form
14. Type(s) of excavation equipment to be used:
Lo-�qq r cox_Vl ejca\jix mv-, Short r ea c11 excrcvaj-or',
�nru V,5.
rgea 'k Puyn P
15. Will waters or wetlands be crossed in transporting equipment to or from the site?
(check one) X'es ❑No
I es, explain)
bred In equlpmevi%r' C'.t-will be, rc�� �
ore via Imfin4 pignf'
t., .
m CaS+rm 1bocv� o� ce E6+g3jA GLY',eCx rds5
r �r t
16. Will return water re-enter the reservoir? (Check one) ❑Yes ❑No .b�4/A
(If Yes, vecifY point(s)of re-entry and show on Excavation Area Drawirr) %
17. Is there an existing facility (e.g. pier) that access is being maintained to by conducting the
excavation? ❑Yes UNO New L�c�S �a �e eons i-u c�cd
(If Yes, provide the existing permit number. If No, include a scaled drawing of the proposed
facility). Permit #
18. Total planned duration of the work (Include f rst equipment mobilization, excavation
through final mitigation measures complete):
START �1 04 FINISH 1 �v
(Month) (Year) (Month) (Year)
Duke Energy Page 7 of 13 rev t tr22l21
Excavation Program

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Duke Enenzy Excavation Permit Alpolication Form
C. Applicant's Signatures
Comments:
Applicant Name (print) �y
Applicant Signature*iag, Date 7
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 of 13 rev 11/22/2021
Excavation Program

Duke Eneruv Excavation Permit Application Form
Part III. Additional Information
A. Deed and Survey Plat: A copy of the deed and registered survey plat or other instrument
under which each applicant and co -applicant claims title to the affected property (the
shoreline adjoining the excavation area, equipment staging area, area crossed by any spoil
and return water lines, and the disposal area). if the applicant(s) is(are) not the owner(s) of
said property, then forward a copy of the deed and registered survey plat or other instrument
under which the owner(s) claim title plus written authorization from the owner(s) to carry
out the project on their land.
S. Excavation Area Drawing: An accurate drawing of the area to be excavated. The drawing
must show at a minimum, a North arrow; the boundaries and acreage of the proposed
excavation area and equipment staging areas; lake, county, city, cove, tributary, road and
subdivision names and lot numbers (as applicable); property corners for project front lots;
the full pond elevation contour and lines dividing the cove width into equal thirds (as
applicable); approximate volume in cubic yards of the material to be excavated; point(s) of
return water re-entry; the boundaries of any adjoining areas that are to be specifically
avoided or protected during the work and the location (address) of the disposal area for the
excavated material. [NOTE: A copy of this drawing must also be provided to the
excavation contractor to ensure restricted areas are not impacted.]
C. Disposal Area Drawing: An accurate drawing of the proposed design for the disposal area.
The drawing must show at a minimum, a North arrow; the boundaries and acreage of the
proposed disposal area; lake, county, city, cove, tributary, road and subdivision names and
lot numbers (as applicable); the full pond elevation contour (unless disposal is well away
from the lake); the boundaries of any adjoining areas that are to be specifically avoided or
protected during the work; the location (address) of the excavation area from which the
material came and a statement of the disposal area's capacity with all dimensions labeled
that were used in the volume calculation. [NOTE: A copy of this drawing must also be
provided to the excavation contractor to ensure restricted areas are not impacted.]
Also note for projects larger than one (1) acre in North Carolina, including excavated,
equipment staging, and disposal areas, you must submit an erosion control plan. For
projects larger than two (2) acres in South Carolina, including excavated, equipment staging
and disposal areas, you must submit an erosion control plan. For projects < two (2) acres in
South Carolina, you must submit a completed standard reportingform for construction sites
disturbing two (2) acres or less to the South Carolina Dept. of Health and Environmental
Control (SCDHEC) - Stormwater Management
D. Vicinity Map and Driving Directions- A vicinity neap and directions by road showing
directions to both the excavation area and disposal area. Include the latitude and longitude of
both the excavation area and the disposal area.
Part IV. Agency Reviews and Approvals
Begin this section with a summary table of all agencies consulted and applicant response to
agency comments as shown in the example table below. Agencies should be listed in the order
Duke Energy Page 11 of 13 rev 11/22/2021
Excavation Program

Duke Enera Excavation Permit Application Form
shown in the Agency/Organization List. Consultation letters must be dated within the two years
preceding Duke Energy's receipt of the application.
Table IV-1. Sample Agencv Comment and Res onse Table
A2ency Comment Applicant Response
Agency 1
The activity is approved as proposed. INA
A&Lncy 2
The on -site well provides drinking water to the
Contacted Mr. Smith on 111120xx. No
public. Please contact Mr. Smith to discuss the
further action needed.
proposed changes and potential issues
associated with Your prrosal.
You must contact us immediately if
Applicant will contact Agency 2 if
endangered species are located during the
endangered species are located during
course of construction,
construction
Azencv 3
Requested agency comments on 111120xx and
NA
again on 211120xx. No response as of
2116120xx.
Azenev 4
Section 401 Water Quality Certification
Applicant will comply with the conditions of
the 401 Water Quality Certification
Following the table of agency comments and applicant responses, include a table of permits and
certifications issued by the reviewing agencies. As with the table of agency comments and
applicant responses, agencies should be listed in the same order as they are listed in the
Agency/Organization List.
Table 1V-2. Sample A2enev Permits and Certifications Table
Agency
Permit/Certification Name
Date of
Date of
Issuance
Expiration
Agency 1
Surface Water Withdrawal Permit
Agency 2
Section 401 Water Quality Certification
Following the two summary tables, include a copy of all correspondence to and from any local,
regional, state and federal agencies or other organizations with which you are required to consult,
including any required permits (e.g., Section 401 water quality certifications, Section 404
dredge/fill permits, building permits, etc.) or other approvals or comments which have been
obtained from these organizations regarding this activity. Include a copy of any local, regional,
state or federal regulations or guidelines that will be followed. All permitting issues must be
resolved and clearly documented. Correspondence should be organized in the order the agencies
are listed on the Agency/Organization list with the applicant's request for comments followed by
additional correspondence in chronological order. All permits must be valid at time of
DAe Energy Page 12 of 13 rev 11/22/2021
Excavation Program

Duke Energy Excavation Permit Amfication Form
application and have a term longer than the projected schedule for completing the permitted
project.
Part V. Additional Information
Provide relevant additional information. Reference previous parts as applicable. Include the
FERC-required Environmental Assessment if you were directed to do so during the initial site
visit. If there are co -applicants, this is where their information would be provided (see Part I).
Duke Energy Page 13 of 13 rev 11I2212021
Excavation Program

B37364 - P 491
For Registration
Fredrick Smith
Register of Deeds
Mecklenburg County, NC
Electronically Recorded
2022 May 24 11:42 AM RE Excise Tax: $ 3500,00
Book: 37364 Page: 491 - 493 Fee: $ 26.00
Instrument Number: 2022078662
NORTH CAROLINA GENERAL WARRANTY DEED
Excise Tax: $3,500.00
Parcel Identifier No. 078-017-12
Mail after recording to: Grantee
This instrument was prepared by: David W. Smith, III Attorney — Gray, Layton, Kersh, Et Al
Brief description for the Index: Lots 122 & 123 Crown Harbor North Subdivision
THIS DEED made this 19th day of May, 2022, by and between
GRANTOR:
CHIN JEN and wife,
I-MEI JEN
Address: 4717 Castle Ford Road Boone, NC 28607
and
GRANTEE:
WILLIAM JAMES GRANT and wife,
KELSIE HOWE GRANT
Property & Mailing Address: 20107 Bascom Ridge Drive, Cornelius, NC 28031
The designation Grantor and Grantee as used herein shall include said parties, their heirs,
successors, and assigns, and shall include singular, plural, masculine, feminine or neuter as
required by context.
WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt
of which is hereby acknowledged, has and by these presents does grant, bargain, sell and convey
unto the Grantee in fee simple, all that certain lot or parcel of land situated in the City of
Cornelius, Mecklenburg County, North Carolina and more particularly described as foil ows (the
"Property"):
Submitted electronically by "Gray, Layton, Kersh, Solomon, Furr & Smith PA"
in compliance with North carolina statutes governing recordable documents
and the terns of the submitter agreement with the Mecklenburg county Register of Deeds.

B37364 - P 492
SEE EXHIBIT "A" ATTACHED HERETO;
The subject property IS NOT the primary residence of the Grantor.
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all priviicges and
appurtenances thereto belonging to the Grantee in fee simple.
And the Grantor covenants with Grantee, that Grantor is seized of the premises in fee simple, has
the right to convey the same in fee simple, that title is marketable and free and clear of all
encumbrances and that Grantor will warrant and defend the title against the lawful clairns ofall
persons whomsoever except for the following exceptions:
I . Ad valorem taxes for the year 2022 and subsequent years, not yet due and payable; and
2. Utility easements and unviolated covenants, conditions or restrictions that do not
materially affect the value of the property.
IN WITNESS WHEREOF, the Grantor has caused this General Warranty Deed to be duly
executed as of the day and year first above written.
GRA OR:
(SEAL)
CHI EN
STATE OF NORTH CAROLINA
COUNTY OF Alp, 1(Ijo,, lw,,
(SEAL)
I-MEI JEN
11 u , a Notary Public of the County and State aforesaid, do
hereby certify that CHIH JEN AND WIFE, 1-ME1 JEN, Grantor(s) either being personally
known to me or proven by satisfactory evidence (said evidence being
Ne ), personally appeared before me this day and acknowledged the
execution of the foregoing instrument.
Witness my hand and official seal, this 70 day of May, 2022.
Notary Public /]
Print Name:
My commission expires:
Official Seal (must be legible)
=WILLIAMDES II
h Carolina
nty
s Sep 8, 2026

B37364 - P 493
Mgt 1 fParcef No. 001762261
BEING all of Lots 122 and 123 of CROWN HARBOR NORTH SUBDIVISION, PHASE 1, MAP 6 as shown on map thereof
recorded in Map Book 27 al Page 151 in the Mecklenburg County Reg isler of Deeds Office.
And also including that certain .037 acre. more or less, parcel as shown on the revision of Crown Harbor North Subdivision
as found in Map Book 31 at Page 339 of the Mecklenburg County, North Carolina Public Registry and beginning at an
existing iron pn as shown on said map, said existing iron pin located at the intersection of Line 4 and Line 5, also as shown
on said map, and running thence with Line 4 as shown on said map, said Line 4 being also one of the lines of Lot 123 as
shown on said map. N 75.14-33 E. 40.57 feet to a nail set; thence leaving the line of said Lot 123 and running with Line 12
as shown on said map, S 18-46-02.2 E 5.27 feet in Line 7 as shown on said map, S 46.16.27 E 37,88 feet to a nail set, said
nail being also in one of the Was of said Lot 123; thence with Line 6 as shown on said map and one of the lines of said Lot
123, S 80- 51.33 W 37,62 feet to a new iron pin; thence with Line 5 as shown on said map N 21.16.27 W 39.70 feet td the
point and place of beginning, and containing .037 acre, mre or less, all as per survey of Graylon W. Pippin, N.C.P.L.S.
And also including that certain .105 acre, more or less, of land designated as "Area to Lot 122' as found on the map of the
Revision of Crown Harbor North Subdivision as found in Map Book 31 at Page 339. said tract adjoining Lot 122 on two
sides, Lot 123 on one side, and that certain properly designated as "Area to Lot 129' on one side, and with "side
designated Line 14 on said map being very dose if not on the borders of Lake Norman.
And also including that certain property shown on the final subdivision plat of Phase I Me 6 Crown Harbor North Subdivision
recorded in Map Book 27 at Page 151 of the Mecklenburg County Public Registry and more particularly described
as BEGINNING at a point located in the right of way of Bascom Ridge Drive said point" the northwest corner
of Lot 123 as shown on said map; and thence from said point and place of Beginning. North 23-43-31 West with the arc of a
curve to the left having an arc radius of 45 feet and a chord of 26.12 feet, a distance of 26.51 feet to a 0 n I located in line
margin of the public right of way of Bascom Ridge Drive; thence North 49-24-01 East 15,27 feet to a point; thence South 40-
35-59 East 25 feel to a point; thence South 4W24.01 West 22,65 feet to said point and place of Beginning.
Title Reference' See Deed Book 9436, Page 609 in the Mecklenburg County Public Registry.
"t 2 Warcal bl on17s22a',
All that cenain tract of land being oesignated as "TOTAL AREA = 0.490 ACRE, more or Iess' as shown on Duke Energy
Corporation survey entilled.'Property Owned by Crescent Resources, Inc„ Cowans Ford Deve"ent. Being Portion of
Mary Gordon Kelly Tract, UM1.973. Lemley Township, Mecklenburg County, N,C.," dated April28. 1998, revised May 2,
2000. and recorded as an attachment to that Special Warranty Deed recorded in Deed Book 11543 at Page 532 in the
Mecklenburg County Register of Deeds Office.
Title Reference: See Deed Book 11543, Page 532 in the Mecklenburg County Public Registry -
BEG INNI NO at a point said point being the Northeast corner of Lot 44 of Phase I, Map 3 Crown Harbor Subdivision as
shown on Map recorded in Map Book 26 at Page 739 of the Mecklenburg Caunlyy Public Registry and from said point and
place of BEGINNING; thence N .72-33-32 W. 40,92 feet to a new pin Set; thence N. 57-41-32 W. 139,30 feel to a new pin
set; thence S. 71-14.28 W. 104.90 feet to a now pin set; thence S- 62.54-28 W. 47.70 feet to a new pin set; thence N- 73-
25-32 W. 56.00 feet to a new pin set; thence, S. 44.25-28 W, 47.00 feet to a new pin set thence N. 11-07-32 W. 66,30 feet
to a new pin set; thence N. 42-14-32 W. 92.60 feet to a new pin set; thence S. 7W1-28 W. 95.00 feel to a new pin set;
thence N. 89-40.32 W. 73.00 feet to a new pin set the N. 12-21-28 E, 102.40 feat to a new pin set; thence N. 66-53-28
E. 41,20 feet to a new pin set; thence S. 88-01-32 E. 58.40 feet to a new pin set; N. 04.45.28 E. 63.80 feet to a new pin set;
thence N. 14-22-32 W. 73.60 feet to a new pin set; thence S. 80-53.28 W. 41.10 feet to a new pin set thence N. 21.14-32
W. 39.70 feet to a new pin set. thence N- 76-16-28 E. 47.80 feet to a new pin set; thence N. 16.39.32 W. 40.40 feet to a new
pin set; thence N. 54.17-32 W- 10,80 feet to a new pin set; thence S. 89-16-28 W. 69.10 feet to a new pin set. thence S. 86-
36.28 W. 117.40 feet to a new pin Sol; thence S. 79.20-28 W. 146,50 fees to a new pin set; thence N- 30-13.001-. 273,60
feet fa a new pin set; thence N. 30-25-00 F= 377.40 feet to a new pin set thence S. 53-47-00 E. 921.60 feet to a new pin set
thence S. 69-19-00 E. 85.17 feet to a new pin set; thence S. 23-24-35 W. 537.89 feel to the point and place of BEGINNING
and containing 13.69 acres, more or less.
LESS AND EXCEPT 1.904 ACRES which is a poti ion of the property mnveyed in deed recorded in deed look 8241 at
page 142 in the Mecklenburg County Public Registry and more particularly described as follows BEGINNING at a point said
point being the Northeast corner of Lot 44 of Phase 1, Map 3 Clown Harbor North Subdivision as shown on Map recorded in
Map Book 26 at Page 739, of the Mecklenburg County Public Registry and from said point and place of BEGINNING;
thence N. 72.33.32 W. 40,92 feet to a new pin set; thence N. 57.41-32 W. 139.30 reef to a new pin set; thence N. 21-39.16
E. 539.59 feet to a point; thence S. 53-49-W E. 79.85 feet to a point; thence S. 6941-08 E. 85.17 reel to a point; and
thence S. 23-72.27 W, 537.69 fees to the point and place of BECANNIING.
Grantors herein reserves an exclusive perpetual easement, appurtenant to Lot 124, to erect, maintain and ulilize a private
pier and gazebo Over and across the property being conveyed by this Warranty Deers. This easement shall benefit the
successors in title of the property being conveyed by this Werra nty0eed end Shalt tre binding upon Iha successors in title of
Grantee. The pier and gazebo referred to herein shall be located contiguous to the northern boundary line of Lot 124 as
shown on the final Subdivision plat of Phase 1, Map 6 Crown Harbor North Subdivision recorded in Map Book 27 at Page
151 (hereinafterreferred to as "Lot 124') and further shall be located between the northwest comer of Lot 124 and the
northeast comer of Lot 124 and shall extend a distance of no more than 100 feet north into the property being conveyed by
this Warranty Deed and shall have a width of no more than 30 feet t"Easement Area).

LAKE NOR11dAN �$` p{N1HIyM,
f 6 DA Y W.LONG.P.
.w 01 d , 16335 OLD STAT86ViLLE OAP s* 2 " g
WE— A �i O
I7 g CORN&IUS,IN.C. 26031 Oq SLf Y; ►Z`
[phone] iy Yi �W •LINE L
w-
v1cIx�f u+uP WARM., DISTANCE ADDITIONAL REFERENCES:
Li s 49,33,05,S
La N awes 6 It 2zeelMAP BOOK 31, PG 39
I. xn xoDs MpNnMENr ,,,,,41„1L 3 s 5 9 2 E {O, } MAP BOOK 27, PG 151
FOUND W1TH1N 2(w. serore ea.now 6 g DEED BOOK 24281, PG 566
s rcerORE DEED BOOK 11127. P6234
1PROPERTY MAY BE, I@ SUSLT 19'38 23 E 5.27
TO OTH ER COVENANTS, L 31 448 37411 _
N E 46
RESTRICT IONS, FJ�5Rh4Ei+'1'S ` �4 L9 q}7 43 75.80
OR RTOHT"F-WAY THAT 5 03� 6 Yf 6a4t F ADJOI B 5PI G 88 ELOPE
MAY BE OF TIECORD- � {l
3. SETBACKS SHOWN ARE PER EEO 002.762-99 V
.LSB. 13. Pa. W. "UNDERWATER' t
' CNIKJEW
4, A PORTION OFTHE TPRf I•LAEI 7EN
PROPERTY LIES IN A SPECIAL . _
ruii lax.S8 DB 1k143, PG 037
FLOOD HA7.ARDAi FA 1
ACCORDSNOToFEMAFLOOD 4Lr 1
PANEL MAPS, HOW BVERTI1E
PRTNCtPAL S•fRUCTURR Is HELD LOCATED
ABOVE AND BEYOND THE ~ 760' LAKE CONTOUR
SPECIAL FLOOD HAZARD] So,[e� DATUM: NVGD 29
AREA PER FF.MA PANE MAP
37104MO0K; DATED 3RI2009,
5. CONSULT WITH GOVMN1NG w _
AOENCY FOR PRFVAILTNO� 'S
(•�j:
LA100 DEVELOMiENT AND �2• ¢�j�7N��'
c ZONING REQU I RF.MENTS [em ' C�
PRIOR TO N OR
CONS'YC!nQNOF ANY • �• 'r rerwwrieeeuNerEx ��^
I1.tPROVF.JrVEMU 1IINTS35, Epp �� � a Nnim.atsAxrn
C . It_ FIELDGiW
EY
OOI-782-24 x ar �Y�r
DB 11543, PG 532 � • �
L L3- 1
001.762.23
ROSIN E. SURANE m y C¢
06 1161L PG 895
TOTAL j
AREA I `
l , FT. 4906 I
49062ACAC RE5
001.762.28
iryrl jl ` �� MY WENDYRILEY
D5 3528, PCt 534
U �Ni , Graphic sc+lc
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n V Saaic of 3lgg I ].eh ado Foes
O6 001-762.27
COPY BARTER LE:OEND:
SARA BA%TER
.per DB 35655, PG 997 FOUND
$AR
`5COMPUTED PON7
a�RHVAC
�B 11GNT POLE i}
a6 i 4 ' ELECTRIC BOX �1
} , 2 37 s 'a it E SUBJECT PROPERTY LINE — —
.5 45.00 i. N 591333 E ADJDENER PROPERTY LINE
43 0 5 1 RUILDING SETBACK
erkjA nnnn k—
�p IPhysical Survey of Lot 122 & 123 of Crown Harbor, Phase 1, Map 6 (Revised)
Professional
Prorpe
Recordcd in:
site Address.
► o s, Inc.As
Inc.Road
Property of-
Map Book 33, Pg 365
20107 Bascom Ridge Drive
18333 pld Statesville Ste. A
Will Gmnt
Deed Book 8998, Pg 460
Cornelius, NC 280S1
Cornelius, N.C.28031
704-765-5134 Phone/Fax
Deed Book 9436, Pg 609
Mecklenburg County
Firm Liomsc C•3656
M2522-01
5ML
x 131.0 010
1"a40'
001-752-26 File Name
1 of I 4l28l2022
]n17N°.
�-
Ett°r of Closure
Drawl Seale
Tax i'ercei?dumlra t]rawin Flier N,i ,
umber Dma

KE NOR.hf.AN
Graphic Soak
su as o so
Scale of Draving i inch - 50 Fat
►.1i �F��164iSh
I i i�:�:�
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SEr ON !RANGY
SA'ONLINE
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Dk h;[Iy 5lgned by D- _ .J. LDrq 11NM11
H CARll
Prok"onel Property Surveyors• Ir1a. B1 OM O¢{K`
2 aWi
DARYTW" LOt3O, P.
k8335OLD STATESVILLP.ROAD S yea
SUrIE A
CORNBUUS, N.C. 2801 4q
[phone] pry yy • V
11141114
ADDITIONAL REFEREAiCES:
MAP BOUTT79U
ass MAP BOOK31, PG 39
MAP BOOK 27, PG 151
DEED BOOK 24221, PG 566
a + DEED BOOK 11127, PG 234
sj xr 4 x �d►
"UNDER WA
WiLUAM J. GRANT _
NELSIE H. GRANT AT7}'�7fFR'S PIER ENVELOPE
06M64,PG491 {� MB51,Pr. as
fed. `� "�� � � • �,�� _ � ��
FIELD LOCATED
760' LAKE CONTOUR
DATUM: NVGD 29 f ` "oi -- \�. `� \' '•�7 �
FIELD LOCATED
760' LAKE CONTOUR
DATUM: WGD 29
. i 1' / rl ' OEM--\� �r.. ,i'�R'J•� a .Y
ROBIN E. RIRANC ��
DID 116111 M 995 � +1 ! ! � - M1 � C• MA F1r1RPUNE PER
�s -?IDAi1�WlJ-q7'62.24 M
him eaio�cwTSEo
% 2I,8 7S]'k'!.'�f•_gpE� � ~`� i 1 't t, �tONf'AP
R, 01 ACRES 'AySq�
us
d
"i a / M=� � r � -- f ...ldS� ��•'.\:. ➢➢1-762.26
N • e _ MICHAEL P. RILEY
WENDY RILEY
i, f{ ,f •ql.• - 053528, PG 534
.N4 f _.
' ' y
•5
V , , 1.NONCORMONUMENT FOUND WITHIN VWD VFRTICA1.INFORMATION
FM TM PROIBCr WME POROUCFA WTH VRS GPS CEISERVATME ANC
PROQBSa '6!t , AACCURACYY ED OF TUC rrH VRs DERIV ➢YOsl1.71O AI, nl¢A4 �'OR TS OKTS GAP NETWORK rAN
001 762.27 St RV aY CI.AM WEST8 OR RXCEF.D CLASS C. VEIVnCAL DATUM USAI
CORY BAXTER NAVDBR.
SARA BAITER
DR "655, PG 897 L PROPERTY MAY BE SU&fECT TO OmR COVENANTS. RFmRIC MHS,
TBMI EASEMENTS OR RIOIIP15-0E-WAY TKAT MAY BE OP RECORD
601) MAGRAIL
ELEV•7188 35' 3" SETBACKS SHOWN ARE FFRMB.33, M S65.
LEGEND:
FOUND
RREEBBAR
OI PUTEO POINT
® ,
•
LLIIGHT POLE
ELECTRIC BOX
SUBJECT PROPERTY LINE
ADJDINER PROPERTY LINE
BUWNG SETBACK —
— -
FEMA FS.000 UNE---
SEWER EASEMENT
C A PORTION OF THE PROPERTY LM IN A FA-ECIAi. FLOOD HAM" AklL
ACCORTDNLI TO FEMA FTAOD PANEL MAPS- HOWEVER THLET%OICMAL
STRZMTLME IS ABOVE A140 BRYOMD THE SPRtiIAI. FLOODTIALARD ARIi
PER FEMA PAN- LEAP 371046U05K: ELATED 3+92f2U04.
3. NO RESIDRNTW, STRIJCrUk]' PERMANENT OR TO&CRARY MAY BE
CONSTRUCTED OR 3R=ED ON PID M-362.24. K RAB 1154%1G 531.
6. PID M]-762-24 MAY NOT BE DIVIDED TO CREATE AMMONAL LOTS(
PARCELS PERM 11543.PO 351.
7, CONSSJLT Wrlli OOVPRNRIO AG1ti1 O FCR-PRHVAU,1NO LAND
DRVEL08b4@7C AND Y.O DREQUIRF]MI-IiB PRIOR70 DESIGN OR
CONSTRUCTION OF ANY MVAOVtir1EP7CS.
Topographical Survey of Lot 122 & 123 of Crown Harbor, Phase 1, Map f (Revised)
& PID # 001-762-24 Former Crescent Resources Inc. Tract
professional
mperty Property of: As Recorded in: Site Address:
► Surveyors, Inc. p ' Map Book 33, Pg 365 20107 Bascom Ridge Drive
18335 Old Statesville Road Ste. A William & Kelsie Deed Book 8988, Pg 460 Cornelius, NC 28031
Cosnetius, N.C. 28031 Grant heed Book 37364, Pg 491 Mecklenburg County
704-765-5134 Phone/Fax
Firm License: C•36M
042522-01 JA+C 1:10 U00 1"=50' 001.762.26 TOP0 1 of 1 6�0/2022
naror 5rroriasure IhAwina 3caln Tax cell NLLv-oer Drawiie HumC net Nulnba ��

THE INFORMATION CONTAINED IN THIS DRAWING fS THE SOLE PROPERTY OF LANCASTER'S DOCK& LIFTS SYSTEM INC.
ANY REPRODUCTION W PART OR AS A WHOLE MTHOUT THE WRITTEN PERMISSION OF LANCASTERS DOCK & LIFTS SYSTEM INC. IS PROHIBITED.
ALL DIMENSIONS USED IN THIS DRAWING ARE NOMINAL
c
49-0" 20'-o'Fb
C2
N 4' 0" —
34'•0'
\N' -1l ,r-P-9uiVT 8 61 apes
ISSUE CLIENT
10-16-23 William and Kelsie Grant
Q Lancaster Custom Dock and Lifts
u DRAWN 9Y 20107 Bascom Ridge Drive 1156 Perth Road Troutman
r M.H North Carolina
Cornelius, N.C. 28031
Ii]

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DUKE ENERGY DIRECTIONS BY ROAD FORM
Lake Use Permit Applications and Contractors: Ease of locating a proposed project
site can have a big impact on permitting processing time. Please complete this form
and return it along with your completed application to:
DUKE ENERGY
CIO LAKE SERVICES — EC 12Q
526 SOUTH CHURCH STREET
CHARLOTTE, NC 28202
Applicant's Name: William Grant
Street Address tat lake): 20107 Bascom Ridge Road
Lake Name: Norman
Subdivision Name: Crown Harbor North Phase 1
Property Section: Map Section 6
City: Cornelius
State: NC
Directions (from major road or highway):
Lot #: 122
County: Mecklenburg
Zip Code: 28031
From 1-77 NB, Exit 28, Turn left onto Catawba Ave. WB, Turn right on Torrence
Chapel Road, Turn right on Schooner Dr., Turn Left onto Crown Lake Drive, Turn left
onto Bascom Ridge Road. Property is at the end of the cul-de-sac to the right.
Descriptive Structure(s) on Property (i.e. brick garage, white fence, mobile home,
etc.)
Note: Please use the back of this form if desired to draw us a map to the site.

20107 Bascom Ridge Road Cornelius, NC 28031
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CRM ■ Deg ■ DM5 Help

D UKE IENERGY DIRFCTIGNS BY ROAD FORM
LANCAanR CUSTOM DOC= DrsP.,, S,,.
Lake Ilse Permit Applicants and Contractors: Ease of lacatin the r
site csnhawa big imps as proposed l�roj ect
return it along with your compllee�ted applicatioMcen to..ing Lime. Please eaMpleie this farm and
DUKE ENERGY
C/o LADE SERVICES — EC 12 Q
526 SOUTH CHURCH si'i iir
CHARLOTTE, NC 28202
Applicant's Name:
IkW Address (at lake): 1162 ltiv ' hwa M
N 28117
Lake Name:
Subdivision Name: Bi
Prop" Section: Lot #:
City: o Mile County:
State:
--�� 71p: Z
Telephone _ OS
Directions (fmm major road or highway): From 1-77 NT3, Exit 36, Lett onto NC-
150 WE, Disposal Area is an the right behind Big Daddy's Restaurant
Complex.
Descriptive Structure(s) an Property (i.e. brick garage, white fence, mobile
home, etc.)
*Note: Please use the back of this form it dent and to draw as a map to the site.

1162 River Highway Mooresville,NC 28117
0 250 5o0 750 ft�
mmmb� ms .
€ USTIC WAY LN
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3 5.604043, - 80.99 0 286
Drag Me!
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Foothills Marine
d Maps legal of Lake Norman
Performance
Hitch and Trucl
Accessories
CRM ■ Deg ■ DIMS Help
Decimal Degrees Latitude: 35.604043
Decimal Degrees Longitude:-80-910286
Clear Show Point

DUKE Lake Services
ENERGY® Duke Energy
EC120 1 526 South Church Street
Charlotte, NC 28202
Mailing Address:
EC12Q j PO Box 1006
Charlotte, NC 26201-1005
Pro' ected PrODerty Line AnDroval Letter
L i (Print Name) ^` ► owner of Lot # j in Subdivision
HA :iS'Cr,- give approval to W I W - _ -�y r )7 ,
(Print Name)
owner of adjacent Lot # in Subdivision -O CD vAN f'a, - to
encroach over the projected property line between our lots for uses that are
checked below:
0//Dock
❑ Dock Cable Anchor
Dredge
WAWRA�
arlu-2O
(DM)
()PaVLAK9MGMTlf2ekage iarmMionlProiWed Pmperry Line Approval Letter dae
www.duke-enerFy.com

Project N2rne/address.,
.
q �, NL
laeat o R dress: re i t wb
V r
Parcel #. 4 �,p,3g
Parcel/lot size
rc
Disposal area required (sq ft Omd/or acreage)
,4ck 7 r-, pe►nent of N00f cation
r files bu �P
—1 V�County: �re C-54 !
P
r S4 y.-
and rules regarding sedl ent and erosio ❑ntrol and wateram 1"Ware hauality51And g Ve pete rn
ere to ali $
state regulations
r
Name of Individual and Company
to dispose of their dredge material at the above stated location
Owner: ►. � , f Ir a v 1 �s _ n _� _ A rZ x O�
Print
Date: Jam- �JS18n�aure
Along with form, please provide:
Aerial of parcel/lot (County G15)
Photo of proposed spoil site
Identified proposed spoil site

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THE INFORMATION CONTAINED IN THIS DRAWING IS THE SOLE PROPERTY OF LANCASTER'S DOCK & LIFTS SYSTEM INC.
ANY REPRODUCTION IN PART OR AS A WHOLE WITHQUT THE WRITTEN PERMISSION OF LANCASTERS DOCK & LIFTS SYSTEM INC. IS PROHIBITED.
ALL DIMENSIONS USED IN THIS DRA WIN(: ARF MOMIM AI
ISSUE CLIENT
10-18-23 William and Keisie Grant
DRAWN BY 20107 Bascom Ridge Drive
M.H.
Cornelius, N.C, 28031
Lancaster Custom Dock and Lifts
1156 Perth Road Troutman
North Carolina
ti

THE INFORMATION CONTA fNED IN THIS DRAWING IS THE SOLE PROPERTY OF LANCASTERS DOCK& LIFTS SYSTEM INC.
ANY REPRODUCTION IN PART OR AS A WHOLE WITHOUT THE WRITTEN PERMISSION OF LANCA STEPS DOCK & LIFTS S YSTEM INC. IS PROHIBITED.
ALL DIMENSIONS USED IN THIS 6RAWAG ARE NOMINAL
issue CLIENT
D 10-18-23 William and Kelsie Grant Lancaster Custom Dock and Lifts
IjDRAW
MA. N BY 20107 Bascom Ridge Drive 1156 Perth Road Troutman
J 'HCornelius, N.C. 28031 North Carolina CUSTOM DOCK & Ll

THE INFORMA TION CONTAINED IN THIS DRAWING IS THE SOLE PROPER TY OF LANCAS TER IS DOCK& LIFTS SYSTFIN INC.
ANY REPRODUCTION IN PA RT OR A A WHOLE WITHOUT THE WRITTEN PERMISSION OF LANCASTER'S DOCK & LIFTS SYSTEM INC. IS PROHIBITED.
A LL DIMENSIONS USED IN THIS DRA WING ARE NOMINAL
. . 1 �
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• �.
II'�_AT �' i
er
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411
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�i ISSUE CLIENT
■ 1 i}18-23
William and Kelsie Grant Lancaster Custom Dock and Ufts
{� DRAWN BY 2-0107 Bascom Ridge Drive 1156 Perth Road Troutman
r M.H. North Carolina
Cornelius, N.C. 28031
W,
N

1
THE INFORMATION CONTAINED IN THIS DRAWING IS THE SOLE PROPERTYOF LANCASTER'S DOCK& LIFTS SYSTEM INC.
ANYREPRODUCTION IN PART OR AS A WHOLE WITHOUT THE WRITTEN PERMISSION OF EANOASTERS DOCX & LIFTS SYSTEM INC. IS PROHIDITED.
ALL DIMENSIONS USED IN THIS ORA WING ARE NOMINAL
a issue CLI ENT
0 23 William and Kelsie Grant Lancaster Custom Dock and Dfts
F+ °RAIIN BY 20107 Bascom Ridge Drive 1156 Perth Road Trautman
M.H. North Carolina
Cornelius, N,C, 28031
W
TV
W
fV
fV

THE INFORMATION CONTAINED IN THIS DRAWING IS THE SOLE PROPER T Y OF LANCA S TER'S DO( ►A& LIFTS SYSTEM INC.
ANYREPRODUCTION IN PART OR AS A WHOLE UVITHOUT THE WRITTEN PERMISSION OF LAN CASTER'S DDCIC & LIFTS SYSTEM INC. IS PROHIBITED.
ALL DIMENSIONS USED IN THIS DRAWA;G ARE NOMINAL
ISSUE CLIENT
10-1&23 William and Kelsie Grant
DRAWN 6Y 20107 Bascom Ridge Drlve
M.H.
Cornellus, N.C. 28031
Lancaster Custom Dock and Lifts
1156 Perth Road Troutman
North Carolina
M1]

AGENT AUTHORIZATIrON FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. _ 122 PLAN NO. PARCEL ID. 00176224
STREET ADDRESS: 20107 Bascom Ri a Drive
Cornelius. NC 28031
Please print:
Property Owner: _1Nilliam Grant
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Donna P. Hrko
of
(Contractor J Agent)
Lancaster's Custom Dock and Lift Systems, Inc.
(Dame of consulting firm)
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):
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized SignatKY
Authorized Signature
9/25/23
Date: Date:

Project Namefaddress:
Owner: t 1 1
Print
Contractor/agent:
TAWBR RIPARIAN BUFFER NOTIFICATION FOR
Print
jj nZU,07&5co►r, Rid
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 028 ,0243(8)j
Trees are not allowed to be removed from Zone 1 of the Suffer (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 028.0243(6)1
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 028.0243(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 028.0243(5), (5)]
Acknowledgement of Notification f
vIl 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
Quality Certification and Buffer Rules, the approved plan(s) and specification(s), and other supporting
materials.
Signature (owner): Date.