20150978 Ver 1_Shoreline Stabilization_20150921

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State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
- - --~'� 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
Division of Water Resources
ORM: SSGP 10 -2013
E.
Shoreline Stabilization Application Form ri
Three copies of the application (including attachments) and the application N' should be sent
to: SEP 201
Division of Water Resources __ ____ _�J
401 & Buffer Permitting Unit D401i& BUFFER PERMITTING
1617 Mail Service Center
Raleigh, NC 27699 -1617
I. Applicant Information f15A NCAC 02H .0502(a)j 2 9 7 8
1. Owner Information
Name: Chris G. Watson
Mailing Address: 253 Sandpit Road
Advance, NC 27006
Telephone Number: 336/529 -3426 Fax Number:
E -mail Address:
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
http: / /www.saw.usace.armv. mil / Portals /59 /docs /regulatory /regdocs /Permits /SAMPLE AGENT AUTH
ORIZATION FORM.odf) must be attached if the Agent has signed this application form.
Name: N/A
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E -mail Address:
Person to receive the Certification Approval:
II. Project Information f15A NCAC 02H .0502(a) & (b)j
1. Attach a vicinity map (i.e. street map) clearly showing the location of the property with
respect to local landmarks such as towns, rivers, and roads.
2. Provide a detailed site plan showing property boundaries and proposed locations of
vegetation clearing, structures (buildings, retaining walls, docks, impervious surfaces,
FORM: SSGP 10 -2013 Page 1 of 4

etc.), rip rap, excavation or dredging below Full Pond/ Normal Water Level elevations,
and construction access corridors. You may use the diagram provided at the end of this
application form.
3. Attach a photograph of the shoreline/ buffer proposed to be stabilized. (Include a scale
of some sort- a yard stick, shovel handle, etc.)
4. Location of the property (where work is to be conducted)
County: Rowan Nearest Town: Richfield
Subdivision name or site address (include phase /lot number):
Rowan County Tax Parcel 504 010. 1190 Panther Point Road
Directions to site - please include road names and numbers, landmarks, etc.:
1 -85 S to Salisbury exit. L on East Innes Street. L on Stokes Ferry Road. L on Providence
Church Rd., R on Bringle Ferry Rd., L on Panther Point Rd.. R on Panther Point Trail. and
property is on the left.
Latitude (in decimal degrees) 35.599805 Longitude (decimal degrees) 80.25888615
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Existing developed residential property
6. Property size (acres): 0.84 acres
7. Lake/ river/ ocean adjacent to property: High Rock Lake
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): To stabilize and existing eroded shoreline and protect
It from further erosion.
9. Will work be conducted from land? ® From water? ❑
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:
200 Sq. Ft.
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: 700 Sci. Ft.
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): Site has an existing
house on the property. No trees will be impacted by the shoreline stabilization.
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Owner /Agent's Signature` (15A NCAC 02H .0502(f)l Date
kAgent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10 -2013 Page 2 of 3

Full Pond/
Normal Water Level
T M 7
Shoreline
Lake
(At Full Pond /Normal Water Level)
SEE ATTACHED WE PLAN AND DETAU
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ft x 100 ft) *:
1. All proposed vegetation clearing
2. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
3. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
4. Location of any proposed structures such as buildings, retaining walls, docks, etc.
5. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
FORM: SSGP 10 -2013 Page 3 of 3

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VEGETATE DISTURBED AREA
ABOVE SLOPE
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EXISTING GRADE
EROSION CONTR
TYPICAL CONDITIONS
12" TO 36" ERODED CUT
WAVE EXPOSURE
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FOR: Chris G. Watson
LOCATION: 1040 Crane View Road
RESERVOIR: High Rock Lake
PROJECT: SHORELINE STABILIZATION PROGRAM
PHASE I SITE EVALUATION
YADKIN, INC. — BADIN, NORTH CAROLINA
DRAWING TITLE: I DETAIL
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MINOR RIP RAP STABILIZATION I 2

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