20240135 Ver 1_Site Plan_20240124

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FORM: SSGP 09-2020 Page 5 of 6

Full Pond/ Normal Water
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Shoreline
Plan View
La ke
(At Full Pond/ Formal Water Level)
Lake
(At Ful l Pondf Normal ware,
Le Ie
Existing Dock
304tx 7 ft
3Rx 150R
Fudl Pond/ Normal Water Level
aelow lull pond/ NWL
7horerine
� af[z150R
Riprap
Above full pond/ NWL
2 FL x is"it.
additlonal clearing
" i3 necessary
EXAMPLE
Plan View
FORM: SSGP 09-2020 Page 4 of 6

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8045 Water View Dr, Belmont, NC 28012
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Map data ©2024 Google 200 ft ■. ■

AGENT AUTHORIZATION FORM
Property legal description
Lot No. Plan No. Parcel ID:
Street Address
Property Owner:
The undersigned, registered property owner of the above noted property, do
hereby authorize
Contractor/ agent y Business Name
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 from above):
Telephone: —lbw - ck`Iy.--C4,pp
We hereby certify the above information submitted in this application is true
and accurate to the best of our knowledge.
Date.
Au "zed Signature
Date: i 5 a