20240151 Ver 1_Site Plan_20240125

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' State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Water Resources 15A NCAC €12H .A500 -- Water Quality Certification, Shoreline Stabilization
SNV1R0NMf_NTAL OUALITV FORM.• SSGPQ2-2017
Shoreline Stabilization Application Form
Three copies of the application (including attachments) and the application fee should be sent to:
!f sending via US Postal Service
Paul Wojoski
DWR — 401 & Buffer Permitting Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
A. Applicant Information [ I5A N CAC 02 H ; 0502 a
I. Owner Information
lfsending via delivery service (UPS, FedFx, etc.)
Paul Wojoski
©WR — 401 & Buffer Permitting Branch
512 N. Salisbury Street
Raleigh, NC 27604
Name:
Mailing Address: 4023 8th St C NW
Hickorry, NQ 28601 ...,...,,_._..... _.....,. _ .,....�
Telephone Number: ($28)612_-U56_ Fax Number: NIA
E-mail Address: UUMEyarlattCbewcom
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter must be attached If the Agent has
signed this application form. (A form can be downloaded here:
htt www.saw.usac .arm .mil Port Is 59 flocs re uIato re dory Permits $AMPLE AGENT AUTHORlZ
ATION FORM. d#)
Name: Charlie Washburn
Company Affiliation: Marine Construction LLC
Mailing Address: PO Sox 6400
Hickory- NC 28603
Telephone Number: 828-495-3Q4Q Fax Number: - NIA .
E-mail Address: office marineconstructionllc.com
B. Project information 15A NCACO2H .05021gl_C [b)]
1. Attach a vicinity map (i.e. street map) clearly showing the location of the property with
respect to local landmarks such as towns, rivers, and roads.
2. Provide a detailed site plan showing property boundaries and proposed locations of
vegetation clearing, buildings, retaining walls, docks, impervious surfaces, 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.
FORM: SSGP 02-201-1 Page 1 of 3

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; Catawba_ . _ Nearest Town: Hickow
Lake/ river/ ocean adjacent to property: _Lake Hickory _... _--
Property size (acres):. am Acres
Subdivision name or site address (include phase/lot number).
4016 Sth St Ct NW Hickory NC 28601
Directions to site - please include road names and numbers, landmarks, etc.:
Included in packet
Latitude (in decimal degrees) Longitude (decimal degrees) -
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): _ Residential, QMIgped
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary), Yft plan to construct a Hadi-flMli.,alac t spawall..to
rev nt forth r erosion.
7. Will work be conducted from land? x
From water?
8. Total amount of impacts below the normal pool lake level f Normal Water Level
Permanent impacts {including all excavation, hackfill, rip rap, retaining wails, etc.) in square feet:
ft
Temporary impacts in square feet:
s ft
9. Total amount of impacts above the normal pool lake level/ Normal Water Level and 50 feet
land -ward
Permanent impacts (including back fill, excavation, rip rap, retaining wails, etc.) in square feet:
Temporary impacts (temporary clearing, construction corridor) in square feet:
Construction corridor_- 1.20Q 5 ft
10. Please describe the vegetation above the normal pool lake fever Normal Water Level and so
feet landward to be impacted (number of trees, for instance): - The lot is.,grimy fleig,
11. Signatu —�
owner/Agent's Signs ure 1sA fVCAC O�H .0502 Date
Agent's signature is valid only if on authorization letter from the owner is provided
FORM: SSGP 02-2017 Page 2 of 4

12. Please approximately sketch the following information on this plan and provide dimensions far
each item:
a. All proposed vegetation clearing
b. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
c. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
d. Location of any proposed structures such as buildings, retaining walls, docks, etc.
e. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
r:1
Full Pond/ Normal Water Level
Shoreline
Plan View
La ke
(At Full Pond/ Normal Water Level)
1U
W x IV", CMWW nco COCOAX
M 6 090L Ro o C�e4t
COn
Com��
FUH Pond/ Normal Water L
' �'3hore Me !
2 ft.x 150k
addkFawl dealing
• if necessary
F
Plan View
Lake
[At F..II Pond/ Hormel water Level)
Existing Dock
,�30h x 7ft
3ftx i50 Tt
" Befow TuR POWNWL
4hr150ft
Abo Upond/HWL
�- (wowi 6� Pond I
NwL
1 x 1ao
have fb>> � l
FORM: SSGP 02-2017 Page 3 of 4

Lake
(At Full Pond/ Normal Water Level)
Or
Side View
10 ft. bank
height
Side View
rx W�.e
tb`
L rem NGaN � '� 1�b1. �'�en� 1at11 'rye.,
WmU A SP,*KN ko ei�Sv*ie M6%* 1A0Yn
�, 5ac.CCSS
L ❑
❑ C-
Z Ln
3 ft. below full pond water level 4 ft. above full pond water level 2 ft• additional clearing
If necessary
FORM: SSGP 02-2017 Page 4 of 4

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project
Owner
rrint algrla[ure
Contractor/agent: Charlie Washburn— Marine Construction
Print 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 02B .0243(8)]
Trees are not allowed to be removed from Zone 1 of the Buffer (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. 115A NCAC 02B .0243(6)]
Benching and 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 (611
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. [L5A NCAC 02H .0502 and 1SA NCAC 02B .0243 (4), (6),(8)1
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 02B .0243(5), (6)]
Acknowledgement of Notification
i, David and Tarnela Everett . 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: �G

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Hickory
North Carolina
T I . Head east on 2nd Ave NW toward 3rd St NW
0 Pass by Bank of America (with Drive-thru services)
(on the left in 0.3 mi)
0.5 mi
+1 2. Turn left onto 2nd St NE
0 Pass by Starbucks (on the right in 1.2 mi)
T 3. Continue onto N Center St
<-, 4. Turn left onto 29th Ave Dr NW
T 5. Continue onto 6th St Dr NW
4-) 6. Turn left onto 36th Ave NW
f4 7. Turn right onto $th St Ct NW
4) Destination will be on the left
4015 8th St Ct NW
Hickory, NC 28601
1.4 mi
1.2 mi
0.9 mi
0.4 mi
0.2 mi
�>�

catawba county Geospatial
µ zxo. trvim, efrrre. Real Estate Search
Information Services
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Parcel: 370519511349, 4015 8TH ST CT NW HICKORY, 28601
Owners: EVERETT DAVID K, EVERETT TAMELA W
Owner Address: 4023 8TH ST CT NW
Values - BuiId! ng(s): $9,300, Land: $570,800, Total: $580,100
1 in=400ft
This maplreport product was prepared from the Catawba County, NC Geospatial information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and €abeling information contained on this map or data on this report. Catawba County promotes and recommends
the independent verification of any data contained on this maplreport product by the user. The County of Catawba, its employees, agents, and
personnel, disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or may
arise from this map/report product or the use thereof by any person or entity.
Copyright 2023 Catawba County NC
12/18/2023

AGENT AUTHORIZATION FORM
Please note that multiple fomns may be necessary if there are more than two owners of the property.
PROPERTY LEGAL DESCRIPTION:
SiREEi' ADDRESS OF WS ING HOME or LATrPJDEILONGITUDE OF NEW CONSTRUCTION:
4015 8th St Ct NW FlickoM NO 2M1
Parcel ID: Z 1251134E
Property Owner Names) — please print:
Property Owner: David Evers
Property Owner: Tamela L rn
The undersigned, registered property owners of the above noted property, do herebyauthorize
Charlie Washburn
(contractor/)
, of Marine Construction LLC
(Name of cpmpary)
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 Owners Mailing Address (if different than property address above);
Property Owner(s) Telephone: [phone]
We hereby certify that: the above Information submitted in this application Is true and accurate to the
Frnlr R :-� 4
cur knowledge.
Contractor/Agent
Date