20151042 Ver 1_Shoreline Stabilization_20151005

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Division of Water Resources 15A NCAC 02H.0500—Water Quality Certification,Shoreline Stabilization
FORM: SSGP 10-2013
Shoreline Stabilization Application Form
Three copies of the application (including attachments)and the application fee should be sent
to:
Division of Water Resources i@VigD
401&Buffer Permitting Unit
1617 Mail Service Center OCT o 5
Raleigh, NC 27699-1617 of 0/5Ig
NR W
40,$e FTER REs
ER PERMf0 CGs
Applicant Information 115A NCAC 02H .0502(a)]
1. Owner Information nn
Name: Tii-nld's h') 0 hrc,
Mailing Address: 15-1 o q L,c,✓o a 4 v y D,a.
ZALCi6N , WC 2_7 (to
Telephone Number: ¶q- -q $6 O Fax Number:
E-mail Address: RA-71 K /�►-)(4 K- @ a.n t, o-
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.army.mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE KANT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
Person to receive the Certification Approval:
II. Project Information [15A NCAC 02H .0502(a) & (b)]
1. Attach a vicinity map(i.e. street map)clearly showing the location of the property with
respect to local landmarks such as towns, rivers,and roads.
2. Provide a detailed site plan showing property boundaries and proposed locations of
vegetation clearing, structures(buildings, retaining walls,docks, impervious surfaces,
FORM:SSGP 10-2013 Page 1 of 3

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'DPP.
etc.), rip rap, excavation or dredging below Full Pond/Normal Wat= L&, levationseo 1S O
and construction access corridors. You may use the diagram provided a +'ez,e ' his
psM��Gapplication form. N
s
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: C FU D Nearest Town: Ci R i4t.r
Subdivision name or site address(include phase/lot number): F KIG&+a Ks LAKpi kr9
Sv6 - vi.;on ; trig GtQEEka wITE FAwS , NC. Z�63O
Directions to site - please include road names and numbers, landmarks,etc.: 6coM Rt 3 2.I
otT GRAIN('ft': PA(-US IJC I .S re.i le east on Falls Ore ; le:31Ato-n
H1eantlev in, 1nfb►-v . :or •2 nv k Left o ►-t 11 ye.r kJ far 50 �1 j
Lek/ or, Gree,A s 2d sva.✓e-q rtea,s S 68°24 5'7"6 1\430°,j-`7'416" H/
Latitude(in decimal degrees) 35". 7914'19 Longitude (decimal degrees)81,,3 785-C
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped,etc.): E5 I o cN T I Oil. vrfbera, GO e.r srrt .1C-Tt o h1
6. Property size (acres): 2 e..c v e g
7. Lake/river/ocean adjacent to property: L 4Ft , 141c,tc..o l2.y
8. Describe proposed work(include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Se-e- G CttO■CJm—e A
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:
SC..e- Qr G.GN
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: SPA a'tork c-h 'r
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): S ge. o:f'l+a CI(vv-1 ehi'
c)04YA9p f ° ° ' l c CC 115
0 3o
Owner/Agent's Signature* [15A NCAC 02H .0502(f)1 Date
`Agent's signature is valid only if an authorization letter from the owner is provided.
FORM:SSGP 10-2013 Page 2 of 3

1
Lake
(At Full Pond/Normal Water Level)
My Provo sect
c)cis`ri rt
a o a.t house, Es"i 5'i"'n
g3�ak hov�s� 1 5.00 house,
i I J, f [
Full I / - - - - - - - - - - - - -� �
Normal W r Level
... ■ ■ •I.-..-_-..-.-....s- -- — lir ... I=
Shor I ne co
a X L A S; .t-(2-9.6 6 -+-) 2 -h re-e-s 411 b e.
I A 3 x ( S,. .t 01135- f+)
rip ra. . 000Ve,
of t-Z9 rwp
fk1o.r YerR%reA. wit Iti .v11 ?DNA
e--11) roor Il Qtha
bc,I1S
•
con 5krvcAor >
I access c-ov-r∎dor
P"'0 p`r r( ""c- ' t
he vs,e t n.aQ.,r-
constr , A:aVI eropzvt Ire
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

ATTACHMENT
8. My lakefront is 145 ft long and is located on a cove in Lake Hickory. It is used heavily by
ski/wakeboard boats that create large wakes. My shoreline is heavily impacted and in many places has
sustained erosion as much as five feet above full pond. I plan to place rip rap at an angle of two feet
horizontal to one foot vertical as is recommended by the"Duke Energy Shoreline Stabilization Technique
Selection"website.
10. There will be approximately two feet of rip rap below full pond. I have 145 ft of shoreline. The total
impacted area below the lake level will be 290 sq ft(2 x 145).
11. There will be approximately three feet of rip rap above full pond for a total of 435 sq ft(3 x 145).
12. There are approximately 20 trees in my 50 ft buffer that will be left. My proposed boat house will
be built directly out into the water across from two trees with exposed root balls pictured in photo#7. I
will be requesting to remove these trees with permission from Duke Energy. They pose a severe danger
to the people who will be using my boat house.

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