20240388 Ver 1_Site Plan_20240307

Water Resources
ENVIRONMENTAL QUALITY
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SSGP 02-2017
Shoreline Stabilization Application Farm
Three copies of the application (including attachments) and the application fee should be sent to:
If sending via US Postal Service If sending via delivery service (UPS, FedFx, etc.)
Paul Wojoski Paul Wojoski
DWR — 401 & Buffer Permitting Branch DWR — 401 & Buffer Permitting Branch
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699-1617 Raleigh, NC 27604
A. Applicant Information 115A NCAC 02H .0502(ai
1. Owner Information
Name: Juan and Jennifer Restreao
Mailing Address: 6310 SW 65 Avq
Miami FL 33143
Telephone Number: [phone] Fax Number: N/A
E-mail Address: [e-mail]
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:.
httrr//www.saw.usace.armv.mil/Portals/59/docs/reaulatorv/reRdocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf)
Name: Charlie Washburn
Company Affiliation:. Marine Construction LLC
Mailing Address: PO Box 6400
Hickory, NC 28603
Telephone Number: 828-495-3040 Fax Number: N/A
E-mail Address: [e-mail]
B. Project Information [ISA NCAC 02H .OS02(a) & 4b11
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 02-2017 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: @iurke Nearest Town: Connelly Springs
Lake/ river/ ocean adjacent to property: Lake Rhodhiss
Property size (acres): 1.14 Acres
Subdivision name or site address (include phase/lot number): Lakeside Reserve. Lol 157
Phase 1 2224 Pikes Peak Ridge Connelly Springs, NC 28612
Directions to site - please include road names and numbers, landmarks, etc.:
Included in oacket
Latitude (in decimal degrees) 35.782 Longitude (decimal degrees)-81,456
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Reside ntial,undeveloped
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): We ply to stabilize the shoreline with riprap tQprevent further.
7. Will work be conducted from land? From water? x
8. Total amount of impacts below the normal pool lake level / Normal Water Level
Permanent impacts (including all excavation, backfill, rip rap, retaining walls, etc.) in square feet:
1 nn soft
Temporary impacts in square feet:
0 saft
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 walls, etc.) in square feet:
inn soft
Temporary impacts (temporary clearing, construction corridor) in square feet:
Construction corridor s ft
10. 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): The lot is wooded.
11
Signatgi-�
02/26/2024
Qwne0gent's Signature" [15A NCAC 02H .0502(f)] Date
'Agent's signature is valid only if an 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 for
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
Full Pond/ Normal Water Level
Shoreline
Plan View
La ke
(At lull Pond/ Normal Water Level)
5P.
No GofNshvt" ('000GIor
Na i"exn,ay I RVCAcb
oo h e -s re mavI!J
Lake
{At Nil Pond)Normal Water
Lent)
Existing pock
d6f[x711
3kxmft
Full Pond/+rN�orm�a€ Water LeARO
BCtlryw' FUR pones "M
r ShorellnC— —
s6r150ft
adl pwd/ NWI
2ft.x150R.
addhnonal dea ft
if ne -mary
EXAMPLE
Plan View
I�� FC7t l iUV
Imo.... 'r■rlr ..� � I�
a ft.
5bf=
M'do-- wtit ,p�f
N W 1--
FORM: SSGP 02-2017 Page 3 of

ask-x 60
voroL� NWL
Lake
(At Full Pond/ Normal Water
0,X eft.
flaw �tl
Side View
W ca+Tn&\C('
r,�n s rMavr-A
1� rr1C1,�nOq wt tE Yjp- ftoctkj
1 n �Of bang-
>
w
a
3 ft. below full pond water level 4 ft. above full pond water level 2 ft• additional clearing
if necessary
Existing hank
10 ft. bank
height ye'
Qv
FORM: SSGP 02-2017 Page 4 of 4

CATAIIVBA Rll'ARIAiV �4 FFER NOTIFICATION FORM
Project blame/address: Restre o- lakeside Reserve Lot 1457 CountY: Burke
Owner: Juan and Jennifer RestralL
Print ; Signature, —�
Contractor/agent: Charlie.Washburn—Marine r3nstruction
Print Signature
The approval is for the purPase 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. [ISA NCAC
02H -0506 and 15A NCAC 02B .0243(8))
Trees are not allowed to be removed from Zane 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. [15A NCAC 028 ,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 (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 028 .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 ar
sheet flow at non -erosive velocities to the lake. [15A NCAC 02B .0243(5), (6)1
Acknowledgement of Notiftcotlon
I' Any work
ifk conducted r hereby state that I have been informed of the Catawba Riparian Buffer Rule.
in -the buffer, not specifically stated in the application and approved by the Envision of
Water Resources (DWR), is a violation and subject to enforcement. Due diligence will be taken such that the
Buffer Rules, the approved plans} and spe
construction will be built within substantial compliance and intent of the 401 Water Quality Certification and
cification(s), and other supporting materials.
Signature ]owner):
Late. ". r

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p j3�/qpn Hickory, North Carolina to 35.7814451, Drivel 0.1 miles, 20 min
i _81.4569698
imagery U2024 Alexander County, Burke County, CNES / Airbus, Landsat / Copernicus, Maxar Technologies, Orbis Inc, U.S. 2000 ft
Geological Survey, USRA/FPAC/GEO, Map data @2024

Hickory
North Carolina
Take 1 st Ave SW and Cape Hickory Rd to Decker Rd in Burke
County
15 min (8.0 mi)
1' 1. Head south on 4th St NW toward 1 st Ave NW
0' 2. Turn right onto 1st Ave SW
f-* 3. Turn right onto 39th St NW
T 4. Continue onto Cape Hickory Rd
5. Turn left onto Burke StlRhodhiss Rd
0 Continue to follow Rhodhiss Rd
Continue on Decker Rd to your destination
& 6. Turn right onto Decker Rd
& 7. Turn right
? 8. Slight right
+1 9. Turn left
0 Destination will be on the right
35.7814451,-81.4569698
0.3 mi
3.1 mi
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1.0 mi
5 min (2.1 mi)
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Please note that multiple forms may be necessary if there are more than two owners of the property,
PROPERTY LEGAL DESUCIPTION.-
STREET ADDRESS OF DaSnNG HOME or l-ATrrU1)E/LON2TUDE OF NEW CONSTRUMON:
2224 Pikes Peak Ridge Connelly Spring$ NC 28612
35. 78 J-a �1456
Parcel ID: 2774183358
PmPertY Owner Narne(s) — please print:
Property Owner: Juan Restrepo
PrOPerty Owner: Jennifer Restrepo
The undersigned, registered PrOPertY Owners of the above noted property, do herebyauthorize
Charlie Washburn
of Marine Construction LLC
(COntraclor/Agent) (Name of company)
to act on MY behalf and take all actions necessary far the Processing, issuance and acceptance of this
Permit or Certirication and any and 611 standard and special conditions attached.
0"4" owners Mailing Address (if different than PrOperty addressa ve).
6310 SW 65 Ave Miami FL 3314:3 bID
IrOP8ItY Owner(s) Telephone. [phone]
We hereby
y certify that the above information submitted in this aPPlication is true and accurate to the
best Of Our knowledge.
Autho ' —Signature
Z �onzed Signature
Date