20240504 Ver 1_Site Plan_20240403 (2)

cz
tr
c
•
m 2; C:
ip
01
4,1
%,A2 6­50f
so, Bog —0,
66.78 ­111-97 WES= "Is -too
JOAS
03
t"."tpl.m as
G=:81 ..MST !!'IMP
224
39
z z Am 3 n z is z
. . . . .
. I I
. . . . . . . . .
ITT"
� . . . . . . . .... . . . . .
. . . . .
.41
Z.,Sum m::2
99s:8
9
I.El—L R.. Is
114 -2s
z
21V
'71
mq
41q- It- 45.
:n: MSI. 299
.Zts 54'.
mgo st" V21;
_pp
21 .111h 11
w. 8,a,2 I S:- MI_

!Full Pond/ N
Ulu "
-'1c 6 -7(,0
I
0
take
� S Te42-S
P�6 Aef7)A-
,�-q 44k-
per, a
so, bxfi�e�
... . .... .... ......
F.--;Iistlrg Ducif
full!!Ot lb —M.rm —'r, ft
UlUater Level
Pi rap • fall Pond/ Nvu t
3nm dea,l"3 -11
;oral
f5

19'-10"
D
z
Ln
s
a.
co

!Full Pond/ M Lave
Shu" -7GO
ZDAJC d. In,
Lake.
Ot Pu,`
erg
,) S7e-4s
Pub A-eFA-
Gsiis¢irg Doc.:
may' C
Betom fdl Pond/ NVJI.
rull 1Vn/ NOT wr2ter kGri
ova f.9 pond/ Nmu
Haft.
.d,tt and CIMA.3
Plan V, �,
-- I = = =
sf
`,arth smio., `;I—L f 1.jj*.%j.j 5�,jee _'ante; Raleigh. 27049-1417

D
z
c
s
m
m
a
0
0
X
J
O
0
n
m
N
LA
n
D
r
m
I I
O
Irk
d
Np
ti�
24'
34' OR 35' OR 36' +1_ MAS E MENOS

23'-1"
19'-10"

(At l°bd1A� dLaice
/N®6°mat Wat;rL@jfe1)
Full Pond/
l"b — E? EZ�% pC,f0c
tVmVI J-V% L 8/,Sj-j jj
P(easa approxirnatel
Item, such dS V sketch xzo the f®ltovuin i11f®rr�ation1�,�
2®f�-a�20®ft)�0 � A p
�.. All Pr0POSed v� fP.,0 96gfe C/Im�
2, Location ofrl r00ii®n
3. Location Of Flo Pap o� titito he PIace�9h®�� the Full l�®
4. Location �frart o by placed below $ha P�11 pond/ IPIVormal Water Level elevatlon
S• location ®fan pY®dosed rUCtura8 such a� buildl�v��g r�tatnln� waling ���
Y excavation Or dredging A / 1V®real UUagar Lat,�l elevation
6� LoCati0n ®i COnStructlon access COrrrid®ralow ghe Full pond docks, a•ke,
®rr�al IA/ater Level elevation
FORM! SSGP 10.2013
Sage J ®f a

5. Describe the existing land use or condition of the site at the time of this application (residential,
undeveloped, etc.):
6. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
7. Will work be conducted from land? j From water? r7
&. 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:
Temporary impacts in square feet:
fu �
9. Total amount of impacts above the normal pool lake level / Normal Water Level and 50 feet land-
wa rd
Permanent impacts (including back fill, excav9 rip rap, retaining walls, etc.) in square feet:
Temporary impacts (temporary clearing, construction corridor) in square feet:
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):
11. Signature
By signing below, I, as the project proponent, certify to the following:
® The project proponent hereby certifies that all information contained herein is true, accurate,
and complete to the best of my knowledge and belief
© The project proponent hereby requests that the certifying authority review and take action on
this OWA 401 certification request within the applicable reasonable period of time
3/� ley
Owner/Ag s Signat re° 115A NMC Q2� 0502Ei J1 Date
'Agent's s' is valid only if an authorization letter from the owner is provided.
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
' �`�•�rti:6"'u1.•.�i1zr�:�ai�F�sie?>L�.�[t`� '�'it E rt�ti�t�E�E;tt�FGsu��s?a

5. Describe the existing land use or condition of the site at the time of this application (residential,
undeveloped, etc.): -,5, Oe �► ,n
6. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
7. Will work be conducted from land? Q From water? CD
S. 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:
Temporary impacts in square feet:
9. Total amount of impacts above the normal pool lake level / Normal Water Level and 50 feet lands
ward
Permanent impacts (including back fill, excavation, rip rap, retaining walls, etc.) in square feet:
RD'
Temporary impacts (temporary clearing, construction corridor) in square feet:
NIr
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):
11. Signature
By signing below, I, as the project proponent, certify to the following:
o The project proponent hereby certifies that all information contained herein is true, accurate,
and complete to the best of my knowledge and belief
o The project proponent hereby requests that the certifying authority review and take action on
this CW,4.401-.wtifiutiocnre4uest wi__�the applicable reasonable period of time
i
Owner/ nt's Sign re' .Ni AcG-2H .l�b2MI ®ate
°Agent s signo ure is valid only if on outhori7ation letter from the owner is provided.
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
�`?^:c:.ta av:anbc..�tittxF klx! aia�Su.o[,r :: vatns [2an., iA. �aMln�utvlin�t. �'Y(>•ltLt�t7
Nor

1V;
s
"f
1

!Full Pond/ M Lave
Shu" -7GO
ZDAJC d. In,
Lake.
Ot Pu,`
erg
,) S7e-4s
Pub A-eFA-
Gsiis¢irg Doc.:
may' C
Betom fdl Pond/ NVJI.
rull 1Vn/ NOT wr2ter kGri
ova f.9 pond/ Nmu
Haft.
.d,tt and CIMA.3
Plan V, �,
-- I = = =
sf
`,arth smio., `;I—L f 1.jj*.%j.j 5�,jee _'ante; Raleigh. 27049-1417

D
z
c
s
m
m
a
0
0
X
J
O
0
n
m
N
LA
n
D
r
m
I I
O
Irk
d
Np
ti�
24'
34' OR 35' OR 36' +1_ MAS E MENOS

23'-1"
19'-10"

7
w N
o7(D � si
u rm N
z u ^
' s z
z
> • W 3'' F H N 0 gg
y 4 z
L «. z t o ¢ Y W~ O J
O w J CC D: (J o f
¢x=� u aJ wW
U i
Q`. � \ •i O
\\ b 6st66.li
' \ ♦6k p�230.96
r
00
04
0�C 626.66 602-60C so, Bog = +' OL'EOt ..-. pc91!•t �05 m ...�
M1nb 64 6t �U tp.gi.e6 ( 66.79 ( N=111 •97 iL'i9= NI9-f09 P=126.22 Ps si J .: 0,7 `ry♦ bb
4 '
ZZ!!i r m. R• O'
o gat, 1— "7 w m Z o0o cat • t
o
z e •• ct `.� �
d9l• I1b �q4 • � '
cr x 11 W V
t4�1 Os\ m N• � L Y N � \ \
cr
Im
1
ao`�0w !o u, t53 31_
$•eN,mAna� as 92, ..MST emr oW .�01
wm m.mm mNe: mm: o-�:� ymwema++wmnAn .m.$ h mtl1 0% lg WpS �Ns rVW
W
o1 wwo�
m •m �l JO to. .mm o
a W . 54
::z:3 m s 3 N moo M'dm "' :��s a
m :a:
Ao _M
`-: uw e.oama »aoo 0 000 .............. � o � ��u b� m c �m
�a�o� wimu o� s rc
y mmm ♦ wmmw� W W
o my mm Ar.. . `m ...:N o m-.m--.-
9::z: �:aa �:::: � ::::::zmmmA wwm _$�. `� '''_ �'
y A pp pp 11pp ��jj A' yy _ _..
.A..Q ... .. ...aw wwwwwa N�nw Ne. P.^ NwwNN W uy '6' r9 Y.Y1r 0 0 0 0 0 0 0 0 m A o AAA O O O O O O Y L q Wq.. a S W eeyy 11��
N 2 O1_-O m1W6 56�iO�
i

CATAWAA R110f nn.% o �UFFER NOTIFICATION FORM
Project Name/address:
Owner:
Print
Contractorlagent: Ai
I
Signature
Pririt LA {[.e (�,rM/ T LL L
ianat
The approval is for the purpose and design described in your application. Impacts not indicated in the
application is a vio►ation of the Buffer Rule. Site specific work should be provided in the application. [15A NCAC
02H .0506 ar,u! 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 anu sloping along the immediate shoreline is allowed. [15A NCAC 02B .0243(6)]
Benching, grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 02B .0243 (6)]
L'eacfies, in;pervious patios, impervious walkways, etc. are not allowed in the buffer unless specifically approved
uy the Divisioi-i. Tne e are limitation on size for decks. [15A NCAC 02B .0243(4) and (6)]
VVorlk to be conducted prom land must indicate an access and indicate any trees that are to be removed. The
wort: corridor should be described. The approved access corridor shall be restored. Staging, spoil, construction
rr,acerial muse be uatside the buffer. [15A NCAC 02H .0502 and 15A NCAC 02B .0243 (4), (6), (8)]
Stormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
discharges musi ue ac the natural elevation and discharged prior to entering the buffer directed as diffuse or
sheet flow a'c non -erosive velocities to the lake. [15A NCAC 02B .0243(5), (6)]
nowied cr ,cnt 0:-: PV0eification
MA—C D,:ter,,
hereby state that I have been informed of the Catawb
-',ny vvork cone ed in the buffer, not specifically stated in the application and as roved
by the Division of VVater Resources (DWR), is a violation and subject to enforcement. Due diligence will be suci. cr:c,t ti,e Alan 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
�j`(jS Date:

CATAWBA RIPAMAN BUFFER N®TIF9Ce4T6®RI F�R9i41
Project ► Varne,/address: � � p / 57�6 FAST /
3PJ
Owner:,Contractor/agent: Signatu
The approval is for the purpose and design described in Your application is a violation of the Buffer Rule. Site specific work should berprordedl npthetappl applicas not tion.
O' 1 .0506 an 115A NCAC 02B .0243(8)] C
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 •frees that are severely undermined along the immediate shoreline can be removed.
PJiinirrial shapi;ig &n,) sloping along the immediate shoreline is allowed. [15A NCAC 02B .0 )'
243(6)]
Benching, grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 02B .0243
in Pe'--viaus patios, impervious walkways, etc. are not allowed in the buffer unless specifically a pproved
uy hie i7ivis10 7��crc are limitation on size for decks. [15A NCAC 02B .0243(4) and (6)]
p y
VVork io be conducted iron) 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
r(,a"Ee gal muse be outside the puffer. [15A NCAC 02H .0502 and 15A NCAC 02B .0243 (4), (6), (8)]
S ormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormw
discharges nwst ue at the natural elevation and discharged prior to entering the buffer directed as diffuse or
sheet flow ati non-elvelocities to the lake. [15A NCAC 02B .0243(5), (6)] ater
v-��:�i�5*„e' PRJ9e�d�=C-i,fJc"'6'8i� �;' IF�Fi�%j?��'��'i�i'➢
herepy state that I have been informed of the Catawba
is Griar. " :;`'" .','Y wor'l: concucted in the buffer, not specifically stated in the application and arov
by the DivisiOrr Of VUacer Resources (DWR), is a violation and subject to enforcement. Due diligence will be
y'``'` suc�s r'° =' e :.,"ruz:tion will be built within substantial compliance and intent of the 401 Wateprp approved
Quality Certification and Buffer Rules, the approved plan(s) andsp ecification(s), and other supporting
i'�7c?t8rialS.
ignazure
`C+- Date: L

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. ) 97 ;L PLAN NO. �r PARCEL ID: `% or-b
STREET ADDRESS: 3 8
800e&ZK l� /vr //7
Please print:
Property Owner: — H:2MA S , V, j S Tp
Property Owner:+C
The undersigned, registered property owners of the above noted property, do hereby authorize
'T 4A-6of
Contra or / Agent) (Name of consulting firm)
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 than property above):
- S,AYvlrr� --
Telephone: 7 dLf
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Date: 3 � g /j`j
Authorized Signature
Date: