DLC.SSGP 10-2013 Shoreline Form.REV.07.15.24.pdf

State of North Carolina
Department of Environment and Natural Resources
DWR 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
401 & Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
I. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name:
Mailing Address
GREGORY B GRIGSBY
411 Main Street
Lot under Contract to
Pat Calaiaro
20 Pieeon Foree Ct
Bridgton, Me, 04009 Murrells Inlet, SC, 29576
Telephone Number: [phone] Pat: 609.577.3447
E-mail Address: [e-mail] [e-mail]
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
htti)://www.saw.usace.armv.mil/Portals/59/docs/reRulatorv/reedocs/Permits/SAMPLE AGENT A
UTHORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: Robert L Morgan Jr
Company Affiliation: R Morgan Homes LLC
Mailing Address: 4110 Little Tree Ln
Denver NC 28037
Telephone Number: 704-607-4438 Fax Number:
E-mail Address: [e-mail]
Person to receive the Certification Approval: Robert L Morgan Jr
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. Vicinity map attached.
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

etc.), 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. Site plan attached.
3. Attach a photograph of the shoreline/ buffer proposed to be stabilized. (Include a scale
of some sort- a yard stick, shovel handle, etc.) Photograph attached
4. Location of the property (where work is to be conducted)
County: Catawba Nearest Town: Catawba
Subdivision name or site address (include phase/lot number):
8840 Dog Leg Rd. - Lot 24 Sherwood Shores Block A - Mountain Creek Township
Directions to site - please include road names and numbers, landmarks, etc.:
From NC Hwy 150, North on Sherrill's Ford Rd approx 2mi turn right on Molly's
Backbone, approx 1/2 mile turn right on Azalea Rd; approx 1/2 mile left on Dog Leg Rd,
approx 1 mile to 8840 Dog Leg Rd
Latitude (in decimal degrees) 35.645697
Longitude (decimal degrees)-80.959557
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Undeveloped residential lot with trees and heavy
underbrush. eroding Lake Norman shoreline and no structures or improvements
6. Property size (acres): 0.7
7. Lake/ river/ ocean adjacent to property: Lake Norman
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Bank and shoreline with moderate to severe undercutting
and erosion and in need of stabilization by applying fabric and rip -rap
9. Will work be conducted from land? ® From water? FI
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:
752 sa ft
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: 1440 sq ft
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): Treed with
undergrowth... Smaller trees and small vegetation will be removed to provide work access
for stabilization. Tree removal will be minimized and shoreline stabilization will be
performed in keeping with Shoreline Management Best Management Practices.
FORM: SSGP 10-2013 Page 2 of 4

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v7/ 5/24
Owner/Agent's Signature* [15A NCAC 02H .0502(f)] Date
*Agent's signature is valid only if an authorization letter from the owner is provided.
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 (as noted on attached Site Plan, vegetation clearing only as
required to stabilize shoreline; two trees w/ dia > 12" require removal for rip -rap placement;
Shoreline BMP to be utilized in buffer).
2. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation.
(see attached site plan and below for item 2 above)
3. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation.
(see attached site plan and below for item 3 above)
4. Location of any proposed structures such as buildings, retaining walls, docks, etc.
(see attached Site Plan for proposed dock)
5. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
N/A
6. Location of construction access corridors
(as noted on attached Site Plan)
L.ake Norman
Plan view
Notes=
1. Dimersfons may be
ad;usted as rscsbsa,� so
as to compl� with
shoreline BMP
2. Rfp-rap placed via
site access corridor and
via barge
JEGtior1 View
Rip Rap Placement
FORM: SSGP 10-2013 Page 3 of 4

DWR
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
Vicinity Map
�akg
N--
340
_, Rd
Shoreline Photo w/ Shovel
FORM: SSGP 10-2013 Page 4 of 3