20150890 Ver 1_More Info Received_20160229

SState of North Carolft
Department of Environment and Natural Resources
DWR Division of Water Resources
Dhrision of Water Resources 15A NCAC 02H .0500 – Water Quality Certification, Shoreline Stabilization
FORM: SSCP 10-2013
Shoreline Stabilization Application Form
Four copies of the application (including attachments) and the application fee should be sent to:
1.
Division of Water Resources
401 & Buffer Permitting Unit @ 0
1650 Mail Service Center
Raleigh, NC 27699-1650 r r.H 2 9 2416
Applicant Information ISA NCAC 02H .0502 a]+,grafi FIR PERMITTING-
Owner
ERMITTING
Owner Informap'°n I
Name: 5-c�JA✓f� ��%SK
Mailing Address:
AfC ✓A1C, ,1A_5, /JC. X8$03/
Telephone Number: 70 V. ( D y'. 8¢ 3 Fax Number -
E -mail Address: �&-)A - 6Q e %,�C��if rte%/ • Cd>►+'�
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/PoU@LsZ5_9/`­doalregulatory/recdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM odf) must be attached if the Agent has signed this application form.
Name: �,r 8, -;die s
Company Affiliation:
Mailing Address: 83 DAF-eCG/ �•-,it
Telephone Number: 7_q. (ie).,6/1 j Fax Number: 70A o gd, cf7g< 9—
E -mail Address: r-& 5efi 04w/v (Z- A/; n/ _5 iY 64Ak
Person to receive the Certification Approval: _ C/ip /g +rid, ew
II. project Information F15A NCAC 02H.0502(a) & („b)l
I. 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 4

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.
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: T! a-,4 Nearest Town:. rD ►'/VC(' 1/,-S
Subdivision name or site address (include phase/lot number): i ✓ e� 5/10 Y -e, A7-�/
Directions to site - please Include road naro
es and numbers, landmarks, etc.; ,T % /l�
7� 6X 070 Onl a-114-0 iw_ . _ k 4-m j � W gvei i�/ iP T
S. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): V'CS ; e tj km -1 me- W. -K cf
6. Property size (acres);1-2.513
7. Lake/ river/ ocean adjacent to property: IAKC AAWMAJ
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):i4-/JA-�%1,e
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:
--156 X+ /
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:J��1 �. f
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). rA-s5
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

Lake
(At Full Pond/Normal water Levet)
Full Pond/ , -
. . '76
Please approximately sketch the following information on this pian (provide dimensions for each
item, such os 10 ft x 1 oo f#) *:
1. All proposed vegetation clearing
2. location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
I 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 wails, docks, etc.
S. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
FORM: SSCP 10-2013 Page 3 of 3

DUKE tNERGY WnRNAL USE ONLY-
Damen: j`— --- Construction
1---- FAE Paid,
Application t_ . =i_:
DUKE
❑ Ap�sticatfon Cmnpiete w2swn 13P ENERGY
T�
HEP Fund �— Permit No. Water Stmt
Strategy; Hydra Licensing and lake Services
Duke Energy
Site ID Oos�Out Date PO Box 7 OU6/ EC12Q
Charlotte, NC 2V01
I. DATE OF APPUCATM* _-
..f{. APPUGANT � S _ xPemtiifl`'ag
' ` - _ ` INFORMATION (appilcant rnagla add
drM and write:[ information)
Name*
g Primary Phone -
Address{ Jt 4"
Secondary Phone
city-
State -W zip code
a SO Fax Number
Email* 1I / A
111. PROPERTYON don of
Addtess'F
ry-3 14
City*
S State* & Zip Code�Coin}+ Parcel ID number
Lake*: o r � � (e g. Pin, Tax ID, TMS 9'16,9
Number...) ��/� 0 � D 7
suhdivisio ! jj/e, 15 Lot(sip
---�-- Plat BookMage 7
To enter the Latitude and Longitude oFthe-
service/software too pr pety. please use a
should s a* acquire the location information. Values Latitude (e 9.35.3 Z345r
provided in Dedmal Degrees fafthat (35.1245). 77
example service http;/Jrit0uehrnap.cQm/ladong.htrnl Longitude (eg. -80.12345)"
IV. PROPOSED ACTIVITY -
r New/Mod icauon of Existing structure --------�- __
r Maintenance of Existing Structure IsDodc-'"-'�
New/AAodificatian oib�ting Shoreline Maintenance
t` MaintenancevfExistin Shoreline Covered?
r NewlModlflcation of Zftdng Structure & 5tabii¢aoion g titan
C' Maintenance of Existing Structure & Stabiliz b. # of SU S
f' Transfer of Owner�ip
(" Other (please describe below) f of Jetports
Area over land (sq ft) Arca eWe3rvt►aser {ser fiH
Tota! Sttuare f=eet
SI:Ore11r1E$ubjjj=fWn Req
lerto of �.J D i)iStance from Sitore�ina
Stahli
fzation
Materials l4 Fi h114 Uj
Brief the Gt�A��� i �l �YooJ e yt 5 j 0�-
�1 _ J ' -T
Describe Briefly tate Existing
Structures Over Land and
Water fndude sq ft) �%

V. Dods guilder or Engineer - - - -
Name/Company
Address Lzlo83 ri G Phone Number
• city_l' _State � Z11p Cade �g/ S^ (=mail �6G�.I��i�S p it%iA/�S✓ r�/k , mac.!_
VI. Cheddlst of Required Docume� (to include hhiitih-Application Submission)
annt Survey (stemped/signed by a professional licensed surveyor showing the location of the existing or proposed H
structure and/or survey of the existing or proposed stabilization)
Q Photos along p►nAeny shoreline and photos of any existing structures and/or Stabilization in or near the water
3"'AAPPlication fee (check arty, payable to Duke Energy) ❑ Signed User Agreement Letter
L' Applicable local, state, and federal permits ❑ Plan and profile dravAng shawtng an measurements and elevations
❑ Habitat Enhancement payment Cfiapplimble;
-
• Application is reviewed and determined if complete. Fields with an asterisk are required.
• If application is not complete or does not include all items and information listed in the checklist, the
application will be returned as incomplete.
• A Duke Energy representative will visit the site to conduct a visual Inspection.
• Applicant will be notified of approval or denial.
• Applicant is to have the notice, to be supplied by Duke Energy upon application approval, posted and
must be viewable from water. The no#lce must remain posted until a representative inspects the
Project and determines the project is complete and within the application specifications.
VBl. Directions ftoed
Directionsby Ot�l/ /►'Ie,7* r1�•
Road} �l
W oil/ CA-,rA-vob*- •� �{taoJ c .J
o.✓t
,a. _.Y._....r . _ . .......1
1X. ApAticUiori Subtniissioh..._...�..-.T.....
Please complete, print and sign this apPlication. Then enclose all items from the checklist above in an envelope and
submit all the infornwion to the address below.
Water Strategy, Hydro Ucensing and l aM Services
Duke Energy Print form
PO Box 1006/ EC120
Charlotte, NC 28201
I agree that the information contained within is

LOCATION MAP
NOT TO SCALE
CAROB
pQ;••''FEssio'• �2
][p_ QIF
SEAL 'S '•
�y •L-2993 �
... .:••��G
CRAIG L. LONG P.L.S.
121 KELLY COVE COURT
MOORESVILLE, N.C. 28117
(704) 7992292
LEGEND
0
ODI-OD®RABJ PARKS �-06 �/
08 12296 PC 988 ('/
#4 REBAR FOUND
I#4 REBAR SET
PK NAIL FOUND
UTILITY POLE
PROPERTY OF
Ile
s?N
6c,
-p
�\
C Nf
M �tn A POkTION i °F
AN, TOTAL ARFA
22,368 SQ. FT'
/� 0,513 ACRE
Pz w
Ch
-< O
\` ll -
�o
4.
,�\tea 9Z"LN
�0kp-\�c+ �'
-Pir� o
OR 4, 1.1
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P.HY,S'1'CAL
A PORTION OF LOT 1
jos
lm�
AREA 00 VEM
COLVIN H. OVON
PER D.B. 17706 --
ANO M.B. 42-15:
NORTH PER M.B. 42. PC. 153
1,
co
W
Gi
W
WOOD
PIER
LAKE
NORMAN
,f-�
N
001-091-53
COLVIN H. VDONNELL
NIKKI C O•DONNELL
D8 8104 PO 777
NOTES:
TO 1. NO NCGS MONUMENT FOUND
NELL WITHIN 2000'
2. PROPERTY MAY BE SUBJECT
TO OTHER COVENANTS,
RESTRICTIONS, EASEMENTS OR
RIGHTS -OF --WAY THAT MAY BE
OF RECORD.
S' UR VE Y OF
of DIANE SHORES
SCALE: i"=50' CORNELIUS, MECKLENBURG COUNTY, N.C. DATE: 3/7/2007
1 AS RECORDED IN: MAP BOOK 42, PAGE 153 PID: 001-086-07
19519 TRESIA LANE EOC >=1:10,000
LINE TABLE
LINE
LENGTH -1
BEA ING
L1
11.60
N7355'0 "W
L2
29.99
S69'16'35'E
L3
19.24
N7333'291 -
L4
30.49
N80'01'42"W
0
ODI-OD®RABJ PARKS �-06 �/
08 12296 PC 988 ('/
#4 REBAR FOUND
I#4 REBAR SET
PK NAIL FOUND
UTILITY POLE
PROPERTY OF
Ile
s?N
6c,
-p
�\
C Nf
M �tn A POkTION i °F
AN, TOTAL ARFA
22,368 SQ. FT'
/� 0,513 ACRE
Pz w
Ch
-< O
\` ll -
�o
4.
,�\tea 9Z"LN
�0kp-\�c+ �'
-Pir� o
OR 4, 1.1
Q - -
P.HY,S'1'CAL
A PORTION OF LOT 1
jos
lm�
AREA 00 VEM
COLVIN H. OVON
PER D.B. 17706 --
ANO M.B. 42-15:
NORTH PER M.B. 42. PC. 153
1,
co
W
Gi
W
WOOD
PIER
LAKE
NORMAN
,f-�
N
001-091-53
COLVIN H. VDONNELL
NIKKI C O•DONNELL
D8 8104 PO 777
NOTES:
TO 1. NO NCGS MONUMENT FOUND
NELL WITHIN 2000'
2. PROPERTY MAY BE SUBJECT
TO OTHER COVENANTS,
RESTRICTIONS, EASEMENTS OR
RIGHTS -OF --WAY THAT MAY BE
OF RECORD.
S' UR VE Y OF
of DIANE SHORES
SCALE: i"=50' CORNELIUS, MECKLENBURG COUNTY, N.C. DATE: 3/7/2007
1 AS RECORDED IN: MAP BOOK 42, PAGE 153 PID: 001-086-07
19519 TRESIA LANE EOC >=1:10,000

(Page 1 of 2)
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OWNER. JAMES G. GALLOWAY
' 11551 BEATTIES FORD ROM/
HUNTERSME. NC
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(704) 875 - OaO4
OWNER COLNNH O'DONNELL
19525 TRESIA LINE
CORNEOUS,NC
We ��
(704) 892 -4450 Ts NY
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