20160306 Ver 1_Shoreline Stabilization_20160328

�b oo State of North Carolina
Department of Environment and Natural Resources
DWRDivision of Water Resources
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
Division of Water Resources 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 2 0 1 6
401 & Buffer Permitting Unit 3 B
1617 Mail Service Center
Raleigh, NC 27699-1617 t__@_
nt Information 15A NCAC 02H .0502 a Applica 2 8Owner InformationZ016
Name:fer ROES
Mailing Address:401 UFER PERMI ING
/c lZL 2,8
Telephone Number:A29- sl S Fax Number:
E-mail Address: cZM,Spfi f? a C/` '/Z -i E2 "NST
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
httq //www saw usace armv mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: RV I�AV'4
Company Affiliation: _OTL Qr^a:tix Li -0
Mailing Address: T" 0 o�
kefce\\ 'r'p C q.`61o`VZ'
Telephone Number: 7 oH-902-13 yS Fax Number:
E-mail Address: d -re 6r-J­%-y—d dmg,'I, cewsi
Person to receive the Certification Approval: Lrk%s 00'.0 �-Z
11. 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

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: dA I~d4'y4+b,*- Nearest Town: -�Fticri Il g Fp-,J,
Subdivision name or site address (include phase/lot number):
yl 91 1 oj� -st. she: fly FVd ry-C-- 7-y1.73
Directions to site - please include road names and numbers, landmarks, etc.:
11 me t r. A_ \ l I �f I _ 0-1-k ^2CrJ1\.
GA
Latitude (in decimal degrees) Longitude (decimal degrees)
5. Describe the existing land use or condition 1of the site at the time of this application
(residential, undeveloped, etc.): (' es eAl i oa \ afO'SS UA4A w:4ti \�ousC-
6. Property size (acres):5�
7. Lake/ river/ ocean adjacent to property: LA k -r- Yl)o-(rvsv^
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): I eVt"C- � Z0 (Zia P,4-0
f o -I -o ( 00' S 1;; I•w
9. Will work be conducted from land? IV 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:
10 `I.3D 4Cc-e� Ar�r�. -� ti ^fib. +� �,u��<< .fob g� 1 '\'err►Jort�N�
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: _+ * m- � .s' _ ✓►o 4,re',is 4a 6,
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):
I iK %DO A\ -K60
LX ( i 10 Sy P4-
3-273,16
4-
3-273-16
Owner/AkeXs Signature' [15A NCAC 02H .0502(f)1 'D a-te-
Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013 J� Page 2 of 3

Full Pond/
Norma'.
Si-
Please
r
Lake
(At Full Pond/ Normal Water Level)
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ftx 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
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 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

CONTRACT
Shoreline
3/23/16
Mr.
4191 Todd st.
Sherrills ford nc 28673
Description
1. Rip Rap
A. Install geotex fabric over exposed soil
B. Rip -rap to be placed for an even heavy border
C. Work to be performed by land
D. Includes all required permits processing
E. Remove all trees that have exposed root system on the shoreline
F. Materials, class B rip rap 5 loads
G. Owner is responsible for all permit fees
TOTAL.................................................
CTC Grading LLC, hereby proposes to furnish material & labor to complete in accordance
with the above specifications for Total payment to be made as follows: 100% at
completion. 1.5% interest added monthly if balance not paid upon completion. Warranty
is void if contract is not paid per the contract terms.
Material is guaranteed as specified. All work to be completed in a workmanlike manner
according to standard practices. Any alteration or deviation from the above specifications
involving extra cost will be an extra charge not included in this contract. All agreements
are contingent upon strikes, accidents/delays beyond our cont
CTC Grading LLC is fully covered for Workman's Compensation and Liability.
Homeowner is responsible for fire, theft, tornado and other necessary insurance. The
above prices, specifications and conditions are satisfactory and hereby accepted. By
signing below, I authorize CTC Grading LLC to do the work specified. Payment will be
made as outlined. Contract price is valid for a period of 10 days from contract date.

,._,-Any additional work over and above this contract will be done via a change order and may
have to be scheduled for another time to allow our crew to make it to the next scheduled
job on time. All change orders require a 50% deposit of the total change order amount and
is to be paid upon approval of the change order. CTC Grading LLC will not be held liable
for any diving incidents. Water levels must be at acceptable levels for work to be done.
CTC Grading LLC is not responsible for underground utilities, irrigation, landscape,
pillions, HOA approvals, or Acts of God. It is the customer's responsibility to have
underground utilities marked, we recommend calling U Loco 1-800-632-4949 if you are not
able to locate yourself.
CTC Grading LLC Chris Handy 3/23/26
Homeowner's Name
Homeowner's Signature
Date
Fol

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3/Z;i12016 Parcel Report
Parcel Report - Catawba County NC
Parcel Information:
Parcel ID: 460719514709
Parcel Address: 4191 TODD ST
City: SHERRILLS FORD, 28673
LRK(REID): 13392
Deed Book/Page: 1339/0097
Subdivision: MT CREEK TERRACE
Lots/Block: 3/ A
Last Sale:
Plat Book/Page: 13/110
Legal: LOT 3 3A PL 13-110 LK NORM PL 13-110
Calculated Acreage: .550
Tax Map: 012CX 02003
Township: MOUNTAIN CREEK
State Road #:
Tax/Value Information: Tax Rates(pdf)
City Tax District: All in County
County Fire District: SHERRILLS FORD
Building(s) Value: $208,500
Land Value: $126,700
Assessed Total Value: $335,200
Year Built/Remodeled: 1978/1989
Current Tax Bill
Miscellaneous:
Building Permits for this parcel.
Building Details
WaterShed: WS -IV Critical Area
Voter Precinct: P31
Parcel Report Data Descriptions
List all Owners Deed History Report
Owner Information:
Owner: JONES ELBERT CURTIS JR
Owner2: LANE GRADDIE L JR
Address: 4191 TODD ST
Address2:
City: SHERRILLS FORD
State/Zip: NC 28673-8331
School Information:
School District: COUNTY
Elementary School: SHERRILLS FORD
Middle School: MILL CREEK
High School: BANDYS
School Map
Zoning Information:
Zoning District: COUNTY
Zoning1: R-30
Zoning2:
Zoning3:
Zoning Overlay: CRC-O,WP-O,FPM-O
Small Area: SHERRILLS FORD
Split Zoning Districts: /
Zoning Agency Phone Numbers
Firm Panel Date: 2007-09-05
Firm Panel #: 3710460700J
2010 Census Block: 3045
2010 Census Tract: 011504
Agricultural District:
Assessment Report
This maplreport product was prepared from the Catawba County, NC Geospatial Information Services. Catawba County has made substantial efforts to ensure
the accuracy of location and labeling information contained on this map or data on this report. Catawba County promotes and recommends the independent
verification of any data contained on this map/report product by the user. The County of Catawba, its employees, agents, and personnel, disclaim, and shall not
be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or may anse from this map/report product or the use
thereof by any person or entity.
wZuio, uarawm County uovemment, North Garohna. All rights reserved.
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