20160428 Ver 1_Shoreline Stabilization_20160502

'State inff+tatfh'Camuna
Department of Environment and NaWral Resaurtes
DWR Division of Water Resourzes
i3ivisfon of Water ResoUme--5 13A N1 UALD2H_X5iU- -iter Quality"CeTtifrcation,-Shorelim-SStabil!Mton
FORM: SSCP 10-2D33
Shoratine-Stabilization Application form
Four copies of the application {inducting attachments) and the an fee should be sent tri:
Division of Water Resources 140I®
401 & Buffer Permitting Unit —
1550 Mail Service Center 2
Raleigh, KC -27699-1.650O 6 Q 4 2 8
3.
1_
Applicant Information [' A {ICAC X214 .05QZI )1
Owner Information
Name. __Air k of ► A S u.1i rL E
Mailing Address: __.�2_7067M091V?r
KIIAY O 2 ' 'U Jo
"Telephone Numbrer: q 0, %2/. 14/7 Taxtfrlurnber:
E-mail Address: �`"Su4 70-e Ya�1o� , Com
:2. Agent/ f=antactPemun°information
A signed and dated vopy -af fhe Agent Authorization letter"(a form �;an be downloaded here:
ht .- /www.saw.usace arrn�AGENI_ AAUTH
ORI TION FUR `M,pdf) nius t bAAP attacFr d if the bent h
mas sigrrecFfiltis.application form.
f4ae: /r./1 i0 AV -1 "q -e-3
Company Affatiatilin:
Mailing Address:
re- + oCec: c_1;A(
ride
T ' nl C .moi rc
W
Tpiephon-e Number. ��T. 6 20 ' Pll I fax Number.:
E-mail Address:��J _&CJ
Person to receive the Certification Approval: ` i i'O cs
fl. Project Information '[15A NCAC 02l; .4502 a & fh�j
1. ACtach a vicinity map'(i_e. ttreet,map) •clearly showing -the lurcatiort of the property with
respect to focal landmarks such as towns, rivers, and roads.
2. Provida,a-detailed site plan-showipgg property boundaries.arrd proposad loratians.of
vegetation.clMarmg,strurturE-% (buildings,'retuinittg-walLs, ctcxkE, imerviows,�sutfaces,
FORM: SSCP 10-2013
Fate 1 of 4

-etc-), rip rap, excava.±ian or drptiging Belo -w Full Pend/ !`formal `hater Level ­,Eeuaticins,
aria ronstrartion-access corridors_ you may Erse the diagram provided at il•re end of this
application four:.
Attach a phatograph of the shcrt-Lliine/ burfer proposed to be stabiRzeed. (include a scale
of -some soit--a,yard stick, sIh-civel handle, etc.)
d. Location of the property (Vvilem work is to be conducted) �
County: M eeg (<,1 b Our- Nearest Town- 0 rrer­
Subdivision na .e-orsiteiiddre' ( iciu � 1phase/let number): �=sI c �rr�o,,
1 -f - -�
DirPt-tions for Site - {ilea, include road aeries and lumbers, landmarks, e_ii.:
- �13I� (�q-v�l 01- fir o� 1,e��- �
S. Describe the existing land use ar,condition of the -site at the time of thts-application
(residential, undeveloped, etc.): _'CS i -A e 4 , A-
6. Property -size (acres): 01701-
7.
o%OQ-
7. lake/ river/ ocean adjacent to property. A .0 TM A fJ ---
8. Describe proposed work (include discussion as to how hardening off shoreline as been
,avoided, or why itis necessary): � i ze.. S 6-c.1; m e p-rC�er) I 'C"s 10 Id
9. Will work be conducted from land? Frorn water?
.10 -i otal amount of disturbarzce,(including-all excavation,.ba:ckfili, rip,rap, retaining walls, etc.)
below the nomyl pool lake revel/ Normal Water level in square feet or acres:
I.I. Tbtfi l amount of disturbance (including all rlearing, -back fill, excavation, rip -rap, retaining
wails, etc.) above the normal goal lake level/ Normal Water Leval and SL feet land -ward in
square feet or acres: l G 0 X l
12. Please describe the :regettation above -the normal pociHake iFvel/Worrmai WatarLevel anti
'54 feet landward robe impacted fnumberof trees, for insrance): —_q r R r �}
Owner/Agent' ' ' naturex_T5A f.IC:LC OZH .( 5�2 fes' Date
Agent3 si[gnatur,ei5 Valid only,f ten Out toriFntion ieger fmrn the ownerls proWdLn,,d
FORM: SSCP 10-2013 PUP,2-of 3

take
1 1t s�liF;nri; itcrrrr :wa erLevcij
v e C) ED
Oo>p ©�0 p 0CIO Ge GC j,
l=ull Pond/ Co o �� 6 G o o p��o o Ub p O
Normal Ya e Lem M..E CF 6 ° o rJ oo vo ° *a no so
6horeiire �°e o 0 0 0 'D Q�Coo
pi) rd -5,
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as-10frx 100 ft)*:
I . Ail propnsBd vegetation clearing
Z Location of rip rap or fill to'be placed above the'Full Pond/ Normal Water Level elevation
S. Location of rip rap or fill to be placed below the Fulf Pond] Normal Warr Level elevation
-4- Location of any proposed;strur_tur--s-such --as tzuiidings, returning waN, clacks, etc.
5. Location af-any-exc-aeration or dredging -below the full Pond/ Normal Water level-ielp dtian
6. Location o construction access corridors
M. SSGP 10-2013 Page 3 of 3

Constme Won
Date pcerved'!ald
cation
`J-Appilcafivr, Campfi=re
-'�'errrtit tdo. t
£+� Fund tNarei 5trteczy lRydro bceisimg and L -4:e SL -Mc --
Duke Energy
Stie ID _ f C1rsse Gur iYa PL' Bex ? ©L)6/ F—F T2Q
1. OA? E OF APPLICATIGW �i � •�� _��G Femu�lTatJ �.. � i
il. APPUCAN; INF I Ail0! jappiic2nt,MrMIlnq addres3aclt card C�itlf�ntid%ivri) - - .- i
PHmary ?ho,ne
Addi eis'
C tax ' -fir d 41 Stat=� t �Y Zip edea �� /'4 1 -cmx NumbEr i
{J'�su t � A-�� v • � o r�
Address,,-- - - - - -
ecg
City' 2ipCode'
-Caunty `r�drw-i fD-number
elx`_ QYMA ; (e g. Prn, Tdv, ID. TiYfS { D3 /A 3 /a '7
Nueber--) !
Subdivision �j ` � gat)I� +
-- ---- -----------
--1 ptatE�altit}age
987
r�En:ertiteiat�tude-and-E�r►---'--•---,.-._- " .�� --" •------
q ttWz.oit4e properyy,Ph'a� uae-a -- -- - -
servicelsof ware to easily5cquire the comttan jnforr,-jatiorL Values LzMtUde (e_g_35J2345? IF3 Yj . 3 yli
should he }provided in Dedmal Degrees farmat (35.3 NS). ` —
i example service" hztPIMOUChmap.com/larceny"lttrn! Lor itutie {E g, 20, 12345), 75/
- - —�
W. PROPOSED A&iWL -
!�_ /`N ' lModflc'dtian of &isiim Structure - .� Maintenw-ce of Edsong 5trucrtwe" a is Doric
--w, f iadidcation Df-ExiitirlqShnreT�
riebitization - N—Covered?
itiew;Rkodcfu2tton oi�*tisting5trurture-�,.3�7��n
(-'Transfer Of -Ownership
Aver. jwmr land fsgfi4) }
anFerOrMe of.£xtsimy Srmrelhre5tablizaftn
14ainterrrXU-a`i3:iming Structure&Siab!!jzw?v
i Other (piazze describe below)
liras nuc► �vatnr to W"rcE)
-TSA:a t Sgcare t•eer6
-� o�iips
��J��orts
Share'.lne5tabii7Y3t[9n.[��s) Lfl]o0{
Stabii{ratian i /OD ffOMSFO_rPjinfw;�` 0i1/ �i 5- -"—
�
1'U
—.-_-- _ — lvratetials QIC {r rl rX
E _
-aris+f Da ces pYiarr J 1 //%�
oftheAcnvi�' �u� ��T 5A roc '5 !� 6e- /Jff/¢ �i✓ pf�l�/`�4`uial
[Tescri�'tir�ilyt`��x!sirrtg. / % fj
"5tructtrres overlsnd and 1'e 1 �- /,(%�+� i G� j
W'.ter{ndude_c ft) n

V. fuck 8.411 fer or Engitse_er
NaMeKo, neany i �% 0/vL � '000(i,
pddre<-, 1 �µ -, P are Number ;
Li"y ✓i�% StatiVKILir)�cde i ref tmazln / I /�'_ �/�s S�►-e 4l".A14
13. Cheddist of Required DecoMents (to intlade wdh Applifutian 3ubm€ssson)
► .rani SLr�ey (staa:�dis►nrt¢d by a +�rnf�ie:�ai;cc-er�se�rtc+Ayc,; s{sovuint}ti�l�ation citrN:�:i�irrg zJr�t��;��ed
J _m, ui.:ureZndlorsmleyofThNxrstingorprgwe ednabft2at;on)
j 1p'r0tdsalongpOpe?I}r��3l�iriea�7ti�?'rJiosSFc7tlyf7p�2%n<1SintQifd�3�rld1t7rSLdi3,�3fZiiOnlilynearI-bewa'Lfr
!-i! ArlpkaVCM fee ifhethr�r,?Y, payableta Diake Eneigy) S ;n ---d LkeTATeen, ena i_ener
y��tlp; lisab a k�ai,,race arrdfirdetal prints E] Plan and profite--rFaxli?g sl�uwi tg�IfTr vtnntents arr�televai bns
10 t wftat.k nb-,riw-mra rraymmit Ofappik-abiv)
VIL Approval Process
$ Application is rfvie d -and determirred if.complete. Fields with -on asudsk-arerequired.
K -application Ps not Co mpkete ur dins not rrtclude all hems and -information ll d in the checklist, the
app:icetiori will he returned as incomplete.
tr A Duice Energy represernati a milli visit the:sifie .to ronduc[ a visual inspectiun.
Applicant will be -notified ofappcoval or&mai.
Applicant is to Dave the notice, to be supplied by Duke Energy uport applicator, apprDval, posted and
must,be-viewable f - m water. The-nD ice rnustremiin.pastel) smtii-a representariue'ir4pbr-tsthm
prtt{ett-ants-determines the -project is complete and tvhh n the application sAecifrcat€ons.
VII-. DirecHarns kry Road - _ �. _ _.- . _ _.. , - -- - --- •.- -
Flo kl- P e. -d-9
I:}r'--taps Ery � � }
Road 1 f
Ii4. f ihcaltrnSubmission
Ptft-�e complete, print andsign this.applkation. Thenrr=kose all lte" from the rher ltlistabove in an envelope and
si rnit-alttbe inforn-otton to the -ed dress bO&w.
;Nater snate9Y, MY43ro t.icensinVzod Lake Servkes
Duke Frergy �
P4 8ax 10061 EC120
Chavitmie, KC 29201
l agree tbat :he infvrmation contained vAi , tr :s attune:

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