20160528 Ver 1_Application_20160523

State of North Carolina
Department of Environment and Natural Resources
DWR Division of Water Resources
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
Division of Water Retiou c es FORM: SSGP 10-2013
Shoreline Staoilization Application Form
Three copies of the application (includini; attachments) and the application fee should be sent
to:
Division of Water Resources
401 & Buffer Permitting Unit
1617 Mail Service Center 2 0 1 6 0 5 2 8
Raleigh, NC 27699-1617
I. Applicant Infor-nation [15A NCA( 02H .0502(a)]
1. Owner Information
Name: Carr ? & Ted Coleman
Mailing Address: _1857 Lassiter Mill Road
Ashe )oro. NC 27205
YiAy 2 3 2016
DEQ -WATER RESOURCES
4( 1 & BUFFER PERMITTING
Telephone Nur,be-: _336i'453-4113 Fax Number:
E-mail AddrEss } . .
2. Agent/ Contact Person Informs do
A signed ane detec copy of tl-e Ag nt Authorization letter (a form can be downloaded here:
http:/jNwtitisan ,'ace.a-rnA_rI %)__r X 154/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTH
ORIZATiorJ I.Oi{ d pdf) mint be 3tt� ched if the Agent has signed this application form.
Name: /A _
Company Af;ilijtion:
Mailing Addres!.:
Telephone tour be-:
E-mail AddrEss.
Person to re .ei,,(? the Certif catior Ap )roval:
Fax Number:
II. Project Information [ .5A h CAC C H 0502(a) & (b)]
1. Attach a vicility map (i.e. street n- ap; clearly showing the location of the property with
respect to local landmarks such as rov✓ns, rivers, and roads.
2. Provide a detailed site plan showi, g K roperty boundaries and proposed locations of
vege_ation c ea -in€, structu-es (bL Idi igs, retaining walls, docks, impervious surfaces,
FORM: SSGP 10-2013 Page 1 of 4

etc.), rip rap excavation or dredgi g k elow Full Pond/ Normal Water Level elevations,
and construction a:cess corrida,s. You may use the diagram provided at the end of this
application forr).
3. Attach a phctograph of the shore ne,' buffer proposed to be stabilized. (Include a scale
of some sort- a yard stick, 5110Vel t andle, etc.)
4. Location of the property (where ti )rk is to be conducted)
County: _ Montgomery___ _ Nearest Town: New London
Subdivision name or site address ( icl.ide phase/lot number):
Lot 42-1, Glerbrook ';;rings Section, Uwharrie Point
Directions tc site - please include )ad names and numbers, landmarks, etc.:
NC Hwy 49 :) Badin Lake Road (SF 1132) south to old North State Club entrance, see
gate attendnt for directions to pr �3E rty•
Latitude (in cYc`mo' degrees)_ N62` 771 Longitude (dec,mcl degrees) E1674011
5. Describe the ex sting land use or c mcition of the site at the time of this application
(residential, undeveloped, etc.: _ developed lot in existing subdivision
6. Property size (azres): _ _ 1.54 acres
7. Lake/ river/ ocean adjacent to arc )er:y: Badin Lake
8. Describe prcpo sed work (incl id ( fisc fission as to how hardening of shoreline has been
avoided, or why- it is necessary;: 1 ) stabilize and eroding shoreline and protect it from
further erosion._
9. Will work be conducted from land ❑ From water? ❑
10. Total amount c: disturbance i inch. Jing all excavation, backfill, rip rap, retaining walls, etc.)
below the norrr al pool lake It`el/ 4ormal Water Level in square feet or acres:
:.40 Sp. Ft.
11. Total amount o-' disturbance (in-_li Jing all clearing, back fill, excavation, rip rap, retaining
walls, etc.) aoo,e the normal pcol ak ? level/ Normal Water Level and 50 feet land -ward in
square feet or jcres: � 40 Sq. Ft.
12. Please descr Le the vegetation orb. ve the normal pool lake level/ Normal Water Level and
50 fee: landward to be impacted ( wriber of trees, for instance): Many trees of varied
species, size and condition will be emoved in order to complete the stabilization project.
Owner/Agent s Signature' [15-a NC -AC D2F .0'Q02 f Date
Agent's signature is solid only ifon outtor'zc ior.- letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 3

Full Pond/
Normal Water Level
S1
(Al Ful:
s-.
SEE ATTACHED SITE RAI J AND DETAILS
Please approximate y sketch the followin. inf ormation on this plan (provide dimensions for each
item, such as i 0 It x I00 f t) *:
1. All proposed vegetation clearing
2. Location of rip rap or fili to be place at ove the Full Pond/ Normal Water Level elevation
3. Location of rip rap or fill to be p kite bE low the Full Pond/ Normal Water Level elevation
4. Location of an I p -oposed structures suc h as buildings, retaining walls, docks, etc.
5. Location of an / e:(:avation or dredg ag )elow the Full Pond/ Normal Water Level elevation
6. Location of co est -uction access torr Joi s
FORM: SSGP 10-2013 Page 3 of 3

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FOR:
LOCATION:
RESERVOIR:
PROJECT:
DRAWING TITLE:
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VE( ET 4TE DISTURBED AREA
J 48 VE SLOPE
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EXISTING GRADE
EROS CN COI``TROL FAE¢
TYPICA-CCIr )MONS
' 2" TC :36' ERODED CUT
WAVE EX.PC SURE
SSS 1 RIP RAP
Carri 8 Ted Coleman
Lct 21, Glen:)r )o< Springs, Uwharrie Point
Badin Lake
PHASE_
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BOTTOM
1 � BILIZATION PROGRAM
c -')ITE EVALUATION
- 1EADIN, NORTH CAROLINA
V11v10'R I';F RAP STABILIZATION

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