20160544 Ver 1_Shoreline Stabilization_20160526

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 Uni pAip 440160,544
1617 Mail Service Center
Raleigh, NC 27699-1617
D
I. Applicant Information [15A NCAC 02H .0502(a)] [dIAY 2 6 2016
1. Owner Information
Name: Doris C Rhyne 401
DEQ-WATER RESOURCES
PERMITTING
Mailing Address: 5147 Hickory Grove Rd
Gastonia, NC 28056
Telephone Number: 704-866-0158 Fax Number:
E-mail Address:
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
http:/Iwww.saw.usace.army.mil/Portals/59/docs/regulatory/reRdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: Robert Mark Morgan
Company Affiliation: R. Morgan Homes, LLC
Mailing Address: 14101 Black Farms Rd.
Huntersville, NC 28078
Telephone Number: 704-582-3818 Fax Number: 1-866-999-6921
E-mail Address: [e-mail]
Person to receive the Certification Approval: Robert Mark Morgan
II. Project Information (15A NCAC 02H .0502(a) & (b)J
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

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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: Catawba Nearest Town: Sherrills Ford
Subdivision name or site address (include phase/lot number): Asbury Park lot# 7
5093 Lakeview Cir. Sherrills Ford, NC 28673
Directions to site - please include road names and numbers, landmarks, etc.:
177 south to exit 36 HWY 150, go west on HWY 150, Turn LEFT on Slanting Bridge
Rd, Turn LEFT on Keistlers Store Rd, Turn LEFT on Barkley Rd, Turn LEFT on Lakeview Cir
Property on the left.
Latitude (in decimal degrees) -80.986198 Longitude (decimal degrees) 35.555558
S. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): undeveloped vacant lot
6. Property size (acres): 0.538
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): stabilize eroded shoreline by reshaping and applying fabric
and rip rap, also construct dock
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:
500 salt
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: 500 soft
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): Seven pine 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.
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Owner/Agent's Signature" [1
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Date
FORM: SSGP 10-2013 Page 2 of 3

SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT N0. 7 PLAN NO. PARCEL ID: 460604923839
STREET ADDRESS: 5093 Lakeview Cir. Sherrills Ford, NC 28673
Please print:
Property Owner:
Property Owner:
DORIS C RHYNE
The undersigned, registered property owners of the above noted property, do hereby authorize
Robert Mark Morgan Of R. -Morgan Homes, LLC
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
5147 Hickory Grove Rd Gastonia, NC 28056
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
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Authorized Signature U Authorized Signature
Date: VaU 5,2-0 Date:

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