20160646 Ver 1_Shoreline Stabilization_20160629

DUKE EPUERGS' iNTERA1AL USE ONLY:
Construction
I
Date Received: FAFPaid ApplicationApplicationComplete �""°,,,�'�•t��,.q 9 2(]16
NEP Fund Permit No Water Strategy, Hydro Licensie1S�e�Yn-icGesDuke Energy -WATER RESOUR(
Site ID Close-0ut Date PO Box 10061 ECi 2Q BUFFER P SOU Ti
Charlotte, NC 28201
I. DATE OF APPLICATION* jfo Permit/Tag #..-
IL APPLICANT INFORMATION (applicant mailing addr9ss and contact infonnaiin)
NamesOMO-�%APrimary Phoney _ �b
Address
1 �b
Secondary Phone p _
City" State* Ztp Codes (�
Fax Number
Email*
Ill. PROPERTY INFORMATION (location of permit)
Address* 13Qn - --- -- - - -- _ �. -
�LUCNS-S�i (� j County ecv-k
C't �1 States JNA Zip Code* aYa County Parcel ID number
Lake' �' _� (e.g. Pin, Tax ID, TMSO 3 I I / � �e3
Number_.) 10
Subdivision Lots) ii
_ 1 Plat Book/Page d
To enter the Latitude and Longitude of theProperty,
- _ please
serv'ce/software to easily acquire the location in
ation. Valuesjs O �6
Latitude (e.g. 35.12345)*
should be provided in Decimal Degrees format (35.1245).
example service: http:l/itouchmap.com/lationg.htm! Longitude (e g. 80.12345)' Q, 93 f �� 3
t New/Modification of heisting Structure--
NewModificationofExistingorelineStabli twtw
[" New/Modification of Existing Structure & Stabilf2ation
( Transfer orOvinership
Area over land (sq ft) I
Shoreline Stabilization (feet)
Length of
Stabilization
Brief Description rni 4lor t(
of the Activity
i ReAftvY-
Describe Briefly the Existing
Structures Over Land and
Water (include sq h)
C' Maintenance of Existing Structure
i Maintenance of Existing Shoreline Stabilization
C' Maintenance of Existing Structure & Stabilizatic
r Other (please describe below)
Arca cve►water tsq ft) Total Square Feer
67o
Is Dock
Covered?
It of Slips
B of Jetports
Distance From ShorelineLW 4116co Cp' s A"'V j
Materials
-ReAA —Rocr- lop'" i `j ArCC 14'(1 4)IV- L1 cv/ .S A✓e,
Q
o10F

V. Dock Builder or Engineer
Name/Company
Address �O (J�/K�I qLM Phone Number
City � r/jt�State �` 21p Cade t L-5IEmail 5 � �5 ef-) it%! A1015
V1. Cheddistof Required Documents (to include with Application Submission)
ent Survey (stamped/signed by a professional licensed surveyor showing the location of the existing or proposed
structure and/or survey of the existing or proposed stabikation)
25hotos along property shoreline and photos of any existing structures and/or stabilization in or near the water
V A plication fee (check only, payable to Duke Energy) &IIII User Agreement Letter
Applicable local, state, and federal permits ❑ Plan and profile drawing showing all measurements and elevations
[] Habitat Enhancement payment (if applicable)
vli. Approval Process
e Application is reviewed and determined if complete. Fields with an asterisk are required.
a If application is not complete or does not include all items and information listed In the checklist, the
application will be returned as incomplete.
v A Duke Energy representative will visit the site to conduct a visual inspection.
Applicant will be notified of approval or denial.
a Applicant Is to have the notice, to be supplied by Duke Energy upon application approval, posted and
must be viewable from water. The notice must remain posted until a representative inspects the
project and determines the project is complete and within the application specifications.
Vill.Directions byRoad
4E/
Cliff_.._cam. ---_ 7
Directions by
Road'
IJC Application Submission -�."_ ._ ,� .. _ ...._ __. , _..__ , �y „ _ � �_ _ .._ � -, - •- --�._. _....,_ _..�_ ...._ _...,-.. ____,...�„-.__-._._
Please complete, print and sign this appilcatiom Then enclose all items from the checklist above in an envelope and
submit all the information to the address below.
water strategy, Hydro Licensing and Lake services Print Form
Duke Energy
PO Box 10061 ECt 20
Charlotte, NC 28201
I agree that the Information contained within is accurate. /

State of North Carolina
'MI Department of Environment and Natural Resources
Division of Water Resources
Division of Water Resource PA0H .0500 — Water Quality Certification, Shoreline Stabilisation
���jjj/// FORM: SSGP 10-2013
Shoreline Stabilization Application Form
Four copies of the application (including attachments) and the application fee should be sent to:
Division of Water Resources
401 & Suffer Permitting Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
Applicant Information F15A NCAC, 02H .0502(a))
Owner Inform -tion
Name:
Mailing
Address:
mc
Telephone Number. lDq -4(cQ-2l(4aQ(0 Fax Number:
E-mail Address: kp Wig— W S t"( P CLp1. CDCY'1
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/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM. df) must be attached if the Agent has signed this application form.
Name:
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Address:
D . s// I Fax Number: %4. k 6 D. =5--Y6 9
Person to receive the Certification Approval:
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 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: ('e Nearest Town:"
Subdivision name or site address (include phase/lot number): jb
01RiVZrr3J,-_Dr.
Directions to site - please include road n
o Al A Ls 1401 � "1-kk
5. Describe the existing land use or condition of
and numbers, landmarks, etc.: ILLP
r5yt94-& •I \ 0Irf11�Y_N--o_�
(residential, undeveloped, etc.): A-
6. Property size (acres): d. as
7. Lake/ river/ ocean adjacent to property:
t the time of this application
8. Describe proposed work (include dis ussion as to how hardening ofrrshoreline ha been
avoided, or why it is necessary): /� r 1i 5{ vy jve t� v`GYL'4;46rio sio�u
9. Will work be conducted from land?
From water? V
10. Total amount of disturbance (including all excavation, backfill, rip rap, retaining walls, etc.)
below the normal pool lake levet/ Normal Water Level in square feet or acres:
11. Total amount of disturbance (including all clearing, back fili, excavation, rip rap,,retaining
walls, etc.) above the normal pool laky level/ Normal Water Level and 50 feet land -ward in
square feet or acres: 9d X
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): OrA.55
Owner/Agent's Signature 1 A NCAC 02H .0502 Date
Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSCP 10-2013 Page 2 of 3

Full Pond/
Normal Water Level
7 �e w
Shoreline
t 6j6ove-
Lake
(At Full Pond/Normal Water Level)
0
r
�wwa��e
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
3. 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 10-2023 Page 3 of 3

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