20160819 Ver 1_Shoreline Stabilization_20160822

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
_D
l
A 00 —Water Quality Certification, Shoreline Stabilization
Division of Water Resources Yn FORM: SSGP 10-2013
Shoreline Stabilization Appli
Four copies of the application (including attachments) and the application fee should be sent to:
Division of Water Resources
401 & Buffer Permitting Unit 2 0 1 8 0 8 8 D
1650 Mail Service Center ��
Raleigh, NC 27699-1650 A D
UG 2 l 2016 I
Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name:
Mailing
Telephone Number: C/r'7�'• 3y7 • q/573 Fax Number:
E-mail Address: us+ /n A-. • G�
2. Agent/ Contact Person Inf ation
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 FOR df) m1 uust b attached if the Agent has signed this application form.
Name: kI P �r� �e S
Company Affiliation:
Mailing Address:
,li/1 oyes v & R e`'W P4 l l 5!"
Telephone Number: `TO jL (d 0. M
E-mail Address: C 5 -e
Person to receive the Certification Approval:
Fax Number:
I
0.5-56
e r4 r^ . n/ c
@1191111111r"_�
II. 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

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: 7T�-Cae_ til Nearest Town: 1 ro L'JV ,r4ni r�
Subdivision name or site address (include phase/lot number): -115
Directions to site - please include road names and numbers, landmarks, etc.:T77
�>�W and W4 R+on)
MnD �atl ei. �'1 G nl E M e Y VA A �t��-�. K.,- 8
�i� b e- Y- 61 -Ke- `%fir
Latitude (in decimal degrees) J � • �5 7 Longitude (decimal degrees) 90 • I T
5. Describe the existing land use or condition of thetite at the time of this application
(residential, undeveloped, etc.): Ut AId e
6. Property size (acres):
7. Lake/ river/ ocean adjacent to property: c— NOrM A -A)
8. Describe proposed work (include dis sf$ion` as to how hard ning f shoreline h s been
avoided, or why it is necessary): YJM r Z2 �"6' lr c -r er1 GroS (-0 A)
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:
1'�©'X Z`
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: O 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): e_5 � 5�r-t." h t,
Owner/Agent's
;AME"S ArVOINK-TE]
Printed Name
`Agent's signature is valid only if an authorization letter from the owner is provided.
Date
FORM: SSGP 10-2013 Page 2 of 3

Lake
(At Full Pond/Normal Water Level)
r
Full Pond/
Normal Waow w W
Shoreline
1 ����'.
P �.
5
1 i A
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ft x 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: SSCP 10-2013 Page 3 of 3

DUKE ENERGY INTERNAL USE ONLY: Construction DUKE
^�,'' [[
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Date Received: fAF Paid Application DUKE
❑ Application Complete version 13p
HEP Fund Permit No. Water Strategy, Hydro Licensing and Lake Services
Duke Energy
PO Box 1006/ EC12Q
Site ID Close -Out Date Charlotte, NC 28201
1. DATE OF APPLICATION* I �� . �0/� Permitffag
11. APPLICANT INFORMATION (applicant mailing address and contact infonnation)��
Name* Z)A `%/ D 6 -UA V Primary Phone* I`/ 7r�, yzj/, `� /5-3a
Address* 4i t Av -d qA( Q, t< I rGI L- Secondary Phone
City" vml.ft State*I •tet Zip Code* Fax Number
Email* d hq Ct, Ay (-J q (A 0,;1. CO kv\
Ill. PROPERTY INFORMATION (location of .permit)
Address* I 5 / rt jey A4Xe. Dr. County" =Y'tcQ{ 0
City" Y01t MA-; State* Zip Code* a1�/ County Parcel ID number
p rm Pin, Tax ID, TMS
Lake*: Nu 3 q 39914
� Number...)
Subdivision IFA115 �'O✓�� %�I�K Wde Lot(s) Plat Book/Page ,b ;2-$4d6 �� 7
To enter the Latitude and Longitude of the property, please use a ftLatitude (e.g. 35.12345)* 35. 45 % 7
service/software to easily acquire the location information. Values
should be provided in Decimal Degrees format (35.1245). ��
example service: http✓Atouchmap.comAatlong.htmi
Longitude (e.g. -80.12345)* 6 .
IV, PROPOSED ACTIVITY
New/Modification of Existing Structure (` Maintenance of Existing StructureIs Dock
Covered?
ew odification of ExistingWbreline Stabilization
(' New/Modification of Existing Structure & Stabilization
C Transfer of Ownership
C Maintenance of Existing Shoreline Stabilization ❑
(-Maintenance of Existing Structure & Stabilization # of Slips
(' Other (please describe below) # of Jetports ❑
Area over land (sq ft) I I Area over water (sq ft) I I Total Square Feet
Shoreline Stabilization (feet) Length ofj-30
Distance From Shoreline I e u
Stabilization l -3 (�jJ� /- rr
Materials L_._ tit`f r`GTAS 4,�
Brief Description�� �� �� ��-� I D/lI
of the Activity � AlpreveAj�(�Y-0_
Describe Briefly the Existing
Structures Over Land and
Water (include sq ft)
wo4.a IIJ
iw

V. Dock Builder or Engineer
Name/Company I rA 6 -)- 7-OAQ I
Address t Phone Number
City OOrCSI,i I l e State Zip Code g S Email66:�t e 'Vq/54-ttl )4
VI. Checklist of Required Documents (to include with Application Submission)
M�ecent 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 stabilization)
[Photos along property shoreline and photos of any existing structures and/or stabilization in or near the water
Ci Application fee (check only, payable to Duke Energy) Vsigned User Agreement Letter
applicable local, state, and federal permits ❑ Plan and profile drawing showing all measurements and elevations
❑ Habitat Enhancement payment (if applicable)
VII. Approval Process
• Application is reviewed and determined if complete. Fields with an asterisk are required,
• If application is not complete or does not include all items and information listed in the checklist, the
application will be returned as incomplete.
• A Duke Energy representative will visit the site to conduct a visual inspection.
• Applicant will be notified of approval or denial.
• 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.
Vlll. Directions by Road r
77 4 h P -x•
rA
Directions by Q� S7�T
Road
�i'►�er�-Id C�ee� (�
M Application Submission
I o ff"'j 1-50/ K e v 7%-K4.) T
. L o n1 �'( I yrvSon1 f:7* �VA ,L oN
Please complete, print and sign this application. 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
Duke Energy Print Form
PO Box 1006/ EC12Q
Charlotte, NC 28201
I agree that the information contained within is accurate:

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Daryl W. Long,
Professional Land Surveyor
18335 Old Statesville Road Suite A
Cornelius, N.C. 28031
Phone / Fax [phone]
Subject 19.5 Timberlake Drive
Troutman, NC 28166
This is to certify that the subject property is not located in a special flood hazard area according
to FEMA flood panel map 37104639001, Dated 03/182008.
.�``�qH CR R �•••'•
. Es 8i0���y''s
:9 4418
'ice•• Q9 SURVF.,{.:'rj
J 2-
Daryl 0. Long Profen ' Land Surveyor L-4918

SURVEYOR'S REPORT
I hereby report that I have made an accurate survey of the premises situated at:
TROUTMAN IREDELL
City County
Known as Street Numbers: 195 TIMBERLAKE DRIVE
N.C.
State.
and shown on the accompanying map. I made a careful inspection of said premises on
FEBRUARY 4 2016 , and at the time of inspection I found to be in possession of said
premises: DANNY & JEANNINE MCCONNELL as
OWNERS
(tenant or owner)
I made a specific examination with respect to the following items and report the existence of the following (If
none, state "None"):
1. Rights of way, lanes, driveways or walks across said premises serving other property:
NONE OBSERVED
2. Streams, ponds, or lake located bordering on or running through said premises:
YES LAKE NORMAN
3. Telephone, telegraph or electric power poles or wires overhanging or crossing said premises and serving
other property: 10' UTILITY EASMENT SEE MAP NOTE #2
4. Underground installations such as sewers, water pipes, gas or oil pipe lines, conduits, across said
premises: UNDERGROUND SERVICES
5. Drainage ditches or underground drain tile across said premises:
10' STORM DRAINAGE EASEMENT. SEE MAP, NOTE #2
6. Joint driveways or walkways, party or curtain walls: NONE
7. Encroachments or overhanging projections including (fences, walks, drives or similar adjoining structures
encroach upon premises, specify: NONE OBSERVED
8. Physical evidence of boundary line on all sides:
YES. SEE MAP
9. Any unusual elements of use or possession affecting said premises (cemeteries, parks, etc.):
NONE OBSERVED
10. Evidence of commenced or newly completed construction:
VACANTLOT
11. Does the premises adjoin a publicly maintained road? YES. (SEE MAP
CAR ,'''i
O
,..9
:r to 0. (J.p9�g C, .
`���
..... `p .` Daryl W. JZng Professio I d Surveyor (L4918)

DA W LO G. P.
18335 OLD S'CATESVFLLE ROAD
SUITE A
CORNELIUS, N.C. 28031 /
[phone]
111 V�CIUTY AiI► f
!4
Q
PINA639299977
ERIC K. TROUTMAN
KENDALL F. TROUTMAN
D.B. 2379, PG. 1143
E GE Of
C3 �E�C
71E LINE 6 l
1
t
PIN.4£39390785
ROBERT E BAXLEY JR. L O T
SANDRA BAKLEY
D.B. 2380, PG. 2375 6+24 ✓r
�,, 44,063 SQ. FT.
0 1 1.012 ACRES 1N
f' (VACANT)
` � m
NORTH PER MAP BOOK 52, PAGE 43
LINE TABLE
LINE
LENGTH BEARING
L1
3216
L2
26.83
L3
34.03 8
L4
9,21
L5
39.24 S
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NOTES.
1 NJONCGSMONUVIENT
FOUND WnM 2000'
2 PER MAP BOOK $2, PAGE 43
LOT 6Z5 HAS A IV STORM
DRAINAGE & 10' UTILrfY
EASEMENT ALONG FRONT
AND SIDE LINES, AS WELL AS
A 10' FLOOD EASF. ENT TO
ELEVATION 770'
2, PROPERTY MAY BE SUBJECT
TO OTHER COVENANTS
RESTRICTIONS, EASEMENTS
OR RIGHTS-OF-WAY THAT
MAY BE OF RECORD
3 SETBACKS TAKEN FROM
IREDELL COUNTY'S CURRENT
RA ZONING CIRITERIA.
4 CONSULT WITH GOVF.RNIING
AGENCY FOR PREVAJ1JNG
LAND DEVELOPMFNI'AND
ZONING REQUWMENiS
PRIOR TO DESIGN OR
CONSTRUCTION OF ANY
IMPROVEMENTS
FIELD LOCATED
76W CONTOUR
t t
L i
k PIER LEGEND,
t
ZONE t #4 REBAR FOUND O
COMPUTED POINT •
•t .t
i t
LAKE NORMAN t ; Gra*c Scale
�� 60 30 0 60
Scale of Drawing I IDch o 60 Fed
Physical Survey of LOT 624 of PALLS COVE-PARKWOOD, PHASE 6, MAP 1
CURVE TABIE
CURVE I LENGiH I RADIUS
CHORD
CHORD BRG
CII 124.491
122.591119.21N42'52*STW
As Recorded in:
18335 Old Statesvilie Road
C2 1.00
177.50
1.00
•W
W
50.93
123.05
50.57
OI"*
-W
122.601m.5DI
IREDELL COUNTY
120.18S51T)7'arE
Firm License, C-3666
�N CAP
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NOTES.
1 NJONCGSMONUVIENT
FOUND WnM 2000'
2 PER MAP BOOK $2, PAGE 43
LOT 6Z5 HAS A IV STORM
DRAINAGE & 10' UTILrfY
EASEMENT ALONG FRONT
AND SIDE LINES, AS WELL AS
A 10' FLOOD EASF. ENT TO
ELEVATION 770'
2, PROPERTY MAY BE SUBJECT
TO OTHER COVENANTS
RESTRICTIONS, EASEMENTS
OR RIGHTS-OF-WAY THAT
MAY BE OF RECORD
3 SETBACKS TAKEN FROM
IREDELL COUNTY'S CURRENT
RA ZONING CIRITERIA.
4 CONSULT WITH GOVF.RNIING
AGENCY FOR PREVAJ1JNG
LAND DEVELOPMFNI'AND
ZONING REQUWMENiS
PRIOR TO DESIGN OR
CONSTRUCTION OF ANY
IMPROVEMENTS
FIELD LOCATED
76W CONTOUR
t t
L i
k PIER LEGEND,
t
ZONE t #4 REBAR FOUND O
COMPUTED POINT •
•t .t
i t
LAKE NORMAN t ; Gra*c Scale
�� 60 30 0 60
Scale of Drawing I IDch o 60 Fed
Physical Survey of LOT 624 of PALLS COVE-PARKWOOD, PHASE 6, MAP 1
Professional
Property
Surveyors, Inc.
of:
Site Address:
Site
As Recorded in:
18335 Old Statesvilie Road
DAVID GUAM
195 TIMBERLAKE DRIVE
DEED BOOK 2330, PAGE 787
Ste. Cornelius, N.G. 28031
PATTI GUAY
TROUTMAN, NC 28166
MAP BOOK 52, PAGE'S 4345
704-7
7 65-5134 Phone/Fax
IREDELL COUNTY
Firm License, C-3666
020116-01 GCW
2 1,10.000
1"-69
46393909100000 95 TIMB -
l of t 01*412016
lob No B
Error of Clostac
bm% Scale
Tax Parcel Number Vta Fik Name
Shcrl Number Dote

195 Timber Lake Dr - Google Maps
Gin, gic Maps 195 Timber Lake Dr
Page 1 of 1
Carter Canopies
195 Timber Lake Detre
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Map data 02016 Google 500 ft',, ---j
195 Timber Lake Dr
Mooresville, NC 28115
https://www.google.com/maps/place/I 95+Timber+Lake+Dr,+Mooresville,+NC+28115/g... 8/16/2016

MapCard - Print your custom map
Page 1 of 1
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http://map-pass.mytopo.com/maps/print_local.asp?print=l&scale=5.00&layer=DRG&lat 8/16/2016

Lll--l--Ew,

f64, DUKE
T-ye'ENERGY.,
Lake Services
Duke Energy
526 South Church St
Charlotte. NC 28202
Mailing Address:
EC12Q I PQ Box 1006
PRIVATE, FACILITIES USER'S Charlotte, NC 28201-1006
AGREEMENT LETTER
(You may use this letter and fill in the requested information. Please Print)
Date 9 .iG - 01-61%
TO: Duke Energy
c/o Lake Services - EC12Q
PO Box 1006
Charlotte, NC 28201-1006
RE: (Project Name)
(Lake Address) r M hl l K e
T o O -A) /VC
Y-\ 1
(Applicant's full name) 1 �Ibrt:h
hereby agrees to comply
with all requirements and conditions sety Duke Energy's Lake Services' office, or
any federal, state or local agen toMy"'11
F litwigs application to
5 / \1
construct d/or lain a '4o
on Lake r 1FA In addition, Uwe have read and agree to comply with Duke
Energy's Shoreline Management Guidelines (SMG) and understand that written
authorization must be obtained from Duke's Lake Services' office prior to beginning any
activity/construction within the Project boundary. The construction will be completed as
described in the approved private facilities program application and within twelve (12)
months following the date of approval by Lake Services. Failure to complete construction
within the twelve-month build -out period will require the applicant to file a new
application within the then -current guidelines. The filing will include any applicable fees
and security deposits.
Uwe attest to be the owner or lease holder of the tract of land immediately adjoining the
Project boundary where the proposed private facility is to be con
JAve understand that the structures to be installed and/or maintained are my/our Property
and Ave therefore agree to be fully responsible for the permitted reservoir use including
maintaining structures in good repair. If the private facility is deemed unsafe by a Lake
Services Representative, Ave agree to repair or remove the private facility at my/our own
Page 1 of S
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expense and within the specified timeframe set by Lake Services. This responsibility is
considered to transfer automatically along with ownership and leases of the adjoining
tract.
Ilwe agree to fully disclose all information regarding the approved private facility to any
prospective buyer/leaseholder of the property and any new owner/leaseholder. I/we agree
to notify Duke Energy Lake Services immediately of any sale/transfer of the property,
including the name and address of the new owner and to transfer the permit to the new
owner/leaseholder.
1/we understand that unless the private facility was permitted by Lake Services before
June 1, 1996, no more than (1) pier/dock or one Common Use boat slip per waterfront lot
will be considered for approval. ownership/interest in a Common Use Facility or
residential marina eliminates the option of having a separate private facility on any other
owned or leased lot within the affected subdivision.
Uwe understand that Lake Services' approval of the requested reservoir use in no way
constitutes assignment of an interest in real property (i.e. land rights). The approval is
granted and maintained solely at Duke's discretion. I/we also understand that the
permitted use may be revoked at any time by Duke Energy or its successors for any
reason whatsoever. If the approval is revoked, Ave agree to remove the facility at my/our
own expense within the specified timeframe set by Lake Services.
Ave specifically waive any claim for consequential damages arising out of or relating to
this application, Duke's approval or denial of it, or Duke's subsequent revocation of
approval, and Ave specifically understand and acknowledge that, because Duke Energy
can revoke the permitted use at any time, l/we are not entitled to reliance damages.
Uwe understand during drought conditions Duke Energy may request reduced usage or
discontinued usage of any water withdrawal or related systems, until such drought
conditions improve. Failure to do so may cause possible removal of the system and/or
any other permitted facilities that Ave may have, and any costs associated with removal
of the facilities will be assessed to the lot owner.
Ave understand that this lake was constructed as a working hydropower reservoir for the
primary purpose of producing cost-effective electric energy and that this remains as the
lake's primary purpose. Ifwe understand that the lake and its associated hydropower
station are operated by Duke Energy Lake Services under the terms of a license issued by
the Federal Energy Regulatory Commission (FERC) and that there will be no change in
hydro project operations as a result of the construction and/or use of any facilities that
Uwe may be allowed to place within the FERC Project boundary or on Duke Energy Lake
Services -owned property.
11we understand that the proposed private facility will be used only for the purposes
described in the information submitted for approval by Lake Services and other
appropriate governing bodies.
Page 2 of 5
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]Ave understand that this lake is open for use by the general public and that maintaining
safe and lawful public use is one of the primary lake management objectives of Duke
Energy Lake Services.
N,e understand that the use for which we are applying is a private use and it should not
interfere with the general public's safe and lawful use of the lake.
11we understand that every reasonable effort must be made to minimize any adverse
impact on fish, wildlife, and other natural resources.
]Ave understand that trees and vegetation growing within the Project boundary play an
important role in the overall environmental condition of the lake. The ecological impact
the vegetation has on the fish and wildlife habitat is necessary to ensure a sound and
healthy lake environment. Uwe also understand that unauthorized removal of shoreline
vegetation (i.e. button bushes, willows, cattails, etc.) and/or disturbance of the shoreline
buffer may result in suspension or denial of lake use permitting requests and require
metas to re-establish the vegetation if the disturbance is found to be in violation of the
state or county watershed buffer regulations or Duke Energy's Vegetation Management
Requirements.
(For construction on Lake Keowee) 11we agree that if land disturbing activities are to
occur within the Project boundary prior review/approval from Duke Energy Lake
Services, the State Historic Preservation Office and the Eastern Band of the Cherokee
Indians is required prior to work beginning.
]Ave agree that if any historic or archaeological resources are discovered during
construction of an approved activity the applicant must stop work immediately and
contact Duke Energy Lake Services. Uwe understand that in the event that anyone
discovers a potential site of archaeological or historic significance including any
gravesite within the Project, the individual must immediately notify Duke Energy Lake
Services.
Uwe agree to notify Lake Services when construction is completed. During the
construction period, the weather-proof "Duke Energy Approved Lake Use Activity" sign
(to be provided by Duke Energy) must be posted at the job site, visible from the water's
edge.
Uwe agree to notify Lake Services if the property is sold and provide the name and
address of the new owner.
Uwe have included a check for any applicable filing fees, security deposits and copies of
all other necessary permits.
11we agree that if any action is taken by Duke Energy to enforce any provision, covenant
or agreement contained in this user agreement or Duke Energy Lake Services SMG or if
Duke Energy is required to retain an attorney to enforce any provision, covenant or
agreement contained in this user agreement or SMG (including, without limitation, the
payment of fees due hereunder or the removal of an encroachment constructed in
Page 3 of 5
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violation of this user agreement or SMG), then Duke Energy shall be entitled to recover
all of its reasonable costs associated with such an action, including but not limited to,
attorneys' fees and court costs incurred in such action and/or enforcement.
Uwe understand that Lake Services' representatives may issue Stop Work Directives for
any violations of the SMG or engagement in prohibited acts or activities on Duke Energy
Lake Services' property as specifically identified in the SMG. Uwe understand that
persons found to be in violation will be subject to Duke Energy Lake Services sanctions
which can include: 1) restoration of the impacted area at the person's expense; 2) loss of
consideration of any future lake use permitting activities for up to five years for improper
vegetation removal or until vegetation is satisfactorily re-established (even if there is a
change in property ownership); 3) revocation of a previously issued permit and loss of
consideration of any future lake use permitting activities and/or reinstatement of the
revoked permit; 4) increases in fees; 5) modification or removal of non -complying
structures; and/or 6) further legal action being taken by Duke Energy Lake Services .
Uwe understand that certain activities specified in the SMG are prohibited because of
environmental concerns, boating capacity limitations, safety considerations and other
reasons.
Uwe understand that ownership/interest in a Common Use Facility eliminates the option
for me/us to also have a separate facility on any other lot within the affected subdivision
that Ave own or lease.
Ave understand that this lake is open for use by the general public and that maintaining
safe and lawful public use is one of the primary lake management objectives of Duke
Energy Lake Services.
Uwe understand lake use permit holders have the authority to prevent others from
trespassing on the structures they have built Uwe also understand that Uwe, however, do
not have any authority to impede anyone from pursuit of the lawful public recreation
enjoyment of FERC Project lands and waters. Except as specified otherwise in the SMG
or other Duke Energy Lake Services documents (e.g. Public Safety Plans), anyone may
fish aroundlunder structures built by others, may walk/wade/fish within the FERC Project
boundary or any Duke Energy Lake Services -owned peripheral strip, boat in the lake's
waters, etc. without having to get anyone's permission to do so. Boaters may not block
ingress/egress to piers/docks.
Uwe agree to exercise all care and due diligence to preserve and maintain the character of
the Duke Energy Lake Services's adjacent property. ]Ave agree to comply with the Duke
Energy Lake Services Vegetation Management Requirements. Ave agree further to not
allow sewage, including discharge from septic tanks (or similar facilities) or boat holding
tanks, garbage, trash, or other waste material to be discharged or dumped into the
reservoir, tributaries or adjacent property.
Ave understand that as an adjoining property owner ]Ave can make no change in land
form of land within the FERC Project boundary or land owned by Duke Energy Lake
Page 4 of 5
"rQMmMqhw&AMVwMbTNvUeperMc FxM xs Users Aum"Dwo CW K7 rnW 112 08 ish revAOc

Services ; such as grading, excavation or filling without prior written approval by Lake
Services.
1/we agree for myself/ourselves, members of naylour family, guests and invitees that I/we
assume all risks of personal injury or property damage incident to my/our occupancy and
use of the premises; including but not limited to any personal injury or property damage
which may be sustained as a result of flood waters or in connection with the rise and fall
of water in the reservoir as a result of floods or of the operation of Duke Energy's hydro
electric facilities. 1/we as the adjoining property owner further agree that 1/we will
indemnify, protect, defend, and save harmless Duke Energy from any and all loss, cost,
claims damages, expenses, judgments and causes of action for all injuries and damages
sustained by the members of my/our family, guests, and invitees arising or claimed to
have arisen in connection with their occupancy or use of the Duke Energy Lake Services
-permitted facility(s).
11we acknowledge that Duke Energy Lake Services has the right to charge reasonable
user's fees for private use of its property and that failure to pay any applicable user's fees
in a timely manner can result in the suspension or cancellation of any previously
approved lake use permit.
1/we recognize that N,e have the continuing responsibility to ensure that the constructed
structures are maintained in good repair, including, but not limited to maintenance of the
dock and boat slips, and proper erosion control within the permit area and along the
shoreline, and agree to take all reasonable steps necessary to meet this responsibility. Uwe
agree to maintain all structures within the Project boundary on Duke Energy Lake
Services - owned property in a sound condition and in a neat appearance and pay all costs
for said maintenance.
Sincerely,
(Apes 3}ame)
Lake Street Address
City/Siate/Zip 6ode
Lake Phone Number
(Designated Duke Energy Agent)
0
4l A,J �
r AIII 04-,4< C IiG��
Home Street MdTess
City/State/Zip ecde
q 7Y. 3�q- 41 s 3
Home Phone Number
Page 5 of 5
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Date:
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