20160868 Ver 1_Shoreline Stabilization_20160906

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 Resources 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 & Buffer Permitting Unit
1650 Mail Service Center 2 0 1 6 0 8 6 8 --
Raleigh, NC 27699-1650 d Lgko
1. Applicant Information [15A NCAC 02H .0502(a)] SEP 0 6 2016
1. Owner Information
j�4 DEQ - WATER RESOURCES
Name: A CGS (� r 401 & BUFF ITTING
Mailing Address: "[5/0),
M 1)0�c5vi'me /,/, < 7
Telephone Number: d Fax Number:
E-mail Address: ,oA) e 5 n1-e_r.'ol r IL&w e -S • Co m
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 FO M. df) must be attached if the Agent has signed this application form.
Name:��&r,41
5
Company Affiliation: 6-recP 7J Ste► Pe, -s 5t, -vice s
Mailing Address: J? 7 1 m -
Telephone Number. -76 abl).5711 Fax Number: 4
E-mail Address:s - 5� ��94-
Person to receive the Certification Approval: ck i F 4, u
11. Project Information [15A NCAC 02H .0502(x) & (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: �� eke 1l Nearest Town: A6oy"eSJ ue
Subdivision name or site address (include phase/lot number): 11,
Directions t site- please include road names and numbers, landmarks, etc.:
- 0 �✓ ,� ; �¢/YI 6 on/ �d rite
v4-mni /6(-, ,cam 61V_ 5 71-A/ ,,', � !-..� .
Latitude (in decimal degrees)_3S • S3 09 Longitude (decimal degrees) Ob - 'T -J a J
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Y _ 5 i d ¢,n/ I
6. Property size (acres): 0 /
7. Lake/ river/ ocean adjacent to property: c°
8. Describe proposed work (include discussion aJ� to how hardens of shWe line has been/-
r
een
avoided, or why it is necessary): �Jf1-!! Ze, i fie- ��B
9. Will work be conducted from land? 'K From water? ❑
10. Total amount of disturbance (including all excavation, backfill, rip rap, retaining walls, etc.)
below the normal y
ool lake level/ Normal Water Level in square feet or acres:
ZY& X
11. Total amount of disturbance (including all clearing, backfill, 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: (�� /x /
12. Please describe the vegetation above the normal pool lake level/ Normal Water Level d 50
feet landward to be impacted (number of trees, for instance): ( rA.5 5 +r 4- t' e_s
Owner/k/ent's lCflgnature*
Name
[15A NCAC 02H .0502(f)]
Agent's signature is valid only if an authorization letter from the owner is provided.
Date
FORM: SSGP 10-2013 Page 2 of 3

Full Pond/
Normal Water Level
,■■ � . 7®
Shoreline
( ( 6�cvc-
Lake
(At Full Pond/Normal Water Level)
,}'blow
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.
S. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
FORM: SSGP 10-2013 Page 3 of 3

DUKE ENERGY INTERNAL USE ONLY:
Construction DUKE
t
Date Received: FAF Paid Application
Application Complete vemionl4p ENERGY.:
Permit No. Duke Energy Lake Services
HEP Fund Mail Code EC12Q
SChurch
Site ID Close -Out Date Cha.rlo
Chatte, NC 288
202
I. DATE OF APPLICATION* 08/31/2016 Permit/Tag #.:
11. APPLICANT INFORMATION (applicant mailing address and contact information)
Name* ACz i�l r�y , _ . _.., Primary Phone* [phone]
Address P O Box 4297 Secondary Phone
City* Mooresvlle State* NC Zip Code* 28117
Email* [e-mail]
III. PROPERTY INFORMATION (location of permit)
Address* 156 Standish Ln
City* Mooresville State* NC Zip Code* 28117
Lake*: Norman
Subdivision The Point Lot(s) 621
Fax Number I
County* Iredell
County Parcel ID number
(e.g. Pin, Tax ID, TMS )56
Number...)
Plat Book/Page
To enter the Latitude and Longitude of the property, please use a
service/software to easily acquire the location information. Values Latitude (e.g. 35.12345)* 35.5309
should be provided in Decimal Degrees format (35.1245).
example service: http://itouchmap.com/latlong.html Longitude (e.g. -80.12345)* 80.9328
IV. PROPOSED ACTIVITY
New/Modification of Existing Structure C Maintenance of Existing Structure Is Dock
Covered?
{: New/Modification of Existing Shoreline Stabilization C Maintenance of Existing Shoreline Stabilization
(' New/Modification of Existing Structure & Stabilization (Maintenance of Existing Structure & Stabilization
C Transfer of Ownership
(' Other (please describe below)
# of Slips 11
# of Jetports F]
Area over land (sq ft) Area over water (sq ft) Total Square Feet
Shoreline Stabilization (feet) Length of Distance From Shoreline will follow existing sfiarelme
Stabilization 196
Materials enhanced boulder Va fieldstone boulder wall
Brief Description
of the Activity
Will install enhanced VA Fieldstone boulder wall including a set of steps 6' at the bottom and ascending to 4'
at the top.
Describe Briefly the Existing
Structures Over Land and
Water (include sq ft)
Residential home under construction. No other structures.

V, Dock Builder or Engineer
Name/Corr
Address �J 1i: r; y-/yi Phone Number o° !J `5
City Bye State C Zip Code-jf((rj Emai) I
_GJ . e l's.q�%
VI. Checklist of Required Documents (to include with Application Submission) s
e7ecent Survey (stamped/signed by a professional licensed surveyor showing the location of the existing or proposed
L� structure and/or survey of the existing or proposed stabilization)
[�`Ohotos along property shoreline and photos of any existing structures and/or stabilization in or near the water
QrApplication fee (check only, payable to Duke Energy) ErSignecl User Agreement Letter
Q 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
77 t �/ �
RoadDirections by� / -� (f }O 5� 8-® J
o� 5 -rt -,AW; -:5A LAI.
IX. Application Submission
ftp `5T-oA,c,,j �:" � ,&-
r
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 f'rin Form
Duke Energy
PO Box 1006/ EC12Q
Charlotte, NC 28201
I agree that the information contained within is accurate-.

OaaE TA[IIE _ - _. aoinnEM - yrynu
0E1TA ARC
lJ � �ae��u CdNxaxN �brb etavO eJ a Td t.OT ST Sx'00'E w 10.00' tA..m E evwa �b�v�x +Nrrwlxr�. (r�ae_VpA®n�� n
1 RmR�r� y braeim er fwnr�� ae FMr d MP er,me Uw TABI£� vrie� r��rW w� br ec. isn
alAU pRdsu oS- wvP.q i RW Rm sa n e SRdu xux BEARB1c AN¢ w rM r J' mr°'�Nx'°'"" p'r "re w
Larmed ex w .Oro N9R� RA1E� S� Lt xbYS'tG'N �Tfl10' m�iN r ra rwi. � u � n�e n xvu oa.
1Iy Ibbr JTOY9.50'N - [Rsriw n /+ma � XB310 ]]'N 25, o' 0M� Y ssm xm
31 w Rmek Nne.�r Aw .wni aMOv' d sop..e Pm�rs �t n N �K '°� �r °'err's /a°+ r yvsr ei as me ev mt
q a.sxrA. m�..e,F. a lA. R.nr ..drds n m rmM-�Poc. a sfls]o N St u.,R .� .a.rnM
LS x]9•a5't!'w 11.58 mis lam EFY o] Ocfoed. XI b.
LEGEND
mrolNrr uxE (Rill
anrr rr ur (RMJ
----- KLNF
_ _ _ _ _ Ao.nNwc RaaERn urr
PROM xEa ae PGI
— — A.EDWC 2lBAC1( UNE
-------------- PULL AYrD
-•__•-•___ ;EMT
Ex EVS
PMR ONlIN01NAn13aPYpP
MN NIM'F NEIN
GFN CAar IElMS%AF BOY
CB GICN BASIN
b 0 40 80
S : I' = 40'
w.I4 au nAm xuAwrs rota Nl
IV ams Land Surveying. Inc.
llcrx� NumMa C-a88B
R4 8xmowt dnq 84bM.114 M 8>Uffi
PenneYx>•1 eoNyMe ... emdbunalRMmblNNbteeuauee
rvb stJ aNi4fl.
�8 t
� sig
\ � J
LAKE NOP\MAN
AREA 5LUMARY
LOT 621
0.670 ACRE
37,917 SQFT.
Indene E MM/hms. H�[5 aT18
> t 622
,, � SN rCAgQ�••A
SiON,y v�E
4 SEAL r'
1
L4718 i =
Boundary and Physical Survey
156 Standish Lane
THE POINT ON NORMAN
PHASE 6, MAP 3
LOT 621
Davidson Township, Iredell County, NC
Tax PIN 4625-63-5527 — D.B. 2312-696 — P.B. 36-143
Property of. Brent & Jaycee Kirby

Google Maps Page 1 of 1
Ge. gie Maps
The Point
ro° Trump National
cn` Golf Club Chafione
3
w a�
Im
Map data ©2016 Google 500 ft_.-
https://www.google.com/maps/@35.5309373,-80.9328872,15.7z 8/29/2016

MapCard - Print your custom map
Page 1 of l
yf
l ,,p'}^�- t ;^•.�\ t �r`�:y� i�'�l""�� 6'1 i `-��� �tJ� !� % i ,M�� \ � �_=.1j� �\�'�' r -
°(' /. r1 ` ..,f' , 1 �� � i) 7P-� � /-\ ......�--� 1,���1 C, �,•_-
•b. �F ty„'�� i, �..i""—;.. 'f S' F� �` � t i .. ;�..�� ,% �0w.., • � �� � i ^-� � ff
,'
• /��% _� i fi � � � = int ti "`�_...Ij�.�� i � ��1-' ��, ,-. !,
r'
L A S E
80
CO
v
�. � �✓,.-moi � S 1� '; A`a.� '' � y �� � �''tr -
0 0.5 Mi
0 2000 R
http://map-pass.mytopo.com/mapslprint_local.asp?print=l &scale=5.00&layer=DRG&lat=... 8/29/2016