20160889 Ver 1_Shoreline Stabilization_20160913

r 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
Three copies of the application (including attachments) and the application fee should be sent
to:
Division of Water Resources D;.
t: 7,i
401 & Buffer Permitting Unit Z o R
1 6 0 8 8
1617 Mail Service Center
Raleigh, NC 27699-1617 4 ��15
I. Applicant Information [15A NCAC 02H .0502(a))
1. Owner Information
Name: Raymond H. Catlett
Mailing Address: 20935 Island Forest Drive
Cornelius, NC 28031
Telephone Number: 704 264-9767 Fax Number:
E-mail Address: [e-mail]
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.armv.mil/Portals/59/docs/reRulatory/re2docs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM. df) must be attached if the Agent has signed this application form.
Name: moi,
Company Affiliation:
Mailing Address:
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Telephone Number: %fit (o&0•-5 /1 /
E-mail Address:
Person to receive the Certification Approval:
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

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: Mecklenburg Nearest Town: Cornelius
Subdivision name or site address (include phase/lot number):
Island Forest - Lot 39
Directions to site - please include road names and numbers, landmarks, etc.:
Interstate -77 to Exit 28, Catawba Rd., right on Bethel Church Rd., right on Pinehurst Rd.,
right on Island Forest Dr., bear left until site, iust before hairpin -turn.
Latitude (in decimal degrees) 35.495278 Longitude (decimal degrees) -80.914680
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): residential
6. Property size (acres): .243 acre
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): 40 -year-old seawall was damaged by a boating accident.
Will remove old broken structure and replace with a permanent seawall structure.
9. Will work be conducted from land? Yes k 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:
Approximately 2 feet of existing wall is submerged at full pond. Linear measure is 10t feet.
So approximately 300 square feet of seawall will be underwater at full pond.
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: Approximately 300 square feet.
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): "' � 4i
Owner/Agent's Signature* [15A NCAC 02H .0502(f)j
SZc)l
Date
`Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 3

Full Pond/
Normal Water Level
Shoreline
La ke
(At Full Pond/ Normal Water Level)
CIS
,
—rz - _---]
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 l' 0K.Q--
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 4k4i
pood
FORM: SSGP 10-2013
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Page 3 of 3

DUKE ENERGY INTERNAL USE ONLY.
Date Received: FAF Paid
j— Application Complete
HEP Fund Permit No.
Construction
Application 1P
version 14p
Duke Energy Lake Services
Maii Code EC12Q
526 S. Church St.
Site ID Close -Oat Date Charlotte, NC 28202
1. DATE OF APPLICATION* 9/2/2016 Permit/Tag #.:
11. APPLICANT INFORMATION (applicant mailing address and contact information)
DUCE
ENERGY,
Name* Raymond H. Catlett Primary Phone* 7042649767
Address*
20935 Island Forest Drive
Secondary Phone
City*
ornelius State* NC
Zip Code* 28031
Fax Number
Email*
111. PROPERTY INFORMATION (location of permit)
Address*
0943 Island Forest Drive
County* Mecklenburg
City*
Cornelius State* NC
Zip Code*8031
County Parcel ID number
(e.g. Pin, Tax ID, TMS 00111403 Parcel ID
Lake*:
Norman
E
Number...)
Subdivision Island Forest Lot(s) 39 Plat Book/Page L39 M12-341
To enter the Latitude and Longitude of the property, please use a Latitude (e.g. 35.12345)* 35.495278
service/software to easily acquire the location information. Values
should be provided in Decimal Degrees format (35.1245).
,, Longitude (e.g. -80.12345)* 80.914680
example ser iii e: http l jtouch-rnap tom/latlong_html
IV. PROPOSED ACTIVITY
G New/Modification of Existing Structure Cs Maintenance of Existing Structure r Is Dock
Covered?
(— New/Modification of Existing Shoreline Stabilization C Maintenance of Existing Shoreline Stabilization
C New/Modification of Existing Structure & Stabilization (Maintenance of Existing Structure & Stabilizatic
(1 Transfer of Ownership
(' Other (please describe below)
# of Slips I
# of Jetports F
Area over land (sq ft) Area over water (sq ft) Total Square Feet �—
Shoreline Stabilization (feet) Length of Distance From Shoreline it �%a� �jCi 5 1!`r 5A'1'&
Stabilization /
0(0 Materials
40 year-old seawall was damaged in a boating accident. Need to remove damaged seawall material and
Brief Description replace with a permanent replacement structure.
of the Activity
Describe Briefly the Existing Vertical seawall with boat ramp along 106 foot water -facing property line.
Structures Over Land and
Water (include sq ft) I'

V. Dock Builder or Engineer
Name/Company CBC Stone and Recycling
Address 638 Oakridge Farm Highway Phone Number 7046605111
City Mooresville State NC Zip Code F8115 Email [e-mail]
VI. Checklist of Required Documents (to include with Application Submission)
,Recent Survey (stamped/signed by a professional licensed surveyor showing the location of the existing or proposed
�� rr structure and/or survey of the existing or proposed stabilization)
VPhotos along property shoreline and photos of any existing structures and/or stabilization in or near the water
r✓pplication fee (check only, payable to Duke Energy) j�Signed User Agreement Letter
--1-Applicable Applicable local, st,�jte, and federal p rmits "Ian and profile drawing showing all measurements and elevations
N ` Q F- ' Proylk S" CA �� ✓` S j— 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
1-77 Exit 28 to Catawba Road. Right on Bethel Church Road. Right on Pinehurst Road. Right on Island Forest
)rive. Bear Left. Continue to end. On left before hairpin turn.
Directions by
Road*
IX. Application Submission
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.
Duke Energy Lake Services Print Form
Mail Code ECII 2Q
526 S. Church St.
Charlotte, NC 28202 p .1 11 1 n
I agree that the information contained within is accurate:- `\F%"r VLA -kA, Ill` \-� v-

NOTES:
• PROPERTY MAY BE SUBJECT TO RECORDED OR
UNRECORDED RIGHTS OF WAYS OR EASEMENTS
NOT OBSERVED
• OWNER TO VERIFY ALL SETBACKS AND ZONING
REGULATIONS PRIOR TO ANY PLANNING OR
CONSTRUCTION.
•
DIMENSIONS OF ALL IMPROVEMENTS SHOWN ON
THIS PUT SHOULD NOT BE SCALED OR REIJED
UPON FOR DESIGN OR CONSTRUCTION WITHOUT
A FIELD VERIFICATION OF ALL DIMENSIONS.
• DIGITAL COPIES OF THIS FILE ARE FOR REFERENCE
ONLY AND MAY NOT BE USED FOR DESIGN WORK.
#4
BOAT RAMP
Course I Bearing I Distance
L7 1 S 51'43 42 E I
LAKE
DOCKS, PIERS OR O1NER'
INP ENTS BUILT ON V!(C
:E%THFOWN ON 1N15
#4 REBAR
\
I
rs �
LINE
144 REBAR O�I� std
\
\
300 30 60 90
GRAPHIC SCALE — FEET
TOPOGRAPHIC SURVEY
FOR
RAYMOND HOLLIS
CATLETT, JR.
LOT #39, ISLAND FOREST SUBDIVISION
LEMLEY TOWNSHIP, MECKLENBURG COUNTY, NC
SCALE 1' - 30,
DEDMON SURVEYS
CHUCK POOVEY, PLS #3761
ROBERT DEDMON, PLS #3899
3704 NC HIGHWAY#16 NORTH
P.O. BOX 494 - DENVER, NC 28037
PHONE: [phone]
FAX: [phone]
SEAL
L-3899
I, ROBERT J. DEDMON, CERTIFY THAT THIS PLAT WAS
DRAWN FROM AN ACTUAL SURVEY MADE UNDER MY
SUPERVISION (DB 29163, PG 960)(PB 12, PG 341);
THAT THE RATIO OF PRECISION AS CALCULATED
EXCEEDS 1:10,000'; THAT THIS PIAT WAS PREPARED
IN ACCORDANCE WITH GS 47-30 AS AMENDED.
WITNESS MY ORIGINAL SIGNATURE, APRIL 27, 2015.
LToie ui ,yr. 3899
PROFESSIONAL. LAND SURVEYOR LICENSE NO.
SURD. BY: WT DRAWN: RD JOB# MF39
VICINITY NAP
ISLAND FOREST DR

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