20160949 Ver 1_401 Application_20161016

cj-"r is �_ Copra- ►N kc. C�
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
DW.'R 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 2 0 1 6 0 9 4 8 O ��
1650 Mail Service Center �Oj]
Raleigh, NC 27699-1650
Z016
1. Applicant Information [15A NCAC 02H .0502(a)] ,cFFR
1. Owner Information p RMi�R,�F,c
Name: CHRIS & CARA MCCOY
Mailing Address: 8941 SUMMER CLUB RD
CHARLOTTE NC 28277
Telephone Number: 704-281-4125 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:
httr)://www.saw.usace.armv.mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: CARISSA PARKER
Company Affiliation: BENNICK ENTERPRISES LLC
Mailing Address: 7836 HWY 70 E
NEBO NC 28761
Telephone Number: 828-659-1000 Fax Number: 828-659-1001
E-mail Address: CARISSA(@BENNICKGRADING.COM
Person to receive the Certification Approval: CARISSA PARKER
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,
etc.), rip rap, excavation or dredging below Full Pond/ Normal Water Level elevations,
FORM: SSGP 10-2013 Page 1 of 4

Cy\'rks �- &-ra - 6\c-1-0+
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: MCDOWELL Nearest Town: NEBO
Subdivision name or site address (include phase/lot number): 1780 LOT 54
2172 DRAGOON DEMISE DR
Directions to site - please include road names and numbers, landmarks, etc.:
FROM MORGANTON TAKE HWY 126 / TL ONTO CAMPBELLS TRACE / TR ONTO TEN WHIGS
RIDGE / TR ONTO DRAGOON DEMISE DR / PROPERTY ON RIGHT
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): VACANT WOODED LOT AREA
6. Property size (acres): 2.19
7. Lake/ river/ ocean adjacent to property: LAKE JAMES
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): 40' OF SHORELINE STABILIZATION BY BARGE, HEIGHT
WILL BE 5'
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:
3' X 40' = 120 SQ FT
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: 2'X 40'= 80 SQ FT
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): NO TREE REMOVAL.
14A
O er/Agen s Signature* [15 NCRC 02H .0502(f)] Da e
Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 3

C�,S 4- tea- VV cCL�.
La ke
At Full Pond.
Full Pond i i
SI
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: SSGP 10-2013 Page 3 of 3

CHRIS & CARA McCOY
LAKE JAMES
1780 LOT 54
TO: NORTH CAROLINA DIVISION OF WATER QUALITY
I GIVE CARISSA PARKER, OF BENNICK ENTERPRISES, LLC.,
PERMISSION TO SIGN AS MY AGENT ON MY APPLICATION FOR
SHORELINE STABILIZATION.
SIGNATURE (S) _
DATE ct I c / .

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Chris McCoy - 1780 54
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1780 lot 54
2472 Dragoon Demise
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Latitude: 35.75859 N
126
Lon nude: 81.92750 W
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