20161038 Ver 1_401 Application_20161016

DUKE ENERGY INTERNAL USE ONLY: Construction
Date Received: FAF Paid Application DUKE
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,7 Application Complete veo on 73p
Permit No. Water Strategy,Hydro Licensing and Lake Services
HEPFund Duke Energy
PO Box 1006/EC12Q
Site ID Close-Out Date T Charlotte,NC 28201
I.DATE OF APPLICATION* �Q. �. �Q Permit/Tag
IL APPLICANT INFORMATION (applicant mailing address and contact information) ro p~
Name* Urp;;P1'e'v7- 6 c"p I I C PrimaryPhone
Address* 0,;,I den t Secondary Phone
City* (,v��kp,, State*a Zip Code` ,Z F/'�3 Fax Number I Ito C/' g
Email* - 1�
111.PRO TY INFORMATION (location of permit)
Address* D/S c.r.r fir,.. tin C County* L, 111 Cd J q D
City* State© Zip Code* County Parcel ID number L4
(e.g.Pin,Tax ID,TMS
i S
Lake*: AJC-IQ,» A Number_) 1
Subdivision v r I Lot(s) L41 Plat Book/Page 5 T-5- / 3 7 S
To enter the Latitude and Longitude of the property,please use a Latitude(e.g.35.12345)* 35. 'g7 15 OcI 'i
service/software to easily acquire the location information.Values
should be provided in Decimal Degrees format(35.1245). Longitude(e.g.-80.12345)*
example service: http:Hitouchrnap.com/) atlong hemi
IV,PROPOSED ACTIVITY
New/Modification of Existing Structure C Maintenance of Existing StructureIs Dock
Covered?
C New/Modification of Existing Shoreline Stabilization C Maintenance of Existing Shoreline Stabilization ❑
C'New/Modification of Existing Structure&Stabilization (-Maintenance of Existing Structure&Stabilization #of Slips
('Transfer of Ownership ( Other(please describe below) #of Jetports
Area over land(sq ft) F- Area over water(sq ft) Total Square Feet
Shoreline Stabilization(feet) Length of Distance From ek. l�ocJ 5 M 5 w �
Stabilization 9
Materials
,�✓ Suis-u�R l� I ttl� r p Ar
Brief Description '�/t�blCv5 f r1 d/
of the Activity V-,4,�A/1AJ ic�Al�� �I,/ y-(-f G W�r!1 /���/'�/3l�Cl�
Describe Briefly the Existing Ijj �� j
Structures Over Land and re 5 0.� (A' l VIl{9 w J
Water(include sq ft)

V. Dock Builder orEngineer
Phone Number
VI.Checklist of Required Documents(to include with Application Submission)
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)
Ffhotos along property shoreline and photos of any existing structures and/or stabilization in or near the water
�(JAA plication fee(check only,payable to Duke Energy) [91-Sli'9'ned User Agreement Letter
pp
VA
icaNelocal,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.
w
If application is not complete or does not include all items and information listed in the checklist,the
application will be returned syincomplete.
w
A Duke Energy representative will visit the site to conduct a visual inspection.
w
Applicant will benotified mfapproval ordenial.
*
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.
VilX'Directions byRoad
Directions by
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 oothe address below.
Water Strategy,Hydro Licensing and Lake Services PrintForm
Duke Energy
POBox x006/EC I 2Q
Charlotte,NC 28201

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 1 0 3 3
Raleigh, NC 27699-1650
I. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name:
Mailing Address: e1i oN I'N,
Telephone Number: TL/ Fax Number: 76 • Talo. ;Z51 3
E-mail Address: Ate' E'3 j rJ ✓ " A-6, v, Ct"vK
2. Agent/Contact Persoi4nfo4ation
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: alY'L'a,je-S
Company Affiliation: C�TZ�N' Sc
Mailing Address: 63 Y 69AKe-,' Arm
GcrG9Je(�Y C ���I
Telephone Numberd• Fax Number: 7. �(,b" 5 '4
E-mail Address: ecAC r GlS �� 5' °/V<
Person to receive the Certification Approval: ch;oe /3 r i'd 9e—n.
11. 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: L.AZC2 1A Nearest Town: ,t),en J e ,­`
Subdivision name or site address (include phase/lot number): W ey-E- o r-r4 �-
Directions to site-please include road names and numbers, landmarks, etc.:
A. — To W£8 S if l2 — 8 ter 4-a•.
Latitude(in decimal degrm).!�S St SC J Qi Longitude(decimal degrees) -JD- 4,-7 0-1
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): rre S(C40
6. Property size (acres): 011 -717
7. Lake/river/ocean adjacent to property: I-e. k e
S. Describe proposed work(include di ussion as to how hardening of shoreline has been
avoided, or why it is necessary): �i-4E'_
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:
Y-7 `X 3
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: q V X / r
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): rRsS Sccs0
Owner/Agent's Signature J/ C-�' Printed Name (�,Afuf �s�o �.-,/ Date /0- 13"
[15A NCAC 02H .0502(f)] r►''`'^�� e
`Agent's signature is valid only if an authorization tetter from the owner is provided.
FORM:SSGP 10-2013 Page 2 of 3

Lake
(At full Pond/Normal Water Level)
i �w�viJ
u
Full Pond/ 0. ,t Normal Wat eel CC ..
Shoreline C--2 C3 CZY—L-L—L
q7
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 10-2013 Page 3 of 3

NOTES'
•PROPERTY MAY BE SUBJECT TO RECORDED OR LZGEND: PHYSICAL SURVEY
UNRECORDED RIGHTS OF WAYS OR EASEMENTS
NOT OBSERVED BOUNDARY UFOR
NE O
•OWNER TO VERIFY ALL SETBACKS AND ZONING �—SANITARY SEWER UNE G O{. G
REGULATIONS PMOR TO ANY PLANNING OR —�• �—NATURAL GAS LINE O
CONSTRUCTION, UNDERCAOUNO POWER I INVESTMENT GROUP, LLC
•OIMENSIONS OF ALL IMPROVEMENTS SHOWN ON OVERHEAD UTILITIES
THIS PLAT SHOULD NOT BE SCALED OR REUEO UNDERGROUND TELEPHONE W
UPON FOR DESIGN OR CONSTRUCTION WITHOUTFENCE(TYPE NOTED)WATER LINE LOT #7 OF WESTPORT 3 &X A
O O
A FIELD VERIFICATION
OF All DIMENSIONS. CP - COMPUTED POINT(UNMARKED) � aI ADDRESS
'DICTTA.COMES OF IRIS FILE ARE FOR REFERENCE R/W-MCHT-OF-WAY d g
ONLY AND MAY NOT BE USED FOR DE54N WORK. E/P EDGE OF PAVEMENT
'ALL UNDERGROUND UTILITIES ARE NOT SHOWN HEREON. C/L CENTERUNE CATAWBA SPRINGS TOWNSHIP - LINCOLN COON
•NO PORTION OF THE RESIDENTIAL STRUCTURE IS IN A FLOOD ZONE. -UTILITY POLE PB l
E-1 0A I SCALE: I' - 40'
li l,J�'F � DEDMON SURVEYS
OCHUCK POOVEY,PLS#3761
FENCE CORNER
ROBERT DEDMON,PLS#3899
IS 0.85' OVER � � 3704 NC HIGHWAY#16 NORTH
11 PROP. LINE NAIL 0 P.O.BOX 494-DENVER,NC 28037
`1 N5 PLN PHONE:[phone]
FAX:[phone]
1`#4 PIN FENCE 10' LINE 12.49' —` O WWW. EDM SURVEYS.0
IN RIP RAP — __ — H
PAVED DRIVE - r �PPPM,y
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�1 ECK FRAMI I rYfiiii{'13Y�TTp
-____ _ m WiTN A F+ - I, DAVID C.POOVEY,CERTIFY THAT THIS PLAT WAS
-LAKE--- 38,6: l3AS M NT 0.769 AC,+- DRAWN FROM AN ACTUAL SURVEY MADE UNDER MY
...- UT R DANE - ` FENCE SUPERVISION(DB 785, PG 375XPS E,PG 104;
..NORMAN -- THAT
THE RAT10 OF PRECISION AS CALCULATED
WANGAr pD�oves,NEpnMS On aTHEr= � — E%CEEDS 1:10000;THAT THIS PIAT WAS PREPARED
IN ACCORDANCE WITH GS 47-30 AS AMENDED.
` — _ _ __ u_ ;y5 PIN NWITNESS My ORIGINAL UMBER AND EGL TH SIGNATUURE RE19 OF g IRATI DN
2018.
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