20161123 Ver 1_Shoreline Stabilization_20161116

DUKE ENERGY EXCAVATION PERAW APPLICATION FORM
FOR DUKE ENERGY USE ONLY
Duke File No.
Application Fee $ Security Deposit $ Check # Date Recv'd Initials
Date of Duke Energy Lake Services, applicant and/or contractor on-site inspections Date t �'' +y Initials OU -10
Date Final Protection/Avoidance Area Markings Field - Verified
Approved to Start Work By * :
Date Completion Required
Date Passed Closeout Inspection*
(Print)
Date of Any Approved Extension
Initials
Initials
Date
(Sign)
Initials
Any Stop Work Orders or SMG Violations*? (check one) OYes ONo (If Yes, explain in PART V)Aak
110 k �%
Date Deposit Refunded Initials Date Permit Database Updated5
¢ Forward copy of approved application (all pages, plus any attachments that Duke Energy changedapipiLni 6 2016
with Approval Letter and highlight any changes. File copies of Approval and Close-out ChecklistsStop Work
PART LL -- APPLICANT INFORMATION (Please Print)
Name
Lake Address / 7Z 2I 8f Ile, D r
Co --u us, �C �13I
Contractor Company
C'P�LS
Contractor Contact Person „
LAKE LOT INFORMATION
Lake County &Aw
Subdivision
Telephone 70 l lO • J 2 -'O's
Mailing Address
(Ifdifferent)
City l,0t(-MC6 WS
i GGS
Telephone r7O V) (o& 0. -5-11 1
State (4 C Tax Map No.
Lot I Section No. - [ Q Lot sizefl' 7/1+ --Acres
Are there any Co -Applicants'? (check one) OYes ONo (If Yes, include names, addresses, phone nos., lot nos., lot
sizes in PART V — ADDITIONAL 114FORIYIATTON) * Co -Applicants exist when the proposed work is being done under a
single application, will be performed by a single contractor as one continuous project and is done to benefit multiple owners /
lease holders of project -front properties within a single development. The check for the application filing fee and security
deposit should be from the party shown as Applicant and not several checks from the Applicant and Co -Applicants.
Do not continue the application until an on-site inspection has been conducted between a Duke Energy Lake Services
Representative (DELSR) and the applicant and/or the excavation contractor. NOTE: Initializing this portion of the
application by a DELSR in no way consdArtes approval or eminent approval of the excavation or any other lake use
pernn8' acdp4.
Date of on-site inspection 11 16 l :.t Initials (Duke Energy) J 12 (1 (appiicant/contractor)
Duke Energy Page 1 of 14 rev 9/19/14
Excavation Program
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application 113 10.docx

DUKE ENERGY EXCAVATION PERMIT APPLICATION FORM
PART II. - DESCRIPTION OF PROJECT
A. BASIC INFO
1. Type of excavation: (check one) *e -W excavation O Maintenance excavation
2. Purpose of excavation: (check one)twwtewata
oat Access Channel ❑ Water Intake Channel
Discharge Channel ❑ Other (sped):
3. Lake user category: (check one)va
tbli�
OResidential Marina ElCommercial Marina
OOther (specify):
4. Max. Excavation Area Dimensions (ft): Length 10 Width 50 Depth 5
(Note. include additional area dimensions if necessary so response to #S below equals max area dimensions in #4)
5. Volume of Excavated Material (TOTAL for the project): %2 SC`ub�ic yards
6. Type of material removed (applicant determines by field sample rf practical): 1 ^ "' f jrt l
7. Excavation Site a= _0 .1 ( Acre (s)
Disposal Site area: 0.11 Acre (s)
8. Total Disturbed Area (including equipment staging area): 00. 2-2— Acre (s)
9. Does the project meet the requirements of the applicable General Permit? (check one) XYes ONo
10. Do you claim title to the disposal area? (check one) Yes ONo
11. Do you claim title to the equipment staging area? (check one) 1'es ONo
12. Are there any water -treatment facilities within 50 feet of the proposed excavation area? (check one) CIYes *0
(If Yes,cif')=
13. How will the excavated material NAM and the �rosiop controlled? (e. _ see
disposal area design): Whrf_ Lia 11 O-�d D�, eb 4 10 Aro L 4 Z
14. Type(s) of excavation equipment to be used:
plan and
15. Will waters or wetlands be crossed in transporting equipment to or from the site? (check one) OYes to
(Ifilees, explain)
16. Will return water M-enta the reservoir? (Check one)
show on Excavation Area Drawing)
OYes )(No ON/A (If Yes: specify points) of re-entry and
17. Is there an existing facility (e g. pier) that access is being maintained to by conducting the excavation?ON
9,1
(If Yes, sped the existing permit number. If No, include a scaled drawing of the proposed facility). Permit/# -�
18. Total planned duration of the work (Include first equipment mobilization excavation through final mitigation measures
co)Vlete): START ]�f e-_/..�2VJ(4 FINISH sMCC / 2O/4
(Month) (Year) (Month) (Year)
Duke Energy Page 2 of 14 rev 9/19/14
Excavation Program
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application 113 l0.docx

DUKE ENERGY EXCAVATION PERMIT APPLICATION FORM
PART IL (Continued)
B. PROTECTION / AVOIDANCE AREA DESCRIPTION
Complete the following table including all land areas within and Immediately adjoining the disturbed area:
Protection/Avoidance Areas
(check all that apply)
ARProz.
Acreaee
Identification Method M
Avoid (A1 or Mitigate (ND
,rr
Field ID
Work Area Dwe. ID
a. Marshland, swamp, ponds, beneficial
aquatic vegetation or other potential wetlands (circle all
that apply)
r
N
b. Buffer Zones (sped width & source of
requirement)
('
'- pW,)C e GC O ►'� L
IN
f4n�
c. Environmental Areas as identified by Duke
Energy
rr
d. Natural Areas as identified by Duke Energy
A / �j
I ,
e. Historic properties (specify)
L Rare or threatened species (specify)
/ 4..
Duke Energy Page 4 of 14
Excavation Program
rev 9/19/14
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DUKE ENERGY EXCAVATION PERMIT APPLICATION FORM
Protection/Avoidance Areas
(check all that apply)
Acreae
Identification Method
(Aor Mitleate (M)F
*•
ID
—Avoid
WorkArea D E. ED
e. Buried gas, water, sewer, communications
or electric lines (circle)
��
h. Impact Minimization Zones as identified by
Duke Energy
1. Other areas requiring specific avoidance,
protection or mitigation (specj&)
* For "Field ID" column, specify entity or person that performed the identification and how it was physically marked (e.g. Duke Energy (John DoeyPink and purple -dotted tape,
Corps of Eng. (John Smith)/ yellow flagging). For "Work Area Dwg ID" column, show the symbol that is used on the drawings to identify the protection/avoidance area.
** List and attach mitigation plans
Duke Energy Page 5 of 14 rev 9/19/14
Excavation Program
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C.
Comments:
DUKE ENERGY EXCAVATION PERMaTAf'P1.ICA -'C 0'� F ORM
7 433
5,-l1 �- V-- �*k t
(Z �c>` — S D
Applicant Name (print) Lot #'
Applicant Signature*
Date f'�� 5• �j6
Co-Applieant Name (print) Lot 4
Co -Applicant Signature* —
Date
Co -Applicant Name (print) Lot #
Co-Appbcant Signature* Date
Co -Applicant Name (print) Lot #
Co-Appb=t Signature* Date
Co-Appfmnt Name (print) Lot #
Co-AppReaut Signature* Date
Co-Appkwt Name (print) Lot #
co-Appltesnt Signature'
Date
*Per any 846Llre, the information provided in this applzeatlnll Ic coTreet to the best of my knowledge.
BEFORE YOU MAIL THE APPLICATION 'MO DUKE 1NE2GY LAKE SERVICES ENSURE YOU HAVE:
* CHECKED THE INFO THOROUGHLY
c NN4FT ALL REQUIREMENTS FOR A COMPLETE APPLICA'1'lOh (see cover letter ofapplication package)
* II3CLUDED A SINGLE CHECK TO DUKE ENERGY POR THE APPLICATION FILING FEE AND SECUR.rit'B
DEPOSIT
BEI'OSALL AGENCY PERMITS OR CO?^M jZr[ERS AND RESOL t'ED ALL ISSUES RAISED
e INCLLWMD ALL REQUIRED DRAWINGS (INCLUDING gROI'OSI D FACII I'I I1 S), PF RMTT # FOR MST*
I<ACUMES, SURVEYS AND PLANS
* INCLUDED COPIES OF DEEDS AND AUTHORIZ.AMN 1,F -T t ERS
Duke E=9t Page 6 of 14 rev 9119r14
Excavation Ptog'am
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application 1.13 10.doex

State of North Carolina
Department of Environment and Natural Resources
DWR Division of Water Resources
Division of Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
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
401 & Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617 2 0 1 6 1 1 2 3
1
Applicant Information [15A NCAC 02H .0502(a)1
Owner Information
Name:
Mailing
Telephone Number: 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:
http://www.saw.usace.army.mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTHO
RIZATION FORM. df) must be attached if the Agent has signed this application form.
Name: C' h -, o T�wiJgcs
Company Affiliation:
Mailing Address:
Z
r J i c.c s, L-(-(Z—
Telephone Number:? D• %([ Fax Number: 6 5 (o
E-mail Address: r _GSC _�5A ekj,4115 J
P 1A)iAf f 54-'" m • Ok_
Person to receive the Certification Approval: Gh � 8rr, es
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, and
FORM: SSGP 10-2013 Page 1 of 3

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 pro Ferty {where work is to be conducted
County: MIOCglaityq Nearest Town:r��
Subdivision name or site address (include phase/lot number): _ q0
Dir ions to s' e - please i elude road OxInp1qand numbers, landmarks, etc.:
-t-
4e
Latitude (in decimal degreesk�J.3 Longitude (decimal cegrees) 96 - loll /.0 7
5. Describe the existing land use or condition of the,site at the time of this application
(residential, undeveloped, etc.): iaa47 *1
6. Property size (acres): tA(-
7. Lake/ river/ ocean adjacent to property: KC OfMAA)
8. Describe proposed work (include discussi n as toow I arde ing of shoreline has been
avoided, or why it is necessary): t D
9. MR work be conducted from land? ❑ From water?
10. Total amount of disturbance (including ail excavation, backfill, rip rap, retaining walls, etc.)
below the normal pool lake level Normal 1Nater Level in square feet or acres:
--
11. Total amount of disturbafte (vncludang all clearing, back fill, excavation, rip rap, retaining
walls, etc.) ab the normal pool lake level/ Normal Water Level and 50 feet land -ward in
square feet or acres:
12. Phase describe the vegetation above the normal pool lake level/ Normal Water Level and; w
feet landward to be impacted (number of trees, for instance):
GtX if r
Signature* Printed Name (late
[15A NCAC 02H .0502(8]
'Agent's signature is valid only if an authorization kMr from the owner is provided.
FORM: SSGP 10.2013 Page 2 of 3

Ft
Normo
S
Lake
(At Full Pond/Normal Water Level)
it
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

VICR y MAP__ -
NO SCAiB
T p,
PIER MAP
.. BLR,RS- .
LAKE
NORMAN
N
N. 24090 E
9
�9p
(�
ELEVATION 759.0'
p PER DUKE POWER
ON
QTR
ON 07/15/2014
RO
EXISTINGg
0
j4✓
04 REBAR h--__
(760.8
PIER MATCH LINE
-
APPROXIMATE.-
.- -•- -•-•- - -
a-----------
760' CONTOUR
- -
.............
SIDE SETBACK IS 10' PER (761.1•)
MAP BOOK 17-554
CORNELIUS MAY REQUIRE
DIFFERENT SETBACKS
PER OLD DUKE POWER DEEDS
DUKE'POWER HAS AN EASEMENT
TO THE 770' ELEVATION
HOUSE OFFSETS TO HOUSE, ---
FOUNDATION EXTENDS OUT
ON FROM HOUSE
8
EXISTING ROBERTL.. PRIMM-
q RREETAR DEED 8389-932
MAP BOOK 17-55
T•
PER
PROPERTY IS IN THE CHORD
LAKE NORMAN WATERSHED J' �bT h CHORD 8'
CRITICAL AREA. SUBJECT
�
AR
SET V
N
N. 24090 E
LEGEND
REBAR BY
313:671
of �a.� SENT REBAR 3,
4z14p N a3ag9,
PROPERTY LINELIM \ . t^ ' ; '
ME
OF PAVE
— — — — — — — —
— "— —SETBACK
EXISTINGg
0
APPROXIMATE
50_BUFFFR
04 REBAR h--__
(760.8
31,740 SOFT. -------~-
-
0.729 ACRES
()PRT
4 =
§
0
PER
PROPERTY IS IN THE CHORD
LAKE NORMAN WATERSHED J' �bT h CHORD 8'
CRITICAL AREA. SUBJECT
TO RESTRICTIONS
\y �p,� 0�l(1$
2
LEGEND
va unuTY9ox ol�j—
PROPERTY LINELIM \ . t^ ' ; '
ME
OF PAVE
— — — — — — — —
— "— —SETBACK
BACK OF WRQ _
UNE
UN9UROEVD LINE PER DEEDS OR MAPS
COMMONER NTS NOT TO SCALE60'
�PUMP FIRE PUFIRE HYDRANT}
' . :•�
10T I
CLU
FOA
PP POKER P0.E MC AIR
R/r IUGHT-a-wAY Mv.
HLINE COPYRIGHT ©2014 I. JAM LYNN STROU6 CZRTWY THAT THIS MP WAS DRAWN FROM AN ACTUAL St1am MOO UM92
A STROME LAND UY DIRECT 8UPS9FISIOHF -THAT 1'as l ra= Oe.cWmM 41.1':10.000+ BEFORE: ADtUS'UMM
SURVEYING CO. AND TUT THIN YAP URXT8 UM REQUIRSURRM OF THE STANDARDS OF PRACTICE FOR LAND
SURVBYINO IN NORM CAROUNA (81 NCAC 56.1600). THIS SURVEY IS OF AN EXISTING FARC.E(. OF LAI
An IS SUBJECT TO AM RASEI®ITS OR WORTS -OF -WAY PRIOR TO DIED ROOK. 280913-326
THIS SURVEY WAS PERFORMED WfTH0 TT A FULL TTD.E 86ARCH. �„Ru�lan
Wp1E1L WITNESS UY RAND AND OPFICIA4 sm THL4 15T14 DAY OF JULY 2D15 iN
F� 2014_, A =DUE LAND SURVEYING COMPANY e>t 2 E si •af ����
1125 SARANDON DRIVE, MATTHKWS NC. 28104 ara Q
- [phone] F= #0-847
-r - PER MECKLENBURG STORM WATER WEB SITE °
HOUSE WAS REMOVED FROM FLOOD PLAIN IN, 2008
OUSTING SEE LETTER ON STORM WATER WEB SITE
REBAR PER STORM WATER WEB SITE, HOUSE IS
I M �A tN PIPE NON-COMPLIANT WITH THE FLOOD
�1_55 41yF;� (76T•17 PROTECTION ELEVATION, SUBJECT TO RESTRICTIONS
35 1� NOTES.
136• APPROXIMATE FEMA ��
SET FLOOD LINE PER 1. THIS PROPERTY •IS• LOCATED IN A DESIGNATED FLOOD 2 E
REBAR GIS WEB SITE PER THE MECKLENBURG COUNTY GIS WEB SITE. ALSO SEE FIRM
SEE N071i ABOVE MAP #3710-4622K OATED. 0.JM/"2009,
2. AREA DETERMINED BY COORDINATE COMPUTATION.
'-- 3. CP DENOTES COMPUTED POINT, NO MONUMENT FOUND OR SET.
Q�g Aja N SET NAIL 4. UNDERGROUND UTILITIES NOT LOCATED AS OF THIS DATE.
•(6PJ �•i ON LINE 5. PROPERTY IS .SUBJECT TO ANY SETBACKS.. EASEMENTS
g0p 6� POOLS WIL.LIS DEATON RIGHT
AND RESTRICTIONS OF RECORD.
o� DEED 3897-269 6. A FULL TITLE SEARCH WAS NOT PERFORMED BY LAND SURVEYOR.
O�EQUIP dip= MAP BOOK 17-554 7. NO GRID MONUMENTS APPEAR TO BE WITHIN 20OW OF PROPERTY.
J7QPI E $, O A ayFt Yo m MAP BOOK 27-221 8 FLOOD LINES SCALED FROM THE MECKLENBURG COUNTY (AS.
9 THIS MAP DOES NOT REPRESENT A FLOOD SURVEY.
10. ELEVATIONS SHOWN BASED ON ELEVATION OBTAINED FROM DUKE
} aissl 1 ,.nay 4 1 1 POWER. (NOT NAVO 88 ELEVATION).
V1�C�rN"�� 411 d°1 {�inr' a \k 11. THIS MAP DOES NOT REPRESENT A PER SURVEY.
DRIVE;.
Cj COCHERE 5 R
b:
w
SEWERYALVEINE CHART
NUMBER IDIRECTION IDISTANCE
Lt S 3447'22"IV22.89'
L2 S' 32'16'19' W 2.79
L3 IN 37'59'21" E 286.62'
BOUNDARY/PHYSICAL SURVEY FOR:
GEM PODESTA
AND TRACY PODESTA
NOW OR FORMERLY THE PROPERTY OF:
WELLS FARGO BANK (TRUSTEE)
17221 BELLE ISLE DRIVE: LOT 90, SECTION 2
LAKE NORMAN RECREATIONAL LOTS, MAP 17-554
DEED BOOK 28298-126, TAX ID 001-312-81
LEMLEY TOWNSHIP, MECKLENBURG CO..
CORNELIUS, NORTH CAROLINA
JULY 15, 2014
Fhe name: C:\EPWIN13\BEL1:7221 40EI# 2140145
Scale 1" = 40'
40 0 40 80

Title I ure Form
hereby re I have made � a demises shinnied et
r=u1+
s, Vie_ �s
Inown as street numbers:
and shown on the accompanying map or plat of survey. in bion with such
survey I made a careful. Inspection of said premises on:
At the time of inspection- l found to be in the possession of said premises: WeILsAMM am* I iusAsel
I made s specific examination with respectto thetollowing items end report #*
existance of evidence of the following:
1. Rights of way,. ktdtfding those for roads, lanes, driveways or walks across fluke PoMerh an m on
sold premises serving'other property °n i
2. Streams. ponds, or lakes located. bordering on or running through said [slue Abmren
premises:
3. Telephone, telegraph or electric power poles or wires overhanging or;/lprerooroundr . execYlarsteton I
crossing sold premises and serving other property or properties: unknown: 0MIMWUMS. on sora* sar,Y.
4. Underground Installations such as sewers, water pipes,.gas or oil pipe lines. Sewernumn on west
conduits, across said promises:
5. Drainage ditches or underground drain tie across sold premises: Mch aur west t
S. Joint driveways or walkways: party or curtain waU% beam rights, porches. Lett ne a/ovro!/rear: /owner urtrhrnrbr�)
slaps, or roofs used in common or joW garages: j
Z. Encroachnients, or overhanging p v*;dwm (if our bulkling or its eaves, fire
-
escapes,tnsywindows, doors, flue pipes. stoops, or.ereaways, orsigns affixed
thereto, or our farm. walks, drives, .gates or entrances encroach upon or Kane Ob:swved
offing adjoining: properties, orsimitar adjoining strictures mtaoach upon or j
overhead our premises, specify sante and N buildings are substantially on
property lines Indicate if wails are plumb and if fo indatim and foaling are
wOhlt lines):
8, Physical evidence of boundary lines on all sides (Be specific as to how
boundary Ung ere:evidenced; that is byfences. plantings. etc. 7ndi ate whether
same differ from deed Ones and whether there is evidence of disagreement as
to boundaries)
g. Any unusual elements of use or possession affecting said premises:
(cemeteries. parks. etc.)
10.. Evkdettceof contemplated. commenced or newly completed construction
(be specific as to what has been done and indicate the names of any parties
Who may crave or WHI supply eltiner labor or materials)

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DESIGNED BY:
DLC
DRAWN BY:
PWG/EBM
CHECKED BY:
DLC
B 1: PERMANENT BUFFER ZONE 1 IMPACT
B 1: PERMANENT BUFFER ZONE 2 IMPACT
PROJECT NO.:
2293 • CD
B2: TEMPORARY BUFFER ZONE 1 IMPACT
DATE:
132: TEMPORARY BUFFER ZONE 2 IMPACT
SEPTEMBER 2016
SCALE:
� B3: PERMANENT BUFFER ZONE 1 IMPACT (MITIGATION REQUIRED)
AS NOTED
133: PERMANENT BUFFER ZONE 2 IMPACT (MITIGATION REQUIRED)
S1 : STREAM IMPACT NUMBER
SHEET 17 OF 29
S2 :STREAM IMPACT NUMBER
S3 :STREAM IMPACT NUMBER
C-3.03
S4 : STREAM IMPACT NUMBER