20161194 Ver 1_Shoreline Stabilization_20161205

Shoreline Stabilization Application Form
Three copies of the application (including attachments) and the
should be sent to:
Division of Water Resources
401 & Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
• Applicant Information [J.51u, NCAC 02H .0502(a)1
nFr 0 5 2016
u, e
1. Owner Information 1 1 94
Name: cxtaaW, n
cl
Mailing Address: Q/ 30%us lc�r I?�. vv�cn�, N. C.
Telephone Number: 704- gr3o - 707(r Fax Number:
E-mail Address: Fypet�) 0 m 10 0 Me,..- I. c.01VIL
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be
downloaded here:
htto://�vww.saw.usace.armr t.mil/Portals/59/docs/regulators,/regdocs/Permits/SAMPL
E AGENT AUTHORIZATIOfu FORM.pd ) must be attached if the Agent has signed
this application form.
Name:_
L;x s-tru
Company Affiliation: jqinrnpC
Mailing Address: SfsdS�`es ►Zre Uove,r, S -C. oLq-g0
1

Telephone Number: _ $03- Fax Number: fro3-ff3l-56
E-mail Address: f ua-' tS 3 S te e"A-h 1; nk.. Ag+
Person to receive the Certification Approval: ___"_�_q %0,Nson
• Project Information [15A NCAC 02H .0502(a) & (b)]
• 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.
• 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 construction access corridors.
You may use the diagram provided at the end of this application form.
• Attach a photograph of the shoreline/ buffer proposed to be stabilized.
(Include a scale of some sort- a yard stick, shovel handle, etc.)
• Location of the property (where work is to be conducted)
County: &MS1. Nearest Town:B-e(wtoe4-
Subdivision name or site address (include phase/lot number):
Directions to site - please include road names and numbers, landmarks, etc.:
Taker 1 e + ori _�- e it han"'A ic�"Cte'S or, do
Latitude (in decimal degrees) 3� /� 023. (� (e"/V Longitude (decimal degrees):al °
• Describe the existing land use or condition of the site at the time of is
application (residential, undeveloped, etc.): Unr�n�r.� o
• Property size (acres): a5u
• Lake/ river/ ocean adjacent to property: �A kA - w`l,-e_
2

• Describe proposed work (include discussion as to how hardening of shoreline
has been avoided, or why it is necessary): dex essa ry he,caas�
kocusl 6,0- -pmt P: Ips cau,.P&� erosionQllol- sl�.,e1�►ti2 �-
erg M
• Will work be conducted fro land? From water?
• Total amount of disturbance (inc uding all excavation, backfill, rip rap,
retaining walls, etc.) below the normal pool lake level/ Normal Water Level in
square feet or acres:
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: s
/3.3
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): / /, 9, " f -,-,.e s Cc. s rot_eli �, e
o kj 5A c, rc-- -74, b r ,
atralwr b r ush
Owner/Agent's Signature' [15G NCAC 021-1 .0502(f)l Date
`Agent's signature is valid only if an authorization letter from the owner is provided.
3

Home Insert Design-nlmsilons Slid=_ shc. a::r:, neo: lasertich%
rae:, —
Sl:da- 'J Delete
'J
Full Pond/
Normal Water Level
- Shoreline
Lake
(At Full Pond/Normal WaterLevel)
-10
N
% / 710744
Please approximately sketch the following information on this plan (provide
dimensions for each item, such as 10 ft x 100 ft) *:
• All proposed vegetation clearing
• Location of rip rap or fill to be placed above the Full Pond/ Formal Water Level
elevation
• Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level
elevation
• Location of any proposed structures such as buildings, retaining walls, docks, etc.
• Location of any excavation or dredging below the Full Pond/ Normal Water Level
elevation
4

• Location of construction access corridors

. . .
SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT N0. q 0 PLAN NO.
PARCEL ID:
Please print:
Property Owner:y 4 S /�{ /�� 1 c–i?J �✓
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
of ��a.u�rson's ?k l rvIAg, 4- Con.
( ontractor �/Agge�nt))��� (Name of consulting firm) 0—
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
Z/4.30 7- r -72d. l oA4- WI C. ,"1.z
Telephone:
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Z�jt'h'nlri,pmd Signature Authorized Signature
Date: -1G Date:

STATE OF NORTH CAROLINA
GASTON COUNTY
1 certify that this map =s drawn Gam an actual Hovey made under my YA9NaUA
supervision.
CO The unadjusted error of dos" oecalculatedY
calculated is • V 6
or) Boundaries not surveyed If any, are note . d ,ora..,, ♦" m
y C J<• >
recorded M Book AS .Pegs
Wltnesa my hand and seal this 13 day of Qo�� � ^
1\ \ .`ad cr -M.
ROCKY vEer cr.
a�y, 3.�A �1�` LOCAnai MAP -NOT To
iL
\ WOODLAND BAY - PHASE 1
LOT 29
I.wN(F)
P8 70, PG. 38
WOODLAND BAY -PHASE 1
LOT 30
PB 70, PG. 38
/
LPW(F)
sf
I.I.PIN(F)
a8 /
v
LEGEND
oa,
IPIN(F)
58335'45`E
/
X40• yep 90.28•
LA DO
WOODLAND BAY - PHASE 1..,
/
(\
LOT 40
PB 70 PG 3S-
AREA =1238 ACRES
LPIN(F)
- NC P.
LA
Gap ;p GP.
IVis
NAS•nc•. —....
LINESSURVEYED
LINES NOT SURVEYED- -
ALL CORNERS ARE AS N07M O
N.T.S. NOT TO SCALE
CP. CALCULATED POINT
OVERHEAD UTILITY LINES
U71UTY POLE
METAL FENCE
WOODEN FENCE - - - - - -
SEWER MANHOLE
MBSL - MINIMUM ULRUDING SETBACK LINE
I.PIN(S) - IRON PW SET
I.PIN(F) -IRON PW FOUND
1. - IRON OAF - CONCRETE MONUMENT(F)
(5 FOU
SETS.
264.
LPDI(F)
P'
LA DO
LPIN(F)
- NC P.
LA
Gap ;p GP.
IVis
¢All
?+C.P.
V
iv
LPiN(F) P
A�-CS5 ,Qdl�h,
WOODLAND BAY - PHASE 1 I
LOT41 �% ..Q X CLf 1/4
P6 70, PG. 38
LINE TABLE J
LINE I LENGTH I BEARING
I CURVE TABLE J
CURVE ALENGTH I RADIUS I CHORD I DIST.
NOTES SURVEY MADE USNG EASRNG PHYSICAL
EVIDENCE FOUND AT TIME OF SURVEY.
SUBJECT PROPERTY MAY BE SUBJECT TO
RECORDED OR UNRECORDED EASEMENTS.
RIGHT-OF-WAYS, SETBACICS AND/OR
CAROLINAS HEREON CRVE COVENANTS NOT SHorN
DESIGN GRAPHIC SCALE
GROUP,PLLC 60 30 0 60 120
.LAND SURVEYING•LANO PLANNING
201 West Second Avenue Gastonia, NC 28052 SCALE IN FEET
Phone: 704-83A-9320 . 704-854-9007 • Fax [phone]
BOUNDARY SURVEY
OF
8012 ROCKY VIEW COURT
5
SCALE: 1" = 60' SOUTH POINT TOWNSHIP — GASTON COUNTY, NC DATE:OCTOBER 7. 2016
PROPERTY TO BE ACQUIRED BY. -DOUG AND SUSAN HAMILTON
MAP RECORDED IN BOOK 70 AT PAGE 38 DEED RECORDED IN BOOK 3774 PAGE 594
BOOK NO. CADD # 7940HAMILTON WORK ORDER # 7940 DRAWN BY: MLC TAX ID NO. 193276

Li
I- �
fir. '���/ i;_
Ao
Ir
:
oj.R,v,� omllnl,�
iz-
�A rrr `J'•61
�,'
`� •,.. ._ -.'� rho ., ��_ , ,. - ,� �.

.� , , � ��{, � ,' �ip� " � e � �y - :�� °``may 't?�'%Y'�
,C s Q awl .. � - 'a � i W ,- } '` ,,,_���JJJylll�' _ 'L
ti;
_., 1 .`a�!F It ��'

r. � tit ,.T ,� s .. y P ,1 !h- 1 �+. �N �:� �•�,.�•.
t •k�e r.�y�l i. .' �� �4 n-

70