20161228 Ver 1_Shoreline Stabilization_20161212

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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 30-2013
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
Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: Peter J.Tierney
Mailing Address: 549 Myrtle Road
Naples, Florida 34108
Telephone Number: 239-591-3837 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:
htti)://www. saw.usace.army.mil/Portals/59/docs/reeuIatory/regdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.Pdf) must be attached if the Agent has signed this application form.
Name: Ben Odom
Company Affiliation: Odom' s Landscaping
Mailing Address: PO Box 1358
Cashiers, NC 28717
Telephone Number: 828-506-2695 Fax Number:
E-mail Address: [e-mail]
Person to receive the Certification Approval: Ben Odom
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,
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: Jackson Nearest Town: Glenville
Subdivision name or site address (include phase/lot number):
Lot 5-L
Hummingbird Trail Fetner-Stafford-Carter Subdivision
Directions to site - please include road names and numbers, landmarks, etc.: Hwy 107 N
to N. Norton Rd, 2 miles to Fenley Forest Trail on right,
1.5 miles to Hummingbird Point on right
Lot 5-L at bottome of hill on right
Latitude (in decimal degrees) 3 5. 162 877 Longitude (decimal degrees) - 8 3.13 72 8 7
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): underdeveloped lot in residential community
6. Property size (acres):
1.01 acres
7. Lake/ river/ ocean adjacent to property:
Lake Glenville
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): stabilize shoreline from extreme soil erosion
using a stacked boulder sea wall
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: 11
below 8' x 115' 920 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: 10, x 115, 1150 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): oak, pine and maples
above normal pool will not be impacted some small rhododendron
abd mt laurel may have to be cut back, 6-8 maximum
Owner/Agent's Signature* [15A NCAC 02H .0502(f)l Date
'Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSCP 10-2013 Page 2 of 3

No
Lake
(At full Ra t�4ormai Water Levet)
V
atel sketch the following in
on this plan (provide dimensions for each
Please approximately
item, such as 10 ft x 100 ft)*:
1• All proposed vegetation clearing
Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
2• laced below the Full Pond/ Normal Water Level elevation
I Location of rip rap or fill to be p
structures such
ngs) retaining wls, docks, etc.
4• Location of any proposed to the Full Pond/ Nomal Water Level elevation
5. Location of any
excavation or dredging below h
6. Location of construction access corridors
Page 3of3
FORM: SSGP 10-2013

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. 5 - L
PLAN NO. F 10 8 - 8 PARCEL ID:
STREET ADDRESS: Lot 5-L Hummingbird Trail
Fetner-Stafford-Carter Subdivision
Please print:
Property Owner: Peter J Tierney
Property Owner:
7563-39-8902
The undersigned, registered property owners of the above noted property, do hereby authorize
Ben Odom
(Contractor / Agent)
of Odom's Landscaping
(Name of consulting firm)
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):
549 Mvrtle Road Naples, Florida 34108
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
i nature
Date: November 18, 2016
Authorized Signature
Date:

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I. L. STEPEN FOSTER PIIOFESSIQWLL LAND, SURVEYUR HO. L-1273 CERTIFY TO ONE UR
NOSE OF THE FOLLOWING AS INDICATED TAI@ %
❑A: THAT IS PLAT IS OF A SURVEY OF A SUG3I1111IX1 M LANO WIMIH THE AREA OF
THE COUNTY TWT HAS AN OSOIIANCE THAT RESULAI. PAACE39 OF LARD.
❑a THAT MIS MAT IS OF A "VEY TAT IS LOCATED IN SVON PORTION OF A COUNTY
OS MNICIPALITY THAT IS UYEOILATED AS TO AN ORDINANCE TWAT IEGULATE9
PARCELS OF LAM,
THAT THE SURVEY IS OF AN EXISTING PARCEL OR PARCELS OF LAND AND DOES MT
CREATE A NEW STREET OW D) OR CHANGE AN EXISTING STREET WAG).
0 I THAT THIS PLAT IS OF A SURVEY OF ANOTHER CATEGORY, SUCH AS THE i—THATION
O: EXISTING PANCELS. A COURT DWE E0 SURVEY OR OTEi EXCEPTIONS TO ME
DEFINITION ON SUBDIVISION.
OE MAT THE INFORMATION AVAILABLE TO MIS SURVEYOR IS SUCH THAT IAM
UNABLE TO MAKE A DETERMINATION TO THE GEST O' MY PROFE53IONLL
ABILITY AS TO RISIWS CONTAINED IN A: 1R 0: ABOVE
WORM CAROLINA
JACKSON COOKY
1. L. WOMEN FOSMH, CERTIFY T1AT THIS PLAT WAS DMMN BY ME FRW AN AC AL
SURVEY MADE BY ME MED AEC—. IN BOOK 868 PAGE 317
TWAT THE BOUNDARIES MT SURVEYED ARE CLEARLY INDICATED AS DRAWN FGON
BOOK 9 REFERENCIA THAT TME RATIO BF PRECISION AS CALCULATED IS 1 : 7,500
TWT THIS RAT 15 PREPARED IN ACCONUMM WITH B.S. 47-M AS AMENDED. WITNESS
MY ORIGINAL SIGNATURE• HEGISMATION NO. AND SEAL THIS 11th DAY 6
MAY A.O. 2011.
LAND SUNVEYOR NO. L-1273
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ALL STATUTORY MOUI-11 FBp OMINB.
DATE)(,(,(L
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REGISTER OF DEEDS
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WATERSHED CERTIFICATE OF APPROVAL
1 OEATIFY TNAI THE PLAT SMMR HEREON COFIIES NIM THE NATEMH D
PMTECTION ORDINANCE AID I4 APPMVED SY THE E 0 AONINISTWTUR
FUR C IM WITH TIE REGIST. OF DEEDS
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NOTtCE .IS PIOPFATY IS LOCATED WITHIN A PUBLIC WATER SUPPLY I' Iv LIOIE 1 ` W 3122
NATEILSIED- OEVELOPIEHt PESTRICi[ONS MAY APPLY. i! 9 20 3�4i�
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SUBDIVISION G pA1R
PARCEL # 758430-8114
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PARCEL # 758413-4832
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FETNER-STAFFORD-CARTER
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- \ SUBDIVISION3f
A 24 24
- PT. PARCEL # 788339-8902
vJ TRUE ELEVATION I N.P.GL 3110'
D.B. 888 / PO. 317
G �— CONTOUR LINE IS 3501.75' L NGOV 69 )
1.01 ACRES
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NOTES
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NO NORTH CAROLINA CONTROL MONUMENT LOCATED WITHIN 2.000 FEET
\
MERIDIAN --MAGNETIC NORTH 2011
.. 1' OPEN TOP L1
SR PIPE '!0'
FOWD :'%- R BBID
THE PROPERTY SHOWN HEREON IS NOT LOCATED WITHIN ANY DESIGNATED
FLOOD HAZARD AREA
N E
m H60 Og ZO % \EUGENE FETNER KY TP7,FXTIIR. CARTER TOLPUBLIOC USEOWN ON THIS PLAT ARE PRIVATE AND ARE NOT DEDICATED
PARCEL # 78839-8898
m 3
NDOR
BEING LAS RECORDED IN BK. S. / PD, 317
D.B. 1124 / PO. 888
F�OaD
SURVEY FOR:
uTTL
POLE
ROBERT B. REICHE and
mCDNTY SEMIrm
ANN M. REICHE
0
Rrm TO C LO.ME Certificate of Approval for Recording
ceniry Nal KM 11M MNOAW 4.— —,r*'
w
I�IISKINGBIRD '.T th SPEC m a� Ab .n M I4 .
TRAIL OarNbWMirc OiWNAaM A b appovef
Nap A 4wr al oe onNW
FINLEYOrsD•5/` // �
CURRENT OWNER:
TODD N. THEODORE
DaM •y �..-...,
LOT B -L, FSPNSEL-STAFFORD-DARTER 6IIBDIVIBIOA
PARCEL # 788339-8902
BAXIBURO TOWNSHIP, JACEBON COUNTY, CAROLINA
NORTH NORTON
MAD
SCALE: f' - 30' PPROVED BY: WN
DRA8Y BBF
ANN B
GATE: 5/11/2011
107 GRAPHIC SCALE
1--30'
TO CASHIESS
L_ STEN ATES
P.O. BOX 100. THIGHLANDSCN.C. 28741 1 M:BELS LICENSE NO. C-2098
0 30 60
90 UM
OFFCE 828-743-4154 DRAWING NBER
WEBSITE wwI. fOeferelandeurveylnq.con 1108-8

Jackson County, NC
Detailed Tax Parcels Report
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Franktfn
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WARNING: THIS IS NOT A SURVEY!* This
map is prepared for inventory of real property
within Jackson County. It is compiled from
recorded deeds, plats, and public data
records. Users of this map are hereby notified
that the aforementioned public information
sources should be consulted for verification.
Jackson County or any County representative
assumes no legal responsibility for the
contents of this map.
Tuesday, November 29, 2016
TIERNEY, PETER J
Owner 2:
Physical Address:
LT 5L HUMMINGBIRD TRL
Property Description:
LT 5L SR 1144
Account Number:
177395
PIN:
7563-39-8902
dr+"
549 MYRTLE RD
Mailing Address2:
City State:
NAPLES FL
kis
34108
,y �* Pisgah Fc
2138/301
Deed Date:
2016-06-03 00:00:00
Bm wd
$380,000.00
Bataan brave
1.01
Map Sheet:
7563.01
Plat Reference:
19/12
Fire District:
CASHIERS 6 MI
Appraisal Neighborhood:
GLENVILLE LAKE EAST
Rosman
15029
Like Tnxw ay. .
HAMBURG
Township Code:
15
.u,13.` apphire
$0.00
Land Value:
$500,000.00
Owner 1:
TIERNEY, PETER J
Owner 2:
Physical Address:
LT 5L HUMMINGBIRD TRL
Property Description:
LT 5L SR 1144
Account Number:
177395
PIN:
7563-39-8902
Mailing Addressl:
549 MYRTLE RD
Mailing Address2:
City State:
NAPLES FL
Zip Code:
34108
Deed Reference:
2138/301
Deed Date:
2016-06-03 00:00:00
Sales Price:
$380,000.00
Assessed Acreage:
1.01
Map Sheet:
7563.01
Plat Reference:
19/12
Fire District:
CASHIERS 6 MI
Appraisal Neighborhood:
GLENVILLE LAKE EAST
Neighborhood Code:
15029
Township:
HAMBURG
Township Code:
15
Total Building Value:
$0.00
Land Value:
$500,000.00
Total Value:
$500,000.00

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