20170099 Ver 1_Shoreline Stabilization_20170123

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
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
D 1A @�ad�
I. Applicant Information [15A NCAC 02H .0502( a)] JAN 2 3 2017
1. Owner Information
Name: James S and Alice V Hill _ _ UR Es
Mailing Address: 131 Claiborne Dr. 401 & BUFFER PERMITTING
Mooresville, NC 28031
Telephone Number: 585-820-4666 Fax Number:
E-mail Address: 14ph#[e-mail]
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 AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name:
Company Affiliation
Mailing Address:
James S Hill
Property Owner
131 Claiborne Dr.
Mooresville. NC 28117
Telephone Number: 585-820-4666 Fax Number:
E-mail Address: [e-mail]
Person to receive the Certification Approval: James S Hill
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: Iredell Nearest Town: Mooresville
Subdivision name or site address (include phase/lot number): 175 Binns Rd./131 Claiborne Dr.
Lot 238 Crescent Land and Timber Corp., Sect. 6
Directions to site - please include road names and numbers, landmarks, etc.: 1-77 exit 35,
West on Brawley School Road, through the traffic circle at the Point and continue on
Brawley School Rd Rifht on Tuskarora Trail, Right on Binns Rd. Property is on the corner of
Binns Rd and Claiborne Dr.
Latitude (in decimal degrees) 35.511169 Longitude (decimal degrees) -80.951002
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Residential
6. Property size (acres): 0.69 acres
7. Lake/ river/ ocean adjacent to property: Lake Norman
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Installation of stone rip rapto-prevent continued erosion.
Will work be conducted from land? 9X From water? ❑
9. 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: 200_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: 120 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): Grass will be disturbed.
No trees will be impacted
11
?wner/AgenVs Signature [15A NCAC 02H .0502(f)] Date
Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 4

La ke
(At Full Pond/ Normal Water Level)
80 ft 40 ft
new P 80 ft 80 ft exist
ing
Full Pond/ rip a existing -L existing rip
Normal Water Level rap r beach T shoreline � rap
Shoreline
Minimum loft-,` •
access-------�
Work Staging
area 10 X 20 Neigh
bor's
Drive
way —
access House
appro
ved
by
owne
rs
No Trees
Removed
0 =Trees
FORM: SSGP 10-2013 Page 3 of 4

The diagrams above and below show that 200 sq ft of riprap is below full pond and 120 sq ft of riprap is
above full pond.
The work will be done from land.
Bank height varies from 1.5 ft to 4 ft. There will be no grading/clearing/notable buffer impact.
80 ft new rip rap 80 ft existing beach 80 ft existing shoreline 40 ft existing
rip rap
Below full pond
1.5 h
1.5 ft
Above full pond
FORM: SSGP 10-2013 Page 4 of 4

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I, certify that this map was drawn under my supervision from an actual
survey made under my supervision recorded in deed book 4345 _, page 560 and/or
plat book 34 page --19— that the ratio of precision t1y' 10,000,• that this map
was prepared in accordance with the General Statutes of t�Chapter 89C.
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