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Home My WebLink About20170069 Ver 1_Shoreline Stabilization_20170118State 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 applicatiort, clflditigt ichments) and the application fee should be sent to: Division of Water Resources 401 & Buffer Permitting Unit 7 0 0 6 1617 Mail Service Center Raleigh, NC 27699-1617 t"D I. Applicant Information [15A NCAC 02H .0502(a)] JAN 2017 1. Owner Informations DE(1 yVATE Name: TED MOORE 401 & BUFF R P Mailing Address: 3951 COUNTRYSIDE LANE CLAREMONT NC 28610 Telephone Number: 828-446-6905 Fax Number: E-mail Address: TCM OORE@CHARTER.NET 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: N/A Company Affiliation: Mailing Address: Telephone Number: E-mail Address: Person to receive the Certification Approval: Fax Number: 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: CATAWBA Nearest Town: SHERRILLS FORD Subdivision name or site address (include phase/lot number): 4271 BARBRICK STREET ERRILLS FORD NC 28673 Directions to site - please include road names and numbers, landmarks, etc.: Latitude (in decimal degrees) Longitude (decimal degrees) 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): 3/4 ACRE 7. Lake/ river/ ocean adjacent to property: LAKE 8. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or why it is necessary): REFRESH RIP -RAP AT RETAINING WALL. IT HASN'T BEEN DONE IN OVER 35 YEARS 9. Will work be conducted from land? X❑ 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: ADDING RIP - RAP TO RETAINING WALL WHILE THE LAKE IS DOWN ALL WILL BE BELOW NORMAL POOL LAKE LEVEL APPROX. 200 LINEAR 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: 0 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): NO VEGETATION WILL BE IMPACTED THE AREA IS GRASS. _�rwo 1/9/2017 Owner/Agent's Signature* [15A NCAC 02H .0502(f)] Date FORM: SSGP 10-2013 Page 2 of 3 -Agent's signature is valid only if on authorization letter from the owner is provided. Full Pond/ Norma SI La ke (At Full Pond/ Normal Water Level) GLa'K Please approximately sketch the following information on this plan (provide dimensions for each item, such as 10 ft 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 1•:b�ROp' Trt 5fa. OR f,QFLL fA 7/4 I BEARINGS AND OIsrANCEs 9011 Lora ON COIIfOUR ELCy. »o LOT Yt LOT 72 LOT 93 I Sit•6f;w•1{.It t3.Nllf11-�. I/: Ml}•d't:ll 14. N4;:3N6i-iii% 2.a60f w•a7wfpr8O,' !LN /1 - N F6,.n1ua �A.LA_ a s .� I I 3 N7fe O'1w1-w:t2' zi Ntt.7 ;W-7{:os; fl IR f1/O wr s! 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TO ACRE \\� \ d�'i;a� \0.6.6.a - a'A L[vll 1.03ACIK9 >s'M 40LLOW6 - CONTOUR ELEY. _OArOMI Y• LOT TIN 0.73 ACRE i 242.0 a \ LOT 64 0.62 ACRE (( -'� 10.-••,--_� / 6 •. r LAKE LOT ACR OE 4 W .•A../ / 1 . \ 0•gM' Lor 62 CR 0LO �a a�`NOO. +be, '• ACRE .TIN%./ } �••' LOT 61 �Riy 0.67 ACRE I I 1401 1 . BILLY W. HILL =uF LOT 60 a t ! NOTE: ri. )7 /�» MTN. 15. DWS. NO. 379 �a ALL STREET CORNER RADII ARE EO PEET. • 7t 096 ACRE . ' PROPERTY LINE DN74NCE3 ARE COMPUTED 10 CRESCENT LAND B TIMBER CORP. �' MINT of INTERSECTION AT STREET CORNERS. x790 -... O LAKE NORMAN GYRE POWER COMPANY TO CRESCENT LANG • WINNER NAP Of #O •T, c"Ad..A - On'A-bA C.A.AR,.y C. _ _ -- so CORP. DEE* INDOOR w1, PA9E Nz UAW I, Mg. RECREATION LOTS �AY RIG"T a SE7NI LINES ARE b IT,Tou Raa SECTION 33 ',��P} tL 760 UIS G S�SEArIEV[�08TUNFT R MD IfROY SIDE ✓-I.7AIt, �' .tea- �y.�� LOT LINE. 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