20170190 Ver 1_Shoreline Stabilization_20170213

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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 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 PAI®
1617 Mail Service Center
Raleigh, NC 27699-1617
Applicant Information [15A NCAC 02H .0502La
1. Owner information
Name: —0-006 5 ilER-TL
Mailing Address: 42-t 8 QUOu L #uw T LAPt5>
K "A- bo *<- 0 C_ vvZ�
Telephone Number: boy- 5,7(o- t{3gL Fax Number:
E-mail Address: A --� oe ZrL e. A Tr • N E
2. Agent/ Contact Person Information
20170190
A signed and dated copy of the Agent Authorization letter (a form can be
httn://www.saw.usace.ariTiv.mil/Portals/59/docs/r eeulatory/ree.docs/Pc-ritiils/5
RIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: -0c3'-J L.L,AV" �-
Company Affiliation: S 'rl:M.L�i . �iVL L
Mailing Address: 3 Z 3 OL lb 45tZ or-, IZ h
C -WA 2 leo L-� , ll L L 9 Z 7 3
Telephone Number: 70N • 30, Z5SIC1 Fax Number:
E-mail Address: Jad e 50,61^ LO1J5T-aMC_Te"J ClAaL-luft. (-,DM
Person to receive the Certification Approval: L j% Mt -_-
A-
11. Project Information 115A NCAC Q2H .0502(a) & (b)1
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 property (where work is to be conducted) _
County: 6P43Tv-" Nearest Town: 5t L�o._rti
Subdivision name or site address (include phase/lot number): 1.-o T t�
ID A,1v113 LAtc-.1,-1•1L Z3®t'L _Lr4 £ Oot#'T
Directions to site - lease include road names and numbers, landmarks, etc.:
57 = S- V7 3 J'*'S� e .,►-r� T I IL Z ?3 — -i-% 1 5,0 v
C 2131 T3 Eke RT v 77 AXON t I -r m .� I i ✓ .
0 S%A �4.h✓f1i f o
Latitude (in decimal degrees) 3 J• t 1 Z 7 S 3 Longitude (decimal degrees)
5. Describe the existing land use or condition � /of the site at the time of this application .'11
(residential, undeveloped, etc.): UPJ10' ,-"Per 15dr*4- of-vwl wo �� P,,1-bn't6%
6. Property size (acres): Z8 44 L 5 ¢ AGr-s 5
7. Lake/ river/ ocean adjacent to property: �rz (-O-T—
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): SE Curt Cpa Lf, L10-6 e_V,t^0L 2Vr-
�S - b 124 I?�j,�, r� -Iv w► �-�ua LX )4f re n GOTr t k e- c •� r...,,,
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:
I Z Sa s4 P -T•
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:
C3
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): VAt-1+t w4 SMA41 50P/7(1,V
L b 49 AMC 'r"C it '+A -LCC MA; � � y� (a,�- � (fir v �.tA t o A.IL W bJ 7'I y
Owner/Agent's Signature* Printed Name Date
[15A NCAC 02H .0502(f)]
`Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: S5GP 10-2013 Page 2 of 3

I►
Full Pond/
Normal Waatter evel ..�
Shoreline
eC4--J '�JV
Lake
(At Full Pond/Normal Water Level)
1-")
am am
Please approximately sketch the following information on this plan (provide dimensions for each
item, such os 10 ft x 100 ft) *:
1. Ali 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
`FA,U N4 4EAAA .5 -,o 1_4 N4 1 � u
FORM: SSGP 10-2013 rO Is L"'/ vk A w $A,-,_ Page 3 of 3

LEGEND
THIS IS TO CEFMFY THAT ON THE 28 DAY OF December 20-jb--AN ACTUAL
SURVEY WAS DONE UNDER MY SUPERVISION OF THE PROPERTY SHOWN HEREON. THIS MAP IS NOT K ENDED
TO MEET GS 4730 RECORDING REOUIRBdENTS.
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SIGNED
Bishop Land Surveying, Inc.
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THE PROPERTY OF Douglas J. Sperr & wife, Kell/ A. Speff
MAP RECORDED IN BOOK 77 AT PAGE 35 OEM RECORDED IN BOOK 4770 PAGES 2161
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Spain Construction, Inc.
323 Old Hebron Road
Charlotte, NC 28273
Don DellaMea 704.309.2559
[e-mail]
Re: Sperr Project
1045 Peninsula Drive
Belmont, NC 28012
02/07/2017
Site Work Scope of Work
Phase 1: (Above the Buffer Zone) (Completed) (See Compliance Letter)
1. Secure County and City Permits.
2. Construct Construction Drive.
3. Install silt fence.
4. Grade lower lot for preparation of lower yard grade.
5. Use existing top soil on lot for lower lot prep.
6. Back fill with existing fill dirt at proposed terrace area.
7. Cut house footprint for future house footprint at basement.
8. Cut and grade surrounding lot footage for proper drainage.
9. Supply and place #1 Hammer mulch at rear lot above Buffer Zone to protect soil.
Note: Spain Construction is in final negotiations for contract of work for the performance of this
project. We are down to two contactors that are listed on the Duke Website. Andy Thompson
Grading and Clawson Pile Driving. Both contractors have performed work on our past permits.
We are pulling the permits for the project in order ready for start once contracts are final.
Clawson has been behind due to loss of a family member and Thompson subs permit phase.
See inspection report from Gaston County. We have consulted Gaston County Soil Erosion and
Sedimentation Control on several occasions. This property has heavy run off from this lot and
adjacent lots. A natural sloping hill slightly left of center gathers heavy run off. It has been
determined by Gaston County and our contractors that a stone flume is necessary along with
mulching and plantings to control this run off.
This is noted in our below scope of work.

Phase 2•
1. Secure shoreline and flume permit.
2. Secure tree removal plan and remove trees at shoreline per Duke and DWR
Requirements. (see photos)
3. Construct rip rap shoreline. (Gray rock)
4. Shoreline will have an 1,250 sq ft of rock at lower 100 mark and 960 sq ft above 100'
mark.
5. Left of center at the 50' buffer is a deep ravine that is fed majority of water from this lot
and lots left and right. We have consulted contractors and Gaston County Soil Erosion
Sedimentation Control on how to secure soil and control run off. It was concluded a
proper river creek flume bed would be best solution to address filtration and slow water
run off. We will be using brown river rock with a few large stones to address
construction. Plan is for a solid stabilization and architecturally appealing flume. The
plan is to not have a "commercial" feel for this area. Homeowner will plant native
approved plants later to assist in protection of soil and to keep landscape correctness.
6. Flume will preserve several large trees in the lower 50. Again, trying not to disturb to
many trees in area which are adding security of soil. Plus trees bring shade.
7. We are primarily removing the "leader sapling trees." (Also noted dead trees)
8. All Shoreline and Flume work to be performed from land via access of construction drive
per Gaston County Requirements.
9. Dump trucks to deliver all materials. (Rock and Mulch)
10. Track Hoe and Skid Steer will be used to remove trees, grade lot and place rock and
mulch.
11. All removed debris will be via lot construction drive.

Gaston County
Soil Erosion and
Sedimentation Control
Program
www.aastongow.com
/departments
/Natural -Resources
CONTACT:
Gaston Natural
Resources Department
1303 Cherryville Hwy
Dallas, NC 28034
Telephone: [phone]
Gaston County
Belmont
Bessemer City
Cherryville
Cramerton
Dallas
Dellview
Gastonia
High Shoals
Kings Mountain
Lowell
McAdenville
Mount Holly
Ranlo
Spencer Mountain
Stanley
Mission Statement
"To provide leadership
and conservation
assistance to the
people of Gaston
County to improve and
sustain their soil,
water, air, plant and
wildlife resources."
INSPECTION REPORT
Project: 1045 Peninsula Dr.
Location: LAKEPOINT
Person Financially Responsible:
Douglas J Sperr
X In compliance Out of compliance
Inspection date: 02/07/2017
Violations:
Sediment damage:
Corrective actions:
None.
Compliance date:
Comments:
Continue monitoring erosion at the rear of the lot. Mulch has been moved to improve
erosion and sediment control.
It is understood that a stone flume will be installed at the run off area at the rear of the lot
and that landscape measures in the yard will be installed too that will help slow the water
and prevent erosion and sedimentation.
Report by: William J. Wier: Conservationist
Contact made with: .

THIS 6 TO CERTIFY THAT ON THE 28 DAY OF Daoan bur 20__Ifi_AN ACTUAL
SURVEY WAS DOBE UNDER MY SUPERVSION OF THE PROPERTY SHOWN HEREON. THIS MAP IISS NNTIOTNTENDED
TO MEET 08 47-30 RECORDING REOUF13MDFM !C� / ✓/
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THE PROPERTY OF Douglas J. Spen' & wife, Kelly A Spell
MAP RECORDED N BOOK 77 AT PAGE 35 DEED RECORDED IN SOCK 4770 PAGEs 2161
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DUKE ENERGY INTERNAL USE ONLY:
Construction DUK6
Date Received: I I FAF Paid Application I` V`
M Application Complete "mfontap r ENERGY.
Permit No. Water Strategy, Hydro Licensing and Lake Services
NEI' Fund Duke Energy
�� Box 1006/ ECI 2Q
Site ID C1gse-0ut Date Charlotte, NC 282018201
-
1. DATE OF APPLICATION* Z 7 % ► 7- Permit/Tag
1L APPLICANT INFORMATION (applicant maailing addnesr and contact information)
Name* p 'D 9 C7r V fb S fli Primary Phone*
--r
Address* 51-5 D (D At-$ fLo rs to Secondary Phone 1-71) q- SS �%Oo
City- 1, 114riottc 5tate* © Zip Code* y4,Z??j Fax Number —�
Email* A I -I C 5f .410% C01.1IT'A ctIV-4 C �^ ,V L4 � L 6M
111. PROPERTY INFORMATION (location of permit)
Address* S Z h i n s uL� b-1 V eL County" 66511 PJ
City" AI o,v r State* I. O Zip Code* Z$ D 12 County Parcel ID number
-
(e.g. Pin, Tax ID, TMS
Lake": �,. P, w ((� Number-)
Subdivision1 Ip,'L D i N 1 1 Lot(IS) 1 Plat BooWPage
To enter the Latitude and Longitude of the property, please use a
Latitude (e.g. 35.12345)*
service/software to easily acquire the location information. Values
should be provided in Decimal Degrees format (35.1245).
Longitude (eg. -80.12345)#
example service: httwhioucm p.cor; /latlong tttr -
M PROPOSE AcOTIVJTY
(' New/Modification of Existing Structure C' Maintenance of Existing StructureIs Dock
�
VTlew/Modification of Existing Shoreline Stabilization (' Maintenance of Existing Shoreline Stabilization Covered?
(' New/Modification of Existing Structure & Stabilization (-Maintenance of Existing Structure & Stabilization # of Slips
(' Transfer of Ownership (" Other (please describe below) # of Jetports
Area over land (sq ft) I I Area over water (sq ft) I I Total Square Feet
Shoreline Stabilization (feet) Length of 1 Distance From Shoreline
t7 5 1 Stabilization Materials R-1 r
Brief Description
of the Activity
5S;4/ E
5t-1ro�i 1.1�c
— n,.o Vim, uN Dt.. tM to Q n
-Fn ( S 1 �oo7Fl
41^cc et& <
p (Q t -t t h
�A Ip IA+► ra�l'ctr! L ki J Tr n i
L (7 t�+ w rr.-� ►
Describe Briefly the Existing
Structures Over Land and
Water (include sq ft)
v IJ a t vE Lo Pa*to �,-�-
f(

r
V. Dock 0 er or Engineer
Name/Company �-
Address Phone Number L
City ryState Zip Code Email
VI. Checklist of Required Documents (to include with Application Submission)
,.(Recent Survey (stamped/signed by a professional licensed surveyor showing the location of the existing or proposed
u structure and/or survey of the existing or proposed stabilization)
6?f Photos along property shoreline and photos of any existing structures and/or stabilization in or near the water
❑ Application fee (check only, payable to Duke Energy) ❑ Signed User Agreement Letter
❑ Applicable local, state, and federal permits ❑ Wan and profile drawing showing all measurements and elevations
❑ Habitat Enhancement payment (if applicable)
uVII. Approval Process
... .... ...,.-. ._. ,.._....,..,__.,_ ,.-.-_.�--... �.a..-G _..,�.�....-....�.....o...... .. ..
• Application is reviewed and determined if complete. Fields with an asterisk are required.
• If application is not complete or does not include all items and information listed in the checklist, the
application will be returned as incomplete.
• A Duke Energy representative will visit the site to conduct a visual inspection.
• Applicant will be notified of approval or denial.
• Applicant is to have the notice, to be supplied by Duke Energy upon application approval, posted and
must be viewable from water. The notice must remain posted until a representative inspects the
project and determines the project is complete and within the application specifications.
Vlii. Directions WRoad
Directions by
Road"
bmincale. n+4v4-
IX. Appiicittiop Submission
Please complete, print and sign this application. Then enclose all items from the checklist above In an envelope and
submit all the Information to the address below.
Water Strategy, Hydro Licensing and Lake Services Print Duke Energy Form
PO Box 1006/ EC12Q
Charlotte, NC 28201
I agree that the information contained within is accurate:

Lake Services
DUKE
, Duke Energy
ENERGY
I 526 South Church St
1 Charlotte, NC 28202.
Mailing Address:
EC12Q I PO Box 1006
PRIVATE FACILITIES USER'S Charlotte, NC 28201-1006
AGREEMENT LETTER
(You may use this letter and fill in the requested information. Please Print)
Date l _
TO: Duke Energy
c/o Lake Services - EC12Q
PO Box 1006
Charlotte, ITC 28201-1006
RE: (Project Name) 7D D U (,. S fp", Pp.a7, g q—
(Lake Address) I D S r" r S Lk S 4
Z
(Applicant's full name) '4.3 _11�4 et AMhereby agrees to comply
with all requirements and conditions set forth by Duke Energy's Lake Services' office, or
any federal, state or local agencies pertaining to our Private Facilities application to
construct and/or maintain a " Lt wz& St*,G,t L J J_e.-
-ho�J
on Lake t.J In addition, a have read and agree to comply with Duke
Energy's Sho eline Management Guidelines (SMG) and understand that written
authorization must be obtained from Duke's Lake Services' office prior to beginning any
activity/construction within the Project boundary. The construction will be completed as
described in the approved private facilities program application and within twelve (12)
months following the date of approval by Lake Services. Failure to complete construction
within the twelve-month build -out period will require the applicant to file a new
application within the then -current guidelines. The filing will include any applicable fees
and security deposits.
1/we attest to be the owner or lease holder of the tract of land immediately adjoining the
Project boundary where the proposed private facility is to be constructed.
1/we understand that the structures to be installed and/or maintained are my/our property
and 1/we therefore agree to be fully responsible for the permitted reservoir use including
maintaining structures in good repair. If the private facility is deemed unsafe by a Lake
Services Representative, I/we agree to repair or rcinove the hrirrate facility at m�lM7 - own
Page 1 of S
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NydrolakessesNsersA@reementhrPriwrdPri�vre Faculties Wcrs Agiecmcm CW X7 final 1 12 09 ish res,doc R"2.21-10

expense and within the specified timeframe set by Lake Services. This responsibility is
considered to transfer automatically along with ownership and leases of the adjoining
tract.
1/we agree to fully disclose all information regarding the approved private facility to any
prospective buyer/leaseholder of the property and any new owner/leaseholder. ]/We agree
to notify Duke Energy Lake Services immediately of any sale/transfer of the property,
including the name and address of the new owner and to transfer the permit to the new
owner/leaseholder.
Uwe understand that unless the private facility was permitted by Lake Services before
June 1, 1996, no more than (1) pier/dock or one Common Use boat slip per waterfront lot
will be considered for approval. Ownership/interest in a Common Use Facility or
residential marina eliminates the option of having a separate private facility on any other
owned or leased lot within the affected subdivision.
1/we understand that Lake Services' approval of the requested reservoir use in no way
constitutes assignment of an interest in real property (i.e. land rights). The approval is
granted and maintained solely at Duke's discretion. I/we also understand that the
permitted use may be revoked at any time by Duke Energy or its successors for any
reason whatsoever. If the approval is revoked,11we agree to remove the facility at my/our
own expense within the specified timeframe set by Lake Services.
Ave specifically waive any claim for consequential damages arising out of or relating to
this application, Duke's approval or denial of it, or Duke's subsequent revocation of
approval, and I/we specifically understand and acknowledge that, because Duke Energy
can revoke the permitted use at any time, Ave are not entitled to reliance damages.
1/we understand during drought conditions Duke Energy may request reduced usage or
discontinued usage of any water withdrawal or related systems, until such drought
conditions improve. Failure to do so may cause possible removal of the system and/or
any other permitted facilities that Ave may have, and any costs associated with removal
of the facilities will be assessed to the lot owner.
.7/we understand that this lake was constructed as a working hydropower reservoir for the
primary purpose of producing cost-effective electric energy and that this remains as the
lake's primary purpose. 1/we understand that the lake and its associated hydropower
station are operated by Duke Energy Lake Services under the terms of a license issued by
the Federal Energy Regulatory Commission (FERC) and that there will be no change in
hydro project operations as a result of the construction and/or use of any facilities that
I/we may be allowed to place within the FERC Project boundary or on Duke Energy Lake
Services -owned property.
11we understand that the proposed private facility will be used only for the purposes
described in the information submitted for approval by Lake Services and other
appropriate governing bodies.
Page 2 of 5
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]Ave understand that this lake is open for use by the general public and that maintaining
safe and lawful public use is one of the primary lake management objectives of Duke
Energy Lake Services.
Uwe understand that the use for which we are applying is a private use and it should not
interfere with the general public's safe and lawful use of the lake.
Ilrve understand that every reasonable effort must be made to minimize any adverse
impact on fish, wildlife, and other natural resources.
Ilwe understand that trees and vegetation growing within the Project boundary play an
important role in the overall environmental condition of the lake. The ecological impact
the vegetation has on the fish and wildlife habitat is necessary to ensure a sound and
healthy lake environment. Uwe also understand that unauthorized removal of shoreline
vegetation (i.e. button bushes, willows, cattails, etc.) and/or disturbance of the shoreline
buffer may result in suspension or denial of lake use permitting requests and require
me/us to re-establish the vegetation if the disturbance is found to be in violation of the
state or county watershed buffer regulations or Duke Energy's Vegetation Management
Requirements.
(For construction on Lake Keowee) 1/we agree that if land disturbing activities are to
occur within the Project boundary prior review/approval from Duke Energy Lake
Services, the State Historic Preservation Office and the Eastern Band of the Cherokee
Indians is required prior to work beginning.
]Ave agree that if any historic or archaeological resources are discovered during
construction of an approved activity the applicant must stop work immediately and
contact Duke Energy Lake Services. Uwe understand that in the event that anyone
discovers a potential site of archaeological or historic significance including any
gravesite within the Project, the individual must immediately notify Duke Energy Lake
Services.
11we agree to notify Lake Services when construction is completed. During the
construction period, the weather-proof "Duke Energy Approved Lake Use Activity" sign
(to be provided by Duke Energy) must be posted at the job site, visible from the water's
edge.
I/we agree to notify Lake Services if the property is sold and provide the name and
address of the new owner.
1/we have included a check for any applicable filing fees, security deposits and copies of
all other necessary permits.
1/we agree that if any action is taken by Duke Energy to enforce any provision, covenant
or agreement contained in this user agreement or Duke Energy Lake Services SMG or if
Duke Energy is required to retain an attorney to enforce any provision, covenant or
agreement contained in this user agreement or SMG (including, without limitation, the
payment of fees due hereunder or the removal of an encroachment constructed in
Page 3 of 5
)ivdraltkesvn/UwsAeramcMlltPrivtivWvNt Facilities Users Aenecmtnl CN KT final 1 1704 uh rcv do, Rev 7.11-10

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violation of this user agreement or SMG), then Duke Energy shall be entitled to recover
all of its reasonable costs associated with such an action, including but not limited to,
attomeys' fees and court costs incurred in such action and/or enforcement.
Ave understand that Lake Services' representatives may issue Stop Work Directives for
any violations of the SMG or engagement in prohibited acts or activities on Duke Energy
Lake Services' property as specifically identified in the SMG. Ywe understand that
persons found to be in violation will be subject to Duke Energy Lake Services sanctions
which can include: 1) restoration of the impacted area at the person's expense; 2) loss of
consideration of any future lake use permitting activities for up to five years for improper
vegetation removal or until vegetation is satisfactorily re-established (even if there is a
change in property ownership); 3) revocation of a previously issued permit and loss of
consideration of any future lake use permitting activities and/or reinstatement of the
revoked permit; A) increases in fees; 5) modification or removal of non -complying
structures; and/or 6) further legal action being taken by Duke Energy Lake Services .
Ave understand that certain activities specified in the SMG are prohibited because of
environmental concerns, boating capacity limitations, safety considerations and other
reasons.
Uwe understand that ownership/interest in a Common Use Facility eliminates the option
for me/xis to also have a separate facility on any other lot within the affected subdivision
that Ave own or lease.
Uwe understand that this lake is open for use by the general public and that maintaining
safe and lawful public use is one of the primary lake management objectives of Duke
Energy Lake Services.
Uwe understand lake use permit holders have the authority to prevent others from
trespassing on the structures they have built. Ave also understand that Ave, however, do
not have any authority to impede anyone from pursuit of the lawful public recreation
enjoyment of FERC Project lands and waters. Except as specified otherwise in the SMG
or other Duke Energy Lake Services documents (e.g. Public Safety Plans), anyone may
fish- around/under structures built by others, may walk/wadeJfish within the FERC Project
boundary or any Duke Energy Lake Services -owned peripheral strip, boat in the lake's
waters, etc. without having to get anyone's permission to do so. Boaters may not block
ingress/egress to piers/docks.
11we agree to exercise all care and due diligence to preserve and maintain the character of
the Duke Energy Lake Services's adjacent property. Ave agree to comply with the Duke
Energy Lake Services Vegetation Management Requirements. Uwe agree further to not
allow sewage, including discharge from septic tanks (or similar facilities) or boat holding
tanks, garbage, trash, or other waste material to be discharged or dumped into the
reservoir, tributaries or adjacent property.
Ave understand that as an adjoining property owner Uwe can make no change in land
form of land within the FERC Project boundary or land owned by Duke Energy Lake
Page 4 of 5
HvdroM"vGOU p$AgmwoeyAbfpf u&WvsK Fadhiia them Avremoo CW K7 rml 1 12 08 iA mala Rev 7-2 1-10

4
Services , such as grading, excavation or filling without prior written approval by Lake
Services.
Mve agree for myself/ourselves, members of mylour family, guests and invitees that 1/ive
assume all risks of personal injury or property damage incident to mylour occupancy and
use of the premises; including but not limited to any personal injury or property damage
which may be sustained as a result of flood waters or in connection with the rise and fall
of water in the reservoir as a result of floods or of the operation of Duke Energy's hydro
electric facilities. Five as the adjoining property owner further agree that 1/14,e will
indemnify, protect, defend, and save harmless Duke Energy from any and all loss, cost,
claims damages, expenses, judgments and causes of action for all injuries and damages
sustained by the members of my/our family, guests, and invitees arising or claimed to
have arisen in connection with their occupancy or use of the Duke Energy Lake Services
-permitted facility(s).
I/We acknowledge that Duke Energy Lake Services has the right to charge reasonable
user's fees for private use of its property and that failure to pay any applicable user's fees
in a timely manner can result in the suspension or cancellation of any previously
approved lake use permit.
11we recognize that Ilwe have the continuing responsibility to ensure that the constructed
structures are maintained in good repair, including, but not limited to maintenance of the
dock and boat slips, and proper erosion control within the permit area and along the
shoreline, and agree to take all reasonable steps necessary to meet this responsibility. Ave
agree to maintain all structures within the Project boundary on Duke Energy Lake
Services - owned property in a sound condition and in a neat appearance and pay all costs
for said maintenance.
Sincerely,
(Applicant'. Name)
Lake Street Address
?-e. I M o.✓ - N c -2901'"7—
City/State/Zip
2901"ZCity/State/Zip Code
-7 t9c.f- 3j 1- s 5 5- _
Lake Phone Number
(Designated Duke Energy Agent)
Applicatpt's Signature
Home Street Address
C ka - W jk- M c Zo Z? '3
City/State/Zip Code
Home Phone Number
zl�Date: �,,
Page 5 of 5
Date:
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