20170274 Ver 1_Shoreline Stabilization_20170308

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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
Four copies of the application (including attachments) and the application fee should be sent to:
Division of Water Resources
401 & Buffer Permitting Unit
1650 Mail Service Center ~ Y
Raleigh, NC 27699-1650
I. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: Joseph C. Patterson
Mailing Address: 1235 Squire Drive
Charlotte, NC 28211
Telephone Number:
E-mail Address:
704-365-2909 Fax Number:
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.armv.miI/Portals/59/docs/reRulatory/reRdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: Leah Smith
Company Affiliation: Rowboat Dock and Dredge
Mailing Address: 858 Williamson Road
Telephone Number:
Mooresville, NC 28117
704-663-3478 Fax Number: 704-663-5298
E-mail Address: [e-mail]
Person to receive the Certification Approval: Leah Smith
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 4

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): The Farms Lot 456
397 Grasshopper Circle Mooresville, NC 28117
Directions to site - please include road names and numbers, landmarks, etc.: 1-77 S to
exit 35, left on Brawley School Road, right on McKendree Road, right on Grasshopper Circle
S. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): resedential
b. Property size (acres):
75 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): _Install rip rap wedged along approximately 164' of
shoreline
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:
Rip Rap- 492 sq. ft. (3' wide x 164' long)
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:
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):
414,4.4 el 3/2-/17
ner/Agent's Signature* [15A NCAC 02H .0502(f)] Date
Agent's signature is valid only if on authorization letter from the owner is provided.
FORM: SSCP 10-2013 Page 2 of 3

Ft
Norma
SI
La ke
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ft x 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