20170301 Ver 1_Shoreline Stabilization_20170316

r�ffl State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
ENVIRONMENTAL QUALITY FORM: SSGP 02-2017
04'
Shoreline Stabilization Application Form 2 0 1 7 0 3 0 1
Three copies of the application (including attachments) and the application fee should be sent to:
If sending via US Postal Service If sending via delivery service (UPS, FedEx, etc.)
Karen Higgins Karen Higgins
DWR — 401 & Buffer Permitting Branch DWR — 401 & Buffer Permitting Branch
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699-1617 Raleigh, NC 27604
A. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: Robert (Bob) Victor and Sandra (Sandi) Gail Povlock
Mailing Address: 5 Uppercross Court, Raleigh, NC 27613
Telephone Number: 919-219-9842 (Sandi); 919-949-9049 (Bob) Fax Number: N/A
E-mail Address: [e-mail] or [e-mail]
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter must be attached if the Agent has
signed this application form. (A form can be downloaded here:
http://www.saw.usace.army.miVortals]5.9/d_o_cs/regulatory/regdocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf)
Name: N/A
Company Affiliation:
Mailing Address:
I
Telephone Number: N/A Fax Number: N/A
E-mail Address: N/A
B. 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. See NC WR 12-28-16 Buffer
Determination Letter which includes such maps.
2. Provide a detailed site plan showing property boundaries and proposed locations of
vegetation clearing, buildings, retaining walls, docks, impervious surfaces, 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.
FORM: SSGP 02-2017 Page 1 of 3

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) 1191 Sagamore Road, Louisburg, NC
County: Franklin Nearest Town: Bunn
Lake/ river/ ocean adjacent to property: Lake Royale
Property size (acres): 0.722 acres
Subdivision name or site address (include phase/lot number): Lake Royale Subdivision; Lot
2087
Directions to site - please include road names and numbers, landmarks, etc.: (from Salisbury
Street location) Take 401 N to NC -98E. Continue straight onto E. Jewett Ave/Baptist Church
Rd. to the end. Turn right on Sledge Road, left on Shawnee Drive into Lake Royale entrance.
Turn right onto Sagamore Drive. Property is approximately 3-1/2 miles on left on Sagamore.
(Gated community --please let us know the date/time of any visit so we can notify the guard.)
Latitude (in decimal degrees) 35.965272 Longitude (decimal degrees) -78.193567
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): undeveloped vacant lot in residential area
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Shoreline eroding, vegetation tipping into lake. Cut notch into
shoreline approx. 20'd x 36'w for double boathouse (boathouse will then extend 10' over lake
from shoreline); install bulkhead (vinyl or wood but possibly steel) across shoreline and inside
notched area; construct a covered 1O'd x 14'w deck to one side of the boathouse; from each
side property line inward to the covered deck area/boathouse a 6'-10' deep decking will be
constructed over lake w/pylons set (anticipate decking to be 6' deep). (Survey to shoreline tie
lines notes shoreline as 158.16')
7. Will work be conducted from land? ® From water? ❑
8. Total amount of impacts below the normal pool lake level / Normal Water Level
Permanent impacts (including all excavation, backfill, rip rap, retaining walls, etc.) in square feet:
1O'd x ^36'w of boathouse will be below normal pool lake level from shoreline (-360 s.f.) [-20'd x
—36'w area will be excavated above normal pond for rest of boathouse]; install bulkhead (vinyl or
wood but possibly steel) across shoreline and in interior of notched boathouse area (^'198' of
bulkhead with —122' at shoreline (-102 s.f.); set landscape fabric; backfill with dirt/gravel as
needed but not more than regulations restrict (-122-244 s.f.); build 10'd x 14'w covered deck
(treated wood or composite) to one side of boathouse (140 s.f.); set pylons with decking (treated
wood or composite) to extend no greater than 10'd over water (anticipate 6'd) running from
boathouse side and covered deck side to each property line (depending on decking depth s.f.
could range from —648 s.f. (if 6'd) to 1081 s.f. (if 1O'd). (see diagram)
Temporary impacts in square feet:
FORM: SSGP 02-2017 Page 2 of 5

9. Total amount of impacts above the normal pool lake level / Normal Water Level and 50 feet
land -ward
Permanent impacts (including back fill, excavation, rip rap, retaining walls, etc.) in square feet:
Excavate ^20'd x —36'w area (-720 s.f.) for boathouse (remainder of boathouse will set 10' out
from shoreline); see bulkhead/backfill details (see details in #8 above); 0' to 1' off and down
each side property line a fence will be installed in future for child/pet safety and fencing will
also run parallel to shoreline in one of two ways as shown on diagram (^'129 s.f.); utility
trench(es) for boathouse will also be needed; clearing —10' perimeter around structures;
possible random stepping stones/permeable pavers may be added in future from house down
to boathouse
Temporary impacts (temporary clearing, construction corridor) in square feet:
Silt fence parallel to shoreline (-79 s.f.)
10. 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): some pines and various other
tree species, some brush, some vines
11. Signature
3/
Owner/Agent's Signature` [15A NCAC 02H .0502(f)] D6
*Agent's signature is valid only if an authorization letter from the owner is provided.
12. Please approximately sketch the following information on this plan and provide dimensions for
each item:
a. All proposed vegetation clearing
b. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
c. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
d. Location of any proposed structures such as buildings, retaining walls, docks, etc.
FORM: SSGP 02-2017 Page 3 of 5

�4. Project Information
Vicinity Map: Vacant Lot at 1191 Sagamore Drive, Louisburg, NC (Lake Royale Lot 2087)
d 1191 5.9.- Dan'
From Franklin Countv GIS website:

WaterResources
ENVIRONMENTAL QUALITY
December 28, 2016
William and Lynne Wood
255 West End Dr.,
Unit 2411
Punta Gorda, FL 33950-5363
PAT MCCRORY
Govemor
DONALD R. VAN DER VAART
Secretary
S. JAY ZIMMERMAN
Director
Subject: Buffer Determination Letter
TPBRRO #16-422
Franklin County
Determination Type:
Buffer
Intermittent/Perennial
❑ Neuse (15A NCAC 26 .0233)
Start@
® Tar -Pamlico (15A NCAC 2B .0259)
0 Intermittent/Perennial Determination (where local buffer
USGS
ordinances apply)
❑ Jordan (15A NCAC 2B.0267)
(governmental and/or intedurisdictional
projects)
Surve
Project Name: 1191 Sagamore Dr
Address/Location: 1191 Sagamore Dr.
Louisburg, NC_
Stream(s): Unnamed tributary to Lake Royale
Determination Date: 12/28/2016 Staff: Joan Schneier
iFeature
E/I/P*
Not Subject
Subject
Start@
Stop@
Soil
USGS
I
Surve
To o
Lake
X
Off Property to
Off Property
X
X
Royale
North
to South
Stream A
X
Entire stream
Lake Royale
X
No
off property
*E/IIP = Ephemeral/IntermittentIPerennial
This nroaerty meets the criteria for Session Law 2012-200.
Explanation: The stream(s) listed above has been located on the most recent published NRCS Soil Survey of
Franklin County, North Carolina and/or the most recent copy of the USGS Topographic map at a 1:24,000 scale.
Each stream that is checked "Not Subject" has been determined to not be at least intermittent or is not present.
Streams that are checked "Subject" have been located on the property and possess characteristics that qualify it to be
at least an intermittent stream. There may be other streams located on the property that do not show up on the maps
referenced above but may be considered jurisdictional according to the US Army Corps of Engineers.
Division of Water Resources, Raleigh Regional Office, Water Quality Operations Section http://portal.ncdenr.org/webiwq/aps
1628 Mail Service Center, Raleigh, NC 27699-1628 Phone: [phone]
Location: 3800 Barrett Drive, Raleigh, NC 27609 Fax: [phone]

1191 Sagamore Dr
Franklin County
12/28/2016
Page 2 of 2
This on-site determination shall expire rive (5) years from the date of this letter. Landowners or affected
parties that dispute a determination made by the DWR may request a determination by the Director. An
appeal request must be made within sixty (60) days of date of this letter. A request for a determination by the
Director shall be referred to the Director in writing. If sending via US Postal Service: c/o Karen Higgins;
DWR — 401 & Buffer Permitting Unit, 1617 Mail Service Center; Raleigh, NC 27699-1617. If sending via
delivery service (UPS, FedE_r, etc.): Karen Higgins; DJVR — 401 & Buffer Permitting Unit; 512 N. Salisbury
Street, Raleigh, NC 27604.
This determination is final and binding unless, as detailed above, unless an appeal is requested within sixty
(60) days.
This project may require a Section 404/401 Permit for the proposed activity. Any inquiries should be
directed to the US Army Corp of Engineers (Raleigh Regulatory Field Office) at (919)-554-4884.
If yo ve questions regardi this de ermination, please feel free to contact Joan Schneier at [phone].
i
Sincerely,
V
Danny Smith
Supervisor, Water Quality Regional Operations Center
cc: RRO DWR File Copy
Sandy & Bob Pavlock, 5 Uppercrust Ct; Raleigh NC 27613-8702

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REFERENCES: Lot 2087, Lake Royale Subdivision
Deed Book 1225, Page 348
Deed Book 1815, Page 638
Deed Book 2006, Page 778 — Restrictive Covenants
Plat Record File 1, Slide 104—A
Tax Record No. 022684
LEGEND: • . . found iron as noted
0. . . set iron as noted
------------------ . . 100—year flood limits line
— — — — — — —. . . property line plotted from record
. . . easement line
NOTE: N.C. Grid station unavailable within 2000' at this time.
NOTE: This survey is subject to all easements, agreements,
rights—of—way and restrictive covenants recorded prior to
the date of this survey.
NOTE: Area of Lot = 0.722 Acre (Coordinate Method)
NOTE: 100—Year Flood Limit line copied and plotted from FEMA DFIRM
"Franklin County, NC", Map No. 3720283000K, effective 01/16/13
I, William T, Dement, Jr., certify that this map was drawn under my supervision from an
actual survey made under my supervision (deed description recorded in Book 1225, Page
348 & Book 1815, Page 638); that the boundaries not surveyed are indicated as drawn
from information in Plot Record File 1, slide 104–A: that the ratio of precision is 1/
20,000; and that this map meets the requirements of The Standards of Practice for Land
Surveying in North Carolina (21 NCAC 56.1600). This 3rd doy f Januo 2017.
C
Professional Land Surveyor L-1456
`',�pUtn4lppi
FSSfO,,,Z/�q
SEAL
4- L-1456
Found 1/2- Iran V�
Pipe ./Top 3 -
Belo. Ground
Sun—
H
G Tp `
( 2089 ) „• 5
RECORD NORTH
( P.R.F. 1, S. 104—A)
N� ✓
J .00
O d•
i O
NoorFormerly F— 1/2- Iron i
Freddie J. Sloanim, et al "eP` "�p�• k
( D.B. 2037, P. 168) %deae \
100–Year Flood Limits
( See Notes ) Foune 1/2' Iron( 1 Eos- g
—n
r G
\\ SuA ca routl
1 E
SetIron Rebar
/Topep t'
Ground Surtatt
Edge of Lake— �
High Water Mark of Lake
0,
o
Is Property Llne
so
a
— LAKE ROYALE
�
LAKE
ROYALE
l
I
1
Tie Line From Found Mag Nail In
V Apparent Centerline Intersection of
Sagamore Drive & Mayan Drive:
S 14.01.40-E 316.35'
Chd.: S 28.51'45"E 54.71'
L=54.98' R=160.00'
\ \'-�
Chd.; S 48'32'45'E
\54.71 1 \
Set 5/e• I on �
/ Ab— Grcur
sar,eae
2087 Ab /
Fouts 1/2-
nor.%�aGr�w�e
O �O / Surf-
2086
unave
ro
Now orFormerly( 2085 )
Lawrence L.
Creech, Jr.
( D.B. 1784, P. 844 )
Found 1/2- Iron
Reber x/Top 2 -
Bela" Grouts
Surface
Edge of take
Now or Formeny
Lake Royale P.O.A., Inc.
( 0.8. 1803, P. 923 ) 5a \
sN s/a- Iran Rebar ` 50' Tar River Basin
c�� a sue / Riparian Buffer
PLAT OF BOUNDARY SURVEY FOR
ROBERT POVLOCK & WIFE, SANDRA
(Property Owner — William Wood, at ux) POVLOCK
Cypress Creek Township, Franklin County, North Carolina
Scale: 1"=60' Date: January 3, 2017
60 0 60 120 180
GRAPHIC SCALE — FEET [NOTE..O,:ner's name shown for indexing
purpoesonlyand doesnot constitute
Surveyed & Mapped By title ertification_
WILLIAM T. DEMENT, JR., Professional Land Surveyor, P.A.
L-1456, C-0649
(0)919-496-6159 (M)919-496-9502
102 West Nash Street Louisburg, N.C. 27549 (File No. 3752)

� � r• V
PRELIMINARY PLAT — Not jp' Recordation, e or Sales
Now or Formed Found 1/2' Iron
y Pipe /Top 2" 7�„ Calculated Point
Freddie J. Sloanim, el al Above Ground In Power Pole
( D.B. 2037, P. 168) Surface Chd.: S 28'
t L=54.98
100—Year Flood Limits e(INet1 a 91�
( See Notes ) Found 1/2" Iron �1 ILO
Below Ground
1" ,`'ol t0��29/ Ng a
\ Surface round O, V 10 3
1 40„� Zq�O
I � 06 Chd.: S 48'32'45"E
54.71'
Set 5/8" Iran Rebar 1 N �� '/ /
Gr Top 1" Above 1` �.
Ground Surface �� � ,0 �. \`
Set 5/e"boon
moo
qg j3 x o ae ' P. / Rebar p r
g Yj qj g. Gro Above Ground
> �, / Surface /
\ J
i"� \ N. Oj• / Found 1/2' Iron
Edge of Lake �. G i �l ti� � e�` /� Rebar w/Top
1 ' Flush w/Ground
High Water Mark of Lake `.\ �.� w �Q5 Surface
Is Property Line O, o \ >• O
SOsm el�� \86
\KA Nowor
Formerly ( 2085 )
�g�0 Lawrence L.
LAKE ROYALE C'@ Creech, Jr.
(.P 0` D.B. 1784, P. 844 )
�•_/ Pound 1/2" Iron
Bellow Gba ond
Q1 Surface
Edge of Lake j 1-1
Now or Formerly
Lake Royale P.O.A., Inc. 1 \\
( D.B. 1803, P. 923 ) 1 y0R\
Set 5/8, Iran (Rebar \ 50' Tar River Basin
w/Top Flush w/ Riparian Buffer
Ground Surface
W c des n o+iia-Y-� � a� P�a-Vie___ w r JAS_

LAKE
Bob & Sandi Povlock
1191 Sagamme Drive (vacant lot)
Louisburg, NC
Double Boathouse approx. 36'w x 30'd
(Lake Royale Subdivision, Lot 2087)
(w/metal roof with 8'w x 36'I upper widow's walk across lakefront;
919-219-9842; 919.949.9049
10'd of boathouse extends into water & 20'd notched into land)
s� aeddnx to run to aide preverty line ^sl'
Decking to nun to side property Nne `St'
-51
10'd x
(shown here as -22- due to pate space llmnatimsj
14'w I
covered deck c
CL
a, _
(metal
roof)
�
w
00
Two
Boat slip
separate
---
10"d bulkhead with 6'd decking will run to side +w
a'w a,w
PWC slips
10"d bulkhead with 6'd necking will run to side
property line (survey notes 158.16' shoreline) decking
de&ins d«k,
property line (survey notes 156.16' shoreline)
(Cleared/shaded area approximately 10'
(Geared/shaded area approximately 10'
around structure perimeters)
around structure perimeters)
Fence (0' to 1' off property line
Fence (0' to 1' off property line
Ste= within restrictions with clearing
F [ bulkhead
within restrictions with clearingr='
_ along fence line as needed)
along fence line as needed)
bulkhead
ria Fence will either rvnnear/around boathouse
°pt1OA'p�`�O1f
area, then ocross/near bock of shoreline
decking to each side property fine OR will
_
run straight arrass from the back of the
boathouse to rrc h to ride property Ger
f0eared/shoded area approximately 10' around structure perimeters)
w w Structure dimensions are approximate
i
� based on builder and may be adjusted
A slightly in field (but not more than
regulations allow) (drawing is to scale)
$g ' �I
LAND
h�
N'% �w
p `Q ^
i A
it
/I
Tapering property lot lines @ 50' from shore = per survey
l qlr ry

Bob & Sandi Povlock
1191 Sagamore Drive (vacant lot)
Louisburg, NC
(Lake Royale Subdivision, Lot 2087)
919-219-9842;919-949-9049
'" sl' Decking to run to side property line -51'
a
CD Q!
3 d
go
10"d bulkhead with 6'd decking will run to side
property line (survey notes 158.16' shoreline)
(Cleared/shaded area approximately 10'
around structure, perimeters)
Fence (0' to 1' off property line
within restrictions with clearing
along fence line as needed)
Cil
LAKE
Double Boathouse approx. 36'w x 30'd
(w/metal roof with 8'w x 361 upper widow's walk across lakefront;
10'd of boathouse extends into water & 20'd notched into land)
-5 .-0 36'-0" 11 14'-0„ i
Decking to run to side property line - 52'
J-• Y (shown here as -22' due to page space limitations - a 52'
10'd x 14'w
c o
A covered deck n
'o (metal roof) o,
'-r n
Two 0n
Boat slip separate
4'w 4'wPWC slips 4'w 30"d bulkhead with 6'd decking will run to side
decking decking deckin property line (survey notes 158.16' shoreline)
(Cleared/shaded area approximately 10'
N
A around structure perimeters)
�Z
a
Fence (0' to 1' off property line
N A
E bulkhead within restrictions with clearing
along fence line as needed)
bulkhead A F.pli.naTme7t nR Fence will either run near/around boathouse
ea area, then across/near back of shoreline l
decking to each side property line OR will /
run straight across from the back of the /
boathouse to each to side property line _
(Cleared/shaded area approximately 10' around structure perimeters)
d� G
o
0 0
x -0
Structure dimensions are approximate
0mo
based on builder and may be adjusted
..Q
o ?
slightly in field (but not more than
r 0
regulations allow) (drawing is to scale)
0-
LAND
J >�
Tapering property lot lines @b 50' from shore = per survey
I tit r / y

e. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
Full Pond/ N"
Shoreli
Plan View
Lake
(At Full Pond/ Normal Water Level)
Lake
NhAPxdJH—WwaterLee4 Existing Dock
/ 36ft.7h
3ft.ISOh
Full Pond(Normal Water Leve) W"fu0 o�/Nw3
. r r r �..s
�hore�ne
Riprap Ab—NU «a/Nvr
2 ft.. I W ft.
! mkkt , deer.p�
i• M rrrevaary
EXAMPLE
f
I
Plan View
M
FORM: SSGP 02-2017 Page 4 of 5

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RE: Meet Sandy Povlock - Sandi Povlock
RE: Meet Sandy Povlock
Williams, Andrew E CIV USARMY CESAW (US) <[e-mail]>
Thu 1/26/2017 10:22 Ar.
Sandi Povlock <[e-mail].
Mrs. Povlock:
Pagel of 2
The only letter I would write would say there are waters of the US on the lot (the lake) and that if you are going to place any fill material
below the ordinary high water mark of the lake, you would need a permit.
If you end up applying for a permit, we have a file regarding my visit and there wouldn't be a need for another site visit.
Andrew Williams
Regulatory Project Manager
U.S. Army Corps of Engineers
3331 Heritage Trade Drive: Suite 106
Wake Forest North Carolina 27587
919-554-4884 ex. 26
-----Original Message -----
From: Sandi Povlock [mailto:povlocks [e-mail]
Sent: Thursday, January 26, 201710:08 AM
To: Williams, Andrew E CIV USARMY CESAW (US) <[e-mail]>
Subject: [EXTERNAL] Re: Meet Sandy Povlock
Andy is there any type of inspection letter we are to receive from your visit to the lot?
Thanks for your help.
Sandi
From: Williams, Andrew E CIV USARMY CESAW (US) <[e-mail]>
Sent: Wednesday, January 11, 2017 11:34 AM
https://outlook.live.com/owa/?viewmodel=ReadMessageltem&ItemID=AQMkADAwATE2MTUwLTk2Y... 2/27/2017

RE: Meet Sandy Povlock - Sandi Povlock
To: [e-mail]
Subject Meet Sandy Povlock
When: Friday, January 13, 2017 9:00 AM -10:00 AM.
Where: 1191 Sagamore Drive, Louisburg, NC
919-219-9842
[e-mail]
' Page 2 of 2
hapsWoutlook.live.com/owa/'h►iewmodel=ReadMessageltem&ItemID=AQMkADAwATE2MT[J'*LTk2Y...- :2/272017

Version 12/22/2016
Office Use Only:
USACE Action ID No.
DWR No.
�oi
Form Version Dec. 2016
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A
Applicant Information
1. Owner/Applicant Information
Name: Robert (Bob) Victor and Sandra (Sandi) Gail Povlock
Mailing Address: 5 uppercross court, Raleigh, NC 27613
Telephone Number: 919-219-9842 (Sandi); 919-949-9049 (Bob) Fax Number: N/A
E-mail Address: [e-mail] and [e-mail]
2. Agent/Consultant information (A signed and dated copy of the Agent Authorization letter must be
attached if the Agent has signatory authority for the owner/applicant.)
3.
Name: N/A
Company Affiliation:_
Mailing Address: N/A
Telephone Number: N/A Fax Number: N/A _
E-mail Address: N/A
II. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local landmarks such as
towns, rivers, and roads. Also provide a detailed site plan showing property boundaries, and development
plans in relation to surrounding properties. Both the vicinity map and site plan must include a scale and north
arrow. The specific footprints of all buildings, impervious surfaces, or other facilities must be included. If
possible, the maps and plans should include the appropriate USGS Topographic Quad Map and NRCS Soil
Survey with the property boundaries outlined. Plan drawings, or other maps may be included at the
applicant's discretion, so long as the property is clearly defined. For administrative and distribution purposes,
the USACE requires information to be submitted on sheets no larger than 11 by 17 -inch format; however,
DWR may accept paperwork of any size. DWR prefers full-size construction drawings rather than a
sequential sheet version of the full-size plans. If full-size plans are reduced to a small scale such that the final
version is illegible, the applicant will be informed that the project has been placed on hold until decipherable
maps are provided. (See attached NC Water Resources Buffer Determination Letter dated 12-28-16 for maps.)
.Location 1191 Sagamore Drive, Louisburg, NC (vacant lot)
County: Lake Royale, Franklin County Nearest Town: Bunn
Subdivision name (include phase/lot number): Lake Royale Subdivision; Lot 2087
Site coordinates:
Decimal Degrees (6 digits minimum): °N 35.965272 OW(rieg,) -78.193567
Directions to site (include road numbers/names, landmarks, etc.): Highway 98E. Continue straight on to
E. Jewett Ave./Baptist Church Road. Tum right onto Sledge Road, left on Shawnee Drive into Lake Royale Subdivision. Turn
right onto Sagamore Drive. Lot is approx. 3-1/2 miles on left on Sagamore. (Gated community, so let us know the date/time
someone plans to arrive so we can notify the guard.)
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Version 12/22/2016
3. Property size (acres): 0.722 acres
4. Name ofnearest named receiving body of water(stream/river/lake): Lake Royale
5. Describe the purpose of the proposed work: install bulkhead, build a double boathouse, build a covered deck section,
build decking across remaining shoreline install fencing along side lot lines and parallel to shoreline area
6. List the type of equipment to be used to construct the project: excavator/dozer/backhoe, air compressor,
chainsaws shovels hand tools, silt fencing, etc.
7. Type and amount of impact (including all back fill, excavation, riprap, retaining walls, other fill,
eettCC 11 hee�ow the normaJtgcto� lake level i s�ua f��t ��lac ets and distance �rom shoreplir�g (see diagram)
f0 d'�(=36 w of boathouse will a ow normal poo ake ve s.. res o boa ouse wi e a ove norma oo ake level];
bulkhead (vinyl/wood/steel) across shoreline an in interior of boathouse notched area (-198' of bulkhead x 10")(-165 s.f.); set landscape
fabric; backfill w/dirt/gravel as needed, but not more than regulations restrict (-122-244 s.f.); build 10'd x 14' covered deck (treated wood or
composite) to one side of boathouse (140 s.f.); set pylons w/decking (treated wood or composite) to extend no greater than 10'd (anticipate 6'd)
over water running from either side of boathouse to property lines (-648 s.f. if 6'd- -1081 s.f. if 10'd), clear -10' around perimeter of structures.
8. a..Type and amount ofimpact (including all clearing, back fill, excavation, riprap, retaining walls,
other fill, etc.) above the normal pool lake level and 50 feet land -ward in square feet or l :J,pres:
Excavate -20'd x -36'w area (-720 s.f.) for boathouse (remaining 10' is out from shoreline); fence sifting 0'-1' from property line will be installed at later date for
child/pet sa e y (-129 s.. ; utility renc needed o boathouse; possible tuture random stepping stones/permeable pavers house down to boaffiouse
b. Please describe the vegetation above the normal pool lake level and 50 feet land -ward to be
impacted (number of trees for instance): pine and various trees, some brush, some vines
Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
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7. Type and amount of impact ... below normal pool lake level..:distance from shoreline...
• Excavate area approximately 36'w x 30'd for double boathouse. Boathouse will be —36'w x —30'd and project
10' out from the shoreline with —20' notched into the land. 10'x —36' will be below normal pool lake level
(-360 s.f.)
• Install bulkhead and cap (vinyl, wood or possibly steel) across shoreline to each property line and in —20'
notched out area to control erosion. —198' length of bulkhead total with —122' at shoreline x 10" thick = —102
s.f.)
• Install landscape fabric at bulkhead
• Backfill at bulkhead as needed with dirt/gravel within regulation limitations (-122-244 s.f.)
• Build a 10'd x 14'w covered deck area to one side of the boathouse (140 s.f.)
• Build decking 6'd (but no more than 10'd) out from bulkhead over water and running from boathouse side
and from covered deck side to each side property line (-648 s.f. --1081 s.f.)
• Future fence will be installed down each property line (per restrictions and setback requirements) and run to
(and possibly onto) the decking built on the lakeside property lines; fence will also run parallel to shoreline
(either where the land meets the seawall and around notched out boathouse or at back of boathouse and
straight across to property lines in buffer zone 1)
S. Type and amount of impact -above normal pool lake level and 50' landward...
• As noted in no. 7 above, area will be notched inland —20' for a double boathouse x —36'w and excavated in
depth as necessary for boats; bulkhead will be installed at shoreline and in notched area and backfilled with
dirt/gravel within regulation requirements. Notched area of —20'd x —36'W = 76'1 bulkhead @ 10" thick or —63
s.f.
• Future fence will be installed parallel with or at each side property line (per restrictions and setback
requirements), running throughout the 50' buffer ( and possibly onto the decking), fencing will run parallel to
shoreline either at shoreline and around boathouse, or one straight run across at the back of the boathouse
(see diagram)
• Utility trench(es) to run in 50' buffer
• Possibly random stepping stones/permeable pavers placed for path to boathouse
• Vegetation clearance of —10' from structures. Diseased trees in danger of causing damage to structures or
persons will be removed and stumps ground to limit soil disturbance.

Version 12/22/2016
Full Pond/
Normal Water Level
Shoreline
Ste a 4-ae-ilA
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rJ
Plan View
Lake
(At Full Pond/ Normal Water level)
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(( ice, _ iv coo (�((� Z11' �►D<t�
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V, c,4 c u �k
10( C-�t-U i
LUc,t- Z' I'
Cross Section View
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