20170367 Ver 1_Shoreline Stabilization_20170330

2 0 1 7 0 3 6
State of North Carolina
N; Division of Water Resources
Department of Environment and Natural Resources
Water Resources 1SA NCAC 02H -OSOO — Water Quality Certification, Shoreline Stabilization
ENVIRONMENTAL QUALITY FORM: SSGP 02-2017
Shoreline Stabilization Application Form
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
@ 1E ow
A. Applicant Information [15ANCACO2H.0502(a)]
1. Owner Information MAR 3 0 2017
Name: PETER HATHAWAY
ES U S
Mailing Address: 3978 BURTON LANE DENVER NC 28037 kDE -WA
INIG�
Telephone Number: 704-575-2287 Fax Number: ri a
E-mail Address: [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.mil/Portals/­59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf)
Name: MICKEY LARSON /LAKE NORMAN DREDGING & MARINE CONSTRUCTION, IN
Company Affiliation: OFFICE MANAGER
Mailing Address: PO BOX 3156 MOORESVILLE NC 28117
Telephone Number: 704-664-1010 Fax Number: 704-664-6232
E-mail Address: [e-mail]
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.
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.
3. Attach a photograph of the shoreline/ buffer proposed to be stabilized. (Include a scale of
some sort- a yard stick, shovel handle, etc.)
FORM: SSGP 02-2017 Page I of 3

4. Location of the property (where work is to be conducted)
County: LINCOLN Nearest Town: DENVER
Lake/ river/ ocean adjacent to property: NORMAN
Property size (acres): 0.42
Subdivision name or site address (include phase/lot number): CATAWBA SPRINGS LOT A
Directions to site - please include road names and numbers, landmarks, etc.: SEE ATTACHED
Latitude (in decimal degrees)_15.154257 Longitude (decimal degrees)_&0.970972
Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): RESIDENTIAL
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): DELIVER & INSTALL APPROX 45 TONS OF CLASS B RIP/RAP BY
BARGE TO BARE SPOTS, STABILIZE SHORELINE & PREVENT FURTHER EROSION
7. Will work be conducted from land? F] From water? K
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:
,2/
Temporary impacts in square feet:
9. Total amount of impacts above the normal pool lake level / Normal Water Level and 50 feet
land -ward
Permanent imDacts (including back fill, excavation, rip rap, retaining walls, etc.) in square feet:
/I f
Temporary impacts (temporary clearing, construction corridor) in square feet:
WIA
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): A[/A
11. Signaturpe
2A, 17
Owner/A rit"s pignatur *[115ANCACO2H.0502(f)] Date
'Agent's signature is valid only if an authorization letterfrom the owner is provided.
12. Please approximately sketch the following information on this plan and PrOvide dimensionsfor
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
FORM: SSGP 02-2017
Page 2 of 4

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.
e. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
Lake
(At Full Pond/ Normal Water Level)
T3
Full Pond/ Normal Water Level, I)o
Shore'line
Plan View
FORM: SSGP 02-2017 Page 3 of 4
Lake
JAI Full PorxV Nomlal MW
L—ll1l
Existing Dock
30 ft. 7 ft
3 ft . 150 ft
Full fLnd./N�= fr:�atZlevel
8.1— full P-& Nwi,
+ —
I
—
�ft� 150 ft
Riprap
Ab� full PWd/ NWL
2 ft- x M I'L
addltfi�) cclear"OV
if --ry
E
A M
P"'L
E
Plan View
FORM: SSGP 02-2017 Page 3 of 4

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- AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. _A_ PLAN NO.
-----------
Wo WX-��A
Please print:
Property Owner:
Property Owner:
PARCELID: - 1;,L?
The undersigned, registered property owners of the above noted property, do hereby authorize
(Contractor / Agent) (Nam f cons�ultirg r�lrm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property owner's Address (if different than property above):
Qaxwe,
Telephone:
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
re
YA' ed Signa Authorized $Ignature
Ig
Date:

� Robert T. I(Ow. Pto(css:orbW Land Steveyor certify ftat Ws plot VICINITY
;s d-a&m frwn am, miud s�te w�vey by ,,s of the physical moroments SKETCH
%V -ch we re*4vmt to ttm deeds rated. Wwwements. and obV�
*Qs4m*M$' hD& ver; vwbstfvtd easetnents rmy ";St. %nes not surveyed
we dr.— as 0:1.d, 1ft the all. .1 ,echim U'otad as 1 10.001)
that Me pgot Is do� A accardocs -. th cor,ended.
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P.O. Box 1583 RLS L-3145
GASTONIA, NC 28053
F-0983
ROBERT HURST
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PETER HATHAWAY
APRYL HATHAWAY
DEED BOOK 729 PAGE 233
NEAR CITY OF DENVER
CATAWBA SPRINGS TWSP., LINCOLN CO., N.C.
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Lv bing maps
Bing Maps - Directions, trip planning, traffic cameras & more
A Marshall Steam Station, 8320 Nc Highway 150 E, Terrell, NC 28682
B 3978 Burton Ln Denver, NC 28037, 3978 Burton Ln, Denver, NC 28037
;Peter Hatahway
A Marshall Steam Station
26 min, 13.7 mi
Light traffic (24 min without traffic)
Via NC -150, NC -16
1—
1.
Depart NC -1 SO toward Kiser Island Rd
6.7 mi
4.6 mi
2.
Turn left onto NC -16/ NC -16 BR/S NC 16 Hwy
Pass BP in 3.0 mi
3.
Turn left onto Webbs Rd
1.7 mi
4.
Turn right onto Burton Ln
0.8 ml
5.
Arrive at Burton Ln on the left
The last intersection is Westcape Dr
If you reach Holly Ct, you've gone too far
B 3978 Burton Ln Denver, NC 28037
Mps:llwww.bing.com/MapWdoWtaspx?rtp=adr.-pos.35.514232635498--80.9708709716797-3978+Btrt0n+LnOlo2c+Deriver%2c+NC+28037-3978+Burton+Ln... U2

3/24/2017 Bing Maps - Directions, trip planning, traffic cameras & more
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These directions are subject to the MicrosoftdD Service Agreement and are for informational purposes only. No guarantee is made regarding their completeness or accuracy.
Construction projects, traffic, or other events may cause actual conditions to differ from these results. Map and traffic data Oc 2017 HERE-.
https://www.bi ng.com/m aps/defaultaspx?rtp=adr.- pos.35.514232635498-80.97087097167973978+ Burton+ Ln%2c+ Denver%2c+ N C + 280373978+ Burton+ Ln. . . 2/2