20170190 Ver 2_Shoreline Stabilization_20170518

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CState of North Carolina
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Department of Environment and Natural Resources
�l1 Division of Water Resources
Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
ENVIRONMENTAL QUALITY FORM: SSGP 02-2017
Shoreline Stabilization Application Form $�
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Three copies of the application (including attachments) and the application fee should be sent to:
If sending via US Postal Service
Karen Higgins
DWR-401 & Buffer Permitting Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
A. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
If sending via delivery service (UPS, FedEx, etc.)
Karen Higgins
DWR — 401 & Buffer Permitting Branch
512 N. Salisbury Street
Raleigh, NC 27604
RECEIVED
Name: Doug Sperr MAY 18 2017
Mailing Address:
711
Belmont. NC28012
Telephone Number: 704-576-4396 Fax Number:
E-mail Address: [e-mail]
2. Agent/ Contact Person Information
PFRMI
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:
htto://www.saw.usace.armv.miI/Portals/59/docs/reeulatory/readocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf)
Name: Don DellaMea
Company Affiliation: Spain Construction, Inc.
Mailing Address: 323 Old Hebron Road
Charlotte, NC 28273
Telephone Number: 704.309.2559 Fax Number:
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.
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)
County: Gaston Nearest Town: Belmont
Lake/ river/ ocean adjacent to property: LakeWylie
Property size (acres): 28,491 sq ft. (.061 acres)
Subdivision name or site address (include phase/lot number): Lot12
1045 Peninsula Drive. Lake Point Subdivision. Belmont NC 28012
Directions to site - please include road names and numbers, landmarks, etc.:
South Point rd South. Rt Lower Armstrong, Rt Peninsula Dr.
Latitude (in decimal degrees) 35.17253 Longitude (decimal degrees) 81.036765
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Undeveloped building new home.
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Shoreline is steep grade and runoff along with shoreline
erosion is dumping red mud into river. Heavy trees have been under washed and are falling in
river. Rip Rap stabilization requested to tie into existing developed lots in community to unify
rip rap shorelines.
7. Will work be conducted from land? YES❑ 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:
1250 sq ft.
Temporary impacts in square feet:
960sgft.
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:
1250 sq ft with a 10'-12' shelf which covers in mulch and rip rap at shore.
Temporary impacts (temporary clearing, construction corridor) in square feet:
1500sgft. Will be placing mulch in pathway.
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): Small variety of small
FORM: SSGP 02-2017 Page 2 of 5

trees along with full grown trees. Birch, Maples, Oak and Poplars.
11. Sig ature
Owner/Agent's Signature' [15A NCAC 02H .0502(f)l Date
`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.
e. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
(Full Pond/ Normal Water Level
Flan
La ke
(At Full Pond/ Normal Water Level)
FORM: SSGP 02-2017 Page 3 of 5

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