HomeMy WebLinkAbout20170930 Ver 1_Shoreline Stabilization_20170727Water Resources
ENVIRONMENTAL QUALITY
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SSGP 02-2017
Shoreline Stabilization Application Form 2 0 1 7 0 9 3 0
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)] RECEIVED
1. Owner Information 'I'I_. 2 7 2017
Name: Thomas (Scott) Pleune DENR-LAND QUALITY
Mailing Address: 2400 Lake Adger Pkwy STORMWATER PERMITTING
Mill Spring, NC 28756
Telephone Number: 828-894 3901 / 215-510-6361 Fax Number:
E-mail Address: tspleune@aol.com
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:
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Address:
Fax Number:
B. Project Information [15A NCAC 02H .0502(a) & (b)]
1. A h a vicinity` p (i.e. street map) clearly showing the location of the property with
respect to local landmarks such as towns, rivers, and roads.
2. Provi a detailed site plan showing property boundaries and proposed locations of
egetation clearing, Ichngs, 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. Ata photogra h f the shoreline/ buffer proposed to be stabilized. (Include a scale of
4",_
some sort- a yard stick, shovel handle, etc.)
4. Location of the property (where work is to be conducted)
County: Polk Nearest Town: Mill Spring & Columbus
Lake/ river/ ocean adjacent to property: Lake Adger - on the Green River System
Property size (acres): 2.5
Subdivision name or site address (include phase/lot number): Lake Adger Community
Lot D -;W- 30
Directions to site - please include road names and numbers, landmarks, etc.: Rt. 9 -
to Garra Rd. - to L.A. Entrance (Greens Hills Rd.) - to Lake Adger Pkwy t0 2400.
Latitude (in decimal degrees),
Longitude (decimal degrees)
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): all Residential Housing
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): The sandy shore -line is badly eroding along the lake shore.
In my case it is only a about 10 –15 feet – as most of my shore -line is solid Granite.
7. Will work be conducted from land? ❑ From water? XX
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:
15 linear feet along the shore -line – by 4 feet in height. 3 feet below the high water
id 1 foot above the hieh water level – 911.6 feet
Temporary impacts in square feet: This 15 linear feet by 4 feet would equal 60 square feet of
impact along the shore -line – no back -fill or change in the shape of or location of the shore-
line.--_--------- — -- _------
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:
No impact, other than the row of river rock approx. 1 foot above the water level.
Temporary impacts (temporary clearing, construction corridor) in square feet:
None - all work done from the lake
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): Nothing will be removed
or damaged in this area All natural wild growth along the Lake Shore has been preserved.
NO changes in the Peripheral Stip.
FORM: SSGP 02-2017 Page 2 of 5
11. Signature
XasScottrPleune /17
Owner/Agent's Signature* [15A NCAC 02H .0502(f)] 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
s , i
Full Pond/ Normal Water Level i
Shoreline/� ;i
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6",
Plan
La ke
(At Full Pond/ Normal Water Level) /
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FORM: SSGP 02-2017 Page 3 of 5
La ke
(At Full Pond/ Normal Water Level)
Side View
10 ft. bank
height
Side View
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3 ft. below full pond water level 4 ft. above full pond water level 2 ft. additional clearing
if necessary
Existing bank
FORM: SSGP 02-2017 Page 4 of 4
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