20170961 Ver 1_Shoreline Stabilization_20170803

C�CA� 0_�
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 2 0 1 7 0 9 6 1
r` �, ; ''l C
T
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
Raleigh, NC 27699-1650
I. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: JARRETT J2, KA CLAY
Mailing Address: 8600 CEDAR HOLLOW RD
GREENSBORO NC 27455
Telephone Number: 336-447-9174 Fax Number:
E-mail Address:
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.mil/Portals/59/docs/reaulatory/reRdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: CARISSA PARKER
Company Affiliation: BENNICK ENTERPRISES LLC
Mailing Address: 7836 HWY 70 E
NEBO NC 28761
Telephone Number: 828-659-1000 Fax Number: 828-659-1001
E-mail Address: CARISSA(@BENNICKGRADING.COM
Person to receive the Certification Approval: CARISSA PARKER
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,
etc.), rip rap, excavation or dredging below Full Pond/ Normal Water Level elevations,
FORM: SSGP 10-2013 Page 1 of 4

Q\,aAy
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: MCDOWELL Nearest Town: MARION
Subdivision name or site address (include phase/lot number):
PENINSULA LOT 61
Directions to site - please include road names and numbers, landmarks, etc.:
FROM MORGANTON TAKE HWY 126 / TL ONTO SOUTH MOUNTAIN INSTITUTE RD /
TO LAKE JAMES RD / TL INTO PENINSULA DEVELOPMENT
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): VACANT WOODED LOT AREA
6. Property size (acres): 1.08
7. Lake/ river/ ocean adjacent to property: LAKE JAMES
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): 349' OF SHORELINE STABILIZATION BY BARGE HEIGHT
WILL BE 5'
9. Will work be conducted from land? ❑ 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:
3'X 349'= 1047 SQ FT
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: 2' X 349' = 698 SQ FT
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): 18 TREES LESS THAN 6"
AND 4 TREES GREATER THAN 6" WILL BE REMOVED TO COMPLETE THIS PROJECT. THEY
WILL BE REPLACED INCH FOR INCH, WITH TREES TOTALING THE SAME DIAMETER. ANY
REMAINING DISTURBED AREA WILL HAVE MULCH APPLIED TO IT.
3
Owner/Agent's Si ature* [1 02H .0502(f)1 Dat
Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 3

Full Pond
Shoreline
4;�Yowv-�%'P- cno�
Lake 5a' `mss
At Full Pond,
Please approximately sketch the following information on this plan (provide dimensions foreach
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

JARRETT & JAMIE CLAY
LAKE JAMES
PENINSULA LOT 61
TO: NORTH CAROLINA DIVISION OF WATER QUALITY
I GIVE CARISSA PARKER, OF BENNICK ENTERPRISES, LLC.,
PERMISSION TO SIGN AS MY AGENT ON MY APPLICATION FOR
SHORELINE STABILIZATION.
SIGNA
DATE

.•,vi w}1+µ + 3'� :1'"r"S S8J
Z lb
lawq)
WIVDS IIHdVHJ
To.. - -- quga
aw»as awxa wam ww� xiamcary aru7w swna
3reri 3nma
JTI UNVI SHIIYi
xt� Itlgmnll¢/( Powo
_
`- • y S9 �
53837-iPf
339Fid7
s3mw mn
• ":". spur r,Pl
+ry �� �i r ''cq�a
a(eexw
Lf-tlB J,c\
s3nrr xin
ugm lomm� s®o n cnsm,�
• mumg m Ww-muo -n ~
ss
9-9:Od
LZ Id:X8
a'mW - .tea
Y 5,wi0 'x 90B41K-LZlO
5TI ltvz.L N`JISHU lima mxl l"SkM0910i
lll�m

Jarrett & Jamie Clay
The Peninsula lot 61

Jarrett Clay - Peninsula 61
Pisgah National Forest
n 126
The Peninsula bt 61
vd'�e s Peninsula Dr N y<z
Latitude: 35.75290 N 'A
Lon nude: 81.93000 W N
- rn
Lake James
Omi 0-2 04 n n 1
Copyright © and (P) 1988-2012 Microsoft Corporation and/or its suppliers. All rights reserved. http://www.microsaft.com/streets/
Certain mapping and direction data © 2012 NAVTEQ. All rights reserved. The Data for areas of Canada includes information taken with permission from Canadian authorities, including:
Her Majesty the Queen in Right of Canada, © Queen's Printer for Ontario. NAVTEQ and NAVTEQ ON BOARD are trademarks of NAVTEQ. © 2012 Tele Atlas North America, Inc. All rights
reserved. Tele Atlas and Tele Atlas North America are trademarks of Tele Atlas, Inc. © 2012 by Applied Geographic Solutions. All rights reserved. Portions © Copyright 2012 by Woodall
Publications Corp. All rights reserved.