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Home My WebLink About20171025 Ver 1_Shoreline Stabilization_20170815State of North Carolina Department of Environment and Natural Resources Division of Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization i7ivision oi ydater Resources FORM: SSGP 10-2013 Shoreline Stabilization Application Form Three copies of the application (including attachments) and the application fee should be sent to: Division of Water Resources 401 & Buffer Permitting Unit 2 0 1 7 1 0 2 5 1617 Mail Service Center Raleigh, NC 27699-1617 I. Applicant Information [ 1. Owner Infor tion Name: Mailing dr ss: �� /%� PP DRM b �y - 1 Z17310I "'� ""tKMIT7ING Telephone Numbed:- - JG V �J 3 --Z-U0Fax Number:` N/4 E-mail Address: �� 2. Agent/ Contact Person Informs ion A signed and dated copy of the Agent Authorization letter (a form can be downloaded here: ) must be attached if the Agent has signed this application form. Name: Company Affiliation: Mailing Address: Telephone Number: E-mail Address: Person to receive the Certification Approval: Fax Number: II. Project Information [ 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, FORM: SSGP 10-2013 Page 1 of 3 c etc.), 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 yardstick, shovel handle, etc.) 4. Location of the prbperty (where work is to be conducted) County: dam! Nearest Town.' Subdivision name or site addr s (include phase/lot number 0111 1/" , Directions to site - please include road names and n tubers, landmarks, etc.: el— — /1-it�" X.7L l 1 0 0 Latitude (in decimal degrees) -S �% �Mongode (decimal degrees)_ 5. Describe the existing land use or condition of the site at,the time of this application (residential, undeveloped, etc.):S�d 6. Property size (acres): 0-0 7 Lake/ river/ ocean adjacent to property: � Describe proposed work (include discussion as to how hardening f sho line h s bee necessary): �� N- Af d1 avoided, or why it is ry) a Will work be conducted from land? [�}� From water? ❑ 10. Total amount of disturbance (including all excavation, backfill, rip rap, retaining walls, etc.) below the',pormal pool lake level/ Normal all clearing, back fill, excavation, rip rap, retaining r Level in square feet or acres: 11. Total amount of disturbance (i walls, etc.) above the normal pool lake level/ Normal Water Level and square feet or acres: 12. Please describe the vegetation above the normal pool lake 50 feet landward to be imp ed (nu ber of trees, for instance): feet land -ward in Normal Water Level and .11 Owner Age is Si ature* Printed Name Date Agent's signature is valid only if an authorization letter from the owner is provided. Page 2of3 FORM: SSGP 10-2013 1 '; eq / Full Pond/ Normal Water Level Shoreline La ke (At Full Port d/Normal A'aterlevel 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 FORM: SSGP 10-2013 Page 3 of 3 IRF Duke Energy Co. Lake Tillery Project IPF k,te 5 PFJ I IP PF )i" IPF Z7 PF f z IPFi Thomas D. Poston do We, m o �1 10 Deborah C. Poston 1 1 Parcel # o 6575 07 67 4830 I DB 568; PG 65 W Lot 32 UD m \Swift Island o Plantation Charles E. Stockhom do Wife, Kathleen A. Stockham Parcel# 6575 07 67 2743 DB 624; PG 914 Lot 30 Swift Island Plantation %7 IRF_i�� Line table w. Line # Direction Length L7 N6659'51"W 11.59' L2 N73'43'15"E 2296' L3 S62'JrWE 25.10' L4 N0696'42"E 31.09' L5 N72B0'02"E 47.64' 1-6 N67'14'33"W 1 15.57' IRF Duke Energy Co. Lake Tillery Project IPF k,te 5 PFJ I IP PF )i" IPF Z7 PF f z IPFi Thomas D. Poston do We, m o �1 10 Deborah C. Poston 1 1 Parcel # o 6575 07 67 4830 I DB 568; PG 65 W Lot 32 UD m \Swift Island o Plantation Charles E. Stockhom do Wife, Kathleen A. Stockham Parcel# 6575 07 67 2743 DB 624; PG 914 Lot 30 Swift Island Plantation %7 IRF_i�� 1� a IRF n viol C prt�pte R�, 9h. plo0totio I certify that this map was drawn by me from an actual survey made by me (deed description recorded in Book 674, page 588); that the boundaries not surveyed are indicated as drawn from information in (N/A); that the ratio of precision or positional accuracy is 1:10,000'+; and that this map meets the requirements of The Standards of Practice for Land Surveying in North Carolina (21 NCAC 56.1600). This 26th day of August, 2016. Charles R. Stephen , Jr NCPLS L-5143C'A �R a"`aaaumuuuupr��''''/ ESS/�� Setbacks Front = 30' Side = 10' Lake Front = 10' IRF Legend: IRF=Iron Rod or Rebar Found IPF=Iron Pipe Found R/W=Right—of—Way DB=Deed Book PG=Page NTS=Not to Scale GRAPHIC SCALE 60 0 30 60 120 ( IN FEET ) 1 inch — 60 ft. w. 0 ? 0.55 Acres A- John H. Capell Kerry L Capell N N 1 6575Parcel 67 3747 DB 674; PG 588 1 Lot 31 Swift Island Plantation 1 Water Electric Meter ✓g•W� 1� a IRF n viol C prt�pte R�, 9h. plo0totio I certify that this map was drawn by me from an actual survey made by me (deed description recorded in Book 674, page 588); that the boundaries not surveyed are indicated as drawn from information in (N/A); that the ratio of precision or positional accuracy is 1:10,000'+; and that this map meets the requirements of The Standards of Practice for Land Surveying in North Carolina (21 NCAC 56.1600). This 26th day of August, 2016. Charles R. Stephen , Jr NCPLS L-5143C'A �R a"`aaaumuuuupr��''''/ ESS/�� Setbacks Front = 30' Side = 10' Lake Front = 10' IRF Legend: IRF=Iron Rod or Rebar Found IPF=Iron Pipe Found R/W=Right—of—Way DB=Deed Book PG=Page NTS=Not to Scale GRAPHIC SCALE 60 0 30 60 120 ( IN FEET ) 1 inch — 60 ft. I - Jrch B.eaclt � 1 R'ndal/r S Church � Q Q -. Randallls 9oa o C 01 v� y44y,� Emerald,::'. Shores ! I - Jrch I B.eaclt � SPILLWRV ECEL' 278 Q -. v� y44y,� Pa10Norwood Dam Wy�r0 - . 731 52 .' I ON T r4 , *L F y � C . p 111 �'��,F'r►' ��• . J� - 4 � ,1j.-1+• ��•` �•' . LIQ - t