20170990 Ver 1_Shoreline Stabilization_20170807

2p
Lake Norman Custom Dock and Pile Driving, INC. 0 e 9 0
P.O. Box 1439
Denver, NC 28037 b�
D
rA0 7 2011
Office: 704-483-2144
[e-mail]
To Whom It May Concern,
I'm working on getting a permit from Duke for excavation,
and I've included the information I will be sending them along with
this letter. I've attached the excavation site, and plans. I've also
attached site pictures and site maps for reference. If you have any
questions, or need any further information, please let me know.
You can reach myself (Brittney), or my boss Dean Fisher, at the
office. You can also reach either of us by email. Thank you for
your time and assistance.
Regards,
Brittney

State of North Carolina
Department of Environment and Natural Resources
DWR Division of Water Resources
Division of Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
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
1617 Mail Service Center
Raleigh, NC 27699-1617
I. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner information
Name: Rob Fulford
Mailing Address: 20032 Norman Colony Rd
Cornelius, NC 28031
Telephone Number: 7047517799 Fax Number:
E-mail Address: [e-mail]
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
http:/Iwww.saw.usace.army.mil/Portals/59/docs/regulatory/repdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.0 ) must be attached if the Agent has signed this application form.
Name: Lake Norman Custom Dock and Pile Driving, INC.
Company Affiliation:
Mailing Address: P.O. Box 1439
Denver NC 28037
Telephone Number: 704-483-2144 Fax Number:
E-mail Address: [e-mail]
Person to receive the Certification Approval: Dean Fisher
11. 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,
FORT SSGP 10-2013 Page 1 cf, 3

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 yard stick, shovel handle, etc.)
4. Location of the property (where work is to be conducted)
County: Mecklenburg Nearest Town: Cornelius
Subdivision name or site address (include phase/lot number): 20032 Norman Colony Rd
rcrnelius. NC 28031
Directions to site - please include road names and numbers, landmarks, etc.: From 1-77 S
take exit 28 toward W Catawba Ave. Keep right at the fork, follow signs for U.S. 21 and
merge onto W Catawba Ave. Merge onto W Catawba Ave. Turn right onto Bethel Church
Rd- Turn right onto Norman Colony rd. Destination 20032 Norman Colony Rd will be on the
ri ht.
Latitude (in decimal degrees) 35.486403 Longitude (decimal degrees) -80.891576
S. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Residental lot with existing dock
6. Property size (acres): G . `I 4 A-
7. Lake/ river/ ocean adjacent to property: Lake Norman
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): 91ei? C_ E fir► ID i?_ E r ►'�► %2 CS � i S T J Jc.
2, N? (1-n.-0 hS N EED (4LLvw l3arn'T 14�5-
9. Will work be conducted from land? From water? 11-1
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:
S ci o s q V-A 'r ��@ 9� V` c�
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: V CS 5 ,--V "IkN 20 o SQ fk--v
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): Sk r'v b5
Owner/Agent's Signature'
FORM: SSGP 10-2013
_4.6-• 2
Date
Page 2 of 3

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LOT 26A
N/F
ROLAND L. & MARTHA K.
BROWN
DB. 3756, PG. 150
733'E
o.L
FOUND
8.81w
0.311 I
LAKE NORMAN
� L4
0.WN
FOUND
12 2vW
O.L.
FOUND r LOT 27A
N/F
GARY W. LOOBY 3 PAMELA S. SARDINIA
DB. 13378, PG. 941 ^ FENcX
I
Io.�
MPERVIOUS AREA = ,
4,120 SQ.�
1
23 ss ~ Wool i 34.W aL.
I
3 1 DECK
�– 41.3&
2 STORY
BRICKNo. 2DOU Its! is
Wood
ooac —
WOOD RET.
WALL
CONC. PAD WITH
-w-MECH. EGUIPMENi
I
SPLIT RML
�- FENCE
LOT 28A
MB. 25, PG. 936
� t�0 NIF
JON D. 8 PATRICIA L.
Go
HAIR
? OB. 7681, PG. 945
9 0.44
F
I
5c Po1ia+ 34.73'
36,ar
------_-'�,� 26SETBACK
---- 4AW
20,654 SQ.FT. °'17N
0.47 ACRES O
FOUND PIPE %
0.151N � 1 FOUND
01°"- R=402.90'
_=150 80' ----
1 iq aP CH BRC=N2gjT36"E
A CH=14 9.9 2'
NORMAN COLONY ROAD
60' PUBLIC R/W
GENERAL NOTES:
1. APPARENT SOIL OF TITLE: DEED BOOK 13370. PAGE 941.
2. PROPERTY SHOWN B AN E=TNG PARCEL OF LAND.
3. LINEAR ERROR OF CLOSURE EXCEEDS 1;20.000.
4. AREA CALCULATED BY COORDINATE GEOMETRY METHOD.
S. N.C.G.S. MONUMENT NOT LOCATED WITHIN 2000 FEET OF THIS SITE.
0. THIS SURVEY WAS PREPARED WITHOUT THE BENEFIT OF A TITLE
REPORT AND IS SUBJECT TO FACTS THAT SUCH MAY REVEAL.
7. UNLESS BIOMED AND SEALED THIS MAP IS PRELIMINARY.
S. PROPERTY CURRENTLY ZONED *W.
SUMMIT
A
SURVEYING COMPANY
16716 W. CATAWBA AVENUE
CORINELIUS. NC 21110111
PREPARED FOR
GARY W. LOOBY
I,JOHN W. BALZEFL CERTIFY THAT THIS PLAT
WAS DRANK FROM AN ACTUAL FIELD SURVEY
PERFORMED UNDER MY DIRECT SUPERVISION,
IS CORRECT TO THE BEST OF MY IVNOWLEDGE.
JOHN W.BALZER
NCPLS L-38118
20032 NORMAN COLONY ROAD
LEMLEY TOWNSHIP MECKLENBURG COUNTY
NORTH CAROLINA
GRAPHIC SCALE
0' 20' 40'
wm�li"
1"=40'
JOB NO. 03-0811
LINE TABLE
LINE
BEARING
DIST.
L1
S44051'00"W
14.7T
L2
S87.38'00"W
39.42'
L3
S27.46000E
43.61'
L4
S05042'00"W
40.00'
LOT 26A
N/F
ROLAND L. & MARTHA K.
BROWN
DB. 3756, PG. 150
733'E
o.L
FOUND
8.81w
0.311 I
LAKE NORMAN
� L4
0.WN
FOUND
12 2vW
O.L.
FOUND r LOT 27A
N/F
GARY W. LOOBY 3 PAMELA S. SARDINIA
DB. 13378, PG. 941 ^ FENcX
I
Io.�
MPERVIOUS AREA = ,
4,120 SQ.�
1
23 ss ~ Wool i 34.W aL.
I
3 1 DECK
�– 41.3&
2 STORY
BRICKNo. 2DOU Its! is
Wood
ooac —
WOOD RET.
WALL
CONC. PAD WITH
-w-MECH. EGUIPMENi
I
SPLIT RML
�- FENCE
LOT 28A
MB. 25, PG. 936
� t�0 NIF
JON D. 8 PATRICIA L.
Go
HAIR
? OB. 7681, PG. 945
9 0.44
F
I
5c Po1ia+ 34.73'
36,ar
------_-'�,� 26SETBACK
---- 4AW
20,654 SQ.FT. °'17N
0.47 ACRES O
FOUND PIPE %
0.151N � 1 FOUND
01°"- R=402.90'
_=150 80' ----
1 iq aP CH BRC=N2gjT36"E
A CH=14 9.9 2'
NORMAN COLONY ROAD
60' PUBLIC R/W
GENERAL NOTES:
1. APPARENT SOIL OF TITLE: DEED BOOK 13370. PAGE 941.
2. PROPERTY SHOWN B AN E=TNG PARCEL OF LAND.
3. LINEAR ERROR OF CLOSURE EXCEEDS 1;20.000.
4. AREA CALCULATED BY COORDINATE GEOMETRY METHOD.
S. N.C.G.S. MONUMENT NOT LOCATED WITHIN 2000 FEET OF THIS SITE.
0. THIS SURVEY WAS PREPARED WITHOUT THE BENEFIT OF A TITLE
REPORT AND IS SUBJECT TO FACTS THAT SUCH MAY REVEAL.
7. UNLESS BIOMED AND SEALED THIS MAP IS PRELIMINARY.
S. PROPERTY CURRENTLY ZONED *W.
SUMMIT
A
SURVEYING COMPANY
16716 W. CATAWBA AVENUE
CORINELIUS. NC 21110111
PREPARED FOR
GARY W. LOOBY
I,JOHN W. BALZEFL CERTIFY THAT THIS PLAT
WAS DRANK FROM AN ACTUAL FIELD SURVEY
PERFORMED UNDER MY DIRECT SUPERVISION,
IS CORRECT TO THE BEST OF MY IVNOWLEDGE.
JOHN W.BALZER
NCPLS L-38118
20032 NORMAN COLONY ROAD
LEMLEY TOWNSHIP MECKLENBURG COUNTY
NORTH CAROLINA
GRAPHIC SCALE
0' 20' 40'
wm�li"
1"=40'
JOB NO. 03-0811

LOT 26A
NIF
ROLAND L. & MARTHA K.
BROWN
DB. 3756, PG. 150
FINAL SURVEY
NORMAN COLONY
MAP BOOK 15, PAGE 47
LOT 27A
PARCEL ID: 001-134-24
LAKE NORMAN
VICINITY MAP
(NO SCALE)
WOOD
1 \ Dept
FOUND
CON1 ;z
1229W
O.L.
FOUND V
LOT 27A
LEGEND
•
FOUND OR SET RE -BAR
- —
- LINES NOT SURVEYED
❑
TELEPHONE PEDESTAL
------
EDGE OF PAVEMENT
®
ELECTRIC TRANSFORMER
O
CABLE BOX
A
P.K. NAIL (LANDMARK TIE)
LOT 26A
NIF
ROLAND L. & MARTHA K.
BROWN
DB. 3756, PG. 150
FINAL SURVEY
NORMAN COLONY
MAP BOOK 15, PAGE 47
LOT 27A
PARCEL ID: 001-134-24
LAKE NORMAN
VICINITY MAP
(NO SCALE)
WOOD
1 \ Dept
FOUND
CON1 ;z
1229W
O.L.
FOUND V
LOT 27A
LINE TABLE
NIF
LINE
BEARING
DIST.
L1
S44'51'00`W
14.7T
L2
S87'38'00"W
39.42'
L3
S27.4600"E
43.61'
L4
S05°42'00"W
40.00'
LOT 26A
NIF
ROLAND L. & MARTHA K.
BROWN
DB. 3756, PG. 150
FINAL SURVEY
NORMAN COLONY
MAP BOOK 15, PAGE 47
LOT 27A
PARCEL ID: 001-134-24
LAKE NORMAN
VICINITY MAP
(NO SCALE)
WOOD
1 \ Dept
FOUND
CON1 ;z
1229W
O.L.
FOUND V
LOT 27A
NIF
GARY W. LOOBY & PAMELA B. SARDINIA
DB. 13378, PG. 941 FENCE
O.L.
IMPERVIOUS AREA = � �
4,120 SO FT
I
5p. ►�f�
25.31,
I
_ _ -
23,E V- - - - - I
I
FENC
O.L.
34.98'
OOEECK
MW
; 2 STORY
I�
WOOD RET.
WALL
CONC. PAD WITH
-w—MEC>i. EQUIPMENT
J SPLIT RAIL
�— FENCE
LOT 28A
MB. 25, PG. 936
NIF
JON D. & PATRICIA L.
HAIR
Z DB. 7681, PG. 945
I BRICK 6 FRAME 2S 12S F c,
L - a HOUSE m C
" ► Nc. 20032 ,a �v 1t
a
Xth
41.3& %1 PORCH 341T
.73'
C
25 SETgpCK t
751E r -m --------- '� 4AW
O.L i r env 20.854 SQ.FT. •AYNO
FOUND PIPE
r 0.47 ACRES
0,161N / � I FOUND
0'1°" R=402.90'
�: --�--
-612:15 "
150 80' -_--- -
R6=N12gjT36`E
1 a
CH= 14 9.9 2'
NORMAN COLONY ROAD
60' PUBLIC R/W
GENERAL NOTES: ��

8/2/2017 20423-20443 W Catawba Ave, Cornelius, NC 28031 to 20032 Norman Colony Rd - Google Maps
20423-20443 W Catawba Ave, Cornelius, NC Drive 1.2 miles, 3 min
C7 9I ���' 28031 to 20032 Norman Colony Rd
^0032 Norman
-- [
CO "'V RCaC The Fresh Market
Lake Norman Chrysler
Dodge Jeep Ram
0
The Strops A?
The Fresh Market
20123-20413 West
Catawba Avenue
0
24 min
n i.-:
Lucky Dog Bark
`z 3 min
0 Doitar Tree B Brew LKN
♦ - 17 in
0
One:Nor,_, G g
Map data @2017 Google United States 500 ft
20423-20443 W Catawba Ave
t 1. Head west on W Catawba Ave toward Torrence Chapel Rd
0.7 mi
r► 2. Turn right onto Bethel Church Rd
0.3 mi
ro 3. Turn right onto Norman Colony Rd
4P Destination will be on the right
0.3 mi
20032 Norman Colony Rd
These directions are for planning purposes only. You may find that construction
projects, traffic, weather, or other events may cause conditions to differ from the
map results, and you should plan your route accordingly. You must obey all signs or
notices regarding your route.
https:/Avww.google.com/maps/dir/35A832892,-80.8767302/20032+Norman+Colony+Rd,+Comelius,+NC+28031 /@35.4829395,-80.8835637,16zlam--Ydata=!4m8!4m7! 1 m0! 1 m5!1 m111 sOx8856abfc3520... 111

Duke Energy Excavation Permit Application Form
FOR DUKE ENERGY USE ONLY
Duke File No.
Application Fee $ Security Deposit $ Check # Date Recv'd Initials
Date of Duke Energy Lake Services, applicant and/or contractor on-site inspection$ bate Initials
Date Final Protection/Avoidance Area Markings Field - Verified
Approved to Start Work By * :
Date Completion Required
Date Passed Closeout Inspection*
Initials
(Print) (Sign)
Date of Any Approved Extension Initials
Initials
Any Stop Work Orders or SMG Violations*? (check one) ❑Yes ❑No (yYes, explain in PART V)
Date
Date Deposit Refunded Initials Date Permit Database Updated Initials
* Forward copy of approved application (all pages, plus any attachments that Duke Energy changed) back to applicant
with Approval Letter and highlight any changes. File copies of Approval and Close-out Checklists and any Stop Work
Part I. Applicant Information (Please Print)
Name 1 11 t CJSYYl P . FLA CO Y Ck Telephone (tea -1 5 i'l -Ict"t
Email address: rob v.1 rc�LL�� o©. co rY1
Lake Address ��
2 6 O 3, Z �� o Yy�n�e.iv, C-01 o )W
�t1rr1P1trl� N`. 2go31
Mailing Address (ifdif`erent)
Contractor Company Lake N o v ry�a n CtyS-}y wm D or - a d 1� � ► - � r'�v'� ►1q
Contractor Contact Person Dec�� 1�7i %)C& r Telephone (1?0 L1 T-2,- 2l 4 Ll
Contractor Email Address: 1 k r1 dock- G Yn a % 1 . C o r-)
LAKE LOT INFORMATION
Lake I� V rrr0.n County AeAlenbyL� City Cox n 21 5 State -14C Tax Map No. 00 1134 Zy,
Subdivision NOf Man Utonu Lot / Section No. 7-7A Size Act Acres
Duke Energy Page 4 of 14 rev 2/6/17
Excavation Program

Duke EnerLy Excavation Permit Application Form
Are there any Co -Applicants*? (check one) ❑Yes Mf�o (If Yes, include names, addresses or
lot numbers, phone numbers, lot sizes in PART V — ADDITIONAL INFORMATION)
* Co -Applicants exist when the proposed work is being done under a single application, will be
performed by a single contractor as one continuous project, and is done to benefit multiple
owners / lease holders of Project -front properties within a single development. The check for the
application filing fee and security deposit should be from the party shown as Applicant and not
several checks from the Applicant and Co -Applicants.
Do not continue the application until an on-site inspection has been conducted between a
Duke Energy Lake Representative and the applicant and/or the excavation contractor.
NOTE. Initializing this portion of the application by a Lake Representative in no way
constitutes approval or eminent approval of the excavation or any other lake use permitting
activity.
Date of on-site inspection OU IS 7
Initials (Duke Energy) `J�1 (applicant/contractor)
Duke Energy Page 5 of 14 rev 2/6/17
Excavation Program

Duke Ener v Excavation Permit Application Form
Part II. Description of Project
A. BASIC INFO
1. Type of excavation: (check one) ❑ New excavation Cd Maintenance excavation
2. Purpose of excavation: (check one) [Boat Access Channel
❑ Water Intake Channel ❑ Wastewater Discharge Channel
❑ Other (specify):
3. Lake user category: (check one) Okvate ❑Residential Marina
❑Commercial Marina ❑Public
❑Other (specify):
4. Max. Excavation Area Dimensions (ft): Length I Width 2(]
Depth -2) R HO V a} cult aoAct)
(Note: include additional area dimensions if necessary so response to #S below equals max. area
dimensions in #4)
5. Volume of Excavated Material (TOTAL for the project): -4 /'Z5 d Cubic yards
6. Type of material removed (applicant determines by field sample if practical): 5 i I 0.
It ► _ -1 - .
9,eck}2r }hA n iAC res
7. Excavation Site area: l_.d 4 Acre (s) Disposal Site area:) oC S' ir Acre
(s)
8. Total Disturbed Area (including equipment staging area): 15 U O S Acre (s)
9. Does� project meet the requirements of the applicable General Permit? (check one)
i9Yes ❑No
10. Do you claim title to the disposal area? (check one) ❑Yes l9No
11. Do you claim title to the equipment staging area? (check one) ❑Yes R(No
12. Are there any water -treatment facilities within 50 feet of the proposed excavation area?
(check one) ❑Yes ONo
(If Yes, specify):
13. How will the excavated material be entrapped and the erosion controlled? (e.g. see attached
erosion control plan and disposal area design): _l7 t 1_0 -'uv be d Qr o uyL>l b-�o red % ,n
borap- WReY'
Duke Energy Page 6 of 14 rev 2/6/17
Excavation Program

Duke Enemy Excavation Permit Application Form
14. Type(s) of excavation equipment to be used: L 11'i i u c 2a_Gln e X CCW cx i o v- W
-Aee.\ bcuYup hoDjper.
15. Will waters or wetlands be crossed in transporting equipment to or from the site?
(check one) [fYes ONo
(If yes, ex lain) b ocr G-eC mfgytd 0. Cy o S S I U -k -e Al> CA i 9J r p L
^�V ULcol-�SiVe_
16. Will return water re-enter the reservoir? (Check one) ❑Yes QNo
points) of re-entry and show on Excavation Area Drawing)
ON/A (If Yes, specify
17. Is there an ex sting facility (e.g. pier) that access is being maintained to by conducting the
excavation? [ es 17No
(If Yes, specify the existing permit number. If No, include a scaled drawing of the proposed
facility). Permit #
18. Total planned duration of the work (Include first equipment mobilization, excavation
through final mitigation measures complete):
START _O 12611 FINISH 01
(Month) (Year) (Month) (Year)
Duke Energy Page 7 of 14 rev 2/6/17
Excavation Program
A-

Duke Enemy Excavation Permit Application Form
PART II. (Continued)
B. PROTECTION/ AVOIDANCE AREA DESCRIPTION
Complete the following table including all land areas within and immediately adjoining the disturbed area:
Duke Energy Page 8 of 14 rev 1& 17
Excavation Program
Identification
Method *
Avoid (A) or Mitigate (M)
Protection/Avoidance Areas
(check all that apply)
Approx
Acre
Field n)
Work Area DWQ. ID
a. Marshland, swamp, ponds, beneficial
aquatic vegetation or other potential wetlands
(circle all that apply)
b. Butler Zones (speck width & source
of requirement)
►p, t_L W O R-1� �� � �
/ f
/v
c. Environmental Areas as identified by
Duke Energy
d. Natural Areas as identified by Duke
Energy
_ !
e
!(�
e. Historic properties (specify)
�J
L Rare or threatened species (specify)
Duke Energy Page 8 of 14 rev 1& 17
Excavation Program

Duke Energy Excavation Permit Application Form
Protection/Avoidance Areas
(check all that apply)
Aoprox
Identification
Method *
Avoid (A) or Mitigate (M)
Acre
Field ID
Work Area Dwg. ID
fin
R. Buried gas, water, sewer,
communications or electric lines (circle)
l
/
h. Impact Minimization Zones as
identified by Duke Energy
r�
i. Other areas requiring specific
avoidance, protection or mitigation (specify)
111
* For "Field ID" column, specify entity or person that performed the identification and how it was physically marked (e.g. Duke
Energy (John Doe)/Pink and purple -dotted tape, Corps of Eng. (John Smith)/ yellow flagging). For "Work Area Dwg ID" column,
show the symbol that is used on the drawings to identify the protection/avoidance area.
** List and attach mitigation plans
Duke Energy Page 9 of 14 rev 2/6(17
Excavation Program

Duke Energy Excavation Permit Application Form
C. APPLICANT'S SIGNATURES
Comments:
Applicant Name (print)W t � � r--- T�A, �-!�O C� Lot #
Applicant Signature* Date
Co -Applicant Name (print)
Lot #
Co -Applicant Signature*
Date
Co -Applicant Name (print)
Lot #
Co -Applicant Signature*
Date
Co -Applicant Name (print)
Lot #
Co -Applicant Signature*
Date
Co -Applicant Name (print)
Lot #
Co -Applicant Signature*
Date
Co -Applicant Name (print)
Lot #
Co -Applicant Signature*
Date
*Per my signature, the information provided in this application is correct to the best of my
knowledge.
Duke Energy Page 10 of 14 rev 2/6/17
Excavation Program

Excavation Project User's Agreement Letter
(Please till in the blanks. Please Print)
Date - \-I
TO: Duke Energy
c/o Lake Services - EC12Q
526 S. Church Street
Charlotte, NC 28202
RE: Excavation For (S�bdivision and L t #'s or Other Project
Name) 0
(Lake/County/City) l
(Applicant's full name) & 11',ayyx hereby agrees to comply with all
recommendations, requirements and/or conditions of Duke Energy Lake Services, General
Permit(s) (if applicable) and other federal, state and local agency requirements pertaining to the
application to excavate for the purpose of a IOoa.i- aC CeSS
In addition, I/tive have read and agree to comply with Duke's current Shoreline Management Plan
(SMP), much of which is repeated herein, and understand that written authorization must be
obtained from Duke Energy Lake Services prior to beginning any activity within the FERC
project boundary or on Duke Energy land. The excavation will be completed as described in the
approved application and within eighteen (18) months from the date of written approval by Lake
Services, unless specifically noted otherwise in the application or unless I/we obtain approval for
a single, time extension (maximum of one year) in writing from Duke Energy Lake Services.
1/we understand that if the SMP or other applicable rules change during any extension period,
1/we will be expected to comply with the new requirements to the maximum extent practicable.
I/we also recognize that failure to complete the excavation within this build -out period will
require the filing of a new application within the then -current SMP and the new application must
include any applicable fees and security deposits.
I/we attest to be the owner(s) or lease holder(s) of the land immediately adjoining the project
boundary or Duke -owned peripheral strip where the excavation activity is to take place, or if not
the owner or lease holder, I/we have included proof of title to the property and written
authorization from the owner(s) or lease holder(s) to carry out the proposal within the project
boundary adjacent to their land.
Ihve attest to be the owner(s) or lease holder(s) of the land that will be used for equipment
staging and disposal of excavated material or if not the owner or lease holder, Ihve have included
Duke Effigy Page ( Rev: 5.19,17

proof of title to the property and written authorization from the owner(s) or lease holder(s) to
carry out the work on their land.
Am understand that all excavation work must be done directly in front of my/our property and
within the third of the cove nearest my/our property or within any middle third of the cove that
Duke Energy owns, or Yvve have written authorization from the owner(s) or lease holder(s) to
carry out the proposal within the project boundary adjacent to/on their land. I/we also understand
that access channels must run perpendicular to the shoreline while within the third of the cove
area that is nearest my/our property.
I/we understand that for proposed excavations, I/tive must notify the appropriate local, state and
federal agencies in advance of the activity by sending them a completed copy of Duke's
Excavation Permit Application Form and other required information. I/we understand that
written authorization and/or other permits may be required by some of these agencies and such
required authorizations must be obtained before I/we submit the final application to Duke
Energy Lake Services.
I/we understand that except for maintenance excavations, any excavation exceeding 2000 cubic
yards of material removed or any excavation or shoreline stabilization work needed to support an
application that requires Federal Energy Regulatory Commission (FERC) review does itself
require specific review and approval by the FERC before Duke Energy can issue any approvals.
[/We agree that unless specifically approved otherwise in the application, explosives will not be
used as part of this excavation activity.
I/we understand that every reasonable effort must be made to minimize any adverse impact on
fish, wildlife and other natural resources.
I/we understand that applicants in South Carolina proposing excavations that are not covered
under the General Permit, or are greater than 150 cubic yards, must receive prior written
authorization from the South Carolina Department of Health and Environmental Control
(SCDHEC) or the US Army Corps of Engineers (as applicable) before submitting the completed
application to Lake Services.
I/►ve agree that excavation activities in North Carolina and South Carolina will not occur during
the months of March, April, May and June because of the potential impacts to fish spawning
areas.
1/we understand that trees and vegetation growing within or adjoining the lake play an important
role in its overall environmental condition, and the ecological benefit the vegetation has on fish
and wildlife habitat directly supports a sound and healthy lake environment. I/we also understand
that unauthorized removal of shoreline vegetation (e.g. button bushes, willows, cattails, etc.)
and/or disturbance of the shoreline buffer may result in suspension or denial of lake use
permitting requests, forfeiture of security deposits and require re-establishment of vegetation at
my/our expense, particularly if the disturbance is found to be in violation of state or local
ordinances or impacts FERC project buffers.
Duke EnQ,ry Page 2 Rev: s',s,,,

Ave agree that all excavated material will be placed in upland areas, landward of the project
boundary, and confined to prevent erosion and sedimentation back into the lake or nearby
streams.
1/we agree to adequately stabilize all excavated material and all disturbed shoreline to prevent
erosion and runoff into the lake.
I/tive understand that the double handling of excavated material will not be allowed; therefore, all
excavated material must be placed above the project boundary in one handling.
I/we have designed the hydraulic excavation process (if any will be used so that return water re-
enters the lake in the same general vicinity and cove as the excavation, to the maximum extent
practicable.
Ave agree that the proposed excavation will not be for the purpose of creating additional
shoreline, will not alter the project boundary or the full pond contour, and will not impact
threatened or endangered species, historic properties, or environmentally -important areas, unless
special public entity provisions were made in the application.
1/we recognize that it is my/our responsibility to clearly locate in the field and label on my/our
work area drawings any areas that require specific protection or avoidance during this excavation
work. Examples of these protection/avoidance areas include but are not limited to, any
Environmental Areas, Natural Areas or Impact Minimization Zones as identified by Duke;
jurisdictional wetlands; historic properties; rare or threatened species; and buried gas, water,
sewer, electric or communications lines. I/we agree to provide my/our contractor with a copy of
these work area drawings showing these areas to stress the necessary protection measures.
I/we agree that if any archaeological resources (e.g. pottery shards, Indian artifacts, etc.) are
discovered during the excavation, work shall be halted immediately. I/we will then notify Duke
Energy Lake Services and the State Historic Preservation Office to determine what measures, if
any,1/we must pursue to protect or salvage the archaeological resources.
Mve agree that any excavation from within the project boundary will not exceed the volume as
outlined in the application and will remove and disturb only what is absolutely necessary to
achieve the project's stated purpose.
I/we agree to be fully responsible for the permitted lake use and I/we understand that this
responsibility is considered to transfer automatically along with ownership and leases of the
adjoining tract.
1/ive understand Duke Energy representatives may issue Stop Work Directives for violations of
the SMP and other consequences may result from such violations, including but not limited to
suspension or cancellation of approved permits, increases in fees, modification or removal of
non -complying structures and restoration of disturbed areas at my/our own expense or loss of any
consideration for future lake use permits. 1/tive agree to immediately comply with any Stop Work
Duke Em7gy Page 3 Rev: S 13,17

Directives, to fully cooperate with Duke Energy Lake Services and other agencies as necessary,
and to perform the necessary remedial actions within the specified time frame.
Ave agree to develop any required mitigation plans and to complete any required mitigation
activities at my/our own expense within the specified time frames. Am recognize that the
excavation work is not considered complete and deposits will not be refunded until the
mitigation requirements (if any) have been satisfactorily fulfilled.
Ave agree to notify Lake Services by phone when the excavation is initiated and to ensure that
during the excavation period, Ave will post Duke Energy's approval letter in a clear waterproof
bag at thelob site and visible from the water's edge.
I/we agree to notify Lake Services in writing when the excavation is completed (including any
required mitigation measures) and that the excavation was completed per the approved
application, so a close-out inspection can be performed.
1/we recognize security deposits will not be refunded if any violations of the SMP or this user's
agreement occur.
1/we understand there will be no change in hydro project operations as a result of the excavation
and/or utilization of the excavated area.
Uwe agree to maintain the work area in a safe condition and to fully indemnify and save Duke
Energy harmless from any and all claims, liability, loss or damage that may arise from this
excavation project.
1/we understand that this user's agreement does not, in any way, constitute the transfer of any
rights in real property and that my/our use and enjoyment of FERC project lands and waters shall
not hinder the general public's lawful use and enjoyment of the same.
Sincerely,
Applicant's Name (Print) Lot # Applicant's Sign atur
*Co -Applicant's Name (Print) Lot # *Co -Applicant's Signature
*Co -Applicant's Name (Print) Lot # *Co -Applicant's Signature
*Co -Applicant's Name (Print)
Lot #
*Co -Applicant's Signature
o.ka s -W Page 4 Rte.: 5,19117

*Co -Applicant's Name (Print) Lot # *Co -Applicant's Signature
* Co -Applicants exist when the proposed work is being done under a single application, will be performed by a
single contractor as one continuous project and is done to benefit multiple owners / lease holders of project -front
properties within a single development. The check for the application filing fee and security deposit should be from
the party shown as Applicant and not several checks from the Applicant and Co -Applicants. By signing this
agreement, Co -Applicants are in fact recognizing and agreeing to the same conditions as is the party signing as
Applicant.
Duke Energy Page 5 rte: 5 i8n7

Lake Norman Custom Dock and Pile Driving, INC.
P.O. Box 1439
Denver, NC 28037
Office: 704-483-2144
[e-mail] 11,C,/
AUG V,To Whom It May Concern, o 1720"?
STS MWgrFN�4(lq��ry
I'm working on getting a permit from Duke for excava �fi-vyi,rING
and I've included the processing fee. If you have any questions,
or need any further information, please let me know. You can
reach myself (Brittney), or my boss Dean Fisher, at the office. You
can also reach either of us by email. Thank you for your time and
assistance.
Regards,
Brittney
704-483-2144