20171152 Ver 1_Shoreline Stabilization_20170908

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DUKE ENERGY INTEf2NALUSE ONLY: V
Construction �\
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Date Received: � FAFPaid Application� ` �� ENERGY.
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Application Complete
Permit No. ( Water Strategy, Hydro Licensing and Lake Services
HEP Fund Duke Energy
PO Box 10061 EC12Q
Site ID Close -Cut Date Charlotte, NC28201
I. DATE OF APPLICATION* Permit/Tag #.:
II. APPLICANT INFORMATION (applicant mailing address and contact information)
Name* !`/ t- 112AG"' Primary i
Address* ( 2 05 Pf20V1 bG-NCG VIEW LN. %condaryPhonel
Oty* I CLI A4a4 FE -State* [tj C Zip Code* 2S2-7 b Fax Number ( �
Email* 1'� i i eC' c < 6 ! 1- 01 0-P Cj, Q r Ut}'? . �j�
III. PROPERTY INFORMATION (location of permit)
Address" RCPG t�-cl-iW PT 13LV 6. County" (2A S I rjfV
City*State" Zip Zip Code*(jr County Parcel ID number
(e.g. Pin, Tax ID, TMS U Ll U 0 o
Lake*: Number...)
Subdivision � �i't(3 ni PT, Lot{s} �� Z _,.,,..., ..j Plat Book/Page 1'4 b��3
.��
To enter the latitude and Longitude of the property, please use a
service/ softto easily acquire the location information. Values Latitude (e.g. 35.12345)" �?6 _ 1,SL44/q I
should be provided in Decimal Degreesformat (35.1245). r ---N 1
example service: httpJ/itouchmap.com/lationg.html Longitude (e.g. -80.12345)*;-- $
IV. PROPOSED ACTIVITY
C" New/Modification of Existing Structure c ` Maintenance of Existing Structure 1- Is Dock
Covered?
C' New/Modification of Existing Shoreline Stabilization t Maintenance of Existing Shoreline Stabilization
(' New/Modification of Existing Structure & Stabilization ( Maintenance of Existing Structure & Stabilization #of Sips F�
(" Transfer of Ownership C" Other (please describe below) # of Jetports F
Area over land (sq ft) - Area over water (sq ft)Total Square Feet I�
Shoreline Stabilization (feet) Length of r Distance From Shoreline 0
Stabilization � � � -
Materials f %C% l— IZ
f theAscrlpyon
o
of the Activit
Describe Briefly the Existing
SructuresOver Land and n
Water (include sq ft)

V. Dock Builder or Engineer
Name/Company
" � /
Address I L2 (z3a
City ' fig,} State d. Zip Cade �9-j r 0 Email � � ��'
VI. Checklist of Required Documents (to includewith Application Sub"rnisslon)
colt- MauA-a
Phone Number y7 v�/_ 2 e3o -
F�cent Sarvey (stamped/signed by a professional licensed surveyor showing the location of the existing or proposed
structure and/or survey of the existing or proposed stabilization)
F- Photos along property shoreline and photos of any existing structures and/or stabilization in or near thewater
Application fee (check only, payable to Duke Energy) 1— Signed User Agreement Letter
r Applicable local, state, and federal permits F Flan and profile drawing showing all measurementsand elevations
F Habitat Enhancement payment (if applicable)
VI ApprovalProcess
Application is reviewed and determined if complete. Fields with an asterisk are required.
If application isnot complete or does not include all items and information listed in the checklist, the
application will be returned as incomplete.
- A Duke Energy representative will visit the site to conduct a visual inspection.
Applicant will be notified of approval or denial.
Applicant isto have the notice, to be supplied by Duke Energy upon application approval, posted and
must be viewable from water. The notice must remain posted until a representative inspects the
project and determines the project is complete and within the application specifications.
Vlll. Directionsby Road
Directionsby
Road*
IX. Application Submission
Please complete, print and sign this application. Then enclose all itemsfrom the checklist above in an envelope and
submit all the information to the address below.
Water Strategy, Hydro Licensing and Lake Services
Duke Energy Print Form
PO Box 1006/ EC12Q
Charlotte, NC28201
I agreethat the information oontained within isaccurate:
Cru / -"

State of North Carolina
Department of Environment and Natural Resources
0 Division of Water Resources R-
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15A NCAC 02H .0500 – Water Quality Certification, Shoreline Stabilization
ivision of Water 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
1617 Mail Service Center
Raleigh, NC 27699-1617
I. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: IeIFN L I PA C,<
Mailing Address: SUS' P%4 U I o L---), -J C, F V I L= W Lp(pi
C.4� ai'rc- N C 7-19 -2 -7 O
Telephone Number: _lU 4-S19 -239 1 Fax Number:
E-mail Address: k I i pa Gk © %k - Of 04 Char l otl-e Com
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.miI/Portals/59/docs/reeuIatory/regdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.odf) must be attached if the Agent has signed this application form.
Name: CGseu Nl i cAn#S (ilia4teiack Marine- Cbpskuc bod
Company Affiliation: eLrl - -rcz c:. )J?
Mailing Address: 62 ")o6tio. 12ba ( LG? L4) q 1i,e S'C ZC�1110
Telephone Number: 101 -2_q0 -Q 49 Fax Number: U66- TG I —234(o
E-mail Address: C. G -c et, t6) I ) r'*i C G4- _ r nm
Person to receive the Certification Approval: L 0 Seci J)S_ WQ J:4 a Ck
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* -Sec S vrV eye
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

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: (fie) J..tcyr 1 Nearest Town: lrnan-f
Subdivi 'on name or site address (include phase/lot number): _/' SS Z RsDecl/ on P .Me,
�
2,L'
be c 4ic,r, i hv)-I& / -I- -yj-
Directions to site - please include road names and numbers, landmarks, etc.:
C Aou latf c 4o PeClec-f%cyl 021h k n-eigliloorknoc�
Latitude (in decimal degrees) 96, /S4ti�] / Longitude (decimal degrees) °-y1.0 3 U1� d
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): re S; dl -el) i G t ()/1 Q'eye
6. Property size (acres): Q. U 3
7. Lake/ river/ ocean adjacent to property: LCa r'�'Q filit�tl i -L
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): &► (/,Q r'OCIc 6nI)rde4- W -Q( ( - 0 J -WI P
r'
9. Will work be conducted from land? From water? V /Z74)
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:
44� Li; 4a X 6 ' // -7-SZ) Sq 4�4' e f
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: 2S- SG 44
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): -1rer- ' S I„ ):J/k
o / 0 3 4v 6 -cvtmomyed r moi
2q- g
Owner/Agent s Signature* Printed Name nate
[15A NCAC 02H .0502(f)l
`Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013
Page 2 of 3

F
Norm
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

RECEIVED
SO 0 8 20;1
DENR-LAND,QUALITY
STORMWOEP IPE -k -M1 -n-1 I
SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT N0. 2S- Z PLAN NO. PARCEL ID: _ Z-(-) y bQ ()
STREET ADDRESS: I S Sa REEF,. -C llod Poi.r�l— SLUU .
F3 EZm or,17 f J C_ 2-S b 1 -2
Please print:
Property Owner: V Cr\1 L_ 1 PAG%
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
, of U � 1"AGc' l'Y1�L211�(/-
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, Issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
Telephone: `7 Z39
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
uthorized Signature Authorized Signature
Date: Date:

VICINITY MAP (NOT TO SCALE)
Approximate Flood Line
*Property line along the lake is the
569.40 foot mean sea level line.
,a Og ,op jetted e
`N gU1LDA8LE AREA
1
LAKE WYLIE
I Point
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CURVE RADIUS ARC LENGTH CHORD LENGTH CHORD BEARING
C1 50.00' 49.98' 47.92' S 43°31'00" E
P+� cess��� /
(X:rl�
L4 - Tie Line
Pk Nai
Set )&
Tax Map # 204001 #5 ASetDavid C Cook & Fracine DupontLot 253, Reflection Pointe Db. 4020 Pg. 0143
Pb. 067 Pg. 087 �5
#5 Rebar / Ao,
Found / /
#5 Rebar', 06 d9
Found @ N I,
10.16' 1 PITTMAN
Pb. 67 P . 86-88
9� _ i
X on
Transformer
Set
A
Z 1 ',\ o
Tax Map # 204000 / 1b
Lot 252, Reflection Pointe ^ 5
o , Db. 4052 Pg. 0636 /
Z 1 Pb. 067 Pg. 087 / #5 Rebar
m 1 0.43 Acres ± Crds. Bent Found
#5 Rebar
g II / Found
Si /
15�1 m 1 / Tax Map # 203999
C-41Flood Line
i / 9h Approximate Jack H & Dianne W Morris
{
NLot 251, Reflection Pointe
V Db. 4038 Pg. 0414
V Pb 067 P 087
D°'�� '� 150' Natural Lake Buff�r� 9
Point g {
Water's Edge 1 �•�������♦
#5 Rebar
Found @ 9.93'
Point
LAKE WYLIE
Flood Certification:
This Project DOES lie within a F.E.M.A. Special flood hazard area according
to Map Number 371 0 3 591 00L effective September 2, 2015.
General Notes:
1. Measurements on this map are in feet and decimals thereof.
2. All set corners are #5 (5/8") Rebar unless otherwise noted.
3. This plat is subject to any Easements, Agreements, or Rights
of Ways of Record prior to date of this plat, which was not
visible at the time of our survey.
4 All Setbacks must be verified by the Zoning Department
on 6/20/17:
•tTH
i BOE ESS /�.� ♦
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SEAL �
■ L-3341
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♦♦♦ S JEnrER P\� •�
LEGEND
– — – SETBACK LINE
@ FOUND PROPERTY CORNER
• SET PROPERTY CORNER
@ CALCULATED POINT
LINE BEARING DISTANCE
L1
S 48°56'04" W
32.51'
L2
N 55°45'12" W
2.01'
L3
N 25°19'46" W
20.28'
L4
N 54°17'35" E
32.28'
prior to construction. Surveyor assumes no liability for setback SURVEYED 6/20/17 SCALE 1" = 50'
information as shown. Setbacks per Plat Book 67 Page 86.
50 0 50 100
"I, JAMES JETTER PITTMAN, CERTIFY THAT THIS PLAT WAS
DRAWN UNDER MY SUPERVISION FROM AN ACTUAL SURVEY
MADE UNDER MY SUPERVISION (DEED DESCRIPTION
RECORDED IN BOOK 402 , PAGE —636 ETC.) (OTHER);
THAT THE BOUNDARIES NOT SURVEYED ARE CLEARLY
INDICATED AS DRAWN FROM INFORMATION FOUND IN BOOK
--L7--. PAGE —87—; THAT THE RATIO OF PRECISION AS
CALCULATED IS 1: 194Q0_: THAT THIS PLAT WAS PREPARED
IN ACCORDANCE WITH G.S. 47-30 AS AMENDED. WITNESS
MY ORIGINAL SIGNATURE, REGISTRATION NUMBER AND SEAL
THIS 20TH DAY OF JUNE , A.D., 20 17.
I FURTHER CERTIFY TO THE FOLLOWING:
ANY ONE OF THE FOLLOWING:
X (A), THAT THE SURVEY IS OF AN EXISTING PARCEL OR
PARCEL ANQ AND DOES NOT CREATE A NEW STREET
OR CHA OE N EX TING STREET;
PLS #L-3341 F ! r1-2
BOUNDARY AND PHYSICAL SURVEY FOR
KEN LIPACK
LOCATED AT
1552 REFLECTION POINTE BLVD
GASTON COUNTY SOUTH POINTE TWSP NORTH CAROLINA
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AN
)rofessional land surveying
1w,
7_I WWW.PPLSSURVEY.COM
P.O. BOX 1512, FORT MILL, SC 29716 [phone]
P:\T338\F30\T338F30.dwg JCB

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