20171331 Ver 1_401 Application_20171016

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%.01 71 331
State of North Carolina
Department of Environment and Natural Resources
Division of water Resources
Alvlslatl of 1Ndter it+esaarces ISA NCAC 02H .0500 — water Quality certification, Shorellne.Stabilization
FORM: SSCP 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
16.7 Mail Service Center t� k
Raleigh, NC 27699-1617 ` Y>
OCT
1. Applicant Information i5A NCAC 02H .0502 a 6 2017
1. Owner information
Name: Diane L. Gossett
Mailing Address: 245 White Crane Road
5alisbu NC 28146
Telephone Number: 7041239-0467 Fax Number:
E-mail Address: h:[e-mail]
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
httwww.saw,usace.arrn .rnil Portais 59 docs re ulato re docs Permits 5 MPLE AGENT RUTH
ORIZATI 'N FORM,Pdf) must be attached if the Agent has signed this application form,
Name: N A
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
Person to receive the Certification Approval:
II. Pro}ect information 15A NCAC 02H .0502 a & b
I. Attach a vicinity map (Le. 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: $SGP 1U-2013
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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: Rowan Nearest Town:.SSallsb
oy
Subdivision name or site address (include phase/lot number):
245 White crane Rod Salisbury NC
Directions to site - please include road names and numbers, landmarks, etc.:,
1-85 to Longcr lFem Rd exit east on Long F@rN Rd Ron Blu Herron Rd Ron White
Crane Rd. house # 245 is on the left.
Latitude (in dedmai degreesi 35.66756 Longitude (dec(mal deprees) 80.341744
S. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.):-,F�_ Existin evPerty�
eloped residential
6. Property size (acres): 0.70 acres
7. Lake/ river/ ocean.adjacent to property: high Rock Lake
S. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): To stabili a and existing eroded shoreline and rotect
It from further erosion.
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:
30 0 So. 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: 1550 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): Site has an existin
house on t o e No trees will be im a ed by the Proeosed.shorelinestabilizatlon.
10/10/2017
Owner/Agent's Signature' j1. 5A NCAC 02H .0502ff1T Date
`AgenCF signature is valid only if an authorization letter from the owner is provided
FORM: SSGP 10-2o.3
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SEE ATTACHED SITE PLAN AND DETAI
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as Z oft x 1 Do 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,
S. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
FORM. SSGP 10-2[)13
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'10/1012017 08:24 7046456036 PLATINUM CLINIC PACE 07107
1�
3
VEGETATION AND EROSION
CONTROL FABRIC
CLASS 2 RIP RAP
7
2
EROSION C0NTROL FABRIC -•---'"rte
"o i o
36" TO 72" ERODED CUT
WAVE EXPOSURE
EXISTING • GRADE
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LAKE: BoTroif
DIANE GOSSETT
�ocAnoN: LOTS 20/21. CRANE COVE
RESERVOIR: HIGH ROCKLAKE
PROJECT: SHORELINE .STABILIZATION PROGRAM
PHASE I SITE EVALUATION
YADKIN, INC. --- BADIN, NORTH CAROLINA
7RAIMNO TITLE;
MODERATE RIP RAP. STABILIZATION DETAIL
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