20171328 Ver 1_Shoreline Stabilization_20171016

DUKE ENERGY INTERNAL USE ONLY: _ Construction DUKE
FAF Paid
ApplicationENERGY
Date Received:E : i ,
vrrvnn inp
Application Complete Duke Energy Lake Services
Permit No. 2
HEP Fund Mail Code EC12Q 0 ' l
— -T ! 526 S Church st 3
WC 28202
site 0
1.WEMOfAPPLICATION* � PermitfTag�.
11 APPLICANT INFORMATION (applicant mail' address and contact Infortnatton)
n�
•
Primary Phone* - AS
Name* � W��i► -)
Secondary Phone
City-��- States` � Zip Code'���� Fax Number
ldLl�"
Email" KK -
HL PROPERTY INFORMATION (location of permit)a,., . -..... u
--------------
'�/�j�/'� �LA��� County"'
City* C State* Zip Code* 'Z County Parcel ID number
(e.g. Pin, Tax 10, TMS
Number...)
Lake*;
Lot(s)
1� Plat Book/Page
Subdivision
Zo enter the Latitude and longitude of the property, please use a Latitude (e.g. 35.12345)*
nfrwrnatinn_ ValUes
service/s0'ft atcet-- �WA- •..�4,•••• - -r i
Degrees format (35.1245L Locigrtude � g -80.12345)*
should be provided in Decimal.Y.
service http:l/itouchmap� comAadong.htmi
example .:....,,......�...,...�:..-
IV. PROPOSED ACTNITY
u.
„ ..... -�. Is Dock
m � (' Maintenance of Existing Structure � Covered?
C New/Modification of Existing Structure
ew/Modification of Existing Shoreline Stabilization C Maintenance of Existing Shoreline Stabilization # of Slips
���yi, »x rc, ,g 4,:,re & Stabilization ( Maintenance of Existing Structure & Stabilization
Transfer of Ownership ( CttfiEt (p)ease devcrik�e t3eiovw)
of Jetts
Area over land (sq ft)
Shoreline Stabilization (feet) Length of
.Stabilization
Brief Descripti
of the Activity
Describe Briefly the Existing V W�
Structures Over Land and
water (include sq fr)
Area over water (Sq ft)
Total Square Feet
} Distance From Shoreline��i(,l
{ �� ' ✓J Materials
f't P F --
OCT 16 2011
S'iG=

V. Dock Builder or Engineer
Mame/Con
Address
City1 State 9 Zip Code Email
V6 Chaclslist of Required Documents (to include with Application Sulamissionl
ent Survey (stamped/signed by a professionat iicensed.surveyor showing the location of the existing or proposed
Rlication
ture and/or survey of the existing or proposed stabilization)
os along property shoreline and photos of any existi��i
tructures and/or stabilization in or near the water
fee (check only, payable to Duke Energy) gned User Agreement Letter
pplicable local, state, and federal permits 0 Pian and profile drawing showing all measurements and elevations
Habitat Enhancement payment (if applicable)
AM Approval Process
• Application is reviewed and determined if complete. Fields with an asterisk are required.
• if application is not 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 is to 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.
Vt!!. Olrectlons by Road
Mentions by
Road"
way.mac l/ e vv `fsu -t..
JX. Application Submission
..
Please complete, print and sign th6 application. Then enclose all items from the checklist above in an envelope and
submit all the information to the address below.
Duke Energy Lake Sery%es Print Form
Malt Code EC12Q
526 S. Church St.
Charlotte, NC 28202
I agree that the information contained within is accurate:.
c:.,-„va o.>

State of North Carotin
Department of Environment and Natural'Resources
Division of water Resources
D_W�_R
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
Dtvislon 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 115A NCAC 02H .0502(a)]
1. Owner information
Name: /.4,445
Mailing Address
I
3v T��rj r_. vr—
Telephone Number: `7 _ 1f � r S S F7 S Fax Number:
E-mail Address: 1,gAlC L.4s T5R't C.-f�f �� - C C04
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 arrry rr�z /Porta sl /docsLreguiatoralr� docs/Permitb/Sr'.MPLE AGENT AUTHO
RIZATION FORM.Wf1 must be attached if the Agent has signed this application form.
Name: CLW
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
Person to receive the Certification Approval:
11, Project Information (15A NCAC 02H .0502(a) & (b)]
1. Attach a vicinity map (i:e. street mars) 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, and
FORM: SSGP 10-2013 Page 1 of 3

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) o
County: r'� Nearest Town:
Subdivision name or site address (include phase/lot number): Vi-__r=G,s
69
Directions to site - please include road names and numbers, landmarks, etc.:
Latitude (in dedmaidegrees) % .0 Longitude (decimal
Describe the existing land use or condition of the site at the time of this application
(residential, undeveic
5. Property size (acres):
7. Lake/ river/ ocean ad
B. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): UMH aAl -e- OE W-
9. Will work be conducted from land? From water? 0
10. Total amount of disturbance (including all excavation, backfill, rip rap, retaining wails, etc.)
below the normal pool lake levy/Normal Water Level in square feet or acres:
_2__:MJA ',
11. Total amount of disturbance (including all clearing, backfill, excavation, rip rap, retaining
wails, etc.) above the normal pool lake level/ Normal Water Level and 50 feet land -ward in
square feet or acres: t-
12. Please describe the vegetation above the normal pool lake leveV Normal. Water Level and S0
feet landward to be impacted (number of trees, for instance): IYOCS,
�i�l... �.�, �.� � A {✓�:: [ r4 -5;a 7 tic � i ' �(� p
Owner/Agent's Signature's Printed tame Date
(15A NCAC 02H .0502MI
`Agent's signature is valid only if on authorization letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 3

Lake
Full Pond/
Normal YV&Lkeg
Shoreline
�� 1041
12'7 -?✓- -tom • \ ,
4° L ; iP2
1277 - 3 CW
44- •
1 f
Jt�5iv C+ -
Please approximately sketch the following information on this plan (provide dimensions far each
item, such as toff x 1 oo ft)*:
1. . AN 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 wails, docks, etc.
S. Location of any excavation or dredging below the l=ull pond/ Normal Water Level elevation
6. Location of construction access corridors
FORM: SSCP 10-2013 Page 3 of 3

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MIL H ttTON, INC.
5102 C aF'PER DRNE
CNNO ;TTE. N.C.25214
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APOF '!ON OF Gd8 PARM ll3Mt8
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Google Maps
Man Baia X32017 Gooale United States 1000 ft
httr)s://www.googt,e.com/niapst@35.22282K-&0.9997791,15z
Page 1 or 1
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110 1 aft'd

Shoreline Stabilization for 6230 Jepson Court
1. Existing Pathway from Lower Lawn to Shore
2. Pathway Continuing down hill to Dods
3. Pathway Continuing down hill to Dock 4. Shoreline North of the Dock

Shoreline Stabilization for 6230 Jepson Court PAGE 3
G rincpsan of crahili2ation Area North of Dock

f
Shoreline Stabilization for 6230 Jepson Court PAGE 4
6. Closeup of Stabilization Area South of Dock