20180020 Ver 1_Shoreline Stabilization_20180102

State of North Carolina
Department of Environment and Natural Resources
k_ Division of Water Resources
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
Division of water Resources FORM: S5GP 10-2013
Shoreline Stabilization Application Form
Four copies of the application (including attachments) and the application fee should be sent to:
Division of Water ResourcesD � :D:
401 &Buffer Permitting Unit T 1650 Mail Service Center V n 20
Raleigh, NC 27699-1650
Applicant Information [15A NCAC 02H .0502(a)]
1_ Owner infnrmatinn
Name:
Mailing
Telephone Number:7164-/ /?- /33R Fax Number:
E-mail Address: .5e.6*- -k.rr si ho oma.« .Ccim
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.army.mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the A ent has signed this application form.
Name: (A 4. 'Bn
Company Affiliation: c5
Mailing Address: &5q 61 L43 W
Telephone Number761- (9&0 ".5/1 Fax Number:70 -
E-mail Address: cbCs e.awaa [s o@w.M.-s+ream
Person to receive the Certification Approval: 13obb i e—I � ✓Y► IM
Cbe�eat,vc�.l [s®w ne�s-I ��ea rn 1VJ..'+
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,
FORM: SSGP 10-2013 Page 1 of 4

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 th property (where work is to be conducted)
County: 4,W � Nearest Town: 166 Cal _'S, —4(3rj
Subdivision name or site address (include phase/lot number): k6 --t— 3.
^r_ -,. L J _ - _ _ neat- /I _ I_ _. I eL
Directions o site - please include road names and numbers, landmarks, etc.: 7 �,
Latitude (in decimal
baa, Longitude (decimal degrees) 78 f . t A 4A6
5. Describe the existing land use or condition of the ite at the time of this application
(residential, undeveloped, etc.):
6. Property size (acres): • 51
At -
7. Lake/ river/ ocean adjacent to property: _
8. Describe proposed work (include discussi(
avoided, or why it is necessary): iAlbl
9. Will work be conducted from land? ©�
as to how hardening of shoreline has been
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:
3' 6*A oLA_�
11. Total amount of disturbance (including all clearing, backfill, 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: I r&oolhe ,
12. Please describe the vegetation above the normal pool lake level/ Normal Water Level and 50
feet landward to be impacted (number of trees, forYYinstance): /YD 'f
l�uv-I Gfmpilq t Teyl .
uwner/Hgenrs �ignaiure Nrmtea Name nate
[15A NCAC 02H .0502(fll
'Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 3
J

Full Pond/
Normal Water Level
Shoreline
I % v
C%C�
Lake
(At Full Pond/Normal Water Level)
�— os
dd6s I -RI-P-IzaP
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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

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CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address:/�`f 5 ,r`L� S - f -- County: �p
tow
ner: fcc/C r
Print � Signature
Contractor/agent: S '
Print Signature
The approval is for the purpose and design described in your application. Impacts not indicated in the
application is a violation of the Buffer Rule. Site specific work should be provided in the application. [15A NCAC
02H .0506 and 15A NCAC 02B .0243(8)]
Trees are not allowed to be removed from Zone 1 of the Buffer (within 30 ft of the full pond elevation), unless
approved. Exception, those trees that are severely undermined along the immediate shoreline can be removed.
Minimal shaping and sloping along the immediate shoreline is allowed. [15A NCAC 02B.0243(6)]
Benching, grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 0213.0243 (6)]
Beaches, impervious patios, impervious walkways, etc. are not allowed in the buffer unless specifically approved
by the Division. There are limitation on size for decks. [15A NCAC 02B .0243(4) and (6)]
Work to be conducted from land must indicate an access and indicate any trees that are to be removed. The
work corridor should be described. The approved access corridor shall be restored. Staging, spoil, construction
material must be outside the buffer. [15A NCAC 02H .0502 and 15A NCAC 0213.0243 (4), (6), (8)]
Stormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
discharges must be at the natural elevation and discharged prior to entering the buffer directed as diffuse or
sheet flow at non-erosive velocities to the lake. [15A NCAC 02B .0243(5), (6)]
Acknowledgement of Notification
1, �-2 r hereby state that I have been informed of the Catawba
Riparian Buffer Rule. Any work conducted i the buffer, not specifically stated in the application and approved
by the Division of Water Resources (DWR), is a violation and subject to enforcement. Due diligence will be
taken such that the construction will be built within substantial compliance and intent of the 401 Water
Quality Certification and Buffer Rules, the approved plan(s) and specification(s), and other supporting
materials. --
Signature (owner)_44M
owner): Date: /2 --/--17
S;a!e of forth Caroiu a ; cm:ironmeniai Quali Water Resources
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12/1/2017
Preview
Date: Friday, December 1, 2017 1:31 PM
From: Scott <[e-mail]>
To: [e-mail] <[e-mail]>
Subject: Scott Terry's shoreline pictures
119

1211/2017 Preview
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12/20/2017
7395 Gabriel St
7395 Gabriel St - Google Maps
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Map data @2017 Google 200 ft, --
7395 Gabriel St
Sherrills Ford, NC 28673
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12/20!2017 638 OalQidge Farm Hwyto 7395 Gabriel St, Sherrills Ford, NC 28673- Google Maps
Google Maps 638 Oakridge Farm Hwy to 7395 Gabriel St, Sherrills Ford, NC 28673 Drive 13.4 miles, 24 min
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Map data ©2017Google 1mir
638 Oakridge Farm Hwy
Mooresville, NC 28115
t 1. Head southwest on NC-150 W toward Brushwood Ln
12.6 mi
�. 2. Turn right onto Little Mountain Rd
0.5 mi
r► 3. Turn right onto Gabriel St
8 Destination will be on the right
0.3 mi
7395 Gabriel St
Sherrills Ford, NC 28673
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.
htb)sJ/wuwv0000le.comlrnans/dir/638+Oakridop+Farm+HinhAnv+Mmrvcvillp+N(+2R11ri7Qd7+1ICAfnCPS+rnhriaJ+St+Charrillc+Fnrri+N(`+9fIA7'Urn)IRG 111