20180051 Ver 1_Shoreline Stabilization_20180108

�Y
State of North Carolina
2 0 1 8 0 0 5 1 Department of Environment and Natural Resources
Div4sion `pf,Water Resources
Water Resources Y 15A NCAC 02H .0500 —Water Quality Certificati I Shoreline Stabilization
ENVIRONMENTAL QUALITY FORM. SSCP 02-2017
Shoreline Stabilization Application Form
Three copies of the application (including attachments) and the application fee should be sent to:
If sending via US Postal Service If sending via delivery service (UPS, FedEx, etc.)
Karen Higgins Karen Higgins
DWR — 401 & Buffer Permitting Branch DWR — 401 & Buffer Permitting Branch
1617 Mail Service Center 512 N. Salisbury Street D O V
Raleigh, NC 27699-1617 Raleigh, NC 27604 v
A. Applicant Information [15A NCAC 02H .0502(a)] JAN 0 8 2018
1. Owner Information
Name: r D..iRlIFFER-Fn�21
404 iatlEE9
Mailing Address:
Telephone Number: (obZ- 2355 Fax Number: -7 64 - (W-04- 7493
E-mail Address: +i rn C_n�nclrnr) an t V +e Dred Llc±�:i . COY1
Y
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter must be attached if the Agent has
signed this application form. (A form can be downloaded here:
htto://www.saw.usace.armv.mil/Portals/59/docs/reeulatory/reRdocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf) , /
Name: �nv�inn� q r 1 r)
Company Affiliation:
Mailing Address: 1I I)P-r 741 Y) r)Dd
m \ r
Telephone•' Ir M 40 Number:A, J L.•
E-mail Address: cion M_ \a)o ra'--)+e'rCA0C Y-15 QM0,1 I - cc)
B. 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, buildings, retaining walls, docks, impervious surfaces, 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.
FORM: SSGP 02-2017 Page 1 of 3
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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) II
County: I cede I I Nearest Town: MDO► e5yI fie -
Lake/ river/ ocean adjacent to property: Norman
Property size (acres): /. /8
Subdivision name or site address (include phase/lot number): Tau 4(DZ.S- 7 7- %%Q 1
T P o� al TAM 4 �L3,35-137-/43 ,L.c f# 441
Directions to site - please include road names and numbers, landmarks, etc.: I
+ ar l r Why Is�on
2 i.q h -N o n -b w �� Ve er7d - c-•
Latitude jin dec al degrees) Longitude (decimal degrees) -
5. Describe the existing land use or condition of thesiteat the time of this application
(residential, undeveloped, etc.):�P_6J ej T7Q�
R
Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
4�le Shore li ne .
7. Will work be conducted from land? ❑
From water? X
8. Total amount of impacts below the normal pool lake level / Normal Water Level
Permanent impacts (including all excavation, backfill, rip rap, retaining walls, etc.) in square feet:
Temporary impacts in square feet:
9. Total amount of impacts above the normal pool lake level / Normal Water Level and 50 feet
land -ward
Permanent impacts (including back fill, excavation, rip rap, retaining walls, etc.) in square feet:
A-1
9ZD 6-F
Temporary impacts (temporary clearing, construction corridor) in square feet:
10. 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):
11. Signature
Owner/Agent's Signature; [15A NCAC 0 H .0502(f)I Date
Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 02-2017 Page 2 of 4

12. Please approximately sketch the following information on this plan and provide dimensions for
each item:
a. All proposed vegetation clearing
b. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
c. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
d. Location of any proposed structures such as buildings, retaining walls, docks, etc.
e. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
La ke
(At Full Pond/ Normal Water Level)
Wor K -iv be C mp ►e4-eJ
-�-o ►m W C&e.r.
8ci Ali nuc boo -
Full Pond/ Normal Water Level ,.3 to L"P""d�►�"�L
mmmmm_ mmmmm
Shoreline S'X 04' DNdlAUA
I�jD ad�,�iona
C��Qri ✓JG� an�C
Plan View
FORM: SSGP 02-2017
G'�c,o-eabri c,
f�a.mmerr )' ck-
Class' I" P kaa .
Lake
(At Full Pond/ Normal Water Leuel(
Existing Dock
/30ft K 7 ft
E AMP E
Plan View
Page 3 of 4
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�:r �•ri
rine—
4 ft
t ftnrore'
ftAbo�
���•rr�� •�
i•••�••�7iii _ter
rr,�r;•'W'W
_ full
Q ��•
full pond/ NWILadditional
clearing
E AMP E
Plan View
Page 3 of 4

La ke
(At Full Pond/ Normal Water
Abo q f
b �lw
s(U
c
E
`o °
Z n
-a
Side View
U-
Geo A -e-31 ro.'Oric,
4arylocer Rock-
5�a►,;1 i Za-i o ✓\ .
/�l
C1 ecu;
4 5h0r",I %. ri e.
additional clearing
3 ft. below full pond water level 4 ft. above full pond water level 2 ft. I
"if necessary
Existing bank
10 ft. bank a
height Die
I Q�ol
Side W�-M.
FORM: SSGP 02-2017 Page 4 of 4

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FINAL SURVEY
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GENERAL NOTES. rlrnnl r+Vlaru
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Disclaimer: While every effort is made to keep information provided over the internet accurate and up-to-date, the County does not certify
the authenticity or accuracy of such information. No warranties, express or implied, are provided for the records and/or mapping data
herein, or for their use or interpretation by the User.
owiW<</i-rop�ity Info
Tax Account Number: 80024421
Old Parcel Number:
Owner Name: CONDRON TIMOTHY+DENISE M
Mailing Address: 101 BROWNSTONE DRIVE MOORESVILLE NC 28117
Property Location: BROWNSTONE DR
Lot Number: 441
Legal Description: THE POINT P4 M4 PB35-137-143
'Cion
Township Code: 17
City Code: Nun
Neighborhood Code: 17011
Value Information - Current Year Property Record Card (PRC)
Building Value: 728960
Other Building Features: 7610
Land Value: 385000
Tax Assessed Value: 1121570
Deferred: 0
Latae liji0i inaiio+i - Register of Deeds Online Search

Date Recorded
20150429
Exemption
Null
Document Type Deed Book Deed Page Plat Book & Page Land Area Land Type Zoning
WD 2353 1912 35-137 1.18 AC R20
Tax Code 1 Tax Code 2 Tax Code 3 Tax Code 4 Tax Code 5
C ADVLTAX Null FR04ADVLTAX Null Null
Iredell County 704.878.3118
Harmony 704.878.3118
Love Valley 704.878.3118
City of Statesville 704.878.3575
Town of Troutman 704.528.7600
Town of Mooresville 704.662.7040
Village of Davidson 704.892.7591