20171620 Ver 1_Shoreline Stabilization_20171212 (2)

SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT N0. 4 PLAN NO.
$ PAID
PARCELID: 462705078573
STREET ADDRESS: 3544 Osprey Cove Ct. Terrell NC 28682
Please print:
Property Owner: Barringer & Smith Properties, LLC
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Michael Wetter of
(Contractor / Agent)
Nest Homes
(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):
1133 Metropolitan Ave Charlotte, NC 28204
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized Signature Authorized Signature
Date: 121 (0C l-+' Date:

State of North Carolina
Department of Environment and Natural Resources
DWR Division of Water Resources
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
Division 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: Barringer & Smith Properties, LLC
Mailing Address: 1133 Metropolitan Ave Charlotte, NC 28204
Telephone Number: 704-208-4251 Fax Number:
E-mail Address: [e-mail]
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.miI/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: Michael Wetter/ Nest Homes, LLC
Company Affiliation: Project Manager
Mailing Address: PO Box 3965 Mooresville NC 28117
Telephone Number: 704-433-9947 Fax Number:
E-mail Address: [e-mail]
Person to receive the Certification Approval: Michael Wetter
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.
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: Catawba Nearest Town: Terrell
Subdivision name or site address (include phase/lot number):
Osprey Cove - Lot #4
Directions to site - please include road names and numbers, landmarks, etc.:
NC150 W towards steam plant. Left onto Greenwood Rd. Left onto Osprey Cove Ct.
Latitude (in decimal degrees) 35.596079 Longitude (decimal degrees) -80.947394
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): New home under construction
6. Property size (acres): 1.27
7. Lake/ river/ ocean adjacent to property: Lake Norman
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Stabilization of severely eroded bank with rip rap
9. Will work be conducted from land? 12 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:
780 SF
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: 1300 SF
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):
natural grassed & kudzo buffer
12/6/17
Owner/Agent's Signature* [15A NCAC 02H .0502(f)] Date
Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 3

La ke
(At Full Pond/ Normal Water Level)
Full Pond/
Normal Water Level
$1
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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