20180141 Ver 1_Shoreline Stabilization_20180128

eOrth Carolina
20Y
IP
nt of Envj�m�nt Cal Resources
-Du�isinn offer Resources
SU ES r uality Certification, Shoreline Stabilization
401 8 BUFFER PERMITTING FORM: SSGP 02-2017
Shoreline Stabilization Application Form
20180141
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
Raleigh, NC 27699-1617 Raleigh, NC 27604
A. Applicant Information [ I 5 NCAC 02H .0502(a)]
1. Owner Information
Name: Dirk Burleson
Mailing Address: 123 Somerset Place Marion
Marion, NC 28752
Telephone Number: 704-473-6578 Fax Number:
E-mail Address: dburleson Premc.com
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:
http:/Iwww.saw.usace.army.miI/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf)
Name: N/A Owner
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Address:
Fax Number:
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

3. Attach a photograph of the shoreline/ buffer proposed to be stabilized. (Include a scale of
some sort- a yard stick, shovel handle, etc.) Photos of four locations attached.
4. Location of the property (where work is to be conducted)
County: Burke Nearest Town: _Morganton, NC
Lake/ river/ ocean adjacent to property: Lake James
Property size (acres): .914 Acres
Subdivision name or site address (include phase/lot number): 3092 W. Moonlight Place
Lot 31; Waters Edge; Morganton, NC 28655
Directions to site - please include road names and numbers, landmarks, etc.: 1-40 West Exit
100; right on Jamestown Rd. to Freedom High School. Left on Hwy 126 go approximately seven
miles and Waters Edge development will be on the left; enter the development on Mast Hook
Way and go to the first paved road on the left; Blue Water Drive, travel until you have to stop
and turn right on Moonlight Place; Lot 31 is located at the end of the cul-de-sac.
Latitude (in decimal degrees) 35.769824 Longitude (decimal degrees) -81.828083
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): undeveloped land
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): The existing shoreline consists of mature trees/vegetation;
however; due to the constant waves caused by boats and wind, the shoreline is eroding
therefore, hardening is necessary to avoid further erosion.
7. Will work be conducted from land? X From water? ❑
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:
380 sq ft.
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:
380 sq ft.
Temporary impacts (temporary clearing, construction corridor) in square feet:
3240 sq ft.
FORM: SSGP 02-2017 Page 2 of 4

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):
small undergrowth and approximately 20 trees (mostly Virginia pine)
11. Signature
Owner/Agent's Signature* (LSA NCAC 02H .0502(f)) Date
*
Agent's signature is valid only if an authorization letter from the owner is provided.
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
Full Pond/ Normal Water
Shoreline
Plan View
La ke
(At Full Pond/ Normal Water Level)
S4c 91"', -4,L"k a
Lake
(At Full! PMWN—WWaoerie o Existing Dock
/ 3ca,7n
r�...:�
z.In r...z.. ...
�•Qri •
` "AM Op"'A' 102E�
FORM: SSGP 02-2017 E Page 3 of 4
Plan View

S QX CL. Ie 6.100.
Low, 40d.4".4 -�o
Lake a�
(At full Pond/ Normal Water Level) M
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Side Viers
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--- - _._ _...... ---- ---- ----- --- - - -
�(ft. below full pond water levelft. above full pond water level 2 ft additional clearing
'if necessary
Existing bank
VGr��s
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f� �t
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Side View-
FORM: SSGP 02-2017 Page 4 of 4

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