20180429 Ver 1_Shoreline Stabilization_20180323

DUKE ENERGY INTERNAL USE ONLY: Construction I
Date Received: FAF Paid Application t
EN �U
�F:: �-----�
Application Complete version lop
Permit No. Duke Energy Lake Services
HEP Fund Mail Code EC12Q 2 0
526 S. Church St. 1 080 4 2 9
Site ID Close -Out Date Charlotte, NC 28202
I. DATE OF APPLICATION* 3 . I q. 18 Permitffag #. tAq
11. APPLICANT INFORMATION (applicant mailing address and contact information)
Name* ) av t ' Primary Phone*
Address* 3R Q-'4- Ynou A.(T' A i j Secondary Phone % O -'7S (o --7 U
City* C R _, a State* r4 Zip Code* a�{a) (� Fax Number
Email* 6� A Vi h -E IkC-
III. PROPERTY INFORMATION (location of rmit)
Address* 3q as rnoum-rn i t4 U jE- Dkivid County" y-ni✓-7, (-E-L' g U (-
City" A1e(A State* © Zip Code* 5iii p County Parcel ID number
(e.g. Pin, Tax ID, TMS (jai) g l� 9
Lake*: bow m-rm i LigN Number...)
Subdivision Q ULOO K- Lot(s)
To enter the Latitude and Longitude of the property, please use a
service/software to easily acquire the location Information. Values
should be provided in Decimal Degrees format (35.1245).
example service: httpJ/itouchmap.com/latlong.htmi
IV. PROPOSED ACTIVITY
Plat Book/Page�';L Z L 55 i —�
Latitude (e.g. 35.12345)* 35-33j=-71
Longitude (e.g.-80.12345)* —So , 550 `p 9%71
( New/Modification of Existing Structure C1 Maintenance of Existing Structure
( New/Modification of Existing Shoreline Stabilization (' Maintenance of Existing Shoreline Stabilization
(New/Modification of Existing Structure & Stabilization ( Maintenance of Existing Structure &
(v4ransfer of Ownership C' Other (please describe below)
4.. Is Dock
Covered? �j ES
# of Slips
# of Jetports
Area over land (sq ft) Area over water (sq ft) Total Square Feet
Shoreline Stabilization (feet) Length of 5 Distance From Shoreline VELI l 1 ..90c ow e -xi S i�v
Stabilization
Materials i 1/,6R RVC4
Brief Description 54A b i fiziN3
of the Activity J
Describe Briefly the Existing �,�
Structures Over Land and rt S ` ( t 04e\ 1 i' r MAR 2 3
Water (include sq ft)

V. Dock Builder or Engineer �...,..�.�,.�.e......_.�..__.____. .� Name/Company 01-1E} V
Address Dr- . Phone Number 17'64-750-709
City f'1' p t State Yip Code Email Jam` � � . CD
d�-ucKs7 e ml v x
VI. Checklist of Required Documents (to Include with Application Submission)
cent Survey (stamped/signed by a professional licensed surveyor showing the location of the existing or proposed
structure and/or survey of the existing or proposed stabilization)
Photos along property shoreline and photos of any existing structures and/or stabilization in or near the water
El"Application fee (check only, payable to Duke Energy) igned User Agreement Letter
[7j Applicable local, state, and federal permits ❑ Plan and profile drawing showing all measurements and elevations
Habitat Enhancement payment (if applicable)
VII. 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.
VIII. Directions by Road
,may 14ff
��d��,�
Directions by
Road* ON S t°X /OO V—
IX. Application Submission
�/ WAWAIV50-11'e ". /-�--
Please complete, print and sign this application. Then enclose all items from the checklist above in an envelope and
submit all the information to the address below.
Duke Energy Lake Services Print Form
Mail Code EC12Q
526 S. Church St.
Charlotte, NC 28202 /
I agree that the information contained within is accurate. _ _

11-41 141L- i AJ
Owner: n 6^i d
Primo Signature
Contractor/agent:
Print Signature
i'de approval is for ft purpose and design deschbed in your appfication. 'Impacts not inciicatcxl is 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 elevations unless
approved. Exception, those trees that are severely undermined along the immediate shoreline can be removed.
JMmm'a 5;7s}rsa9 M6 Sl M.20, akr5 p tbe wm %Avft 0"e we 6 A%DwedL �k5A XCAC 0M AVS(6),
Benching, grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 02B .0243
(6)]
Beaches, impervious patios, impervious walkways, enc. 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. [ISA NCAC 0211.0502 and 15ANCAC 02B.0243 (4),(6), (8)]
Stormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
discharge must be as the nato:at elcv&dm Bad dischwVd prim to ewwrag. dine buffer daaeeted as Muse or
sheet clow ar non-erosive velocities to vie lake. 115A N' AC t;
Acknowledgement of No 'cation
.hereby state that I have been informed of the Catawba
Riparian Buffer Rule. Any work conducted in 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 subs rtial complizacc and intent of the 401 Water Quality
Calf QWxw. arid- IS) and ficatlorn(s), and other sWozVng matm-nds.
Signature (owner):7,r6 Date: �• /17 too

State of North Carolina
Department of Environment and Natural Resources
DWR Division of Water Resources
Divlsfon of Water Resources ISA NCAC 02H.0500 — Water Quality Certification, Shoreline Stabilization
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
Applicant Information (15A NCAC 02H .0502(a)l
I. Owner Information _
Name: 3 n
Mailing Address:
3151) rn0 u &c ng i 4
14 t4 le. L�o 1 rIE- , KI C_
Telephone Number:' o --7510 --79—:;Q Fax Number: _
E-mail Address: Asti -'A -41 Lr_ _v - 5-)@ o► rn
a.l
KIVE-
-9g Sq
2. Agent/ Contact Person Information L, U Ci p n 3 „ arna t L • L -D rr)
A signed and dated copy of the Agent Authorization letter (a form can be downloaded heltd-
http://wArw..saw.usace.army.mil/Portals/59/docs/reeulatorv/reedocs/Permits/­S­`AMPLE AGENT AUTHO
RIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: D4 vl p —r-�A.ck
Company Affiliation:
Mailing Address: v e
9.;2-i
Telephone Number: 7b . 7.56.7Fax Number: 7 . 973. 9931
E-mail Address: -dAWlIZc4t STOP 4�l ep—M
Person to receive the Certification Approval: �L>1>l /� •-j j�tG/C
Project Information (15A NCAC 02H .0502(a) & (b)1
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, 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.
I 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 gropeqy(w ere work is to be conducted)
county: Al ectk, Lviakff4Nearest Town:
Subdivision name or site address ffinclude phase/lot number): ✓ 3
Dire��'onsto- pl se include road mes and numb jrs, landmarks, etc.: kl //
- S✓i �f/t /GIr•+DIU t90
B w)02 UAJ43}
Dr—
Latitude (in decimal degrees)31. 13 771 Longitude (decimoi degrees) • ` 5 o r'o 87
5. Describe the existing land use or condition=Z+4
'e at the time of this application
(residential, undeveloped, etc.): Y -CS
6. Property size (acres):
7. Lake/ river/ ocean adjacent to property: Al �,& f1 �✓ Z kt
8. Describe proposed work (include d;gu;sion� is to how harden of s oreline has n
avoided, or why it is necessary): i !, Z t s`j p✓ti I& � - �r-D
9. Will work be conducted from-land?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:
/D5/ X ;I-/
11. Total amount of disturbance (including all clearing, backfill, excavation, rip rap, retaining
walls, etc.) above the normal pool lake leve Normal Water Leve_ I and 50 feet land -ward in
square feet or acres: 16.5 " X
12. Please describe the vegetation above the normal pool lake level/ Normal WaU;��
d 50
feet I ndward to be impacted (number f tr , for instance): !� � ,4 'lum hCf—
ry�nr,
will be ir'zpi4c <<(
kit, YVAC�iaq lb oohs, ��ICV A—C,/ ekhAA1,,CS
_ J
Owner/Agent's Signature' Printed Name Date
MA NCAC 02H 0502(f)l
Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013
Page 2 of 3

Lake
(At Full Pond/Normal Wateriave4 �
Fun Pond/
NormH,e} ,
Shore lne L
i
t'
t, jar Y
Please approximately sketch the following information on this plan (provide dimensions for each
item, such os loft x loo ft)*:
I. All proposed vegetation clearing
2. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
I 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.
S. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
FORM; SSGP io-2o13
Page 3 of 3

THIS IS TO CERTIFY THAT ON THE _ 9th ---DAY OF JULY ` 2017 AN ACTUAL SURVEY WAS MADE
UNDER MY SUPERVISION OF THE PROPERTY SHOWN ON THIS PLAT, AND THAT THE BOUNDARY LINES AND THE
IMPROVEMENTS, IF ANY, ARE AS SHOWN HEREON.
NOTES: 0
1. PID: 02318119
2. DEED RECORDED AT OB: 24230 PG: 88
MAP RECORDED AT MB:27 PG: 551
3. AREA COMPUTED BY COORDINATE METHOD.
4. THIS PROPERTY MAY BE SUBJECT TO ADDITIONAL RECORDED OR
UNRECORDED EASEMENTS, RIGHTS—OF—WAY, OR RESTRICTIVE COVENANTS,
OTHER THAN SHOWN.
5. THE SUBJECT PROPERTY IS LOCATED IN A SPECIAL FLOOD HAZARD AREA
AS SHOWN ON MAPS PREPARED BY THE F.E.M.A. AND FEDERAL INSURANCE
ADMINISTRATION.
6. SETBACKS SHOWN ARE PER PLAT SPECIFICATIONS.
7. GENERAL UTILITY EASEMENT 10' ALONG FRONT do 5' ALONG SIDE LINES.
8. THE FEMA FLOOD ELEVATION FOR THIS PROPERTY IS 656.6.
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