20180803 Ver 1_Shoreline Stabilization_20180608

2 0, 8 0 8 0 3 State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
ENVIRONMENTAL QUALITY FORM: SSGP 02-2017
Shoreline Stabilization Application Form
Three copies of the application 0 ud� � it ents) and the application fee should be sent to:
If sending via US Postal Se If sending via delivery service (UPS, FedEx, etc.)
Karen Higgins Karen Higgins
DWR — 401 & Buffer Permitting Branch DWR — 401 & Buffer Permitting BrancR��
1617 Mail Service Center 512 N. Salisbury Street )/ C�C71V
Raleigh, NC 27699-1617 Raleigh, NC 27604 J11N p8 �O
A. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name:
Mailing
Ps&R?41B
`�T pRMwq 1ER P Q,o q UT l'
1/tr_1NG
Telephone Number:?, -,5(p -8-(p 25 FaxNumber: tt��
E-mail Address: L-S0he)5+0y-) 206W 0c)+Ioo K , Cn YYl
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.mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTHORIZ
Name: _I )nn
Company Affiliation
Mailing Address:
Telephone Number:
E-mail Address:
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.
[nDnn• ccrD n,) -7n17 Dn— 1 „f Q

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: L, Yl r_n I n Nearest Town:
Lake/ river/ ocean adjacent to property
Property size (acres): /,.504 Q
: Ao rma n
Subdivision name or site address (include phase/lot number): ,(..Ol
NN e-16be0 ia pe- Lsr)v e,
Directions to site - please include road names nd numbers, landmarks, etc.: �:m m NC-Ilo Ng
'Rto8�} o n10 t;m rt 3'grnp,6 Churc)n Rd, .`At?t oni-p_ NC-1lo bus 9>%, L4f+pnta 1NebbS
—f ltwood. Mw✓Yla is o -rvie 1eIV+. Ili
Latitude (in decimal degrees) Jr' . Longitude (decimal degrees)- £30. C(CA875
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): �,e�ldeniiQl
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
7. Will work be conducted from land? ❑ 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 squa
ge feet:
Temporary impacts in square feet: UJ
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:
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): 6_77r
11. Signatur
v
Owner/Agent's Signa urF' [15A NCAC 02H .0502(f)] 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
Full Pond/ Normal Water Level
Shoreline
Plan View
Lake
(At Full Pond/ Normal Water Level)
Lake
(At Full Pond/ Normal Water Levey Existing Dock
/30ft K7ft
-'t.-
fo
red
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1 E AMPLE
FORM: SSGP 02-2017 Page 3 of 4
Plan View

Q)
La ke
(At Full Pond/ Normal Water Level)
Side View
LL -
10 ft. bank
height
Side Vi
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p r- � CIGGO ✓1l� � 1 S� vYl
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03(o
I I be Iov,J fA Mohd vela -ler leve I I
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3 ft, below full pond water level 4 ft, above full pond water level 2 ft. additional clearing
if necessary
Existing bank
FORM: SSGP 02-2017 Page 4 of 4

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Address: 7435 Tallwood Drive Denver, NC 2F GO Mobile Version
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Latitude: 35.529317
Longitude: -80.999875
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Latitude: 35 31 45.5406
Longitude: -80 59 59.55
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�IINN� DRAWN BY: PAH HOUSE LOCATION PLAN FOR
DRAWING FILE 41E:14116.WCC23
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PROJECT NO: 141116 HARRIS LAND SURVEYING, PLLC
..
i u _ PROPERTY ADDRESS: FIRMLICENSE P-1295
TALLWOOO OR 4080 DAMSS RD
DENVER NC 28037 CATAWBA SPRINGS TOWNSHIP, LINCOLN COUNTY, NC MAIDEN, NC 28650
DATE: DECEMBER 31, 2014 LOT 23 OF WEBBS CHAPEL COVE, MAP 4 AS REVISED 704-400-6800
?1 j11�1R1��\ SCALE: 1"=40' REFERENCES: DB: 2235-871 h PB: 13-230
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' OWNER TO VERIFY ALL SETBACKS AND ZONING
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REGULATIONS PRIOR TO ANY PLANNING OR
CONSTRUCTION.
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• ALL DISTANCES ARE HORIZONTAL GROUND DISTANCES
UNLESS OTHERWISE NOTED.
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' ALL AREAS SHOWN HEREON WERE DETERMINED BY
COORDINATE COMPUTATION.
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LINE TABLE
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L1 S 59'07 3 iJ.79
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{y WRl•£ I LENGTH RADIUS BfARINC CHORD
' C7 2J.89 50.00' S 7134 35 23.66
C2 1 21.02 S 8279V7-Wi 20.41
�IINN� DRAWN BY: PAH HOUSE LOCATION PLAN FOR
DRAWING FILE 41E:14116.WCC23
1
PROJECT NO: 141116 HARRIS LAND SURVEYING, PLLC
..
i u _ PROPERTY ADDRESS: FIRMLICENSE P-1295
TALLWOOO OR 4080 DAMSS RD
DENVER NC 28037 CATAWBA SPRINGS TOWNSHIP, LINCOLN COUNTY, NC MAIDEN, NC 28650
DATE: DECEMBER 31, 2014 LOT 23 OF WEBBS CHAPEL COVE, MAP 4 AS REVISED 704-400-6800
?1 j11�1R1��\ SCALE: 1"=40' REFERENCES: DB: 2235-871 h PB: 13-230
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BK 2498 PG 634 - 635 (2)
This document presented and filed.
01/15/2015 08:16:08 AM
DEED
Fee 326.00 Transfer Tax: $300.00
529135
Lincoln County North Carolina
Danny R. Hester, Register of Deeds
2(aCLi NORTH CAROLINA GENERAL WARRANTY DEED
Excise Tax: S 300.00
Parcel Identifier No. 81986 Verified by County on the _ day of 20_
By:
JMail/Box to: Grantee
This instrument was prepared by: The Jonas Law Firm, PLLC / Peter C. Capece, 2279 North NC Hwy 16/PO Box 1594,
Brief description for the Index: LOT 23, Webbs Chapel Cove (13/227-232)
THIS DEED made this 14th day of January , 2015 by and between
GRANTOR
Richard L. Biegel unmarried
1235A N Clybourn Unit 187
Chicago, IL 60610
Tallwood Legacy, LLC
2279 N. NC Highway I
Denver, NC 28037
Enter inappropriate block for each Grantor and Grantee: name. trailing address, and, if appropriate, character of entity, e.g.
corporation or partnership.
The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and shall include
singular, plural, masculine, feminine or neuter as required by context.
WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby acknowledged, has and
by these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that certain lot or parcel of land situated in the
City of Catawba Springs Township, Lincoln County, North Carolina
and more particularly described as follows:
BEING all and the full contents of Lot No. Twenty-three (23) of WEBBS CHAPEL COVE Subdivision as shown on plats
entitled WEBBS CHAPEL COVE prepared by Ronnie Dedmon Surveyor PA dated May 27, 2005 and recorded in Plat Book 13,
Page 227 through 232 in the Office of the Register of Deeds for Lincoln County, North Carolina.
The property hereinabove described was acquired by Grantor by instrument recorded in Book 2235 page 871
All or a portion of the property herein conveyed _ includes or X does not include the primary residence of a Grantor.
A map showing the above described property is recorded in Plat Book 13 page 227-232 .
NC Bar Association Form No. 3 ® 1976, Revkwd O 1/1/2010
Printed by Agreement with the NC Bar As iwion

BK 2498 PG 635 DOC# 529135
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in
fee simple.
And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple, has the right to convey the same in fee
simple, that title is marketable and free and clear of all encumbrances, and that Grantor will warrant and defend the title against the
lawful claims of all persons whomsoever, other than the following exceptions: Valid and enforceable restrictions, right-of-ways
and easements that appear in the record chain of title.
IN WITNESS WHEREOF, the Grantor has duly executed the foregoing oft day and yey ftp %abovc wAtten.
l�C-•oL [ /:Zjn=- (SEAL)
(Entity Name) PrinVrype Name: Richard L. Bieuel
By:
(SEAL)
Print/Type Name & Title: PrinVrype Name:
By: (SEAL)
Print/Type Name & Title: Print/fypc Name:
By:
PrinVrype Name & Title: Print/Type Name:
State of North Carolina - County or City of Lincoln
I, the undersigned Notary Public of the County or City of Lincoln and State aforesaid, certify that
personally appeased before me this day and
acknowledged the due execution of the foregoing instrument f!q gMvpsRtSterein expressed. Witness my hand and Notarial stamp or
seal this 6th day of January 20-1 �P
V ,OT,ggy
My Commission Expires: March 27. 2016 i A ©audia E. Talbot Notary Public
(Affix Seal)V B � L % C -Z�C) Fotary's Printed or Typed Name
State of - County or City of
I, the undersigned Notary Public of the County or
of
Vbliand State aforesaid, certify that
personally came before me this day and acknowledged that _he is the
a North Carolina or
corporation/limited liability company/general partnership/limited partnership (strike through the inapplicable), and that by authority
duly given and as the act of such entity, _he signed the foregoing instrument in its name on its behalf as its act and deed. Witness
my hand and Notarial stamp or seal, this day of 20_
My Commission Expires: Notary Public
(Affix Seal) Notary's Printed or Typed Name
State of - County or City of
I, the undersigned Notary Public of the County or City of and State aforesaid certify Utat
Witness my hand and Notarial stamp or seal, this day of
My Commission Expires:
(Affix Seal)
NC Bar Association Form No. 3 O 1976. Revised C 1/12010
Printed by Agreement with the NC Bar Association
20.;
Notary's Printed or Typed Name
Public

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: TQIIwood L.C'"V'IgbVV5'I; " County: L ncol ✓1
'74 3 5 Tq Wwobd -b-r. evnv er, NG 2803-7
owner: ICLII 7
Pri
Contractor/agent:
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 02B .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 02B.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
I, LLt rr-:SAla n , hereby state that I have been informed of the Catawba
Riparian Buffer hule. 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 substantial compliance and intent of the 401 Water
Quality Certification and Buffer Rules, the approved plan(s) and specification(s), and other supporting
materials.
Date: 5"AU QQ "fl_
Signature (owner):
���