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Home My WebLink About20180808 Ver 1_Shoreline Stabilization_20180611w 2p Shoreline Stabilization Application Form ' 8 0 8 0,6 Three copies of the application (including attachments) and t ea�ic t' T.fee should be sent to: �A Division of Water Resources 401 & Buffer Permitting Unit rJU V1617 Mail Service Center `/ �5Raleigh, NC 27699-1617 .2018 • Applicant Information [15A NCAC 02H .0502(a)] 1. Owner Information Name: Tw'-a--5 LmLa- MailingAddress: EL ]?a. I to "-e-., nl .0 . aS :2-7 O Telephone Number: 70l{ - 7[ 4 - y 25S Fax Number: E-mail Address: «yke-SIcoLP� V-4 c n/k T^ 2. Agent/ Contact Person Information A signed and dated copy of the Agent Authorization letter (a form can be downloaded here: http://www.saUv.usace.armv.mil/Portals/59/docs/re,-ulatory/regdocs/Permits/SAMPL E AGENT AUTHORIZATION! FORM.pdf) must be attached if the Agent has signed this application form. I Name: :ILS ( �[ytnlSovt / a�Jsari s ��1.� ��r;..a er• Company Affiliation: Mailing Address: frd S -1-Lj - /"IoS -C . 2Q-1 1 Telephone Number: Fax Number: �3 -is31- S c, 55 E-mail Address: r_-lmrs 3.GE ecu *klryxj=. he+ Person to receive the Certification Approval w Project Information [15A NCAC 02H .0502(a) & (b)] • 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. • 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 construction access corridors. You may use the diagram provided at the end of this application form. • Attach a photograph of the shoreline/ buffer proposed to be stabilized. (Include a scale of some sort- a yard stick, shovel handle, etc.) • Location of the property (where work is to be conducted) County: Nearest Town: Subdivision name or site addrgss (include phase/lot number): Directions to site - please include road names and numbers, landmarks, etc.: its; I I !.-ML G^ ( Q. -r+ Latitude (in decimal degrees) , 5. l5lo754 Longitude (decimal degrees) - �s/• ct(a'iQq Describe the existing land use or condition of the site at the time of this application (residential, undeveloped, etc.):�,r�- Lv f Property size (acres): �. 57W cure • Lake/ river/ ocean adjacent to property: (a(ce- (Al ili-E, 2 • Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or why it is necessaTry): G ,r hoatsloLc a re, -erD�i�C a�O^/J/LbiG�lnPi- O_l%r ,vc.� G✓OSI—L / �`C, Sf1ai'G�t°alt j4eeA -to h.,— • Will work be conducted from land? /,e_5. From water? • 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: 31-14l/X//�/�;� 1332 a,7ct, 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: Took- 592t'L• / ,-Zealv+c 4( it? -C4.05 Z4 ?4 ai-k.. ('zeey -ts m�-Iy 3"e2 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 V -rrce_s PejV_ to -tiv- 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. 3 r= A ♦ry •- ° .-: _._: _ -_ _.. __ . - i..,c, e --cit i'.:: erPc�nt Home Insert Design Animations Slide Sha., Reae'n 'JIM Lasertiehe . _j Layout \ 14-� CD --' tj Reset14:l _ ,= _-.= = •. 1l Past+ Slide - ,� Delete sr :l. Uaartl >1idl5 F:.f: �i13SJ3(^ J - e i Lake (At Full Pond/ Normal Water Level) Full Pond/ Norma�W M Shoreline Slide at 'Ohne Meme lip 3 j140 3 - 11 Ufa (.n &X Please approximately sketch the following information on this plan (provide dimensions for each item, such as 10 ft x 100 ft)*: • All proposed vegetation clearing • Location of rip rap or fill to be placed above the Full Pond/ Formal Water Level elevation • Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation • Location of any proposed structures such as buildings, retaining walls, docks, etc. • Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation I] P^ • Location of construction access corridors SAMPLE AGENT AUTHORIZATION FORM PROPERTY LEGAL DESCRIPTION: LOT NO. ;4 PLAN NO. Gic315-- Ca PARCEL ID: _3391 - 7S= qC7cl Please print: Property Owner: �l Property Owner:_ _ �� t ►yt �2 l�- The undersigned, registered property owners of the above noted property, do hereby authorize j2a-, J V Ua-j,%-Q ✓l rof Mt-JS0 VL s 17, Ie �r # % •mow ( ontractor / Agent) (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): Telephone: 701/- 71c(- '� X55 We hereby certify the above information submitted in this application is true and accurate to the best of our knowledge. Lt' "�� - 6�" '- thorized Signature Authorized Signature Date: - 0 / 9-0 1 1�- Date: CATAWBA RIPARIAN BUFFER NOTIFICATION FORM Project Name/address: k( J7ec t1 Lica rx LA- Bed Mprl�, AL C • County: _ �._4'n l 6� I — Owner: ,,� J4_W1e S Print Contractor/agent:d„�r5 Print nature Signature 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 0213.0243 (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 -2�-14-v1.te-S Cool -e . herebv 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 substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plan(s) and specification(s), and other supporting materials. Signature (owner): 1/ ��i� ri Date: ,S ? U [ State of North Carolina Environmental Quality ; Water Resources 512 N. Salisbury Street 1611 Mail Service Center Raleigh, NC 27699-1611 919.7079000 � �� .t .... _ y e.�\. / - �1 a ►r �\ .�+ • 1: - �. �"�. vis kk Am rat µ.x 7LO rix. LO r 34 25.2M SO, F.. 0-579 ACRE !ji Pr°�ie�nxti i. e6 Sunn LO r 34 25.2M SO, F.. 0-579 ACRE !ji Pr°�ie�nxti i. Pmm Sunn .4b LA.VP t -IJP fkkA (-7. F2 t.-4 LO r 34 25.2M SO, F.. 0-579 ACRE -L4K,E WyLfE 4L~ 14 01 I-ol .114 01 pfla, !ji Pr°�ie�nxti i. Pmm Sunn t -IJP fkkA (-7. F2 t.-4 I h ---, � �fq,; Teti! iktt }t 1-4 sk ':f� V7, -L4K,E WyLfE 4L~ 14 01 I-ol .114 01 pfla, !ji Pr°�ie�nxti Pmm Sunn t -IJP fkkA (-7. F2 t.-4