20180897 Ver 1_Shoreline Stabilization_20180628

20! 80 89T
P p�1�
State of North Carolinaook
Department of Environment and Natural Resources
DWK Division of Water Resources
Division of Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SSCP 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
L�
,lUN 2 8 2018 U
1. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: Michael C. Bray, Sr.
Mailing Address: 981 Wolf Island Road
Reidsville, NC 27320
Telephone Number: 336/552-6434 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:
htt2://www.saw.usace.army.mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: N/A
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Address:
Person to receive the Certification Approval:
Fax Number:
11. 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 4

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: Davidson Nearest Town: Lexington
Subdivision name or site address (include phase/lot number):
Lots 29 & 30, Hickory Point, at 513 Hickory Point Drive
Directions to site - please include road names and numbers, landmarks, etc.:
1-85 to Lexington exit for NC Hwy 8, go south on NC Hwy 8. R on Linwood — Southmont
Road, R on Rockcrusher Road, L on Hickory Point Dr.. #513 is on the left side of road.
Latitude (in decimal degrees) - Longitude (decimal degrees)
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Single-family residential community
6. Property size (acres): Approx. 0.50 acres
7. Lake/ river/ ocean adjacent to property: High Rock Lake
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): To stabilize an eroding shoreline and protect it from
further erosion.
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:
332 Sa. Ft.
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: 1,275 Sq. Ft.
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): No trees
will be removed in order to complete the stabilization project.
ner/Agent's Signature* A 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

Full Pond/
Normal Water Level
Sl
Lake
(At Full Pond/ Normal Water Level)
SEE ATTACHED SITE PLAN AND DETAILS
Please approximately sketch the following information on this plan (provide dimensions far each
item, such as 10 ft x 100 f t) *:
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.
S. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
FORM: SSCP 10-2013 Page 3 of 3

Ad
s1+11 '0-�Pwmw r4aaq N I14
Nj-lff
,ea �:5�SANS —rqv;Fa -I-Iq

110-
.✓.
� _.A@!aVt Nut
M A&U15 AfWS
I VKPkcT A"A, L Y- 'D 'c>

OR.
f-Xl-,,fTjg&
ficusF
41
w
N
��l
1
Z
1
x
`^
Z
70
1
y
('1
41
� m
Z
r
x
l t15TM,L APP 1goX I t 6 Lf� Of
ST S►L1��TiaN} PER PETiAiL. 5

VEGETATION AND EROSION
CONTROL FABRIC
EXISTING GRADE
CLASS 2 RIP RAP
HIGH WATER ELEV.
EROSION CONTROL FABRIC
LAKE BOTTOM
TYPICAL CONDITIONS
36" TO 72" ERODED CUT
WAVE EXPOSURE
FOR: MICHAEL C. BRAY
LOCATION: LOTS 29 & 30, HICKORY POINT
RESERVOIR: HIGH ROCK LAKE
PROJECT. SHORELINE STABILIZATION PROGRAM
PHASE I SITE EVALUATION
YADKIN, INC. - BADIN, NORTH CAROLINA
DRAWING TITLE: DETAIL
MODERATE RIP RAP STABILIZATION 1 3

2
�. a k by
P,.t
t '• �, 5
r
,
AFI
K
k
r,..3
x" ,

WNW%.-

W,7

Now Tab Swch X ��' 513 Hickory Point Drive.
C 6 Sivur hul ..!/search.yahoo.com/yhti/ r,mh0h.pori ptyRhaimp yhv lay inaps2Lparam2 al'iih2c,i V2,� 447.' 8(1.i9 rlc711A),1-12-o-,_. * A,