20180959 Ver 1_Shoreline Stabilization_20180711

Water Resources
ENVIRONMENTAL QUALITY
20 1 8 0 9 5 9 State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
11)
FORM: SSGP 02-2017
Shoreline Stabilization Application Form D Jti�Z
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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 [15A NCAC 02H .0502(a)]
1. Owner Information
Name: r
Mailing Address:
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i. e7 " Y i(1. c
Telephone Number: 331- b85 I 5a Fax Number:
E-mail Address: LIQ -(2n 4S4 -5A/e/ c i * 0G r-rl /, (7e M
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:
htto://www.saw.usace.armv.miI/Portals/59/docs/reeulatory/reedocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf)
Name: IUI Z
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.)
4. Location of the property (where work is to be conducted) 1"
County: � Ui 10_ S D Pi Nearest Town: �e x 1'4 S ly
Lake/ river/ ocean adjacent to property: 2 PrP�� c �rr�%l, A j �C- 0,
Property size (acres): 2 At' Z e
Subdivision name or site address (include phase/lot number): 1 L F10 R.(u (,► \; t r L0
D)J.JQI 1e;I ri %10 P IV, e
Directions to site - please include road names and numbers, landmarks, etc.: 1 l 00
0,yC Jy 1 e w U )\,IC1 O, l \m ; k_5 S a "A\ .
Latitude (in decimal degrees) 35, 1 11-17 2 Longitude (decimal degrees) -10 -3)'7 '-I _15-
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): �@ 5), 01 P n 4 1 cx �
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): orf 1147 Gc 4- A c1 r -A w
'o C�"4 ,c A
7. Will work be conducted from land? �� From water? EI
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:
. / /.l / , 1 . — /5 , w n
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:
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 Snumber of trees, for instance):
�_iSm
11. Signature
/>" fi/,/� , M 7 -A-9 -
Owner/Agent's Signature' [15A NCAC 02H .0502(f)l Date
`Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 02-2017 Page 2 of 4

Information for Reservoir and Shoreline Alteration
1- Map of reservoir area where the Excavation is proposed (See attached drawing)
2- Description of planned Excavation:
a. The Applicant will finish the Excavation 75 feet from the shoreline.
b. The Applicant will Excavate from a starting point of 4.8 feet (Current Level) down to 6
feet from the end of the proposed Pier. The proposed excavation will start from the
main channel and excavate back to the pier allowing for drainage & rainfall. The
estimated sediment to be removed is 160 yards
3- Plan for disposal of excavated material:
a. Applicant plans to dispose of sediment at location 753 Riverview Blvd or Alternate
location at 1651 Riverview Blvd. Silt fencing will be provided if needed.
4- Resource impacts assessment:
a. There will be no impact on water quality or fish habitat. The proposed excavation site
has minimal Vegetation (See attached photo)
5- Schedule for Excavation to begin between December 2018 & January 2019 depending on water
depths According to the Nigh Rock Reservoir Operating Curve or sooner if possible.

Proposed excavation site
for 1600 Riverview Blvd
Lexington NC 27292
Lake
20 Ft Wide
Dig to drain
15 to t
Slope 1
opel p 15 to 1
Slope
30 toslop
Rip Rap
60' 1 40'
Home site
I

h S12 0K
sl
15K
S174K $ 5... 532K0
/ S110K
S119K'
f %
S58K
units
7S91KS91K
+ S14K 5900 _
f 2 units SIOK
/ S102K f � S119K
S20K
S3
\,. S86K