20181169 Ver 1_Shoreline Stabilization_20180820

State of North Carolina
Department of Environment and Natural Resources
DWR Division of Water Resources
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
Division of Water Resources FORM: SSGP 10-2013
Shoreline Stabilization Application Form 20 18 1189
Three copies of the application (including attachments) and the application fee should be sent
to:
Division of Water Resources
401 & Buffer Permitting Unit RECE
1617 Mail Service Center ��,E0
Raleigh, NC 27699-1617 AUG e 0 2016
P �Tp� IVR'IAND QUALITY
I 1. OwnerlApplicant Information 15A N 0 02 a ] MW�T�RP�M� NG
Name: Dean Rowell
Mailing Address:
PO Box 837
Oakboro NC 28129
Telephone Number: 704-363-5213
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:
htto://www.saw.usace.army.miI/Portals/59/docs/regulatory/reRdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: Dean Rowell
Company Affiliation: Owner
Mailing Address: PO Box 837
Oakboro NC 28129
Telephone Number: 704-363-5213
Fax Number:
FORM: SSGP 10-2013 Page 1 of 3

E-mail Address: [e-mail]
Person to receive the Certification Approval: Dean Rowel
II. 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,
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: Stanly
Nearest Town: Norwood
Subdivision name or site address (include phase/lot number): Turner Beach Lot 125
Directions to site - please include road names and numbers, landmarks, etc.: From
Norwood Hwy 52 South to left on Fork Rd (1765 or 1766) to left on Piney Point Rd (1768) to
left on Willow Oak Rd_ (1800). 10561 Willow Oak will be on the left.
Latitude (in decimal degrees) 35.222906 Longitude (decimal degrees)
-80.090795
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Residentia
6. Property size (acres): Less than acre
7. Lake/ river/ ocean adjacent to property: Lake Tillery
FORM: SSGP 10-2013 Page 2 of 4

8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Want to build an interlocking stone wall approximately 3'
tall to prevent erosion. Want to dredge approximately 6720 sq ft 2ft deep to remove silt.
Pictures show how bank is eroding. Also want to demo existing dock and build new dock
with 2 covered boat slips.
9. Will work be conducted from land? X❑ 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:
Approximately 6720 Sq
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: Approximately 2240 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
impacted, only grass in yard.
Owner/Agent's Signature` [15A NCAC 02H .0502(f)]
e -,i -/
Date
*Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013 Page 3 of 4

6010"
Full Pond/
Normal Water Level
Shoreline
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Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ft x 100 ft)*:
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.
5. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
FORM: SSGP 10-2013 Page 4 of 4

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Tax Record
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PIN
Owner Name
Road Name
Physical Address
10561 WILLOW OAK RD
Subdivision
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Excel 2000/2003
Display Labels 1-1 Display P Y 50
Property
Tax
Owner Mailing
Record
Deed Plat PIN Owner
Name Mailing Address City
State Zip Physical Deed Lots
Deed Deed Plat Plat Descriptions Year Finished
DateSold SaleAmount TotalFMVCurrent DI
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Record Name
2 Address 2
Address Acres
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Book Page Book Page Built Area Record
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ROWELL
414
10561
1 :, Record
Deed Plat 973 657301472823 BRUCE
LINDSEY OAKBORO
NC 28129 WILLOW 0 1
1078 441 DWELLING 1968 1020 No
0 238359 11
Card
DEAN JR
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OAK RD
(02009-2018 Dude Solutions. All Rights Reserved. I software Notices
I of 1 8/13/2018, 8:13 PM

BOAT HOUSE AND PIER
WILLOW OAK ROAD
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S 745'41„
LOT 124 30.00. E S 83°55'41" E IRON FOUND
50.11'
E LOT 125
29•
13 1 STORY �'k LOT 126 \'
BLOCK `� 6 1 Lro \
IRON SET
N 81' 12'45"
W — 97.46' IRON SET \
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SHORELINE - '
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s\oa PIER OT 127 /'
LAKE TILLERY
STATE OF NORTH CAROLINA, UNION COUNTY
eOUN0okW MW LOCOM SUMiEY Of WT 113 TURNER W. CH MM M"
I, BOBBY F. SIMPSON A NORTH CAROLINA
BOBBY F. SIMPSON NCPLS 3626
PROFESSIONAL LAND SURVEYOR, CERTIFY THAT THIS
MAP WAS DRAWN FROM AN ACTUAL SU BY ME,
DEED RECORDED IN BOOK t0 11 PAGE.
DATE
THAT THE SURVEY IS OF AN EXISTING PARCEL
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OR PARCELS OF LAND, THAT THE RATIO OF PRECISION
SEAL
IS 1 IN 10,000 + ; THAT THIS MAP WAS PREPARED
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IN ACCORDANCE WITH G. S. 47-30 AS AMENDED.
WITNESS MY HAND AND THIS s¢H DAY OFpGr 2005
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(SEEEAAL,
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BOBBY F. SIMPSON NCPLS 3626
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BAR SCALE
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DEAN ROWELL
eOUN0okW MW LOCOM SUMiEY Of WT 113 TURNER W. CH MM M"
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BOBBY F. SIMPSON NCPLS 3626
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DATE
1704-A MORGAN MILL ROAD
BFS
9-30-vm
MONROE, NC 28110
PHONE: [phone]
APPHCNED
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