20181170 Ver 1_Shoreline Stabilization_20180821

State of North Carolina
Department of Environment and Natural Resources
DWR Division of Water Resources
Division of Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SSGP 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
20181170
I. Applicant Information [15A NCAC 02H .0502(a)]
Owner Information
Name:Ark:P[Ck 1 a►''Mailing Address: 301a,
Telephone Number: qac -562 — (n 153 Fax Number:
E-mail Address: . cn a r I/-, ED�� b10, t� CA � CO YYI
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
http://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:
Company Affiliation:
Mailing Address:
Telephone Number: '10 1- (,(ab - 5 11 1 Fax Number: _qo c4 (.D la0 - 5gQq
E-mail Address:
neJ-
Person to receive the Certification Approval: �1i nir-e- E D�D-,4
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,
FORM: SSGP 10-2013 Page 1 of 3

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) 1
County: Ca,�O_UJ�rj0_ Nearest Town: �pp,r'CV ► 5Ike..
Subdivision name or site address (include phase/lot number): RIUA ka0. jog Cr
Te,rrell' air_ 266221, Lc,t 1_3
Directions to site - please include road names and numbers, landmarks, etc.: -Ctl_
ko ex;I Up lura leo orAu W. 15D LLEP,4 C t4inve orx We 15c)
+VwjrN��rzL�� r,���] ►�eic l .fhe���,/c1b�3� o n +o _
�aIr Cr'. -�y1rn Y'1Qh% +o E4C1 nY-) &-r6o9- CIC
Latitude (in decimal degrees) 3�j.SSQt)U Longitude (decimal degrees) - $b _ Q(po I (y
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): uIp eget T,�d },rt,5AW11 Q�
6. Property size (acres): L( 010
7. Lake/ river/ ocean adjacent to property: t4or fna n
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): SlCapp J 56ne- noa-i am I ftswt
bnu k de.r 6 iD ra-01
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:
r/
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: ___
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):
ShoreIIY-ve G.rea_ mdoxger of Vo -11 ty�n+o IOLA, .
Zoo &�1 ryst-ee,bonQ�l°►CAPU �e✓t%v Trust 8 -- —
Owner/Agent's Signature' [_` r' = g_ 11 '"'(t 7 Date
Agent's .signature is valid only if on authorisation letter from the owner is provided,
FORM: SSGP 10-2013 Page 2 of 3

Full Pond/
Normal Water Level
i i i i i
Shoreline
La ke
(At Full Pond/ Normal Water Level)
1 belmo
I I Abo\jC..
I
ke.ce lard
LC'+ +0
Ier� rec;
ko
k feel
,oe,
vn e -
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 3 of 3

b SURVEYORS CERnRCAMON
1. WILLIAM M. ALLEN Q Ak v ryyTHIS MAP WAS DRAW
UNE TABLE
\ UNDER MY SUPERVISIONRFROM ANT ACTUAL SURVEY MADE
ER
PTION
$�in LINE BEARING LENGTH INNBOOK SLIPPAGE DEED THAT�THE RATIOOFRECORDED 4 PRECISION AS CALCULATED BY LATITUDES AND
L4 0 ' DEPARTURES IS 1:10000, (THAT THE BOUNDARIES NOT
SURVEYED ARE SHOWN AS BROKEN LINES PLOTTED FROM
\ F S INFORMATION FOUND IN BOOK PAGE VICINITY MAP�MNO SCALE. / v L7 N THAT THIS MAP WAS PREPARED IN ACCORDANCE WITH
LOT 1 1 �'� a / t°\\ \ L 18' G.S. 47-30, AS AMENDED.
JOSEPH PAUL � l j \ i L9 N 1 748"18,15'�\ \ VA SS MY HANDAAOND20 aAL THIS DAY OF
DUCEY mry aY LOT 12 i'
I 3208 1726 / = h��� CLARENCE i �rn
I / / ry° MICHAEL G �1 _
/ UNDERWOOD vaorE5a=�' / R SSiONAL LAND SURVIWOR
1433/598 r _ ate. I LAKE OFFICIAL SEAL — ,,,�;,%tCAff,,,,o"
NORMAN REGISTRATION NU.........
5548'00-E I �E$S/' 'L
I;, I — SEAL l i
/ :� (TIE ONLY) "-q 1,3499
Ir3499
I —354 3D'00'E 2j fP $I I
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LEGEND x,�,1111#P.P. - POWER POLE "111#1811110"
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(V%g� I I.P.S. -X14 REBAR SET
R/W - RIGHT—OF—WAY
LOT 13 J qe N I CP - COMPUTED POINTae� 1 NAOME L. PICA71ARD l ti I Ia I m
0.07 AC. REVOCABLE LIVING Q `ONOTES
(INSIDE OVERLAP TRUST ' n gLDM off' r I JEANNENE H. ALLEN
s 1966\495 n I f 2922\1465 ') ANY EASEMENT AND/OPERTY MAY OR RIGHTS—OF—WAY
RIGHTS OF WAY
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0.44 AC. * o; I OF RECORD.
SHED 7� — 2) AREA COMPUTED BY THE COORDINATE
: (OUTSIDE OF r LOT 14 YnI METHOD
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9 \ OVERLAP) 3) EXISTING 780' & 781' CONTOUR ELEV—
\ I s JOSEPH H. I ATION BASED ON LAKE NORMAN LAKE
s JD•yI\ GLENN, IV LEVEL AT COWAN'S FORD DAM (READING
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� MONUMENT FOUND WITHIN
H�BYB I Q I / 8) 30' BUFFER FROM 780 CONTOUR PER
ALAN JOHNSON (NCDENR)
0' 20' 40' 100' l6 1-6-0. 011p 3'10 \ �c
\ h'/�j/i? � (nE aria w�q^ �_/ "�avu, BOUNDARY SURVEY
\ J ��4g�q 18• v/ 00
SCALE IN FEET Bg 3 1 fm oxy) ,4 � OF
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"32-718"
IDT LOT 13 B. L 10 -SER #2
81.10
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DON ALLEN & ASSOCIATES P.A. MOUNTAIN CREEK TWSP., CATAWBA CO., N.C.
\ "Since 1971" SCALE: 1" - 40' DATE: AUGUST 15, 2017
Commercial • Residential a Mortgqage Surveys a Multi—Family \ \ UPDATED: JAN. 15, 2018 (ADDED 30' BUF
Construction Stoking • Subdivlelon Design a Topogrophlcal
131 Crosslake Park Drive — Suite 102 • Mooresville , N.C. 28117 OWNER: NAOME L. PICKHARD ` �.
[phone] [phone] Fax s REVOCABLE LIVING TRUST
donallensurw~on.c6n �,

0catawba county Geospatial Real Estate Search
`�" MAKING. LIVING.MM, Information Services
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Parcel: 461604740164, 8762 HARBOR CIR TERRELL, 28682
Owners: PICKHARD NAOME L REVOCABLE LIVING TRUST,
Owner Address: 392 BREWSTER DR
Values - Building(s): $0, Land: $281,200, Total: $281,200
1 in=200ft
This map/report product was prepared from the Catawba County, NC Geospatial Information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and labeling information contained on this map or data on this report. Catawba County promotes and recommends
the independent verification of any data contained on this map/report product by the user. The County of Catawba, its employees, agents, and
personnel, disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or may
arise from this map/report product or the use thereof by any person or entity.
Copyright 2014 Catawba County NC
08/16/2018

8/16/2018
Google Maps 8762 Harbor Cir
8762 Harbor Cir - Google Maps
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Map data ©2018 Google 100 ft,
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8/16/2018
Go gle Maps 8762 Harbor Cir
8762 Harbor Cir - Google Maps
Imagery 02018 Google, Map data @2018 Google 100 ft
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Project Name/address: 81 l0 609 Cr lCr-MI N '�_a Sa County:
/1/L Yk FrcKhtp-d� Tl -res tee,,
Owner: adhr ? _L �ickh ��y L,`✓ �ust' _
Print Signature
Contractor/agent: _( Q('�,G i. Boal r011•n.y I I P (� , __ _„
Print L .J i r ature
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 sioping 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 .4243 (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)]
Mork 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 02E1 .0502 and 15A NCAC 02B.0243 (4), (6), (8)
Stormwater cannot be piped or channeled for direct discharge to they 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
1, _Akk i ekha hereby 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): N�Oyv12 L %2i%�'hUrd %�PV L�✓ / rG(St -- Date: - o /

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