20181187 Ver 1_Shoreline Stabilization_20180823

�y 201 81 1 87
state of North Carob+.
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_ Dh*d= of Wocr Resources
Water Resources 1sA N'AC 02H 'OM— Wntw Cug&1' CMjNkNdM Uwafto SUbMurtion
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ENVIRONMENTAL QUALITY SSW 02-=7
Shoreline Stabilization Applkadon Form
Three copies of the application (ktc mft attodurterrts) and the eppjk;gM n fee dmid be sartt tori D A l
ffsending via US Posta/ Service /f 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 �+�'�/V�
A. ApplicanthtformaUon 115A NCAC 02H .0502(a)j O�AU� �3'cQld
1. Owner Information / /
Name: 654A le51e y I'J/r A /l'ISp/)
Mailing Address: .3130
/A-, 5 A�l
Telephone Number:,,7en'I)63V- dyOc% Fax Number: 6100
E-mail Address:
L A"W Cortlact Parson IntommNion
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:
http://www saw usace army mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf)
Name: "t/A
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Address:
Fax Number:
B. Project Infonrtation 115A NCAC 02H .0502(a) & (b)]
1. Attach a viddty 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.
3. Attach a photograph of the shoreline/ buffer proposed to be stabilized. (Include a scale of
FORM: SSCP 02-2017 Page 1 of 3
Scanned with CamScanner

some sort- a yard stick, shovel handle, etc.)
4. Location of the property (where work is to be conducted) J
County: lhp�y' Nearest Town: 19)%••
Lake/ river/ ocean adjacent to property: _ Z'4 Re- Til el- jl
Property size (acres): , �'i 7 •� C/ r S
Subdivision name or site address (include phase/lot number): 3So ddir� s loiiol� Gr /e
'117-';'A7C/ 773x6 Cdaperlll� S✓6c�v�l�H �o� /�9
Directionstosite - please include road names and numbers, landmarks, etc.: %/-n mn
12d. TZ', -n (4)e/ 0,1 SkY�� IW t4 ova s lke f ,X/ollred ��.1•�i� o..
0n � r/ o,,r/
Latkudefh7deoi7i
w de��J 3S. 3/8 876 Longitude t*dvn✓degrrrsJ -80 0 758'7,(
5. Describe the existing land use or condition of the tev;hetime of this application
(residential, undeveloped, etc.): Ke S� 4,1
6.
Describe proposed work (include on as to how hardening of shoreline has been
avoided, or why ry): Aeit is necessa,,eS11 PS AD AeP14 Ce-- AA Y, Sc) / 410d4l &U//
f &eeyle Q 6,/1c1 itS r� Ar '-Z-Oa-4 ie -'a4 Cy c/ir�a9�r i/
7. Will work be conducted from land? Lq nw-/ From water?
8. Total amount of impacts below the normal pool lake level / Normal Water Level_
Permanent impacts (including all excavation, backfill, rip rap, retaining walk, etc.) in square feet:
ASa s,C
Temporary impacts in square feet:
9. Total amount of impacts aborta the normal pod lake level / Normal Water Level and 50 feet
land -ward
Permanent impacts (including back fill, excavation, rip rap, retaining walls, etc.) In square feet:
�S0 151--
Temporary
rTemporary impacts (temporary clearing, construction corridor) in square feet:
S� Sl
10. Please describe the vegetation above the normal pool lake level/ Normal Water level and 50
feet landhard o be impacted (number of trees, for instance): IV
o A40,1,<
A (IF A4 0� to 4 rr KI
li. Signature
Le 0 he
er/Agent's Signature A .050 Date
;4yp, &sVwt"Lt vOW w*#'vn ovlha kaMbn k+tWfrom dwocvnerlspin~
FORM: SSGP 02-2017 PqP 2 of 4
Scanned with CamScanner

Lake
(At Full Pond/Normal WatrrtaWI)
Full Pond/
Normajeowi a rsl
Shoreline
frpper�-Z'
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.
S. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
g. Location of construction access corridors
Foam.: SSGP 10-2013 Pale 3 of 3
Scanned with CamScanner

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NOTES=
1 BOUNDARY PREDICATED ON EXISTING
MONUMENTATION FOUND IN THE FIELD.
2 AREA COMPUTED BY COORDINATE COMPUTATION,
4 THIS PROPERTY IS IN A COUNTY WHICH
REGULATES THE SUBDIVIDING OF LAND.
5 THIS IS A SURVEY OF AN EXISTING PARCEL
OF LAND.
COURSE RADIUS CHORD CHORD BEARING
C-1 310.00' 59-03' S 5250'34E
C-2 20.00' 26.15' S 1737'23"E
T
O�
cs,
\ OS
r
C'
EJP/CAP so-
R��
C-2
LOT 1296 \ > REBAR/CAP
0.47 ACRES / S 23'04'01'W
NC DB 666/PG 454- --49.9f
EJP/CAP
S 225521'W
44.36'
2512 �v
REBAR
OVER HANG OF
ROOF 0.5' INTO
10' SETBACK
N 1252'26'W
29.72'
�h
REBAR
S 54'28'57"W yc
5.26' �` l
ETP/CAP 1 i
C.
1.7 INTO � SIDEWALK/
ALLOCATION LINE \ \ L-11 /
EA KS , EIP/CAP
TILLERY
ALLOCATION LINE t
LOT 1295
COURSE BEARING DISTANCE
L-1 N 1238'32"W 55.33'
LEGEND:
0 E]P - EX6TING IRON PIN (As Described
0 SIP - SET IRON PIN (1/T IRON RERAR
CM - CONCRETE MONUMENT
NPS - NO POINT SET
PROPERTY LINE
— -- — ADJACENT PROPERTY LINE (NOT SURVEYED)
RIGHT OF WAY
—� POWER UNE
I, George W. Simpson, certify that this
map was drawn from an actual survey r r i
made under my supervision, that the N'.01 °ja��
error of closure as calculated by 11" �� H 2." r•
I�trtudes and deRartures is 1:10,000+. �` O0"
s
that the boundaries not surveyed are * ?, PpFESS��
shown as broken fines and the angular Q Y : �•,
error was seconds per tum. -M
SL
S L-3491 O
• , SUR14
L-3491
Ptofassional Lard Surva�ar
CE3NN/EYANCE PL-A7-SUFVErOF
PROPERTY OF - W A" 0 A' S E L L E R S
LOT IN UW RIE Twp., MONTGOMERY CO, NC
N THE pry OF MT, GILEAD ON FIDDLRES GHOST CIRCLE (PRNATE)
HOUSE NO, 350 IN BLOCK N0. _ ON MAP OF WOODRUN SUB.
MAP RECORDED IN BOOK A PG 680 DEED RECORDED IN
BOOK 666 pG 484 omm HE OF TRQOsrER OF DEEDS
suwer EOR: JOHN & KIMBERLY WILKINSON
SCAM' 1" = 60' DATE: APRIL 27- 2017
SMUE IN FW
sO 30 0 so 120
SIMPSON SURVEYING
F -.E3. $DX 1413
MT. GILEAD, NC 27306
CS10"1 220-4000

350 Fiddlers Ghost Circle
350 Fiddlers Ghost Circle
350 Fiddlers Ghost Circle 350 Fiddlers Ghost Circle