20181205 Ver 1_Shoreline Stabilization_20180829

August 24, 2018
Karen Higgins
DWR - 401 & Buffer Permitting Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
Dear Ms. Higgins:
William S. Jones Jr.
17919 Margie Lane
Norwood, NC 28128
704/474-9136
20181205
Enclosed is the NC Shoreline Stabilization Application Form requesting a permit to replace a collapsed
seawall that was lost during a storm. I have enclosed three copies of:
- Shoreline Stabilization Application Form (Completed)
- Vicinity Map
- Detail site plan
-Photographs of the shoreline/buffer proposed to be stabilized
- Check for the application fee
If there are any questions of concerns, I can be contacted at the address, phone number or email
address.
Sincerely,
William S. ones

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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. Ap dma bdarr sdm 115A NCAC 02H .0502(a)1
1. Owner
Name:
Maung Address:
Telephone Number
E-mail Address:
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704147 4 -`i l 5 Fax Number:
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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://wwwAw usam army mil/Portals/59/docs/rei ulatory/readocs Permit A MPLE AGENT AUTHORS
Name: / let YL H'/ j
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Company Affiliation: IV A G
Mailing Address: JO 75'S 6J,'11,, o r NO u /-GL , C
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Telephone Number. 76 �/ YkS 6 e S2 Fax Number:
E-mail Address: ,aill IilJ (2 -le k14 CL 1 , [ eYU-y'
L ProjeLtbOWWA ma 115A NCAC 02H .0502(a) & (b)I
1. Attach a MdNlty m" (Le. street map) dearly showing the location of the property with
respect to local landmarks such as towns, rivers, and roads. 444acr W
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: SSGP 02-2017 Paas 1 of 3
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some sort- a yard stkk, shovel handle, etc.) 3 p+ L5 A�}���
4. Location of the property (where work is to be conducted)
County: S k Nearest Town: �� o ` woo D
Lake/ river/ ocean adAcent to property: T- ► SN
Property size (acres): 40 4W occ'Cc-5 I
Subdivision name or site address (include phase/lot number): p'
Directions to site - please include d names ap�dd numbers, landmarks etc.: Z-4
1'a T6-ALcl� (�OUK� R . L�t-tocc�5 RaoB�(� C��+ �ic
Latitude fk ai.awaoiwree J S 5, Z b 8 3 Longitude jdmWW A u, s) - E30. 1 15 (
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): C)Ne r�> L- d e, YC G Lo ,-(+ se-- W cz[( -� d o C=
6. Describe proposed work (include ckscusdon as how hardens of shoreline has been
avoided, or why it is necessary): Cwrru�L 1�v�Y�
StWCn , `1Z. e - i
S
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7. Will work beGond from land? From water?
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B. Total amount of impacts below the normal pool lake level / Normal Water Level_
Pent�nent impacts (including all excavation, baMR, rip rap, retaining waft, etc.) in square feet:
3 X/03' = 302
Temporary impacts in square feet:
' X/03° Z: S'iS s'X-
9. Total amount of impacts aborta the normal pod lake level / Normal Water Level and SO feet
land -ward
:rrruerut impacts (including bade flit, excavation, rip rap, retaining walls, etc.) in square feet:
sX /U3` = SIS` Sg,Fi-
impacts (temporary clearing, construction corridor) in square feet:
IU3" = 1030
10. 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): Ar'ee, Ao 6 e-
re /111aV,�2
11. Sig
Owner/ s Signature' 115A NCAC 02H .0502(fll Date
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Please approximately sketch the Mowing mformaWn on this plan {prmWe dimensions for each
item, such as 10 f t x 100 fo*..
1. All Proper vegetation deaft
2. Location of rip rap or fdl to be placed above the NN Pond/ Normal Water Level Ql atmn
3. Nation of rip rap or fIN to be Placed blow the Fun Pend/ Normal water Leve! elevation
4. LOMMOn Of any propos SWUdU s sudt as buddies, walls, dodos. er-
5. t,aca400 of any excavation or dr+edang below the Full Pond/ Normal Water Level elevadon
6. location of construction access corridors
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