20181229 Ver 1_Shoreline Stabilization_20180905

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2 0 1 8 1 2 2 8 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
49 PAID
Three copies of the application (includi nd the application fee should be sent
to:
Division of Water Resources
401 & Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
1. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information 1
Name: lmA&aw+i5Cw Cove. LL_
Mailing Address: 3 _�OGa 1610d �2
D2@110d[go
SEP 0 5 2018
DEO-WATER U ES
401 8 BUFFER PERWTTING
Govi Wr4ftu, LA 704-33
T AaVRer , I�lavla yea_ &fVe2
Telephone Number: C185 -70S- 2_2_-77 Fax Number: C{BS- 839-&7(n
E-mail Address: C iyy1aQeq- � YY1aQee nan(,,',6LI • Ccm
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
http:Hwww.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: Fax Number:
E-mail Address:
Person to receive the Certification Approval:
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)
County: �LICSOA) Nearest Town: r�ShiC'f2S, /%C
Subdivision name or site address (include phase/lot number):
4-S
It Am
� - J
Directions to site - please include road names and numbers, landmarks, etc.: FYLom
Latitude (in decimal degrees) 35 f i 9 5l0 9 Longitude (decimal degrees) —&:' I
�j Vd
I low
co�j
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): reS;"-Eia.i 4- LlKl Cudope
6. Property size (acres): 3 L2 a i(CP S 14.x`7 Lare.5
7. Lake/ river/ ocean adjacent to property: La bf % le tiU i (le..
8. Describe proposed work (include discus 'on as to how hardening of shoreline has been
avoided, or why it is necessary): k � � 1� W01A W � h
9. Will work be conducted from land? ❑ From water? SZ
10. Total amount of disturbance (including all excavation, backfill, rip rap, retaining walls, etc.)
below the normal pool lal�e level/ Normal Water Level in square feet or acres:
11. Total amount of disturbance (including all clearing, back fill, excavation, rip rap, retaining
walls, etc.) above the normal poolAake 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): Sm-&' kl
e ill�vu� IGi�%
LA P -
Ave- 2 Cv�l LLC 8 9 2 01
Owner/ gent's Sign ture" [1 A NCAC 02H .0502(f)j Date
}Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 3

Ft
Normz
Si
La ke
(At Full Pond/Normal Water Level)
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ft 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

FL
Normz
SI
Lake
(At Full Pond/ Normal Water Level)
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

Full Pond/
Normal Water Level
Shoreline
La ke
(At Full Pond/Normal Water Level)
kA s
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

LARCHER
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MAGEE MOUNTAIN COVE, LLC
WITT
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Cheri NC Tract A 1.211 ac. by GB 1 8/7/2017
Scale: 1 inch= 75 'Feet File: Cheri NC Tract 141.211 ac..ndp
Tract 1: 1.2110 Acres (52750 Sq. Feet), Closure: n44.5220e 0.01 ft. (1/190835), Perimeter= 1213 ft.
01 s75.5811 w 162.08
02 s75.581 1w 221.73
03 n01.2851e 53.82
04 n38.4846e 34.01
05 n44.5652e 42.35
06 n23.2713w 64.29
07 n23.0322w 62.58
08 s87.5858e 63.69
09 s33.1846e 16.3
10 s41.3357e 18.15
11 s54.2947e 22.3
12 s65.2449e 33.75
13 s79.3914e 26.92
14 n87.3934e 69.21
15 n65.5713e 42.57
16 n61.0717e 102.16
17 n75.4500e 20.0
18 s42.3000e 28.0
19 s12.3000w 100.0
20 s08.3000w 29.0

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