20181280 Ver 1_Shoreline Stabilization_20180917

,,, 2 8 2 g p State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
ENVIRONMENTAL QUALITY FORM: SSGP 02-2017
Shoreline Stabilization Application Form
Three copies of the application (incitiding`at"tachments) and the application fee should be sent to:
If sending via US Posttrf'SerVlce. If 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
A. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: Claire Ari
Mailing Address:
248 The Prado NE
Atlanta, GA 30309
Telephone Number: [phone] Fax Number:
E-mail Address: [e-mail]
2. Agent/ Contact Person Information
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.armV.mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf)
Name:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
B. 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, 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.
FORM: SSGP 02-2017 Page 1 of 3

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: Jackson Nearest Town: Cashiers
Lake/ river/ ocean adjacent to property:
Property size (acres):
Subdivision name or site address (include phase/lot number): 145 Old Farm Road, Cullowhee,
Directions to site - please include road names and numbers, landmarks, etc.: Take Lloyd
Hooper Road of North Norton Rd. In .5 miles turn right onto Old Farm Road, then an
immediate left through a blue gate. The site can be reached by going left at the fork, and right
onto a lumber road Oust before the next blue gate. In approximately 0.2 miles, turn left Oust
before the closed gate site is at bottom of the road by the dock.
Latitude (in decimal degrees) 35' 9' 44.55396
Longitude (decimal degrees) -80° 9' 11.38428
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Undeveloped... dock installed. 1 home on acreage, 500"
elevation above shoreline. Trail from house down to water and old timber road.
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): To stop erosion of bank with use of Filtrexx Envirosoxx
Compost Siltsoxx to place under collapsing bank (as concrete blocks are used behind rock
walls). It can be left as is or planted with natural materials. We would like to keep it natural
looking. We can ad Conosoxx if you wish.
7. Will work be conducted from land? ® 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 walls, etc.) in square feet:
Temporary impacts in square feet:
Approximately 84 linear feet
9. Total amount of impacts above the normal pool lake level / Normal Water Level and 50 feet
land -ward
Permanent impacts (including back fill, excavation, rip rap, retaining walls, etc.) in square feet:
None
FORM: SSGP 02-2017 Page 2 of 5

8. Total amount of impacts below the normal pool lake level / Normal Water Level
Permanent impacts (including all excavation, backfill, rip rap, retaining walls, etc.) in square feet:
Approximately 85 linear feet, as far back as the bank is eaten away underneath. It would likely
take one row of product which is about 8" in diameter, making the square footage about 57
square feet.
Temporary impacts in square feet:
Product will be palletized at the top of the lake lot and walked down to the work site, one
at a time. The temporary impact would be from 2 people standing on the shoreline as it's
installed.
9. Total amount of impacts above the normal pool lake level / Normal Water Level and 50 feet
land -ward
Permanent impacts (including back fill, excavation, rip rap, retaining walls, etc.) in square feet:
None
Temporary impacts (temporary clearing, construction corridor) in square feet:
None
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): None will be impacted
11. Sign t e -
'1 9/12/18
Owner/Agent's Signature" [15A NCAC 02H .0502(f)] Date
'Agent's signature is valid only if an authorization letter from the owner is provided.
12. Please approximately sketch the following information on this plan and provide dimensions for
each item:
a. All proposed vegetation clearing NONE
b. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
NONE
c. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
d. Location of any proposed structures such as buildings, retaining walls, docks, etc. NONE.
DOCK ALREADY IN PLACE
FORM: SSGP 02-2017 Page 3 of 5

e. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
R
Full Pond/ N 'til Wats
Shoreline
Plan View
Full
2 ft.. 750 ft.
• H rrmsery
La ke
(At Full Pond/ Normal Water Level)
Lake
W F UK caw! K-4 water L-+! Existing Dock
/3ofts7ft
R4—p
E AMP E
Plan View
FORM: SSGP 02-2017 Page 4 of 5
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Side View CL
LL -
U
Side Vi
3 ft. below full pond water level 4 ft. above full pond water level 2 ft. additional clearing
V necessary
FORM: SSGP 02-2017 Page 5 of 5