20181385 Ver 1_Shoreline Stabilization_20181009

Ic-State of North Carolina
Department of Environment and Natural Resources
�ater Resources
15A NCAC 02H .0500 - Water Quality C ication, Shorieliine Stabilization
7FUM7_'5SGP 02-2017
Shoreline Stabilization Application Form2 0 1 8 1 3 8 5
Three copies of the application (including attachments) and the application fee should be sent to:
If sending via US Postal Service
Karen Higgins
DWR - 401 & Buffer Permitting Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
A. Applicant Information [15A NCAC 02H .OS02(a)]
If sending via delivery service (UPS, FedEx, etc.)
Karen Higgins
DWR - 401 & Buffer Permitting Branch
512 N. Salisbury Street
Raleigh, NC 27604 - '_ D ) (- n
',Owner Information
Name: pc, \),-A -
Mailing Address: 3 b D z S P_ 1 M U 4 C it e 5'%
(+e_cn3 wtv AJC_ 17Yo6
Telephonc Numbcr: 334 - 2-13- ?33fFax Number:
E-mail Address: Co.f .k-eC �.� L gtC'J:.+J cc 01
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:
httr)://www.saw.usace.armv.mil/Portals/59/docs/reeulatory/recdocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf)
Name: cc, C�ec LU.h
Company Aftiliation: GCc.-a� d Cc �krcccr}v{
Mailing Address:
2o�(boCoI ,NL 27 5-7J
Telephone Number: 336 ' Sq j-9ftax Number: 3 3G - Sclq So
E-mail Address: Ca f 4-ei iV 1 L a C14 c� no - C o r-1
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.
FUKM: SSCP 02-LU1/ Nage 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: 9 tC So ►r\ Nearest Town: a bo { 0 11J C
Lake/ river/ ocean adjacent to property: N \I Co ts Let
Property size (acres): I • V 4,-
Subdivision name or site address (include phase/lot number): tieSC (4
k- - t n a o k V� S-i'g4mQ d.
Directions to site - please include road names and numbers, landmarks, etc.: Tut IN WA cFf-
'. • qs -Io anA +- -iin Iefk on (iA'e�Q(c, Cr Skcf'
't .0 b -of J c y o -6 V%U+ eYL .
_ Longitude (decimal degrees)
jV (- S7 a K k o 2 ;,o K Le
o �3, ,%,; 1.4 leach Its 1 q
Latitude (in decimal degrees)
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): v VI deYcto -e-
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
7. Will work be conducted from land? &K 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:
2. ti o a sc-If t'
Total amount of impacts above the normal pool lake level / Normal Water Level and 50 feet
land -ward 1 43 -16 ,Sct -f k --
Permanent impacts (including back fill, excavation, rip rap, retaining walls, etc.) in square feet:
1 ism s..(1—
Temporary impacts (temporary clearing, construction corridor in square feet:
I goo ti.4t­
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): :> /VM 11 Ked'A ••,&OJ
rYI i'l' { d tJ S 6t -C (
11. Signature
-f �a-6- 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.
FORM: SSGP 02-2017 Page 2 of 4

12. Please approximately sketch the following information on this plan and provide dimensions for
each item:
a. All proposed vegetation clearing
b. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
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.
e. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
Lake
(At Full Pond/ Normal Water Level)
Full Pond/ Normal Wate L vel
Shoreline/'"
?
Plan 'View
Full Pond/ Norma{ Water Le
'%harerne
2kasa`t-
additional dearirg
_ � nR?55crV
Lake
I,a r„ a PWW i VVMw tr.Q Existing tock
3 ft. 150ft
&slow fud pond/ N WL
4 ntt .
�iso�r
Am-'ui! pc id/ N%L
EX0 AM PL,E
Plan View
FORM: SSGP 02-2017 Page 3 of 4

3 ►
Lake
(At ¢ull Pond/ Normal Water level) tO
a
I`
Side View
U-
10 ft. bank
Side Vi
FORM: SSGP 02-2017
3
3 ft. below full pond water level 4 ft. above full pond water level 2 ft. additional clearing
if necessary
Existing bank
Page 4 of 4

10/8/2018 Raleigh, NC to Estate Rd, Semora, NC 27343 - Google Maps
GO Cgle MapS Raleigh, NC to Estate Rd, Semora, NC 27343 Drive 69.9 miles, 1 h 32 min
Imagery 02018 Landsat / Copemicus, Map data 92018 Google 5 mi
Raleigh
Take E Edenton St to N McDowell St
'Ip' Ls',
t 1. Head north on S Wilmington St toward New Bern
PI
,01 2. Turn left onto E Edenton St
Take 1-40 W, NC -147 N, S Duke St and US -501 N to Concord
Rd in Roxboro
,, J'Y In -1 iY.
10 3. Turn right onto N McDowell St
t 4. N McDowell St turns slightly right and becomes
httos://www.aooale.com/mans/dir/Raleigh_+NC/Estate+Rri+Samora+NC+971d1/n1R 1a1Q1R9-7Q 1Q75aRA 1gn79amJnm=t/rhtn=t'Ar„')11o'ttdh1IA— 1 1/1),
Capital Blvd
5.
Use the right lane to take the U.S. 70/NC-50/Wade
Avenue ramp to RDU International Airport/Res TO
Park/Interstate 40
A
t 6.
Continue onto NC -50 N/US-70 W/Wade Ave
'1 7.
Use any lane to tum slightly left onto Wade Ave
t 8.
Continue onto Wade Avenue (signs for Wade Ave)
9.
Merge onto 1-40 W
httos://www.aooale.com/mans/dir/Raleigh_+NC/Estate+Rri+Samora+NC+971d1/n1R 1a1Q1R9-7Q 1Q75aRA 1gn79amJnm=t/rhtn=t'Ar„')11o'ttdh1IA— 1 1/1),

10/8/2018 Raleigh, NC to Estate Rd, Semora, NC 27343 - Google Maps
jw 10. Use the right 2 lanes to take exit 279B to merge
onto NC -147 N toward Durham/Downtown
A
tv 11 Exit onto S Duke St
8
t 12. Continue onto US -501 N/N Roxboro St
41 13. Turn left onto Long Ave
41 14. Turn left onto Leasburg Rd
Take NC -57 N/Semora Rd to Estate Rd in Semora
ro 15. Turn right onto Concord Rd
t 16. Continue onto NC -57 N/Semora Rd
ro 17 Turn right onto Zion Level Church Rd
41 18 Turn left onto Pinesborough Estates Rd
*1 19. Turn left onto Estate Rd
8 C
r -
Estate Rd
These d!recticns are for piann;ng purposes only
'+'on may find that ccnsuuction projects, traffic,
weather, or ether everts may cause condMons !c
s,4fpr frrjrn `he m60 Jesuits, anti you should olar
volar route accordingly You must obey all siens of
-oboes regardv,g your route-
�.._ +N(-./Fstate+Rd +Semora.+NC+27343/(a�.36.1439162,-79.1975484,120724m/am=t/data=!3m2!1e3!4b1!4m1... 212

4
4-
n
is I
P
t
�4 t
lI a 1
f
�
r
Y
AN—
�1
JJ
r
i
MI
r1
0
t.

t Id I t r
•t 1 1 A�'y' �r'.�i� ij ��'+I+ '��j�j� I' � j ( i:�� `t ICS �,
., 'I
�t.�' •�'' �+IIh1,�i%i� I' i �� � %I � '� .� (:J�i�� ` l'Il?. i (f
�;. - � 'rl'f�tr Il �'I �•' •I f( ti" �' r��� � r �"4 ' 111" j Ir�' , F l 1
To
r r i ff 1, I s
+�'y�� �
PF t r p
� Y
+�';t j �i� l ! I11 r
(� �Ir � ( �i I I I ,
Wi f v
i�1�1 � #� 1� :� ► 1 � J�" r :;
�. a �• � s i ,,
• '��• .. 1',j t• ��� t �'�p�li'� p i.�l � �' III,,( r�,�+ft - :�J
... �_: + ,1 ,, 1:�,��1'► {+ a�r,'� fi,.1.} �l�,���I�,��t �I .!._1.11,
-
!
• V : 11 � t ;i i •
r ol
1 ! tt I r
fIf 1 �-ill f .t•.
• .. • 1'141 "j.� I.�' i 1'1} 1 ;�F � il.. �' t�yl JI� `� 'ti :tt 1 �., � it:
f !! 1.11
14
'f - , 1II s,l'1{`; , �1r..�f � �{}T� �M'fi i.�• A .ytr k-%f�19 4i� 1.. t �1;, iii�7
'41
�4It
um�.;.