20181560 Ver 1_Shoreline Stabilization_20181114

Version 12/22/2016
For Regional
201 8 156 0
DWR
Division of water Resources
PMD
Abbreviated Applica on Form
General Permit 80 (Bulkheads and Riprap)
For Section 404 Regional General Permits, Section 401
General Water Quality Certifications, and Riparian Buffer and Watershed Bu fVAO_[_�—n i—
This application cannot be used for wetland or stream impacts. /VC)V V D
4 2018 � J
This form is to be used for projects qualifying for the U.S. Army Corps of Engineers' (USFi al
General Permits 80 (General Permit No. 197800080) as required by Section 404 of the Clea
the North Carolina Division of Water Resources' (DWR) associated General 401 Water Quality Certifica i
This form is also to be used for any project requiring approval under any Riparian Buffer Rules implemented by
the N.C. Division of Water Resources. This form should not be used if you are requesting an Individual 404
Permit or Individual 401 Water Quality Certification.
The USACE is the lead regulatory agency. To review the requirements for the use of General permits, and to
determine if general permit 80 applies to your project, please go to the USACE website at
http://www. saw.usace.anny.mil/Missions/Regulatory-Permit-Pro ram/, or contact one of the field offices listed
on page 4 of this application. The website also lists the responsible project manager for each county in North
Carolina and provides additional information regarding the identification and regulation of wetlands and waters
of the U.S.
The DWR issues a•corresponding Certification (General or Individual), and cannot tell the applicant which 401
Certification will apply until the 404 Permit type has been determined by the USACE. Applicants are
encouraged to visit DWR's 401 & Isolated Waters website at http://deq.nc.gov/401-sw to read about content
requirements for the 401 Water Quality Certification Program and to determine whether or not Riparian Buffer
Rules are applicable. The applicant is also advised to read the full text of the General Certification (GC) matching
the specific 404 Permit requested. Applicants lacking access to the internet should contact DWR's Central
Office in Raleigh at [phone].
USACE Permits - Submit one copy .of this form, along with supporting narratives, maps, data forms, photos,
etc., to the applicable USACE Regulatory Field Office.
401 Water Quality Certification or Buffer Rules - All information is required unless otherwise stated as
optional. Incomplete applications will be returned. Submit four collated copies of all USACE Permit materials
to the Division of Water Resources, 401 & Isolated Wetlands/ Waters Program, *50 -MaUjiMmice=
Aeigh;�._„�1r.65#.PApplication fees are required by DWR in accordance with the DWR website at
http://deg.nc.gov/401-sw#FeesProcedures. A check should be made payable to "N.C. Division of Water
Resources", with the specific name of the project or applicant identified, and stapled to the front of the
application package.
hhhhhh Page lof4

version 12/22/2016
Office Use Only: Form version Dec. 2016
USACE Action ID No. DWR No.
�.
(If any particuiar item is not appncae,e w urns piuic pn­­ - rr.._,..,.-
. Applicant Information
1. Owner/App 'c t Intormatio
Name: 11 m e- e r%.
Mail'Address:
C_ 6
Telephone Number: 011 #1 — S;LA-t Fax Number: AA
E -mail Address: M M e.
2. Agent/Consultant information (A signed and dated copy of the Agent A'aithorization letter must be
attached if the Agent has signatory authority for the owner/applicant.)
Name:
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Address:
II. Project Information
Fax Number:
Attach a vicinity map clearly showing the location of the property with respect to local landmarks such as
towns, rivers, and roads. Also provide a detailed site plan showing property boundaries, and development
plans in relation to surrounding properties. Both the vicinity map and site plan must include a scale and north
arrow. The specific footprints of all buildings, impervious surfaces, or other facilities must be included. If
possible, the maps and plans should include the appropriate USGS Topographic Quad Map and NRCS Soil
Survey with the property boundaries outlined. Plan drawings, or other maps may be included at the x
applicant's discretion, so long as the property is clearly defined. For administrative and distribution purposes,
the USACE requires information to be submitted on sheets no larger than I I by 17 -inch format; however,
DWR may accept paperwork of any size. DWR prefers full-size construction drawings rather than a
sequential sheet version of the full-size plans. If full-size plans are reduced to a small scale such that the final
version is illegible, the applicant will be informed that the project has been placed on hold until decipherable
maps are provided.
.Location F
County: i"t to►r>t �' in Nearest Town:
Subdivision name (include phase/lot number): Ke- G94
Site coordinates:
Decimal Degrees (6 digits minimum):°N61�SS �2•� °W(neg.)_�"�4
Directions to site (include road numbers/names, landmarks, etc.):
Lv : lo.. 2.1 s
A
Page 2 of 4
U

Version 12/22/2016
3. Property size (acres): �ro Gr't. O 967 S P
4. Name of nearest named receiving body of water(stream/river/lake): ( A ke- kf�,K I e-
5.
5. Describe the purpose of the proposed work:
6. List the type of equipment to be used to construct the project:
.,._..1 e-Ad.H Ase:U4 SIC Gear
7. Type and amount of impact (including all back fill, excavation, riprap, retaining walls, other fill,
etc.) below the normal pool lake level in square feet or acres, and distan a from shorelin :
�"a G.��Gt SK •�} o�ack s-
8. a..Type and amount of impact (including all clearing,Oack fill, ex cavation,.i�iprap, retaining walls,
other fill, etc.) abov the normal pool lake level and 50 feet land -ward i square feet or I :J,pres:
�.� }- : a're�-S�.•� RI o •� b ••�. k . FiXt a v.► {-+ o ., se o�,,.,( 6•.t l
r
lease describe the vegetation above the normal pool lake level and 50 feet land -ward to be
impacted (number of trees for instance): /�/(_ 0 !Ykf �5 5 T� (S�Zy 4 -Me S
•{K,a s o ` k bac C �.�- 4 C -or. •
Applicant/Ap*lf Signature
Agent's signature is valid only if an
Page 3 of 4
1(15-1(9
Date
letter from the applicant is provided.)

Version 12/22/2016
La ke
Pund/Normal Water Levolj
Full Pond/ park
Norma,"er Level
Shoreline
•
Cross Section View
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/ Norma!I Water Level elevation
6. Location of construction access corridors
P ( A.K6 0"+ � c. `1-4-j

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ELEVATION
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5
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36.54'
ShIl'ViERING BOATHOUSE
118 BIGHORN DRIVE
LOT 1399

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CN RISSIM.-AINC R. 41M !!n.GlNEEFUNG III DESIGN
DOCK
SIMMERING RESIDEN
PLAN
118 BIGHORN DfU%E, LOT
LOUISBURG, NC 2,919 C 3479

DOCK PIAN
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UPPER DECK
DR*
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RED ENGINEERING & DESIGN
...... .............
PLAN
SIMMERING RESIDENCE
118 B G HWX DRIVE. LOT 1199
I i i �ilL i L M -
L-O,U-lS,B'U'-0.b-NC2-9
C-3479
I I I 1 I INP 11 121y 121 plt 1
54,
III I T7-17
UPPER DECK
DR*
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RED ENGINEERING & DESIGN
...... .............
PLAN
SIMMERING RESIDENCE
118 B G HWX DRIVE. LOT 1199
L-O,U-lS,B'U'-0.b-NC2-9
C-3479

I DECLARE THAT THIS SURVEY COMPLIES WITH THE NORTH
CAROLINA STANDARDS OF PRACTICE FOR SURVEYING,
(SECTION 1600) FOR CLASS A SURVEYS AND THAT THE
CALCULATED RATIO OF PRECISION BEFORE ADJUSTMENTS
IS 1:10,000+. FURTHERMORE, PROPERTY CORNERS SHOWN
ARE PRIMARY CONTROL MONUMENTATION FOR THE RE-
ESTABLISHMENT OF PROPERTY CORNERS IN THE ABSENCE
OF GRID MONUMENTS AND OTHER SUBDIVISION PROPERTY
CORNERS. THIS SURVEY IS NOT TO BE RECORDED WITH-
OUT THE WRITTEN ALI.DkORIZATION OF 11LE SURVEYOR.
77,10MAC LANID SURVEYOR L—t
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$ q_ (&, EIB
\ APPROXIMATE
1X ANNUAL FEMA
m� I FLOOD LIMIT ZONE 'AE'
EDGE OF MAP # 3720-2831—OOK
WATER a 6DATED 4-16-2013
NOTES:
1. THIS PLAT SUBJECT TO ALL
EASEMENTS, AGREEMENTS AND
RIGHTS OF WAY OF RECORD
PRIOR TO THE DATE OF THIS PLAT.
2. NO UNDERGROUND UTILITIES
HAVE BEEN MARKED OR LOCATED
FOR THIS PLAT.
3. ALL BEARINGS AND DISTANCES ARE
HORIZONTAL GROUND MEASUREMENTS
4. ALL ELEVATIONS ARE BASED ON
NGVD NAD '88.
5. ALL CONTOURS ARE AT 1' INTERVALS
HIGHLIGHTED EVERY 5'.
% C-1399
18,567 sq.ft.
LAKE\'`e , . 0.426 AC.
ROYALE '
to (AREA TO EDGE OF WATER)
TOPOGRAPHIC SURVEY FOR
LOT C-1399
LAKE ROYALE SUBDIVISION
` e
,♦ 50` TAR/Pe MLICO \
RI R RIP RIAN
EDGE OF 4 �, e \ \ BUFFEP MEASWRED 5d
WATER , , `, 'FROM, TOP Oft BANK `
\ ♦ ` e
j• ♦ o
118 BIG HORN DRIVE
OWNER: DAVID GOULD •7,,,-e-3 4 Toe
REF. D.B. 2074 PAGE 67 re- r Aa V4
REF: PRF 1, SLIDE 99A
CYPRESS CREEK TOWNSHIP
FRANKLIN COUNTY, NORTH CAROLINA
40 20 0 40 80
h
10.0'
8.0' N
PAUL CIM NTOSH
BLOCK WALL & JUDY MCINTOSH
D.B. 1894 PG. 256
PIN 2831-63-2476
LEGEND:
EIP — EXISTING IRON PIPE
LINE
EIB — EXISTING IRON BAR
L-1
EPK — EXISTING PK NAIL
NIP — NEW IRON PIPE SET
WIT
R/W — RIGHT OF WAY
$
CATV — CABLE TV BOX
°a
EB — ELECTRIC BOX
oa
TEL — TELEPHONE PEDESTAL
N"
PP — POWER POLE
OHL — OVERHEAD LINE
LP — LIGHT POLE
WM — WATER METER
WV — WATER VALVE
VICINITY MAP
CO — SEWER CLEAN—OUT
Z , PP
IS{ , he�
+0
LP TANK i )GRAVEL` _ - _
DRIVEWAY hog/A
eAr
h -
29 iv
3•' - - - -EIP
WM
'v
v
ROBERT S. SIMONOWICH
& PAULINE B. SIMONOWICH
D.B. 1570 PG. 455 N e p
PIN 2831-63-2335
LINE TABLE
LINE
LENGTH BEARING
L-1
536.93' S 24'53'32" W
EIB I ,
0
/rye
SCALE 1 =40LINE TYPE LEGEND EIB Q /
MARCH 9, 2018
ZONED AR
PIN # 2831-63-2441
II
wl
TIE TO THE INT. OF
BIG HORN DR.
& HOPI DR.
C A WTH OR N E, MOSS & P A N C I E R A, P.C. PROFESSIONAL LAND SURVEYORS, D-1525, 333 s. WHITE STREET, P.O. BOX 1253. WAKE FOREST N.C., 275M (91
As
556-3148
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