20181568 Ver 1_Shoreline Stabilization_20181114

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
Three copies of the application (including attachments) an the application fee should be sent
to:
1
Division of Water Resources
401 & Buffer Permitting Unit�, Q W 11
1617 Mail Service Center 2 0 1 8 1 5 6$
Raleigh, NC 27699-1617 1 NOV 4 2018
Applicant Information [15A NCAC 02H .0502(a)]
Owner Information
Name: Jo l•„n
Mailing Address: [ to I O C1 �lCII-1✓hPr(► c (1 �n o L.
Telephone Number: 7o4- ggta• qu I I Fax Number:
E-mail Address:
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
http://www.saw.usace.army.miI/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: fJ()c4-(p(jQ -5(1 I Fax Number: flog- (,,U0 - 5q Log
E-mail Address: C Spat ► ,.Ik5 [i! .� nCi��1 r - hA+-
Person to receive the Certification Approval: M.,ntc Ft'-V�7
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) 1
County: Nearest Town: RU A4'P_rS
Subdivision nam or site address (include phase/lot number): J Lg J !9 P_0.
ppn
I IA1 l.l..�,�..c.�`.i�.. vii, _Q7i T }
1i.Me5
AI T' ^^I )1&11_ n"l
Directions to site - please include road names and numbers, landmarks, etc.:
Latltuae (in decimal degrees) S J . '-1 wd r1 U_ Longitude (decimal degrees) —Bo, q 13 qoo
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): j�e.S tdvn+lioL yin koySe.
6. Property size (acres): _ 3L azres
7. Lake/ river/ ocean adjacent to property: tAorYYjX-A
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): shQ,pP-
C1M knc)1Aer 60 07
9. Will work be conducted from land? Q" From water? [v]'
10. Total amount of disturbance (including all excavation, backfill, rip rap, retaining walls, etc.)
below the normal pool lake level/ Normal Water Level in square feet or acres:
`i! IO U-)
11. Total amount of disturbance (including all clearing, back fill, excavation, rip rap, retaining
walls, etc.) above the normal pool lake level/ Normal Water Level and 50 feet land -ward in
square feet or acres: I I a"OVe _
12. Please describe the vegetation above the normal pool lake level/ Normal Water Level and
50 feet landward to
to` be impacted (number of trees, for instance): morass
tt
no 4yeeS -rp Yp2y mny ed -
/Agent's Sign at [ ,.5AC 02H .O502(f)1 Date
`Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 3

Full Pond/
Normal Water Level
M � � � �
Shoreline
Lake
(At Full Pond/ Normal Water Level)
Ll I bellow
I I ►x.10 0v'e-
319 ' I e- r,5 -11--
queSS
3'ohn Yooy-, blood
" Ug Ckf cC,4E 1e r I l�a�
1-i�n-�er5v 1 Ile, N.0 I8018
i�o -gees
r -e, m0 ve-C1
M -, n ', ,ma.l d 15+U rbarw
fo bo FF-- r
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

`CI Y UD 32!!0 r
MMM 4 fill
�--IT h
a

Project I
Contract
CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
The approval is for the purpose and design described in your application. Impacts not indicated in the
application is a violation of the Buffer Rule. Site specific work should be provided in the application. [15A NCAC
02H .0506 and 15A NCAC 02B .0243(8)1
approved. Exception, those trees that are severely undermined along the
Trees are not allowed to be removed from Zone 1 of the Buffer (within 30 ft of the full pond elevation), unless
immediate shoreline can be removed.
Minimal shaping and sloping along the immediate shoreline is allowed. [15A NCAC 02B .0243(6)]
Benching, grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 0213.0243 (6)]
Beaches, impervious patios, impervious walkways, etc. are not allowed in the buffer unless specifically approved
by the Division. There are limitation on size for decks. [15A NCAC 02B.0243(4) and (6)]
Work to be conducted from land must indicate an access and indicate any trees that are to be removed. The
work corridor should be described. The approved access corridor shall be restored. Staging, spoil, construction
material must be outside the buffer. [15A NCAC 02H.0502 and 15A NCAC 0213.0243 (4), (6), (8)]
Stormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
discharges must be at the natural elevation and discharged prior to entering the buffer directed as diffuse or
sheet flow at non-erosive velocities to the lake. [15A NCAC 02B .0243(5), (6)]
Acknowledgement of Notification
1' 6 V u nq610 hereby state that I have been informed of the Catawba
Riparian Buffer Rul .Any rk conducted in the buffer, not specifically stated in the application and approved
by the Division of Water Resources (DWR), is a violation and subject to enforcement. Due diligence will be
taken such that the construction will be built within substantial compliance and intent of the 401 Water
Quality Certification and Buffer Rules, the approved plan(s) and specification(s), and other supporting
materials.
Date:
State of North Carolina I Environmental Quality I Water Resources
512 N. Salisbury Street l 1611 Mail Service Center ! Raleigh. NC 27699-1611
919.707.9000

THIS IS TO CERTIFY THAT ON THE__9 DAY OF MAY 19 88 1 SURVEYED THE
PROPERTY SHOWN ON THIS PLAT, AND THAT THE TITLE LINES AND THE WALLS OF THE BUILDINGS IF ANY
ARE AS SHOW ON,
ED
l:AqSIGN
z- R. *. PHARR B ASSOCIAT96. R[OISTERtD SURV[YORS
217 EAST INDEPENDENCE BLVD
\1 CHARLOTTE. N C 262M
Q TEL 1131&21" Z
L749
N
CANu N�
s�iRVEYOQ pi
\\Q 9 DHAR9L
�1t 09,�24
Sy6'`�9
10 1
ED
BOUNDARY SURVEY
OF
PROPERTY AS SHOWN
LEMLEY TOWNSHII�, MECK. COUNTY,_ N. C. _ _--
BCALE 1" = 40' CHARLOTTE. N.C.
THE PROPERTY OF JOHN F_ YOIINGBLOOD A WF NITA W YO IN B 000
MAP RECORDED IN BOOK AT PAGEDEED RECORDED IN B00 +3 PAGE 666
60'

Polaris 3G Map — Mecklenburg County, North Carolina

11SM18
Google Maps 16109 Weatherly Way
16109 Weatherly Way- Google Maps
Map data02018 Google 100 ft,
tt"Jtm&w.google.cornVmaps/place(16109+Weatherly+Way+HuntersvAlle,+NC+28078)@35.4403116;80.9167291,18z/data=!4m5!3m4!1s0)S856af2741e7c3dF.0x7b08flcad4S64d66!8mQ!3d35.440761!4d-80.9139?N=en 112

1116/2018
Google Maps 16109 Weatherly Way
16109 Weatherly Way- Google Maps
16109 Weatherly Way
Huntersville, NC 28078
imagery twzui a uooge, Map am wzu i o 000gro vu it
hftM://www.google.corWmaps/place/16109+Weadwyly+Way+Hunters,ille,+NC+280781@35.4407574; 80.9146832,327rrVdata=!3ml!1eTft5!3m4!1s0A856aW41e7c3df:Ox7b08f1cad4564d66!8rn2!3d35.440761!4d-... 1/2

11/612018
MyTopo Map Print
Marlins , x
r p
2145 -. • - J i ='"`
/r : SJ .'�� � �' i • it 1
iV
68
Vi
�' f!
""�t(�� � s. + � t �( t��� �' .. � 1 I �� l� If� ��I Imo`' �� �•� �_ ��1�
'� + � ... ".tic".: t�„ ! +t f a \ , i' !",••xY 1 }, L._
1, � �fi �`'" . " }. r •�. .� \�� �
I�_ � h -,...: 'i r� '`"1 \ 1 �1 `� � ! t_'• • " r r r r � ��
li
` a 1 f • 78A 1, 753
` "'�' . �• /.'1^:' f, � � " 'r. fie`` � i L i _ �. / i � ) .
4 � i M
0 0 .5
0 .5 M 1 t Map provided by MyTopo.com
http:J/rrep-pass.mytopo.cor,Vmaps/print mytopo.asp?print=20Bscale=2.5&IaWr=DRG&layer=HILLSHADE&Iat=35.440736761302546&Ion=-80.9140566500D002&orient--1&res=144 111

,r
l:-
.-
low
i f �+! kt a+� `�w•."s�i2,w* `•cif ,{'+ r t ' s. ,^4 a ,.pss••'�
fi�,i' lrlii z�,,,,r'�.✓",'av �(Sfi'-,�'��*- K !r ti4 �y' '� �,
-17 _ e
.. •.. T -. ` "� s: -_'mac � f. .-sF '-�`j ':� «� i,�t.. � �� ... +��..
- •i` r Jt,Y' • r 'j iw. ¢ �T�=Tr~sy7 �L� >K�'� � rt 5 'v:. _ -.'°"-> 6 •l
• _' - .- jt'' �, Cyt ,_r �..
r
o
k

-.a--.^tom..-.
Wr
_
�" r /•�
.r
`www—s "�_ p✓Mj(L n ,.�... �'y�a'.�' � '- 'S=" -� .. _ - r ,
5
- - _
16109
Huntersville, NC 28078