20190017 Ver 1_Shoreline Stabilization_20181228

' State of North Carolina
Department of Environment and Natural Resources
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) and the application fee should be sent
to: $ PAIL
Division of Water Resources �J �
401 & Buffer Permitting Unit G
�� �\ \
1617 Mail Service Center
Raleigh, NC 27699-1617
20190017
I. Applicant Information [ J
1. Owner Informati/o�
Name:
Mailing Address: 7i0S-
Z %a //cyvU d' )n �L_-'
&„✓ev- 4c 3-7
Telephone Number: J) 5�l> Fax Number:
E-mail Address: 6A51J1 r � . q1w
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
must be attached if the Agent has signed this application form.
Name:
Company Affiliation: sl c� .1
Mailing Address: /
a,oj k t� /l 2f037
Telephone Number: W q�l, / % Fax 70
x Number:
E-mail Address: ' / t? 444 0. low
Person to receive the Certification Approv :�S
II. Project Information [ J
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: /_jklGLI�� Nearest Town:
Directions to site - please include road names and ��numbers, landmarks, etc.:
S' _ ems- lye -11, ,cgus� h `ss S -* f c��s l //� <.a /fir.
Latitude (in decimal degrees) 35. T7 / Longitude (decimal degrees) —P.19/05— O . //05—
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): 1e -
6.
e6. Property size (acres): 3Yl
7. Lake/ river/ ocean adjacent to property:
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
9. Will work be conducted from land?
From water? ❑
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:
�-6
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: /D�_eV
12. Please describe the vegetation ab&e the normal pool lake level/ Normal Water Level and
50 feet landward to be impacted (number of trees, for instance):
re -ss
Owner/Agent's Signature`
Date
Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 3
VIAII

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 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.
S. 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

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address.:/1:?:i�dL� iu County:j
Owner: `°�,�
Contractor/
Signature
Print Sieiiature
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)]
Trees are not allowed to be removed from Zone 1 of the Buffer (within 30 ft of the full pond elevation), unless
approved. Exception, those trees that are severely undermined along the immediate shoreline can be removed.
Minimal shaping and sloping along the immediate shoreline its allowed. [15A NCAC 02B.0243(6)1
Benching, grading in the buffer is not allowed. Excessive disturbance of ground cover, [15A NCAC 02B.0243 (6)
Beaches, impervious patios, impervious walkways, etc. are not allowed in the buffer unless specifically approved
by the Division. There are {imitation on size for decks. [15A NCAC 02B .0243(4) and (6)j
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 02B .0243 (4), (6), (8)j
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 028 .0243(5), (6)j
Acknowledgement of Notification
hereby state that I have been informed of the Catawba
Riparian Buffer Rule. Any work 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.
Signature (owner): 'J Date:

Lincoln County, NC
Office of the Tax Administrator, GIS Mapping Division
Lincoln County and its mapping contractors assume no legal responsibility for
the information contained on this map. This map is not to be used for land
°p conveyance. The map is based on NC State Plane Coordinate System 1983 NAD.
1' t Date: 12/17/2018
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Parcel ID 31598 Owner NORMANDY ROAD LLC
Map 4613 Mailing 7456 TALLWOOD DR
Account 0235149 Address DENVER, NC 28037
Deed 2267 675 Last Transaction Date 09/06/2011 Sale Price $0
Plat C 44 Subdivision SHADY GROVE Lot 13 14 15 & 16
Land Value $310,245 Improvement Value $13,877 Total Value $324,122
Previous Parcel
-----All values for Tax Year 2018 -----
Description 13-16-G SHADY GROVE PARK Deed Acres 0
Address NORMANDY RD Tax Acres 0.381
Township CATAWBA SPRINGS Tax/Fire District EAST LINCOLN
Main Improvement Value
Main Sci Feet Stories Year Built
Zoning District Calc Acres Voting Precinct Calc Acres
R -SF 0.38 TA37 0.38
Watershed Sewer District
0.38 SEWER 0.38
Census County Tract Block
109 071202 1001 0.38
Flood Zone Description Panel
X NO FLOOD HAZARD 3710461300 0.34
AE SPECIAL FLOOD HAZARD AREA BASE ELEVATION 3710461300 0.04
DETERMINED - 100 YEAR