20190048 Ver 1_Shoreline Stabilization_20180109

1 I��
From: Montalvo, Sheri A °�heri.r [e-mail] �,N1
,subject: RE: Shoreline stabilization
Date: Dec 18, 2018 at 2:0004 PM
To: [e-mail] 1
Tom, 2 0 1 9 0 0 4 8
We received your application and fee from the shoreline stabilization
project, however the application that was included is only the Duke Energy
construction app. We will need for you fill out the DWR application and sign
it that I have attached for your use. You can email me back the completed
app to save on time. If you have any questions feel free to call me.
Thanks
Sheri Montalvo
Administrative Assistant
401 & Buffer Permitting Branch
Division of Water Resources
North Carolina Department of Environmental Quality
**please note my phone number has changed**
919-707-3635 (office)
sheri.montalvot_nc err. fav
Physical: 512 N. Salisbury St., Ste 942-D, Raleigh, NC 27604
Mailing: 1617 Mail Service Center, Raleigh, NC 27699-1617
Kc- -' Nothing Compares__
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.

State of North Carolina
Department o ty
DivisiUees
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:
Division of Water Resources
401 & Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
I. Applicant Information 115A NCAC 02H .050201
1. Owner Information �// ,,' j
Name: II�'/NnJrJ leleC er
Mailing Address:
���7 x� lkgsTote
C4410 -H(, /SCC dg -d77
Telephone Number: Fax Number:
7011-669-V909
E ma'%►(ddress;eCke%p P&1
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
h_www.saw.usace.army.mil/Portals/59/docs/regulatorv/r g
docs/Permits/SAMPLE_AGENT _AUTHORIZATION—FOR
hLpdL must be attached if the Agent has signed this application form.
Name: 5JWa�JQA 6040,! / I V C1 / OW
Mailing Address:
Company Affiliation: %/
'�
4vd- 00d f, IN C a
Telephone Number: Fax Number: 7101
/
- Y;E,-
E-mail A dress:
150W + SoHNyS (�09 s7YVC710AJ o 0
Person to receive the Certification Approval: SON' 7 T 7- yS'Olq
11. Project Information (15A NCAC 02H .0502(a) & (lb)]
I . 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.
v*"*'2. Provide a detailed site Dlan showing nronerty hontidnriec anti nrnnngi-A Innatinnc .,f

/ vegetation clearing, structures (buildings, retaining walls, docks, impervious surfaces,
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.)
V/4. Location of the property (where work is to be conducted)
County: 57/9M l Nearest Town: A)?eMAPle
Subdivision name or site address (include phase/lot number):
o? 3 51 416rk 7`)IteVY ROAD
"Ie, 0?8 do (
Directions to site - please include road names and numbers, landmarks, etc.: ��
A3 Aa��- -A� 1� 7-11 leI`Y RSA P►naQihQ �' Yo
"110-Y f,04
Rooke d -Pe ke H-- btt ),,+Ke
Latitude (in decimal de ee_ Longitude (decimal
• a9 y �l -- r�o -- a g 9 a 1 o
degmuss)
v/5. Describe the existing land use or condition of the site at the time of this a plication
(residential, undeveloped, etc.):G I'a S 1 trff A IY 1 �.% / �►
XA-k. Kctu 'er s lv o 10, 1rr e >r Cows vtl s se ; k m 1-�
Property size (acres):
1�4 pp
`r
V16.
10-t- 1, 4e
Lake/ river/ ocean ad' a nt to property:
\//%.
�C e 16-1
fg. Describe proposed work (include discussion as to how hardening of sh reline has been �
avoided, or why it is necessary): _/,d S1C3d -IC C'�U4pvv N7-69W1V`
10sUf-d,r' "
A Ngo T4.4} -AQ-, km fe" dvt iF'�t �� tie,S SF rcr�Ct wtl ti
'
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/ Norniffl Water Level in square feet or acres:
,A7,—.> wow wm �Pe_ ChAfa BQ oc / L k t�toL
/11. Total amount of disturbance (including all clearing, back fill, excavation, rip rap, retaining
walls, etc,) above the normal ool lake level/ Normal Water Level and 50 feet land -ward
in square feet or acres:T-�— _ ���-( (,� j (�-t
�Pd
Rif t~'Tf
V/12. Please describe the vegetation above the normal pool lake level/ Normal Water Level and
50 feet landward to be impacted (renumber of trees, for instance):
04�e ]7V sty 04 �J ` e 0+ kt p W(
t
Owner/Agent's Signature Priv d
Name j � d eCVe�r Date 1 -L 14�V 1
[I 5A NCAC 02H .05020]
'Agent's signature is valid only if an authorization letter from the

owner is provided.
sr
- 1r8n! YM." U"V— A-ft"OM ymm'" MMM W"M toot.," -
�1 aw � u �: � � ,.. � +� � � ♦t 'i 'ti't i ) ,,t . +mow.
qM! A • .,..,. r Iitr
-
_, -.._..F.YL�K+fi1153tv'ca6F�f•�6eils "^•5-.- "•'-`:iWW�4' _ _ _ -. -
Full Pond/
Lake
�;--- -- 12 �t Jeer
t
L„ _ _
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ft x 100 ft) *:
l . All proposed vegetation clearing ^ ONe 'BUSH 0A C'60.1br OS, RN7tCr
LL (1
2. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation 3 7 D Y
,,pp
3. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation 2e P0 R.6 ` P PhP Q'OU3
4. Location of any proposed structures such as buildings, retaining walls, docks, etc. LU SV'(kK vft,' Oi
5. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
01
E
Iris
FORM: SSGP 10-2013 Page 1 of 4

COMOMIS Feature Report
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Albemarle
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85 Locust
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Lease Land Records
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WpsJlstanVconnectgis.COMVownloadFUe.ashx?i=_Bgak_mEtplo222ef3e7o5485e85c&la&95cldbc568x.htrn&t=prhtd Page 1 of 2

ConnectGIS Feature Report
11/27118, 424 PM
OBJECTID Tax Record Owner Name
504 26861 KLECKER LLC
Owner Name 2 Wiling Address Mailing Address 2
6717 ELMSTONE DR
�IX1C State Zile
CHARLOTTE NC 28277
PIN Deed Acres Lots
657602681384 0 3
Physical Address District Code District Desc
23510 LAKE TILLERY RD. 116 EASTSIDE FD
Township Code Towna ft DDesc Descriptionl
113 S ALBEMARLE #1 TWP DWELLING
Year Built Finished Area DateSold
1977 896 7/17/201712:00:00 AM
SaleAmount Deed Book Deed Page
0 1616 749
Plat Book Plat Pang Landuse Record
5 105 No
TotaIFMVCurrent
133500
is map is prepared for the inventory of Real Property found within this Jurisdiction, and Is compiled from recorded deeds, plats and other public records and data.
sers of the map are hereby notified that the aforementioned public primary information sources should be consulted for verification of the Information contained on thit
'nap. The Stanly County Geographic Information Systems Division of the Office of Information Technology assumes no legal responsibility for the information contain
Do this map. Also, when the deeds and or plats are viewed for a parcel, the Stant' County Register of Deeds Office makes no guarantees regarding the coiiecuon
accuracy, authenticity, or use of these records. The web site is for informational use and convenience only. The Register of Deeds shag in no way be held responsbk
or errors or omissions In these records nor for any actions resulting from their use. The official records are kept In the Stanly County Register of Deeds Office. To vie
eeds on this site you must Install the ARernaTIFF viewer. To Install, please visit httpJAvww.afterrmatdf.comlinstal -W Warning: City of Norwood: Within the dy gMRs
orwood any Improvements such as boathouses or piers that have been buil on land owned by Duke Energy are considered to be located on leased land and tlmeref
II not be found using this program. These Improvements are also not considered to be looted within the city ImRs of Norwood and are taxed accordingly
eased land records can be Identified by going to StanlyTaxcom. R a property Is located on Lake Mary lo Norwood has a parcel number of 1234 then the tax big for t
atedront Improvements located on Duke Energy property could be found by placing an LL01 after the parcel number. On StarfyTax.com search by Parcel /
umber and enter 1234LL01 for this example.
https•J/stanly.connectgis.cornlDownloadFge.ashx?i=_ags_map10222ef3e705486e85cgaa855Wbc568x.hbr&tepdntid Paget of 2

Prom: Johnson, Alan z7dan jiohnson@,n r- tee= r.g
Sutec'r: RE: [External] Re: shoreline
Date: Nov 29, 2018 at 4:29:31 PM
Tom Klecker L�orn.kle,cke: �F r" (jib, nnadxom
You look up the county GIS site. They have photos and all your information. Or you can
Print off from Google maps. Put in your address. You will have to manually identify your
boundary
From: Tom Klecker <i•om.klecker44 _gmail.com>
Sent: Thursday, November 29, 2018 428 PM
To: Johnson, Alan <alan.]ohnson@ncdenrgov>
Subject: [External] Re: shoreline
Hi Alan,
I can comply with everything you have requested but I do have a question concerning the
"aerial photo exactly what does that consist of? I do not have an aerial photo of my
property and really don't know how to gather one up.
Thanks Alan for your prompt attention concerning this...... I really do appreciate it.
Tom Klecker
704-668-4808
Sent from my iPhone
IOn Nov 29, 2018 at 1:49 PM, Alan <afan i4hnson@ncdenr g2y> wrote:
$240 fee
Photo of shoreline and along lake
Aerial photo
Plat of property
Diagram/site plan for work
Location/street map
Mail to: Wetlands unit, mail service center 617, Raleigh NC 27699
Thanks
Alan
<mage003.png>
Alan D Johnson — Senior Environmental Specialist

NC Dept. of Environment & Natural Resources (NCDENR)
Division of Water Resources - Water Quality Regional Operations
610 East Center Ave., Suite 301, Mooresville, NC 28115
Phone: [phone] Fax: [phone]
E-mail correspondence to and from this address may be subject to the North Carolina Public Records
Law and may be disclosed to third parties unless the content is exempt by statute or other regulation.
<Abbreviated PCN shoreline New.docx>

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ConneCIGIS Feature Report
657602682469
Physical Address
LAKE TILLERY RD
Township
113
SaieAmount
0
Plat Book
5
12102
Tax Record
28604
Mailing Address
6717 ELMSTONE DR
State
NC
Deed Acres
0
District Code
116
Townshig_Desc
S ALBEMARLE #1 TWP
Finished Area
0
Deed Book
1616
Plat Pag
105
Owner Name
KLECKER LLC
Mailing Address 2
Zia
28277
Lots
District Desc
EASTSIDE FD
VACANT
DateSold
7/17/201712:00:00 AM
Deed Pagg
749
No
11)27/18,426 PM
rn nis map is prepared for the Inventory of Real Property found within this Jurisdiction, and Is compiled from recorded deeds, plats and other public records and
sers of the map are hereby notified that the aforementioned public primary information sources should be consulted for verification of the information contained on th
ftft
ap. The Stanty County Geographic information Systems Division of the Office of Information Technology assumes no legal responsibRy for the information oorda
this map. Also, when the deeds and or plats are viewed for a parcel, the Stang County Register of Deeds Office makes no guarantees regaftV the collection
ocuracy, authenticity, or use or these records. The web site Is for Informational use and convenience only. The Register of Deeds shall in no way be held
or errors or omissions in these retards nor for any actions resulting from their use. The official records are kept In the Stardy County Register of Deeds Office. To
rro d this site you must Install the AfiemaTIFF viewer. To install, please visit httpJ/www.a#effatiff comllrmsM4e/ Worming: Cly of Norwood: Within the cdy To
any Improvements such as boathouses or piers that have been buil on Mand owned by Duke Energy are considered to be located on leased land and
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ate d l nt imecords can located ie Dy going
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y property
couldumber and enter 1234ito1 r�r thtc AYAm„me could found placing 8n U-01 atter the parcel number. On SfanryTax com search by Parcel /
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DUKE ENERGYINTERNALUSE ONLY Construction. DUKE
Date Received �— App Fee Amt Application ,�,. ENERGY.
version 18c
Site IDL. HEP Fee
Duke Energy Lake Services
Mail Code EC12Q
526 S. Church St.
Charlotte, NC 28202
I. APPLICANT INFORMATION (applicant mailing address and contact information)
Name* homas Klecker Primary Phone*
04-668-4808
Address* 16717 Elmstone Drive Secondary Phone [phone]
city*harlotte State* NC zip Code 8277
Email [e-mail]
II. PROPERTY INFORMATION (location of permit)
Is there an existing dock or other facilities 0 Yes if yes, include Dock Tag #. If tag
along the shoreline property or over the Lake? ❑ No cannot be located, note that here. * AR -35820
Address* 3510 Lake Tillery Road County* tanly
City* Ibemarle State* K Zip Code* `8001 Lake* illery
Subdivision
Lot(s) -�
Latitude and longitude of the property. Please use a service/software to acquire the location information. Values should be provided
in Decimal Degrees format (35.1245). Latitude e. ( g. 35.12345)* 35 -29411
Example service: http://getiationg.net/ Longitude (e.g. -80.12345)*
III. PROPOSED ACTIVITY (check all that apply)
❑New/Modification of Existing Structure Fj Maintenance of Existing Structure
❑New/Modification of Existing Shoreline Stabilization ✓Q Maintenance of Existing Shoreline Stabilization
QTransfer of ownership (check box if you want a copy F--1Other (Describe below. If the activity involves an irrigation
of permitting history F) withdrawal, include the pump capacity.)
Structure size (square Is dock covered? ElYes MNo Number of slips
feet) Is structure a
common use dock? ❑Yes* F�No Number of jetports
*lf yes. see special note in Section Vil
Shoreline Stabilization Length of 100 Feet
stabilization (feet) Distance from shoreline (feet) n Shoreline
Brief Description of
the Activity
Describe briefly the
existing structures
over land and water
(include sq ft)
Materials
Rip Rap
,Erosion has caused the current shoreline stabilzation to detach from the shoreline
NA

IV. Additional Requirements (include with application; limit document sizes to 11"x Ir or smaller)
You must include the following items with your application (unless specifically excluded for your application type).
Survey stamped/signed by a professional licensed surveyor
0 showing the location of the existing or proposed structure
and/or survey of the existing or proposed stabilization (not
required for transfer)
ZPhotos along property shoreline and photos of existing
structures and/or stabilization in or near the water
❑✓ Application fee (check only, payable to Duke Energy)
r✓ Signed Applicant's User Agreement Letter
V. Application Processing
Plan and profile drawing showing all measurements,
F1 elevations, and irrigation line routing (not required for
transfer UNLESS tag number can't be located, sketch can be
used in such cases, not required for shoreline stabilization)
Local and state permits (building permits orexemption
letter required for all structure applications at Catawba -
21 Wateree lakes in NC, • Tega Cay, SC,- Kershaw County, sc,•
NCDWR approval required for shoreline stabilization in NC,
not required for other applications)
Habitat Enhancement Program payment (required only for
New/Modified structures at Catawba-Wateree and Keowee-
Toxaway lakes and shoreline stabilization at Keowee-
Toxaway)
• Application is reviewed and determined if complete. Fields with an asterisk are required.
• If application is not complete or does not include all items and information listed in the checklist, the application
will be returned as incomplete.
• A Duke Energy representative will visit the site to conduct a visual inspection.
• Applicant will be notified of approval or denial, typically via email.
VI. Directions by Road
ead east on 24/27 from Albemarle and prior to crossing the bridge of Lake
illery you would take a right on Lake Tillery Road. 23510 is the first house on
e left on Lake Tillery Road.
Directions by Road*
VII. Application Submission
Please complete, print and sign this application. Then enclose all items required per Section IV above and submit to the
address below.
Duke Energy Lake Services
Mail Code EC12Q
526 S. Church St.
Charlotte, NC 28202
I agree the information contained within is accurate:
Applicant signature
Common Use Dock Co -Owner Signature(s) and Information (all owners of common use docks must submit o signed
Applicant's User Agreement and application fee)
Name
Address
Signature
Name
Address
Signature
Attach additional sheets if there are more co-owners

DUKE ENERGY PRIVATE FACILITIES
"APPLICANT'S USER AGREEMENT"
(Fill in blanks with required information. Please Print)
Date December 3, 2018
TO: Duke Energy
c% Lake Services - EC12Q
526 S. Church Street
Charlotte, NC 28202
RE: (Lake Name) Tillery
(Lake Address) 23510 Lake Tillery Road
Albemarle NC 28001
(Applicant's full name) Thomas Klecker hereby
agrees to comply with all requirements and conditions set forth by Duke Energy's Lake Services
(Duke Energy) office, and any federal, state or local agencies pertaining to our application to
construct and/or maintain a
stabilization of the shoreline on Lake Tillery In addition,
1/we have read and agree to comply with Duke Energy's Shoreline Management Guidelines
(SMG) and understand that written authorization must be obtained from Duke Energy prior to
beginning any activity/construction within the Federal Energy Regulatory Commission (FERC)
Project boundary. The construction will be completed as described in the approved application
and within twelve (12) months following the date of approval by Duke Energy. An extension
will be considered for legitimate extenuating circumstances (as determined by the sole discretion
of Duke Energy) provided a specific timeframe in which to complete the construction, not to
exceed an additional 12 months, is provided in writing to Duke Energy by the applicant. Failure
to complete construction within the 12 -month build -out period or any Duke Energy approved
extension will require the applicant to file a new application that complies with the then -current
SMG. The new application filing will include any applicable fees and security deposits.
11we attest to be the owner or lease holder of the tract of land immediately adjoining the Project
boundary where the proposed private facility is to be constructed.
Ilwe agree to comply with all FERC orders (as modified or interpreted by FERC), with -all other
applicable FERC Rules and Regulations implemented by Duke Energy, and with all rule
regulations imposed on Duke Energy by any governmental agency. s or
Page I of 5
Rev 11/9/2016

Ave understand the physical location of My/our lot in relation to the common property line with
Duke Energy, if any, the FERC Project boundary, and any deeded flood easements or required
building setbacks.
Uwe understand that this lake was constructed as a working hydropower reservoir for the primary
purpose of producing cost-effective electric energy and that this remains as the lake's primary
purpose. Uwe understand the lake and its associated hydroelectric facilities are operated by Duke
Energy under the terms of a license issued by the FERC and there will be no change in hydro
project operations as a result of the construction and/or use of any facilities that Ave may be
allowed to place within the FERC Project boundary or on any Duke Energy -owned property.
Uwe understand during drought conditions Duke Energy may request reduced usage or
discontinued usage of any water withdrawal or related systems, until such drought conditions
improve. Failure to do so may cause possible removal of the system and/or any other permitted
facilities that Ave may have, and any costs associated with removal of the facilities will be
assessed to the lot owner.
Ave understand lake levels will rise and fall over time in response to weather events and hydro
project operations and Duke Energy does not guarantee an approved facility will always have
sufficient waxer depth to be accessible by boat or for other water depth related recreation
activities.
Ave acknowledge Duke Energy provides no guarantee of any specific quantities (except those
identified in the FERC license) or quality of water in the lake.
Ave understand the facilities to be installed and/or maintained are my/our property and Uwe
therefore agree to be fully responsible for the permitted reservoir use including maintaining
facilities in good repair. If the private facility is deemed unsafe by Duke Energy, L'we agree to
repair or remove the private facility at my/our own expense and within the specified timeframe
set by Duke Energy.
Uwe understand Duke Energy approval of the requested reservoir use in no way constitutes
assignment of any interest in real property Duke Energy may have (i.e. land rights). The approval
is granted and maintained solely at Duke Energy's discretion. Uwe also understand the permitted
use may be revoked at any time by Duke Energy or its successors for any reason whatsoever. If
the approval is revoked, Uwe agree to remove the facility at my/our own expense within the
specified timeframe set by Duke Energy.
Ave understand ownership/interest in a Common Use Facility or residential marina eliminates
the option of having a separate private facility on any other owned or leased lot within the
affected subdivision.
Uwe understand this lake is open for use by the general public and that maintaining safe and
lawful public use is one of the primary lake management objectives of Duke Energy.
Page 2 of 5
Rev 11/9=6

IAve understand the use for which we are applying is a private use and it should not interfere with
the general public's safe and lawful use of the lake.
Ifwe understand lake use permit holders have the authority to prevent others from trespassing on
the facilities Uwe have built. Uwe also understand Uwe, however, do not have any authority to
impede anyone from pursuit of the lawful public recreation enjoyment of FERC Project lands
and waters. Except as specified otherwise in the SMG, other Duke Energy documents (e.g.
Public Safety Plans), or a separate lease agreement, anyone may fish around/under facilities built
by others, may walk/wade/fish within the FERC Project boundary, boat in the lake's waters, etc.
without having to get anyone's permission to do so.
Uwe agree to fully disclose all information regarding the approved private facility to any
prospective buyer/leaseholder of the property and any new owner/leaseholder. Ave agree to
notify Duke Energy immediately of any sale/transfer of the property, including the name and
address of the new owner and to transfer the permit and/or Duke Energy lease to the new owner.
Ave agree the adjacent Duke Energy Project property, if any, shall be used exclusively for non-
commercial recreational purposes and that Uwe shall not rent or otherwise allow third parties
(except for temporary use by guests, family members, and leaseholders of the residential
property) to use any facilities permitted to me/us by Duke Energy.
Uwe agree not to allow any use of the adjacent property, and will exercise due care and diligence
to prevent all other persons that are affiliated with my/our property (including invitees, family
members, guests, etc.}, to violate an applicable federal, state or local law or regulation. Examples
include, but are not limited to nudity, illegal discharge of firearms or fireworks, controlled
substance abuse, public drunkenness, public urination or defecation, or other activities
determined to be a nuisance by law enforcement officials.
Ifwe agree to exercise all care and due diligence to preserve and maintain the character of the
Duke Energy's adjacent property, if any. Uwe agree to comply with the Duke Energy vegetation
management requirements as stated in the SMG Ifwe agree further to not allow sewage,
including discharge from septic tanks (or similar facilities) or boat holding tanks, garbage, trash,
or other waste material to be discharged or dumped into the reservoir, tributaries or adjacent
property.
Ave understand that as an adjoining property owner Uwe can make no change in land form of
land within the FERC Project boundary or land owned by Duke Energy, if any, such as grading,
excavation or filling without prior written approval by Duke Energy.
Ave agree for myself/ourselves, members of my/our family, guests and invitees that Ave assume
all risks of personal injury or property damage incident to my/our occupancy and use of the
FERC Project boundary or land owned by Duke Energy, if any; including, but not limited to, any
personal injury or property damage which may be sustained as a result of flood waters or in
connection with the rise and fall of water in the reservoir as a result of floods or of the operation
of Duke Energy's hydroelectric facilities. Ave as the adjoining property owner(s) fiirther agree
Uwe will indemnify, protect, defend, and save harmless Duke Energy from any and all loss, cost,
Page 3 of 5
Rev 11"16

claims damages, expenses, judgments and causes of action for all injuries and damages sustained
by the members of my/our family, guests, and invitees arising or claimed to have arisen in
connection with their occupancy or use of the Duke Energy permitted facility(s).
Uwe agree if any action is taken by Duke Energy to enforce any provision, covenant or
agreement contained in this user agreement or Duke Energy SMG or if Duke Energy is required
to retain an attorney to enforce any provision, covenant or agreement contained in this user
agreement or SMG (including, without limitation, the payment of fees due hereunder or the
removal of an encroachment constructed in violation of this user agreement or SMG), then Duke
Energy shall be entitled to recover all of its reasonable costs associated with such an action,
including but not limited to, attorneys' fees and court costs incurred in such action and/or
enforcement
Ave understand certain activities specified in the SMG are prohibited because of environmental
concerns, boating capacity limitations, safety considerations and other reasons.
Uwe specifically waive any claim against Duke Energy for consequential damages arising out of
or relating to this application, Duke Energy's approval or denial of it, or subsequent revocation
of approval, and Uwe specifically understand and acknowledge that, because Duke Energy can
revoke the permitted use at any time, Uwe am/are not entitled to reliance damages.
Uwe understand the proposed facility will be used only for the purposes described in the
information submitted to Duke Energy and other appropriate governing bodies for approval.
Uwe understand every reasonable effort must be made to minimize adverse impacts on fish,
wildlife, and other natural resources.
Uwe understand trees and vegetation growing within the Project boundary play an important role
in the overall environmental condition of the lake. The ecological benefit the vegetation has on
the fish and wildlife habitat supports a sound and healthy lake environment. Uwe also understand
unauthorized removal of shoreline vegetation and/or disturbance of the shoreline buffer may
result in suspension or denial of lake use permitting requests and require me/us to re-establish the
vegetation, if the disturbance is found to be in violation of the state or county watershed buffer
regulations or Duke Energy's vegetation management requirements as stated in the SMG
Uwe agree to maintain any prescribed mitigation activities that are required in order to gain
approval for facility construction, as long as the facility exists.
Love recognize Uwe have the continuing responsibility to ensure that the constructed facilities are
maintained in good repair, including, but not limited to maintenance of the facilities, and proper
erosion control within the permit area and along the shoreline, and agree to take all reasonable
steps necessary to meet thi's responsibility. Uwe agree to maintain all facilities within the Project
boundary and on Duke Energy -owned property, if any, in a sound condition and in a neat
appearance and pay all costs for said maintenance.
Page 4 of 5
Rev ! UM16

Uwe understand Duke Energy representatives may issue Stop Work Directives for any
violation(s) of the SMG or engagement in prohibited acts or activities on Duke Energy property,
if any, as specifically identified in the SMG Uwe understand persons found to be in violation
will be subject to Duke Energy sanctions which can include, but are not necessarily limited to: 1)
restoration of the impacted area at the person's expense; 2) loss of consideration of any future
lake use permitting activities for up to five years for improper vegetation removal or until
vegetation is satisfactorily re-established (even if there is a change in property ownership); 3)
revocation of a previously issued permit and loss of consideration of any future lake use
permitting activities and/or reinstatement of the revoked permit; 4) increase in fees; 5)
modification or removal of non -complying facilities; and/or 6) further legal action being taken
by Duke Energy.
Uwe agree that if any historic or archaeological resources are discovered during construction of
an approved activity the applicant must stop work immediately and contact Duke Energy. Uwe
understand that in the event that anyone discovers a potential site of archaeological or historic
significance including any gravesite within the Project, the individual must immediately notify
Duke Energy.
Uwe acknowledge Duke Energy has the right to charge reasonable user's fees for private use of
its property, if any, and the Project and failure to pay any applicable user's fees in a timely
manner can result in the suspension or cancellation of any previously approved lake use permit.
Uwe agree to notify Duke Energy when construction is completed and during the construction
period, Uwe will post the Duke Energy approval (to be provided by Duke Energy) at the job site
visible from the water's edge.
Thomas Klecker
Applicant Name 4.-AEL hcant ippgnature
23510 Lake Tillery Road
Lake Street Address
Albemarle NC 28001
City/State/Zip Code
704668-4808
Preferred contact Phone Number
[e-mail]
Email Address
Page 5 of 5
6717 Elmstone Drive
Home Mailing Address
Charlotte NC 28277
City/State/Zip Code
704-668-4808
Home Phone Number
December 3, 2018
Date
Rev 1119MI6

From.:
[e-mail]
SubJect:
Your parcel has been delivered
Date:
Dec 4, 2018 at 12:20:05 PM
I o:
[e-mail]
Your parcel has been delivered
Join our email pLogram to receive exclusive offers and resources
The parcel to NC DIV OF WATER RESOURCES has been delivered.
Who sent it... Carrier detail...
TOM KLECKER UPS Ground
(Sender's street address omitted
intentionally from this email)
Charlotte, NC 28277
Who will receive it...
NC DIV OF WATER RESOURCES
WETLANDS UNIT
(Recipient's street address omitted
intentionally from this email)
RALEIGH, NC 27699-1600 US
Tue 04 Dec 2018 10:57 AM
Who is carrying it...
THE UPS STORE #3771
704-759-9601
Tracking details...
Tracking No.: 1Z7A402R0343152131
Shipment ID: MM97MN7C9ZA7M
Order / Item #: --
Reference #: --
Ship date
Monday, December 3, 2018
Delivery date...
Tue 04 Dec 2018 10:57 AM

N
From: Johnson, Alan [e-mail]
Subject: RE: [External] Re: shoreline
Date: Nov 29, 2018 at 4:2931 PM
To: Tom Klecker [e-mail]
You look up the county GIS site. They have photos and all your information. Or you can
print off from Google maps. Put in your address. You will have to manually identify your
boundary
From: Tom Klecker <[e-mail]>
Sent: Thursday, November 29, 2018 4:28 PM
To: Johnson, Alan <alan.johnson@ncdenr.g�v>
Subject: [External] Re: shoreline
External email. bam- P, ck it ks or open attachments unless verified Send all
if as an attachment to, +?® -
Hi Alan,
I can comply with everything you have requested but I do have a question concerning the
"aerial photo........ exactly what does that consist of? I do not have an aerial photo of my
property and really don't know how to gather one up.
Thanks Alan for your prompt attention concerning this...... I really do appreciate it.
Tom Klecker
704-668-4808 FyL
Sent from my iPhone� 0 4;2013On Nov 29, 2018, at 1:49 PM, Johnson, Alan <alan.iohnson@ncdenr.q.,,,.--
$240 fee
Photo of shoreline and along lake
Aerial photo
Plat of property
Diagram/site plan for work
Location/street map
Mail to: Wetlands unit, mail service center 617, Raleigh NC 27699
Thanks
Alan
<image003.png>
Alan D Johnson — Senior Environmental Specialist
I

NC Dept. of Environment & Natural Resources (NCDENR)
Division of Water Resources - Water Quality Regional Operations
610 East Center Ave., Suite 301, Mooresville, NC 28115
Phone: [phone] Fax: (774,) 663-6040
E-mail correspondence to and from this address may be subject to the North Carolina Public Records
Law and may be disclosed to third parties unless the content is exempt by statute or other regulation.
<Abbreviated PCN shoreline New.docx>

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ConnectGIS Feature Report
J,PCONNECTGIS �
WEB HOSTING STAI�.Y COUNTY
(AI
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86
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11/27/18, 4:26 PM
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Printed November 27, 2018
See Below for Disclaimer
!o
3367
1 :46 Feet
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Rail Roads
i
Roads
Parcels
City Limits
(15)
1 Albemarle
-------__��
■Badin
LOCLSt
Misenheimer
New London
4
■ Norwood
Oakbom
■ Red Cross
Richfield
Stanfield
83
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■
Surrounding Counties
11
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https://stanly.connectgis.com/DownloadFile.ashx?i=_ ags_map3507b7cf0feb4011a34675bf251edea0x.htm&t=pdntid Page 1 of 2

ConnectGIS Feature Report
CHARLOTTE
PIN
657602682469
Physical Address
LAKE TILLERY RD
113
12102
Tax Record
28604
Mailing Address
6717 ELMSTONE DR
State
NC
Deed Acres
District Code
116
S ALBEMARLE #1 TWP
Finished Area
0
Deed Book
1616
Plat Paag
105
Owner Name
KLECKER LLC
Mailing Address 2
ZIR
28277
Lots
3
District Desc
EASTSIDE FD
VACANT
Dt 1
7/17/2017 12:00:00 AM
Deed Page
749
No
11/27/18, 426 PM
his map Is prepared for the Inventory of Real Property found within this jurisdiction, and Is compiled from recorded deeds, plats and other public records and data.
secs of the map are hereby notified that the aforementioned public primary information sources should be consulted for verification of the Information contained on th'
ap. The Stanty County Geographic Information Systems Division of the Office of Information Technology assumes no legal responsibility for the Information contalne
n this map. Also, when the deeds and or plats are viewed for a parcel, the Stanly County Register of Deeds Office makes no guarantees regarding the collection,
ccuracy, authenticity, or use of these records. The web site is for informational use and convenience only. The Register of Deeds shall in no way be held responsibl
or errors or omissions in these records nor for any actions resulting from their use. The official records are kept in the Stanty County Register of Deeds Office. To vie
his
on this site you must Install the AffemaTIFF viewer. To install, please visit hftp://www.affematlff.comfinstall-lel Waring: City of Norwood: Within the city limits o
orwood any Improvements such as boathouses or piers that have been built on land owned by Duke Energy are considered to be located on leased land and thereto
If not be found using this program. These Improvements are also not considered to be located within the city limits of Norwood and are taxed accordingly. Th
eased land records can be Identified by going to StanlyTax.com. If a property is located on Lake Tillery In Norwood has a parcel number of 1234 then the tax bill for th
aterfront Improvements located on Duke Energy property could be found by placing an LL01 after the parcel number. On SlanlyTax.com search by Parcel / Recor
umber and enter 1234LLO1 for this example.
https://stanly.connectgis.com/DownloadFile.ashx?i=_ags_niap35O7b7cf0feb4Ol1a34675bf251edea0x.htm&t=printid Page 2 of 2

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DUKE ENERGYINTERNAL USE ONLY Construction ,If.' DUKE
Date Received App Fee AmtApplication *ENERGY
version 18c
Duke Energy Lake Services
Site ID HEP Fee Mail Code EC12Q
526 S. Church St.
Charlotte, NC 28202
I. APPLICANT INFORMATION (applicant mailing address and contact information)
* homas Klecker 04-668-4808
Name Primary Phone*
Address* 717 Elmstone Drive Secondary Phone [phone]
City* lCharlotte State*� Zip Code 8277
Email [e-mail]
II. PROPERTY INFORMATION (location of permit)
Is there an existing dock or other facilities Fi/ Yes If yes, include Dock Tag #. If tag
along the shoreline property or over the Lake? ❑ No cannot be located, note that here. * AR -35820
Address* 3510 Lake Tillery Road I county* tanly
city* Ibemarle State* NC Zip Code* 8001 Lake* rillery
Subdivision Lot(s)
Latitude and longitude of the property. Please use a service/software to acquire the location information. Values should be provided
in Decimal Degrees format (35.1245).
Latitude (e.g. 35.12345)* 135 - 7.944-11
Example service: http://getlatlong.net/ Longitude (e.g. -80.12345)* —so -0992 to
III. PROPOSED ACTIVITY (check all that apply)
❑New/Modification of Existing Structure ❑ Maintenance of Existing Structure
❑New/Modification of Existing Shoreline Stabilization✓Q Maintenance of Existing Shoreline Stabilization
QTransfer of Ownership (check box if you want a copy F-� Other (Describe below. If the activity involves an irrigation
of permitting history '� ) withdrawal, include the pump capacity.)
Structure size (squares dock covered? Yes 1:1 No Number of slips
feet) Is structure a
common use dock? [:]Yes*No Number of jetports
*If yes, see special note in section VI/
Shoreline Stabilization Length of 100 Feet Distance from shoreline (feet) n Shoreline
stabilization (feet) I i
Brief Description of
the Activity
Describe briefly the
existing structures
over land and water
(include sq ft)
Materials
Rip Rap
Erosion has caused the current shoreline stabilzation to detach from the shoreline

IV. Additional Requirements (include with application; limit document sizes to 11"x 1T or smaller)
You must include the following items with your application (unless specifically excluded for your application type).
Survey stamped/signed by a professional licensed surveyor
❑V showing the location of the existing or proposed structure
and/or survey of the existing or proposed stabilization (not
required for transfer)
Photos along property shoreline and photos of existing
structures and/or stabilization in or near the water
✓❑ Application fee (check only, payable to Duke Energy)
MSigned Applicant's User Agreement Letter
V. Application Processing
Plan and profile drawing showing all measurements,
elevations, and irrigation line routing (not required for
transfer UNLESS tag number can't be located, sketch can be
used in such cases; not required for shoreline stabilization)
Local and state permits (building permits or exemption
letter required for all structure applications at Catawba-
❑� Wateree lakes in NC,Tega Cay, SC,Kershaw County, SC,
NCDWR approval required for shoreline stabilization in NC, -
not required for other applications)
Habitat Enhancement Program payment (required only for
New/Modified structures at Catawba-Wateree and Keowee-
Toxaway lakes and shoreline stabilization at Keowee-
Toxaway)
• Application is reviewed and determined if complete. Fields with an asterisk are required.
• If application is not complete or does not include all items and information listed in the checklist, the application
will be returned as incomplete.
• A Duke Energy representative will visit the site to conduct a visual inspection.
• Applicant will be notified of approval or denial, typically via email.
VI. Directions by Road
aad east on 24/27 from Albemarle and prior to crossing the bridge of Lake
Ilery you would take a right on Lake Tillery Road. 23510 is the first house on
e left on Lake Tillery Road.
Directions by Road*
VII. Application Submission
Please complete, print and sign this application. Then enclose all items required per Section IV above and submit to the
address below.
Duke Energy Lake Services
Mail Code EC12Q
526 S. Church St.
Charlotte, NC 28202
I agree the information contained within is accurate:.
Applicant signature *
Common Use Dock Co -Owner Signature(s) and Information (all owners of common use docks must submit a signed
Applicant's User Agreement and application fee)
Name
Address
Signature
Name
Address Signature
Attach additional sheets if there are more co-owners

DUKE ENERGY PRIVATE FACILITIES
"APPLICANT'S USER AGREEMENT"
(Fill in blanks with required information. Please Print)
Date December 3, 2018
TO: Duke Energy
c/o Lake Services - EC12Q
526 S. Church Street
Charlotte, NC 28202
RE: (Lake Name) Tillery
(Lake Address) 23510 Lake Tillery Road
Albemarle NC 28001
(Applicant's full name) Thomas Klecker hereby
agrees to comply with all requirements and conditions set forth by Duke Energy's Lake Services
(Duke Energy) office, and any federal, state or local agencies pertaining to our application to
construct and/or maintain a
stabilization of the shoreline on Lake Tillery In addition,
Ifwe have read and agree to comply with Duke Energy's Shoreline Management Guidelines
(SMG) and understand that written authorization must be obtained from Duke Energy prior to
beginning any activity/construction within the Federal Energy Regulatory Commission (FERC)
Project boundary. The construction will be completed as described in the approved application
and within twelve (12) months following the date of approval by Duke Energy. An extension
will be considered for legitimate extenuating circumstances (as determined by the sole discretion
of Duke Energy) provided a specific timeframe in which to complete the construction, not to
exceed an additional 12 months, is provided in writing to Duke Energy by the applicant. Failure
to complete construction within the 12 -month build -out period or any Duke Energy approved
extension will require the applicant to file a new application that complies with the then -current
SMG. The new application filing will include any applicable fees and security deposits.
I4e attest to be the owner or lease holder of the tract of land immediately adjoining the Project
boundary where the proposed private facility is to be constructed.
IAve agree to comply with all FERC orders (as modified or interpreted by FERC), with all other
applicable FERC Rules and Regulations implemented by Duke Energy, and with all rules or
regulations imposed on Duke Energy by any governmental agency.
Page I of 5
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I/we understand the physical location of my/our lot in relation to the common property line with
Duke Energy, if any, the FERC Project boundary, and any deeded flood easements or required
building setbacks.
Ifwe understand that this lake was constructed as a working hydropower reservoir for the primary
purpose of producing cost-effective electric energy and that this remains as the lake's primary
purpose. I/we understand the lake and its associated hydroelectric facilities are operated by Duke
Energy under the terms of a license issued by the FERC and there will be no change in hydro
project operations as a result of the construction and/or use of any facilities that I/we may be
allowed to place within the FERC Project boundary or on any Duke Energy -owned property.
I/we understand during drought conditions Duke Energy may request reduced usage or
discontinued usage of any water withdrawal or related systems, until such drought conditions
improve. Failure to do so may cause possible removal of the system and/or any other permitted
facilities that I/we may have, and any costs associated with removal of the facilities will be
assessed to the lot owner.
I/we understand lake levels will rise and fall over time in response to weather events and hydro
project operations and Duke Energy does not guarantee an approved facility will always have
sufficient water depth to be accessible by boat or for other water depth related recreation
activities.
I/we acknowledge Duke Energy provides no guarantee of any specific quantities (except those
identified in the FERC license) or quality of water in the lake.
I/we understand the facilities to be installed and/or maintained are my/our property and I/we
therefore agree to be fully responsible for the permitted reservoir use including maintaining
facilities in good repair. If the private facility is deemed unsafe by Duke Energy, I/we agree to
repair or remove the private facility at my/our own expense and within the specified timeframe
set by Duke Energy.
I/we understand Duke Energy approval of the requested reservoir use in no way constitutes
assignment of any interest in real property Duke Energy may have (i.e. land rights). The approval
is granted and maintained solely at Duke Energy's discretion. Ave also understand the permitted
use may be revoked at any time by Duke Energy or its successors for any reason whatsoever. If
the approval is revoked, I/we agree to remove the facility at my/our own expense within the
specified timeframe set by Duke Energy.
Ave understand ownership/interest in a Common Use Facility or residential marina eliminates
the option of having a separate private facility on any other owned or leased lot within the
affected subdivision.
Ifwe understand this lake is open for use by the general public and that maintaining safe and
lawful public use is one of the primary lake management objectives of Duke Energy.
Page 2 of 5
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Uwe understand the use for which we are applying is a private use and it should not interfere with
the general public's safe and lawful use of the lake.
I/we understand lake use permit holders have the authority to prevent others from trespassing on
the facilities I/we have built. I/we also understand Uwe, however, do not have any authority to
impede anyone from pursuit of the lawful public recreation enjoyment of FERC Project lands
and waters. Except as specified otherwise in the SMG, other Duke Energy documents (e.g.
Public Safety Plans), or a separate lease agreement, anyone may fish around/under facilities built
by others, may walk/wade/fish within the FERC Project boundary, boat in the lake's waters, etc.
without having to get anyone's permission to do so.
I/we agree to fully disclose all information regarding the approved private facility to any
prospective buyer/leaseholder of the property and any new owner/leaseholder. Ifwe agree to
notify Duke Energy immediately of any sale/transfer of the property, including the name and
address of the new owner and to transfer the permit and/or Duke Energy lease to the new owner.
I/we agree the adjacent Duke Energy Project property, if any, shall be used exclusively for non-
commercial recreational purposes and that Ifwe shall not rent or otherwise allow third parties
(except for temporary use by guests, family members, and leaseholders of the residential
property) to use any facilities permitted to me/us by Duke Energy.
Ave agree not to allow any use of the adjacent property, and will exercise due care and diligence
to prevent all other persons that are affiliated with my/our property (including invitees, family
members, guests, etc.), to violate an applicable federal, state or local law or regulation. Examples
include, but are not limited to nudity, illegal discharge of firearms or fireworks, controlled
substance abuse, public drunkenness, public urination or defecation, or other activities
determined to be a nuisance by law enforcement officials.
I/we agree to exercise all care and due diligence to preserve and maintain the character of the
Duke Energy's adjacent property, if any. I/we agree to comply with the Duke Energy vegetation
management requirements as stated in the SMG. I/we agree further to not allow sewage,
including discharge from septic tanks (or similar facilities) or boat holding tanks, garbage, trash,
or other waste material to be discharged or dumped into the reservoir, tributaries or adjacent
property.
Ave understand that as an adjoining property owner Uwe can make no change in land form of
land within the FERC Project boundary or land owned by Duke Energy, if any, such as grading,
excavation or filling without prior written approval by Duke Energy.
Uwe agree for myself/ourselves, members of my/our family, guests and invitees that Ifwe assume
all risks of personal injury or property damage incident to my/our occupancy and use of the
FERC Project boundary or land owned by Duke Energy, if any; including, but not limited to, any
personal injury or property damage which may be sustained as a result of flood waters or in
connection with the rise and fall of water in the reservoir as a result of floods or of the operation
of Duke Energy's hydroelectric facilities. Ifwe as the adjoining property owner(s) further agree
Ifwe will indemnify, protect, defend, and save harmless Duke Energy from any and all loss, cost,
Page 3 of 5
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claims damages, expenses, judgments and causes of action for all injuries and damages sustained
by the members of my/our family, guests, and invitees arising or claimed to have arisen in
connection with their occupancy or use of the Duke Energy permitted facility(s).
Uwe agree if any action is taken by Duke Energy to enforce any provision, covenant or
agreement contained in this user agreement or Duke Energy SMG or if Duke Energy is required
to retain an attorney to enforce any provision, covenant or agreement contained in this user
agreement or SMG (including, without limitation, the payment of fees due hereunder or the
removal of an encroachment constructed in violation of this user agreement or SMG), then Duke
Energy shall be entitled to recover all of its reasonable costs associated with such an action,
including but not limited to, attorneys' fees and court costs incurred in such action and/or
enforcement.
I/we understand certain activities specified in the SMG are prohibited because of environmental
concerns, boating capacity limitations, safety considerations and other reasons.
I/we specifically waive any claim against Duke Energy for consequential damages arising out of
or relating to this application, Duke Energy's approval or denial of it, or subsequent revocation
of approval, and Uwe specifically understand and acknowledge that, because Duke Energy can
revoke the permitted use at any time, I/we am/are not entitled to reliance damages.
Ave understand the proposed facility will be used only for the purposes described in the
information submitted to Duke Energy and other appropriate governing bodies for approval.
I/we understand every reasonable effort must be made to minimize adverse impacts on fish,
wildlife, and other natural resources.
I/we understand trees and vegetation growing within the Project boundary play an important role
in the overall environmental condition of the lake. The ecological benefit the vegetation has on
the fish and wildlife habitat supports a sound and healthy lake environment. l/we also understand
unauthorized removal of shoreline vegetation and/or disturbance of the shoreline buffer may
result in suspension or denial of lake use permitting requests and require me/us to re-establish the
vegetation, if the disturbance is found to be in violation of the state or county watershed buffer
regulations or Duke Energy's vegetation management requirements as stated in the SMG.
I/we agree to maintain any prescribed mitigation activities that are required in order to gain
approval for facility construction, as long as the facility exists.
I/we recognize Uwe have the continuing responsibility to ensure that the constructed facilities are
maintained in good repair, including, but not limited to maintenance of the facilities, and proper
erosion control within the permit area and along the shoreline, and agree to take all reasonable
steps necessary to meet this responsibility. I/we agree to maintain all facilities within the Project
boundary and on Duke Energy -owned property, if any, in a sound condition and in a neat
appearance and pay all costs for said maintenance.
Page 4 of 5
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Uwe understand Duke Energy representatives may issue Stop Work Directives for any
violation(s) of the SMG or engagement in prohibited acts or activities on Duke Energy property,
if any, as specifically identified in the SMG. I/we understand persons found to be in violation
will be subject to Duke Energy sanctions which can include, but are not necessarily limited to: 1)
restoration of the impacted area at the person's expense; 2) loss of consideration of any future
lake use permitting activities for up to five years for improper vegetation removal or until
vegetation is satisfactorily re-established (even if there is a change in property ownership); 3)
revocation of a previously issued permit and loss of consideration of any future lake use
permitting activities and/or reinstatement of the revoked permit; 4) increase in fees; 5)
modification or removal of non -complying facilities; and/or 6) further legal action being taken
by Duke Energy.
Ifwe agree that if any historic or archaeological resources are discovered during construction of
an approved activity the applicant must stop work immediately and contact Duke Energy. Ifwe
understand that in the event that anyone discovers a potential site of archaeological or historic
significance including any gravesite within the Project, the individual must immediately notify
Duke Energy.
Ifwe acknowledge Duke Energy has the right to charge reasonable user's fees for private use of
its property, if any, and the Project and failure to pay any applicable user's fees in a timely
manner can result in the suspension or cancellation of any previously approved lake use permit.
Ifwe agree to notify Duke Energy when construction is completed and during the construction
period, I/we will post the Duke Energy approval (to be provided by Duke Energy) at the job site
visible from the water's edge.
Thomas Klecker
Applicant Name
23510 Lake Tillery Road
Lake Street Address
Albemarle NC 28001
City/State/Zip Code
704-668-4808
Preferred contact Phone Number
[e-mail]
Email Address
Page 5 of 5
Applicant Signature
6717 Elmstone Drive
Home Mailing Address
Charlotte NC 28277
City/State/Zip Code
704-668-4808
Home Phone Number
December 3, 2018
Date
Rev 11/9/2016