20190066 Ver 1_Shoreline Stabilization_20190109

Y � S i �• �s �',
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: $ FA I D
Division of Water Resources
401 & Buffer Permitting Unit 2 0 1 9 0 0 6 6
1617 Mail Service Center
Raleigh, NC 27699-1617
I. Applicant Information [15A NCAC 02H .0502(a)] \ ��
1. Owner Information
Name: l-<, -D .
Mailing Address: �'2 L. l,.,1 C- (; '7V,',,_� !�)�
Telephone Number(_? U 5� Fax Number:
E-mail Address: J b6ir V Q VAi-10 a C_�3 M
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 mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: r k c N--r„n J
Company Affiliation:
Mailing Address:
i -H LL
Telephone NumbeC7C' GjC,J - I �1Fax Number:
E-mail Address: rbill s
Person to receive the Certification Approval: —D {ICV -Z_ `n LAG.(-,/(& J7,04"Oua
II. Project Information [15A NCAC 02H .0502(a) & (b)]
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.
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.
I 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: , 1.���1 l_ Nearest Town: Add a,-" VL"I /_' N L
Subdivision name or site address (include phase/lot number): fhA4hAAa vr_E
PCwl NSU LA / ZoT 4t 37
Directions to site - please include road names and numbers, landmarks, etc.:
Sl� r ,pit_ HEn
Latitude (in decimal degrees) E35-,, '-lei �% Longitude (decimal degrees) Z-8 Q. 0 el C/ �
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.):
6. Property size (acres): _
7. Lake/ river/ ocean adjacent to property: 14 0f -AV A-nI Z CAjA-WB A
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): _ i}}� �,q-��\ �-. C LAgF � t/vvoAF
/",IL)J\J
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:
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: _motLr, - 'By ' 3AILcg
12. 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):
e
Ohner/Agent's Signature* [15A NCAC 02N .0502(f)1_fzl-01 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)
N-0r� EL=S Ic-MNQ
GLA SNI )k A�< L D1S7-uK>3,nc
TT i3u
u,�)p6 boN67 IZEA-CP
E�ccAvA76c- a— b C
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
I 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
�-oN C-)
Page 3 of 3

CTC GRADING LLC. AUTHORIZATION TO OBTAIN THE NECESSARY
INFORMATION FOR STABILIZATION AND DREDGED PERMITS.
I AGREE: X
DATE: 14-21" 21"

— •-1��Lt.; LY,.
Project Name/address. T� t L �i tiA� �iG i C County:
Location Address:
rl,�Ls 121tiDL j-l1L_L IZC?(hr ST IILEI•='Il_L('_ ;r'��. �����.�
Parcel #• _ -7 E -J - :2 5 5,
Parcel/lot size
Disposal area required (sq ft and/or acreage) r fj j � S
iclrnoxdedgement of iV-o icatio � 1 /
I, -5 Y am aware that the site must adhere to all state reeulations and
rules regarding sediment and erosion control and water quality. And sive permission for
Name of Individual and ContpanN
to dispose oP4i, r dredge material at the above stated location
Owner: / -H ,,AO
ll P 'nt — Signature
Date:J -2 j L,
Along with form, please provide:
Aerial of parcel/lot (County GIS)
Photo of proposed spoil site
Identified proposed spoil site

YOUR TRIP TO: mzz:x�
183 Commodore Loop
18 MIN I 110.0 MI �}
Est. fuel cost: $0.84
Trip time based on traffic conditions as of 7:25 PM on December Print a full health report of your car with HUM
24, 2019. Current Traffic: Light vehicle diagnostics [phone]
n 1. Start out going southwest on NC Highway 150/NC-150 toward Marshall Rd.
Then 0.09 miles
^ 2. Make a U-turn at Marshall Rd onto NC -150.
FYI Then 5.43 miles
3. Turn right onto Morrison Plantation Pkwy.
Morrison Plantation Pkwy is 0.2 miles past Good Luck Ln.
Then 1.15 miles
4. Turn right onto Brawley School Rd.
Brawley School Rd is 0.1 miles past Swift Arrow Dr.
Then 1.56 miles
` 5. Turn left onto Slutts Rd -
+1 Stuffs Rd is 0.2 miles past Esquire Dr.
If you reach Blume Rd you've gone about 0.2 miles too far.
Then 1.40 miles
8. Turn left onto Commodore Loop.
Commodore Loop is just past Marina Ln.
If you reach Baywatch Or you've gone a little too far.
Then 0.34 miles
7. 183 Commodore Loop, Mooresville, NC 28117-7496,183 COMMODORE LOOP
is on the left.
Your destination is just past Osprey Ln.
If you reach Mainview Or you've gone a little too far.
0.09 total miles
5.51 total miles
6.66 total miles
8.23 total miles
9.63 total miles
9.97 total miles
Use of d—tions arM maps is subject to our Terms of Usewe don't guarantee accuracy. route condition, or usability. You assume all rink of use.

Lake
Norman
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save with some great deals! MapQuest Roadside
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From: Tamara Hager [e-mail]
Subject: Barbee pics
Date: Dec 26, 2018 at 8:13:21 AM
To. [e-mail]
Thank You
LaKe PeRmiTs LLC
T.Shaye Hager
704-575-2227