20190071 Ver 1_Shoreline Stabilization_20190114

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State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
Division of Water Resources FORM: SSGP 10-2013
Shoreline Stabilization Application Form
PAID
Three copies of the application (including attachments and the application fee should be sent
to:
Division of Water Resources
401 & Buffer Permitting Unit 2 0 1 90 0 7 1
1617 Mail Service Center
Raleigh, NC 27699-1617
1. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
..•,int • u.•- s.
.- as
Telephone Number: &y - Lpgb -aQDq Fax Number:
E-mail Address: 9reSh rQtA lei) Q rna-, L
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: ' aq- Lo1e0 -,till I Fax Number: JC)q -1cl, h - Sq coq
E-mail Address: 0. 6C 5 LI -30-1 I'.n Q iI-, riLl 01�k-rr um. r1e.-i-
Person to receive the Certification Approval: Tu-nice
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)
►►
County: Iffleck Ien�n u ro Nearest Town: (_o r r - l 'i uS
Subdivision name or site address (include phase/lot number): al (O (y 1\Zorn-"A %Or_, -S Dr,
0.0r nG_l A %J 5 Int C, afo3 ► I_0i- DL ULL i�i\Aer Solid V i S t0 n
Directions to site - please include road names and numbers, landmarks, etc.: 7t—T7 N
" o ea, i a B. ah, oba 1 S " Ave . n ri�V'r1 Q V14 -n
i10 rre. -Tor n ri is %YE anib s l7. r nfla�YL �a rer.
l n�-'n,se S�ra►a1'1� In 5+OA nn NLrn-,Ian kores �,,r_
Latitude (in decimal degrees) 35. 505 i o 4 Longitude (decimal degrees) 8'19(03a
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): t�e5 tde,n�,—L
6. Property size (acres): (). 3 y AA II
7. Lake/ river/ ocean adjacent to property: Ko r YY1QY1
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): P
c6t-�ka_11�t remove 2x Si i no u)oar% uuctj
Inwider r'Inra4 and iAS6_ll rI? rn.� io nn+n�ex;54inown(�
9. Will work be conducted from land? El� 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:
3' 61C)w
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: k 1 "n\.(e_
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):
Owner/Agent's Sig
'Agent's signature is
Date
only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 3

Full Pond/
Normal Water Level
Shoreline
Lake
(At Full Pond/ Normal Water Level)
31 6 e mo
I I above.
113' Lena+} i
ACCESS
r � � � � �
Ro Arrees re moved
6. rna.t d i'j+v r 6xrie-.-
to b� FFe.r
c Access w I l
6e
?cu4ialti on +'%.
ne t ghbor5 p ropert Lj .
Seefh-e a44aehed .
19A.A.e r 91 v ► ng Fe.rm ► s51 a n
+0 use.
IR, chard a C .poly n Z; miner Man
aIU 114 Norman'3hores l7. r.
Cornel106,KC 38031
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

Project P
Owner:
Contract
CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Z ► enrY e.vrrr"*i
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 is allowed. [15A NCAC 02B.0243(6)]
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 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
1,1;iC - lgn Z, c nrewr+n-nn. hereby state that I have been informed of the Catawba
Riparian Buffer'Rule. AnV 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. / _ "ter
Signature (owner):
State ol'North Carolina I Environmental Quality I Water Resources
512 N. Salisbury Street 1 1611 Mail Service Center I Raleigh, NC 27699-1611
919.707.9000

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� r y BE SUBJECT
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'':-KS TAKEN FROM
a TE-MECKLENBURGS
N GENERAL
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-7:25'
W
1 =R: 50' FROM 760 CONTOUR
<- CONSULT WITH GOVERNING
;GENCY FOR PREVAILING LAND
DEVELOPMENT AND ZONING
REQUIREMENTS PRIOR TO
DESIGN OR CONSTRUCTION OF
ANY IMPROVEMENTS. _
589N 8'23" W 0.67'
#4 REBAR FOUND
EAST OF 1/2- PIPE
(TIE ONLY)
001-431-24
JAMES LARRY
SHOEMAKER, JR.
DB 4665 PG 47
LEGEND
NORTH PER M.B. 13, PG 271
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001-431-26
CHARLES V. BARRETT
91
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PG 9113
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FETAC14ED ;,ARAGE � DRIVE
#4 REBAR FOUND 0.88'
EAST OF 1/2" PIPE
•24.L
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LOT 4 \a
16,066 Sq.Ft. \
1 0.369 Acres \
1
t�E 0W
N1? 5s 2
197.58
N06'13"20 w 1
(TIE ONLY) ?4v— F �Ir
SO4 21'36"W } w (TIE ONLY 73' Y)
1 j N70'34'40'�E
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ti co f STONE -� Tl R
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- 60, PUBLIC SHORES D
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Date Printed: 12/18/2018 11:46:03 AM
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This map or report is prepared for the inventory of real property within Mecklenburg County and is compiled from recorded deeds, plats. tax maps, surveys, planimetric maps, and other public records and data,
Users of this map or report are hereby notified that the aforementioned public primary information sources should be consulted for verification. Mecldenbur Count and its ma
responsibility for the information contained herein. 9 Y Aping contractors assume no legal

12/26/2018
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January 8 ,2019
To CBC Stone and Recycle, LLC
We, Charles and Angie Barrett, residing at 21608
Norman Shores Drive Cornelius, NC, give your company
permission to access our property to transport the
necessary equipment and stone work necessary for
repair/construction on the sea wall of our neighbor,
Carolyn and Richard Zimmerman ,residing at 21614
Norman Shores Drive Cornelius, NC, to be done during
the upcoming spring/summer season of 2019.
We understand that your company will not be
responsible for any damage to our landscaping, trees
or fencing during the transport of the above materials
to the lake.
Sincerely,