20160076 Ver 2_Shoreline Stabilization_20190114

DWR
' 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 h
Division of Water Resources 2
401 & Buffer Permitting Unit
1617 Mail Service Center $ PA L4 PJA4
Raleigh, NC 27699-1617�!IApplicant Information [15A NCAC 02H .0502(a)]N 1 4 2019
1. Owner Information
'•• / \♦ /�No A
00 t •
Telephone Number(764) 574 '71 g a Fax Number:
E-mail Address:
Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
ht_tp://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: S "( LEL_ a, LLf CT—
Company Affiliation: LLAJ D VL)DCa/M 6
Mailing Address: 12� LAC4S C�!?ASS LtQ
.A4 a t) 2, ES V L to AJK QL I ! 7
Telephone Number:(ZcbLJ)677S-9aa'7 Fax Number: .--,
E-mail Address: 't"q,nlerz - 0 :J�2=u)ufp . (' 4M
Person to receive the Certification Approval: j,/y)_Ci,• hGtCt�C�,�Lt!�. CSM
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: CAThORAk Nearest Town: SI-rC IZ—IZI L LLS ECYC
Subdivision name or site address (include phase/lot number):
Directions to site - please include road names and numbers, landmarks, etc.:
Sf-- L ,❑ RED
Latitude (in decimal degrees) ��). S J d -1 -] Longitude (decimal degrees)
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): 12�i (�r�rrA2
6. Property size (acres): t (�
7. Lake/ river/ ocean adjacent to property: l %f{'1�1i A
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): &M L I f VILL
9. Will work be conducted from land? ❑ From water? r `g�C�[ 4- LOA(-) L -f
10. Total amount of disturbance (including all excavation, backfill, rip rap, retaining walls, etcf
below the normal pool lake level/ Normal Water Level in square feet or acres:
N b N c — 'M BA-9(�
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: wour — 13y'13M_gg c
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):
W��&I c - 3'� am=(,C-
�6 -0 P�O�� C
Owner/ nt's Signature/[15A NCAC 02H .0502(f)) 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
Shoreline
La ke
(At Full Pond/ Normal Water Level)
A&vE
� � � I -ems SNI �� L DisruK�ru
T 13u �`lz
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
Nr LL y F-Ds7LT--
5 I LnL, C1L�-KI 4JU6D S.etE-T
9��U-S Fc" Mk
FORM: SSGP 10-2013 Page 3 of 3

Project r
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)]
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 026.0243 (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 026.0243 (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
whereby state that I have been informed of the Catawba
Riparian Bu er Rule. An 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):
Date: �

C
GIVE
LAKE NORMAN DREDGING INC. AUTHORIZATION TO OBTAIN THE NECESSARY
INFORMATION FOR STABILIZATION AND DREDGED PERMITS.
DATE: 1 14 Lei

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0 catawba county Geospatial Real Estate Search
MAKING. LIVING. 91111 11. information Services
N
W+E
VS
Subdivision: J G EDWARDS PROP UNREC
1 in=150ft
This map/report product was prepared from the Catawba County, NC Geospatial Information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and labeling information contained on this map or data on this report. Catawba County promotes and recommends
the independent verification of any data contained on this map/report product by the user. The County of Catawba, its employees, agents, and
personnel, disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or may
arise from this map/report product or the use thereof by any person or entity.
Copyright 2014 Catawba County NC
01/07/2019

Parcel Report - Catawba County NC
Parcel Information:
Parcel ID: 461603112877
Parcel Address: 5166 GLENWOOD ST
City: SHERRILLS FORD, 28673
LRK(REID): 18736
Deed Book/Page: 2008E/0757
Subdivision: J G EDWARDS PROP UNREC
Lots/Block: 10/
Last Sale:
Plat Book/Page:
Legal: LOT 10 LAKE NORMAN
Calculated Acreage: .460
Tax Map: 018 X 02011 G
Township: MOUNTAIN CREEK
State Road #: 1981
Tax/Value Information: Tax Rates(pdD
City Tax District: All in County
County Fire District: SHERRILLS FORD
Building(s) Value: $365,300
Land Value: $249,600
Assessed Total Value: $614,900
Year Built/Remodeled: 1971/
Current Tax Bill
Miscellaneous:
Building Permits for this parcel.
Building Details
WaterShed: WS -IV Critical Area
Voter Precinct: P41
Parcel Report Data Descriptions
List all Owners Deed History Report
Owner Information:
Owner: FOSTER GAYNELL Y
Owner2:
Address: 5166 GLENWOOD ST
Address2:
City: SHERRILLS FORD
State/Zip: NC 28673-9216
School Information:
School District: COUNTY
Elementary School: SHERRILLS FORD
Middle School: MILL CREEK
High School: BANDYS
School Map
Zoning Information:
Zoning District: COUNTY
Zoning1: R-30
Zoning2:
Zoning3:
Zoning Overlay: CRC-O,WP-O,FPM-O
Small Area: SHERRILLS FORD
Split Zoning Districts: /
Zoning Agency Phone Numbers
Firm Panel Date: 2008-03-18
Firm Panel #: 3710461600L
2010 Census Block: 4036
2010 Census Tract: 011504
Agricultural District:
Assessment Report
This map/report product was prepared from the Catawba County, NC Geospatial Information Services. Catawba County has made substantial efforts to ensure
the accuracy of location and labeling information contained on this map or data on this report. Catawba County promotes and recommends the independent
verification of any data contained on this map/report product by the user. The County of Catawba, its employees, agents, and personnel, disclaim, and shall not
be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or may arise from this map/report product or the use
thereof by any person or entity.
0 2019, Catawba County Government, North Carolina. All rights reserved.

Go gle Maps 5166 Glenwood St
Go gle
Map data @2019 Google 200 ft L-1

Go gle Maps Marshall Steam Station to 5166 Glenwood St, Drive 4.9 miles, 8 min
Sherrills Ford, NC 28673
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8320 NC -150, Sherrills Ford, NC 28673
t 1. Head south toward NC -150 E
r► 2. Turn right onto NC -150 W
41 3. Turn left onto Slanting Bridge Rd
•1 4. Turn left onto Keistlers Store Road
«1 5. Turn left onto Mountain Shore Dr
41 6. Turn left onto Glenwood St
®Destination will be on the right
5166 Glenwood St
Sherrills Ford, NC 28673
These directions are for planning purposes only.
You may find that construction projects, traffic,
0.2 mi
1.7 mi
2.0 mi
0.3 mi
0.4 mi
0.2 mi
Map data ©2019 Google 1 mit

Thank You
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INC SURVEY CREATES A SUBDIVISION DF LAND IN AN
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FEMA INFORMATION:
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EFFECT. DATE: 9 -1 -Bo
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PHYS/CAL SURVEY
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FEBRUARY 20, /997 SCALE: 1'-1o0'
RONNI£ D£DMON SURVEYORS, P.A.
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YITNESS M, NAND AND SEAL 71415 ZDDAY O, Feb____, 1997
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NORTH CAROLINA, _aT_+_r�J-_.r __COUNTY
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RONNI£ OED64ON, REG. SURVEYOR L-1222,� '
CHUCK POOVEY, REG. SURVEYOR L-3762 ,p
P.O. BOX 494 DENVER, N. C. 28037 -, .
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THIS PLAT WAS APPROVED UNDER THE PROVISIONS OF A FAMILY % Z
SUBDIVISION. ANY FUTHER SUBDIVIDING OF ANY OF THESE A \/
PARCELS FOR OTHER THAN FAMILY MEMBERS, AS DEFINED IN
SECTION 514.002 OF CATAWBA COUNTY'S SUBDIVISION ORDINANCE. /00 0 /00 200
SHALL REOUIRE ROAD IMPROVEMENTS ACCORDING TO CATAWBA 300 F ,�
COUNTY'S SUBDIVISION ORDINANCE.-u-
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