20190081 Ver 1_Shoreline Stabilization_20190115

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
Three copies of the application (including attachments) and the application fee uld be sentry
to:
Division of Water Resources
401 & Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: ­�)rL1CP_ J�hnSnr�
Mailing Address:
2 0 1 90 0 g I
Telephone Number: A38 - y 18-4450 Fax Number:
E-mail Address: kru1er- oh cam. ne)[ , Cnm
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: 104 - tt(DO - Sll ( Fax Number: -104 - CpIaU - 5(1 (.D9
E-mail Address: e6CSecLu)+[1;,ad) iL'iodi:, ,-ecj_ l.n -
Person to receive the Certification Approval: cA Y1 ,c e. L-,�rte D
11. 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 > till Pond.1 Normal Wat-er ? e'. ei clevatiorl..
acrd construction access corridors. You may use the diagram provided at the end of this
application fora:
I Attach a photograph of the shoreline/ buffer proposed to be stabilized. lInelude a scale
Off some sort• a yard stick, shovel handia. etc 1
Location of th.- property I'where work is to be conducted,
Ci7llrit3(' ( �) Neaarest TD.%n: -_ lske r't It5 o rd -
Subdivision name or site address f include phases -110L number;
0..Y111don ._ S.k2.rr i Ile, NC- a8Lt .'3
Directions to size - please inc ude road names and n;lrnbers. iandmark% -etc : -Ta'1 1�
-ko.e%lk 3C Tun lei Ory tO�tom. Tjrn r_,iah+ on > SJ6e ; it Vora
rn_r►oh+ n,�o oll4�crtie.. ri�h-onk-&uIeAl �d. Tarr,
1P-4 ovil, U�g ort6�un�r,�
Latitude : �:r�c:e•e' �C7red:i • �D, 1$ ZOZrItl2G�t ' Sz a -� �rt�, � O. i 77V991L
.y �
5 Describe the existing land use or cor,ditiun of the site ai the time o= this application
(residential, undevelope.^', etc., -
6. rrore.-Ty s.ze hues;:
river:` C'cean adjacent :o property prYY1On_
S. Describe proposed-vcri•: (include discuss -on aS is ho --v hardening of ha3 been
avoided, or why it is necessary): �.�o � ma� !('(��
on-00`1nr Sl�,rell ne, r- Pte, r OLt in�� on IaJ i kon and la(.g I jee4ll rL
9. Lii1 work conducted frCn; land? :
From voter?
T1 - -
10. Total aw.aurt of dis urbance ell+ exc wa:icn, backfill, rip rap. retaining :i'�:lS, ezC E
belov• ti:e normalpoo.' laky Ie:•Pi;' lvo.'it•ai'v:rater Level icy squere feet or acres:
LQ_' __%.e,i e) U)
t 1 Total arltount of disturbance (including all clearing, back fill, czcavatior, rip rap, retaining
walls, Etc.) above the normal pool latce level; Normal %'Vale,- Level and 50 fee: land -v --aro it
squr:re feet or ares: _ � / O�.�p0V LO _
12. PleaS,'- descnbe the vegetation aci',TJVP :he normal pool lite leve)! Normal "thief Level and
50 feet land:•iard to be irnpaccec i number of trees, for ins€ance :
110_- re e5 rPanrloV ► mo-[ 81 _ _ by
Date
•�4,�i S Si �i1'I�Li �F Ii '� � % �, t � f .. i •. t�
FORM, V;GP

Lake
(At Full Pond/ Normal Water Level)
AC'Ce5S
l3r�ce Johnson
X 3'13 L-andon
Sherr i l l s rd , KC
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
6-i 5+*1 nq
l�oc. K
r
Full Pond/
Normal Water Level
Shoreline ! Rases.;
7�
�r
�o E -Tees �o be�
neerJe�d
I'abo�e.
a 3 �i
need
re.rYto v ecl
lab'
las'
�Yl i n i m a1 C� ► ��ur�aYK
y S8
AC'Ce5S
l3r�ce Johnson
X 3'13 L-andon
Sherr i l l s rd , KC
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

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Y 9 673
Project Name/address: i3�13 Lanc�n �� . 5htrrt(t5 tore NG County
Owner:
Print
Contractor/agent: (
Print
Signature
Sigr)616re
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 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, Rrryice c) ny' -'s r-) , 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): Date:
State of 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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0 catawb county Geospatial Real Estate Search
MAKING. LIVING. BETTER. Information Services
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Parcel: 461901497400, 1373 LANGDON RD SHERRILLS FORD, 28673
Owners: JOHNSON BRUCE L, JOHNSON SANDRA J
Owner Address: 1373 LANGDON RD
Values - Building(s): $964,300, Land: $485,500, Total: $1,449,800
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
01/08/2019

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1373 Langdon Rd - Google Maps
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Bruce Johnson
1373 Langdon Rd.
Sherrills Ford, NC 28673