20190127 Ver 1_Shoreline Stabilization_20190125

'C�
State of North Carolina
\ t a
Mimi Department of Environment and Natural Resources
Division of Water
Resources
Water Resources 15A NCAC 02H .0500 - Water Quality Certification, Shorelina
ENVIRONMENTAL OUAL11Y
FORM: P 02 10
Shoreline Stabilization Application Form 2 0 1 9 0 1 2 7
Three copies of the application (including attachments) and the application fee should
be sent to:
If sending via US Postal Service
Karen Higgins
DWR - 401 £t Buffer Permitting Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
If sending via delivery service (UPS,
FedEx, etc.)
Karen Higgins
DWR - 401 R. Buffer Permitting Branch
512 N. Salisbury Street
Raleigh, NC 27604
A. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: '�" > No,,
Mailing Address:
i? t r-< ti Y
Telephone Number: -3 J 6SJ& o s- Fax Number:
E-mail Address: 4 A qA♦° LO Z -A . AW -7-
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter must be attached if the
Agent has signed this application form. (A form can be downloaded here: http:
www.saw.usace.armv. mil/Portals/59/docs/regulatory/regdocs/Permits/
SAMPLE AGENT AUTHORIZATION FORM.pdf)
Name:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
B. Project Information [15A NCAC 02H .0502(a) Et (b)]
1. Attach a vicinity map (i.e. street map) clearly showing the location of the

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) 2 21 i5
County: ,.x(2 e, Dat 4. Nearest Town: SM 7-95 y, JLX JVC
Lake/ river/ ocean adjacent to property: IWXK = m a R hit A N Z&U`�677
Property size (acres):
Subdivision name or site address (include phase/lot number):
P 6Q L 12- 51. �m +- 3 K
6 rkl �f�— n si a p e-aseinclude road names and numbers, landmarks, etc.: irlruM
,,11 �uf ��I� ��„ �.�ls �:.( -lvr� � ,����rel Cue F.,�� G� � �.S I��,�, �,Y� �{ � �^��e fe��-•�l
Latitude (in decimal degrees) Longitude (decimal degrees) 8O–`% 9Z75
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): � e if o,
6. Describe proposed work (include discussion as to how hardening of shoreline has
been avoided, or why it is necessary): Sko,-tiwu �tw) Pfvir �e/N
hvS UPJ2rMtj,,{nq v-7,1. irk{ (ttl Bio tIA h7 W0,lfr, �Jctkde1 inc,te rPMC✓i �^c Cv{,°�li� ��fi
Ok 5 Lqo re , T
7. Will work be conducted from land? (, q,,�a From water?
8. Total amount of impacts below the normal pool lake level / Normal Water Level
Permanent impacts (including all excavation, backfill, rip rap, retaining walls, etc.)
in square feet: V 'Too 1,;<y �4e l-
Temporary impacts in square feet:
3 oc cls „e �e
9. Total amount of impacts above the normal pool lake level / Normal Water Level
and 50 feet land -ward
Permanent impacts including back fill, excavation, rip rap, retaining walls, etc.) in
square feet: '300 &V %q)iw-t
Temporary impacts (temporary clearing, construction corridor) in square feet:
7 00 5goOfe kP�+

10. Please describe the vegetation above the normal pool lake level/ Normal Water
Level and 50 leet landward to be impacted (number of trees, for instance): _
11. Signature ! Z - 6— zel:l
-- / 8'
Owner/Agent's Signature' [ 5A NCAC 02H .0502(f)1 Date
'Agent's signature is valid only if an authorization letter from the owner is provided.
12. Please approximately sketch the following information on this plan and provide
dimensions for each item:
a. All proposed vegetation clearing
b. Location of rip rap or fill to be placed above the Full Pond/ Normal Water
Level elevation
c. Location of rip rap or fill to be placed below the Full Pond/ Normal Water
Level elevation
d. Location of any proposed structures such as buildings, retaining walls, docks,
etc.
e. Location of any excavation or dredging below the Full Pond/ Normal Water
ull Pond/ Normal
Shorehr
Plan Vipi
Lake
(At Full Pond/ Normal Water Level)
fl0Ck

, N�Ce—s -1y
� I Q
w
CU
J
La ke a,
(At Full Pond/ Normal Water Level) i
c
M —
o °
z v
0
Side View
LL
Lake
("`full Pond/ Normal wait` level)
Existing Dock
Soh:7h
3h■150h
Below M pond/ NM
Full Pond/ Normal Water Level
nrreTlne — —
4hx150h
Riprap
Above full pond/ MM
2 h. x 150 h_
additional clearing
• if necessary
E(AMPLE
Plan View

Nov 08 09 03 58p Frank Sondra
704-799-2324 p.6
THIS IS TD CERTIFY THAT ON THE 1M GAY OF DECD—JOLR 2005 AN ACTUAL SW&Y WAS
MME UNDER MY SLIPER415ION OF THE PROPERTY SHOWN ON " PLAT, Am THAT THL WUNDRKY UNE$ AND
THE IMPROVEMENTS. IF ANY, ARE AS SHOWN HEREON. THIS PLAT NESTS THE MPlWIUM SMOAROS OF PRACTICE
FOR UWO SURVEYING W NORTH CARCLD44. BOARD RULE .1600 (21 NCAC 56) AND THE RATIO OF PRECISION
DOES NOT EXCEED AN ERROR OF CLOSURE OF ONE (1) FOOT PER 10.000 FEET OF PERI6ETFR SURVEYED
NOR 25 SECONDS TIMES THE SQUARE ROOT OF THE POJ48EP OF AMGtFS TMNED,
SIGNED
i� REMS£D J4Nthw 29 2006 TO SAM -%Rff )24XFEACE
f S 7aLgE' Mt AND $LACK MGILL
i
i�
FROM THE OFFICE OF
JASON LEE WYL E
NC & SC PROFESSIONAL_ IANC SURVEYOR
2417 FAY JONES ROAD
DENVER., N.C. 28037
PHONE: [phone]
FAX: [phone]
LOT 33
LAKE NORMAN
DP N59r2550 iY 109.96fS.INJ7 ERAF COAWER
or Lor 1.5
REFFAENCE: DB 824-224 do P8 12-52
�h TAX PIN: 4710583528 000
LEGEND
EJP - E=nNG IRON PIPE
QR - EXMMNG IRON RM
R/W - RICFIT-01:'-WAY
PB - PLAT BOOK
08 - DEED BOOK
SQ -FF- - SQUARE FEET
4S°7E`Lqr
D�
SPtn R1iG fern'
O
R .S
LOT 35
VICLWFY MA - IM
&NFKD SHORES FO
N
SI1e
_ - f uo-"3
CHORD 1 t5r22 54 wjo
0 �"� SURVEY OF
LOT 34, RIVER HILLS ESTATES
FALLSTOWN TOWNSHIP. 1REDELL COUNTY, N.C.
50 FEET
so ' 0 so 100
N
��
E/R
LOT 34
VAC,Wr. AV&VD
w
61coaY wail is
ro a' OM
tN
PRapEafr tare
�„
2I J34 .SLIFT. OR QJ34 AC,7PE
4S°7E`Lqr
D�
SPtn R1iG fern'
O
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LOT 35
VICLWFY MA - IM
&NFKD SHORES FO
N
SI1e
_ - f uo-"3
CHORD 1 t5r22 54 wjo
0 �"� SURVEY OF
LOT 34, RIVER HILLS ESTATES
FALLSTOWN TOWNSHIP. 1REDELL COUNTY, N.C.
50 FEET
so ' 0 so 100

Property Data
Page 1 of 2
Iredell County
Property Data
Parcel Number: 4710583528.000
Inquiry Date: 7/27/2012
Disclaimer: While every effort is made to keep information provided over the internet accurate and up-to-date, the County does not
certify the authenticity or accuracy of such information. No warranties, express or implied, are provided for the records
and/or mapping
data herein, or for their use or interpretation by the User.
Property Map
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Owner/ Property Info
Tax Account Number: 77440250
Old Parcel Number: 1503LO4000A034
Owner Name: BONDRA FRANK J+HOLLY C
Mailing Address: 61 GRAND MYRTLE DR PONTE VEDRA FL 32081
Property Location: ISLAND TERRACE RD
Lot Number: 34
Legal Description: RIVER HILLS ESTATES SHT1 PB12-52-52A
Municipal Information
Township Code: 15
City Code: 00
Neighborhood Code: 15017
Value Information - Current. Year Property Record Card (PRC)
Building Value: 0
Other Building Features: 2530
Land Value: 90000
Tax Assessed Value: 92530
httn-//web2.mobi1e31 I.com/IredellReDort/reDort.asl)x?PIN=4710583528.000 7/27/2012

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