20190403 Ver 1_Shoreline Stabilization_20190327

Project amelatYtYress: C C I l_•( S! t col", - y� �l�j e.( ✓��
w ____ I®
Owner: d -� '�`""-
1'rint Signature
Contractor/agent:
Print S ignaturc
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 021 .0506 and 15A NCAC 02B .0243(8)]
Trees are not allowed to be removed from Zone l of the Buffer (within 30 11 of the full pond elevation), unless
approved. Exception, those trees that are severely undermined along the immediate shoreline can be removed.
Minimal shaping and slopimg a -long the immediate shoreline is allowed. ;l5A.NCAC 02...tX?446)J
Benching, grading in the buffer is not allowed. Excessive disturbance of ground cover. [ 15A NCAC 02B .0243
(6)1
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 shalt be r-c-stmed. Staging„ spoil, cunstructiun
material must be outside the butfer. [15A NCAC 02I3.0502 and 15A NCAC 02B .0243 (4), (6), (8)]
Stornrwater 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 fie Cake. (f5lt NCAC NTS .0,243(5), (6)j
Aeknoivler genre it u utiftcation
hereby state that I have been informed of the Catawba
the
Riparian Buffer Rule. Any work conducted in buffer, not specifically stated in the application and appro
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 bjWirwithin,snbstantial compliance and intent of the 401 Water Qual
Certs cin ions. anud l +r}%er Rua , �i � : " `ped ) arm' sp rca+icxt{s), mnd dtrlttrr srpportj e, materials.
Signature (owner.): is ;! Y f z� % ��_ _ ___._ bate:
20190403
MAR 2 7 2019

State of North Carolina
Department of Environment anal Natural Resources
0Division of Water Resources
+,:
Division of iN�lter reesource: R
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:
Division of Water Resources
401 & Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Applicant Information f15A NCAC 02H .0502fail
1. owner r-`- -- -
Name:
Mailing
Telephone Number: 'PI -W41-7172 Fax Number.
E-mail Address: s'i'c%-& 4, r (#) &Y►'1"i' J* r -ex i; , c--ot
2. Agent/ Contact Person information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
http• /vg& saw usace army,nW/portalsIS91docs/regulaWndreadocs/Permits/SAMPLE AGENT AMO
RMON FDRM.pdf) must be attached if the Agent has signed this application form.
Name: Y, mu.11_e q --,r i rjs
Company Affiliation: W OW M &r; 4 -#—
Mailing Address: q_6 i i cliR kl<. (t A! z; Tc.
-- '0rNe- tiLSr /V, C. 9$903 1
Telephone Number: -70V-765-32-o5 Fax Number:
E-mail Address: Se -0,h ke_ We w mAt'r-i",r- • C-0 rr
Person to receive the Certification Approval: 5CG/ rT— 50100{'__r
II. Project Information (15A NCAC 02H .002(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, etc.),
rip rap, excavation or dredging below Full Pond/ Normal Water level elevations, and
FORM: SSCP 10.2013 Page 1 of 3

LF i;C
J':1 rail L:'24:?r uzzvr'
Futf PbPd/ ,r: rA%'
Norm"lr der fg! o ao o i m .
�horeiir',e: O
D T
CA3a 4 C. I/
CerN4/ias1 4C .403 j
Flit' jse approxlrriately Sketcth inc,rillowing u,ferrnalien on thl! plan (prcvide dimensions fu etch,
frPM, surf, ns 76 ft x 100fr)'
1. All proposed vegetation clearing,
i- Location of rip rap or fill u., be placed above the Full Pond/ Normal Water Level elevation
I nr2tor. .'f r'r rf_y*., fi' fif! r. 1„ pl it -(! 1, 1!hf fMl PC,nd/ Nr,r!riat oldster Lev,p' plo•rg�•pf,
�.t•�_cit�h a�.' i1r•y t„UjGS!-il :il Ul.t'al rS S+JCI'i c`_, hV�lCiia�,5, lCi a'f:r•� wb!i:., C1Gi;i:�, CLC.
s Location cf any eAcavat,on e r dfedginE Lelow the fult Pond/ Normal WatC-r Level elevanc.r!
6. Location of construction acres,. corridors

DUKE ENERGY INTERNAL USE ONLY: Construction
Date Received: FAF Paid Application : 31� DUKE
��:' ENERGY
Application Complete I I
-A- "P
Permit No. Duke Energy Lake Services
HEP Fund Mail Code EC12Q
526 S. Church St.
Site ID —� Close -Glut Date Charlotte, NC 28202
I. DATE OF APPLICATION* �� '—� Permit/Tag
II. APPLICANT INFORMATION (applicant mauling address and contact information)
Name* PrimaryPhone*
Address* ( * p I mac, CA47
Secondary Phone
City* (cNY1C%t , State -g Zip Code* Fax Number C
Email* j S C 1A (,l r 'T & cL r'1 C 01'11
Ill. PROPERTY INFORMATION (location of permit)
Address*got) i I County' Alen rc_
City* I ,� State* Zip Code* County Parcel ID number
(e.g. Pin, Tax ID, TMS p01 3:3
i L
Lake*: �[t�@ `� ,1 Number.-)
Subdivision �� L { T--� Lot(s) Plat Book/Page �j 36 (a Z 6
To enter the Latitude and Longitude of the property, please use a Latitude (eg. 35.12345)* j, 7d'
service/software to easily acquire the location information. Values
should berovided in Decimal Degrees format (35.1245). fro p�1
p Longitude(e.g.-80.12345)* off. /7 Jr%fp5
example service: httpJ/itouchmap.com/lationghtml
IV. PROPOSED ACTIVITY
(' New/Modification of Existing Structure (' Maintenance of Existing StructureI Is Dock
Covered?
(' New/Modification of Existing Shoreline Stabilization (' Maintenance of Existing Shoreline Stabilization F1(' New/Modification of Existing Structure & Stabilization Maintenance of Existing Structure & Stabilization # of Slips
(' Transfer of Ownership (' Other (please describe below) # of Jetports
Area overland (sq ft) Area over water (sq ft) �� Total Square Feet
Shoreline Stabilization (feet) ! N
Length of nr�� Q/ Distance From Shoreline w; / lick) / 3 � �41-c.�i�tJ
Stabilization O( � Materials F Ria R4,p
Brief Description CSA "`"`"' �` a" ""
of the Activity
Describe Briefly the Existing
Structures Over Land and
Water (include sq ft)

V. Dock BuBder or Engineer
Name/Company
Address I 2031t C11 A} r t W
%-Wi—
Number %b - 76 5- 3 Z. -D 5�
State Z iro 31 Email
N
City t Nr ccS N P Code Scan Q WOW AY,t, COM
VI. Chedrrist of Required Documents (to include with ApplicationApplicationSubmissiontlon .., . �,.. .. ... .. .
,(Recent Survey (stamped/signed by a professional licensed wnreyor showing the location of the existing or proposed
uu structure and/or survey of the existing or proposed stabilization)
Photos along property shoreline and photos of any existing structures and/or stabilization in or near the water
[]"Application fee (check only, payable to Duke Energy) dSigned User Agreement Letter
A licable local, state, and federal permits ❑ Plan and profile drawing showing all measurements and elevations
pp
� Habitat Enhancement payment (if applicable)
VII. Approval Process
• Application is reviewed and determined if complete. Fields with an asterisk are required,
• if application is not complete or does not include all items and information listed in the checklist, the
application will be returned as incomplete.
• A Duke Energy representative will visit the site to conduct a visual inspection.
• Applicant will be notified of approval or denial.
• Applicant is to have the notice, to be supplied by Duke Energy upon application approval, posted and
must be viewable from water. The notice must remain posted until a representative inspects the
project and determines the project is complete and within the application specifications.
viii r]lra[tlans by Road
Directions by
Road"
IK Application Submission
Please complete, print and sign this application. Then enclose all items from the checklist above in an envelope and
submit all the information to the address below.
Duke Energy Lake Services Print Form
Mall Code 9C1 2Q
526 S. Church St. Jf t r
Charlotte, NC 28202
I agree that the information contained within is accurate: Signed"By d

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