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Home My WebLink About20190516 Ver 1_Shoreline Stabilization_20190422n State of North Carolina Department of Environment and Natural Resources DWR 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 should be sent to: Y PA'b Division of Water Resources 401 & Buffer Permitting Unit L Gt 1617 Mail Service Center �\'� Raleigh, NC 27699-1617 20� 9o5�s I. Applicant Information [15A NCAC 02H .0502(a)] 1. Owner Information Name: Michael Sullivan Mailing Address: 18 Chestnut Hill Rd Griswold CT 06351-2668 Telephone Number: 8606080046 Fax Number: E-mail Address: iomikgabgatlanticbb.net 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.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: Dean Fisher, President Company Affiliation: Lake Norman Custom Dock & Pile Driving Inc Mailing Address: PO Box 1439 Denver INC 28037 Telephone Number: 7044832144 Fax Number: E-mail Address: Ikndock(a-)gmail. com Person to receive the Certification Approval: Dean Fisher / Michael Sullivan H. 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: Catawba Nearest Town: Terrell Subdivision name or site address (include phase/lot number): CHARLES WLsoN AND WLuE BEAT 3602 Dockside Ln Sherrills Ford, NC 28673 (lot 8) Directions to site - please include road names and numbers, landmarks, etc.: Take Hwy 16 Bus to NC 150 towards Mooresville. Tum left onto Mt Pleasant Rd. Turn right onto Dockside Ln. Property is 0.4 miles on left. Latitude (in decimal degrees) 35.59339 Longitude (decimal degrees) -81.0086437 5. Describe the existing land use or condition of the site at the time of this application (residential, undeveloped, etc.): residential 6. Property size (acres). .760 7. Lake/ river/ ocean adjacent to property: Lake Norman 8. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or why it is necessary): Is it severly undermined 9. Will work be conducted from land? ® 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: 800 sq ft 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: 2,000 sq ft 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): trees, shrubs Owner/Agent's Signature [15A NCAC 02H .0502(f)l Date 'Agent's signature is valid only if an authorization letter from the owner is provided. FORM: SSGP 10-2013 Page 2 of 3 SAMPLE AGENT AUTHORIZATION FORM PROPERTY LEGAL DESCRIPTION: LOT NO. 8 PLAN NO. 12-51 PARCEL ID: 460701365921 STREET ADDRESS: 3602 Dockside Ln Sherrills Ford NC 28673 Please print: Property Owner: Michael Sullivan Property Owner: The undersigned, registered property owners of the above noted property, do hereby authorize Dean Fisher President of Lake Norman Custom Dock & Pile Driving, Inc (Contractor / Agent) (Name of consulting firm) to act on my behalf and take all actions necessary for the processing, issuance and acceptance of this permit or certification and any and all standard and special conditions attached. Property Owner's Address (if different than property above): 18 Chestnut Hill Rd. Griswold, CT 06351-2668____ Telephone: 8606080046 We hereby certify the above information submitted in this application is true and accurate to the best of our knowledge. Authorized Signature Authorized Signature Date: l Date: catawba county Geospatial Q �p Real Estate Search NAllNG. IIYiM4. 6ETrEE, Information Services h� 7 me 10, 1(0.00 V- �.- �-es- A %,s �-� r b . 41110o�k TTJ .Al 8 Q 0' — R] M NNn wE VVVVS Parcel: 460701365921, 3602 DOCKSIDE LN SHERRILLS FORD, 28673 Owners: SULLIVAN MIKE, SULLIVAN JOANN MARGARET Owner Address: 18 CHESTNUT HILL RD Values - Building(s): $0, Land: $131,900, Total: $131,900 1 in=50ft 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 02/15/2019 2/15/2019 Go )gie Maps 3602 Dockside Ln Vicinity map 1901 Cs Family camp Q �a dir o` �b 4� 4` e 71 glondale "trve,, 3602 Dockside Ln - Google Maps � 1975 i3602,cks+de lane TT 2G�R+n dove 1901 S HT6 3 51H1wula 4 U Kip' 4 IA 40 ,965 y Map data 02019 Google 500 ft , https://www.google.com/mapslplace/3602+Dockside+Ln,+Sher6lis+Ford,+NC+286731@35.591237,-81.0015822,16zldata=!4m5!3m4li sOx88514d4702ablfdf:Ox3fb9768d2ad277de!8m2!3d35.59339!4d-... 1/1 Arr M - r k _ �► - �:�. `yam_ . �. y�,'�..�.' •a. ` fix'"" a F• '�. « .. > Existing site photo 3 3602 Dockside Ln. Sherrills Ford, NC 28673 Michael Sullivan