20190594 Ver 1_Shoreline Stabilization_20190502

State of North Carolina
Department of Environment and Natural Resources
r' "J 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
$ PAID
Three copies of the application (including attachments) and the application f&- b®s9't9 4
to:
Division of Water Resources
401 & Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
I. Applicant Information [15A NCAC 02H .0502(a)1
Owner Information 2 0 1 9 0 5 9 q
Name: ever cynd 4rn4 ica I re vsc
Mailing Address te5 Ma hQgO-n' I)r
Telephone Number: d 3Q - a4 3 ' UOdB Fax Number:
E-mail Address: C ndw _ dreuFusSg rna� l porn
Agent/ Contact Person Information v
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/reeulatory/regdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name:
Company Affiliation:
Mailing Address: C 13C S- one hie C uc V, Li r
a ri rC J L� 1
(l�Uyresyil� � NC �RiiS
Telephone Number: 'pc(- , 00 - ttt Fax Number: _lou- LQ p Lpci
E-mail Address: �)-,� S a� ui lls n�t o4 nd + r : M n -k-
Person to receive the Certification Approval: Jnnir,- p
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: 7r- ce AeJ I Nearest Town: fYlooresvi lle.
Subdivision name or site address (include phase/lot number): l Lot)l0, di�ord Ln.
�e� v ► l lP. lVC aall'1 („�.7+ � 15� 3 C.'re Scenk land e-T►nnber Cor
Directions to site - please include road names and numbers, landmarks, etc.:
See ached
Latitude (in decimal degrees) 35,* 510 923 Longitude (decimal degrees) - 80. Q30 H 13
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Residen-l:i A
6. Property size (acres): I. 180 acres
7. Lake/ river/ ocean adjacent to property: igorman
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): �J'hanQ r �C,r�e_ _ r� ��r� l l ma k k aB
9. Will work be conducted from land? � From water? Q
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:
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: t' o\je-
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): nrdss hu��er
no +ree5 rernov ed , m, n', rnn.l 6,
y( Ila
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
® 'e '
La ke
(At Full Pond/ Normal Water Level)
a.5' 6 -low
180' I en9th
I'IUUSe-
M
LU k d -e.,
A cLf;5S
No +rccs rc-rnosed
(Y1. n, mo.l d 1 S+or6),nc e -
to bu � � e,r
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
Peter and Cynthia Dreyfuss
160 Wickford Ln.
Mooresville, NC 28117
FORM: SSGP 10-2013 Page 3 of 3

4/24/2019 MooresHlle, NC to 160 Wicldord Ln, MooresNlle, NC 28117- Google Maps
Go( -Ile Maps Mooresville, NC to 160 Drive 8.5 miles, 20 min
Wickford Ln, Mooresville, NC 28117
Mooresville
North Carolina
Take W Iredell Ave to N Academy St
1 min (0.3 mi)
t 1. Head southwest on N Main St
r' 2. Turn right onto W Iredell Ave
0.1 mi
0.1 mi
41 3. Turn left at the 2nd cross street onto N Academy St
2min (0.6mi)
Take NC-1100/Brawley School Rd to McKendree Rd in
Davidson
13min (6.5mi)
r' 4. Turn right onto W Wilson Ave
i 5. Continue onto NC-1100/Brawley School Rd
1.2 mi
5.2 mi
Continue on McKendree Rd. Drive to Wickford Ln
3 min (1.1 mi)
F* 6. Turn right onto McKendree Rd
r' 7. Turn right onto Millhouse Rd
0.2 mi
"1 8. Turn left onto Wickford Ln
384 ft
https://www.goog!e.corn✓maps/dir/Moores%ille,+NC/160+Wic!dord+Ln,+Moores)iIle,+NC+28117/@35.5741576,-80.9045896,13z/am=Udata=!4m14!4m13! 1m5! 1... 112

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DATE SU9WWN ADMINSTMTOR
PROFESSIONAL tµO SU1MYOa ND. 1597
.PT... I!. 2015
STATE OF NORTH GNOUNA
COUNTY OF IREDE I
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11HEREBY CERTIFY TNAT NC PUT FOR aEEARDA11pN IS AN
RIVIIW OFFICER OF LRN 10 THC SVBOVtSIW 000INNJCE OF IREpEl1
HFDELL COW/Y. Glitln [NAT INE YAP COUNTY, NONM CAROlR1A
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NOTES: \ P�� / SECTION 8 - LOTS 478 & 1573
o DONNE C. MARRY N: SHEY E. R)2EABRY, OIFNERS•
THE SUN`C`W 151 k 160 mCKFORD LANE - MOORESVIILE. N.L. 26117
NAP 77101E2600J.RDO NpF E DATEj/18/2000, A r1000 INTARO ARU AS OEf[AMINED UY 1000 `I
T"MO PRDPDNI' K SUB1ECr TO ANF' ESDIETR5 OR R INT OF WAR OF RECORD 1 C
MOCN YAY ExIST ACgp55 SAID PpOPEATY. £
BION PNS ARE SET AT ALL PROPERTY CORNERS UNLESS ORIERWISE NOTED.
LEOEND
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Peter and Cynthia Dreyfui
160 Wickford Ln.
Mooresville, NC 28117
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Peter and Cynthia Dreyfui
160 Wickford Ln.
Mooresville, NC 28117

Project I
Owner:
CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Contractor/agent:
Print . L, — / ISiRnature
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
tom_ 1� -e-U Ls S ,hereby state that I have been informed of the Catawba
1, �IPr aM CsA rrl-h
Riparian Buffer Ru e. 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 anBu Iqs, tt� tpproved plan(s) and specification(s), and other supporting
materials. I / / 1 1,
Signature (owner): Date: Lf 16ry Iq
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