20190640 Ver 1_Shoreline Stabilization_20190513

State of North Carolina
Department of Environment and Natural Resources
DWR 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
Three copies of the application (including attachments) and the application fee s$u lbe enter
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
Name: Heal'
Mailing Address:
20190640
Telephone Number: 7bLi-Zg0j-948A Fax Number:
E-mail Address: K i e.0 lAn v- a) ama►1. cc>rrn
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:
Company Affiliation:
Mailing Address:
MV o• 1XHIII CJ]A0I'fi111111111:E:f1L.
Telephone Number: "lou- LD6O - 5 (l I Fax Number: `T044 -1 oto() - 54 hq
E-mail Address: ChC�',eaLX)0J1Sa_)10'in84rec n'M- 1e: -
Person to receive the Certification Approval: __T0_n'IC e E34-10�
II. 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: Trp dp-II Nearest Town: YY)00re5,JJItr
Subdivision name or site address (include phase/lot number): Sba Icl7,endr . Ind
CYlooresv�LlP Nc aBlt-1 ��* j ?jne IAnoU C'ovr+ S�bri� ,�sinh
Directions to site - please include road names and numbers, landmarks, etc.:
se'e- 0,-4a A-, P rjl
Latitude (in decimal degrees)_ 35 � 55�5 Longitude (decimal degrees) _ RO_ g5D X59
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): J�e_-,LAe_n+ir L
6. Property size (acres):
7. Lake/ river/ ocean adjacent to property: or rn0-ri
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):p
-a L P_r Ll
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:
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: I c hnpVP
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): Qr(IT 6oip der
e-�, L- k tt, lA 1, q12.9/3,)
Owner/Agent's Signature' [15A NCAC 02H .0502(f)] Date
"Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 3

Lake
(At Full Pond/ Normal Water Level)
31 �elou�
Full Pond/
Normal Water Level�
Shoreline
No -k'reeS removed
I' Igbove `
fn,, n', mak d
45' length
house I O �
ACC£55
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
Halfback Enterprise
808 McKendree Rd.
Mooresville,NC 28117
FORM: SSGP 10-2013 Page 3 of 3

5/912019 610 East Center Avenue, Mooresville, NC to 808 McKendree Rd, Mooresville, NC 28117- Google Maps
Go gle Maps 610 East Center Avenue, Mooresville, NC to 808 Drive 10.5 miles, 24 min
McKendree Rd, Mooresville, NC 28117
610 E Center Ave
Mooresville, NC 28115
t 1. Head south on Evergreen St toward E Center Ave
197 ft
r . 2. Turn right onto E Center Ave
41 3. Turn left onto S Church St
r► 4. Turn right onto E Wilson Ave
t 5. Continue onto NC-1100/Brawley School Rd
r► 6. Turn right onto McKendree Rd
8 Destination will be on the right
808 McKendree Rd
Mooresville, NC 28117
These directions are for planning purposes only.
You may find that construction projects, traffic,
weather, or other events may cause conditions to
differ from the map results, and you should plan
your route accordingly. You must obey all signs or
notices regarding your route.
0.5 mi
0.4 mi
1.5 mi
5.2 mi
2.8 mi
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NOTES
• PROPERTY MAY BE SUBJECT TO RECORDED OR
LEGEND
FOUNDATION SURVEY
Nin OBS RVED ECODED cars of WAYS OR EASEMENTS
Curve RadiuS
Length
I Chord I Chord Bear.
FOR
• OWNER TO VERIFY ALL sETeacKs AND ZONING
REGULATIONS PRIOR TO ANY PLANNING OR
RIGHTEDGE OF ��
CENTERUNE
Cl 480.00'
63.02'
62.97' S 00°3169 E
MAIN DEVELOPMENT
CONSTRUCTION.
• DMENSIONS OF ALL IMPROVEMENTS SHOWN ON
PDE
PERMANENT DPAOUGE FASWENT
UTRRY POLE
COUree
Bearing DSStanCe
THIS PLAT SHOULD NOT BESCALEDTIOR RELIED
tt
LIGHT POS
L1
S 75'20E
4°4' 76'
10.
UPON FOR DESIGN OR CONSTRUCTION
A FIELD VERIFICATION OF ALL DIMENSIONS. NS.
SWIT�, SEINER MANHOLE
808 McKENDREE RD - MOORESVILLE, NC
• COPIES OF THIS FILEM/W1n.OV
ARE FOR
RHFAD UMRY LINE
LOT Hl, PINE KNOLL COURT
ONLY
ONLY AND MAY NOT BE USED FOR DESIGN WORK.
USE DESIGN WORK.
DAVIDSON TOWNSHIP, IREDELL COUNTY, NC
• A PORTION OF THIS PROPERTY IS LOCATED IN A I I
100 YEAR FLOOD PAN.
SCALE: 1"- 40'
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DEDMON SURVEYS
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CHUCK POOVEY, PLS #3762
RICHARD GWILT
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DRAWN FROM AN ACTUAL SURVEY MADE UNDER MY
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DICEEDS 1:10,000; THAT THIS PLAT WAS PREPARED
IN ACCORDANCE WITH GS 47-30 AS AMENDED.
WITNESS MY ORIGINAL SIGNATURE. OCTOBER 30, 2018.
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Project
Owner:
CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
1 n111
rI111L --� wgnature ,,
Contractor/agent:
Print I` — /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
C"n4eCR r tis 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: q12 30
State of North Carolina I Environmental Quality I Water Resources
512 N. Salisbury Street 1 1611 Mail Service Center 1 Raleigh. NC 27699-1611
919.707.9000