20081273 Ver 2_Shoreline Stabilization_20190606

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
One copy of the application (including attachments) and the application fee should be sent to:
Division of Water Resources
401 & Buffer Permitting Uno'
1617 Mail Service Cent
Raleigh, NC 27699-1617 Gj�jIL�
7b
Applicant Information [15A NCAC 02H .0502(a)] �C
1. Owner Information
l,Y
Name: Gg arq am -i 1ire-ndcA, t"o r"' e -v—
Mailing Address: I alp i'Ao r c MSS Lr, _
blobre S'J tIC tits" aP�I (:I
Telephone Number: 104 - 3to_ - alas Fax Number:
E-mail Address: �_ra7nhar16++e_mK+.c.om
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: CRC SAnne_ ci- �liecuel J, na . LLC.
Mailing Address: Co 38 ( QaY ridc►eV&�rm I-LuuU.
Telephone Number: 1py-ta6n -Silt Fax Number: 10?4- I ala(b -Sq Log
E-mail Address: 0Ihe(i ujcLt�5 i Lj', nd M recwn . nc-+
Person to receive the Certification Approval: :un-, Ge E.Sd=
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,
etc.), rip rap, excavation or dredging below Full Pond/ Normal Water Level elevations,
FORM: SSGP 10-2013 Page 1 of 3

La ke
�lJ� Ql (At Full Pond/ Normal Water Level)
5�
�elow
Full Pond/
Normal Water Level
• - - r •rr�r��,>rt�
No +rce.S rernOV e d
ljo d t 5�urA nc:e--
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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
Gary and Brenda Porter
126 Norcross Ln.
Mooresville, NC 28117
FORM: SSGP 10-2013 Page 3 of 3

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: 1 re I Nearest Town: on 00rc5y.Ike.
Subdivision name or site address (include phase/lot number): I au t orGros5 L.O.
M Gres v '� I le . NC 2811'1 Lg± :4 \19S �'_rP cera-� LlLryi and—T 1 m6e r
Directions to site - please include road names and numbers, landmarks, etc.:
See alla_ched
Latitude (in decimal degrees) 3 Jam, Sqq I q O Longitude (decimal degrees) ` 8(), Qa 1 OQR
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): S*kAen-baa
6. Property size (acres): IDA acres,
7. Lake/ river/ ocean adjacent to property: hLorrnv.,(�L
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): 5i�De. _ Slam _ ins- ,r 11 ma +i % nn
nn U1c1e2r r\,-\ rciP on �9' o� Shore,lln�,Znsiarll utder r4) fa..9
9. Will work be conducted from land? ❑ From water?4� bc�5e o�eXiS+i ns
W CO I
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:
5 �I
Le ou l r 1 �'I r o 5 sl� o fnc• et i
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: (� Q-LoVe— 6 288 ' of SV orelin Q-0' 66: a:1 ort_ a4 to5
12. Please describe the vegetation above the normal pool lake level/ Normal Water Level and O �
50 feet landward to be impacted (number of trees, for instance): 4 r 1Ss yn-�r
Slnoref ��
no ±r . -S V- tMosi ed, 6o d 15- - 0 r Dance +t) C -4=c
ate-- 5
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

6/3/2019 610 East Center Avenue, Mooresville, NC to 126 Norcross Ln, Mooresville, NC 28117 - Google Maps
610 East Center Avenue, Mooresville, NC to 126 Drive 8.0 miles, 22 min
GgI . - Maps Norcross Ln, Mooresville, NC 28117
610 E Center Ave
Mooresville, NC 28115
t 1. Head south on Evergreen St toward E Center Ave
14 s (197 ft)
Take NC -150 W to Quiet Cove Rd in Davidson
16 min (6.9 mi)
r 2. Turn right onto E Center Ave
0.5 mi
41 3. Turn left onto S Church St
397 ft
F* 4. Turn right onto E McLelland Ave
1.1 mi
'1 5. Use any lane to turn left onto NC -150 W/E Plaza Dr
8 Continue to follow NC -150 W
• Pass by Zaxby's Chicken Fingers & Buffalo Wings
(on the right in 1.3 mi)
5.2 mi
Take Ridgetop Rd and Greenbay Rd to Norcross Ln
4 min (1.1 mi)
11 6. Turn left onto Quiet Cove Rd
r 7. Turn right onto Ridgetop Rd
t 8. Continue onto Green bay Rd
'*1 9. Turn left onto Norcross Ln
126 Norcross Ln
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.
0.3 mi
0.3 mi
0.4 mi
495 ft
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G gi Maps 126 Norcross Ln
126 Norcross Ln - Google Maps
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Gary and Brenda Porter
126 Norcross Ln.
Mooresville, NC 28117