20190804 Ver 1_Shoreline Stabilization_20190613

State of North Carolina
nw R Department of Environment and Natural Resources
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
PAID
Three copies of the application (including attachments) and the application fe ould be sent
to:
Division of Water Resources
401 & Buffer Permitting Unit 1'- i 2 0 1 9 0 8 0 4
1617 Mail Service Center .. --" \° /x-
Raleigh, NC 27699-1617 V \\C\
C
I. Applicant Information [ RA NCAC 02H .0502(a)] U\°
1. Owner Information
Name: Thomas Franz
Mailing Address: 603 Bourton House Drive
Charlotte, NC 28211
Telephone Number: 773/620-1207 Fax Number:
E-mail Address: Tfranz35('gmail.com
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/Portalsj59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: Beth Mosteller
Company Affiliation: Dale & Beth Lake Use Permit Service
Mailing Address: 988 Clear Creek Circle
Lincolnton, NC 28092
Telephone Number: 704-996-3245 Fax Number:
E-mail Address: [e-mail]
Person to receive the Certification Approval: Beth Mosteller
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: Catawba Nearest Town: Terrell
Subdivision name or site address (include phase/lot number): Lot 9
Directions to site- please include road names and numbers, landmarks, etc.:
- see attached
Latitude(in decimal degrees) 35.588590 Longitude(decimal degrees) -80.954450
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): .49
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): new rip rap class B, shoreline wave action
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:
177.19' along shoreline
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: 177.19' along shoreline will be rip-rapped. Access for small
skid steer along project
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): grass-fescue
fa o ,, "ir'ierarat en. Beth Mosteller
Owner/Agent's Signature* Printed Name Date
FORM:SSGP 10-2013 Page 2 of 3

[15A NCACO2H .0502ff'
`Agent's signature is valid only if an authorization letter from the owner is provided.
Lake
(At Full Pond/Normal Water Level)
0000000000000000000000000000000000000000
0000000000000000000000000000000000000000
Full Pond/ 0000000000000000000000000000000000000000
Normal Water LevelAll IMF 0000000000000000000000000000000000000000
Shoreline 0000000000000000000000000000000000000000
Rip-Rap will be placed: 177.19' to
follow contour of shoreline,
one foot above full pond,
and 3-4 feet below full pond
Thomas Franz
8927 Bourton House Drive
Charlotte, NC 28211
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ftx 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
FORM:SSGP 10-2013 Page 3 of 3

SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. 9 PLAN NO. PARCEL ID: _ 461704849876
STREET ADDRESS: 8927 Holdsclaw Road, Terrell,NC 28682
Please print:
Property Owner: Thomas Franz
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Beth Mosteller , of Dale & Beth's Lake Use Permit Service
(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):
same as above
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
-------7-----
A tho ized SigOi//,
naat re Authorized Signature
Date: Date:

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: 8927 Holdsclaw Road,Terrell, NC 28682 County: Catawba
Owner: Thomas Franz
Print Signature
Contractor/agent: Beth Mosteller es0, Y1l! ,.,
Print Signature
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 02B .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 02B .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
I, Thomas Franz , 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 lan(s)and s ecification(s), and other supporting materials.
Signature (owner): 1-1'..' Date: 62/8//

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3507-0299 FILED ELECTRONICALLY
CATAWBA COUNTY NC
DONNA HICKS SPENCER
FILED May 22, 2019
AT 12:59:00 PM
BOOK 03507
START PAGE 0299
END PAGE 0301
INSTRUMENT # 08438
EXCISE TAX $1,200.00
Excise Tax: $1,200.00
This instrument was prepared by: Matthew L.Benton,Attorney at Law
Return to: Gottholm,Ralston&Benton,PLLC, 114 Morlake Drive,Suite 203,Mooresville,NC 28117
Parcel ID:0009302
Brief Description for the Index:
NORTH CAROLINA GENERAL WARRANTY DEED
This DEED made this 21st day of May 2019 by and between
GRANTOR GRANTEE
RANDY G.WAGONER and wife, THOMAS FRANZ
BOBBIE JO CRAVER
MAILING ADDRESS: MAILING ADDRESS:
206 N.East 65th Street 8927 Holdsclaw Road
Oak Island,NC 28465 Terrell,NC 28682
The designation Grantor and Grantee as used herein shall include said parties,their heirs, successors, and
assigns,and shall include singular,plural,masculine,feminine or neuter as required by context.
W.TNESSETH,that the Grantor,for a valuable consideration paid by the Grantee,the receipt of which is
hereby acknowledged,has and by these presents does grant, bargain, sell and convey unto the Grantee in
fee simple, all that certain lot or parcel of land situated in Catawba County, North Carolina and more
particularly described as follows:
SEE EXHIBIT"A"ATTACHED HERETO.
Submitted electronically by "Gottholm, Ralston & Benton, PLLC"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Catawba County Register of Deeds.

3507-0300
For back title_reference,see Deed Book 2600 at Page 526,Catawba County Registry.
All or a portion of the property herein conveyed does include the primary residence of a Grantor.
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto
belonging to the Grantee in fee simple.
And the Grantor covenants with the Grantee,that Grantor is seized of the premises in fee simple, has the
right to convey the same in fee simple,that title is marketable and free and clear of all encumbrances,and
that Grantor will warrant and defend the title against the Iawful claims of all persons whomsoever, other
than the following exceptions: Subject to such easements, rights of way, restrictions, ordinances and
environmental matters as may exist on, over, and under said property; Subject to the 2018 ad valorem
taxes which are to be prorated as of this date; Subject to any matters that may be revealed by a recent and
accurate survey.
IN WITNESS.WHEREOF,the Grantor has duly executed the foregoing as of the day and year first above
written.
R G. Wagone 4
Zel4,4ciaatf,te.t....
Bobbie Jo Cra er
,
STATE OF NORTH CAROLINA
COUNTY OF IREDELL
I,Connie E.Valverde,a Notary Public of the State of North Carolina,County of Iredell,certify that
Randy G. Wagoner and wife,Bobbie Jo Craver,being known to me or proved on the basis of satisfactory
evidence to be the person described, personally appeared before me this day and acknowledged the due
execution of the foregoing instrument for the purposes therein expressed. Witness my hand and Notarial
stamp or seal this 2151 day of May 2019.
_
( O N V( . E. V/4 V R D E ' / 9 / J;,,,.(.� ,,
i 'fed l! County, i I h Connie E.Valverde,Notary Public
cv
f.tii My i,MM SSiC S ?� 2Q2 y'
`•��XFRr, ii„1`f ��tf
My Commission Expires:May 30,2021

3507-0301
EXHIBIT"A"
BEGINNING at a#4 rebar set in the centerline of the 45-foot right of way for Holdsclaw Road,
said rebar also being set at the southeasternmost corner of the Billy Holdsclaw and Betty
Holdsclaw property(Deed Book 3097 Page 1367 Catawba County Registry)thence South 25
degrees 42 minutes 35 seconds East 26.36 feet;thence South 35 degrees 18 minutes 56 seconds
East 60.88 feet;thence South 31 degrees 47 minutes 47 seconds East 72.88 feet to a#4 rebar set
in the centerline of the 46-foot right of way for Holdsclaw Road; said rebar also being set at the
northernmost corner of the Tanya L. Frye property(Deed Book 3145 Page 1415,Catawba
County Registry)thence South 58 degrees 16 minutes 30 seconds West 150.18 feet,to a#4
rebar;thence North 20 degrees 08 minutes 15 seconds West 44.28 feet to a#4 rebar;thence
North 32 degrees 44 minutes 00 seconds West 50.12 feet to a#4 rebar;thence North 53 degrees
08 minutes 49 seconds West 82.82 feet to a#4 rebar;thence North 07 degrees 22 minutes 05
• seconds West 4.01 feet to a#4 rebar;thence North 41 degrees 49 minutes 36 seconds East 21.33
feet to a#4 rebar set;thence North 66 degrees 04 minutes 20 seconds East 150.56 feet to the
point and place of BEGINNING and being.583 acres,more or less according to the survey
prepared by Rufus Jackson Love,PLS,L-2844 entitled"Boundary/Physical Survey for Tom
Franz,"dated April 25, 2019, and bearing reference to File:Franz-Tom.
PROPERTY ADDRESS: 8927 HOLDSCLAW ROAD
TERRELL,NC 28682
PARCEL ID: 0009302

Thomas Franz, 8927 Holdsclaw Road,Terrell, NC 28682
PIN 461704849876,Lot 9
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Thomas Franz, 8927 Holdsclaw Road,Terrell, NC 28682
PIN 461704849876,Lot 9
Latitude and Longitude are the units that represent the coordinates at geographic
place, city, state, or address, or click the location on the map to find lat long coon
Place Name
8927 Holdsclaw Road, Terrell, NC Find
Add the country code for better results.Ex:London,UK
Latitude Longitude
35.588590 -80.954450
f
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