20190737 Ver 1_Shoreline Stabilization_20190603

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Water Resources 15A NCAC 02H .0500—Water Quality Certification,Shoreline Stabilization
LNVIIZONMEN I AL QUALITY FORM: SSGP 02-2017
44-4
Shoreline Stabilization Application Form
Three copies of the application (including attachments) and the application fee should be sent to
If sending via US Postal Service If sending via delivery service (UPS, FedEx, etc.)
Karen Higgins Karen Higgins
DWR—401 & Buffer Permitting Branch DWR—401 & Buffer Permitting Branch
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699-1617 Raleigh, NC 27604
9 \L\O
A. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Informatio-� _ i
Name: ��f � 1 Q
Mailing Address: ' �v1 T�
/c9/ ///5 1 ii'►
roc-}, e I 1174111 022576. -ye.)is
Telephone Number: / Fax Number:
E-mail Address:
2. Agent/Contact Person Information
A signed and dated copy of the Agent Authorization letter must be attached if the Agent has
signed this application form. (A form can be downloaded here:
http://www.saw.usace.army.mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf) / �1
Name: j��i(YID� l C� G'Y� (/ die/9 JJC'Vn 5 7 ; "
Company Affiliation: �ci e eyvi f/J't'Yt/ .�lM (Gry1SJ l r', LL-L f /cir e [ iOS rer-45/rac kfl-
Mailing Address: /yg e i,c'c„r)
Se Ca NC. 73 3
Telephone Number: 333(e to-SO3 -330 Fax Number: 1
E-mail Address: -3ei r►1 2y ('c�,-y1 -try..Cc,1S�r 4chc'1 - wjrna, (. L0 01
B. 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, buildings, retaining walls, docks, impervious surfaces, 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.
FORM:SSGP 02-2017 Page 1 of 3

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: Pe r s c Nearest Town: - I-c)C X ICJ o CO j NC
Lake/ river/ocean adjacent to property: C c3 Lca 1< e.
Property size (acres): 02. V c?c,re 5
Subdivision name or site address (include phase/lot number): 771e Te..5erye. Lit /0
77 tede /<c1. (/Mnh�.rx)J1G vvi
Directions to site - please include road names and numbers, landmarks, etc.: Fi'crvviRL1 Xhtv v
fake S7N hi 2 614 Lcve ()hurc 1�J. turn r,q kt"—c,Jv f 5 j
-/-urn /eft .4'f✓e.. �/z , pv1
Latitude (in decimal degrees) 3(• 0 0 Longitude (decimal degrees7 /.0 7 /
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): 'Re*kc jent)��
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): , r1a p.Sc ce I J\.
7. Will work be conducted from land? Nr From water?
8. Total amount of impacts below the normal pool lake level/ Normal Water Level
Permanent impacts (including all excavation, backfill, rip rap, retaining walls, etc.) in square feet:
0236, 49• ' x 3 -
Temporary impacts in square feet:
9. Total amount of impacts above the normal pool lake level / Normal Water Level and 50 feet
land-ward
Permanent impacts (includin back fill, excavation, rip rap, retaining walls, etc.) in square feet:
Temporary impacts (temporary clearing, construction corridor) in square feet:
10. 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): J
11. Signature%
Jii/
Owner/Agent's Signa6re` [15A CAC 02H .0502(f)1 Date
'Agent's signature is valid only if an authorization letter from the owner is provided.
FORM:SSGP 02-2017 Page 2 of 4

12. Please approximately sketch the following information on this plan and provide dimensions for
each item:
a. All proposed vegetation clearing
b. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
c. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
d. Location of any proposed structures such as buildings, retaining walls, docks, etc.
e. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
Lake
(At Full Pond/Normal Water Level)
c c)(30 a ce:51(:),C)GU G
s6- C-6 zS73 dla& o
Full Pond/ Nit ) 7
)(9:467-prici cs GcXD o c)00O Cry d- oc k 7d d Do 0
C G G 6 a�C C� dO.CC�."C}C) l2-7dOc "C`., YcJc dC,/�
Od61c7 ) d UOod�dd dGJd CCe.) c) o
Plan View
Lake
(At Full Pond/Normal Water Level)
Existing Dock
/30 ft•7ft
:Atee. .�.�.ee.�ate I[ • 3ftc I50ft
��������r�r�r� � • Below full pond/NWL
Full Pond/Normal Water Level iitt�eit rA!*!�.51. fRir _
nhore�ne�� ^ n w
�������� * siostigi 4hz 150ft
r��:�:�•. Riprap • Above full .d por /NWL
2 h,z 150 h. �������� ��
additional clearing I
if necessary
AMPLE
E .
Plan View
FORM:SSGP 02-2017 Page 3 of 4

(:)G°
6c)
6:761C)
C
9G
�J
lake 424, 3.6,
(At Full Pond/Normal Water Level) L,
-t .es
) '
E °' 6
`-
z �� 6
�-� /oe/uv3
Side View 0f-f \re-
U-
3 ft.below full pond water level 4 ft.above full pond water level 2 ft.additional clearing
II 'if necessary
.••
Existing bank ,
',r
10 ft.bank ,, a
height ,r Q42'
e
^ ,e
/ AmpLE
Side View
FORM:SSGP 02-2017 Page 4 of 4

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70 CURVE DATA �Arri'�
Y� CURVE DELTA RADIUS ARC TAN CHORD BIG CHORD 420' ISr•54 PLAT OF SURVEY
c,,; C- 9 18'32.57• 195.00 63.13 31.64 .77.36.20.E 82.65
c C-11 12'II'J6• 145.00 173.37 3/.12 S34'I9'03•E 173.29 THE RESERVE
CONTOUR
CI C-11 23.52.06.3. 345.00 73.77 .92 552'21.N•■ 42.2368 �1�� 95
C-12 23'52'0J• 345.00 143.71 72.91 552'21'23.9 1/2.68 A.., '1\J ,,
�^' C- 13 06•50'41• 345.00 53.26 26.66 569'42'056. 53.21 'M• �F 1 SEE
V C- 14 13.33'S5• 345.00 81.68 41.03 N89'31.22.. e1.49 Je' / se HYCO LAKE AT HYCO LAKE
C- IS 07'33'71• 345.00 45.48 22.77 N89'31'22•W 45.45 7.1 / �L0T 9LD 1,U IF CONTOUR DATA
C- 18 09'46.05• 215.00 36.65 18.37 N89.22'12•E 36.61
C- 17 Oa'41.09• 505.00 76.5588 38.3355 1456.40.52.E 76.46 CAROLINALIGHTCOMPAN7 4. 15 --` o CUNNINGHAM TWP., PERSON COUNTY, N.C.
O C-19 08.43.53• 505.00 78.96 38.55 N47.58.21•E 76.86 HYCO LAKE IFf IS,/ h / HAMLETT-JENNINGS & ASSOCIATES, C-948
V.C-63 17'25'O2• 560.00 170.23 e5.78 .52.18.35.E 169.58 ��m� A 10 „ 212 S. LAMAR STREET, ROXBORO, N.C.
C-64 19'14'27• 270.00 90.67 45.77 N70'38'39•E 90.2/ IS 67� n
1 es o3.30'{6• 270.00 16.56 e.ze 982 01'17•E 16.55 ��s' DATA f ' 2.47 MAY 2013, HEAL C. HAMLETT L-2465
66 10'28'34• 270.00 49.37 24.75 N69.00'S7•E 49.30 SEE Y •, f' CAROLINA POWER
87 27'16'43• 275.00 130.93 66.73 S80'36'53.1 129.69 HYCO LAKE 4 iy!I4' • '1
�60 03'07.36• 275.00 15.01 7.51 565'24.43•1 15.01 CONTOUR DATA-� 0 9 ACRES I = a LIGHT COMPANY ,44 1m
�,p 35'36'39• 285.00 177.14 91.53 546'O2'36•R 174.J0 s1 1A5 Ex
INCLUDING HYCO LAKE I ; ; i J
C- 0 40'O5'38. 255.00 178.44 93.05 N48.17'03•E 174.62 '' AA; IS 2.56 CEMETERY I
BOUNDARY DATA BOUNDARY DATA BOUNDARY DATA Is ..6..; ACRES I ;s OAR GRAPHS inch. MOO r1.
ANDf ROAD DATA AND ROAD DATA AND ROAD DATA 1; _ ::". A/
4
LINE l,6EARING DIST LINE BEARING DIST LINE BEARING DIST : MAP 2 OF 6
L- 6 19.51.E 226.70 L-66 N01.13'03.9 75.66. L-ill 518'24'13•W 93.20' + RYA.A��fY, •�•'01'• is �// o� FIlEO PAT
[.w1V, IC
L- 7 l4'I5•E 35.52 L-67 N59'20'16•E 21.05' L-112 N64'42'I3•W 44.21' \�� C°f \7.Y7 q�., A,! .iF ..Oct OI 20L} 1 09353•i Ae
L- a 15.E 66.54 L-68 .56'35'19•W 90.36. L-238 576.43.35.E e5.06' p ,y.� /'A o • s / AIIAWOA N GhMET1
L- 9 N2 15•E 28.57 L-69 SIO'28'12•E 77.25• L-237 528'12.50.E 53.65' \ IS '6.F• ��y cMrout $J IS CIS R D< �(E
L- 10 S8s 6*4e•E 50.78 L-70 527.30'02•E 71.65' L-238 N06.06'25•E 28.15' *FoP I;3e',0. `9 (r , �' y(�, j� PLAT CAB HANGER 9•Z
L- II 565.44p{6•E 26.17 L-71 526'S6`3e•W 21.26' L-239 N07'12'so•W 52.70' ♦/ '4t ♦4 S IF �� 71F iv1C I��II��1�I I�IIIM /^!,_- ' , /(.������'
L- 13 S85'4416.E 15.00 L-72 S24'55'34'E 01.17' L-240 SISN11'44.14•1E 69.22' IS 1S, \Jl \p 'Y (.r�'2! i �S'�„^^'
L- 13 Se5'!1'46. ('E 57.23 L-73 S21'SS'34'9 101.17' L-241 N11'{{'11•9 69.22' RAiLl1EJ 1 IF / Tl _ •��
L-14 585'44' 45.46 L-71 $59'25'18•W 52.21' L-212 S6e'13'21•W 77.31' • REGISTER OF DEEDS
L- 15 N61.02.1 37.05 L-75 587'16'I5•W 31.66' L-243 N52'3e'I2•E 96.80' IS 236 IS EASEMENT Z eASEE IF / LOT 13
L-16 N61'00'Se 68.36 L-76 IO2.32'16'W 77.92' L-244 558•45'27'R 36.04' 1 0 •,, DATA \
L-17 N43.36.24• 62.45 L-77 Ne4'22'37.9 55.71' L-245 571.30'SO•W 40.77' ~T AIRFIELD et V' +u pp
L-44 S61'01'2691 41 L-78 .01.00.21.E 53.03' IF/ EASEMENT w �` / E*?.
L-45 S61'01.2891 .00 L-79 588'28.32•W 48.30' \ LOT 6B \ f g / 'J°
L-46 561.01.28•W 2y 009 L-60 No6'36.35•■ 84.55' IS IS NOTE: DASHED LINES ALONG HYCO LAKE
i-47 r�ss•ii'ia•i lid- i- 102 N64'SO'31•E ,oe:es' 1' '�`` 1AZ IS u 801�""T f 1 133 IF 1 34 'Or, SEE MAP 420'PLATCONTOUROF
WERE ADOPTED FROM
THE OF SURVEY RECORDED AT
L-49 NB5'44.46•1 56S L-104 N77'32'24•E 102.58. SJ IS Z DATA ACRES Y 3 OF 6 PLAT CABINET 15 PAGE 994. NO
L-50 N26'09'056. 10. L-105 S77'41'29•E 18.87' I, .. �t\\ a • I o 112 IF ry CE ACRES FIELD SURVEY WAS PERFORMED ON
L-51 S28'14.15•. 43.980 L- 108 N01.22'39•W 75.97' SEE J •4•''' IS NIS Yi -' IF ~ TIE DASHED LINES AT THIS DATE.
L-52 528'14'15•W 15.00'r"(L- 107 N79.01'10.E 60.32' HYCO LAKE A•T. �,•1 ;u IS 1S IS' IS CORNERS SHOWN ALONG HYCO LAKE
L-52A S28'14.1s•W 71.68' et_ 108 N25•p8'00•E 17.50' Y' 420' \ 240 � o i 1N 75 6pROARY EAPLI� 420• CONTOUR ARE MATHEMATICAL
UL CONTOUR DATA 'L, rCONTOUR Y I MAPLINE�;
L-53 568'19'S1'W 226.70' - 109 NO2.32'18•W 6.17' • / IF ''s' O f •' �n o IS 9I. DATA � ? / ) POINTS UNLESS NOTED.
L-65 532'I9'H•E 90.12' L- 110 573'I3'11•E 72.89' 37 37A I 38 saA Ji\-• CE }n ,;g o [Allow J, 4, a //
HYCO LAKE 4rt Ire .........
I±_IS _IF___ !-- Yi M V `_ -. 1s, = NlhiliNE 5 °o 1Ojy� '•'+'`�P gam IS /
CONTOUR DATA �j Y/,� 1S ` ls• $ 9 rip PUIPLINE ��'"m"109 n -.6 e 4P hi"•
ROAD
LINE BEARING DIST N11'S{'07•W IS ET IF EASE1ElR -taffy-15__1� CE DATA
L-23 S38.59'00•E 67.27. �____` 1..61i. _ 105 I6 9
L-24 516'21'53'E 112.e9' O JO ,� 7 , _- IS , ` __� Is--- w111-P. �,� 4
L''
L-25 525'25'33•E 116.83' _ 1-174.56 j lanrlm o nm n
L-26 1424.05.26.E 82.25. .(t\ 1.39 - �`- .27,31'W Z 1 4 °' `-77 ��.,
IF OUIHE MELD tm 1111 79
L-27 .32.18.46.E 70.60' - LOT 6 z u t0i 6 (i
L-28 N32'42'S6•E 83.90' I ACRES - --- AZ;
I03 - �I Is o• / s° [.
L-29 $ee'01'17•E 53.56' 420. f `(� :C. r1 S 71 IS IS IF
L-30 Ne5.57.2591 78.82' y'• CONTOUR---'1 'o N ME 1 0 56 / p6S °, 1
L-70A 551'OS'33'E 95.19' W •Zi:^f 8 0,:+ 0 f IS DRAW T 1y I§ SITE
L-31 N51'16'03•W 157.27' JLoy. \y IW
L-32 N26'20'S6•W 116.6/' 1 ., f 1.25 . s C14 IS CI5, 10 11
L-33 N10.17.12•R 14. ' ,0 1ACRES GN5 s 21 IS14 C1e -••C'i jam.. ESTATE ROAD ' u14120
L-34 N79'M'31•E 54.52'
L-35 .19.45.34.E 47.97' '''co.';'a `s iIs _ VARIABLE o;
L-36 N82'49'SI•E 9e.77' ay `3
L-37 5e7.21'53•E 57.57' 1\ 6 1J G'L/''/ '20' "' WIDTH R/W
L-37A 567.21'53•E 47.46' CAROL POWER _
L-38 .67.21.53.E 44.88' A LIGI OIPANY \J� 1.20 �'' Cg7 /1 47 C66 •TAW/ / (PRIVATE/
L-38A 566.52.23.E 1J7.ee' HYCO�(E \ ACRES ,°of o SEE // 14Wpl IHE 'OI 1313 TS
L-39 Ns3.50.44•R 84.93' Y} \ IS - �'- �� '\ CE /'` r`EASFJENT `.E 8I
L-40 N18'00'I2'R 65.80' • X 1
L-Al N18'00'12'R 64.06' C.' IF 4^ 469 CE 22A 21A
L-42 .zi•m'ze•E 48.oT St• O \1 \ 'I SEE VICINITY MAP
L-43 .21.31.25.E 37.17' \t IF 6A� 7.7 1 RICO LAKEo
L-44 N21'}1'25•E 80.35' '� D'IZ, / �O CE 'CONTOUR DATA
L-45 N33.50'51•R 52.35' •�J J� ♦ IS , \ 11A \
L-46 N13'36'37•W 52.38' IF ?J) e<
L-47 N13.36.57•1 64.08' \ '28
20A NORM CAROLINA PERSON COUNTY
L-46 IOS'01'S2•E 61.12' ...14.... IS • ) \ /
L-49 M77.12'46'E 27.57' 4p, / ? eA 1 ,W I, NEAL C. HAMLETT ,CERTIFY THAT THIS
L-50 .37.12.46.E 75.60' u.rGIR D4 n I )SEE MAP Ia. I / SURVEY CREATES A SUBDIVISION OF LAND WITHIN
L-51 549'39.00.E 102.51' Z Y9 / ` 420 __EE8598__COUNTY. WITNESS MY HAMO AND SEAL THIS
L-52 5/9•}9'00•E 54.14. o %����@.-�� �, 6 OF 6 `f�DaRAR 3L DAY OF MAY , 20_Ll_.
L-53 .56.33.37.E 122.42.
L-54 .56.53.37.E 22.42' LOT 5 p \ ^/ / Y� IBA 19A J 11%
L-55 573'39.25•E 91.69' h `E �O ::.:1
I =1:
L-56 517.20'04•E 56.20' / SEE 4 30A °' •�•
L-57 512'29'46•W 236.87. f \ / ROAD /' m A PROFESSIONAL LAND"1 --A n SURVEYOR
L-se S40.59'43•1 116.20'
L-59 575'06'15•E 85.32. SEE MAP : \ e/ 0 DATA / oD "2 IA \ �76
L-60 56E1'57'05•E 111.41. C, w 29A 7A 17A
L-61 535'15'03•E 110.06. 1 OF 6 Z \ 6.�.1/f.- 1DI 28A CE
L-62 N16'S6'2e•E 114.71' ./ j-' CE of 4A 2A I 1•;
L-83 .27.28.51.E 37.02. 7 ,pN
�' ® 1J PL__ A4_D$RA_._ U_EF,TT__. CERTIFY THAT THIS
L-214 521.49'27•2 72.02' �6 ---- -------_
L-215 510.19.54.E 102.41' {2.N - '--- -- -- -__--'-- -- --- AT W R MY SUPERVISION FROM
/' 5 IF Ne8'}7'06•W 165.43 - - Nee•}2'00•W 276.45 ------- 123. IF AN ACTUAL SURVEY MADE MINDER MY SUPERVISION
L-216 576.19.56.E 39.05' ---�IF�"" 5 .E Nee'25'II•W 23J.96 IF/ - 218
L-217 S10'04'07•E 82.48' CONTROL NBe'J7'J7'W 350.86 -/ (DEED DESCRIPTION RECORDED IN BOOK
L-216 550'15'16•W 17.61' - p CORNER BRENDA DANIEL /oy j / i PAGE ETC.I fOT1ER7; THAT TIE BOUNDARIES
° D.B. 177, P. 909 / LOT 65 1 LOT 64 / LOT 63 NOT SURVEYED ARE CLEARLY INDICATED AS DRAWN
UNLESS SIGNED, SEALED AND DATED, THIS IS A ------ �„ ~<' / FROM INFONATION FOLIO IN B00K__C-_,PAGE
__E__; THAT THE RATIO OF PRECISION AS CAL-
OR PLAT,NOT FOR RECORDATION, SALES NF•LNAIL�FOUND CE ''' / •PINESBOROUGH ESTATE. :'1N CARO4�•,,., CULATED IS I:_10.. __; THAT THIS PLAT WAS
OR CONVEYANCES. STATE Oi HORN CAROLINA /¢ P.B. 11, P. 16 i P•••. PREPARED IN ACCORDANCE WITH G.S. 47-30 AS
NF• IRON SET
OOUND COUNTY of PERSON / , :0EES5/�;�:_
116. AMENDED. WITNESS MY ORIGINAL SIGNATURE,
I. Pp .61 'Pt REGISTRATION NUMBER AID SEAL THIS_S I_DAY
,k2 t]4Li_556a .REVIEW OFFICER •� r;
ok
HAMIETT�IE S. PA. I$O IRON SET aF PERSON COUNTY, TTFY THAT THE YAP I HEREBY CERTIFY THAT TIE SUBDIVISION PLAT AS . L-2465 . OF MAT , A.D., 20_13_.
ASSOCIATES. 0 MATHEMATICAL - OR PLAT TO WHICH THIS CERTIFICATE IS DEPICTED HEREON HAS BEEN GRANTED FINAL APPROVAL _
PROFESSIONAL L/1ND SURVEYORS POINT AFFIXED MEETS ALL STATUTORY REQUIREMENTS PI$SUAIIT TO iK PERSON CO. SUBDIVISION AEOULATIONS. •: ' Altai.
V1 _o
212 S LAMAR STREET-Po BOX 1286 FOR RECpOING. SUIN• SURVEYOR 1_`�tai. C, ""' '\
ROXBORO NORTH CAROLINA 27573 CE CONSERVATION EASEMENT P N 4-ZI.'13 -,,...../. t
[phone] __ NON-SURVEYED LINES _ I Q-'��. 1 DATE .................. REGISTRATION NUMBER
L-2465
- �.,L_/k353 .,__ 1 f PLAINING AIO ZONING
WUL WATER USE LINE VIEW OFFICER DATE ADMINISTRATOR
16 I/9z

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