20170244 Ver 2_Shoreline Stabilization_20190710

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1.4 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
ENVIRONMENTAL QUALITY FORM: SSGP 02-2017
.I -
Shoreline Stabilization Application Form N., TO%
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 Bra
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699-1617 Raleigh, NC 27604
A. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: Joseph & Rosemary Pelissier
Mailing Address: 111 Lochview Dr
Cary, NC 27518
Telephone Number: 503-789-3074 Fax Number: none
E-mail Address: ioelissi(@hotmail.com
2. Agent/ Contact Person Information
JA 1 0 2019
DEQ -WATER RESOURCES
401 &BUFFERPERMITTING
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.armV.mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf)
Name:
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Address:
Fax Number:
B. Project Information [15A NCAC 02H .0502(a) & (b)J
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: Wake Nearest Town: Cz
Lake/ river/ ocean adjacent to property: Lake Lochmere
Property size (acres): 0.49
Subdivision name or site address (include phase/lot number): 111 Lochview Dr, Cary, NC
Lot 141, Lochmere
Directions to site - please include road names and numbers, landmarks, etc.:
Lochmere Dr, turn North on Lochview Dr, proceed to address 111.
Latitude (in decimal degrees) 35.7304588 Longitude (decimal degrees) -78.769426
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): residential
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Install bulkhead to prevent continued shoreline erosion.
7. Will work be conducted from land? ❑ 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:
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 (including back fill, excavation, rip rap, retaining walls, etc.) in square feet:
Temporary impacts (temporary clearing, construction corridor) in square feet:
0
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): None
11. Signat
7/r/ '2,2 1 �1
Owner/Agent's Signature` f 15A NCAC 02H .0502(f)] Date
'Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 02-2017 Page 2 of 7

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.
Lake
(At Full Pond/ Normal Water Level)
Install 145' of bulkhead, approx. 24" from shore line and backfill with #57 stone.
Bulkhead to be built approx. 26" above normal pond level, backfill approx. 24" above normal pond level.
Pond is approximately 6" deep in the backfill area.
No vegetation clearing, rip rap, or any structures othertha the bulkhead are proposed.
Full Pond/Waw neve
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Plan View
e. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
FORM: SSGP 02-2017 Page 3 of 7

La ke
(At Full Pond/ Normal Water Level)
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Bulkhead placed approx. 24" from shore
Backfilled to approx. 24" above water level
Bulkhead approx. 26" above water level
Pond is approx. 6" deep in area of backfill
Lake
(At Full Pond/ Normal Water Level)
Existing Dock
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Plan View
FORM: SSGP 02-2017 Page 4 of 7

FORM: SSGP 02-2017 Page 5 of 7
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FORM: SSGP 02-2017 Page 5 of 7

The vegetation in this picture is rooted sufficiently high to allow the bulkhead and backfill to be
installed without removal. The lake level is unusually low in this picture. The mud that is visible
along the shore is normally underwater and is the approximate location where the backfill will be
installed.
FORM: SSGP 02-2017 Page 6 of 7

These pictures contain the existing dock which is the approximate height to which the bulkhead
will be built. Normally there is water between the dock and shore, but it is currently dry due to the low
lake level.
The vegation to the left in this picture is on the neighbors property and just beyond the extent of the
bulkhead.
FORM: SSGP 02-2017 Page 7 of 7