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Home My WebLink About20190886 Ver 1_Shoreline Stabilization_20190701State of North Carolina Department of Environment and Natural Resources _r Division of Water Resources K-1 I a - Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization ENVIRONMENTAL QUALITY FORM: SSGP 02-2017 Shoreline Stabilization Application Form 2 0�9� Three copies of the application (including attachments) and the application fee should be sent to 6 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 A. Applicant Information [15A NCAC 02H .0502(a)] 1. Owner Information Name:L� Mailing Address: Telephone 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 Name: L Company Affiliation: Mailing Address: Telephone Number: E-mail Address: Y_ 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: Nearest Town: Cnrna I l u�� Lake/ river/ ocean adjacent to property: lNOrrmr) Property size (acres): 2.05 QCre� Subdivision name or site address (include phase/lot number): 20701 Be.lbe lWond Lay)&_ Pnrne l; u,-:� " NC 28031 Directions to site - please include road names and numbers, landmarks, etc.: PorAPT7 Al 7MXKe, Exit ZB _Le-Ftor7fV VV . W150,A-re, 19i4)?t onto.e,1_Churcy, a Latitude (in decimal degrees) 35.4q/ /38 Longitude (decimal degrees)—W.0 5. Describe the existing land use or condition of the site at the time of this application (residential, undeveloped, etc.): 1 leSl6en4, eel 6. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or why it is necessary): -t,'xPrnove.Ehi Y_ 100al- 5l i p access . 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 IrnPC? ..US aMuare ICC L. 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: r - ir'ee e-- W ► �-h Ro r\ -u. stn K eck- e n Ltr C? ►� rl �/ -b �-►tay !z -}-Y' 5 o n e. !-fe 2�Q ro Yes D Te��7llpora`ry`i acII s tern rary clearing, construction corridor)in square /ffe t./� r�yy1GVC_ 1 nV\"TVr1It lk/1V\ /1V`r�(inr fnCC % X !r)` �i7"�;n / . 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): `�ee BQ,mOVaI- 11. Sig &-25-19 O nw er/Ages Signature* [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 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 Full Pond/ Normal Water Shoreline Plan View FORM: SSGP 02-2017 Lake (At Full Pond/ Normal water Level) ,U6 n �o v� Lake (At full Pond/ No lWater Le I) Existing Dock 30 ftx7ft 3ftx 150 ft Below full pond/ NWL Full Pond/ Normal Water Level �� nh`oreTne a ft x Iso ft Riprap Above full pond/ NWL 2 ft. x 150 ft. add'Monal clearing ' if necessary E AMPLE Plan View Page 3 of 4 Lake (At Full Pond/ Normal Water Level) w c O r N c Side View CL IL 3 ft. below full pond water level 4 ft. above full pond water level 2 ft. additional clearing f necessary Existing bank 10 ft. bank Side Vi FORM: SSGP 02-2017 Page 4 of 4 Polaris 3G Map — Mecklenburg County, North Carolina DeJesus 20701 Bethelwood Lane Cornelius 28037 Date Printed: 5/28/2019 1:14:18 PM 13 i F I 1) e Sest,s K� x �' nc a b CATAWBA RIPARIAN BUFFER NOTIFICATION FORM Project Name/address:Zablffi County: C{ I 1 �J owner: Print coo- ature Contractor/agent: I' Printk U Signa ure 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 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 W vYib , 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 Rule approved plan(s) and specification(s), and other supporting materials. Signature (owner): Date: MECKLENBURG COUNTY, North Carolina POLARIS 3G PARCEL OWNERSHIP AND GIS SUMMARY Date Printed Identity Parcel ID I GIS ID 00112134 100112134 Zoning Contact appropriate Planning Department or see Map. Water Quality Buffer Parcel Inside Water Quality Buffer I Yes FEMA and Community Floodplain Property Characteristics Legal desc M58-426 Land Area 1.92 AC Fire District CORNELIUS Special District FIRE SERVICE B Account Type INDIVIDUAL Municipality CORNELIUS Property Use SINGLE FAMILY RESIDENTIAL - WATERFRONT Zoning Contact appropriate Planning Department or see Map. Water Quality Buffer Parcel Inside Water Quality Buffer I Yes FEMA and Community Floodplain FEMA Panel# 3710463300J FEMA Panel Date 03/02/2009 FEMA Flood Zone INVIEW FEMA FLOODPLAIN TO VERIFY Community Flood Zone OUT:VIEW COMMUNITY FLOODPLAIN TO VERIFY Situs Addresses Tied to Parcel 05/28/2019 Ownership Owner Name Mailing Address LOUIS DEJESUS 5552 ROXBURY DR GENEVA OH 44041 JEANETTE DEJESUS 5552 ROXBURY DR GENEVA OH 44041 Site Location Deed Reference(s) and Sale Price Deed Sale Date Sale Price 29911-652 04/22/2015 29911-649 04/22/2015 26298-497 02/17/2011 25808-213 08/04/2010 25137-424 10/08/2009 04712-952 08/19/1983 1$45,500.00 Site Location ETJ Area Cornelius Charlotte Historic District No Charlotte 6/30/2011 Annexation Area No Census Tract # 62.03 Post Construction District Jurisdiction Cornelius District Cornelius Stream Watershed Districts Stream Watershed Name I LAKE NORMAN Regulated Drinking Watershed Districts Watershed Name LAKE NORMAN Watershed Class CA Built -Upon Area Restriction Limit on amount of Built -Upon Area Yes Allowed Built -Upon Area 10.00 sq ft This map or report is prepared for the inventory of real property within Mecklenburg County and is compiled from recorded deeds, plats, tax maps, surveys, planimetric maps, and other public records and data. Users of this map or report are hereby notified that the aforementioned public primary information sources should be consulted for verification. Mecklenburg County and its mapping contractors assume no legal responsibility for the information contained herein. Page 1/1 CERTIFICATE OF SURVEY & ACCURACY: I, PHIWP A HARRIS, CERTIFY THAT THIS MAR WAS DRAWN BY ME FROM AN ACTUAL SURVEY MODE UN SUPERVISION DESCRIPTION RECORDED IN BOOK PAGE BOOK XXX , PAGE X�C BOOK . PAGE _XXX TWAT THE RATIO OF PRECISION AS CALCULATED BY LATITUDES AND DEPARTURE IS 1: 10,000 + (THAT THE BOUNDARIES NOT AND ARE SHOWN A5 B�0 LINES PLOTTEDINiOflMATION FOUND IN 8001( _XXX_. PAGE ): THAT THIS MAP WAS PREPARED IN ACCORDANCE WITII G.S. 47-30 �MENDEO. WTTNESB MY NANO AND SEAL THIS THE DAY OF S Ei/TEAIB EIS, AD. 2015. I FURTHER CERTIFY *THAT THE SURVEY IS OF ANOTHER CATEGORY, SUCH AS THE RECOMBINATION OF EXISTING PARCELS, A COURT-ORDERED SURVEY, OTHER EXLn/CEPTION 0 THE DEFINITION OF A SUBDMSION'. U SURVEYOR - PLS /4164 Z��b6��'i'•/ L 4164 �: S Z. aDWo5l� IW B66 - P426 CERTIFICATE OF OWNERSHIP & DEDICATION: 1 HEREBY CERTIFY THAT I AM THE OWNER OF THE PROPERTY SHOWN AND DESCRIBED HEREIN, WHICH IS !LOCATED IN THE SUBDIVISION JURISDICTION OF THE TOWN OF CORNEOUS AND THAT 1 HEREBY ADOPT THIS PLAN OF SUBONMON WITH MY FREE CONSENT. ESTABLISH MINIMUM BUILDING SETBIGK ONES, PRESERVE AND PROTECT ALL SIOWIGW FT TREES OVER IS INCHES DIAMETER W THE TREE IND ROOT PROTECTION AREA, PLANT SUPPLEMEMNFY TREES ER. ARDEDICATE LL STRT ALLEYS, 6. PARKS. AND EA5EMIJI TO PUBLIC OR PRIVATE USES AS NOTED. FURTHERMORE. I HERESY DEDICATE ALL SANITARY SEWER, STORM SEWER. AND WATER LINES THAT ARE LOCATED IN FUSTIC unlet OR RIOHT—CA—WAYS ro THE TOWN OF maw S AAD TI uMi➢S IJECKLEWEUG UTWRY DEPARTMENT. CERTIFICATE OF APPROVAL FOR RECORDING: I HEREBY CERTIFY THAT THE SUBDIVISION PUT SHOWN HEREON 5 EXEMPT FROMTHE SUBDIVISION PROVISIONS OF THE CORNEOUS LAND DEVELOPMENT CODE, AND IS THEREFORE EXEMPT FROM ITS PROVISMS. THE PIAT HAI EN BEFOUND TO COMPLY WITH THE ZONINGREGIXATIONS OF THE CORNELIUS LAND DEVELOPMENT CODE. AND HAS BEEN APPROVED BY THE MIN OF CORNELIUS FOR RECORDING IN THE OFFICE OF THE REGISTER OF DEEDS OF MECKLENBURG COUNTY. 0 PLANNING (RECTOR DATE CORNELIUS. NC "J � 1 ao,5oq16;� �o (LED O Pau 329 / eo-avPR REC3IBTRATION�14_4555�p� / a a4� aNYFI'6� OCT 191" D0' Z \ 20101 PAR/ / TRA111, DO, 298111-1632 \\ IS 1.43 AC. +- O� It /// \ z ols s a • ADM /� / / , ' 2.05 ACRES + — j5 1 / (TOTAL) # 5'MT / 20601 1 PARCEL 10: 00112153 TRACT LOB: 29911 -BST 0.60 AO +- LAKE NORMAN V W Ex N Ie[B.R I Y� N Dy15 � Fx mYr AA RLTAI � i� ST DB 2i�Y GENERAL NOTES: 1) PROPERTY MAY BE SUBJECT TO RECORDED OR UNRECOIAED RIGHTS OF WAYS OR EASEMENTS 2) OHAARs WNER TOO vuuDESERVEDrKl SLTBIGI(S MID 2WNIN RFLAA.ATIONS PRIOR TO ANY wANNWG OR 3) AL_ DWANCES ARE HORIZONTAL GROUND WMNCES UNLESS Ol"ERSBE a) AREASAWL 9 1 I WERE DETERMINED BY COORDINATE COMRrtATRWN. 3) PORTIONS OF THIS PROPERTY DO LLE WITHIN A SPECIAL 8000 AWARD AREA AS DETERYMED BY THE FEDERAL EMERGENCY MANYXMEAR IAElI(.Y. ►fll( R4FOHIIAMN: COMM. PANEL 1T10b3]ODI EFFECT. DAIS '/2/]0011 ZONE: X t AE B) NO NCGS M9HUMENTS XHOWN TO EXIST Mn WN 2000 OF PROPERTY. T) PHYSICAL IMPROVEMENTS EXIST ON THS PROPERTY THAT ME NOT SHOWN HEREON. B) TMS PROPEIOY, TO THE BEST OF W KNOWLEDGE. LES WIN w THE LAKE NORMAN WATERSHED CRTIGL IAEA AS DESIGNATED B•I THE NORTH CAROLINA DNSKw DA EN U ONMENOLL AINALEMENT. 9) THIS PROPERTY IS NJPENNOUS EXEMPT. 10) THE SOLE PURPOSE OF THIS AMP S TO COMBINE TRACT I t TRACT II OF OB: 29911—A52 -0 ONE PARCEL LEGEND: Tn 1 ABNUMMI BURL VG SETBACKS BOUNDARY LINE PRRIOHL STIR 101 SOIOL 5FT'q.O R /W FENCE (ME NOTED) UNE CP COMPUTED PONT (UNMARKED) REAR: 2s'Fvvw LOT LASO ZE IOP • FRLWI R/W - RIGHT-OF-WAY \S 685728"W 16O' CpIRX/R UNE MIgO#VER IS CREA TER. EDP EDGE OF POF PAVEMENT 9.18' CIL CENNMJNE ACCESSARY SIRUCnM.' w " UOLPY POLE .AOL 3�ILVOT LVNF REM: LOT LINE LII 50' FROM ' 180' IAL, MMOEIER M GREATER. n TY CERTIFICATE OF APPROVAL FOR RECORDING: 798 PROPERTY IS LOCATED WII14N A PUBLIC WATER SMUY WATERSHED. REVIEW OFFICER CERTIFICATE: DEVELOPMENT aLSTR1CIIaNE MAY APPLY. I CERDFY THAT THE PUT Sad ,('ABEL N1Y SHOWN HEREON COMPLA3 WON THE WATERSHED PROTECTION ORDUMLCE PHCi°ERry mcXamA ' R STATE OE NOM HRI I't�M 1K AMREVIEW OFFICER OFFICE OFF AND IS THE RRUXSTERED BY INETOM OF OF DEEDS OF�FECKENBURG COUNTY. US FOR RECORDING IN THE 551? ROXBWPY DR 1 s $ OF MECKLENBURG COUNTY CERTIFY THAT THE IMP Ofl PUT GENEVA ON 44011 TO WHICH THIS CERTIFICATION IS AFFIXED MEETS ALL PARCEL M: 001121J4 & 001121ST 0 40 80 120 STATUTORY/��j;IREMENTS FOR RECORDING. 1\ / ZONING GR AVL / \' n o-8- - � 1 \ \(1 -8 - is POM NU USE: RESf11ENlI �P REVIEW OFFICER DATE WATERSHE ADMINISTRATOR DATE TOTAL NUMBER OF LOTS i 4 SCALE: 1"=40� CORNELIUS. NC TOTAL ACREAGE BEAC COMBINED: 2.05 AC + U) otl y �W yG F W Uj L cLu 6. w Nz a 0W � O� w V. PAR TRENT: 15093BE71ELWOOD AMECF HD 15093 PROPFNII'AODR6S _BETHELWDOO LN CORLELKISA NC 28031 DAZE• AUGUST 19, 2015 SONE 1'.40- R"SIi t L'QLIRI LE LEY TOWN5HP MECKIFNBURG GO., NC F9i[T "'E"1 of 1 Duke Energy Lake Services Guidance for Completing an Excavation Permit Application Step 1: Contact Duke Energy Lake Services Complete "Part I" of the application and contact Duke Energy Lake Services to schedule a site visit. Lake Services will conduct a site visit to determine if Duke Energy will accept an excavation permit application for the proposed work. If the Lake Services representative determines the application process may proceed, he/she will initial Part I of the application. Step 2: Draft Application Development Complete Parts II -IIIA -G and Part V of the Excavation Permit Application. Note: If you are proposing excavation in association with the permitting of a facility under the Marina or Conveyance Programs, you do not need to complete this application. Instead, you should incorporate the excavation request into the permit application for the marina/conveyance using the appropriate application forms. Step 3: Agency Consultation Send the draft application developed during Step 2 to the agencies for review and comment on the proposed activity. Refer to the Agency / Organization List available from Duke Energy to determine which federal, state, regional, and local agencies and organizations require consultation or review. Note: Duke Energy reserves the right to require consultation with additional organizations beyond those included in the Agency / Organization List. Each agency / organization must be provided at least 30 days prior notification. Evidence must be provided (e.g., response letter or Certified Mail receipt) in the complete application to show each agency / organization was given the opportunity to review the proposal. Consultation letters must be dated within the two years preceding Duke Energy's receipt of the application. All permits must be valid at time of application and have a term longer than the projected schedule for completing the permitted project. What to Expect During Agency Review and Comment: • You will typically receive a letter from each agency / organization either documenting its concurrence with your proposal, requiring additional information, recommending modifications, or offering no comment. You must address each agency's / organization's comments with a follow-up letter and in your final application as described in part IV. • If you do not receive any documentation from an agency / organization within 30 days of its receipt of your proposal, you must provide the agency / organization with a follow-up letter requesting comment on your proposal within 15 days from the date of the follow-up letter. If you still do not receive any response as a result of the second letter, type "NO RESPONSE" at the top of the follow-up letter and include it in the application along with proof of the agency's / organization's receipt of the letter (e.g., Certified Mail receipt). You may proceed Duke Energy Page 1 of 14 rev 6W17 Excavation Program. with the application process recognizing, however, that if its comments come later in the application process, you will be required to address them. • From the United States Army Corps of Engineers (Corps): (* * Note — The Corps may have additional forms to submit for your proposal and an additional fee.) If the excavation can be done under the requirements of the General Permit (GP) or a Nationwide Permit (NWP), you will typically receive a copy of the Corps' tear sheet documenting authorization and providing any additional instructions. If the excavation isn't covered under the GP or a NWP, you'll be required to obtain an individual 404 Dredge and Fill permit from the Corps. You must receive written documentation from the Corps that your application either (1) meets the requirements of the GP or a NWP or (2) the proper 404 Dredge and Fill permit has been received before Duke Energy can process your application. • From the North Carolina Department of Environmental Quality (NCDEQ), Division of Water Resources: (Note NCDEQ may have additional forms to submit for your proposal and an additional fee.) If the proposal meets the requirements of the Clean Water Act Sect. 401 Water Quality Certification, you will typically receive a letter from the NCDEQ Division of Water Resources documenting Sect. 401 Certification and providing any additional instructions. You may also receive a letter requiring additional information or recommending modifications. You must receive written documentation from NCDEQ noting any required Sect. 401 Certification has been received before Duke Energy can process your application. • From the North Carolina Wildly Resources Commission (NCWRC): If you do not receive any documentation from the NCWRC within 30 days of their receipt of your application, you may proceed with the application process without submitting a follow-up request, recognizing however if comments come in later in the application process, you will be required to address them • From the South Carolina Department of Health and Environmental Control (SCDHEC): (Note — SCDHEC may have additional forms to submit for your proposal and an additional fee.) The SCDHEC conducts a joint application process with the USACOE in S.C. If the proposal meets any applicable requirements of the Clean Water Act Sect. 401 Water Quality Certification, you will typically receive a letter from SCDHEC documenting Sect. 401 Certification and providing any additional instructions. You may also receive a letter from USACOE requiring additional information for the agencies participating in the joint application process. You must receive written documentation from SCDHEC noting Sect. 401 Certification has been received if required before Duke Energy can process your application. • From the South Carolina Institute ofArchaeology and Anthropology (SCIAA): The applicant must wait 30 days after receiving the signed postal returned receipt. If a response from SCIAA has not been received by this time you may proceed with the application process without submitting a follow-up request, recognizing however if comments come in later in the application review process, you will also be required to address them. Step 4: Final Application & Submittal to Duke Energy Duke EneW Page 2 of 14 rev M20/17 Excavation Program. Following the consultation process, finalize the application. The final application submitted to Duke Energy should incorporate all comments and recommendations provided by agencies and organizations during the agency consultation process as well as copies of all permits received. In addition to the final application include the following: • One check payable to Duke Energy for the application fee and security deposit • If applicable, a separate check payable to the appropriate Habitat Enhancement Program fund • Signed Excavation Program Applicant's Agreement Note: Co -applicants must also submit the application fees and HEP fees, if applicable, with the application. Duke Energy Page 3 of 14 =6=7 Excavation Program. Duke Energy Excavation Permit Application Form FOR DUKE ENERGY USE ONLY Duke File No. Application Fee $ Security Deposit $ Check # Date Recv'd initials Date of Duke Energy Lake Services, applicant and/or contractor on-site inspections DateCLI Initi A / Date Final Protection/Avoidance Area Markings Field - Verified Approved to Start Work 13y * : Date Completion Required Date Passed Closeout Inspection* _ Date of Any Approved Extension Initials Initials Date (Sgn) _ Initials Any Stop Work Orders or SMG Violations*? (check one) Dyes 17No (If Yes, explain in PART V) Date Deposit Refunded Initials Date Permit Database Updated Initials * Forward copy of approved application (all pages, plus any attachments that Duke Energy changed) back to applicant with Approval Letter and highlight any changes. File copies of Approval and Close-out Checklists and any Stop Work Part I. Applicant Information (Please Print) Name Louts Telephone (21po- -7 -7 88,5 Email address:_] OLl 1 P Ori +V-l.M , Vic 0m Mailing Address (:fdierent) Contractor Contact Person 'bnY)V)j2 Telephone (a) Q& Contractor Email Address: LAKE LOT INFORMATION Lake &fA4County1VwX1P-Y)hQ CityrrlaliU6_ State L Tax Map No. 0011Z134 - Subdivision Lot / Section No. Lot Size=Acres Duke Energy Page 4 of 14 rev 6/20/17 Excavation Program. Duke Energy Excavation Permit Application Form Are there any Co -Applicants*? (check one) ❑Yes XNo (If Yes, include names, street addresses or lot numbers, pier numbers, phone numbers, and email addresses in Part V — Additional Information) * Co -Applicants exist when the proposed work is being done under a single application, will be performed by a single contractor as one continuous project, and is done to benefit multiple owners / lease holders of Project -front properties within a single development. There can be no more than 4 co -applicants in addition to the lead applicant on any application. Do not continue the application until an on-site inspection has been conducted between a Duke Energy Lake Representative and the applicant and/or the excavation contractor. NOTE: Initialling this portion of the application by a Lake Representative in no way constitutes approval or eminent approval of the excavation or any other lake use permitting activity. Date of on-site inspecti _ ' j. t Initials (Duke Energy) ' (applicant/contractor) Duke Energy Page 5 of 14 rev 6/20/17 Excavation Program. Duke Energy Excavation Permit Application Form Part H. Description of Project A. Basic Info 1. Type of excavation: (check one) Cg New excavation ❑ Maintenance excavation 2. Purpose of excavation: (check one) X Boat Access Channel ❑ Water Intake Channel ❑ Wastewater Discharge Channel ❑ Other (spec): 3. Lake user category: (check one) ]Private ❑Residential Marina ❑Commercial Marina ❑Public ❑Other (spec): 4. Max. Excavation Area Dimensions (ft): Length SAY, Width (A 5 Depth I C) (Note: include additional area dimensions if necessary so response to #5 below equals max. area dimensions in ##4) Y. 0.reo- uvxa er do cV% T -bo+ p rA n+ W;11 n o i- be d red�e� 5. Volume of Excavated Material (TOTAL for the project): Cubic yards 6. Type of material removed (applicant determines by field sample if practical): 7. Excavation Site area: Acre (s) Disposal Site area: Acre (s) 8. Total Disturbed Area (including equipment staging area): (p8 Acre (s) 9. Does the project meet the requirements of the applicable General Permit? (check one) 19Yes ❑No 10. Do you claim title to the disposal area? (check one) ❑Yes MINo 11. Do you claim title to the equipment staging area? (check one) ❑Yes WNo 12. Are there any water -treatment facilities within 50 feet of the proposed excavation area? (check one) ❑Yes ]UNo (If Yes, spec): 13. How will the excavated material be entrapped and the erosion controlled? (e.g. see attached r sion control plan and disposal area design):r a ex Qvjft:�J VIN kNappe'r in Duke Energy Page 6 of 14 rev 6120/17 Excavation Program. Duke Energy Excavation Permit Application Form ) of excavation equipment to be r 15. Will waters or wetlands be crossed in transporting equipment to or from the site? (check one) X Yes ONo 16. Will return water re-enter the reservoir? (Check one) OYes ONo PqN/A (If Yes, speck point(s) of re-entry and show on Excavation Area Drawing) 17. Is there an existing facility (e.g. pier) that access is being maintained to by conducting the excavation? Oyes Myo G,x i Sr}�j n pi es �pberenlOV ed • Next dAc �b b e.b u I+-, (If Yes, sped the existin permit number. No, include a sc d drawing o the proposed facility). Permit # � �� dj r t�a�-et �1� �S Coo10�1 �e- V-eeme , 18. Total planned duration of the work (Ynclude first equipment mobilization, excavation through final mitigation measures complete): START C) C1_ / I (�_ FINISH O Z / (Month) (Year) (Month) (Year) Duke Energy Page 7 of 14 rev 6/20/17 Excavation Program. Duke Energy Excavation Permit Aaplication Form Part H. (Continued) B. Protection / Avoidance Area. Description Complete the following table including all land areas within and immediately adjoining the disturbed area: Protection/Avoidance Areas check all that apply) Approx Identification Method * Avoid (A) or Mitieate ** Acre held ID Work Area Dwg. ED a. Marshland, swamp, ponds, beneficial aquatic vegetation or other potential wetlands l/� A (circle all that apply) AV% / b. Buffer Zones (specify width & source m4erIGLIS wol I be e1+C16 *ka of requirement) J . YLLlMM q 014. }w� h10h�grth E"A&1=4P�4L I+n►'tbpp��Cr bq�e5.Tidu" _ por}-# o Kn1 1WW lajofirlA fo rc ftImc V101061Nt e— leveledbff by'c�ge• _ c. Environmental Areas as identified by Duke Energy N/A, d. Natural Areas as identified by Duke Energy A' /A— e. Historic properties (spec) Duke Energy Page S of 9 my 2/6/17 Excavation Program Duke EneM Excavation Permit Application Form * For "Field ID" column, specify entity or person that performed the identification and how it was physically marked (e.g. Duke Energy (John Doe)/Pink and purple -dotted tape, Corps of Eng. (John Smith)/ yellow flagging). For "Work Area Dwg ID" column, show the symbol that is used on the drawings to identify the protection/avoidance area. Duke Energy Page 9 of 9 rev 216/17 Excavation Program E Rare or threatened species (specify) N/,k �. Buried gas water, sewer, communica ectric lines (circle) h. Impact Minimization Zones as identified by Duke Energy next as Ij p!, i yam, Y101 t FY , v r r' re ` en 7.' I eX�(',gyq � yt L Other areas requiring specific avoidance, protection or mitigation (spec) A k — * For "Field ID" column, specify entity or person that performed the identification and how it was physically marked (e.g. Duke Energy (John Doe)/Pink and purple -dotted tape, Corps of Eng. (John Smith)/ yellow flagging). For "Work Area Dwg ID" column, show the symbol that is used on the drawings to identify the protection/avoidance area. Duke Energy Page 9 of 9 rev 216/17 Excavation Program Duke Egg= Excavation Permit ApQlication Form ** List and attach mitigation plans Duke Energy Page 10 of 9 m,?16/17 Excavation Program Duke Enerav Excavation Permit Application Form C. Annlicant's Signatures Comments: Applicant Name (print) Applicant Signature* Date Co -Applicant Name (print) Co -Applicant Signature* Co -Applicant Name (print) Co -Applicant Signature* Co -Applicant Name (print) Co -Applicant Signature* Co -Applicant Name (print) Co -Applicant Signature* Date Date Date Date *Per my signature, the information provided in this application is correct to the best of my knowledge. Duke EncW Page 11 of 14 rev 2/6/17 Excavation Program Duke Ener¢v Excavation Permit Application Form Part M. Information Requirements for All Applicants In addition to the completed application form PARTS I dt II, the following items must be provided to Duke Energy by all applicants: A copy of the deed and registered survey plat or other instrument under which each applicant and co -applicant claims title to the affected property (the shoreline adjoining the excavation area, equipment staging area and the disposal area), OR if the applicant(s) is(are) not claiming to be the owner(s) of said property, then forward a copy of the deed and registered survey plat or other instrument under which the owner(s) claim title plus written authorization from the owner(s) to carry out the project on their land. An accurate scaled drawing (1"=25' for projects <1000 cubic yards of material removed or P'= for larger projects) of the area to be excavated. The drawing must show at a minimum, a North arrow; a vicinity map; the boundaries and acreage of the proposed excavation area and equipment staging areas; lake, county, city, cove, tributary, road and subdivision names and lot numbers (as applicable); property corners for project front lots; the full pond elevation contour and lines dividing the cove width into equal thirds; approximate volume in cubic yards of the material to be excavated; point(s) of return water re-entry; the boundaries of any adjoining areas that are to be specifically avoided or protected during the work and the location (address) of the disposal area for the excavated material. [NOTE: A copy of this drawing most also be provided to the excavation contractor to ensure restricted areas are not impacted.] An accurate scaled drawing (1"=25' for projects <1000 cubic yards of material removed or 1 "=100' for larger projects) of the proposed design for the disposal area. The drawing must show at a minimum, a North arrow, a vicinity map; the boundaries and acreage of the proposed disposal area; lake, county, city, cove, tributary, road and subdivision names and lot numbers (as applicable); the full pond elevation contour (unless disposal is well away from the lake); the boundaries of any adjoining areas that are to be specifically avoided or protected during the work; the location (address) of the excavation area from which the material came and a statement of the disposal area's capacity with all dimensions labeled that were used in the volume calculation. [NOTE: A copy of this drawing must also be Provided to the excavation contractor to ensure restricted areas are not impacted.] Also note for projects larger than one (1) acre in North Carolina, including excavated, equipment staging, and disposal areas, you must submit an erosion control plan. For projects larger than two (2) acres in South Carolina, including excavated, equipment staging and disposal areas, you must submit an erosion control plan. For projects < two (2) acres in South Carolina, you must submit a completed standard nw--rting form for construction sites disturbing two (2) acres or less to the South Carolina Dept, of Health and Environmental A map or directions by road showing directions to both the excavation area and disposal area. Duke En=W Exc avadon Program Page 12 of 14 iev 2/N17 Duke EneMy Excavation Permit ApplLeation Form E. A USGS topographic map with a directional arrow indicating the exact location of the excavation project and Latitudinal and Longitudinal coordinates for the project site. F. A list of names and addresses of adjoining property owners for both the excavation area and disposal area G. The existing permit number if excavation is being conducted to maintain access to an existing facility (e.g. pier) or provide an accurate scaled drawing of any proposed facility if a facility does not currently exist. Note: A separate application and approval is required for proposed Private Facilities (e.g. pier). H. A copy of all permits and/or letters of correspondence to/from local, state and federal agencies that require notification or issue individual permits. Duke Energy Pap 13 of 14 ra 2107 Excavation Program Duke Enernv Excavation Permit Application Form Part IV. Agency Reviews and Approvals (Begin this section with a summary table of all agencies consulted, comments receivett and applicant response to agency comments (see example table below). Agencies should be listed in the order shown in the Agency/Organization List. Consultation letters must be dated within the two years preceding Duke Energy's receipt of the application. IV -1. Sample A eney Comment and Agency 1 I The activity is approved as Agency 2 The on-site well provides drinking water to the public. Please contact Mr. Smith to discuss the proposed changes and potential issues associated with your nronosal. You must contact us immediate endangered species are located the course of NA Contacted Mr. Smith on 1/l/20xx. No further action needed. if IApplicant will contact Agency 2 if endangered species are located Agency 3 Requested agency comments on NA 1/l/20xx and again on 2/1/20xx. No rewnse as of 2/16/20xx. construction Following the table of agency comments and applicant responses, include a table of permits and certifications issued by the reviewing agencies. As with the table of agency comments and applicant responses, agencies should be listed in the same order as they are listed in the Agency/Organization List. Table IV -2. Sample Aoenev Parmus end !`n..t:f:..s44..,.- •r..Lv_ Following the two summary tables, include a copy of all correspondence to and from any local, regional, state and federal agencies or other organizations with which you are required to consult, including any required permits (e.g., Section 401 water quality certifications, Section 404 dredgeffill permits, building permits, etc.) or other approvals or comments which have been obtained from these organizations regarding this activity. Include a copy of any local, regional, state or federal regulations or guidelines that will be followed All permitting issues must be resolved and clearly documented Correspondence should be organized in the order the agencies are listed on the AgencyfOrganization list with the applicant's request for comments followed by additional correspondence in chronological order. All permits must be valid at time Duke Energy Page 14 of 14 ?J6/17 Excavation Programmv - - -- - . num, Agency Permit/Certification Name Date of Date of Agency 1 Surface Water Withdrawal Permit Issuance Expiration Agency 2 Section 401 Water Quality Certification Following the two summary tables, include a copy of all correspondence to and from any local, regional, state and federal agencies or other organizations with which you are required to consult, including any required permits (e.g., Section 401 water quality certifications, Section 404 dredgeffill permits, building permits, etc.) or other approvals or comments which have been obtained from these organizations regarding this activity. Include a copy of any local, regional, state or federal regulations or guidelines that will be followed All permitting issues must be resolved and clearly documented Correspondence should be organized in the order the agencies are listed on the AgencyfOrganization list with the applicant's request for comments followed by additional correspondence in chronological order. All permits must be valid at time Duke Energy Page 14 of 14 ?J6/17 Excavation Programmv Duke Eneruv Excavation Permit Application Form ofapplication and have a term longer than the projected schedule for completing the permitted project. Part V. Additional Information (Provide arty relevant additional information. Reference previous parts as applicable. Include the FERC -required Environmental Assessment if applicable. If there are co -applicants, this is where their information would be provided) Duke finft'SY Page 15 of 14 my 2M7 Excavation Program 04=1 1-1 - rbaz FOR REGISTRATION J. David Granberry REGISTER OF DEEDS Mecklenburg County 2015 APR 2Z 02:25:" PM BK:22011 PG'652-654 FEE:S26.00 EXCISE TAX: gg1 768.00 INSTRUMENT T2SL0 i 5047648 11111111111 5047648 NORTH CAROLINA GENERAL WARRANTY DEED Excise Tax: $1$768.00 Parcel Identifier No. 001-121-34 Verified by County on the _ day of , 20_ By: Mail/Box to: Grantee This instrument was prepared by: Peter N. Carlino, Attorney at Law, 6743-A Fairview Road Charlotte North Carolina Brief description for the Index: THIS DEED made this 21st day of April , 2015 by and between GRANTOR Amajes, LLC a North Carolina limited liability company 17701 Speakwell Court Cornelius, NC 28031 GRANTEE Louis DeJesus and wife, Jeanette DeJesus 5552 Roxbury Drive Geneva, OH 44041 Enter in appropriate block for each Grantor and Grantee: name, mailing address, and, if appropriate, character of entity, e.g corporation or partnership. 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. WITNESSETH, 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 the City of Cornelius Township, Mecklenburg County, North Carolina and more particularly described as follows: SEE ATTACHED EXHIBIT A The property hereinabove described was acquired by Grantor by instrument recorded in Book 26298 page 497 All or a portion of the property herein conveyed _ includes or 2L does not include the primary residence of a Grantor. A map showing the above described property is recorded in Plat Book page NC Bar Association Form No. 3 ® 1976. Revised ® l/12010 Printed by Agreement with the NC Bar Association h.A6.70 r r - rvao TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in fce 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 lawful claims of all persons whomsoever, other than the following exceptions: All valid and enforceable easements and restrictions of record, including the ad valorem taxes for the current year. IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year first above written. Amajes, LLC a North Carolina limited liability company _„(entity Nar - (SEAL) By: rV� kV [G PnntrI ype Name: Print/Type Name & Title:_ Mark Le, Member/Manager(SEAL) PrintlType Name: By: PrinVrype Name & Title: (EALI Print/Type Name: By: Print/Type Name & Title: (SEAL) Print/Type Name: State of - County or City of I, the undersigned Notary Public of the County or City of and State aforesaid, certify that 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 day of .,70—. My Commission Expires: (Affix Seal) Notary's Printed or Typed Name Notary Public State of North Carolina - Countyor City of Mecklenburg 1, the undersigned Notary Public of the County or City of Mecklenburg and State aforesaid, certify that Mark Le personally came before me this day and acknowledged that _he is the Member/Manager of Ama'es, LLC —,a North Carolina or corlmuftneirnited liability companyl trike through the inapplicable), and that by authority duly given and as the uct of such entity, _he signed the foregoing instrument in its name on its behalf as its act and deed. Witness my hand and Notarial stamp or seal, this2l st day of Aril , 2015 %.x04 -I ER My Commission Expires: December 9. 2017 ,4? �� C9,9°'�. Peter N. Carl ino 7Z�— (Affix Sea]) �i �. Notary Public �A MN401:� �'^ Notary's Printed or Typed Name State of - County or 1, the undersigned Notary Public of the Q Witness my hand and Notarial stamp or seal, this My Commission Expires: (Affix Seal) NC Bar Assmiatitm lrorm No. 3 ®1976. Revised O I/1/?olo Printed by Agmemcnt with the NC Bar Association V� and State aforesaid, certify that ,)0_ Notary Public Notary's Printed or Typed Name B29911- P664 EXHIBIT A TRACT I: 20631 Bethelwood Lane (PIN#: 001-121-53) BEGINNING at a point located in the centerline of the Bethelwood Lane right-of-way, said point also being the northeast corner of the Amy K. Clement and Steven D. Clement Property (now or formerly) as same as described in deed recorded in Deed Book 24515 at Page 127 of the Mecklenburg County Public Registry; thence from said point of BEGINNING and running with the Clement Property (now or formerly) line the following two (2) courses: (1) S 63-56-06 W 367.03 feet (passing through an existing iron pin at 30.19 feet) to an iron pin, and (2) S 68-44-05 W 109.58 feet to an iron pin; thence N 18-29-09 W 60.01 feet to an iron pin; thence N 71-26-00 E 155.88 feet to a point; thence N 61-45-30 E 317.75 feet (passing through an iron pin at 286.54 feet) to a point located in the centerline of the Bethelwood Lane right-of- way; thence running with the centerline of the Bethelwood Lane right-of-way S 22-30-14 E 60.50 feet to the point and place of BEGINNING and containing 0.597 acres more or less as same as shown on a survey by Brian K. Eversole, NCPLS dated March 3, 2015, reference to which is hereby made for a more particular description. way. SUBJECT TO, that portion of the property located within the Bethelwood Lane right -of - 213. BEING all of the same property more particularly described in Deed Book 25808 at Page TRACT II: 20701 Bethelwood Lane (PIN#: 001-121-34) BEGINNING at a point located in the centerline of the Bethelwood Lane right-of-way, said point being located N 22-30-14 W 60.50 feet from the common point of northeast corner of the Amy K- Clement and Steven D. Clement Property (now or formerly) as same as described in deed recorded in Deed Book 24515 at Page 127 of the Mecklenburg County Public Registry and the centerline of the Bethelwood Lane right-of-way; thence from said point of BEGINNING and running S 61-45-30 W 317.75 feet (passing through an iron pin at 31.21 feet) to a point; thence S 71-26-00 W 155.88 feet to a point; thence N 18-05-00 W 6.00 feet to an iron pin; thence N 09- 32-00 W 132.70 feet to a calculated point; thence N 66-41-49 E 427.02 feet (passing through an iron pin at 417..51 feet) to a point located in the centerline of the Bethelwood Lane right-of-way; thence running with the centerline of the Bethelwood Lane right-of-way S 15-09-22 E 121.61 feet to the point and place of BEGINNING and containing 1.454 acres more or less as same as shown on a survey by Brian K. Eversole, NCPLS dated March 3, 2015, reference to which is hereby made for a more particular description. way. SUBJECT TO, that portion of the property located within the Bethelwood Lane right -of - BEING all of the same property more particularly described in Deed Book 25808 at Page 213. cNERLCATN Or SUNY t ACIVIACT: L PNNLIP A. IIAROB, COMFY WX 1W NAP MLS CPoM11 B NE PITON AN ACFUX SIOYEY NAGE . 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K O Iq NCW�N 10 WN 7)111M I/K OMf 011 A6 NOFEINY O � we N11I1MNNN�NA1 ON INS ONINOW EI�IAMOIONWIINNIA.IIIIIOWNINORMIIII. SI" N) NM NMPONY M N/ONygMM BMW. 0q IN) 1 I ,1 N I O! 2c1p,-w NIOI� 2.05 ACRES V / (TOTAL)FARGO. AD: j y.. MAL74 D bbD/l-S3P 6AG +- i LAM NORM" IOAO'l NINMI(MNMMNIw 1� iw aaNr w Ns 11rs I �'st ID- 0 40 so 120 SCALE: 1'-40' RKVMW OPF4CRH cza?M ATX: O�IY MK NNOMANNUNG a 210" OFFNZN A FIWM C 6 A 1110 M IIAP NI PLAT D IIISDI 1 �NL o DOE C&RTIMATR M APPROVAL FOR RROOROR(k TM6 PRDPDIY N tOW1ID MMN A FONUO wu RFFIY 1MwIBIDA alvNAnINIT N®MOIM/1 1AK AP1NY. 1 CNIINY NINT TNC PIAT SMDSN NOmll ONIMID! 1111 M NAIDM® NtlISCRNI ORpW/Cf AID M APPRMm ST M 10111 0► OWQRM !OR RSDONONM N M ONFNE a M IOMOINt OF O®S K NN70EOIN0 OOINIIK 11Li..,,- �-. w b•As C"N'WC B•IMWR DME �z g S o� w �C4 FFa N J 8 46xppBE w f v j ONN m PMN 1MOBEIONOOp —60113.01100 111 CNSRNNL NC MMI AUQUAY IL M SCAB f -W ANNA k MAIM 16MEIMI�IRO�CO. MC NNNTMNm1 1 of 1 No Dredge DocWootprint e-�esta5 - ZO?Ol r �f Dredge Disposal Area 1162 River Highway Mooresville, NC 28117 N ' SCf�'� Q:�PS�3 ��J'�P� M100- ff- Lepld DUKE ENERGY DIRECTIONS BY ROAD FORM Lake Use Permit Applicants and Contractors: Ease of locating the proposed project site canlavea big impact on permitting processing time. Please complete this form and return it along with your completed application to: DUKE ENERGY C/O LAKE SERVICES — EC 12 Q 526 SOUTH CHURCH STREET CHARLOTTE, NC 28202 Applicant's Name: Louis DeJesus Street Address (at lake): 20701 Bethelwood Lane Cornelius NC 28031 Lake Name: Norman Subdivision Name: Property Section: Lot #: City: Cornelius County: Mecklenburg State: NC Zip: 28031 Telephone: Cell 216-389-7883 Directions (from major road or highway): From I-77 North Bound, take Exit 28, left onto West Catawba Ave., Right onto Bethel Church Road, Right onto Bethelwood Lane, Property is on the left Descriptive Structure(s) on Property (i.e. brick garage, white fence, mobile home, etc.) *Note: Please use the back of this form if desired to draw us a map to the site. bob -09 - "brIVS2 MIMMI'ModoeLS� wmwl4mp YMIMRD amirmUll 3modagmun mmolvao's-A SHIP 11203z� -) f l;-n ! I 2 \-A J 0-3 (;I . ou� O's ........... AS 0 -nmn C C3 "Wit, bJ it 1* tc w t7'A — 7 Nor bob -09 - "brIVS2 MIMMI'ModoeLS� wmwl4mp YMIMRD amirmUll 3modagmun mmolvao's-A SHIP Louis DeJesus 20701 Bethelwood Lane Cornelius, NC 28031 Disposal Neighbors Finley William M III + Jeanne T Revoc TR ETA 1178 River Highway Mooresville, NC 28117 Hager Sidney B + Hallie 139 Robinson Road Mooresville, NC 28117 Excavation Project User's Agreement Letter (Please fill in the blanks. Please Print) Date - I TO: Duke Energy c/o Lake Services - EC12Q 526 S. Church Street Charlotte, NC 28202 RE: Ftxcavation For (Subdivision and Lot #'s or Other Project Name) (Lake/County/City) (Applicant'sll name ' .�` � L) ► S � e. � 5L hereby agrees to comply with all recommendations, requirements and/or conditions of Duke Energy Lake Services, General Permit(s) (if applicable) and other federal, state and local a ency requirements pertaining to the application to excavate for the purpose of ab (��-}- �-j '� 0 n rr P In addition, I/we have read and agree to comply with Duke's current `Shoreline Management Plan (SMP), much of which is repeated herein, and understand that written authorization must be obtained from Duke Energy Lake Services prior to beginning any activity within the FERC project boundary or on Duke Energy land. The excavation will be completed as described in the approved application and within eighteen (18) months from the date of written approval by Lake Services, unless specifically noted otherwise in the application or unless I/we obtain approval for a single, time extension (maximum of one year) in writing from Duke Energy Lake Services. I/we understand that if the SMP or other applicable rules change during any extension period, 1/we will be expected to comply with the new requirements to the maximum extent practicable. I/we also recognize that failure to complete the excavation within this build -out period will require the filing of a new application within the then -current SMP and the new application must include any applicable fees and security deposits. I/we attest to be the owner(s) or lease holder(s) of the land immediately adjoining the project boundary or Duke -owned peripheral strip where the excavation activity is to take place, or if not the owner or lease holder, I/tive have included proof of title to the property and written authorization from the owner(s) or lease holder(s) to carry out the proposal within the project boundary adjacent to their land. I/we attest to be the owner(s) or lease holder(s) of the land that will be used for equipment staging and disposal of excavated material or if not the owner or lease holder, I/we have included proof of title to the property and written authorization from the owner(s) or lease holder(s) to carry out the work on their land. Duke Emw Page 1 Rev: 6116117 I/we understand that all excavation work must be done directly in front of my/our property and within the third of the cove nearest my/our property or within any middle third of the cove that Duke Energy owns, or I/we have written authorization from the owner(s) or lease holder(s) to carry out the proposal within the project boundary adjacent to/on their land. I/we also understand that access channels must run perpendicular to the shoreline while within the third of the cove area that is nearest my/our property. 1/we understand that for proposed excavations, I/we must notify the appropriate local, state and federal agencies in advance of the activity by sending them a completed copy of Duke's Excavation Permit Application Form and other required information. Ifwe understand that written authorization and/or other permits may be required by some of these agencies and such required authorizations must be obtained before Uwe submit the final application to Duke Energy Lake Services. Uwe understand that except for maintenance excavations, any excavation exceeding 2000 cubic yards of material removed or any excavation or shoreline stabilization work needed to support an application that requires Federal Energy Regulatory Commission (FERC) review does itself require specific review and approval by the FERC before Duke Energy can issue any approvals. Ave agree that unless specifically approved otherwise in the application, explosives will not be used as part of this excavation activity. Uwe understand that every reasonable effort must be made to minimize any adverse impact on fish, wildlife and other natural resources. Ifwe understand that applicants in South Carolina proposing excavations that are not covered under the General Permit, or are greater than 150 cubic yards, must receive prior written authorization from the South Carolina Department of Health and Environmental Control (SCDHEC) or the US Army Corps of Engineers (as applicable) before submitting the completed application to Lake Services. I/we agree that excavation activities in North Carolina and South Carolina will not occur during the months of March, April, May and June because of the potential impacts to fish spawning areas. 1/we understand that trees and vegetation growing within or adjoining the lake play an important role in its overall environmental condition, and the ecological benefit the vegetation has on fish and wildlife habitat directly supports a sound and healthy lake environment. I/we also understand that unauthorized removal of shoreline vegetation (e.g. button bushes, willows, cattails, etc.) and/or disturbance of the shoreline buffer may result in suspension or denial of lake use permitting requests, forfeiture of security deposits and require re-establishment of vegetation at my/our expense, particularly if the disturbance is found to be in violation of state or local ordinances or impacts FERC project buffers. Doke Boggy Page 2 Rev 6/16/17 1/we agree that all excavated material will be placed in upland areas, landward of the project boundary, and confined to prevent erosion and sedimentation back into the lake or nearby streams. 1/we agree to adequately stabilize all excavated material and all disturbed shoreline to prevent erosion and runoff into the lake. 11we understand that the double handling of excavated material will not be allowed; therefore, all excavated material must be placed above the project boundary in one handling. I/we have designed the hydraulic excavation process (if any will be used) so that return water re- enters the lake in the same general vicinity and cove as the excavation, to the maximum extent practicable. I/we agree that the proposed excavation will not be for the purpose of creating additional shoreline, will not alter the project boundary or the full pond contour, and will not impact threatened or endangered species, historic properties, or environmentally -important areas, unless special public entity provisions were made in the application. I/we recognize that it is my/our responsibility to clearly locate in the field and label on my/our work area drawings any areas that require specific protection or avoidance during this excavation work. Examples of these protection/avoidance areas include but are not limited to, any Environmental Areas, Natural Areas or Impact Minimization Zones as identified by Duke; jurisdictional wetlands; historic properties; rare or threatened species; and buried gas, water, sewer, electric or communications lines. Ihve agree to provide my/our contractor with a copy of these work area drawings showing these areas to stress the necessary protection measures. I/we agree that if any archaeological resources (e.g. pottery shards, Indian artifacts, etc.) are discovered during the excavation, work shall be halted immediately. I/we will then notify Duke Energy Lake Services and the State Historic Preservation Office to determine what measures, if any, I/we must pursue to protect or salvage the archaeological resources. I/we agree that any excavation from within the project boundary will not exceed the volume as outlined in the application and will remove and disturb only what is absolutely necessary to achieve the project's stated purpose. I/we agree to be fully responsible for the permitted lake use and I/we understand that this responsibility is considered to transfer automatically along with ownership and leases of the adjoining tract. I/we understand Duke Energy representatives may issue Stop Work Directives for violations of the SMP and other consequences may result from such violations, including but not limited to suspension or cancellation of approved permits, increases in fees, modification or removal of non -complying structures and restoration of disturbed areas at my/our own expense or loss of any consideration for future lake use permits. 1/we agree to immediately comply with any Stop Work Duke °oar' Page 3 Directives, to fully cooperate with Duke Energy Lake Services and other agencies as necessary, and to perform the necessary remedial actions within the specified time frame. I/we agree to develop any required mitigation plans and to complete any required mitigation activities at my/our own expense within the specified time frames. I/we recognize that the excavation work is not considered complete and deposits will not be refunded until the mitigation requirements (if any) have been satisfactorily fulfilled. I/we agree to notifv Lake Services by phone when the excavation is initiated and to ensure that during the excavation period I/we will host Duke Energ!s approval letter in a clear waterproof bag at the lob site and visible from the water's edge. 1/we agree to notify Lake Services in writing when the excavation is completed (including any required mitigation measures) and that the excavation was completed per the approved application, so a close-out inspection can be performed. I/we recognize security deposits will not be refunded if any violations of the SMP or this user's agreement occur. I/we understand there will be no change in hydro project operations as a result of the excavation and/or utilization of the excavated area. 1/we agree to maintain the work area in a safe condition and to fully indemnify and save Duke Energy harmless from any and all claims, liability, loss or damage that may arise from this excavation project. 1/we understand that this user's agreement does not, in any way, constitute the transfer of any rights in real property and that my/our use and enjoyment of FERC project lands and waters shall not hinder the general public's lawful use and enjoyment of the same. Sincerely, LQL-6C_nT)P_, p. Applicant's Name (Print) Co -Applicant's Name (Print) Co -Applicant's Name (Print) Co -Applicant's Name (Print) Co -Applicant's Name (Print) AVpli_canVs Signature Co -Applicant's Signature Co -Applicant's Signature Co -Applicant's Signature Co -Applicant's Signature Duke rrwgy Page 4 Rev: 6/16/17