20190946 Ver 1_Shoreline Stabilization_20190716

State of North Carolina
Department of Environment a Yatural Resources
Divisio ?V es
Division of Water Resources 15A NCAC 02H .0500 —Water Quality Certification, Shoreline ation
FORM: SSP
10-20•
Shoreline Stabilization Application Form 2 0 1
9.0 9 4 8
One copy of the application (including attachments) and the application fee should be sent to:
Division of Water Resources
401 & Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
I. Applicant Information [15A NCAC 02H .0502(a)] I ^ Q
1. Owner Information 11i I
Name: &v:0 eller
Mailing Address: 13l a Mar! n P_r_Pe, r ke (--n _
�Y1oo �r csv ,►�� . cyc._ a S 1 � "7
Telephone Number: 'iog - 7i,3 - 30Qq Fax Number:
E-mail Address:1-Cry�,11�r a�hev�clf �ckSt�-*in+l. Cbm
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.0 ) must be attached if the Agent has signed this application form.
Name:
Company Affiliation:
Mailing Address:
Telephone Number: `10+x- [o Lon -5111 Fax Number: qo&4- QLot)
E-mail Address: 016Csea1taa-1 U; a_� LL k nd -ZA rea.rn _ +ne-A-
Person to receive the Certification Approval: Sf y) %ce. Edo
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

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. r�c1A_l� Nearest Town: Moorc.�y►<<P_
Subdivision name
^orr site address (include phase/lot number): ►
_^V �31a �r czLn1i`�_
44 /r. ,_ .a[
Directions to site - please include road names and numbers, landmarks, etc.:
Latitude (in decimal degrees) 35, 6d5 I lol Longitude (decimal degrees) ' SO. 4 38 5
S. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.):
6. Property size (acres): b. P�5
7. Lake/ river/ ocean adjacent to property: Iib rrncX1
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): 5keCoe_ - SIODPTn.-Aal( m -}+i n
and `noulc(Qr r "Lr� o
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:
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: d �n�12_ 105 SW e�q ;mpaeA)
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): 9'-aiss u�r:
l
f 15A NCAC 02H .0502(f)l
1A 20/9
Date
'Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 3

Lake
(At Full Pond/ Normal Water Level) ,
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ft 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
Kevin Miller
136 Mariner Pointe Ln.
Mooresville, NC 28117
FORM: SSGP 10-2013 Page 3 of 3

7/9/2019
610 East Center Avenue, Mooresville, NC to 136 Mariner Pointe Ln - Google Maps
Google Maps 610 East Center Avenue, Mooresville, NC to 136 Mariner Pointe Ln Drive 9.1 miles, 20 min
610 E Center Ave
Mooresville, NC 28115
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Turn left onto E Iredell Ave
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Turn left onto NC -150 WE Plaza Dr
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6.
Turn left onto Mariner Pointe Ln
0 Destination will be on the right
--
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136 Mariner Pointe 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.
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DEDUON SURVEYS
GRAPHIC 8CALE —FEET
14 PIN
PHYSICAL SURVEY
FOR
JENNIFER L. & KEVIN M.
MILLER
LOT 65 OF PINNACLE SHORES BUBO. P3
136 MARINER POINT LANE - MOORESVILLE, NC
DAVIDSON TOWNSHIP - IREDELL COUNTY
SCALE; 1" - 40'
DEDMON SURVEYS
CHUCK POOVEY, PLS 173762
ROBERT DEDMON, PLS #3899
3704 NC HIGHWAY #t6 NORTH
P.O. BOX 494 - DENVER, NC 28037
PHONE, 70a148314908
FAX: [phone]
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1, DAVID C. POOVEY, CERT" THAT THIS PIAT WAS
DRAI&W FROM AN ACTUAL SURVEY WOE UNDER NY
S-tfFERVTOM D8 2429, PO 24.74}(PB 27, PG 104;
NUMBER AND SEAL THIS 21 DAY OF NOV., AD
2017. A - Fl
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,'s' '' �'ti of Fr`!'136 Mariner Pointe Ln.
Kevin Miller
i
ooMresville, NC 28117

Project P
Owner:
Contract
CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
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 0213.0243 (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, K Q_v't n 1f _' ] lQ r , hereby state that I have been informed of the Catawba
Riparian duffer 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 ap 7d plan(s) and specification (s), and other supporting
materials. / / /
ignature (owner) 1 Date: -7 9 WI9
State of North Carolina I Environmental Quality I Water Resources
512 N. Salisbury Street 11611 Mail Service Center I Raleigh, NC 27699-1611
919.707.9000