20190953 Ver 1_Shoreline Stabilization_20190719

PAID, 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
Shoreline Stabilization Application Form 2 0 1 9 0 9 5 3
Three copies of the application (including attachments) and the application fee should be sent to:
Ifsending via US Postal Service Ifsending 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 n ,
Raleigh, NC 27699-1617 Raleigh, NC 27604 ��►(/ A r
A. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name:
Mailing Address:
/' o
Nl .
_V10 01
Telephone Number: 8a8 b Z -t)4 ft"umber: �1a8- a1'1 -'{Z28
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:
htti)://www saw usace army mil/Portals/59/docs/regulatory/readocs/Permits/SAMPLE AGENT AUTHORI
ZATION FORM.odf)
Name: �ohN�e s
Company Affiliation:
Mailing Address:
RS
Telephone Number: $�:8 Fax Number:
E-mail Address: wnci-t'oe'.'V2."
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: 0- Nearest Town: t.�QQA
Lake/ river/ ocean adjacent to property: L Kazoo
Property size (acres): - ark
Subdivision name or site address (include phase/lot number): C "{ '1� 9'10
Gac\e ,V�,.J , tSL a860 \
Directions to site - please incVde road names and numbers, landmarks, etc.:
Latitude (in decimal degrees) 35.'I b Tg l Longitude (decimal degrees) - 81. 35L4S6
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): 'Rem. cig4o_\
6. Describe proposed work (include di ssion as to Kw hardening of shoreline has been (1
avoided, or why it is necessary): } �aCe ` vc, � osS �r► l ru�� a T
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, ri rap, retaining walls, etc.) in square feet:
ri(J�oo t- �W ST �E ('mac✓
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
k fill, excavation, rip rap, retaining walls, etc.) in square feet:
�00S� 4SO-� (_l (����1
Temporary impacts (temporary clearing, construction corridor) in square feet:
Al 41 h e
10. Please describe the vegetation above the normal pool lake level/ Normal Water Level and 50
feet landward to be impacted (number
M, _77— s (
trees, for instance):
✓oSS�
11. Signature
Owner/Agent's Signature*1 A NCAC 02H .0502(f)] ate
'Agent's signature is valid on y if an authorization letter from the owner is provided.
FORM: SSGP 02-2017 Page 2 of 4

FL
Norma
SI
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
FORM: SSGP 10-2013 Page 3 of 3

,W catawba county Geospatial Real Estate Search
MAKING. urree. errrEr. Information Services
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Parcel: 370417126310, 970 18TH AVE CIR NW HICKORY, 28601
Owners: ZAGAROLI DAVID PETER, ZAGAROLI NANCY K
Owner Address- 316 4TH ST NW
Values - Building(s): $539,800, Land: $412,800, Total- $952,600
This map/report product was prepared from the Catawba County, NC Geospatial Information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and labeling information contained on this map or data on this report. Catawba County promotes and recommends
the independent verification of any data contained on this map/report product by the user. The County of Catawba, its employees, agents, and
personnel, disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or may
arise from this map/report product or the use thereof by any person or entity.
Copyright 2014 Catawba County NC
07/15/2019

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FOX RIDGE
FAST BURKE FARMS
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Petra Mills Bethlehem
1173 Shiloh
IR 20 min
62mi
970 18th Ave Circle NWEkory,
North Carolina 28601, United States
r Viewmont
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Construction projects, traffic, or other events may cause actual conditions to differ from these results. Map and traffic data 0 2019 HERE'.
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B 970 18th Ave Circle NW, Hickory, North C...
Millersville
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IR 20 min
62mi
970 18th Ave Circle NWEkory,
North Carolina 28601, United States
r Viewmont
Hickory
Regional'
Airport
Hickory
,Longview
Sweetwater
Lv Bing
ut
Hildebran _ ?:
A 1173 Shiloh Church Rd, Hickory, North Ca...
Im
L—A k
FOREST HILLS
;¢�9 i20t9 Llcrosort Gorporarloll�70fe 11BtE'.
These directions are subject to the Microsoft® Service Agreement and are for informational purposes only. No guarantee is made regarding their completeness or accuracy.
Construction projects, traffic, or other events may cause actual conditions to differ from these results. Map and traffic data 0 2019 HERE'.
St Stephens Oxford Pi
+.
16
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r_--- OM9"ME
B 970 18th Ave Circle NW, Hickory, North C...

bing maps
A 1173 Shiloh Church Rd, Hickory, North Carolina 28601, United States
B 970 18th Ave Circle NW, Hickory, North Carolina 28601, United States
A 1173 Shiloh Church Rd, Hickory, North Carolina 28601, United States
20 min, 6.2 mi
Moderate traffic (6 min delay)
Via NC -127
Local roads
'('
1
Depart Shiloh Church Rd toward Lynwood Ln
0.2 mi
()Turn
2
right onto NC -127
Pass Exxon/Circle K in 3.9 mi
4.6 mi
r>
3
Turn right onto 20th Ave NW
0.5 mi
4.
Turn right onto 2nd St NW
0.2 mi
5
Bear left onto 20th Ave Dr NW
0.2 mi
6
Bear left onto 18th Ave Dr NW
0.4 mi
0'
7
Turn right onto 18th Ave Circle NW
0.2 mi
8•
Arrive at 18th Ave Circle NW on the right
The last intersection is 18th Ave Dr NW
B 97018th Ave Circle NW, Hickory, North Carolina 28601, United States

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: °1qO �$i� (�fe • C��e. County:
Owner:
Print
Contractor/agent: _
Signatu
Print N Signa
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, �\ C 3ZO \ hereby state that I have been informed of the Catawba
Riparian Buffer Rule. Ar4work 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 plan(s) and specification(s), and other supporting
materials.
11
Signature (owner): Date: 30 ��

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catawba county Geospatial Real Estate Search
LIVING. ,,,,E,. Information Services
Mill ,,.„,„
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Parcel- 370417126310, 970 18TH AVE CIR NW HICKORY, 28601
Owners: ZAGAROLI DAVID PETER, ZAGAROLI NANCY K
Owner Address:
Values - Building(s): $539,800, Land: $412,800, Total: $952,600
This map/report product was prepared from the Catawba County, NC Geospatial Information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and labeling information contained on this map or data on this report. Catawba County promotes and recommends
the independent verification of any data contained on this map/report product by the user. The County of Catawba, its employees, agents, and
personnel, disdaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or may
arise from this map/report product or the use thereof by any person or entity.
Copyright 2014 Catawba County NC
05/30/2019

0catawba county Geospatial Real Estate Search
�' MAKING. LIVING. K[n,K. Information services
I!-
N
WN 1 in= 100ft
Parcel: 370417126310, 970 18TH AVE CIR NW HICKORY, 28601
Owners: ZAGAROLI DAVID PETER, ZAGAROLI NANCY K
Owner Address:
Values - Building(s): $539,800, Land: $412,800, Total: $952,600 _ 53►,35��5G
35.%b99k
This map/report product was prepared from the Catawba County, NC Geospatial Information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and labeling information contained on this map or data on this report. Catawba County promotes and recommends
the independent verification of any data contained on this map/report product by the user. The County of Catawba, its employees, agents, and
personnel, disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or may
arise from this map/report product or the use thereof by any person or entity.
Copyright 2014 Catawba County NC
M1011110*1

W catawba county Geospatial Real Estate Search
N•► MAKING. LIVING. W,E,. Information Services
N
W+E 1 in=80ft
Vs
Parcel: 370417126310, 970 18TH AVE CIR NW HICKORY, 28601
Owners: ZAGAROLI DAVID PETER, ZAGAROLI NANCY K
Owner Address: 316 4TH ST NW
Values - Building(s): $539,800, Land: $412,800, Total: $952,600
This map/report product was prepared from the Catawba County, NC Geospatial Information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and labeling information contained on this map or data on this report. Catawba County promotes and recommends
the independent verification of any data contained on this map/report product by the user. The County of Catawba, its employees, agents, and
personnel, disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or may
arise from this map/report product or the use thereof by any person or entity.
Copyright 2014 Catawba County NC
07/15/2019

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DUKE ENERGY INTERNAL USE ONLY Construction 6%, DUKE
Date Received App Fee Amt Application -r ENERGY.
version 19a
Duke Energy Lake Services
Site ID HEP Fee Mail Code EC12Q
526 S. Church St.
Charlotte, NC 28202
I. APPLICANT INFORMATION (applicant mailing address and contact information)
Name*
---C)W-(4 o- Primary Phone*
Address* n r`o t g1j- Secondary Phone
City*LA �eko—a4 State* Zip Code
Email
ll. PROPERTY I
OT permit)
gas (.. �z- coo I.-,
gav Z+'l-'1222?
Is there an existing dock or other facilities ❑ Yes
If yes, include Dock Tag #. If tag
along the shoreline property or over the Lake?
❑ No
cannot be located, note that here. *
Address*�fe
�l� c . Ghia¢_, .L ] .
County*
City* ;&e-,,o,,State*E
'� Zip Code* Lake* � p
Subdivision
Lot(s)
F -s31
Latitude and longitude of the property. Please use a service/software to acquire the location information. Values should be provided
in Decimal Degrees format (35.1245).
Latitude (e.g. 35.12345)*
Example service: http://getlatlong.net/
Longitude (e.g. -80.12345)*
III. PROPOSED ACTIVITY (check all that apply)
❑ New/Modification of Existing Structure
❑ Maintenance of Existing Structure
❑ New/Modification of Existing Shoreline Stabilization
® Maintenance of Existing Shoreline Stabilization
❑Transfer of Ownership (check box if you want a copy
❑ Other (Describe below. If the activity involves an irrigation
of permitting history ❑ )
withdrawal, include the pump capacity.)
Structure size (square
feet)
Is dock covered?❑
Yes ❑ No Number of slips ❑
Is structure a
common use dock?
❑Yes* ❑ No Number of jetports ❑
*If yes, see special note in Section vil
Shoreline Stabilization Length of
stabilization (feet) L Distance from shoreline (feet)
Materials
Brief Description of
the Activity
Describe briefly the
existing structures
over land and water
(include sq ft)

IV. Additional Requirements (Include with application; limit document sizes to 11"x 1T' or smaller)
You must include the following items with your application (unless specifically excluded for your application type).
Survey stamped/signed by a professional licensed surveyor
❑ showing the location of the existing or proposed structure
and/or survey of the existing or proposed stabilization (not
required for transfer)
❑ Photos along property shoreline and photos of existing
structures and/or stabilization in or near the water
❑ Application fee (check only, payable to Duke Energy)
❑ Signed Applicant's User Agreement Letter
V. Application Processing
Plan and profile drawing showing all measurements,
❑ elevations, and irrigation line routing (not required for
transfer UNLESS tag number can't be located; sketch can be
used in such cases, not required for shoreline stabilization)
Local and state permits (building permits or exemption
letter required for all structure applications at Catawba-
❑ Wateree lakes in NC; Tega Cay, SC; Kershaw County, SC;
NCDWR approval required for shoreline stabilization in NC;
not required for other applications)
Habitat Enhancement Program payment (required onlyfor
❑ New/Modified structures at Catawba-Wateree and Keowee-
Toxaway lakes and shoreline stabilization at Keowee-
Toxaway)
Application is reviewed and determined if complete. Fields with an asterisk are required.
If application is not complete or does not include all items and information listed in the checklist, the application
will be returned as incomplete.
• A Duke Energy representative will visit the site to conduct a visual inspection.
• Applicant will be notified of approval or denial, typically via email.
VI. Directions by Road
Directions by Road*
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2-11.2r..�.—
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VII. Application Submission
Please complete, print and sign this application. Then enclose all items required per Section IV above and submit to the
address below.
Duke Energy Lake Services
Mail Code EC12Q
526 S. Church St.
Charlotte, NC 28202
I agree the information contained within is accurate:
nt signature *
Common Use Dock Co -Owner Signature(s) and Information (all owners of common use docks must submit a signed
Applicant's User Agreement and application fee)
Name
Address
Name
Address
Signature
Signature
Attach additional sheets if there are more co-owners

DUKE ENERGY PRIVATE FACHAT ES
"APPLICANT'S USER AGREEMENT"
(Fill in blanks with required information. Please Print)
Date j lq
TO: Duke Energy
c/o Lake Services - EC12Q
526 S. Church Street
Charlotte, NC 28202
RE: (Lake Name)(LakeAddress)
(Applicant's full name) L-aagtay\ hereby
agrees to comply with all requirements and co tions set forth by Duke Energy's Lake Services
(Duke Energy) office, and any federal, state or local agencies pertaining to our application to
construct and/or maintain a
ZZ�,o (LSA D on Lake In addition;
Mwe have read and agree to comply with Duke Energy's Shoreline Manage e t Guidelines
(SMG) and understand that written authorization must be obtained from Duke Energy prior to
beginning any activity/construction within the Federal Energy Regulatory Commission (FERC)
Project boundary. The construction will be completed as described in the approved application
and within twelve (12) months following the date of approval by Duke Energy. An extension
will be considered for legitimate extenuating circumstances (as determined by the sole discretion
of Duke Energy) provided a specific timefiame in which to complete the construction, not to
exceed an additional 12 months, is provided in writing to Duke Energy by the applicant. Failure
to complete construction within the 12 -month build -out period or any Duke Energy approved
extension will require the applicant to file a new application that complies with the then -current
SMG. The new application filing will include any applicable fees and security deposits.
Uwe attest to be the owner or lease -holder of the tract of land immediately adjoining the Project
boundary where the proposed private facility is to be constructed.
I/we agree to comply with all FERC orders (as modified or interpreted by FERC), with all other
applicable FERC Rules and Regulations implemented by Duke Energy; and with all rules or
regulations imposed on Duke Energy by any governmental agency.
Page 1 of 5
Rev 1MOM

Uwe understand the physical location of my/our lot in relation to the common property line with
Duke Energy, if any, the FERC Project boundary, and any deeded flood easements or required
building setbacks.
Uwe understand that this lake was constructed as a working hydropower reservoir for the primary
purpose of producing cost-effective electric energy and that this remains as the lake's primary
purpose. I/we understand the lake and its associated hydroelectric facilities are operated by Duke
Energy under the terms of a license issued by the FERC and there will be no change in hydro
project operations as a result of the construction and/or use of any facilities that Uwe may be
allowed to place within the FERC Project boundary or on any Duke Energy -owned property.
Uwe understand during drought conditions Duke Energy may request reduced usage or
discontinued usage of any water withdrawal or related systems, until such drought conditions
improve. Failure to do so may cause possible removal of the system and/or any other permitted
facilities that Uwe may have, and any costs associated with removal of the facilities will be
assessed to the lot owner.
Uwe understand lake levels will rise and fall over time in response to weather events and hydro
project operations and Duke Energy does not guarantee an approved facility will always have
sufficient water depth to be accessible by boat or for other water depth related recreation
activities.
Ave acknowledge Duke Energy provides no guarantee of any specific quantities (except those
identified in the FERC license) or quality of water in the lake.
Uwe understand the facilities to be installed and/or maintained are my/our property and Uwe
therefore agree to be fully responsible for the permitted reservoir use including maintaining
facilities in good repair. If the private facility is deemed unsafe by Duke Energy, I/we agree to
repair or remove the private facility at my/our own expense and within the specified timeframe
set by Duke Energy.
I/we understand Duke Energy approval of the requested reservoir use in no way constitutes
assignment of any interest in real property Duke Energy may have (i.e. land rights). The approval
is granted and maintained solely at Duke Energy's discretion. Uwe also understand the permitted
use may be revoked at any time by Duke Energy or its successors for any reason whatsoever. If
the approval is revoked, Uwe agree to remove the facility at my/our own expense within the
specified timeframe set by Duke Energy.
Uwe understand ownership/interest in a Common Use Facility or residential marina eliminates
the option of having a separate private facility on any other owned or leased lot within the
affected subdivision.
Uwe understand this lake is open for use by the general public and that maintaining safe and
lawful public use is one of the primary lake management objectives of Duke Energy.
Page 2 of 5
Rev 11IM016

Uwe understand the use for which we are applying is a private use and it should not interfere with
the general public's safe and lawful use of the lake.
Ifwe understand lake use permit holders have the authority to prevent others from trespassing on
the facilities Uwe have built. Uwe also understand Uwe, however, do not have any authority to
impede anyone from pursuit of the lawful public recreation enjoyment of FERC Project lands
and waters. Except as specified otherwise in the SMG, other Duke Energy documents (e.g.
Public Safety Plans), or a separate lease agreement, anyone may fish around/under facilities built
by others, may walk/wade/fish within the FERC Project boundary, boat in the lake's waters, etc.
without having to get anyone's permission to do so.
Uwe agree to fully disclose all information regarding the approved private facility to any
prospective buyer/leaseholder of the property and any new owner/leaseholder. Uwe agree to
notify Duke Energy immediately of any sale/transfer of the property, including the name and
address of the new owner and to transfer the permit and/or Duke Energy lease to the new owner.
Uwe agree the adjacent Duke Energy Project property, if any, shall be used exclusively for non-
commercial recreational purposes and that I/we shall not rent or otherwise allow third parties
(except for temporary use by guests, family members, and leaseholders of the residential
property) to use any facilities permitted to me/us by Duke Energy.
Uwe agree not to allow any use of the adjacent property, and will exercise due care and diligence
to prevent all other persons that are affiliated with my/our property (including invitees, family
members, guests, etc.), to violate an applicable federal, state or local law or regulation. Examples
include, but are not limited to nudity, illegal discharge of firearms or fireworks, controlled
substance abuse, public drunkenness, public urination or defecation, or other activities
determined to be a nuisance by law enforcement officials.
Uwe agree to exercise all care and due diligence to preserve and maintain the character of the
Duke Energy's adjacent property, if any. Uwe agree to comply with the Duke Energy vegetation
management requirements as stated in the SMG_ Ifwe agree further to not allow sewage,
including discharge from septic tanks (or similar facilities) or boat holding tanks, garbage, trash,
or other waste material to be discharged or dumped into the reservoir, tributaries or adjacent
property.
Uwe understand that as an adjoining property owner Uwe can make no change in land form of
land within the FERC Project boundary or land owned by Duke Energy, if any, such as grading,
excavation or filling without prior written approval by Duke Energy.
Uwe agree for myselffourselves, members of my/our family, guests and invitees that Uwe assume
all risks of personal injury or property damage incident to my/our occupancy and use of the
FERC Project boundary or land owned by Duke Energy, if any; including, but not limited to, any
personal injury or property damage which may be sustained as a result of flood waters or in
connection with the rise and fall of water in the reservoir as a result of floods or of the operation
of Duke Energy's hydroelectric facilities. Uwe as the adjoining property owner(s) further agree
Uwe will indemnify, protect, defend, and save harmless Duke Energy from any and all loss, cost,
Page 3 of 5
Rev 11MM16

claims damages, expenses, judgments and causes of action for all injuries and damages sustained
by the members of my/our family, guests, and invitees arising or claimed to have arisen in
connection with their occupancy or use of the Duke Energy permitted facility(s).
1/we agree if any action is taken by Duke Energy to enforce any provision, covenant or
agreement contained in this user agreement or Duke Energy SMG or if Duke Energy is required
to retain an attorney to enforce any provision, covenant or agreement contained in this user
agreement or SMG (including, without limitation, the payment of fees due hereunder or the
removal of an encroachment constructed in violation of this user agreement or SMG), then Duke
Energy shall be entitled to recover all of its reasonable costs associated with such an action,
including but not limited to, attorneys' fees and court costs incurred in such action and/or
enforcement.
I/we understand certain activities specified in the SMG are prohibited because of environmental
concerns, boating capacity limitations, safety considerations and other reasons.
Uwe specifically waive any claim against Duke Energy for consequential damages arising out of
or relating to this application, Duke Energy's approval or denial of it, or subsequent revocation
of approval, and 1/we specifically understand and acknowledge that, because Duke Energy can
revoke the permitted use at any time, Ihve am/are not entitled to reliance damages.
Ifwe understand the proposed facility will be used only for the purposes described in the
information submitted to Duke Energy and other appropriate governing bodies for approval.
I/we understand every reasonable effort must be made to minimize adverse impacts on fish,
wildlife, and other natural resources.
I/we understand trees and vegetation growing within the Project boundary play an important role
in the overall environmental condition of the lake. The ecological benefit the vegetation has on
the fish and wildlife habitat supports a sound and healthy lake environment. IAve also understand
unauthorized removal of shoreline vegetation and/or disturbance of the shoreline buffer may
result in suspension or denial of lake use permitting requests and require me/us to re-establish the
vegetation, if the disturbance is found to be in violation of the state or county watershed buffer
regulations or Duke Energy's vegetation management requirements as stated in the SMG.
I/we agree to maintain any prescribed mitigation activities that are required in order to gain
approval for facility construction, as long as the facility exists.
Ihve recognize Ilwe have the continuing responsibility to ensure that the constructed facilities are
maintained in good repair, including, but not limited to maintenance of the facilities, and proper
erosion control within the permit area and along the shoreline, and agree to take all reasonable
steps necessary to meet this responsibility. Ifwe agree to maintain all facilities within the Project
boundary and on Duke Energy -owned property, if any, in a sound condition and in a neat
appearance and pay all costs for said maintenance.
Page 4 of 5
Rev 1119=6

Uwe understand Duke Energy representatives may issue Stop Work Directives for any
violation(s) of the SMG or engagement in prohibited acts or activities on Duke Energy property,
if any, as specifically identified in the SMG. Uwe understand persons found to be in violation
will be subject to Duke Energy sanctions which can include, but are not necessarily limited to: 1)
restoration of the impacted area at the person's expense; 2) loss of consideration of any future
lake use permitting activities for up to five years for improper vegetation removal or until
vegetation is satisfactorily, re-established (even if there is a change in property ownership); 3)
revocation of a previously issued permit and loss of consideration of any future lake use
permitting activities and/or reinstatement of the revoked permit; 4) increase in fees; 5)
modification or removal of non -complying facilities; and/or 6) further legal action being taken.
by Duke Energy.
Uwe agree that if any historic or archaeological resources are discovered during construction of
an approved activity the applicant must stop work immediately and contact Duke Energy. Uwe
understand that in the event that anyone discovers a potential site of archaeological or historic
significance including any gravesite within the Project, the individual must immediately notify
Duke Energy.
Uwe acknowledge Duke Energy has the right to charge reasonable user's fees for private. use of
its property, if any, and the Project and failure to pay any applicable user's fees in a timely
manner can result in the suspension or cancellation of any previously approved lake use permit.
Uwe agree to notify Duke Energy when construction is completed and during the construction
period, Uwe will post the Duke Energy approval (to be provided by Duke Energy) at the job site
visible from the water's edge.
Ap Ip�licant Name r
Lake Street Address
l� . Q' -
City/State/Zip Code
sag (Oka- oo(,g
Preferred contact Phone Number
Email Ad
Page 5 of 5
�J
Applicant 4ignature
Home Mailing Address /
City/State/Zip Cod
F;L9 AtI--1 a.z8
Home Phone Number
b I3ol lq
Date
Rev 1119/1016