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Home My WebLink About20190952 Ver 1_Shoreline Stabilization_20190719/ State of North Carolina Department of Environment and Natural Resources Division of Water Resources 15A NCAC 02H .0500 - Water Quality Certification, Shoreline Stabilization Division of Water Resources FORM: SSGP 10-2013 Shoreline Stabilization Application Form Three copies of the application (including attachments) and the application fee should be sent to: Division of Water Resources 1 401 & Buffer Permitting Unit ✓ 2 0 1 90952 1617 Mail Service Center " Raleigh, NC 27699-1617 I. Applicant Information (15A NCAC 02H .0502(a)] 1. Owner Information �'® Name: gc)% (4-V U Mailing Address: ;2(0 2'6 rrudl w nn d 7J. G , c to 1 -I -t A( -C • .7-k2_11 Telephone Number: 7oy-577- 7(oS8 Fax Number: E-mail Address: roL"P-C+• bi`au Q rs (2 61 o, -A An 54-'6L'1 1'e-, I , coin 2. Agent/ Contact Person Information A signed and dated copy of the Agent Authorization letter (a form can be downloaded here: http:/Iwww.saw.usace.army.mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTH ORIZATION FORM.pdf) must be attached if the Agent has signed this application form. Name: CIC. LJS o n Company Affiliation: ' aw 's ' UL;v;'�a Owna r Mailing Address: SSS Fresh iw C10Vec, S -C • -ItO - Telephone Number. 7oq 5o to 74en Fax Number: '&&3-5 31- S tv 55 E-mail Address:6 44,%l T vx • ell�� Person to receive the Certification Approval:ky 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, FORM: SSGP 10-2013 Page 1 of 3 etc.), 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. 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) �cCounty: cNearest Town: Subdivision name or site address (incjRde phase/lot number): dt Directions to site - please include road names and numbers, landmarks, etc.: Latitude (in decimal degrees) -IL X Longitude (decimal degrees) -0 /0 5. Describe the existing land use or condition of the site at the time of this application (residential, undeveloped, etc.): 6. Property size (acres): D, qD 3 X,, r �S 7. Lake/ river/ ocean adjacent to property: 8. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or why itisnecessary): �r,T- � 1�Lyla,J ./ecLCs eco J)"4 19fJ f'AM-r_ Lt 4t,Cinn�.s%//I , i�/d 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: 9D9.� rf 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: /f 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): Alp irrc� --r. r b c, N It Owner/Agent's ignature* [15A NCAC 02H .0502(f)l Date Agent's signature is valid only if an authorization letter from the owner is provided. FORM: SSGP 10-2013 Page 2 of 3 Full Pond/ Normal Water Level SI La ke (At Full Pond/ Normal Water Level) t I L5�e-- '5kc�� 'r / Please approximately sketch the following information on this plan (provide dimensions for each item, such as 10 ft x 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 R SAMPLE AGENT AUTHORIZATION FORM PROPERTY LEGAL DESCRIPTION: LOT NO. 3 PLAN NO. PARCEL ID: STREET ADDRESS: Please print: Property Owner: Property Owner: cis i � • The undersigned, registered property owners of the above noted property, do hereby authorize of cldw-�'O's (Contractor / Agent) (Name of consulting firm) ' to act on my behalf and take all actions necessary for the processing, issuance and acceptance of this permit or certification and any and all standard and special conditions attached. Property Owner's Address (if different than property above): Cz� 7e . 2�� Telephone: _70V -S-77- 7 5� We hereby certify the above information submitted in this application is true and accurate to the best of our knowledge. Authorized Sign re orized Signature C� Date: Date: 6 &6.otf Alqq i Ll- aX' x 14ov�eFul/ 44- r X o?oa LF Z,4 3 o?ol, 77 IF ANN ��I I. -1 lk �Pprox� %, g;f gap bu ccs r� V A rN Il l+ b • a:Aj r A. •i =� tr Ax - -'w~ •`� 'ts� Jw T•..S# '`msµ'. �J& i}:�.-� ► WL �.., If I s �'��sSrl►` � =fi At t'f f'�G.r �.r�+r '� ��j%i�fi M� �N,,` i k ��^. /� a ° P ��i` ,r! • t �ti i, �—._ { rte/. �7A:1 � •�iy�i!{��` �1►; .r .i4lR n., _+�, )�';� v f .�� 7/12/2019 3990 Charlotte Hwy, Clover, SC 29710-8083 to 17431 Snug Harbor Rd, Charlotte, NC, 28278-8626 Directions - MapQuest -3 �}YOUR TRIP TO: �,f �C�J�3 17431 Snug Harbor Rd, Charlotte, NC, 28278-8626 9 MIN 1 4.7 MI R Est. fuel cost: $0.46 Trip time based on traffic conditions as of 2:56 PM on July 12, Print a full health report of your car with HUM 2019. Current Traffic: Light q19, vehicle diagnostics (800) go6-2501 1. Start out going northwest on Charlotte Hwy/SC-49 toward Blucher Cir. Then 0.05 miles 0.05 total miles In 2. Make a U-turn at Blucher Cir onto Charlotte Hwy/SC-49 (Crossing into North �Y, Carolina). If you reach Executive Ct you've gone about 0.2 miles too far. Then 0.39 miles 0.44 total miles T 3. Charlotte Hwy/SC-49 becomes York Rd/NC-49. Then 0.85 miles 1.29 total miles r+ 4. Turn right onto Grand Palisades Pkwy. Pass through 1 roundabout. Grand Palisades Pkwy is 0.4 miles past Red Fez Club Rd. If you are on S Tryon St and reach Langston Dr you've gone about 0.1 miles too far. Then 2.93 miles 4.22 total miles TS. Enter next roundabout and take the 2nd exit onto Snug Harbor Rd. Then 0.49 miles 4.71 total miles ® 6. 17431 Snug Harbor Rd, Charlotte, NC 28278-8626, 17431 SNUG HARBOR RD. Your destination is just past Terryglass Ln. If you reach New Mark Ave you've gone a little too far. Oa Save to My Maps Use of directions and maps is subject to our Terms of Use. We don't guarantee accuracy, route conditions or usability. You assume all risk of use. https://www.mapquest.com/directions/list/1 /us/sc/clover/29710-8083/3990-charlotte-hwy-35.106658,-81.041425/to/us/nc/chadotte/28278-8626/17431-... 1/2 7/12/2019 3990 Charlotte Hwy, Clover, SC 29710-8083 to 17431 Snug Harbor Rd, Charlotte, NC, 28278-8626 Directions - MapQuest r L O , a Pri yt+avdldnd�� I P Or urffeld Ct Q� if / / I urffeld Ct Q� https://www.mapquest.Gom/directions/list/l /us/sc/clover/29710-8083/3990-charlotte-hwy-35.106658,-81.041425/to/us/nc/charlotte/28278-8626/17431-... 2/2 / / I f / https://www.mapquest.Gom/directions/list/l /us/sc/clover/29710-8083/3990-charlotte-hwy-35.106658,-81.041425/to/us/nc/charlotte/28278-8626/17431-... 2/2