20190974 Ver 1_Shoreline Stabilization_20190719

State oo li 'a
Department of Environment and NatOre& esou
DWR
Division of Water Resoucc s
15A NCAC 02H .0500—Water Quality Certification,Shoreline Stabilization
Division of Water Resources
FORM: SSGP 10-2013
Shoreline Stabilization Application Form 2 0 1 9 0 9 7 4
Three copies 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 �'� \ (1 — r,
Raleigh, NC 27699-1617
\r'5
Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: Ghordon a,Sh;on / Louise- abh;ori - nisi-
Mailing Address: tom.0 k�oX 5 AO
C`orr�el� uS, NIC d8O31
Telephone Number: toy- ant - to-N Fax Number:
E-mail Address: gordanca.skt i- ro ,1.Cnm
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/dots/regulatory/regdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name:
Company Affiliation: Chime(' A- ne e �eCyC(,nc� ,1 C.
Mailing Address: (a A8 Idae t-G.r i-1
ooresv►lle, NIC
Telephone Number: -704-1Dh0- 51[[ Fax Number: 104-(iu3- Sctlici
E-mail Address: C6nSeuwal(5 1.1.);1-165--reurn. rle.t'
Person to receive the Certification Approval: J 1n►c . &A-cc,
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)
County: =rcdell Nearest Town: `ooresv )te.
Subdivision name or site address (include phase/lot number): Undeveloped Lo-1-'
I\l's W(pd41Lo 15a5 ee.jOr I(osresv►lle,NO— 38111
Directions to site - please include road names and numbers, landmarks, etc.:
See 0.+ acl-,9C3
Latitude (in decimal degrees) 35. 511 y(1 a Longitude (decimal degrees) —8O, 9)5 001
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): U n1levdol3e.d wooded io-4'
6. Property size (acres): 'a.S acres
7. Lake/ river/ocean adjacent to property: Nor r .n
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): 5ha.l)e. ) , tns (Yyr-1--', n�
and bo cl er V 4 \T r a p
9. Will work be conducted from land? i/' From water? V
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:
3' k e1o„ ( I) qq7 oc 0-f4)
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
I
square feet or acres: lo��
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): ,EllraES...bc.)F-Per
no tees rernrnaPdA n r(Yk1 diS+t)rhance#o b Fier
r
4D1 d Gal& 0.1S mai) "Ft-ts,4e, "iidtain
Owner/Agent's Signature* [15A NCAC 02H .0502(f)1 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)
3 ' I��low
Full Pond/
Normal Water Level
- H. MI - NMMMI
Shoreline
' aho v 2 No ---reed rerrbJed
�Y1► fv% rno-I d► �-� r�xcnc
boKer
'-1 c16 ` I er\ fh
lo '
ACCESS
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
David Gordon Cashion
Undeveloped Lot
PIN# 46244761525
Mooresville, NC 28117
FORM:SSGP 10 2013 �✓e s i d e 3 5 �rt cr i cars IP Page 3 of 3
'moort.5v, 11e ,NC a31

7/17/2019 610 East Center Avenue,Mooresville,NC to 354 Greyfriars Rd,Mooresville,NC 28117-Google Maps
610 East Center Avenue, Mooresville, NC to 354 Drive 12.2 miles, 26 min
Greyfriars Rd, Mooresville, NC 28117
610 E Center Ave
Mooresville,NC 28115
Ad jace.4 o nde\relop .d le+
t 1. Head south on Evergreen St toward E Center Ave 1�d
14s(197ft) tU 3 514 Gtre.Jr tC��5
Take NC-1100 to Torrence Chapel Rd in Davidson
23 min(11.3mi)
r' 2. Turn right onto E Center Ave
0.5 mi
41 3. Turn left onto S Church St
0.4 mi
r 4. Turn right onto E Wilson Ave
1.5 mi
t 5. Continue onto NC-1100/Brawley School Rd
5.6 mi
t 6. Continue straight onto NC-1100
1.7 mi
¢ 7. At the traffic circle,take the 2nd exit and stay on
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Drive to Greyfriars Rd
3 min(0.8 mi)
41 8. Turn left onto Torrence Chapel Rd
0.4 mi
41 9. Turn left onto 3012/Greyfriars Rd
® Continue to follow Greyfriars Rd
0 Destination will be on the right
0.4 mi
354 Greyfriars Rd
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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CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
?TV A, qual.116 (5-an5
Project Name/address: Crcrey�ri ar5 hct r)lcnresu e,NC. air I'7 County: T redel L
Owner: t)ld(t1OM l�►110JN bNIt� 6 M (t€J.)1074
Print Signature
Contractor/agent: C 17(', Slone t.�eet CJ J nc511_LC r� t'�.
Print J Signature
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, (hvic1 lrtordonCaskion , 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 Rules, the approved plan(s) and specification(s), and other supporting
materials. ,^ r��,'`,, asimorp / /, nSignature (owner): �d 60001 `j 1ee Date: `/9
1
arn
State of North Carolina I Environmental Quality I Water Resources
512 N.Salisbury Street 11611 Mail Service Center I Raleigh,NC 2 76 9 9-1 611
919.707.9000