20191289 Ver 1_Shoreline Stabilization_20190925

State of North Carolina
Depa�tpent of Environment and Natural Resources
DWR
t� 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 4) 9 1 2 8 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)]
1. Owner Information
Name: Hln.n
Mailing Address:
Telephone Number: 7(x3- U5?,p- 389 l Fax Number:
E-mail Address: cc nd1x r)QVxx (3DQm(i ,I cc)M
2. Agent/ Contact Person Information
SEP 2 5�
1p�rn4:a�`i�c� �ectao;,
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
htto://www.saw.usace.armv.mil/Portals/59/docs/reizuiatory/reRdocs/Permits/SAMPLE AGENT RUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name:
Company Affiliation: 1\�Qjru rcd Giceet1 SCS 5 Sci ►c'F" 1. L LC,
Mailing Address:
Telephone Number: 110LA - LflLQb - 5111 Fax Number: 'SOLI - CQt oD - 5cting
E-mail Address: w'kndS-�ream
Person to receive the Certification Approval: JC1nic-e L eX�
11. Project Information [15A NCAC 02H .0502(x) & (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: mT-ckle n , r Nearest Town:
Subdivision name or site address (include phase/lot number): 21OG I l -', nnamonTee. Lr)
Directions to site - please include road names and numbers, landmarks, etc.:
See Qt4ac3neccE
Latitude (in decimal degrees) 35-gi 88882, Longitude (decimal degrees) r Sb, $43 y 3
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): J�e5kdm X03 New duS.e lnq bo; 1 �'
6. Property size (acres): 1.501 ac -MS
7. Lake/ river/ ocean adjacent to property: �or mcx.Y�
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): =,ns+a-ll VA die-06:6ne- wa-�Lo-,+ h
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
off.5 10-e-1 r,
b-e1r, i 2.50 SO rX ,mrv►n--1
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: below
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) grass 60(yc.r'
d; 64or6oance -f c> 5o
A0 ] 3- Z GI - (.0 - 2e, ►c�
Owner t_'_s Signat SA NCAC 02N .0502(M Date
Agent's signature is va15only if an authorization letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 3

Full Pond/
Normal Water Level
m '� � � =
Shoreline
C --T -�
La ke
(At Full Pond/ Normal Water Level)
\/R Ftelcl s�cn-
No krees �'emo�ed
YI n t mat d x 4ur6o nc e_
tQ 6u��er
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
Alan and Kimberly Cunningham
20911 Cinnamon Tree Ln.
Cornelius, NC 28031
FORM: SSGP 10-2013 Page 3 of 3

9/182019 610 Fast Cana AAnue, Mooresville, NC to 20911 Cinnamon Tree Ln - Google Maps
Google Maps 610 East Center Avenue, Mooresville, NC to 20911 Drive 10.2 miles, 20 min
Cinnamon Tree Ln
610 E Center Ave
Mooresville, NC 28115
t
1. Head south on Evergreen St toward E Center Ave
-
14S (197 ft)
Take S Main St, NC -115 Sand 1-77 S/US-21
S to Bethel
Church Rd in Cornelius
18 min (9.5 m)
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2. Turn right onto E Center Ave
0.6 mi
41
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1.6 mi
4
4. Continue onto NC -115 S
2.1 mi
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5. Turn right onto Langtree Rd
1.1 mi
6. Use the left 2 lanes to turn left onto the Interstate
77S/US 21 Sramp
0.2 mi
7. Merge onto 1-77 S/US-21 S
2.9 mi
8. Take exit 28 for US -21
- 0.2 mi
9. Merge onto W Catawba Ave
0.7 mi
Drive to Norman Colony Rd
2 min (0.7 m)
r� 10. Turn right onto Bethel Church Rd
0.3 mi
r' 11. Turn right onto Norman Colony Rd
0.4 mi
20911 Cinnamon Tree Ln
Cornelius, NC 28031
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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9/162019 610 Fast Caller Avenue, Mooresville, NC to 20911 Cinner on Tree Ln- Google Maps
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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 recordsand 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.

9/4/2019
Google Maps 20911 Cinnamon Tree Ln
20911 Cinnamon Tree Ln - Google Maps
Imagery ©2019 Google, Imagery ©2019 Maxar Technologies, Orbis Inc, U.S. Geological Survey, Map data ©2019 100 ft
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9/4/2019
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0911 Cinnamon Tree Ln.
Cornelius, Nc 28031

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Project blame/address: o, o o i 1 Ir -e-41- LTJ- � � County: Al 0-C,
Owner:
Print
Contractor/agent: N
Print
re
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)j
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 0213 .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
1,_ 4� A V'A, CL3 k)'%Q C34& W\ , hereby state that I have been informed of the Catawba
Riparian Buffer Rule. Any wok 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 � �
Sigra ure,t)
6wner): Date: C9 !
State of North Carolina I Environmental Quality I water Resources
_ 12 N. Saiisburw Street 116111 NAM Service Center 1 RaldgK NC 2?699-1611.
919.107.9000