* DEQ: Permit application fees required for Virginia Water Protection permits - while detailed in 9VAC25-20 = are conveyed to the applicant by the applicable DEQ office Complete the Permit Application Fee Form and submit it per the instructions to the address listed on the form. Instructions for submitting any other fees will be provided to the applicant by DEQ staff. * VMRC: An application fee of $300 may be required for projects impacting tidal wetlands, beaches and/or dunes when VMRC acts as the LWB. VMRC will notify the applicant in writing if the fee is required. Permit fees involving subaqueous lands are $25.00 for projects costing $10,000 or less and $100 for projects costing more than $10,000. Royalties may also be required for some projects. The proper permit fee and any required royalty is paid at the time of permit issuance by VMRC. VMRC staff will send the permittee a letter notifying him/her of the proper permit fees and submittal requirements. * LWB: Permit fees vary by locality. Contact the LWB for your project area or their website for fee information and submittal requirements. Contact information for LWBs may be found at ECET - - M E n FOR AGENCY USE ONLY Notes: MAY 3 0 2025 25050485 JPA # By 9M APPLICANTS Part 1 - General Information PLEASE PRINT OR TYPE ALL ANSWERS: Ifa question does not apply to your project, please print N/A (not applicable) in the space provided. If additional space is needed, attach 8-1/2 x 11 inch sheets of paper. Check all that apply Pre-Construction Notification (PCN) Regional Permit 17 (RP-17)L1 NWP # (For Nationwide Permits ONLY - No DEQ- VWP permit writer will be assigned) County or City in which the project is located:Gloucaster. Waterway at project site: North River PREV7OUSACTIONS RELATED TO THE PROPOSED HORK (Inchde all federal, state, and local pre application coordination, site visits, previous pernits, or applications whetherisste, withdran, or denied) Historical information for past permit submittals can be found online with VMRC or VIMS Agency Action / Activity Permit/Project number, including any Date of If denied, give reason non-reporting Nationwide permits Action for denial previously used (e. g, NWP 13) ALL BAAAKOMTEAS 2e02- 025+ 4-10-ot Application Revised: October 2019 5 Part 1 - General Information (continued) 1. Applicant' S legal name* and complete mailing address: Contact Information: Ingeborg Marie Katharina Glasel Home Work 7791 Berkshire Lane Fax Gloucester, VA 23061 Cell e-mail State Corporation Commission Name and ID Number (if applicable) 2. Property owner(s) legal name* and complete address, if different from applicant: Contact Information: Home Tiger Enterprises Inc. Work 4401 Dominion Blvd. Fax Glen Allen, VA 23060 Cell e-mail State Corporation Commission Name and ID Number (ifa applicable) 3. Authorized agent name* and complete mailing Contact Information: address (if applicable): Home Jeff Watkins/Shoreline Structures, LLC Work P.O. Box 515 Fax Gloucester, VA 23061 Cell 804 815-0813 e-mail watkins49@cox.nel State Corporation Commission Name and ID Number (if applicable) * Ifn multiple applicants. property owners, and/or agents. each must bel listed and each must sign the applicant signature page. 4. Provide a detailed description of the project in the space below, including the type of project, its dimensions, materials, and method of construction. Be sure to include how the construction site will be accessed and whether tree clearing and/or grading will be required, including the total acreage. If the project requires pilings, please be sure to include the total number, type (e.g. wood, steel, etc), diameter, and method ofinstallation (e.g. hammer, vibratory, jetted, etc). Ifadditional space is needed, provide a separate sheet of paper with the project description. Shoreline Erosion Control and Pier Projects. -160 L.F. of headland breakwater - 1,350 c.yds of sand nourishment - spartina plantings - replace existing pier in the same footprint. Application Revised: October 2019 6 Part 1 - General Information (continued) 5. Have you obtained a contractor for the project? X Yes* No. *Ifyour answer is "Yes" complete the remainder of this question and submit the Applicant's and Contractor's Acknowledgment Form (enclosed) Contractor's name* and complete mailing address: Contact Information: Home Shoreline Structures, LLC Work Jeff Watkins P.O. Box 515 Gloucester va 23061 Fax Cell 804 815-0813 email Jwatins49@coxnet State Corporation Commission Name and ID Number (if applicable) * Ifmultiple contractors. each must be listed and each must sign the applicant signature page. 6. List the name, address and telephone number of the newspaper having general circulation in the area of the project. Failure to complete this question may delay local and State processing. Name and complete mailing address: Telephone number Gloucester Gazette Journal 693-3101 7. Give the following project location information: Street Address (911 address if available), 8718 Elmington Lane Lot/Block/Parcel#: T.m. 26-88. RPC 24605 Subdivision NA City / County Gloucester ZIP Code 23061 Latitude and Longitude at Center Point of Project Site (Decimal Degrees): / - (Example: 36.41600/-7630733) If the project is located in a rural area, please provide driving directions giving distances from the best and nearest visible landmarks or major intersections. Note: ifthe project is in an undeveloped subdivision or properly, clearly stake and identify property lines and location ofthe proposed project. A supplemental map showing how the property is to be subdivided should also be provided. State route 14 East of Gloucester Courthouse approximately 3 miles. Elmington lane is on right. #8718 is at the end. Call agent for appointment. 804-815-0815 8. What are the primary and secondary purposes ofand the need for the project? For example, the primary purpose may be "to protect property from erosion due to boat wakes" and the secondary purpose may be "to provide safer access to a pier. 99 Erosion Control Safe access to river and boating. Application Revised: October 2019 7 Part 1 - General Information (continued) 9. Proposed use (check one): x Single user (private, non-commercial, residential) Multi-user (community, commercial, industrial, government) 10. Describe alternatives considered and the measures that will be taken to avoid and minimize impacts, to the maximum extent practicable, to wetlands, surface waters, submerged lands, and buffer areas associated with any disturbance (clearing, grading, excavating) during and after project construction. Please be advised that mavoidable losses oftidal wetlands andlor aquatic resources may require compensatory mitigation. NA 11. Is this application being submitted for after-the-fact authorization for work which has already begun or been completed? Yes X No. Ifyes, be sure to clearly depict the portions ofthe project which are already complete in the project drawings. 12. Approximate cost oft the entire project (materials, labor, etc.): $>500k Approximate cost oft that portion ofthe project that is channelward of mean low water: $1 Tbd 13. Completion date of the proposed work: TBD 14. Adjacent Property Owner Information: List the name and complete mailing address, including zip code, of each adjacent property owner to the project. (NOTE: Ifyou own the adjacent lot, provide the requested information for the first adjacent parcel beyond your property line.) Failure to provide this information may result in a delay in the processing ofyour application by VMRC. Left side: tax map 27-30, Ingeborg Marie Katharina Glasel. 4401 Dominion Blvd, Glen Allen, VA 23060 Right side: t.m. 27-23C, Lindsay W. South Trust, 4804 Courthouse st. Ste 1A Williamsburg, VA 23188 Application Revised: October 2019 8 Part2 - Signatures 1. Applicants and property owners (if different from applicant). NOTE: REQUIRED FOR ALL PROJECTS PRIVACY ACTSTATEMENT The Department of the Army permit program is authorized by Section 10 of the Rivers and Harbors Act of 1899, Section 404 of the Clean Water Act, and Section 103 of the Marine Protection Research and Sanctuaries Act of1972. These laws require that individuals obtain permits that authorize structures and work in or affecting navigable waters ofthe United States, the discharge of dredged or fill material into waters of the United States, and the transportation of dredged material for the purpose pf dumping it into ocean waters prior to undertaking the activity. Information provided in the Joint Permit Application will be used in the permit review process and is a matter of public record once the application is filed. Disclosure ofthe requested information is voluntary, but it may not be possible to evaluate the permit application or to issue a permit if the information requested is not provided. CERTIFICATION: I am hereby applying for all permits typically issued by the DEQ, VMRC, USACE, and/or Local Wetlands Boards for the activities I have described herein. Iagree to allow the duly authorized representatives ofany regulatory or advisory agency to enter upon the premises pfthe project site at reasonable times toi inspect and photograph site conditions, both in reviewing a proposal to issue a permit and after permit issuance to determine compliance with the permit. In addition, I certify under penalty oflaw that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate thei information submitted. Based on my inquiry of the person or persons who manage the system or those persons directly responsible for gathering thei information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. Iam aware that there are significant penalties for submitting false information, including the possibility off fine and imprisonment for knowing violations. Glasel Applicant' S Legal Name (printed/typed) (Use if more than one applicant) 6 A1 / Applicant's Signature (Use if more than one applicant) 5-15-25 Date Tiger Ent. Inc. Property Owner' s Legal Name (printed/typed) (Use if more than one owner) (Ifdifferent from Applicant) ay Eiz IHK. ProperlyOwner's Signature (Use if more than one owner) 5-15255 Date Application Revised: October 2019 9 Part2-Signatures (continued) 2. Applicants having agents (fapplicable) CERTIFICATION OF AUTHORIZATION Watkins I(we), Glasel hereby certify that I (we) have authorized (Applicant's legal name(s)) (Agent's s name(s) to act on my behalf and take all actions necessary to the processing, issuance and acceptance of this permit and any and all standard and special conditions attached. We hereby certify that the information submitted in this application is true and accurate to the best of our knowledge. (Agént's Signaruré) (Use ifmore than one agent) 5-1525 (Date) A A TApplicant' s Signature) (Use ifr more than one applicant) -43 (Date) 3. Applicant's having contractors (f applicable) CONTRACTOR ACKNOWIEDGEMENT Glasel Shoreline Structures, LLC I (we), have contracted (Applicant's legal name(s)) (Contractor's name(s)) to perform the work described in this Joint Permit Application, signed and dated M/ 5-2 5 We will read and abide by all conditions set forth in all Federal, State and Local permits as required for this project. We understand that failure to follow the conditions ofthe permits may constitute a violation of applicable Federal, state and local statutes and that we will be liable for any civil and/or criminal penalties imposed by these statutes. In addition, we agree to make available a copy of any permit to any regulatory representative visiting the project to ensure permit compliance. If we fail to provide the applicable permit upon request, we understand that the representative will have the option of stopping our operation until it has been determined that we have a properly signed and executed permit and are in full compliance with all terms and conditions. Shoreline Structures, LLC P.O. Box 515 Contractor's name or name of firm Contractor's or firms address Gloucester va 24061 Coptractor' S signature and title Contractor's License Number Hel Applicant's signature (use ifmore than one applicant) 5-15-25 Date Application Revised: October 2019 10 Tiger Part3-Appendices (continued) Appendix B: Projects for Shoreline Stabilization in tidal wetlands, tidal waters and dunes/beaches including riprap revetments and associated backfill, marsh toe stabilization, bulkheads and associated backfill, breakwaters, beach nourishment, groins, jetties, and living shoreline projects. Answer all questions that apply. Please provide any reports provided from the Shoreline Erosion Advisory Service or VIMS. NOTE: It is the policy of the Commonwealth that living shorelines are the preferred alternative for stabilizing tidal shorelines (Va. Code $ 28.2-104.1). Information on non-structural, yegetative alternatives (i.e., Living Shoreline) for shoreline stabilization is available at tmaimalaemal zone/living shorelines/nder.htm, 1. Describe each revetment, bulkhead, marsh toe, breakwater, groin, jetty, other structure, or living shoreline project separately in the space below. Include the overall length in linear feet, the amount of impacts in acres, and volume of associated backfill below mean high water and/or ordinary high water in cubic yards, as applicable: 160 L.F. of headland breakwater 1,350 c.yds. sand nourishment Spartina plantings 2. What is the maximum encroachment channelward of mean high water? 58 feet. Channelward of mean low water? 33 feet. Channelward of the back edge oft the dune or beach? NA feet. 3. Please calculate the square footage of encroachment over: Vegetated wetlands 0 square feet Rock - : à 24-70 Non-vegetated wetlands ZA-70 square feets Subaqueous bottom 6570 square feet, pock - - 3840 Dune and/or beach square feet SANb a 273 C 4. For bulkheads, is any part oft the project maintenance or replacement of a previously authorized, currently serviceable, existing structure? Yes No. Ifyes, will the construction of the new bulkhead be no further than two (2) feet channelward of the existing bulkhead? Yes No. Ifr no, please provide an explanation for the purpose and need for the additional encroachment. Application Revised: October 2019 17 Tig1 Part 3 - Appendices (continued) 5. Describe the type of construction and all materials to be used, including source ofbackfill material, if applicable (e.g, vinyl sheet-pile bulkhead, timber stringers and butt piles, 100% sand backfill from upland source; broken concrete core material with Class II quarry stone armor over filter cloth). NOTE: Drawings must include construction details, including dimensions, design and all materials, including fittings if used. Class II & II armor stone, A1 & gabion stone as core. 6. Ifusing stone, broken concrete, etc. for your structure(s), what is the average weight of the: Core (inner layer) material 5-50 pounds per stone Class size Al * qobiers Armor (outer layer) material 150-1,500 pounds per stone Class size I * 11 7. For beach nourishment, including that associated with breakwaters, groins or other structures, provide the following: Volume of material 900 cubic yards channelward of mean low water cubic yards landward of mean low water 3.2 cubic yards channelward of mean high water cubic yards landward of mean high water Area to be covered 2730 square feet channelward of mean low water 24-72 square feet landward of mean low water E culsg, aRschannelward of mean high water cubie ads landward of mean high water 56 Source of material, composition (e.g. 90% sand, 10% clay): go% Coarsesd Method cay of transportation and placement: Thock heavey &21A A Describe any proposed vegetative stabilization méasures to be used, including planting schedule, spacing, monitoring, etc. Additional guidance is available at hmamsaadsaasnadacsaaeaiain: SparTiug ALTeflcc & PTEws zt'oucite Application Revised: October 2019 18 a Map 8348 725 a 4 - w - d 4 e S - à e E e 9 1 3 WARE MECE - 5 A R - & Roio 3 4 2 n S ar A GLEN ROY LA b EMO ORIL ONRa * a - a 5 3 / 3 à S P he : : E - o Gae - / o EW30 C CUNLU R HASSE 6 EWSTENO LA 4 a f * : 4 P 4 A C 3 de 3 a 3 d S * a e & 1 4 - - E : - - a 3 E 4 LON 3s PCaS 000T 563 0912 HLHON, 1a 83AI8 2 f % 1. 86 7N 9 Ve 06€ SN - e PMIe & FIII AB N 1 OPDe 68 a LSix 97. > 22.94 002-7 a 4" 19 59 C a CE: - 879 0 2 $35 Pies S - Breakwater Section Sand fill continues to the upper edge of wetlands/lawn grass interface class II stone 3' wide crest @ +2.5' MHW Wetland plantings 1.5:1 2:1 2.5' MHW Sand Fill 2.6' MLW 11.5 Existing substrate 1-2' apron 22-24' base 3 E P S / a V 8 3 4 / de Marsh Sill Section Sand fill to match MHW class II stone 3' wide crest @ +1.5' MHW 1.5:1 * 4 1.5' V MHW 4 2:1 2.6' MLW 4 Existing marsh scarp Existing substrate 12-14' base