20200800 Ver 1_Shoreline Stabilization_20200617

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 6/16/2020 5:14:45 PM (Submittal)
Approve by Montalvo, Sheri A 6/17/2020 11:55:12 AM (Non -DOT - Approver)
• The task was assigned to Montalvo, Sheri A 6/16/2020 5:15 PM

Submission Form
I. Applicant Information [15A NCAC 02H .0502(a)]
Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all
mandatory questions are answered.
Owner Information:
Name:*
Ruth Waggoner
Email:*
[e-mail]
Phone Number:*
[phone]
(xxx)xxx-xxxx
Mailing Address:*
Street Address
2341 Robinwood Rd
Address Line 2
City
Gastonia
Fbstal / Zip Code
28054
Is there an agent working on the r Yes
project?* r No
Agent/Consultant Information
Name: * Terri Kindley/Shannon Miller
Company Affiliation:* Lake Norman dredging
Email: * [e-mail]
Phone Number:* [phone]
(xxx)xxx-xxxx
State / Rovince / Fbgion
NC
Country
US

Mailing Address:* Street Address
PO Box 3156
Address Line 2
City
State / Province / Pegion
Mooresville
NC
Fbstal / Zip Code
Country
28117
US
Asigned and dated copyof the Agent Authorization letter:*
Review and sign document(s) _ DocuSign.pdf 896.27KB
2020-06-16 16.56.57.pdf 298.81KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 021-11.0502(a) & (b)]
.....................................................................................................................................................................................
Project Name:* Ruth Waggoner/shoreline stabilization
If your project has a formal name please use this. If your project does not hake a formal name, please identify your project by
the owner name and proposed activity (Jones Property Access Road, Smith Guest House, etc.) List in parentheses any
other names that have been used to identify the project in the past.
1. Provide 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.*
f• Upload File
r Lookup address
Upload Map: 6A8AB7FA E09A 4458-AF5B-
286.73KB
DA0378309CAC. jpeg
Latitude:* 35.587310 Longitude:*-81.006540
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, and construction access corridors. You may use the
diagram under section 12.normal pool lake level/normal water level*
E1FB6EBA 8F45-4176-B082-
881.03KB
24AFFFD17508.jpeg
Please use the diagram at the link below:
https://edocs.deq.nc.gov/WaterResources/0/edoc/616616/Shoreline%20Layout.docx
3. Attach a photograph of the shoreline/ buffer proposed to be stabilized. (Include a scale of some sort- a
yard stick, shovel handle, etc.)*
2EB5F853-6A80-4631-B12F-
263.5KB
6245DA89B170. jpeg
8CB1 A331-9F78-4FB7-BBSA
257.73KB
89C085E97291. jpeg
4. Location of the property (where work is to be conducted)
Nearest Town:* Terrell
County:* Catawba

Lake/ river/ ocean adjacent to Norman
property:
Subdivisions name or site address:* 7373 Herring -Waggoner Point Sherrills Ford NC
hclude phase/lot nunber
Directions to site:*
177 exit 36 Highway 150 towards Lincolnton 9.2 miles
Right on Little Mountain Road 1.2 in
Right on Mount pleasant Road 0.7 in
Right on dockside 0.6 M
Right toward Burton Street 100 feet
Left on Burton Street 0.1 M
Right on Herring Waggoner 350 feet
Aease include road narres and nunbers, landmarks etc.
5. Describe the existing land use or condition of the site at the time of this application:*
Residential
Pesidential, undeveloped, etc.
6. Property Size 0.71 acres
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
Shoreline stabilization to existing Rip Rap using Rip Rap.
All work to be done by water using barge and long reach.
8. How will the work be done?* r From Land
rJ From Water
9. Total amount of disturbance below the normal pool lake level/ normal water level:*
(including all clearing, back fill, excavation, rip rap, retaining walls, etc.)
780sq ft
square feet
10. Total amount of disturbance above the normal pool lake level/ normal water level and 50 feet
land -ward: *
(including all clearing, back fill, excavation, rip rap, retaining walls, etc.)
0
square feet
11. 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)
None
Sketch: 6D2A904E-2A92-437A AB34-
732.13KB
656279A664BC. jpeg
DE4A8DDF-1 BE0-48F3-A741-
3.68MB
F034B1480D76. jpeg
Application Fee:
Once the application has been accepted. You will need to send a corresponding fee in with the appropriate DWR#. The
application fee is as follows (pursuant to G.S. 143-215.3D):
o $240.00 for impacts to lake (below normal water level) of less than 1 acre
o $570.00 for impacts to lake (below normal water level) of greater or equal to 1 acre
By digitally signing below, I certify that:

• I have given true, accurate, and complete information on this form;
• I agree that submission of this form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the
"Uniform Electronic Transactions Act")
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes
(the "Uniform Electronic Transactions Act');
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
• I intend to electronically sign and submit this form.
Full Name:* TerriKindley
Signature:
��

Initial Review
Is this accepted into the review
process?*
Project Number:* 20200800
Select Reviewer:*
Select Reviewing Office
Has payment been received?*
What amount is owed?*
rYes allo
Version:* 1
Alan Johnsomeads\adjohnsonl
Mooresville Regional Office - [phone]
r No Payment Needed
r Fee Received
r Need Fee - send electronic notification
r $240.00
f $570.00

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AGENT AUITHORIZATEOM FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO:
PLAN NO:
STREET ADDRESS:
Re
Please print:
Property
Owner:
Property
Owner:
PARCEL
ID:
The undersigned, registered property owners of the above noted property, do hereby
authorize
k7lJL &-43�
:f4L-
(/4ntractor/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 Owners Address (if different than property above):
Telephone: —Io — -1 [ SZ (D I C�'LI
We hereby certify the above information submitted In this application is true and
accurate to the best of our knowledge.

1850
w
�a
mc�
my
1901
� 9
7373
1815
Sherrills Ford
1975
Herring
Waggoner Point
Pi
1934

Temporary impacts (temporary clearing, construction corridor) in square feet:
10. 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):
11. Signature
Owner/Agent's Signature I15A NCAC 02H .0502(1)1 Date
Agent's signature is valid only if an authorization letter
from the owner is provided.
12. Please approximately sketch the following information on this plan and provide dm siorfs far
each item:
a. All proposed vegetation clearing
b. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
C. Location of rip mp or fill to be placed below the Full Pond/ Normal Water Level elevation
d. Location of any proposed structures such as buildings, retaining walls, docks, etc.
e. Location of any excavation or dredging below the Full Pond/ Normal Water Level eleC� nn'
11
Lake
utr Fan Pond/ Morrrk>f water ) ��
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�D
Full Pond/
pre 9
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Plan View I�b
https://files.nc.gov/ncdeq/WateF4/*200ualityjSurface%2OWate ... OPermits/SSGP%2002-2017%2OShoreline%2OForm_final.docx
514/20, 3:03 PM
Page 3 of 5

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Lake
(At full Pond/ Normal Water Level)
Side View
10 ft. bank
Side Vi
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3 ft. below full pond water level 4 ft. above full pond water level 2 ft. additional clearing
'if necessary
Existing bank
FORM: SSGP 02-2017 Page 4 of 4

LO Ea
12,
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Project Name/address:
Gwrlei:
Print
Cor' LL Mr/agent, J k A I
Print
FFERV
Signatura-.
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pproval is Signature
ror the purpose and design application is a violation of the Buffer g described in
02H -0506 and Rule. Site s Q shou Your application. Impacts not indicated in the
15q NCAC 02B .0243 g P�cmc work should be provided '
( )1
Trees are not allo,h�Q �n the application. (15A iVCaC
.d to be removed from Lone 1 of the But
approved. be
�
Minimal shaping hose trees that are severelyer (within 30 of the full pond elevatio
p d and sloping undermined along the immediate shoreline 1 n), unless
p g along she immediate shoreline is allowed. �5 Benchin Q A NCAC 02B .0243(6 n be removed_
i;, oradina in -' )1
�nz bu, ter is not allowed. Excessive disturbance of
Beaches, irnpervious oa11°gr impervious
cover. [1$q (NCAC 02B .024
by the Division. T Walkways, 3 (6)j
here are limitation on size ford<s. are not allowed in the pu„er unless specificall
Work to b� �-SA iVCACO2B .02='3(4) and 6 ' Yapproved
conducted from land ()�
Work corridor should be must indicate an access and indicate an
material must be described, The a ythat ar=e approved access corridor shall be r•zstoered s- in `0 be re outside the buffer- moved• ►he
[15A NCAC 02H .0502 and 15A NCAC 02B ,O�a3 lg °' sp°il, constructior. Stormwater cannot be ( •U
discharges must be Piped or channeled for direct dischara
d at the natural elevation and discharged tie to the lake'
sheet floe atnon- Ali constructed erosive velocities to the lake ii5 g prior to entering d storjL1se er
- A NCAC 02B . 3 (S) (6 j� the bu;; er directed as di;; use or
�' . )-
A °'��edae,;'enc of /Voei�icacion
Riparian Bufier Rule. hereby state that I have been informed
Any work conducted in the bufi`er., not specificall
by the Division of Water Resources (DWR), is a viola=' °i the Catawba
taken such that the construction will be built withi 1 stated in the application and a
iron and subject to enforce approved
Qualit�� CerCifiCation and rt,
-` n substantial compliance and i� en of drirgence will be
materials. Rules, she approved of the a0�
Plan(s) and specifications LinR
(), and othersupportinQ
Signature� 1
(owner-.)•/•�_
Date: