20110396 Ver 2_Shoreline Stabilization_20200807

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 8/6/2020 1:37:02 PM (Submittal)
Approve by Montalvo, Sheri A 8/7/2020 1:23:47 PM (Non -DOT - Approver)
• The task was assigned to Montalvo, Sheri A 8/6/2020 1:37 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.
Primary Contact Email *
Owner Information:
Name:
*
Email:
*
Phone Number:*
Mailing Address:*
Is there an agent working on the
project?*
Agent/Consultant Information
.................................................................................................................
Name:
Company Affiliation:
Email:*
Phone Number:*
[e-mail]
Rease provide an email address for payment and requests for more information here.
David Walthall
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
8455 Sherryn Run
Address Line 2
city
Terrell
Fbstal / Zip Code
28682
r Yes
r No
Terri Kindley/Shannon Miller
Lake Norman dredging
[e-mail]
[phone]
(xxx)xxx-xxxx
State / Frovince / Region
NC
Country
US

Mailing Address:* Street Address
PO Box 3156
Address Line 2
city
State / Province / Region
Mooresville
NC
Fbstal / Zip code
Country
28117
US
Asigned and dated copy of the Agent Authorization letter:*
2020-08-06 13.29.20.pdf 291.82KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 021-1.0502(a) & (b)]
....................................................................................................................................................................................
Project Name:* David Walthall/Shoreline Stabilization
If your project has a formal name please use this. If your project does not have 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.*
C Upload File
r Lookup address
Upload Map: 830CD7CD-94BA44B4-AB20-
F70AFD36CE23. jpeg
Latitude:* 35.574380
Longitude:*-80.969620
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*
60DBAD 10-24C9-4A46-BBD3-
I.
2FB9D2F81047.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.)*
9908BB6D-A6CA 4560-962E-
5.42MB
FOFB4B2DD968.jpeg
5535DCFD-28D4-436E-B96B-
4.72MB
993D7EB6D086.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:* 8455 Sherryn Run Terrell NC 28682 Lots 1&2
hclude phase/lot nunber
Directions to site:*
177 exit 36 NC-150 towards Lincolnton 6.5 miles
Left on Kiser Island Road 1.5 miles
Right on Sherryn Run 0.2 miles
Rease include road names and numbers, landrrarks etc.
5. Describe the existing land use or condition of the site at the time of this application:*
Residential
Residential, undeveloped, etc.
6. Property Size 1.768 AC/ 0.914 AC
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
Shoreline stabilization to bare and eroded areas 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
V 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.)
600 sq 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.)
None
square feet
11. Please describe the vegetation above the normal pool lake level/ normal water level and 50 feet
landward to be impacted:*
(nunber of trees, for instance)
None
Sketch: ED4C880C-2205-4DF7-83FF-
880.4KB
AADC4D1FB69DJpeg
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):
a $240.00 for impacts to lake (below normal water level) of less than 1 acre
a $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
o I intend to electronically sign and submit this form.
Full Name:* Terri Kindley
Signature: f

Initial Review
Is this accepted into the review
process?*
Project Number:* 20110396
Select Reviewer:*
Select Reviewing Office
Has payment been received?*
What amount is owed?*
rYes allo
Version:* 2
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

PROPERTY LEGAL IDESMIPTIOU:
LOT NO: PLAN NO: PARCEL
ID:
STREET ADDRESS:
Please print:
Property
Owner: _ft) 1 D (,-_-_ I _—T Pr —L
Property
Owner:
The undersigned, registered property owners of the above noted property, do hereby
authorize
of
(Co ctor/Agent) " (Marne of consulting firm)
to act on my behalf and take all actions necessary fbr the processing, issuance and
acceptance of -this permit or certification and any and all standard and special conditions
attached.
Properly Owners Address (ifr different than property above):
Telephone: 9 f q" ?Fo r a
We hereby certify the above information submitted in this application is true and
accurate tothe best of our knowledge. j c ; �,� �x i i; f 1

�,. Eocauon of any excavauT
5 Lake
3 (x ` j (At Felt Pond/ Wmai Heater Level)
Full Po
rzz::::
Plan View
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Terrell
8455 Sherryn Run

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