20210714 Ver 1_Shoreline Stabilization_20210701

Submission Form
Pre -Filing Meeting Information
Before submitting this form please ensure you have submitted the Pre -Filing Meeting Request Form as we will not be able
to accept your application without this important first step. The Pre -Filing Meeting Request Form is used in accordance
with 40 C.F.R. Section 121.4(a) "At least 30 days prior to submitting a certification request, the project proponent shall
request a pre -filing meeting with the certifying agency" and in accordance with 40 C.F.R. Section 121.5(b)(7), and (c)(5)
all certification requests shall include documentation that a pre -filing meeting request was submitted to the certifying
authority at least 30 days prior to submitting the certification request. Click here to read more information on when this
form is needed prior to application submission or here to viewthe form.
Attach documentation of Pre -Filing Meeting Request here:
Tim & Dori Kirkland - Prefile Approval.pdf 758.69KB
Pre -fling Meeting or Request Date 4/8/2021
ID# 20210714 Version 1
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 * [e-mail]
Rease provide an err -ail address for payrrent and requests for pure infornation here.
Owner Information:
Name: * Tim & Dori Kincaid
Email: * timhkirkland@charter. net
Phone Number:* [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
4324 30th St Ln NE
Address Line 2
City
State / Frovince / Region
Hickory
NC
Fbstal / Zip Code
Country
28601-8453
US

Is there an agent working on the
project? *
Agent/Consultant Information
.................................................................................................................
Name:
Company Affiliation:*
Email:
Phone Number:*
Mailing Address:*
F Yes
r No
Charlie Washburn
Marine Construction LLC
[e-mail]
[phone]
(XXX)XXX-XXXX
Address
1173 Shiloh Church Road
Address Line 2
City
Hickory
Fbstal / Zip Code
28601-7855
Asigned and dated copyof the Agent Authorization letter:*
Tim & Dori Kirkland - Agent Auth Form.pdf 1.51MB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* Kirkland - Hickory NC
State / Province / Fbgion
NC
Country
United States
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 acti\ity (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.*
r Upload File
r Lookup address
Upload Map: Tim & Dori Kirkland -Directions and GIS.pdf 1.62MB
Latitude:* 35.799933 Longitude:* 81.270576
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*
Tim & Dori Kirkland - Drawings &
3.47MB
Summary.pdf
Please use the diagram at the link below:
https://edocs.deq.nc.gov/WaterResources/0/edoc/616616/Shoreline%2OLayout.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.)*

Tim & Dori Kirkland - Property Pic.pdf 1.1MB
4. Location of the property (where work is to be conducted)
Nearest Town:* Hickory
County:* Catawba
Lake/ river/ ocean adjacent to Hickory
property:
Subdivisions name or site address: * Catawba Shores. 4325 30th St Ln NE Hickory NC 28601
hclude phase/lot nun ber
Directions to site:*
Printed map and directions included above.
Rease include road narres and numbers, landmarks etc.
5. Describe the existing land use or condition of the site at the time of this application:*
Residential, undeveloped lot.
Ibsidential, undeveloped, etc.
6. Property Size .82
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
We plan to place riprap along the shoreline because it is undermined.
8. How will the work be done?* I7 From Land
r From Water
9. Total amount of disturbance below the normal pool lake level/ normal water level:*
(including all clearing, backfill, excavation, rip rap, retaining walls, etc.)
262 perm, 0 temp
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.)
262 perm, 800
temp
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)
Some small bushes and small trees.
Sketch:
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:
o I, the project proponent, hereby certifies that all information contained herein is true, accurate, and complete to the

best of my knowledge and belief
o I, the project proponent, hereby requests that the certifying authority review and take action on this CWA 401
certification request within the applicable reasonable period of time.
o I agree that submission of this Shoreline Stabilization online form is a "transaction" subject to Chapter 66, Article 40 of
the NC General Statutes (the "Uniform Electronic Transactions Act');
o 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');
0 1 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 the Shoreline Stabilization online form.
Full Name:* Charlie Washburn
Signature:

Initial Review
Is this accepted into the review
process?*
Project Number:* 20210714
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

UP] 4 Z k ff TA ti I : M t]
PROPERTY LEGAL DESCRIPTION:
LOT NO:
STREET ADDRESS:
4325 3001 St Ln f
Hickory NC 28601
Please print:
Property Owner
Tim Kirkland
Property Owner: Dori Kirkland
PLAN NO:
PARCEL ID: 372515638640
The undersigned, registered property owners of the above noted property, do herebyauthorize
Charlie Washburn
(Contractor/Agent)
of -Marine Construction LLC
(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):
(mailing) 4324 301h St Ln NE__
Hickory NC 28601
Telephone: - 828-256-46SB
We hereby certify the above information submitted in this application is
best of ur knowledge.
Authorized Signature
Date
Authorized Signtiru
Y// _�_az
Date
tothe

4/8/2021
1173 Shiloh Church Rd to 4325 30th St Ln NE, Hickory, NC 28601 - Google Maps
Google Maps 1173 Shiloh Church Rd to 4325 30th St Ln NE, Drive 7.2 miles, 13 min
Hickory, NC 28601
I x
Can=ogle
Map data 02021 2000 ft
1173 Shiloh Church Rd
Hickory, NC 28601
t 1. Head southwest on Shiloh Church Rd toward
Rosenbalm Ln
_.._._ 10 s (387 ft)
%k 2. Slight left to stay on Shiloh Church Rd
2 min (1.0 mi)
Continue on NC-127 S. Take Cloninger Mill Rd NE and Snow
Creek Rd NE to 44th Ave Dr NE in Clines
8 min (5.1 mi)
r► 3. Turn right onto NC-127 S
1.0 mi
41 4. Turn left onto Cloninger Mill Rd NE
1.1 mi
41 5. Turn left onto 16th St NE
0.5 mi
r► 6. Turn right onto Snow Creek Rd NE
1.8 mi
https://www.google.com/maps/dirll l 73+Shiloh+Church+Rd,+H ickory,+NC+28601-7855,+USA14325+30th+St+Ln+N E,+Hickory,+NC+28601 /@35.7990... 1 /2

4/8/2021 1173 Shiloh Church Rd to 4325 30th St Ln NE, Hickory, NC 28601 - Google Maps
47 7. Turn left onto Sulphur Springs Rd NE
0.6 mi
Continue on 44th Ave Dr NE. Drive to 30th St Ln NE
3 min (1.0 mi)
#1 8. Turn left onto 44th Ave Dr NE
0.8 mi
41 9. Turn left onto 30th St Ln NE
Destination will be on the right
0.2 mi
4325 30th St Ln NE
Hickory, NC 28601
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.
httos://www.google.com/maps/dir/1173+Shiloh+Church+Rd,+H ickory,+NC+28601-7855,+USA/4325+30th+St+Ln+N E,+Hickory,+NC+28601 /@35.7990... 2/2

Geospatial Real Estate Search
hmwr
0axe, ►rv�eu, e�rrrn. catawba county Information Services
NN 1 in=400ft
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Parcel: 372515638640, 4325 30TH ST LN NE HICKORY, 28601
Owners: KIRKLAND DORI DIANE,
Owner Address: 4324 30TH STREET LN NE
Values - Building(s): $0, Land: $99,800, Total: $99,800
This map/report product was prepared from the Catawba County, NC Geospatial Information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and labeling information contained on this map or data on this report. Catawba County promotes and recommends
the independent verification of any data contained on this map/report product by the user. The County of Catawba, its employees, agents, and
personnel, disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or may
arise from this map/report product or the use thereof by any person or entity.
Copyright 2021 Catawba County NC
06/30/2021

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: Catawba Nearest Town: Hickory
Lake/ river/ ocean adjacent to property: Hickory
Property size (acres): 0.82 acres
Subdivision name or site address (include phase/lot number):
4325 30`h St Ln NE Hicko NC 28601
Directions to site - please include road names and numbers, landmarks, etc.:
Included in packet. ---
Latitude (in decimal degrees) 35.799933 Longitude (decimal degrees)-81.270576
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.):
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
7. Will work be conducted from land? From water? [�
8. Total amount of impacts below the normal pool lake level / Normal Water Level
Permanent impacts (i cluding all excavation, backfill, rip rap, retaining walls, etc.) in square feet:
Temporary impacts in quare feet:
9. Total amount of impacts above the normal pool lake level / Normal Water Level and 50 feet
land -ward
Permanent impacts (including back fill, excavation, rip rap, retaining walls, etc.) in square feet:
_ z % 2- `-C
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): `t _ r
11. Signature
yid z/
Owner/Agent's Signature' L15A NCAC 02H .05021f)) Date
Agent's signature is valid only if an authorization letter from the owner is provided.
FORW SSGP 02-2017 Page 2 of 4

12. Please approximately sketch the following information on this plan and provide dimensions for
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 rap 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 anv excavation or dredging below the Full Pond/ Normal Water Level elevation
Lake
(At. F'L411 ty'"d/ Normal Water L'v i)
M. r
Pon
Full Pond/ Normal Water
Shoreline
Plan View
O.,Jv l--
Iec"ir ,� E � 1% e �� I 2 f -1- t bo �'� Fu l l
r Pond N �l L
Lake
(At W1 Poudl tdwma{Water leuen Existing Dock'
Full 1Water level ..
`.
a�S;t
I,
vim.
■
if necetury f
M!
Plan View
FORM: SSGP 02-2017 Page 3 of 4

c
Side View
LL-
2 ft. additional clearing
3 ft, below full pond water level 4 ft. above full pond water level *if necessary
10
Side Vi
FORM: SSGP 02-2017 Page 4 of 4

6/30/2021 IMG_5443.jpg
https://maiI.google.com/mai1/u/2/#inbox?projector=1 1 /1

DWR Pre -Filing Meeting Request Form
ID#* 20210714 Version* 1
Regional Office * Mooresville Regional Office - [phone]
Reviewer List* Alan Johnson
Pre -Filing Meeting Request submitted 4/8/2021
Contact Name * Charlie Washburn - Marine Construction LLC
Contact Email Address*
[e-mail]
Project Name *
Kirkland - Hickory NC
Project Owner*
Tim & Diane Kirkland
Project County*
Catawba
Owner Address:
Street Address
4325 30th St Ln NE
Address Lane 2
City
State / Rovince ( Legion
Hickory
NC
Postal / Zip Code
Cbuntry
28601
USA
Is this a transportation project?* C Yes r No
Type(s) of approval sought from the DWR:
r 401 Water Quality Certification - I'°'" 401 Water Quality Certification -
Regular Express
F Individual Permit r Modification
W Shoreline Stabilization
Does this project have an existing project ID#?*
r• Yes r• No
Do you know the name of the staff member you would like to request a meeting with?
Please give a brief project description below and include location information.*
Place riprap on shoreline.
Please give a couple of dates you are available for a meeting.
.... .._.........._....
........................... ......... .... . .
4/12/2021

4/13/2021
4/ 14/2021
Please attach the documentation you would like to have the meeting about.
pdf only
By digitally signing below, I certify that I have read and understood that per the Federal Clean Water Act Section
401 Certification Rule the following statements:
• This form completes the requirement of the Pre -Filing Meeting Request in the Clean Water Act Section 401 Certification
Rule.
• I understand by signing this form that I cannot submit my application until 30 calendar days after this pre -filing
meeting request.
• I also understand that DWR is not required to respond or grant the meeting request.
Your project's thirty -day clock started upon receipt of this application. You will receive notification regarding meeting location
and time if a meeting is necessary. You will receive notification when the thirty -day clock has expired, and you can submit an
application.
Signature
Submittal Date 4/8/2021