20211603 Ver 1_Shoreline Stabilization_20211104

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 view the form.
Attach documentation of Pre -Filing Meeting Request here:
Pre -Submittal Meeting Form.pdf 942.84KB
Pre -fling Meeting or Request Date 11/4/2021
ID# Version
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]
Please provide an email address for payment and requests for more information here.
Owner Information:
Name: * Justin and Karli Hahn
Email: * [e-mail]
Phone Number: * [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
7923 Lake Vista Dr.
Address Line 2
City
State / Province / Region
Denver
NC
Postal / Zip Code
Country
28037
US

Is there an agent working on the project?* Yes
No
Agent/Consultant Information
............................................................................................................................................................................
Name: * Janice Estep
Company Affiliation:
Email: *
Phone Number:
Mailing Address:*
CBC Stone & Recycling, LLC
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
638 Oakridge Farm Hwy
Address Line 2
City
Mooresville
Postal / Zip Code
28115
A signed and dated copy of the Agent Authorization letter:
Auth. Form.pdf 564.5KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name: * Hahn Shoreline
State / Province / Region
NC
Country
United States
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.*
Upload File
Look up address
Property Address Lookup: * Street Address
7923 Lake Vista Dr
Address Line 2
City
Denver
Postal / Zip Code
28037-8573
Latitude: * 35.460151
State / Province / Region
NC
Country
US
Longitude: *-80.978149
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*
Site Plan.pdf 1022.05KB
Buffer Form.pdf 1.01MB

Please use the diagram at the link below:
https:Hedocs.deq.nc.gov/WaterResources/O/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.)*
Shoreline Pics.pdf 10.63MB
4. Location of the property (where work is to be conducted)
Nearest Town: * Denver
County: * Lincoln
Lake/ river/ ocean adjacent to Norman
property:
Subdivisions name or site address:* Lot 22 Nixon Heights
Include phase/lot number
Directions to site:
610 E Center Ave
Mooresville, NC 28115
Get on I-77 S/US-21 S from S Main St, NC-115 S and Langtree Rd
13 min (5.9 mi)
Head south on Evergreen St toward E Center Ave
197 ft
Turn right onto E Center Ave
0.5 mi
Turn left onto S Church St
0.5 mi
Turn right onto College St
0.1 mi
Turn left onto S Main St
1.2 mi
Continue onto NC-115 S
2.1 mi
Turn right onto Langtree Rd
1.1 mi
Use the left 2 lanes to turn left to merge onto I-77 S/US-21 S
0.4 mi
Follow I-77 S and NC-73 W to Club Dr in Lincoln County
16 min (12.3 mi)
Merge onto I-77 S/US-21 S
Continue to follow I-77 S
5.4 mi
Take exit 25 toward Concord/Huntersville
0.3 mi

Turn right onto NC-73 W/Sam Fun• Rd
Continue to follow NC-73 W
6.5 mi
Continue on Club Dr. Drive to Lake Vista Dr
5 min (2.7 mi)
Turn right onto Club Dr
1.9 mi
Merge onto Hagers Ferry Rd
0.5 mi
Turn right onto Nixon Heights Ln
0.1 mi
Turn left onto Lake Vista Dr
Destination will be on the right
0.1 mi
7923 Lake Vista Dr
Denver, NC 28037
Please include road names and numbers, landmarks etc.
5. Describe the existing land use or condition of the site at the time of this application:
Residential new construction
Residential, undeveloped, etc.
6. Property Size 0.563 acres
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
Shape and slope shoreline, install matting and class "B" rip rap for new
stabilization
8. How will the work be done?* ✓ From Land
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.)
4' below (504 sf)
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.)
F above (126 sf) 10'
x 50' access
corridor (500 sf of
temp. impact)
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)
Grass buffer, remove undermined trees on immediate shoreline that are
leaning into lake to properly stabilize shoreline. Minimal disturbance to
buffer.
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):
0 $240.00 for impacts to lake (below normal water level) of less than 1 acre
0 $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:* Janice Estep
Signature:
Submittal Date: 11/4/2021

Initial Review
Is this accepted into the review process?* Yes No
Project Number:* 20211603 Version: *
Select Reviewer:*
Select Reviewing Office:
Has payment been received?*
What amount is owed?*
Alan Johnson: eads\adjohnson I
Mooresville Regional Office - [phone]
No Payment Needed
Fee Received
• Need Fee - send electronic notification
• $240.00
$570.00

AGENT AUTHORIZATION FORM
PROPERTY LEGAL. DESCRIPTION:
LOT NO. 32, .PLAN NO. PARCEL ID:
STREET ADDRESS: -1 q ?.3 � d is c V ?. ri of
nvw--tt c f 1-4c- VbV3_71
Please print:
Property Owner:+
Property Owner: L:4 Y- i ` tb-h r,
The undersigned, registered property owners of the above noted property, do hereby authorize
Ct n CC ---- of C l c 7)�! r C i I f1Q �.
(Contractor / 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 Owner's Address (if different than property above):
Telephone: -104 ' S ( 2 - S S"_j B
104- 4-S e - 3 c3 t
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge,
Au $orized Signature
D te:
Y _..
Authorized Signature
Date: ? OBI 2 ,1'2_ ,

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Pull Pond/
Normal Water Level
Shoreline
La ke
(At Full Pond/ Normal Water Level)
y 1 6d 0 W X X ace ,
I , a ho'4 e.. X I au `
a
t�ernc�v e. u r,der�-i � red
fire25 OV-) ,YhY(�eCi,Gl��
S\-)orerl ; ne thG.F c�r�
Please approximately sketch the following information on this plan, length of shoreline
(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
FORM: SSGP 10-2013 Page 3 of 3

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address.• _ 12-3 1_.a s~fc V �s lR D r, vr. 74 VAve r , r—' e- 7"'L3-
County: L-lvi c o
l
Owner: Kvi a- C, I J
Print
Contractor/agent:
Signatur
Print
�e azure
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 026.0243(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)]
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 02B .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), (8)]
Acknowledgement of Notification
1, J US'"n ktal,v% K_�;, g' Viaytm hereby state that I have been informed of the Catawba
Riparian Buffer Rule. Any work 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 spgcification(s), and other supporting
materials. :1
Signature fawner): ,2U 11 RV Date:

�
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14

11/4/21, 10:03 AM
Submission Completed
Contact Name*
Contact Email Address*
Project Owner*
Project Name*
Project County*
Owner Address:'
Is this a transportation project?*
Janice Estep
[e-mail]
Justin and Karli Hahn
Hahn Shoreline
Lincoln
Street Address
7923 Lake Vista Dr.
Address Line 2
City
Denver
Postal / Zip Code
28037
Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Individual Permit
Shoreline Stabilization
Does this project have an existing project ID#?
Yes No
Yes No
n
r
"4a`ww:b
NORTH CAROLINA
E-imtunmr.1 Quality
State / Province / Region
NC
Country
us
401 Water Quality Certification - Express
Modification
Do you know the name of the staff member you would like to request a meeting with?
Alan Johnson
Please give a brief project description below and include location information. *
Remove undermined trees on immediate shoreline that are leaning into lake to properly stabilize. Shape and slope
shoreline, install matting and install class "B" rip rap for new shoreline stabilization
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.
https:Hedocs.deq.nc.gov/Forms/Form/Submit 1/2

11/4/21, 10:03 AM
Submission Completed
a I understand by signing this form that I cannot submit my application until 30 calendar days after this pre -filing
meeting request.
• 1 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 11/4/2021
https://edocs.deq.nc.gov/Forms/Form/Submit 2/2