20211657 Ver 1_Shoreline Stabilization_20211116

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:*
[e-mail]
Please provide an email address for payment and requests for more information here.
Mike and Regina Mulligan
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
119 Milledge Drive
Address Line 2
Suite 200
City
Cornelius
Postal / Zip Code
28031
Is there an agent working on the project?* Yes
No
Agent/Consultant Information
Name: *
Company Affiliation:
Email: *
Phone Number: *
Randy Jordan
Lyfe Marine
[e-mail]
[phone]
(xxx)xxx-xxxx
State / Province / Region
NC
Country
United States

Mailing Address:*
Street Address
19109 W. Catawba Ave.
Address Line 2
Suite 200
City
Cornelius
Postal / Zip Code
28031
A signed and dated copy of the Agent Authorization letter:
Agent Auth + Catawba Riparian-Mulligan.pdf 451.79KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* Mulligan Shoreline Project
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
• Lookup address
Property Address Lookup: * Street Address
119 Milledge Drive
Address Line 2
Latitude: * 35.597706
City
State / Province / Region
Mooresville
NC
Postal / Zip Code
Country
28117-8887
US
Longitude: *-80.926865
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*
Mulligan Diagram.pdf 279.38KB
Please use the diagram at the link below:
https://edocs.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.)*
Mulligan Photo Lpdf
9.86MB
Mulligan Photo 2.pdf
4.14MB
Mulligan Photo 3.pdf
4.91MB
Mulligan Photo 4.pdf
9.53MB
Mulligan Photo 5.pdf
5.53MB

4. Location of the property (where work is to be conducted)
Nearest Town: * Mooresville
County: * Iredell
Lake/ river/ ocean adjacent to Norman
property:
Subdivisions name or site address: * 119 Milledge Drive Mooresville NC 28117
Include phase/lot number
Directions to site: *
77N to Exit 36; turn left onto NC-150 to left onto Paradise Peninsula Rd.
to a slight left onto Greenbay Rd. to right onto Milledge Drive.
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 with existing shoreline stabilization.
Residential, undeveloped, etc.
6. Property Size .6570 Acres
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
Push down existing rip rap, install fabric after shaping the bank, install
new Class "B" Rip Rap along the 1801f of shoreline.
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.)
1800
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.)
180
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)
Grassy yard
Sketch: Mulligan Diagram.pdf 279.38KB
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:
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');
a 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:* Randy Jordan
Signature:
)�,31401afJ4
Submittal Date: 11/10/2021

Initial Review
Is this accepted into the review process?* Yes No
Project Number:* 20211657 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: 164 PLAN NO: PARCEL ID:
4627772965
STREET ADDRESS:
119 Milledge Drive
Mooresville, NC 28117
Please print.
Property Owner: Mike and Regina Mulligan
Property Owner:
The undersigned, registered property owners of the above noted property, do herebyauthorize
Randy Jordan , of Lyfe Yiarine, Inc.
(Contracter(Agent) (Name of consulting firm)
to act an 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 properly above):
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate tothe
best of our knowledge.
Elate

CATAWBA RIPARIAN BUFFEE NOTIFICATION FORM
Proles nfarnefaddress:- y ,�4t — _ County--- �
Owner:
Print �_gnature - f—
Contractorjagent; --
rint 5igrature
The approval is for the purpose and design described ire yow application. lrnpGmr s not indicated in the
application is a violation of the Buffer Rule- Site specific worc should be provided in the application. [iSA NCAC
02Y> .0506 and 15A NCAC 02B .OZ43(8)j
Trees are riot ailo%ved to be removed from Zone 1 of the Buffer (within 30 It or the full pond e!evation), unless
approved. Exception, those trees that are severeiv undermired along the immediate shoreline can be removed -
Minimal shading and Gaping along the immediate shoreline is allowed. [15A NCAC 028 .0243f6)l
Benching and grading in the buffer is not allowed. Excessive disturbance of ground clover. [15A NCAC 02B .0243
Pi
Beaches, impervious patios, impervious walkways, etc_ are rs3t allowed inthe buffer unless sperificatly approved
by the Division_ There are limitation an site for decks. 115A NCAC 02B .0243(4) and (6))
Work to be conducted from Sand must indicate an ac{ess and indicate any trees that are to be removed. The
work corridorshould be described_ The approved access corridor shall be restored. Staging, spoil, constructinri
material must be outside the buffer. i15A NCAC 02H .050Z find 15A NCAC 02B .0243 (4), (5), (8)j
Storrrwater cannot be piped or channeled for direct dis_naroe to the lake, All constructed stormvi-ater
discharges must be at the natural elevathon and dischargeC prior to entering the buffer directed as diffmL, or
sheet flow at non-eresive velocities to the lake. [15A NCAC 02B M43(5I, (6)]
Acknowledgement of Notification
hereby stag -hat] have been informed of the Catawba
Riparian Buffer Rule. Any work cori,iucted in the buffer, not specifically stated in the application and approved
by the DiVi5iQn of Water Resources (L)IAIR), N a violation and subject to enforcement. Due diligence will be
taken such that the construction will be built within substantial compliance and intent ofthe 401 Water
Quality Certification and Buffer Rules, the approved plan(s) and specification(s), and other supporting
materials.
Signature (ownerj: mate:

Lake
(At Full Pond/Normal Water Level)
oily)
to l \
Norm
Please approximately sketch the following information on this plan, length of shoreline
(provide dimensions for each item, such as loft x IOO ft)*:
1. All proposed vegetation clearing
I 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, [locks, etc_
5. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
5. Location of construction access corridors
FORM: s56P 10.2013
Page 3of3

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Lake
(At Full Pond/Normal Water Level)
oily)
to l \
Norm
Please approximately sketch the following information on this plan, length of shoreline
(provide dimensions for each item, such as loft x IOO ft)*:
1. All proposed vegetation clearing
I 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, [locks, etc_
5. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
5. Location of construction access corridors
FORM: s56P 10.2013
Page 3of3