HomeMy WebLinkAbout20220002 Ver 1_Shoreline Stabilization_20220103Shoreline Stabilization Application Form
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SSGP 10-2013
DRAFT -NOT FOR USE AT THIS TIME
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*
rickandsherylb@aol.com
Please provide an email address for payment and requests for more information here.
Owner Information:
Name: * Richard Balsley
Email: * rickandsherylb@aol.com
Phone Number: (248)431-9610
(xxx)xxx-xxxx
Mailing Address: *
Street Address
3560 Fountain Circle
Address Line 2
Apt. 101
City State / Province / Region
Auburn Hills MI
Postal / Zip Code Country
48326-3986 US
Is there an agent working on the project?*
Agent/Consultant Information
Name: *
Company Affiliation: *
Email: *
Phone Number: *
Yes
No
Janice Estep
CBC Stone & Recycling, LLC
info@cbcstoneandrecycling.com
(704)660-5111
(xxx)xxx-xxxx
Mailing Address: *
Street Address
638 Oakridge Farm Hwy
Address Line 2
City State / Province / Region
Mooresville NC
Postal / Zip Code Country
28115 United States
A signed and dated copy of the Agent Authorization letter: *
Auth. Form.pdf 583.7KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:*
Balsley Shoreline
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
Upload Map: Plat Map.pdf 1.85MB
Vicinity Maps.pdf 5.53MB
Latitude:*
35.499247
Longitude: *-80.969709
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
Buffer Form.pdf
Please use the diagram at the link below:
953.54KB
1.03MB
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.)
Shoreline Pics.pdf 7.76MB
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 26 Governor's Island subdivision
Include phase/lot number
Directions to site:*
610 E Center Ave
Mooresville, NC 28115
Head south on Evergreen St toward E Center Ave
13s(197ft)
Take NC-150 W and Slanting Bridge Rd to Webbs Rd in Lincoln County
33 min (18.2 mi)
Turn right onto E Center Ave
0.5 mi
Turn left onto S Church St
397 ft
Turn right onto E McLelland Ave
1.1 mi
Use any lane to turn left onto NC-150 W/E Plaza Dr
Continue to follow NC-150 W
Pass by Zaxby's Chicken Fingers & Buffalo Wings (on the right in 1.3 mi)
9.9 mi
Turn left onto Slanting Bridge Rd
2.3 mi
Continue onto Campground Rd
2.1 mi
Turn left onto Will Proctor St
0.5 mi
Turn left onto NC-16 Business S
1.7 mi
Continue on Webbs Rd. Take Burton Ln to Governors Island Dr in
Westport
9 min (3.5 mi)
Turn left onto Webbs Rd
1.7 mi
Turn right onto Burton Ln
1.3 mi
Continue onto Governors Island Dr
0.2 mi
Turn right to stay on Governors Island Dr
Restricted usage road
Destination will be on the right
0.3 mi
3407 Governors Island 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
Residential, undeveloped, etc.
6. Property Size
0.406 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 boulder rip rap in front of and to top of
existing wood wall
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.)
5' below (515 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.)
1' above (103 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, no trees removed, 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):
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:
a I, the project proponent, hereby certifies that all information contained herein is true, accurate, and complete to the best
of my knowledge and belief
a 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.
a 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");
a 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 I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
a I intend to electronically sign and submit the Shoreline Stabilization online form.
Full Name: * Janice Estep
Signature:
Submittal Date: 12/22/2021
Initial Review
Is this accepted into the review process?* 4 Yes No
Project Number:* 20220002 Version:*
Select Reviewer: * Doug Perez:eads\djperez
Select Reviewing Office: Mooresville Regional Office - (704) 663-1699
Has payment been received? * No Payment Needed
Fee Received
• Need Fee - send electronic notification
What amount is owed?*
• $240.00
$570.00
AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. oZ tv PLAN NO. PARCEL ID:
STREET ADDRESS: 31-401 Governors TSland fir_
17, e \\ler NG aAb3-1
Please print:
Property Owner: l' tchard 64,161e.J
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
janir.e c'5 , of CBC $ -one e Icy d; n�c , LLCG
(Contractor / Agent) (Name of consulting )
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):
3SL.o rrourvka.i n Cr. Av.. 1b1 ,tu6urn l4 i 115, nrii. 14 3a6) - 3g6to
Telephone: ?AS- 431- q u 1 °
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized Signature Authorized Signature
Date: I a.- a.1- a 1
Date:
1
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NOTES
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IN.. BOOK 45e AT PAGE I Tx
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E LINCOLN COUNTY MOLT.
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ED Ov ' FA,, DOM., MANA,..ARt MEN°I> m NOWESSO IER TO A
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MEAN s LEVEL BASED ON THE oi•OTETIO YPEAPTIDATOO .0T
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Tarn mil. /•srT• DOW e(Tr• N�NATO NI 6 is.
CON NOL-TYIT
AREA SUNNMY
us oHDIUDIND L.SE.NO. . I 60001 ACRES OR 744.410 SO FT.
ITN. AREA - OaON01T5 &MO 228000 MBES OP ;� ;' BOSSED ,a R.
:
94 FT
STATE OF aNm NEaN0N0 O ONE
IHREOTIONR.ERNOON TILT MAP WAS NE -NE S ACCaOBNOE WITH AO OS
47 -AWOVOEN TINT THIS B n WINE. MAP MADE RIM AM ACDML FIELD
COAY EI L 0L6. 0.0. fA; m.i TIE FIELD SM.. AAA A NINIMN
MEAN P.O. TTO a n0.000 WITH A.63.1 AWaIAA UNDO
TAPR ON . ONES ARO. HERO! BIN
NoT SLAVETO. ARE NO. THAT M.O..
00. E ARE NO ENDxaw cENTS EITHER WAY
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AND en
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50
G��
REPUTEQ OWNER
GOVERNOR'S ISLAND ASSOCIATES,
A NOrlh Carotins Goners! Partnership
DEED BOON 659 PAGE 172
DOES DREW GSM PAGE 115
AGoil
NCPE 51656
SC.PE 632/5
TENN PE 46553
FINAL PLAN
GOVERNOR'S ISLAND
LOTS 15 THROUGH 30
GOVERNORS ISLAND ASSOCIATES - OWNER
LINCOLN COUNTY
CATAWBA SPRINGS TOWNSHIP NORTH CAROLINA
W. TOM COX, P.E., INC.
SCALE I" + 50•
CONSULTING ENGINEERS
CHARLOTTE, NORTH CAROLINA
DATE, JULY 2S, Nee
SCALE. I"• 50'
SHEER 3OF 3
12ez
December 22, 2021
1:869
o 0.01 0.01 0.02 mi
' , ' .1 I , , I , I
0 0.01 0.02 0.04 km
December 22, 2021
1:869
o 0.01 0.01 0.02 mi
0 0.01 0.02 0.04 km
Esri., Inc., Lincoln County, NC
fig
Legend
3407 Governors Island Dr
LA KJi
Full Pond/
Normal Water Level
.! NM EMI NMI NMI
Shoreline
Lake
(At Full Pond; Normal Water Level)
!I c�1�ov2 Y. 103'
/ /
t o'
s
5
iU3' 1e.nakh
boost..
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
5+u r ixi 1�e2�
Page 3 of 3
CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: 3 401 Cinve -ors 16 land Dr N
Owner: 'Pp ci, and 5 \6_9
Print , Signature
Contractor/agent: C3C c5- vine e, ec�c.1ir3 ) LLC
Print Sig hatu re
The approval is for the purpose and design described in your appl`catation. 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 02B .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), (6)]
Acknowledgement of Notification
vChard 15te , hereby state that I have been informed of the Catawba
Riparian Buffer Rule. AnylOork conducted in the buffer, not specifically stated in the application and approved
by the Division of Water Resources (DWR), is a violation an.... ject to enforcement. Due diligence will be
taken such that the construction will be built witt..'�� stoma to ial compliance and intent of the 401 Water
Quality Certification and Buffer Rules .wed plan s - : specification(s), and other supporting
materials.
Signature (owner
Date: la- ak- a 1
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