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Home My WebLink About20220787 Ver 1_Shoreline Stabilization_20220609Shoreline Stabilization Application Form NORTH CAROLINA Environmental Quality 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 * brittany@lakelifepermits.com Please provide an email address for payment and requests for more information here. Pre -Filing Meeting Date Request was 6/8/2022 submitted on: * Owner Information: Name: * Email: * Phone Number: Mailing Address: * John Foutz jackfoutz@icloud.com (704)985-5608 (xxx)xxx-xxxx Street Address 254 Fiddlers Ghost Circle Address Line 2 City Troy Postal / Zip Code 27371 State / Province / Region NC Country US Is there an agent working on the project?* Yes No Agent/Consultant Information Name: * Brittany Hepler Company Affiliation: * Lake Life Permits, LLC. Email: * brittany@lakelifepermits.com Phone Number:* (704)230-7297 (xxx)xxx-xxxx Mailing Address:* Street Address 123 Institute Street Unit 393 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:* John foutz Auth agent form.pdf 446.38KB Link to: Sample Agent Authorization Form Project Information [15A NCAC 02H .0502(a) & (b)] Project Name: * Foutz Seawall Replacement 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: * Latitude:* 35.322209 Street Address 254 Fiddlers Ghost Circle Address Line 2 City State / Province / Region Mt. Gilead NC Postal / Zip Code Country 27031 US Longitude: *-80.078701 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* foutz plan.pdf foutz survey.pdf Please use the diagram at the link below: 905.73KB 521.71KB 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.) foutz images.pdf 2.07MB 4. Location of the property (where work is to be conducted) Nearest Town: * Troy County: * Montgomery Lake/ river/ ocean adjacent to Lake Tillery property: Subdivisions name or site address: * Directions to site: * 526 S Church St Charlotte, NC 28202 Woodrun/Lot 1311 Include phase/lot number Head southwest on S Church St toward W Stonewall St 1 min (0.3 mi) Take NC-27 E to River Rd in Montgomery County 1 hr 8 min (50.5 mi) Turn right at the 3rd cross street onto W Morehead St 89 ft Turn right onto the I-277/US-74 E ramp to I-77/1-85 0.5 mi Keep left and merge onto I-277 N/US-74 E 1.1 mi Keep right at the fork to continue on US-74 E, follow signs for NC-27 E/Independence Expy 2.0 mi Keep left to continue on US-74 E/E Independence Blvd/E Independence Expy 0.9 mi Keep left to continue on E Independence Blvd/E Independence Expy 0.8 mi Use the left 2 lanes to take exit 246 for NC-27 E/Albemarle Rd 0.4 mi Continue onto NC-27 E/Albemarle Rd Continue to follow NC-27 E Pass by Taco Bell (on the right in 37.5 mi) 37.6mi Turn right onto NC-24 E/NC-27 W/E Main St Continue to follow NC-24 E/NC-27 W 7.2 mi Continue on River Rd. Take Woodrun Dr to Fiddlers Ghost Cir 6 min (2.2 mi) Turn left onto River Rd 0.6 mi Turn left onto Woodrun Dr 0.9 mi Turn left onto Skyland Dr/Skyland Ct Continue to follow Skyland Dr 0.2 mi Turn left onto Sleepy Hollow Ln 0.1 mi Turn right onto Fiddlers Ghost Ln 0.2 mi Continue onto Fiddlers Ghost Cir Destination will be on the right 0.1 mi 254 Fiddlers Ghost Cir Troy, NC 27371 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 0.41 Acres 7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or why it is necessary): Replacing wooden sea wall along the 159' shoreline. Seawall is failing in some areas and falling into the lake. Homeowner would like to replace to reinforce and stabilize 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.) 636 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.) 159 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) none Sketch: foutz images.pdf foutz survey.pdf Application Fee: 2.07MB 521.71KB 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 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 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. 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"); 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"); o I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND • I intend to electronically sign and submit the Shoreline Stabilization online form. Full Name:* Brittany Hepler Signature: Submittal Date: 6/8/2022 Initial Review Is this accepted into the review process?* Yes No Project Number:* 20220787 Version:* 1 Select Reviewer: * Chad Turlington:eads\ccturlington Select Reviewing Office: Fayetteville Regional Office - (910) 433-3300 Has payment been received?* ( No Payment Needed C Fee Received C• Need Fee - send electronic notification What amount is owed?* C• $240.00 C $570.00 SAMPLE AGENT AUTHORIZATION FORM PROPERTY LEGAL DESCRIPTION: v1 rl 110e?5 IT�1Z LOT NO. �_ PLAN NO. PARCEL IDI�[�A STREET ADDRESS: W - 61 lea vrl Please print: Property Owner: Property Owner: The undersigned, registered property owners of the above noted property, do �here}byy authorize -Fh t �"' `\1 i� �� , of Iral'-i. of pe 1 V �i I5 , W`- (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: We hereby certify the above information submitted In this application is true and accurate to the best of our knowledge. C"- Aut orized Si natu Date: Z Authorized Signature Date: Scanned with CamScanner Proposed (Plan View) Full Pond/ Normal V Shoreline Lake (At Full Pond/ Normal Water Level) ISci ' SIHc ko I Iri-(--i AaeSS -z5q -i dd (Coi�; C-*ns-f- G+ycte NY - aead ivL Z`l 3',l71D Lake u<wn Perm Na em lL—) Existing Dock /n—n Plan View E AMP�E Scanned with CarnScanner Proposed (Side View) (At Full Pond/ Normal Wate Level) Q � C a m `o � r 3 k.below fun pond wafer levee 4tt.abpve full pond wahrlevel 2h. aamr"nm aeaane 1 •n ne e 1 1 Existing bank loft. bane >) ne�env ye.. Side Vi ` ` MPLE, Scanned with CamScanner LAKE `' •... - ` Lim VI n '3147.35 ]F"L 26jI,F7' 1 a` EIR VF IR REVISION 61291aa PHYSICAL SURVEY PERFORN£0, AND NA:Af, CHANGED IN TITLE BLOCK. EI NII•y70 rl(R�v 07 a AY• IA r O O, �I ACRE OY D.M.D. I]12i NOODRUN "UEDIVISION P.U.7j' 53 RAD 67 2T0. 0 APL 22. EIR ESR ' '80.06 OS W O.1 NiLF iJ F30CLERs Gn0_• C�y.:.c C1RL1L (60 RIW P- 1, ROGELL E, HUNSUCKER. CERTIFY THAT 11113 LAP WAS DRAY111 UNOE.R MY SUPERVISION FROM AN ACTUAL FIELD SURVEY PEREORWD BY A1f, THAT THE ERRDR OF CLOSURE A4 COW11T ED DY LATITUDES IUD OEPARTURE4 to I ARD WAS aALANCED EY THE COMPA9'i`7�L ' ��' Ce 'A c. *a = El 50' R5' 0' SO LEGEND EIR EXISTING IRON ROD tI RILtIT OE WAY CENTERLINE REF. P.D,7,P.55 D,N,228,P,258 NOTE THIS LAND IS NOT LOCATED IN A HAZARDOUS NOT ZONE. BOUNDARY SURVEY CDR JOHN D. FOUTZ, JR. and vIfr ELIZABETH R. FOUTZ IMIIAHNIE TVO, WN10U1✓LRP CO .,NC SCALE; 1.. 50' 29 SEP TE MNEN Igor BAR SCALE: 1'. 50' ROGELL E. HUNSUCKER R,L .S. L-'tidd ALUEMARLE, N,C. Scanned with CamScanner a.4 1 41 A0 k. '10 SIAME— la i _ <<: ,.1 .. - c f'- � 41'y h. .�.. r y _ - 1 _� d` v - V� a'�r fw. ; ` 4 gyp, Vr, �S �n �ti� ��. � ice` ��' _'.��y ..� .'�� ii '_ .�� t. � � j �'l. �a �-` - �� ` of 1 i7 pM IMG_0193.jpeg Scanned with CamScanner a.4 1 41 A0 k. '10 SIAME— la i _ <<: ,.1 .. - c f'- � 41'y h. .�.. r y _ - 1 _� d` v - V� a'�r fw. ; ` 4 gyp, Vr, �S �n �ti� ��. � ice` ��' _'.��y ..� .'�� ii '_ .�� t. � � j �'l. �a �-` - �� ` of 1 i7 pM IMG_0193.jpeg Scanned with CamScanner LAKE `' •... - ` Lim VI n '3147.35 ]F"L 26jI,F7' 1 a` EIR VF IR REVISION 61291aa PHYSICAL SURVEY PERFORN£0, AND NA:Af, CHANGED IN TITLE BLOCK. EI NII•y70 rl(R�v 07 a AY• IA r O O, �I ACRE OY D.M.D. I]12i NOODRUN "UEDIVISION P.U.7j' 53 RAD 67 2T0. 0 APL 22. EIR ESR ' '80.06 OS W O.1 NiLF iJ F30CLERs Gn0_• C�y.:.c C1RL1L (60 RIW P- 1, ROGELL E, HUNSUCKER. CERTIFY THAT 11113 LAP WAS DRAY111 UNOE.R MY SUPERVISION FROM AN ACTUAL FIELD SURVEY PEREORWD BY A1f, THAT THE ERRDR OF CLOSURE A4 COW11T ED DY LATITUDES IUD OEPARTURE4 to I ARD WAS aALANCED EY THE COMPA9'i`7�L ' ��' Ce 'A c. *a = El 50' R5' 0' SO LEGEND EIR EXISTING IRON ROD tI RILtIT OE WAY CENTERLINE REF. P.D,7,P.55 D,N,228,P,258 NOTE THIS LAND IS NOT LOCATED IN A HAZARDOUS NOT ZONE. BOUNDARY SURVEY CDR JOHN D. FOUTZ, JR. and vIfr ELIZABETH R. FOUTZ IMIIAHNIE TVO, WN10U1✓LRP CO .,NC SCALE; 1.. 50' 29 SEP TE MNEN Igor BAR SCALE: 1'. 50' ROGELL E. HUNSUCKER R,L .S. L-'tidd ALUEMARLE, N,C. Scanned with CamScanner