20220890 Ver 1_Shoreline Stabilization_20220630

Shoreline 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 *
[e-mail]
Please provide an email address for payment and requests for more information here.
Pre -Filing Meeting Date Request was 1/3/2022
submitted on: *
Owner Information:
Name: *
Email: *
Phone Number:
Mailing Address: *
Brandon Huffstetler
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
1004 Benton Ct
Address Line 2
City
Reidsville
Postal / Zip Code
27320-565
State / Province / Region
NC
Country
United States
Is there an agent working on the project?* Yes
No
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name: *
Rip Rap on shoreline for shoreline stabilization
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:*
36.515989
Street Address
162 Cane Creek Drive
Address Line 2
City State / Province / Region
Semora NC
Postal / Zip Code Country
27343 US
Longitude: *-79.059104
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 435.37KB
Please use the diagram at the link below:
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 photos.pdf 3.04MB
4. Location of the property (where work is to be conducted)
Nearest Town:* Semora
County: * Person
Lake/ river/ ocean adjacent to Hyco Lake
property:
Subdivisions name or site address: *
Oak Pointe
Include phase/lot number
Directions to site: *
McGhees Mill Rd - Oak Pointe Drive - N. Plantation Drive - Cane Creek
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: *
Lot cleared for construction of house
Residential, undeveloped, etc.
6. Property Size .92
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
Rip Rap on shoreline permit to maximize shoreline 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.)
238.5
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.)
238.5
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)
ground vegetation, small grouping of small trees (appx. 5)
Sketch: sketches.pdf 1.34MB
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
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
o I intend to electronically sign and submit the Shoreline Stabilization online form.
Full Name:*
Signature:
Brandon Huffstetler
Submittal Date: 6/29/2022

Initial Review
Is this accepted into the review process?* Yes No
Project Number: * 20220890 Version: * 1
Select Reviewer: * Colleen Cohn:eads\cmcohn
Select Reviewing Office: Raleigh Regional Office - [phone]
Has payment been received?* No Payment Needed
Fee Received
Need Fee - send electronic notification
What amount is owed?* $240.00
$570.00

FEMA FLOOD ZONE AE
ELEV. 413.0
NOTE: FEMA FLOOD ZONES AS
SHOWN ON PANEL 3711908000J
DATED 6/4/2007
vc4GO
420 CONTOUR
ox‘6'
56551
C
EXISTING
111 IRON PIPE
REFERENCES
D. B. 963-659
P.C. 4-231
ZONING
R. RESIDENTIAL
FRONT SETBACK 25' 70.
SIDE YARD 20' — EXISTING
REAR YARD 25' \ / NAIL
\\/
/
EXISTIN
IR%N IPE
APPROXIMATE
WATER LINE
014
564 05 26
FEMA FLOOD
ZONE X
SS9S9?
F �
7,
LOT 19
'S-
/
1" IRON
PIPE SET
LOT 18
0.92 AC.
WOODED LOT
NO BUILDING
/
LOT 17
LOT 20
R. = 50'
N7814'04"E
/ I
JERRY W. DAVIS LAND SURVEYING
FIRM NO. F-1144 / LOT 21
921 RUFF DAVIS ROAD
ROXBORO, NC, 27574
PH. 336— 583— 4881

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11. Sign r e
Owner/Agent' gnature* [15A NCAC 02H .0502(f)l Date
*Agent's signature is valid only if an authorization letter from the owner is provided.
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 any excavation or dredging below the Full Pond/ Normal Water Level elevation
Lake
(At Full Pond/Normal Water Level)
Li rsi 006 ic-14
/ 434- A 4104.
Full Pond/ Normal Water Level * 4 a .+.'or-+zr‘:i= ::. :;.-7.
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Plan View
FORM:SSGP 02-2017 Page 3 of 5

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ring
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Plan View
additional
FORM:SSGP 02-2017 Page 4 of 5