20240009 Ver 1_Shoreline Stabilization_20240102

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.
CHRISTOPHER M LINDSEY
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
4874 EMMA LOVE DR
Address Line 2
City
DENVER
Postal / Zip Code
28037
Is there an agent working on the project?* Yes
No
Agent/Consultant Information
Name: *
Company Affiliation:
Email: *
Phone Number:*
TAMARA HAGER
State / Province / Region
NC
Country
US
LAKE PERMIT LLC / JAB CONSTRUCTION
[e-mail]
[phone]
(xxx)xxx-xxxx

Mailing Address: *
Street Address
PO BOX 5335
Address Line 2
City
MOORESVILLE
Postal / Zip Code
28117
A signed and dated copy of the Agent Authorization letter:
LINDSEY AUTH AGENT.pdf
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* LINDSEY
State / Province / Region
NC
Country
US
248.13KB
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:
Latitude: * 35.559283
Longitude: *-81.029828
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 *
Please use the diagram at the link below:
https:Hedocs.deq. nc.gov/WaterResou rces/0/edoc/616616/Shorel i ne%2OLayout.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.)
I...
I�
4. Location of the property (where work is to be conducted)
Nearest Town: * DENVER

County: * Lincoln
Lake/ river/ ocean adjacent to NORMAN/ CATAWBA
property:
Subdivisions name or site address:* EMMA LOVE PHASE II/ LOT 32A
Include phase/lot number
Directions to site:*
FROM MARSHALL STEAM STATION TRAVEL WEST HWY 150 4.8 MILES, LEFT GRASSY CREEK RD .80 MILES,
LEFT LOVE POINT RD .60 MILES, RIGHT EMMA LOVE DR 600 FT. PROPERTY ON LEFT
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 .60
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
DREDGE 20' X 30' X 4' DEPTH
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.)
600'
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.)
0
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)
NO IMPACTS, NO TREES REMOVED
Sketch: LINDSEY SKETCH.pdf
128.35KB
LINDSEY SURVEY.pdf
325.78KB
LINDSEY INFO.pdf
222KB
LINDSEYI INFO.pdf
158.37KB
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 $323.00 for impacts to lake (below normal water level) of less than 1 acre
1 $767.00 for impacts to lake (below normal water level) of greater or equal to 1 acre
By digitally signing below, I certify that:
d I, the project proponent, hereby certifies that all information contained herein is true, accurate, and complete to the best
of my knowledge and belief

d 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
d I intend to electronically sign and submit the Shoreline Stabilization online form.
Full Name:* CHRISTOPHER M LINDSEY
Signature:
C#1Vf AfR # L/Ipffy
Submittal Date: 12/14/2023

Initial Review
Is this accepted into the review process?* Yes No
Project Number:* 20240009 Version: *
Select Reviewer: *
Select Reviewing Office
Has payment been received?*
What amount is owed?*
Andrew Pitner:andrew.pitner
Mooresville Regional Office - [phone]
No Payment Needed
Fee Received
Need Fee - send electronic notification
$240.00 $570.00
$323.00
$767.00

S. Describe the existing land use or condition of the site at tree time of this appikation (residential,
undeveloped, etc.):
5. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why It Is necessary):
7. Will work be conducted from land? �R From water? 7-
8. Total amount of impacts below the normal pool lake level / normal Water Level
Permanent Impacts (including a excavation, back)ll, rip rap, retaining wafts, etc,) In square feet:
Temporary impacts In squarefeet
i:r A.
9. Total amount of impacts above the normal pool lake level / Normal Water Level and 50 Beet [and -
ward
Permanent Impacts (including back PA-
ll, excavation, rip rap, retaining walls, *M) in squarefeet:
Ad _
Temporary Impacts (temporary Gearing, construction corridor) In square feet:
14. Please describe the vegetation above the normal pool lake ievel/ Normal Water i..eweI and 50 feet
landward to be impacted (number of trees, for Instance): Al in ZL
N"+yce3
11_ Signature
By signing below, I, as the project proponent, certify to the foiLow ing:
The project proponent hereby certifies that all information contained herein is true, accurate,
and complete to the best cf my knowledge and belief
The project proponent hereby requests that the certifying aurthorfty review and take action on
this CWA 401 certification request within the applicable reasonable period of time
I I 23
0 r/ it's Signature' Data
S i rvn tUre !S volld autily an authorimiior� letter Barr the owner is proufdled.
12. Please approximately sketch the following information on this plan and peeoWdle dimenOomfa'
each Item:
a. 4 prcposed vegetation clearing
b. Location of rip rap or-lll tc be placed above the full Pond/ Normal Water Level elevation
c. Locat on of rip rap or fill to be placed blow the Full Pond/ Normal Water Level elevation
d. Location of any proposed structures such as bulldirtgs, retaining, wails, docks, etc.
e. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
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S. Describe the existing land use or condition of the site at the time of this appalcation lresidentLal,
u noeve loped, etc.),,
Describe proposed work (include discrsslon as to how hardening of shoreline has been avoided, or
why it is necessary). '
7, Will work be conducted from land? From wate`? �]
8. Total amount of impacts below the normal pool lake level / Normal Water Level
Permanent impacts (Inciuding all excavation, backfili, rip rap, retal ning walls, etc) In square feet:
Temporary impacts in square feat:
rLIA.
9. Total amount of impacts above the normal pool Lake ievel f Normal Water Level and 50 feet I"-
wa rd
Permanent impacts (including back 11, excavation, rip rap, retaining wails, etc.) in square feet:
#4 rft
Teh'porary impacts (temporary clearng, construction corridor) In square feet:
10. Pieasa describe the vegetation above the normal pool lake ievel/ formal Water Levei and 50 feet
landward to be impacted (number of trees, for Instance)- A -o
t4 u- +Vce"�'
11. Slgnatu re
By signing below, 1, as the project proponent, certify to the following;
• The project proponent hereby certifies that ail Information contained hereln is true. accurate,
and complete to the best of my knowiedge and belief
4 The project proponent hereby requests that the certifying authorfty review and take action on
this CW►7 401 certAcation request within the applicable reasonab a period of time
t
aV � j .nt's $iSn*tura 'fJ5A ti" 02H-0502tfil Date
s sJ�rwtune is valid anly i an authorization letter; ram tree owner is provided.
12. Please approximately sketch the following information on this plan and provW dknenslons tour
each teem:
a, rill proposed vegetation clearing
b. Location of rip rap o- fill to be placed above the Full Fond/ Normal Water Level elevation
c- Location of rip rap or fill to be placed below the Full pond/ Normal Water Level elevation
d. Location of Any proposed structures such as buildings, retaining walls, dada, etc.
e. Location of any excavation or dredging below the Full Pond/ Normal Water level elevation
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CA kWRA RIPARIAN BUFFER NOTl I ATION FORM!
Project Name/address:
Owmr: _C" X - � LIAlL�1.5fr
Print
ContracCar/a��m:
Print
Sign
Ar
sty:_. ( A -ram. _
f,G app:'ovai is for the purpose and design described in your application. Impacts not indicated in the
application is a viuia,ion of the Buffer Rule. Site specific work should be provided in the application. (15A NCAC
.CSOS a :. 1- A NCAC 02B .0243($)]
Trees are 114t ailo%ved to be removed from Zone 1 of the Buffer (within 30 ft of the full pond elevation), unless
ap?;ru,red. Z-•cept,w), those xfts that are severely undermined along the immediate shoreline can be removed,
tw:itdrT,al s$api,r$ ar4a stzipiao along me immediate shoreline Is allowed. 115A NCAC 028 ,0243(6)]
Ben&ng, grading ;n the puffer is not allowed. Excessive disturbance of ground cover. (I SA NCAC 02B 0243 (6))
acr+as, lrzy�.. ions paCJOS, Irilpervious walkways, etc, are not al#awed in the buffer unless specifically approved
wv she ivis, i'1fie are I:.r,:tation on size for flecks. (15A NCAC 02B .0243(4) and (6))
't'-Iork :a b: c:.rrdxted from ;and must indicate an access and indicate any trees that are to be removed. The
work corrtanr should be described. The approved access corridor shall be restored. Staging, spoil, construction
rr,�cer ai rnu3r t,je ,puffer, I15A NCAC 02H .0502 and 1SA NCAC 02B 0243 (4), (6), (8))
Siormwat:er cannot lie piped or channeled for direct discharge to the lake, All constructed stormwater
rgts muSu ae attW ra:ural elevation and discharged prior to entering the buffer directed as diffuse or
`'-Ow a -co the lake. [15A [NCAC 028 .0243(5), (6)1
�l;:rcr�owle�#�,-rr�rrt �; kbor�ro#lan
M. L , Ivreby state that i have been Informed of the Catawba
.vork conducted in the buffer, not specificaiiy stated in the application and approved
e ❑iv!s! , . ,. ` NV$ per Resources (DWR), is a violation and subject to enforcement. Due diligence will he
be built within substantial compliance and intent of the 401►Nater
QLaiity CertifiCarion and dutfer Rules, the approved plan(s) and specification(s), and other supporting
1 7=ian�I$.
Date, ► ��I

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO, 2- A PLAN NO. PARCEL ID: itf3 7
STREET ADDRESS: 8 14 *Zi} L 4 YL
Mease print:
Pro4eltr Owner: L!!N4- ti
PrcVe ty Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
7,4-6 S C O AI -Sr
of __. dc— r am
(Co ftr / Age ) (Name of consulting firm
to act on my behatf and take aft actions necessary for the processing, issuance and aoaeptance of
this perrntt or certfficadan and any and at1 standard and special conditions atUKbed.
Property Owiver's Address (if different than property above)
Teiephone:
We hereby cer* the above information Submitted in this application is true and accurate to the
best of our knov+rtedge,
AirthcIrtaed
Gage: