20241246 Ver 1_Shoreline Stabilization_20240918

Shoreline Stabilization Application Form
NORTH CAROLINA
Environmental Quality
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SSGP 10-2013
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: *
shorecreekforestandgarden@,)gmail.com
Please provide an email address for payment and requests for more information here.
Dan Weldon Lawrence
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
2929 Semora Road
Address Line 2
City
Roxboro
Postal / Zip Code
27574-6612
Is there an agent working on the project?*
Yes
No
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name: *
Dan Lawrence Boat House and Shoreline
State / Province / Region
NC
Country
US
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:*
36.452520
Longitude: * 79.079980
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://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.)
4. Location of the property (where work is to be conducted)
Nearest Town:* Roxboro
County:* Person
Lake/ river/ ocean adjacent to Hyco Lake
property:
Subdivisions name or site address: *
Quail Hollow Subdivision - 667 Summer Oak Drive
Include phase/lot number
Directions to site: *
From Roxboro NC take 57 North (Semora Road) to Concord Church Road. Turn Left. Continue for 0.8 mile. Turn right onto Quail
Hollow Drive for 0.4miles. Turn right onto Summer Oak Drive and continue for 0.6 mile to destination.
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 use.
Residential, undeveloped, etc.
6. Property Size
1.11 Acres
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
The land was cleared and a boat house is being built. We would like to prevent erosion of the shoreline by placing a base of
landscape fabric with large rocks at the water level, then above the water level approximately five feet. Grass will be planted above
the rocks.

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.)
None
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.)
1500 square feet (approx.)
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)
There is a small amount of vegetation above the lake level. Roots and small bushes will be removed. No large trees to be removed.
Landscape fabric will be placed at the water level and continue landward five feet. Large stone will be placed on this landscape
fabric. the land above the stone will be seeded with grass to prevent erosion in this area.
Sketch:
Shoreline with rocks and grass for
stabilization.pdf
Application Fee:
402.97KB
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
o $767.00 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");
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
o I intend to electronically sign and submit the Shoreline Stabilization online form.
Full Name:* Dan Weldon Lawrence
Signature:
,weir 1411/efeW jeZ4,, rr
Submittal Date: 9/12/2024

Initial Review
Is this accepted into the review process? * Yes No
Project Number:* 20241246 Version:* 1
Select Reviewer: * Joseph Myers:joseph.myers
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
$323.00 $767.00

Hyco Lake
(At Full Pond/Normal Water Level)
-D_E
NORTH CAROLINA
Department of Environmental ppallry
Existing Boat House
i 2'x120' elow Full Pond/NWL
5'x120' Above Full Pond/NWL
(Already Cleared)
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 11617 Mail Service Center I Raleigh, North Carolina 27699-1617
919.707.9000

2' Below Full
Pond Water Level
PIA
Hyco Lake
(At Full Pond/
Normal Water Level)
5' Bank Height
5' Above Full
Pond Water Level
NORTH CAROLMA
0¢yarim¢rrl of Environmental Uaallry
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 11617 Mail Service Center I Raleigh, North Carolina 27699-1617
919.707.9000