20200426 Ver 1_Shoreline Stabilization_20200330

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 3/27/2020 3:05:22 PM (Submittal)
Approve by Montalvo, Sheri A 3/30/2020 7:33:04 AM (Non -DOT - Approver)
• The task was assigned to Montalvo, Sheri A 3/27/2020 3:05 PM

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.
Owner Information:
Name:*
Phillip Tyler Gaddy
Email:*
[e-mail]
Phone Number:*
[phone]
(xxx)xxx-xxxx
Mailing Address:*
Street Address
150 Forest Lake Ct
Address Line 2
Cly
Norwood
Wstal / Zip Code
28128-4500
Is there an agent working on the r Ye:
project?* r No
Project Information [15A NCAC 02H .0502(a) & (b)]
.........
Project Name:* Phillip Tyler Gaddy, Tillery Rentals LLC
State / Frovince / Pegion
NC
Country
US
If your project has a formal name please use this. If your project does not hake a formal name, please identify your project by
the owner name and proposed acti\ity (Jones Property Access Road, Smith Guest House, etc.) List in parentheses any
other names that ha\e 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.*
r Upload File
r Lookup address

Property Address Lookup..*
Latitude:* 35.271015
Street Address
150 Forest Lake Court
Address Line 2
city
Norwood
Postal / Zip Code
28128-4500
State / Frovince / Region
NC
Country
us
Longitude:*-80.097817
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*
img03272020_0001. pdf 54.63KB
Please use the diagram at the link below:
https://edocs.deq.nc.gov/WaterResources/0/edoc/616616/Shoreline%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.)*
Shoreline 1.png 2.42MB
untitled Shoreline 1.png 2.71MB
4. Location of the property (where work is to be conducted)
Nearest Town:* Norwood
County:* Stanly
Subdivisions name or site address:* Edgewater
Include phase/lot nun ber
Directions to site:*
Pee Dee Ave from Norwood toward Hwy 24/27, right turn onto
Randalls Church Rd, left turn into Edgewater development , right
turn onto Forest Lake ct , 4th house on the right.
Rease include road nacres and numbers, landmarks etc.
5. Describe the existing land use or condition of the site at the time of this application:*
New construction on lot, natural area past duke energy line to lake
undisturbed.
Residential, undeveloped, etc.
6. Property Size .54
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
Shoreline stabilization with rip rap added per development bylaws.
Scrub trees removed some pines removed, 4-5 pines saved.
8. How will the work be done?* 17 From Land
r 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.)
270sf
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.)
5000 sf
square feet
11. Please describe the vegetation above the normal pool lake level/ normal water level and 50 feet
landward to be impacted:*
(nunber of trees, for instance)
Scrub trees10-15, some live and some dead.
7-10 Large pines , underbrush and briars
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):
$240.00 for impacts to lake (below normal water level) of less than 1 acre
$570.00 for impacts to lake (below normal water level) of greater or equal to 1 acre
By digitally signing below, I certify that:
• I have given true, accurate, and complete information on this form;
• I agree that submission of this form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the
"Uniform Electronic Transactions Act")
• 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');
• 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 this form.
Full Name:* Phillip Tyler Gaddy
Signature:

Initial Review
Is this accepted into the review
process?*
Project Number:* 20200426
Select Reviewer:*
Select Reviewing Office
Has payment been received?*
What amount is owed?*
r Yes f No
Version:* 1
Alan Johnson:eads\adjohnson1
Mooresville Regional Office - [phone]
r No Payment Needed
f Fee Received
r Need Fee - send electronic notification
* $240.00
f $570.00

[ L" tie a
got( ?U�-tJ
� Y � 69
�Y
eOoc-)
G U Oo cG
l� 5-- F
(3( FI-
s
Itwo
g - CO -
Gov C0 c v C. r G �V'`re✓ i ��

^�f
,..x . .

i
s Ov L
2 � a
e d
Jae I