20200650 Ver 1_Shoreline Stabilization_20200518

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 5/18/2020 8:31:21 AM (Submittal)
Approve by Montalvo, Sheri A 5/18/2020 11:19:08 PM (Non -DOT - Approver)
• The task was assigned to Montalvo, Sheri A 5/18/2020 8:31 AM

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:*
Ken Hogston, Jr.
Email:*
[e-mail]
Phone Number:*
[phone]
(xxx)xxx-xxxx
Mailing Address:*
Street Address
201 Sunstede Drive
Address Line 2
City
Mooresville
Fbstal / Zip Code
28117-7322
Is there an agent working on the r Yes
project?* r No
Agent/Consultant Information
Name:* Randy Jordan
Company Affiliation:* Lyfe Marine, Inc.
Email:* [e-mail]
Phone Number:* [phone]
(xxx)xxx-xxxx
State / Rovince / Fbgion
NC
Country
us

Mailing Address:*
Street Address
19109 W. Catawba Ave.
Address Line 2
Suite 200
City
Cornelius
Fbstal / Zip Code
28031
Asigned and dated copy of the Agent Authorization letter:*
Hogston Agent Authorization. pdf _
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* Ken Hogston 201 Sunstede
State / Rovince / Region
NC
Country
United States
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 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
Upload Map: Hogston Map.pdf
Latitude:* 35.504640
372.09KB
Longitude:*-80.957570
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*
Hogston drawings.pdf
Please use the diagram at the link below:
https://edocs.deq.nc.gov/WaterResources/O/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.)*
Hogston photo 1.jpg 4.63MB
Hogston photo 2.jpg 5.61VIB
Hogston photo 3.jpg 3.68MB
4. Location of the property (where work is to be conducted)
Nearest Town:* Mooresvillel
County:* Iredell
Lake/ river/ ocean adjacent to Norman
property:

Subdivisions name or site address:* 201 Sunstede Dr. Mooresville, NC 28117 Lot 296
Include phase/lot number
Directions to site:*
Brawley School Road to Right onto Tuskarora Trail to Right onto
Sunstede Dr.
201 is on the left
Rease include road narres 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 .987
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
Add additional Class "B" Rip Rap to the existing Rip Rap shoreline.
8. How will the work be done?* V From Land
r From Water
9. Total amount of disturbance below the normal pool lake level/ normal water level:*
0
(including all clearing, back fill, excavation, rip rap, retaining walls, etc.)
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.)
173
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)
Grass/yard. No tree removal. Lot and shoreline already has Rip
Rap.
Impacts ABOVE: 173 sq. ft permanent, 865 temporary
Impacts BELOW: 692 sq. ft permanent, 0 temporary
Sketch: Hogston drawings.pdf 405.11KB
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
o I intend to electronically sign and submit this form.
Full Name:* Randy Jordan
Signature:
1?,914dI ,T4)114

Initial Review
Is this accepted into the review
process?*
Project Number:* 20200650
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

SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL
LEGAL DESCRIPTION:
LOT PLAN NO. PARCELID:
STREET ADDRESS: �D � � �11
Please print: . � � 7 � '
Property Owner: �' --�
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
of
(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 to this application is true and accurate to the
best of our knowledge.
Authorized Signature
Date:
Author Signature
Date: Y ��

201 Sunstede Dr
Mooresville, NC 28117
0
&)
directions Save Nearby
Send to your Share
phone
Photos
hUps:l/www.google.com/mapslplace/201+Sunstede+Dr,+Mooresv i1lc,+NC+281171@35.5165158: 80 9518239,1421data=Mm513 m4? 1 sOx8856adc426457Oa7:Ox 1 Odg... 1 /2

12. Tease 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 dredeine below the Fuld Pond/ Normal Wntpr I vvai plpvatinn
Lake
(At Full Pond/ Nrx T al Water Level)
{
1 Pond/ Normal dater Levu
Shoreline
Plan View
iz
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Plan View
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Side View
3 ft. UeiOW Pali WA water ievei 4 ft. 4t-- flA PMO water I&M 2 � additGonal clearing `if necessary .
EXi5tine bank
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FORM: SSGP 02-2017
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12. Tease 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 dredeine below the Fuld Pond/ Normal Wntpr I vvai plpvatinn
Lake
(At Full Pond/ Nrx T al Water Level)
{
1 Pond/ Normal dater Levu
Shoreline
Plan View
iz
Fuld PoudupNaffrre�l. Wgter IA
a h.e LSCft
ai�b+x�itkxxri
0-:1
Plan View
FORM: SSGP 02-2017
3 R x sSu.R
agile. kle+xdf KAt
f
A 4Pr YN F, �
Page 3 of 4

v
Side View
3 ft. UeiOW Pali WA water ievei 4 ft. 4t-- flA PMO water I&M 2 � additGonal clearing `if necessary .
EXi5tine bank
It h- bank
"hr �Q
Side Viow
FORM: SSGP 02-2017
Page 4 rf 4

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