20200665 Ver 1_Shoreline Stabilization_20200520

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 5/19/2020 9:29:26 PM (Submittal)
Approve by Montalvo, Sheri A 5/20/2020 2:49:26 PM (Non -DOT - Approver)
• The task was assigned to Montalvo, Sheri A 5/19/2020 9:29 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:*
John Martin
Email:*
[e-mail]
Phone Number:*
[phone]
(xxx)xxx-xxxx
Mailing Address:*
Street Address
211 Isabel St
Address Line 2
City
Greensboro
Rbstal / Zip Code
27401
Is there an agent working on the r Yes
project?* r No
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* Martin Shoreline Stabilization
State / Frovince / Pegion
NC
Country
USA
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
Upload Map: Section 2 Question 1 - Vicinity Map.pdf 224.31 KB
Latitude:* 36.466253 Longitude:*-79.165670

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*
Section 2 Question 2 Site Plan.pdf 316.25KB
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.)*
Section 2 Question 3 Site Photo.pdf 1.35MB
4. Location of the property (where work is to be conducted)
Nearest Town:* Semora
County:* Caswell
Lake/ river/ ocean adjacent to Hyco Lake
property:
Subdivisions name or site address:* 188 Thomas Drive - Caswell GIS parcel # 0125.01.00.0058
Include phase/lot nunber
Directions to site:*
From intersection of Hugh McAden Rd & Osmond Rd (in Semora,
NC), take Hugh McAden (gravel road) East. Follow navy blue
arrows labeled "Martin" (located at major intersections) to the
house. You will bear left at the first fork, then take your first left
onto a dirt road (Thomas Dr.), then your first right onto another
dirt road. After the road curves, you will come upon the house, the
only one on this road. There are two parking spots at the bottom
of the driveway and several more next off the road at the top of
the driveway.
Rease include road naves and numbers, landmarks etc.
5. Describe the existing land use or condition of the site at the time of this application:*
The existing land use is residential, wooded and a grass lawn.
Ibsidential, undeveloped, etc.
6. Property Size 1.36
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
This is a shoreline/erosion stabilization project, consisting of the
installation of stone riprap. The bank has experienced (and
continues to experience) significant soil erosion, resulting in a
"undercutting of the bank". The purpose of this project is to
stabilize bank from further erosion.
8. How will the work be done?* 17 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.)
198
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.)
396
square feet
11. Please describe the vegetation above the normal pool lake level/ normal water level and 50 feet
landward to be impacted:*
(nunter of trees, for instance)
The vegetation 50 feet landward is mostly grass, with
approtamately 3-4 trees.
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):
o $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:* John Martin
Signature:

Initial Review
Is this accepted into the review
process?*
Project Number:* 20200665
Select Reviewer:*
Select Reviewing Office
Has payment been received?*
What amount is owed?*
r Yes f No
Version:* 1
Sue Homewood:eads\slhomewood
Winston-Salem Regional Office - [phone]
r No Payment Needed
f Fee Received
r Need Fee - send electronic notification
* $240.00
f $570.00

Martin Application — Riprap at 188 Thomas Drive, Semora, NC (Hyco Lake)
Please see following site photos:
View of Shoreline, facing North. Note the
erosion undermining the bank (at tree, and
extending length of bank).
View of Shoreline, facing East (South of dock)
View of Shoreline, facing South
View of Shoreline facing East (North of Dock)

K- State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
it arcr Resourors 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
a r4vk pNp;Er;i AL L3L Rk.::4 FORM: SSGP 02-2017
Please approximately sketch the following information on this plan and provide dimensions for
each item:
a. Al I 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 wails, docks, etc.
e. Location of any excavation or dredging below the Full Pond/ Norma Water Level elevation
fm[� 4 Lame
(At Full Pond1 Norma€ Wa Eer Level)
DIX 37
q&j Sir
Full Pond/ IVipTmal Waiter Level
Shore�lln:-Rr
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Plan View
FORM: SSG 02-2017 Page 1 of 3
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f At Full Parid/ i
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FORM: SSG 02-2017
Lake
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FUIJ Pend/ Nurrna€ Water
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Existing Dock
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Page 2 of 3