20200764 Ver 1_Shoreline Stabilization_20200611

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 6/9/2020 10:37:18 PM (Submittal)
Approve by Montalvo, Sheri A 6/11/2020 10:43:00 AM (Non -DOT - Approver)
• The task was assigned to Montalvo, Sheri A 6/9/2020 10:37 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:* Joanne Wright
Email:* [e-mail]
Phone Number:* [phone]
(xxx)xxx-xxxx
Mailing Address:* S
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Is there an agent working on the F Yes
project?* r No
Agent/Consultant Information
Name: * Terri Kindley/Shannon Miller
Company Affiliation:* Lake Norman Dredging
Email:* [e-mail]
Phone Number:* [phone]
(xxx)xxx-xxxx
Address:* S
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Asigned and dated copy of the Agent Authorization letter:*
Please DocuSign_Scan_Jun 08_20_081454... 1008.64KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
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Project Name:* Joanne Wright/Shoreline Stabilization
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 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.*
r Upload File
r Lookup address
Upload Map: 73BDF609-D2F9-42DF-BB22-
222D1B403177.jpeg
Latitude:* 35.636630
Longitude:*-80.935030
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*
76795DF7-EO3E-4BO3-A6DB-
678.06KB
BC03D3EOBl 1 F. jpeg
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.)*
FB593A3E-FBI E-495B-82A7-
5.53MB
26934408595Rjpeg
2FFBEBC8-052F-4F5C-8039-
5.06MB
81 F629CCFEBI. jpeg
4. Location of the property (where work is to be conducted)
Nearest Town:* Fallstown/Troutman
County:* Iredell
Lake/ river/ ocean adjacent to Norman
property:
Subdivisions name or site address:* 113 Tinker Place Troutman NC 28166
Include phasellot nunber
Directions to site:*
177 exit 36 Hwy 150 W.Plaza Dr. towards Lincolnton 2.3 miles
Right on Perth Rd 6 miles
Left on State Park Rd 1.4 miles
Left on Morrison Farm Rd 2.1 miles
Right on April Rd 0.1 miles Left on Windwood Ln 0.4
Right on Tinker Pl. 300 ft
Rease include road nacres and nunbers, landnarks 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 .75 Acres
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
Shoreline stabilization using Rip Rap to existing Rip Rap
in eroded areas. All work to be done by water using barge
and long reach.
8. How will the work be done?* r- 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 w ails, etc.)
645 Sq Ft
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.)
None
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)
NONE
Sketch: 735D279E-4245-4F92-970C-
623.06KB
CA2E6C344946. jpeg
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
o $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');
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
• I intend to electronically sign and submit this form.
Full Name:* Terri Kindley
Signature:
�;� -..- Gtt?

Initial Review
Is this accepted into the review
process?*
Project Number:* 20200764
Select Reviewer:*
Select Reviewing Office
Has payment been received?*
What amount is owed?*
rYes allo
Version:* 1
Alan Johnsomeads\adjohnsonl
Mooresville Regional Office - [phone]
r No Payment Needed
r Fee Received
r Need Fee - send electronic notification
r $240.00
f $570.00

— DocuSign Envelope ID: 5EOFD87F-54B2-446E-A98E-B4774EFE635A
AGENT AUTHORIZATION FORM
PROPERTY LEGAL. DESCRIPTION:
LOT NO:
STREET ADDRESS:
Please print;
PLAN NO:
Property
Owner: r _
Property
Owner:�-
PARCEL
ID:
The undersigned, registered property owners of the above noted property, do hereby
authorize
p t-+ rJ ►f1�1 l L( r of � i9-
{PDnU=or/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 Owners Address (if different than property above);
n L
Telephone:
We hereby certify the above information submitted in this application is true and
accurate tothe best of our knowledge.
DocuSigned by:
6/�j 2020�
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