20200803 Ver 1_Shoreline Stabilization_20200618

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 6/17/2020 10:06:21 AM (Submittal)
Approve by Montalvo, Sheri A 6/18/2020 11:39:27 AM (Non -DOT - Approver)
• The task was assigned to Montalvo, Sheri A 6/17/2020 10:06 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: *
Michael McGoey
Email:*
[e-mail]
Phone Number:*
[phone]
(xxx)xxx-xxxx
Address:*
Street Address
295 Lake Mist Drive
Address Line 2
City
Mooresville
P>stal / Zip Code
28117-3515
Is there an agent working on the r Yes
project?* r No
Agent/Consultant Information
Name:* Janice Estep
Company Affiliation:* CBC Stone & Recycling, UC
Email: * [e-mail]
Phone Number:* [phone]
(xxx)xxx-xxxx
State / Province / Region
NC
Country
US

Mailing Address:*
Street Address
638 Oakridge Farm Hwy
Address Line 2
city
Mooresville
Fbstal / Zip Code
28115
Asigned and dated copy of the Agent Authorization letter:*
Auth. Form.pdf 200.82KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* McGoey Property
State / Rovince / Region
North Carolina
Country
United States
If your project has a formal name please use this. If your project does not ha),e 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.*
F Upload File
r Lookup address
Upload Map: PlatMap.pdf
Vicinity.pdf
buffer form. pdf
duections.pdf
Latitude:* 35.539257
647.8KB
1.57MB
446.47KB
211.77KB
Longitude:*-80.934022
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*
site plan.pdf 313.08KB
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.)*
Shorehne.pdf 1.81MB
4. Location of the property (where work is to be conducted)
Nearest Town:* Mooresville
County:* Iredell
Lake/ river/ ocean adjacent to Norman
property:

Subdivisions name or site address:* The Harbour Lot #19
Include phase/lot nunber
Directions to site:*
610 E Center Ave
Mooresville, NC 28115
Head west on E Center Ave toward Cedar St
0.5 mi
Turn left onto S Church St
0.4 mi
Turn right onto E Wilson Ave
1.5 mi
Continue onto NC- 1100/Brawley School Rd
5.6 mi
Continue straight onto NC-1100
0.6 mi
Turn right onto Bay Harbour Rd
0.4 mi
Turn left onto Lake Mist Dr
0.7 mi
295 Lake Mist Dr
Mooresville, NC 28117
Aease include road names and nunbers, landmarks etc.
5. Describe the existing land use or condition of the site at the time of this application:*
Residential
Pesidential, undeveloped, etc.
6. Property Size 0.7
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
Re -stack wall sections that have fallen and add 1' row of additional block
to existing wall Install boulder rip rap in front of wall
8. How will the work be done?* I7 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.)
3' below (240 sf)
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.)
l' above (80 sf) 10'
x 50' access
corridor (500 sf
temp. impact)
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)
Grass buffer, no trees removed, minimal disturbance to buffer
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:* Janice Estep
Signature:

Initial Review
Is this accepted into the review
process?*
Project Number:* 20200803
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

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO, PLAN NO. PARCEL ID:
STREET" ADDRESS, Rq 5 Lct.ke,,, M 6+ —Dr
Please print:
Property Owner:
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
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(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:.. 5 U I- 11 L{ - u to L4 8
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Au"Y
ize Authorized Signature
Date: 6 /S'l Dd�V Date;

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Signature
The approval is for the purpose and design descried in your application: Impacts not indicated in the
application is a violation of the Buffer Rule. Site specific work should be provided in the application_ [15A NCAC
02H .0506 and 15A NCAC 023.024 ()]
Trees are not allowed to be removed from Zone 1 of the Buffer (within 30 ft of the full pond elevation), unless
approved_ Exception, those trees that are severely undermined along the immediate shoreline can be removed.
Minimal shaping and sloping along the Immediate shoreline is allowed. [15A NCAC 02B .0243(6)1
Benching, grading in the buffer is not allowed.. Excessive disturbance of ground cover. [15A NCAC 028 .0243 (6)1
Beaches, Impervious patio.s, impervious walkways, etc, are not allowed in the buffer unless specifically approved
by the Division. There are limitation can size for decks. [15A NCAC 026 .0243(4) and (6))
Work to be conducted from land rnust indicate an access and indicate any trees that are to be removed. The
work corridor should be described. The approved access corridor shall be restored. Staging, spoil, construction
material must be outside the buffer. [15A NCAC € 2H .0502 and 15A NCAC 02B .0243 (4), (6),(8)]
Stormwaiter cannot be piped or channeled for direct discharge to the lake, All constructed stormwater
discharges roust be at the natural elevation and discharged prior to entering the buffer directed as diffuse or
sheet flow at non -erosive velocities to the lake. [15A NCAC 02B .0243(5), (6))
Acknowledgement of Notification
i, hereby state that I have been informed of the Catawba
Riparian. Buffer Rule. Any work conduJted in the buffer, not specifically stated In the application and approved
by the Division of Water Resources (DWR), is a violation and subject to enforcement. Due diligence will be
takers such that the construction will be built within substantial compliance and intent of the 402 Water
Quality Certification and Buffer Rules, the approved plan(s) and specifieation(s), and ether supporting
materials.
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Shoreline
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Please approximately sketch the following information on this plan, length of shoreline
(provide dimensions for each item, such as 10 ft x 100 ft)*:
1. All proposed vegetation clearing
2. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
3. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
4. Location of any proposed structures such as buildings, retaining walls, docks, etc.
5. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
FORM: SSGP 10-2013 Page 3 of 3

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