20200849 Ver 1_Shoreline Stabilization_20200629

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 6/26/2020 1:28:18 PM (Submittal)
Approve by Montalvo, Sheri A 6/29/2020 11:15:48 AM (Non -DOT - Approver)
• The task was assigned to Montalvo, Sheri A 6/26/2020 1:28 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: *
Leonard Gamberg
Email:*
gambergl@gmail. c om
Phone Number:*
[phone]
(xxx)xxx-xxxx
Mailing Address:*
Street Address
10840 HASTY RD
Address Line 2
City
LAURINBURG
F bstal / Zip Code
28352
Is there an agent working on the r Ye:
project?* r No
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* Leonard Gamberg, Shoreline Stabilization
State / Rovince / Fbgion
NC
Country
United States
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:* Street Address
192 Crain ct
Address Line 2
city
mount gilead
Rbstal / Zip Code
27306
Latitude:* 35.267600
State / Rovince / Pegion
nc
Country
United States
Longitude:* 80.088099
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*
shoreline diagram .pdf 831.53KB
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.)*
A59CCDA8-1001-46BE-BF15-
3.37MB
0019E267D5C1.heic
4. Location of the property (where work is to be conducted)
Nearest Town:* Mount Gilead
County:* Montgomery
Lake/ river/ ocean adjacent to Lake Tillery
property:
Subdivisions name or site address:* 192 Cram Ct/ Lot#14 The Peninsula at Lake Tillery
Include phasellot nunber
Directions to site:*
from lillys bridge road turn onto twin harbor driver
continue onto hide -a -way trail/ holly harbor trail .3 mi
turn right onto cherokee trail .2 mi
turn right onto Canyon loop rd 282 ft
turn left to stay on Canyon Loop Rd .1 mi
turn right toward Crain Ct destination will be on your right .2 mi (192
Crain Ct)
Rease include road narres and nunbers, landrrerks etc.
5. Describe the existing land use or condition of the site at the time of this application:*
Residential
Fbsidential, undeveloped, etc.
6. Pro pertySize .15
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
Natural rock shoreline stabilization with natural boulders 12"-24" placed
on top of mat insulation against shoreline

8. How will the work be done?* 17 From Land
F 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 alls, etc.)
100
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.)
240
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)
bare dirt with 11 small trees
Sketch: survey sketch.pdf 2.43MB
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:
a I have given true, accurate, and complete information on this form;
a 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")
a 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');
a 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:* LeonardGamberg
Signature:

Initial Review
Is this accepted into the review
process?*
Project Number:* 20200849
Select Reviewer:*
Select Reviewing Office
Has payment been received?*
What amount is owed?*
rYes allo
Version:* 1
Chad Turlingtoweads\ccturlington
Fayetteville Regional Office - [phone]
r No Payment Needed
r Fee Received
r Need Fee - send electronic notification
r $240.00
f $570.00

Lake
(At Full Pond/ Normal water Level)
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Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ftx 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
_. -.t e_Y r_--r^-,-.-I .-+......+.,.-..� --1, — buildinPrc_ rntaininu wallr,_ dnckS. 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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MontgomeiyCounty, NC WebGIS
5128/20, 4:16 PM
Disclaimer: The information contained on this page is No r to De Hpw Vh•
construed or used as a survey or legal description. Map information is 190 ft 380 ft
believed to be accurate but accuracy is not guaranteed. 0
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Layer: Patil
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108401
LAURIN[
NC
28352
CRAIN
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LAKE T
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tY FIRE
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DISTRICT: 1
Layer: Fire Districts
Name: Tillery
Layer. Townships
Name: PEE DEE
Layer: Proposed Voting Commissioner's I
Districts
_ District: 1
Layer: Zoning
Zoning: Residential 1 i
City:
Layer: Voting District Precincts
Name: PEE
y Layer_ Watersheds
Class: WS-IV 7
Name: Lake Tillery
River Basin: Yadkin i
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