20200870 Ver 1_Shoreline Stabilization_20200702

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 7/1/2020 2:29:40 PM (Submittal)
Approve by Montalvo, Sheri A 7/2/2020 10:44:05 AM (Non -DOT - Approver)
• The task was assigned to Montalvo, Sheri A 7/1/2020 2:29 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: *
Email:*
Phone Number:*
Mailing Address:*
Is there an agent working on the
project?*
Agent/Consultant Information
......................................................................................................
Name: *
Company Affiliation:*
Email:
Phone Number:*
Lindsey Pyle
[e-mail]
[phone]
(xxx)xxx-xxxx
Address
20334 Bethel Church Road
Address Line 2
City
Cornelius
Postal / Zip Code
28031-7008
r Yes
r No
Dean Fisher
State / Province / Region
NC
Country
Us
Lake Norman Custom Dock & Pile Driving, Inc
[e-mail]
[phone]
(xxx)xxx-xxxx

Mailing Address:* Street Address
PO Box 1439
Address Line 2
City
State / Province / Region
Denver
NC
Fbstal / Zip Code
Country
28037
United States
Asigned and dated copy of the Age nt Authorization letter:*
Lake Forms.pdf 254.66KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* Pyle seawall
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 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 Look up address
Upload Map: 20334 Bethelwood Ln - Google Maps.pdf 329.7KB
Latitude:* 35.487807 Longitude:*-80.903194
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*
plot layout.pdf 133.83KB
Lake Forms 2.pdf 359.73KB
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.)*
IMG 1783.jpg 148.17KB
IMG 1784.jpg 137.79KB
IMG 1786.jpg 125.34KB
IMG 1704.jpg 144.9KB
4. Location of the property (where work is to be conducted)
Nearest Town:* Cornelius
County:* Mecklenburg
Lake/ river/ ocean adjacent to Norman
property:

Subdivisions name or site address:* 20334 Bethelwood Ln lot 8
Include phase/lot nunber
Directions to site:*
Take NC-73 E towards Huntersville. Turn left onto W Catawba Ave.
Turn left onto Bethel Church Rd. Turn right onto Bethelwood Ln.
Property is on the right.
Aease include road narres 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 1.510 acres
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
Installation and grading of approx 2x100ft along shoreline for Boulder
RipRap to minimize rock slide. Installation of approx 1001nft of footer
with compacted gravel and 70 Rockwood 8" block to create base level
Installation of approx 100 Rockwood 8" segmented block wall along base
course to obtain a Ift border wall above RipRap. Installation of approx
100 Rockwood 8" segmented block wall along base course to obtain a Ift
border wall above RipRap.
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.)
400 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, backfill, excavation, rip rap, retaining walls, etc.)
1500 sq ft
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)
One tree, manicured lawn and woods.
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):
a $240.00 for impacts to lake (below normal water level) of less than 1 acre
a $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');

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:* Dean Fisher
Signature:
C,44�4.

Initial Review
Is this accepted into the review
process?*
Project Number:* 20200870
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

AMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO, 8 PLAN NO. PARCEL ID: 001121
STREET ADDRESS: 20334 Bethelwood L:n. Cornelius, NO 80 1
Please print-.
Property Owner:
Property Owner:
The undersigned, registered property owners of the above fasted property, do hereby authorize
Dean Fisher of Lake Norman Custom Dock & Pile Driving, Inc
(Contractor J Agent) (fame of consulting fFrm)
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 conditiins attached.
Property Owner's Addfess (if different than property above):
e hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge,
Authorized Signature, Authoaized Signature
Date; Date:

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CATAI BA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: Pyle Shprii�kin�1 2U334 9etneh%'Cg L-i Co
Owner: Lindey Pyle
NG28031 County: Mecklenburg
Print Signature
Contractor/agent: Dean Fisher
Print Signature
The approval is for the purpose and design described 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 02 B .0243(8)]
Trees are not allowed to be removed from Zane 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)]
Benching and grading in the buffer is not allowed. Excessive disturbance of ground cover_ [15A NCAC 02B .0243
(6)]
Beaches, impervious patios, impervious walkways, etc, are not allowed in the buffer unless specifically approved
by the Division. There are limitation on size for decks_ 115A NCAC 02B .0243(4) and (6)]
Work to be conducted from land must 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 02H _0502 and 15A NCAC 02B _0243 (4), (6), (B)]
Stormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
di$041rgeS must 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 0 2 B .G243(5), (6)]
Acknowledgement of Notification
I. hereby state that I #gaye been informed of the Catawba
Riparian Buffer R u I L0 Any 4 rk conducted 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
taken such that the construction will be built within substantial compliance and intent of the 401 Water
Quality CeIification and Buffer Roles, the approved plans) and spec ification(s), and other supporting
materials -
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