20200931 Ver 1_Shoreline Stabilization_20200721

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 7/19/2020 2:39:31 PM (Submittal)
Approve by Montalvo, Sheri A 7/21/2020 10:08:37 AM (Non -DOT - Approver)
• The task was assigned to Montalvo, Sheri A 7/19/2020 2:39 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.
Primary Contact Email *
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:*
[e-mail]
Rease provide an email address for payment and requests for rmre information here.
Shawn Foster
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
728 Beauregard Street
Address Line 2
city
Charleston
Postal / Zip Code
29412-4503
a Yes
d No
Janice Fstep
CBC Stone & Recycling, LLC
[e-mail]
[phone]
()=)xxx-xxxx
/ Province / Region
SC
Country
US

Mailing Address:*
Street Address
638 Oakridge Farm Highway
Address Line 2
city
Mooresville
Fbstal / Zip Code
28115-7947
Asigned and dated copy of the Agent Authorization letter:*
Auth. Form.pdf 215.73KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 021-1.0502(a) & (b)]
Project Name:* Shawn Foster Property
State / Province / Fegion
NC
Country
US
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.*
F Upload File
r Lookup address
Upload Map: Survey.pdf
Vicinity.pdf
Buffer Form.pdf
Directions.pdf
Latitude:* 35.586250
372.64KB
1.9MB
369.65KB
223KB
Longitude:*-81.012637
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 380.91KB
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 3.36MB
4. Location of the property (where work is to be conducted)
Nearest Town:* Sherrills Ford
County:* Catawba
Lake/ river/ ocean adjacent to Norman
property:

Subdivisions name or site address:* 7244 Right Angle St. Sherrills Ford, NC 28673 Lot #3
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
397 ft
Turn right onto E McLelland Ave
1.1 mi
Use any lane to turn left onto NC-150 W/E Plaza Dr
Continue to follow NC-150 W
Pass by Zaxby's Chicken Fingers & Buffalo Wings (on the right in 1.3
mi)
11.0 mi
Turn right onto Little Mountain Rd
0.7 mi
Turn right onto Right Angle St
Destination will be on the left
0.2 mi
7244 Right Angle St
Sherrills Ford, NC 28673
Rease 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
Residential, undeveloped, etc.
6. Property Size 0.58
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
Clean debris on shoreline. Shape and slope, install matting and class "B"
rip rap.
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, backfill, excavation, rip rap, retaining walls, etc.)
3' below (399 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.)
1' above (133 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: -�!!
�s'�.asC��f�'% c�frmrtr �jrnvr�t

Initial Review
Is this accepted into the review
process?*
Project Number:* 20200931
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. __*� 3 _ PLAN NO. PARCEL ID:
STREET ADDRESS:
Please print:
Property Owner: 36 0- i f% T'iss+er ....
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
of ii
(Contractor / Agent) (Name of consulting fir )
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:
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized Signature Authorized Signature
Date: - 5_,1 q 120 Date:

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CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address:...I.Qgq g igh- ,A-okyT:.,,a eri) r .�.. County: 0
Owner:
Print �.r Signa
Contractorlagent:_�rL CJtoYI� Ppea;c/;o�i
Print C AiRnature
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 02B .0243(8)]
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 026 .0243(6)]
Benching, 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. [15A 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), (8)]
Stormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
discharges 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 02B .0243(5), (6)]
Acknowledgement of Notification
1, - Q nai&2n t 6aft v _ , hereby state that I have been informed of the Catawba
Riparian Buffer Rule. Any work 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 Certification and Buffer Rules, the approved plan(s) and specification(s), and other supporting
materials.
Signature (owner): Hate: _51q L40

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Full Pond/
Normal Water Levu
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Shoreline
Lake
(At Full Pond/Normal.Water Level)
31 el ow X 133 �--
I' o bove x 133'
�en�c+h
to' kou5 c
AC,CC5$
�Ao +rces rerno\jed
M',,rt, ma4 a 150r6anm
io \0uTer
Please approximately sketch the following information on this plan, length of shoreline
(provide dimensions for each item, such as 1Oft 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 wails, docks, etc.
5. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
b. Location of construction access corridors
FORM: SSGP 10-2013 Page 3 of 3

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