20200937 Ver 1_Shoreline Stabilization_20200722

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 7/20/2020 1:20:19 PM (Submittal)
Approve by Montalvo, Sheri A 7/22/2020 10:45:14 AM (Non -DOT - Approver)
• The task was assigned to Montalvo, Sheri A 7/20/2020 1:20 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 more information here.
Lyn Reid
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
7280 Blackwelder Road
Address Line 2
city
Denver
Fbstal / Zip Code
28037-8296
r Yes
r No
Janice Estep
CBC Stone & Recycling, LLC
[e-mail]
[phone]
(xxx)xxx-xxxx
State / Frovince / Region
NC
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 219.92KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 021-1.0502(a) & (b)]
Project Name:* Lyn Reid 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.*
(-- Upload File
r Look up address
Upload Map: Plat.pdf
Vicinity.pdf
Buffer Form.pdf
Directions.pdf
Latitude:* 35.552238
587.48KB
1.72MB
389.01KB
277.77KB
Longitude:*-81.005171
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 363.16KB
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 1.45MB
4. Location of the property (where work is to be conducted)
Nearest Town:* Denver
County:* Catawba
Lake/ river/ ocean adjacent to Norman
property:

Subdivisions name or site address:* 7280 Blackwelder Rd. Denver, NC 28037 Lot #191
hclude 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)
9.9 mi
Turn left onto Slanting Bridge Rd
2.3 mi
Turn right onto Independence Ln
62 ft
Slight left onto Blackwelder Rd
0.8 mi
7280 Blackwelder Rd
Denver, NC 28037
Pease include road narres 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 .630 acres
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
Install (12) 4' wide steps at point of lot for lake access and install
stepping stones above step area on shoreline
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.)
8' below (32 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 (4 sf)
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:* 20200937
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. 1 0� 1 PLAN NO. PARCEL ID:
STREET ADDRESS: C� C L6A WE.I CI e.Ct
1�7, en ter , NC Z 9037
Please print:
Property Owner:
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
,T=:i.eP.of C (3t6rle eco i no T�..C.
(Contractor / Agent) (Name of consulting ftrm) �J J
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: 163 - UbZo - 9UL S __
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
JAo 4dS1atureAuthorized Signature
Date: 14 Date:

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CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address:
Owner: Lyles
Print
Contractor/agent:
Print
Signature
ure
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 02B .0243(6)]
Benching, grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 028.0243 (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
I, 7R, hereby state that I have been informed of the Catawba
Riparian ffer 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 Buff Rules, the approved p n s) and specification(s), and other supporting
materials.
Signature (owner): Date:

Go gle Maps 610 East Center Avenue, Mooresville, NC to 7280 Blackwelder Rd, Denver, NC 28037 Drive 14-6 miles, 27 min
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Go gle
Wpd8tatP2020 2mit_
610 E Center Ave
hrionrLs,Alle, NC 2W 15
t 1. Head west on E Center Ave toward Cedar St
C.5 Fri
.1 2. Turn left onto S Church St
397 Ft
p 3_ Turn right onto E McLelland Ave
1,1 m1
ry 4. Use any laneto turn left onto NC-150 W/E Plaza Dr
8 Continue to follow NC-1SOW
8 Pass by Zaxby's Chicken Fingers & Buffalo Wings (on the
right in 1.3 m i)
94mi
e1 5. Turn left onto Slanting Bridge Rd
2a mi
6. Turn right onto IndependenceLn
62 n
ti 7. Slight left onto Blackwelder Rd
0.6m!
7280 Blackwelder Rd
Denver. NC 26?3'
These directions are for planning purposes ony
You mayfind that construction projects, traffic,
weather, or other events may cause conditions to
differ from the map results, and you should plan
your route acccrdingP You most obey A signs or
notices regarding your route,

Full Pond/
Normal Water Level
r rye � . i
Shoreline
Lake
(At Full Pond/.Normal Water Level)
61 104ow X 4 1
oac
I'0,.6'je-Xq
10
W tdc' ilou5e
■MW �
lib Vrc 5 rem6ved
M', n', ma,t 6isfur6nce.
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
5. Location of construction access corridors
FORM: SSGP 10-2013 Page 3 of 3

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