20201111 Ver 1_Shoreline Stabilization_20200903

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 8/27/2020 1:19:45 PM (Submittal)
Approve by Montalvo, Sheri A 9/3/2020 5:46:37 PM (Non -DOT - Approver)
• The task was assigned to Montalvo, Sheri A 8/27/2020 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.
John Rizzo
jrizzo_2004@yahoo. c om
[phone]
(xxx)xxx-xxxx
Street Address
20330 Norman Colony Rd
Address Line 2
city
Cornelius
Fbstal / Zip Code
28031
r Yes
r No
Randy Jordan
Lyfe Marine
[e-mail]
[phone]
(xxx)xxx-xxxx
State / Frovince / Region
NC
Country
United States

Mailing Address:*
Street Address
19109 W. Catawba Ave.
Address Line 2
Suite 200
City
Cornelius
Fbstal / Zip Code
28031
Asigned and dated copy of the Agent Authorization letter:*
John Rizzo Agent Auth.pdf 146.99KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* John Rizzo Shoreline
State / Province / Pegion
NC
Country
United States
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 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
Property Address Lookup:*
Latitude:* 35.489560
Street Address
20330 Norman Colony Road
Address Line 2
Oty
Cornelius
Fbstal / Zip Code
28031
State / Province / Pegion
NC
Country
United States
Longitude:*-80.891140
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*
Rizzo Diagram.pdf 139.28KB
Please use the diagram at the link below:
https://edocs.deq.nc.gov/WaterResources/0/edoc/616616/Shoreline%2OLayout.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.)*
John Rizzo photo l.jpg
3.89MB
John Rizzo photo 2.jpg
4.07MB
John Rizzo photo 3.jpg
6.27MB
John Rizzo photo 4.jpg
6.48MB
John Rizzo photo 5.jpg
3.42MB

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:* 20330 Norman Colony Road/ lot 11A
hclude phasellot nunber
Directions to site:*
77-N to Exit 28; turn left onto W. Catawba Ave to right onto Norman
Colony Rd.
Rease include road naves and nunbers, landnarks etc.
5. Describe the existing land use or condition of the site at the time of this application:*
Residential with existing dock and shoreline
Fbsidential, undeveloped, etc.
6. Property Size .54
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
Shape the bank, install Geo-tech fabric and install new Class II Rip Rap
along the 129' shoreline.
8. How will the work be done?* PF 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 w alls, etc.)
774 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, back fill, excavation, rip rap, retaining walls, etc.)
129 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)
Grassy, flat yard.
Sketch: Rizzo Diagram.pdf 139.28KB
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:
o I have given true, accurate, and complete information on this form;
o 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:* Randy Jordan
Signature:
1?a14d1 ,TZV14

Initial Review
Is this accepted into the review
process?*
Project Number:* 20201111
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: 11A PLAN NO. N:'A PARCEL ID: 00113412
STREET ADDRESS-.
20330 Norman Colony Rd
Cornelius, NC 28031
Please print:
Property Owner: Jahn Rizzo
Property Owner:
The undersigned, registered property owners of the above noted property, do herebyauthorize
Randy Jordan , a€ Lyfe Marine, Ine.
-----------------
[ion ra�tY'Rs z ,tj (Naor a of CDnsul';ng F m)
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 spedai conditions attached.
Property Owners Address (it different than property above):
Telephone: 70- - 952
we hereby certify the above information sul3mitted In this application is true and accurate tothe
best of our knowledge.
----------------
uthor zed Sigma AuMor el Signature
Date (late

Lake
(At Full Pondj Normal Water Level)
Ft
Normz
SI
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
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Lake
(At Full Pondj Normal Water Level)
Ft
Normz
SI
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 ... 4L