20201207 Ver 1_Shoreline Stabilization_20201022

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/20/2020 7:16:44 PM (Submittal)
Submit by Montalvo, Sheri A 10/22/2020 4:28:29 PM (Non -DOT - Approver)
• The task was assigned to Montalvo, Sheri A 10/20/2020 7:16 PM

Submission Form
Pre -Filing Meeting Information
Before submitting this form please ensure you have submitted the Pre -Filing Meeting Request Form as we will not be able
to accept your application without this important first step. The Pre -Filing Meeting Request Form is used in accordance
with 40 C.F.R. Section 121.4(a) "At least 30 days prior to submitting a certification request, the project proponent shall
request a pre -filing meeting with the certifying agency" and in accordance with 40 C.F.R. Section 121.5(b)(7), and (c)(5)
all certification requests shall include documentation that a pre -filing meeting request was submitted to the certifying
authority at least 30 days prior to submitting the certification request. Click here to read more information on when this
form is needed prior to application submission or here to viewthe form.
(First click here is the EPA Clean Water Act,
second click here will be the form Pre Filing Meeting.)
Attach documentation of Pre -Filing Meeting Request here:
DWR Pre -Filing Meeting Request Form
51.74KB
Cherry.pdf
Pre -fling Meeting or Request Date 9/18/2020
ID# 20201207 Version
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 * [e-mail]
Rease provide an enail address for payment and requests for more infornation here.
Owner Information:
Name: * Harold and Cathy Cherry
Email:* [e-mail]
Phone Number:* [phone]
(xxx)xxx-xxxx

Mailing Address:* Street Address
4210 Pointe Norman Dr.
Address Line 2
City
State / Province / Fegion
Sherri% Ford
NC
Fbstal / Zip Code
Country
28673
United States
Is there an agent working on the F Yes
project?* r No
Agent/Consultant Information
Name:* Randy Jordan
Company Affiliation:* Lyfe Marine, Inc.
Email: * [e-mail]
Phone Number:* [phone]
(xxx)xxx-xxxx
Address:* Street Address
19109 W. Catawba Ave.
Address Line 2
Suite 200
City
State / Province / Fbgion
Cornelius
NC
Fbstal / Zip Code
Country
28031
United States
Asigned and dated copy of the Agent Authorization letter:*
Agent Auth + Catawba Riparian Cherry.pdf 520.54KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* Cherry Shoreline
f your project has a formal name please use this. If your project does not have a formal name, please identify your project by
he owner name and proposed activity (Jones Property Access Road, Smith Guest House, etc.) List in parentheses any
Dther 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
F Lookup address

Property Address Lookup.*
Latitude:* 3�.6100�0
Street Address
4210 Pointe Norman Dr.
Address Line 2
city
Sherrills Ford
Fbstal / Zip Code
28673
State / Rovince / Region
North Carolina
Country
United States
Longitude:*-80.932170
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*
Cherry Diagram.pdf 350.12KB
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.)*
Cherry 1 stump.png
IAMB
Cherry photo 2.png
1.76MB
Cherry Photo 3.png
1.35MB
Cherry Photo 4.png
IAMB
Cherry Photo 5.jpg
5.8MB
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:* Pointe Norman: 4210 Pointe Norman Dr.
Include phase/lot nunber
Directions to site:*
77-N to Exit 36; turn left onto Hwy. 150 to left onto Pointe Norman Dr.
4210 is on the left.
Aease include road narres and nunbers, landr arks etc.
5. Describe the existing land use or condition of the site at the time of this application:*
Residential
Pesidential, undeveloped, etc.
6. Pro pertySize .95
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
67 lineal feet of new Class "B" rip rap + 62 lineal ft of new Class "B" rip
rap on top of existing rip rap; install Geo-fabric; remove 5 trees and 1
stump. (circle in red on photos)

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.)
1032
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)
Grass yard
Sketch: Cherry Diagram.pdf 350.12KB
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, the project proponent, hereby certifies that all information contained herein is true, accurate, and complete to the
best of my knowledge and belief
o I, the project proponent, hereby requests that the certifying authority review and take action on this CWA 401
certification request within the applicable reasonable period of time.
o I agree that submission of this Shoreline Stabilization online form is a "transaction" subject to Chapter 66, Article 40 of
the NC General Statutes (the "Uniform Electronic Transactions Act');
o I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the INC General Statutes
(the "Uniform Electronic Transactions Act');
a 1 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 the Shoreline Stabilization online form.
Full Name:* Randy Jordan
Signature:
1?a14d1,T0I'bb14

Initial Review
Is this accepted into the review
process?*
Project Number:* 20201207
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
pRt3Pi ,f rif LEGAL DESCRIPTION:
LOT No: 25 PLAN MO: PARCEL I13: ±N7193617576
STREET ADDRESS:
4210 pointe Norman Dr.
sherrills Ford, NC 28673
Tease print:
Property Goner: Harold Ch
prop" Owner: Cathy Cherry
The undersigned, registered property Owners of the above noted properly, do herebyau%hvriZe
Randy Jordan ,cif Lyfe Marine, Inc.
(contractor/Agent) (Name of MW-Uting firm),
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of this
permit or certificaiJon and any and all standard and special conditions attached.
property owners Address (if different than property above):
Telephone: ZL4-882-5131
We hereby certify the above information submitted in this application is true and accurate tothe
best of our knowledge.
r
`�r7tE r

Project tti1���5e '"^_' a ti�'-��- �c �, � 3 � ti c`+�� • �rz� •��
r
'ri�:'l• �rgn�Gi�:
Ti e approval is for the purpose and design described in your application. Impacts not indicate in the
application is violation. o=tiie Su er Rule. Site specific Vierk should be provided in the sp lication. 1 5A NCAC
02H .0506 and ISA FNCAC 0213,0243(8)l
Trees are prat allowed to be reprieved from Zane 1 of the Buffer (within 30 it of the fuli pond elevation), unless
approved. Exception, those trees that are sevareiy undermined along the immediate shoreline can be rerrmovad.
rtlnimal shapiprg �hd sloping along the irnmediate shoreline is above , li5A 3NCAC C12B .C243(6);
Benching and grading it the buffer is not aliovied. Excessive disturbance of ground cover. (15A NCAC 02B .0243
(ill
geache5, impervious patios, imperviduswalkwsys, etc. are not alto led in the buffer unless specificaily approved
y tide Division. There are limitation on 67,e for decks.115A FQCACC2i .0243(a) anon (611
work to be conducted 'frorn land riust indicate an access and Indicate any trees that are to be removed- The
work corridor should be described. Tine arsproved access corridor shall be restored. Staging, span: construction
material ,must be outside :he bufFer. (15A NICAC 02H .051-02 and 15A NCAC 025.0243 (4), (6), (g)?
5tormwater cannot. he piped or c :anneied for direct dis&iarge to the lake_ .411 constructed storir A ter
discharges rn ust be at the natural elevation and discharged prior to entering the buffer directed as dffuse or
skeet flog at non -erosive velocities to the take. (?:5A NCAC 02B.0243(5) , (5)7
r ' •'. "' e Y �raLi r Mate that F L, ie been i iformed o the Catavvbe-
Ripariar} Buffer Rule. Any work conducie€ ;n the buffer, not specifically salted in the appiicariorr and approved
by the Division of Water Resojsrces (DWR), is a 4�'t�latiorc ap d subject to er;ror�rese€�t. Due d'siigi'nce vr�J! be
taken such that the mnstruction gill be bruit withiin, substantial compliance and intent of she 401 Water
QuaEfty Cerdfication and Buffler Rules, the approved plans and specificat€on(.$), and other supiacr ting
mattermis.

La ke
(At Full Pond/ Normal Water Level]
�11
Full Pond/ I
Norma Water Level
Shoreline
tl
r
Please approximately sketch the following information on this plan, length of shoreline
(provide dimensions for each item, such as 30ftx 100 ft)*:
1. All proposed vegetation clearing
2. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level eh
3. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level el(
4. Location of any proposed structures such as buildings, retaining walls, docks, etc.
S. Location of any excavation or dredging below the Full Pond/ Normal Water Level E
6. Location of construction access corridors
Ea
FORM: 55GP 10-2013 Pag�3 of 3

La ke
(At Full Pond/ Normal Water Level]
�11
Full Pond/ I
Norma Water Level
Shoreline
tl
r
Please approximately sketch the following information on this plan, length of shoreline
(provide dimensions for each item, such as 30ftx 100 ft)*:
1. All proposed vegetation clearing
2. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level eh
3. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level el(
4. Location of any proposed structures such as buildings, retaining walls, docks, etc.
S. Location of any excavation or dredging below the Full Pond/ Normal Water Level E
6. Location of construction access corridors
Ea
FORM: 55GP 10-2013 Pag�3 of 3

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