20201349 Ver 1_Shoreline Stabilization_20201106

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 11/4/2020 10:40:45 AM (Submittal)
Submit by Montalvo, Sheri A 11/6/2020 1:37:21 AM (Non -DOT - Approver)
• The task was assigned to Montalvo, Sheri A 11/4/2020 10:41 AM

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.
Attach documentation of Pre -Filing Meeting Request here:
DWR Pre -Filing Meeting Request Form.pdf 51.38KB
Pre -fling Meeting or Request Date 11/4/2020
ID# 20201349 Version 1
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 email address for payment and requests for more information here.
Owner Information:
Name: * William
Email: * [e-mail]
Phone Number:* [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
4800 Cherry Woods Lane
Address Line 2
City
State / Frovince / Region
Charlotte
NC
Fbstal / Zip Code
Country
28277
US

Is there an agent working on the F Yes
project?* r No
Agent/Consultant Information
Name: *
Terri Kindley/Shannon Miller
Company Affiliation: *
Lake Norman dredging
Email:*
[e-mail]
Phone Number:*
[phone]
(xxx)xxx-xxxx
Address:*
Street Address
PO Box 3156
Address Line 2
City
Mooresville
Fbstal / Zip Code
28117
Asigned and dated copy of the Agent Authorization letter:*
2020-11-03 15.54.47.pdf 293.58KB
Link to: Sample Agent Authorization Form
State / Province / Pegion
NC
Country
US
Project Information [15A NCAC 02H .0502(a) & (b)]
................................................................................................................................................................................................................................................................
Project Name:* William Harris Maintenance to Rip Rap for shoreline stabilization
If your project has a formal name please use this. If your project does not hake 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 Lookup address
Upload Map: CB5A689B-7845-407B-843E-
3.42MB
D7F300349784.png
Latitude:* 35.488360 Longitude:*-80.968250
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*
8FC153CB-B27C-4A7A B47C-
3.8MB
7F46F8A62EED.jpeg
348712AC-CFF5-4EE1-AF7F-
861.42KB
7B9099A20AFF.jpeg
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.)*
20EAA421-3488-42E4-9D69-
184.29KB
5EA089955ADA.jpeg
If-vA040111RI:13fll.)0913fa
164.34KB
5A7AAC9107CE. jpeg
4. Location of the property (where work is to be conducted)
Nearest Town:* Denver
County:* Lincoln
Lake/ river/ ocean adjacent to Lake Norman
property:
Subdivisions name or site address:* 2814 Cherry Lane Denver N.C. 28037
Include phase/lot nunber
Directions to site:*
I-77 exit 25 NC 73 West Sam Farr Rd 7.6 M
Right onto N pilot knob Road 0.9 M
Right onto NC 16 business North 1.5 M
Right onto unity Church Road 1.3
Left onto Cherry Ln 0.5 Stay left on Cherry Ln 0.2
Pease 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. Property Size 0.658 AC
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
Maintenance to existing Rip Rap to eroded and bare areas.
All work to be done
by water using barge and long reach.
8. How will the work be done?* r From Land
rJ 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.)
600 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.)
None
square feet
11. Please describe the vegetation above the normal pool lake level/ normal water level and 50 feet
landward to be impacted:*
(number of trees, for instance)
None

Sketch: A912F91E-4B19-405D-AA4C-
764.46KB
7611288B9BB2.jpeg
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
0 $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 NC General Statutes
(the "Uniform Electronic Transactions Act');
0 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:' Terri Kindley
Signature: ^`

Initial Review
Is this accepted into the review
process?*
Project Number:* 20201349
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

LOT NO: O PLAN NO: PARCEL
I I ADDRESS:
Pleew-2 Drf:lt=
Property
Owner: Lill
Froperiy
Owner:
The underigned, registered propery owner of the above noted property, do hereby
authorize
(Contrar a�lAgertj (Name oilconsulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and
acceptance of this permit or cer'�iicaiion and any and all standard and special conditions
attached.
Rropea i; y Grsners AddMss (a: drZ� rent ;= prope �y above):
<�qL -
Telephone- 3jSc-;),
`.�c��.l�ltl,��;� ►ill i'�l
We harahv cer"ifv the above information submitted in this cation i� 'iru� d ,

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Project
Owner.-
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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. [I5A
NCAC 0211.0506 and 15.A NCAC 02B .0243(S)1
Trees are not allowed to be removed from Zone 1 of the Buffer (within 30 ft of the fall pond elevation), unless
approved Exception, those trees that are severely undemtined along the immediate shoreline can be removed -
Minimal shaping and sloping along the immediate shoreline is allowed [15ANCAC 02B .0243(6)]
Benching and grading in the buffer is not allowed Excessive disturbance of ground cover. [15A NCAC 02B
.0243 (6)1
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. [15ANCAC 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 stored. Staging, spoil, construction
material must be outside the bLffer. [I5A NCAC 02FI.0502 and I5A NCAC 02B .0243 (4), (6), (S)]
Stormwmter cannot be piped or channeled for direct discharge to the lake. All constructed stonnwater
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. f 15.A NCAC 02B .0243(D7, (6))
Ackninvkdgemazt ofA'ofifrcadon
L W \ t_L( AWN [A�L-'4 (?- hereby state that I have been informed of the Catawba
Riparian Buffer Rule. Any Work conducted ih 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( and specifrcadon(s), and other supporting materials.
Signature {owner): � llate:

s, 4

(At Full Pond/ Normal Water Level)
Side View
3 ft. below full pond water level 4 ft, above full pond water level 2 ft. additional clearing
if necessary
Existing bank
10 ft. bank
Side V
FORM: SSGP 02-2017 Page 4 of 4