20201404 Ver 1_Shoreline Stabilization_20201109

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 11/6/2020 8:31:41 AM (Submittal)
Submit by Montalvo, Sheri A 11/9/2020 8:58:24 PM (Non -DOT - Approver)
• The task was assigned to Montalvo, Sheri A 11/6/2020 8:31 AM

Water Resources
ENVIRONMENTAL QUALITY
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 view the form.
Attach documentation of Pre -Filing Meeting Request here:
Pre -Filing Meeting Request.pdf 425.74KB
Pre -fling Meeting or Request Date 10/6/2020
ID# 20201404 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*
Owner Information:
....................................................................................
Name:
Email:
*
Phone Number:*
Mailing Address:*
[e-mail]
Pease provide an email address for payment and requests for pure information here.
David Boyd
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
17344 Connor Quay Court
Address Line 2
city
Cornelius
Fbstal / Zip Code
28031-6504
State / Province / Flegion
NC
Country
US

Is there an agent working on the
project?*
Agent/Consultant Information
..................................................................................................................
Name:
Company Affiliation:
Email:*
Phone Number:*
Mailing Address:*
r: Yes
d No
Janice Fstep
CBC Stone & Recycling, LLC
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
638 Oakridge Farm Hwy
Address Line 2
City
Mooresville
Fbstal / Zip Code
28115
Asigned and dated copy of the Agent Authorization letter:*
Auth. Form.pdf 216.83KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* Boyd Property
State / Province / Fbgion
NC
Country
United States
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: Survey.pdf
Vicinity Maps.pdf
Directions.pdf
Latitude:* 35.449325
527.81 KB
1.76MB
265.5KB
Longitude:*-80.938291
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 321.82KB
Buffer Form.pdf 374.47KB
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.)*
Shoreline Pics.pdf 3.27MB
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:' 16423 Belle Isle Dt. Cornelius, NC 28031 Lot 52 Crescent Land &
Timber Corp.
Include phasellot number
Directions to site:*

610 E Center Ave
Mooresville, NC 28115
Take Evergreen St to E Center Ave
44 s (0.1 mi)
Head east toward Evergreen St
108 ft
Turn right onto Evergreen St
417 ft
Take S Main St, NC-115 S, Langtree Rd, I-77 SIUS-21 S, ... and Jetton
Rd to John Connor Rd in Cornelius
22 min (11.8 mi)
Turn right onto E Center Ave
0.5 mi
Turn left onto S Church St
0.4 mi
Turn right onto E Wilson Ave
0.1 mi
Turn left onto S Main St
1.2 mi
Continue onto NC-115 S
2.1 mi
Turn right onto Langtree Rd
1.1 mi
Use the left 2 lanes to turn left to merge onto I-77 S/US-21 S
3.1 mi
Take exit 28 for US-21 S toward Catawba Ave/Lake Norman/Cornelius
0.2 mi
Keep right at the fork, follow signs for Lake Norman and merge onto W
Catawba Ave
1.1 mi
Turn right onto Jetton Rd
2.0 mi
Continue on John Connor Rd. Drive to Belle Isle Dr
5 min (2.0 mi)
Turn left onto John Connor Rd
1.1 mi
Turn right onto Belle Isle Dr
Destination will be on the right
1.0 mi
16423 Belle Isle Dr
Cornelius, NC 28031
Rease include road names and nurrbers, landmarks etc.
5. Describe the existing land use or condition of the site at the time of this application:*

Residential
Fbsidential, undeveloped, etc.
6. Property Size 0.811
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
Install boulder rip rap in front of and to top of existing wall. Install TN
Crab Orchard steps.
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, backfill, excavation, rip rap, retaining walls, etc.)
5' below (855 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 (171 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):
0 $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, 1 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:* Janice Estep
Signature:

Initial Review
Is this accepted into the review
process?*
Project Number:* 20201404
Select Reviewer:*
Select Reviewing Office
Has payment been received?*
What amount is owed?*
r Yes (` No
Version:* 1
Alan Johnson:eads\adjohnsonl
Mooresville Regional Office - [phone]
r No Payment Needed
r Fee Received
F Need Fee - send electronic notification
F $240.00
* $570.00

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. Jai T PLAN NO. PARCEL ID:
STREET ADDRESS:
Please print:
Property Owner:
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
�Da E-f e 1D of _W moons. , &cq6 illy4L
(Contractor / Agent) I (Name of consulting firm)
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: 1044 -'A0 f " 3 89a
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: _10 d Q Date:

LEGEND:
14 REBAR FOUND
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COMPUTED POINT
$
BENCHMARK
NCGS MONUMENT
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TV PEDESTAL
HVAC
UTILITY POLE
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SUBJECT PROPERTY LINE
ADJOINER PROPERTY LINE
BUILDING SETBACK
—
OVERHEAD UTILITIES
❑U
FEMA FLOOD LINE-------""---
1v.69' onuNf
APPROXIMATE LOCATION OF I/ v
THE 100YEAR FEMA FLOOD LINE { ( f
(SEE NOTES 4-6) N f
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?MOTES: 1
1. TIE TO NCGS MONUMENT SHOWN
HEREON. VERTICAL POSITIONS ARE
REFERENCED TO NAVD 88 (GEOI) 12A).
2. PROPERTY MAY BE SUBJECT TO OTHER
COVENANTS, RESTRICTIONS, EASEMENTS
OR RIGHTS -OF -WAY THAT MAYBE OF
RECORD.
3. THE SET13ACKS SHOWN ARE PER MB. 17,
PG. 552.
4. PORTION OF SUBJECT PROPERTY IS
LOCATED WITHIN A SPECIAL FLOOD
HAZARD AREA ACCORDING TO FEMA
FLOOD INSURANCE, RATE MAP -PANEL
937104622WK; EFFECTIVE DATE: 03102f2009.
001-312-45
MON ICA YATES
LLOYD YATES
DB 34192, Pg 365
,197. u•�i I+,
CLEMMER, P.L.S
19335 OLD STATESVILLE ROAD
A
— ';<,y L-531
SUITE
CORNELTUS.
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001-312-47
BELLE ISLE PROPERTY, LLC
DO 27320, Pg 604
LINE
BEARING
DISTANCE
L7
N 31-38.57" W
58.90'
L2
N 1539'00- W
43.10'
L3
S 28'52'29" E
155.63'
NOTES
5. FLOOD ZONES DEPICTED HEREIN WERE NOT FIELD
LOCATED BY PPS AND ARE SHOWN USING INFORMATION
FROM FEMA PANEL 437I0462200R, DATED 031022009, AND
ALSO USING INFORMATION PROVIDED BY MECKLENBURG
COUNTY FLOODZDNE MAPPING.
6. THE FLOOD MAPS ARE SUBJECT TO CHANGE WHEN
FLOODINSURANCE RATE MAPS (FIRM's) ARE UPDATED AND
ADOPTED BY THE FEDERAL EMERGENCY MANAGEMENT
AGENCY (FEMA), TFIESE CHANGES SUPERCEDE THE
RECORDED PLAT.IMPROVEMENTS.
7. CONSULT WITH GOVERNING AGENCY FOR PREVAILING
LAND DEVELOPMENT AND ZONING REQUIREMENTS PRIOR
TO DESIGN OR CONSTRUCTION OF ANY IMPROVEMENTS.
' NCGS MONUMENT
(NAD83f2011)
.20R AZ MK`
N:638,206.9O ft.
E:1,431,939.91'11.
ELEVATION: 762.40'ft.
COMBINED FACTOR
0.99984810
PUBLISHED
ep
ELEV:E �TWN L
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GraphicScale
40 20 0 40
Scale Of Dm ix z I Inch = 40 Feet
Topographical Survey of Lot 52 of Crescent Land & Timber Corp Recreation Lots, Section 2
Professional
Property
Surveyors, Inc.
Property of:
P 1tY
As Recorded in:
Site Address:
19335 Old Statesville Road Ste. A
David & Kathryn
Map Book 17, Pg 552
16423 Belle Isle Drive
Cornelius, NC 28031
Cornelius, N.C.
Boyd
Deed Book 6563, Pg 846
hone/
704-765-5134 Phone/fax
Mecklenburg
g County
Firm License: C-3666
D30220-07
JML
>_ 1,10,000
1"�0'
Drawin Scale
001-312-46 16423 Se11e
Talc Parcel NumbEr brave ng File Name
I of 1 3/05/2020
Sheet Number Dllc mi
Job No.
Pre areal By
Error of Closure

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Polaris 3G Map -- Mecklenburg County, North Carolina
Date Printed: 10/5/2020 3:13:04 PM

Legend
4

11I612020 510 East Center Avenue, Mooresville, MC to 16423 Belle Isle Or, Cornelius, NC 28031 - Google Maps
Go ..gle Maps 610 East Center Avenue, Mooresville, NC to 16423 Drive 13.9 miles, 28 min
Belle Isle Dr, Cornelius, NC 28031
tr
l.
J
Go gle
Map data@2020 2mil -------------
610 E Center Ave
(`.4o,1i r-+S'dllle, t'K:28115
Take Evergreen St to E Center Ave
4s s (0.1 ml)
t 1. Head east toward Evergreen St
108 ft
ro 2. Turn right onto Evergreen St
417 ft
Take S Main St, NC-115 S, Langtree Rd,1-77 S/US-21 S, .„
and Jetton Rd to John Connor Rd in Cornelius
22 min (11.8 mi)
r
3.
Turn right onto E Center Ave
0,5 m
h
4.
Turn left onto S Church St
0A or;
f'
5,
Turn right onto E Wilson Ave
0-1 ml
41
6.
Turn left onto S Main St
L2 and
t
7.
Continue onto NC-115 S
2.1 mi
111612020
610 East Center Avenue, Mooresville, NC to 1544 6e11e Isio or, Cornelius, NC 28031 - Google Maps
r►
8.
Turn right onto Latlgiree Rd
9.
I 'I mi
Use the left 21anes to turn left to merge onto 1-77
S/US-21 S
31 mi
jr
10.
Take extt 28 for US-21 S toward Catawba
Ave/Lake Norman/Cornelius
0 2 mi
11,
Keep right at the fork, follow signs for Lake
Norman and merge onto W Catawba Ave
I I mi
1+
12,
Turn right onto Jetton Rd
217 mi
Continue on John Connor Rd. Drive to Belle Isle Dr
5 min (2.0 MI)
13. Turn left onto John Connor Rd
V ml
r' 14. Turn right onto Belle Isle Dr
IS Destination will be on the right
1 ❑ ml
16423 Belle Isle Dr
These directions are for planning purposes only.
You may find that conatructiop projects, i,
weather, or other events may cause cor itiens to
differ from the map results, and you should plan
your route accordingly You must obey all signs or
notices regarding your route-
hltps:lfwww.google.comlmapaldir1a10+L:aa#+Cenfar+Avenue.+Mooresville,+NC148e23+galls+Isle+nn+Cornelius,+NC+280311�36.6i54004,•80.9407... 1f2 hllpsJAwmv.goagle.comlmapsldirf610+East+Center+Avenue,+Mooresville,+NCf16423+belle+Isle+pr,+Cornelius,+NC+280311Q35.5154004,-60.9407.., 2!2

Full Pond/
Normal Water Level
Shoreline
La ke
(At Full Pond/Normal water Level)
t o'
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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
I 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

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: 1C Ala I,r. CrngliQ51, NC_ County:
Owner:
Print `J Signature
Contractor/agent: C'R' Cj n e_� 31eri 101 inn U C-
Print C D J , Sig
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. 115A 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
I, hereby state that I have been informed of the Catawba
Riparian Buffer Rule. An ork 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): V \w k l Date:

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