20201431 Ver 1_Shoreline Stabilization_20201110

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 11/9/2020 1:38:43 PM (Submittal)
Submit by Montalvo, Sheri A 11/10/2020 4:04:19 PM (Non -DOT - Approver)
• The task was assigned to Montalvo, Sheri A 11/9/2020 1:38 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.
Attach documentation of Pre -Filing Meeting Request here:
DWR Pre -Filing Meeting Request Form.pdf 52.21KB
Pre -fling Meeting or Request Date 10/13/2020
ID# 20201431 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 payrrent and requests for pure information here.
Owner Information:
Name: * Gene Merchant
Email: * [e-mail]
Phone Number:* [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
176 Hazehon Loop
Address Line 2
City
State / Frovince / Region
Denver
NC
Fbstal / Zip Code
Country
28037
United States

Is there an agent working on the F Yes
project?* r No
Agent/Consultant Information
Name: *
Dean Fisher
Company Affiliation: *
Lake Norman Custom Dock
Email:*
[e-mail]
Phone Number:*
[phone]
(xxx)xxx-xxxx
Address:*
Street Address
PO Box 1439
Address Line 2
City
Denver
Fbstal / Zip Code
28037
Asigned and dated copy of the Agent Authorization letter:*
AGENT AUTHORIZATION FORM.pdf 34.OlKB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* Merchant Wall
State / Province / Flegion
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 acti\ity (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: 176 Hazelton Loop - Google Maps.pdf 524.31KB
Latitude:* 35.571815 Longitude:*-80.882283
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*
Catawba Notification Form.pdf 52.07KB
site plan.pdf 122.16KB
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.)*

Bankleft.jpg 178.42KB
bankright. jpg 182.17KB
4. Location of the property (where work is to be conducted)
Nearest Town:* Mooresville
County:* Iredell
Lake/ river/ ocean adjacent to Norman
property:
Subdivisions name or site address:* 176 Hazelton Loop Mooresville NC 28117
Include phasellot nunber
Directions to site:*
Take NC-150 E towards Mooresville. Turn right onto Morrison Plantation
Pkwy. Use the right 2 lanes to turn right onto NC-1100Brawley School
Rd. Use the left lane to turn left onto Canvasback Rd. Turn left onto
Regency Rd. Turn right onto Hazelton Dr/Hazelton Loop. Property is on
the left.
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
Pbsidential, undeveloped, etc.
6. Property Size 0.51
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
Grading, clearing and backfill along shoreline to allow for seawall.
Installation of approx 1201nft of footer with compacted gravel, RiverRock
and 80 block to create base level along shoreline. Installation of approx
480 Rockwood 8' segmented block wall along base course to obtain a 4ft
total wall height. Installation of approx. 85 Rockwood 4' Caps for 601nft
along top of wall
8. How will the work be done?* [.7' 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.)
360 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 w alls, etc.)
1200 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)
manicured lawn
Sketch: diagram.pdf 38.11KB

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, 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:* Dean Fisher
Signature:
CA-Oel

Initial Review
Is this accepted into the review
process?*
Project Number:* 20201431
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

SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. 13
PLAN NO.
PARCEL ID: 4628-08-9344
STREET ADDRESS: 176 Hazelton Loop Mooresville NC 28117
Please print:
Property Owner: Gene Merchant
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Dean Fisher
(Contractor / Agent)
of Lake Norman Custom Dock & Pile Driving, Inc
(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: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized Ngnature
Date: _ //
Authorized Signature
Date:

Map data ©2020 1000 ft
176 Hazelton Loop
vicinity map
CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: Merchant shore/ 176 Hazelton Loop, Mooresville, NC 28117 County: Iredell
owner: Gene Merchant
Print
Contractor/agent: Dean Fisher
Print
go
ature
Signature
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 and grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A 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 026 .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
1, Gene Merchant , hereby state that I have been informed of the Catawba
Riparian Buffer 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 Buffer Rules, the approved plan s) and specification(s), and other supporting
materials.
Signature (owner): r Date:_ �f av;-0

DON ALLEN & ASSO CIATES, P. A
"Since 1971"
Commercial * Residential * Mortgage Surveys * Multi —Family
Construction Staking * Subdivision Design * Topographical
131 Crosslake Park Drive — Suite 102 * Mooresville * NC * 28117
[phone] [phone] Fax
1, certify that this map was drawn under my supervision from an actual
survey made under my supervision recorded in deed book 2615 page 181 —, and/or
plat book 10 _, page 59 that the ratio of precision is 1':10,000, that this map
was prepared in accordance with the General Statutes of North Carolina Chapter 89C.
my hand and seal on the _ 16 ,day of VMARCH __ .,���!��-/�/'���
A.D. 20 20 /1_�
LAKE
NORMAN
760 CONTOUR LINE PER S06 55 c5 j
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NOTES
1) THIS PROPERTY MAY BE SUBJECT
TO ANY EASEMENTS AND/OR
RIGHTS OF WAY OF RECORD.
2) ACREAGE COMPUTED BY THE
COORDINATE METHOD.
3) OVERHEAD POWER
O' 20' 40' tOD' 4) NO GRID MONUMENT FOUND WITHIN
LEGEND r I -- 2000 FEET.
E.I.P. = EXISTING IRON FOUND �- t SCALE IN FEET
I.P.S. = #4 REBAR SET PHYSICAL SURVEY
R/W = RIGHT—OF—WAY OF
176 HAZELTON LOOP
LOT 13 REGENCY LAKE VILLAGE
SCALE 1" — 40' DAVIDSON TWSP., IREDELL CO., N.C. FIELD saga
FILE RREGEEGENCY LAM VILLAGE 72
oa FILE
ACQUIRED BY: EUGENE E. MERCHANT
TAX MAP NO: 469608934#

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