20201425 Ver 1_Shoreline Stabilization_20201110

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 11/10/2020 5:26:38 PM (Submittal)
Submit by Montalvo, Sheri A 11/10/2020 8:38:54 PM (Non -DOT - Approver)
• The task was assigned to Montalvo, Sheri A 11/10/2020 5:26 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:
HARBOUR PRE FILE APPROVAL.pdf 367.2KB
Pre -fling Meeting or Request Date 10/7/2020
ID# 20201425 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 pure information here.
Owner Information:
Name: * HARBOUR TOWN YACHT CLUB LLC
Email: * SUSAN@GBHINC. COM
Phone Number:* [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
P O BOX 386
Address Line 2
city
State / Frovince / Region
KENNESAW
GA
Fbstal / Zip Code
Country
30156
United States

Is there an agent working on the
project? *
Agent/Consultant Information
.................................................................................................................
Name:
Company Affiliation:*
Email:
Phone Number:*
Mailing Address:*
F Yes
r No
TAMARA HAGER
PERMIT FACILITATOR FOR LKN DREDGE
HAGER@LAKEPERMIT. COM
[phone]
(XXX)XXX-XXXX Address
P O BOX 5335
Address Line 2
City
MOORESVILLE
Fbstal / Zip Code
28117
Asigned and dated copyof the Agent Authorization letter:*
HAROBUR AUTH:pdf 723.82KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
............................................................................................................................................................................................
Project Name:* HARBOUR TOWN YACHT CLUB LLC
State / Province / Region
North Carolina
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: HARBOUR TOPO.pdf 1.42MB
Latitude:* 35.470002 Longitude:*-80.939677
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*
HARBOUR SURVEY.pdf 395.46KB
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.)*
HARBOUR TOWN YACHT CLUB LLC.pdf 482.27KB

4. Location of the property (where work is to be conducted)
Nearest Town:* CORNELIUS
County:* Mecklenburg
Lake/ river/ ocean adjacent to LAKE NORMAN
property:
Subdivisions name or site address:* THEPENINSULASUBDIVISION/LOT# 614
hclude phasellot number
Directions to site:*
FROM COWANS FORD DAM GO EAST ONTO NC 73 4.3 MILES,
TURN LEFT ONTO W CATAWBA AVE 2.4 MILES, TURN LEFT
ONTO JETTON RD 2.6 MILES, TURN LEFT ONTO SQUARE SAIL
RD .20 MILES, TURN RIGHT ONTO AMERICA CUP RD .1 MILES,
TURN LEFT AT THE 1ST CROSS STREET ONTO TOWN HARBOUR
RD .3 MILES
Rease include road narres and numbers, 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 .88 ACRES
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
RIP RAP AND INSTALL BOULDERS TO SHORELINE FOR
STABLIZATION
8. How will the work be done?* r From Land
V 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.)
0
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.)
0
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 - BY BARGE
Sketch: HARBOUR SKETCHpdf 230.51KB
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 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: * HARBOUR TOWN YACHT CLUB LLC
Signature:
0WA 7i,W f Y,fCi{T

Initial Review
Is this accepted into the review
process?*
Project Number:* 20201425
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

etc-), rip rap, excavation or dredging below Full Pond/ Normal Water Level elevations,
and construction access corridors. You may use the diagram provided at the end of this
application form.
3. Attach a photograph of the shoreline/ buffer proposed to be stabilized. (include a scale
of some sort- a yard stick, shovel handle, etc.)
4. Location of the property (where work is to be conducted)
County:l✓jI rr Nearest Town:
Subdivision name or site address (include phase/lot number): iy
Directions to site - please include road names and numbers, landmarks, etc.:
Latitude (in decimal degree-5)3 �'%OV02-- Longitude (decimal degree,)=b O A aJ (. 7 7
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): ,2 - i '� --.7„
6- Property size (acres): 92 _ qc4-e-S
7. Lake/ river/ ocean adjacent to property: 0 r AA 3 � rF !
S. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): '`'Fir
9. Will work be{conducted from land? ❑ From water? F)
10. Total amount of disturbance (including ail excavation, backfill ri ❑ ��r� i_ �L
p rap, retaining walls, etc.)
below the normal pool lake level/ Normal Water Level in square feet or acres:
14_C_�L
11. Total amount of disturbance (including all clearing, back fill, excavation, rip rap, retaining
walls, etc.) above the normal pool lake level/ Normal Water Level and 50 feet land -ward in
square feet or acres: i (�1= _ ;�' C�
12. 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):
2A1Lvza
Owner/Agent's Signatu 5A NCAC 02H .0502 f)-
AAgent's signature is valid only if an authorization letter from the owner is DA ovided.
FORM: sSGP 10-2013
Page 2 of 3

Project Pdame%address:
Pri nt��
Call tt'uC E3'iage 3 : 5ignatur�
print
The approval is ;or the Signatu e
0PPlication is a violationofthe Suffer R rPose and ue$Siign doncribed in
Your application. irnpacLs not indicated in th-e
Qzf d .050E and 1SA NCAC 02„ clftc work should be- provided in the applkatian. l SSA itICAC
B -0Z :3(8)f
Trees are not allowe
to Le removed irQm Lang ? u
aAprovrsd. Exca a� :he But (wlLhin 30 0-' the E u11 and 4
ptian chase trees that are severely undermined aian
Minimal sha !n� p levation), unless
A o and sloping along the immediate shoreline is 21lowed T immed(atashoreline can be removec.
Benching, grading in _
-SA NCAC 028 .0?43(E)j
Lne bu; Teris notailow2d- Excessive disturbance of ;round cover. f t
Beaches, im _SA NCAC 028 -0243 (G)J
iJ�r+Maus pcLlos IrnpErvio[a,- walkways, etc are not allay
bl! the {�i�liSEan. Thera are fimitatian On si=e iQr dOCi;S. i�
Ned in the bu;;er uniessspecir'icalfy approved
-SA' ItiICaC 0?S .r17n
Work ` 3 (4) and (5) i
LO be COnCillCted'
morn land must indicate an access and indicate an
+n�ork corridor should be described. Th -
e approved ac Y trees that are -o be removed. T ha
materiai must be Outside t,` -a bu�;er_ I!5�', iti1C�C 0� �050� and or snail be restored.
(` /^ j� 5;a,jn,7, sooll, constr!3Ctior.
�!. NCAC 023 .0}43 1!i) r
Starrrnwater cannot be i () (8)r
�ISCl1aT�e P Ped Or channeled f Or s Must be �t -L dir ct discnar_a to th
L tie naLUl cl �I C�Lr.�Li�[i rl Ca�T C} d15Crla'T = Jake- AJ) ConSEI I.iCL�Q
sheet i104Lr �L non --a rc ged pri©r to J �r17lN�t��
�c-focries Lo the fake- [ (5), (5ng the buffer direCtLe _.5A NCRCO?B .p?�3f5 , Q+� d as di;�L=sa or
riC:C�70r1i ) ( 1!
GGBfitQr� Q1 1 0tijfCC7-J
On
RiParian Bus ter hula. Any ric �erahy state that 1 ' �e been - -c
wa cand na` n in;ar
Q1, she Division used In ihe bll,rer, informed Qi LhE' Ca�avlba
sign o; lr�rater Resou ,not speri;ically stated in the application and approved
talten such thattha ca rces (D1rl�iti}, is a violation and subject to en:orcement Due dilig d a p�
nstrucQ0n will be built tnrithln subs
�llQllt+� C�rtt'iicatia Lcrltia} CD cnCC t
n ane Buffer Rules mplianCe and intent o; Lha A
�ateriais, ,the approved Plan(s) ands tVater '
pect ica�Ion(s), =nd aLhersupportins
$it;nzture (alma V

11/10/2020 M yTopo Search
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18210 Town Harbour Road, C orneli us, North C aroli na 2…
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CAIA
6//:SdUL]
DON ALLEN & ASSOCIATES, P. A
"Since 1971"
Commercial * Residential * Mortgage Surveys * Multi—Fam€iy
Construction Staking * Subdivision Design * Topographical
131 Crosslake Park Drive — Suite 102 * Mooresville * NC * 28117
[phone] (704) $64-8041 Fax
i, certify that this map was drawn under my supervision from an octual
survey made under my supervision recorded in deed book 26149 page 800 , and/or
plat book 28 , page 493 , 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 sea] on the 24_, day of AUGUST �
A.D. 20 20
MCINiTY MAP— SAp� FlJRF
NO SCALti
IRANSCONT NENTAL
GAS PFEUNZ CO. .
4 DB.1819 PG.69
1 /
1
I
LOT 613
HARBOUR TOWN
YACHT CLUB LLC.
.2852515`48
1
iI
i
I
i
I
tSy.L4
(TIE ONLY) }
LEGEND 4
E.LP. s FASTING IRON FOUNB
;P-S_ = 14 REBAR SET
R/W - RIGHT-OF-WAY
CP = COMPUTED POINT
SCALE 1 r = 40'
ACOUIR®,B ., S2J
LAKE NORMA_Ai
LOT 616
CAROLE T. &
GE`ORGE MENNE'N JR_
18007/579
LINE TABLE
LINE BEARING
ILENGTH
L1 IS 1)7-16'37" W1
23.70'
L2 IN 30'30'18" W1
10.54'
CURVE TABLE
CURVE
RADIUS
LENGTH
BEARING
CHORD
C1
55.DC'
61.30'
N 49-16'39" W
74.09'
C2
25.00'
26.67'
S 61 0351 E
25.42'
C3
225.00'
33.73'
S 26'12'48" E
33.70'
TOWN HARBOUR RD.
1 (50' PUBLIC R/W}
NOTES
1) THIS PROPFiTY MAY BE SUBJECT TO
0' 20' 40' 1oo'
ANY EASEMENT AND/OR RtGHTS-OF-WAY
Or RECORD.
2) AREA COMPUTED BY THE COORDINATE
METHOD.
3) E76STING 76a' & 761' CONTOUR ELEV-
SCALE IN FEET
A11ON BASED ON LAKE NORMAN LAKE
P H YS I C A L SU RVEY
LEVEL AT S FORDO 5 (READING
ON 8-19-20) 20) ELEVATION;
EVATION: 758.4
4 UNDERGROUND POWER
OF
5 NO GRID MONUMENT FOUND YAMIN
2000 FEET.
1821C TOWN HARBOUR RD
LOT 614 THE PENINSULA PHASE XVII
LEMLEY TWSP., MECKLENBURG CO_, N.C.
no
FlEZO BOOK- -
FILE'. PENINSULA 614.DWG
DC FlLE:
'FfiA (AitllFfVW:f 1 00181126
podajj lamed
OZOZ/6Z/6

From: TAMARA HAGER :,[e-mail]
Subject: Harbour town yacht club LLC shoreline
Date: Sep 30, 2020 at 1:44:10 PM
To: TAMARA HAGER iager lakepermit.com
0) r, Jvs PJ
C) 05
E,4�4
PI C'

CAL
,L \41-vn f
Tamara Hager
704-575-2227
Lake Permit LLC
h _g,[e-mail]

Full Pond/
Norma �f m am =Le
W evif .m
Shorellne
Lake
(At Pull Pond/Normal WaterLevei)
G
I
jEI0t&;
3'�c;,Vfe
101
��OW�MW
L 3 U �r�12-
Tease approximately sketch the following information on this plan (provide dimension
rem, such a5.10 ftx igoict)*. sfoeach
1. All proposed vegetation clearing
2. Location of rip rap or{ill 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 wa115, docks, etc.
I Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
5. Location of construction access corridors
FORM; 5SGP 10-2013
Page 3 of 3