20201463 Ver 1_Shoreline Stabilization_20201110

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 11/10/2020 8:53:07 PM (Submittal)
Submit by Montalvo, Sheri A 11/10/2020 8:57:43 PM (Non -DOT - Approver)
• The task was assigned to Montalvo, Sheri A 11/10/2020 8:53 PM

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:
MILLER 4987 PRE FILE APPVL.pdf 348.66KB
Pre -fling Meeting or Request Date 10/7/2020
ID# 20201463 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 pore information here.
Owner Information:
Name:* THOMAS & LYNDA MILLER
Email: * [e-mail]
Phone Number:* [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
4973 Wildlife Ln
Address Line 2
city
State / Province / Pegion
Sherrills Ford
NC
Fbstal / Zip Code
Country
28673-9282
US

Is there an agent working on the
project?*
Agent/Consultant Information
..................................................................................................................
Name:
Company Affiliation:
Email:*
Phone Number:*
Mailing Address:*
r Yes
d No
Tamara hager
LKN DREDGE AND MARINE CONST
HAGER@LAKEPERMIT. COM
[phone]
(xxx)xxx-xxxx
Street Address
PO BOX 5335
Address Line 2
City
MOORESVILLE
Fbstal / Zip Code
28117
Asigned and dated copy of the Agent Authorization letter:*
MILLER 4987 PRE FILE APPVL.pdf 348.66KB
MILLER 4987 AUTH.pdf 717.41KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* MILLER 4987 WILDLIFE LN
State / Province / Region
North Carolina
Country
United States
If your project has a formal name please use this. If your project does not have 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
UploadMap: MILLER 4987TOPO.pdf 1.31MB
Latitude:* 35.559922 Longitude:*-80.993056
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*
MILLER 4987 SURVEY.pdf 984.42KB
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.)*

MILLER 4987 PICS.pdf
386.49KB
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:* MOUNTAIN CREEK 4987 WILDLIFE LN
Include phase/lot number
Directions to site:*
FROM MARSHALL STEAM STATION, HEAD SOUTH TOWARD NC
150 E .2 MILES, TURN RIGHT ONTO NC 150W 1.7 MILES TURN
LEFT ONTO SLANTING BRIDGE RD 1.8 MILES, TURN RIGHT
ONTO WILDLIFE LN PROPERTY ON LEFT .20 MILES
Rease include road namas and nunbers, landmarks etc.
5. Describe the existing land use or condition of the site at the time of this application:*
RESIDENTIAL
Residential, undeveloped, etc.
6. Pro pertySize 1.13 ACRES
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
CONSTURCT RIP RAP TO SHORELINE FOR STABLIZATION
8. How will the work be done?* C From Land
17 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.)
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, backfill, 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:*
(nunber of trees, for instance)
NONE
Sketch: MILLER 4987 SKETCH.pdf 239.79KB
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):
$240.00 for impacts to lake (below normal water level) of less than 1 acre
$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:* THOMAS AND LYNDA MILLER
Signature:
Of" saff

Initial Review
Is this accepted into the review
process?*
Project Number:* 20201463
Select Reviewer:*
Select Reviewing Office
Has payment been received?*
What amount is owed?*
r Yes r 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

Contact Name *
Contact Email Address*
Project Owner
Project Name *
Project County*
Tamara Hager
[e-mail]
Thomas & Lynda Miller
Miller
Catawba
Owner Address:* StreetAddre---s
4987 Wildlife Lane
Address Une 21-1�
esville
28 (,13
Is this a transportation project? * (" Yes c No
Type(s) of approval sought from the DWR:
* 401 Water Quality Certification - r 401 Water Quality Certifi cation -
Regular Express
r Individual Permit I" Modification
* Shoreline Stabilization
Does this project have an existing project tD#?
CYesf--No
Stater Ro�,irce 1 rRsgm
North Carolina
u1-1r:r/
United States
Do you know the name of the staff member you would like to request a meeting with?
Doesn't need meeting
Please give a brief project description below.*
Install rip rap to shoreline for stabilization
Please give a couple of dates you are available for a meeting.
Please attach the documentation you would like to have the meeting about.
By digitally signing below, I certify that I have read and understood that per the Federal Clean Water Act Section
401 Certification Rule the following statements:
This form completes the requirement of the Pre -Filing Meeting Request in the Clean Water Act Section 401 Certification
Rule.

. I understand by signing this form that I cannot submit my application until 30 calendar days after this pre -filing
meeting request.
i also understand that DWR is not required to respond or grant the meeting request.
Your projecfs thirty -day clock started upon receipt of this application. Yau wi[I receive notification regarding meeting location
and time if a meeting is necessary. You will receive notification when the thirty -day clock has expired, and you can submit an
application.
Signature
464- Dj�L
Submittal Date 10/7/2020

Pr
PleU Name ddres .,
Print
C"." Er GcLE3rJ @gent; L
Print ,—r ,,. •� ti ture .�
�• Signa
The approval is tar the purpose and design described in your application. lmpaCs noL ind' -
02H - anon fs a violation ofthe Buffer Rule. Site specific work should be Providedin the application aced inl zhe
02H .0 505 and 15A NCAC 02B .p 43(8) 9
reel are not ailalJjed to be removed tram Lplle F Buffer
approved. F"Ce Tian - o; the au:�zr (�ufthin30 ,' ofthe full pond ?levaiiorr}, unless
11/linimal shaping andsloping-eestlatzreseverely undermined alon
along -the irFlmediaLe shoreline is allowed.[ 5A ft�'CAC G,Bfrrimeciia-LeoOelcne can b2 rem€aved.
3f5)j
Benching, grading In Tna but ler is r 0—allowed_ L(cessive disturbance ofaround cover. F:L5NCAC 28
.02.3 (Q)I
=acll�s impervious patios, impervious walkways �-
Lhe by Obfision. There are Lc. are not allowed In the buffer unfessspeciaicaflyappraved
[imitation on size Tor decks. f:5A NCACO2B .0243(4) and (6)i
V,lorlc Lo he conducted from land'must indicate an access and indicate an e s
work ct�rridor should be described. the approved
y Tr,.es Lna� ar to be removed. T ne
rt7Bt�rlai must be access corridor shall be restored, 5ta�incr cp c-r
outside the buffer. j �;;. NCAC Q2F� 0502 and i-I i11C�,C 0?� ,Q7 (40,tl' -: oil, con �. u�ior
< <r ,
STormwater cannot be i
discharges piped or channeled for direct dfscnargE to the lake. A
nfUsL be ctif72 naturGl elevation c )Q G1SCl ar ELT rfOr = a Ali CanSLr UCL-0 �tOrlTlyNct2r
=h®4L;lour aL non -erosive veloci�.ies to the 12ke. f15A NCAC Q P ° enter -frig chi bummer directed as di-- se ar
3 .02 3(5), (fl)I
ait,�a,fleeil,ercaJ iVazilfcciar
3,
I � r
Il3arl2 Sup t er Rule. ^ hereby S Gte that l have been informed of ti]e C�Lasa
Any world' conducted fn the s7u;ie;, not speciifcalfy staiee in the ap lication andfacorov
by the i)16JIS10n ai WaLwr Resources {IDIAIR), is a violation and subjeCta enforcement. p
taken such that -the co p, ad
ns�ruction will be buflt within substantial ca Due diligence will be
Quality Certification and m lfaneea
f3u;—,'er Rules, the approved plans p nd Intent aI the �!Q� VVater
materials_ () and specf;'Icstfon(sj and other sup
pCrLing
�o--ti,
-Signature �ncF:4?v,.

etc.), rip rap, excavation or dredging below Pull Pond/ Normal Water Level elevations,
and construction access corridors. You may use the diagram provided at the end ofthi=
application norm.
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: �" _ N ea rest Town: _� I i l- S 1;� i
Subdivision name or site address (include phase/lot number):,
0
Directions to site - please include road names and numbers, landmarks, etc.:
Latitude (in decimal degrees)_ . Longitude (decimal degrees) -80. 439 sp !s�
5, Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.):
5. Property size (acres):
7. Labe/ river/ ocean adjacent to property:
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
9. Will work be conducted from land? ❑ From water? 4- Z °11; J
10. Total amount of disturbance (including all excavation, backfill, rip rap, retaining walls, etc.)
belowthe normal pool lake level/ Normal Water Level in square feet or acres:
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: 1 (ai 1r — `�� [ Ik' c,
12. Please describe the vegetation above the normal pool lake level/ Normal Water Level and
Qwrery
"Agent's
50 feet landward to be impacted (number of trees, for instance):
A
's Signature* [15A NCAC 02PI .0502(f)] Date
ure is valid only if an authorization letter from the owner is provided.
FORM:55GP 10-2013
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4987 Wildli fe Lane, Sherrills Ford, North Carolina 28673…
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IE FOLLOWS DUKE ENERGY PROJECT
BOUNDARY (LAKE NORMAN)
OF THE PROPERTY DESCRIBED HEREON,
LION REGULATION JURISDICTION OF
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LOT #2
PORTION OF PIN 4606-0474-3348
AREA = 3.588 ACRES
(INCLUDING 0.318 ACRE IN ROAD R/W)' <
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From: Tamara Hager [e-mail]
Subject: Lot 2 4987 wildlife
Date: Sep 30, 2020 at 10:44:48 AM
To: [e-mail]
q6 87
�-S jl � L
gad vW#

� SOH P,-*
Tamara Hager
704-575-2227

ruH Pond/
orma[ Water Level
s� +ter � mm
5�orefine
La ke
(At Full Pond/Normal WazerLevel)
7. / 3-� o!
G
Ir7& ' 4
��MWEM�
3u AE;P�2-
S 1 j L ONC-? J-zQ/<'C
LA-V1-6 ( ,r 15,A-P—q t`
Please appraxim@tely sketch the following information on this plan (provide dimensionsforeach
item, such as 10 ftX 100 ,rt)' :
. Rll proposed vegetation clearing
z. Location of rip rap or fill to be placed above the Fuff Pond/ -Formal 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.
S. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
o. Location of construction access corridors
FORM: SSGP 3.0-2D13
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