20201310 Ver 1_Shoreline Stabilization_20201116

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:
Amber Tramble Pre File Approval.pdf 51.68KB
Pre -fling Meeting or Request Date 9/25/2020
ID# 20201310 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: * Amber Tramble
Email: * [e-mail]
Phone Number:* [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
4391 33rd St Ln NE
Address Line 2
City
State / Frovince / Region
Hickory
NC
Fbstal / Zip Code
Country
28601-7099
US

Is there an agent working on the
project? *
Agent/Consultant Information
.................................................................................................................
Name:
Company Affiliation:*
Email:
Phone Number:*
Mailing Address:*
F Yes
r No
Tony Gaines
Marine Construction of Hickory
[e-mail]
[phone]
(XXX)XXX-XXXX
Address
1173 Shiloh Church Road
Address Line 2
City
Hickory
Fbstal / Zip Code
28601-7855
Asigned and dated copyof the Agent Authorization letter:*
Amber Tramble Agent Authorization. pdf 314.96KB
Link to: Sample Agent Authorization Form
State / Province / Region
NC
Country
US
Project Information [15A NCAC 02H .0502(a) & (b)]
....................................................................................................................................................................................................................................................................
Project Name:* Amber Tramble - 0 Bible Camp Ln Lot 90, Taylorsville NC 28681
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: Amber Tramble GIS Map.pdf 336.98KB
Amber Tramble Directions.pdf 981.24KB
Latitude:* 35.818000 Longitude:*-81.241000
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*
Amber Tramble Shoreline Layout.pdf 1.88M13
Please use the diagram at the link below:
https://edocs.deq.nc.gov/WaterResources/0/edoc/616616/Shoreline%2OLayout.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.)*

Amber Tramble Pictures of Shoreline.pdf 2.32MB
4. Location of the property (where work is to be conducted)
Nearest Town:* Taylorsville
County:* Alexander
Lake/ river/ ocean adjacent to Hickory
property:
Subdivisions name or site address:* Bible Camp Lane - Lot 90
Include phase/lot number
Directions to site:*
From 1173 Shiloh Church Rd
Hickory, NC 28601
Head southwest on Shiloh Church Rd toward Rosenbalm Ln
354 ft
Turn left onto Rink Dam Rd
5.5 mi
Turn right onto Church Rd
0.7 mi
Turn left onto Bible Camp Ln
Destination will be on the left
0.7 mi
Bible Camp Ln - Lot 90
Taylorsville, NC 28681
Reese include road narres and nunbers, landmarks etc.
5. Describe the existing land use or condition of the site at the time of this application:*
Residential/Undeveloped
Residential, undeveloped, etc.
6. Property Size .75
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
We plan to remove fallen trees and lay fabric and riprap.
8. How will the work be done?* I7 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.)
148
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.)
444 sgft permanent
- riprap, 1400 sqft
temporary
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)
Approximately 20 trees, averaging 4 to 6 inches, thorny vines, brush and
a couple of fallen trees.
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, 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:* Tony Gaines
Signature:
f �A�y CTIZIWeIv

Initial Review
Is this accepted into the review
process?*
Project Number:* 20201310
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

PROPERTY LEGAL DESCRIPTION:
LOT NO: 90
STREET ADDRESS:
0 Bible Camp Lane — Lot 90
Ta lorsville NC 28681
Please print:
Property Owner:
Property Owner:
PLAN NO:
Amhar Tramhle
PARCEL ID: 0002683
The undersigned, registered property owners of the above noted property, do herebyauthorize
Gaines , of Marine Construction of Hickory, Inc.
(Contractor/Agent) (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 Owners Address (if different than property above):
d-�aj '4'4rd Cf 1 n NF
NC 28601
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate tothe
best of our knowledge.
Authorize Signature
Date
n
o ;ized Sig ature
Date

1
CD
X
Q
CD
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O
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1-A .1

1173 Shiloh Church Rd
Hickory, NC 28601
t 1. Head southwest on Shiloh Church Rd toward
Rosenbalm Ln
354 ft
2. Turn left onto Rink Dam Rd
5.5 mi
r' 3. Turn right onto Church Rd
- 0.7 mi
.h 4. Turn left onto Bible Camp Ln
0.7 mi
Wittenburg
North Carolina
These directions are for planning purposes only.
You may find that construction projects, traffic,
weather, or other events may cause conditions to
differ from the map results, and you should plan
your route accordingly. You must obey all signs or
notices regarding your route.
https://www.google.com/maps/dir/1173+Shiloh +Church+Rd,+Hickory,+NC+28601-7855,+USA/35.817566,-81.240784/@35.8326513,-81.3058364713z!... 112

12. Please approximately sketch the following information on this plan and provide dimensions for
each item:
a. All proposed vegetation clearing
b. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
c. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
d. Location of any proposed structures such as buildings, retaining walls, docks, etc.
e. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
Lake
(At Full Pond/ Normal Water Level)
Full Pond/
At
Ri�r-f
Plan View
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FORM: SSGP 02-2017 Page 3 of 4

f'}' 3✓b rill'�r`�l
b.,t.Q hvr I 4hd
d
k-A
LaKe
(At Fill Pond/ Normal Watei"
t
l
C
Side View
ILL -
10
I
Side Vi
A
......__............. ....
2 ft. additional clearing
3 ft. below full pond water level 4 ft, above full pond water level 'if necessary
FORM: SSGP 02-2017 Page 4 of 4

1
C

ID#* 20201310 Version* 1
Regional Office * Mooresville Regional Office - [phone]
Reviewer List* Alan Johnson
Pre -Filing Meeting Request submitted 9/25/2020
......................................................................................................................................................................................................................................................
Contact Name* Tony Gaines - Marine Construction of Hickory
Contact Email Address* [e-mail]
Project Name* Amber Tramble - Hickory NC
Project Owner*
Project County*
Owner Address:
Amber Tramble
Alexander
Street Address
4391 33rd St Ln NE
Address Line 2
aty
Hickory
Postal/ Zip axle
28601
Is this a transportation project?* r Yes (' No
Type(s) of approval sought from the DWR:
* 401 Water Quality Certification - F 401 Water Quality Certification -
Regular Express
* Individual Permit F Modification
F Shoreline Stabilization
Does this project have an existing project ID#?*
C Yes (-- No
State / Province / Region
NC
Country
USA
Do you know the name of the staff member you would like to request a meeting with?
Please give a brief project description below.*
Property address: 000 Bible Camp Lane - Lot 90
We will remove fallen trees and place fabric and riprap.
Please give a couple of dates you are available for a meeting.

10/1 /2020
10/2/2020
10/8/2020
10/9/2020
Please attach the documentation you would like to have the meeting about.
pdf only
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.
1 understand by signing this form that I cannot submit my application until 30 calendar days after this pre -filing
meeting request.
1 also understand that DWR is not required to respond or grant the meeting request.
Your project's thirty -day clock started upon receipt of this application. You will 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
Submittal Date 9/25/2020