20201459 Ver 1_Shoreline Stabilization_20201117

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 APPL MARTIN.pdf 357.75KB
Pre -fling Meeting or Request Date 10/13/2020
ID# 20201459 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 more information here.
Owner Information:
Name: * GARY MARTIN
Email: * debimartin 1953 @gmail. com
Phone Number:* [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
3743 Mill Run
Address Line 2
City
State / Frovince / Region
TERRELL
NC
Fbstal / Zip Code
Country
28682-9791
US

Is there an agent working on the F Yes
project?* r No
Agent/Consultant Information
Name: * TAMARA HAGER
Company Affiliation:* LKN DREDGE & MARINE CONSTRUCTION
Email:* HAGER@LAKEPERMIT. COM
Phone Number:* [phone]
(XXX)XXX-XXXX
Address:* Street Address
PO BOX 5335
Address Line 2
City
State / Province / Region
MOORESVILLE
North Carolina
Fbstal / Zip Code
Country
28117
United States
Asigned and dated copy of the Agent Authorization letter:*
AUTH MARTIN.pdf 647.62KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* MARTIN
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: MARTINTOPO.pdf
Latitude:* 35.588386
275.77KB
Longitude:*-80.956728
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*
SURVEY MARTIN.pdf 555.69KB
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.)*
MARTIN PICS.pdf 467.98KB

4. Location of the property (where work is to be conducted)
Nearest Town:* TERRELL
County:* Catawba
Lake/ river/ ocean adjacent to NORMAN
property:
Subdivisions name or site address:* RIVERWOODPL
hclude phasellot number
Directions to site:*
FROM MARSHALL STEAM STATION HEAD SOUTH TOWARD NC
150 E .20 MILES, CONTINUE ONTO KISER ISLAND RD .50 MILES,
TURN LEFT ONTO RIVERWOOD RD .20 MILES, TURN LEFT ONTO
MILL RUN PROPERTY ON LEFT .30 MILES
Rease include road names and numbers, landmarks etc.
5. Describe the existing land use or condition of the site at the time of this application:*
RESIDENTIAL
Residential, undeveloped, etc.
6. Property Size .55 ACRES
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
REFURBISH RIP RAP 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, 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, 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
Sketch: SKETCH MARTIN.pdf 243.62KB
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:* GARY MARTIN
Signature:
�Wy NiM))V

Initial Review
Is this accepted into the review
process?*
Project Number:* 20201459
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: 13 Nearest Town: r"
Subdivision name or site address (include phase/lot number): LOB
wUc�.l� AXVI �
Directions to site - please include road names and numbers, landmarks, etc.:
Latitude (in decimal degrees)_. �?y$ 3 Longitude (decimalde rees
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): iZ i r
5. Property size (acres): ,
7. Lake/ river/ ocean adjacent to property: f`r` J f ;,VI A, I
S. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): S�f
}i q_
9. Will work be conducted from land? ❑ From water?
10. Total amount of disturbance (including all excavation, backfill, riprap,retaining
1
p, a Wing walls, etc.)
below the 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: 10(,J r — '),V R, �v
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):
1' �' C�
Owner/Agent's Signature' j15A NCA p 1-1 ,0502(f) D' t � �
Date
Agent's signature is valid only if an authorization letter from the owner is provided.
FORM:55GP 1p-2p.1,3
Page 2 of 3

projp-ct Nan, e/ '�J
C0#rtE'>acj0f/6gent: r Aj 5ignature� �
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5ignaLure
The approvai is for the purpose and design described in your appl€cation. lmoas I - _
application is a violation o the Buffer Rule. Site sneciifc Work should be r
02H _Q5{3o and ? � not .rtdicaied in the
SANCACO28.024-9(8)1 Provided In the application. i i5A NCAC
i reeas are not allowed ,�
_d tQ Lie removed rom 2
approved. t;cce one ! Q, the i3u;—:"er f�riLhin 30 , i Dt 1, Jufl nand elevaiionj, un{es5
priori thosetreesthataresevzrel+� undermined alpn
Il�{lnima{ shaping and sloping along the immediate shoreline is affowedh� irrlmediateshoreline can be removed.
_5'. NC —AC 02B .0243f6)j
S217CP)n�, �F201ng rn one F31i icr i5 nQtallolrled_ �;CC SSitJt* disturbance tli ground cover. ilSA i\I ^
3eac€res i n?crviou CACO2o_02^3(6}j
5 4-tiOS, irilpefZJi0u5 walkwa}+5, --C- are nC1i 8{IO+Nei In-f]? !ricr LlnI�SSS
�V she DIVI$lon. There
are {imi4atian on si<e for decks_ f 15A fVCACO23-0243(4) and 5 j peci;ical€Yapprot+ed
`JUQrk to oG _ ()_
conducted rpm land must [rlClicdZ2 an 2CCE55 and indicate anVirEeS that art L LiB ?
na e corridor should be' described. The approved access corridor shall be restored, at area s -
matEriai n!usz moved. The
bE Out the bu,rer_ f i5r iVCAtC 02; ; _0502 and s5� NCB C 023.07� r„i r a' spoil, consirL=ctior.
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� be piped or charm '
discharge elad for direr disc
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the na�uraf efaVatian and disehar�a All construct=d S-of
=f7eci 7i01:c� 2t non-?i05lVc"' V loCfil ES �o tll� fare. f"F ,�Jrl.0 %a entering TIME buffer directed as se or
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on CACO23.0243(5), (6)� di;
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by -he Division o; �'-�� h buffer, not spccf;fca{€}+stater' i
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Quality lvithin substantial compliance a
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ONLINE MAPS CONTACT US LOGIN
Step 1: Where should your map be centered?
Enter aplace name oraddress to find maps available it? ycur area ofinterest.
3743 Mill Run Road, Terrell, North Carolina 28682, Unit(
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From: TAMARA HAGER [e-mail]
Subject: Martin pics shoreline
Date: Aug 24, 2020 at 10:56:22 AM
To: TAMARA HAGER [e-mail]
3-q4 3 SILL 2.uN
-T GWCA , (-,)G 0^0�52,
' �• C

2��»-

Le ke
(At Full Pond/Normal Water l evef )
l=UN Pond/
NormaI WaterLevef
on S h O r� am
Wt�IMSMMR
fv-b j2t=-meq�
please approximately sketch the following information on this plan (provide dirnensionsforL
item, such as 10 ftxl0p ft)~:
? • All proposed vegetation clearing
?. Location of rip rap or fill to be placed above the Full Pond/'Normal Water Level elevation
3• 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
r`
FORM: sSGP 10-2013 37g3
(jPage 3 of 3
i d�"OL

ID#* 20201459 Version* 1
Regional Office * Moaresvilie Regional Office - [phone]
Reviewer List* Alan Johnson
Pre -Filing Meeting Request submitted 10/13/2020
Contact Name Tamara Hager
Contact Email Address* [e-mail]
Project Name * Martin
Project Owner`
Gary Martin
Project County*
Catawba
Owner Address:
Street Address
3743 Mill Run
Address Line 2
City
State I i rovince 1 P,-wn
Terrell
North Carolina
Rutal l Zip CDde
a Dlry
28682
United States
Is this a transportation project?* C Yes �-- No
Type(s) of approval sought from the DWR:
F 401 Water Quality Certification - W 401 Water Quality Certification -
Regular Express
r Individual Permit F Modification
W Shoreline Stabilization
Does this project have an existing project ID#?*
r Yes (-- No
Do you know the name of the staff member you would like to request a meeting with?
None needed
Please give a brief project description below.*
Refurbish rip Rap to Shoreline for stablization
Please give a couple of dates you are available for a meeting.

Please attach the documentation you would like to have the meeting about.
pdi ony
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 forth that I cannot submit my application until 30 ca€endar days after this pro -filing
meeting request.
• I also understand that DWR is not required to respond or grantthe 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 10/13/2020