20201629 Ver 1_Shoreline Stabilization_20201202

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:
MDC PRE FILE APPROVAL.pdf 51.12KB
Pre -fling Meeting or Request Date 10/28/2020
ID# 20201629 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: * MDC CAPITAL LLC
Email: * IBMDCOX@GMAIL. COM
Phone Number:* [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
125 PRESTWICK LN
Address Line 2
City
State / Frovince / Region
RURAL HALL
NC
Fbstal / Zip Code
Country
27045
United States

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:*
MDC AUTITpdf 727.58KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* MDC CAPITAL LLC
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: MDC TOPO.pdf
Latitude:* 35.568734
IMI iiI
Longitude:*-80.979442
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*
MDC SURVEY.pdf 351.3KB
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.)*
MDC PICS.pdf 1.12MB

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:* CRESENT LAND & TIMBER
hclude phasellot number
Directions to site:*
FROM MARSHALL STEAM STATION TURN RIGHT ONTO HWY 150
W GO 1.7 MILES, TURN LEFT ONTO SLANTING BRIDGE RD GO
.40 MILES, TURN LEFT ONTO DRENA DR GO .20 MILES, SLIGHT
RIGHT ONTO GILES AVE .60 MILES, TURN RIGHT ONTO
WELBORN DR, PROPERTY WILL BE ON LEFT .10 MILES.
Rease include road narres and numbers, landrrsrks 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 .85 ACRES
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
DREDGE 30X40X4'DEEP
8. How will the work be done?* r From Land
fJ 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, 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:*
(number of trees, for instance)
NONE, WORK BY BARGE
Sketch: MDC SKETCHpdf 230.91KB
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):
a $240.00 for impacts to lake (below normal water level) of less than 1 acre
a $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:' MDC CAPITAL LLC
Signature:
A CMACL b COX

Initial Review
Is this accepted into the review
process?*
Project Number:* 20201629
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

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application is a vfolatineof�he Bu�ar p, ue�SftesJQ =
an described in your applir anon. fJ;fpa�s not indica-ed in the
02J� .0506 arZd 3SA VCAC p2g 0243 chic Work should be provided in the appiiCafion, t r i ,�
a(s}1 Iti.0
?rees are nOT aiia,Ale
d to lee rer; loved from Tana ? Ofthe approved. Scceptfon he ouiier
iMinimal S � a ,those trc2S hat are severely (cif hin 3i i i Oi ti i2 i lll� and
ha ina and slo Pn' undermined aloe A levatfon}, unless
p o along irnm- l� ine imrnedif tesnarelfne can la
cdiare shoreline fs allo e removes.
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rn the 5u=;eris nay. ailQuie .
d )fcessflle disturbance ❑i around cover. �! r �
aaci�es; impervfQu _5A t�1.�AC�2o _02�3 (B)1
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bvthe Di:rision. T; Ik lays
"sere ar- ' rc-are not altol�ed in he uniesss Ccir'ir zfl
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A� YCppratred
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cted ;corn land
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Work
muss indf�te an access and indlCate
material be descrfbed. The a anV treeS ^hat are _ �e
rial rnust be approved
acCe55 corridor shall be r removed. { he
outside the boi,er [SSA FVC C CSLOi � 4 C�
_f]SQ7 and �, _Ring spa11, cons r u-,-, f`
Stor . -S" i 1CnC C23' .G24 1r rnvJater cannai be B -:. (�`?, E8j'
dfscharg- toip='d or channel-d s be ==the tor dirat l dischaf—ze -h
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she_- natural=lavation ar,d disc e izi;e_ i iov�f z n z 11 cQnstr��ted sZarm �a2 ar
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prosedQuallL}CeLclor1fiJ be bLitt n 'oenTOrC27�rt- e diFi,CL.on and Suffer Rules, oneZ7orov�d L^11Li2l COr102nce2rd iltzrCe Will be
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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 yardstick, shovel handle, etc.)
4. Location of the property (where work is to be conducted)
County: �q-w�
Nearest Town: � 0
Subdivision name or site address (include phase/lot number):
Directions to site - please include road names and numbers, landmarks, etc.:
S r
Latitude (in decimal degrees)3� .�%'�L j� Longitude (decimal degrees) d ,
5. Describe the existing ]and use or condition of the site at the time of this application
(residential, undeveloped, etc.):
6. Property size (acres):
7. Lake/ river/ ocean adjacent to property: D i1� A� ] f !
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): ie
9. Will work be conducted from land? ❑ From water?
-
10. Total amount of disturbance (including all excavation, backfill, rip rap, retaining walls, etc.)
beiow 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: f l.i= �\ ( gig
12. Piease describe the vegetation above the normal pool lake level/ Normal Water Level and
50 feet landward to be impacted (number of trees, for instance):
Owner/Agent's Signature' (15A NCAC 02H .0502 f
Date
Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 20-2013
Page 2 of 3

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11/30/2020 M yTopo Search
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4619 Welborne Drive, Sherri lls Ford, North C aroli na 286…
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From: TAMARA HAGER '[e-mail]
Subject: MDC Capital LLC dredge pics
Date: Oct 31, 2020 at 2:22:45 PM
T0: TAMARA HAGER [e-mail]
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From: TAMARA HAGER [e-mail]
Subject: Cox pics dredge
Date: Nov 10, 2020 at 2:15:33 PM
To: TAMARA HAGER [e-mail]
-D,4
Mrs Uvi7rL L�

Tamara Hager
704-575-2227
Lake Permit LLC
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Please approximately sketch the following information on this plan (provide dimensionsfarerzch
item, such as I ft x 10o fi)T:
! . All proposed vegetation clearing
1• Location of rip rap or fill to be placed above the Full Pond/`Normal Water Level elevation
3. Location of rip rap or rill to be placed below the Full Pond/ Norma[ 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
5. Location of construction access corridors
FORM: SSGP 10-2013
Page 3 of 3

DWR Pre-Fil ing Meeting Req u est Form
ID#*Ve rsion *
Re gional Office *
Re v ie we r List *
Contact Name *
Contact Email Addre ss *
Proje ct Name *
Proje ct Owne r *
Proje ct County *
Owne r Addre ss:
Is this a transportation proje ct?*
Type (s) of approv al sought from the DWR:
Doe s this proje ct hav e an e xisting proje ct ID#?*
Do you know the name of the staff me mbe r you would like to re que st a me e ting with?
Ple ase giv e a brie f proje ct de scription be low.*
Please give a couple of dates you are available for a meeting.
20201629 1
Mooresville Regional Office - [phone]
Alan Johnson
Pre-Filing Me eting Reque st submitte d 10/28/2020
Tamara Hager
[e-mail]
MDC CAPITAL LLC
MDC CAPITAL LLC
Catawba
City
Sherrills Ford
State / Province / Region
North Carolina
Postal / Zip Code
28673
Country
United States
Street Address
4619 Welborn Dr
Address Line 2
Yes No
401 Water Quality Certification -
Regular
401 Water Quality Certification -
Express
Individual Permit Modification
Shoreline Stabilization
Yes No
Not needed
Dredge 40x40 x 2 deep
Ple ase attach the docume ntation you would like to hav e the me e ting about.
Signature
Submittal Date
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.
· 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 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.
10/28/2020