HomeMy WebLinkAbout20201719 Ver 1_Shoreline Stabilization_20201211Submission 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:
KETNER DWR.pdf 49.19KB
Pre -fling Meeting or Request Date 11/10/2020
ID# 20201719 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 * HAGER@LAKEPERMIT.COM
Rease provide an email address for payment and requests for more information here.
Owner Information:
Name: * SWK LLC
Email: * SAMUELKETNER@YAHOO. COM
Phone Number:* (704)239-0527
(xxx)xxx-xxxx
Mailing Address:* Street Address
17235 Connor Quay Court
Address Line 2
City
State / Frovince / Region
Cornelius
NC
Fbstal / Zip Code
Country
28031-6503
US
Is there an agent working on the F Yes
project?* r No
Agent/Consultant Information
Name: * TAMARA HAGER
Company Affiliation:* LKN DREDGE & MARINE CONSTRUCTIN
Email:* HAGER@LAKEPERMIT. COM
Phone Number:* (704)575-2227
(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:*
KETNER AUTH.pdf 736.37KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* SWKLLC
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: KETNERTOPO.pdf
Latitude:* 35.462484
Longitude:*-80.926359
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*
KETNER SURVEY.pdf 1.11 MB
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.)*
KETNER PICS.pdf 537.79KB
4. Location of the property (where work is to be conducted)
Nearest Town:* CORNELIUS
County:* Mecklenburg
Lake/ river/ ocean adjacent to NORMAN
property:
Subdivisions name or site address:* CONNORQUAYLOT 15 & 16
hclude phasellot number
Directions to site:*
FROM COWANS FORD DAM GO LEFT ONTO HWY 73 5.2 MILES,
TURN LEFT ONTO W CATAWBA AVE GO 2.4 MILES, TURN LEFT
ONTO JETTON RD GO 2.0 MILES, TURN LEFT ONTO JOHN
CONNOR RD .70 MILES, GO RIGHT ONTO CONNOR QUAY CT .20
MILES PROPERTY ON RIGHT.
Rease include road nacres and numbers, landrrarks 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
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
REBURBISH RIVER ROCK TO SHORELINE FOR STABLIZATION
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
Sketch: KETNER SKETCHpdf 232.73KB
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:* SWKLLC
Signature:
14#RFL I(f LFA IWA LCC
Initial Review
Is this accepted into the review
process?*
Project Number:* 20201719
Select Reviewer:*
Select Reviewing Office
Has payment been received?*
What amount is owed?*
rYes allo
Version:* 1
Alan Johnsomeads\adjohnsonl
Mooresville Regional Office - (704) 663-1699
r No Payment Needed
r Fee Received
r Need Fee - send electronic notification
r $240.00
f $570.00
Project
0WnLm,r.
/ (Print
i to
The approval is ;or the Srgnature
apPlrcarrori is a violation ❑prheose Buffer Rule. Siiesae '=
an described in your application.
OZH _C15Q6 and er,rc work should be Praviderifin h;= a no' fndica ed in the
15A NCAC 02B .0Z-"3(g)j
APffcation, i?5A it}SAC
reel are no, allo,h,ad i
approved g�cce o be removed era
Exception, zrcasthanar+rn %one 1 o� the Bu,ferfwit
ll�#inimal sha fn, with 3Q ; ` a' the ttrl# pond e
p o and sloping severely underrnrned along i immediatesnoreline fevatfon), units;
a along '
rml-nedial e shoreline can be re
1 tits allowed. i?5A tJCACO? rnavee_
Benrning, radin� I 5.02 3(5)1
none bu;ieris not Cflo�,ja
d=='{c=ssfve disturbance at gro[�nd cover. f �
a2Ches, Imp; rvioL.,s p=— —SA NC
--eras, Irrt ACQZB.OZ^3 (5)1
Oy the Division. There are pervious walkways, atc are not alfo, lfrnftatfon an si?e ;or dacks. r� Ned in the aur,'er unless sPeci;Ically apprmtsd
-5A itirCACOZB _Q?q3 e VLloric to be conducted from land must indicate an access and i () and (5)i
'"rfc corn' dor should be
ma+:erial �- described. The approved access corrfdordrecLe any trees that are to be rmmovcd. I iiC
Must be outsidezhv bu,--;?r [?�A fVCAC shall
RZ)-; _QS 3 C Ci2 r$S�DrcG. $ Gina, =3fffl, C c'rL:
R2 and —'J�r. i�iCr on_t ci#or.
StorrnwaLar can AC 023 .Q743 i41 !
not be ,5), ,$);
dfschar�as _ ❑r channeled r'or _
must ba direct disehar=
-shut loV,, a a _ The naturai clev=ton veld toe LO she lake_
i nor[- ro5iV2 r� dischargeci p,Tor �O y c All COn r fJCi'G SiOrr l llQiaP
iOcftfe5 i0 tl7`c f�iic_ �+ n ntering the puffier ciireC=L d
5 IVCAC Q�$ _QZ43(5), (�1' as d1`- L�sc ar rlekf�o,�lr�GGPe17C'T� C7j'f.j/Oaj�
ICU,
li7r
L
r fparf2n Buffer Rule. hereb,•
by the Div Any 1NOrf( Conducted in `h a .� f SicTE if dz ( h2"P- been intOr rsfon oz water �a� �n� nu'— Hat s e med O the Ca�au1ba
alcen such tha4 the corer of rces (01AIR), fs a violation, andsubJ t of}�niorc rnen�. Duz dfli�
he applica�ion and n'truc1lon will be bu'-, apAra„ad
Quaf iiLV cerilf c2t. on and if i nllthin 5ub5tcnti2l cam ence ,
plf�nce c Will be
rnateriafs, u" r t li=s, ihw approved titans
and 1frLenC al theQp'j Water.
() and sp cf,-fcation(s), and othersuppor�ins
Signatur G (otvnei ��,� 7
ii a �2167
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: Nearest Town: `1
Subdivision name or site address (include phase/lot number); 4-
Directions to site - please include road names and numbers, landmarks, etc.:
Latitu d e (in decimal deg,,")3g , q &Z 4SLf �„
Longitude (decimo7degrees) —pu. Q��J
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): l�Cl r i= "
5. Property size (acres):
7. Lake/ river/ ocean adjacent to property: f'J„1)1 ,,, 7
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
61r 7a+1sti.�
9. Will work be conducted from land?
❑ From water? ;<, ❑�t�r ��� ,L i ���"r 10. Total amount of disturbance (including all excavation, backfill, rip rap, retaining walls, etc.) � �ti
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
wails, etc.) above the normal pool lake level/ Normal Water Level and 50 feet land -ward in
square feet or acres: i oj( ,l,!% — s.`j ( i�_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):
Agent's
16
s Signature- [ i A NCAC 02H .0502 —�
Date
FORM: SSGP 10-2013 --
Page 2 of 3
12/11 /2020
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17235 Connor Quay Point, Cornelius, North Carolina 2E
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From_ TAMARA HAGER hager@lakepermit.com
Subject: SWK LLC pics shoreline
Date: Dec 11, 2020 at 11:28:05 AM
To: TAMARA HAGER halter@lakepermit.com
x 17235 Connor Quay Ct
Tamara Hager
704-575-2227
Lake Permit LLC
hager@lake ermit.com
Full Pond/
larmaONUmamomam
Shoreline
Lake
(A, Full Pond/Normal Waterlevel)
J_,
-Zfwv�!
3
,
I 2- eiv L
r� law� UM
[,)-b - tz5 Z;r�nc✓�
f���►�L�� t— Dl57"Lr1? z3�r
13�1�
e)�C-A-VA--6( �t— '1�4 Zqt
Please approximately sketch the foffowing information on this plan (provide dimensionsfor
item, such as 1 o ft x 100 ft) each r_
1. A11 proposed vegetation clearing
2. 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
5. Location of construction access corridors
FORM: S56P 10-2013
Page 3 of 3