20201953 Ver 1_Shoreline Stabilization_20210120

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 Meeting Request Form
51.73KB
Sorrells.pdf
Pre -fling Meeting or Request Date 1/20/2021
ID# 20201953 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 *
Owner Information:
Name: *
Email:*
Phone Number:*
Mailing Address:*
todd@lw do llc. com
Rease provide an er ail address for payment and requests for more infornation here.
William Sorrells
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
19012 Kailua Circle
Address Line 2
City
Tega Cay
Fbstal / Zip Code
29708
State / Rovince / Fbgion
SC
Country
United States

Is there an agent working on the F Yes
project?* r No
Agent/Consultant Information
Name: *
Todd Flowers
Company Affiliation: *
Lake Wylie Dock Construction
Email:*
[e-mail]
Phone Number:*
[phone]
(XXX)XXX-XXXX
Address:*
Street Address
19012 Kailua Circle
Address Line 2
City
Tega Cay
Fbstal / Zip Code
29708
Asigned and dated copy of the Agent Authorization letter:*
Authorization Mr. Sorrells.PDF 161.57KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* 4317 The Bluffs Way
State / Province / Fbgion
SC
Country
United States
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
Property Address Lookup:* Street Address
4317 The Bluffs Way
Address Line 2
city
Belmont
Fbstal / Zip Code
28012-6754
Latitude:* 35.153955
State / Province / Region
NC
Country
US
Longitude:*-81.020016
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*
Shoreline Mr. Sorrells.PDF 972.78KB
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.)*
4317 the Bluffs way PICTURE
1.64MB
SHORELINE.pdf
4. Location of the property (where work is to be conducted)
Nearest Town:* Belmont
County:* Gaston
Lake/ river/ ocean adjacent to Wylie
property:
Subdivisions name or site address:* Refection Point Phase 1 lot 83
hclude phase/lot nunber
Directions to site:*
Head east on NC-273 N toward S Point Rd,Tum right onto S Point
Rd,Turn right onto Reflection Pointe B1vd,Tum left onto Lake Pointe
Dr,Turn left onto The Bluffs Way, Destination will be on the right
Aease include road narres and nunbers, landnarks etc.
5. Describe the existing land use or condition of the site at the time of this application:*
Home on Property occupied Residential Condition is very nice a well
maintained yard. That is why we are doing the entire job by water. The
Shoreline already has rip rap. Adding to it
Pesidential, undeveloped, etc.
6. Pro pertySize .52
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
This is a maintenance rip rap job. The builder did not do the job right with
a good 45 degree angle on the rip rap and not enough volume to created a
good 45 degree angle ..so we will do it right
8. How will the work be done?* r From Land
rJ 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.)
450
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 we are only by water no sketch needed No impact to sketch install
by water by water

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:* Todd Flowers
Signature:

Initial Review
Is this accepted into the review
process?*
Project Number:* 20201953
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

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION :
LOT NO:1?
Please print:
Property Owner:
Property Owner:
The undersigned, registered property owners of the above noted property, do herebyauthorize
,of
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,
Prqperty Ownerc Address (if different than prcperty above):
We hereby ceftiry the above information submitted in this application is true and accurate tothe
best of our knowledge.
Fro\4o(#' \,' eoeon13
Ite tJ*,,
(Contractor/Agert)
Authorized Sign+ure
It/r3lz)Authorized Slgnature
lValer tes*urces
r|j!rior.;filil rrt at.l' IY
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
15A NCAC 02H ,0500 - Water euatity Certification, Shoreline Stabilization
FORM: SSGp 0:t-2017
Please approximately sketch the folrowing information on this plan and provide dimensions foreach item:
a. All proposed vesetation ctearins - lVne CemVV in fiprn WOW nlqb. Location of rip rap or fill to be placed above the rJlt ConaT trtormal witirr revlt eleJ"tion
Location of rip rap or fill to be placed below the Full pond/ Normal water Level elevation
Location of any proposed structures such as buildings, retaining walls, docks, etc. ,- llah e
c.
d.
Location of any excavation or dredging berow the FuI pond/ Normar water Leu"r ulJri.iion'
Full Pond/
orelIne affi,+lau*
4*ttpuul3
Pla n View
F0RM: SSGP 02-2017
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FORM: SSGP 02-2017
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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.*
20201953 1
Mooresville Regional Office - [phone]
Alan Johnson
Pre-Filing Me eting Reque st submitte d 12/14/2020
Todd Flowers
[e-mail]
William Sorrells
Todd Flowers
Gaston
City
Belmont
State / Province / Region
NC
Postal / Zip Code
28012
Country
United States
Street Address
4317 The Bluffs Way
Address Line 2
Yes No
401 Water Quality Certification -
Regular
401 Water Quality Certification -
Express
Individual Permit Modification
Shoreline Stabilization
Yes No
Alan Johnson
Please give a couple of dates you are available for a meeting.
Ple ase attach the docume ntation you would like to hav e the me e ting about.
Signature
Submittal Date
Rip Rap Job 150 feet by barge/water only
Todd Flowers at Lake Wylie Dock construction is agent for the owner
Mr. William Sorrells
The address is his primary residence
4317 The Bluffs Way
Belmont NC 28012
Alan this is the one we talked about in Belmont We are coming in by
water the client has some rip rap now this is maintenance
1/6/2021
12/29/2020
1/7/2021
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.
12/14/2020