20201642 Ver 1_Shoreline Stabilization_20210220

Water Resources
ENVIRONMENTAL QUALITY
0
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 view the form.
Attach documentation of Pre -Filing Meeting Request here:
Michael Harris - Prefile Approval.pdf 739.59KB
Pre -fling Meeting or Request Date 10/30/2020
ID# 20201642 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:*
marinecon 1 @embargmail. com
Rease provide an email address for payrrent and requests for pore information here.
Michael Harris
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
2357 Keith Avenue
Address Line 2
city
Granite Falls
Postal / Zip Code
28630-9414
State / Province / Region
NC
Country
Us

Is there an agent working on the
project?*
Agent/Consultant Information
..................................................................................................................
Name:
Company Affiliation:
Email:*
Phone Number:*
Mailing Address:*
Q Yes
d No
Tony Gaines
Marine Construction of Hickory, Inc.
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
1173 Shiloh Church Road
Address Line 2
City
Hickory
Fbstal / Zip Code
28601-7855
Asigned and dated copyof the Agent Authorization letter:*
Michael Harris - Agent Authorization. pdf 299.64KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name: * Michael Harris - Hickory NC
State / Province / Rion
NC
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
Upload Map: Michael Harris -Directions and GIS.pdf IAMB
Latitude:* 35.761000 Longitude:*-81.391000
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*
Michael Harris - Detailed plans. pdf 4.33MB
Please use the diagram at the link below:
https://edocs.deq.nc.gov/WaterResources/o/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.)*
Michael Harris - Picture of Shorchne.pdf 961.82KB

4. Location of the property (where work is to be conducted)
Nearest Town:* Hckory NC
County:* Caldwell
Lake/ river/ ocean adjacent to Hickory
property:
Subdivisions name or site address:* None - Parcel ID 0871129B& 0871131
Include phasellot nurrber
Directions to site:*
Included in this permit submission (above).
Rease include road narres and numbers, landmarks etc.
5. Describe the existing land use or condition of the site at the time of this application:*
Residential/Undeveloped
Fbsidential, undeveloped, etc.
6. Property Size .23 acres and .37 acres
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
We plan to build a concrete block seawall measuring 220 ft long. And
place Rip rap to avoid further erosion.
8. How will the work be done?* PF From Land
r 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.)
660
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.)
440
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)
Grass. And decayed wooden wall. NO trees will be impacted.
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):
$240.00 for impacts to lake (below normal water level) of less than 1 acre
$570.00 for impacts to lake (below normal water level) of greater or equal to 1 acre
By digitally signing below, I certify that:
I, the project proponent, hereby certifies that all information contained herein is true, accurate, and complete to the
best of my knowledge and belief
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');
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:
.� tea`

Initial Review
Is this accepted into the review
process?*
Project Number:* 20201642
Select Reviewer:*
Select Reviewing Office
Has payment been received?*
What amount is owed?*
FYes rNo
Version:* 1
Amy Annino:eads\amannino
Asheville Regional Office - [phone]
r No Payment Needed
r Fee Received
r Need Fee - send electronic notification
F $240.00
* $570.00

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO: 1 & Adjacent to 1 PLAN NO: PARCEL ID: 0871129B &
0871131
STREET ADDRESS:
000 Sunshine Lake Court Lot # 1
Hickory, NC 28601
Please print:
Property Owner:
Property Owner:
Michael Harris
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):
7'157 Kaith Ave
Granite Falls, NC 28630
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate tothe
best of our knowledge.
Authorized Signature Autt<oriied Sig ture
0;- 19/202-1 U�,) .26
Date Date

10/30/2020 1173 Shiloh Church Rd to Sunshine Lake Ct, Hickory, NC 28601 - Google Maps
Google Maps 1173 Shiloh Church Rd to Sunshine Lake Ct, Hickory, Drive 9.3 miles, 16 min
NC 28601
G ce Chapel
A
V6.
20 min
16 min
9 3-1.
North akes F2
StutshlneLake
Hickory
erlord Regional
IINe Airport In St G1
co-11Y 9.6 19em
Frye Reg anal Springs
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Go e :g !..g v—
Map data @2020 1 mil
1173 Shiloh Church Rd
Hickory, NC 28601
Take Hubbard Rd and Grace Chapel Rd to Midway Sand Rd
in Lovelady
14 min (8.8 mi)
t 1. Head southwest on Shiloh Church Rd toward
Rosenbalm Ln
387 ft
t 2. Continue straight onto Hubbard Rd
1.9 mi
t 3. Continue onto Icard Dam Rd
1.4 mi
41 4. Turn left onto Petra Mill Rd
0.9 mi
41 5. Turn left onto Grace Chapel Rd
4.1 mi
1+ 6. Turn right onto US-321 N/Hickory Blvd
0.4 mi
Continue on Midway Sand Rd. Drive to Sunshine Lake Ct
2 min (0.5 mi)
https://www.google.com/maps/di r/1 1 73+Sh iloh +Church+ Rd, +Hickory,+ NC+28601-7855, +USA/Sunshine+Lake+Ct, +Hickory,+NC+28601 /@35.78448 1 ... 1/2

10/30/2020 1173 Shiloh Church Rd to Sunshine Lake Ct, Hickory, NC 28601 - Google Maps
+1 7. Turn left onto Midway Sand Rd
0.4 mi
r► 8. Turn right onto Sunshine Lake Ct
312 ft
Sunshine Lake Ct
Lovelady, NC 28601
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/Sunshine+Lake+Ct,+Hickory,+NC+28601 /@35.784481... 2/2

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This map is NOT of land survey quality and is NOT suitable for such use.
Owner HARRIS MICHAEL R
Deferred Val
$0
Caldwell County
Assessed Val
$16,000
2357 KEITH AVE
1:1,613
GRANITE FALLS, NC 28630
Calc Acreage
0.26229
0 0.0125 0.025 0.05 mi
Land Units
0.23 (AC)
i i i i
+ + 0 11
Acct Number 19797
Legal Desc
BK 1858 PG 1239 YR 2014 ST 368.00
0 0.02 0.04 0.08 km
Parcel ID 0871 1 296
Plat Ref
/
October 30, 2020
NCPIN 2794008611
Property Add r
0

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: Caldwell Nearest Town: Granite Falls
Lake/ river/ ocean adjacent to property: Hickory
Property size (acres): 0.23 acres and .37 acres
Subdivision name or site address (include phase/lot number):
Sunshine Lake Ct — Lot 1 and Lot Adiacent to Lot 1
Directions to site - please include road names and numbers, landmarks, etc.:
Included in packet
Latitude (in decimal degrees) 35.761 Longitude (decimal degrees)-81.391
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Residential/Undeveloped
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): I t- 0 l .- �o 6, t 1 !a- cowele- k I a c k SP,a (./G II.
I e 24c, 1r+ long. -f-[,-a a I1 tile, li b (1744dah "I
J
7. Will work be conducted from land?
From water? ❑
8. Total amount of impacts below the normal pool lake level / Normal Water Level
Permanent impacts (including all excavation, backfill, rip rap, retaining walls, etc.) in square feet:
Nyn sa '(4 n4 \da\\ -r a'a.m of- P"aro 662-14, 4
Temporary impacts in square feet:
k 6d tr 4
9. Total amount of impacts above the normal pool lake level / Normal Water Level and 50 feet
land -ward
Permanent impacts (including back fill, excavation, rip rap, retaining walls, etc.) in square feet:
51
Temporary impacts (temporary clearing, construction corridor) in square feet:
I -Jr
10. 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): "C�&- I'+'11 be N9
.�( Z. f_rioc%rd. �etq i5 0�.i`( 9radS and ot, is('der, Odd &I" I1.
11. Signature., r�
Owner/Agent's Signature* [15A NCAC 02H .0502(f)]
11 - 1 7- 262,�
Date
*Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 02-2017 Page 2 of 4

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
Full Pond/ Normal Water Level
�._---M
Shoreline
Plan View
Lake
(At Full Pond/ Normal Water Level)
��x,`5�-►� Doc4c
OLI—W
aaa 4-�
NO Cltpxl11 1
NO C-le"r;'j
La ke
(At wu P-d/ N.—1 W.Wr L-1) Existing Dock
/ 30Rx7ft
• r
rrr rrrrrr
�i9i�����,� �iAbow
full pond/ NWL
E 'Wo AMPLE
Plan View
af}x OA�.o w-
Z�r x aa,u �-i-
FORM: SSGP 02-2017 Page 3 of 4

Lake
(At Full Pond/ Normal Water Lev
j� rap
I
-0
c
0
Side View
U-
2 ft. additional clearing
3 ft. below full pond water level 4 ft. above full pond water level *if necessary
Existing bank
10 ft. bank
height
Side Vi
FORM: SSGP 02-2017 Page 4 of 4

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CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: Michael Harris —Sunshine Lake Court Hickory County: Caldwell
Owner:
Contractor/agent:
Print
Print
Signature
The approval is for the purpose and design described in your application. Impacts not indicated in the
application is a violation of the Buffer Rule. Site specific work should be provided in the application. [15A NCAC
02H .0506 and 15A NCAC 02B .0243(8)]
Trees are not allowed to be removed from Zone 1 of the Buffer (within 30 ft of the full pond elevation), unless
approved. Exception, those trees that are severely undermined along the immediate shoreline can be removed.
Minimal shaping and sloping along the immediate shoreline is allowed. [15A NCAC 02B .0243(6)]
Benching and grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 02B .0243
(6)]
Beaches, impervious patios, impervious walkways, etc. are not allowed in the buffer unless specifically approved
by the Division. There are limitation on size for decks. [15A NCAC 02B .0243(4) and (6)]
Work to be conducted from land must indicate an access and indicate any trees that are to be removed. The
work corridor should be described. The approved access corridor shall be restored. Staging, spoil, construction
material must be outside the buffer. [15A NCAC 02H .0502 and 15A NCAC 02B .0243 (4), (6), (8)]
Stormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
discharges must be at the natural elevation and discharged prior to entering the buffer directed as diffuse or
sheet flow at non -erosive velocities to the lake. [15A NCAC 02B .0243(5), (6)]
Acknowledgement of Notification
I, Michael Harris . hereby state that I have been informed of the Catawba Riparian
Buffer Rule. Any work conducted in the buffer, not specifically stated in the application and approved by the
Division of Water Resources (DWR), is a violation and subject to enforcement. Due diligence will be taken such
that the construction will be built within substantial compliance and intent of the 401 Water Quality
Certification and Buffer Rules, the approved pla,n(s) and specification(s), and other supporting materials.
Signature (owner): �%�� �i^ Date:

ID#* 20201642 Version* 1
Regional Office * Asheville Regional Office - [phone]
Reviewer List* Amy Annino
Pre -Filing Meeting Request submitted 10/30/2020
Contact Name * Tony Gaines
Contact Email Address* marinecon'!@embargmail.com
P t Name* 000 Sunshine Lake Court
rolec
Project Owner*
Michael Harris
Project County*
Caldwell
Owner Address:
Street Address
000 Sunshine Lake Court - Lot 1 and Lot Adjacent to 1
Address Line 2
arty
State / Frovince / region
Hickory
NC
fbstal / Zip Code
Country
28601
USA
Is this a transportation project? * r Yes r No
Type(s) of approval sought from the DWR:
r 401 Water Quality Certification - r 401 Water Quality Certification -
Regular Express
r Individual Permit r Modification
p Shoreline Stabilization
Does this project have an existing project ID#?*
r Yes r No
Do you know the name of the staff member you would like to request a meeting with?
Please give a brief project description below.*
Installation of riprap along shoreline.
Please give a couple of dates you are available for a meeting.
11 /2/2020

11 /3/2020
11 /4/2020
Please attach the documentation you would like to have the meeting about.
pdf - S
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.
Signature
Submittal Date 10/30/2020