HomeMy WebLinkAbout20210214 Ver 1_Shoreline Stabilization_20210309Submission 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:
ARIK PRE FILE.pdf 51.52KB
Pre -fling Meeting or Request Date 1/29/2021
ID# 20210214 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: * EQUIPMENT & SUPPLY INC
Email: * ARIK.ADAMS@EQUIPSY.COM
Phone Number:* (704)989-3503
(xxx)xxx-xxxx
Mailing Address:* Street Address
3625 ANTIOCH CHURCH RD
Address Line 2
City
State / Frovince / Region
MATTHEWS
NC
Fbstal / Zip Code
Country
28104
United States
Is there an agent working on the
project? *
Agent/Consultant Information
.................................................................................................................
Name:
Company Affiliation:*
Email:
Phone Number:*
Mailing Address:*
F Yes
r No
TAMARA HAGER
LKN DREDGE & MARINE CONST
HAGER@LAKEPERMIT. COM
(704)575-2227
(XXX)XXX-XXXX
Address
PO BOX 5335
Address Line 2
City
MOORESVILLE
Fbstal / Zip Code
28117
Asigned and dated copyof the Agent Authorization letter:*
ARIK AUTH.pdf 969.05KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* EQUIPMENT & SUPPLY INC
State / Province / Region
North Carolina
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: ARIKSURVEY.pdf
Latitude:* 35.495589
958.74KB
Longitude:*-80.911087
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*
ARIK SKETCH.pdf 898.27KB
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.)*
ARIK PICS.pdf 1.39MB
4. Location of the property (where work is to be conducted)
Nearest Town:* CORNELIUS
County:* Mecklenburg
Lake/ river/ ocean adjacent to NORMAN/CATAWBA
property:
Subdivisions name or site address:* RAINTREE GREENS LOT # 22
hclude phasellot nunber
Directions to site:*
FROM COWANS FORD DAM TURN LEFT ONTO HWY 73 5.2
MILES, TURN LEFT ONTO WEST CATAWBA AVE 2.7 MILES,
TURN LEFT ONTO BETHEL CHURCH RD 1.4 MILES, TURN RIGHT
ONTO PINEHURST DR .10 MILES, TURN RIGHT ONTO ISLAND
FOREST DR .30 MILES, TURN RIGHT ONTO EASTPOINT DR .10
PROPERTY ON RIGHT.
Rease include road naves and nunbers, 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 .67
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
RIP RAP BARE ERODED AREAS FOR SHORELINE STABLIZATION
8. How will the work be done?* r- From Land
IW From Water
9. Total amount of disturbance below the normal pool lake level/ normal water level:*
0
(including all clearing, back fill, excavation, rip rap, retaining walls, etc.)
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:*
(nunber of trees, for instance)
NONE
Sketch: ARIKSKETCH.pdf 898.27KB
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:* EQUIPMENT & SUPPLY INC
Signature:
IQujWT& My" 1f'e-
Initial Review
Is this accepted into the review
process?*
Project Number:* 20210214
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
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Lake
(At Full Pond/Normal Water Levei)
lUN Pond/
INorma Water Ve
Shoreline '
Ni, 1Ni• j )u'A L D isi Lt1�j
Q
Please approximately sketch the fallowing information on this Plan (provide dimensions for�c�ch
ir�rrr, such as ?o jtx goo-fL
1 • All proposed vegetation clearing
2. Location of rip rap or fill to be placed above the Full Pon d/'€Normal Water Level elevation
3• Location of rip rap orfill to be placed belovv the Full Pond/ Normal Water Level elevation
4- Location of any proposed structures such as buildings, retaining walls, docks, etc.
Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
�- Location of construction access corridors
FORM. SSGP 10-2-013
Page 3 of 3
From: TAMARA HAGER hager@lakepermit,com
Subject: Equipment & supply shoreline pics
Date: Feb 2, 2021 at 4:15:13 PM
To: TAMARA HAGER hager@lakepermit.com
1\3 U _Pt (>S
Lqu.i PM-C,4 pIi SYic
zo 9I 2. L W PWW' J9P-
Go,r� N�O3 I
Tamara Hager
704-575-2227
Lake Permit LLC
Lake
(At Full Pond/Normal Water Levei)
lUN Pond/
INorma Water Ve
Shoreline '
Ni, 1Ni• j )u'A L D isi Lt1�j
Q
Please approximately sketch the fallowing information on this Plan (provide dimensions for�c�ch
ir�rrr, such as ?o jtx goo-fL
1 • All proposed vegetation clearing
2. Location of rip rap or fill to be placed above the Full Pon d/'€Normal Water Level elevation
3• Location of rip rap orfill to be placed belovv the Full Pond/ Normal Water Level elevation
4- Location of any proposed structures such as buildings, retaining walls, docks, etc.
Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
�- Location of construction access corridors
FORM. SSGP 10-2-013
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.
20210214 1
Mooresville Regional Office - (704) 663-1699
Alan Johnson
Pre-Filing Me eting Reque st submitte d 1/29/2021
TAMARA HAGER
HAGER@LAKEPERMIT.COM
ADAMS
EQUIPMENT & SUPPLY INC
Mecklenburg
City
CORNELIUS
State / Province / Region
NC
Postal / Zip Code
28031
Country
United States
Street Address
20812 EASTPOINT DR
Address Line 2
Yes No
401 Water Quality Certification -
Regular
401 Water Quality Certification -
Express
Individual Permit Modification
Shoreline Stabilization
Yes No
NONE NEEDED
RIP RAP BARE ERODED AREAS FOR SHORELINE STABIZATON
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.
1/29/2021