20071296 Ver 2_Shoreline Stabilization_20210521

Shoreline Stabilization Application Form
15ANCAC 02H .0500 — Water QualityCertification, Shoreline Stabilization
FORM SSGP 10-2013
DRAFT -NOT FOR USE AT THIS TINE
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:
LOMBARDI PRE FILE.pdf 51.28KB
Pre -fling Meeting or Request Date 4/17/2021
ID# 20071296
I. Applicant Information [15A NCAC 02H .0502(a)]
Version 2
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]
Reese provide an email address for payrrent and requests for pore information here.
Owner Information:
Name:*
Email:
*
Phone Number:*
Mailing Address:*
TIMOTHY LOMBARDI
TLOMBARDI 18@GMAIL. COM
[phone]
(xxx)xxx-xxxx
Street Address
160 Windwood Lane
Address Line 2
CitY
Troutman
Rbstal / Zip Code
28166-7661
State / Rovince / Region
NC
Country
US

Is there an agent working on the
project? *
Agent/Consultant Information
.......................................................................................................
Name:*
Company Affiliation: *
Email:*
Phone Number:*
• Yes
✓ No
TAMARA HAGER
LKN DREDGE & MARINE CONSTRUCTION
HAGER@LAKEPERMIT. COM
[phone]
(x)m-
Mailing 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:*
LOMBARDI AUTHpdf 1.25MB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* LOMBARDI
If your project has a formal name please use this. If your project does not have 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.*
✓ Upload File
✓ Look up address
Upload Map: LOMBARDI SURVEY.pdf 6.31MB
Latitude:*
35.638887
Longitude:* -80.933354
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*
LOMBARDI SURVEY.pdf 6.31MB
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.)*
LOMBARDI PICS.pdf 4.36MB

4. Location of the property (where work is to be conducted)
Nearest Town:* TROUTMAN
County:* Iredell
Lake/ river/ ocean adjacent to NORMAN/ CATAWBA
property:
Subdivisions name or site address:* HAWKES BAY LOTNUMBER41
hclude phase/lot number
Directions to site:*
FROM MARSHALL STEAM STATION HEAD NORTHWEST ON WHY
150 E .50 MILES, TRN LEFT ONTO PERTH RD 4.2 MILES, TURN
LEFT ONTO STATE PARK RD 1.4 MILES, TURN T,FFT ONTO
MORRISON FARM RD 2.1 MILES, TURN RIGHT ONTO APRIL RD
.10 MILES, TURN LEFT ONTO WILDWOOD IN .30 MILES
PROPERTY ON RIGHT.
Rease include road naves and nurrbers, landmarks etc.
5. Describe the existing land use or condition of the site at the time of this application:*
RESIDENTIAL
Residential, undeveloped, etc.
6. Property Size 1.6420
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 STABILIZATION
8. How will the work be done?*
r From Land
I� 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.)
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, 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:*
(number of trees, for instance)
NONE
Sketch:
LOMBARDI SKETCHpdf 923.72KB
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");
o I 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:* TIMOTHYLOMBARDI
Signature:
TMOTWW ZO JAi{JI

Initial Review
Is this accepted into the review fr Yes 0 No
process?*
Project Number:* 20071296
Select Reviewer:*
Select Reviewing Office:
Has payment been received?*
What amount is owed?*
Version:* 2
Alan Johnson:eads\adjohnsonl
Mooresville Regional Office - [phone]
r No Payment Needed
r Fee Received
C' Need Fee - send electronic notification
C' $240.00
r $570.00

CATAWBA .RIIPAROAN BUFFER NOT IICATi s G� i
Project hlame/addren: l.b IL[
Cwnen -j-,4 b
Print
Contractor i r gent
Print
1(.K) i N,DI,J[a0Llq
D County:
• S ri turn
7)re4( 4—Witt4—Witt re j7
T
rr,
The approval 15 for the purpose and design described in vDuf application. Impacts not indicated in the
application is a violation of tc Buffer Rule. Site specific work should be provided in the application. Il5A NCACO2H .0506 and 15A NCAC 02 B .0243(8) V
Trees are not allowed to be removed from Iona 1 of the Buffer (within 30 ft or the full pond elevation), unless
approved_ Exception, Chase trees that are severely undermined alongthe immediate shoreline can be ram0ve.d.
Minimal shaping and sloping, along. the immediate shoreline is allowed. i 16Y NCAC 025.0243(5) j
5enchine, gradirly in the buffer is not allowed_ =>Ccessive dist•.irbence of around cover. [ SA NCAC 02 .0243 (Ell
Seaci ies, impervious patios, impervious walkways, etc. are not allowed in the buffer unless specifically approved
O-y the Division. € h r e are limitation on sip e for decks. i 15A NCAC 025 .0242(4) and (5)]
Work to be conducted from land must indicate an access and indicate- arw trees that are. to be i �rl oved. I r iC
work corridor should be described. The approved access corridor shall be restored. St rin?, spoil, cost ]strlJtitior
material must be outside the buffer_ 115A NCAC O2 _0502 and ?5�: NCAC 0E 0743 (4)5, ;8 :
Stormwater cannot b biped or chcnn`E ed for C1rect dlschar-,a to the constructed storrowat.4r
discharges must be et the n=tur 2levztion 7-nd dlschar_ad prior to entering the buffer directed es diffuse. or
=heel Tlow c . non erosive velocities to _h i2K _ (1511. NCAC 023 _0243 (5); (6)1
Ack+nowlecicern Eft a1 WO _ian
'11 t.t37fiti LiM ;,Aie_riT thereby sta a that 1 have hce n 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 Re_ourrac (D.WR), is a violation and subject to enforcement Due diligence will be
:keen such that Lana construction will be built within substantial compliance and intent of the 401 Water
Quality Certification end Buller Rules, the approved plants) and apecification(s), end other suppoitine
material__
Jlal'iBLUI (own C] Date: !717-4

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OWNER: CRESCENT RESOURCES INCAA1nn[x.ci6n1G2
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A00 S. 1NYON ST,01300
CH ARLOTTE,N. C, 2 H201-1003
1-704-.)n-2012
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A11 LOTS N1M1 THE RAVINES BAY
SUB1k5SION, TO TIE BEST 071 MY KHOO CODE,
LIE IMIHIN THE MS -IV tA. OF THE LAKE
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From TAMARA HAGER halter@lakeper i com
Subject: Lombardi shoreline pics
Date: Apr 18, 2021 at 5:41:56 PM
To: TAMARA HAGER [e-mail]

Tamara Hager
704-575-2227
Lake Permit LLC
[e-mail]

Full Pone
Non-nal aterLeve
DM Ent R
Shoreline
it
Lake
(At Full Pond/Normal WaterLeveff
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Please approximately sketch the following information on this tan item, such as 10 ftx 100 (provide dimensions for each
L • All proposed vegetation tearing
2. Location of rip rap or fill to be placed above the Full Pond 'Norma! Water Level elevation
3. Location of rip rap or till to be placed below the Full Pond/ Normal Water Level elevation
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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 Leve
6. Location of construction access corridors 1 elevation
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 and include location information.*
20071296 2
Mooresville Regional Office - [phone]
Alan Johnson
Pre-Filing Me eting Reque st submitte d 4/17/2021
TAMARA HAGER
[e-mail]
LOMBARDI
TIMOTHY LOMBARDI
Iredell
City
TROUTMAN
State / Province / Region
NC
Postal / Zip Code
28166
Country
US
Street Address
170 WINDWOOD LN
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
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.
Signature
Submittal Date
· 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.
4/17/2021