20210931 Ver 1_Shoreline Stabilization_20210616

Shoreline Stabilization Application Form
15ANCAC 02H .0500 — Water Quality Certification, 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:
LYERLY PRE FILE.pdf 50.89KB
Pre -fling Meeting or Request Date 5/10/2021
ID# 20210931
I. Applicant Information [15A NCAC 02H .0502(a)]
Version 1
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 rrore information here.
Owner Information:
Name:*
Email:
*
Phone Number:*
Mailing Address:*
RONALD E LYERLY
RELYERLY@GMAIL. COM
[phone]
(xxx)xxx-xxxx
Street Address
128 Sunset View Lane
Address Line 2
CitY
Statesville
Rbstal / Zip Code
28677
State / Bovine / 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]
( )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:*
LYERLY AUTHpdf 370.51KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* LYERLY
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: LYERLYSURVEY.pdf 384.87KB
Latitude:*
35.677559
Longitude:* -80.966427
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*
LYERLY SKETCHpdf 236.46KB
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.)*
LYERLY PICS.pdf 629.25KB

4. Location of the property (where work is to be conducted)
Nearest Town:* STATESVILLE
County:* Iredell
Lake/ river/ ocean adjacent to NORMAN/CATAWBA
property:
Subdivisions name or site address:* SPRING SHORE
hclude phase/lot number
Directions to site:*
FROM MARSHALL STEAM STATION, HEAD NORTHWEST ONTO
HWY 150 .80 MILES, TURN RIGHT ONTO SHERRILLS FORD RD 3.0
MILES, TURN RIGHT ONTO MOLLYS BACKBONE RD 2.7
MILES,TURN LEFT ONTO MONBO RD 1.3 MILES, TURN RIGHT
ONTO LONG ISLAND RD .90 MILES, SHARP LEFT ONTO KALE RD
1.3 MILES, TURN RIGHT ONTO HUDSON CHAPEL RD .20 MILES,
CONTINUE ONTO BUFFALO SHOALS RD 1.5 MILES, TURN RIGHT
ONTO PINEVILLE RD 2.1 MILES, TURN R SPRING SHORE RD .60
MILES,CONTINUE STRAIGHT ONTO SUNSET VIEW IN,
PROPERTY ON RIGHT .10 MILES
Rease include road nairea and nurrbers, landrrarks 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 59
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
8. How will the work be done?*
r From Land
17 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:*
(nunter of trees, for instance)
NONE BY BARGE
Sketch: LYERLY SKETCHpdf 236.46KB
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
• I intend to electronically sign and submit the Shoreline Stabilization online form.
Full Name:*
Signature:
RONALD E LYERLY
1(6.6169 f LYfLY

Initial Review
Is this accepted into the review fr Yes 0 No
process?*
Project Number:* 20210931
Select Reviewer:*
Select Reviewing Office:
Has payment been received?*
What amount is owed?*
Version:* 1
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

tA &WM ROPARIAN BUFFER NOTIFICAMO FORM
Project NE e)&dir s: ! , .. 1_y / 12.2 .sIAArri you Lguritv: _ .
0 wil @.n Pop.teybr r_.;-, LvaLLy t.,J 404-16, f' 4 ii:,
Print signaturE
Canna ar aaeyit:1,14 ,- lkitel.lili
Prim ci �a
approval is for the purpose arid design described in your application. Impacts not indicated in the
application is a violation o; the Butter Rule. Site spec}iic work should be provided in the application. !,L 5P NCAC.
02H _0506 and 15A NCAC 07B .0743(3)]
Trees are not allowed -to be removed from lone ? of thre Buffer (within BD r . of the 'full pondelevation), unless
approved. i~,icaption, those trees that ors severely underrninad along the irnrnedisie shor&Ine can be removed.
Minimal shaping and soaping along the immediate shoreline is-ltavued_ 115A RQCAC 023 .0243(6))
Benching, grading in the buffer ilp- allowed_ Excessive disturbance o; vround cover. [ISA NCAC 02B _ 2.3 (6)]
i'2?ches, impervious pervious patios, impervious walkways, etc. era not allowed in the bus F cr uniess specifically proved
oV thz- D vislo n. There are limitation on si7e for decks_ i,1 S. NCAC 02B .021-13{-) End (6)_
Work to be conducted from lane must indicate an access and indicate any tries that art o be removed. The
ttro+k corridor should be described. i hW-pproved -ccess corridor shad be restored, SteEin , spoil, constr ruc;io
rrl taC!=_l 1i� be outside the buffer_ i.J: NCAC 07= _0502 aid t P. NCAC 022 .1.:P43 i4),
SLorm;id 2 .er cannot b? piped or channeled for direct discherge to the lake. 11 construct -et star F is
discharges must be et the n tural =devotion Bad diecherged prior to entering the build, directed as isri tuna or
Sheet sloe+ act lion erosive velocities to the lake. [15i_ NCAC 02B _02 3(5). (6)1
AcknovnedgernEnt oj'Notification
y[. OpA41.2,1EILLJ n n r by state that I rave been informed of the Catawba'
Riparian 'Bu r r'ula. r`ro/ work conducted ill the buffer not specifically stated in she application and appru, .d
by the Division of Vhi.ster Resources (MR), is - violation and subject to enforcement_ Due diilgence will be
taken such Ch22ttthe eanVcr uctiort will be built within substantial compliance and intent of the 4-01 +eater
Quality C rl{ficatton and du fer _Ulas, the approved pian(s) and abeclfication(sL, end othersupporbnc
materiels.
Signature (owner-.
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ulI Porid/
Normal W er i_eve
UN MR
Shoreline
Lake
(At Full Pond/Normal Water Level)
3'
�;•. (Ut f E2 J? AcvLL
i3c��
iN6j LO '6 .17E r
Please approximately sketch the followin information on this plan
item, such as 10 g P (provide dimensions for each
1 ftx 1p� ft-j-`:
All proposed vegetation clearing
?. 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
4. Location of any proposed structures such as buildings, retaining walls docks
5. Location of any excavation or dredging below the Full Pond/ Normal Wa' etc
6. Location of construction access corridors ter Level elevation
FORM: SSGP 10-2013
Page 3 o, 3

From: TAMARA HAGER [e-mail]
Subject: Lyerly shoreline pics
Date: May 15, 2021 at 3:17:47 PM
To: TAMARA HAGER Magerlakepermit.com

ulI Porid/
Normal W er i_eve
UN MR
Shoreline
Lake
(At Full Pond/Normal Water Level)
3'
�;•. (Ut f E2 J? AcvLL
i3c��
iN6j LO '6 .17E r
Please approximately sketch the followin information on this plan
item, such as 10 g P (provide dimensions for each
1 ftx 1p� ft-j-`:
All proposed vegetation clearing
?. 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
4. Location of any proposed structures such as buildings, retaining walls docks
5. Location of any excavation or dredging below the Full Pond/ Normal Wa' etc
6. Location of construction access corridors ter Level elevation
FORM: SSGP 10-2013
Page 3 o, 3

DWR Pre -Filing Meeting Request Form
ID#*
Regional Office *
Reviewer List*
20210931
Version*
1
Mooresville Regional Office - [phone]
Alan Johnson
Pre -Filing Meeting Request submitted 5/10/2021
Contact Name * TAMARA HAGER
Contact Email Address* [e-mail]
Project Name* LYERLY
Project Owner* RONALD E LYERLY
Project County* Iredell
Owner Address: Street Address
128 SUNSET VIEW LN
Address Line 2
City State / Rovince / Region
STATESVILLE NC
Fbstal / Zip Code Country
28677 US
Is this a transportation project?* C Yes ( No
Type(s) of approval sought from the DWR:
W 401 Water Quality Certification - I— 401 Water Quality Certification -
Regular Express
I— Individual Permit I— Modification
W Shoreline Stabilization
Does this project have an existing project ID#?*
C Yes ( No
Do you know the name of the staff member you would like to request a meeting with?
NONE
Please give a brief project description below and include location information.*
RIP RAP BARE ERODED AREAS FOR SHORELINE STABILIZATION
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.
• !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
o WL8 f LYf LY
Submittal Date 5/10/2021