20211414 Ver 1_Shoreline Stabilization_20210927

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:
Pre -Submittal Meeting Request.pdf 2.5MB
Pre -fling Meeting or Request Date 8/27/2021
ID# Version
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 * gregmartin70gme.com
Rease provide an email address for payrrent and requests for pure information here.
Owner Information:
Name: * Greg Martin
Email: * gregmartin70@me. com
Phone Number:* [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
3483 Pearl Ridge Way
Address Line 2
City
State / Frovince / Region
Buford
GA
Fbstal / Zip Code
Country
30519
US

Is there an agent working on the
project? *
Agent/Consultant Information
.................................................................................................................
Name:
Company Affiliation:*
Email:
Phone Number:*
Mailing Address:*
F Yes
r No
Janice Estep
CBC Stone & Recycling, LLC
[e-mail]
[phone]
(XXX)XXX-XXXX
Address
638 Oakridge Farm Hwy
Address Line 2
City
Mooresville
Fbstal / Zip Code
28115
Asigned and dated copyof the Agent Authorization letter:*
Auth. Form.pdf 5.32MB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* Martin Shoreline
State / Province / Fdegion
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
Property Address Lookup:*
Latitude:* 35.576570
Street Address
478 Lakeview Shores Loop
Address Line 2
City
Mooresville
Fbstal / Zip Code
28117
State / Province / Region
NC
Country
US
Longitude:*-80.945903
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*
Site Plan.pdf 2.53MB
Buffer Form.pdf 5.56MB

Please use the diagram at the link below:
https://edocs.deq.nc.gov/WaterResources/0/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.)*
Shoreline Pics.pdf 12MB
4. Location of the property (where work is to be conducted)
Nearest Town:* Mooresville
County: * Iredell
Lake/ river/ ocean adjacent to Norman
property:
Subdivisions name or site address: * Lot 274 Crescent Land & Timber Corp
Include phase/lot nunber
Directions to site:*

610 E Center Ave
Mooresville, NC 28115
Head south on Evergreen St toward E Center Ave
13 s (197 ft)
Take NC- 1100/Brawley School Rd to McKendree Rd
17 min (7.6 mi)
Turn right onto E Center Ave
0.5 mi
Turn left onto S Church St
0.4 mi
Turn right onto E Wilson Ave
1.5 mi
Continue onto NC -I I00/Brawley School Rd
1.0 mi
Continue straight to stay on NC- 1100/13rawley School Rd
4.3 mi
Continue on McKendree Rd. Drive to Lakeview Shores Loop
4 min (2.1 mi)
Turn right onto McKendree Rd
1.6 mi
Turn right onto Lakeview Shores Loop
0.1 mi
Turn left onto Abbot Road
0.1 mi
Turn right onto Lakeview Shores Loop
Destination will be on the left
0.2 mi
478 Lakeview Shores Loop
Mooresville, NC 28117
Rease include road narres and nunbers, landmarks etc.
5. Describe the existing land use or condition of the site at the time of this application:*
Undeveloped Lot (will be cleared for new construction)
Residential, undeveloped, etc.
6. Property Size 0.64 acres
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
Shape and slope shoreline. Install matting and boulder rip rap. Install TN
Crab Orchard steps.
8. How will the work be done?* I7 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.)
3' below (498 sf)
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.)
F above (166 sf)
10' x 50' access
corridor (500 sf of
temp. impact)
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 buffer, remove small, undermined trees on immediate shoreline to
properly stabilize, minimal disturbance to buffer
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:* Janice Estep,
Signature:
0"-6 5 � xWi_ " "e C—F - --,-� , {'Zr- x
Submittal Date: 9/27/2021

Initial Review
Is this accepted into the review
process?*
Project Number:* 20211414
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