20211431 Ver 1_Shoreline Stabilization_20210929

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:
DWR Pre -Filing Meeting Request Form.pdf 53.96KB
Pre -fling Meeting or Request Date 8/24/2021
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 * [e-mail]
Rease provide an email address for payrrent and requests for pure information here.
Owner Information:
Name:* Jeffrey (Tracy) ITipple
Email: * [e-mail]
Phone Number:* [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
172 Hazehon Loop
Address Line 2
City
State / Frovince / Region
Mooresville
NC
Fbstal / Zip Code
Country
28117
USA

Is there an agent working on the f Yes
project?* r No
Project Information [15A NCAC 02H .0502(a) & (b)]
....................................................................................................................................................................................................................................
Project Name:* 1lipple - Boulder Riprap-Irrigation-Buffer Landscaping
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.
r Upload File
r Lookup address
Property Address Lookup:* Street Address
172 hazelton Loop
Address Line 2
City
mooresville
Postal / Zip Code
28117
Latitude:* 35.571514
State / Province / f;bgion
nc
Country
usa
Longitude:*-80.880173
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*
2-Detailed Site Plan - Duke Diagram.pdf 263.42KB
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.)*
3-Shoreline Photos.pdf 1.97MB
4. Location of the property (where work is to be conducted)
Nearest Town:* Mooresville
County:* Iredell
Lake/ river/ ocean adjacent to Lake Norman
property:
Subdivisions name or site address:* 172 Hazelton Loop, Mooresville, NC 28117, Regency Lake Village, Lot
#12
Include phasellot nunber
Directions to site:*

Brawley School Road Exit #35 Interstate 77, Follow Brawley School
Road West (2.1 mi), Left Turn onto Canvasback Road (0.2 mi), Turn
Left onto Regency Road (0.4 mi), Turn Right onto Hazelton Loop (0.3
mi), Destination 172 Hazelton Loop on the Right
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 site, house built 2018
Residential, undeveloped, etc.
6. Property Size 0.62 Acres
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
Replace the existing riprap with boulder riprap to better harden and
protect shoreline erosion due to the steepness of the hill. The boulder
riprap intended to integrate / align with the neighbors Seawall for
aesthetics. There is a mixture of English Ivey, Periwinkle and weed
growth along the buffer zone. I would like to remove weeds from the
hillside and landscape to mitigate erosion. Lastly, would like to install a
irrigation pump for minor lake water withdrawals.
8. How will the work be done?* r From Land
V 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.)
321 sq. ft. (107 ft
shoreline X 3ft)
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.)
5,350 sq ft (107 ft.
shoreline X 50 ft.)
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)
The buffer zone is a steep hillside with 2 large trees and remaining hillside
is ground cover (English Ivey, Periwinkle, bare areas and weed growth)
Sketch: 3-Shoreline Photos.pdf 1.97MB
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 certifythat:
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.
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');
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');
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:' Jeffrey Hipple
Signature:
Submittal Date: 9/29/2021

Initial Review
Is this accepted into the review
process?*
Project Number:* 20211431
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

E
N
O
C6
O
U
C6
ro
co QJ
U 4-
O
C O
O
rH L O
J
O o
J J ++
N
�cij_� CU
nA E 2
Cij
N
N
C
O
J cij
U � _
C C6 H
�Qj
LL O
O
C Ln ro
E _v
O
O �: Q
Z " 00
QJ m J
CO C
J O O
O 4J
L.LN
ra
U (U
ra O
L
(U
4J W
Ln L
U �
Z 4-
v LXU E
ra
N o 0
O O
0 cr6 oC
L
i
a Coo
O H O
-O •2 v
, V J
J C �
•� �� y! t r
C� � c a ��
N
o ..
O 4
o��°�°I-�i bi.i3 Viz.
oa v NNNNNo❑N❑❑❑N❑o❑NNN
a
N m ti
z'`om"
' v
- - a
v - f III E'll
�Flr
I \�
\ _ Y
d 7'�,r ,,��'• \-ram
]ax \ \ e
- _
S \ - L \
12
Pf
x 8 `.
}#\\\ o ry
IQ
LL rIEcn
f �W
w
C!f

zzz
i \
O
�:R$Hv IH H
w*0O40-6rfl®®0®OCI
kI aee
II ��
Eli o�
n�pu H,, ,
N
ig YS =3
a
z
g>qqm�7
'?MMZiiu2
Y
�_ a
r
i�B�3ad��
du1n60.
Oc�a
IR
Val L�
mo�
<�023z
OSI I
^
oa
xz
w
d
d
221
n,
w��3
^om
NN
a'\
(�
y
� LLI
do
a
i Opa
z
a o f
o�
w
o LU
V
a
g
s�
I Z
a

O
N
N
O
a —
I
V
L
O
LL
cz o
Ln
E °J
E c
•L _
E
E o
J +
N N
N
C1A �
C Q
� C6
N v
N N
C
C6
J
ME
o v
>
L
M `~ N
O
Q
m
C N
C
— O�
1
OR
en
�
Q)
L
LL
LL
c6
Ln
00
N
O
r-i
r
M
Aw

N
J
z
z
Lr) C
O
O p Q
fl- X —
X _ a:�
3 I 4
M 3 >
O I -0
co°J a
c
O
0 i
° �, °p N
M v) iD
f `�"
GA X LL
ro �
vLn O O
X O_ O
w *'
N O
N
0-
0
m
N a°
J I u p
U
N N
: O
L
}� I 4
X _ :a
f6 O > E
I
Lli O o
},
O
d
LL

CL
a
I
.to
L
CL
L
CL
O
m
L
m
0
CL
CL
w
Vf
Q
0
a
H
�9
L
,
�.
I
•
w
r,
i +4 l
i
c
r
�
.•'7
...
t
4�.
S
wwr
x'

0
ow
Qi
L
O
N
L
Q
O
L
Q
4-
O
a-J
0
2
t
M
Ln
V)
U
O
X
LL
4--
O
Q
O
O
L
-J
m
i
Qi -0
u
U
N
4.J �
f0
L
N
bn 4-
C I
W
O
X
Q
[m
Q
a)
4i

`d�c
04
TTTiiR.FF -° a-. .� •Mk+ i
r
�
F
S � �,p � •��� r1iJ1,
T. .. i

CL
a
I
.to
L
CL
L
CL
O
m
L
m
0
CL
CL
w
Vf
Q
0
a
H
�9
L
,
�.
I
•
w
r,
i +4 l
i
c
r
�
.•'7
...
t
4�.
S
wwr
x'

0
ow
Qi
L
O
N
L
Q
O
L
Q
4-
O
a-J
0
2
t
M
Ln
V)
U
O
X
LL
4--
O
Q
O
O
L
-J
m
i
Qi -0
u
U
N
4.J �
f0
L
N
bn 4-
C I
W
O
X
Q
[m
Q
a)
4i

`d�c
04
TTTiiR.FF -° a-. .� •Mk+ i
r
�
F
S � �,p � •��� r1iJ1,
T. .. i

Contact Name*
Contact Email Address*
Project Owner*
Project Name*
Project County*
Owner Address:*
Is this a transportation project?*
Jeffrey Hipple
[e-mail]
Jeffrey Hipple
Shoreline Stabilization, Landscaping & Irrigation Pump
Iredell
Street Address
172 Hazelton Loop
Address Line 2
aty
Mooresville
Postal / Zip axle
28117
C Yes c: No
Type(s) of approval sought from the DWR:
F- 401 Water Quality Certification - F- 401 Water Quality Certification -
Regular Express
F- Individual Permit F- Modification
W Shoreline Stabilization
Does this project have an existing project ID#?*
C Yes c: No
State / Province / Pegion
NC
Country
USA
Do you know the name of the staff member you would like to request a meeting with?
Please give a brief project description below and include location information.*
I would like to submit a Lake Permit Application for 3 activities
including Shoreline Stabilization (seawall), landscape/plantings and
irrigation pump installation
Location: 172 Hazelton Loop, Mooresville, NC 28117 (Latitude 35.57 /
Longitude-80.88)
Thanks,
Jeff Hipple
Cell: 704-907-4193
e-mail: [e-mail]
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 Icannot submit myapplication 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 8/24/2021