20211447 Ver 1_Shoreline Stabilization_20211001

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:
4301 The Bluffs Way DWR Pre -Filing
49.73KB
Meeting Request Form (26).pdf
Pre -fling Meeting or Request Date 10/13/2021
ID#
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]
Rease provide an email address for payment and requests for more information here.
Owner Information:
Name: *
Email: *
Phone Number:*
Mailing Address:*
Gordan Hurrell
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
4616 Napa Oak Drive, Apt.310
Address Line 2
City State / R-ovince / Region
Charlotte NC
Rasta) / Zip Code Country
28216 US

Is there an agent working on the
project? *
r Yes
C: No
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:*
4301 The Bluffs Way Huffell property
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.*
F Upload File
r Look up address
Upload Map: 4301 The Bluffs Way Directions.pdf 947.99KB
Latitude:*
35.154878
Longitude:* -81.019676
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*
4301 The Bluffs Way Site Sketch.pdf 1.08MB
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.)*
4301 The Bluffs Way pics.pdf 47.67MB
4. Location of the property (where work is to be conducted)
Nearest Town:* Belmont
County:* Gaston
Lake/ river/ ocean adjacent to Lake Wylie
property:
Subdivisions name or site address:* Reflection Point
hclude phase/lot nunber
Directions to site:*
See Map (vicinity map)
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:*
Vacant wooded future residential home site
Residential, undeveloped, etc.
6. Property Size .651
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):

Removing all fallen and dead trees in buffer by shoreline. As seen in
provided pictures shoreline has been eroding for years and damage by
beavers has taking down several large trees. Placing Rip Rap along
shoreline will help stabilize shore and prevent futher erosion.
8. How will the work be done?*
17 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.)
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.)
2244 sq.ft.
square feet
11. Please describe the vegetation above the normal pool lake level/ normal water level and 50 feet
landward to be impacted:*
(nurrber of trees, for instance)
We have 3-8" diameter and 1- 6" tree to be removed. The 8" trees are
eroded and will fall shortly. The 6" trees has the top broken out. Small
scub trees and brush at edge of bank will need to come out. All disturbed
areas to be mulched when all rock is in place.
Sketch: 4301 The Bluffs Way Agent Form -Buffer
Form.pdf
Application Fee:
1.65MB
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):
a $240.00 for impacts to lake (below normal water level) of less than 1 acre
a $570.00 for impacts to lake (below normal water level) of greater or equal to 1 acre
By digitally signing below, I certify that:
a I, the project proponent, hereby certifies that all information contained herein is true, accurate, and complete to the
best of my knowledge and belief
a 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.
a 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");
a 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");
a 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:*
Signature:
Submittal Date:
Randall S Clawson
10/1/2021

Initial Review
Is this accepted into the review fr Yes 0 No
process?*
Project Number:* 20211447
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