20211534 Ver 1_Shoreline Stabilization_20211025

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:
1780 POA pre file.pdf 531.63KB
Pre -fling Meeting or Request Date 9/2/2021
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*
Owner Information:
Name:
Email:
Phone Number:
Mailing Address:*
[e-mail]
Please provide an email address for payment and requests for more information here.
1780 HOA Inc.
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
5970 Fairview Road
Address Line 2
Ste 710
City
Charlotte
Postal / Zip Code
28210
State / Province / Region
NC
Country
US

Is there an agent working on the project?* Yes
No
Agent/Consultant Information
...................................................................................................
Name: *
Company Affiliation:
Email: *
Phone Number:
Mailing Address:*
Carissa Parker
Bennick Grading
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
7836 US Hwy 70 E
Address Line 2
City
Nebo
Postal / Zip Code
28761
A signed and dated copy of the Agent Authorization letter:
1780 POA auth.pdf 202.75KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name: * 1780 Community Dock Area
State / Province / Region
NC
Country
USA
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
Property Address Lookup: * Street Address
2401 Cornwallis Trail
Address Line 2
City
Nebo
Postal / Zip Code
28761
Latitude: * 35.745330
State / Province / Region
NC
Country
US
Longitude: *-81.898675
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*
1780 POA site plan.pdf 371.12KB
1780 POA plat.pdf 937.02KB

Please use the diagram at the link below:
https:Hedocs.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.)*
1780 HOA Pic.pdf 3.78MB
4. Location of the property (where work is to be conducted)
Nearest Town: * Nebo
County: * Burke
Lake/ river/ ocean adjacent to Lake James
property:
Subdivisions name or site address:* 2401 Cornwallis Trail - 1780 Community Dock area
Include phase/lot number
Directions to site: *
From Morganton take NC 126 / TL onto Carson Dr / TR onto Yellow Fork
Trl W / TL onto Cornwallis Trl to property
Please include road names and numbers, landmarks etc.
5. Describe the existing land use or condition of the site at the time of this application:
1780 Common dock area, wooded lot
Residential, undeveloped, etc.
6. Property Size .92
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
185' Shoreline stabilization by barge, height will be 4'
8. How will the work be done?* From Land
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.)
185
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.)
555
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)
4 TREES LESS THAN 6" AND 3 TREES GREATER THAN 6" WILL
BE REMOVED TO COMPLETE THIS PROJECT. THEY WILL BE
REPLACED INCH FOR INCH, WITH TREES TOTALING THE SAME
DIAMETER. ANY REMAINING DISTURBED AREA WILL HAVE
MULCH APPLIED TO IT
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:* Carissa Parker
Signature:
�irQ�-ISS,#
Submittal Date: 10/21/2021

Initial Review
Is this accepted into the review process?* Yes No
Project Number:* 20211534 Version: *
Select Reviewer:*
Select Reviewing Office:
Has payment been received?*
What amount is owed?*
Mitchell Anderson:eads\mlanderson
Asheville Regional Office - [phone]
No Payment Needed
Fee Received
• Need Fee - send electronic notification
• $240.00
$570.00