20211573 Ver 1_Shoreline Stabilization_20211101

111M1111"111111111M111"1111711"1111112 `" S
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. DANIEL SMITH
Director
NORTH CAROLINA
Environmental Quality
pfil
State of North Carolina
Department of Environment Quality
Division of Water Resources
1.5A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SSGP 09-2020
Shoreline Stabilization Application Form
Three copies of the application (including attachments) and the application fee should be sent to:
If sending via US Postal Service if sending via delivery service (UPS, FedEx, etc.)
Paul Wojoski Paul Wojoski
DWR — 401 & Buffer Permitting Branch DWR — 401 & Buffer Permitting Branch
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699-1617 Raleigh, NC 27604
NOTE: 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) which states "At least 30
days prior to submitting a certification request, the project proponent shall request a pre -filing
meeting with the certifying agency." In accordance with 40 C.F.R. Section 121.5(b)(7), and (c)(5), all
certification requests must 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 to this application.
Date of Pre -filing Meeting Request: q / / / -?C)-1 (required)
DWR ID # Version (if applicable)
A. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: Karl & Joyce Milliren
Mailing Address: 6862 Colonial Club Drive
Thomasville, NC 27360
Telephone Number: 336/880-0252 Fax Number:
E-mail Address: [e-mail]
RECEIVED
NOV - 1 2021
DEQ-WATER RESOURCES
401 & BUFFER PERMITTING
: D_E North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 11617 Mail Service Center I Raleigh. North Carolina 27699-1617
919.707.9000

•
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter must be attached if the Agent has
signed this application form. (A form can be downloaded here:
http://www.saw.usace.army.mil/Portals/59/dots/regulatory/regdocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf)
Name: N/A
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Address:
Fax Number:
B. Project Information [15A NCAC 02H .0502(a) & (b))
1. Attach 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.
2. Provide a detailed site plan showing property boundaries and proposed locations of
vegetation clearing, buildings, retaining walls, docks, impervious surfaces, rip rap, excavation
or dredging below Full Pond/ Normal Water Level elevations, and construction access
corridors. You may use the diagram provided at the end of this application form.
3. Attach a photograph of the shoreline/ buffer proposed to be stabilized. (Include a scale of
some sort- a yard stick, shovel handle, etc.)
4. Location of the property (where work is to be conducted)
County: Davidson Nearest Town: Lexington
Lake/ river/ ocean adjacent to property: High Rock Lake
Property size (acres): 1.46 acres
Subdivision name or site address (include phase/lot number):
Lot 12, Yachtsman Point, 1206 Scout Rd., Lexington
Directions to site - please include road names and numbers, landmarks, etc.:
1-85 to Lexington exit for NC Hwy 8, go south on NC Hwy 8, L on Wildlife Recreation Area
Access Rd., straight onto Scout Road, property is on right, #1206.
Latitude (in decimal degrees) 35.41.0508 Longitude (decimal degrees) 80.18.3780
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): house under construction in residential subdivision
FORM: SSGP 09-2020 Page 2 of 6

1
6. Describe proposed work (Includediscussion as to how hardening ofshoreline has been
avoided, or why it is necessary): Tostabillze an eroding shoreline andprotect it
from further erosion.
7. Will work be conducted from land? ® From water? ❑
8. Total amount of impacts belowthe normal pool Take level J Nor mai Water Level
Permanent Impacts (including all excavation; backfill, rip rap, retaining walls, etc.) in square feet:
920 SF
Temporary impacts:in:square feet:
None
9. Total amount of impacts above the norrttal poai lake level / Normal. Water Level and 50 feet
land -ward
Permanent Impacts (including back fill, excavation, rip rap, retaining walls, etc.) in square feet:
960 SF
Temporary impacts (temporary clearing, construction corridor) in square feet:
800 SF
10. Please describe the.vegetation above the normal pool lake:levelf Normal Water Level and 50
feet landward to be impacted (number -of trees, for instance):
There are.15 to 20 existing trees -located on the shoreline that will be removed to
accommodate: the proposedshoreline stabilization:
11. Signature
By signing below, 1, as the project proponent, certify to the following:
• The project proponent hereby certifies that all information contained herein is true,
accurate, and complete to the best of my knowledge and belief
• Theproject.proponent hereby requests that the.certifying authority .review and take action:
On thls CWA 401 certi€itatlonrequest within the applicable reasonable period of time
�wner(Agent`s Signature' [15A NCAC O2.H .05020 Date
•Agerlt'3slgnature is volldonly if an authorization letter from the ownerfs provided.
12. Please: approximately sketch the following information on this plasm and provide dimensions for
each Item:.
a. All proposed vegetation clearing
FORM: SSGP 09-2020 Page 3 of 6

b. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
c. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
d. Location of any proposed structures such as buildings, retaining walls, docks, etc.
e. Location of any excavation or dredging below the Full Pond/ Normal Water Level
elevation
Lake
(At Full Pond/ Normal Water Level)
Full Pond/ Normal Water Level
Min NM
Shoreline
Plan View
UM MIMI Y;a
FORM: SSGP 09-2020
Page 4 of 6

Lake
(At Full Pond/ Normal Water Level)
Full Pond/ Normal Water Level
aar"1 r1rrr
Shorea�nlie
2 ft.1150 ft.
additional cleating
' if necessary
Lake
(At Full Pond/ Normal Water Level)
a= s
ivies row • inn
Riprap 'ipi
4.00::ram '.XXtalri
Existing Dock
J 30ft 17 ft
3 ft 1150 ft
Below full pond/ NWL
4 ft 150ft
Above full pond/ NWL
E AMPLE
Plan View
FORM: SSGP 09-2020 Page 5 of 6

3 ft. below full pond water level 4 ft. above full pond water level
2 ft. additional clearing
'If necessary
10 ft. bank
height
Existing bank
••
,,
j,7AM,"A M P L E
•r
FORM: SSGP 09-2020 Page 6 of 6

NCDEQ 401 WATER QUALITY CERTIFICATION
SHORELINE IMPACT AREA CALCULATIONS
APPLICANT: Karl & Joyce Milliren
Lot 12 Yachtsman Point
STABILIZATION IMPACT AREA CALCULATIONS
The attached shoreline site plan shows 160 LF of proposed shoreline stabilization measures.
Detail 3 indicates a proposed shoreline slope that is graded at 2:1 and reflects the estimated
normal pool level and the estimated height of the subject shoreline above the normal pool
level.
Calculation 1— Impact Area Below Normal Pool Level
(Item 8 on NCDEQ Form SSGP 09-2020)
Area of Impact = Shoreline Length x Depth* x Slope
=160'x1'x2
= 320 sq. ft.
*For this calculation, an average water depth of 1 ft. has been assumed. This will
produce a conservative overestimate of the stabilization impact area.
Calculation 2 — Impact Area Above the Normal Pool Level
(Item 9 on NCDEQ Form SSGP 09-2020)
Permanent Impact From Shoreline Stabilization Measures
Height of Bank Above Normal Pool Varies Across the Shoreline
Estimate 160 LF of Shoreline = 3 ft. Above Normal Pool

Area of Impact = Length x Height x Slope
= 160'x3'x2
= 960 sq. ft.
Impact From Construction Above Shoreline Stabilization
Assume 5 ft. Wide Zone
Area of Impact = 160 x 5 ft.
= 800 sq. ft.
Total Area of Impact Above Normal Pool Level = 1760 sq. ft.

---,,)
A0 /lb-
9 --,
/
u.)
/./
1
cO-
0,9
'.99NNN.

CLASS 2 RIP RAP
VEGETATION AND EROSION
CONTROL FABRIC
•
•P
1
EROSION CONTROL FABRIC'
TYPICAL CONDITIONS
• 36" TO 72" ERODED CUT
• WAVE EXPOSURE
EXISTING GRADE
2 p_ I
\/44.'
\ \�i"..•t ,
Approx.
3 ft.
Assume
1 ft.
LAKE BOTTOM _ —
FOR:
LOCATION:
RESERVOIR:
KARL & JOYCE MILLIREN
LOT 12, YACHTSMAN POINT
HIGH ROCK LAKE
PROJECT:
SHORELINE STABILIZATION PROGRAM
PHASE I SITE EVALUATION
YADKIN, INC. - BADIN, NORTH CAROLINA
DRAWING TITLE:
MODERATE RIP RAP STABILIZATION
DETAIL
3

DWR Pre -Filing Meeting Request Form
Contact Name* Karen Baldwin, Agent for Karl and Joyce Milliren
Contact Email Address * [e-mail]
Project Owner* Eagle Creek Renewable Energy
Project Name* High Rock Reservoir
Project County * Davidson
Owner Address: *
Street Address
6862 Colonial Club Drive
Address Line 2
City State / Province / Region
Thomasville NORTH CAROLINA
Postal / Zip Code Country
27360 United States
Is this a transportation project? * Yes
Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Individual Permit
Shoreline Stabilization
Does this project have an existing project ID#?*
Yes No
NCkTN CAROLINA
Eneronmentol Quality
401 Water Quality Certification - Express
Modification
Do you know the name of the staff member you would like to request a meeting with?
N/A
Please give a brief project description below and include location information. *
Shoreline Stabilization in accordance with Cube Hydro Shoreline Management Plan Guidelines
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.
https://edocs.deq.nc.gov/Forms/Form/Submit
1/2

• 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 9/15/2021
https://edocs.deq.nc.gov/Forms/Form/Submit
2/2

DWR Pre -Filing Meeting Request Form
Contact Name *
Contact Email Address*
Project Owner*
Project Name*
Project County*
Owner Address:*
Is this a transportation project?*
Type(s) of approval sought from the DWR:
r- 401 Water Quality Certification -
Regular
r Individual Permit
rJ Shoreline Stabilization
Does this project have an existing project ID#?*
r Yes ( No
Karen Baldwin, Agent for Karl and Joyce Milliren
[e-mail]
Eagle Creek Renewable Energy
High Rock Reservoir
Davidson
Street Address
6862 Colonial Club Drive
Address Line 2
City
Thomasville
Fbstal / Zip Code
27360
r Yes r No
r" 401 Water Quality Certification -
Express
r Modification
State / Bovine / Dion
NORTH CAROLINA
Country
United States
Do you know the name of the staff member you would like to request a meeting with?
N/A
Please give a brief project description below and include location information.*
Shoreline Stabilization in accordance with Cube Hydro Shoreline
Management Plan Guidelines
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.
• 1 understand by signing this form that I cannot submit my application 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.

Submittal Date

G04 rgle-Maps 1206 Scout Rd
A+ Autor• otire
Board a Batten Brenta
QFeeds;nu;.t..
Certer UN .
Ecar ct
9
Go gle
Q Larry Carris
(; ConstrJeci
Map data ©2021 1000 ft r
https://www.google.com/maps/place/1206+Scout+Rd,+Salisbury,+NC+28146/@35.6459811,-80.2626436,15z/data=!4m5!3m411 s0x88538591 a3d 17cb... 1/1