20211583 Ver 1_Shoreline Stabilization_20211102

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:
Roxboro Lake Shore Stabilization Permit.pdf 369.67KB
Pre -fling Meeting or Request Date 8/4/2021
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]
Please provide an email address for payment and requests for more information here.
Owner Information:
Name: * Patrick C Hester
Email: * [e-mail]
Phone Number: * [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
7616 Gordonton Road
Address Line 2
7616 Gordonton Rd
City
State / Province / Region
Hurdle Mills
NC
Postal / Zip Code
Country
27541
United States

Is there an agent working on the project?* Yes
No
Project Information [15A NCAC 02H .0502(a) & (b)]
................................................................................................................................................................................................................................................................
Project Name: * Roxboro Lake Shoreline Stabilization, Patrick Hester Lakehouse
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
542 Briggs Place
Address Line 2
City
Hurdle Mills
Postal / Zip Code
27541
Latitude: * 36.330598
State / Province / Region
NC
Country
US
Longitude: *-79.151781
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*
Roxboro Lake Shore Stabilization Aerial for
324.8KB
Rip Rap.pdf
Please use the diagram at the link below:
https://edocs.deq.nc.gov/WaterResources/0/edoc/616616/ShoreIine%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.) *
Shoreline photo pd£pdf 1.2MB
4. Location of the property (where work is to be conducted)
Nearest Town: * Hurdle Mills
County: * Person
Lake/ river/ ocean adjacent to Roxboro Lake, Caswell/Person County line
property:
Subdivisions name or site address:* 542 Briggs Place, Hurdle Mills, NC 27574
Include phase/lot number

Directions to site: *
From Raleigh, go to Hilslborough. Go north on Highway 86 into Caswell
County. Take Highway 49 north into Person County. Turn left onto
Gordonton Road, SR 1102. Go 4 miles and turn left on Wilson Road. (Dirt
Road) Go 1 mile and turn left onto Briggs Place at 1075 Wilson Road,
Hurdle Mills. Briggs Place looks like a private driveway. There is a green
FedEX/UPS box there. Follow the gravel Briggs Place and dead end at my
house.
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:
Residential Lake home. The home is on a 116 acre farm.
Residential, undeveloped, etc.
6. Property Size 116
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
Shoreline is eroding due to natural water action.1 would like to place rip
rap rock along the shoreline to reduce the erosion. There will be NO
clearing or disturbance to the existing vegetation and/or root system.
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.)
492
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.)
0
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)
No vegetation and or existing root system will be impacted. I only wish to
place rip rap rock along the existing shoreline.
Sketch: Roxboro Lake Shore Stabilization Aerial for
324.8KB
Rip Rap.pdf
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):
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.

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');
a 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:* Patrick C Hester
Signature:
05 ,71 & `3`tol /--�
Submittal Date: 11/1/2021

Initial Review
Is this accepted into the review process?* Yes No
Project Number:* 20211583 Version: *
Select Reviewer:*
Select Reviewing Office:
Has payment been received?*
What amount is owed?*
Colleen Cohn:eads\cmcohn
Raleigh Regional Office - [phone]
No Payment Needed
Fee Received
• Need Fee - send electronic notification
• $240.00
$570.00

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Contact Name*
Patrick C Hester
Contact Email Address*
[e-mail]
Project Owner
Patrick Hester
Project Name *
Shore Stabilization
Project County*
Caswell
Owner Address:*
Street Address
7616 Gordonton Road
Address Line 2
aty
Hurdle Mills
Ftstal 1 Zip Code
27541
Is this a transportation project?*
'� Yes (-- No
Type(s) of approval sought from the DWR:
f— 401 Water Quality Certification - )— 401 Water Quality Certification -
Regular Express
I— Individual Permit r Modification
W Shoreline Stabilization
Does this project have an existing project ID#?*
r' Yes f-- No
state: / Rovince I f 1w
North Carolina
Country
Caswell
Do you know the name of the staff member you would like to request a meeting with?
NO
Please give a brief project description below and include location information.*
The shoreline on my lake property is washing. The banks are high.
Due to the natural wave action of the water, the soil is being eroded
in an undercut manner below the tree line, and trees are beginning to
lean and fall into the lake. I would like to place Rip Rap stone along
the shoreline to correct further erosion of said shoreline and to
stabilize the existing vegetation.
By digitally signing below, I certify that 1 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.
0 1 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 thirtyday clock has expired, and you can submit an
application.
Signature
X� C- #u6%
Submittal Date 814/2021