20211596 Ver 1_Shoreline Stabilization_20211104

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:
Pre -Submittal Form.pdf 1.02MB
Pre -fling Meeting or Request Date 10/14/2021
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: * Chris Foschini
Email: * [e-mail]
Phone Number: * [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
P.O. Box 297
Address Line 2
City
State / Province / Region
Cleveland
NC
Postal / Zip Code
Country
27013
US

Is there an agent working on the project?* Yes
No
Agent/Consultant Information
............................................................................................................................................................................
Name: * Janice Estep
Company Affiliation:
Email: *
Phone Number:
Mailing Address:*
CBC Stone & Recycling, LLC
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
638 Oakridge Farm Hwy
Address Line 2
City
Mooresville
Postal / Zip Code
28115
A signed and dated copy of the Agent Authorization letter:
Auth. Form.pdf 607.62KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name: * Foschini Shoreline
State / Province / Region
NC
Country
United States
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
225 Gainswood Drive
Address Line 2
City
Mooresville
Postal / Zip Code
28117-9272
Latitude: * 35.508344
State / Province / Region
NC
Country
US
Longitude: *-80.933583
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*
Site Plan.pdf 1.03MB
Buffer Form.pdf 1.17MB

Please use the diagram at the link below:
https:Hedocs.deq.nc.gov/WaterResources/O/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.)*
Shoreline Pics.pdf 8.05MB
4. Location of the property (where work is to be conducted)
Nearest Town: * Mooresville
County: * Iredell
Lake/ river/ ocean adjacent to Norman
property:
Subdivisions name or site address:* Lot 500 Crescent Land & Timber Corp.
Include phase/lot number
Directions to site:
610 E Center Ave
Mooresville, NC 28115
Head south on Evergreen St toward E Center Ave
11 s (197 ft)
Take NC- 1100 to Gainswood Dr
23 min (11.7 mi)
Turn right onto E Center Ave
0.5 mi
Turn left onto S Church St
0.4 mi
Turn right onto E Wilson Ave
1.5 mi
Continue onto NC-1100/13rawley School Rd
1.0 mi
Continue straight to stay on NC-1100/13rawley School Rd
6.4 mi
At the traffic circle, take the 2nd exit onto NC-1100
2.0 mi
Turn left onto Gainswood Dr
Destination will be on the left
1 min (0.5 mi)
225 Gainswood Dr
Mooresville, NC 28117
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, new construction
Residential, undeveloped, etc.

6. Property Size 0.79 acres
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
Install VA Fieldstone rip rap to the top of and over the top of existing
gabion baskets to completely cover. Install TN Crab Orchard steps
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.)
5' below (1045 sf)
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.)
1' above (209 sf) 10'
x 50' access
corridor (500 sf of
temp. impact)
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)
Grass buffer, no trees removed, minimal disturbance to buffer.
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):
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:
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");
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:* Janice Estep
Signature:
071-ir [ r. [`-i�feIt 4?V-f it
Submittal Date: 11/3/2021

Initial Review
Is this accepted into the review process?* Yes No
Project Number:* 20211596 Version: *
Select Reviewer:*
Select Reviewing Office:
Has payment been received?*
What amount is owed?*
Alan Johnson: eads\adjohnson I
Mooresville Regional Office - [phone]
No Payment Needed
Fee Received
• Need Fee - send electronic notification
• $240.00
$570.00

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. 5CC) PLAN NO. PARCEL ID:
STREET ADDRESS:
.Dons' L aSc aa<<_ ]________� _
Please print:.
Property Owner:
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
cxn-icy s
of
(Contractor /Agent) (Name of consulting fir )
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
—.-Po Go)( jq: C.�e l p n l ,,L ado L3
Telephone: `` O - '` 40
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge,
Vrizead
gnature Authorized Signature
Date: 10 - i 3 -_-2 1 Date:

'•""'�M4WfAiP@gWu1@PMAWRgtnuX®PP44MOWPN4xuIx91gAI1XiM4gglnRllAAqA5YA0A1ry4q4fu1qqtlnuAx'an44NxIPgAIXNtlgAeu4gtlryA4qqN,EANuumwuuYApgMA4Wuenu4AItlYYNIA�NYPoWm�4Yu�KnMmnuAVFIu6uAAMgququmeyneuYAA4uXlgmuquumAUWUTAWAmvwlquxvuliNinLu®nnmlePlAtlAlAYW4pgY0plAXgolp�A®.'gm®tlyApmomppugpgp,px,PonpAMpxyggxAlA�
Q
1—All \ LOT 403 LOT 402 I LOT 401 LOT 400
r> o m m w c ay CONT. ON � DWB MD. I C F. 6-E r�1
yqg on 03
m o rm, a z m - / III I I ROAD NO. 216••--O�lL.... RS>•1 Ar �r p
y ti l .gym / 2 t ! U•3.H
-Pm a ,„a 39019N M� WL ?N0. y� %� -y:_.. /•
zy o3 y w m� 7 Am 184.. t1l
omix .'Oi R,s CjOTj / mw I �920f�8.4
' I r��'�''-' �, •i
,m„mA m rr NG oi I .�I I A w U 044
w - 4
poi bi[� n /moo n'a q. A 1 n _ an Qi GIF&- ro
CD
it
y07 r m
gq
o° s�
r
pyfo
IREDELL CQ
.20
2l ya/`Y
NT0 �Po\ qq ?�'3qqg
M ��_
`Ok���1. Plow
i'r'w�
X7a N d � i
top" Ak
4, Y�'{�t/'1'3t*?•3 y.`s.7?e• q Or � � ` , t: s � R i � "
+ o
1.PrN .! r.MN • ti , 1 r `.� a" ` d • Y
ow
- - -
3T+ w O All ri ,\p.\1 y ��1�•� .
N�rio3. //x a RID
i m
R,+ o,^•t� �a \ Y� y� A rya\
G
t Moir b 3a• / A��� � a 8 c � �: � � S '4 �y . Q$ \ m TM
PrN
sl M s ,� g p . °a �S ssIL
1 r$°1 deb `�'� � 3�� �� \ !rob `�� •�\\ � �Yi
II /aT�
M� t \ ro • N , / $\'. 940 + ` p�ilP r •t v A+n
op 1� T —A ';a� ,�0� Ali
dnab
•� a.0 2�'�' .II a 'P Ovs �� r� p'w Areal N,,•i3,
V A =
--1 nbyy 30
O N : i <S• '/lV ar�`� �P tea. - ` +
r- f m a dnv N
4 t ti %p O O ' 2 $$ w o o o �s "• i- - >' `�A\� d,tY'a „�\^d� �p'� b�` 6•
zq
A7 03 gg 5a08N31481f
o ���o�oeais:,..i 3u� m �' t � a $• 9.}Y \*� Me
g'�� 5nE Hd12�S91�1' ��v o °�• eP��q�
ata9'o' ` i

CD
Q
CD
n
O
CD
O

ya��as
A
T

N
° �
�4
Ci
0
D
O
C
m
S
O O
C
O
N
Q.
Z 7
O
0 7
7
fD
O
(am
(a
CL m
m
to
OF.
D
n
._w
3
O
O
O
7
O•
n
N
°
O
coO
3
D
z
m
n
m
$
<
°
ro
v
93
O
W
D
cn
D
m
O
m
N
Z
L`_
O
X
N
o
O
c
p
c
m
o
y
�
v
m
3
� w
_
C/J
C)0,
O N+
ID
y
O N
n n
�
N y o
jD � N
U
� C
'p
Ho �m 3io
O C71
� �3'2 R
Z C/)
0 o m
N p
o
—�°;7--
O
3a�o o
N

Lake
(At Full Pond/ Normal water Level)
Full Pc, 01"
M�ry.�rar.=.�r .i.��Iw.gr+isf►��i.rara�.
NormalShoreline
+r•�r'�� �'ir��'w y.`.i«f.:fir
r3�lfraiir ��ir!'l11�•'`�.�isa�acar+�s
otoT Le,+nPi
►NA e.�-o
w ui�'
C
C
Please approximately sketch the following information on this plan, length of Shoreline
(provide dimensions for each item, such as 10 ft x 100 ft)*:
1. All proposed vegetation clearing
2. Location of rip rap or fill to be placed above the Full Pond/ Formal Water Level elevation
3. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
4. Location of any proposed structures such as buildings, retaining walls, docks, etc.
5. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
& Location of construction access corridors
FORM: SSGP 10-2013 Page 3 of

CATAWBA► RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: a 3.5
Owner:
Print
Contractor/agent:
Coun :
Signature �.
Print U J J '
S' n t are
The approval is for the purpose and design described in your applica, n. Impacts not indicated in the
application is a violation of the Buffer Rule. Site specific work should be provided in the application. [15A NCAC
02H .0506 and 15A NCAC 02B .0243(8)]
Trees are not allowed to be removed from Zone 1 of the Buffer (within 30 ft of the full pond elevation), unless
approved. Exception, those trees that are severely undermined along the immediate shoreline can be removed.
Minimal shaping and sloping along the immediate shoreline is allowed. [15A NCAC 02B .0243(6)]
Benching, grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 02B .0243 (6)]
Beaches, impervious patios, impervious walkways, etc. are not allowed in the buffer unless specifically approved
by the Division. There are limitation on size for decks. [15A NCAC 02B .0243(4) and (6)]
Work to be conducted from land must indicate an access and indicate any trees that are to be removed. The
work corridor should be described. The approved access corridor shall be restored. Staging, spoil, construction
material must be outside the buffer. [15A NCAC 02H .0502 and 15A NCAC 028.0243 (4), (6), (8)]
Stormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
discharges must be at the natural elevation and discharged prior to entering the buffer directed as diffuse or
sheet flow at non -erosive velocities to the lake. [15A NCAC 02B .0243(5), (6)]
Acknowledgement of Notification
11 (I r E Ls Cy,r n r hereby state that I have been informed of the Catawba
Riparian Buffer Rule. Any work conducted in the buffer, not specifically stated in the application and approved
by the Division of Water Resources (DWR), is a violation and subject to enforcement. Due diligence will be
taken such that the construction will be built within substantial compliance and intent of the 401 Water
Quality Certification and Buffer Rules, the approvers plan(s) and specification(s), and other supporting
materials.
Signature (owner)_ — Date: i 0 \3 - 0

Contact Name*
Contact Email Address*
Project Owner*
Project Name*
Project County*
Owner Address:
Is this a transportation project?*
Janice Estep
[e-mail]
Chris Foschini
Foschini Shoreline
Iredell
Street Address
225 Gainswood Dr.
Address Line 2
city
Mooresville
Postal / Zip Code
28117
Yes No
Type(s) of approval sought from the DWR:
401 Water Quality Certification - 401 Water Quality Certification -
Regular Express
Individual Permit Modification
v Shoreline Stabilization
Does this project have an existing project ID#?
Yes No
State / Province / Region
NC
Country
us
Do you know the name of the staff member you would like to request a meeting with?
Alan Johnson
Please give a brief project description below and include location information.
Install VA Fieldstone rip rap to the top of and over the top of existing
gabion baskets to completely cover. Install TN Crab Orchard steps
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.
• 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 10/14/2021