20211651 Ver 1_Shoreline Stabilization_20211115

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ROY COOPER ii
Governor
MICHAEL S.REGAN em !
Secretary '�
S.DANIEL SMITH NORTH CAROLINA State of North Carolina
Director Environmental Quality
Department of Environment Quality
Division of Water Resources
15A 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: I0 / Og /202( (required)
DWR ID# Version I (if applicable) RECEIVED
N O V 1 5 2021
A. Applicant Information [15A NCAC 02H .0502(a)1 DEO-WATER RESOURCES
1. Owner Information 401 &BUFFER PERMITTING
Name: terry MOrgen f 6111/-
Mailing Address: ISO 50,411 Lo e.j(d,,, 1,4,,e_
A mr,°s v,I I& r NC, 3-`6117
Telephone Number: $SO -'- q-33-G6 Fax Number:
E-mail Address: (.r'+or3evl't641•r32-660gna;l.CUe
Q
����//// 512 NorthNorth CarolinaSalisbury DepartmentStreet1 of EnvironmentalMailService Center Raleigh.Quality I Division of WaterNorthCaro Resoulina 2769rces9-1617
NO,:N tI ALAA D
1617
Dapartmard m emaon a*Wily 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/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf)
Name: tht(43 n tnyeurk
Company Affiliation: LAM- litoreA4A Lrcd3;
Mailing Address: I Stfq K.to-rt/ (rati
Co. irk, Aft zg 6 09
Telephone Number: 70,f-(fox- 3740 O Fax Number:
E-mail Address: — , k.k me;I.co,.1
B. Project Information [15A NCAC 02H .O502(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: ✓e do II Nearest Town: /Lloores ir Ito
Lake/river/ocean adjacent to property: L._arte Naongn
Property size(acres): a ni
Subdivision name or site address(include phase/lot number): Tie. P,;nl- / I-of- IZ II
Directions to site-please include road names and numbers, landmarks,etc.: Ave, 14,.ry ISO
+ay, onM -Alektris01 plwika-ka, 4in ✓lh+ 0100 Gravity sthoeI rd, j oro-r new No dr/ f-
Latitude(in decimal degrees)Wrigitigl Longitude (decimal degrees)-$0, cj16 '/i j s.LM.fcIIg
35.sigg4 7 `tF m.44150,1-
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped,etc.): re s;dem,a I
6. Describe proposed work(include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Apo l,ca1 rA p$ (:ter rock }o ('On fro I er05r'o-
FORM:SSGP 09-2020 Page 2 of 5

7. Will work be conducted from land? From water? [Z7(
8. Total amount of impacts below the normal pool lake level/Normal Water Level
Permanent impacts (including all excavation, backfill, rip rap, retaining walls,etc.) in square feet:
le," ,( )3 7 o+
Temporary impacts in square feet:
9. Total amount of impacts above the normal pool lake level/Normal Water Level and 50 feet
land-ward
Permanent impacts (including back fill, excavation, rip rap, retaining walls, etc.) in square feet:
Temporary impacts(temporary clearing, construction corridor) in square feet:
10. 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): l_i k -ly lryd¢d
11. Signature
By signing below, I, 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
• 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
(ofi5-1 a1
Owner/Agent's S nature' [15A NCAC 0 .0502(f)] Date
`Agent's signature is valid only if an authorization letter from the owner is provided.
12. Please approximately sketch the following information on this plan and provide dimensions for
each item:
a. All proposed vegetation clearing
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
FORM:SSGP 09-2020 Page 3 of 5

Lake
(At Full Pond/Normal Water Level)
CCc� Coc:7C3Q 14} 137111
Full Pond/ Normal Water— Level OG �'i belay IU"� an
Shoreline �2 U zfl X 13741-
Plan View
Lake
(At Full Rood/Normal Water Level) Existing Dock
30nz7n
Or.O.O.lO 0.0.01.0.0 O.00.00O MADAM 3nx150n
rsr niri r � r. Below full Wnd/NWl
♦ ♦ ♦rr�0�r�r�
Full Pond/Normal Water Level p��Zg104s!0 ��J. �'�a _
nhore�ne ri��iii'�. *a ane,
031 ;ono.
�����.i � .. Above full pond/NWL
2ft.k150n. • �:���'�W ��4 •
additional clearing
'If necessary
[ ' AMP E
Plan View
FORM:SSGP 09-2020 Page 4 of 5

IPA- bc4a✓ 2 0- al
I P-wLk ryvvi 1 POI pod i
, # ./
1 m JO
U &. >
Lake iii.!
(At FWI Pond/Normal Water L; el fo
2
E �
O
Z 1N
G
O
Side View
I3 ft below full pond water level 4 ft above full pond water level 2 ft additional clearing
I I I 'if necessary
Existing bank ,
10 ft.bank ,
height '' �clie'a
04
Qk
Sigilir
• , ,
40, 7/
Side View ti
.
FORM:SSGP 09-2020 Page 5 of 5

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: [Arty Mon3¢n O4/ s 're kw- 5 Cltb i a'E'County: vt6141
Owner: 1-QIRn,y C ,&oRGEA r-110.1.4i1 t-
Print gnature
Contractor/agent: V ct t3a L+n Eh y e arr �'✓ �""-4 -
Print Signature
The approval Is for the purpose and design described in your application. 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 and 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 02B.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
I, t-Aftx'/ C MdR G Jfl Al-eY1— ,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 approved plan(s)and specification(s),and other supporting
materials. �,•,�-.
Signature(owner): CIS"'� c' Date: 1 0.4$11-0-1

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DWR Pre-Filing Meeting Request Form t ;
NOR,-CAROLINA
Environmeneal Quality
Contact Name* Vaughn Enyeart
Contact Email Address* [e-mail]
Project Owner* Larry Morgenthaler
Project Name* Larry Morgenthaler Shoreline Stabilization
Project County* Iredell
Owner Address:* Street Address
150 South Longfellow Lane
Address Line 2
aty Slate!Bovine i Region
Mooresville NC
Fbstal 1 Zip Code Country
28117 USA
Is this a transportation project?* r Yes C No
Type(s)of approval sought from the DWR:
✓ 401 Water Quality Certification- r 401 Water Quality Certification-
Regular Express
r- Individual Permit r- Modification
Pi' Shoreline Stabilization
Does this project have an existing project ID#?*
r Yes a No
Do you know the name of the staff member you would like to request a meeting with?
Please give a brief project description below and include location information.*
Installation of new shoreline for stabilization.We will be placing river
rock where necessary.Work will be done by water using an excavator
on a barge.Work is done for the purpose of erosion control.
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
�Jra9.¢.r cbr -tt
Submittal Date 10/8/2021