20211691 Ver 1_Shoreline Stabilization_20211120

Submission Form
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.
Dan Stehle, Diane Shores HOA
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
19577 Meta Road
Address Line 2
City
Cornelius
Postal / Zip Code
28031-7545
Is there an agent working on the project?* - Yes
O No
Agent/Consultant Information
...................................................................................................
Name: *
Company Affiliation:
Email: *
Phone Number:*
Janice Estep
CBC Sone & Recycling, LLC
[e-mail]
[phone]
(xxx)xxx-xxxx
State / Province / Region
NC
Country
US

Mailing Address:*
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:
Authorization Form.pdf 177.71KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
......................................................................................................................................................................................................
Project Name:* Diane Shores HOA Community Boat Ramp
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
19407 Tresia Lane
Address Line 2
City
Cornelius
Postal / Zip Code
28031
Latitude: * 35.477119
State / Province / Region
NC
Country
US
Longitude: *-80.917989
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 909.24KB
Buffer Form.pdf 931.27KB
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.)*
Boat Ramp Pics.pdf 15.35MB
4. Location of the property (where work is to be conducted)
Nearest Town: * Cornelius

County: * Mecklenburg
Lake/ river/ ocean adjacent to Norman
property:
Subdivisions name or site address: * Diane Shores PID# 00108601
Include phase/lot number

Directions to site: *
610 E Center Ave
Mooresville, NC 28115
Head south on Evergreen St toward E Center Ave
9s(197ft)
Take S Main St, NC-115 S, Langtree Rd, I-77 S/US-21 S,... and Jetton Rd
to Meta Rd in Cornelius
20 min (10.8 mi)
Turn right onto E Center Ave
0.5 mi
Turn left onto S Church St
0.5 mi
Turn right onto College St
0.1 mi
Turn left onto S Main St
1.2 mi
Continue onto NC-115 S
2.1 mi
Turn right onto Langtree Rd
1.1 mi
Use the left 2 lanes to turn left to merge onto I-77 S/US-21 S
3.1 mi
Take exit 28 for US-21 S toward Catawba Ave/Lake Norman/Cornelius
0.2 mi
Keep right at the fork, follow signs for Lake Norman and merge onto W
Catawba Ave
1.1 mi
Turn right onto Jetton Rd
1.0 mi
Follow Meta Rd and Bustle Rd to Tresia Ln
3 min (0.7 mi)
Turn right onto Meta Rd
0.1 mi
Continue straight to stay on Meta Rd
0.1 mi
Turn left onto Bustle Rd
0.4 mi
Turn left onto Tresia Ln
210 ft
19407 Tresia Ln
Cornelius, NC 28031
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:
Community HOA Access (boat ramp and master dock)
Residential, undeveloped, etc.
6. Property Size 1.102 acres
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
Remove and haul of existing damaged concrete boat ramp. Install new
concrete boat ramp to replace. Section 1: Pour a 20' x 12' concrete slab
with rebar, allow to cure and slide into place. Section 2: Pour a 20' x 12'
concrete slab with rebar, allow to cure and slide into place. Section 3: Pour
a 20' x 20' slab for top of boat ramp (this section is not in water). Install
class "B" rip rap 2' wide one each side of boat ramp sections 1 and 2.
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.)
4' below for rip rap
(8 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 for rip rap
(2 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):
o $240.00 for impacts to lake (below normal water level) of less than 1 acre
o $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: * Janice Estep
Signature:
Submittal Date: 11/5/2021

Initial Review
Is this accepted into the review process?* Yes No
Project Number:* 20211691 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. PLAN NO. PARCEL ID:
STREET ADDRESS:
Please print:
Property Owner:
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
ail
(Contractor / Agent) (Name of consulting firm)
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):
Telephone:
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized Signature Authorized Signature
Date: Date:

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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/ Normal 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
6. Location of construction access corridors
FORM: SSGP 10-2013
Page 3 of 3

Pro]eat Name/,@dclress- y�r
Ovvner: _ Ci C i f, L/
Print
Contractor/agent:
Print
Signatu
ine approval is for the purpose and design described in your app' Lion. Impacts not indicated in the
application is a violation of the Buffer Rule. Site specific work should be provided in the application. [15A i\1CAC
02H .0506 and 15A NCAC 0213 .0243(8)1
k
Trees are not allowed to be removed from Gone 1 of the Buffer (within 30 ft of the full pond elevation), unless
approved. Exception, thosetrees 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)]
Vt[ork 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 stormoater
discharges must be at the natural elevation and discharged prior to entering the buffer directed as diffuse OF
sheet flow at non -erosive velocities to the lake. [15A NCAC 02B .0243(5), (6)]
Acknowledgement of .'Votification
1, � `_h I Q hereby state that I have been informed of the Catay.--ba
Riparian Buffer Rule. Any work conducted in the buffer, not specifically stated in the application and approved
by "he Division of Water Resources (DWR), is a violation and subject to enforcement. Due diligence is%ill 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
_.-------- — _.__. _. Date:

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