20211699 Ver 1_Shoreline Stabilization_20211123

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.
WELDON M HITCHCOCK
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
292 South Fork Road
Address Line 2
City
Mooresville
Postal / Zip Code
28117-6814
Is there an agent working on the project?* - Yes
O No
Agent/Consultant Information
...................................................................................................
Name: *
Company Affiliation:
Email: *
Phone Number:*
TAMARA HAGER
State / Province / Region
NC
Country
US
LKN DREDGE & MARINE CONSTRUCTION
HAGER@LAKEPERMIT. COM
[phone]
(xxx)xxx-xxxx

Mailing Address:*
Street Address
PO BOX 5335
Address Line 2
City
MOORESVILLE
Postal / Zip Code
28117
A signed and dated copy of the Agent Authorization letter:
HITCHCOCK.pdf 373.82KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* HITCHCOCK
State / Province / Region
North Carolina
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
Upload Map: HITCHCOCK SURVEY.pdf 367.14KB
Latitude: * 35.556491 Longitude: *-80.932581
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*
HITCHCOCK SKETCH.pdf 237.62KB
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.) *
HITCHCOCK PIC.pdf 209.96KB
4. Location of the property (where work is to be conducted)
Nearest Town: * MOORESVILLE
County: * Iredell
Lake/ river/ ocean adjacent to NORMAN/CATAWBA
property:
Subdivisions name or site address:* CRESENT LAND & TIMBER LOT NUMBER 13
Include phase/lot number

Directions to site: *
FROM MARSHALL STEAM STATION TRAVEL LEFT ONTO 150 5.4
MILES,TURN RIGHT ONTO MORRISON PLANTATION 1.1 MILES
RUNT RIGHT ONTO BRAWLEY SCHOOL RD 3.1 MILES, TURN
RIGHT ONTO S FORK RD .40 MILES, TURN LEFT ONT S FORK RD
.30 MILES, PROPERTY ON RIGHT
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
Residential, undeveloped, etc.
6. Property Size .98
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
RIP RAP SHORELINE FOR STABILIZATION OF 218' SO FT
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.)
0
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)
NONE
Sketch: HITCHCOCK SKETCH.pdf 237.62KB
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:* WELDON M HITCHCOCK
Signature:
WLF1Rof � Ilx#c0cA
Submittal Date: 11/18/2021

Initial Review
Is this accepted into the review process?* Yes No
Project Number:* 20211699 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

PrIject
Owe
PrIn t
C-M:'tr av,,or/@,q i7t: L
IRrtn-L
C. s � 1Q),Ma FOR1
a, !•
t x+l J; L"ll%F rk.
Signsture
The 2LlPrOl+21 is or the purpose and design described In youl- 'appliCcilClrl. fiilp3CLS Y30L IIiGiG2ied In tli�
2bj;}f-050 rl and
i/IOJNCA of 3. 1�Ltii2r,Rule. �i%r5T1=CIiiCwarkshould. be provides! in the 2pplicetiori. I �jL', ikiC;a 0?N.4�{}Gand15ANC'r�C�}?�_�J7"3($J ..
Does Ere not BjlOih" to be r"°cC:1OUAd KIM LOn3 ! of the Bugler iwitl'79n M s i of thefu f pond ta-
aPproved. E,Ccep+Ljon?, thosetrE_S thstaraseverHly underrriined21ong_ #cn be ra ovec.
1Fflrllrrl'a(5118 i['7� 2 Lr7E fil's1ilECiicLc SF'lOrBiiFi� Cci} �2 rc'lOb'��.
a and S1Opino along the i[njimedi2ic shoreline i5 allaimed_ rt C,'IC 0- .O2r foJj
c IC lricr yr adi fw 1i1 _ 3w ' r �' _-
7 1[[ r fs P-OLaIIOVIJad. mcessiy2 d1st-2rb^-_:"3Ca of ground cover. [ 5A Njc. ^. C 0 _(]?f3 (6)1
511flus Pan, i[ilpenAous 1LFG#"1!$ SO are nat.211 lad ' ' -
i"1= �I�JI{1Gi1. 1h=r= 2r ' At.. in =R2 fly tO�i icr L[rilwSC5�1tiC1i[Co�.L,•'c7,[,1"iOLl2i
;:I'i m tat'70n On SiZefOf d=cks. i15A 1LC(- CO23 .0143 YJ and
1iLlQrlf t0 JM COndLCL4d iroiz{ lane ni35L indlC2 e gel 2CCcS_ and i:lCilcats any %r S_S th2t Ere to �c removed.. hs
s`Lrcr;Cc0rridOrshould be described.. 1 he ?�rt]lleCs-CC:.SS l.L�.l F 1r[ir �rl ��
jli � IC.�.L�i;=�. ..T;=?iZYF
ai�rlc nll!�g Onside the �iiirer_ i �'. fLCr`.0 07 _0,r1_7 an_
Stormvdater cannot ba piped Or cii 'cie'lcl C 'Cif G?i:..ri. islSCii"ui"�c � '^i- Ali
'�f'rSCilcr�CS fi7iJ5= - Slava_ LO Lr'I� is��a_ ..1i COc'l� rL��
-f'ka-- r i r3Di3- [ � � Cit3Gficrg�C3' (]fipr tO 2i"ti.�i•ina ii72 C71J�ier gii2C: driir,gc Or
sloes a- _ 5A AICRCO?3.0 r� 17 Gi ca
rQSIJ_ l lOCl�[�$ LQ _i7� !ails, n 1
�—��J1: iOl;
r.. :'ereh aL--Lr:CL 1 '
7i_i[iw r ` F 3 `- i i Eve bee, Mformed of the Catawba
lr the Cr:r g �{ _ flr': r nC[1Ctcd ill the bu[i2 not SpaciiiGaiilf5tci�d in the adz i.
€o 10EL{011 c'1 a f71J2^
f3L•rCe_ (• S+1Ii?�, i : yip�st1O% cs[C SFJ�jaC t6 ci1iGrGa[il2iti. �U8 Gli�i�crlC= t?,r
2ken such t st'Lh ConstrLG [ bunt F t ill fl2
'� } 'LiQil Ie Fflc fl�1IL[lli Liiirl Sfl.��'rIGiIL1cI Cfl im Pliance 2n}C in Lent Ofthe 40- W2L2.r
�' feria l- LII'10cii�3r! ^cilLZ �[ItICr RL�'si Lil approved Ji nN) and sL`�''••ci1�cEU,,Nb �,, o h r5[.1ppoiL17C
is12F. ricf=__
SiEri?tUr 2 A

.••Q00
�.biPN
�� W N WOO
oO •�..G
YNt WN-1
:t&ATM% CR
�OOa J
wiPNw Ybf gpGiOm
Z i y
r
auZiG O
�O +
ONOibW y
'
�♦♦3P
�GZ
W
�= a a
�iliAu JN
E NPNp Wq .P114Pi wW r
��••••
t All p
L R S i Z_ 2 i r
r mM�M
mb ppW
yp
A RIry w
�y
WpW
l9Mt w
qq
i/.ICrii J
wwJ
Cif ;
��miL M
twPOMN-.1Porrlu qY ti
cam. i
O
GPPfO
l9 MN.i `•
w •, W 00 y
�'v
qq
MtP
bumoWiWO
.+1N �
•{
� pENiN6
y
NNW Ww.lYnJ -1 �
oP Wm
b ► N W d y0 W
NN
e�
J
OWN
yWw�=�
po
+*6
pp_
•i1w94..
qq -
n
m
W
0
$
�
m
^ �
n
l` , a N
I 1.426.DDO
Ym
nr o
w-
a
a•
x
$ �
n
ao 9
z
"ao cn
m
c rn n
ti
M m cx) C )
r
a
rR c
p 4
H. •,y
0 i
a ►-� [] o
z t
a o
KNA7 Z z"
A
CD
m
O i
• T
(D °�
n
ra
A
Y
G U
�P
m
•�y `S d 1
7 n
.426.DOD
1

Full PonH,(
+Norm
5
Ia fie
(At FLli Pond/Normal Waterl-evel)
2; , TELL-)"(
�1<Z7 - =AACfq-)
T r3U
L6'f,\3 e--,) z-()dvL- F
�y
Please approximately sketch the roJiowing intorrnation on this 1a
riem, such as 10
All Proposed vegeati
1�X 1D(7 !� n (Prod da dimensions forEcach
1 p ton clearing
Location of rip rap or fill to be placed above the Full Pond 'Nor
3. Location of rip rap or fill to be placed beio�v the Full Aon
4 / mat Water Level elevation
Location of any proposed structures such as buildings, nNormal Water Level elevation
Location O- any excavation or dredging below the Full P
Location of construction access corridors retaining walls, docks eve
Pond/ Normal Water Level elevation
FORM: sSGP ? 0-2-073
page 3 of 3

From: TAMARA HAGER [e-mail]
Subject: Hitchcock pic
Date: Oct 16, 2021 at 5:16*35 PM
To: TAMARA HAGER [e-mail]
Tamara Hager
704-575-2227
Lake Permit LLC
[e-mail]

Full PonH,(
+Norm
5
Ia fie
(At FLli Pond/Normal Waterl-evel)
2; , TELL-)"(
�1<Z7 - =AACfq-)
T r3U
L6'f,\3 e--,) z-()dvL- F
�y
Please approximately sketch the roJiowing intorrnation on this 1a
riem, such as 10
All Proposed vegeati
1�X 1D(7 !� n (Prod da dimensions forEcach
1 p ton clearing
Location of rip rap or fill to be placed above the Full Pond 'Nor
3. Location of rip rap or fill to be placed beio�v the Full Aon
4 / mat Water Level elevation
Location of any proposed structures such as buildings, nNormal Water Level elevation
Location O- any excavation or dredging below the Full P
Location of construction access corridors retaining walls, docks eve
Pond/ Normal Water Level elevation
FORM: sSGP ? 0-2-073
page 3 of 3