20211738 Ver 1_Shoreline Stabilization_20211203

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* [e-mail]
Please provide an email address for payment and requests for more information here.
Owner Information:
Name: *
Plattner Custom Builders
Email: *
[e-mail]
Phone Number:*
[phone]
(xxx)xxx-xxxx
Mailing Address: *
Street Address
PO Box 1138
Address Line 2
City
Davidson
Postal / Zip Code
28036
Is there an agent working on the project?* Yes
No
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* Island Forest
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
21211 Island Forest Drive
Address Line 2
City State / Province / Region
Cornelius NC
Postal / Zip Code Country
28031 US
Latitude: * 35.497341 Longitude: *-80.911709
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 *
Island Forest Lot layout.pdf 1.67MB
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.)*
21211 Island forest Drive shoreline #l.pdf 2.7MB
21211 Island forest Drive shoreline #2.pdf 2.63MB
4. Location of the property (where work is to be conducted)
Nearest Town: * Cornelius
County: * Mecklenburg
Lake/ river/ ocean adjacent to Lake Norman
property:
Subdivisions name or site address:* 21211 Island Forest Drive Lot #58
Include phase/lot number
Directions to site: *
I-77S exit 28 Keep right, Turn Right on Bethel Church Rd, Right on
Pinehurst Dr. Right on Island Forest Dr.
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:
A house under construction shoreline is currently grassy area up until the
50 ft buffer then it has silt fence.
Residential, undeveloped, etc.
6. Property Size .50
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
Remove 2 to 3 courses of current seawall and clean up shore line. Crease a
desireable slope and put down fabric and class B rip rap and tie into
current rip rap that is down at bottom of sea wall. Put down grass seed and
Straw matting in disturbed area along shore line upon completion.

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.)
920
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.)
2760
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 area no trees will be impacted.
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");
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:* HOYTE A POPE JR
Signature:
Submittal Date: 11/29/2021

Initial Review
Is this accepted into the review process?* Yes No
Project Number:* 20211738 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

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