20211777 Ver 1_Shoreline Stabilization_20211209

Shoreline Stabilization Application Form
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SSGP 10-2013
DRAFT -NOT FOR USE AT THIS TIME
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:
[e-mail]
Please provide an email address for payment and requests for more information here.
Name: * Tom Van Popering
Email: * [e-mail]
Phone Number:* [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
16824 Fidler Lane
Address Line 2
City State / Province / Region
Cornelius NC
Postal / Zip Code Country
28031-8776 US
Is there an agent working on the project?* O Yes
O No
Agent/Consultant Information
Name: * Janice Estep
Company Affiliation: * CBC Stone & Recycling, LLC
Email:* [e-mail]
Phone Number:* [phone]
(xxx)xxx-xxxx

Mailing Address: *
Street Address
638 Oakridge Farm Hwy
Address Line 2
City State / Province / Region
Mooresville NC
Postal / Zip Code Country
28115 United States
A signed and dated copy of the Agent Authorization letter:*
Auth. Form.pdf 538.11KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:*
Van Popering Shoreline
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: *
Latitude:*
35.449882
Street Address
16824 Fidler Lane
Address Line 2
City State / Province / Region
Cornelius NC
Postal / Zip Code Country
28031-8776 US
Longitude: *-80.901219
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
Buffer Form.pdf
Please use the diagram at the link below:
987.66KB
1.02MB
https://edocs.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.)*
Shoreline Pics.pdf 15.12MB
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: *
16824 Fidler Ln. Cornelius, NC 28031 PID # 00153139
Include phase/lot number

Directions to site: *
610 E Center Ave
Mooresville, NC 28115
Get on I-77 S/US-21 S from S Main St, NC-115 S and Langtree Rd
13 min (5.9 mi)
Head south on Evergreen St toward E Center Ave
197 ft
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
0.4 mi
Continue on I-77 S to Cornelius
9 min (7.2 mi)
Merge onto I-77 S/US-21 S
Continue to follow I-77 S
5.4 mi
Take exit 25 toward Concord/Huntersville
0.3 mi
Turn right onto NC-73 W/Sam Furr Rd
Continue to follow NC-73 W
1.4 mi
Continue on Norman Island Dr. Drive to Fidler Ln
2 min (0.6 mi)
Turn right onto Norman Island Dr
0.3 mi
Turn right onto Fidler Ln
Destination will be on the right
0.3 mi
16824 Fidler 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: *
Residential
Residential, undeveloped, etc.
6. Property Size
0.23 acres
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
Push down existing rip rap on shoreline. Reshape and re -slope bank,
install matting, reinstall existing stone and install fresh layer of boulder rip
rap to refresh shoreline
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.)
2' below (298 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 (149 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:
a 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.
a 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");
a 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");
o I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
a I intend to electronically sign and submit the Shoreline Stabilization online form.
Full Name: * Janice Estep

Signature:
Submittal Date: 12/6/2021

Initial Review
Is this accepted into the review process?* - Yes No
Project Number:* 20211777 Version:* 1
Select Reviewer: * Alan Johnson:eads\adjohnsonl
Select Reviewing Office: Mooresville Regional Office - [phone]
Has payment been received? * No Payment Needed
Fee Received
• Need Fee - send electronic notification
What amount is owed?*
• $240.00
$570.00

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. PLAN NO. PARCEL ID: 00 t 53 t 3 9
STREET ADDRESS: I t.u$ a4 rtdler Ln
C.orne k k.) 1 N.C. D.8031
Please print: _
Property Owner: 1 om Van Ro kerI Y1q
Property Owner: �1
The undersigned, registered property owners of the above noted property, do hereby authorize
Jan; ce � � , of C?C 3ra)ne E tct4c1; n9 ,LLC_(Contractor / Agent) (Name of consulting)
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: 104 - 110911'1 y
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
AutTorized Signature
Date: t l- 3b - a1
Authorized Signature
Date:

$tote of North Carolina, Oaaoty of Mecklenburg
Mho foregoing r' ifS s (s rof
e
Notar(y) (ties) lie (is)'�(are)ycertified
to be correct.
'pdsie 7A. say 00 of D _19 Q7
Jodi A. Gibson, Register of Peelle
(.slit.. Pepaty
f�Ohadmte is oar sMecklenburthe
Count vbiobdlvie nho City
o chin cos nd deal t raquir the appro I of the
Ch lotto-Meeklenbur not
Commission. However. any
further subdivision orthu property may be subject
to those p vis.
�� fI Ch sionI ere-Msoklenb rg Planning Commission
Planning C000ision Staff Dote
NOTES:
I. This survey creates the division of a trace far the purpose
of transfer of a parcel by bona fide gift an exception to
the definition of subdivision.
2. This property was granted zoning variance to Section
12.101 of the Mecklenburg County Zoning Ordinance by
The Mecklenburg County Zoning Board of Ad'ustmenf.
Zoning Variance 97-36 on September 10. 1997.
3. Current Zoing is R-3 Loke Norman Watershed Critical.
4. Minimum Setback lines are 30' Front 50' Rear. And 6' Side.
5. No NC Grid Monuments are located within 2000'.
6.05 Rebore Set at all Corners unless otherwise noted.
7. Area computed by DMD Method.
1. Thomas E. Montgomery certify that this map was drawn
under my supervision from an actual survey made under my
supervision the ratio of precision as
calculated by latitudes
and departures is 1:10.000. that theboundaries not surveyed
are shown 0s broken lines platted from deed information.
that this map was prepared in accordance with G.S. 47-30
as amended. Witness my original signature, registration number
and seal this 16th day of September. 1997.
Thomas E. Montgomery N. L.S. L 2593
North Carolina. Mecklenburg County
1, Shirley P. Montgomery. a Notary Public of the County
and State oforesold certify Thomas E. Montgomery. a
Registered Land Surveypersonally appeared before me
this day and acknowledged the s xecution of the foregoing
instrument. Witness m hand andofficial seal, this 16th
oy of September. 19y97.
My commission expires August 12. 2002
Tonmyy L. Broomo
503-B65
5106-410
Z
Map Beck as Pd9e 6 49
"ed
3rOr
CBS
Lake Norman
Duke Power Company
Deed Book 2273 Pogo 592
U71 - 912
(D.A. Fidler Heirs/
R. Follows Duke Power Co.
Project Boundary
Lake Norman/
Address 16816
Lot Too
0.59 Acre
L-16
L-17
L-t
Dawes W. Roynolds d
Pad E. Rs nolds. Sr.
6633--617
1,19
FILED FOR
REGISTRATION
SEP 18 1997
m[a Aeknn�mw ai on u'9H. P.
We
Wa 102.
WC
o 114
Vicinity Mop
LINE N0. 1 DIRL-OIION
L- I
L-2
L-3
L-4
L - 5
L-6
L-7
L-8
L-9
L-10
L- I 1
L-12
N 39'35' 19' W
N 81'17'00- W
N 64'29'00' W
N 32'21'00" W
N 3'17'00' W
LENGTH
36,44
50.70
156.00
6.300 A
N 9 9 64'Il'00' E
�
5 18'47'22' E
S 13'50'00' E
S 25'09'33" E
S 30'51'13' E
S 46'21'53' E
.94
20.32
49.70
27.64
40.99
23.18
L-13
L-14
L-15
L- 16
L-17
L- 1 8
L-19
L-20
L-21
-L-22
L-23
L-24
L-25
5 57'17'50' E
S 65'06'05" E
5 71'29'20" E
S 80'38'50 E
5 89'08'03' E
N 83'25'05' E
N 79'04'29- E
S 86'38'49' E
S 18'26'58' E
S 25'15'0
S 30'41'15'
5 70'36'08' EEE
5 64'55'40" W
23.85
16.09
24.06
27.20
20.29
10.13
21.29,_
13.79
34.25
24.82
16.28
2.7
(7 35
Legend
RBS - Reber Set
N/C - No Corner Found or Set
Subdivision of
Tax Parcel 001-531-21
Lonnie Hager & wife Smitta J. Hager - Owners
Described in Deed Book 2630 Page 213
and Deed Book 8626 Page 393
Lemley Township. Mecklenburg County, NC
September 10. 1997 Scale 1" - 30'
30 80
90 120
GRAPHIC SCALE
FAWN f L815YrFf
05,n690 W Axta t-iN
CM Gm Rood
o:,aa<smm
resnasm

Polaris 3G Map — Mecklenburg County, North Carolina
Date Printed: 12/2/2021 3:57:02 PM
is map ur report is prepared for the inventory of real property within Mecklenburg County and is compiled from recorded deeds, plats, tax maps, surveys, planimetric maps, and other public records and data.
Users of this map or report are hereby notified that the aforementioned public primary information sources should be consulted for verification. Mecklenburg County and its mapping contractors assume no legal
responsibility for the information contained herein.

Polaris 3G Map — Mecklenburg County, North Carolina
Date Printed: 12/2/2021 3:56:12 PM
0.003).006 0.012 Miles
I I I t I I 1 t I
i nis map or report is prepared for the inventory of real property within Mecklenburg County and is compiled from recorded deeds, plats, tax maps, surveys, planimetric maps, and other public records and data.
Users of this map or report are hereby notified that the aforementioned public primary information sources should be consulted for verification. Mecklenburg County and its mapping contractors assume no legal
responsibility for the information contained herein.

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Legend
16824 Fidler Ln
..'41.19IM011

Full Pond/
Normal Water Level
MB MIN MIN ME NMI
Shoreline
Lake
(At Full Pond/ Normal Water Level)
a'b��owXiyq,
(I o..bave X '`-19
W 1 qF.
IA
C
C
E.
S
5
P-19 ' l€x *-h
house.
o 4-,rees r e.rnc3 J ec!
YYt n, rmo..1 bkur\naoct
Please approximately sketch the following information on this plan, length of shoreline
(provide dimensions for eo eh 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

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: �CD8a�1 F�elter i r�. C
Owner: tom vc,. y' oer i rCt
Print
Contractor/agent: CBC B to e i✓ -qec.�.�C (i n3 1 r_
Print III
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, 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
1, am \(Q.r1 Ca e r n1y , hereby state that I have been informed of the Catawba
Riparian Buffer Rule. Any wo 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 anBuffer Rules, the approved plan(s) and specification(s), and other supporting
materials.
Signature (owner):
Date: (I-3b-a1

. .E

01