20211787 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* [e-mail]
Please provide an email address for payment and requests for more information here.
Owner Information:
........ ...........................................................................................................................................................................................................................................................................................................................................................................................
Name:* GARY GARDNER
Email:* [e-mail]
Phone Number:* [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
118 WINDING SHORE RD
Address Line 2
City State/Province/Region
TROUTMAN NC
Postal/Zip Code Country
28166 US
Is there an agent working on the project?* * Yes
J No
Agent/Consultant Information
Name:* TAMARA HAGER
Company Affiliation:* GENE RENEGAR
Email:* [e-mail]
Phone Number:* [phone]
(xxx)xxx-xxxx

Mailing Address:* Street Address
PO BOX 5335
Address Line 2
City State/Province/Region
MOORESVILLE North Carolina
Postal/Zip Code Country
28117 United States
A signed and dated copy of the Agent Authorization letter:*
GARDNER AUTH.pdf 370.74KB
Link to: Sample Agent Authorization Form
Project Information[15A NCAC 02H.0502(a)&(b)]
Project Name:* GARDNER
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: GARDNER SURVEY.pdf 292.74KB
Latitude:* 35.660524 Longitude:* -80.898763
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*
GARDNER SKETCH.pdf 236.44KB
Please use the diagram at the link below:
https://edocs.deq.nc.gov/WaterResou rces/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.)*
GARDNER PICS.pdf 461.55KB
4. Location of the property(where work is to be conducted)
Nearest Town:* TROUTMAN
County:* Iredell
Lake/river/ocean adjacent to NORMAN/CATAWBA
property:
Subdivisions name or site address:* CRESENT LAND&TIMBER LOT NUMBER 157
Include phase/lot number

Directions to site:*
FROM MARSHALL STEAM STATION TRAVEL WEST,4.2 MILES
TURN LEFT ONTO PERTH RD 4.4 MILES,TURNLEFT ONTO
WINDING FOREST DR,50 MILES,TURN RIGHT ONTO WINDING
SHORE RD.20 MILES PROPERTY ON LEFT.2 MILES.
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 Acres
7. Describe proposed work(include discussion as to how hardening of shoreline has been avoided,or
why it is necessary):
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 BY BARGE
Sketch: GARDNER SKETCH.pdf 236.44KB
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:
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
a 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");
a I 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:* GARY GARDNER

Signature: �7
(1 yA . AJ 2i
Submittal Date: 12/7/2021

Initial Review
Is this accepted into the review process?* Yes No
Project Number:* 20211787 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

CAT sWBA RfiPANAN BUFFER R NOTORCATDON FORM
+ -
Project NomeJaddrese: Cl /1pi- 1 itat_ S11,4 Cl Uritlr.
°wl=cr: )
Print 5i� •_u
contractor/agent:
Print = _
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. 3 15r. NCAC
02H .0506 and 15ANCAC .0?43(8)i
reel era not allowed to b.,removed from Pone; of the Butter(within 30 i-of the full pond elevation), unless
approved_ Exception,those trees that are severely underfmined along the immediate shorelinecan be removed.
Minimal shaping and sloping along the immediate shoreline is allowed. f15A r Ca.0 028.0243(5);
Benchinsf grading in the buffer is not allowed_Excessive disturbance of sro=und cover_ ESrt NCAC 028_0243 (6)1
5e_ches,Impervious patios,impervious walkways,etc.are not all(,3w d in the buffer er unless specifically approved
by the Division. There are limitation on si_efor decks. liSA NCAC 02 _0243(4) and (5)
Work to be conducted from land must indicate en access end indicate any trees that are to be removed. The
work corridor should be deescribed. i he=pproved access corridor shall be restored. Staging, spoil, Cun=t"
material must be outside tc Mutter_ rasp_ NCAC 02H-0507,and 17A NrAC 28 .CP411 ( (^), (8)
Storsmv,rater cannot be piped or ci anne/ed for direct dischar a to _h2 =fS_ Ali constructed -tor rmw;tsr
discharges must be gat the nr—turel e}2 'at rand di_cherEe prior to mitering the buffer directed as diffuse' or
sheet flow at non erosive velocities to the lake. f15A NCAC 02B.0243(5), (6fl
icknolW dgem nt of No_ljlcGsloon;
hereby state that I have been informed med of the Catawba
Riparian Buffer Rule. Any work conducted in the _ur not specifically stated the '' -- , in the application and approved
by Division of Water sources(D1NR), is a violation and sublectto 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 copr oVed plan(s) and speclfication(s),and other ssuppci zinc
materiels.
Signature (oI,maT),;L : Date: jDi D17, i

LOT 164 •"`
6B -O 49.42
99 110 e ` i .
N00-2lE 1E 49.42
LE,'; N64-4514 65.46
1D1 N73-39N 15.62
1gz "11-31E 20.93 CRESCENT LAND 4 TIMBER CORP.
LOT 159
N.
102 NI4 a9E 7t 4a 1 MARY ALL SON 1 I.PIN II:
109 N15-32u I07.96 MTN. IS- DWG. NO. 386
I05 NS$-19F 25.71 U. M. I . - 564
106 M79-34E 94.26
LOT Is6 CRESCENT LAND & TIMBER CORP.
106
701.000 107 N61-9gE 193.25 f J. L. MCLA IN 1
LOT 157 t 115. MTN. IS. DWG. NC. 40$
�. U. M. 1 I. -- -10 6
107 N33-52E 69.24 CRESCENT LAND 4 TIMBER CORP. .7
109 M00-43N [00.2s i AVERY L• MONEYCUT7 f ,f, 8ii
LOT 15a MTN. IS. DWG. N0. 262 o
N04-3714 29.15 U. M. I. - 436 I•P[N h m
Ill M47-INE 42.03 69M1
l2 N66-19E 50.04 . 113 : �.31W
1[3 N7Y-14E 07.26
LPIN J. L. Mc LEAN
•
LOT INN TO 119 LOT 155 I.PIN (NOW OR FORMENLYI
I.PIN�`9 DA5T ACRE p_ o IV3 LOT 111E 50.02 m
F 11
Nga z
"1INNSB-59E 31.01 2rO�y 4 NE9.63E 99.113 116 N 5_37E 48.49 LRKC NORMAN ~-__._ =,
4,3 2.R3N4O-3a E 24.75 1_PIN8 .\ LOT 157 11
N•
7130,709.61\.64 WEREm E. 1.436.182.59 I.PIN 107
'8.&�'ry, bA
` '1 1•P1N 4,7
LOT 156' [.PIN T40;7`L C
� !7 L�` BELL 106 �9 ACRE yMa V`\
CR09§NAgpg
SECTION 6 IREOELL Hea `` �~
.,s COUNTY O.o aeH t.FLN y $
76G CONTOUR - ' _ so. �}
In LOT ISE : F
• C ) 'tA I` � ,j\///,
II v%rio /( .� 0.79 ACRE I': \
LLLIII \%`l \
CA TAW BA 'r,. 562-s2W 1.r1N a N
COUNTY eol ' 1.PIN102 zls.lE m �� CRESCENT LAND 4 TIMBER CORP.
000u=. ( JEANETTE OSTWRLT MAYHEW 1
' \
6£OGRAPHf -'t L2OmATI0N LOT 154 a > MTN. I5. DWG. NO. 203
LOCALS 1 7 2 MILES
0.05 SORE Z U. M. I I. - 382
•
g4�,S9�0 G4. ,OA. /�
sprl. Cb /fi
/ fifS
I.PIN - 97 LOT 153 lb l�p
4,0 '1O
i/ P 'PO\ sb A1.W
CiM,r
700.000 \
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700.000
NOTES . . . 1
SEE ONG. NO.
DUKE POKER COMPANY TO CRESCENT LAND a C. F. lg - H
TIMBER CORP. DEEC BOOK 491 PRGE AI.
DATED MAY I. 1969
BUILOINO 6E709CN LINES ARE F„y FEET FROM
ROAD RIDNT OF NAY. 50 FEET FROM CONTOUR _
ELEVATION 760. 0.6.0.S. SEA LEVEL ORTUN II CRESCENT LAND 0. TIMBER CORP.
RNO 10 FEET FROM 91 OE LOT LINE. � J LANE NORMAN
P OF
RLL STREET CORNER RADII ROE 20 FEET. /
PROPERTY LINE DISTANCES ARE COMPUTED TO % R�.y RE CI�I~R TRI ON LOTS
POINT OF INTERSECTION AT STREET CORNERS.
♦ SECT
I ON
f C
PROPERTY LINES SltOWN WHICH FORM THE ECOE a.,V' / J L 4. I I'1 V
OF LANE NORMAN FOLLOWS CONTOUR ELEVATION / LOTS
f �f_1 O
760. I U.6.0.5. SEA LEVEL 0ATUM I Gfl 1 1 'P O
i'� EALLSTDWN TOWNSNiP
ti.1•r.1••it^u.�q.n r..l.r�.n1rn y'1'IOFrr.1.Il nl_eI�_nL�•1�n 1'rsf��• l,r. .e /,r,0 IREOSLI_ COUNTY. N. C.
n. II 1 Ir I"� 1"' ioa 100 100
��..-.. /'+' • _.. .- {�.... X. /. .. ' ti MISC. ROOK NO. 1B. 4E0 4 421 O - 1C' IF 7516 - 1
5CRLE 1'' 100' DECEMBER
Wn NO
it r.l.r lr rrrli,.�1 i r... °i..rlir i.l=•1rrf1 ijt, rrlr 4iie _.__....__..._.. ..,.-_-

lake
(At Full Pond/Normal WaterLevel)
i Lull Pond/ � �Z C /�`
Normal Ut/�fier ,*'Oa 3c*� 2''a�1'fs
INN �r eve I�+t�r 1irifi }Virg marl drrori vide/,���
Shoreline . ;�� •�t; , , `#*"ri/kc.� cili a►ai fa,,� •
�: !f/J"I�I %iil it j,I �' tI in -t . !tr ' �wX�i..w
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(vt�, i juiI. P zn
rSru q
IT 3 iA- OR—
I 1AS t N>✓j LOff`4 E I.
i
I yJ
Please approximately sketch the following information on this plan
item, such as 1 Q r�
.� ]�X 1 L1p f��=_ (provide dimer�sians for e�c%
• All proposed vegetation clearing
2. Location of rip rap or fill to be placed above the Full Pond/Normal
3. Location of rip rap or fill to be placed below the Full Pond/Normal Water Level elevation ter
4. Location of any proposed structures such as buildings, retaining walls,docks,/el etc.fevaticrn
5. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
FORM:SSGP 1 o-20 3
Page 3 or 3

From: TAMARA HAGER . [e-mail]
Subject: Gardner shoreline pics
Date: Dec 7, 2021 at 7:29:21 PM
To: TAMARA HAGER [e-mail]
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704-575-2227
Lake Permit LLC
hagerPlakepermit.eom

lake
(At Full Pond/Normal WaterLevel)
i Lull Pond/ � �Z C /�`
Normal Ut/�fier ,*'Oa 3c*� 2''a�1'fs
INN �r eve I�+t�r 1irifi }Virg marl drrori vide/,���
Shoreline . ;�� •�t; , , `#*"ri/kc.� cili a►ai fa,,� •
�: !f/J"I�I %iil it j,I �' tI in -t . !tr ' �wX�i..w
L,,' �j
(vt�, i juiI. P zn
rSru q
IT 3 iA- OR—
I 1AS t N>✓j LOff`4 E I.
i
I yJ
Please approximately sketch the following information on this plan
item, such as 1 Q r�
.� ]�X 1 L1p f��=_ (provide dimer�sians for e�c%
• All proposed vegetation clearing
2. Location of rip rap or fill to be placed above the Full Pond/Normal
3. Location of rip rap or fill to be placed below the Full Pond/Normal Water Level elevation ter
4. Location of any proposed structures such as buildings, retaining walls,docks,/el etc.fevaticrn
5. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
FORM:SSGP 1 o-20 3
Page 3 or 3