HomeMy WebLinkAbout20211789 Ver 1_Shoreline Stabilization_20211209Shoreline 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*
jcfaircloth@bellsouth.net
Please provide an email address for payment and requests for more information here.
Owner Information:
Name: * Christie Faircloth
Email:* jcfaircloth@bellsouth.net
Phone Number:* (704)779-1229
(xxx)xxx-xxxx
Mailing Address:* Street Address
13509 McCord Rd
Address Line 2
City
Huntersville
Postal / Zip Code
28078
Is there an agent working on the project?*
Yes
No
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:*
Springwood Dock and Seawall replacement
State / Province / Region
NC
Country
USA
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:*
35.240470
Street Address
402 Springwood Drive
Address Line 2
City State / Province / Region
Mt Gilead NC
Postal / Zip Code Country
27306 US
Longitude: *-80.076508
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*
Sketch - jackfaircloth@gmail.com - Gmail.pdf 58.42KB
Please use the diagram at the link below:
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 photo - jackfaircloth@gmail.com -
Gmail.pdf
58.42KB
4. Location of the property (where work is to be conducted)
Nearest Town:* Mt. Gilead
County: * Montgomery
Lake/ river/ ocean adjacent to Lake Tillery
property:
Subdivisions name or site address: *
402 Springwood Dr. Mt. Gilead NC 27306
Include phase/lot number
Directions to site: *
Go to Fairway Shores North Subdivision. We are the house that has grey
gravel parking pad and 4 vacant lots beside it.
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: *
The home is a lake house that has an existing seawall and dock. Both are
rotting and falling in.
Residential, undeveloped, etc.
6. Property Size
1.0
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
Our Contractor will tear out the existing dock and sea wall. He will
replace the dock with a 1200 sq foot dock w one boat slip. The sea wall is
currently wood and we are replacing with boulders.
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.)
500
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)
3 trees that are ready to fall on dock or seawall are requested to be
removed.
Sketch:
Sketch - jackfaircloth@gmail.com - Gmail.pdf 58.42KB
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");
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:*
Signature:
Christie Faircloth
Submittal Date: 12/7/2021
Initial Review
Is this accepted into the review process?* Yes No
Project Number:* 20211789 Version:* 1
Select Reviewer: * Chad Turlington:eads\ccturlington
Select Reviewing Office: Fayetteville Regional Office - (910) 433-3300
Has payment been received? * No Payment Needed
Fee Received
• Need Fee - send electronic notification
What amount is owed?*
• $240.00
$570.00
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