20210532 Ver 1_Shoreline Stabilization_20220103

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:* Gary B. Schwartz
Email:* [e-mail]
Phone Number: [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
65 King Arthurs Court
Address Line 2
City
Hickory
Postal / Zip Code
28601
Is there an agent working on the project?* O Yes
O No
Agent/Consultant Information
State / Province / Region
NC
Country
United States
Name: * Charlie Washburn
Company Affiliation: * Marine Construction LLC
Email: * [e-mail]
Phone Number:* [phone]
(xxx)xxx-xxxx

Mailing Address: *
Street Address
1173 Shiloh Church Rd
Address Line 2
City State / Province / Region
Hickory NC
Postal / Zip Code Country
28601 United States
A signed and dated copy of the Agent Authorization letter: *
Gary Schwartz - Agent Authorization.pdf 302.49K B
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:*
Schwartz - Hickory
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: Gary Schwartz - Directions and Survey.pdf 2.31MB
Latitude: * 35.800000
Longitude: *-81.316000
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*
Gary Schwartz - Scope of Work.pdf 2.23MB
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.)
Gary Schwartz - Buffer and Prop Picture.pdf 1.59MB
4. Location of the property (where work is to be conducted)
Nearest Town: *
County:*
Lake/ river/ ocean adjacent to
property:
Subdivisions name or site address: *
Hickory
Alexander
Hickory
65 King Arthurs Ct (Lot 24)
Include phase/lot number

Directions to site: *
Printed directions included above.
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 / Developed
Residential, undeveloped, etc.
6. Property Size
.50 acres
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
We plan to remove existing deteriorating wooden seawall and replace with
Everlast vinyl seawall.
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.)
208
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.)
208 perm (back fill
and panels) and
2080 temp
(construction
corridor)
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)
Grassy yard with bushes and 1 tree. Nothing will be removed.
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");
• 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:*
Charlie Washburn
Signature:
Submittal Date: 12/23/2021

Initial Review
Is this accepted into the review process?* 4 Yes No
Project Number:* 20210532 Version:*
Select Reviewer: * Doug Perez:eads\djperez
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: 24
STREET ADDRESS:
65 King Arthurs Ct
Hickory, NC 28601
Please print:
PLAN NO: PARCEL ID: 0004835
Property Owner: Gary B. Schwartz
Property Owner:
The undersigned, registered property owners of the above noted property, do herebyauthorize
Charlie Washburn , of Marine Construction LLC
(Contractor/Agent) (Name of consulting firm)
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 Owners Address (if different than property above):
same
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorize
Authorized Signature
t 2 - - ' 2-4
Date i / / Date

1:2,73
0 0.0125 0.025
0.05 mi
0 0.0225 5
0.09 km
Owner.
Mailing Address:
Physical Address:
Parcel ID:
PIN:
Deed Reference:
SCHWARTZ GARY B &
65 KING ARTHURS CT
HICKORY, NC 28601
65 KING ARTHURS CT
0004835
3715342385
0410 0694
Acreage:
Fire District:
Structure Value:
Land Value:
Misc Value:
Fair Market Value
Tax Value:
Account #:
0
BETHLEHEM FIRE
278642
115625
5850
400117
400117
0302935
Alexander County
Alexander County
assumes no legal responsibility
for the information
contained on this map.

12/20/2021
1173 Shiloh Church Road, Hickory, NC to 65 King Arthurs Ct, Hickory, NC 28601 - Google Maps
Google Maps 1173 Shiloh Church Road, Hickory, NC to 65 King
Arthurs Ct, Hickory, NC 28601
Drive 2.0 miles, 4 min
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1173 Shiloh Church Rd
Hickory, NC 28601
t 1. Head southwest on Shiloh Church Rd toward
Rosenbalm Ln
is 2. Slight left to stay on Shiloh Church Rd
r) 3. Turn right onto Wildlife Access Rd
4-1 4. Turn left onto Cemetery Loop
4-1 5. Turn left onto Moretz Ct
r* 6. Turn right onto King Arthurs Ct
0 Destination will be on the left
65 King Arthurs Ct
Hickory, NC 28601
387 ft
0.6 mi
0.4 mi
0.1 mi
0.7 mi
302 ft
Map data C12021 1000 ft
https://www.google.com/maps/dir/1173+Shiloh+Church+Road,+Hickory,+NC/65+King+Arthurs+Ct,+Hickory,+NC+28601/@35.8084331,-81.3222003,1... 1/2

BOUNDARY AND LOAN SURVEY FOR.
FOX SURVEYING COMPANY, P.C.
105 MAIN AVENUE DRIVE S.E.
P.O. BOX 637
TAYLORSVILLE, N.C. 28681
OFFICE: 704-635-1902 FAX: [phone]
"A. T. MORETZ" PROPERTY
PLAT BOOK 2 PAGE 43
40 0 40 B0 120
{Illlllllll I I
GRAPHIC SCALE - FEET
EX. P.K. NAIL C/L OF S.R. /1190
AND C/L OF KING ARTHURS COURT
EIP 3/4" PIPE 79.99'
N 87°00'28"W
28.75'
GARY B. & wife BETTY F. SCHWARTZ
TOWNSHIP
WITTENBURG
COUNTY
ALEXANDER
STATE
N.C.
TAX MAP CODE:
B-12-B, BLOCK 1, PARCEL #23
REFERENCE PLAT:
2/43, LOT #24
DRAWN BY:
WES
REVISED:
JOB 84-00
DATE.
04/01/00
FIELD BOOK
9
PAGE
81
REFERENCE DEED(S):
383/2092, TRACT #4
SCAT F:
1 "=40'
DRAWING b 1 39-B
FILE NAME(S):
"SCHW6400" & "SCH6400A"
LAKE WALL
EIR 3/8" REBAR
LAKE HICKORY
N 56°12'11"W-'94.72'
If) (TRACT #1)
/jv GRIME PUYNOUSE
C/ (ENCROACHMENT)
JANICE F. BUTLER
383/2092
TRACT #2-#3 0S
In
127.91' DP 3/4" PIPE
EIP 3/4" PIPE 53°08'00"E 332.96' (TOT )
0.51 ACRE
(ENCROACHMENT)
DOC FENCE
125.06'
NOTE: THE SURVEYED PROPERTY HAS A BOAT
HOUSE LOCATED IN FRONT. ON LAKE HICKORY.
EIR 1/2" ROD
MRS. WEBB PRICE
TAX MAP CODE: B-12-B,
BLOCK 1, PARCEL #25
25
EIR 3/8" REBAR
30' R/W (PLAT BOOK 2 PAGE 43) PAVED KING ARTHURS, COURT
"A.T. MORETZ" PROPERTY WILLIAM HART
PLAT BOOK 2 PAGE 44 381/2131
SPECIAL NOTES
NOTE: ALL AREAS SHOWN HEREON WERE DETERMINED BY COORDINATE COMPUTATION.
NOTE: THIS PROPERTY IS SUBJECT TO ANY AND ALL RIGHTS -OF -WAY, COVENANTS,
FA -CEMENTS, RESTRICTIONS, AND ALL OTHER ITEMS OF RECORD AFFECTING SAID PROPERTY.
NOTE DASHED UNES REPRESENT PROPERTY ONES WHICH ARE NOT ACTUALLY SURVEYED.
THE POSITION OF DASHED ONES ARE TAKEN FROM DEEDS.
NOTE THERE ARE NO N.C.G.S. CONTROL MONUMENTS WITHIN 2000' OF THIS PROPERTY.
cox CAR°
OEE.SSIO^
SEAL
L-3874
sUR�
'S‘LEY G•
11
O
I, WESLEY G. FOX, L-3874, PROFESSIONAL LAND SURVEYOR, CERTIFY THAT
THIS PLAT WAS DRAWN FROM AN ACTUAL FIELD SURVEY PERFORMED UNDER
MY DIRECTION AND SUPERVISION, THAT THE RATIO OF PRECISION AS CALCULATED
IS 1:10000+, WITNESS MY ORIGINAL SIG TURE, REGISTRATION NUMBER
AND SEAL THIS 4th DAY OF APRIL, 2000
PRO ZONAL LAND SURVEYOR
LEGEND
EXISTING IRON ROD - •
EXISTING IRON PIPE - •
NEW IRON REBAR - 0
CONCRETE MONUMENT -
CALCULATED POINT - +
R.R. SPIKE -
P.K. NAIL - 3E
N.C.G.S. HORIZONTAL MONUMENT - ■
STONE - A
NAIL de CAP -
NAIL - I&
MAG NAIL - 0
T.LO. - TIE UNE ONLY
R/W - RIGHT-OF-WAY
----P---- - OVERHEAD SERVICE UNES
C.M.P. - CORRUGATED METAL PIPE
R.C.P. - REINFORCED CONCRETE PIPE
C/L - CENTERUNE
POWER POLE - 0
NOTE: ALL NEW CORNERS SET ARE 1/2" REBAR
UNLESS OTHERWISE NOTED.
LOCATION MAP (NO SCALE)
SR #1142

3. Attach a photograph of the shoreline/ buffer proposed to be stabilized. (Include a scale of
some sort- a yard stick, shovel handle, etc.)
4. Location of the property (where work is to be conducted)
County: Alexander Nearest Town: Hickory
Lake/ river/ ocean adjacent to property: Hickory
Property size (acres): .50 acres
Subdivision name or site address (include phase/lot number):
65 King Arthurs Ct Hickory NC 28601 - Lot 24
Directions to site - please include road names and numbers, landmarks, etc.:
Printed directions included in this packet
Latitude (in decimal degrees) 35.800 Longitude (decimal degrees) -81.316
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Residential / Developed
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Existing seawall is deteriorating and soil is washing away
7. Will work be conducted from land?
From water? n
8. Total amount of impacts below the normal pool lake level / Normal Water Level
Permanent impacts (including all excavation, backfill, rip rap, retaining walls, etc.) in square feet:
208 sqft (backfill and panels)
Temporary impacts in square feet:
0 sqft
9. Total amount of impacts above the normal pool lake level / Normal Water Level and 50 feet
land -ward
Permanent impacts (including back fill, excavation, rip rap, retaining walls, etc.) in square feet:
208 sqft (backfill and panels)
Temporary impacts (temporary clearing, construction corridor) in square feet:
2080 sqft (construction corridor)
10. 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): Grassy yard, bushes and
1 tree. Nothing will be removed.
Owner/AgenSignature* [15A ' C 02H .0502(f)l Da e
*Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 02-2017
Page 2 of 4

10ft. bank
height
Side Vi
3 ft. below full pond water level 4 ft. above full pond water level
2 ft. additional Bearing
*if necessary
FORM: SSGP 02-2017
Page 4 of 4

12. Please approximately sketch the following information on this plan and provide dimensions for
each item:
a.
b.
c.
d.
e.
All proposed vegetation clearing
Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
Location of any proposed structures such as buildings, retaining walls, docks, etc.
Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
Full Pond/
Shoreline
l/2' govt. cv i l
NtJL
Plan View
f`�'.7—T.',r. T-r:1-
0•...•� Riprap .. .....
w,����•� •. �m*Wm.
'.: -a.,
FORM: SSGP 02-2017
Page 3 of 4

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: Schwartz — Hickory County: Alexander
Owner: Gar B. Schwartz
Print Signat r�-
Contractor/agent: Charlie Washburn — Marine Construction LLC
Print Signature
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 and 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
I, Gary B. Schwartz , hereby state that I have been informed of the Catawba
Riparian Buffer Rule. Any work 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 and Buffer Rules, the approved plan(s) and specification(s), and other supporting materials.
Signature (owner):
Date: /178