20200913 Ver 2_Shoreline Stabilization_20220104

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:
Name: *
Email: *
Phone Number:
Mailing Address: *
[e-mail]
Please provide an email address for payment and requests for more information here.
Thomas & Lisa Natale Contessa
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
829 Portobello Road
Address Line 2
City
Lincolmon
Postal / Zip Code
28092
Is there an agent working on the project?* Yes
No
Agent/Consultant Information
Name: *
Company Affiliation:
Email: *
Phone Number:*
Saundra B Mosteller
State / Province / Region
North Carolina
Country
United States
Dale & Beth's Lake Use Permit Service
[e-mail]
[phone]
(xxx)xxx-xxxx

Mailing Address: *
Street Address
988 Clear Creek Circle
Address Line 2
City
Lincolnton
Postal / Zip Code
28092
A signed and dated copy of the Agent Authorization letter:
agent.pdf 657.97KB
Catawba Form.pdf 1.09MB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name: * Contessa Lot 101 stabilization
State / Province / Region
North Carolina
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:*
Latitude: * 35.537150
Street Address
5079 Fox Hollow Drive
Address Line 2
City
Denver
Postal / Zip Code
28037-9402
State / Province / Region
NC
Country
US
Longitude: *-80.961224
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*
stabilization drawing.pdf 156.54KB
vicinity.pdf 185.48KB
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.)
pictures.pdf 255.12KB
4. Location of the property (where work is to be conducted)
Nearest Town: * Denver

County: * Lincoln
Lake/ river/ ocean adjacent to Norman
property:
Subdivisions name or site address:* 5079 Fox Hollow Drive Denver NC 28037, Lot 101
Include phase/lot number
Directions to site: *
head southeast on NC-16 Business S., turn left onto Webbs Rd, turn left
onto Burton Ln, turn right onto Webbs Chapel Church Rd., turn right onto
McConnell R., turn left onto Fox Hollow 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..
residential, shoreline wall and rip rap in need of redo
Residential, undeveloped, etc.
6. Property Size 0.698
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
class B rip rap with fabric redo 263 feet following contour of shoreline,
behind rip rap redo 120 feet wall
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.)
1052
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.)
3130
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)
manicured lawn, no trees removal
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:* Saundra B Mosteller
Signature:
�l�rP�GfrT ��oY1t�
Submittal Date: 12/24/2021

Initial Review
Is this accepted into the review process?* Yes No
Project Number:* 20200913 Version: *
Select Reviewer:*
Select Reviewing Office:
Has payment been received?*
What amount is owed?*
Doug Perez:eads\djperez
Mooresville Regional Office - [phone]
No Payment Needed
Fee Received
• Need Fee - send electronic notification
• $240.00
$570.00

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. I PLAN NO. PARCEL ID: 4730612041
STREET ADDRESS: 108 Winding Shore Rd Troutman NC 28166
Please print:
Property Owner: Earl P Jr & Reachelle L Barban
The undersigned, registered property owners of the above noted property, do hereby authorize
Beth Mosteller , of Dale & Beth's Lake Use Permit Service
(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.
Pr erty Owner' Address if different th p perry a ove):
P $a
Telephone: 4�'l00Y'e5U 1 e, I&C
ag/)5-
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
A�e-
Authorized Signature Authorized Signature
Date; / I -0 A - 20 9,i

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: 108 Winding Shore Rd Troutman NC County: Iredell
Owner: Earl P Jr & Reachelle L Barban e�j t R
Print "Signature
Contractor/agent: Beth Mosteller�,c,_QQ,y
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
02i-! .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
worm 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, Earl P Jr & Reachelle L Barban 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 specif ation(s), and other supporting materials.
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Signature (owner): Date: ;t
Signature (owner): "E.c�

Side View
Lake
(At Full Pond/Normal Water Level)
Norman Wa
Shoreline
..........................
f............................................... 10.
4 foot base below full pond
Top View
Lake
(At Full Pond/Normal Water Level)
231 feet following contour of shoreline
Corridor Access
10'Wide x 250' Long o
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