20220132 Ver 1_Shoreline Stabilization_20220125

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:
Name: *
Email:*
Phone Number:
Mailing Address: *
[e-mail]
Please provide an email address for payment and requests for more information here.
Lynette Santomenna
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
112 Dime Lane
Address Line 2
City
Mooresville
Postal / Zip Code
28117-6941
Is there an agent working on the project?*
Agent/Consultant Information
Name: *
Company Affiliation: *
Email: *
Phone Number:*
Yes
No
Janice Estep
CBC Stone & Recycling, LLC
[e-mail]
[phone]
(xxx)xxx-xxxx
State / Province / Region
NC
Country
US

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 587.99KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name: *
Santomenna 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:*
35.609686
Street Address
248 Hermance Lane
Address Line 2
City State / Province / Region
Mooresville NC
Postal / Zip Code Country
28117-8852 US
Longitude: *-80.916907
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:
964.29KB
1.06MB
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 24.97MB
4. Location of the property (where work is to be conducted)
Nearest Town: * Mooresville

County: * Iredell
Lake/ river/ ocean adjacent to Norman
property:
Subdivisions name or site address: *
Directions to site: *
610 E Center Ave
Mooresville, NC 28115
Lot 241 Crescent Land & Timber Corp.
Include phase/lot number
Follow E Center Ave and E McLelland Ave to NC-150 W/E Plaza Dr
6 min (1.7 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
397 ft
Turn right onto E McLelland Ave
1.1 mi
Use any lane to turn left onto NC-150 W/E Plaza Dr
Continue to follow NC-150 W
Pass by Zaxby's Chicken Fingers & Buffalo Wings (on the right in 1.3 mi)
11 min (5.4 mi)
Follow Hermance Ln to your destination
2 min (0.7 mi)
Turn right onto Waddle Rd
236 ft
Turn right onto Hermance Ln
0.6 mi
Turn right at Golden Pond Ln
108 ft
248 Hermance Ln
Mooresville, NC 28117
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 (new construction)
Residential, undeveloped, etc.
6. Property Size
0.73 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. Reshape and re -slope shoreline, install matting
and install VA Fieldstone boulder rip rap to refresh shoreline. Install TN
Crab Orchard steps for lake access.

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.)
4' below (672 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 (168 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, clear access to shoreline, no trees removed, minimal
disturbance to buffer and approved access through buffer to be restored to
original condition.
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
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:* Janice Estep
Signature:
Submittal Date: 1/25/2022

Initial Review
Is this accepted into the review process?* Yes No
Project Number: * 20220132 Version: * 1
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. a H I PLAN NO. PARCEL ID:
STREET ADDRESS: ; el-maii 2-Q1° (402043 (.«« Cis C- ov %
7
Please print:
Property Owner:
Property Owner:
ilk2 QQ n l g 1'rL4 f) r)C%'(
d'
mot rye:11 rem
The undersigned, registered property owners of the above noted property, do hereby authorize
of C 6
(Contractor / Agent) (Name of consulting f�)
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):
- me, Lane_ (roo , NC o1 111
Telephone: 1 b z1- LI g - -1014LA
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized Signature Authorized Signature
Date: t-a5-a'2�
Date:

,37 LOT 243
138 546-36E
139 524-13E
LOT 242
��� 526-34E
141 532-43E
142 530-32E
LOT 241
143 534-09E
144 504-14E
LOT 240
144 N68-07E
I�B 878-31E
147 547-50E
LOT 256
97 N23-30E
88 N36-33K
89 N70-50K
90 N51-54W
LOT 244
135 550-02E 20.88 / \
575-58E 81.05 / \
61.55
66.71 LOT 264
1
92.04
45.33
37 .00
80.00
LAKE N O R M A N
91.99
55.90
54.25
48.81
57.94
139.37
56.04
48.95
79.48
CRESCENT LRND 4 TIMBER CORP.
( J. J. MAYHEW )
U. M. 1. - 193
682.000
NOTES...
DUKE POKER COMPANY TO CRESCENT LAND 4
TIMBER CORP. DEED BOOK 481 PAGE 91.
DATED MAY 1. 1969
BUILDING SETBACK LINES ARE 25 FEET FROM
ROAD RIGHT OF NAY. 50 FEET FROM CONTOUR
ELEVATION 760. U.5•G.S. SEA LEVEL DATUM
AND 10 FEET FROM SIDE LOT LINE.
ALL STREET CORNER RA011 ARE 20 FEET.
PROPERTY LINE DISTANCES ARE COMPUTED TO
POINT OF INTERSECTION AT STREET CORNERS -
PROPERTY LINES SHOWN WHICH FORK THE EDGE
OF LAKE NORM8N FOLLOWS CONTOUR ELEVR770N
760. ( U.S.0.5. SEA LEVEL DATUM 1
5
I.P1
I
-�760 CONTOUR
\ SEE DWG. N0.
\C. F. It - V
SEE OWG. NO.
C. F. I I - U
LOT 246
N43641 _E
32 .34/,.1 •PIN
N79-20E
LOT 244
0 .81 RCR8 hF.
h'
Io ��� fl=58 .70 �! 2'DJ•� laa 1.PIN
1•PIN
LOT 258
-_____-7
CRESCENT LAND a TIMBER CORP
( GEORGE F CLOUSE 1
U. M. 1 - 163
BELL
;OSSR pYp1 _��^
IREDELL SI
t COUNTY
f
ii h r J
CATAW BA
COUNTY �I` DoOLEY
L
SECTION
GEOGRAPHICLOCATION
E SCALI_= 2 MILES
SEE DWG. NO.
C. E 11-W
.57
CRESCENT LAND 4 TIMBER CORP.
( O. L. CORWELL )
U. M. 1. - 114
760 CONTOUR
I .PIN
p -.T
;0. LOT1240
0.77 ACRE
-1 .PIN i4,
N 35.52 W- 26 1 I ,5o
9 ' o' 88
96 '8 ti
LOT 239
CRESCENT LAND 4 TIMBER CORP.
( MRS. S. E. CHRISTIE )
U. M. 1. - 169
I
CC
Q
J
14T
I.PIN
N.E.
881.980.41 / E
E. 1.430.277.85
CRESCENT LAND 4 TIMBER CORP.
LAKE NORMAN
MAP OF
RECREATION LOTS
SECTION 11
LOTS 240-256
DAVI050N TOWNSHIP
IREDELL COUNTY. N. C.
SEE DWG- N0.
C. F. 11 - S
loo 00
SCALE 1" e 100'
MISC. BOOK N0. 412. 413 c 415
00 400
ROVER/1ER 21, 1975
OW0. NO. C. F. 11 - T
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Legend
248 Hermance Ln
1396
,
A,.
k.

Fu l Pond/
Normal Water .eve_l
Shoreline
Lake
(At Fuii Pond/ Normal Water Level)
41:witig
Or ate So
4'be_iow.xILoe
Sand it aced,
i. above X I l08 ` sfcp
NQw
co rl S'-r,
I�o ree5 re\Mov2c�
(Yl',n',rna1 c\ e '4t
±p Iv�Fer
W d DF.
A
Please approximately sketch the following information on this Plan, length of shoreline
(provide dimensions for each 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

CA AW L RIPAMAN BUFFER NOTRICATON FORM
-1.
Project Nan a/address:% 6�C�� >% . -C\ 1l , county; I
lb' 1
Owner: 1\0\.1\, y" Lk.,\ r` 1 fL a\11- 0 PY'tk(),1\0\
Print Signatu r
tContractoriagent: C C Sone.Z Pe9C1'incn 1 u...c Ytl�Q , C c i ,(�
Print Lure
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)]
Ackn twie dgement of Notification
I, ne+.1-e 60,n-k-o SY1 C, , hereby state that I have been informed of the Catawba
Riparia 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):
04D hivoA,„
Date: i�

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