20220174 Ver 1_Shoreline Stabilization_20220201

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ROY COOPER ^� '� ' J
Governor a 4Y.
MICHAEL S.REGAN
Secretary
S.DANIEL SMITH NORTH CAROLINA
Director Environmental Quality State of North Carolina
Department of Environment Quality
Division of Water Resources
15A NCAC 02H.0500—Water Quality Certification,Shoreline Stabilization
FORM: SSGP 09-2020
Shoreline Stabilization Application Form
Three copies of the application (including attachments)and the application fee should be sent to:
If sending via US Postal Service If sending via delivery service(UPS, FedEx, etc.)
Paul Wojoski Paul Wojoski
DWR—401 & Buffer Permitting Branch DWR—401 & Buffer Permitting Branch
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699-1617 Raleigh, NC 27604
NOTE: Before submitting this form, please ensure you have submitted the Pre-Filing Meeting Request
Form as we will not be able to accept your application without this important first step.The Pre-Filing
Meeting Request Form is used in accordance with 40 C.F.R. Section 121.4(a)which states "At least 30
days prior to submitting a certification request,the project proponent shall request a pre-filing
meeting with the certifying agency." In accordance with 40 C.F.R. Section 121.5(b)(7), and (c)(5), all
certification requests must include documentation that a pre-filing meeting request was submitted to
the certifying authority at least 30 days prior to submitting the certification request. Click here to read
more information on when this form is needed prior to application submission or here to view the
form.
Attach documentation of Pre-Filing Meeting Request to this application.
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Date of Pre-filing Meeting Request: / / cT/ / ...14904 (required)
RECEIVED
DWR ID# Version (if applicable)
A. Applicant
OwnerIln Information on ion r15A NCAC 02H .0502(a)] 40E&eUF,-csoURCES
1. RMI7TING
Name: Annette Phillips Dorsett
Mailing Address: 4600 Tenby Drive
Greensboro, NC 27455
Telephone Number: 336-908-2361 Fax Number:
E-mail Address: [e-mail]
D_E Q North Carolina Department of Environmental Quality 1 Division of Water Resources
512 North Salisbury Street i 1617 Mail Service Center Raleigh.North Cardin 27699-1617
...,,..,m t-mtrovorw.Oa, /✓ 919.707.9000

2. Agent/Contact Person Information
A signed and dated copy of the Agent Authorization letter must be attached if the Agent has
signed this application form. (A form can be downloaded here:
http://www.saw.usace.army.mil/Portals/59/dots/regulatory/regdocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM.pdf)
Name: N/A
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
B. Project Information [15A NCAC 02H .0502(a) & (b)]
1. Attach 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.
2. Provide a detailed site plan showing property boundaries and proposed locations of
vegetation clearing, buildings, retaining walls, docks, impervious surfaces, rip rap, excavation
or dredging below Full Pond/Normal Water Level elevations, and construction access
corridors. You may use the diagram provided at the end of this application form.
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: Montgomery Nearest Town: New London
Lake/river/ocean adjacent to property: Badin Lake
Property size (acres): 0.11 acres
Subdivision name or site address (include phase/lot number):
Lot 165, Dixie Shores, 702 Shoreline Rd., New London
Directions to site- please include road names and numbers, landmarks, etc.: NC Hwy 49 to
Badin Lake Road, L on Blaine Road, R on Charlotte Dr., L on Skyline Dr., L on Shoreline Rd.,
property is on the right side of road.
Latitude (in decimal degrees) 35.28.4385 Longitude (decimal degrees) 80.04.2436
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Existing mobile home in subdivision development
FORM:SSGP 09-2020 Page 2 of 6

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6. Describe proposed work(include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): To stabilize an eroding shoreline and protect it
from further erosion.
7. Will work be conducted from land? ® From water? []
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:
110 sq.ft.
Temporary impacts in square feet:
None
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:
290 sq.ft.
Temporary impacts(temporary clearing,construction corridor) in square feet:
275 sq.ft.
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): 8 to 10 trees of varied
condition and species will be removed to complete the shoreline stabilization.
11. Signature
By signing below, I, as the project proponent, certify to the following:
• The project proponent hereby certifies that all information contained herein is true,
accurate, and complete to the best of my knowledge and belief
• 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
- c'
Owner/Agent's Signature' (15A NCAC 02H .0502(f)] Date
*Agent's signature is valid only if an authorization letter from the owner is provided.
12. Please approximately sketch the following information on this plan and provide dimensions for
each item:
a. All proposed vegetation clearing
FORM:SSGP 09-2020 Page 3 of 6

b. Location of rip rap or fill to be placed above the Full Pond/Normal Water Level elevation
c. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
d. Location of any proposed structures such as buildings, retaining walls, docks, etc.
e. Location of any excavation or dredging below the Full Pond/ Normal Water Level
elevation
Lake
(At Full Pond/Normal Water Level)
Full Pond/ Normal Water Level
MISIN NM =IP M ! �s.. M ® ME - -
Shoreline
Plan View
FORM:SSGP 09-2020 Page 4 of 6

a)
a)
Lake
(At Full Pond/Normal Water Level) 03
W
C
L. a)
O
O -
Z cn
Side View
U—
Lake
(At Full Pond/Normal Water Level)
Existing Dock
30fto7ft
•N•.w.w.w.w.w.ww.w.w.0 104000 3 ft z 150 ft
,i�w�rw�rwwwwwb�.w awwww Below fun pond/NWL
Full Pond/Normal Water Level w���O � ��:ww ��w� *0 �! _
.1horOrne A .00:0 !w::1 R00:�' aftr150ft
0.w,w,w,w�� r . Above full pond/NWL
2 ft.x 150 ft. N 0� oar
additional clearing
•If necessary
ECA M P lE
Plan View
FORM:SSGP 09-2020 Page 5 of 6

3 ft below full pond water level 4 ft above full pond water level 2 ft.additional clearing 1
I I if necessary
I I
Existing bank %•
?lir'
lO ft.bank
,,
height ,, y
1' ea
oqo
I Qu
■w •
Side Vi tow
FORM:SSGP 09-2020 Page 6 of 6

NCDEQ 401 WATER QUALITY CERTIFICATION
SHORELINE IMPACT AREA CALCULATIONS
APPLICANT: Annette Dorsett
Lot 165, Dixie Shores
STABILIZATION IMPACT AREA CALCULATIONS
The attached shoreline site plan shows 55 LF of proposed shoreline stabilization measures.
Detail 3 indicates a proposed shoreline slope that is graded at 2:1 and reflects the estimated
normal pool level and the estimated height of the subject shoreline above the normal pool
level.
Calculation 1—Impact Area Below Normal Pool Level
(Item 8 on NCDEQ Form SSGP 09-2020)
Area of Impact = Shoreline Length x Depth* x Slope
= 55'x1' x2
= 110 sq.ft.
*For this calculation, an average water depth of 1 ft. has been assumed. This will
produce a conservative overestimate of the stabilization impact area.
Calculation 2—Impact Area Above the Normal Pool Level
(Item 9 on NCDEQ Form SSGP 09-2020)
Permanent Impact From Shoreline Stabilization Measures
Height of Bank Above Normal Pool Varies Across the Shoreline
Estimate 20 LF of Shoreline =2 ft.Above Normal Pool
Estimate 35 LF of Shoreline = 3 ft.Above Normal Pool

Area of Impact = Length x Height x Slope
= ( 20' x 2' x 2) + (35' x 3' x 2)
= 80sf + 210sf
= 290 sq.ft.
Impact From Construction Above Shoreline Stabilization
Assume 5 ft.Wide Zone
Area of Impact = 55' x 5 ft.
= 275 sq.ft.
Total Area of Impact Above Normal Pool Level = 565 sq.ft.

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VEGETATION AND EROSION
CONTROL FABRIC
EXISTING GRADE
A/ 3 *_
Ct� I 3' MAX
CLASS 2 RIP RAP ��,
1 4c41h
2
411.
HIGH WATER ELEV.
EROSION CONTROL FABRIC— ?►
\\/�%\ .\\/ LAKE
\.\\. BOTTOM
TYPICAL CONDITIONS
• 36" TO 72" ERODED CUT
• WAVE EXPOSURE
FOR: ANNETTE PHILLIPS DORSETT
LOCATION: LOT 165, DIXIE SHORES
RESERVOIR: BADIN LAKE
PROJECT: SHORELINE STABILIZATION PROGRAM
PHASE I SITE EVALUATION
YADKIN, INC. - BADIN, NORTH CAROLINA
DRAWING TITLE: DETAIL
MODERATE RIP RAP STABILIZATION 3

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DWR Pre-Filing Meeting Request Form
nORTH CAk3./NA
&Wt.:memo!QuaWy
Contact Name* Karen Baldwin Agent for Stephen and Annette Dorsett
Contact Email Address* [e-mail]
Project Owner* Eagle Creek Renewable Energy
Project Name* Narrows Reservoir
Project County* Montgomery
Owner Address:*
702 Shoreline Road
State/Province'Region
New London NORTH CAROLINA
28127 United States
Is this a transportation project?* Yes No
Type(s)of approval sought from the DWR:
401 Water Quality Certification- 401 Water Quality Certification-
Regular Express
Individual Permit Modification
Shoreline Stabilization
Does this project have an existing project ID#?*
Yes No
Do you know the name of the staff member you would like to request a meeting with?
N/A
Please give a brief project description below and include location information.*
Shoreline Stabilization in accordance with Cube Hydro's Shoreline
Management Plan.
By digitally signing below, I certify that I have read and understood that per the Federal Clean Water Act Section
401 Certification Rule the following statements:
• This form completes the requirement of the Pre-Filing Meeting Request in the Clean Water Act Section 401
Certification Rule.
• I understand by signing this form that I cannot submit my application until 30 calendar days after this pre-filing
meeting request.
• I also understand that DWR is not required to respond or grant the meeting request.
Your project's thirty-day clock started upon receipt of this application. You will receive notification regarding meeting
location and time if a meeting is necessary. You will receive notification when the thirty-day clock has expired, and you
can submit an application.

Signature*
Submittal Date 9/29/2021

1/5/22, 11:31 AM 702 Shoreline Dr-Google Maps
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