20220195 Ver 1_Shoreline Stabilization_20220208

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* [e-mail]
Please provide an email address for payment and requests for more information here.
Owner Information:
........ ...........................................................................................................................................................................................................................................................................................................................................................................................
Name:* Nicky Lee Watts
Email:* [e-mail]
Phone Number: [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
117 Rutan Ct
Address Line 2
City State/Province/Region
Mooresville NC
Postal/Zip Code Country
28117 United States
Is there an agent working on the project?* 9 Yes
No
Project Information[15A NCAC 02H.0502(a)&(b)]
Project Name:* 4125 Cascade St RIP RAP Project
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: 4215 Cascade St MAP.pdf 320.12KB

Latitude:* 35.579430 Longitude:* 80.978930
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*
Plan View.pdf 600.39KB
Please use the diagram at the link below:
https://edocs.deq.nc.gov/WaterResou rces/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.)
Estimate 1509 from DON ALLEN AND... 84.54KB
4. Location of the property(where work is to be conducted)
Nearest Town:* Sherill Ford
County:* Catawba
Lake/river/ocean adjacent to Lake Norman
property:
Subdivisions name or site address:* 4215 Cascade St
Include phase/lot number
Directions to site:*
Hwy 150 to Shirell Ford Rd,right onto Hobb lane and left onto Cascade
st,property on right
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:*
Vacant
Residential,undeveloped,etc.
6. Property Size .64 acres
Acres
7. Describe proposed work(include discussion as to how hardening of shoreline has been avoided,or
why it is necessary):
RIP RAP to be added to existing RIP RAP,care will be taken to not
disturb any other areas
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.)
300
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.)
300
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)
none
Sketch: Plan View.pdf 600.39KB
Side View.pdf 472.68KB
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
o I intend to electronically sign and submit the Shoreline Stabilization online form.
Full Name:* Nicky Lee Watts
Signature:
Submittal Date: 1/31/2022

Initial Review
Is this accepted into the review process?* Yes No
Project Number:* 20220195 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

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DON ALLEN AND ASSOCIATES, PA a.411111110%
131 Crosslake Park Drive STE 102 Quality Surveying
Mooresville, NC 28117 USTop Quality since 1971
704 664-7029
donal lens [e-mail]
Estimate
PDDRESP ESTIMATE 1509
NICKY WATTS DATE 08/16/2021
[e-mail] EXPIRATION DATE 09/16/2021
704.453.1340
19&ADJ THAD AND HAROLD
GABRIE
DATE DESCRIPTION QTY RATE AMOUNT
PHYSICAL PHYSICAL SURVEY(WITH MAP) 1 575.00 575.00
19&ADJ THAD AND HAROLD GABRIEL TOTAL $575.00
4215 CASCADE STREET TERRELL 28682
Thank you for the opportunity to submit an estimate for this job!This estimate is
valid for 30 days from the date quoted. Please fill out and return the attached
form if you would like to accept the proposal and proceed with payment and
scheduling.
We look forward to working with you!
Don Allen&Associates, PA
Accepted By
Accepted Date
Page 1 of 1

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Water Resources 15A NCAC 02H.0500—Water Quality Certification,Shoreline Stabilization
LNVIRONMLN i AL OUALI I Y FORM: SSGP 02-2017
Please approximately sketch the following information on this plan and provide dimensions for
each item:
a. All proposed vegetation clearing
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
( $ Pond/ ater Level)
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Plan View Ynis55 1
FORM:SSGP 02-2017 Page 1 of 3

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Water Resources 15A NCAC 02H.0500—Water Quality Certification,Shoreline Stabilization
LNVIRONMLN i AL OUALI I Y FORM: SSGP 02-2017
Please approximately sketch the following information on this plan and provide dimensions for
each item:
a. All proposed vegetation clearing
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
( $ Pond/ ater Level)
gc gUG%E"
4R6 1
III, f,� � • �n Ai. • �A ,�t1 ii(i
Full Pond/ Normal Water-el �7 �i�,I [i 1 �I4) Y'
:TWO�!► A1�11�'�V �>♦'I I �.�1�`� 4Rj� t
Shoreline ���r� rift vTXAM �!r,4r_►=. 3 X z?
• • rY I�I► imArau ���1.�►�
t(P
dIva-
.: ;p is Ql's'A
Prgc`-+ ' S k ;s
+, c pl2
Plan View Ynis55 1
FORM:SSGP 02-2017 Page 1 of 3

3 ft.below full pond water level 4 ft.above full pond water level 2 ft.additional clearing
I I I *if necessary
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FORM:SSGP 02-2017 Page 3 of 3