20220200 Ver 1_More Information Received_20220227

Staff Review Form
NORTH CAROLINA
Ertrlmnmertlrtl Quality
Updated September 4, 2020
Staff Review
Does this application have all the attachments needed to accept it into the review process?*
Yes No
ID# *
20220200
Version* 1
Is this project a public transportation project?*
Reviewer List: * Doug Perez:eads\djperez
Select Reviewing Office: *
Yes
No
Mooresville Regional Office - [phone]
Does this project require a request for payment to be sent?*
Yes
No

Project Submittal Form
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.
Project Type: *
For the Record Only (Courtesy Copy)
New Project
Modification/New Project with Existing ID
More Information Response
Other Agency Comments
Pre -Application Submittal
Re-Issuance\Renewal Request
Stream or Buffer Appeal
Is this supplemental information that needs to be sent to the Corps?*
Yes No
Project Contact Information
Name: tom and donna golino
Who is submitting the information?
Email Address: [e-mail]
Project Information
Existing ID #:
20220200
20170001 (no dashes)
Project Name: GolinoProperty
Is this a public transportation project?
Yes
No
Existing Version:
1
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
Yes No Unknown
County (ies)
Mecklenburg
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach document
shoreline.pdf
21516 Blakely Shores Dr land survey.pdf
Only pdf or kmz files are accepted.
Describe the attachments or
comments:
6.74MB
1.77MB
attached are pictures of the shoreline staked out for the length of wall. Also included is a land survey
Sign and Submit

By checking the box and signing box below, I certify that:
• I, the project proponent, hereby certifies that all information contained herein is true, accurate, and complete to the
best of my knowledge and belief.
• 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.
• I agree that submission of this online form is a "transaction" subject to Chapter 66, Article 40 of the NC General
Statutes (the "Uniform Electronic Transactions Act");
• 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
• I intend to electronically sign and submit the online form.
Signature:
Submittal Date: 2/27/2022
Is filled in automatically.

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CATAWBA AVE
VICINITY MAP I
NOT 1 O SCALE
e.A9
4714) Cb
Cb
CO
NOTES:
1. NO NCGS MONUMENT
FOUND WITHIN 2000'.
LAKE
NORMAN
WOOD DOCK
& PIER
4
,
gip
001-561-09
JOHN S. NELLYJR
ANN C. NELLY
DB 4122, PG 927
2. PROPERTY MAY BE SUBJECT
TO OTHER COVENANTS,
RESTRICTIONS, EASEMENTS
OR RIGHTS -OF -WAY THAT
MAY BE OF RECORD.
3. THE SETBACKS SHOWN ARE
PER CORNELIUS'S
CURRENT GR ZONING.
4. THE PROPERTY MAY BE
SUBJECT TO THOSE
RESTRICTIONS AS RECORDED
IN DEED BOOK 4129, Pg 683.
5. THE PROPERTY MAY BE
SUBJECT TO A 10' UTILITY
EASEMENT ALONG THE ROAD
R/W & 5' ALONG THE SIDE
PROPERTY LINES, PER DB 4129,
PG 683.
6. THE PROPERTY IS SUBJECT
TO A SHARED WELL
AGREEMENT & EASEMENT TO
SERVE PID #001-561-09 FROM
THE EXISTING WELL FOUND
ON SUBJECT PROPERTY.
7. CONSULT WITH GOVERNING
AGENCY FOR PREVAILING
LAND DEVELOPMENT AND
ZONING REQUIREMENTS
PRIOR TO DESIGN OR
CONSTRUCTION OF ANY
IMPROVEMENTS.
SUBJECT'S CONCRETE
DRIVE CROSSES THE
PROPERTY LINE BY
3.8' X 301.6' X 5.3'
03
3.8'
co
rfl
3.8'
1
ADJOINER'S CONC DRIVE
CROSSES THE
PROPERTY LINE BY
3.8' X 30.5' X 31.3' X 6.9'
6.9'
AREA CONVEYED BY
DB 4184, PG 650
4,600 SQ FT.
(0.106 ACRES)
C c
s
4319 2
1g 94
BLAKELY SHORES DRIVE
60' PUBLIC R/W 28' B/C TO B/C
(MB. 18, PG. 208)
DARtL, W. LONG, P
18335 OLD STATESVILLE ROAD
SUITE A
CORNELIUS, N.C. 28031
[phone]
FIELD LOCATED 760'
LAKE CONTOUR
71 E
WELL AGREEMENT
EASEMENT
(PER DB 4197, Pg 370)
*SEE NOTE #6
PID ##
001-561-1 0
40,882 SQ. FT.
0.939 ACRES
CURVE
LENGTH
RADIUS
CHORD
CHORD
BRG
C1
71.04'
189.93'
70.63'
N
00'37'34"
W
C2
4
06'
189.93'
4.06'
N
13'08158"
W
C3
71.61'
189.93'
71.18'
N
22'47'46"
W
C4
28.20'
189.93'
28.18'
N
37'06'11"
W
C5
5.12'
189.93'
5.12'
S 32'12'16"
E
Graphic Scale
40
i
NN
POSSIBLE LINE BY
DB 7876, PG 752
N 64'55'39" W
383.82'
AREA CONVEYED BY
DB 4637, PG 28
4,364 SQ FT.
(0.100 ACRES)
001-561-11
JOEL D. GALLIHER
JEANETTE C. GALLIHER
DB 7876, PG 752
POSSIBLE LINE BY
DB 4637, PG 28
S 66'04'32" W
390.02'
LEGEND:
,�'
111111/C A R •
So 71— 94°
7 %
/ Tcf. I i la
:Zi
.9 L-491 ��:
6.-P .SURD +o
.,��}-1. W . �,0,t�\
�,,,...11111�
�
#4 REBAR FOUND
MAG NAIL FOUND
COMPUTED POINT
UTILITY PEDESTAL
SUBJECT PROPERTY LINE
ADJOINER PROPERTY LINE
BUILDING SETBACK
(724.
PROPERTY CORNER
DETAIL
20 0 40
V//
Scale of Drawing 1 Inch = 40 Feet
eta
BOOir
PG
3
0
LINE
BEARING
DISTANCE
L1
S
01
'42' 40"
E
18.34'
L2
S 41'27'51"
E
20.72'
L3
N
11'54'55"
E
3.36'
L4
N
15'09'42"
E
1.64'
L5
S
65'46'35" W
2.24'
r
Physical Survey of 21516 Blakely Shores Drive
Professional
Property
/ ® Surveyors, Inc.
18335 Old Statesville Road Ste. A
Cornelius, N.C. 28031
704-765-5134 Phone/Fax
Firm License: C-3666
Property of:
Tom & Donna
Golino
As Recorded in:
Deed Book 4129, Pg 683
Deed Book 4184, Pg 650
Deed Book 4637, Pg 28
Site Address:
21516 Blakely Shores Drive
Cornelius, NC 28031
Mecklenburg County
121117-05
JML
Prepared By
>_ 1:10,000
Error of Closure
1 "=40'
Drawing Scale
001-561-10
Tax Parcel Number
GOLINO
Drawing File Name
1 of 1
Sheet Number
12/19/2017
Date