20220342 Ver 1_Shoreline Stabilization_20220307

war
ROY COOPER , Sa
Governor 1.r
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 02-2022
Shoreline Stabilization Application Form
A complete copy 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 DWR -401 & Buffer Permitting
Branch Branch
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699-1617 Raleigh, NC 27604
RECEIVED
MAR - 7 2022
A. Applicant Information [15A NCAC 02H .0502(a)] DEQ-WATER RESOURCES
1. Owner Information 401 &BUFFER PERMITTING
Name: Dee Buckminster
Mailing Address: 8914 Linden Grove Ct
Sherrills Ford, NC 28673
Telephone Number: 704-763-1468 Fax Number:
E-mail Address: [e-mail]
DENorth Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 11617 Mall Service Center I Raleigh,North Carolina 27699-1617
NORTH CAROUNA
041.1.1entofEnvironmental \ /�" 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/docs/regulatory/regdocs/Permits/S
AMPLE AGENT AUTHORIZATION FORM.pdf)
Name:
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: Catawba Nearest Town: Sherrills Ford
Lake/ river/ ocean adjacent to property: Lake Norman
Property size (acres): .90
FORM:SSGP 09-2020 Page 2 of 7

Subdivision name or site address (include phase/lot number): Lot 124 1333
Roundstone Rd. Sherrills Ford, NC 28673
Directions to site - please include road names and numbers, landmarks, etc.:
Interstate 77N. to exit 36 turn left towards Denver on Hwy 150, turn Rt
Sherrills Ford Rd., turn RT on to Molly's backbone rd, turn RT on to Azalea Rd,
turn Left onto Dogleg Rd., turn left on Roundstone, stay on Roundstone rd.
Lot on the left.
Latitude (in decimal degrees) 35.6565 Longitude (decimal
degrees) -80.96481
5. Describe the existing land use or condition of the site at the time of this
application (residential, undeveloped, etc.): residential
6. Describe proposed work (include discussion as to how hardening of shoreline
has been avoided, or why it is necessary): The lot has been used as a
vacation trailer. We are building a new house and need to refresh old rip rap
7. Will work be conducted from land? X land X From water? ri
8. Total amount of impacts below the normal pool lake level / Normal Water
Level We are not adding to the rip rap below the water
Permanent impacts (including all excavation, backfill, rip rap, retaining walls,
etc.) in square feet: Rip Rap water front 250 feet wide. The bank ranges
from gfeet tall on the sides to 12' in the center Picture attached
Temporary impacts in square feet:
FORM:SSGP 09-2020 Page 3 of 7

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: we are not putting anything on the 50' buffer
area. Only on the side of the hill from the water to the yard. We are only
putting new rip rap over existing rip rap. Original rip rap installed in
1965
Temporary impacts (temporary clearing, construction corridor) in square feet:
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): 111 d/12,
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
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 4 of 7

3 ft.below full pond water level 4 ft.above full pond water level 2 ft.additional clearing
if necessary I I I I
Existing bank ,
', 1
'F
10 ft.bank \(i.d.'
,, a
height ',►
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Side View/ � ,/
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a)
Lake
(At Full Pond/Normal Water Level)
c
+tit —
rie4t695 a<IV/9e. °E. 04)
g` la'
Side View l_
LJ—
Lake
(At Full pond/Normal Water Level) Existing Dock
/3o ftt lft
• IG •..• 3kx150ft
$=s'!s='="s's'sSS"S'� '�rr�rr aebwfuN rvwl
Full Pond/Normal Water Level•���M0��4����� !
'�n Orellne' S=tis ffx nn
RipraP -Mint � •• Abnve full pond/NWL
2 It.lsa ft .��.'• SUS
additIonal clearing '
•if necessary
E AMPLIE
Plan View
FORM:SSGP 09-2020 Page 6 of 7

b. Location of rip rap or fill to be placed above the Full Pond/ Normal Water
Level elevation IUD P gicA4P 0-bide- qwji Nnb,.
c. Location of rip rap or fill to be placed below the Full Pond/ Normal Water
Level elevation ND add i fiZral +p iJ Q b01Dw paAJci.
d. Location of any proposed structures such as buildings, retaining walls,
docks, etc. ,6, - �'--mi I DA ale.. 'Tlft nb1- S -
e. Location of any excavation or dredging below the Full Pond/ Normal°201 10` i2`'
Water Level elevation ND pr is
er[1c w --�'P '
Lake 1-c16 `i n5 Due.aZ old_
(At Full Pond/Normal Water level) L P 4�`_
4* A TT. "�'t,'
NORMAN**
.ut•�».-� "N
.// \(%
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wDDD DDOW'cC/y /�ti for
4/ ,r PIER , �4 45)
/ iaoA o klacks
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X Ngg CP
Full Pond/NormIna a WaterUw ¢.0 N22-46'00"E 100.41 ,w
_._-:.-.._6z..
Shoreline ---- _ ... Iv
t FLOOD CP N352.'00"E C yZU
0 uNs 41.00' /
_____ 50'BUFFER 4 -------
_-----7
i a LOT 124 a'
3 h (0.90 AC.) l y
1 0 ^J Eck
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^ 1RAILER ' GRAVEL t0
7. DRIVE µ
b N
2 30'FRONT T�-6� N
Plan View C1
I225.34' -532 04 00"yy
-3)41
S,des (use_ ,, and 6 C'ee--- (S h.
QLs 0 ' -Ge-I- ba-`) -- Q1e--ru-ems a. "
FORM:SSGP 09-2020 Page 5 of 7

DS DON ALLEN"Since 19& A71"SSOCIATES , P. A.
Commercial * Residential * Mortgage Surveys * Multi-Family
Construction Staking * Subdivision Design * Topographical
131 Crosslake Park Drive - Suite 102 * Mooresville * NC * 28117
[phone] [phone] Fax
I, certify that this map was drown under my supervision from an actual
survey made under my supervision recorded in deed book 3277 page 1326 , and/or
plat book 16 _, page 2 , that the ratio of precision is 1':10,000, that this map
was prepared in accordance with the General Statutes of North Carolina Chapter 89C.
my hand and seal on the 20_, day of JANUARY
A.D. 20 22
44,
E TABLE
LINE UN BEARING LENGTH WILLIAM M. ALIIQSS/Oy/2;
L7 N 06 04'00" E 20.88' „SEAL �7 2
� hh L2 N 01'0T00" W 16.10' C
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FLOOD
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Fs. UNE 4100'
LOT 125 , I
FREDERICK --— LOT 123
GOODWIN _ sD•BUFFER __f' RAYMOND
2074/1696 — — RARRON
,:i (o.so Ac.1 �'`'' to- 2598/1899
Z 3 'n / WOOD �'
t`r: f DECK co
m O JIf .(4 TRAILER ' ORIVE� `r
N
2 30'FRONT •
Cl / v
_ • - OP
R/N 225.34' - S32.04 00 W W R
/' 24
F-C), -P.P. POWER POLE 6.
LEGEND
ROUNDSTONE RD r--0�1oN
4'n
(.60' R/W) \I-
CP - COMPUTED POINT PK ` NOTES
EI.P. =EXISTING IRON FOUND RAY NAiL
` R/W1) 1HIS PROPERTY MAY BE SUBJECT TO
I.R.S. - �14 REBAR SET ..�.. ��., ANY EASEMENT AND/OR RIGHTS-OF-WAY
OF R/W-RIGHT-OF-WAY CURVE TABLE 2) AREA COMPUTED BY THE COORDINATE
Xtr - UGHT POLE CURVE'RADIUS'LENGTH! BEARING 1 CHORD METHOD.
ELEV-
C1 733.63'JJ 57.02' S 30'02'27" W 57.00' ATIONB BASED N LAK761'E CONTOUR LAKE
ATION BASED ON LAKE NORMAN LAKE
LEVEL AT COWAN'S FORD DAM(READING
0' 25' 50' 100' PHYSICAL SURVEY ON HID D 022)ELE FOUND
: 755.13
'
I l 4 OVERHEAD POWER
If 5 N0 GRID MONUMENT FOUND WITHIN •
OF 2000 FUT.
6) SETBACKS SHOWN PER ZONING
SCALE IN FEET 1333 ROUNDSTONE ROAD ZONED: R-3D CATAWBA
LOT 124 CRESCENT LAND AND TIMBER SECTION 25
SCALE 1" = 50'
CATAWBA TWSP., CATAWBA CO., N.C. FELo ' 505A
ACQUIRED BY: FILE: CLT 124JAC
DEE BUCKMINSTER DC FILE:
TAX MAP NO: 461902693536