20220474 Ver 1_Shoreline Stabilization_20220324

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.
Vickie Pope
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
7987 Holly Ct
Address Line 2
City
Denver
Postal / Zip Code
28037
Is there an agent working on the project?* Yes
No
Agent/Consultant Information
...............................................................................................................................................................................
Name: * Mark Davis
Company Affiliation: *
Email: *
Phone Number: *
New Testament Trees Tractor
[e-mail]
[phone]
(xxx)xxx-xxxx
State / Province / Region
NC
Country
United States

Mailing Address:* Street Address
PO Box 934
Address Line 2
City
State / Province / Region
Denver
NC
Postal / Zip Code
Country
28037
United States
A signed and dated copy of the Agent Authorization letter:
Pope - Agent Authorization Form.pdf 498.46KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* Pope
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: * Street Address
7987 Holly Ct.
Address Line 2
Latitude: * 35.517880
City
State / Province / Region
Denver
NC
Postal / Zip Code
Country
28037-8084
US
Longitude: *-80.968392
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*
pope diagram side l.pdf 125.88KB
pope diagram side 2.pdf 268.62KB
Please use the diagram at the link below:
https:Hedocs.deq.nc.gov/WaterResources/O/edoc/616616/Shoreline%2OLayout.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.)
Pope project pictures.pdf 1.36MB
4. Location of the property (where work is to be conducted)
Nearest Town: * Stanley

County: * Lincoln
Lake/ river/ ocean adjacent to Lake Norman
property:
Subdivisions name or site address: * Westport Peninsula, Block A Lot 11
Include phase/lot number
Directions to site: *
Hwy 16 Business, Webbs Rd, Burton Ln, Holly Ct
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 Home
Residential, undeveloped, etc.
6. Property Size .568
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
Install segmented retaining wall in buffer zone, installing 16 ton rip rap to
refresh existing rip rap.
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.)
0
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.)
2,000
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)
Turf grass
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:
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');

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
o I intend to electronically sign and submit the Shoreline Stabilization online form.
Full Name:* Virginia Mackel
Signature:
Submittal Date: 3/23/2022

Initial Review
Is this accepted into the review process?* Yes No
Project Number:* 20220474 Version: *
Select Reviewer:*
Select Reviewing Office:
Has payment been received?*
What amount is owed?*
Doug Perez:eads\djperez
Mooresville Regional Office - [phone]
No Payment Needed
Fee Received
Need Fee - send electronic notification
$240.00
$570.00

SAMPLE AGENTAUTHORIZATION FORM
PROPER"ry LEGAL DESCRIPTION:
LOT NO, �� %_�.. m ..�. � LAN NO.......__ PARCEL ID;
_. .._.
STREET ADDRESS.,
Please print:
Pr party Owner: ! V,
'The undersigned, registered property owners of the above noted property, do hereby authorize
tntrac carAgent)
g (Name rid= conR lting firm)
+ �u�ut)
o act can my behalf and take all actions necessary for the processing, iSSUance and acceptance of
this permit or c:eiti i ation and any and all standard and special conditions attached.
Propc fly Owner's Address (it different than property above):
t
e hereby certify the above information submitted it) this application is truce .and aCCUrate to the
best of our knowledge,
Authorized
fl n..�_.
-� g atajsu�^ Authorized SignatUrCl
Date:
Date:

11-1fr. "1-y
(Plan View')
La ke
(At Full Pond/ Normal Water Level)
ffm Um I= 11111111101000 W=
La ke
(At Full Pond/ Novatal Water tevOO Existing Dock
.10 It A 7 ft
3 f
f
tX 150 It
�
aLlow full pond/ NWt
Full Pond/ Normal Water ILeve� fU 111Ullmllk NWM qvMOam=111Kr0 eMine 4 4 X 150 ft
Abuye dull pond/ NVVL
11 2 It, x 150 rt, xl .3
[f necessary
EAMPLE
Plan View
. .... .... . . . . . ......... ....

(Side View)
A
Fu
9
0
take
(At Full Pond/ Normal WatO Lovel) 0 Q)
=1 0
M

Lake
lAt Full Pond/ Normal Water Level)
Full Brand Narriffal Water Level
Aw I law I on wM
ro"reline
Ri rap
2 ft, x 150 ft.
additional dedrin 8
I if necessary
Plan'wie...
Mw HIM RM on NM
Existing Rock
Z 30 frX 7 ft
3,ft i 150 tt
Below full pond/ NVVL
"M wM am Maw
4 ft x 150 ft
Above fuU pund/ NWL

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