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Home My WebLink About20220483 Ver 1_Shoreline Stabilization_20220328 002 ROY COOPER6-11' Governor + 15 ;rk 4. MICHAEL S.REGAN Secretary 1w +1dc4- S.DANIEL SMITH NORTH CAROLINA State of North Carolina Director Environmental Quality 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. Date of Pre-filing Meeting Request: /1 -( / 0?O2 (required) RECEIVED DWR ID# Version (if applicable) LIAR 2 8 2022 A. Applicant Information [15A NCAC 02H .0502(a)] DEO.WATER RESOURCES 401 &BUFFER PERMITTING 1. Owner Information Name: t��n c trk �� L��1 rol� NC Mailing Address: AcAlV. 1 b CuC _13' , ado'. tc, Telephone Number: (704-0309_ c O 1d Fax Number: E-mail Address: VV0 bguse Cx cv-1 o 1 QDE � North Carolina Department of Environmental Quality I Division of Water Resources 512 North Salisbury Street 11617 Mail Service Center I Raleigh,North Carolina 27699-1617 aatN /'"dr 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.armv.mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTHORIZ ATION FORM.pdf) L Name: ��t�t[� YI.Y wc. be p C p An." ,�C.Y1rAci fCl Company Affiliation: G }\,p; ` ' rr c--)%-c.4pc.�� .O-t'o� tiArld1 4 Co r- eat i ny Mailing Address: CIO ��/I�n 7l d p. ocid —re.) L' a.Ii(`► I Telephone Number: 304 -7 f jL/ 3 Fax Numbe . 3Q4.-I - 7'7— I 4 L D7 E-mail Address: yy Ado �)wJ a -Hart 47'ec . 0_/1,1q 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: C GttC,.c,Jl(�C� Nearest Town: -Nef Forci Lake/river/ocean adjacent to property: No C r`r cLy� Property size (acres): , 3V0 Subdivision name or site address (include phase/lot number): Directions to site -please include road names and numbers, landmarks, etc.: 04 E NO /5 v i)1.., . ,(.►.rn o '- -o c kaj e_ )2)-k Pe I c Latitude (in decimal degrees) 36 '°/v Longitude (decimal degrees) ,OL a cJ 5. Describe the existing land use or condition of the site at the time of this application (residential, undeveloped, etc.): tkKat.Jac )e G 6. Describe proposed work(include discussion as to how hardening of shoreline has been avoided, or why it is necessary): KA�rr)O 1nCI 0"4-4 e-V• e 40 Frow fie. 6 G-A FORM:SSGP 09-2020 i 1-64 1 0 vl (N./y L 1 ) r + eroVA of6 7. Will work be conducted from land? From water? I l 8. Total amount of impacts below the normal pool lake level/ Normal Water Level Permanent pa tss (including all excavation, backfill, rip rap, retaining walls, etc.) in square feet: — 5� • Temporary impacts in squ re feet: 9. Total amount of impacts above the normal pool lake level/Normal Water Level and 50 feet land-ward Permanent impacts (' luding back fill, excavation, rip rap, retaining walls, etc.) in square feet: Temporary impacts ( mporary clearing,construction corridor) in square feet: 1 i g6t, eici • 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): '/! en 6).:0A. lea -ale_ 6 04�' CA-m_ci0 a ci, ntk elocZr1 bt 4c- larrths 01` re e . No I-re e S Co a I f kt re_ talc' . 11. Signature tO� GI;b t e4 arena W 1 R. ,ee. 4, Pe_S .c�e.ct �Y1. Qp4'`C0—% Qc. "� j(`O Mc)lC 9ft-sS l�Wfh . By signing below, I, as the project proponent, certify to the followi�g: • 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 17. ./.....-. ..----..-------/9//....„-- 1 /9 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 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 FORM:SSGP 09-2020 Page 3 of 6 NORTH CAROLINA Enrrrnnnkmulgaolur Contact Name* William Meador Contact Email Address* meadorwood@frontier.com Project Owner* Bob the Builder of Charolette NC Project Name* 6902 Shade Tree Lane Project County* Catawba Owner Address:* Street Address PO Box 5647 Address Line 2 City State!Province/Region Charolette NC Postal 1 Zip Code Country 2$?99 Catawba Is this a transportation project?* Yes No Type(s)of approval sought from the DWR: 401 Water Quality Certification - Regular 401 Water Quality Certification - 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? Please give a brief project description below and include location information.* Clean exisitng shoreline of all debris and slop to specification to ensure proper drainage/run-off. Remove any loose debris. No trees will be removed during this process. Install rip rap stone along shoreline to prevent erosion. Repair any disturbed areas above the rip rap installation to reestablish lawn growth. 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. I N g .. 1 \Ili 141%s °"%--°%...'.'10.0 J Nil 440 4i 4 ,,, , % 440p e, .„,t 1 4,4,411IP II i \ Ilite ( 11.91A \ 1 II # 14 aTR Vir 30114ti IA i all16441** . ' .pvite tot -.,019 1:0 1,CM USA 1.01.1A Ce rr .n 1v/ TileStitch/printuchgx7.jpg Sher6902 6902 Shade Tree Ln ."" 6902 Shade Tree Ln, S... 35.58'N, r,"; 02'W riot 6902 Shade Tree Ln trit: :A .14 Google Earth Imagery date: 1/23/21-... I 10 m I Camera. 322 in 35`34'32"N 81'01'20"W 1 l 4 8< x r +f3s �,k d h ' 3; x h Nr a dab,, ;n ry a 1 t 'k,"Y �u,s. ° 4: +". s y t * zF` st � " 3 1 "' A✓3 ' t � kg !y�w hy r U z 5 ��a ��t'fA� C�r`•�,�A.�; ��Fl s h� ` , � ^t, • ,4, shoreline a , a• ;it/midi !, Oh Ailik Shoreline 116 ft. Total installation area 1,044 6902 Shade Tree Shoreline 114 ft. Total installation area 1026 6908 Shade Tree AGENT AUTHORIZATION FORM Please note that multiple forms may be necessary if there are more than two owners of the property. PROPERTY LEGAL DESCRIPTION: STREET ADDRESS OF EXISTING HOME or LATITUDE/LONGITUDE OF NEW CONSTRUCTION: ( ' j . i 1 Loy?, Vn epic; '30(cd W03 Parcel ID:iI.O $l 5• Ez7576.7 Property Owner Name(s)—please print: Property Owner: 1 #2) � -3re z 5y :ave. Property Owner: The undersigned, registered property owners of the above noted property,do hereby authorize JO Name of company) ( (a,,,ec(hits to act on my behalf and take all actions necessary for the processing, issuance and acceptance of this permit or certification and any and all standard and special conditions attached. Property Owners Mailing Address(if different than property address above): ' x uvr / . 60y. (141 ,eO t a Property Owner(s)Telephone: t 7 ) X)1 —i 8.61,0 We hereby certify that the above information submitted in this application is true and accurate tothe best of our knowledge, X'1:411.o• —/ uthorized natur Authorized Signature Date Date