20220539 Ver 1_Shoreline Stabilization_20220406

Shoreline Stabilization Application Form
NORTH CAROLINA
EnWnnmentufQu&lry
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 *
Owner Information:
Name:*
Email:*
Phone Number:
Mailing Address: *
[e-mail]
Please provide an email address for payment and requests for more information here.
Tony B Owen
[e-mail]
[phone]
(x)o)xxx-xxxx
Street Address
749 Crabtree Crossing
Address Line 2
City State / Province / Region
Cary North Carolina
Postal / Zip Code Country
27513 United States
Is there an agent working on the project? * ® Yes
No
Agent/Consultant Information
Name: *
Company Affiliation: *
Email:*
Phone Number:*
Saundra B Mosteller
Dale & Beth's Lake Use Permit Service
[e-mail]
[phone]
(xxx)xxx-xxxx

Mailing Address: *
Street Address
988 Clear Creek Circle
Address Line 2
City State / Province / Region
Lincolnton North Carolina
Postal / Zip Code Country
28092 United States
A signed and dated copy of the Agent Authorization letter:*
agent.pdf
catawba buffer.pdf
Link to: Sample Agent Authorization Form
542.78KB
1.06MB
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name: *
Owen 245 Indian Trail
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: lat long.pdf 44.9KB
vicinity.pdf 133.8KB
plat.pdf 140.6KB
Latitude: *
35.554090
Longitude: *-80.940590
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*
stabilization drawing.pdf 191.52KB
Please use the diagram at the link below:
https://edocs.deq.nc.gov/WaterResources/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.)
pictures.pdf 159.93KB
4. Location of the property (where work is to be conducted)
Nearest Town: * Mooresville
County:* Iredell
Lake/ river/ ocean adjacent to Norman
property:

Subdivisions name or site address: *
245 Indian Trail Mooresville NC 28117 Lot 1672
Include phase/lot number
Directions to site: *
from 526 S Church St Charlotte NC, get on I-277S, head SW on Church
St toward W Stonewall St, turn right to merge onto I-277S, follow I-77N
to NC 1100 Brawley School Rd in Iredell Co, take exit 35 from I-77N,
continue on NC 1100 Brawley School Rd drive to Indian Trail
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, dock, 11 trees have been topped out along shoreline (stump
and roots have not been removed)
Residential, undeveloped, etc.
6. Property Size
1.44
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
stabilize 85 feet of shoreline (property in back of cove) use class B rip rap,
(adding to the end of existing rip rap), roots on 11 trees along the shoreline
are exposed due to wave action
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.)
340
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.)
500
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)
11 trees (roots exposed) along shoreline only
Sketch: pictures.pdf 159.93KB
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):
• $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:
a 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.
a 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");

a 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 Shoreline Stabilization online form.
Full Name: * Saundra B Mosteller
Signature:
Submittal Date: 4/6/2022

Initial Review
Is this accepted into the review process?* Yes No
Project Number:* 20220539 Version:* 1
Select Reviewer: * Doug Perez:eads\djperez
Select Reviewing Office: Mooresville Regional Office - [phone]
Has payment been received?* ( No Payment Needed
C Fee Received
C• Need Fee - send electronic notification
What amount is owed?*
C• $240.00
C $570.00

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. 1672 PLAN NO. PARCEL ID: 4626228215
STREET ADDRESS: 245 Indian Trail, Mooresville, NC 28117
Please print:
Property Owner:
Tony B Owen
The undersigned, registered property owners of the above noted property, do hereby authorize
Beth Mosteller
, of Dale & Beth's Lake Use Permit Service
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take ail actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
749 Crabtree Crossing, Cary, NC 27513
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Tony B Owe
Authorized Sgna
Date:

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: 245 Indian Trail, Mo
Owner
Tony B Owen
Print
Contractor/agent: Beth Mosteller
Print
resville NC 28117
111C.
County: Iredell
Signature
Signature
The approval is for the purpose and design described in your application. Impacts not indicated in the
application is a violation of the Buffer Rule. Site specific work should be provided in the application. [15A NCAC
02H .050E and 15A NCAC 02B .0243(8)]
Trees are not allowed to be removed from Zone 1 of the Buffer (within 30 ft of the full pond elevation), unless
approved. Exception, those trees that are severely undermined along the immediate shoreline can be removed.
Minimal shaping and sloping along the immediate shoreline is allowed. [15A NCAC 02B .0243(6)]
Benching, grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 023.0243 (6)]
Beaches, impervious patios, impervious walkways, etc. are not allowed in the buffer unless specifically approved
by the Division. There are limitation on size for decks. [15A NCAC 02B .0243(4) and (6)]
Work to be conducted from land must indicate an access and indicate any trees that are to be removed. The
work corridor should be described. The approved access corridor shall be restored. Staging, spoil, construction
material must be outside the buffer. [15A NCAC 02H .0502 and 15A NCAC 02B .0243 (4), (6), (8)]
Stormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
discharges must be at the natural elevation and discharged prior to entering the buffer directed as diffuse or
sheet flow at non -erosive velocities to the lake. [15A NCAC 026 .0243(5), (6)1
Acknowledgement of Notification
I, Tony B Owen hereby state that I have been informed of the Catawba Riparian Buffer Rule. Any work
conducted in the buffer, not specifically stated in the application and approved by the Division of Water
Resources (DWR), is a violation and subject to enforcement Due diligence will be taken such that the
construction will be built within substantial compliance and intent of the 401 Water Quality Certification and
Buffer Rules, the approved .. n(s) and specification(s), and other supporting materials.
Signature (owner): Date: 4 \ 1\z_z=..=
Ton wen

Latitude and Longitude Finder
latitude and Langnude sie the unrts tar represent the coo ciaraares ar geographic coordinate system To make a seardr,
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Lake Norman 760 Elevation
(At Full Pond/Normal Water Level
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Top View
'VLake'
(At Full Pond/Normal Water Level)
85 feet following contour of shoreline
Shoreline
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50
50 foot land in ward corridor access x 10 ft wide = 500 sq ft
4 foot base below full pond lake bottom x 85 ft along shoreline = 340 sq ft
840 square feet total

The trees that's been cut would have to be removed for secure placement of rip rap in
my opinion. Buffer and shoreline pictures

The trees that's been cut would have to be removed for secure placement of rip rap in
my opinion. Buffer and shoreline pictures