20221007 Ver 1_Shoreline Stabilization_20220727

Shoreline Stabilization Application Form
NORTH CAROLINA
Environmental Quality
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 *
[e-mail]
Please provide an email address for payment and requests for more information here.
Pre -Filing Meeting Date Request was 7/25/2022
submitted on: *
Owner Information:
.....................................................................................................
Name: * Dorothy Hausman
Email: * [e-mail]
Phone Number: [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
319 Highland Golf Drive
Address Line 2
City
Hickory
Postal / Zip Code
28603
State / Province / Region
NC
Country
United States
Is there an agent working on the project?* Yes
No
Agent/Consultant Information
Name:* Yvette Huffman
Company Affiliation: * Lake Permit Services
Email: * [e-mail]

Phone Number: *
[phone]
(xxx)xxx-xxxx
Mailing Address: *
Street Address
PO Box 6369
Address Line 2
City State / Province / Region
Hickory NC
Postal / Zip Code Country
28603 United States
A signed and dated copy of the Agent Authorization letter: *
Dorothy Hausman Agent Authorization.pdf 528.25KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name: *
Huasman - Stony Point
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: Dorothy Hausman Directions and GIS.pdf 1.58MB
Latitude: * 35.771296
Longitude: *-81.102432
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*
Dorothy Hausman Scope of Work with
drawing from Alan Johnson.pdf
Please use the diagram at the link below:
2.58MB
https://edocs.deq. nc.gov/WaterResou rces/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.)
Dorothy Hausman pic shoreline 1.PDF 11.74MB
Dorothy Hausman pic shoreline 2.PDF 12.11MB
Dorothy Hausman GIS Landscape View.PDF 214.75KB
Dorothy Hausman Survey.PDF 1.29MB
Dorothy Hausman Buffer.pdf 647.25KB
4. Location of the property (where work is to be conducted)
Nearest Town: * Stony Point

County: * Iredell
Lake/ river/ ocean adjacent to Lake Lookout Shoals
property:
Subdivisions name or site address:* 318 Rivercliff Dr, Stony Point NC 28678 - Riverwalk Subd Lot 34
Include phase/lot number
Directions to site: *
Included in details above.
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/Developed, with a dock.
Residential, undeveloped, etc.
6. Property Size .88
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
Homeowner requests riprap to be placed along 80 ft of the property
shoreline, to prevent further erosion. Based on the included drawing, from
Alan Johnson, homeowner plans to back fill and remove 3 trees as well.
8. How will the work be done?*
O From Land
O 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.)
160
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.)
640, (200 sqft for
corridor)
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)
Brush, vines, and multiple large and small trees. One dead tree that has
fallen into the water.
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");
o 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");
o 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: * Yvette Huffman
Signature:
Submittal Date: 7/25/2022

Initial Review
Is this accepted into the review process?* O Yes 0 No
Project Number: * 20221007 Version: * 1
Select Reviewer: * Doug Perez:eads\djperez
Select Reviewing Office: Mooresville Regional Office - [phone]
Has payment been received?* 0 No Payment Needed
O Fee Received
® Need Fee - send electronic notification
What amount is owed?*
® $240.00
O $570.00

PROPERTY LEGAL DESCRIPTION:
LOT NO: Riverwalk, Lot 34 PLAN NO: PARCEL ID: 3774-62-4367.00
STREET ADDRESS:
318 Rivercliff Dr
Stony Point, NC 28678
Please print:
Property Owner: Dorothy Hausman
Property Owner:
The undersigned, registered property owners of the above noted property, do herebyauthorize
Yvette Huffman , of Lake Permit Services, LLC
(Contractor/Agent) (Name of consulting firm)
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 Address(if different than property above):
(Mailing) 319 Highland Golf Dr
Flat Rock, NC 28731
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
4/7_,:g4L/Client Signae Yvette uffman—Lake Permit Seivic4s
7 -Zt - ZC)Z.Z
Date Date

Iredell County, North Carolina
July 21, 2022
ff v-y} e
(C&ss FD )
on ?a+ c \
6hort( r
f
1" = 755.1522723180585 ft
• PIN 3774624367.000
• Address 318 RIVERCLIFF DR
• GIS Owner HAUSMAN GARY J+DOROTHY
e
• Deed Ref. 2785 / 1971 - WO
• Deed Date 20210224
• Tax Acres 0.88 Ac.
• Lot # 34
• Plat Ref. 26-44
• Subdivision RIVERWALK
• SD Phase 54
• Description RIVERWALK S4 PB26-44-46
• Old Parcel # 1408R02000D034
• Total Assessed $470,910
Value
MAP FOR REFERENCE ONLY
NOT A LEGAL DOCUMEN
Iredel County, North Carofna makes no claims and no
warranties, expressed or implied, concerning the validity or
accuracy of the GIS data presented on this map.
Print map scale is approximate.
Critical layout or measurement
activities should not be done using
this resource.

7/20/22, 9:28 PM
1-40, Hickory, NC to 318 Rivercliff Dr, Stony Point, NC 28678 - Google Maps
i-40
Hickory, NC
1-40, Hickory, NC to 318 Rivercliff Dr, Stony Point, NC Drive 8.8 miles, 13 min
aps
28678
318 Riverchff Drive -
Interstate 40
Follow 1-40 E and Sharon School Rd to Paul Payne Store
Rd/Stewart Rock Rd in Alexander County
T' 1. Head east on 1-40 E
(4 2. Take exit 141 for Sharon School Rd
3. Turn left onto Sharon School Rd
4. Slight left to stay on Sharon School Rd
8 min (6.5 mi)
2.5 mi
0.1 mi
1.5 mi
2.3 mi
Continue on Stewart Rock Rd. Drive to Rivercliff Dr in Iredell
County
5 min (2.3 mi)
-1 5. Turn left onto Paul Payne Store Rd/Stewart Rock
Rd
Continue to follow Stewart Rork Rd
(-1 6. Turn left onto Fulbright Rd
0.7 mi
0.3 mi
!!A
Go gC�
Map data ©2022 1 mi ..
https://www.google.com/maps/dir/1-40,+Hickory,+NC/318+Rivercliff+Dr,+Stony+Point,+NC+28678/@35.7660439,-81.1135827,13z/am=t/data=!3m 1 !4b... 1/2

7/20/22,9:28 PM 1-40,Hickory,NC to 318 Rivercliff Dr,Stony Point,NC 28678-Google Maps
r3 7. Turn right onto Gardner Point Dr
0.5 mi
t-> 8. Turn right onto Rivercliff Dr
0.8 mi
318 Rivercliff Dr
Stony Point, NC 28678
These directions are for planning purposes
only.You may find that construction projects,
traffic,weather,or other events may cause
conditions to differ from the map results,and
you should plan your route accordingly.You
must obey all signs or notices regarding your
route.
https:l/www.google.com/maps/dir/1-40,+Hickory,+NC/318+Riverc!iff+Dr,+Stony+Point,+NC+28678/@35.7660439,-81.1135827,13z/am=t/data=!3m1!4b... 2/2

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: Iredell Nearest Town: Stony Point
Lake/river/ocean adjacent to property: Lake Lookout Shoals
Property size (acres): .88 acres
Subdivision name or site address (include phase/lot number):
318 Rivercliff Drive, Stony Point NC 28678—Riverwalk Subd, Lot 34
Directions to site- please include road names and numbers, landmarks, etc.:
Included in this packet
Latitude (in decimal degrees) 35.771296 Longitude (decimal degrees) -81.102432
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Residential/Developed/With a dock
6. Describe proposed work(include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Homeowner requests to have riprap placed along the
shoreline to prevent further erosion. (_gO--P4- Oc I ry')
7. Will work be conducted from land? XX From water?
8. Total amount of impacts below the normal pool lake level/ Normal Water Level
Permanent impacts (including all excavation, backfill, rip rap, retaining walls, etc.) in square feet:
Ito C) sqft
Temporary impacts in square feet:
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:
614-osgft
Temporary impacts (temporary clearing, construction corridor) in square feet:
.2.0CAFt- (construction corridor)
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):
r►4.5h Oil n s ana tateS . (Rem i(Removal o3--ryes ry Mah
11. Signa/Aure Johnson's draw
, A' -X - 1-2
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.
FORM:SSGP 02-2017 Page 2 of 4

(ornrntivi (cdi on 1& 1 fh
i 10x) C kf CC v\i r
This is suggestion from Alan Johnson from NC dept of Water Resources (his dept
approves permit):
"I would riprap below the area in red hatch, about a a foot or two above full pond
Backfill the area with the brown hatch, pack the soil well, mat and seed to get a
quick cover and let nature take its course
Remove the three trees (cut to the stump) to prevent more slope failure.,,
184' ‘ ' -; --:t -,t' ;ill -;,47; 1,\ 741P i i —-:,1,,._ ,....
, ,., . .- 3 , - *$ _
. *- f a a. _�
Allik
614(
-11
4 d .t i ' e _ ..dl
- 3r -to +-f'11!' _ ,, 4 `".. _
oe
a • AY '
a
i,,ititi,t,t#x 4478).',Alkro,-.. - - t tz-,s‘f y, 7y 7 -rf- ci _ -_,--; -
4411/4.44X Aitt , .. 1,'Lk 1
o
- :.. 4

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
Lake
(At Full Pond/Normal Water Level)
P('pRap
(üos 513 Sftie) B tAI
Full Pond/ Normal Water Level �+' ' a tt am.:
was sus MBE rala
Shoreline vititorat„
M?
I E-- g
rric r i I 1q4,
kshore i nle
70)(10- ?moo
Plan View i istorgPorri-rIG
22-(657.9
Lake
(At Pull Pond/Normal
o,al Water Leal Existing Dock
30Rx7ft
ibieuegionsieuereireisowoo 3ftx150ft
_.rArtii�`�ir► rt S"� � � &low fUl Ponds NWL
Full Pond/Normal Water Level•00���!"..;is�� !.t•.'!
SA reline in <rixisOft
likeikeIneir.er'i1r ee d Oar led eararee Above VI Pond/NWL
additional clearing
4 necessary
Plan View
FORM:SSGP 02-2017 Page 3 of 4

4r.
`.^ 3
74 le -Mr
-0,
_
--
,,
4.1
17-

vpolAk c;,
\ `1, •1‘
V.00t.

. _. •
. __
lredell
*CON NEC I F . 2021
t'' I� ■EI I. Printed January19,2021
WEB HOSTING Iredell CountySee Below for Disclaimer
x f t • _.
•
4 : ,�, r "•`` =,ddresses
x +' �� ; A Infrastructure
_ • n$' .'• i .; ' .} No nRes idential Use
..:ix. • ..,,,.
' - yk y.. • Res:, ii.;,,;•„...•: a..... ..• .
idential Use
. , •
•
. •
• •
Interstate
- Ramp
• •
— USHwy
. — State Hwy
•
•
•
— Main Road
s: :- . . Q
Local Road
e`
Residential
:. 4 `ter }.1• .
,� s
Private
�p � x
7. A ! Inattive
•--e ,- _;" , • +*.. .tip o.• Parcels
rt r. , F' Lake Norman
i . al
i.
•
NV
0
v.
•
t '�i Tfi y • �GYG'
. i
lY
he maps prepared for this website are generated from recorded deeds,plats,and other public records.Users of these maps are hereby notified that the information
provided herein should be verified.Iredell County assumes no legal responsibilities for any of the information contained on this site.Users are advised that the use of
.ny of this information is at their own risk.All maps on this site were prepared using a 1000a€''Grid based upon the North Carolina State Plane Coordinate System from
he 1983 North American Datum.The delinquent real property tax overlay is updated monthly.The information presented is not intended to be used or relied upon as
•fficial notice of tax liens.For additional information re.ardin.delin.uent taxes,contact the Iredell Count Tax Collector's Office.

aCCbui REPROG.PMICS 1-0.,8,0r55

ACCaft 0000.000Z 1 0020 00 003/0
V.,y.::,
87F,"
A ,
SEE SHEET 3 OF 3
29'
77
7 7 7 7 7 7 7 7 7 7
ZZZ ZZZMZ

a—1.ee0-1e6666e
i 3 3± o u o eJ : ma $ a91i w ^- S u s
% w»!
N W W♦ .I.
W• W• W. W•8 i1 W Y aP Y 0 V p R A A tl ^f 4.
Y +# P Y i T.
V YpN 4' T N 3 Y
'4- ;
�YHppppJS♦♦Yp 0;94
4
4..8=444110444444J » .O—W♦ON . .OqX. O
w N g N y N q q M; S O L O o 0 S. N Y w I Jti J• J O; 0 "� Y S 8Y Y S 2! Y$ O O o P O N W 2 O O O O O Y P V A W J N 8 8 A O O O
1 �
asp
8
a a a 1 a t t t, a s a t o ,t t* t* +t +t 1 t a t * * * a t a t a a t e, e, - e, e, e, e, e, e, e, e,
0 P 0 3 Y V 8 V M 4 ^, Y p; Y 0 033
1444 ..................
e • - • w . . . w . . w ., 4 w t
e:a:39311:a3ga22o
C 8 8 8$ i i 8 8 8 8 8 8 8 8 i 8 -g
:es:»sax
7 4 7 L 7 o t x 4 s 0" a E: i•
q: 4 4 7. 4 s- 4 1 4 1 1 7 4
1q:1: 4 t 1 xas :gs;
:. .. w w m n w n m
D :: ' a n 0 a :: 3:; y :::
444 11sa:a1
8
0
o'
SEE SHEET 2 OF 3
3
8
1
p q » • O
a o i a w
ee
Q7
FILED
IREDELL COPITY NC
Bv. --
04iDY% 8,51 aN
HR:NCW D. BELL
Register Of Deeds

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: Hausman - Stony Point County: Iredell
Owner: Dorothy Hausman
Print
Contractor/agent: Lake Shore Grading - Mike Miller
Print Signature
se:
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 .0506 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 and grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 02B .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. Alt 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 02B .0243(5), (6)]
Acknowledgement of Notification
Dorothy Hausman , 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 plan(s) and specification(s), and other supporting materials.
Signature (owner): 14-19 Date: 7 -021- 2 Z
Signature (owner): Date: