20221171 Ver 1_Shoreline Stabilization_20220831

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 *
JOHNSTON
Please provide an email address for payment and requests for more information here.
Pre -Filing Meeting Date Request was 8/29/2022
submitted on: *
Owner Information:
Name: *
Email: *
Phone Number:
Mailing Address: *
ROBERT JOHNSTON
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
4422 Patricia Dr
Address Line 2
City
Brunswick
Postal / Zip Code
44212-2083
State / Province / Region
OH
Country
US
Is there an agent working on the project?* Yes
No
Agent/Consultant Information
Name: * TAMARA HAGER
Company Affiliation: * LAKE PERMIT LLC
Email:* [e-mail]

Phone Number:*
Mailing Address:*
[phone]
(xxx)xxx-xxxx
Street Address
PO BOX 5335
Address Line 2
City State / Province / Region
MOORESVILLE NC
Postal / Zip Code Country
28117 US
A signed and dated copy of the Agent Authorization letter:*
JOHNSTON AUTH.pdf 1.4MB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name: *
JOHNSTON
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: JOHNSTON SURVEY.pdf 1.37MB
Latitude:*
35.780332
Longitude: *-81.437346
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*
JOHNSTON SKTECH.pdf 807.76KB
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.)
JOHNSTON PIC.pdf 849.75KB
4. Location of the property (where work is to be conducted)
Nearest Town: * GRANITE FALLS
County: * Caldwell
Lake/ river/ ocean adjacent to RHODHISS/ CATAWBA
property:

Subdivisions name or site address: *
BROADWATER LANDING LOT 32
Include phase/lot number
Directions to site: *
FROM US 40- EXIT 70A E .50 MILES, TURN LEFT ONTO 39TH
STREET .30 MILES, CONTINUE CAPE HICKORY RD 3.30 MILES,
TURN RIGHT ONTO CAPE HICKORY CUTOFF 3.0 MILES, TURN
RIGHT ONT BURKE ST 1.0 MILES, CONTINUE W CALDWELL DR
.60 MILES, CONTINUE STATE RD 1106 .30M MILES, TURN LEFT
ONTO DUKE POWER RD .40 MILES, TURN RIGHT .10 MILES,
TURN LEFT EDGEWATER CT , PROPERTY ON RIGHT.
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
Residential, undeveloped, etc.
6. Property Size .83
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
RIP RAP SHORELINE FOR STABILIZATION
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.)
0
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)
NONE BY BARGE
Sketch:
JOHNSTON SKTECH.pdf 807.76KB
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):
a $240.00 for impacts to lake (below normal water level) of less than 1 acre
a $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
a 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");
a 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: * ROBERT JOHNSTON
Signature:
Submittal Date: 8/29/2022

Initial Review
Is this accepted into the review process?* Yes No
Project Number:* 20221171 Version:* 1
Select Reviewer: * Mitchell Anderson:eads\mlanderson
Select Reviewing Office: Asheville 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

CATAWBA ROPARBAN BUFFER OTORCA IO KThr
'1
Project Na nladdvage! ry�� 5-76 i 12® &D �nMT -Cro y � LVtra•••..Nt! iVii- ____P
Print Signa►ure / -
Cat1;raCtOrAgent. mil! 1
Print Sianeturin�`` .
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. j .SA i1CAC
42H.0506 and 15A NCAC 01B.0?43(6))
Trees ere not allowed to be removed from Zone®of the Buffer(within BO;t of the full pond elevation), unless
approved.Exception;those.6reasthatareseverely undermined 2Iong tile immediate shoreline can be removed.
Minimal shaping and sloping along the Immediate shoreline Is allowed.[15A nicAc Ogg.0243(6)1
Benchlnea grading in the buffer is not allowed.-Excessive,disturbance of_round cover.(iSA NCAC OZB.0243(e)]
Beaches,impervious patios,imperviouT walkways,etc.ere not allowed in the buffer unless specifically pproved
w the Division. There ere limitation on size for decks.1 5A iaCa C Oi .O24'(4)end(6)3
Work to be conducted from imnd must indicate an emcaam and indicate,any trees that ora=® be removed. The
work corridor should be esc°isdd.The approved cLCr ��oeId®P shell 3s restored.u. e�l�a,_poil; construction
materiel must be outsidethe buffer. ('S^ NCAC® P.0S0,e end q :NCAC l.oB.02® ® (4); (5): (3))
ttormweter cannot be piped or channeled for direct discharge to the lake. P: constructed = rrr.laser
li 04�
discharges must be et the natural elevation end discharged prior to entering the buffer directed as diffuse or
sheet flow at non-erosive velocities to the!eke. r15A AICAC 02E.0243(5), (6))
A ckno wiedgernent of Notification '
i; 1 .I '� ii �gS76 i t hereby state that i have bran informed of the Catawba
Riparian Buffer Rule. Any work conducted in the buffer,not specifically stated in the application end approved
by the Division of Water Resources(DWR) is a violation and subject to enforcement Due diliccrCe will be
taken such that the.construction will be built within substantial compliance and Intent of he 401 Water
Qualitc!Ce.ificeclon silt ferRules,the
approved plants)and a poislariion(s),=9C othersupporting
materiels. /
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Lake
(At Full Pond/Normal Water Level)
Z ...Li Ali;
Full Pond/
��lorma(UV ter Levu �; � 2i lt ���,frh lgvi>�ie4A4 ' r:�
OP,ram
� �►��3�.triM`II►ar�►[i�ir1�'s.r� � r�
Shoreline `"ft ,Ol%Att;,Yg ' '�1/, ,�i,.,; ,,,�- e,`., T ��n12 -.2
do
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fvb —77.EES R nnc%-3)
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Please approximately sketch the following information on this plan (provide dimensions for each
item,such as 10 ftx 100 f)*:
1. All proposed vegetation clearing
2. Location of rip rap or fill to be placed above the Full Pond/'Normal Water Level elevation
3. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
4. Location of any proposed structures such as buildings, retaining walls, docks, etc.
5. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
FORM:SSGP 10-2013
Page 3 of 3

Tamara Hager t mmmaraha [e-mail]
Johnston shoreline pics
Aug 22, 2022 at 11:03:47 AM
Tamara Hager
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Tamara Hager
704-575-2227

Lake
(At Full Pond/Normal Water Level)
Z ...Li Ali;
Full Pond/
��lorma(UV ter Levu �; � 2i lt ���,frh lgvi>�ie4A4 ' r:�
OP,ram
� �►��3�.triM`II►ar�►[i�ir1�'s.r� � r�
Shoreline `"ft ,Ol%Att;,Yg ' '�1/, ,�i,.,; ,,,�- e,`., T ��n12 -.2
do
�aC�J`�c eta. �krr%�l��i•��.
A( L Vl=
fvb —77.EES R nnc%-3)
M.TJV L D iSTu 8/4h
c 3 bt(I kr, e_A-vA-Toez_4— 13,k1247'
� J
Please approximately sketch the following information on this plan (provide dimensions for each
item,such as 10 ftx 100 f)*:
1. All proposed vegetation clearing
2. Location of rip rap or fill to be placed above the Full Pond/'Normal Water Level elevation
3. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
4. Location of any proposed structures such as buildings, retaining walls, docks, etc.
5. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
FORM:SSGP 10-2013
Page 3 of 3