20221289 Ver 1_Shoreline Stabilization_20220919

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 9/18/2022
submitted on: *
Owner Information:
Name: *
Email: *
Phone Number:
Mailing Address: *
ROBERT JOHNSTON
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
120 EDGEWATER CT
Address Line 2
City
GRANITE FALLS
Postal / Zip Code
28630
Is there an agent working on the project? * Yes
No
Agent/Consultant Information
State / Province / Region
NC
Country
US
Name: * TAMARA HAGER
Company Affiliation: * RENEGAR CONSTRUCTION
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 l .4M 6
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 1.36MB
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 SKETCH.pdf 805.67KB
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 853.72KB
4. Location of the property (where work is to be conducted)
Nearest Town: * GRANITE FALLS
County: * Caldwell
Lake/ river/ ocean adjacent to RHODHISS
property:

Subdivisions name or site address: *
BROADWATER LANDING LOT 32
Include phase/lot number
Directions to site: *
FROM 1-70 6.4 MILES TO 70A HWY E .40 MILES, TURN 1ST AVE
.20 MILES, TURN EFT OTO 39TH ST .30 MILES, CAPE HICKORY
3.3 MILES, W CALDWELL DR 1.6 MILES, LEFT ONTO DUKE
POWER RD .70 MILES, TURN RIGHT .10 MI,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 .67
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
RIP RAP SHOREINE 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 SKETCH.pdf 805.67KB
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

a I intend to electronically sign and submit the Shoreline Stabilization online form.
Full Name: * ROBERT JOHNSTON
Signature:
00t/77861070
Submittal Date: 9/18/2022

Initial Review
Is this accepted into the review process?* , Yes No
Project Number: * 20221289 Version: * 1
Select Reviewer: * Mitchell Anderson:eads\mlanderson
Select Reviewing Office: Asheville Regional Office - [phone]
Has payment been received?* No Payment Needed
Fee Received
Need Fee - send electronic notification
What amount is owed?* $240.00
$570.00

POO NaraWatitiVigati s`A, 1)1 & 6 avh- ' C.01111: Welk
Print
C01:7treCtOu f cegenf i
Signature
Signature
The approval i. For the purpose and design described in your application. Impacts not indicated in she
application is a violation of the Buffer Rule. Site specific work should he provided in the application. l 25A it1CAC
02H .0506 and 15A NCAC 07B .0243(8)3
Trees are not allowed to be retrieved from !one 1 of she Buffer (within 30 i of he full pondelevation), unless
approved. Exception, those trees that ars severely undermined along the immediate srhor&iine can be removed.
Minimal shaping and sloping along the immediate shoreline is allowed. lmaA BICAC 02B .0242(6))
Benching, grading in the. buffer is not allowed.EMeessiv:,disturbcnce,of mrnandcover. I ISANCACO25.0243 (6)I
Beaches, impervious patios, in1perviouSwalkways, etc. are not allowed inthe. buffer unir55apcCificEUvappproved
5y the DNisinn. sherd are limitation on size for decks. (1 5A WCAC 028 .0243(4) and (6)i
Work to be. conducted from land must indicate an ercasm end indicate any trees that ere :o be removed. The
re
work corridor should be deseribad. 1 n_ mpprov d access corridor _hall be restored. Staging, spoil, construction
ruction:
material must be outside the buffer. fib' NCAC 02H .0502 and 1 ,A NCAC qv r7 .0 (4), (- )3)
Stormwate'r cannot be piped or channeled for dived discharge to the lake. All constructed stor:nwster
discharges must be et ha natural elevation end discharged prior to entering the busier directed as diffuse or
=heat flow at non -erosive velocities to he lake. (iSA NCACO2B .02 3(5). (6)
Acknowledgement elf f+lotificceion
AAA) ?hereby state th-at I heva been informed cf she Catawba
Riparian Shinier Rule. Any work conducted in the _®Char, riotspecifically stated in the application and approved
by the Division of Water Resources {DWR), ism violation -and subject to eniorc.ement. i)ue diligence will bet
taken Eueh that the construction will be built within substantial compliance and intent of the 40 i 1.Nater
Quality Certification and liar Rules, the approved pian(s) and spee(f cation(s)i a and .the supporting
rriatarials.
Signature (owne-

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13 SHEET 1 OF
IR

Full Pond/
Normal VaterLev
Shoreline
La ke
(At Full Pond/Normal Water Level)
0 I eel i j jL-
.L)
J
(vim 1 e EL'S jZ nrtc'✓��
Avv i j-tl: L DiSTItt?-13411
T 31c Eta.
LAS) 0 6j LOAl 4 .iW f
Please approximately sketch the following information on this plan (provide dimensions foreoch
item, such as 10 ft x 100 ft)
1. All proposed vegetation clearing
2. Location of rip rap or ill 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 10-202
Page 3 of 3

Tamara Hager
Johnston shoreline pics
Aug 22, 2022 at 11:03:47 AM
Tamara Hager 'lager� .:
Tamara Hager
704-575-2227

Full Pond/
Normal VaterLev
Shoreline
La ke
(At Full Pond/Normal Water Level)
0 I eel i j jL-
.L)
J
(vim 1 e EL'S jZ nrtc'✓��
Avv i j-tl: L DiSTItt?-13411
T 31c Eta.
LAS) 0 6j LOAl 4 .iW f
Please approximately sketch the following information on this plan (provide dimensions foreoch
item, such as 10 ft x 100 ft)
1. All proposed vegetation clearing
2. Location of rip rap or ill 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 10-202
Page 3 of 3