20221590 Ver 1_Shoreline Stabilization_20221110

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 11/8/2022
submitted on: *
Owner Information:
Name: *
Email: *
Phone Number:
Mailing Address: *
STEPHANIE LOPEZ
S TACYLOPEZ9973 @GMAIL. COM
[phone]
(xxx)xxx-xxxx
Street Address
17208 Island View Drive
Address Line 2
City
Cornelius
Postal / Zip Code
28031-8684
Is there an agent working on the project? * Yes
No
Agent/Consultant Information
State / Province / Region
NC
Country
US
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:*
LOPEZ AUTH.pdf 167.9KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:*
LOPEZ
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: LOPEZ SURVEY.pdf 254.19KB
Latitude: * 35.447341
Longitude: *-80.908312
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*
LOPEZ SKETCH.pdf 100.99KB
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.)
LOPEZ PIC.pdf 89.68KB
4. Location of the property (where work is to be conducted)
Nearest Town: * CORNELIUS
County: * Mecklenburg
Lake/ river/ ocean adjacent to NORMAN/CATAWBA
property:

Subdivisions name or site address: *
LAKE NORMAN ISLAND LOT NUMBER 18
Include phase/lot number
Directions to site: *
FROM COWANS FORD DAM TRAVEL EAST HWY 73 6.5 MILES,
MAKE U TURN ON W CATAWBA AVE 344 FT TURN RIHT ONTO
NORMAN ISLAND DR .80 MILES, PROPERTY ON LEFT
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 .19
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
MAINTAIN SHORELINE
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: LOPEZ SKETCH.pdf 100.99KB
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:* STEPHANIE LOPEZ
Signature:
Submittal Date: 11/8/2022

Initial Review
Is this accepted into the review process?* Yes No
Project Number: * 20221590 Version: * 1
Select Reviewer: * Andrew Pitner:eads\ahpitner
Select Reviewing Office: Mooresville 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

Prajr~cc-'aunty. — 'bit r�
>�rin Sign
Print nsturE _`>
The appi-mat is for the purposs end da lgn describad in yoUF appllseion. jr;jpac—,s not Indicated In tht
appfrcetfon is a Wolstion ofthe Suffer Rule. Site speclticwork should be pro►r,'ded In the applltatlOa. 115A RiCAIC
02H _0506 and 1SA NCAC 02B .0,24a18)]
`: ree- are not allowed to be removed from Zone !of the BufFer {wlmhln 30 +t of thefuil pond afiaystlonj, unless
spprovwa 5(oap'tlon, thosetrees that are severely undermined siongthti fmmedlste shoraiina can be removed.
Mlnlmal ihe ping and sloping a)onj the Immediate shoreline Is allowed. [1SA NCAC 028.0243(6)'
Senching, grading inthe bu fs hot sHaaFe:. 6,t^cusl-m dLrturbanae of jrcund cover. [15A NCAC 0ZE .0243 46jj
2av&,es, f, npervieus patias, impervious walkways, atc. 'ore not allowed in the buifar uniassspeciilca.+ly app--auat
ay tie DI%4sion. The~ are are Elm tatfon ors size for decks. ['-SA NCAC 028.0243 (4) and (6)1
WO& to be conduc-te# from land must indlmts an aceesr and (ndlcM ;ny trees that are tc be removed. Tha
woo* corridor should be drscrib>ad. The approved access corridor shall be restorad. SiRgjng, spoil, constru:iier.
matvrial must be outside the buf Fer. (15A NCAC 02H _0502 and 15 A Ni AC 02 3 .4-2+:: 'A, 15), R)I
ftorrrtwata� cannot oe piped or channeled for direct discharge to the :aica, All cons"trueted stormw:tar
discharges must be e# t, a natural a!evgtian and dischargad prior to entering the buffer dsracted as dtMI AS or
sheet fow at non -erosive veiocmes to the hke. [15A MCAC 02.8.0243 {5], [5)]
Acknowiedgnmento; rVafffiit&?lop
�]-t�L� L� 1- -, `� erebt s� that I have bap_n fnforrnsd o`the Cata►�rb:
:i€Parton ufer Rule. An, w�duomd in the b;rF--r, not spec M- cally stated in the application and al=roved
by the Olvis€on of Wster RBsources (DWR), €s a vialatien and€ sub,lect to enforcement true dillger Ica w!11 be
taken such thatthe constructicri w[ll be builtwftriin-50stEntl33 compliance end Irrwit of the 401 Uvate-r
Oil AItY Certificeticn end $uf'far R41as, the approved pian(s) and soecMc tWn(s), and othersuapo=ti7j
,'siaiZrsait.
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Full Pond/
1Norm"Liv
Shoreline
La ke
(At MI Pond/Normal avatar Ceyel l
3EIZVI,r
N�,TJV1Mkt Dt ruP-$1??-\
76- 3u
II&W6 Nv-f
E�r,C-AVA - a- 16,kg-q 6:
Please approximately Sketch the fallowing lnformadon on this plan (provide dimensions fore,ch
tram, such as Ioff x 3Gb ft)*:
I• All proposed vegetation Clearing
2. l-ocation of rEp rap or `ill to be plated above the Full Pond/'Normal Water Level elevation
I Location of rlp rap or fill to he placed below the FuII Pond/ Normal Water Level elevation
4, Location ofany proposed structures such as buildings, retaining walls, docks, etc.
5. Location ofany excavation or dredging below the full Pond/ Normal Water level etevation
5. Location of construction accPss corridors
FORM; MP lo.2o13
eage 3 of 3

From- Tamara Hager -A^"[e-mail]
Subjec Lopez shoreline Pics
Date Nov S, 2022 at 4:25*25 PM
To- TAMARA HAGER [e-mail]
Tamara Hager
704-575-2227

Full Pond/
1Norm"Liv
Shoreline
La ke
(At MI Pond/Normal avatar Ceyel l
3EIZVI,r
N�,TJV1Mkt Dt ruP-$1??-\
76- 3u
II&W6 Nv-f
E�r,C-AVA - a- 16,kg-q 6:
Please approximately Sketch the fallowing lnformadon on this plan (provide dimensions fore,ch
tram, such as Ioff x 3Gb ft)*:
I• All proposed vegetation Clearing
2. l-ocation of rEp rap or `ill to be plated above the Full Pond/'Normal Water Level elevation
I Location of rlp rap or fill to he placed below the FuII Pond/ Normal Water Level elevation
4, Location ofany proposed structures such as buildings, retaining walls, docks, etc.
5. Location ofany excavation or dredging below the full Pond/ Normal Water level etevation
5. Location of construction accPss corridors
FORM; MP lo.2o13
eage 3 of 3