20221605 Ver 1_Shoreline Stabilization_20221115

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 11/10/2022
submitted on: *
Owner Information:
Name: * Henry Stevie Lee Jr.
Email: * [e-mail]
Phone Number: [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
8551 Plank Road
Address Line 2
City
Norwood
Postal / Zip Code
28128-7706
Is there an agent working on the project? * Yes
No
Project Information [15A NCAC 02H .0502(a) & (b)]
State / Province / Region
NC
Country
US
Project Name: * 129 Tilley Cove
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: 129 Tillery Cove_Survey.pdf 263.6KB
129 Tillery Cove_Vicinity.pdf 331.63KB
Latitude:*
35.218420
Longitude: *-80.062400
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*
129 Tillery Cove_Site Map.pdf 237.35KB
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.)
129 Tillery Cove_Photo.pdf 325.24KB
4. Location of the property (where work is to be conducted)
Nearest Town: *
County:*
Lake/ river/ ocean adjacent to
property:
Subdivisions name or site address: *
Directions to site: *
Mt. Gilead
Montgomery
Lake Tillery
Tillery Cove
Include phase/lot number
NC-24
Albemarle, NC
Head east on NC-24 E/NC-27 E/NC-73 E/US-52 S
Continue to follow NC-24 E/NC-27 E/NC-73 E
2.0mi
Turn right onto NC-24 E/NC-27 W/E Main St
Continue to follow NC-24 E/NC-27 W
6.3 mi
Turn right onto NC-73
1.1 mi
Turn right onto Lillys Bridge Rd
5.2 mi
Turn right onto Tillery Cv Dr
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: *
Existing dock 1200 sq ft. No existing shoreline stabilization. See attached
photo.
Residential, undeveloped, etc.

6. Property Size .5
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
Want to install 100' rip rap stone for shoreline 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.)
200
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.)
200
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)
See attached photo
Sketch: 129 Tillery Cove_Photo.pdf 325.24KB
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:* Jeff Page
Signature:
lar
Submittal Date: 11/10/2022

Initial Review
Is this accepted into the review process?* Yes No
Project Number: * 20221605 Version: * 1
Select Reviewer: * Chad Turlington:eads\ccturlington
Select Reviewing Office: Fayetteville 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

a MaFPm rvr our¢ flf11cr ««OP®]. iL
rrr AAv ,cawArr
mmm rn' n,x x Awx rn rwoeiv. m rrr �
t
sarr.
CRal.o 0lS,AM�
Itrlr}r
,,,,,,� ���rr,,,
smir a'r1 rwa, a..r rcarw«,11�wlrw.niw,rer rw
.rrc..,•naa _
3. �,poi �
w.
rare. rn Nw• vArp a nook" i
= au.
¢ '
:
� a .Mrxwl tvocva uu
Td. raua elw,6 nr areK i>�>�
�j yyy}_..S� _
''r'pp.';;9���y/,�
%`n' �. �r•`
' �r�trrlrrr
. aofr .rr.ar r-
aMr as s:M'�,.•i rm s agar.
N �.v�v.r,[rws bue waw ara. i�.o �
, �� // � ^�� /j. '
'
fAC171�N L
� J� lal �i
' �
y,rca as Se»a As s.aa. arE MctiwrrK
�
•rl
r.imr:r. r.w ..«o...r
� �/ //�
Cf(.f Y/ � fLYfa�MA
•lrlT' 4 iO(' , 1.
�ss+mAe w•r�•w.r .r xmr.•n.v
/' V i.�2�T��TFT1
r•L1,Tr 4 N • SKCN.
AAoe T 4v=sr a NVP
rF c r Cmxv rA2 a rWma
//11�� /�
/�/�/iv L--^^.
�� �� � L
S A.= FO
A11E! AS Ar- L= -L—
r,lt r qra RLoL LgLcr ,uncrla
ZL a'*I[tAa'M 1 7am se.cC' ro
� ] w
mY rwCa� a
W. P ffr R!MAP t7, MftT. P ap(f A
MAUI rr AP ulmr CY. 11R011a1T' W4T
a RiLdP:%D as iMrnctlD a1 0,
OT
h O! OdQil'JIS M094AY[O
\ .yV' / H
-
,�rl]/ -- -
76 raR ,I11 M8=Cf 6 6A¢,p dV i,(
maAor,Aras ,srAec:sem eT ancas
Ar '•.alln" fM MAY IppyJ7apl S,ArE
AILS 1T.
axs.aca.w (rr}
la1.b77.Y (•T)
o j) a cL" r 2!k C. TMS
«n m ulay rs alwsmss
Mvr
zrsr.�
awma Comm
V,. ! A
�i
+-mc�,w ,Tm xfr
A- c W wo+ -AcC y r
Rb' - a7�To [l1� rf Ma11ACXr S.
]lfrlR�
LJ
rrr7]'t 1�
,,,Y aj
W*K A7i�i' 1
// ,- 4 �i gT 4.
r y //�, IXR prarArp,aai itd ` ��
e1•rtR �/ r
d �is
IR I s�'�a�.w� •a
wY- acrr ar wrr
R R WPkAM
t1
Baw
M.P
M 010,14
t R1
OIC .
rp . qR&". y r4rr
- RAa/a,C
P� i.CGCr INc)DIriS OLAGY lYiD iL
a t
ACM nPtiAE1'r
[LGLrrx[oRa (AtrruY r.
1
?A
>lraan�,wz C.f i7a0lJ
hL C,pppR/CS
y,
x iJr.w7gf'
U
rr.py26175yf'
MJ��-� �riYara6 MMtAO rOIr MO
aEa � WTS � Ar a4.LL
rr,v v.vn af¢w
mwrr v araamavr
Pr YOrlaaAr: A1111rY Auf «� LLV tlr AIr m NOr AR pi,bA'JrP' C M,® r(t',S /11� ria Nlvr Kpmyq'O /or
r
a� afK1/fCr '�
pr_ aarr r,eriK3/4 ?am to
p Al
R+a ra
f.^^r4f ar• K..a
G . fa]trf_}en
7a1L7 An /
f
u
u
�
\\ �f6 Os«crxmr� �
Ar�lrr
T.yi. LL
•A,Gr � M lIIV //6 � /r
I,IcaliY' ,SACr Oa fOM' n aT Fdk4�R-_`wF4 Or,#Gr
+�� rmap d O f a v,aS «� M•r R
ra«•wAwAr arn, Man caxr
A'f'OY'x' A. v .uraar�. h
m�M,n. aw:rv� i
rw
n� mea
rwAAb rY b fat
r iri'er
fie. Towe
[M f ylycya.
tt ".,M-f1Y
l u sas7rYJb
of s7]TCrrt
u ses wm-w
to iE-
tvLe
Ln suv.>•J1-
111 SaSDiyr
ill Aa17fY!'
toa SwRa a in WD iR
OEiICI aaaw I n. PACE I"
om am Sri, tAm ,�
DF1D Y0011 tri. 11,0E 11,
SM. 10,W RAT 2.M ■-Q* {1t1W aoac f, pa2 r7; t
Q'JXP r?4EWY KDI;WSS. INC;
ffCa X'&WAMW Ar LOTS AY nW �� C
TiLLERY COVES orwao-wyr
MT Q5, •,=AD 70"S}I1P
MON7COMIFAY, N,C-
BOclt 2` a a 68 n OK>~ lA,I
OAn_' �� O,I,aM aT ORe
9CAiE: +•.Sa' SGAIi w FEFT
WMl .Qa r
i.4G lallT: itaMiA tt619}O,tIASO7p YAV rpAyA,S_µ{aall i

N`E
a
w
C
Randa!!s Church �
nuggs G
Roan � r
Randalr'S ,�. �/r
f^ f
04,erg f
Road
asp
,1
1
kink
$,
No ood_'
_
Beach
-
�
SF4Lr.war ELE
rldn-
neraid
Bares ----
SE
l 3 1 30l�
cl F/^I
Norwood Dam
-tom c
5
i1
7
1 '
y -
-r.

uli Pond/ Norma! Water Level
Shoreline
Plan View
Full Pond/ Normal Water
z R r 250 fr.
.d3uu(4 CL-,k
rf necei m
La ke
(At Full Pond/ Normal Water Level)
AV'
Lake
(At Full Ford/ h m.t Vim Leal)
ExisLng dock
6lWw fu41 coed! "W,
■ .. .. r.
G I1 s SSafi
Abn full pony NM
EXAMPLE
Plan View
FORM: SSG 09-2020 Page 4 of 6

Side View
FORM: SSGP 09-2020 Page 5 of 6

wr A r '
48
AIIr
AlIi
ray � � I�L I A •ir i. �r 4 r.� _ � _
i,,,�/ r -1�� r tom' ,.(j?� � � - r�:� �l•''tf ,`�S �.�Y�i r r.+P: .
Or 'ter
Xi'-_d+,-•.,,.-
r v. _ 4 uSy . , i - 'T�� �-; -'w � 'l., - ' - r3•,n , r -1� y " ;'J:
•rS 11
� .kti• �_ _'ems-" - - u

wr A r '
48
AIIr
AlIi
ray � � I�L I A •ir i. �r 4 r.� _ � _
i,,,�/ r -1�� r tom' ,.(j?� � � - r�:� �l•''tf ,`�S �.�Y�i r r.+P: .
Or 'ter
Xi'-_d+,-•.,,.-
r v. _ 4 uSy . , i - 'T�� �-; -'w � 'l., - ' - r3•,n , r -1� y " ;'J:
•rS 11
� .kti• �_ _'ems-" - - u