20230039 Ver 1_Shoreline Stabilization_20230110

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 1/2/2023
submitted on: *
Owner Information:
Name: * HOLMES ROAD LLC
Email: * [e-mail]
Phone Number: [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
10262 Hunt Club Lane
Address Line 2
City
Palm Beach Gardens
Postal / Zip Code
33428
Is there an agent working on the project? * Yes
No
Agent/Consultant Information
State / Province / Region
FL
Country
US
Name: * Emma Barden
Company Affiliation: * Odom Engineering, PLLC
Email: * [e-mail]

Phone Number:*
[phone]
(xxx)xxx-xxxx
Mailing Address:*
Street Address
169 Oak St.
Address Line 2
City State / Province / Region
Forest City NC
Postal / Zip Code Country
28043 USA
A signed and dated copy of the Agent Authorization letter: *
SIGNED VELARDO AGENT
44.33KB
AUTHORIZATION FORM.pdf
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name: *
VELARDO SEAWALL
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
Property Address Lookup: *
Latitude:*
35.427656
Street Address
305 Holmes Rd
Address Line 2
City State / Province / Region
Lake Lure NC
Postal / Zip Code Country
28746-9835 US
Longitude: *-82.198263
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*
22177 - 305 HOLMES ROAD SITE -
I.65MB
2023.pdf
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.)
305 HOLMES ROAD SITE PHOTOS.pdf 3.15MB
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: *
Chimney Rock
Rutherford
Lake Lure
Holmes Road
Include phase/lot number
Directions to site: *
From Lake Lure Town Administration, head south on Morse Park Trail.
Turn right to stay on Morse Park Trail. Turn left onto US-64 E/US-74 ALT
E. Tum left onto Holmes Rd.
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 0.82
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
Replacing the existing wood seawall and constructing a new retaining wall
that is connected to the seawall. Installing riprap at the northwest side of
the property.
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.)
250
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)
n/a
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

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
a I intend to electronically sign and submit the Shoreline Stabilization online form.
Full Name: * Nicholas Velardo
Signature:
Submittal Date: 1/2/2023

Initial Review
Is this accepted into the review process?* , Yes No
Project Number: * 20230039 Version: * 1
Select Reviewer: * Mitchell Anderson:eads\mlanderson:[e-mail]
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

AGENT AUTHORIZATION FORM
PROPERTY INFORMATION:
TAX PARCEL # 1621864 DEED BOOK 2065 PAGE 4199-4203
PROPERTY ADDRESS: 305 HOLMES ROAD, LAKE LURE, NC 28746
OWNER: NICHOLAS VELARDO (HOLMES ROAD LLC)
The undersigned, registered property owners of the above noted property, do hereby
authorize (Name of Contractor/Agent) EMMA BARDEN
of (Name of Consulting Firm) ODOM ENGINEERING, PLLC
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 Owner's Address (if different than property above):
10262 Hunt Club Lane, Palm Beach Gardens, FI 33428
Telephone: [phone] Email Address: nvelardo [e-mail]
We hereby certify the above information submitted in this application is true and accurate to
the best of our knowledge.
(Aut)l bri*d ature/Property Owner)
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