20230209 Ver 1_Shoreline Stabilization_20230207

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 2/2/2023
submitted on: *
Owner Information:
Name: * Kelley Cherry Sink
Email: * [e-mail]
Phone Number: [phone]
(xxx)xxx-xxxx
Mailing Address:* Street Address
7747 Tumberry Lane
Address Line 2
City
Stanley
Postal / Zip Code
28164-7810
Is there an agent working on the project? * Yes
No
Agent/Consultant Information
State / Province / Region
NC
Country
US
Name: * Janice Estep
Company Affiliation: * CBC Stone & Recycling, LLC
Email: * [e-mail]

Phone Number:*
[phone]
(xxx)xxx-xxxx
Mailing Address:*
Street Address
638 Oakridge Farm Hwy
Address Line 2
City State / Province / Region
Mooresville NC
Postal / Zip Code Country
28115 United States
A signed and dated copy of the Agent Authorization letter: *
Agent Form.pdf 606.62KB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name: *
Sink Shoreline
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: Plat Map.pdf 1.09MB
Vicinity Maps.pdf 5.78MB
Latitude:*
35.457031
Longitude: *-80.965719
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*
Site Plan.pdf 948.94KB
Buffer Form.pdf 1.07MB
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.)
Shoreline Pics.pdf 18.29MB
4. Location of the property (where work is to be conducted)
Nearest Town: * Denver
County: * Lincoln

Lake/ river/ ocean adjacent to Norman
property:
Subdivisions name or site address: *
Directions to site: *
610 E Center Ave
Mooresville, NC 28115
Lot 85 Crescent Land & Timber Corp.
Include phase/lot number
Get on I-77 S/US-21 S from S Main St, NC-115 S and Langtree Rd
13 min (5.7 mi)
Head south on Evergreen St toward E Center Ave
197 ft
Turn right onto E Center Ave
0.5 mi
Turn left onto S Church St
0.5 mi
Turn right onto College St
0.1 mi
Turn left onto S Main St
1.2 mi
Continue onto NC-115 S
2.1 mi
Turn right onto Langtree Rd
1.1 mi
Use the 2nd from the left lane to turn left to merge onto I-77 S/US-21 S
0.2 mi
Follow I-77 S and NC-73 W to Club Dr in Lincoln County
17 min (12.5 mi)
Merge onto I-77 S/US-21 S
Continue to follow I-77 S
5.7 mi
Take exit 25 toward Concord/Huntersville
0.3 mi
Turn right onto NC-73 W/Sam Furr Rd
Continue to follow NC-73 W
6.5 mi
Continue on Club Dr. Take Hagers Ferry Rd to Windsong Rd
6 min (2.8 mi)
Turn right onto Club Dr
1.9 mi
Sharp right onto Hagers Ferry Rd
0.4 mi
Turn left to stay on Hagers Ferry Rd

0.2 mi
Slight left onto Dogwood Hill Dr
279 ft
Turn left onto Windsong Rd
0.3 mi
8065 Windsong Rd
Denver, NC 28037
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 new construction
Residential, undeveloped, etc.
6. Property Size
0.871 acres
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
Remove existing, damaged wood wall, repair eroded areas and replace
with an Allan Block wall. Install TN Crab Orchard steps for lake access.
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.)
3' below (309 sf)
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.)
1' above (103 sf) 10'
x 50' access
corridor (500 sf of
temp. impact)
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)
Grass buffer, no trees removed, minimal disturbance to buffer. Access
corridor to be restored to original condition once project is completed.
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:
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
I intend to electronically sign and submit the Shoreline Stabilization online form.
Full Name:* Janice Estep
Signature:
i o-rrc Jfg?. rt:+�tlf.J rrq
Submittal Date: 2/2/2023

Initial Review
Is this accepted into the review process?* Yes No
Project Number: * 20230209 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

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. 55 PLAN NO. — PARCEL ID:
STREET ADDRESS:
—�)er\ N sa , NL �3 8 0� -j
Please print:
Property Owner:
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
eLn'tce_ E33 C— C S neL,_LC,
(Contractor j Agent) (Name of consulting firm) I Jl
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):
Telephone: 104 - 5 4 O -
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
�?kmq Lu
Auth rized nature0 Authorized Signature
Date: 1 Date:

m
n
0
�
m
gl2 0
n
A
2= R
�m
o
MEck
a
ic
m
ic
z
0
0
�m
o = o
zon r-
91 ON 'AMN
r
m
zE
z m
z
in
o nv ,
n
zw0�m
x
f!�
v
a_
z
O
zZoom
ZN4
f`�s�
vz-
2ZJ
to.
cFim
p
�_
m CD
kD
9
�
E
�
v
a
z2 NN222222 22222 tnZ
mo ooe °e1Oam Aom�er ow
ie i — w r0 m ie m— O 0 W
NN O m_mdOwa
^i F~ m g F f 1 f; m m l m lA l W v
1 1 I I I I I
u� m ONw �O�m�'Iv O.mim—fin
- _ w`O34-
- - - -
ammV P m ANY 1V�
2222 2Z22ZZ
r w wa aN o I I T ,, I�
BOA OrVd�O
u AwN AA
O _ —
NNN mZaZ ZZZ
w� e
_mmA N dmmw�m mrm Y
Vo=ml m I i m I I Imp l o l l s
m O.mipOw map °1m �° m O
_ e!O�
ON W m m N O -o b= S!:! a 'O a -'p 'O
rn m�F Ff� f�~ FFFU l mfy �fN �
Nom �wA - mwq On OW w baw

E
\
_
\ C)
CD
2
\
\

........ .
. )A
O
O
CD
(D
Ok
cc
0
all
VVINDSONG RD

p� buospuIM S902
cf)

Full Pond/
Normal Water Level
Shoreline
La ke
(At FuHPon d1 Normal Water Level)
C o-bo U e. A 103
-- AM AM "L.
1\i0 �"C��S reV'n0UCd
Please approximately sketch the following information on this plan, length of shoreline
(provide dimensions for each item, such as 10 ft x too ftp:
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 Wafter Level elevation
G. Location of construction access corridors
FORM: SSGP 10-2013
Page 3 of 3

CATAHVIA MPAMAH BUFFER NO T MC ,, TON FORM
(project Name/address. cq0 6 5 `(lyer, pw. County: L nct) in
COMY-2a
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. [15A NCAC
02H .0506 and 15A NCAC 02B .0243(8)]
Trees are not allowed to be removed from Zone 1 of the Buffer (within 30 ft of the full pond elevation), unless
approved. Exception, those trees that are severely undermined along the immediate shoreline can be removed.
Minimal shaping and sloping along the immediate shoreline is allowed. [15A NCAC 02B .0243(6)]
Benching, grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 02B .0243 (6)]
Beaches, impervious patios, impervious walkways, etc. are not allowed in the buffer unless specifically approved
by the Division. There are limitation on size for decks. [15A NCAC 02B .0243(4) and (6)]
Work to be conducted from land must indicate an access and indicate any trees that are to be removed. The
work corridor should be described. The approved access corridor shall be restored. Staging, spoil, construction
material must be outside the buffer. [15A NCAC 02H .0502 and 15A NCAC 02B .0243 (4), (6), (8)]
Stormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
discharges must be at the natural elevation and discharged prior to entering the buffer directed as diffuse or
sheet flow at non -erosive velocities to the lake. [15A NCAC 02B .0243(5), (6)]
AccEsQ owledgement of motificafron
Vl e tc't ��a i n, hereby state that I have been informed of the Catawba
Riparian Buffdr Rule. Any4ork conducted in the buffer, not specifically stated in the application and approved
by the Division or Water Resources (DWR), is a violation and subject to enforcement. Due diligence will be
taken such that the construction will be built within substantial compliance and intent of the 401 Water
Quality Certification and Buffer Rules, the approved plan(s) and specification(s), and other supporting
materials.
Signature (owner): Date:
q

3
fZ
_� 11
41—
3 Ili Ali
I # f
! L I
'Mir,
4
s 3 {P>
-�A I