20230211 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: *
Email: *
Phone Number:
Mailing Address: *
Brooke Adams
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
Quail Ridge Blvd
Address Line 2
City
Lake Lure
Postal / Zip Code
28746
Is there an agent working on the project? * Yes
No
Agent/Consultant Information
State / Province / Region
Rutherford
Country
United States
Name: * Robert White
Company Affiliation: * Knight Strategies
Email:* [e-mail]

Phone Number:*
[phone]
(xxx)xxx-xxxx
Mailing Address:*
Street Address
112 McDaniel Road
Address Line 2
City State / Province / Region
Lake Lure NC
Postal / Zip Code Country
28746-9800 US
A signed and dated copy of the Agent Authorization letter:*
Agent Authorization Form.pdf 1.82MB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:*
Brooke Adams - Kayak Dock
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: VICINITY MAP.pdf 239.89KB
Latitude:*
35.270000
Longitude:* 82.114400
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*
KS - Site Plan 01-27-2023.pdf 422.27KB
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 Photos.pdf 12.68MB
4. Location of the property (where work is to be conducted)
Nearest Town:*
County: *
Lake/ river/ ocean adjacent to
property:
Lake Lure
Rutherford
Lake Lure

Subdivisions name or site address: *
Rumbling Bald Resort / Eagle Creek Lot 653
Include phase/lot number
Directions to site: *
Enter Rumbling Bald Resort off of Buffalo Creek Road. Turn Left onto
Quail Ridge Blvd. Drive approximately 1 mile and turn left to stay on
Quail Ridge Blvd, drive 100 yards and turn to stay on Quail Ridge Blvd.
Lot is on left in approximately 100 yards.
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: *
Undeveloped single-family residential lot.
Residential, undeveloped, etc.
6. Property Size
1.05
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
We are proposing to construct a small kayak dock measuring 40 in width
along the shoreline. We are required to install riprap underneath the dock.
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.)
120
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)
We are removing two dead hemlock trees as they propose a hazard to
proposed dock. No other vegetation will be disturbed. Some rhododendren
may need to be trimmed over hanging proposed dock.
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
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");
• 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:* Robert White
Signature:
odes lukie
Submittal Date: 2/3/2023

Initial Review
Is this accepted into the review process?* , Yes No
Project Number:* 20230211 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

AGENT AUTHORIZATION FORM
Pease ribbe that ramie forms mr ixe- neon I tme am ire Bran two amxfs of ae pwaty.
s"'E� ADDRESS OF EIS m HOME or tATIT MFAONGnurpE OF NEW conmuCrION:
9 Quail Rye Blvd
Lake Lure, NC 28746
Rarer M. 1623938
P"'MW Owner Naffs) — please print:
Pr� Dmen. Brooke Adams
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Knight Strategies
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?ropefty owners NWraW Address (if dii%attfian pry address above):
Lake Lure, NC 28746
Lake Lure, NG 28746
property Owner�
s) Tehem:
704-281-4505
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