20230564 Ver 1_Shoreline Stabilization_20230421

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 4/17/2023
submitted on: *
Owner Information:
.........................................................................................................
Name: *
Thomas L Wilson
Email: *
[e-mail]
Phone Number:
[phone]
(xxx)xxx-xxxx
Mailing Address: *
Street Address
190 Wilson Park Road
Address Line 2
City
Statesville
Postal / Zip Code
28625
Is there an agent working on the project?* Yes
No
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name: * Wilson Knoxview Shoreline
State / Province / Region
NC
Country
United States
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:* Street Address
229 Knoxview Lane
Address Line 2
Latitude: * 35.516392
City State / Province / Region
Mooresville NC
Postal / Zip Code Country
28117 United States
Longitude: *-80.883220
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 *
s...
Please use the diagram at the link below:
https:Hedocs.deq.nc.gov/WaterResources/O/edoc/616616/Shoreline%2OLayout.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.)
4. Location of the property (where work is to be conducted)
Nearest Town: * Mooresville
County: * Iredell
Lake/ river/ ocean adjacent to norman
property:
Subdivisions name or site address: * Kings Landing lot 13, 229 Knoxview lane
Include phase/lot number
Directions to site: *
From 1-77 north, take exit 31 (langtree). Turn left, proceed straight through one round about. Take a left into the subdivision Kings
landing on Knoxview. Vacant lot will be on the right. Lot 13 Kings landing, 229 Knoxview Lane
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 undeveloped land
Residential, undeveloped, etc.
6. Property Size 1.4
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
Construct a new timber framed retaining wall, backtill immediately behind wall with crushed concrete. Place 6" rip rap on lake
side of wall to protect wall/soil from erosion. Length of stabilization will be 228 feet.
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.)
4
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)
There are no trees on this lot. The only vegetation is grass.
Sketch: wilson knoxview site plan.pdf 75.68KB
wilson knoxview shoreline2.pdf 321.15KB
kings landings.pdf 168.71KB
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):
0 $240.00 for impacts to lake (below normal water level) of less than 1 acre
0 $570.00 for impacts to lake (below normal water level) of greater or equal to 1 acre
By digitally signing below, I certify that:
0 I, the project proponent, hereby certifies that all information contained herein is true, accurate, and complete to the best
of my knowledge and belief
0 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.
d 1 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');
d 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');
0 1 understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
d 1 intend to electronically sign and submit the Shoreline Stabilization online form.
Full Name:* Thomas L Wilson

Signature:
Tf MS L tic.W
Submittal Date: 4/18/2023

Initial Review
Is this accepted into the review process?* Yes O No
Project Number: * 20230564 Version:*
Select Reviewer: *
Select Reviewing Office
Has payment been received?*
What amount is owed?*
Andrew Pitner:[e-mail]
Mooresville Regional Office - [phone]
No Payment Needed
Fee Received
Need Fee - send electronic notification
$240.00
$570.00

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.
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer Rules, and any
subsequent modifications, the applicant is required to submit it to the DWR 401 & Buffer Permitting Branch. This form
may be returned to DWR by the applicant, the applicant's authorized agent, or the project engineer. It is not necessary to
send certificates from all of these.
Is this a Public Transportation Project?* Yes
No
USACE Permit# N/A
DWR Project #: * 20230564 Version: *
County: * Iredell
Applicant: * Thomas Wilson
401 Water Quality Certification Issued Date:
6/29/2023
Project Name: * WILSON KNOXVIEW SHORELINE/229 KNOXVIEW LN/LAKE
NORMAN
Supplemental Attachments: Click the upload button or drag and drop files here to attach document
PDF only
Who will be submitting the Certification of Completion?*
Applicant
Agent
Certified Professional
Applicant's Certification
I, hereby state that, to the best of my abilities, due care and diligence was used in the observation of the construction such
that the construction was observed to be built within substantial compliance and intent of the 401 Water Quality
Certification and Buffer Rules, the approved plans and specifications, and other supporting materials.
* By checking the box and signing box below, I certify that:
o I have given true, accurate, and complete information on this form;
o I agree that submission of the "Certificate of Completion" 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");
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 "Certificate of Completion" form."

Printed Name:* Thomas Wilson
Signature*

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