20231040 Ver 1_Shoreline Stabilization_20230726

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 7/24/2023
submitted on: *
Owner Information:
........ ........ ........ ........ ........ ........
Name: * James Fordham
Email: *
Phone Number:
Mailing Address: *
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
171 Southerland Dr
Address Line 2
City
Laurel Springs
Postal / Zip Code
28644
Is there an agent working on the project?* Yes
No
Agent/Consultant Information
...............................................................................................................................................................................
Name: * Janice Estep
Company Affiliation: * CBC Stone & Recycling, LLC
Email: * [e-mail]
State / Province / Region
NC
Country
US

Phone Number:*
[phone]
(xxx)xxx-xxxx
Mailing Address: *
Street Address
638 Oakridge Farm Hwy
Address Line 2
City
Mooresville
Postal / Zip Code
28115
A signed and dated copy of the Agent Authorization letter:
Agent Form.pdf
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* Fordham Shoreline
State / Province / Region
NC
Country
United States
739.53KB
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
125 Dockside Lane
Address Line 2
City
Statesville
Postal / Zip Code
28677
Latitude: * 35.723458
State / Province / Region
NC
Country
US
Longitude: *-81.063775
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 *
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: * Statesville
County: * Iredell
Lake/ river/ ocean adjacent to Norman
property:
Subdivisions name or site address: * Lot 57 River Oaks Landing Phase 1
Include phase/lot number
Directions to site:*
610 E Center Ave
Mooresville, NC 28115
Get on I-77 N from E McLelland Ave and E Plaza Dr
10 min (3.7 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
397 ft
Turn right onto E McLelland Ave
1.1 mi
Use any lane to turn left onto E Plaza Dr
Pass by Zaxby's Chicken Fingers & Buffalo Wings (on the right in 1.3 mi)
1.9 mi
Use the right lane to merge onto I-77 N via the ramp to Statesville
0.2 mi
Follow I-77 N and I-40 W to Sharon School Rd. Take exit 141 from I-40 W
26 min (27.0 mi)
Merge onto I-77 N
14.6 mi
Keep right to continue toward I-40 W
0.1 mi

Keep left at the fork to continue toward I-40 W
1.2 mi
Keep left and merge onto I-40 W
10.9 mi
Take exit 141 for Sharon School Rd
0.1 mi
Continue on Sharon School Rd. Take US-70 W to Dockside Ln
7 min (3.6 mi)
Sharp left onto Sharon School Rd
1.8 mi
Turn right onto US-70 W
1.2 mi
Turn right onto Bluewater Dr
Restricted usage road
0.3 mi
Turn right onto Portside Dr
Restricted usage road
0.2 mi
Turn right onto Dockside Ln
Restricted usage road
Destination will be on the left
0.1 mi
125 Dockside Ln
Statesville, NC 28677
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 Lot (lot to be cleared for new home construction)
Residential, undeveloped, etc.
6. Property Size 0.891
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
Shape and slope bank, install matting and install boulder rip rap for new shoreline stabilization. Install TN Crab Orchard steps
through rip rap 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.)
5.5 below (599.5 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 (109 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)
Remove trees and brush on immediate shoreline necessary to properly stabilize bank. Lot to be cleared for new home construction
prior to start of shoreline project. Minimal disturbance to buffer. Access corridor to be restored to original condition.
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):
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:
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");
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
o I intend to electronically sign and submit the Shoreline Stabilization online form.
Full Name:* Janice Estep
Signature:
Submittal Date: 7/24/2023

Initial Review
Is this accepted into the review process?* Yes O No
Project Number: * 20231040 Version:*
Select Reviewer: *
Select Reviewing Office
Has payment been received?*
What amount is owed?*
Andrew Pitner:andrew.pitner
Mooresville Regional Office - [phone]
No Payment Needed
Fee Received
Need Fee - send electronic notification
$240.00
$570.00

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. E-7 PLAN NO. PARCEL ID:
STREETADDRESS: 5 -OoC � 5 id C
Please print: _
Property Owner: C
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
of �,' 1�� nc E, B C-Cuc'i -0 o. LLC
(Contractor / Agent) (Name of consulting firm)
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):
(-C'L)q
Telephone: 14 ~ '32
We hereby certify the above infon-nation submitted in this application is true and accurate to u e
best of our knowledge.
Authorized Siganature Authorized Signature
Date: '%b7U/ 23 Hate:

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Tax Map Information
maw"Critical
Print map scale is approximate.
•PIN
layout or measurement
• Address
125DOCKSI E
125 DOCKSIDE LN
y
•Account#
Acct80093611
W
activities should not be done using
• Tax Owner
FORDHAM JAMES E III
this resource.
• Mailing
171 SOUTHERLAND DR
Address
MAP FOR REFERENCE ONLY
•
LAUREL SPGS, NC 28644
NOT A LEGAL DOCUMENT
• GIS Owner
FORDHAM JAMES E III+DAWN B
• Deed Info
2927 / 1584 - WD - 20220620
Iredell County, North Carolina makes no claims and no
• Tax Acres
0.908 AC
warranties, expressed or implied, concerning the validity or
• Lot #
57
accuracy of the GIS data presented on this map.
• Description
RIVER OAKS LANDINGS P1 SHT3
Geometry updated 06/05/2023
PB53-35-38
Data updated 06/OS/2023
• Zoning
RA
Old Parcel #
• Bldg Value
$0
• OBXF Value
$0
• Land Value
$127,500
• Total Value
$127,500
• Defer Value
$0
• Tax Districts
-ALLCNTY FIRE- -

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CATAWBA RIPARIAN BUFFER DM } T PR ICAMON FORM
Prniircf:lla fed�3resse ��c ICE e c7 v� e ��y i l ref�sE�o " �� 1
OpfflGr:
Print
CO nbraV,?oV �zgaant:
Print
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. 115A NCAC 02B .0243 (6)]
Beaches, impervious patios, impervious walkways, etc. are not allowed in the buffer unless specifically approved
by the Division. Where are limitation on size for decks. [15P 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 storrnwater
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)]
Acknowle ernen qqj;votificotion
1, L_ _ o v� akvin —1 T hereby state that I have been informed of the Catawba
Riparian Buffer Rule. Any work conducted in the buffer, not specifically stated in the application and approved
by the Division of Water Resources (i3WR), 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): / �. �,�GL_r Date:

Full Pond`
Norima,l Water Level
Shoreline
La ke
(At Full Pond/NormalWaterLevel)
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1 CJ.4j e. A I 09
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Please approximately sketch the following information on this plan, length of shoreline
(provide dimensionsfor each item, such as 10 ft x 100 ft)*a
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 wails, docks, etc.
S. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
6. Location of construction access corridors
FORM: SSGP 10-2013 Page 3 of 3

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