20240012 Ver 1_Shoreline Stabilization_20240102

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*
Owner Information:
Name: *
Email: *
Phone Number:
Mailing Address: *
[e-mail]
Please provide an email address for payment and requests for more information here.
Mike Howard
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
508 Nivens Cove Road
Address Line 2
City
Mt Holly
Postal / Zip Code
28120-9720
Is there an agent working on the project?* Yes
No
Agent/Consultant Information
Name: *
Company Affiliation:
Email: *
Phone Number:*
Erica McIntosh
Premier Permits of the Carolinas, LLC
[e-mail]
[phone]
(xxx)xxx-xxxx
State / Province / Region
North Carolina
Country
United States

Mailing Address: *
Street Address
3782 Yorkshire Place
Address Line 2
City
Sherrills Ford
Postal / Zip Code
28682-8761
A signed and dated copy of the Agent Authorization letter:
Property Owner and Authorized Agent.pdf
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:* Howard Shoreline Stabilization
State / Province / Region
NC
Country
US
106.21KB
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:
for
Latitude: * 35.344317
Longitude: *-80.984614
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/WaterResou rces/0/edoc/616616/Shorel i ne%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.)
Pic
Pic

4. Location of the property (where work is to be conducted)
Nearest Town: *
Mt. Holly
County: *
Gaston
Lake/ river/ ocean adjacent to
Lake Norman
property:
Subdivisions name or site address: *
508 Nivens Cove Road
Include phase/lot number
Directions to site:*
NC-16, Mount Holly, NC 28120
Head northwest on NC-16 / Brookshire Blvd toward Lucia Riverbend Hwy
328 ft
Turn left onto Lucia Riverbend Hwy
361 ft
Turn left onto Nivens Cove Rd
1.0 mi
Arrive at Nivens Cove Rd on the right
The last intersection before your destination is Meacham Pt
B
508 Nivens Cove Rd, Mount Holly, NC 28120
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..
Existing mobile home on site. Current residents of property owner. Existing shoreline not stabilized.
Residential, undeveloped, etc.
6. Property Size .47
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
Clear and grub 182' shoreline of small vegetation. Slope shoreline to desired slop and cover with geo-tech fabric to prevent
erosion. Rip Rap installation from base of slope to top.
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.)
1280
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.)
560
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)
small shrubs and brush to be cleared to create slope. 2 trees to be removed from shoreline due to exposed roots from erosion
Sketch: DEQ Side View Howard.pdf 27.16KB
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 $323.00 for impacts to lake (below normal water level) of less than 1 acre
d $767.00 for impacts to lake (below normal water level) of greater or equal to 1 acre
By digitally signing below, I certify that:
d I, the project proponent, hereby certifies that all information contained herein is true, accurate, and complete to the best
of my knowledge and belief
d 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:* Mark Howard
Signature:
Submittal Date: 12/17/2023

Initial Review
Is this accepted into the review process?* Yes No
Project Number:* 20240012 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
$323.00
$767.00