20240566 Ver 1_Shoreline Stabilization_20240418

Submission Form
1. Applicant Information [1 5A 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.
Sharon & Russell Draper
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
124 Shelby Court
Address Line 2
City
Troy
Postal / Zip Code
27371-9719
Is there an agent working on the project?* Yes
No
Agent/Consultant Information
Name: *
Company Affiliation:
Email: *
Phone Number:*
Yvette Huffinan
Lake Permit Services LLC
[e-mail]
[phone]
(xxx)xxx-xxxx
State / Province / Region
NC
Country
us

Mailing Address: *
Street Address
PO Box 6369
Address Line 2
City
Hickory
Postal / Zip Code
28603
A signed and dated copy of the Agent Authorization letter:
Draper Sharon - Signed Agent Auth.pdf
Link to: Sample Agent Authorization Form
Project Information [1 5A NCAC 02H .0502(a) & (b)]
Project Name: * Draper - Troy
State / Province / Region
NC
Country
United States
379.44Y-B
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
124 Shelby Court
Address Line 2
City State / Province / Region
Troy NC
Postal / Zip Code Country
27371-9719 us
Latitude: * 35.373476 Longitude: * -80.046398

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 *
NC
K
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.)
Pic
4. Location of the property (where work is to be conducted)
Nearest Town: * Troy
County: * Montgomery
Lake/ river/ ocean adjacent to Tillery
property:
Subdivisions name or site address: * 124 Shelby Court Troy NC 27371 (Carolina Forest, Lot 1083)
Include phase/lot number

Directions to site: *
From Charlotte. Take ramp onto E Independence Blvd (US-74 E). Go for 3.4 mi. Take left ramp toward NC-27 E/Albemarle Rd.
Go for 0.4 mi. Continue on Albemarle Rd (NC-27 E). Go for 37.6 mi. Turn right onto E Main St (NC-24/NC-27/NC-73). Go for
7.2 mi. Turn left onto River Rd. Go for 4.2 mi. Turn left onto Carolina Dr. Go for 0.9 mi. Turn left onto Shelby Ct. Go for 256 ft.
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/Developed
Residential, undeveloped, etc.
6. Property Size 1.0 acres
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
Current seawall is deteriorating. Needs replacing.
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.)
324
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.)
324 with 250 construction corridor
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)
Grassy yard with a few scattered trees. No impact to trees. Vegetation of yard will be restored back to current natural state.
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):
* $323.00 for impacts to lake (below normal water level) of less than 1 acre
* $767.00 for impacts to lake (below normal water level) of greater or equal to 1 acre
By digitally signing below, I certify that:
o 1, the project proponent, hereby certifies that all information contained herein is true, accurate, and complete to the best
of my knowledge and belief
o 1, 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:* Yvette Huffman

Signature:
401AW21P 4VA %.-4W
.V
Submittal Date: 4/15/2024

Initial Review
Is this accepted into the review process?* Yes No
Project Number:* 20240566 Version: *
Select Reviewer: *
Select Reviewing Office
Has payment been received?*
What amount is owed?*
Chad Turlington:chad.turiington
Fayetteville Regional Office - [phone]
No Payment Needed
Fee Received
Need Fee - send electronic notification
$240.00 $570.00
$323.00
$767.00