20241027 Ver 1_Shoreline Stabilization_20240801

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.
FRALEY LIVING TRUST
JULIEFHOLLOWELL@GMAIL. COM
[phone]
(xxx)xxx-xxxx
Street Address
5505 CHEGALL CROSSING WAY
Address Line 2
City
MOUNT HOLLY
Postal / Zip Code
28120
Is there an agent working on the project?* Yes
No
Agent/Consultant Information
Name: *
Company Affiliation:
Email: *
Phone Number:*
TAMARA HAGER
LAKE PERMIT LLC
[e-mail]
[phone]
(xxx)xxx-xxxx
State / Province / Region
NC
Country
US

Mailing Address: *
Street Address
PO BOX 5335
Address Line 2
City
MOORESVILLE
Postal / Zip Code
28117
A signed and dated copy of the Agent Authorization letter:
FRALEY AUTH.pdf
FRALEY AGENT.pdf
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name: * FRALEY
State / Province / Region
NC
Country
US
1.6MB
900.22KB
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:
Latitude: * 35.361349
Longitude: *-80.929148
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/Shoreli 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.)
4. Location of the property (where work is to be conducted)

Nearest Town: *
MOUNT HOLLY
County: *
Lake/ river/ ocean adjacent to
property:
Gaston
MT ISLAND LAKE / CATAWBA
Subdivisions name or site address:* IMAGERY AT MT ISLAND LAKE / LOT 297
Include phase/lot number
Directions to site:*
FROM RIVERBEND BOAT RAMP .20 MILES HORSESHOE BEND BEACH RD, SLIGHT LEFT TIRN ONTO IMAGERY
BLVD 1.8 MILES, ROUNDABOUT 500 FT FIRST EXIT ONTO DALI BLVD, RIGHT ONTO CHEGALL CROSSING WAY
.20 MILES, PROPERTY ON LEFT .90 MILES.
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:
RESIDENTAIL
Residential, undeveloped, etc.
6. Property Size .54
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
SHORELINE STABILIZATION OF 136' RIP RAP
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.)
272
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.)
408
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)
NO TREES REMOVED
Sketch: FRALEY SKETCH.pdf 1.08MB
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
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.

d 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
d 1 intend to electronically sign and submit the Shoreline Stabilization online form.
Full Name:* FRALEY LIVING TRUST
Signature:
FiMCy Uu1� TRUT
Submittal Date: 7/29/2024

Initial Review
Is this accepted into the review process?* Yes No
Project Number:* 20241027 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