20241357 Ver 1_Shoreline Stabilization_20241007

Shoreline Stabilization Application Form
NORTH CAROLINA
Environmental Qualify
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
FORM: SSGP 10-2013
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.
Bhagirath Patel
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
100 Seedling Court
Address Line 2
City State / Province / Region
Mt Holly NC
Postal / Zip Code Country
28120-9072 US
Is there an agent working on the project? * Yes
No
Agent/Consultant Information
.............................................................................................................................................................................................................................
Name: * Lake Wylie Dock Construction
Company Affiliation: * Contractor
Email: * [e-mail]
Phone Number: * [phone]
(xxx)xxx-xxxx

Mailing Address: *
Street Address
1975 Gold Hill Road
Address Line 2
City State / Province / Region
Fort Mill SC
Postal / Zip Code Country
29708 United States
A signed and dated copy of the Agent Authorization letter:*
AA and Catawba RR Notification.pdf
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:*
Bhagirath Patel Dredge
332.97KB
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: *
Latitude:* 35.153992
Street Address
5039 Hermitage Court
Address Line 2
City State / Province / Region
Belmont NC
Postal / Zip Code Country
28012-6532 US
Longitude: *-81.025389
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://edocs.deq.nc.gov/WaterResources/0/edoc/616616/Shoreline%20Layout.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:* Belmont
County:* Gaston
Lake/ river/ ocean adjacent to Lake Wylie
property:
Subdivisions name or site address: *
Directions to site: *
from I-85, Belmont, NC 28012
1-85
Belmont, NC 28012
Follow NC-273 S to S Point Rd
13 min (6.4 mi)
Reflection Pointe Lot 209
Include phase/lot number
Continue on S Point Rd to your destination in Belmont
5 min (2.1 mi)
5039 Hermitage Ct
Belmont, NC 28012
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: *
Vacant lot with existing dock
Residential, undeveloped, etc.
6. Property Size
0.98 Acres
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or
why it is necessary):
Dredging to obtain a more sustainable shoreline for boating use. Removal of silt and sediment and prevent shoreline erosion
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.)
1296
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.)
500
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)
Vacant Lot with existing trees. We are doing a dredge by land number 10 includes the 10' wide machine path. number 9 includes
the 36x36 ft dredge included in the drawing.
Sketch: Plan Drawings for Patel.pdf 456.47KB
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
o $767.00 for impacts to lake (below normal water level) of greater or equal to 1 acre
By digitally signing below, I certify that:
• 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");
d I 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:*
Signature:
Nicol Prophet
Submittal Date: 10/2/2024

Initial Review
Is this accepted into the review process? * Yes No
Project Number:* 20241357 Version:* 1
Select Reviewer: * Jesse Mcdonnell:Jesse.Mcdonnell
Select Reviewing Office: Mooresville Regional Office - [phone]
Has payment been received?* No Payment Needed
Fee Received
Need Fee - send electronic notification
What amount is owed?*
$240.00 $570.00
$323.00 $767.00

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
ha I rc&i-R P0-k! S 0 I
Project Name address: 5-61 3 9 14ermi facie, Q. Cf. 3c.!pitAf- Coun @ 11
/ , C tv
Owner: 3haclrc-Ik - Sec aC)f fl Cl,+hozC}i 1 - crr
Print Signature
Contractor/agent: La -Kt I/tit/inf., GC lt. C. 574- LA t l C n 7/'Gid � DWeX
Print Signature
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)1
Benching, grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 02B .0243 (6)]
Beaches, impervious patios, impervious walkways, etc. are not allowed in the buffer unless specifically approved
by the Division. There are limitation on size for decks. [15A 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 stormwater
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)]
Acknowledgement of Notification
I . i o C d r to 'e-r5 , 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 (DWR), 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);
16 � w n.AA Date: 10 r `t/

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION: �7
LOT NO. 061 PLAN NO. ti / A. PARCEL ID:
STREET ADDRESS:
Please print:
Property Owner:
6.3`1 crmjac Cr �_�rv-r
f r It J t�' 5`C 13\
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Property Owner: BhagiraTh Patel
The undersigned, registered property owners of the above noted property, do hereby authorize
�OC�CI. Flc'ZLcrS of Le Li.. 'It Ctfi C 1)S-h-t,Lc.±it;,
(Contractor / Agent) (Name of con 'ulting 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):
r`•1 llA �C. +{�i J\J Ag*i9\Q
Telephone: i' - "
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowtedge.
Bhagirath patel
Authorized Signature Authorized Signature
Date: 10/02/2024 Date:
Signature: .;
Email: [e-mail]

Proposed
(Side View)
U)
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Lake
(At Full Pored/ Normal Water Level)
Full Pond/ No
a
Vacant Lot
0.98 Acres
2 3 ft belrx :::SI pond t•:asc. Ie•m1 4 ft. above full pond ..vatrr IeveS ft, additional clearing
•i! necessary I
Existing bank
10 ft. bank
height
Side View
AMPLE

Proposed
(Plan View)
La ke
(At Full Pond/ Norma! Water Level)
Full Pond/ Normal Water Level
m — — — —
Shoreline
aoo,ni LoT
6L98 acres
11■■ NM NMI
Full Pond/ Normal Water Level
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ore ine
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Lake
{At Frr;tl Pond/ Norma! Water Level)
Existing Dock
30 ft 7 FL
60 ID
isita,o,
A
3h>sISOh
Below lull pond/ NWL
... _ter
artxis0ft
Above full pond/ N W L
ENCAMP E
Plan View

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SHOWN ON THIS PLAT, AND THAT THE PROPERTY LINES, AND THE IMPROVEMENTS IF ANY ARE
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NOTES;
PARCEL ID #203957
SETBACKS SHOWN ARE PER
CURRENT RECORDED PLAT.
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OR RIGHT OF WAYS MAY EXIST
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FLOOD FLOOD LINES SHOWN WERE
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THIS IS TO CERTIFY THAT ON THE 29TH __DAY OF MAR[ 2021 f, SURVEYED THE PROPERTY
SHOWN ON THIS PLAT, AND THAT THE PROPERTY LINES. AND THE IMPROVEMENTS IF ANY ARE
AS SHOWN HEREON.
UCHED
PROFESSIONAL LANO SURAYOR
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7511 OLD CCHCORD RO, CHARLOTTE, N.C. 28213
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NOTES:
PARCEL ID #203957
SETBACKS SHOWN ARE PER
CURRENT RECORDED PLAT.
OTHER SETBACKS. EASEMENTS,
OR RIGHT OF WAYS MAY EXIST
WHICH MAY NOT 8E SHOWN.
FLOOD LINES SHOWN WERE
SCALED PER FEMA FIRM PANEL •
/L377O3591OOL, DATED 9/2/15
& ARE APPROXIMATE. • 4
4`2L.
' WJ
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VICINITY MAP
GRAPHIC SCALE
50 6 25 50
SCALE 4 "=50'
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SYMBOL LEGEND''
NIR NEW IRON RFaw f4 Ey F.
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MAP RECORDED IN BOOK 87 AT PAGE 87 DEED RECORDED IN BOOK PAGE
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