20190715 Ver 1_Shoreline Stabilization_20190530

State of North Carolina
DW R Department of Environment and Natural Resources
Division of Water Resources
15A NCAC 02H.0500—Water Quality Certification,Shoreline Stabilization
Division of Water Resources
FORM: SSGP 10-2013
Shoreline Stabilization Application Form
Three copies of the application (including attachments) and the application fee should be sent
to:
Division of Water Resources 2 0 1 9 0 T 1 5 �ZJ
401 & Buffer Permitting Unit `C) /1617 Mail Service Center 'V c,
Raleigh, NC 27699-1617 �
PAID �
Applicant Information [15A NCA ]
1. Owner Information
Name: Richard Dierker
Mailing Address: 11 Balmoral Drive
Pittstown, NJ 08867
Telephone Number: 706/951-5309 Fax Number:
E-mail Address: [e-mail]
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
http://www.saw.usace.army.mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name: Beth Mosteller
Company Affiliation: Dale & Beth Lake Use Permit Service
Mailing Address: 988 Clear Creek Circle
Lincolnton, NC 28092
Telephone Number: 704-996-3245 Fax Number:
E-mail Address: [e-mail]
Person to receive the Certification Approval: Beth Mosteller
II. Project Information [15A NCAC 02H .0502(a) & (b)]
1. Attach 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.
2. Provide a detailed site plan showing property boundaries and proposed locations of
vegetation clearing, structures (buildings, retaining walls, docks, impervious surfaces,
FORM:SSGP 10-2013 Page 1 of 3

etc.), rip rap, excavation or dredging below Full Pond/ Normal Water Level elevations,
and construction access corridors. You may use the diagram provided at the end of this
application form.
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)
County: Iredell Nearest Town: Mooresville
Subdivision name or site address (include phase/lot number): Lot 28
Lake Norma Bonanza Subdivision
Directions to site- please include road names and numbers, landmarks, etc.:
see attached
Latitude (in decimal degrees) 35.558575 Longitude (decimal degrees) -80.875590
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): residential
6. Property size (acres): 1.0
7. Lake/ river/ocean adjacent to property: Lake Norman
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary): Due to heavy wave action, bank is falling into lake
9. Will work be conducted from land? M From water? IN
10. Total amount of disturbance (including all excavation, backfill, rip rap, retaining walls, etc.)
below the normal pool lake level/ Normal Water Level in square feet or acres:
130.40' along shoreline
11. Total amount of disturbance (including all clearing, back fill, excavation, rip rap, retaining
walls, etc.) above the normal pool lake level/ Normal Water Level and 50 feet land-ward in
square feet or acres: 130.40' along shoreline will be rip-rapped. Access for small
skid steer along project
12. 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): grass-fescue
0,11176-3&00..‘.. Beth Mosteller 5 a 3 -19
Owner/Agent's Signature Printed Name Date
[15A NCAC 02H .0502(f)l
'Agent's signature is valid only if an authorization letter from the owner is provided.
FORM:SSGP 10-2013 Page 2 of 3

Lake
(At Full Pond/Normal Water Level)
0000000000000000000000000000000000000000
Full Pond/ 0000000000000000000000000000000000000000
0000000000000000000000000000000000000000
Normal Water Level 00000000000000o00000000o0000000000000000
e e Shoreline o000000muouou00000000000000000000000000
Rip-Rap will be placed: 130.40' to
follow contour of shoreline,
one foot above full pond,
and 3-4 feet below full pond
Richard Dierker
338 Ponderosa Circle
Mooresville, NC 28117
Please approximately sketch the following information on this plan (provide dimensions for each
item, such as 10 ft x 100 ft)*:
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 walls, docks, etc.
5. 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

SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. 28 PLAN NO. PARCEL ID: 4646232408.000
STREET ADDRESS: 338 Ponderosa Circle, Mooresville, NC 28117
Please print:
Property Owner: Richard Dierker
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Beth Mosteller , of Dale& Beth's Lake Use Permit Service
(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):
11 Balmoral Drive, Pittstown, NJ 08867
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized Signature Authorized Signature
Date: S a3'/9 Date:

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address: 338 Ponderosa Circle, Mooresville, NC 28117 County: lredell
Owner: Richard Dierker
Print Signature
Contractor/agent: Beth Mosteller 6A:el
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)]
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, Richard Dierker , 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 spe 'fication s ,and other supporting materials.
Signature (owner): Date: 5 -023 )9

Richard Dierker
338 Ponderosa Circle, Mooresville, NC
Parcel:4646232408.000 Lot: 28
I Lance D. Schamback, certify that this plat was drawn under my supervision from an actual
survey made under my supervision (deed description and/or Map Book:_.2._......._, Page 7 --.
That the boundaries not surveyed are clearly indicated as drawn from information as shown
survey; that the ratio of precision as • calculated is 1: 10,000+ that' this plat
was prepared in accordance with G.S.— 89-C as amended. Witness my original
signature, registration number and seal /,./�/-
this 1 day of October mil_ .„
A.D. 2018. Lance D. Schamback, PLS
LICENSE NUMBER: L-4295
P.a.;.iv., . lr----� ,,,NuMI.y,,
Lake NormanII Lake Norman
l'— '—-- Conrxfe s1:Qtt•O 0.4`
Exiting 760 Contour Line --��Erlting 760 Contour L1ne d�ottle i ��' ,
16.2 \
V..' Frame
t., Buildh g
NO2'39''11 129:92 NO2J608'W 109.88 Pe
/4'Reeor U; #4 Reear .J/4-IRS
Found Well` Found Found
Bent
50'From Exiting 50'From Exiting
760 Contour Line 760 Contour Line
TJ5'8erbock —1
Lot 28
23,361 Sq.Ft. 1
to 1 1
ol Concrete Fro 1 m<
l ,; Deck 3� Baamnenf 6 I"0
c, IS38 28. y5'0
Lot 29 Cm _ ' Lot 27
`°•e v n m,y � r 193
40.3 f. 22.0 1...v. I
Co T8.8 tb
01
:..1(-, i
CURVE TABLE :::-:-..:.ii r*l
CURVE LENGTH C RADIUS :j:�'35'Setback
kl
Cl 10.09 195.61 ``G..
Chord Distance hrod,Bearing 'i:i (. l
10.09 S04125 43 E LP.S•C1 .'•''•
5 V41 1 Found N024429'W 110.00 Re �ound v
SO2'37'03 E-109 _00 .. ,
_��16 n°
t14�bO1 5780.5 10t E.O.P.
afs Ponderosa Cir .
Lop.
Notes: &OP g.o.P. Bo' R/W
1) This property may be subject
to any Easements, Rights-of-way, - - -- -- -- -- R/W
and/or Restrictive Covenants. Legend
2) Boundary information based on Plot GRAPHIC SCALE no.= Power Pole
Book: 7 at Page: 7 as recorded
in the lredell County Register of Deeds.6° 0 2s so log Q= Guy Wire
3) This survey is of an existing S. E.O.P. = Edge of Pavement
parcel or parcels of land. R/W= Right-of-way
I.P.S. =#4 Reber Set
4) Area by coordinate method. ( IN FEET ) --"s,- = Not to scale
5) Area calculated by coordinate method. 1 inch = 50 ft El = Telephone Pedestal
Boundary Survey SCALE: 1" = 50
FOR
P"°de.,,,,cy Richard A. Dierker FIELD BOOK:
PROPERTY DESCRIPTION FILE: 2018-250
Site CQ,,,,4
oen',ac Lot 28, TAX PIN No.:. 4646232408
Pad •,ch. Lake Norman Bonanza
Sd,cmboc4 Surveying,P.A.
Plat Book 7, Page 7 Pont Office Box alas
Vicinity Map Neoreav➢Ie.NC tam
Not To Scale _ Davidson Township, lredell County. N.C. (704
C 83218 815

Richard Dierker
338 Ponderosa Circle, Mooresville, NC
Parcel: 4646232408.000 Lot: 28
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526 S Church St, Charlotte,NC 28202 to 338 Ponderosa Cir, Mooresville,NC 28117 - G... Page 1 of 2
Go gle Maps 526 S Church St, Charlotte, NC 28202 to Drive 26.0 miles, 41 min
338 Ponderosa Cir, Mooresville, NC 28117
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Map data 02019 Google 2 mi a
526 S Church St
Charlotte, NC 28202
Get on 1-277 S
55 s(0.4 mi)
t 1. Head southwest on S Church St toward W
Stonewall St
0.1 mi
A 2. Turn right to merge onto 1-277 S
0.2 mi
Follow 1-77 N to US-21 S in Davidson. Take exit 33 from 1-77
N
23 min(24.2 mi)
A 3. Merge onto 1-277 S
0.4 mi
t 4. Continue onto US-74 W
75 ft
I' 5. Take exit 1 C to merge onto 1-77 N
23.6 mi
? 6. Take exit 33 for US-21 N toward Lake Norman
0.2 mi
https://www.google.com/maps/dir/526+S+Church+St,+Charlotte,+NC+28202/338+Ponder... 5/21/2019

526 S Church St, Charlotte,NC 28202 to 338 Ponderosa Cir, Mooresville,NC 28117 - G... Page 2 of 2
Follow Williamson Rd to Ponderosa Cir
4 min(1.4 mi)
41 7. Use the left 2 lanes to turn left onto US-21 S
0.1 mi
41 8. Keep left to continue on Williamson Rd
0.4 mi
''1 9. Turn left onto Ponderosa Cir
0.5 mi
10. Turn left to stay on Ponderosa Cir
0 Destination will be on the left
0.4 mi
338 Ponderosa Cir
Mooresville, NC 28117
These directions are for planning purposes only.
You may find that construction projects,traffic,
weather,or other events may cause conditions to
differ from the map results,and you should plan
your route accordingly.You must obey all signs or
notices regarding your route.
https://www.google.com/maps/dir/526+S+Church+St,+Charlotte,+NC+28202/33 8+Ponder... 5/21/2019