20211707 Ver 1_Riparian Buffer Authorization Request_20211122

Water Resources
ENTAL QUALITY
Original Submittal 11/22/2021
A. Owner/Applicant Information
General Information
Primary Contact Email: * [e-mail]
Please list the contact person's email for questions or payment on this project if needed.
Who is submitting the application?* Owner
Applicant other than Owner
Agent
Is there an agent working on this application but Yes
not submitting it? No
1. Property Owner Information:
....................................................................................................................................
1a. Name on Recorded Deed:*
1b. Responsible Party:
1c. Mailing Address:*
1 d. Telephone:* 770-541-9046
TH Property Owner 11 LP Starwood Capital
Group
James Kane
(for Corporations)
Street Address
400 Galleria Pkwy SE
Address Line 2
Suite 1450
City
State / Province / Region
Atlanta
GA
Postal / Zip Code
Country
30339-5989
United States
2. Applicant's Information (if different from owner):
2a. Name: Eric Kulz
2b. Company Affiliation: Town of Cary
1e. Email Address:* [e-mail]
2c. Mailing Address: Street Address
Town of Cary
Address Line 2
P.O. Box 8005
City
State / Province / Region
Cary
NC
Postal / Zip Code
Country
27512-8005
United States
2d.Telephone: [phone]

2e. Email Address: [e-mail]
B. Project Information and Prior Project History
1. Project Information
1a. Name of Project:* Culvert Rehab - W. Dynasty at Poolside
(Subdivision, facility, or establishment name)
1b. Is this a publicly -funded transportation project?*
Yes
No
1d. Subdivision Name: Oak Hollow Apartments
le. Nearest Municipality: Cary
1f. Property Size: 28.93
acres
1g. County (or Counties) where the project is located:
Wake
1h. Property ID# Date of Purchase
RealID: 0055800 7/29/2018
Tax PIN or Parcel id
1i. Deed Information
Type of Book F
Book# Page#
Deed F 99 00949
Map 1784 264
1 j. Attach a copy of the recorded map that indicates when the lot was last platted.
Click the upload button or drag and drop files here to attach document
Oak Hollow Plat.pdf 421.12KB
PDF only
1k. How would you like to provide the Latitude and Longitude information?
Address Lookup
• Manually
Latitude* 35.810488 Longitude*-78.782062
11. Is the project located in any of North Carolina's twenty coastal counties?*
Yes
• No
2. Surface Waters
2a. Name of the nearest body of water to proposed project:
Black Creek

2b. Water Quality Classification of nearest receiving water:
C; NSW
2c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:*
1,100
(linear feet only)
3. Project Description:
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application:
The project site is located in a residential area in northern Cary, with the Oak Hollow
apartment complex to the north and the pool facility for the apartment complex to the
south. The surrounding area is a mix of single-family and multifamily residential
development.
3b. Attach an 8 '/. x 11 excerpt from the most recent version of the USGS topographic map indicating the location of the site.
Click the upload button or drag and drop files here to attach document
Dynasty Poolside USGS.pdf 121.66KB
PDF only
3c. Attach an 8'/2 x 11 excerpt from the most recent version of the published County NRCS Soil Survey Map depicting the project site.
Click the upload button or drag and drop files here to attach document
Dynasty Poolside Soils.pdf 160.22KB
PDF only
4. Proposed Activity
Provide a detailed description of the proposed activity including its purpose and include the type of equipment to be used:
The proposed project site is a road crossing over Black Creek (Crabtree
Creek/Neuse). Two nine -foot by 6.5-foot corrugated metal pipe (CMP) arch culverts
convey the stream beneath W. Dynasty Drive. The road was constructed in the
1980s, and the CMP arch culverts have experienced deterioration, In addition, Trees
have grown up over the culverts on the downstream (north) side of the road. The
proposed project will involve removal of trees from over and in close proximity to the
culverts. Saplings, shrubs and herbaceous vegetation will remain. Additionally, the
culvert joints will be sealed on the inside, and aluminum plates will used to line the
bottom of the culverts. This rehab work will be done by hand, and will not result in
additional buffer impacts beyond the tree removal.
Attach a site plan as applicable to the project:
Click the upload button or drag and drop files here to attach document
WDynasty@Poolside Impacts Map.pdf 691.85KB
PDF only
5. Jurisdictional Determinations
5a. Have jurisdictional wetlands or stream determinations by the Corps or State been requested or obtained for this property/project
(including all prior phases) in the past?*
Yes
No
6. Project History
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*
Yes
• No
7. Future Project Plans
7a. Is this project a phased project?* Yes
No

C. Proposed Impacts Inventory
Buffer Impacts
..........................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Project is in which protected Basin?*
Neuse River Basin (15A NCAC 02B.0233)
Catawba River Basin (15A NCAC 02B.0243)
Randleman Lake Watershed (15A NCAC 02B.0250)
Tar -Pamlico River Basin (15A NCAC 0213.0259)
Jordan Lake Watershed (15A NCAC 02B.0267)
Goose Creek Watershed (15A NCAC 02B.0606 & 15A NCAC 02B.0607)
Individually list all buffer impacts below. If any impacts require mitigation, then you MUST fill out Section D of this form.
Site# - Reason
Stream Name
Buffer Impact*
Impact Type*
Zone 1
Zone 2
Downstream -
Black Creek
Temporary
Allowable
40.00
0.00
Tree Removal
(T)
Square
Square
Map label (e.g. Road
Perm or Temp
Feet
Feet
Crossing 1)
Total Zone 1 Impacts: 40.00
Total Zone 2 Impacts: 0.00
Total Buffer Impacts: 40.00
Comments:
Impacts for protection of existing structures (culverts) total seven trees in two small
areas on the downstream (north) side of the road crossing.
D. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project.*
Impacts are limited to the removal of trees that are or have the potential to cause
damage to the culverts through crushing/deformation and infiltration into the culverts
by roots. A total of seven trees will be removed. Stumps will be left in place, and no
shrubs or herbaceous vegetation will be removed.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.*
Trees will be cut by hand and removed with a crane or trackhoe from the edge of the
road from high ground. No ground disturbance within the buffer will occur.
Rehabilitation of the interior of the culvert (cleaning, joint sealing, and lining with
plates) will all be done by hand without any impacts to the stream or buffers.
E. Diffuse Flow Plan
la. What type of SCM are you providing?*
Level Spreader
Vegetated Conveyance (lower SHWT)
Wetland Swale (higher SHWT)
Proposed project will not create concentrated stormwater flow through the buffer
Other SCM that removed minimum of 30% nitrogen
1 c. Diffuse Flow Documentation* Click the upload button or drag and drop files here to attach document
DIFFUSE FLOW DOCUMENTATION.pdf 49.71K13
PDF only

F. Supplementary Information
Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?
Yes
No
1 b. If you answered "yes" to the above, does the project require preparation of an environmental document pursuant to the
requirements of the National or State (North Carolina) Environmental Policy Act (NEPA/SEPA)?
2a. Is the site in violation of DWR Wetland Rules (15A NCAC 02H .0500), Isolated Wetland Rules (15A NCAC 02H .1300), DWR Surface
Water or Wetland Standards, or Riparian Buffer Rules (15A NCAC 02B .0200)?
2b. Is this an after -the -fact buffer authorization application?
Yes
• No
G. Additional Information
Please upload any additional information you would like the Division to consider during application review.
Additional Attachments: Click the upload button or drag and drop files here to attach document
Dynasty Poolside Aerial.pdf 122.72KB
PTE TH Property Owner 11 LP.pdf 281.08KB
PDF only
Additional Comments:
Project activities will occur on private property, but the activities are associated with
the maintenance of stormwater infrastructure associated with a public roadway, and
will be performed by contractors working for the Town of Cary. Right of entry
documents are included.
H. Sign and Submit
By digitally signing below, I certify that:
o I have given true, accurate, and complete information on this form;
• I agree that submission of this 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');
o 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 application form."
Print Name:* Eric Kulz
Signature
Submission Date: 11/22/21
(Auto populated Feld)

Initial Review
Is this accepted into the review process?*
Is this project a public transportation project?*
ID#*
Version:
Select Reviewer:
Select Reviewing Office*
Has payment been received?*
Yes No
Yes
• No
20211707
1
Colleen Cohn:eads\cmcohn
Raleigh Regional Office - [phone]
• No Payment Needed
Fee Received
Need Fee - send electronic notification

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DIFFUSE FLOW DOCUMENTATION
Proposed project (tree removal) will not create concentrated stormwater flow through the buffer.
Existing contours will not be altered, and any areas disturbed during access with culvert rehab
equipment will be stabilized with seed and straw, and allowed to revegetate. No permanent cleared
areas will be created as part of this project.

DocuSign Envelope ID: CD0723B9-2AD1-4603-8395-E53269023697
NORTH CAROLINA
WAKE COUNTY
PERMISSION TO ENTER AGREEMENT
This Permission to Enter Agreement ("Agreement") is made and entered into by and
between TH PROPERTY OWNER 11 LP, located at 400 GALLERIA PKWY SE STE 1450,
ATLANTA, GA, 30339-5989 ("Grantor") and the Town of Cary, a North Carolina municipal
corporation ("Town").
WITNESSETH:
WHEREAS, Grantor owns a parcel of property located at 102 CHAMNESS DR, CARY
NC, 27513, also identified as PIN 0764492793 ("Property").
WHEREAS, Town desires to perform maintenance of the culverts on or adjacent to your
property as show in the attached Exhibit. ("Work").
WHEREAS, Work requires that certain activities take place on Property.
WHEREAS, Owner has no objection to Town's request and desires to permit entry onto
Property by Town and its agents for such limited purpose and subject to the terms and conditions
contained herein.
NOW THEREFORE, in consideration of the premises and for other good and valuable
consideration, the receipt of which is hereby acknowledged, the parties agree as follows:
1. Purpose. The Recitals are incorporated into this Agreement. This Agreement sets forth the
terms and conditions pursuant to which Town may enter Property to conduct the Work.
2. Term. The term of this Agreement shall be for ninety (90) days from the date Agreement is
executed by the Grantor. The Grantor may extend that term by as much as four months upon receipt
of a written request from Town. The Grantor must receive a written request to extend the
Agreement at least 10 days before the expiration of the original term.
3. Privilege to Enter. The Grantor hereby grants to Town the nonexclusive and revocable
permission to enter upon the Property to conduct the Work, which will include taking actions
necessary for the repair of culvert(s) on or adjacent to your property, which will involve the 1)
removal of trees and woody vegetation over the top of the culverts from the street to just upstream
of the entrance to the culvert, 2) cleaning the inside of the culvert of rocks, sediment and debris and
3) repair of the culvert including sealing pipe joints and refabricating the bottom of the pipe crossing
of the street. Town will take necessary steps and precautions to minimize the impact of the Work
on the Property. Town may permit its employees, contractors, and agents ("Agents"), to enter
Property under this Agreement, and shall be responsible for all the acts and omissions of its Agents.

DocuSign Envelope ID: CD0723B9-2AD1-4603-8395-E53269023697
4. Responsibilities. All equipment or tools brought onto the Property by Town and/or its Agents,
and any waste generated shall be the sole property of Town and/or its Agents. Owner shall have
and assumes no liability or responsibility for the safe use, protection against theft, or disposal of
equipment or other property brought onto the Property or for any waste.
5. Laws and Regulations. Town shall comply with all federal, state and local laws, rules and
regulations, and shall be responsible for the submission of all necessary and appropriate
applications, fees and plans. Rights and obligations granted or imposed upon Town under this
Agreement do not confer any right or privilege other than the specific right or privilege granted.
Town shall comply with and obtain any federal, state or local governmental approvals and permits.
6. Precautions. Town and its Agents shall take precautions to minimize the impact of the work on
the Property. Town and its Agents shall exercise due care in performing all work on the Property.
9. Restoration. Within 30 days of conclusion of Work, Town shall restore the Property to the
condition as it existed prior to its entry onto Property, reasonable wear and tear excepted. In
addition, the Town shall not be responsible for restoring any vegetation or other material removed
from the Property as part of Work.
10. Revocation of Permission. In the event Town fails to comply with the terms and conditions
of this Agreement, Grantor may revoke the permission to enter by providing Town with written
notice of revocation.
11. Miscellaneous.
a) Assi n�. This Agreement may not be assigned without the written agreement
of Town.
b) Electronic Record. Town may convert a signed original of this Agreement to an
electronic record pursuant to a North Carolina Department of Cultural Resources
approved procedure and process for converting paper records to electronic records for
record retention purposes. Such electronic record of the Agreement shall be deemed for
all purposes to be an original signed Agreement.
c) Notice. All notices shall be in writing and delivered to the other party by personal
delivery, commercially recognized overnight courier service, or prepaid U.S. certified
mail, return receipt requested, addressed as follows:
L to Grantor: To address provided in the first paragraph of this Agreement, or as
otherwise specified in writing to Town by Grantor.
ii. to Town: Jan Patterson, PO Box 8005, Cary, NC 27512-8005
Notice shall be effective upon the earlier of: (a) actual receipt; or (b) 3 days after deposit
in the U.S. mail or other service. Each party is responsible for notifying the other of any
change of address.
d) Governing. This Agreement is governed by the laws of the state of North Carolina.
All suits or actions related to Agreement shall be brought exclusively in Wake County,
North Carolina.
e) Public Records. Grantor acknowledges that that records in the custody of Town are public
records and subject to public records requests. Town may provide copies of such records,
including copyrighted records, in response to public record requests
f) No Third -Party Beneficiaries. There are no third -party beneficiaries to this Agreement.
g) Performance of Government Functions. Nothing contained in this Agreement shall be
deemed or construed so as to restrict or inhibit the Town's police powers or regulatory
authority.

DocuSign Envelope ID: CD0723B9-2AD1-4603-8395-E53269023697
h) Entire Agreement. This Agreement constitutes the entire understanding between the parties
with respect to the activities contemplated by this Agreement. All prior agreements or
understandings, whether oral or written, are superseded. This Agreement may be amended
only by a written document duly executed by the parties.
i) Electronic Signatures. Grantor acknowledges and agrees that the electronic signature
application DocuSign may be used, at the sole election of Town, to execute this Agreement
and any associated documents. By selecting "I Agree," "I Accept," or other similar item,
button, or icon via use of a keypad, mouse, or other device, as part of the DocuSign
application, Grantor consents to be legally bound by the terms and conditions of this
Agreement and that such act constitutes Grantor's signature as if actually signed by Grantor
in writing. Grantor also agrees that no certification authority or other third -parry
verification is necessary to validate its electronic signature and that the lack of such
certification or third -parry verification will not in any way affect the enforceability of its
electronic signature. Grantor acknowledges and agrees that delivery of a copy of this
Agreement or any other document contemplated hereby, through the DocuSign application,
will have the same effect as physical delivery of the paper document bearing an original
written signature.
IN WITNESS WHEREOF, as of the days and year below written, this Agreement has been
duly executed by the parties hereto.
TOWN OF CARY:
DocuSigned by:
By V . wJ-111
504E5EE605C446E...
Name: Danna M. Widmar
Title: Assistant Town Manager
11/19/2021
Date:
GRAIJTgRed by:
B : PAS(, Q(A,(,S
98219D9CA5D244F...
Name: Paul Ahls
Title: Authorized signatory
Date: 11/18/2021