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+GENE` AUT'F IORIZ kTION FORM
MUM IR Y LECPAL DESMPTION
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Pmpaty Owner;
The undersigned, "5tered Pro" awfws OfIhe above no W Pr+]pertyf, do heinft authorise
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to act On ry hehWard Floe aq a>ame roemoary for the pr sirmj� IsSwInre and acceptarLca of
dt petmlt Or Offfi%M�M arbd gimpy OW all 4 andard and spodal oorortiians attar-W,
Property bvmAdd Of diffe� than propeityr aborre),
We horeby ❑ertifjr ft abm hbMwUw sulmniMW Fn thlS appfkatbm is true and aacurahe bo the
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Date: 4& .
RIPARIAN BUFFER NOTIFICATION FORM
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- :_ rpc se Rnd demon descrl�ietl in your appl leatlon_ impacts not indicated In the
•:-1e Suffer RUI*, 5ib� 5Qeclflc work should be provrded In the appkatavrl, [15A NC.A,C
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Mnvved from Zane I of the Buffer (withln 30 ft of the full pond elevation), Lertless
I1-i& df2 z6verel f widerml nod along the in med i&DE �;harel Ire c311 be removed,
:. �:,.L'Jg 6 ivu+a V& immediffre sno ml ine is a I lowed, (15A hr-14C fiZe .0 (b)]
_ - -.• ::..: : = . t -: v r . iota =law, d_ �xuessive disturharme of $round carer- [15,A NCAC 02 R _D2Q (b)]
LLS, lff.p.ri'Sr LIM. i WaaicwOS, etc_ are not a Bowed in the buffer unless spectf9olt-r approved
5.sl•.� Li-rli1atioII cn SIze for d�-ck5- [:I 5A NCJAC 02 S .024�(4) $rid (61]
a=:. w CZ _,_-4L%-.1 YL'IYl :ar:;J iYLLLAl in.*:Cate an access and irrdIrate ark trees -chat are to be remfimd. Tha
AL =•_ scribed. The approMed access corridor sha R be restored. Stark, spoil, cor+strtACti:On
j-E _ _"_7 y- rf<I ,.:aid iy A,1' 02 • D2 a nd 1SA WCAC W2 R .Q$ �4). (b)r t8j]
=v; ��:,rra zc ca---;wt ;v :' e'�'Jor &-Annebed for 4irect discharge to the kale_ AH con trurted star. ter
t - f. t �vaJ v J L _L t _ :1 IJ�j y.raJ e;,�vaEiar, aesd diszharge,d pror „o e-nterfirg the oj: far direc-cer, as di6u5e a r
■ + rr ,,�� ��++ p �y �y � 7 y .ba Jake. (!SA lr•jc,Ac WU 9()2 5), (6fl
- -• �' ' . her-2L• 'e state thax I have been Inforr.jad of the Catawba
Li io "ale rKr sp&d lcally stated Irk the appheation and -approrred
J"::. C'..peso if-ces OWRjr Is a violation and subject to enftmerne Rt. Cue Olgence will he
rill ae bulft withl n su Ixtantial comlaliance and intent of the 401 hater
4}.:. d uU-:• L-r Rules, the approved plan(s) and spocif-ication{s}r artd othersupportfn
Date: -(),3