20191507 Ver 1_Riparian Buffer Authorization_20191028

DWR
State of North Carolina
Department of Environmental Quality
Division of Water Resources Division of Water Resources
15A NCAC 02B .0233 (8)(b), .0243 (8)(b), .0250 (11)(b), .0259 (8)(b), .D267 (11)(c), .06D7 (e)(2) -Buffer Authorization
FORM: BA 10-2013
Riparian Buffer Authorization Form
A. Applicant Information
1. Project information
1 a. Name of project
Lot 401
1 b. County:
Wake
1c. Nearest municipality:
Garner
1d. Subdivision name:
Eagle Ridge
le. Is the project located in any of North Carolina's twenty coastal counties?
If yes, answer 1f below.
Yes x® No
1f. Is the project located within a NC Division of Coastal Management Area of
Environmental Concern (AEC)?
Yes ® No
2. Owner Information
2a. Name on Recorded Deed:
JLS Homes LLC
2b. Deed Book and Page No.
17532 1864
2c. Map Book and Page No.
(include a copy of the
recorded map that indicates
when the lot was create
2d. Responsible Party
(for Corporations):
2e. Street address:
121 Holyoke Ct
2f. City, state, zip:
Raleigh, NC 27603
2g. Telephone no.:
9194227306
µ 2h. Fax no.:
_
NA
2i. Email address:
_
[e-mail]
_
3. Applicant Information (if different from owner)
3a. Applicant is:
Agent LOther, specify:
3b. Name:
_
3c. Business name
(if applicable):
3d. Street address:
3e. City, state, zip:
3f. Telephone no.:
3g. Fax no.:
_
_
3h. Email address:_
_
' 4. Agent/Consultant Information (if applicable)
4a. Name:
_
4b. Business name
if applicable):
-
_
4c. Street address:
_
4d. City, state, zip:
_
4e. Telephone no.:
4f. Fax no.:
4g. Email address:
_ -1
FORM: BA 10-2013 Page 1 of 4

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
1609190299
1 b. Site coordinates (in decimal degrees):
Latitude: 35,670953 Longitude: 78.659373
1 c. Property size:
.28 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project:
Swift Creek / Lake Benson
2b. Water Quality Classification of nearest receiving water:
WS III; NSW; CA
2c. River basin: Neuse
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:
Wooded
3b. Attach an 8'/z x 11 excerpt from the most recent version of the USGS topographic map indicating the location
of the site
3c. Attach an 81/2 x 11 excerpt from the most recent version of the published County NRCS Soil Survey Map
depicting the project site
3d. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property;
3e. Explain the purpose of the proposed project:
3f. Describe the overall project In detail, Including the type of equipment to be used:
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by
the Corps or State been requested or obtained for this
property/ project (includingall rior phases)in the past?
Yes No x Unknown
Comments:
4b. If yes, who delineated the jurisdictional areas?
Name (if known):
Agency/ Consultant Company:
Other:
4c. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach
documentation.
5. Project History
5a. Have permits or certifications been requested or obtained
for this project (including all priorphases) in thepast?
Yes No LJ Unknown
5b. If yes, explain and detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project? Yes No
6b. If yes, explain.
FORM: BA 10-2013 Page 2 of 4

C. Proposed Impacts Inventory
1. Buffer Impacts.
1 a. Project is in which protected
basin?
® Neuse
❑ Randleman
Tar -Pamlico
❑ Jordan
Catawba
❑ Goose Creek
1 b. Individually list all buffer impacts below. If any Impacts require mitigation, then you MUST fill out Section D of
this form.
Buffer impact
number—
Permanent (P)
or Temporary
Reason for
impact
Type of impact
(exempt, allowable,
allowable w/
mitigation)
Stream name
Buffer
mitigation
required?
Zone 1
Impact
(sq ft)
Zone 2
impact
(sq ft)
B1 P T
House _.
Allowable
Swift
Yes No
1360 .
02 El P T
Yes 0 No
133 ❑ P ❑ T
❑ Yes No
64 ❑ P ❑ T
Yes ❑ No
B5 EJ P T
Yes ❑ No
B6 ❑ P ❑ T
U Yes U No
Total buffer impacts
.1c. Comments:
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project,
Silt Fence/ Light grading
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction
techniques,
2. Buffer Mitigation
2a. Will the project result In an impact within a protected riparian buffer that
requires buffer mitigation?
Yes No
2b. If yes, then identify the square feet of Impact to each zone of the riparian buffer that requires mitigation and
calculate the amount of mitigation required in the table below.
Zone
Reason for impact
Total impact
(square feel
Multiplier
Required mitigation
(square feet
Zone 1
3 (2 for Catawba)
Zone 2
1.5
Total buffer mitigation required:
2c.
If buffer mitigation is required, Is payment to a mitigation bank or NC DMS
proposed?
El Yes El No
2d. If yes, attach the acceptance letter from the mitigation bank or NC DMS.
2e. If no, then discuss what type of mitigation is proposed.
2f. Comments:
FORM: BA.10-2013
Page 3 of 4

E. Diffuse Flow Plan
All buffer impacts and high ground impacts require diffuse flow or other form of
Diffuse flow
stormwater treatment. Include a plan that fully documents how diffuse flow will be
❑ Other BMP
maintained. If a Level Spreader is proposed, attach a Level Spreader Supplement Form.
If due to site constraints, a BMP other than a level spreader Is proposed, please provide a
plan for stormwater treatment as outlined in Chapter 8 of the NC Stormwater BMP
Manual and attach a BMP Supplement Form.
F. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the
Li Yes No
use of public federal/state land?
1 b. If you answered "yes" to the above, does the project require preparation of an
Yes © No
environmental document pursuant to the requirements of the National or State (North
Carolina) Environmental Policy Act NEPA/SEPA ?
1 c. If you answered "yes" to the above, has the document been finalized by the State
❑ Yes No
Clearing House? (If so, attach a copy of the NEPA or SEPA final approval letter.)
Comments:.
2. Violations
2a. Is the site in violation of DWR Wetland Rules (15A NCAC 02H .0500), Isolated
Yes No
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 permit application?
El Yes No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
i
_Les Clark _9/30/19_
Applicant/Agent's Printed Name Applicant/Agent's Signature Date
Agent's signeture Is valid only If an authorizatlon lotler from the applicant is provided.)
Send 3 complete sets of this form and accompanying documents to the following:
For government transportation projects sent by
First Class Mail via the US Postal Service:
NC DWR, Transportation Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699 -1617
For all other projects sent by first Class Moil via
the US Postal Service
For government transportation projects sent by
delivery service (UPS, FedEx, etc.):
OR NC DWR, Transportation Permitting Unit
512 N. Salisbury Street
Raleigh, NC 27664
For all other projects sent by delivery service
(UPS, FedEx, etc.):
Karen Higgins Karen Higgins
NCDWR — 401 & Buffer Perm.itting Branch OR NCDWR — 401 & Buffer Permitting Branch
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699 - 1617 Raleigh, NC 27604
FORM: BA 10-2013 Page 4 of 4

coLirsel Bearing Distance
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rc Chord Chord Bear.
5� �,, GIIrVB fladius Length N 23`01.26' W
C1 50.00' 41.17' 40.02'
9
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B.O.M.2014, PG.773
1
m PROPOSED
0 17,7' '6B HOUSE � �� 20°• 50' CREEK
\ b
PROPOSED
M DWALK
i r _ B.O.M.2014, PG.773
' Cl 10 C STREET
4,TR PUB EASEMENT
HOLYOKE COURT
J� (55PUBLIC R/W)
NOTE: DECK WILL BE OVER 8'
\ OFF OF FINISHED GRADE.
NOTE: SHOWN I5 LOT 401 OF
EAGLE RIDGE SID • PHASE 68 60 90
REF: B.O.M.2014 PG.772-773 30 0 30
AREA = 0.280 ACRES GRAPHIC SCALE — FEET
121 HOLYOKE COURT
PRELIMINARY PLOT PLAN FOR:
T1as Is TO CERTIFY THAT THIS MAP WAS
PREPARED FROM AN ACTUAL SuRYLY OF THE JLS HOME
PREMISES, MADE UNDER MY SUPU MSION, AND
THAT THERE ARE NOT ANY ENCROACHMENTS,
EXCEPT AS NOTED TO THE BEST OF NY IQiOWLIDCE• PANTHER CREEK TWSP., WAKE CO:, N.C.
THAT THE RATIO OF PRECISION AS.CAL000ITED BY SCALE 1" 30' JUNE 13, 2019
LATRUOES AND DEPARTURES IS 1:10,000. REVISED: SEPTEMBER 24. 2019 (PER CLIENT El
THIS MAP WAS PREPARED FOR TITLE COMPANY USE
AND IS NOT INTENDED FOR RECORDATION OR mob,WATNINS SURVEYING. PA.
CONVEYANCES WITHOUT WRITTEN AUTHORIZATION P.O. BOX 444 / 1301 W. BROAD ST.
OF THE SURVEYOR AND OTHER APPROPRIATE OFROIALS.EREINARY PLAT FUOUAY VARINA. NORTH CAFIOLINA 27828
PROFESSIONAL LINO SURVEYOR R RECORDATION (919) 332—ti32E 2768—
L-3247