20200603 Ver 1_Riparian Buffer Authorization_20200429

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), .0267 (11)(c), .0607 (e)(2) - Buffer Authorization
FORM: BA 10-2013
A.
Applicant Information
1.
Project Information RECEIVEDINCDENWR
1 a. Name of project:
IX 6,4 K
1b. County:
w Aril
2020
1c. Nearest municipality:
1d. Subdivision name:
L� �,� ® a'sNon-Discharge."
1e. Is the project located in any of North Carolina's twenty coastal counties?
If es, answer 1f below.
El Yes No
&
1f. Is the project located within a NC Division of Coastal Management Area of
Environmental Concern AEC ?
❑ Yes R No
2.
Owner Information
2a. Name on Recorded Deed:
!TA Tayc-
2b. Deed Book and Page No.
'Q 0 "771
2c. Map Book and Page No.
(include a copy of the
recorded map that indicates
when the lot was created):
2d. Responsible Party
(for Corporations):
2e. Street address:
j C10 rZ; 1,1 1 ie
2f. City, state, zip:
-0; ' &
2g. Telephone no.:
Z
2h. Fax no.:
2i. Email address:
r50 D r�_sf, r. :+,�•-
3.
Applicant Information (if different from owner)
3a. Applicant is:
oe
Agent ❑ Other, specify:
3b. Name:
1 D x02
3c. Business name
(if applicable):
3d. Street address:
175, A v rw 1C w
D
3e. City, state, zip:
1M o r r. S y l l� "C'
3f. Telephone no.:
qL 3 q,-7
3g. Fax no.:
3h. Email address:
c. t S - S r e
i -, o Ve oce, 4S. Co
4.
AgenVConsultant 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:
FORM: BA 10-2013 Page 1 of 4

M
B.
Project Information and Prior Project History
1.
Property Identification
1 a Property identification no (tax PIN or parcel ID)
D `�- a? Q
1b. Site coordinates (m decimal degrees)
Latitude- 35.93500 1 Longitude -71. 70q 3o
1 c Property size:
s rry acres
2.
Surface Waters
2a Name of nearest body of water to proposed project:
2; c 1 C r-ee,
2b. Water Quality Classification of nearest receiving water
W
2c River basin:
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. l
S I� ai-0-
3b. Attach an 8 '/2 x 11 excerpt ftm the most recent v sion of the USGS topographic map indicating the location
of the site
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
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(including all priorphases) in thepast?
❑ Yes ❑ No P21inknown
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
documentation
or State determinations and attach
5.
Project History
5a Have permits or certifications been requested or obtained
for this project(including all priorphases) in thepast?
❑ Yes ❑ No Unknown
5b If yes, explain and detail according to "help file" instructions.
6.
Future Project Plans
6a Is this a phased project?
❑ Yes VIN o
6b If yes, explain
f—
FORM: BA 10-2013
Page 2 of 4

C. Proposed Impacts Inventory
1. Buffer Impacts
1a 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
this form
fill out Section D of
Buffer impact
number —
Permanent (P)
or Temporary
T
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 RrP ❑ T
QR��M
G llov S!'(
ii�¢x
El Yes No
136
B2 ❑ P ❑ T
❑ Yes ❑ No
B3 ❑ P ❑ T
❑ Yes ❑ No
B4 ❑ P ❑ T
❑ Yes ❑ No
B5 ❑ P ❑ T
❑ Yes ❑ No
B6 ❑ P ❑ T
❑ Yes ❑ No
Total buffer impacts
1 c 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
lb
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 feet
Multiplier
Required mitigation
s uare feet
Zone 1
3 (2 for Catawba)
Zone 2
15
Total buffer mitigation required:
2c.
If buffer mitigation is required, is payment to a mitigation bank or NC DMS
proposed?
❑ Yes ❑ 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 qZ 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
❑ Yes YNo
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 o
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?
❑ Yes o
2c If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s)
Applicant/Agent's Printed Name Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter 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 Mail via
the US Postal Service
Karen Higgins
NCDWR — 401 & Buffer Permitting Branch
1617 Mail Service Center
Raleigh, NC 27699 - 1617
For government transportation projects sent by
delivery service (UPS, FedEx, etc.):
OR NC DWR, Transportation Permitting Unit
512 N Salisbury Street
Raleigh, NC 27604
For all other projects sent by delivery service
(UPS, FedEx, etc.):
Karen Higgins
OR NCDWR — 401 & Buffer Permitting Branch
512 N. Salisbury Street
Raleigh, NC 27604
FORM: BA 10-2013 Page 4 of 4

Pr',Cl'c ;TV LEGAL C[SCFCP}ZOj\1:
L'3T No- �I ` PLM NO. PARCEL VD:
STREET ADU�IESCS-
Prope:;j, Owner: `'a"C rrc—
?=reperiy Own2,: S=ck
i he undersigned, registered property owners of the above noted properly, do hereby authorize
r 5
(Contractor /!agent) (dame of consulxing firm)
o act on nay behalf and take all acions necessary for the prccessing, issuance and accepizncs of
is Pe, - mIt or certification and any and a,l standard and special conditions at ached.
Prope-ty Ow,isr's Address (if dif krent than property above):
Telephone:
U'de hereby certify the above Information submitted In this application Is true and accurate to the
best of our knowledge.
�chorIzed €g'n/a'ttuure Authorized Vgnature
DEte: 7l �� S' Cl) Date:

PROPERTY OF
JOSE IBARRA & RAQUEL MARRA
LOT 49, LAKELAND WOODS
5008 RICHLAND DRIVE
SCALE: 1 "=100' (THIS SHEET ONLY)
DEED BOOK 8210, PAGE 2779
REFERENCES: BOOK OF MAPS 1995, PAGE 817
BOOK OF MAPS 1997, PAGE 1281
LEGEND NOTES:
0
Ex, iron pipeirod or nail
O
Calculated pow
0
Water meter
0
Sanitary sewer manhole
Lamp post
— x —
Fence
— OU —
Overhead utility
DB
Doed Book
PB or BM
Plat Book I Book of Maps
FFE
Finisheddloorelevation
PG
Page
S.F.
Square feet
AC.
Acres
RNV
Right-cfxvay
AG
Above ground
BG
Below gram
YFP
yearfloodplain
Toe
Top of bank (croak) I
RP
Riparian buffer - r
SBFD
Story brickRrame dwelling
STf A OF
NORTH CAROLINA
DB 7305. PG 615
PIN: 0785-18-7931
SEE MEET
2OF2
MEREDITH TOWNSHIP
WAKE COUNTY
RALEIGH, NORTH CAROLINA
JAN UARY 13, 2020
1) Ali distances are horizontal ground in u.s. survey feet unless otherwise noted.
2) The basis of all easements, fight —of —ways, buffers, setbacks and adjoiners, etc., referenced
from Book of Maps 1996, Page 817 & Wake County GIS unless otherwise noted.
3) No investigation into the existence of jurisdictional wetlands performed by Newcomb Land
Surveyors. Riparian buffer shown hereon measured from top of bank of Richland Creek and no
official determination has been made regarding said creek.
4) Rear portion of subject property is located within a special flood hazard zone-FLOODWAY-
per FEMA Flood Insurance Rate Map (FIRM) #3720078500J, effective date May 2.2006.
5) The State Plane Coordinates forthis projeatwene produced with RTK GPS observations
and processed using the North Carolina VRS network. The network positional accuracy of the
derived positional Information Is 30.01r.
VERTICAL DATUM = NAVD 88
J
6) Builder/ homeownerto verify all dimensions, placement of proposed Improvements and
`
applicable zoning regulationstsetbacks priorto construction.
s• \ C$
7) All construction to be in accordance with City of Raleigh and/or NCOOT standards and
\Gy� si
specifications.
y
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PRELIMINARY PLAN FOR BUILDING PERMIT APPLICATION ONLY ����/�G`��N•L. ��` �����
NOT FOR SALES, RECORDATION OR CONVEYANCES ''111111miW."�
NEWCOMB land surveyors, Uc, 7008 Harps Mill Road, Ste. 105, Raleigh, NC 27615
Phone (919) 847-I800, License #P-0203
This survey performed and map prepared without benefit of a title report. This survey subject to any 207551
facts and easements which may be disclosed by a full and accurate title search. PIN' 0785-18-7204
s/a Bt:Nr
LOT d9 FLUSH\
69,189 S.F.
SHED 1.59 AC. `00
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1, Justin L Luther, certify that this plat was drown under my supervision from an actual survey made under my supervision
from references as noted, that the boundaries not surveyed are cleany indicated as drown from information noted under
references, that the ratio of precision or positional accuracy exceeds 1:10,000, and that this plat meets the requirements of
The Standards of Practice for Land Surveying in North Carolina (21 N04C 56.1600)
Witness my original signature, license number and seal this day of
Professional Land