20200662 Ver 1_Riparian Buffer Authorization Request_20200519

Buffer Authorization Application Form
15ANCAC 02B .0233 (8)(b), .0243 (8)(b), .0250 (11)(b), .0259 (8)(b), .0267 (11)(c), .0607 (e)(2) Buffer Authorization Online Fo
Update 10/23/2018
Original Submittal 5/19/2020
A. Owner/Applicant Information
General Information
Primary Contact Email:* [e-mail]
Rease list the contact person's enail for questions or payrrent on this project if needed.
Who is submitting the application?* W Owner
r Applicant other than Owner
r Agent
Is there an agent working on this application r Yes
but not submitting it? r No
1. Property Owner Information:
la. Name on Recorded Deed:*
Karl Kosobucki
1b. Responsible Party:
Karl Kosobucki
(for Corporations)
1c. Mailing Address:*
Street Address
119 PENWOOD DR
Address Line 2
aty
CARY
Fbstal / Zip Code
27511
1d.Telephone:* 2676849993
B. Project Information and Prior Project History
1. Project Information
State / Province / Pbegion
NC
Country
United States
le. Email Address:* [e-mail]
la. Name of Project:* Kosobucki Deck Replacement
(Subdivision, facility, or establishrrent narre)
1b. Is this a publicly -funded transportation project?*
Yes
r No
1d. Subdivision Name: Walnut Ridge
1e. Nearest Cary
Municipality:
1f. Property Size: 0.40
acres

1g. County (or Counties) where the project is located:*
Wake
1h. Property ID# Date of Purchase
PO40
Tax RN or Parcel id
1 i. Deed Information
Type of Book Book# Page#
Deed
Map
1j. 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 docurrent
FDF only
1k. How would you like to provide the Latitude and Longitude information?*
r Address Lookup
r Manually
Address Lookup Street Address
119 Penwood Drive
Address Line 2
City
Ca ry
Postal / Zip Code
27511-4868
Latitude * 35.7717406
State / Province / Region
NC
Country
us
Longitude *-78.7456503
11. Is the project located in any of North Carolina's twenty coastal counties?
r Yes
F No
2. Surface Waters
.............................................................................................................................................................................................................................................................................................................................................................................................................................................................................
2a. Name of the nearest body of water to proposed project:*
Walnut Creek
2b. Water Quality Classification of nearest receiving water:*
2c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:*
0
(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:

Existing house built in 1983 in neighborhood of similarly -aged houses. Desire to
replace 12xl6 deck with 14xl8 deck on same location. Town of Cary approves if I
get state approval because of buffer. There is no stream on or near our property.
The closest one to us is Walnut Creek, which I believe is about 400-500 feet away
from our property at its closest point, behind neighbors' houses across the street,
and we are about fifty feet above the level of the creek, per contour map.
There is a dry (except when it rains) storm drainage ditch on the neighbors'
property behind us that empties into a tributary of Walnut Creek. A 30' Town of Cary
easement protects that.
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 docurrent
Cary Property Research Map.pdf 1.89MB
USGS topo map.pdf 794.57KB
FDF only
3c. Attach an 8 % x 11 excerpt from the most recent version of the published County NRCS Soil Survey Map depicting the
project site.
dick the upload button or drag and drop files here to attach docurrent
FDF only
4. Proposed Activity
.............................................................................................
Provide a detailed description of the proposed activity including its purpose and include the type of equipment to be used:*
Remove rotted 12xl6 deck attached to house, replace with 14xl8 deck attached to
house, same location.
Attach a site plan as applicable to the project:
Click the upload button or drag and drop files here to attach docurrent
2020.5.15, Plot Plan w. deck proposal, revised.pdf 397.94KB
FDF 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?*
r Yes
r No
6. Project History
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*
C Yes
G No
7. Future Project Plans
..................................................................................................................................
7a. Is this project a phased project?* r Yes
r No
C. Proposed Impacts Inventory
Buffer Impacts
Project is in which protected Basin?*

r Neuse River Basin (15A NCAC 02B.0233)
C Catawba River Basin (15A NCAC 02B.0243)
C Randleman Lake Watershed (15A NCAC 02B.0250)
C Tar -Pamlico River Basin (15A NCAC 02B.0259)
r Jordan Lake Watershed (15A NCAC 02B.0267)
f 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 Typef] I
Zone 1 Zone 2
Ivbp label (e.g. Finad Permanent Exempt 0.00 0.00
Crossing 1) (p) Square Square
Perm orTenp Feet Feet
Total Zone 1 Impacts: 0.00
Total Zone 2 Impacts: 0.00
Total Buffer Impacts: 0.00
Comments:
I actually have no idea what buffer impact my rebuilding of a deck would have, or of
what impact type. The Town of Cary told me there is now a fifty foot, post-1983-
construction buffer on my property, which I can only assume must be related to the
dry drainage ditch on the neighbor's property behind our house.
I do not see a link on this form where I can find the information you request above.
The buffer and impact fields require a response, but I don't know if mine are correct.
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.*
I don't know of any measures I need to take. I am rebuilding an existing deck on my
house, extending it an additional two feet wide and two feet long. Also, on the
following page, I am resubmitting my plot plan where a pdf of diffuse flow
documentation is a required field. I have no such document and I havve indicated
that the project will not produce concentrated storm water flow.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.*
Same as above
E. Diffuse Flow Plan
la. What type of SCM are you providing?*
r Level Spreader
r Vegetated Conveyance (lower SMNT)
r Wetland Swale (higher SMNT)
rJ Proposed project will not create concentrated stormwater flow through the
buffer
r' 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 docurrent
2020.5.15, Plot Plan w. deck proposal, revised.pdf 397.94KB
FDF only
r_•
F. Supplementary Information ^
._J

Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?
r Yes
r No
Violations
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)?
f Yes
r No
2b. Is this an after -the -fact buffer authorization application?
r Yes
C 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 docurrent
FDF only
Additional Comments:
I thought I had all my ducks in a row with the Town of Cary, then learned of this
DWR buffer requirement that was added in 1997, after construction of the house in
1983. 1 had a builder lined up to start the deck next week. Please let me know if you
need any other information to expedite this request. Thank you.
H. Sign and Submit ^
k
By digitally signing below, I certifythat:
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');
• 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:* Karl Kosobucki
Signature
bw"
Submission Date: (Auto populated f idd)

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?*
r Yes r No
f Yes
r No
20200662
1
Stephanie Goss:eads\szgoss
Raleigh Regional Office - [phone]
r No Payment Needed
f Fee Received
r Need Fee - send electronic notification

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