20200936 Ver 1_Riparian Buffer Authorization Request_20200926

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 9/26/2020
A. Owner/Applicant Information
General Information
Primary Contact Email:* [e-mail]
Rease list the contact person's en -ail 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:*
1b. Responsible Party:
1c. Mailing Address:*
1d. Telephone:* 704-968-2061
Roger Hendrick
N/A
(for Corporations)
Street Address
2199 Yellow Fork Trail East
Address Line 2
aty
State / Province / Pbegion
Nebo
NC
Fbstal / Zip Code
Country
28761
US
B. Project Information and Prior Project History
1. Project Information
le. Email Address:* [e-mail]
m
1a. Name of Project:* Slide Repair
(Subdivision, facility, or establishrrent narre)
1b. Is this a publicly -funded transportation project?*
C'
(-- No
1d. Subdivision Name: 1780
le. Nearest Nebo
Municipality:
1f. Property Size: 5.00
acres

1g. County (or Counties) where the project is located:*
Burke
1h. Property ID# Date of Purchase
1743165110 7/30/2010
Tax RN or Parcel id
1 i. Deed Information
Type of Book Book#11 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
Latitude * 35.7391049
Street Address
2199 Yellow Fork Trail East
Address Line 2
City
State / Frovince / Region
Nebo
NC
Postal / Zip Code
Country
28761
Us
Longitude *-81.8948795
11. Is the project located in any of North Carolina's twenty coastal counties?
r Yes
r No
2. Surface Waters
2a. Name of the nearest body of water to proposed project:*
Lake James
2b. Water Quality Classification of nearest receiving water:*
Lake James
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 shoreline undisturbed Lake James
3b. Attach an 8 % x 11 excerpt from the most recent version of the USGS topographic map indicating the location of the site.

(lick the upload button or drag and drop files here to attach docurrent
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.
Click 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:*
Slide.
Repaired bank to original condition with soils.
Attach a site plan as applicable to the project:
Click the upload button or drag and drop files here to attach docurrent
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?*
r Yes
r No
7. Future Project Plans
...............................................................................................................
7a. Is this project a phased project?* C Yes
a No
C. Proposed Impacts Inventory
Buffer Impacts
Project is in which protected Basin?*
r Neuse River Basin (15A NCAC 02B.0233)
r Catawba River Basin (15A NCAC 02B.0243)
r Randleman Lake Watershed (15A NCAC 02B.0250)
r Tar -Pamlico River Basin (15A NCAC 02B.0259)
C Jordan Lake Watershed (15A NCAC 02B.0267)
r 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.
�1Site# - Reason I Stream Name Buffer Impact* Impact Type *IF Zone 1 Zone 21�
Slide NIA Temporary Exempt 0.00 0.00
lVbp label (e.g. Road (T) Square Square
Crossing1) FbrmorTerrp Feet Feet
Total Zone 1 Impacts: 0.00

Total Zone 2 Impacts: 0.00
Total Buffer Impacts: 0.00
Comments:
Returned to original state
D. Impact Justification and Mitigation
.... ......... ..... ...... ...... ...... ...... ..... ...... ...... ..... ...... ...... ......
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project.*
Erosion control maintained during re -compaction work. Reseeding upon completion
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.*
Silt fence, diversion ditches, seed, straw.
E. Diffuse Flow Plan
1a. What type of SCM are you providing?*
r Level Spreader
Vegetated Conveyance (lower SHWT)
r Wetland Swale (higher SHWT)
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* (lick the upload button or drag and drop files here to attach document
Slope Repair.pdf 64.88KB
PDF only
F. Supplementary Information
Environmental Documentation
1a. 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)?
r Yes
r No
2b. Is this an after -the -fact buffer authorization application?
F Yes
r No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
This was an emergency repair and not new planned improvement. For
documentation purposes.
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:
H. Sign and Submit
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:* Roger J. Hendrick
Signature
Submission Date: 9/26120
(Auto populated field)

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
20201314
1
Amy Annino:eads\amannino
Asheville Regional Office - [phone]
r No Payment Needed
f Fee Received
r Need Fee - send electronic notification

Slope Repair
2199 Yellow Fork Trail
Nebo, NC
• Remove overburden to sufficient depth for stabilization fabric in recommended intervals
• Terragrid RX1200 (See attached cut sheet)
• All fabric layers shall be tied into sufficient horizontal distance into the bank
• Replace material in lifts while benching into the existing undisturbed bank
• Consolidate soil close to or beyond surrounding native soil compaction
• Grade as close to (2:1) slope as possible
• Stabilize with see/mulch/straw/matting