20201844 Ver 1_Riparian Buffer Authorization Request_20201201

Water Resources
Original Submittal 12/1/2020
A. Owner/Applicant Information
General Information
Primary Contact Email:* [e-mail]
Rease list the contact person's errail for questions or payment on this project if needed.
Who is submitting the application?* ® Owner
❑ Applicant other than Owner
❑ Agent
Is there an agent working on this application O Yes
but not submitting it? O No
1. Property Owner Information:
.....................................................................................................
la. Name on Recorded Deed:*
1b. Responsible Party:
1c. Mailing Address:*
1d. Telephone:* 919-915-0008
Gary Wheeler
(for Corporations)
Street Address
224 Bizzell Grove Church Rd
Address Line 2
City State / Province / Region
Selma NC
Wstal / Zip Code (buntry
27576 United States
le. Email Address:* [e-mail]
..........................................
B. Project Information and Prior Project History
1. Project Information
la. Name of Project:* 412 River Road
(Subdivision, facility, or establishment nacre)
1b. Is this a publicly -funded transportation project?*
r Yes
r No
1d. Subdivision Name: NA
le. Nearest Arapahoe
Municipality:
1f. Property Size: 0.07
acres

1g. County (or Counties) where the project is located:*
Pamlico
1h. Property ID# Date of Purchase
6465437386000/G101-23 5/21/2019
Tax RN or Parcel id
1 i. Deed Information
Type of Book Book# Page#
Deed F48 680
Map
1j. Attach a copy of the recorded map that indicates when the lot was last platted.
nick 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?*
F Address Lookup
r Manually
Address Lookup Street Address
412 River Rd
Address Line 2
aty
State / Frovince / Fbgion
Arapahoe
NC
Fbstal / Zip Code
Country
28510
Pamlico
Latitude * 37.97534 Longitude * 76.78058
11. Is the project located in any of North Carolina's twenty coastal counties?
r Yes
f No
1m. Is the project located within a NC Division of Coastal Management Area of Environmental Concern (AEC)?
G Yes
r No
2. Surface Waters
2a. Name of the nearest body of water to proposed project:*
Neuse River
2b. Water Quality Classification of nearest receiving water:*
River
2c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:*
75
(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:

Mobile home on lot
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
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:
Mobile home on lot with rear porch
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
f• 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
6b. List any permits/approvals that have been requested or obtained for this project in the past.
Application Date Date Issued Permit Type
5/20/2019 Building
r
6c. Please explain and detail according to "help file" instructions.*
Mobile home with rear porch
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)
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)
r 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.

Site# -Reason Stream Name Buffer Impact* Impact Type * Zone 1 Zone 2
Nbp label (e.g. Read
Permanent
Allowable
0.00
0.00
Crossing 1)::1
(p)
Square
Square
F2rmorTerrp
Feet
Feet
Total Zone 1 Impacts: 0.00
Total Zone 2 Impacts: 0.00
Total Buffer Impacts: 0.00
Comments:
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.*
Secondary wall installed to prevent dirt and sediment form running to the water. Al
runoff is held to soak in the ground or run away from the river.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.*
Sloped away from river and secondary wall to prevent runoff.
E. Diffuse Flow Plan
1a. What type of SCM are you providing?*
❑ Level Spreader
❑ Vegetated Conveyance (lower SHWT)
❑ Wetland Swale (higher SHWT)
17 Proposed project will not create concentrated stormwater flow through the
buffer
❑ Other SCM that removed minimum of 30% nitrogen
1c. Diffuse Flow Documentation* Click the upload button or drag and drop files here to attachdocurrent
412 River Rd Drawing.pdf 241.47KB
FUF 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?
f Yes
F No
Violation!
2a. Is the site in violation of DWR Wetland Rules (15A NCAC 021-11.0500), Isolated Wetland Rules (15A NCAC 02H .1300), DWR
Surface Water or Wetland Standards, or Riparian Buffer Rules (15A NCAC 02B .0200)?
r
c
2b. Is this an after -the -fact buffer authorization application?

r Yes
r No
G. Additional Information
Please upload any additional information you would like the Division to consider during application review.
Additional Attachments: (lick the upload button or drag and drop files here to attach docurrent
PDF only
Additional Comments:
H. Sign and Submit
By digitally signing below, I certify that:
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:* Gary Wheeler
Signature
Submission Date: 12/1/20
(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?*
O Yes O No
O Yes
O No
20201844
Robert Tankard:eads\rbtankard
Washington Regional Office - [phone]
C No Payment Needed
r Fee Received
r Need Fee - send electronic notification

VA
VD