20201898 Ver 1_Riparian Buffer Authorization Request_20201207

Water Resources
Original Submittal 12/7/2020
A. Owner/Applicant Information
General Information
Primary Contact Email:* [e-mail]
Please 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:* Laura R Siegmund
1b. Responsible Party: (for Corporations)
1c. Mailing Address:* Street Address
PO Box31912
Address Line 2
city
Raleigh
Fbstal / Zip Code
27622
1d.Telephone:* 9194105542
..............
B. Project Information and Prior Project History
1. Project Information
State / Province / Region
NC
Country
United States
le. Email Address:* travis@midtowncustomhomes.c
om
la. Name of Project:* Siegmund Property House
(Subdivision, facility, or establishrrent narre)
1b. Is this a publicly -funded transportation project?*
r Yes
r No
1d. Subdivision Name: L07 SUB PT B BLB BLDMONTCL BM1964-00192
le. Nearest City of Raleigh
Municipality:
1f. Property Size: 0.31
acres

1g. County (or Counties) where the project is located:*
1 h. Property ID# Date of Purchase
1706455746 9/23/2019
Tax RN or Parcel id
1 i. Deed Information
Type of Book F
Book# Page#
Deed � 17584 0430
Map 1964 00192
1j. Attach a copy of the recorded map that indicates when the lot was last platted.
aick the upload button or drag and drop files here to attach document
5320 Collingswood Deed.pdf 117.33KB
R7F only
1k. How would you like to provide the Latitude and Longitude information?*
r Address Lookup
r Manually
Address Lookup
Street Address
5320 Collingswood Drive
Address Line 2
city
Raleigh
Fatal / Zip Code
27609-4320
State / Fravince / legion
NC
Country
US
Latitude * 35.8536129 Longitude *-78.6472097
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:*
Neuse River
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:*
88
(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:
The site is a developed neighborhood lot with curb and gutter. .
3b. Attach an 8 % x 11 excerpt from the most recent version of the USGS topographic map indicating the location of the site.

nick the upload button or drag and drop files here to attach document
NC_Raleigh_ West_ 20190730_TM_geo.pdf 113.57MB
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
5320 Collingswood Dr Soil Sample Map.pdf 212.65KB
RDF only
4. Proposed Activity
Provide a detailed description of the proposed activity including its purpose and include the type of equipment to be used:*
The proposed activity will be to construction of a new single family dwelling.
Equipment to be used will be a mini excavator and a skid steer.
Attach a site plan as applicable to the project:
aick the upload button or drag and drop files here to attach docurrent
532000LLINGSWOOD PP.pdf 115.69KB
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?* 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)
f Randleman Lake Watershed (15A NCAC 02B.0250)
r 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 Type * Zone 1 Zone 2
A

5320
Neuse River
Permanent
Allowable
0.00
754.00
Collingswood
(P)
Square
Square
rvbp label (e.g. Fbad
Fbrmor Tenp
Feet
Feet
Crossing 1)
Total Zone 1 Impacts: 0.00
Total Zone 2 Impacts: 754.00
Total Buffer Impacts: 754.00
Comments:
This area will be in zone 2 only.
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.*
The house was designed to stay out of zone 1 of the buffer. Proper placement and
labeling of buffer and silt fence.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.*
Proper installation of silt fence and managing it through out project
E. Diffuse Flow Plan ^
..... .... ......... ......... ......... ......... ......... ......... ......... ......... ......... ......... ......... ......... ......... ......... ......... ..................
1a. What type of SCM are you providing?*
r Level Spreader
r] Vegetated Conveyance (lower SHWT)
I- 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
1c. Diffuse Flow Documentation*(lick the upload button ordrag and drop files here toattach docunent
532000LLINGSWOOD PP.pdf 115.69KB
WF 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?
r Yes
F 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:
The site plan was loaded for the difuse plan as the proposed project will not create
concentrated stormwater flow through the buffer
H. Sign and Submit A
.............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
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:* Laura Rinne Siegmund
Signature
�e1z�uS%r�.e�rz'
Submission Date: (Auto populated f ield)

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
20201898
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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BKO17584PGO0430
Excise Tax: $630.00
WAKE COUNTY, NC
CHARLES P. GILLIAM
REGISTER OF DEEDS
PRESENTED & RECORDED ON
09-23-2019 AT 12:28:43
STATE OF NC REAL ESTATE
EXCISE TAX: $630.00
BOOK: 017584 PAGE: 00430 - 00431
NORTH CAROLINA GENERAL WARRANTY DEED
Parcel Identifier No. 0015305 Verified by
By:
Mail/Box to:
County on the day of , 20
This instrument was prepared by: Titchener Law Office, P_O. Box 19468, Raleigh, NC 27619
Brief description for the Index: _Lot 7, Part `B", Montclair S/D
THIS DEED made this 16" day of September, 2019, by and between:
GRANTOR:
JEAN TUTTLE TEDDER, Trustee of
The JEAN TUTTLE TEDDER REVOCABLE TRUST
DATED NOVEMBER 21st 2013
GRANTEE:
LAURA RINNE SIEGMUND, married
3210 Cobblestone Court
Raleigh, NC 27607
This instrument prepared by William R. Titchener, a licensed North Carolina attorney. Delinquent taxes, if any, to be paid by the
closing attorney to the county tax collector upon disbursement of closing proceeds.
WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby acknowledged,
has and by these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that certain lot or parcel of land
situated in House Creek Township, City of Raleigh, Wake County, North Carolina and more particularly described as follows:
BEING all of Lot 7, Part `B", Montclair Subdivision as shown on a map recorded in Book of Maps 1964, Page 192,
Wake County Registry.
Property Known as: 5320 Collingswood Drive, Raleigh, NC 27609
The property hereinabove described was acquired by Grantor by instrument recorded in Book 15514, page 696.
submitted electronically by "Titchener Law office"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the wake county Register of Deeds.

BKO17584PGO0431
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the
Grantee in fee simple.
And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple, has the right to convey the same
in fee simple, that title is marketable and free and clear of all encumbrances, and that Grantor will warrant and defend the title
against the lawful claims of all persons whomsoever, other than the following exceptions:
Declarations, restrictions, easements and encumbrances of record.
IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year fast above written.
JEAN TUTTLE TEDDER REVOCABLE TRUST
UIM C Ce_e�— OA-e 6�
JEAN TUTTLE TEDDER, Trustee
State of North Carolina- County of Wake
1, the undersigned Notary Public of the County and State aforesaid, certify JEAN TUTTLE TEDDER, Trustee of
THE JEAN TUTTLE TEDDER REVOCABLE TRUST personally appeared before me this day and acknowledged the due
execution of the foregoing instrument for the purposes therein expressed. Witness my hand and Notarial stamp or seal this 16" day
of September, 2019.
Notary Public
My Commission Expires: 09/25/2020
"'I M CHENER
NOTARY PUp jC
INA14E Cotk%Ty, ,qC

II
ZpNF I
2pNF
LOT 8
7
IMPERVIOUS COVERAGE
CALCULATIONS
HOUSE
2,759
SF
COVERED PORCH
386
SF
HVAC
18
SF
DRIVE & WALK
1,193
SF
TOTAL
4,356
SF
AREA INZONE 2
HOUSE 368 SF
COVERED PORCH 386 SF
TOTAL
88 LF OF CREEK I
S 74°44'00„� �� /
CREEK .—
LOT 7
BLOCK B
12,448 SF "?
0.2 r�
0
0
Lo
29.82
o COVERED M
1 4. PORCH
19.33 c*o rn
N 29.17 �
{� 2.33 W 4.5
PROPOSED
DWELLING
r-
to
Ln m
o N
CO W
4.926 o
i--i 4.75 0D 9.58
L 0
N
0-
N
I n ss C/o
N84°23'00"W 80.
Q WATER METER
oHu OHU of QHU MH
EXISTING CURB CUT
TO BE ABANDONED
& CURB TO BE REPAIRED
COLLINGSWOOD DR
50'PUBLICR/W
PIN # 1706456725
ZO_VED R-4
TNIMPIS.VOT.I CERTIFIEDSMEI4OfffISNOTBEENHGIEGLF,D-RFALOC_IL 61
I HEREBY CERTIFY THAT THIS PLAT WAS DRAWN FROM AN
ACTUAL FIELD SURVEY r"AT THIS SURVEY WAS MADE
IN ACCORDANCE �54v/
CRIPTION. THERE ARE
NO ENCROAC N.
SEAL
L3083 O
<1evRaER�P
PROFESSIONAL LAND SURVEYOR
R=3.5
5
0
w
v
0
0
�7
co
00
0
LOT 6
REFERENCES
BM 1964 PG 192
7S4 SF
REVISED 10-16-20 SHOW-W CREEKAREAS
REVISED 10-16-20 SHOW S0' CREEACBUFFER
REVISED 09-29-20 SHOWAREA OFDISTURBA_V1VCE
LANDS OF
MIDTOWN CUSTOMHOME'S
5320 COLLINGSWOOD
PART A MONTCLAIR BLOCK B
WOKE COUNTY RALEIGH NORTHC4ROLIAT4
DATE 09-16-20 BERNARD & ASSOCIATES
PROFESSIONAL LAND SURVEYORS
SCALE. I "=30' 324 DIMOCK WAY
532000LLIAIGSWOOD WAKE FOREST, NORTH CAROLINA 27587
C4RLSO.1V DMS [phone]

II
ZpNF I
2pNF
LOT 8
7
IMPERVIOUS COVERAGE
CALCULATIONS
HOUSE
2,759
SF
COVERED PORCH
386
SF
HVAC
18
SF
DRIVE & WALK
1,193
SF
TOTAL
4,356
SF
AREA INZONE 2
HOUSE 368 SF
COVERED PORCH 386 SF
TOTAL
88 LF OF CREEK I
S 74°44'00„� �� /
CREEK .—
LOT 7
BLOCK B
12,448 SF "?
0.2 r�
0
0
Lo
29.82
o COVERED M
1 4. PORCH
19.33 c*o rn
N 29.17 �
{� 2.33 W 4.5
PROPOSED
DWELLING
r-
to
Ln m
o N
CO W
4.926 o
i--i 4.75 0D 9.58
L 0
N
0-
N
I n ss C/o
N84°23'00"W 80.
Q WATER METER
oHu OHU of QHU MH
EXISTING CURB CUT
TO BE ABANDONED
& CURB TO BE REPAIRED
COLLINGSWOOD DR
50'PUBLICR/W
PIN # 1706456725
ZO_VED R-4
TNIMPIS.VOT.I CERTIFIEDSMEI4OfffISNOTBEENHGIEGLF,D-RFALOC_IL 61
I HEREBY CERTIFY THAT THIS PLAT WAS DRAWN FROM AN
ACTUAL FIELD SURVEY r"AT THIS SURVEY WAS MADE
IN ACCORDANCE �54v/
CRIPTION. THERE ARE
NO ENCROAC N.
SEAL
L3083 O
<1evRaER�P
PROFESSIONAL LAND SURVEYOR
R=3.5
5
0
w
v
0
0
�7
co
00
0
LOT 6
REFERENCES
BM 1964 PG 192
7S4 SF
REVISED 10-16-20 SHOW-W CREEKAREAS
REVISED 10-16-20 SHOW S0' CREEACBUFFER
REVISED 09-29-20 SHOWAREA OFDISTURBA_V1VCE
LANDS OF
MIDTOWN CUSTOMHOME'S
5320 COLLINGSWOOD
PART A MONTCLAIR BLOCK B
WOKE COUNTY RALEIGH NORTHC4ROLIAT4
DATE 09-16-20 BERNARD & ASSOCIATES
PROFESSIONAL LAND SURVEYORS
SCALE. I "=30' 324 DIMOCK WAY
532000LLIAIGSWOOD WAKE FOREST, NORTH CAROLINA 27587
C4RLSO.1V DMS [phone]