20210901 Ver 1_Buffer Form_20210625

Strickland, Bev
From: Kim Broome <[e-mail]>
Sent: Friday, June 25, 2021 10:59 AM
To: Perez, Douglas J
Subject: [External] Hardison Buffer Form
Attachments: Hardisonbuffer (2).pdf
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Doug,
I have attached the form you needed us to sign. Please let me know if you need anything else.
Thank You
Kim Broome
1

CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Project Name/address-\�
Print
Contractor/agent �
Print X. `f%nature
The approval is for the purpose and design described in your application. Impacts not indicated in the
application is a violation of the Buffer Rule. Site specific work should be provided in the application. [15A NCAC
02H .0506 and 15A NCAC 02B .0243(8)]
Trees are not allowed to be removed from Zone 1 of the Buffer (within 30 ft of the full pond elevation), unless
approved. Exception, those trees that are severely undermined along the immediate shoreline can be removed.
Minimal shaping and sloping along the immediate shoreline is allowed. 115A NCAC 023.f}243(6)]
Benching and grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 02B .0243
(6)]
Beaches, impervious patios, impervious walkways, etc. are not allowed in the buffer unless specifically approved
by the Division. There are limitation on size for decks_ [1SA NCAC 02B .0243(4) and (6)]
Work to be conducted from land must indicate an access and indicate any trees that are to be removed. The
work corridor should be described. The approved access corridor shall be restored. Staging, spoil, construction
material must be outside the buffer. [15A NCAC 02H .0502 and 15A NCAC 02B .0243 (4), (6), (8)]
Stormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
discharges must be at the natural elevation and discharged prior to entering the buffer directed as diffuse or
sheet flow at non -erosive velocities to the lake. [1SA NCAC 02B .0243(5), (6)]
Acknowledgement of NQtificatian
1, _ r>,rl Buffer
f s Dn hereby state that I have been informed of the Catawba
Riparian Buffer le_ Any work conducted in the buffer, not specifically stated in the application and approved
by the Division of Water Resources (DWR), is a violation and subject to enforcement. Due diligence will be
taken such that the construction will be built within substantial compliance and intent of the 401 Water
Quality Certification and Buffer Rules, the approved plan(s) and specification(s), and other supporting
materials.
Signature (owner): _ O r� Date_ t�_