20210703 Ver 1_More Info Received_20210727 (2)

St te of Narth Caratina
Depertment of Environrr,antat Quetity
Division of Water Rescurces
15A NCAC 028 .0233 {8Xb}, .0243 {8iib}, .0?s0 {11xb), .025e {8iibi, .0267 {1f )-{c), .0607 (ex?} -
Buffer Authorizat*on
FORil: BA 10-2013
Riparian Buffer Authorization Fcrm
A. Applicart lnform*tisn
l, Pryidlnfo*ndiut
la. t'lame of prolact Lot 39S
1b. County:lilake
1c. Nearest rnunicipality:Gamer
1d. Subdrvision name:Eagle Ridge
1e. ls the project lecated in any of l*orth Carolina's twenty esastal
countes? lfyes, answer lfbetow.Yes XNo
1f. ls the project tocated within a NC Diuision of Coastal ManagementArea
of Environrnental Concern (AEC)?Yes XNo
2, Ovmer tniormqtion
2a. Narne on Recorded
Deed;
LJ Clark, LLC
2b-
No"
Deed Book and Page 1813* 1850
2c. Map Book and Page No,
(include e copy of ffie
recorded map that ndicates
when the rol was cr€aled):
2d. Responsible Party
{for CorporBtions):
2e. Street address:t39 G Technology Dr
2f. City, state, zip:Gamer, No(h Cerolina 27529
29. Telephone no.:919.+22-7306
2h. Fax no.:
2i, Email addrms:!rlc1!@!jqa5[Is.eotr
3. Applicant lnformation (if difieeot from ownerl
3a. fuplicant is:Aq€nt Other, specify:
3b. t'lame;
3c. Bueiness name
(if apdicabte):
3d. Sueetad&esa:
3e. City, state, zip:
3f. Telephone no.;
39. Fax no.:
FOR/vt BA 10-2013 Page 1 of 6
3h. Email address:
AgenUConsuttant lnfonrption tif applicahlo)4,
4a. Narna:
4b. Businass name
(if applicahl,s):
4c. Street address:
4d. City, state, zip:
4e. Telephore nc.:
4f. Fax no.:
49. Email addre;
.!
FORM: BA 10-?013 Fage 2 cf 6
B.Proiect lnformation and Prior Project History
1. Pt"p"tty ld*,ift*fi"r,
1a. Property identification no. {tax PIN orparcel lD}:160919139S Real Estate lD:0417261
1b, Site coordinates iin decimal degrees):Latitude: 35.6711423 l-ongitude:
-78.8552721
1c. Property size:-32 acres
Z, $ur'acetttHers
2a. Name of nearest body of water to proposed projeet:Swift CreeUlake Benson
2b, \Alater Quality Clamification of nearest receiving water:\AE tll; NSW:CA
2c. River basin:Neuse
3, Pmiect De*cript*m
3a. Describe the existiag conditions on tfte site and the general land use in the vicinity of the Project at the
time of this applicalion: lillroded. Singte Famity Residences
3b. Attach an & 1A,x 11 excerpt fom the most reoent version of the USGS topographic map indicating the
location of the site
3c. Attach an S Tz x f i excerpt from the most rec9nt version of the published County NRCS Soil Survey Map
depicting the project site
3d. Listthe total estimated linear feet of all existing s?eams {intxmittent and perennial) on the property:
3e- Explain the purpose ollhe props€ed project:
3f. Describe lhe overall project in debil, including the type of equipment to be uaed:
4. Jurisdictional Determinations
4a" Have jurisdictionsl wedand or sfeam determinations by
the Corps or Slate been requested or obtahed for tfiis
prspertyl proiect $trduding all prior phases) in the past?
Yes No XUnknown
Comments:
4b. lf yes, y{ho delineated the jurisdictional areas?
Name 6t known):
ASency/ Gonsuttant Company:
Other:
4c. lf yes, listthe dates of the Corps jurisdictional determinations or State determinations and attach
documentation.
6. Proiest History
5a. Have permits or certifieations been requested or
obtained for this project (including alt prior phases) in
the past?
Yes XNo Unknown
S. ffyas, $#aiu ffid desil acesr&U t* Yldp fle" insuelifrIs'
L F$trr" PnSrct Flans
FORI{: BAlO-2013 Page 3 of 6
€a.
6b.
ls this a phased pro.iecn Yes XNo
lf yes, expiain.
C. Proposed lmpacis lnventory
t. B*frtlmpm*
1a. Project is in u*hich protected basin?X Neuse Tar-Pamlico Catau&a
Randleman Jordan Goose Creek
.tb. lndividuatly list all bufier impacts below. lf any inpacB require mitigafron, then you MU$T fill out Section
D of this form.
Buffer impact
number -
Permanent (P)
or Temporary
IT
Reason for
impact
Type olimpact
(exempt, allswable.
allowahl€ wl
mitig.tion)
$Iream name Buffer
mitigation
required?
Zone 1
impact
(sq ff)
Zane2
impact
(sc ft)
B1 XP T &"r*o*.-**&t**o,*;:';r {*a .Yes X No 800
BZKP T artt!:.<qrl6,r^Nr-r-<r.J*Bl.d l{ iL t-zt:*i Lt gr{x 1l*o
ffiPr Yes No
B1 PT Yes No
B$PT Yes No
ffiFT Yes No
Total hdferimp#h
'1c. Commefits:
FCIRft BAlO-2013 Page 4 of 6
Avoidanc€ and Mimimizalion't"
la.Specifcally describe measures taken to avoid or minimize the proposed impacts in designing project'
. L. r-l: '.\ { t:
1b. Specifically describe mea$ures taken to avc$d or minimize the proposed impacts through construction
techniques. / ,- -._.,. ( .,,. lirL - --
,.
"rtt*M'-S*-ro,2a.wilt the project result in an impact vyithin a p{otected riparian buf$er that
requires buffer mitigation?
Yes XNc
;;y-". th* id".fii, ,h" square feet of inpact to each zone of lhe riparian buffer that requires mitigation
and catculate the amount of mitigation required in ihe table below.
Zone Reason for impact Totat impact
{square feeQ
Multiplier Required mitigalion
{square feet)
Zone 1 3 (2 fot
Catawba)
Zone2 l.c
Total bufier mitQdi,on requir:d:
?c.lf buffer rnitigation is required, is payment to a mitigation bank or NG DMS
proposed?
Yes No
;;y""**tt * "**"nce tetter tam the mi€gation bank or NC DM6'
,-rf ,r, *, dr"t * **t.-type of mfigalion is propasad.
2f. Comments:
E.Diffuse Flow Plan
All bufier impacts and high ground impacts require diftrse flow or other form of i {orm.rT -!w
stormwater Leatment nauOe a plan that fulty docriments how dfr.se flonr will be I OSTer BMP
maintained. lf a Level spreader is proposed, attaeh a Level sprmder $upplenent
Form.
lf due to site cc*sffaints, a BMP other fran a level spreader is proposed, piease
provide a plan for stormwater teatrneflt as oudined in Chapter 8 ol fie NS
$tegnqater EMP Mgnual and attad: a BMP Supplement Form.
FORlvt tsA 10-2013 Fage 5 of S
F" $upplernentery lnformation
1. Envircnnental Documefilation
1a. Does the project involve an expenditure of public (federallstate/local) funds or the
use of public (federal/state) land?
Yes XNo
,lh lf you answered Yee" to the above, does the project require preparaton of an
environmental document pursuant to &e requiremenb af &e Nalional or State
(Nortr Carolina) Environmenhl Policy Ar* (NEPIJSEPA)?
Yes X No
1c.lf you ansrirered Yes" to the above , has the document besn finalized by tbe State
Clearing Hwse? (lf so, attach a copy of the NEPA or $EFA final appraval letter,)
Comments:
Yes X No
2. Violationt
2a.ls the site in violation of DIAR tAHand Rules (15A NCAC 02H .0500), lsolated
Wetland Rules {15A NCAC 02}l .1300), DIfVR Surface \Ahter or \Ileflard
Standards. or Riparian Bufrer Rules {15A NCAC 028 .0200}?
Yes XNo
2b. ls this an after-th+.tuct permit application?Yes X No
2c. lf you answered !es' to one or bo{h of Sre above questions, provide an explanation of the violation{s}:
!'i
' :^
'. .!;: t: I
-
Applicent/Agent's Printed Narne ApplicenUAgent's Sbnature
(Agerffs sbBahls is valil sB if an authuizatim iedttr fffi tte apgtiEot is
pro'{ided.}
Send 3 campl€te sets of this form a*d accompanying documents to the following:
Far governnlent tmlls,portdtlon prajects
sent hy First Class ttloil. via the US Posfof
Service:
NC DWR, Transpartation Permitting Unit
1617 Mail Service Center
Raleiqh, NC 276S9 - 1617
For all other projects sent by First Class
ilail vta fhe US Posfal Sarvrce
Karen Higglns
NCD\AR - 401 & Bufler Permitting Branch
161 7 Mail Service Center
Raleigh. NC 27699 - 1S17
For govenrnenf fransportatian project s
sent by delivery seruice {UPS, FedEx, etc.):
OR
NC DWR, Transportation Permitting Unit
512 N. Satisbury $treet
Raleioh, tic 27E04
For alt other prajects sent by delivery
service
{Ufi, FedEx, etc.):
OR Karen HQgins
II{CD\A,R - 401 & Bufler Permitting Branch
512 N. Salisbilry Street
Raleigh, NC 27604
F0Rin: BA 10-2013 Page 6 of 6