20211176 Ver 1_Riparian Buffer Authorization_20210728

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 7/28/2021
A. Owner/Applicant Information
General Information
Primary Contact Email:*
Who is submitting the application?*
1. Property Owner Information:
la. Name on Recorded Deed:*
1b. Responsible Party:
1c. Mailing Address:*
1d. Telephone:* 919-656-3781
[e-mail]
Rease list the contact person's en -ail for questions or payrrent on this project if needed.
r Owner
W Applicant other than Owner
W Agent
Paul Sappie
(for Corporations)
Street Address
105 Marsden Court
Address Line 2
aty
State / Province / Region
Cary
NC
Rzstal / Zip Code
Country
27518
USA
2. Applicant's Information (if different from owner):
1e. Email Address:* [e-mail]
2a. Name:
Chase Bolesky
2b. Company Affiliation:
Genesis Construction
2c. Mailing Address:
Street Address
1018 Morrisville Parkway
Address Line 2
aty
State / Province / Pegion
Morrisville
NC
Fbstal / Zip Code
Country
27560
USA
2d. Telephone:
9196986402
2e. Email Address:
[e-mail]
2f. Attach a signed and dated copy of the authorization granting the applicant owner approval. An agent authorization form is
acceptable.

Click the upload button or drag and drop files here to attach docurrent
FDF only
3. Agent Information:
3a. Name:
3b. Company Affiliation:
3c. Mailing Address: Street Address
Address Line 2
aty
Fbstal / Zip Code
3d. Telephone:
3e. Email Address:
State / Province / Fegion
Country
3f. Attach a signed and dated copy of the agent Click the upload button or drag and drop files here to attach docurrent
authorization form. FDFOnly
B. Project Information and Prior Project History
1. Project Information
la. Name of Project:* 105 Marsden Deck
(Subdivision, facility, or establishrrent narre)
1b. Is this a publicly -funded transportation project?*
1d. Subdivision Name: Lochside Glen
le. Nearest Cary
Municipality:
1f. Property Size: acres
1g. County (or Counties) where the project is located:*
1 h. Property ID# Date of Purchase
0198921 7/1 /1994
Tax FIN or Parcel id
1 i. Deed Information
Book# F- Page#
0301
1 0301
1j. Attach a copy of the recorded map that indicates when the lot was last platted.
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FDF only
h

1k. How would you like to provide the Latitude and Longitude information?*
C Address Lookup
r Manually
Address Lookup Street Address
Address Line 2
City State / F ovine / Region
Fbstal / Zip Code Country
Longitude * -
Latitude * 35.7379341 78.76043899999999
11. Is the project located in any of North Carolina's twenty coastal counties?
r Yes
f• No
2. Surface Waters
2a. Name of the nearest body of water to proposed project:*
Lochmere Lake
2b. Water Quality Classification of nearest receiving water:*
WS-III:NSW
2c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:*
10
(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:
Deck is existing in residential portion of back yard. Deck is to be torn down and
rebuilt with 2' extension that dips slightly into 50' Riparian Buffer. Land slopes down
to dammed pond found in back yard. Land is currently used lightly for residential
activities like grilling or dogs.
3b. Attach an 8 %. x 11 excerpt from the most recent version of the USGS topographic map indicating the location of the site.
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FDF only
3c. Attach an 81/z 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 hereto attach docunent
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:*
We will be demolishing an old existing decking structure and replacing the structure
with a 2' extension as shown in the permitting site plan below. The purpose of the
new deck is to promote safety and increase the outdoor living space on the deck.
The equipment to be used will be saws, screws, composite decking, and pressure
treated lumber. There will be no use of heavy machinery like a bobcat. The new 2'
deck extension very slightly dips into the riparian buffer zone by inches and must be
addressed. We will take upmost care to not disturb the integrity of the water systems
in the surrounding area.
Attach a site plan as applicable to the project:
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FDF only

5. Jurisdictional Determinations
5a. Have jurisdictional wetlands or stream determinations by the Corps or State been requested or obtained forth is
property/project (including all prior phases) in the past?*
f 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
t: No
7. Future Project Plans
7a. Is this project a phased project?* r Yes
o No
C. Proposed Impacts Inventory
Buffer Impacts ^
Project is in which protected Basin?*
F 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)
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
Deck dips into
Lynn
Temporary
Allowable
0.00
4.00
zone 2 of the
Branch
(T)
square
Square
riparian buffer
Tributary
Perm orTerrp
Feet
Feet
rvbp label (e.g. Fbad
Crossing 1)
Total Zone 1 Impacts: 0.00
Total Zone 2 Impacts: 4.00
Total Buffer Impacts: 4.00
Comments:
The deck extension very slightly dips into the riparian buffer by a couple of feet.
D. Impact Justification and
1. Avoidance and Minimization
......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project.*
No heavy machinery used. We will be far away from impacting any water resources
and the deck will be built above 8 feet to ensure that it is not a impervious surface.
We have designed the deck to be as far away from the water system while still
satisfying the owners desires.

1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.*
All construction to be done diligently and with water features in mind. Use all
precautions with jobsite materials to ensure that no natural areas or water buffer
zones are impacted. Preform as much work as possible outside of buffer zones. Full
and complete clean of entire jobsite materials to ensure no left over materials are
found in buffer zones. Deck to be built 8' high so it is not impervious to the ground
below and water can still move and drain accordingly.
E. Diffuse Flow Plan
1a. What type of SCM are you providing?*
r- Level Spreader
Vegetated Conveyance (lower SHWT)
r Wetland Swale (higher SHWT)
r% Proposed project will not create concentrated stormwater flow through the
buffer
n Other SCM that removed minimum of 30% nitrogen
1c. Diffuse Flow Documentation* Click the upload button or drag and drop files here to attachdocunent
Paul Sappie Deck plot plan (1).pdf 37.49KB
FDF 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?
C Yes
o 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'
r No
2b. Is this an after -the -fact buffer authorization application?
C
o No
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 certify that:
o I have given true, accurate, and complete information on this form;
o 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
14

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:* Chase Bolesky
Signature
Submission Date: 07/28/2021
(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
r No
20211176
1
Stephanie Goss:eads\szgoss
Raleigh Regional Office - [phone]
C No Payment Needed
r Fee Received
r Need Fee - send electronic notification

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