20211617 Ver 1_Riparian Buffer Authorization Request_20211105

Water Resources
ENTAL QUALITY
Original Submittal 11/5/2021
A. Owner/Applicant Information
General Information
Primary Contact Email: * [e-mail]
Please list the contact person's email 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 but Yes
not submitting it? No
1. Property Owner Information:
...................................................................................................................................
1a. Name on Recorded Deed:*
Mary Davenport Smith
1b. Responsible Party:
(for Corporations)
1c. Mailing Address:*
Street Address
10315 US Hwy 158 E
Address Line 2
City
State / Province / Region
Littleton
NC
Postal / Zip Code
Country
27850
US
1d. Telephone:* 2529555580 le. Email Address:* [e-mail]
B. Project Information and Prior Project History
1. Project Information A
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
1a. Name of Project:* Mary Davenport Smith Garage
(Subdivision, facility, or establishment name)
1b. Is this a publicly -funded transportation project?*
Yes
No
1d. Subdivision Name: Quail Haven
le. Nearest Municipality: Red Oak
1f. Property Size: 1.00
acres

1g. County (or Counties) where the project is located: *
Nash
1h. Property ID# Date of Purchase
033756 8/30/2004
Tax PIN or Parcel id
1 i. Deed Information
Type of Book Book#11 Page#
Deed F
719
Map 27 30
1 j. Attach a copy of the recorded map that indicates when the lot was last platted.
Click the upload button or drag and drop files here to attach document
RetrieveCachedPDF.pdf 373.75KB
PDF only
1k. How would you like to provide the Latitude and Longitude information?*
• Address Lookup
Manually
Address Lookup Street Address
4093 Tucker Trail
Address Line 2
City
Rocky Mount
Postal / Zip Code
27804-8312
Longitude*
Latitude * 36.0265387
11. Is the project located in any of North Carolina's twenty coastal counties?*
Yes
• No
2. Surface Waters
2a. Name of the nearest body of water to proposed project:
Unnamed tributary to pig basket creek
2b. Water Quality Classification of nearest receiving water:
C-NSW
State / Province / Region
NC
Country
US
-77.9068135999999
9
2c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
300
(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:
Residential lot in sub-division(1 acre) w/ home and garage. One corner of garage
crosses into riparian buffer.

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 document
Top map.pdf 71.69KB
PDF 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 document
PDF only
4. Proposed Activity
Provide a detailed description of the proposed activity including its purpose and include the type of equipment to be used:
Pay mitigation, requesting to pay mitigation for existing structure due to oversight at
time of construction in 2004
Attach a site plan as applicable to the project:
Click the upload button or drag and drop files here to attach document
Impact map.pdf 44.99KB
2021 survey.pdf 125.67KB
PDF 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?*
Yes
No
6. Project History
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*
Yes
O No
7. Future Project Plans
7a. Is this project a phased project?* Yes
No
C. Proposed Impacts Inventory
Buffer Impacts
Project is in which protected Basin?*
Neuse River Basin (15A NCAC 02B.0233)
Catawba River Basin (15A NCAC 0213.0243)
Randleman Lake Watershed (15A NCAC 02B.0250)
• Tar -Pamlico River Basin (15A NCAC 02B.0259)
Jordan Lake Watershed (15A NCAC 02B.0267)
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.
11 Site# - Reason II Stream Name 11 Buffer Impact* 11 Impact Type* 11 Zone 1 11 Zone 2 11

Corner of existing
No name
Permanent
Allowable
0.00
200.00
Garage in riparian
tributary to
(P)
w/
Square
Square
buffer zone 2
Pig Basket
Perm or Temp
mitigation
Feet
Feet
Map label (e.g. Road
Creek
Crossing 1)
Total Zone 1 Impacts: 0.00
Total Zone 2 Impacts: 200.00
Total Buffer Impacts: 200.00
Comments:
D. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project.*
None, this is an existing structure since 2004, oversight at the build / inspection
phase by the county.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.*
This is an existing structure
2. Buffer Mitigation
..........................................................................................................................................................................................................................................................................................................................................................................................................................................
2a. The table below identifies the square footage of impact to each zone of the riparian buffer and the required mitigation.
Zone 1
Total Impact Multiplier Required Mitigation
0.00
3
0
Square Feet
Square Feet
Zone 2
200.00
1.50
300.00
Square Feet
Square Feet
2b. What is the mitigation plan proposed for this Payment to private mitigation bank
project? * Payment to Division of Mitigation (DMS)
Permittee responsible mitigation
2e. Attach statement of availability from mitigation provider.*
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PDF only
2g. Comments:
E. Diffuse Flow Plan

la. What type of SCM are you providing?*
Level Spreader
Vegetated Conveyance (lower SHWT)
Wetland Swale (higher SHWT)
Proposed project will not create concentrated stormwater flow through the buffer
Other SCM that removed minimum of 30% nitrogen
1 c. Diffuse Flow Documentation* Click the upload button or drag and drop files here to attach document
disperse flow.pdf 37.27KB
PDF only
F. Supplementary Information a,^
Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?
Yes
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)?
Yes
No
2b. Is this an after -the -fact buffer authorization application?
Yes
No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violatiorl
One corner of the garage (built in 2004) crosses into the riparian buffer. This was only
recently discovered and is suspected to be an oversight at the time of building
permitting and inspections.
G. Additional Information l`-n)
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 document
PDF only
Additional Comments:
H. Sign and Submit
............................................................................................................................................................................................................................................................................................................................................................................................................................................................................
By digitally signing below, I certify that:
• 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')
• 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');
o 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: * Mary D Myrick

Signature
Submission Date: (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?*
• Yes No
Yes
• No
20211617
1
Colleen Cohn:eads\cmcohn
Raleigh Regional Office - [phone]
• No Payment Needed
Fee Received
Need Fee - send electronic notification