20220233 Ver 1_Riparian Buffer Authorization Request_20220209

Water Resources
ENTAL QUALITY
Original Submittal 2/9/2022
A. Owner/Applicant Information
General Information
Primary Contact Email: * Pitt Co. Parcel 81056 - Traci Jones
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
1. Property Owner Information:
1a. Name on Recorded Deed:
1b. Responsible Party:
1c. Mailing Address:*
1d. Telephone:* 2525313471
3. Agent Information:
3a. Name:
3b. Company Affiliation:
3c. Mailing Address:
Traci Jones
Traci Jones
(for Corporations)
Street Address
3752 Woodmen Road
Address Line 2
City
Greenville
Postal / Zip Code
27858-8819
State / Province / Region
NC
Country
us
le. Email Address:* [e-mail]
Street Address
Address Line 2
City State / Province / Region
Postal / Zip Code Country
3d. Telephone: 3e. Email Address:
3f. Attach a signed and dated copy of the agent Click the upload button or drag and drop files here to attach document
authorization form. POF only
B. Project Information and Prior Project History
1. Project Information CI^

1a. Name of Project:* Pitt Co. Parcel 81056
(Subdivision, facility, or establishment name)
1b. Is this a publicly -funded transportation project?*
Yes
No
1d. Subdivision Name:
le. Nearest Municipality: Greenville
1f. Property Size: 1.00
acres
1g. County (or Counties) where the project is located: *
Pitt
1h. Property ID# Date of Purchase
Tax PIN or Parcel id
1 i. Deed Information
Type of Book Book# Page#
Deed -IF
Map IF
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
PDF only
1k. How would you like to provide the Latitude and Longitude information?*
Address Lookup
• Manually
Latitude* 35.446934 Longitude* 77.234085
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:
Clayroot Swamp
2b. Water Quality Classification of nearest receiving water:
C, Sw, NSW
2c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:*
350
(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

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
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:
Build single family residence (stick built)
Attach a site plan as applicable to the project:
Click the upload button or drag and drop files here to attach document
Parcel 81056 plans.pdf 951.92KB
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
• No
7. Future Project Plans
..........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
7a. Is this project a phased project?* Yes
`• No
C. Proposed Impacts Inventory
Buffer Impacts A)
...............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Project is in which protected Basin?*
Neuse River Basin (15A NCAC 02B.0233)
Catawba River Basin (15A NCAC 02B.0243)
Randleman Lake Watershed (15A NCAC 02B.0250)
Tar -Pamlico River Basin (15A NCAC 0213.0259)
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.
Site# - Reason 11 Stream Name Buffer Impact* Impact Type Zone 111 Zone 2
B1
Clayroot
Permanent
Allowable
600.00
40.00
Map label (e.g. Road
Swamp
(P)
Square
Square
Crossing 1)
Perm or Temp
Feet
Feet
Total Zone 1 Impacts: 600.00

Total Zone 2 Impacts: 40.00
Total Buffer Impacts: 640.00
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.
Lot is limited by septic and repair areas in the front of the lot, and lot is oddly shaped.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
No machinery will be necessary, just manual labor
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
Parcel 81056 plans.pdf 951.92KB
PDF 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?
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
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 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')
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');
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: * Traci Jones
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
20220233
1
Robert Tankard:eads\rbtankard
Washington Regional Office - [phone]
• No Payment Needed
Fee Received
Need Fee - send electronic notification