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Home My WebLink About20140244 Ver 1_Riparian Buffer Authorization_20140314DR 2 0 1 4 0 2 4 4 State of North Carolina Department of Environment and Natural Resources Division of Water Resources Division of Water Resources 15A NCAC 026 .0233 (8)(b),.0243 (8)(b),.0250 (11)(b), .0259 (8)(b), .0267 (11)(c), .0607 (e)(2) - Buffer Authorization FORM: BA 10 -2013 Riparian Buffer Authorization Form A. Applicant Information 1. Project Information 1 a. Name of project: 5 r O 9c-A, _1b. County: aPa & Ao r 1c. Nearest municipality: CC bi L lei es IL- -1d. d. Subdivision name: 1 e. Is the project located in any of North Carolina's twenty coastal counties. If yes, answer 1f below. Yes El No 1f. Is the project located within a NC Division of Coastal Management Area of Environmental Concern (AEC)? [� Yes ❑ No 2. Owner Information 2a. Name on Recorded Deed: p 2b. Deed Book and Page No. p , i, re 1 20 no 730? 1 2c. Map Book and Page No. (include a copy of the recorded map that indicates when the lot was created): 2d. Responsible Party (for Corporations): Er A e % FCLSr` ,e r 2e. Street address: 9X Lf 2f. City, state, zip: 06111alle. ft/G , 1%VO 2g. Telephone no.: _ d, 9,6,Y 2h. Fax no.: 2i. Email address: 3. Applicant Information (if different from owner) LG , 3a. Applicant is: ❑ Agent ❑ Other, specify: 3b. Name: 3c. Business name (if applicable): 3d. Street address: 3e. City, state, zip: 3f. Telephone no.: 3g. Fax no.: 3h. Email address: 4. Agent/Consultant Information (if applicable) 4a. Name: 4b. Business name (if applicable): ®R) ' 4c. Street address: JUU 4d. City, state, zip: Lull 4e. Telephone no.: 4f. Fax no.: 4g. Email address: FORM: BA 10 -2013 Page 1 of 4 B. Project Information and Prior :Project History 1. Property Identification 1a. Property identification no. (fax PIN or parcel ID): D70 1'b.- Site coordinates (in decimal degrees). Latitude: Longitude: 1c. Property size: 13 acres 2. Surface Waters, 2a. Name of nearest body of water to proposed project: , 2b. Water Quality'Classification of nearest receiving water: 2c. River basin: 3. Project- Description 3a. ,Describe the existing condi 'ons on th- site and the ge eral land a in the /vicinit ofthe P{oject at'the tin]p of this applicati%n: 0� , `D� /' /l�i �p i �1v %i�� Gi�CJ 5 tip° 3b. Attach an 8'72 x 11 excerpt from the most recent version of the USGS topographic map indicating the location of the site 3c. Attach an 8'/ x 11 excerpt from the most recent version of the published County NRCS Soil Survey Map depictingthe project site 3d. List`the total esti ted,linea feet existing strr ams (i ermittent and perennial) on the property: /i • . 3e: lain the purpose "the proposed project: EPal-Coe 3f. De crib the ov rail projectrin detail, inclu ing,t/he,type of equipm nt to be u d:�. Ca/�f`TI`l1G � Il G�6cx.t :�7Ui�C % � � fSCSr(/L�Z • ��n S 4. Jurisdictional Determinations 4a Have jurisdictional wetland or stream- determinations by the Corps or State been requested or obtained for,this property/ project (including all priorphases), in the past? ❑ Yes ANo ❑ Unknown Comments: 4b. If yes, who delineated the jurisdictional re s? Name (if;khown): Agency/ Consultant Company: ''Other: 4c. If yes, list the -dates of the Corps jurisdictional, determinations or State determinations and attach documentation. S. Project History 5a.. Have permits or certifications been requested or obtained for this project (including all prior phases) i'n the past? ❑ Yes X No ❑ Unknown 5b. If yes, explain and detail according to "help file" instructions. 6. Future Project Plans 6a. Is this a phased project ?' ❑ YesIo 6b. Ifyes, explain. FORM: BA 10 -2013 Page 2 of 4 C. Proposed, Impacts Inventory Impact Justification and Mitigation 1. 1. Buffer.lmpacts ta.. Specifically describe measures taken to avoid or minimize the proposed impacts 1'Q- desi%��ing project. 1 b. 1'a. Project is in which protected basin? ❑ Neuse [ Tar - Pamlico ❑ Catawba ❑ Randleman Jordan ❑ Goose "Creek 1b. 'Individually list`all'bufferimpacts` below. Ifany impacts require mitigatioon, then you MUST fill out Section D of -this form. Buffer',impact number — Permanent (P) or Temporary Reason for impact Type,of, impact (exempt, allowable, allowable w/ mitigation) Stream name Buffer mitigation required? Zone 1' impact (sq ft) 'Zone 2; impact (sq ft) B1 PQ P El 0 pa d a Zone 1 ❑Yes: ❑ No 3 (-2 for Catawba) 62 9 P ❑ T Zone.2 ❑ Yes. ❑,No 63 ❑ P ❑'T Total buffer mitigation required: ❑ Yes 'El No If buffer mitigation is required, is paymentto a mitigation'bank "or NC ,EEP proposed? ❑ Yes ❑ No 64 ❑ P ❑ T If yes, attach the acceptance,letter from,the mitigation bank or-NC EEP. 2e. If no, then discuss what type of mitigation'is proposed. ❑Yes ❑ No Comments: 65 ❑ P ❑ T ❑ Yes ❑ No 86 ❑P El ❑Yes ❑No 'Total Jbuffer,impacts 1'c. Comments: D., Impact Justification and Mitigation 1. Avoidance and Minimization ta.. Specifically describe measures taken to avoid or minimize the proposed impacts 1'Q- desi%��ing project. 1 b. Specifically describe measures talon to avoid or- ,minimize the prop osed impacts through nstruction techniques. lrjdlTGl�/) SS t� "G /� m 441�G 2. Buffer Mitigation 2a. Will the project result in an impact within a protected riparian buffer that requires buffer mitigation? ❑ Yes No 2b. If yes, then identify the square feet of'impact to each zone ofthe-riparian buffer that requires mitigation and calculate the; amount of mitigation required in the "table below. Zone Reason for impact Total' impact s uare�feet Multiplier Required mitigation s uare'fe_ et Zone 1 3 (-2 for Catawba) Zone.2 1.5 Total buffer mitigation required: 2c. If buffer mitigation is required, is paymentto a mitigation'bank "or NC ,EEP proposed? ❑ Yes ❑ No 2d. If yes, attach the acceptance,letter from,the mitigation bank or-NC EEP. 2e. If no, then discuss what type of mitigation'is proposed. 2f. Comments: FORM: BA 10 -2013 Page 3. of 4 E. Diffuse Flow Plan All buffer impacts and high ground Impacts require diffuse flow or other form of Diffuse'flow stormwater treatment. Include,ta plan thatfully documents how diffuse flow will be E] Other BMP maintained. If 'a Level Spreader is proposed, attach a.Level Spreader Supplement Form. 1 a. If due to site constraints,'a BMP other than a level spreader is proposed, please provide_ ,a ❑ Yes [X No plan'for stormwater treatment as outlined in Chapter 8 of th&NC Stormwater BMP public (federal /state), land? Manual and attach a BMP Supplement Form.. 1 b. F. Supplementary Information, by First Class= Mail via the VS.Postal Service: 1. Environmental Documentation OR NO DWR, Transportation Permitting Unit 1 a. Does the projectinvolve an expenditure of public (federal /state /local) funds or the use of ❑ Yes [X No Raleigh, NC,27604 public (federal /state), land? For all other projects sent'by delivery service 1 b. If,you answered "yes" to the above, does the project require preparation of an ❑ Yes $�4o- OR Karen Higgins environmental document pursuant to the requirements of the National or State (North NCDWR —401 & Buffer Permitting Unit 1650 Mail Service Center Carolina) Environmental Policy Act (NEPA/SEPA)? Raleigh, NC 27699 - 1650 1 c. If you answered ",yes" to the above, has the document been finalized by the State ❑ Yes ❑ No Clearing House? (If so, attach a copy of the NEPA or SEPA final approval letter') Comments: 2. Violations 2a. Is the site in violation of DWR Wetlarid Rules (15A NCAC 02H .0500), Isolated Wetland ❑ Yes ANo Rules (1;5A NCAC'�02H' 1300), DWR 'Surface Water or1U,lletland; Standards, or Riparian Buffer Rules (15A NCAC 02B .0200)? 2b. Is•this an .after-the-fact permit application? ❑ Yes X No 2c. 'if, you, answered "yes" to one or both of1the -above questions, provide anexplanationof the violation(s): Er A�s APP nted Name Appli6 ant/Agents Signature iDate (Age nt's,signature�is valid only if.amauthorization letter from the applicant is provided) Send 3 complete sets of this form and accompanying documents fo�the following: Forgovernment transportation projects sent For government 'transportaiibn<projects sent by First Class= Mail via the VS.Postal Service: by delivery service (UPS, FedEx, etc.)': NC DWR, Transportation Permitting Unit OR NO DWR, Transportation Permitting Unit 1650 Mall Service Center, 512 N. Salisbury, Street Raleigh, NC 27699 - 1'650 Raleigh, NC,27604 For all other projects sent'by First Class Mail For all other projects sent'by delivery service via the US Postal Service (UPS, FedEx, etc.): Karen Higgins OR Karen Higgins NCDWR — 401 &'Buffer Permitting Unit NCDWR —401 & Buffer Permitting Unit 1650 Mail Service Center 512 N. 'Salisbury Street Raleigh, NC 27699 - 1650 Raleigh, NC 27604 FORM: BA.10 -2013 Page 4 of 4• cq v C- f VI Y\ 3 p1\ ft, -"I y Pel: 7C r 1 2, YS er '7-1,, ril C t,(_ fe btl _ � i 4x, 7j,., s' 0.90" iW i I i i i i i i i i 075° �V 0.40" iW i i i i i i i i i i o7p° �W 0.40" iW i i i i i i i i i i i n6° §s' b0.b0 °'w i i 1 1' 1 i 1' 107s' is o.bo °wv i i i i i i ohs° §s� po bo °wv i i i i i i Copyright (C) 1998, Maptech, Inc. '" y '• � YEw Aw •1. F. � - Nk C C31- Site t ^� j :r + "�• ° _ { ° • • ,•.y ti { !�""`�_ it At '.w. I ti�b J7 '�'f j} °f�if Cq Cockrell S f Magnetic Declination 0 0 0 0 N N � , SCALE 1:12000 MM 0 100 200 300 400 500 600 700 800 900 YARDS 0 1000 2000 FEET 0 100 200 300 400 500 600 700 800 METERS 10° W n6° §s' b0.b0 °'w i i 1 1' 1 i 1' 107s' is o.bo °wv i i i i i i ohs° §s� po bo °wv i i i i i i Copyright (C) 1998, Maptech, Inc. N 3 O O Ort -� Lon 0 3 a 0-0 0 S <y O "! Q O O <a:z3 m L o O. < a o�°- 3 od� C C in C-0 � m m 'o •0 d o, 3' 3 3 L m mo,3 LO rt m O O O :3 � rt m 0 o � o' '« v A- co M D C O C) N O C m Z � Z N O � o CD r = o� C7 D O r_ Z D Z 0 m w 0 C. 0 0 0 0 0 0 ti. w m 0 o' D b� a a 7 Pre &C 6 i jj 5 3 fo n Pee 2-al -ro C)y,5 Fr-t r C r 0 m 4 x toll 1 1 .5 r i SK 10 0 R PC 6. T9 ��IVIL� RNI _8R 10 �" k0N.,'04E�R 'F U:DER'IlYjDIR`E' SURVEY NORTH CAROLINA T � T Ar'hobN SUR S�F 440 S 6�AOTZFR -An 4d 14L NO to SEAVCOT'10UNti, ,R - `SHOWN L RECORD AS �o ERROR 0 Ouf_ 7ICS IC!AL!C4JLAtp SY�LA ,4?rp, T� RES M �w NOTARY fUSLICOF' THE,CPIJNTY M6 S AFORESAID, y PREPWRE,q,IN,',kCq DANCE AFORE$AfD. CERTIFY,,.THAT PE-T RkQry4TiO HQOD:L.�RICH�RbSqy. �A ftEpIs YEYOR,�PERSONALLY APPEARED WW N`OTHEKI�HAN A;)5 :SEFORE ME THIS RAY,AND A; - �OOWLEDGWIU r HA 1p, TwEs' 4 ��S.17T_YfRoesl ED. TEREV�LAND' - :.XECYTIOO, OF THEfOREGONr. SEE, PE, _ INSTRUMENT, WITNESSIMYIKANID,A Op Oi) ITN T� TA m _q,:5ECTjOt4�3_ POF, I AL,'THJ�,.T HE 15TH,04y 'dFAUGUST."199%,' �'AUGUSTJM4._ HOOD L, RICHARbsoN,.jR'I'.S] LARRY L. 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