20220337 Ver 1_Riparian Buffer Authorization Request_20220303

Original Submittal 3/3/2022
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:*
Gillian Duffy
1b. Responsible Party:
(for Corporations)
1c. Mailing Address:*
Street Address
PO Box 2074
Address Line 2
City
Wake Forest
Postal / Zip Code
27588
1d. Telephone:* 9194788149
2. Applicant's Information (if different from owner):
State / Province / Region
North Carolina
Country
United States
1 e. Email Address:* [e-mail]
2a. Name:
Randy Talton
2b. Company Affiliation:
Tobacco Road Custom Builders
2c. Mailing Address:
Street Address
6612 Suite 104 Six Forks Rd.
Address Line 2
6612 Suite 104 Six Forks Rd
City
Raleigh
Postal / Zip Code
27615
2d.Telephone:
9194788149
2e. Email Address:
[e-mail]
State / Province / Region
North Carolina
Country
United States
Water Resources
ENTAL QUALITY

B. Project Information and Prior Project History
1. Project Information
1a. Name of Project:* Hamilton Heights lot 42, 10824 Leslie Dr
(Subdivision, facility, or establishment name)
1b. Is this a publicly -funded transportation project?*
Yes
No
1d. Subdivision Name: Hamilton Heights
le. Nearest Municipality: Raleigh
1f. Property Size: 1.11
acres
1g. County (or Counties) where the project is located:
Wake
1h. Property ID# Date of Purchase
1709057304 5/20/2019
Tax PIN or Parcel id
1 i. Deed Information
Type of Book Book#11 Page#
Deed 017131 01943
I Map -IF IF- I
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
210796 HAMILTON HEIGHTS 42 PLOT PLAN 02-16-
158.46KB
22. pdf
PDF only
1k. How would you like to provide the Latitude and Longitude information?*
- Address Lookup
Manually
Address Lookup
Street Address
10824 Leslie Drive
Address Line 2
City
Raleigh
Postal / Zip Code
27614
State / Province / Region
NC
Country
us
Latitude* 35.93483 Longitude*-78.659797
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:
Falls Lake
2b. Water Quality Classification of nearest receiving water:
WS-IV;NSW
2c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:*
150
(linear feet only)
3. Project Description: A
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
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:
The site is currently a residential wooded lot. The use of this land will be for
residential single family home construction
3b. Attach an 8'/2 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
USGS map 10824 Leslie Dr..pdf 8.71VIB
PDF only
3c. Attach an 8'/2 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
NRCS 1970 Soil Map.pdf 1016.02KB
Web Soils Survey.pdf 714.01 KB
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:
Install 15" RCP driveway piping, compacted structural soil and stone. Equipment to
be used will be Skid steer, mid -size excavator and sheeps foot compactor
Attach a site plan as applicable to the project:
Click the upload button or drag and drop files here to attach document
Diagram.pdf 715.05KB
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
O No
6. Project History h
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
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?* O Yes
O 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 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 0213.0606 & 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
i
Zone 1
J
Zone 2
Residential
Permanent
Exempt
0.00
640.00
driveway
(P)
Square
Square
Map label (e.g. Road
Perm or Temp
Feet
Feet
Crossing 1)
Total Zone 1 Impacts: 0.00
Total Zone 2 Impacts: 640.00
Total Buffer Impacts: 640.00
Comments:
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
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
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
Letter from DENR Senior Specialist [80].pdf 2.48MB
PDF only
Additional Comments:
We are placing 16' of RCP 15" pipe in the ditch line and backfilling with structural
soils/crush and run for the driveway approach.
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")
• 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
• I intend to electronically sign and submit the application form."
Print Name:* Randy Talton
Signature
ww T��
Submission Date: 3-3-22
(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
20220337
1
Colleen Cohn:eads\cmcohn
Raleigh Regional Office - [phone]
• No Payment Needed
Fee Received
Need Fee - send electronic notification