20140920 Ver 1_Riparian Buffer Authorization_20140825

Division of Water Resources
15A NCAC 0213.0233 (8)(b),
2 0 1 4 0 9 2 0
�� State of North Carolina
AUG Department of Environment and Natural Resources
Division of Water Resources
.0267 (11)(c), .0607 (e)(2) - Buffer Authorization
FORM: BA 10 -2013
Riparian Buffer Authorization Form
A. Applicant Information
1. Project Information
1a. Name of project:
5-1A tA
1b. County:
NA 14- UIAA
1c. Nearest municipality:
(Z CLAIM
1d. Subdivision name:
1e. Is the project located in any of North Carolina's
twenty coastal counties. If yes, answer 1f below.
❑ Yes M440
1f. Is the project located within a NC Division of Coastal
Management Area of Environmental Concern (AEC)?
❑ Yes Q NO
2. Owner Information
2a. Name on Recorded Deed:
vi t t (1
tit
2b. Deed Book and Page No.
2,p 9 p
2c. Map Book and Page No.
(include a copy of the recorded
map that indicates when the lot
was created):
✓
Q Z q
1
2d. Responsible Party
(for Corporations):
th � -f
4wl/%

B.
Project Information and Prior Project History
1.
Property Identification
1a.
Property identification no. (tax PIN or parcel ID):
1 b.
Site coordinates (in decimal degrees):
Latitude: 3 (j , b 4 S
Longitude: - l Qj , 6 ( 3 tj
1c.
Property size:
acres , 05 4 ct0
2.
Surface Waters
2a.
Name of nearest body of water to proposed
project:
�Ie S C rr� ki(,
2b.
Water Quality Classification of nearest receiving
water:
n 5
L
2c.
River basin:
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: (A V RAA wv� n 6—C 4MU Lam c Y
3b.
Attach an 8'/ 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
depicting the project site
3d.
List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
�Li
3e.
Explain the purpose of the pro osed project:
3f. Describe the overall project in pdetail, including the type of equipment to be used:
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 prior phases) in the past?
❑ Yes b4o ❑ Unknown
Comments:
4b.
If yes, who delineated the jurisdictional areas?
Name (if known):
Agency/ Consultant Company:
Other:
4c.
If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach
documentation.
5.
Project History
5a.
Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
EKS o ❑ Unknown
5b.
If yes, explain and detail according to "help file" instructions.
6.
Future Project Plans
6a.
Is this a phased project?
❑ Yes @a '4o
6b.
If yes, explain.
FORM: BA 10 -2013 Page 2 of 4

E. Diffuse Flow Plan
All buffer impacts and high ground impacts require diffuse flow or other form of
Effuse flow
stormwater treatment. Include a plan that fully documents how diffuse flow will be
❑ 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
�� tv� alk
a plan for stormwater treatment as outlined in Chapter 8 of the NC Stormwater BMP
�(i%(,
Manual and attach a BMP Supplement Form.
<
F.
Supplementary Information
1.
Environmental Documentation
1 a.
Does the project involve an expenditure of public (federal /state/local) funds or the use of
❑ Yes E pho
public (federal /state) land?
1b.
If you answered "yes" to the above, does the project require preparation of an
❑ Yes @40
environmental document pursuant to the requirements of the National or State (North
Carolina) Environmental Policy Act (NEPA/SEPA)?
1c.
If you answered "yes" to the above, has the document been finalized by the State
❑ Yes Ea 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 Wetland Rules (15A NCAC 02H .0500), Isolated
^'!
❑ Yes U� 4o
Wetland Rules (15A NCAC 02H .1300), DWR Surface Water or Wetland Standards, or
Riparian Buffer Rules (15A NCAC 02B .0200)?
2b.
Is this an after - the -fact permit application?
❑ Yes R No
2c.
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
AAi R r IKLOA�
Applicant/Agent's Printed Name Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Send this completed form and accompanying documents to the following:
For government transportation projects send For government transportation projects send
by First Class Mail via the US Postal Service: by delivery service (UPS, FedEx, etc):
NC DWR, Transportation Permitting Unit OR NC DWR, Transportation Permitting Unit
1650 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699 - 1650 Raleigh, NC 27604
For all other projects send by First Class Mail For.affother`p—rojP?ds send by delivery service
via the US Postal Service rOR PS, FedEx, etc.):
Karen Higgins ren Higgi ns NCDWR – 401 & Buffer Permitting Unit DWR – 401 & Buffer Permitting 1650 Mail Service Center 2 N. Salisbury Street
Raleigh, NC 27699 - 1650 leigh, NC 27604
FORM: BA 10 -2013 1\ "I Page 4 of 4

C. Proposed Impacts Inventory
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
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1. Buffer Impacts
2. Buffer Mitigation
2a. Will the project result in an impact within a protected riparian buffer that requires buffer
mitigation?
❑ Yes EA
1a. Project is in which protected
basin?
Zone
l.'y'Neuse ❑ Tar - Pamlico ❑ Catawba
❑ Randleman ❑ Jordan ❑ Goose Creek
1b. Individually list all buffer impacts below. If any impacts require mitigation, then you MUST fill out Section D of
this form.
Buffer impact
number —
Permanent (P)
or Tem o
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 WP ❑ T
Af W dAdL
1.5
❑ Yes o
®
L90
B2 Q& ❑ T
(r
❑ Yes ❑ No
2d. If yes, attach the acceptance letter from the mitigation bank or NC EEP.
❑ Yes ErNo
Q
B3 ❑ P ❑ T
❑ Yes ❑ No
B4 ❑ P ❑ T
❑ Yes ❑ No
B5 ❑ P ❑ T
❑ Yes ❑ No
B6 ❑ P ❑ T
❑ Yes ❑ No
Total buffer impacts
1c. Comments:
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
�U
1b. Specifically describe measures taken to oid or minimize the proposed impacts through construction
techniques. 4 W �A a
2. Buffer Mitigation
2a. Will the project result in an impact within a protected riparian buffer that requires buffer
mitigation?
❑ Yes EA
2b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation and
calculate the amount of mitigation required in the table below.
Zone
Reason for impact
Total impact
(square feet
Multiplier
Required mitigation
s uare feet
Zone 1
3 (2 for Catawba)
Zone 2
1.5
Total buffer mitigation required:
2c. If buffer mitigation is required, is payment to 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 M'D'iffuse flow
stormwater treatment. Include a plan that fully documents how diffuse flow will be
maintained. If a Level,Spreader is proposed, attach a Level Spreader Supplement Form. ❑ Other BMP
If due "to site constraints; 0MP other than a level spreader is proposed, please provide IV kAA kq tA-
a plan" for stormwater treatment-,as outlined in Chapter 8 of the NC Stormwater BMP
Manual and attach a BMP�Supplsment Form. bleae-
GVIA
F. Su pleinentary lnfo"i i8n
1. Environmental Documentation u
1 a. Does the project involve an expenditure of public (federal/statellocal) funds or the use of
❑ Yes O'No
public (federal/state) land?
1b. If you answered "yes" to the above, does the project require preparation of an
❑ Yes &KO
environmental document pursuant to the requirements of the National or State (North
Carolina) Environmental Policy Act (NEPA/SEPA)?
1c. If you answered "yes" to the above, has the document been finalized by the State ❑ Yes G1.Pao
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 Wetland Rules (15A NCAC 02H .0500), Isolated
❑ Yes af4o
Wetland Rules (15A NCAC 02H .1300), DWR Surface Water or Wetland Standards, or
Riparian Buffer Rules (15A NCAC 02B .0200)?
2b. Is this an after- the-fact permit application?
❑ Yes R No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
34a,P7�
Applicant/Agents Printed Name
Applicant/Agenrs Signature Date
(Agents signature is valid only if an authorization letter from the applicant is provided.)
Send this completed form and accompanying documents to the following:
For government transportation projects send For government transportation projects send
by First Class Mail via the US Postal Service: by delivery service (UPS, Fed&r, etc.):
NC DWR, Transportation Permitting Unit OR NC DWR, Transportation Permitting Unit
1650 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699 -1650 Raleigh, NC 27604
For all other projects send by First Class Mail For all other pi`o7ects_ send by delivery service
via the US Postal Service -'° (UpS, FedFx, etc.):
Karen Higgins rOR 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

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#1403 MAPLESLIDE COURT
LOT 2, NORTH RIDGE VILLAS, PAHSE 12
City of Raleigh, Wake County, North Carolina
PROPERTY OF: WILLIAM TYNDALL
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1500 Piney Plains Road, Suite 102
Cary, North Carolina 27518
Phone [phone]
Firm License III P -0873
HOUSE LOCATION PLOT PLAN
FOR
#1403 MAPLESLIDE COURT
LOT 2, NORTH RIDGE VILLAS, PAHSE 12
City of Raleigh, Wake County, North Carolina
PROPERTY OF: WILLIAM TYNDALL
MAP BOOK 1985 PAGE 2090 DEED REFERENCE
DRAWN BY: ARP I DATE: AUGUST 13, 2014
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RESIDENTIAL
LAND SERVICES, PLLC.
1500 Piney Plains Road, Suite 102
Cary, North Carolina 27518
Phone [phone]
Firm License III P -0873
HOUSE LOCATION PLOT PLAN
FOR
#1403 MAPLESLIDE COURT
LOT 2, NORTH RIDGE VILLAS, PAHSE 12
City of Raleigh, Wake County, North Carolina
PROPERTY OF: WILLIAM TYNDALL
MAP BOOK 1985 PAGE 2090 DEED REFERENCE
DRAWN BY: ARP I DATE: AUGUST 13, 2014

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