20150012 Ver 1_More Info Received_20150128

2 0 1 5 0 0 2 7
State of North Carolina
Department of Environment and Natural Resources
"Division of Water Resources Division of Water Resources
15A NCAC 0213.0233 (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
la
Name of project
Martin Cottage Addition (44 North Pond Road)
1b
County
Hyde
1 c
Nearest municipality
Ocracoke
1 d
Subdivision name
Pamlico Shores
le
Is the project located in any of North Carolina's
twenty coastal counties If yes, answer 1f below
X Yes
❑ No
1f
is the project located within a NC Division of Coastal
Management Area of Environmental Concern (AEC)?
X Yes
❑ No
2.
Owner Information
2a
Name on Recorded Deed
Charles R Martin
2b
Deed Book and Page No
111 -481
2c Map Book and Page No
(include a copy of the recorded
map that indicates when the lot
was created)
X6 -31
2d
Responsible Parry
(for Corporations)
Sally Martin
nn a�
2e
Street address
P O Box 39
2f
City, state, zip
Jones Mills, PA 15646
2g
Telephone no
252 - 921 -0261
2
2h
Fax no
21
Email address
salnchasmartin@gmail corn
401 & SUEEFR pr-PR ER RESOUR
3.
Applicant Information (if different from owner)
3a
Applicant is
x Agent ❑ Other, specify Contractor
3b
Name
Thomas Pahl
3c
Business name
(if applicable)
Landmark Building and Design, LLC
3d
Street address
P O Box 1056
3e
City, state, zip
Ocracoke, NC 27960
3f
Telephone no
860- 933 -0259
3g
Fax no
3h
Email address
thpahl @earthlink net
4.
Agent/Consultant Information (if applicable)
4a
Name
4b
Business name
(if applicable)
4c
Street address
4d
City, state, zip
4e
Telephone no
4f
Fax no
4g
Email address
FORM BA 10 -2013 Page 1 of 7
2
Es

B.
Project Information and Prior Project History
1.
Property Identification
la
Property identification no (tax PIN or parcel ID)
9501 -22 -0243 Lot #9
lb
Site coordinates (in decimal degrees)
Latitude 35-7-112
Longitude - 75 -58-W 36
1 c
Property size
11 acres
2.
Surface Waters
2a
Name of nearest body of water to proposed project
Pamlico Sound
2b
Water Quality Classification of nearest receiving water
Tidal Saltwater SC
2c
River basin
N/A
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
The existing site is developed with an existing 24' X 18' cottage approx 50' back from the high water The site is
cleared, with some overgrown brush between the cottage and the road It is in a residential neighborhood
3b
Attach an 8 Y2 x 11 excerpt from the most recent version of the USGS topographic map indicating the location of
the site
3c
Attach an 8' /Z x 11 excerpt from the most recent version of the published County NRCS Sod Survey Map
depicting the project site
3d
List the total estimated linear feet of all existing streams (intermittent and perennial) on the property
-0-
3e
Explain the purpose of the proposed project
Owner wishes to live there full time and would like to expand the existing cottage to make the current roofed
porch into living space and then to add on a new roofed porch, extending the footprint approximately 6' toward
Pamlico Sound
3f
Describe the overall project in detail, including the type of equipment to be used
Most of the project will take place as a remodel within the existing footprint Worts outside of the footprint includes
the addition of new 6' x 24' roofed porch, which will require the installation of 5 new 8x8 pilings within the 50'
buffer Piling installation will require a small backhoe and a pump to wash the pilings in to a depth of 8' as
required by the budding code The project also includes raising the existing structure approximately 18" in order
place the new finish floor at or above the FEMA/Hyde County required elevation (7' AMHSL)
4.
Jurisdictional Determinations
4a
Have jurisdictional wetland or stream determinations by the
❑ Yes x No ❑ Unknown
Corps or State been requested or obtained for this property/
Comments
project (including all prior phases) in the past
4b
If yes, who delineated the jurisdictional areas?
Agency/ Consultant Company
Name (if known)
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
Yes x No Unknown
project (including all prior phases) in the past?
5b
If yes, explain and detail according to "help file" instructions
6.
Future Project Plans
6a
Is this a phased project?
❑ Yes x No
6b
If yes, explain
FORM BA 10 -2013 Page 2 of 7

B. Project Information and Prior Project History
FORM SSGP3080 8 -13 Page 3 of 7

C. Proposed Impacts Inventory
1. Buffer Impacts
1 a Project is in which protected basin'?
❑ Neuse X Tar - Pamlico ❑ Catawba
❑ Randleman ❑ Jordan ❑ Goose Creek
lb 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 Temporary T
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 X P ❑ T
Addition to
existing house
allowable
Pamlico Sound
❑ Yes X No
0
133
B2 ❑P ❑T
El Yes No
B3 ❑ P ❑ T
❑ Yes ❑ No
B4 ❑ P ❑ T
❑ Yes ❑ No
65 ❑ P ❑ T
❑ Yes ❑ No
gg El p ❑ T
❑ Yes ❑ No
Total buffer impacts
1 c Comments
D. Impact Justification and Mitigation
1. Avoidance and Minimization
is Specifically describe measures taken to avoid or minimize the proposed Impacts in designing project
The existing footprint of this cottage is only 444 square feet, the proposed expansion will add 133 square feet to
the footprint within the buffer This owner wishes to make a space that is both livable and minimal in size and
impact The small size of the cottage to start with and the modest addition that is proposed will keep the
development on this property to a minimum It is worth noting that both adjoining properties contain residences
with significantly larger homes (over 1,000 sq ft of footprint) both of which sit much closer to the high water line
than this project will, even after the proposed addition is completed
1 b Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
Use of washed in pilings — no excavation, no concrete foundations, hacking to take place with light equipment, no
additional bedrooms or baths, therefore no need to enlarge the septic system
FORM. BA 10 -2013 Page 4 of 7

C. Impact Justification and Mitigation, continued
2.
Buffer Mitigation
2a
Will the project result in an impact within a protected riparian buffer that requires buffer
mitigation
❑ Yes x No
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
(square feet
Zone 1
3 (2 for Catawba)
Zone 2
15
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 SSGP3080 8 -13 Page 5 of 7

E. Diffuse Flow Plan
All buffer Impacts and high ground Impacts require diffuse flow or other form of
❑ Diffuse 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
la
If due to site constraints, a BMP other than a level spreader is proposed, please provide a
Butters will catch
plan for stormwater treatment as outlined in Chapter 8 of the NC Stormwater BMP
roof runoff _and
_
Manual and attach a BMP Supplement Form
remove it to a
diffuser beyond
If you answered "yes" to the above, does the project require preparation of an
the buffer, per
attached plan
F.
Supplementary information
1.
Environmental Documentation
la
Does the project involve an expenditure of public (federallstate/local) funds or the use of
❑ Yes x No
public (federal /state) land?
lb
If you answered "yes" to the above, does the project require preparation of an
❑ Yes ❑ No
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 ❑ 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 Wetland
❑ Yes x No
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 x No
2c
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s)
�g's Sign re 12' "t
Ap I Applicant/Agent's Printed Name Date
(Agents signature is valid only if an authorization letter from the applicant is provided )
Send 3 complete sets of this form and accompanying documents to the following
For government transportation projects sent For government transportation projects sent
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 sent by First Class Mail For all other projects sent by delivery service
via the US Postal Service (UPS, FedF_x, etc)
Karen Higgins OR Karen Higgins
NCDWR — 401 & Buffer Permitting Unit NCDWR — 401 & Buffer Permitting Unit
1650 Mail Service Center 512 N Salisbury Street
FORM BA 10 -2013 Page 6 of 7

Raleigh, NC 27699 -1650 Raleigh, NC 27604
FORM SSGP3080 8 -13 Page 7 of 7

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Montalvo, Sheri A
From: Tom Pahl <thpahl @earthlink net>
Sent: Wednesday, January 28, 2015 3 25 PM
To: Montalvo, Sheri A
Subject: Re FW Martin Cottage Addition
Attachments: DWQ Authorization Signed pdf, Revised Site Plan P2 1 -28 -15 pdf, ATT00001 c
Sheri,
Thanks for staying on top of this for me As I explained, I have been having a hard time communicating with
the landowner because she's elderly and her computer skills are limited You may recall that I asked whether
we even had to go forward with this application, because the specifications had changed to eliminate the roof
over the proposed porch It is now just an open deck At your suggestion, I called Mr Scarbrough He says the
application still needs to be processed and updated to reflect the change To that end, I have attached a revised
drawing showing the proposed porch as now an open (un- roofed) deck I have also attached the authorization
form signed by the howeowner
If you need anything additional please feel free to contact me
Again, thanks for your attention to this project
Tom Pahl
Landmark Building and Design, LLC
At 02 48 PM 1/21/2015, you wrote
Good afternoon Mr Pahl,
As per our conversation today here is the contact information for you so you can have an answer to your
question Anthony Scarbrough Phone [phone] Email Anthony scarbroughkncdenr gov
Thank you,
Sheri Montalvo
From: Montalvo, Sheri A
Sent: Thursday, January 08, 2015 12 11 PM
To: thpahlgearthlmk net
Subject: Martin Cottage Addition
Importance: High
Good morning,
We have received the application for the above referenced project We require an agent authorization form to be

filled out that I have attached for your use You can fill it out and email it back to me at
Sheri montalvogncdenr gov or mail it to
Sheri Montalvo
401 & Buffer Permitting Unit
NCDENR- Division of Water Resources
1617 Mail Service Center, Raleigh, NC 27699 -1617
This project will be ppaced on hold until receipt of this form Thank you for your help
Sheri
Phone [phone]
Email Sheri montalvogncdenr gov
E -mail correspondence to and from this address may be subject to public records laws and may be disclosed to
third parties

t ��a
SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION.
} ('AwtL � C-,1
LOT NO. PLAN NO. SitLCZ-- S PARCEL ID• —Z 13
6 -3 11
STREET ADDRESS: L4 it vita 2\iac t N,C
Please print.
Property Owner: J A L
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
I w Lis PA Vt L. , of L As N la k LL �--V t 0 6-
(Contractor J Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
N .3 6 3`f out VV�, i��S l5G4�
Telephone:
we hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge
Authorized Signature S
Date. i ! 1 �5��—
Authorized Signature
Date:

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Q)! spaced decking boards to y y
_ - - allow drainage = 1 0 �-
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Sand Driveway
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Note 14 6%
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within 75' of Normal High Water