20221779 Ver 1_Riparian Buffer Authorization Request_20221215

Buffer Authorization Application Form
15A NCAC 02B .0233 (8)(b), .0243 (8)(b), .0250 (11)(b), .0259 (8)(b), .0267 (11)(c), .0607 (e)(2) Buffer Authorization Online Form -
Update 10/23/2018
Water Reources
ENVIRONMENTAL QUALITY
Original Submittal 12/15/2022
A. Owner/Applicant Information
General Information
Primary Contact Email:*
Who is submitting the application?*
[e-mail]
Please list the contact person's email for questions or payment on this project if needed.
Owner
Applicant other than Owner
Agent
Is there an agent working on this application but Yes
not submitting it? • No
1. Property Owner Information:
....................................................................................................................................
la. Name on Recorded Deed: *
1b. Responsible Party:
lc. Mailing Address:*
Id. Telephone:*
4153787331
Mt. Holly Owner, L.L.0
(for Corporations)
Street Address
2964 Peachtree NW
Address Line 2
Suite 275
City
Atlanta
Postal / Zip Code
30305
2. Applicant's Information (if different from owner):
2a. Name:
2b. Company Affiliation:
2c. Mailing Address:
State / Province / Region
GA
Country
United States of America
1e. Email Address:* [e-mail]
Laura Dadisman
Design Resource Group, PA
Street Address
2459 Wilkinson Boulevard
Address Line 2
Suite 200
City State / Province / Region
Charlotte NC
Postal / Zip Code Country
28208 United States of America
2d. Telephone: [phone]

2e. Email Address:
[e-mail]
B. Project Information and Prior Project History
1. Project Information
la. Name of Project: *
Penler-Mt. Holly
(Subdivision, facility, or establishment name)
1b. Is this a publicly -funded transportation project?*
Yes
No
Id. Subdivision Name:
le. Nearest Municipality:
If. Property Size:
acres
1g. County (or Counties) where the project is located:*
Gaston
1h. Property ID#
226178,226181,226182
Tax PIN or Parcel id
1 i. Deed Information
Date of Purchase
Type of Book
Book#
Page#
Deed
4909
0692 J
Map
3595765217
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* 35.2617
Longitude* -81.0193
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: *
Catawba River
2b. Water Quality Classification of nearest receiving water:
WS-IV CA

2c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
1,280
(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:
3b. Attach an 8 1/2 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
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
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: *
Within the site/property limits, construction of 814 linear feet of a 5 foot wide concrete
path that leads to kayak launch in the Catawba River.
Attach a site plan as applicable to the project:
Click the upload button or drag and drop files here to attach document
60 Kayak Study 102822.pdf
61 Penler - Mt Holly - Kayak Study_12.01.22.pdf
PDF only
5. Jurisdictional Determinations
1.66MB
1.08MB
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?*
5b. Who did the determination on the jurisdictional areas?
Who did the determination?
List name if known
Date
Attach
Corps
Krysta Stygar
(Name if known)
09/20/2021
I 1
pdf only
*** Please include the date of the determination and upload a copy of the determination.
Comments:
6. Project History
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past? *
Yes
No
6b. List any permits/approvals that have been requested or obtained for this project in the past.

6c. Please explain and detail according to "help file" instructions.
7. Future Project Plans
7a. Is this project a phased project?*
C. Proposed Impacts Inventory
Buffer Impacts
O Yes
O No
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 02B.0259)
Jordan Lake Watershed (15A NCAC 02B.0267)
Goose Creek Watershed (15A NCAC 02B.0606 & 15A NCAC 026.0607)
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
Zone 1
Zone 2
Waters A
Map label (e.g. Road
Crossing 1)
Non-
wetland
waters
Permanent
(P)
Perm or Temp
J
Allowable
1,168.
00
Square
Feet
0.00
Square
Feet
Total Zone 1 Impacts: 1,168.00
Total Zone 2 Impacts: 0.00
Total Buffer Impacts: 1,168.00
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.
minimal grading to achieve the least impactful direction and path to the kayak launch
on the river.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
minimal grading to achieve the least impactful direction and path to the kayak launch
on the river.
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

lc. Diffuse Flow Documentation
F. Supplementary Information
Environmental Documentation
Click the upload button or drag and drop files here to attach document
C4.50 OVERALL DRAINAGE PLAN.pdf 1.04MB
C4.57 SCM DETAIL.pdf 1.51MB
PDF only
la. 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)?
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:
Additional Comments:
H. Sign and Submit
By digitally signing below, I certify that:
Click the upload button or drag and drop files here to attach document
PDF only
. A
. A
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")
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: * Laura Dadisman
Signature
46l!/tez OlddG•Yeeaor
Submission Date: (Auto populated field)

Initial Review
Is this accepted into the review process?* • Yes No
Yes
• No
ID#* 20221779
Version:* 1
Select Reviewer: * Andrew Pitner:eads\ahpitner
Select Reviewing Office* Mooresville Regional Office - [phone]
Is this project a public transportation project?*
Has payment been received?* • No Payment Needed
Fee Received
Need Fee - send electronic notification

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