20071296 Ver 4_Riparian Buffer Authorization Request_20230122

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 1/22/2023
A. Owner/Applicant Information
General Information
Primary Contact Email:*
Who is submitting the application?*
1. Property Owner Information:
la. Name on Recorded Deed: *
1b. Responsible Party:
lc. Mailing Address:*
Id. Telephone:*
704-591-3017
3. Agent Information:
3a. Name:
3b. Company Affiliation:
[e-mail]
Please list the contact person's email for questions or payment on this project if needed.
Owner
Applicant other than Owner
Agent
TIMOTHY LOMBARDI
(for Corporations)
Street Address
170 WINDWOOD LANE
Address Line 2
City State / Province / Region
TROUTMAN NC
Postal / Zip Code Country
28166 US
3c. Mailing Address: Street Address
Address Line 2
City
Postal / Zip Code
3d. Telephone:
1e. Email Address:* [e-mail]
3e. Email Address:
State / Province / Region
Country
3f. Attach a signed and dated copy of the agent Click the upload button or drag and drop files here to attach document
authorization form.
PDF Only
B. Project Information and Prior Project History
1. Project Information

la. Name of Project: *
LOMBARDI , CRESENT LAND & TIMBER
(Subdivision, facility, or establishment name)
1b. Is this a publicly -funded transportation project?*
Yes
No
Id. Subdivision Name: CRESENT LAND & TIMBER
1e. Nearest Municipality: TROUTMAN
If. Property Size: 1.64
acres
lg. County (or Counties) where the project is located:*
Iredell
lh. Property ID#
4629524907000
Tax PIN or Parcel id
1 i. Deed Information
Date of Purchase
9/1/2020
Type of Book
Book#
Page#
Deed
2730
1886
Map
34
56
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
LOMBARDI SURVEY 160.pdf 222.03KB
PDF only
1k. How would you like to provide the Latitude and Longitude information?*
Address Lookup
- Manually
Latitude* 35.638806 Longitude* -80.933354
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: *
LAKE NORMAN
2b. Water Quality Classification of nearest receiving water:
CATAWBA
2c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
0
(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:
CONSTRUCTING CART PATH FROM HOME TO SHORELINE
3b. Attach an 8% 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
LOMBARDI TOPO.pdf 75.11KB
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.
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LOMBARDI SURVEY.pdf 224.73KB
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: *
CONSTRUCT CART PATH FROM HOME TO SHORELINE BUFFER
USING EXCAVATOR
Attach a site plan as applicable to the project:
Click the upload button or drag and drop files here to attach document
LOMBARDI TOPO.pdf 75.11KB
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
® No
6. Project History
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past? *
Yes
O No
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

WINDWOOD LN
CATAWBA
Permanent
Allowable
0.00
0.00
Map label (e.g. Road
(P)
Square
Square
Crossing 1)
Perm or Temp
Feet
Feet
Total Zone 1 Impacts: 0.00
Total Zone 2 Impacts: 0.00
Total Buffer Impacts: 0.00
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.
PERMIT CART PATH AND VARIANCE PERMIT FOR CART PATH, MITIGATION
PERMIT AND CREDITS FROM RES
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
NONE
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
LOMBARDI RES LETTER.pdf 132.17KB
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)?
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:
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
LOMBARDI LETTER.pdf
PDF only
183.04KB
o I have given true, accurate, and complete information on this form;
• 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:* TIMOTHY LOMBARDI
Signature
Submission Date:
TJM T/} Z 2M9A ,P/
1/20/2023
(Auto populated field)

Initial Review
Is this accepted into the review process?*
Is this project a public transportation project?*
Yes No
Yes
No
ID#* 20071296
Version:* 4
Select Reviewer: * Andrew Pitner:eads\ahpitner
Select Reviewing Office* Mooresville Regional Office - [phone]
Has payment been received?* • No Payment Needed
Fee Received
Need Fee - send electronic notification