20230501 Ver 1_Riparian Buffer Authorization Request_20230331

Original Submittal 3/31/2023
A. Owner/Applicant Information
General Information Q
..........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
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
p Agent
1. Property Owner Information:
1a. Name on Recorded Deed:* Travis Nathaniel Cox and Kelly Nicole Ellis
1b. Responsible Party: (for Corporations)
1 c. Mailing Address:* Street Address
110 East Dynasty Drive
Address Line 2
City State / Province / Region
Cary NC
Postal / Zip Code Country
27513-3354 us
1d. Telephone:* 919-798-7617 le. Email Address:* [e-mail]
3. Agent Information:
3a. Name:
3b. Company Affiliation:
3c. Mailing Address: Street Address
Address Line 2
City State / Province / Region
Postal / Zip Code Country
3d. Telephone: 3e. Email Address:
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

1a. Name of Project:* Dynasty Deck
(Subdivision, facility, or establishment name)
1b. Is this a publicly -funded transportation project?*
Yes
No
1d. Subdivision Name: ROYAL OAKS
le. Nearest Municipality: Cary
1f. Property Size: 0.50
acres
1 g. County (or Counties) where the project is located:*
Wake
1h. Property ID#
0764499336
Tax PIN or Parcel id
1i. Deed Information
Date of Purchase
10/22/2018
Deed 017272 11 00118
Map
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
1 k. How would you like to provide the Latitude and Longitude information?
Address Lookup
Manually
Address Lookup Street Address
110 East Dynasty Drive
Address Line 2
City
Cary
Postal / Zip Code
27513-3354
Longitude*
Latitude* 35.8088131
11. Is the project located in any of North Carolina's twenty coastal counties?*
2. Surface Waters
2a. Name of the nearest body of water to proposed project: * Black Creek
2b. Water Quality Classification of nearest receiving water: C;NSW
State / Province / Region
NC
Country
us
-78.7808472999999
9
Yes
No

2c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
120
(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:
Original Deck is in place. We will be removing with hand tools only and using the original footprint to rebuild and extend approximately
10 feet.
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
110 E Dynasty.pdf 8.43MB
PDF only
3c. Attach an 8 % 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:
Installing a Deck Addition. No equipment will be used outside of hand tools.
Attach a site plan as applicable to the project:
Click the upload button or drag and drop files here to attach document
survey_plat map.pdf 725.12KB
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
5b. Who did the determination on the jurisdictional areas?
Who did the determination? List name if known11 Date Attach
State Joseph Myers 03/13/2023
(Name if known)
110 E Dynasty (1).pdf 12.24M6
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
7. Future Project Plans
7a. Is this project a phased project?* Yes
No
�J

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 02B.0259)
Jordan Lake Watershed (15A NCAC 02B.0267)
Goose Creek Watershed (15A NCAC 02B.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 Zone 1 Zone 2
Deck Extension
Black Creek
Permanent (P)
Allowable
0.00
3.00
Map label (e.g. Road Crossing 1)
Perm or Temp
Square Feet
Square Feet
Total Zone 1 Impacts: 0.00
Total Zone 2 Impacts: 3.00
Total Buffer Impacts: 3.00
Comments:
Deck Extension Project will extend and impact 3 square feet of Zone 2
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.
We chose to use as much of the existing deck as possible. However, for the home owners sake we needed to make the deck larger
and chose to go left to right next to the stream instead of encroaching more of the stream.
We also are keeping the entire scope of the project in the back yard which is already being taken care of and maintained by the
customers.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
We will be keeping all debris out of the stream and using a silk fence along the existing fence line. We will also be only using hand
tools to complete the scope of the project.
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
Dynasty.pdf 8.32MB
PDF only
F. Supplementary Information
I
Environmental Documentation

1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?
Ere
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
PDF only
Additional Comments:
H. Sign and Submit
By digitally signing below, I certify that:
I
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:* Peter Gitto
Signature
Submission Date: 03/31/2023
(Auto populated field)

Initial Review
Is this accepted into the review process?* Yes No
Is this project a public transportation project?* � Yes
No
ID#* 20230501
Version: *
Select Reviewer: *
Select Reviewing Office*
Has payment been received?*
Zachary Thomas:[e-mail]
Raleigh Regional Office - [phone]
No Payment Needed
Fee Received
Need Fee - send electronic notification