20230623 Ver 1_Buffer Auth for Lot 59 Claremont Road^J Raleigh^J NC_20230427

State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02B .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
1a.Name of project:Lot 59, Anderson Heights Subdivision
1b.County:Wake
1c.Nearest municipality:Raleigh
1d.Subdivision name:Anderson Heights
1e.
YesNo
If yes, answer 1f below.
1f.Is the project located within a NC Division of Coastal Management Area of
YesNo
Environmental Concern (AEC)?
2.Owner Information
2a.Name on Recorded Deed:Woodrow Park III LLC
2b.Deed Book and Page No.DB 17422, P 2408
2c.Map Book and Page No.BM 1949, P 12
(includea copy of the
recorded map that indicates
when the lot was created):
2d.Responsible Party Woodrow Park III LLC
(for Corporations):
2e.Street address:2626 Glenwood Ave Suite 550
2f.City, state, zip:Raleigh, NC, 27608
2g.Telephone no.:
2h.Fax no.:
2i.Email address:
3.Applicant Information (if different from owner)
3a.Applicant is:AgentOther, specify:
3b.Name:Chuck Piratzky
3c.Business nameRWK, PA
(if applicable):
3d.Street address:101 W Main Street
3e.City, state, zip:Garner, NC, 27529
3f.Telephone no.:919-779-4854
3g.Fax no.:919-779-4056
3h.Email address:[e-mail]
4.Agent/Consultant Information (if applicable)
4a.Name:Andrew Thompson
4b.Business name
Waypoint Builders
(if applicable):
4c.Street address:211 Westridge Drive
4d.City, state, zip:Raleigh, NC, 27609
4e.Telephone no.:919-931-2868
4f.Fax no.:NA
4g.Email address:[e-mail]
FORM: BA 10-2013Page 1of 4

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): 1705745333
1b. Site coordinates (in decimal degrees): Latitude: Longitude:
35.82203 78.63706
1c. Property size: .33 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project: Crabtree Creek
2b. Water Quality Classification of nearest receiving water: Class C: NSW
2c. River basin: Neuse
3. Project Description New construction single family residence
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: Currently vacant, prior used single-family residence

3b. Attach an 8 ½ x 11 excerpt from the most recent version of the USGS topographic map indicating the location
of the site
3c. Attach an 8 ½ 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:

3e. Explain the purpose of the proposed project: New single family residence

3f. Describe the overall project in detail, including the type of equipment to be used:
clear grubbing, light grading, install footings and piers, small dozer & backhoe
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by Yes No Unknown
the Corps or State been requested or obtained for this
Comments:
property/ 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 Yes No Unknown
for this project (including all prior phases) in the past?
5b.

6. Future Project Plans
6a. Is this a phased project? Yes No
6b. If yes, explain.

FORM: BA 10-2013 Page 2 of 4

C.Proposed Impacts Inventory
1. Buffer Impacts
1a. Project is in which protected basin? 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 Reason for Type of impact Stream name Buffer Zone 1 Zone 2
(exempt, allowable,
number impact mitigation impact impact
allowable w/
(sq ft) (sq ft)
Permanent (P) required?
mitigation)
or Temporary
(T)
B1 P T clearing/grading allowable Crabtree creek Yes No N/A 1205
B2 P T House allowable Crabtree creek Yes No N/A 57 SF
B3 P T Deck allowable Crabtree creek Yes No N/A 23 SF
B4 P T Yes No
B5 P T Yes No
B6 P T Yes No
80 SF
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.

1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction
techniques. Silt fence along lower side of project. Zone 2 will be revegetated after construction
2. Buffer Mitigation
2a. Will the project result in an impact within a protected riparian buffer that Yes No
requires buffer mitigation?

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 Multiplier Required mitigation
(square feet) (square feet)
3 (2 for Catawba)
Zone 1
1.5
Zone 2

Total buffer mitigation required:
2c. If buffer mitigation is required, is payment to a mitigation bank or NC DMS Yes No
proposed?

2d. If yes, attach the acceptance letter from the mitigation bank or NC DMS.
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 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.
If due to site constraints, a BMP other than a level spreader is proposed, please provide a
plan for stormwater treatment as outlined in Chapter 8 of the NC Stormwater BMP
Manual and attach a BMP Supplement Form.

F. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the Yes No
use of public (federal/state) land?
1b. Yes No
environmental document pursuant to the requirements of the National or State (North
Carolina) Environmental Policy Act (NEPA/SEPA)?
1c. 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 Yes No
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 No
2c.

__________________________ ________________________________________________ __________
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 3 complete sets of this form and accompanying documents to the following:
CƚƩ ŭƚǝĻƩƓƒĻƓƷ ƷƩğƓƭƦƚƩƷğƷźƚƓ ƦƩƚƆĻĭƷƭ ƭĻƓƷ ĬǤ CƚƩ ŭƚǝĻƩƓƒĻƓƷ ƷƩğƓƭƦƚƩƷğƷźƚƓ ƦƩƚƆĻĭƷƭ ƭĻƓƷ ĬǤ
CźƩƭƷ /ƌğƭƭ ağźƌ ǝźğ ƷŷĻ …{ tƚƭƷğƌ {ĻƩǝźĭĻʹ ķĻƌźǝĻƩǤ ƭĻƩǝźĭĻ Λ…t{Ͳ CĻķ9ǣͲ ĻƷĭ͵Μʹ
NC DWR, Transportation Permitting Unit NC DWR, Transportation Permitting Unit
OR
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699 - 1617 Raleigh, NC 27604

CƚƩ ğƌƌ ƚƷŷĻƩ ƦƩƚƆĻĭƷƭ ƭĻƓƷ ĬǤ CźƩƭƷ /ƌğƭƭ ağźƌ ǝźğ CƚƩ ğƌƌ ƚƷŷĻƩ ƦƩƚƆĻĭƷƭ ƭĻƓƷ ĬǤ ķĻƌźǝĻƩǤ ƭĻƩǝźĭĻ
ƷŷĻ …{ tƚƭƷğƌ {ĻƩǝźĭĻ Λ…t{Ͳ CĻķ9ǣͲ ĻƷĭ͵Μʹ
Karen Higgins Karen Higgins
OR
NCDWR 401 & Buffer Permitting Branch NCDWR 401 & Buffer Permitting Branch
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699 - 1617 Raleigh, NC 27604

FORM: BA 10-2013 Page 4 of 4