20230728 Ver 1_Riparian Buffer Authorization Request_20230523

Original Submittal 5/23/2023
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?* 0 Owner
O Applicant other than Owner
O Agent
Is there an agent working on this application but Yes
not submitting it? No
1. Property Owner Information:
.............................................................................................................
1a. Name on Recorded Deed:*
1b. Responsible Party:
1c. Mailing Address:*
1 d. Telephone:* 9193766025
Steven O and Rocio G . Ayscue
(for Corporations)
Street Address
201 Southern Style Drive
Address Line 2
City State / Province / Region
Holly Springs NC
Postal / Zip Code Country
27540 United States
B. Project Information and Prior Project History
1. Project Information
le. Email Address:* [e-mail]
1 a. Name of Project: * Ayscue Lake House
(Subdivision, facility, or establishment name)
1b. Is this a publicly -funded transportation project?*
Yes
No
1d. Subdivision Name: North Bay at Doe Run Subdivision
le. Nearest Municipality: Hickory
1f. Property Size: 0.75
acres

1 g. County (or Counties) where the project is located:*
Caldwell
1h. Property ID# Date of Purchase
08116-2154 3/17/2021
Tax PIN or Parcel id
11. Deed Information
Type of Book Book#11 Page#
Deed 1847 313
Map 18 18
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
Ayscue Plat book
396.21 KB
-2023_05_22_09_54_0460373198_231513.pdf
PDF only
1k. How would you like to provide the Latitude and Longitude information?
Address Lookup
Manually
Latitude* 35.786650 Longitude*-81.468210
11. Is the project located in any of North Carolina's twenty coastal counties?* Yes
No
2. Surface Waters 1 ..........................................................................................................................................................................................................................................................................................................................................................................................................................................
2a. Name of the nearest body of water to proposed project: * Rhodhiss
2b. Water Quality Classification of nearest receiving water: Lake
2c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
99
(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:
Empty lot with vegetation in an established neighborhood
3b. Attach an 8'/z 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
GaiaGPS-2023-05-11 TOO _01_37.pdf 5.24MB
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
SoilMap.pdf
PDF only
R WIRI.17
4. Proposed Activity (�

Provide a detailed description of the proposed activity including its purpose and include the type of equipment to be used:
Cut some trees to enhance the view within the Buffer zone, stumps will no be remove and will be grind. Clear some vegetation at the
lot to build a house, garage and entrance. Also a Septic system. The lot has water and electricity service.
Attach a site plan as applicable to the project:
Click the upload button or drag and drop files here to attach document
Trees Before-After.pdf 438.52KB
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
No
7. Future Project Plans
7a. Is this project a phased project?* Yes
No
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 I Stream Name t* Buffer ImpacImpact Type Zone 1 Zone 2 71
Clear some trees in Zone I
Rhodhiss
Temporary (T)
Exempt
2,970.00
1,980.00
Map label (e.g. Road Crossing 1)
Perm or Temp
Square Feet
Square Feet
Total Zone 1 Impacts: 2,970.00
Total Zone 2 Impacts: 1,980.00
Total Buffer Impacts: 4,950.00
Comments:
Stumps wont be removed, will be grind in Zone I. A revegetation of the Buffer Zone will follow: grass seeding with mulching and grass
seed mat for sloped areas as require.
D. Impact Justification and Mitigation
I

1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project.
There are no structures within the Buffer Zone. We are keeping some existing trees. Minimal grading just for the house, garage and
entrance, it is about 1/3 or less of the lot.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Construction Sequence:
1) Install construction entrance (gravel) to minimized mud on adhyancent roads.
2) Install double line of Silt Fence: 1 rst: at 10' of sea wall, 2nd: at 50' of sea wall
3) Manually Clear trees within the buffer zone and grind in zone 1. Clear vegetation in the area of the house/garage and driveway.
4) Permanent Revegetation of the Buffer zone with grass seeding and mulching and grass seed mats for required areas because of
the slope.
5) Grade for the house, garage and entrance. Construct buildings.
6) Install temporary or permanent groundcover within 21 days
7) Remove erosion control measures
E. Diffuse Flow Plan
1a. 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
Silt fence and road.pdf 516.62KB
Site Erosion Control.pdf 422.78KB
PDF only
F. Supplementary Information
Environmental Documentation
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: 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 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:* Steven Ayscue
Signature
Ski!' C111 t -WI-
Submission Date: (Auto populated field)

Initial Review
Is this accepted into the review process?*
Is this project a public transportation project?*
ID#*
Version:
Select Reviewer:
Select Reviewing Office*
Has payment been received?*
Yes No
Yes
No
20230728
1
Joey Winston: Joey. Winston
Asheville Regional Office - [phone]
No Payment Needed
Fee Received
Need Fee - send electronic notification