Corrected Buffer Application 401 Silverwood Dr Merritt NC

6/26/23, 2:10 PM Submission Completed
C. Proposed Impacts Inventory
C. Proposed Impacts Inventory
Buffer Impacts
.. .............. ...... ......... .
1a. 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 0213.0250)
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)
You can find which river basin you live in at the link below.
http://www.eenorthcarolina.org/riverbasins-gis-map.asp
1c. Individually list all buffer impacts below. If any impacts require mitigation, then you MUST fill out Section D of this form.
Please note: if the impact you list below requires mitigation choose "allow w/ mitigation" under impact type.
Site# - Reason Stream Name Buffer Impact"` Impact Type* Zone 1 Zone 2 I!
Map label (e.g. Road Crossing 1) Permanent (P) Exempt 0.00 IJ&00
Perm or Temp Square Feet Square Feet
Total Zone 1 Impacts: 0.00
Total Zone 2 Impacts: 0.00
Total Buffer Impacts: 0.00
Comments:
LAMA Inspection and Building Inspector at site; inspected and measured with flags
Property is exempt per inspector.
https:Hedocs.deq.nc.gov/Forms/Form/Submit 6/10

6/26/23, 2:10 PM
Submission Completed
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
Link to Soil Surveys for North Carolina Counties. (Please see instructions in the Help Document to determine the most recent published
version.)
4. Proposed Activity
....... ......... ...... ............... ........... .......... ..........._
Provide a detailed description of the proposed activity including its purpose and include the type of equipment to be used:
Building a residence small tools and equipment
Attach a site plan as applicable to the project:
Click the upload button or drag and drop files here to attach document
PDF only
** Below is a link with instructions on what you will need to show on your site plan.
http://edocs.deq.ne.gov/WaterResources/O/doc/402224/Pagel.aspx
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
https://edocs.deq.nc.gov/Forms/Form/Submit 5/10

6/26/23, 2:10 PM
Submission Completed
B. Project Information and Prior Project History
B. Project Information and Prior Project History
...............................................................................................................................................................................................
1. Project Information
...................................................................
1a. Name of Project:*
Haddock House
(Subdivision, facility, or establishment name)
If your project has a formal name please use this. If your project does not have a formal name, please identify your project by the owner
name and proposed activity (Jones Property Access Road, Smith Guest House, etc.) List in parentheses any other names that have
been used to identify the project in the past.
1b. Is this a publicly -funded transportation project?*
Yes
No
1d. Subdivision Name:
le. Nearest Municipality:
1f. Property Size: acres
1g. County (or Counties) where the project is located:
Pamlico
1h. Property ID#
Tax PIN or Parcel id
1 i. Deed Information
Date of Purchase
Type of Book Book# Page#
Deed
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
https:Hedoes.deq.nc.gov/Forms/Form/Submit 3/10

6/26/23, 2:10 PM
Submission Completed
1k. How would you like to provide the Latitude and Longitude information?
Address Lookup
Manually
Address Lookup
Latitude'`
35.10512
Street Address
401 Silverwood Dr
Address Line 2
City
Merritt
Postal / Zip Code
28556
State / Province / Region
NC
Country
USA
Longitude * 76.60284
11. Is the project located in any of North Carolina's twenty coastal counties?* Yes
No
1 m. Is the project located within a NC Division of Coastal Management Area of Environmental Concern (AEC)?
Yes
No
Coastal Management information can be found at:
• About Coastal Management
• Staff Listing
• Coastal County Lookup
2. Surface Waters
2a. Name of the nearest body of water to proposed project: * Pamlico
Link to Soil Surveys for North Carolina Counties. (Please see instructions in the Help Document to determine the most recent published
version.)
2b. Water Quality Classification of nearest receiving water: * B
2c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
1
(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 % 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
Link to TOPO Map lookup: https://viewer.nationalmap.gov/basic/
https://edocs.deq.nc.gov/Forms/Form/Submit 4/10

6/26/23, 2:10 PM Submission Completed
D. Impact Justification and Mitigation
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project.
site has been marked so that only construction area can be accessed.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques. k
site has been marked so that only construction area can be accessed.
https:Hedocs.deq.nc.gov/Forms/Form/Submit 7/10

6/26/23, 2:10 PM
Submission Completed
E. Diffuse Flow Plan
E. Diffuse Flow Plan
All buffer impacts & high ground impacts require diffuse flow or other form of stormwater treatment. If the project is subject to a state
implemented riparian buffer program, upload a plan that fully documents how diffuse flow will be maintained. All stormwater control
measures (SCMs) must be designed in accordance with the NC Stormwater Design Manual. Associated supplement forms and other
documentation must be provided.
For a list of options to meet the diffuse flow requirements, click here.
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
401 Silverwood Dr Merritt NC.pdf 1.01 MB
PDF only
https://edoes.deq.ne.gov/Forms/Form/Submit 8/10

6/26/23, 2:10 PM Submission Completed
F. Supplementary Information
F. Supplementary Information
Environmental Documentation
......... .................. ............ ._ _. _...... ................... ......... ... ..
1a. 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
POF only
Additional Comments:
https://edocs.deq.nc.gov/Forms/Form/Submit 9/10

6/26/23, 2:10 PM
Submission Completed
G. Sign and Submit
G. Sign and Submitt
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')
• 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');
• 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:*
Signature *
Submission Date:
Worth Lewis
6/26/20223
(Auto populated field)
https://edocs.deq.nc.gov/Forms/Form/Submit 10/10

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