20150733 Ver 1_Riparian Buffer Authorization_20150723

I
State of North Carolina
Department of Environment and Natural Resources
DWlslon of Water Resources
Division of Water Resources
1SA NCAC 028.0233 (8)(b),
.0243 (8)(b), .0250 (11)(b), .0259 (8)(b), .0267 (11)(c), .0607 (e)(2) - Buffer Authorization
FORM: BA 10 -2013
0 5 0 7 3 3
Riparian Buffer Authorization Form
A.
Applicant Information
I.
Project Information
la.
Name of project:
S- 2 D ( ,,,, b �A" %e.'?
1 b.
County.
1 c.
Nearest municipality: I
; 4- )� � 4
1 d.
Subdivision name:
1 e.
Is the project located in any of North Carolina's- `
I ❑ Yes No
twenty coastal counties. If yes,
answer if below.
I
1f.
Is the project located within a NC Division of Coastal Yes No
Management Area Environmental
of
Concern (AEC)?
2.
Owner Information
2a.
Name on Recorded Deed:
�} / b sZ ?--t� v Q J
2b.
Deed Book and Page No. I
p p q-,S q/ r o o t
2c. Map Book and Page No
POcs�
map that indicates when the lot
wa q��ryl1�.
2d.
Responsible Party
(for Corporations):
2e.
Street address: I
_�7 2 2 V Gay,, b� r ��n Cjt
2f.
City, state, zip
j2 /� ; S t N C
f 2g.
Telephone no.:
/ - �' CtC -7 f
2h.
Fax no.:
2i.
Email address I
yI n S d h
3. Applicant Information (if different from owner)
3a. Applicant is- ❑ Agent Other, specify:
3b. Name: I
3c. Business name
(if applicable):
3d. Street address:
3e. City, state, zip:
3f. Telephone no. -
3g. Fax no.:
3h. Email address:
4. Agent/Consultant Information (if applicable)
4a. Name:
4b. Business name
(if applicable):
4c. Street address:
4d. City, state, zip:
4e. Telephone no.:
4f. Fax no.:
4g. Email address:
FORM: BA 10 -2013 Page 1 of 4

B. Project Information and Prior Project History
1. Property Identification
1 a. Property identification no. (tax PIN or parcel ID): P ) /N/ = / % 37 ZO � Z 7 T
1 b. Site coordinates (in decimal degrees): Latitude: I Longitude:
1c. Property size: acres
2. Surface Waters
2a. Name of nearest body of water to proposed project: Pa rr CrQQ K
2b. Water Quality Classification of nearest receiving water:
2c. River basin: /N 2�J 0-
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:
12 as' ,',,Ia- e;t« ( Sttb -i /.s� ®n
3b. Attach an 8'/2 x 11 excerpt from the most recent version of the USGS topographic map indicating the location of
the site
3c. Attach an 8' /Z 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 thg property:
3e. Explain the purpose of the proposed project.
� w n Q.►-. �r � .2ts -fro fa et; t cr a1 ag c-!e
3f. Describe the overall project in detail, including the type of equipment to be used: pp
*71 p Ib r V 0 vt.5 d 0CG/C , /1 D h a yo
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the Yes ❑ No ❑ Unknown
Corps or State been requested or obtained for this property/ Comments:
project (including all prior phases) in the past?
4b. If yes, who delineated the jurisdictional areas? Agency/ Consultant Company:
Name (if known)- IV C D LX K Other-
4c. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
7 /ib/ Z0/y
5. Project History
5a Have permits or certifications been requested or obtained for this I ❑ Yes ❑ No
project (including all prior phases) in the past?
5b. If yes, explain and detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project?
6b.' If yes, explain.
❑ Yes No
j Unknown
FORM: BA 10 -2013 Page 2 of 4

E. Diffuse Flow Plan
All buffer impacts and high ground impacts require diffuse flow or other form ofj 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 �i`�✓2, vQ5 - --' ,�,
plan for stormwater treatment as outlined in Chapter 8 of the NC Stormwater BMP / -c", -T> e k
Manual and attach a BMP Supplement Form.
F. Supplementary Information
1. Environmental Documentation
1 a. Does the project involve an expenditure of public (federal /state /local) funds or the use of
public (federal /state) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State (North
Carolina) Environmental Policy Act (NEPA/SEPA)?
1c. If you answered "yes" to the above, has the document been finalized by the State
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 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 0 No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 0 No
❑ Yes ❑ No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
�, ,
Applicant/Agent's Printed Name Applicafit/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided )
Send this completed form and accompanying documents to the following:
For government transportation projects send
For government transportation projects send
by First Class Mail via the US Postal Service:
by delivery service (UPS, FedEx, etc.):
NC DWR, Transportation Permitting Unit
OR NC DWR, Transportation Permitting Unit
1650 Mail Service Center
512 N. Salisbury Street
Raleigh, NC 27699 - 1650
Raleigh, NC 27604
For all other projects send by First Class Mail
For all other projects send by delivery service
via th S Postal Service
(UPS, FedEx, etc.):
Higgins '
OR Karen Higgins
NCDWR — 401 & Buffer Permitting Unit
CRaleCaren
NCDWR — 401 & Buffer Permitting Unit
617 Mail Service Center
512 N. Salisbury Street
igh, NC 27699 - 1650
Raleigh, NC 27604
FORM: BA 10 -2013 Page 4 of 4

C. Proposed Impacts Inventory
1. Buffer Impacts
1 a. Project is in which protected basin?
*euse
❑ Tar - Pamlico ❑ Catawba
❑ Randleman
❑ Jordan ❑ Goose Creek
1 b. 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
number- impact
(exempt, allowable,
mitigation impact
impact
Permanent (P)
allowable w/ mitigation)
required? (sq ft)
(sq ft}
or Temporary (T)
B1 WP ❑T iJQG�
�ll0tn)�4>iQ-
� 7-
7�yr, �w /� - ❑YeS �_No
iQ2
B2 ❑ P ❑ T
❑ Yes ❑ No
B3 ❑ P ❑ T
❑ Yes ❑ No
B4 ❑ P ❑ T
❑ Yes ❑ No
B5 ❑ P ❑ T
I
❑ Yes ❑ No
B6 ❑ P ❑ T
❑ Yes ❑ No
1
Total buffer impacts
1c. Comments:
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
(110 1'f ;Ly i' p' -rare rv; // la 0- an /0 L24" 0'�
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
No 6Q�--v-;� e-,�wI tome -17 '1�- 42 CILtf4 ,�---
2. Buffer Mitigation
2a. Will the project result in an impact within a protected riparian buffer that requires buffer I ❑ Yes % No
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)
Zone 1 - 3 (2 for Catawba) I
Zone 2 -- - - - -- - - -- - - - -- - - - - - 1.5- -
Total buffer mitigation required:
2c. If buffer mitigation is required, is payment to a ❑ Yes ❑ No
mitigation bank or NC EEP proposed?
2d. if yes, attach the acceptance letter from the mitigation bank or NC EEP.
2e. If no, then discuss what type of mitigation is proposed.
2f. Comments:
FORM: BA 10 -2013 Page 3 of 4

4 A
.Q=Aymw�
CDEN
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Albert Veal and Mitzi Logan
5220 Cumberland Plain Dr.
Raleigh. NC 27616
Determination Type
Buffer Cali
July 16, 2015
Donald R. van der Vaart
Secretary
Subject: Surface Water Determination Letter
NBRRO# 15 -314
Wake County
Isolated or EiP Call
® Neuse (15A NCAC 213.0233)
❑ Tar - Pamlico (15A NCAC 2B .0259) ❑ Ephemeral /intermittent/Perennial Determination
❑ Isolated Wetland Determination
❑ Jordan (15A NCAC 2B .0267)
Project Name: 5220 Cumberland Plain Dr., Raleigh
Location/Directions: The projected area is off 5220 Cumberland Plain Dr., Raleigh, Wake
County
Subject Stream Perry Creek
Determination Bate: 7/16/2015
Stream ! E/1/P* I Not Subject
to Buffers
Subject to
Buffers
i A j 1 1 1 X
*£!t /P = £phemeraUlntermittentIPerennial
Staff: Cheng Zhang
Start@ Stop@ Soil USGS
Survey Topo
throughout I I X I
Explanation: The feature(s) listed above has or have been located on the Soil Survey of Wake County, North
Carolina or the most recent copy of the USGS Topographic map at a 1:24,000 scale. Each feature that is checked
"Not Subject" has been determined not to be a stream or is not present on the property. Features that are checked
`'Subject" have been located on the property and possess characteristics that qualify it to be a stream. There may be
other streams located on your property that do not show up on the maps referenced above but, still may be
considered jurisdictional according to the US Army Corps of Engineers and/or to the Division of Water Resources
(DWR).
This on -site determination shall expire five (5) years from the date of this letter. Landowners or affected parties that
dispute a determination made by the DWR or Delegated Local Authority may request a determination by the
Director. An appeal request must be made within sixty (60) days of date of this letter or from the date the affected
party (including downstream and /or adjacent owners) is notified of this letter. A request for a determination by the
Director shall be referred to the Director in writing If sending via US Postal Service c/o Karen Higgins DWR — 401 &
One
N Carolina
Naturally
North Carolina Division of Water Resources 1628 Mad Service Center Raleigh, NC 27699 -1628 Phone [phone]
Internet www ncwaterouality orq Location 3800 Barrett Drive Raleigh, NC 27609 Fax [phone]
An Equal Opportunity /Affirmative Action Employer - 50 1k Recycled/100% Post Consumer Paper

5220 Cumberland Plain Dr.
Wake County
7/16/2015
Page 2 of 2
Buffer Permitting Unit 1617 Mail Service Center Raleigh, NC 27699 -1617. If sending via delivery service (UPS, FedEx,
eta) Karen Higgins DWR — 401 & Buffer Permitting Unit, 512 N. Salisbury Street Raleigh, NC 27604
This determination is final and binding unless, as detailed above, you ask for a hearing or appeal within sixty (60)
days.
The owner /future owners should notify the Division of Water Resources (including any other Local, State, and
Federal Agencies) of this decision concerning any future correspondences regarding the subject property (stated
above). This project may require a Section 404/401 Permit for the proposed activity. Any inquiries should be
directed to the Division of Water Resources (Central Office) at (919 )-807 -6300, and the US Army Corp of Engineers
(Raleigh Regulatory Field Office) at (919) -554 -4884.
If you have questions regarding this determination, please feel free to contact Cheng Zhang at (919) 7914259.
S' ely,
74 t/
Danny Smith
Supervisor, Water Quality Regional Operations Center
cc: RRO DWR File Copy

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