20231583 Ver 1_Riparian Buffer Authorization Request_20231120

Original Submittal 11/20/2023
A. Owner/Applicant Information
General Information
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
Agent
1. Property Owner Information:
1a. Name on Recorded Deed:* IOL UNIVERSITY POINTE, LLC
1b. Responsible Party: Piedmont Natural Gas Company, Inc.
(for Corporations)
1 c. Mailing Address:* Street Address
526 South Church Street
Address Line 2
Plaza 18A
City
State / Province / Region
Charlotte
NC
Postal / Zip Code
Country
28202-1802
US
1d. Telephone:* 8007527504 1e. 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. POF only
B. Project Information and Prior Project History

1. Project Information 0
.....................................................................................................................................................................................
1a. Name of Project:* Line 200 MAOP Reconfirmation
(Subdivision, facility, or establishment name)
1b. Is this a publicly -funded transportation project?*
Yes
No
1d. Subdivision Name:
le. Nearest Municipality: Elon
1f. Property Size: 3.01
acres
1g. County (or Counties) where the project is located:
Alamance
1 h. Property ID# Date of Purchase
8856801086
Tax PIN or Parcel id
NCDOT Right -of -Way
Tax PIN or Parcel id
1 i. Deed Information
Deed 4314 11 518
ODD
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
PB 3 PG 65.pdf 316.89KB
PDF only
1 k. How would you like to provide the Latitude and Longitude information?
Address Lookup
Manually
Latitude* 36°06'43"N Longitude* 79°28'48"W
11. Is the project located in any of North Carolina's twenty coastal counties?* Yes No
2. Surface Waters
2a. Name of the nearest body of water to proposed project: * Gant Lake
2b. Water Quality Classification of nearest receiving water: WS-V;NSW
2c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
390
(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:
The existing use of the property as a whole is for apartments and parking. A Piedmont Natural Gas pipeline easement runs through
the property, along the existing jurisdictional stream. The existing use within the easement is for the existing natural gas transmission
pipeline (Test Site 2). Additionally, there is an adjacent NCDOT right-of-way along the project that will be accessed with riparian
buffers as shown on the plans (Test Site 1).
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
7 - USGS Topo Map.pdf 47.51 MB
PDF only
3c. Attach an 81/. 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
8 - Soil Report.pdf 977.01 KB
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:
The proposed activity will include excavating to expose the existing natural gas pipeline and to perform maintenance on the existing
pipeline. The pipeline will undergo hydro -static pressure testing to ensure maximum allowable operating pressure is sufficient. An
excavator and water storage trucks are expected to be operated within the limits of disturbance for the project.
Attach a site plan as applicable to the project:
Click the upload button or drag and drop files here to attach document
1 - PNG Line 200 MAOP Reconfirmation EC
14.07MB
Plans.pdf
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.
I

Site# - Reason I Stream Name 11 Buffer Impact* Impact Type Zone 1 F ' Zone 2
Test Site 1
Unnamed
Temporary (T)
Exempt
0.00
2,352.00
Map label (e.g. Road Crossing 1)
Perm or Temp
Square Feet
Square Feet
Test Site 2
Unnamed
Temporary (T)
Exempt
3,136.00
2,955.00
Map label (e.g. Road Crossing 1)
Perm or Temp
Square Feet
Square Feet
Total Zone 1 Impacts: 3,136.00
Total Zone 2 Impacts: 5,307.00
Total Buffer Impacts: 8,443.00
Comments:
The existing use will not change. Per the Jordan Lake Buffer rules 15A NCAC 02B.0267 section 6, we are requesting exemption since
the use is present and ongoing and not changing. This project is being performed for utility pipeline maintenance only. Both sites are
existing maintained lawn areas which will be restored immediately upon completion of the maintenance activities.
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.
Limits of disturbance have been reduced to areas that have cleared existing conditions. Limits of disturbance have been reduced to
have no more than 150 linear feet of impact along jurisdictional streams.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Temporary matting will be used along any environmentally sensitive areas in lieu of graveled construction entrances. Filter sock will
be used for sediment control in lieu of silt fence as filter sock requires less disturbance for installation and removal.
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
1 - PNG Line 200 MAOP Reconfirmation EC
14.07MB
Plans.pdf
PDF only
F. Supplementary Information jJ
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
PDF only
Additional Comments:
H. Sign and Submit
By digitally signing below, I certify that:
1�2J
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)
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:* Jon Brown
Signature
014!' OtOk.Y!'
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
20231583
Rebecca Chandler: rebecca.chandler
Winston-Salem Regional Office - [phone]
No Payment Needed
Fee Received
Need Fee - send electronic notification