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From: Tamara Hager tamarahagarIN+c" Corr
5ubjQct: Leo ptvtoe cart path
Date; 5,40—ber 3, 2023 a1 11,09VA
TO: TAMARA WAGE R hager 19, I*epermit oom

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PROPSM LM& DeXP.IKION:
LOT N). 440
P!e3se pr lirt:
►xroperty chmew.
AGENT AllTHORU 4TION FORM
PLANNO,___,PARCEl. 6711 - 2,
+- "rw1eVpswS registered property owners of the above noted property, do hereby authortae
(Name of Consulting firm)
W 4,u an rr Who# and take al actk)ns necessary for the pruCessing, issuance and aoeaptance of
this permit or certify and "and all Standwd and special condidons attached.
I►rrrpm► Cwnwes Addr= Qf different than property above):
*6 hereby ceriify drw ebow in(mution subm tied In this application is true and aowrate to the
,ram: ;f m- fc,'xo-Medge.
Auftrtwd SignilUre* , T
►ale: 1�'� � Z- ^_ �' . .

Prc�euc .gar/�idr;_ �.st �� t County:
Owner' —
Print T -
natUri•
Card;ra�c��eni: [
f%ri7t + mf L Sign
&, p; C al is for Ile pu-Pose and design described in your application""' IMP"U not, indicated in the
apptica; on is a voia--:Ion of the Buffer Rule. Site specific work should be provided In the application, (15A NCAC
Jrn �.._ air► W:.A.0 0213 .C243(8)1
Trees are rot allowed to be removed from Zone 1 of the Buffer (within 30 ft of the full pond elevation), unless
a-LrU : ea. �. �t:Gri, ti,jse trees that are severely undermined along the immediate shoreline can be removed,
i.li,.:real ;�.E�;.18 µrill S+JfJ1.�� i�iUfl� Y.ne Immediate shoreline Is alloyed. I I NCAC 020.0243(6)]
Berl&,: ng. grzdirig �n the !)uf"rer is not allowed, Excessive disturbance of ground cover. [1SA NCAC 02B .0243 (6)]
it pal ,ScjS p3uo5, ir►Zoeivious walkways, etc. are not allowed In the buffer unless specifically approved
T t&:d ara li:v.��tlon on size for aecks. 115A NCAC 02B ,0243(4) and (6))
-ivi s-k z ",A; froln ;andl must indicate an access and indicate any trees that are to be removed. The
work cnrridar should be ;iescr€bed. The approved access corr?dlor shall be restored. Staging, spoil, construction
rr,a,:ar,z ntiu;: L;6 .. 16:1:sa --,1e Duffer. [15A NCAC 024.0502 and 15A NCAC 028.0243 (4), (6), (a))
5tonmv, ;er cai: t .e piped or channeled for direct dis&arge to the lake. All constructed stormwater
,;e o: ra!ural elevation and discharged prior to entering the buffer directed as diffuse or
ra t-�- lake. [ISA;KAC 028 .024a(5), (6)1
AJ , hereby state that F nave been Informed of the Catawba
,.a: � L.;Uucted In the bLifer, not specificaIty stated in the appIIca tion and approved
(DWR), is a violation and subject to enforcement. D;ie diligence will be
Mill be buitt within substantial compliance and intent of the 401 Water
QL3iit%' ?:icn :rsc: SLffer Rules, the appro►+ea pjan(s) and specification{s), and other supporting
-.d.ia_ __ Date: ��