20151045 Ver 1_Riparian Buffer Authorization_20151005

State of North Carolina .
Department of Environment and Natural Resources
Di' vision of Water Resources Division of Water Resources
15A NCAC 02B .0233 (8)(b), .0243 (8)(b), .0250 (11)(b),'.0259 (8)(b), .0267 (11)(c), .0607 (e)(2) - Buffer Authorization
FORM: BA 10 -2013
Riparian Buffer Authorization Form
A. Applicant Information
1. Project Information
1a. Name of project:
f- 2 �J 3 &me*-oJ d -PD I r
1 b. County:
I,0&ke
1 c. Nearest municipality:
( rl I _ %� ���Ct�I e
1d. Subdivision name:
Fiy-)P� , I eJ r1
le. Is the project located in any of North Carolina's ❑ Yes PfNo
twenty coastal counties. If yes, answer If below.
1f. Is the project located within a NC Division of Coastal ❑ Yes V No
Management Area of Environmental Concern (AECj?
2. Owner Information
2a. Name on Recorded Deed:
7:5B 412 C f <?,0 u)1TjL o 4I:: s 7 F'
2b. Deed Beek and Page No.��
_
va
2c. Map Book and Page No.
a the recorded
L04- 255
(include copy
map that indicates when the lot
ISM e- r"Cd C4 �o I 7 h �
was created):
O C') Le, 9 l L°I 09
2d. Responsible Party
�L°•Q.C2� �il
(for Corporations):
2e. Street address:
AVV -
r Jle�'Y] �rlS
2f. City, state, zip:
n eke ll , .t l 0- C>9 '% S �3►
2g. Telephone no.:
c
2h. Fax no.:
i 2i. Email address:
3. Applicant Information (if different from owner)
3a. Applicant is: ❑ Agent ❑ Other, specify:
3b. Name:
13c. Business name
(if applicable):
3d. Street address:
3e. City, state, zip:
3f. Telephone no.:
f 3g. Fax no.: uc %
3h. Email address: o
4. Agent/Consultant Information (if applicable)
4a. Name:
14b. Business name
(if applicable):
4c. Street address:
4d. City, state, zip:
4e. Telephone no.:
f 4f. Fax no.:
4g. Email address:
FORM: BA 10 -2013 Page 1 of 4

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification-no. (tax PIN or parcel ID): / rJ55C%Z25 g
1b. Site coordinates (in decimal degrees): Latitude: 35 , ((p �4pngitude:—,78. (074P k)
1c. Property size: (, , / l p acresg /(p
2. Surface Waters
2a. Name of nearest body of water to proposed project: {h4gPek'ns. (`Jt1T4c-
2b. Water Quality Classification of nearest receiving water:
2c. River basin: A&4- je— A vp� v
3. Project Description LT � Z!j :3 �'�� r �. 1 —/D� 1 n 4
3a. Describe the existing conditions on the site and the general land uVn vicini oof the ect at a time of this
application: er^ G/� it g Q r'' /'e 5147-lie- ?L ��/
,�5tc6d. bo 14-It 4101
( 3b. Attach an 8'A x 11 excerpt from the most recent version of the USGS topographic map indicating the location of
I the site
3c. Attach an 8 % x 11 excerpt from the most recent version of the published County NRCS Soil Survey Map
depicting the project site
13d. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
13e. Explain the purpose of the proposed project:
tti.-,-�1CA -6,� -a._I h D%Y-,e Ca" -\=�r"
13f. Describe the overall project in detail, including the type of equipment to be used: t��r IG1 P-e: n>tdt rt4-a '!
VNn 0, ")L A t-.) A-► n a e e_d, ecl_
4. Jurisdictional Determinations I i
4a. Have jurisdictional wetland or stream determinations by the ❑ Yes o ❑ 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): Other:
4c. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
S. Project History
5a. Have permits or certifications been requested or obtained for this ❑ Yes 4J(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 NNo
❑ Unknown
FORM: BA 10 -2013 Page 2 of 4

C. Proposed Impacts Inventory
1. Buffer Impacts
1a. Project is in which protected basin? I
I [I Neuse ❑
❑ Tar - Pamlico ❑ Catawba
❑ Randleman n
n Jordan ❑ Goose Creek
1 b. Individually list all buffer impacts below. If any impacts require m
mitigation, then you MIUST fill out Section D of this
form.
Buffer impact Reason for T
Type of impact S
Stream name Buffer Zone 1 Zone 2
number — impact (
(exempt, allowable, m
mitigation impact impact
Permanent (P) a
allowable w/ mitigation) r
required? (sq ft) (sq ft)
or Temporary T')
B1 [
E] Yes ❑ No
B2 tP ❑ T ❑
❑ Yes ❑ No
B3 ❑P n
C
C1 Yes E] No
B4 ❑P n
C
C1 Yes ❑No
B5 ❑ P ❑ T ❑
❑ Yes ❑ No
B6 ❑ P ❑ T ❑
❑ Yes ❑ No
Total buffer Impacts
1c. Comments:
D. Impact Justification and Mitigation
11. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
2. Buffer Mitigation
2a. Will the project result in an impact within a protected riparian buffer that requires buffer ❑ 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)
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 30 -2013 Page 3 of 4

E. Diffuse Flow Plan
All buffer impacts and high ground impacts require diffuse flow or other form of ', ❑ 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
plan for stormwater treatment as outlined in Chapter 8 of the NC Stormwater BMP
Manual and attach a BMP Supplement Form.
F. Supplementary Information
1.
Environmental Documentation
la.
Does the project involve an expenditure of public (federal /statellocal) funds or the use of
❑ Yes QWb
public (federal/state) land?
1 b.
If you answered "yes" to the above, does the project require preparation of an
❑ Yes ❑ No
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
❑ Yes ❑ No
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
❑ Yes Ago
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 XNo
2c.
If you answered "yes" to one or both of the above questions, provide an explanation of the
violation(s):
3&KYLl C. C�
Applicadt/Agent's Printed 2plican Agent's Signature Dat
(Agents signature is '421C nly if an authorization letter from the applicant is provided.)
Send this completed form and accompanying documents to the following:
For government transportation projects sent
by First Class Mail via the US Postal Service:
NO DWR, Transportation Permitting Unit
1617 Mail Service Center
Raleigh, NO 27699 - 1617
For all other projects sent by First Class Mail
via the US Postal Service
/ Karen Higgins
V NCDWR — 401 & Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NO 27699 - 1617
For government transportation projects sent
by delivery service (UPS, FedEz, etc.):
OR NO DWR, Transportation Permitting Unit
512 N. Salisbury Street
Raleigh, NO 27604
For all other projects sent by delivery service
(UPS, FedEx, etc.):
OR Karen Higgins
NCDWR — 401 & Buffer Permitting Unit
512 N. Salisbury Street
Raleigh, NO 27604
FORM: BA 10 -2013 Page 4 of 4
..

60' NEUSE RIVER
RIPARIAN BUFF4I 7 - -
MEASURED FROM \
TOP OF BANK
252
N
C
M
253
a
�
rn 0.16 AC
Z
OPEN SPACE
N 61 °49'59" E
�
LEGEND
FEPA-WI
Lines Surveyed
P —
— Lines not surveyed
FORESTVILLE RD, E.I.P.
Existing Iron Pipe
I.P.S.
Iron Pipe Set
i;
P.P
Power Pole
HWY•64 M.H.
Manhole
/
o•
40'
20' 0 40
VICINITY MAP (N.T S)
PROP.
GRAPHIC SCALE
254
V= 40'
I HEREBY CERTIFY THAT THIS MAP IS CORRECT AND THAT THE BUILDING
FOUNDATION WILL LIE WHOLLY ON THE LOT AND THAT THERE ARE NO
ENCROACHMENTS ON SAID LOT EXCEPT AS NOTED
I FUTHER CERTIFY
THAT THIS PROPERTY DOES /DOES NOT LIE IN A SPECIAL FLOOD HAZARD
AREA AS DETERMINED BY F.E.M.A.
60' NEUSE RIVER
RIPARIAN BUFF4I 7 - -
MEASURED FROM \
TOP OF BANK
252
N
C
M
253
a
�
rn 0.16 AC
Z
OPEN SPACE
N 61 °49'59" E
�
65.09'
I
y
Cn
Dec
—
�
n
PROP.
m
254
HOUSE
1II
low
J
20' PUBLIC
DRAINAGE
ry
EASEMENT
DRIVE
I
- -
,_1 82.03'
- _ _. S 54 °29'53 " W
MORGANITE CT-
(50'R/W)
LOT 253, EMERALD POINTE, PH. 3,
RECORDED IN B.O.M. 2006, PG. 1408, WAKE CO.
I, David W. Barrier,certify that this plat
was drawn under my supervision from
an actual survey made under my
supervision; that the boundaries not
surveyed are Clearly indicated and any
encroachments are shown.
PRELIMINARY PLOT
PROPERTY OF
PROFILE CONSTRUCTION
404 MORGANITE CT. KNIGHTDALE, N.C.
SCALE; 1"=49 David W. Barrier
Licensed Surveyor
DATE; 6/25114 421 S. Harrison Ave.
BOOK; Cary, N.C. 27511
(919) 469 -2834

1 MW

`ACCE Mapper 2.1 - 3.7 km NE of Knightdale NC
http: / /mapper.acme.com/
14.0, Zit
200 m
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