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SUFFER NOTIFICATION FORM
Pr®]ect Name/address.Is—
Owner;
Print
C0ntractur/aRen`.
Print `
rTi,
-PLC.Signature
The approval is for the purpose and design den your application. Impacts not indicated in the
application is a violation of the Buffer Rule. Site specific work should be provided in the application. [15A NCAC
02- I .0506 allid 13A NCAC 02B .0243(8)]
Trees are not allowed to be removed from Zone 1 of the Buffer (within 30 ft of the full pond elevation), unless
approved. Exception, tihose trees that are severely undermined along the immediate shoreline can be removed.
fvlinirnal shaping ai;u sloping along the immediate shoreline is allowed. [15A NCAC 02B .0243(6)]
Benching, grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 02B .0243 (6)]
ueaches, impervious patios, impervious walkways, etc. are not allowed in the buffer unless specifically approved
by the Division. `ihcrc are limitation on size for decks. [15A NCAC 02B .0243(4) and (6)]
v"Vork to be conducted from land must indicate an access and indicate any trees that are to be removed. The
wort: corridor should be described. The approved access corridor shall be restored. Staging, spoil, construction
sr,aterial must be outside the buffer. [15A NCAC 02H .0502 and 15A NCAC 02B .0243 (4), (6), (8)]
Stormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
discharges must ire ac the natural elevation and discharged prior to entering the buffer directed as diffuse or
S;17rct flow az non -erosive velocities to the lake. [15A NCAC 02B .0243(5), (6)]
i a'ifd1v@#Jje( ' �s, jep- 0y' 1V9 Ac(31i7od8
---- �� W hereby state that I have been informed of the Catawba
L,:E. „ oy work conducted in the buffer, not specifically stated in the application and approved
by the Division of Vvaer Resources R is a violation and subject to enforcement. Due diligence will be
�r;ruetior, ill be bu It within substantial compliance and intent of the 401 Water
Quality Certification and Buffer ules, the approved plan(s) an pecification(s), and other supporting
materials.
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