Crossgate Trail Right of Way Road Improvement and Repairs Buffer Authorization Form

State of North Carolina
Division of Water Resources
Department of Environmental Quality
Division of Water Resources
15A NCAC 02B .0233 (8)(b), .0243 (8)(b)p *0250 (11)(b)y .0259 (8)(b),r .0267 (11)(c)., .0607 (e)(2) —Buffer Authorisation
FORM: B10-01
Riparian Buffer Authorization Form
A.
Applicant Information
1.
Project Information
la.
Name of project.
Crossgate Trail ROW Road Improvements
+1 b.
County:
Catawba
1.
dearest municipality:
Sherrills Ford
1d.
Subdivision name:
/
1 a.
I s the project located in a ny
If yes, answer 1f below.
of North Carol i n a's tantr coastal counties
Yes X[:] No
1f.
Is the project located within a NC Division of Coastal Management Area of
Environmental Concern(AEQ?
El Yes X[:1 No
.
Owner Information
a.
Name on Recorded Dodd:
ROW Property to be dedicated to the municipality.
h.
Deed Book and Page No.
Kolb land.
.
Map Book and Page No.
(include a copy of the
recorded map that indicates
when the lot was created):
/
d.
Responsible Party
for Cup orati o L;
Big Ranch, LL
a.
Street address:
10 1 E. Matthews St
f.
City, state, zip:
Matthews, NC 28105
.
Telephone no..
980.262.4200
h.
Fax no..
i.
Email address.
[e-mail]
.
Applicant Information (if different from owner)
a.
Applicant is:
E Agent X0 Other} specify. Contractor
b.
Benno:
Big Punch} LL
.
Business rya rna
(if applicable):
d.
Street address:
101 E. Matthews t
.
City, state, zip-
Matthews, C 28105
f .
Telephone no.:
9801.262.4200
.
Fax no.:
h.
Email address:
[e-mail]
.
Agent/Consultant Information
if applicable)
4a.
fame:
b.
Business name
(if applicable):
*
Street address:
4d.
City, state,zip:
a.
Telephone no.:
f.
Fax no.:
.
Email address:
FORM: BA 10- 01 Page 1 of

B.
Project Information and Prior Project History
1.
Property Identification
1 a.
Property identification no. (tax PIN or parcel ID):
Gravel Portion of Crossgate Trail
1b.
Site coordinates (in decimal degrees):
Latitude:
+1
Longitude: -80.9347309
1 c.
Property s i.
.15 acres�
.
Surface Waters
a.
Name of nearest body of water to proposed project;
Labe Norman �
b.
Water Quality Classification of nearest receiving water.
formal
.
Fiver basin.
Catawba River
.
Project Description
a.
Describe the existing conditions on the site and the general
this application:
Gravel Driveway
land use in the vicinity of the project at the time of
b.
Attach an 8 1/2x 11 excerpt from the most recent version of the USGS topographic reap indicating the location
of the site
.
Attach a n 8 1/2x 11 excerpt from the mG t recent version of the published County NRCS Soil Survey Map
depicting the pTqiect site
d.
List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
0
.
Explain the purpose of the proposed project.
W Road d Improvement
f.
Describe the overall project in detail, including the type of equipment to be used.
T -improve and repair the existing ravel road to an asphalt paved road with landscaping and other normal
ancillary road and pedestrian improvements.
.
Jurisdictional Determinations
4a.
Have Jurisdictional wetland or stream determinations by
the Corps or Mate been requested or obtained for this
property/r t(includingall prior ha in the past?
El Yes X0 No F1 Unknown
Comments:
4b.
If yes, who delineated the Jurisdictional areas?
Name (if known):
Agency/ Consultant Company:
Other:
If yes, list the dates of the Corps Jurisdictional determinations r State determinations and attach
documentation.
.
Project History
a.
Have permits r certifications been requested or obtained
for this r t (including all prior phases) in the past?
El Yes El r to X❑ Unknown
b.
If yes, explain and detail according to "help file" instructions.
.
Future Project Plans
a.
Is this a phased project?
XE] Yes El rile
b.
If yes, explain.
The ROW is 30 feet pride. For now it will be made into a o' wide drive with landscaping. In the future there
may be further irr r veme-nt , repairs or maintenance. As is typical with most roads.
FORM. BA 10-2013 Page 2 of 4

C.
1.
Proposed Impacts Inventory
Buffer Impacts
1 a. Project is in
which protected basin?
❑
El
Neuse D Tar -Pamlico
Randleman 0 Jordan
7C❑ Catawba.
El Goose Creek
1 b. Individually
this farm.
list all buffer impacts below. If any impacts require mitigation, then you MUST fill out
Section D of
Buffer impact
number —
Permanent (P)
or Temporary
(T)
Reason for
impact
Type of impact
(exempt, allowable,
allowable wl
mitigation]
Stream name
Buffer
mitigation
required?
Zone 1
impact
(sq ft)
Zone 2
impact
(sq ft)
B1
}C❑ P FIT
Improving road,
Tree removal
Allowable
wlmitigation
Catawba River
X❑ Yes
❑ No
2000
B2
Ll
P
LJ
T
Yes El No
83
El P El T
El Yes [:1 Na
84
E P ❑ T
❑Yes L Na
�
B5
L P ❑ T
L Yes L No
�
B6
❑ P ❑ T
D Yes ❑ No
Total buffer impacts
2000
1c. Comments:
D. Impact Justification n d Mitigation
1. 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. We will install a silt fence in any areas when and it there is a chance for any runoff during
construction.
. Buffer Mitigation
a.
Will the project result in an impact within a protected riparian
requires buffer mitigation?
buffer that
X❑ Yes El No
b.
If yes} then identify the square feet of impact to each zone of
calculate the amount of mitigation required in the table below.
the riparian buffer that requires mitigation and
Zone
Reason for impact
Total impact
(squarefeet)
Multiplier
Required mitigation
(square feet
Zone 1
Road Improvements
(2 for Catawba)
4000
Zone 2
1.5
Total buffer mitigation required:
4,000
2c.
If buffer mitigation is required, is payment to a mitigation bank or NC DIMS
proposed?.
❑ Yes ❑ o
d.
If yes, attach the acceptance letter from the mitigation bark or NC DIMS.
e.
If no, then discuss what type of mitigation is proposed.
f.
Comments.
FORM: BA 10-2013 Page 3 of

E. Diffuse Flow Phan
All buffer impacts and high ground impacts require diffuse flow or other farm of
X❑ Diffuse how
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 5tormwatsr BMP
Manual and attach a BMP Supplement Form.
F. Supplementary Information
1. Environmental Documentation
1 a. Does the project involve an expenditure of public (fed era[/state/I oca 1) funds or the
❑Yes X❑ No
use of public federallstate land?
1 b. If you answered "yes" to the above, does the project require preparation of an
El Yes [:1 No
environmental document pursuant to the requirements of the National or State (North
Carolina) Environmental Policy Act NEPAISEPA ?
1 c. 1f you answered "yes" to the above, has the document been finalized by the State
El Yes [:1 Na
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 Riles (15A NCAC 02H .0500), Isolated
El Yes X❑ No
Wetland Rules (15A NCAG OZH .1300). DV1lR Surface Water or Wetland Standards,
or Ri orlon Buffer Rules 15A NCAC 02B .D200 ?
fib. Is this an after -the -fact permit application?
El Yes XEI No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violations):
Afshin Ghazi, Manager
Big A Ranch, LLC
Applicant/Agent's Printed Name
ApplicanVAgent'sSignature
(Agent's signature is valid only if an authorizatiari latter from the applicant is provided.)
Send ONE complete set of this form and accompanying documents to the following:
5-24-24
For goverment transportation projects sent by For goverment transportation projects seat by
First Class Moil via the US Posted Service. delivery service (UPS.., F dE , etc.). -
Amy Chapman Array Chapman
NCDWR — 401 & Buffer Transportation OR NCDWR — 401 &Buffer Transportation
Permitting Branch Permitting Branch
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699 - 1617 Raleigh, INC 27604
For all other projects seat b y F1 rs t Class MaI/ via For aU other projects seat by delivery service
the US Postal Service (UPS, FedE , etc.). -
Stephanie Goss Stephanie Goss
NCDWR - 401 & Buffer Permitting Branch OR NCDWR - 401 & Buffer Permitting Branch
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27899 - 1617 Raleigh, NC 27604
Date
FORM: BA 10-2013 Page 4 of 4