20160284 Ver 1_Riparian Buffer Authorization_20160318

20160284
DWI
State of North Carolina
, _ Department of Environment and Natural Resources
Division 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
1 n Name of nrniPrt 11 „ !. ✓.i _ ( _
1 b. County: i
1 c. Nearest municipality: G
1d. Subdivision name:AA1.r° L
1 e. Is the project located in any of North Carolina'
twenty coastal counties. If yes, answer 1f below.
Yes ❑ No
1f. Is the project located within a NC Division of Coastal
Management Area of Environmental Concern (AEC)?
ZYes ❑ No
2. Owner Information
2a. Name on Recorded Deed:
Crerad
2b. Deed Book and Page No.
!'K 60 -3 zca
2c. Map Book and Page No.
(include a copy of the recorded
map that indicates when the lot
was created):
I /"o kms!
��� �� 3 P!G Q s 9 �p
J -�6 �l %ref S' ' 3
2d. Responsible Party
(for Corporations):
2e. Street address:
2f. City, state, zip:
l- 2
2g. Telephone no.:
glo• 7� - 6�,
2h. Fax no.:
2i. Email address:
3. Applicant Information (if different from owner)
3a. Applicant is:
❑ Agent ther, specify: OW
3b. Name:
" D i u rr
3c. Business name
(if applicable):
cu 10
3d. Street address:
3e. City, state, zip:
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
4. Agent/Consultant Information (if applicable)
4a. Name:
4b. Business name
(if applicable):
4c. Street address:
4d. City, state, zip:
4e. Telephone no.:
4f. Fax no.:
4g. Email address:
FORM: BA 10-2013 Page 1 of 4

B. Project Information and Prior Project History /'r,� �6y�7�$7�8�� Reeard,,(
9a
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
/,p �6 �r cc - PlafA 51
1 b. Site coordinates (in decimal degrees):
Latitude: 35,035544
1Longitude: 6 1 p
1 c. Property size: -
acres
2. Surface Waters
2a. Name of nearest body of water to proposed project:
Seo
2b. Water Quality Classification of nearest receiving water:
sVd
2c. River basin:
v R,'vpy
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project atthetime of this
application: y% ,�.ahl �7 t''Q,rs; [Qi .fcri�`fX� s'� 7 ,J: �l%e r,,a. f'9' r'ex4,ce DQE✓v1�p
3b. Attach an 8'/ x 11 excerpt from the most recent version of the USGS topographic map indicating the location of
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
3d. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
3e. Explain the purpose of the proposed project:
C d
3f. Describe the overall project in detail, including the type of equipment to be used:,-Op , Pn UJ;hy
2 SCi+N' d' xa&V o" +- mss -/
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property/
project (including all prior phases) in the past?
es ❑ No ❑ Unknown
Comments:
4b. If yes, who delineated the jurisdictional areas? Agency/ Consultant Company:
Name (if known): t hrf,Other:
4c. If yes, list the dates of the Corps urisdictiona , determinations or State determinations and attach documentation.
5. Project History
5a. Have permits or certifications been requested or obtained for this
project (including all prior phases) in the past?
❑ Yes No ❑ Unknown
5b. If yes, explain and detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project?
❑ Yes %No
6b. If yes, explain.
FORM: BA 10-2013 Page 2 of 4

C. Proposed Impacts Inventory
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
I"•+'46 c�e�;� #� b,� i�it �e� wfA0.,/ ' ivy t'P7l+"y4,Vti1 Ah 64/Zone.
1. Buffer Impacts
2a. Will the project result in an impact within a protected riparian buffer that requires buffer
mitigation?
❑Yes �NNo
1a. Project is in which protected basin?
VNeuse ❑ Tar -Pamlico ❑ Catawba
❑ Randleman ❑ Jordan ❑ Goose Creek
1 b. Individually list all buffer impacts below. If any impacts require mitigation, then you MUST fill out Section D of this
form.
Buffer impact Reason for
number— impact
Permanent (P)
or Temporary T
Type of impact
(exempt, allowable,
allowable w/ mitigation)
Stream name
Buffer Zone 1
mitigation impact
required? (sq ft)
Zone 2
impact
(sq ft)
1/
61 P ❑T
/
S,„ 14,
El Yes N—No
-
B2 ❑ P ❑ T
1.5
❑ Yes ❑ No
Total buffer mitigation
63 ❑ P ❑ T
2c. If buffer mitigation is required, is payment to a
mitigation bank or NC EEP proposed?
❑ Yes ❑ No
2d. If yes, attach the acceptance letter from the mitigation bank or NC EEP.
64 El El
El Yes El No
B5 ❑ P ❑ T
❑ Yes ❑ No
B6 ❑ P ❑ T
El Yes ❑ No
Total
buffer impacts
1c. Comments:
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
I"•+'46 c�e�;� #� b,� i�it �e� wfA0.,/ ' ivy t'P7l+"y4,Vti1 Ah 64/Zone.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
N� V� ,' 0(1
2. Buffer Mitigation
2a. Will the project result in an impact within a protected riparian buffer that requires buffer
mitigation?
❑Yes �NNo
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
(square feet
Multiplier
Required mitigation
(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
mitigation bank or NC EEP proposed?
❑ Yes ❑ No
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 10-2013 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.
la.
If due to site constraints, a BMP other than a level spreader is proposed, please provide a
❑ Yes No
plan for stormwater treatment as outlined in Chapter 8 of the NC Stormwater BMP
public (federal/state) land?
Manual and attach a BMP Supplement Form.
1 b.
F.
Supplementary Information
1.
Environmental Documentation
la.
Does the project involve an expenditure of public (federal/state/local) funds or the use of
❑ Yes No
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 ❑ No
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 ko
2c.
If you answered 'yes" to one or both of the above questions, provide an explanation of the violation(s):
Applicant/Agent's Printed Name Applicant/Agent's Signature Date
(Agent's signature is valid only If an authorization letter from the applicant Is provided.)
Send 3 complete sets of this form and accompanying documents to the following:
For government transportation projects sent
by First Class Mail via the US Postal Service:
NC DWR, Transportation Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699 -1617
For all other projects sent by First Class Mail
via the US Postal Service
Karen Higgins
NCDW R — 401 & Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699 -1617
For government transportation projects sent
by delivery service (UPS, FedEx, etc):
OR NC DWR, Transportation Permitting Unit
512 N. Salisbury Street
Raleigh, NC 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, NC 27604
FORM: BA 10-2013 Page 4 of 4

SCALE 1:12000
0 1000 2000 3000
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B0�( 423 PAGE 599
EXIHBIT A
LEGAL DESCRIPTION
Lot Numbered Thirty -Six (36), Buccaneer Bay Subdivisidn, Section Two, as shown
on the plat thereof recorded in Plat Cabinet A, Slide 37-1, Pamlico County Registry,
and as shown on that certain map entitled "A Site Plan for William G. Zettel,"
prepared by Herbert J. "Josh" Nobles, Jr., RLS, dated August 8,1990.
Said property is subject to Restrictive Covenants contained in the instrument dated June
2, 1983, and recorded in Deed Book 222, Page 433, Pamlico County Registry, as
amended by the instrument dated January 20, 1984, and recorded in Deed Book 225, Page
269, Pamlico County Registry, and further amended by the instrument dated February 20,
1984, and recorded in Deed Book 226, Page 239, Pamlico County Registry, by the
instrument dated May 7, 1987, and recorded in Deed Book 254, Page 884, Pamlico
County Registry, and by the instrument dated January 1, 1990, and recorded in Deed
Book 270, Page 001, Pamlico County Registry.
Said property is also subject to the Street Disclosure Statement recorded in Deed Book
216, Page 530, Pamlico County Registry.
Book: 423 Page: 597 Seq: 3

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