20160687 Ver 1_Riparian Buffer Authorization_20160713

Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02B .0233 (8)(b) and .0259 (8)(b) — Buffer Authorization
FORM: BA 10-2015
Riparian Buffer Authorization Form
A. Applicant Information
1. Project Information
1 a. Name of project:
1 b. County: Wake
1 c. Nearest municipality: 6:atrd.(
2. Owner Information
2a. Name on Recorded Deed:
CC t) as Oel oro
2b. Deed Book and Page No.
16430 g
2c. Map Book and Page No.
(include a copy of the recorded
map that indicates when the lot
was created):
2d. Street address:
107 A.
2e. City, state, zip:
Garner N 2--7S,2-It
2f. Telephone no.:
I 327- 06 i92-
22g.
2g.Fax no.:
2h. Email address:
j 77@ �Myi�.Cor1
3. Agent/Consultant Information (if applicable)
3a. Name:
3b. Business name
(if applicable):
3c. Street address:
3d. City, state, zip:
3e. Telephone no.:
Explain the purpose of the proposed project: 7. -
3f. Fax no.:
3g. Email address:
B. Project Information
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
Q -7
q13
1 b. Site coordinates (in decimal degrees):
Latitude: 35, 70001 Z
Longitude: " 7�, �()gJSO
1 c. Property size:
acres
0,
2. Surface Waters
2a. Name of nearest body of water to proposed project:
2b. River basin:
3. Project Description
Explain the purpose of the proposed project: 7. -
FORM:
FORM: BA 10-2015 Page 1 of 2

C. Proposed Impacts
Avoidance and Minimization
Buffer Impacts
E. Diffuse Flow
Individually list all buffer impacts below.
F. Violations
Buffer impact number—Permanent (P) or
Temporary T)
Reason for impact Zone 2 impact
(sq ft
B1 ❑ P ❑ T
❑ Yes ❑ No
B2 ❑ P ❑ T
f tnn; w 2U�1
B3❑PE] T
B4❑PE] T
Total buffer impacts s+
S
Comments:
D. Impact Justification and Mitigation
Avoidance and Minimization
Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
f-ese-)
E. Diffuse Flow
All buffer impacts and high ground impacts require diffuse flow or other form of stormwater treatment. Describe
how diffuse flow will be maintained:
F. Violations
Is the site in violation of DWR Wetland Rules (15A NCAC 02H.0500), Isolated Wetland
Rules (15A NCAC 02H .1300), DWR Surface Water or Wetland Standards, or Riparian
Buffer Rules (15A NCAC 02B.0200)?
❑ Yes ❑ No
Is this an after -the -fact permit application?
❑ Yes ❑ No
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
Ips pe, I T0
Applicant/Agenfs Printed Name
4 4�_ � -� -1-346
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
FORM: SSGP3080 8-13 Page 2 of 5

MINIMUM BUILDING SETBACKS
ZONING: R-9
FRONT................ ._....... »..25'
SIDE_...._................_....._06'
REAR....._.........................20'
CORNER._ ..............._...._. 20'
0
Lf) �\
U
Q m-
Of a-
3 /
5'-,
Q IPI
zoo
< L-0IPF
ctf
SSUH
O
$� 28 �g
14496 SF
IPF
/0.333 ACIPf\`��""
Ls
-
I. N \�
I �
' m 30' RIPARIAN
PROP ED BUFFER _
a H US N a�
2D' 50' RIPARIAN 127
461 427' BUFFER
PP EpSfINO p
GRAVE)
{� OFAy
PP
IPF 5`28'51"W 123.66' IPF —
SMITH DRIVE 35' R/W (PUBLIC)
xe A PORnON OF 1HE PROPOSED HOUSE
LocA(20.)ROF THEou is 50' R1P THE BUFFEERNE
NOTES:
NUMBER DIRECTION DISTANCE
PUBLIC WATER SYSTEM
© YTS O No
WELL
Li
N1455'S9"W
26.27'
HOUSE DIMENSIONS:
44.3' x 37.7'
DRIVEWAY OR ACCESS DRIVE DRAWAGE CULVERT
L2
N00'39'33'Y!
48.03'
m
L3
NO9'2Z38'E
16.02'
L4
'17'E
50.73
L5
-070-F41
S77'08'41'E
70-
24.95'
m
a
v
e
N F
PENNY
0
Sd e F
LOUIS
30
IPF
gV
$� 28 �g
14496 SF
IPF
/0.333 ACIPf\`��""
Ls
-
I. N \�
I �
' m 30' RIPARIAN
PROP ED BUFFER _
a H US N a�
2D' 50' RIPARIAN 127
461 427' BUFFER
PP EpSfINO p
GRAVE)
{� OFAy
PP
IPF 5`28'51"W 123.66' IPF —
SMITH DRIVE 35' R/W (PUBLIC)
xe A PORnON OF 1HE PROPOSED HOUSE
LocA(20.)ROF THEou is 50' R1P THE BUFFEERNE
NOTES:
PUBLIC WATER SYSTEM
© YTS O No
WELL
O YES W NO
PUBLIC SEWER SYSTEM
® YES O NO
HOUSE DIMENSIONS:
44.3' x 37.7'
DRIVEWAY OR ACCESS DRIVE DRAWAGE CULVERT
TYPE AND SIZE
STORWaTER AD"MRX= 9GH=RE
LOT 28
JOHNS OWN GARNE UB
FOR
CARLOS DELTORO
SCALE:6.
20 0 40 So
IMPERVIOUS SURFACE TABLE
HOUSE.......................1439 SF
DRIVE &.W.AL.K._.......... 2400 SF
.............._
TOTAL........... _._................ ._ ........_.3839 SF
LOT AREA ..... ...... .............................. 14496 SF
PERCENTAGE OF IMPERVIOUS AREA ............ 26.5%
TRbT LINA' STlRVffYUA W, P. C.
205 W. MAIN STREET
CLAYTON, N.C. 27520
TELEPHONE [phone]
FAX: [phone]
qlAq� www.trueli nesurveying.com
C -15f
)B NO: 2776.001 JORAVOL DANNY I DATE 7/5/16 1 CHEM: CURK