20160706 Ver 1_Riparian Buffer Authorization_20160718

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State of North Carolina
' \ Department of Environmental Quality
t� va�ic3� ref 'VAr,r 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
Project Information
1. Project Information
1.
1a Name of project:
Fu r-7-0JKJ lr D0 i-rlor'i
1 b County,
L -'j 6 -
1c. Nearest municipality:
C
2. Owner Information
Latitude•_2,g*' 7.19'•Longitude iii
2a Name on Recorded Deed-
; t c i_t_t A- iA .' _ C- A it r� 'T t e njr Nt,' �',rlJ r`1 I~
2b Deed Book and Page No.
.5 c' - '
2c. Map Book and Page No
(include a copy of the recorded
map that indicates when the lot
was created):
T
2d. Street address
rt
2e City, state, zip
-7 i
2f. Telephone no
2g Fax no
--
2h Email address:
"3 t 'L -'L .--Lt C'l-Nl
3. Agent/Consultant Information (if applicable)
3a Name-
, r 't✓vt
3b. Business name
(if applicable)-
8 -
3c Street address,
3d City, state, zip;
6 ,,5
3e Telephone no.:
`1
3f Fax no .
1 - C i i
3g. Email address:
B.
Project Information
1.
Property Identification
la
Property identification no (tax PIN or parcel ID)
S f '" -
lb
Site coordinates (in decimal degrees):
Latitude•_2,g*' 7.19'•Longitude iii
1 c
Property size
acres
2.
Surface Waters
2a
Name of nearest body of water to proposed project:
a �t
2b
River basin
3.
Project Description
Explain the purpose of the proposed project -
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FORM, BA 10-2015 Page 1 of 2
16",

C. Proposed Impacts
Buffer Impacts
Individually list all buffer impacts below.
Buffer impact number — Permanent (P) or Reason for impact Zone 2 impact
Temporary T) (sq ft
B2❑P❑T
B3 ❑ PE] T
B4❑P❑T
Total buffer impacts
Comments -
D. Impact Justification and Mitigation
Avoidance and Minimization
Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
tA.r ' 1, M, .e .� , vs
1
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E. Diffuse Flow sPit Of%e0U,;- 0 P1e-
All buffer impacts and high ground Impacts require diffuse flow or other form of stormwater treatment.
Describe
how diffuse flow will be maintained:
f lost,
1 si = 9�
F. Violations
Is the site in violation of DWR Wetland Rules (15A NCAC 02H .0500), Isolated Wetland
❑ YesXQ
No
Rules (15A NCAC 02H 1300), DWR Surface Water or Wetland Standards, or Riparian
Buffer Rules (15A NCAC 02B .0200)?
Is this an after -the -fact permit application?
❑ Yes
U No
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s).
+ r _
Applicant/Agent's PrmtecTName i Rllcant/Agent's Signature ate
(Agent's signature is valid only if an authorization letter from the applicant is provided )
FORM. SSGP3080 8-13 Page 2 of 5
�s

URVEY NOTES LEGEND
) Deed ref 5793-474, PIN 0752 56 4771 IPS Imo pipe set
The basis of North and all easements, IPF+RFronpipe/rodoun - am
ght-of-way's buffers, setbacks and adlolners, Prerµeert orneereor C
11
art pt (c, referenced from Book of Maps1993, Papa 54 edncma este
4-g p' nless otherwise notednabeled Tele hone etlesta
f�V3 ) There are no environmental, buffer or Cable pedestal
>�
load determinations on this survey, except as noted IF Now r f r
Surveyor has made no Investigation or cP Ca cu aped point
ndependenl search for easements of record, RAV RI ht -o -wa
rcumbrances, restrictive covenants, ownership BM Book of Ma s
Ills evidence or any other facts that an accurate and as
once line
urrent title search may disclose Restrictive covenant —Sanitary ewer pipe
N etbacks may differ from platted setbacks —so— orm rain i a
x
O > ) Iron pipes found(IPFnPS) or set are 3/4" 1 D rebar oRu Overhead uu d
Vicinity Map z i ound or set (IRFRRS) are k5, unless noted otherwise oinm ro e
rty
(No Scale) ) Fietd survey Performed on July 1, 2016 Fire hXdran I
top bolt
Stream top delerminatlon coordinated with NCDENR e o
Mel Minimum Building Line
IPF
IPF IN
rr �
ROOT VFRSq� \
L
NAD 1d z1d
E: 2,055,461.79
Alb
' NAIL/
WALK /
l• F j0> 5.
LOT 911 MacGregor Weet
BM 1992-496 tl
PIN 0752 56 J756 •4(CS / / / \
2SBF
`CONC I PROPOSED I 7s• JO'
ITION
4r ?7J i • jDECK� I f 270 SFJrI//I1r
2 % 110 / 7g• % �s, / ti� 60�1
! LOT 11 MacGreor West
( BN 199 4 5
G y 3-54 9 •� 0 L07 109 Mcc0re9w west
/ '�OO BM 1992-1226
\ dPIN 75 : 2J, 75955 F 71 0 30' y / 7/ PIN 0752 566606
�.*0545 Ac
\ IPF �ZS' 0
Sgt IPF r �• h, l�- is /
6 01 y Ba7p, % try
LOT 104 MocGregor Weal W
BM1990-1402
PIN 0752 56 2563 �OB' d IPF O 4 88
/ OFFSET
/ N 6820'37° W /
1, Ralph V Pendergroph Jr, PL5,' /� 4 86'
certify that this mop was drawn under my 110"5\ _
supervision from an actual GPS/GN55 I, LOT105 MacGregor ft.t /
survey or tie made under my supervision and the BM 1992-874
AN 0752,56 J482
fallowing information was used to perform the survey
r�
Class orsurvey AA / J0' SSE CENTERED ON PIPE(BM1991-1226)
Posifional accuracy @ 959 Confidence H 0 032'
Type of GPS/GNSS field procedure RTK( NCVRS)
Dates) of survey 07/01/2016
Datum/Epoch NAD 83(2011) epoch 2010 00 (1 01
Published/fixed control NCVRS Network / / LOT 108 MocGrpor Wot
Combined Factor 1 000103279348 BM 1991-6J2
Units US Survey Foot - / / PIN 0752 56 5573
Horizontal positions are NAD83\NSRS 2011 /
, I
Plat of Surve
P T 5 for parcel located al
[� 'i� I, Ralph V Pendergroph Jr ,certify that this
..... L 311 Versailles Drive
P131 was drawn under my supervision from an
Q . F,S Land Surveying Cary, NC
� actual survey made under my supervision
_a 7° (deed and description recorded in Books prepared for
referenced on plat), that the boundaries not
_ L-3528 ° CC _ surveyed are clearly indicated as drawn from PO Box 726 • Apex, NC 27502 William H. & Barbara E. Fulton
t \information found in Books referenced on plat Phone [phone]
MacGregor West
4 that the ratio of precision or positional License 4 P-0459
SU1tJF• accuracy meets standards, that this plat was Info@plsnc coni Phase 2D, Lot 110
° Qr-\\\�� prepared in accordance with G S 47-30 as Book of Maps 1993, Page 54
\\�v� amended Witness mloriginal signature, 0 20 40 Cary Township
�'''r • PE11DE1� '�
//y/Jlll4tllllllllllttttll\ registration number and seal this 7th day
of July A D , 2016 - SCALE 1" = 40' Wake County, NC
July 7, 2016