20170135 Ver 1_Riparian Buffer Authorization_20170130

D -WRI(rC�Y' t� State of North Carolina
IV IV I Off- Department of Environmental Quality
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 v
1 3
1a. Name of project: Build a house on Muddy Creek Waterfront
1 b. County: Beaufort
1c. Nearest municipality: Aurora
1d. Subdivision name: Community of South Creek
1 e. Is the project located in any of North Carolina's twenty coastal counties?
If yes, answer 1f below.
X Yes
❑ No
1f. Is the project located within a NC Division of Coastal Management Area of
Environmental Concern (AEC)?
X Yes
❑ No
2.
Owner Information
2a. Name on Recorded Deed:
South Creek Marina, LLC
2b. Deed Book and Page No.
1767/00331
2c. Map Book and Page No.
(include a copy of the
recorded map that indicates
when the lot was creat
724/249
2d. Responsible Party
for Corporations):
Bertie Arnhols
2e. Street address:
285 Muddy Creek Road (project address)
2f. City, state, zip:
Aurora, NC, 2780
2g. Telephone no.:
252/402-5749
2h. Fax no.:
None
2i. Email address:
[e-mail]
3.
Applicant Information (if different from owner)
3a. Applicant is: Agent X Other, specify: Owner
3b. Name: Bertie Arnhols
3c. Business name
if applicable):
3d. Street address: 457 Muddy Creek Road (where I currently reside)
3e. City, state, zip: Aurora, NC 27806
3f. Telephone no.: 252/402-5749
3g. Fax no.:
3h. Email address: [e-mail]
4.
Agent/Consultant Information (if applicable)
4a. Name:
4b. Business name
if applicable):
4c. Street address:
4d. City, state, zip:
4e. Telephone no..-
o.:4f.
4f.Fax no.:
4g. Email address:
FORM: BA 10-2013 Page 1 of 4

B.
Project Information and Prior Project History
1.
Property Identification
1a. Property identification no. (tax PIN or parcel ID): Parcel ID: 6588-95-0383
1 b. Site coordinates (in decimal degrees): Latitude: 35.335957 Longitude: -76.689793
1 c. Property size: 1.6 acres
2.
Surface Waters
2a. Name of nearest body of water to proposed project: Muddy Creek
2b. Water Quality Classification of nearest receiving water: SA, HOW, NSW
2c. River basin: Tar -Pamlico
3.
Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of
this application:
Currently has a Park Model
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'/Z 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 proposedproject: Build a residential house
3f. Describe the overall project in detail, including the type of equipment to be used:
Equipment necessa to construct and elevate a modular house
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?
El Yes El No X Unknown
Comments: May have been done when the Park
Model was placed on property in 2012.
4b. If yes, who delineated the jurisdictional areas?
Name (if known):
Agency/ Consultant Company:
Other:
4c. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach
documentation.
5.
Project History
5a. Have permits or certifications been requested or obtained
for this project(including all priorphases) in thepast?
No X Unknown
5b. If yes, explain and detail according to "help file" instructions. Septic Permit (copy attached
6.
Future Project Plans
6a. Is this a phased project? Yes X No
6b. If yes, explain.
FORM: BA 10-2013 Page 2 of 4

C. Proposed impacts Inventory
1. Avoidance and Minimization
1. Buffer Impacts
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction
techniques.
2. Buffer Mitigation
1 a. Project is in which protected basin?
Neuse X Tar -Pamlico
El Catawba
Zone
Zone 1
Reason for impact
❑ 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
Type of impact
i Stream name
Buffer
Zone 1
Zone 2
number —
impact
(exempt, allowable,
mitigation
impact
impact
Permanent (P)
allowable wi
required?
(sq ft)
(sq ft)
or Temporary
mitigation)
B1 XP OT
Build a house
Allowable
Muddy Creek
Yes X No
B2 OP EIT
Yes No
B3 P T
Yes El No
B4 P T
Yes No
B5 P T
Yes No
66 P T
Yes No
Total
buffer impacts
1 c. 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.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction
techniques.
2. Buffer Mitigation
2a. Will the project result in an impact within a protected riparian buffer that
requires buffer mitigation?
Yes No
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
Zone 1
Reason for impact
Total impact
(square feet)
Multiplier
3 (2 for Catawba)
Required mitigation
(sqare feet
Zone 2
1.5
Total buffer mitigation required:
2c. If buffer mitigation is required, is payment to a mitigation bank or NC DMS
proposed?
0 Yes El No
2d. If yes, attach the acceptance letter from the mitigation bank or NC DMS.
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
0 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.
1 b. If you answered "yes" to the above, does the project require preparation of an
If due to site constraints, a BMP other than a level spreader is proposed, please provide a
environmental document pursuant to the requirements of the National or State (North
plan for stormwater treatment as outlined in Chapter 8 of the NC Stormwater BMP
Carolina) Environmental Policy Act NEPA/SEPA ?
P.1anual and attach a BMP Supplement Form.
1c. If you answered "yes" to the above, has the document been finalized by the State
F. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the
❑ Yes X No
use of 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
❑ Yes X No
Wetland 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 X No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
UeRte lAm OOLS hAr /
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
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.):
Karen Higgins Karen Higgins
NCDWR — 401 & Buffer Permitting Branch OR NCDWR — 401 & Buffer Permitting Branch
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699 - 1617 Raleigh, NC 27604
FORM: BA 10-2013 Page 4 of 4

IMPROVEMENT PERMIT For Office Use Only pa;(. r
Beaufort County Health Department 'CCP File Nu^toer 233190-1
Environmental Health Section 6588950383
Count, rD NurnOer
220 North Market St
Evaluated For NEW,
Washington NC 27889
PERI,tIT :LI^, LINTIL 0 1/ 1 7/ ] 0 2�
Phone- 252-946-6048 Fax- 252-946-2074 . . -
'NOTE TOINSPECT1011S DIVISION Buldnq Permits cannot be issued with only an Improvement Pe mit ❑ FIISheet CA9
4coicani Byre Amhols Prorert, Caner Bertre Amhols
=Caress 457 Muddy Creek Rd :r,ress 457 hft:ddy Creek Rd
^d, Aurora t. A(rrory
State Zir NC 27806
�.t3'e Z:; NC 278%136
Phone a 1252) 402.5749
I,
Phone t 1252) 402.5749
^a to sshtuddy Creek Rd Prooglly location tR Site Informatron —�
Road ra Aurora NC 27806 w:.. _ . aria;
TownShrp
Qrse� trs_a s
Structure SINGLE FAMILY 33E T.'L Spring Creek Rd TSL Kluddy Creek Rd
a of eedroorns 3
• of People 2
'Water Supply PUBLIC
Initial systtm
S�t�m fpe ,Ir�ipns
'Site Classification PS Shallow Placement
Saprolde s.stem' Yes *No 1 �
i !.t;nr^rum Trench Depth Inihei
Oesryn Fw» 3 6 0
I TrencnGtOfn j 5 in. he
Sol) Grout; ill
Fill CtC}h inc he
Soil Application Rate 0 - 4
SoctiCTan- 1 0 0 0 Galion s
'System Classification Description
TYPE 11 C CONV SYSTEM WITH SHALLOT"! PLACEMENT Vu"`c ReOuerea , ti� es �;Nc *M3. Be Re,uue ;
'Proposed System 251, REDUCTION Pu^tC Tan. 1 0 0 0 Gallon; ;
RecauS,stemRequneC res ;"')plc tNo cutnas�.adJ:IeSCace --~�— --'-
`.
Repair system _ T
PS LPP w Pretreat t.t me^tu^t Trench Dectn 1 g inche_
'Site Classification
Sort A00pc311on Rate 0 4 '.t .ae:nu -i Trenrrl Gecth 1 8 in ,Me
'System Classification DesCflptlon Fill Oectn
TYPE V C AEROBIC TREATF,IENT UNIT IATU) Incnei
Purr Recivaeil )res ^)No #1.1 a. ae Re:ulfe-
'Proposed System OTHER Pu rip t 3n• 1 0 0 0
'�3II.ni
I' No grading or construction act(. it, is 3110he•Z ur areas ;ese;nate•: fpr s, ste-i 3n0 fecal( adnout aC cr o. as of Health Department
S1te Mogtjtcabons A detailed site plan ;approved by Department of Envirnomenial Quabty. %finw nq dimensions of house. pkicernent of r
driveway & water uhiity Innes is required prior to ssuance or an Aulhoii rat ort to Construct
i
The issuance of this vermd L, one H•arlh C ac anment ;n no ,%a. vu arantess in. is; u an, -e a other roi nfls The cer-id homier
is respons+0le for chac.,n; -%ith arrn meti
rocriaie ;O,ernin; 'C�tS in their re0m
uireenl;
•Permit C onditions Initial system consists of 1000 gal septic tank 1 (1 -box S 145') 25'. reduction drainllnes. & some cover may tx•
required Repair area requires TS -II pretreatment for reduction of setback from bulkhead A vsarrance of the j
1
Tar -Pamlico R,panan Stiffer Rules 115A NCAC 028 02591 is required prior to utilization of repair area
The Dr>Qat'"OM and Local Health Department may impose conditions on the lssuanr:e and may revoke the permits for failure of the system to
satisfy the conditions, ole rules, or this JIMCltt This permit is subject to revocation if the site plan, pat or inttwidad use changes (NCG S t 30ill
(% The person owning or conttoUtng time system shalt be responsitMe for assuring compliants with the taws, rules, and pump condrtwns
regarang system location. installation, operation, main ant=EJQ�_
eporting. and repair (.1938(bp.
'Authorized State Agent 2319 - Dahlem. Btake`� Date of issue 0 1 / 1 7 / J 0 1 7
Owner Applicant Signature yJ

C \2331,30 pia 01 172017
IMPROVEMENT PERMIT
Owner: Bertie Arhols
Owner Address:285 Muddy Creek Rd.. Aurora
Owner Phone #:[phone]
Property Address
PI N:6588-95-0383
Record #233190
Establishment Type: Home
Type of Well. -Public Well
Design Flow (GPD):360_�,
50.00 feet
vt"�CWDOoae:
1 600
Initial Site
Wastewater System:25°-o Reduction
Long Term Acceptance Rate(GPD/SQFT) 0 4
Trench Width:3 FT
Trench Spacing (OC):9 FT
Trench Bottom From NGL: -15 IN
Septic Tank Volume: 1000 GAL_
war
Authorized Agent: Date 1/17/2017
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