20180383 Ver 1_Riparian Buffer Authorization_20180315

3 State of North Carolina
2 0 DWR a o 3 a 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
1a. Name of project: i -P %
1 b. County: A -
1 c. Nearest municipality: 4
1 d. Subdivision name: �, �� ,E1"4 --,J
1e. Is the project located in any of North Carolina's
twenty coastal counties. If yes, answer if below.
❑ Yes EDI�o
1f. Is the project located within a NC Division of Coastal
Management Area of Environmental Concern (AEC)?
El Yes No
2. Owner Information
2a. Name on Recorded Deed:
,yej_ v a /V,9f A-6 5X z4ybxj.-✓ %1n/S a TKus% �o
2b. Deed Book and Page No.
stt 07 a 6a D
2c. Map Book and Page No.
(include a copy of the recorded
map that indicates when the lot
was created):
'3 / �"d //�� r�""��' eu'A'i
2d. Responsible Party
(for Corporations):
2e. Street address:
CX,W-
2f. City, state, zip:
2g. Telephone no.:
:F,/s . 22_ Z
2h. Fax no.:
2i. Email address:
h S t eexy
3. Applicant Information (if different from owner)
3a. Applicant is:
❑ Agent ❑ Other, specify:
3b. Name:
3c. Business name
(if applicable):
D
3d. Street address:
OA40
LU
3e. City, state, zip:
MAR t 5, LU10
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
oue

B. Project Information and Prior Project History
1. Property Identification
la. Property identification no. (tax PIN or parcel ID):
1 b. Site coordinates (in decimal degrees):
Latitude: /,t Longitude:
1c. Property size:
acres s O
2. Surface Waters
2a. Name of nearest body of water to proposed project:,C�
i(/p,tyi1•�,/
2b. Water Quality Classification of nearest receiving water:
2c. River basin:
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: X-A i S�/.vim /�pA1e— t /✓ 4
3b. Attach an 8'/Z 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 linegr feet of all existing streams (intermittent and perennial) on the property:
N IA-
3e. Explain the purpose of the proposed project: }
/ D15" Cvri c/Let' Acts-5 % v 4,9Ke -I-eVA �O/CAO
3f. Describe the overall project in detail, including the type of equipment to be used:
C v/► E)/CC /tz-y 401,14ex 4v,,(— 13e=K- . u�
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?
❑ Yes ❑ No ❑ Unknown
Comments:
� w
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 eterminations or State determinations and attach documentation.
N /4'-
Project History
-5.
5a. Have permits or certifications been requested or obtained for this
project (including all prior phases) in the past?
❑ Yes ERNo El unknown
5b. If yes, explain and detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project? ❑ Yes o
6b. If yes, explain.
FORM: BA 10-2013 Page 2 of 4
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C. Proposed Impacts Inventory
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing
ri A'
1. Buffer Impacts
2. Buffer Mitigation
2a. Will the project result in an impact within a protected ri a n u r that requires buffer
mitigation?
1a. Project is in which protected basin?
❑ Neuse
❑ Randleman
❑ Tar -Pamlico �tawba
❑ Jordan ❑ Goose Creek
Ib. 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
number — impact (exempt, allowable,
Permanent (P) allowable w/ mitigation)
or Temporary `
Stream name Buffer Zone 1 Zone 2
mitigation impact impact
required? (sq ft) (sq ft)
61 Dt ❑ T
❑ Yes o 190sF
B2 ❑ P ❑ T
2e. If no, th discuss what type of mitigation is proposed.
❑ Yes ❑ No
133 ❑ P ❑ T
❑ Yes ❑ No
B4 ❑ P ❑ T
❑ Yes ❑ No
65 ❑ P ❑ T
❑ Yes ❑ No
136 ❑ P ❑ T
❑ Yes ❑ No
Total buffer impacts
1 c. Comments: �ti
.-J JZk 10-1 •t. CAA -7- T
(11,0 5,--)
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing
ri A'
1b. Specifically describe measures taken to avoid r minimize the proposed impacts th gh construction techniques.
2. Buffer Mitigation
2a. Will the project result in an impact within a protected ri a n u r that requires buffer
mitigation?
❑ Yes ❑ No
2b. If yes, then identify the square feet of impac t c ne of the riparian buffer that requires mitigation and
calculate the amount of mitigation required ith ble below.
Zone Reason for impact Total impact Multiplier Required mitigation
(square feet (square feet
Zone 1 3 (2 for Catawba)
Zone 2 1.5
Total buffer mitigation required:
2c. If buffer mitigation is r ired, is payment to a
mitigation bank or,,N EEP proposed?
❑ Yes E] No
2d. If yes, attach a acceptance letter from the mitigation bank or NC EEP.
2e. If no, th discuss what type of mitigation is proposed.
omments:
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.
If due to site constraints, a BMP other than a level spreader is proposed, please provide a
dT
plan for stormwater treatment as outlined in Chapter 8 of the NC Stormwater BMP
/L
Manual and attach a BMP Supplement Form.
public (federal/state) land?
F.
Supplementary Information
1.
Environmental Documentation
la.
Does the project involve an expenditure of public (federal/state/local) funds or the use of
❑ Yes ErNo
public (federal/state) land?
1 b.
If you answered "yes" to the above, does the project require preparation of an
❑ Yes Ed"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 VNo
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 No
2c.
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
r)114r'ty 4runrt6)�°L' l
Applicant/Agent's Printed Name Applicant/Agent's Signature Date
(Agent's sif nature 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 For government transportation projects sent
by First Class Mail via the US Postal Service: by delivery service (UPS, FedEx, etc.):
INC DWR, Transportation Permitting Unit OR NC DWR, Transportation Permitting Unit
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699 - 1617 Raleigh, NC 27604
For all other projects sent by First Class Mail For all other projects sent by delivery service
via the US Postal Service (UPS, FedEx, etc.):
Karen Higgins OR Karen Higgins
NCDWR — 401 & Buffer Permitting Unit NCDWR — 401 & Buffer Permitting Unit
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699 - 1617 Raleigh, NC 27604
FORM: BA 10-2013 Page 4 of 4

Parcel Report - Catawba County NC
Parcel Information:
Parcel ID: 460719605868
Parcel Address: 4292 POINTE NORMAN DR
City: SHERRILLS FORD, 28673
LRK(REID): 800206
Deed Book/Page: 3408/0620
Subdivision: POINTE NORMAN
Lots/Block: 18/
Last Sale: $267,500 on 1995-10-01
Plat Book/Page: 35/149
Legal: LOT 18 PLAT 35-149
Calculated Acreage: .550
Tax Map: 012FX 01018
Township: MOUNTAIN CREEK
State Road #: 2768
Tax/Value Information: Tax Rates(pdf)
City Tax District: All in County
County Fire District: SHERRILLS FORD
Building(s) Value: $331,300
Land Value: $158,400
Assessed Total Value: $489,700
Year Built/Remodeled: 1995/
Current Tax Bill
Miscellaneous:
Building Permits for this parcel.
Building Details
WaterShed: WS -IV Critical Area
Voter Precinct: P41
Parcel Report Data Descriptions
List all Owners Deed History Report
Owner Information:
Owner: BNY MELLON NATIONAL
ASSOCIATON
Owner2: CONTORINO KRISTIN SUPPL NEEDS
TRUST
Address: 385 RIFLE CAMP RD
Address2:
City: WOODLAND PARK
State/Zip: NJ 07424-3200
School Information:
School District: COUNTY
Elementary School: SHERRILLS FORD
Middle School: MILL CREEK
High School: BANDYS
School Map
Zoning Information:
Zoning District: COUNTY
Zoning1: R-30
Zoning2:
Zoning3:
Zoning Overlay: CRC-O,WP-O,FPM-O
Small Area: SHERRILLS FORD
Split Zoning Districts: /
Zoning Agency Phone Numbers
Firm Panel Date: 2007-09-05
Firm Panel #: 3710460700J
2010 Census Block: 4001
2010 Census Tract: 011504
Agricultural District:
Assessment Report
This map/report product was prepared from the Catawba County, NC Geospatial Information Services. Catawba County has made substantial efforts to ensure
the accuracy of location and labeling information contained on this map or data on this report. Catawba County promotes and recommends the independent
verification of any data contained on this map/report product by the user. The County of Catawba, its employees, agents, and personnel, disclaim, and shall not
be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or may arise from this map/report product or the use
thereof by any person or entity.
© 2017, Catawba County Government, North Carolina. All tights reserved.

Deed
Book: 3408
Page: 0620
View Page
Previous Document
Next Document
Grantor(s):
PHILLIPS, JOHN E.
PHILLIPS, DEBRA WEST
Grantee(s):
BNY MELLON NATIONAL
ASSOCIATION
CONTORINO, MARIO,TR
CONTORINO, LISA,TR
CONTORINO, KRISTIN
KRISTIN CONTORINO
SUPPLEMENTAL NEEDS TRUST
Recorded Date:
7/17/2017
Instrument Type:
DEED
Starting Book & Page:
3408 0620
Description:
LT18 PB35-149 POINTE NORMAN
S/D
Instrument Number:
12033
0
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Parcel Owner Report - Catawba County NC
Parcel ID: 460719605868
4292 POINTE NORMAN DR SHERRILLS FORD, 28673
BNY MELLON NATIONAL ASSOCIATON
CONTORINO KRISTIN SUPPL NEEDS TRUST
CONTORINO MARIO TRUSTEE
CONTORINO LISA TRUSTEE
This map/report product was prepared from the Catawba County, NC Geospatial Information Services. Catawba County has made substantial efforts to ensure
the accuracy of location and labeling information contained on this map or data on this report Catawba County promotes and recommends the independent
verification of any data contained on this map/report product by the user. The County of Catawba, its employees, agents, and personnel, disclaim, and shall not
be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or may arise from this map/report product or the use
thereof by any person or entity.
© 2017, Catawba County Goverment, North Carolina. All rights reserved.

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