20180751 Ver 1_Riparian Buffer Authorization_20180529

DWR��✓ � \# 201 80751
„ `� G State of North Carolina
�` Department of Environmental Quality
Division of Water Resources Division of Water Resources
15A NCAC 02B .0233 (8)(b), .0243 (8)(b), .02S0 (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
la. Name of project: 106 McWaine Lane -Home Addition
1 b. County: Wake
1 c. Nearest municipality: Cary
1 d. Subdivision name: Northwoods
1 e. Is the project located in any of North Carolina's twenty coastal counties?
If yes, answer if below.
Yes ® No
1f. Is the project located within a NC Division of Coastal Management Area of
Environmental Concern (AEC)?
_
Yes ® No
2.
_
Owner Information
2a. Name on Recorded Deed:
Ariadna Alonso Perez and Carlos Jesus Sibello Hernandez
2b. Deed Book and Page No.
016623 / 01174
2c. Map Book and Page No.
(include a copy of the
recorded map that indicates
when the lot was created):
016623, 01174
2d. Responsible Party
for Corporations):
2e. Street address:
106 McWaine Ln
2f. City, state, zip:
Cary, NC, 27513
2g. Telephone no.:
9195971516
2h. Fax no.:
2i. Email address:
[e-mail]
3.
Applicant Information (if different from owner)
3a. Applicant is: 0 Agent 0 Other, specify: J
3b. Name:
3c. Business name
(if applicable):
3d. Street address:
3e. City, state, zip: T
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 5

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
0764662439
1 b. Site coordinates (in decimal degrees):
Latitude: 35.800897 1 Longitude: -78.776697
1c. Property size:
0.26 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project: Black Creek
2b. Water Quality Classification of nearest receiving water: C; NSW
2c. River basin: Neuse
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:
Home addition
_
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'/2 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:
115 linear feet
_
3e. Explain the purpose of the proposed project:
Accommodate family row
3f. Describe the overall project in detail, including the type of equipment to be used:
We are going to be adding some extra square footage to the home. 811 will be called to mark utilities and
_ excavation will be done using a walk behind trencher.
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 priorphases) in thepast?
❑ Yes No El Unknown
Comments:
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?
❑ 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 5

C. Proposed Impacts Inventory
1. Avoidance and Minimization
1 a. Addition to the house will be built with the closest area to the bank at least 30 feet away from it. The project
will be designed to have the least possible impact upon the natural resources on the site and the site's
1. Buffer Impacts
expected.
1 b. - Protected area will the taped off to ensure that the workers respect the buffer limit
- Excavation for the foundation, plumbing, etc will be done using lightweight or manual equipment
1a. Project is in which protected basin?
M Neuse
❑ Randleman
El Tar -Pamlico
❑ Jordan
El Catawba
❑ 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 Stream name
(exempt, allowable,
allowable w/
mitigation)
Buffer
mitigation
required?
Zone 1 Zone 2
impact impact
(sq ft) (sq ft)
B1 ® P ❑ T Home addition
Allowable UT to Black
Creek
❑ Yes ® No
225
B2 El P El T
LJ Yes Ll No
B3 LJ P H T
El Yes No
Yes Ll No
B4 El P Ll T
0 Yes El No
2e. If no, then discuss what type of mitigation is proposed.
B5 El P LJ T
1
0 Yes L1 No
B6 LJ P Ll T
LJ Yes LJ No
Total buffer impacts
225
1c. Comments:
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Addition to the house will be built with the closest area to the bank at least 30 feet away from it. The project
will be designed to have the least possible impact upon the natural resources on the site and the site's
vicinity. This project is taking place due to the need for extra space since the family grew and another child is
expected.
1 b. - Protected area will the taped off to ensure that the workers respect the buffer limit
- Excavation for the foundation, plumbing, etc will be done using lightweight or manual equipment
- No vegetation will be damaged or removed during the construction project
- All the construction debris will be hauled away from the project site
2. Buffer Mitigation
2a. Will the project result in an impact within a protected riparian buffer that
Yes No
requires buffer mitigation?
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 Multiplier
Required mitigation
(square feet
s uare feet
Zone 1 N/A 0 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 DMS
Yes Ll No
proposed?
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 5

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.
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 ?
Manual and attach a BMP Supplement Form.
1 c. If you answered "yes" to the above, has the document been finalized by the State
F. Supplementary Information
1. Environmental Documentation
1 a. Does the project involve an expenditure of public (federal/state/local) funds or the
❑ Yes ® 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 ?
1 c. 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 -1�-
2a. Is the site in violation of DWR Wetland Rules (15A NCAC 02H .0500), Isolated
❑ Yes ® 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 ❑ No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
h(A)64
Applicant/Agent's Printed Name Appli ant/Agent's Signature Date
(Agent's signature is valid onl 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 For government transportation projects sent by
First Class Mail via the US Postal Service: delivery service (UPS, FedEx, etc.):
NC 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 via
the US Postal Service
OR For all other projects sent by delivery service
(UPS, FedEx, etc.):
FORM: BA 10-2013 Page 4 of 5

Karen Higgins Karen Higgins
NCDWR — 401 & Buffer Permitting Branch 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 5 of 5

Impact map: 106 McWaine Lane, Cary
Note�:
Addition is going to
be a 2 story
building attached to
current house,
Building is going to
take an area of
15'x1S' of Zone 2.