20181387 Ver 1_More Info Received_20181030

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60%CONSTRUCTION DOCUMENTS
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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
El Other BMP
maintained. If a. Level Spreader is proposed, attach a Level Spreader Supplement Form.
1 a.
If due to site constraints, a BMP other than a level spreader is proposed, please provide a
® Yes ❑ No
plan for stormwater treatment as outlined in Chapter 8 of the NC' t&m%vater •BMP
of public (federal/state) land?
Manual and attach a BMP Supplement Form.
1b.
F.
Supplementary Information
f
by First Class kfail via the US Postal Service:
1.
Environmental Documentation
OR NC DWR, Transportation Permitting Unit'
1 a.
Does the project involve an expenditure of public (federal/state/local) funds or the use
® Yes ❑ No
Raleigh, NC 27604
of public (federal/state) land?
For all other projects sent by delivery service
1b.
If you answered"yes" to the above, does the project require preparation of an
❑ Yes ® No
OR Karen Higgins
environmental document pursuant to the requirements of the National or State (North
NCDWR-401 & Buffer Permitting Branch
1617 Mail Service Center
Carolina) Environmental. Policy Act (NEPA/SEPA)?
Raleigh, NC 27699 - 1617
1c.
If you answered "yes" to;the above, has the document been finalized by the State
El Yes ❑ No
Clearing House? (If so;, attach a copy of the NEPA or SEPA final approval letter,)
t
Comments:
2.
Violations
2a.
Is the site in violation of DWR Wetland Rules (15A NCAC 02H .0500), Isolated Wetland
❑ Ye; ® 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):
130
'Applicant/Agerit'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
For government transportation projects sent by
by First Class kfail 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 Hail -
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 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
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