20181739 Ver 1_Riparian Buffer Authorization Application_20181228

A. Owner/Applicant Information
ErvvWaiaonmter Resources
Ex,n� ouw�i,r
For instructions on how to fill out this form, see the Buffer Authorization Application Help Document posted on DWR's 401 & Buffer page.
Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all mandatory questions are answered.
A. Owner/Applicant Information
General Information ^
.................................................................................................................................................................................................... .................. ............................................................................................................
Primary Contact Email:* [e-mail]
Flease list the contact person's enail for questions or payrrent on this project if needed.
Who is submitting the application?* r- Owner
rJ Applicant other than Owner
F- Agent
Check all that apply
Is there an agent working on this application r Yes
but not submitting it?* r No
1. Property Owner Information:
la. Name on Recorded Deed:*
1b. Responsible Party:
1c. Mailing Address:*
1d. Telephone:* 2523555805
Bill Clark Fomes of Greenville LLC
Lance Clark
(for Corporations)
Street Address
200 East Arlington Boulevard
Address Line 2
Suite A
city
State / Rovince / Pbegion
Greenville
NC
Fbstal / Zip Code
Country
27858
us
2. Applicant's Information (if different from owner):
2a. Name:* Ken Malpass
le. Email Address:* [e-mail]
2b. Company Affiliation: Malpass & Associates

2c. Mailing Address:*
Street Address
1645 East Arlington Boulevard
Address Line 2
Suite D
aty
State / Fravince / Ibgion
Greenville
NC
Fbstal / Zip Code
Country
27858
US
2d. Telephone:*
2527561780
2e. Email Address:*
[e-mail]
2f. Attach a signed and dated copy of the authorization granting the applicant owner approval. An agent authorization form is
acceptable.*
Click the upload button or drag and drop files here to attach docunent
DWRBUFF ERAUTHORIZATIONSIGENDBYLANCECL...
230.95KB
12.21.2018. pdf
PDF only
If the applicant is not the property owner, in addition to providing the Agents information, select Applicant other than Owner'above, enter the applicant's
information, and attach an authorization granting the applicant owner approval.

B. Project Information and Prior Project History
B. Project Information and Prior Project History
1. Project Information
1a. Name of Project:* Paramore Farms Phases 4 and 5
(Subdivision, facility, or establishrrent narre)
If your project has a formal name please use this. If your project does not have a formal name, please identify your project by the owner name and
proposed activity (Jones Property Access Road, Smith Guest House, etc.) List in parentheses any other names that have been used to identify the
project in the past.
1b. Is this a publicly -funded transportation project?*
r Yes
r No
1d. Subdivision Name: Paramore Farms
1e. Nearest
Municipality:
1f. Property Size
City of Greenville NC
19.28
acres
1g. County (or Counties) where the project is located:*
Pitt
1h. Property ID# Date of Purchase
PN 70417 6/13/2005
Tax RN or Parcel id
1 i. Deed Information
Type of Book Book# Page#-7
Deed F
141-143
Map 64 138 144
1j. Attach a copy of the recorded map that indicates when the lot was last platted.
Click the upload button or drag and drop files here to attach docunent
MB64Pagel 38-144.pdf 1006.14KB
DB1926PAGE141.pdf 115.71 KB
RDF only
1k. How would you like to provide the Latitude and Longitude information?*
f Address Lookup
w: Manually
Latitude * 35.557884 Longitude
11. Is the project located in any of North Carolina's twenty coastal counties?*
r Yes
r No
dr�CIilI17lE?

Coastal Management information can be found at:
o About Coastal Management
• Staff Listing
o Coastal County Lookup
2. Surface Waters
2a. Name of the nearest body of water to proposed project:*
Fork Swamp Canal
Link to Soil Surveys for North Carolina Counties. (Please see instructions in the Help Document to determine the most recent published version.)
2b. Water Quality Classification of nearest receiving water:*
C, Sw, NSW
2c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:*
2,600
(linear feet only)
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:
Vacant field and wooded area
3b. Attach an 8 % x 11 excerpt from the most recent version of the USGS topographic map indicating the location of the site.
aick the upload button or drag and drop files here to attach docurrent
p603con-northern-cluster USGS-7-5MINLTE-QUAD-
352.93KB
GREENVILLE-NC-2016.pdf
FDF only
Link to TOPO Map lookup: https://vievver.nationalmap.gov/basic/
3c. Attach an 8 % x 11 excerpt from the most recent version of the published County NRCS Soil Survey Map depicting the
project site.
nick the upload button or drag and drop files here to attach docurrent
p603con-northern-cluster_SOILS- MAP. pdf 3.65MB
FDF only
Link to Soil Surveys for North Carolina Counties. (Please see instructions in the Help Document to determine the most recent published version.)
4. Proposed Activity
Provide a detailed description of the proposed activity including its purpose and include the type of equipment to be used:*
Excavator to remove existing trees and brush and excavator to construct proposed
swale.
Attach a site plan as applicable to the project:
nick the upload button or drag and drop files here to attach docurrent
p603con-northern-cl u ste r-
TOTALSETFORBUF F ERAUTHORIZATIONSUBMITT... 17AMB
12.27.2018.pdf
p603con-northern-cluster-BUFFER-IMPACT-MAP.pdf 118.13KB
FDF only
** Below is a link with instructions on what you will need to show on your site plan.
http://edocs.deq.nc.gov/WaterResources/O/doc/402224/Pagel.aspx
5. Jurisdictional Determinations

5a. Have jurisdictional wetlands or stream determinations by the Corps or State been requested or obtained for this
property/project (including all prior phases) in the past?*
r Yes
r No
5b. Who did the determination on the jurisdictional areas?
Who did the determination? List name if known 11 Date Attach
Corps Traci Wheeler 08/23/2009
(%rre ff (mown)
pdf only
*** Please include the date of the determination and upload a copy of the determination.
Comments:
6. Project History ^
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*
r Yes
r No
7. Future Project Plans
7a. Is this project a phased project?* r Yes
r No
7b. If yes, explain*
Paramore Farms Phases 1-3 have been completed and phases 4 and 5 as
attached will be the final phases for the project.

C. Proposed Impacts Inventory
C. Proposed Impacts Inventory
Buffer Impacts
1a. Project is in which protected Basin?*
t: Neuse River Basin (15A NCAC 02B.0233)
r Catawba River Basin (15A NCAC 02B.0243)
r Randleman Lake Watershed (15A NCAC 02B.0250)
C Tar -Pamlico River Basin (15A NCAC 02B.0259)
r Jordan Lake Watershed (15A NCAC 02B.0267)
f Goose Creek Watershed (15A NCAC 026.0606 & 15A NCAC 026.0607)
You can find which river basin you live in at the link below.
http://www.eenorthcarolina.org/riverbasins-gis-map.asp
1c. Individually list all buffer impacts below. If any impacts require mitigation, then you MUST fill out Section D of this form.
Please note: if the impact you list below requires mitigation choose "allow w/ mitigation" under impact type.
Site# - Reason
Stream Name
Buffer Impact*
Impact Type *
Zone 1
Zone 2
Buffer Impact#1
Fork
Permanent
Allowable
2,693.
1,830.
K/hp label (e.g. Poad
Swamp
(P)
00
00
Grossing 1)
Canal
FbrmorTerrp
Square
Square
Feet
Feet
Total Zone 1 Impacts: 2,693.00
Total Zone 2 Impacts: 1,830.00
Total Buffer Impacts: 4,523.00
Comments:

D. Impact Justification and Mitigation
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project.*
Construction of wet detention pond.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.*
Swale will be stabalized within 14 days of construction. Faircloth skimmer will be
used to minimize any offsite sediment from the site during construction.

E. Diffuse Flow Plan
E. Diffuse Flow Plan
All buffer impacts & high ground impacts require diffuse flow or other form of stormwater treatment. If the project is subject to a state implemented
riparian buffer program, upload a plan that fully documents how diffuse flow will be maintained. All stormwater control measures (SCMs) must be
designed in accordance with the NC Stormwater Design Manual. Associated supplement forms and other documentation must be provided.
For a list of options to meet the diffuse flow requirements, click here.
1a. What type of SCM are you providing?*
I— Level Spreader
r- Vegetated Conveyance (lower SHWT)
r Wetland Swale (higher SHWT)
I7 Proposed project will not create concentrated stormwater flow through the
buffer
F- Other SCM that removed minimum of 30% nitrogen
1c. Diffuse Flow Documentation* aickthe upload buttonordrag and drop files here toallachdocurrent
P 60 3 F L O W RAT E S F O RO UT L ET PO N D VAR I O U S ST ... 3 3 8.72 K B
FDF only

F. Supplementary Information
F. Supplementary Information ^
......... ......... ......... ......... ................. .... ..... ...... ...... ..... ......... .
Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?
r Yes
F No
Violations
2a. Is the site in violation of DWR Wetland Rules (15A NCAC 02H .0500), Isolated Wetland Rules (15A NCAC 02H.1300), DWR
Surface Water or Wetland Standards, or Riparian Buffer Rules (15A NCAC 02B.0200)?
r Ya -
No
2b. Is this an after -the -fact buffer authorization application?
r Yes
r No
G. Additional Information
Please upload any additional information you would like the Division to consider during application review.
Additional Attachments: aick the upload button or drag and drop f iles here to attach docurrent
FDF only
Additional Comments:

G. Sign and Submit
G. Sign and Submitt
By digitally signing below, I certify that:
o I have given true, accurate, and complete information on this form;
• I agree that submission of this form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic
Transactions Act)
o I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic
Transactions Act');
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
o I intend to electronically sign and submit the application form."
Print Name:* William K. Malpass
Signature *
Submission Date: (Auto populated field)