20190001 Ver 1_Riparian Buffer Authorization_20181221

201 90 001
lv \ State of North Carolina
DW R
Department of Environmental Quality
Division of Water Resources �l/ �V Division of Water Resources
15A NCAC 028.0233 (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
la. Name of project:
801 E Ivy Drive - Lot 10 Fern Valley Subdivision
1 b. County:
Wake
1c. Nearest municipality:
Fuquay-Varina
1d. Subdivision name:
Fern Valley Subdivision Phase Two
1 e. Is the project located in any of North Carolina's twenty coastal counties?
If yes, answer if below.
EJ Yes ® No
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:
Raynor Builders, Inc _
2b. Deed Book and Page No.
DB 17282, Pg. 791
2c. Map Book and Page No.
(include a copy of the
recorded map that indicates
when the lot was created):
Book of Maps 1999, Pg. 982
2d. Responsible Party
for Corporations):
Adam Raynor
2e. Street address:
2f. City, state, zip:
----
725 N. Raleigh Street
Angier, NC 27501
2g. Telephone no.:
919-427-7521
2h. Fax no.:
21. Email address:
[e-mail]
3.
Applicant Information (if different from owner)
3a. Applicant is:
Agent El Other, specify:
3b. Name:
3c. Business name
(if applicable):
3d. Street address:
3e. City, state, zip: ^� _
3f. Telephone no.:
_
3g. Fax no.:
3h. Email address:
4.
Agent/Consultant Information (if applicable)
4a. Name:
Robert Godwin
4b. Business name
if applicable):
Streamline Land Surveying
4c. Street address:
870 NC 55 W
4d. City, state, zip:
Coats, NC 27521 _
4e. Telephone no.:
910-897-7715
4f. Fax no.:
N/A
4g. Email address:
[e-mail]
FORM: BA 10-2013 Page 1 of 4

B. Project information ant! Prior Project History -
......._ .....
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): PIN 0667-35-5955
1 b. Site coordinates (in decimal degrees): Latitude: 35.607086° Longitude: -78.786050°
1c. Property size: 0.3 acres (13,032 sq. ft.)
_
2. Surface Waters '
2a. Name of nearest body of water to proposed project: Terrible Creek — Johnson's Pond
2b. Water Quality Classification of nearest receiving water:
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:
Vacant, wooded lot within established residential subdivision.
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:
70 Linear Feet
_
3e. Explain the purpose of the proposed project:
Construct a residential home
3f. Describe the overall project in detail, including the type of equipment to be used:
Construction of house: Clear trees and undergrowth in immediate area of proposed house and excavation for
footings with commonly used equipment such as excavators and skid -steer loaders. Grading and revegetation after
construction to establish lawn area around 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 priorphases) in thepast?
Yes No El Unknown
Comments:
4b. If yes, who delineated the jurisdictional areas?
Name (if known): S&EC 244 West Millbrook Road Raleigh,
NC 27609. Project # 97-3425
Agency/ Consultant Company: C.G. Bagley, PA
Engineers / Surveyors
4c. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach
documentation.
Unknown — information above taken from recorded subdivision plat.
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 4

C. Proposed Impacts Inventory
L
1. Buffer impacts
1 a. Project is in which protected basin?
® Neuse ❑ Tar -Pamlico ❑ Catawba
2. Buffer Mitigation
❑ 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
Stream name
Buffer
___
Zone 1
Zone 2
number —
impact.
(exempt: allowable,
mitigation
impact
impact
Permanent (P)
allowable wl
required?
(sq ft)
(sq ft)
or Temporary
mitigation)
Clearing and
B1 ❑ P ® T
lawn
exempt
❑ Yes ® No
0
953
establishment
132 ® P ❑ T
House
0 Yes ❑ NQ
0
255.5
Foundation
83 P T
-- ------
--- ----
---
�] Yes �No
B4 P ❑ T
❑ Yes No
B5 P ❑ T
❑Yes ❑ No
B6 ❑ P ❑ T ❑ Yes No
Total buffer impacts
i 1c. Comments:
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
House Plan was redesigned to fit on lot with less encroachment into buffer.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction
techniques. Treeprotection/ silt fencing will be installed 30 -ft from stream bank to protect Zone -1 buffer area.
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 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 required, is payment to a mitigation bank or NC DMS ❑ Yes ❑ 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.
i
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
El 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 INC Storrnwater 13MP
Carolina) Environmental Policy Act NEPA/SEPA ?
:. anuai and attach a BMP Supplement Form.
1 c. ff 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 Z 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. ff 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 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):
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
Karen Higgins
NCDWR — 401 & Buffer Permitting Branch
1617 Mail Service Center
Raleigh, NC 27699 - 1617
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 oll other projects sent by delivery service
(UPS, FedEx, etc.):
OR wren Higgins
NCDWR — 401 & Buffer Permitting Branch
512 N. Salisbury Street
Raleigh, NC 27604
FORM: BA 10-2013 Page 4 of 4

NC OneMap Data Explorer
Find Services Add external Service Chi
200 m
1000 ft
•78.7861, 38.6085
http://data.neonemap.gov/geoportal/dataexplorer/index.jsp

1
Lot 10 - Fern Valley
Topo Map
PIN: 0667355955
PIN Ext: 000
Real Estate ID: 0255105
Map Name: 0667 01
Owner: RAYNOR BUILDERS INC
Mail Address 1: 725 N RALEIGH ST
Mail Address 2: ANGIER NC 27501-9125
Mail Address 3:
Deed Book: 017282
Deed Page: 00791
Deed Date: 10131/2018
Deed Acres: 0.3
Building Value: $0
Land Value: $52,000
Total Value: $52,000
Billing Class: Business
Description: LO10 FERN VALLEY SUB PH2
%J BM1999 -363
HeatArea: 0
Site Address: 801 E IVY VALLEY DR
City: FUQUAY-VARINA
Township: Middle Creek
Year Built: 0
y Sale Price: $0
Sale Date:
Use Type:
Design Style:
Land Class: Vacant
Old Parcel Number: 820-00000-0000
e
N
\ 0 25 50 100 ft
\ t,.
- 1 inch = 50 feet
µ Disclaimer
MM'. �= „+ lAfaps makes every effort to produce and publish
the most current and accurate information possible.
However, the maps are produced for information purposes,
and are NOT surveys. No warranties, expressed or implied
are provided for the data therein, its use,or its interpretation.

Lot 10 - Fern Valley
Soils Map
PIN: 0667355955
PIN Ext: 000
Real Estate ID: 0255105
Map Name: 0667 01
Owner: RAYNOR BUILDERS INC
Mail Address 1: 725 N RALEIGH ST
Mail Address 2: ANGIER NC 27501-9125
Mail Address 3:
Deed Book: 017282
Deed Page: 00791
Deed Date: 10/31/2018
Deed Acres: 0.3
Building Value: $0
Land Value: $52,000
Total Value: $52,000
Billing Class: Business
Description: LO10 FERN VALLEY SUB PH2
BM1999 -363
Heat Area: 0
Site Address: 801 E IVY VALLEY DR
City: FUQUAY-VARINA
Township: Middle Creek
Year Built: 0
Sale Price: $0
Sale Date:
Use Type:
Design Style:
Land Class: Vacant
Old Parcel Number: 820-00000-0000
0 30 60 120 ft
1 inch = 60 feet
Disclaimer
(Maps makes every effort to produce and publish
the most current and accurate information possible.
However, the maps are produced for information purposes,
and are NOT surveys. No warranties, expressed or implied
,are provided for the data therein, its use,or its interpretation

FEMA FLOOD HAZARD STATEMENT LEGEND:
The lot shown on this plat is not Subject Boundary Line
located within the FEMA 100 year — — — Adjoining Boundary Line
Flood Hazard Area as shown on ---- R7W Right -of -Way Line
FEMA map No. 37200667001 - C/L Centerline
Effective date: 5/2/2006 --
Riparian Buffer
/ \ — — — — MBL Minimum Building Line
e CP Calculated Point
EIS/EIP Existing Iron Stake/Pipe
0,
/ \ � oma.
Riparian Buffer:
Zone -1: 30' Undisturbed Area
Zone -2 -
Permanent Impacts:
House 248 s_f.
Deck & steps 87.2 s.f.
Screen Porch 168 s.f.
Total Permanent: 503.2 s.f
= Temporary Impacts.-
Clear
mpacts:Clear and Revegetate 968 s.f.
i 50 Riparian Buffer Lone -2
EIP 1 66°32'37'E 147.32' 8.5'
/ U Il + 20.1
�� = Proposed
rn rn ( 1 ® House
m l +;-��:.
Zone- + \..:= r�K.
Z
FloodHazard
Soils Line
(Adams Soil
Consulting) 4
EIP 5
Lot Area: 13,032 s.f.
\
ProposederyImpervious:
impious: 20.54%
2,677 s.f.
EIP
Proposed o o+
Dr
lve EIP
.4e
i
�Y Note:
Q\��y The Flood Hazard Soils flags
\0 (delineated by others), Stream
Banks, and Existing Lot Corners
(labeled EIP) shown hereon are
from actual survey on August
23, 2018. All other lot lines
calculated from recorded plat.
TiyY VALLY DR
CTLN
: JOCQ?K:jNI VICINITY MAP
801 E Ivey Dr., Fuquay Varina
Lot 10, Fern Valley Subd., Phase Two; B.M. 1999,
Pg. 982, M.B. 1999, Pg. 363, B.M. 2004, Pg. 704
Survey For
Raynor Builders, Inc.
Deed Book 17282, Pg. 791
Middle Creek Twp. Wake Count
Scale: 1 " = 30 Date: Dec. 14, 2018
Surveyed & Mapped By
STREAMLINE
LAND SURVEYING, Inc.
NC FIRM G-1898
870 NC 55 W, Coats, N.G. 27521
Phone: [phone]
PRELIMINARY PLOT PLAN-
- Not an actual survey—
This plan represents proposed improvements
to a lot of record. This plan is subject to
review and approval by County Planning
and Inspections Departments.
0 15' 30' 60'
WS^M' SCALE
NOT FOR RECORDATION