20190121 Ver 1_BA 10-2013_Buffer app._3-14-19_20190313

Lion,L'3
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), .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:
LAYHILL ESTATES
1 b. County:
WAKE
1c. Nearest municipality:
CITY OF RALEIGH
1d. Subdivision name:
LAYHILL ESTATES
1e. Is the project located in any of North Carolina's twenty coastal counties?
If yes, answer 1f below.
❑ Yes Nx No
1f. Is the project located within a NC Division of Coastal Management Area of
Environmental Concern (AEC)?
N Yes Nx No
2.
Owner Information
2a. Name on Recorded Deed:
NAHLA, INC
2b. Deed Book and Page No.
016214, 02003
2c. Map Book and Page No.
(include a copy of the
recorded map that indicates
when the lot was created):
2005, 2001
2d. Responsible Party
(for Corporations):
Khaled A AI-Zoubi, PE
2e. Street address:
5121 KAPLAN DR
2f. City, state, zip:
Raleigh, NC 27606
2g. Telephone no.:
919 271 0051
2h. Fax no.:
2i. Email address:
[e-mail]
3.
Applicant Information (if different from owner)
3a. Applicant is:
❑ Agent❑x Other, specify: owner rep.
3b. Name:
Khaled A AI-Zoubi, PE
3c. Business name
if applicable):
IC Engineering, Inc.
3d. Street address:
5407 Dillard Dr
3e. City, state, zip:
Raleigh, NC 27606
3f. Telephone no.:
919 271 0051
3g. Fax no.:
3h. Email address:
[e-mail]
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
1 a.
Property identification no. (tax PIN or parcel ID): 0782242036, 0782149065
1 b.
Site coordinates (in decimal degrees): Latitude: 35.7392 1 Longitude: 78.7227
1c.
Property size: 15.6 acres (7.62 Ac PH. 1)
2.
Surface
Waters
2a.
Name of nearest body of water to proposed
YATES BRANCH
project:
2b.
Water Quality Classification of nearest
WS-III;NSW
receiving water:
2c.
River basin:
NEUSE RIVER
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:
R -40W, RESIDENTIAL, VACANT WOODS & GRASS
3b.
Attach an 8'/2 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:
700'
3e.
Explain the purpose of the proposed project:
DEVELOP A SIX LOT SUBDIVISION WITH A 492' ACCESS ROAD(45' PUBLIC
RM-18'WIDTH)
3f.
Describe the overall project in detail, including the type of equipment to be used:
A SCM WILL COLLECT THE RUNOFF FROM ROAD AND THE GRADING OF
THE PROP. LOTS(0.92 AC -1.56 AC LOTS). GRADING AND PAVING MACHINERY
WILL BE USED.
4.
Jurisdictional Determinations
4a.
Have jurisdictional wetland or stream
O Yes ❑ No ❑
determinations by the Corps or State been
Unknown
requested or obtained for this property/ project
Comments: STREAM A & B ARE
(including all prior phases) in the past?
SUBJECT
4b.
If yes, who delineated the jurisdictional areas?
Agency/ Consultant Company:
Name (if known): ZACH THOMAS
Other: NCDERN
4c.
If yes, list the dates of the Corps jurisdictional determinations or State determinations and
attach documentation.
7/12/2018
5.
Project History
5a.
Have permits or certifications been requested
O Yes ❑ No ❑
or obtained for this project (including all prior
Unknown
phases) in thepast?
5b.
If yes, explain and detail according to "help file" instructions.
PRELIM. PLANS SUBMITTED TO NCDOT-SEE ATTACH. LETTER
6.
Future Project Plans
6a.
Is this a phased project?
O Yes ❑ No
6b.
If yes, explain.
PH.2 IS EAST OF YATES BRANCH 7.86 AC REMAINING
FORM: BA 10-2013 Page 2 of 5

C. Proposed Impacts Inventory
1. Buffer Impacts
1a. Project is in which protected basin?
❑x Neuse ❑ Tar -Pamlico ❑ Catawba
1 b.
❑ 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 w/
1.5
required?
(sq ft)
(sq ft)
or Temporary
2c.
mitigation)
❑ Yes ❑x No
2d.
If yes, attach the acceptance letter from the mitigation bank or NC DMS.
2e.
T
2f.
Comments:
Yates Branch
OUTFALL
B1 NP El
Allowable
(Basin 20,
El Yes x No
491
230
FROM SCM
Stream 13)
B2 ❑ P ❑ T
❑ Yes ❑ No
B3 ❑ P ❑ T
❑ Yes ❑ No
B4 ❑ P ❑ T
❑ Yes ❑ No
B5 ❑ P ❑ T
❑ Yes ❑ No
B6 ❑ P ❑ T
❑ Yes ❑ No
Total buffer impacts
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.
THE OUTFALL WAS TO DRAIN TO STREAM "B" NO POSITIVE ELEV. COULD BE REACHED
1 b.
Specifically describe measures taken to avoid or minimize the proposed impacts through construction
techniques. PLUNGE POOL USED -TO REDUCE EROSIVE VELOCITY
2. Buffer Mitigation
2a.
Will the project result in an impact within a protected riparian buffer that
requires buffer mitigation?
❑ Yes ❑x 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
(square feet
Multiplier
Required mitigation
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
proposed?
❑ Yes ❑x No
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.
OUTFALL DITCH WILL NOT BE PRPENDICULAR TO YATES BRANCH
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
❑x Diffuse flow
stormwater treatment. Include a plan that fully documents how diffuse flow will be
❑x 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.
1c. 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 0 No
use of public federal/state land?
1 b. If you answered "yes" to the above, does the project require preparation of an
❑ Yes 0 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 0 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 0 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 0 No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
Khaled A AI-Zoubi, PE 3/14/19
Applicant/Agent's Printed Name Date
Applicant/Agent's Signature
(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 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
NCDWR — 401 & Buffer Permitting Branch
1617 Mail Service Center
Raleigh, NC 27699 - 1617
Karen Higgins
NCDWR — 401 & Buffer Permitting Branch
512 N. Salisbury Street
Raleigh, NC 27604
FORM: BA 10-2013 Page 5 of 5