20190583 Ver 1_Riparian Buffer Authorization_20190502

DWR
2 0 1 90 5 83
State of North Carolina
Department of Environmental Quality
Division of Water Resources Division of Water Resources
15A NCAC 026 .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: 6AZF ^ -,S' ,ULTZ
-LO-7-
1 b. County: W
1c. Nearest municipality: _ R
.
1d. Subdivision name:
1e. Is the project located in any of North Carolina's twenty coastal counties?
If yes, answer 1f 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:
IF ARL S' F .
2b. Deed Book and Page No.
B.A•-r 1300 K I✓ Z 2_1
2c. Map Book and Page No.
(include a copy of the
recorded map that indicates
when the lot was created):
�� A9 , Z2_7 - Z 27 Ci )
2d. Responsible Party
for Corporations):
DAv I D [_= ° SN1J LTz
2e. Street address:
7 r S W aC . T,
2f. City, state, zip:
O E Z102
2g. Telephone no.:
vtJ - 2
2h. Fax no.:
2i. Email address:
AZA
DI=LL Sb
3.
Applicant Information (if different from owner)
3a. Applicant is: ❑ Agent ❑ Other, specify.-
pecify:3b.
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:
4b. Business name Q
if applicable): .L
4c. Street address: El
4d. City, state, zip: MAY
V 2 2019
4e. Telephone no.:
4f. Fax no.: MA p - A
UR S
4g. Email address:
FORM: BA 10-2013 Page 1 of 4

B.
Project Information and Prior Project History
1.
Property Identification
1a. Property identification no. (tax PIN or parcel ID): _ _W-4, 8 7 26
1b. Site coordinates (in decimal degrees): Latitude: .781 -/° I Longitude: -81,r5 ibpo
1c. Property size: 1,d31 acres
2.
Surface Waters
2a. Name of nearest body of water to proposed project: L— AKw- RHaowss
2b. Water Quality Classification of nearest receiving water: W5 - IV ' C
2c. River basin: CAA
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: L.1NMVELOPF0 LOT READY Mo BUI1_0 S1NC,iLB PAMIL-Y HoMF-
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 % 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:
Nok
3e. Explain the purpose of the proposed project: AcGE 550Ky STpZUcT O RF -
3f. Describe the overall project in detail, including the type of equipment to be used: /(p'X/!o` GJA-LEso 'W/
SHIJJe,L-l= Roo>r • BLIi-T oM to"xb"P06; w17'H F,LooR AI30vE 6�,p-ApF-.
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 ❑ Unknown
Comments: Np wr---r4Auv5 opzsrP-r-AM
C pW 1 --OT
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?
I ❑ Yes 0 No ❑ Unknown
5b. If yes, explain and detail according to "help file" instructions.
6.
Future Project Plans
6a. Is this a phased project? ❑ Yes fA No
6b. If yes, explain.
FORM: BA 10-2013 Page 2 of 4

C. Proposed Impacts Inventory
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
1. Buffer Impacts
2. Buffer Mitigation
2a. Will the project result in an impact within a protected riparian buffer that
requires buffer mitigation?
1a. Project is in which protected basin?
El Neuse
❑ Randleman
❑ Tar -Pamlico
❑ Jordan
OL 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
number —
Permanent (P)
or Temporary
T
Reason for Type of impact Stream name Buffer
impact (exempt, allowable, mitigation
allowable w/ required?
mitigation)
Zone 1
impact
(sq ft)
Zone 2
impact
(sq ft)
B1 NP TSCrehrsr�lt�/
ALLAiN<c
❑ Yes ❑ No
oNr
2 56 '7F
B2 P ❑ T
❑ Yes ❑ No
B3 ❑ P ❑ T
❑ Yes ❑ No
B4 Ll P ❑ T
❑ Yes Ej No
65 ❑ P T
❑ Yes 0 No
66 ❑ P El T
❑ Yes No
Total buffer impacts
ZS 65F
1c. Comments:
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction
techniques.
2. Buffer Mitigation
2a. Will the project result in an impact within a protected riparian buffer that
requires buffer mitigation?
LJ 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.
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
❑ 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.
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 © 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 ?
1c. 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
2a. Is the site in violation of DWR Wetland Rules (15A NCAC 02H .0500), Isolated
❑ Yes Q 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 Zt No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
-�IA.c.- A.— 4/��o zzol�
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
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 all other projects sent by delivery service
(UPS, FedEx, etc.):
Karen Higgins Karen Higgins
NCDWR — 401 & Buffer Permitting Branch OR 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 4 of 4

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Rhodhiss Lake Topo Map in Caldwell County North Carolina
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Version
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IF -
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Caldwell
FIPS Code
37027
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Latitude, Longitude
35.781970, -81.551600
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State Abbreviation
NC
State FIPS Code
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County Name
Caldwell
FIPS Code
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Aerial Photography
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NC Surface Water Classifications
+ ' Rhodhiss Lake, NC, USA X D
Show search results for Rhodh...
Click a stream for more infor O
der. Gtcew
3of3)
Stream Information:
Stream Index:
11-(37)
Stream Name:
CATAWBA RIVER
(Rhodhiss Lake below
elevation 995)
Description:
From Johns River to
Rhodhiss Dam
Classification:
WS-IV,B;CA
Date of Class.:
August 2, 1992
What does this
More info
Class. mean?
River Basin:
Catawba
2mi -81.440 35.850 Degrees
Pc�k
State of North Carolina DC
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