20190660 Ver 1_Riparian Buffer Authorization_20190515

PLEASE IDENTIFY WHICH RIPARIAN AREA PROTECTION RULE APPLIES:
❑ Neuse River Basin (15A NCAC 02B.0233)
❑ Major Variance x Minor Variance
❑ Catawba River Basin (15A NCAC 02B.0243)
❑ Randleman Lake Water Supply Watershed (15A NCAC 02B.0250)
❑ Major Variance ❑ Minor Variance
❑ Tar -Pamlico River Basin (15A NCAC 02B.0259)
❑ Major Variance ❑ Minor Variance
❑ Jordan Lake Water Supply Nutrient Strategy (15A NCAC 028.0267)
❑ Major Variance ❑ Minor Variance
❑ Goose Creek Watershed (15A NCAC 02B.0606 & 15A NCAC 02B.0607)
A. General Information
1. Applicant's Information(if other than the current property owner): /
Name: f �Ve_�E
n n6o�✓
Title:
f�
+ 53 ry10 JJ S.��)�01 :1)
Street Address:
✓ /
City, State & Zip:
Telephone:
Email:')VUc
, c�(jillli"),1i�
2. Property Owner/Signing Official (person legally for the property and its compliance):
Name:
rrresponsible
c5> Ire
Title:
Street Address:
City, State & Zip:
Telephone:
Email:
FORM: VAR 10-2013

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3. Agent Information:
3a. Name:
Company Affiliation:
Street Address:
City, State & Zip:
Telephone:
E-mail:
3b. Attach a signed and dated copy of the Agent Authorization letter if the Agent has signatory authority for the owner.
4. Project Name (Subdivision, facility, or establishment name):
5. Project Location:
5a. Street Address: +539
City, State & Zip:
5b. County:
� t I r '47.60 N (a6'2V �1' 1n1 H0,00
5c. Site Coordinates (in decimal degrees): IY 2_q 3-1 lq 'E Latitude Longitude
5d. Attach an 8 %: x 11 excerpt from the most recent version of the USGS topographic map indicating the location of the site.
X 5e. Attach an 8 %: x 11 excerpt from the most recent version of the published County NRCS Soil Survey Map depicting the
project site.
6. Property Information:
6a. Property identification number (parcel
ID): LoZ-'
6b. Date property was purchased:
301 cam,
6c. Deed book 1 and page number
6d. Map book]' e�. and page number
6e. Attach a copy of the recorded map that indicates when the lot was last platted.
7. Is your project in one of the 20 Coastal Counties covered under the Coastal Area Management Act (CAMA)?
❑ YES r NO
7a. If you answered yes above, in which AEC do you fall (30 ft or 75 ft)?
7b. If you answered yes above, what is the total percent of impervious cover that you have proposed within the AEC?
FORM: VAR 10-2013 Page 2 of 6

0 Details of roads, parking areas, cul-de-sacs, sidewalks, and curb and gutter systems
0 Footprint of any proposed buildings or other structures
0 Discharge points of gutters on existing structures and proposed buildings
0 Existing drainage (including off-site), drainage easements, and pipe dimensions
0 Drainage areas delineated
C. Proposed Impacts and Mitigation
1. Individually list the square footage of each proposed impact to the protected riparian buffers:
Buffer Impact
Number'— Reason for Impact Buffer
Permanent (P) or Mitigation
Temporary (T) Required
Zone 1 Impact Zone 2 Impact
(square feet) (square feet)
61 -❑P ❑T ❑ Yes ❑No
Required
B2 -❑P ❑T ❑ Yes ❑No
Total Impact
B3 -❑P ❑T ❑ Yes ❑No
Mitigation
Total Buffer Impacts
'-Label on site plan
2. Identify the square feet of impact to each zone of the riparian buffer that requires mitigation from the table above. Calculate
the amount of mitigation required.
'For projects in the Goose Creek Watershed, list all riparian buffer impacts as Zone 1
and use Zone 1 multiplier.
3. Provide a description of how mitigation will be achieved at your site pursuant to the mitigation requirements of the applicable
river basin/watershed. 1 e �� D
3a. Is buffer restoration or enhancement proposed? ❑ Yes s'No
If yes, attach a detailed planting plan to include plant type, date of plantings, the date of the one-time fertilization in the
protected riparian buffers, and a plan sheet showing the proposed location of the plantings.
3b. Is payment into a buffer restoration fund proposed? ❑ Yes ZNo
If yes, attach an acceptance letter from the mitigation bank you propose to use or the NC Ecosystem Enhancement
Program stating they have the mitigation credits available for the mitigation requested.
FORM: VAR 10-2013 Page 4 of 6
Required
Zone
Total Impact
Multiplier
Mitigation
(square feet)
(square feet)
Zone 1'
3
(2 for Catawba only
Zone 2
1.5
Total Buffer Mitigation Required:
'For projects in the Goose Creek Watershed, list all riparian buffer impacts as Zone 1
and use Zone 1 multiplier.
3. Provide a description of how mitigation will be achieved at your site pursuant to the mitigation requirements of the applicable
river basin/watershed. 1 e �� D
3a. Is buffer restoration or enhancement proposed? ❑ Yes s'No
If yes, attach a detailed planting plan to include plant type, date of plantings, the date of the one-time fertilization in the
protected riparian buffers, and a plan sheet showing the proposed location of the plantings.
3b. Is payment into a buffer restoration fund proposed? ❑ Yes ZNo
If yes, attach an acceptance letter from the mitigation bank you propose to use or the NC Ecosystem Enhancement
Program stating they have the mitigation credits available for the mitigation requested.
FORM: VAR 10-2013 Page 4 of 6

11
8. Directions to site from nearest major intersection:
9. Stream associated with riparian buffer to be impacted by the proposed activity:
Name " Water Quality Classification
9a. For Goose Creek only: Is the buffer in the 100 -year floodplain? ❑ YES ❑ NO
10. List any permits/approvals that have been requested or obtained for this project in the past (including all prior phases).
Date Applied: Date Received:
A/Z!
B. Proposed Activity
Permit Type:
1. Project Description
1a. Provide a detailed description of the proposed activity including its purpose:
,J V 11/i'�� _1 P VA A 7-
1b. Attach a site plan showing the following items as applicable to the project:
0 Development/Project name
0 Revision number & date
0 North arrow
0 Scale (1" = 50' is preferred)
0 Property/project boundary with dimensions
0 Adjacent streets and roads labeled with names and/or NC State Road numbers
0 Original contours and proposed contours
0 Perennial and intermittent streams, ponds, lakes, rivers and estuaries
0 Mean high water line (if applicable)
0 Wetlands delineated, or a note on plans that none exist
0 Location of forest vegetation along the streams, ponds, lakes, rivers and estuaries
0 Extent of riparian buffers on the land including Zone 1 and Zone where applicable
0 Location and dimension of the proposed buffer impact (label the area of buffer impact in ft2 on the plan)
FORM: VAR 10-2013 Page 3 of 6

D. Stormwater
1. Provide a description of how diffuse flow will be maintained through the protected riparian buffers (e.g., re -planting vegetation
or enhancem
en
-
1
t of existing vegetation;(' gutter splash pads, level spreader to control of runoff from impervious surfaces, etc.).
1a. Show the location of diffuse flow measure(s) on your site plan.
1b. Attach a completed Level Spreader Supplement Form or BMP Supplement Form with all required items for each proposed
measure. `
1c. Attach an Operation and Maintenance (O&M) Form for each proposed level spreader or -BMP.
2. For Major, Catawba, and Goose Creek variance requests, provide a description of all best management practices (BMPs) that
will be used to minimize disturbance and control the discharge of nutrients and sediments from stormwater.
2a. Show the location of BMPs on your site plan.
2b. Attach a Supplement Form for each structural BMP proposed.
2c. Attach an Operation and Maintenance (O&M) Form for each structural BMP proposed.
E. Demonstration of Need for a Variance
The variance provision of the riparian buffer rules allows the Division or the Environmental Management Commission to grant a
variance when there are practical difficulties or unnecessary hardships that prevent compliance with the strict letter of riparian
buffer protection.
1. Explain how complying with the provisions of the applicable rule would prevent you from securing a reasonable return from or
make reasonable use of your property. Merely proving that the variance would permit a greater profit from the property shall
not be considered adequate justification for a variance. The Division will consider whether the variance is the minimum possible
deviation from the terms of the applicable Buffer Rule that shall make reasonable use of the property possible.
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FORM: VAR 10-2013 Page 5 of 6

2. Explain how the hardship results from application of the Buffer Rule to the property rather from other factors such as deed
restrictions or other hardships (e.g. zoning setbacks, floodplains, etc);
3. Explain how the hardship results from physical nature of the property, such as its size, shape, or topography, which is different
from that of neighboring property.
w.1--*'T-/t a- -)L prof ✓�y Y -)DA- u-&eH e l
4. Explain whether the hardship was caused by the applicant knowingly or unknowingly violating thR applicable Buffer Rule.
S. For Neuse, Tar -Pamlico, Jordan Lake and Goose Creek only: Did the applicant purchase the property after the effective date of
the applicable Buffer Rule and then request a variance?
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6. Explain how the hardship is rare or unique to the applicant's property, rather than the result of conditions that are widespread.
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F. Deed Restrictions
By your signature in Section G of this application, you certify that all structural stormwater BMPs required by this variance shall
be located in recorded drainage easements, that the easements will run with the land, that the easements cannot be changed
or deleted without concurrence from the State, and that the easements will be recorded prior to the sale of any lot.
G. Applicant's Certification
I, 11_I V201 lam) ` IMMI, ) (print or type name of person listed in Section A, Item 2), certify that
the information included on this permit application form is correct, that the project will be constructed in conformance with the
approved plans and that the deed restrictions in accordance with Section F of this form will be recorded with all required permit
conditions.
Signature:
Date:
Nen92 hn LnV*n A�P&14�r
FORM: VAR 10-2013 Page 6 of 6

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