20191183 Ver 1_Riparian Buffer Authorization_20190830

DWR
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
la. Name of project:
FORM: BA 10-2013
Riparian Buffer Authorization Form
A.
Applicant Information
1.
Project Information
la. Name of project:
Screened porch
1 b. County:
Wake
1 c. Nearest municipality:
Cary
1d. Subdivision name:
1 e. Is the project located in any of North Carolina's twenty coastal counties?
If yes, answer 1f below.
❑ Yes X No
1f. Is the project located within a NC Division of Coastal Management Area of
Environmental Concern (AEC)?
❑ Yes X No
2.
Owner Information
2a. Name on Recorded Deed:
Charles Michael Bost, Michael Evan Black
2b. Deed Book and Page No.
06277 Page 2247
2c. Map Book and Page No.
(include a copy of the
recorded map that indicates
when the lot was created):
2d. Responsible Party
(for Corporations):
Charles Michael Bost
Michael Evan Black
2e. Street address:
1200 Manchester Dr
2f. City, state, zip:
Cary, NC 27511
2g. Telephone no.:
919-270-4437
2h. Fax no.:
2i. Email address:
[e-mail]
3.
Applicant Information (if different from owner)
3a. Applicant is:
❑ Agent x❑ Other, specify: Homeowner
3b. Name:
Charles Michael Bost
Michael Evan Black
3c. Business name
(if applicable):
3d. Street address:
1200 Manchester Dr
3e. City, state, zip:
Cary, NC 27511
3f. Telephone no.:
919-270-4437
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): 0773258371
1 b. Site coordinates (in decimal degrees): Latitude: 35.7673 Longitude: -78.7543
1c. Property size: .29 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project:
Walnut Creek
2b. Water Quality Classification of nearest receiving water:
C;NSW
2c. River basin:
Neuse River Basin
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:
Single family home
3b. Attach an 8'/z x 11 excerpt from the most recent version of the USGS topographic map indicating the location
of the site
3c. Attach an 8'/z 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:
80-90ft
3e. Explain the purpose of the proposed project:
Screened in an existing deck on the property
3f. Describe the overall project in detail, including the type of equipment to be used:
The existing deck was screened in 2010. No heavy equipment was used.
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 x❑ Unknown
Comments:
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?
❑ Yes x❑ No ❑ Unknown
5b. If yes, explain and detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project? ❑ Yes x❑ No
6b. If yes, explain.
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
❑ 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
number —
Permanent (P)
or Temporary
T
Reason for
impact
Type of impact
(exempt, allowable,
allowable w/
mitigation)
Stream name
Buffer
mitigation
required?
Zone 1
impact
(sq ft)
Zone 2
impact
(sq ft)
B1 x❑ P ❑ T
Screened in
porch
allowable
Walnut Ceek
❑ Yes x❑ No
none
Total buffer mitigation required:
B2 ❑ P ❑ T
2c. If buffer mitigation is required, is payment to a mitigation bank or NC DMS
proposed?
❑ Yes ❑ No
2d. If yes, attach the acceptance letter from the mitigation bank or NC DMS.
❑ Yes ❑ No
2f. Comments:
B3 ❑ P ❑ T
❑ Yes ❑ No
B4 ❑ P ❑ T
❑ Yes ❑ No
B5 ❑ P ❑ T
❑ Yes ❑ No
B6 ❑ P ❑ T
❑ Yes ❑ No
Total buffer impacts
299
11c. 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?
❑ 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 Multiplier
(square feet
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 ❑ 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.
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
❑ 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.
1 c. 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 x❑ 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. 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 x❑ 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?
x❑ Yes ❑
No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
Michael Black
Applicant/Agent's Printed Name
08/30/2019
Applicant/Agent's Signature _
(Agent's signature is valid only if an authorization letter from the applicant is provided.) Date
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 5

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 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
1a. Does the project involve an expenditure of public (federal/state/local) funds or the
❑ Yes x❑ No
use of public federal/state land?
1 b. If you answered "yes" to the above, does the project require preparation of an
❑ Yes El 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 ❑ No
Wetland Rules (15A NCAC 02H .1300), DWR Surface Water or Wetland Standards,
or Ri adan Buffer Rules 15A NCAC 02B .0200)?
2b_ Is this an after -the -fact permit application?
x❑ Yes ❑
No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
Michael Black / �/ 08/30/2019
Applicant/Agent's Printed Name Applicant/Agent's Signature _
(Agents signature is valid only if an authorization letter from the applicant is provided.) Date
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 seat 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 5

VICINITY MAP (NT$) ECM EXISTING CONCRETE MDNUMENT PERCENTAGE OF IMPEWous AREA 25.97
NPS NO POINT SET
WALNUT HILLS - SECTION 2
B -0_M.1969, PG -59
`1 ECM N 6$'39'50"E 86.49' _
EIP
APPROXIMATE LOCATION
GGREEK
20' DRAINAGE EASEMENT
2- - --- CEN
Cb TERED ON THE CREEK
Q�O� 0.6
PROXIMATE LOCATION `� 20' UTILITY EASEMENT
�• Xp. OF' SEWER UNE .�
z O
TM z y U STONE WALK
N
50' NEUSE RIVER BASIN `t " 16.0
BUFFER AS MEASURED FROM CN WOOD o _ 24.9' rr
THE TOP OF BANK TFORiA DECK B.I 7
�
s
5.1
13.0 0
192 CONCRETE
DRIVE 0101
WALNUT HILLS - SECTION 1 Z a WALNUT HILLS - SECTION 5
B.O.M.1967, PG.382 1 STORY FRAME B.O.M. i 972, PG.324
jj 31.5
l 3.2 3.4 P
z —77.7— ._..,
T I
w
sl
p � A
EiP j NPS Lt EIP
Q W/M
MANCHESTER DRIVE
(50' PUBLIC R/)Y)
LEG
Course
Searing
Distance
NTP
NOTTTO SCALE
S
LI
S 66"30'15' W
32.00'
EkP
EXISTING IRON PIPE
PP
POWER POLE
�pYTN
W/M
WATER METERCurve
Radius
Length Chord
Chord Bear.
T6
TELEPHONE BOX
IPS
IRON PIPE SET
I Cl j
515.62'
1 67.84' 67.79'
S 70.23'10' W
f
CPBcL
TRANSFORMER
S�
CATV
L. POLE
CABLE TV BOX
LIGHT POLE
IMPERVIOUS SURFACE
HOUSE
TABiE
1550
OHPL
OVERHEAD POWER LINE
DRIVEWAY
1045
F.E.S.
FLARED END SECTION (PIPE)
SHED
120
RCP
REINFORCED CONC. PIPE
STONE WALK (APPROX)
200
E.O.C.
BACK OF CURB
DECK & NOT TUB PLATFORM
427
F.H.
FIRE HYDRANT
C\O
SEWER CLEAN OUT
TOTAL IMPERVIOUS AREA
3442
EIS
EXISTING IRON STAKE
TOTAL LOT AREA
13271
I.I.H.
MANHOLE
146
VICINITY MAP (NT$) ECM EXISTING CONCRETE MDNUMENT PERCENTAGE OF IMPEWous AREA 25.97
NPS NO POINT SET
WALNUT HILLS - SECTION 2
B -0_M.1969, PG -59
`1 ECM N 6$'39'50"E 86.49' _
EIP
APPROXIMATE LOCATION
GGREEK
20' DRAINAGE EASEMENT
2- - --- CEN
Cb TERED ON THE CREEK
Q�O� 0.6
PROXIMATE LOCATION `� 20' UTILITY EASEMENT
�• Xp. OF' SEWER UNE .�
z O
TM z y U STONE WALK
N
50' NEUSE RIVER BASIN `t " 16.0
BUFFER AS MEASURED FROM CN WOOD o _ 24.9' rr
THE TOP OF BANK TFORiA DECK B.I 7
�
s
5.1
13.0 0
192 CONCRETE
DRIVE 0101
WALNUT HILLS - SECTION 1 Z a WALNUT HILLS - SECTION 5
B.O.M.1967, PG.382 1 STORY FRAME B.O.M. i 972, PG.324
jj 31.5
l 3.2 3.4 P
z —77.7— ._..,
T I
w
sl
p � A
EiP j NPS Lt EIP
Q W/M
MANCHESTER DRIVE
(50' PUBLIC R/)Y)