20191224 Ver 1_Riparian Buffer Authorization_20190913

BARTLETT
ENGINEERING a WRvErINc, rc
1906 Nash Street North Wilson, NC 27893-1726
Phone: [phone] Fax: [phone]
www.bartlett.us.com
September 6, 2019
Ms. Karen Higgins
NCDWR-401 & Buffer Permitting Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
Reference: Lake Wilson -2019 Park Improvements
Sewer Extension 2 0 1 9 1 2 2 4
Wilson County, NC
Dear Ms. Higgins:
Enclosed for your review and approval are the following items related to the Riparian Buffer
Authorization Application for the above referenced project:
• (3) Signed Riparian Buffer Authorization Form
• (3) Copies of Deed
• (3) Soil Survey Map
• (3) USGS Quad Map
• (3) Copies of Sewer Extension Plan
The Site is located at 4621 Lake Wilson Road N. (S.R. 1332), City of Wilson, Wilson County. The project
will involve the installation of approximately 276 LF of 12" DI Sewer Line, including a steel casing creek
crossing.
Should you have any questions or require additional information, please do not hesitate to call our
office.
Respectfully,
Steve Oliverio 1gSCj:jv :a'DENR/DWR
Enclosures SEP 13 2019
W"lsr RQxourres
plaml:it" Secwtt

State of North Carolina
Department of Environment and Natural Resources
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
A.
Applicant
Riparian Buffer Authorization Form Information
1.
Project Information
1 a.
Name of project:
Sewer Extension Lake Wilson Reservoir
1 b.
County:
Wilson
1 c.
Nearest municipality:
City of Wilson
1 d.
Subdivision name:
N/A
1 e.
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:
City of Wilson, North Carolina
2b.
Deed Book and Page No.
667,164
2c. Map Book and Page No.
(include a copy of the recorded
map that indicates when the lot
was created):
N/A
2d.
Responsible Parry
(for Corporations):
Dale Edmonds
2e.
Street address:
1800 Herring Ave.
2f.
City, state, zip:
Wilson, NC 27893
2g.
Telephone no.:
252-399-2642
2h.
Fax no.:
252-399-2453
2i.
Email address:
[e-mail]
3.
Applicant Information (if different from owner)
3a.
Applicant is:
❑ Agent ❑ 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:
Steve Oliverio
4b.
Business name
(if applicable):
Bartlett Engineering and Surveying, PC
4c.
Street address:
1906 Nash Street N.
4d. City, state, zip:
Wilson, NC 27893
4e.
Telephone no.:
252-399-0704
4f.
Fax no.:
252-399-0804
4g.
Email address:
[e-mail]
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):
3714-85-6778
1 b. Site coordinates (in decimal degrees):
Latitude: 35.790269
Longitude: -777.920005
1c. Property size:
122 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project:
Toisnot Swamp
2b. Water Quality Classification of nearest receiving
water:
WS-III:NSW
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:
The project is located at 4621 Lake Wilson Road N. Lake Wilson Park is existing and is surrounded by
residential and rural uses, bordered on the east by Lake Wilson Road.
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'/ 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:
±295 LF
3e. Explain the purpose of the proposed project:
Sewer extension to serve public park.
3f. Describe the overall project in detail, including the type of equipment to be used:
The project consists of installation of approximately 276 L.F. of 12" DI Sewer Line, including a creek crossing in
steel casing. General construction machinery will be utilized for grading and utility installation.
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 prior phases) in the past?
❑ Yes ® No ❑ 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 prior phases) in the past?
® Yes ❑ No ❑ Unknown
5b. If yes, explain and detail according to "help file" instructions.
City of Wilson S & E Plan Approval & NCDEQ existing sewer permit #WQ0023315
6. Future Project Plans
6a. Is this a phased project?
® Yes ❑ No
6b. If yes, explain.
This is Phase 2 of the approved sewer installation. Phase 1 has been installed & accepted by COW & DEQ.
FORM: BA 10-2013 Page 2 of 4

C. Proposed Impacts Inventory
Impact Justification and Mitigation
1.
1. Buffer Impacts
1a.
Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
1 a. Project is in which protected
basin?
Specifically describe measures taken to avoid or minimize the proposed impacts through construction
techniques.
® Neuse
❑ Randleman
❑ Tar -Pamlico ❑ Catawba
❑ 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
number — impact
Permanent (P)
or Temporary
T
Type of impact
(exempt, allowable,
allowable w/
mitigation)
Stream name Buffer Zone 1
mitigation impact
required? (sq ft)
Zone 2
impact
(sq ft)
B1 ® P ❑ T Utility
Allowable
Toisnot Swamp ❑ Yes ® No 1200
800
B2 ❑ P ❑ T
❑ Yes ❑ No
1.5
B3 ❑ P ❑ T
❑ Yes ❑ No
Total buffer mitigation required:
B4 ❑ P ❑ T
2c.
❑ Yes ❑ No
❑ Yes ❑ No
B5 ❑ P ❑ T
If yes, attach the acceptance letter from the mitigation bank or NC EEP.
❑ Yes ❑ No
If no, then discuss what type of mitigation is proposed.
B6 ❑ P ❑ T
Comments:
❑ Yes ❑ No
Total buffer impacts
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?
❑ 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
(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 EEP proposed?
❑ Yes ❑ No
2d.
If yes, attach the acceptance letter from the mitigation bank or NC EEP.
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 a. Does the project involve an expenditure of public (federal/state/local) funds or the use
If due to site constraints, a BMP other than a level spreader is proposed, please provide a
plan for stormwater treatment as outlined in Chapter 8 of the NC Stormwater BMP
Manual and attach a BMP Supplement Form.
❑ Yes ❑ No
F.
Supplementary Information
1.
Environmental Documentation
1 a. Does the project involve an expenditure of public (federal/state/local) funds or the use
❑ Yes ® No
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 Wetland
❑ Yes ® No
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 explan ' o he violation(s):
Applicant/Agent's Printed Name
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
-19-1,9
Date
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.):
OR Karen Higgins
NCDWR — 401 & Buffer Permitting Branch
512 N. Salisbury Street
Raleigh, NC 27604
FORM: BA 10-2013 Page 4 of 4

� t 1
DEED Born( , 667
INORTH CAROLINA PAGE 164
WILSON COUNTY
THIS DEED executed this day of May, 1957. by
M. A. Smith and wife Mavis E. Smith, and C. A. Baker and wife Ida
Gertrude Baker, parties of the first part, to the City of Wilson,
IN. C., a municipal corporation, party of the second part,
W I T N E S S E T H
For and in consideration of the sum of ten dollars
and other good and valuable consideration to them in hand paid by
the party of the second parts the receipt of which is hereby acknow-
ledged, the said parties of the first part, subject to the reserva-
tion herein contained, have bargained and sold and do hereby bargain,
sell and convey unto the City of Wilson, N. C., its successors and
assigns, in fee simple -
That certain tract of land situate in Taylors Township,
Wilson County, North Carolina;
Beginning at a point, Baker's Northeast corner in the old
high water line of Winstead Mill Pond, said point being North
29 deg. 59 min. West 403 feet from Baker's Southeast corner
iL ? in the road between N. C. Highway #58 and Dunn's Crossroads,
and from said point of beginning runs thence South 29 deg. 59
min. East 53.8 feet, corners and runs thence North 65 deg. 26
min. West 216 feet to a corner, thence along a new line near
the proposed water edge of a proposed lake the following:
North 15 deg.:26 min. West 719 feet; South 64 Tie'
min.
West 306.3 feet; North 8 deg. 00 min. East 181.5 feet; North
42 deg. 30 min. East 236.2 feet; North 41 deg. 15 min. West
344.7 feet; South 38 deg. 08 min. West 202.7 feet; South 61
deg. 29 min. West 151.2 feet; North 63 deg. 44 min. West 327.95
feet; North 43 deg. 25 min. West 475 feet; North 12 deg. 25 min.
West 415 feet; North 64 deg. 10 min. West 769 feet; North 47
deg. 10 min. West 202 feet; North 32 deg. 40 min. West 258.5
feet; and South 45 deg. 42 min. west 150.1 feet to a corner in
A. D. Williams easterly property line, thence North 10 deg.
58 min. East 803 feet along said Williams line to the run'of
Toisnot Swamp, thence down the run of said Toisnot Swamp in a
Southeasterly direction as it meanders 5028 feet, more or less,
to a point in the run of said Swamp, thence South 42 deg. 44
min. West, 60 feet, more or less, to the point of beginning;
containing 34.42 acres.
,1
Book:667 Page: 184 Seq: 1

DEED BOOK • 667 .
f
PAGE 165 j
For sources of title reference is made to deeds of J.
M. Jennings et als, recorded in book 517, page 291; and
R.L. Edwards and wife, recorded in book 521, page 213; all I I4
'sof the Wilson County Registry. t
TO HAVE AND TO .HOLD the aforesaid tract of land unto
;i
the City of Wilson, N. C., its successors and assigns, in fee I�
�k
simple.
r
There is reserved from the operation of this deed, i
s deed the City of Wilson, N. C., grants
and by the acceptance of thi
unto the parties of the first part, their heirs and assigns, the
right, so long as the City of Wilson, N. C., shall maintain a lake j i•
upon the property herein conveyed, to take from the waters of said I i
lake, during the months of June, July and August of each year, suf-
f icient water to irrigate any tobacco planted by the parties of the i f
first.part, their heirs and assigns, upon the lands presently owned
by them and adjacent to the tract herein conveyed.
I
And for the consideration aforesaid, the said parties
of the first part, for themselves, their assigns and personal repre-
sentatives, covenant to and with the City of Wilson, N. C., its i
1
successors and assigns, that they are seized in fee of the fands t
_ herein conveyed and have a good right to convey the same in fee {
ex.simple;
simple; that said lands are free and clear of.encumbrances, and that
they will forever warrant and defend the title thereto against the
lawful claims of any and all persons whomsoever.
IN TESTIMONY 6YHERE� the parties of the first Part
have hereunto set their hands and affixed their respective private {
seals, the day and year first above written.
.�rle,/t,.���.P�✓ (SEAL)
(SEAL)
i (SEAL)
(SEAL) }
t
1
i

�! •:"t7rLti• •t .�•.f ..VC 1J4S71 i14y�.
BED 667.
PACE *166
,.. .. �. North Carolina/• Wilson County
I. oetoGfJ , a Notary Public in and for
'
saidounty and State, do hereby certify that personally appeared
before me this day M. A. Smith and wife Mavis E. Smith, and C. A.
' Baker and wife Ida Gertrude Baker. and that each acknowledged the
due execution by them of the foregoing instrument, for the purpose
and consideration therein expressed.
Witness my hand and Notarial Seal this AA day of May 1957.
Notary Pubilc
�tgm3esion expires:
t
NORTH CARO1ANX
WILSON COUNTY
FLIED vm RFA1SjRA;1 I -
AT L� O'C: "ZK j't.P.M. DAY OF
1917'AND RE= DFD
f 6R OF F.BDS
l
S
4
d-
Book: 867 Page: 184 Seq: 3
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e
f
Book: 867 Page: 184 Seq: 3

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_ SYMBOL_ LEGEND
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6
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GRAPHIC SCALE
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AERIAL PIPE CROSSING GENERAL NOTES:
1. ALL MATERIALS UTILIZED ON THESE DETAIL SHEETS SHALL CONFORM TO NCDOT'S 2012 STANDARD
SPECIFICATIONS FOR ROADS AND BRIDGES, AS WELL AS NCDENR`S MINIMUM DESIGN CRITERIA FOR THE CLASS IRIP•RAP SLOPE CONCRM PIER
PERMITTING OF GRAVITY SEWERS, UNLESS NOTED OTHERWISE HEREIN. PROTECTION, TYP
IANHOLE, TYP
4 RESTRAINED JOINT PIPE AND FITTINGS SHALL CONSIST OF BOLTED RETAINER RINGS AND WELDED DIP CARRIER PIPEWITH
RETAINER BARS OR BOLTLESS TYPE WHICH INCLUDE DUCTILE IRON LOCKING SEGMENTS AND RUBBER RESTRAINED JOINT N LNG )
BETWEEN MANHOLES (SEE NOTE 4j
7 RETAINERS. BOLTS FOR RESTRAINED JOINTS (IF APPLICABLE) SHALE, CONFORM TO ANSI 816.21 RESTRAINED EXTEND RIP -RAP V4m PASTWATER LINE, TYP
PIPE AND FITTINGS SHALL BE FLEX"RING OR LOK•RING TYPE JOINTS."
I
3. CONCRETE PROPERTIES SHALL SEAS FOLLOWS; - -- --
r.'t CONCRETE COMPRESSIVE STRENGTH =4000 PSI ,
NOMINAL SLUMP =4 INCHES STEEL CASING PIPE, SEE
WATERICEMENTlTOUS MATERIALS RATIO =