20000889 Ver 1_COMPLETE FILE_20000707

NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY

JAMES Fj,. HVNT'JR.
GOVERNOR

BILL- HOLMAN, S
' SECRETARY '

,

KERR?T: STEVENS
- DIRECTOR •(;

_.i

i
RECEIPT
October 16, 2000
Donald F. and Kay W. Knowles
3212 Quiet Mill Road, Apt. 132
Raleigh, North Carolina 27612
Subject: DWQ #: 000889
County: Wake
COE Permit #:
The Wetlands Restoration Program has received a check in the amount
of $ 1,584.00 check number 2687 as payment for the compensatory mitigation
requirements of the 401 Water Quality Certification issued for the subject
project. This receipt serves as notification that the compensatory mitigation
requirements for this project have been satisfied. Please note that you must
also comply with all other conditions of this certification and any other state,
federal or local government permits or authorization associated with this
activity.
The NCW RP, by acceptance of this payment, acknowledges that the
NCWRP is responsible for the compensatory mitigation requirements
associated with DWQ #000889 and agrees to provide the compensatory
mitigation as specified in the 401 Water Quality Certification. As specified, the
NCW RP will restore 1,100 square feet of stream buffers in basin/subbasin
030402.
If you have any questions concerning this matter, please contact Ron Ferrell
at [phone].
Sincerely,
Ronald E. Ferrell,
Program Manager
REF/cvb
CC: 'v Rob Ridings i
File'
WETLANDS RESTORATION PROGRAM
1619 MAIL SERVICE CENTER, RALEIGH, NC 27699-1 6 1 9
website: h2o.ennstate.nc.us PHONE [phone] FAX [phone]
AN EQUAL OPPORTUNITY / AFFIRMATIVE ACTION EMPLOYER - 50% RECYCLED/10% POST-CONSUMER PAPER
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
Q??
D E N R
September 6, 2000
DWQ# 00-0889
Wake County
Donald F. and Kay W. Knowles
3212 Quiet Mill Road, Apt. B2
Raleigh, NC, 27612
APPROVAL of Neuse River Riparian Buffer Protection Rules MINOR VARIANCE [15A NCAC 2B
.0233(9)(b)] with ADDITIONAL CONDITIONS
Dear Mr. and Ms. Knowles:
You have our approval, in accordance with the conditions listed below, to impact 1,100 ft'- of Zone 2 of the
protected riparian buffers for the purpose of constructing a driveway crossing to access property adjacent to Glen
Laurel Drive street termination located in the Glen Laurel subdivision in Raleigh, NC. This letter shall act as your
Minor Variance approval as described within 15A NCAC 2B .0233(9)(b). In addition, you should get any other
federal, state or local permits before you go ahead with your project including (but not limited to) Sediment and
Erosion Control, Non-Discharge and Water Supply Watershed regulations.
This approval is only valid for the purpose and design that you described in your Minor Variance request
dated July 7, 2000 except as modified below. 'If you change your project, you must notify us and you may be
required to send us a new request for approval. If the property is sold, the new owner must be given a copy of this
approval and is thereby responsible for complying with all conditions. For this approval to be valid, you must
follow the conditions listed below:
1. No impacts shall occur to Zone 1 of the protected riparian buffers. This office recommends that tree
protection fencing be placed along the boundary of Zone 1 near the construction area to ensure that no
- impacts to Zone 1 occur.
2. Riparian Buffer Mitigation must be provided per 15A NCAC 2B .0242 prior to construction. This
mitigation will require a ratio of 1.5:1 for impacts to Zone 2. Therefore, the required area of mitigation
will be 1,650 ft'-. On option to provide this mitigation is to make a payment into the Riparian Buffer
Restoration Fund at a cost of $0.96/ft'', or $1,584. If you decide to choose this option in accordance with
15A NCAC 2B .0242(7), this contribution will satisfy our compensatory mitigation requirements under
15A NCAC 2B .0233(10). Until the Wetland Restoration Program receives and clears your check (made
payable to: DENR - Wetland Restoration Program), buffer impacts shall not occur. Mr. Ron Ferrell
should be contacted at [phone] if you have any questions concerning the Wetland Restoration
Program. You have one month from the date of this Certification to make this payment. For accounting
purposes, this Certification authorizes payment into the Riparian Buffer Restoration Fund to
compensate for 1,650 fe of required riparian buffer mitigation for impacts to 1,100 fe of protected
riparian buffers; 03-04-02 river and sub-basin.
3. Any additional stormwater located on the property made accessible by this approval shall be directed to
sheet-flow at non-erosive velocities prior to entering the protected riparian buffers. No new ditching or
piping of stormwater through the protected buffers is allowed.
Non-Discharge Branch 1621 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX # [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post consumer paper
If you do not accept any of the conditions of this approval, you may ask for an adjudicatory hearing. You
must act within 60 days of the date that you receive this letter. To ask for a hearing, send a written petition
conforming to Chapter 150B of the North Carolina General Statutes to the Office of Administrative Hearings, P.O.
Box 27447, Raleigh, N.C. 27611-7447. This approval and its conditions are final and binding unless you ask for a
hearing.
This letter completes the review of the Division of Water Quality under the Neuse River Riparian Buffer
Protection Rules [15A NCAC 2B .0233(9)(b)]. Please call Bob Zarzecki at [phone] if you have any
questions or require copies of our rules or procedural materials.
Sincerely,
J
Kerr T. Stevens
cc: Steve Mitchell, Raleigh DWQ Regional Office
Central Files
File copy ,
000889
0 0 0 8 8 9
DwQ zn• app roa CORPS ACTION m: 11t? lo 1?r AAr1au ?3U???r
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWZDE PERYIIT }
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1) NO'T'IFICATION TO THE CORPS OF ENGINEERS
2) APPLICATION FOR SECTION 401 CERTIFCATION
;) COORDINATION RTTH THE NC DIVISION OF COASTAL MA;NAGE'IE:NT
SEND THE ORIGINAL :VND (1) COPY OF THIS COMPLETED FORM TO THE.A FROPRLAT
N
FIELD OFFICE OF THE CORPS OF ENGLNEERS (SEE AGENCY ADDRESSES SHEET). SEVEN
(7) COPIES.M ST BE SENT TO THE NC DIVISION OF WATER
(QUALITY ATT?i• JOHN-1 DORNEY. 4401 REEDY CREEK ROAD.
RALEIGH. NC 27607. PLEASE PRL IT OR TYPE.
?. cWNER'S NA:N1E: nnaia 1 I-F a? .• u??s
2. MAILINiG ADDRESS: ;,2 12. -Ligj 1 -1
SUBDIVISION NAMB .
CITY: R 0'? 'Q i ? ? STATE: h2 L - ZIP CODE. _ Z 7l
PROJECT LOCATION ADDRESS, INCLUDING S DIVISION NAMES ( D
MA. D;G ADDRESS ABOVE): 309? FROM!

?. TELEPHONE NUMBER: (HOME) (tiVORIC)' I - 8q- SS cI
4. IF AMICABLE: AGENT'S N klvfE OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE N IMBER: A/
LOCATION OF WORT{ 1PROVME A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERL-kL, PHOTOGRAPHY WITH SCA..I..E):
CoWry.:.0a 1p NEAREST TOWN e 04 k?A, -
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, I A,,"trIARKS, ECT.) "' 1? Icy
?"d ? 1h " 11_Ro"A Q,,hia G it ?. L u,r QI Q r a?L -f-h Q
,.? -r e-P4 -der m ; n1 ov+ 6) n 01 e .3 t...c"Ar A 1`.
6. IMPACTED OR NEAREST STRE.kNVRIVER: W r ±0 rot8+r eG Gneek
RIIVER BASN: ,Nenu4- :
7a. IS PROJECT LOCATED NEA1R WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA),
HIGH QUALITY WATERS (HQW' , OUTSTAN'DIN'G RESOURSE WATERS (ORW), WATER _
SUPPLY (WS-I OR WS-II)? YES( ) NO (!r) IF YES, EXPLAL,i:
7b. IS THE PROJECT LOCATED WTTHLv A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF E:N'VIRC?VEN"TAL CONCERN (AEC)? YES( ) NO (L-,)
7c. IF THE PROJECT IS LOCATED WTPFI N A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION? ? A _
8a. HAVE, ANY SECTION 404 PER.%IITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES( ) N00-1 IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS
PERMIT AND ANY ADDITIONAL iNFOR.MATION ( INCLUDE PHOTOCOPY OF 401
CERTIFICATION):
8b. ARE ADDMI ONAL PER.NIIT?EQUESTS EXPECTED FOR THIS PROPERTY IN TIE
FUTURE? YES ( ) NO ( tl' IF YES, DESCRIBE r N77CiPATED WORK:
9a. ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: i . ? 'Z..
ESTL-BATED TOTAL NUMBE-R OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
10a. NUMBER OF ACRES Of WETLANDS DAPACTED BY THE PROPOSED PROJECT BY:
Fm:,L rG: EXCAV AnI ON' -
FLOODD;G: OT:-MP.: -
DRAINAGE : _ TOTAL ACRES TO BE NPACTED: --
10b. (I) STREALM C '?T?'CE BOTH ?ORI: ? BY TME PROPOSED PROJECT (T
RELOCATED, PROVIDE
LENGTH BEFORE: FT AF'T'ER:
V,MTH BEFORE (based on normal high water cormou:,s): FT
AVERAGE DEPTH BEFORE: FT `*-MR: _ F'r
(2) S'T`RE.-..\I CHkNNi .T. IMPACTS NVTLL RESULT FROM: (CHECK ALL THAT APPLY)
O?EN CHANNa R,ELOC.kTION: _--- PLaC,7NtENT OF PIPE IN CHANNEL.
CHANNEL EXCAVATION: COONSTRL:CTICN OF A DAWFLOOO NG.
OTHER: r
T 1. LF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF T'HM WATERSIM
DRAVING TO THE POND? WHAT IS iHC &VEGI?D
POND SURFACE AREA" ?--
12. DISCTIPTION OF ?ROP05ED WORK INCLUDING DISCUSSION OF TYPE OF MECT."NICAL
=MTr R1h VNrr TO RR USED? (ATTACH PLANS; $I/2 BY I I,DRAWLNGS ONLY), ?
#l
I?. PURP05E OF PROPOSED ?10RK:.?????.???"7?} n?,?'?s -?'?

14, STATE REASONS WHY P.' IS S ELIEVED THAT 710 AC7N-7 Y MUS'T' BE CAR= Ob7-IN
WETLANDS (INCLUDE ANY kiE.-?SU'RE5 TA.K.NT TO M241M Z,E WE"IL,1'M 114PAC.TS)
00,' cue arc,-e..r.S 7'-© lPr a ??a ? - . Iv c-
(11,I) be c?• ' cl- 0.6- ?b i S ' )Dd
o'0 Cym PJ4vv 7-i D coo ra f- 0,3 k et ;
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE ANVOR
NATIONAL MA.WNE FISHERIES SERIVE REGARDING THE PRESENNCE OF ANY FEDERAL' Y
LISTED OR PROPOSED FOR LISTING ENDAINGERED OR THREATENED SPECIES OR
CRITICAL, HABITAT IN THE PERMIT A THAT MAY BE AFFE'CT'ED BY THE PROPOSED
PROJECT. DATE CONTACTED:
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES NN THE PER.ti1IT AREA
WHICHIn BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED
17. DOES THE PROJECT LNOLVE AN EXPENDITURE OF PUBLIC FUNDS OT `11M USE OF
PUBLIC (STATE; LAND? YES ( ) NO ( L.-' (IF NO, 00 TO 16) _
a. IF YES, DOES THE PROJECT REQUIRE PREPERATION OF AN ENVIRONIMENTAL
DOCUMENT PURUANT TO THE REQUIRENaNTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES( ) NO (
b. IF YES, HAS THE DOCUiNT BEEN REFIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES ( ) NO ( h,.).•
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATIONFROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALE110H.
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH nilS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF &KCAVATED OF FILL MATERIAL INTO
WETLANDS:
a. WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAsMiS, LAKES, AND
FONDS ON THE PROPERTY (FOR NATIONWIDE PERMrl- NLNI HERS 14, 18, 21, 26, 29,
AND 38). ALL STREAM (INTERMPI 1 EN 'I AND PERiMANEN) ON THE PROPERTY
MUST BE SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET
OF 1 INCH EQUALS 100 FEET OF THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED
BY PRODUCT.
c. IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA
SHEET S RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT IF?QQ?
o. WHAT IS LAND USE OF SURROUNDING PROPOERTY? 1
b ors es.
7 APPLICABLE. WHAT 15 PROPOSED METHOD OF SEWAGE DISPOSAL'S
Xe. Lo ip i
g. SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WTLANDS OR WATERS OFTHB US MAY NOT BE IMPACTED PRIOR T0:
1) ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT.
Z) EI'T'HER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, A,;D
3) (N THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE WORTH
CAROLINA DIVISION OF COASTAL MANAGE1'YEEN I' STATING THE PROPO.SED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL
MANAGE:NMN7 PROGRAM.
j ' k 0-" 7 7, -00
OWI E.R'SIAGE`T's SIGNATURE DATE
(AGEINT'S SIGNA'T'URE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
WAKE COUNTY, NORTH CAROLINA -- SHEET NUMBER 38
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NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
RALEIGH REGIONAL OFFICE
Donald Knowles
F 105 River Watch Lane
Southport, N. C. 28461
Meuse River Sabin Riparian buffer Rules
NBRRO 00058
Laurel Kills Property
Nock Nine
Wake County .
;ear Nlr. Knomle&
November 18, 1999,1 met with you aE the eub'eet ?' , • :, to conduct a sits visit for the above referenced project
J P1 OP t
58
'?' bnal Qffice as 1z0 00-0
s project was initially referenced by the Raleigh Rego `+
12
Features represented on the Wake County Bolls and the UK8 Raleigh East maps ?ere evaluated to determine
heir 8ubje.dKity to the Neuse..buffbr Rule. - As a resul it Was determined that is one feature (streams) that emanates
om a pond upstream`tha , is resent on" e ro rt . 'I'hss is a perennial stream and is subject to protection under
he Neuee Raver baaui Nutnent'SenB'ttiv'e.,atecs Management Strategy Protsetson and Matnt?nanee of Exls Riparian
!lreae Admwatf6o ve ?-ocle?T15A02B0233 (NCAC 0233) The unnamed tributary to Crabtreee Creek and the creek
pioper;'have been delineat?cl on'Ahe City of Ralelgh.map received by flue Office on Mareli 31 2000 ,
T".e Table bf Uses for this Rule exempts..,Newsy arosauig for Aingle family lots that dlsturb:;equal to or '"'I 'than 25
ii^ear Feet or 2,500 square feet of riparian buffer Thus Table lists road crossiq that impact equal fa' or less than 150
linear feet or'one;third of an acre of riparian buffer ae alloWable with notification and 8reater than that threshold as
allowable with mitigation. Any proposed impact 8reater than that of the threshold value must meet the no practical
alternative analysis criteria. Subsequent to that,' the project may then require a variance, stormwater control
mcffiodolo8ies, and/or mitigation.
Tne amount of payment ahall be determined by multiplying the square feet of mitigation by ninety six cents ($0.96) times
a factor of 3 for Zone 1(the Fast thirty feet) and a factor of 1,5 for Zone 2 (the next twenty feet). in addition, this is
a perennial stream and may require miti8atio...for the impact incurred at a rate of $125.00 per foot
;his letter only addresses the applicability of the Neuae buffer Rules. Thank you for your attention to this matter and
if this Office can be of any assistance or if you have-additional questions, please do not hesitate to contact us.
=BIncerely, w
Steve Mitchell
Envtrounental Scientist
cc, RRO/John Dorney
Wake County
ii:\nbrletfor\neuse,buf bufoo\knowle6.058 ...`"..
;'• 1828 MAIL 69RVICE CENTER, RALEIGH, NORTH CAROLINA 27689.1628
' rv
. ` ? ?':? ?• '.,,:1A,*, , ',,•'•t ,:.:, PHONe[phone] FAX[phone]
-CONSUMER
EQUAL OPPORTUNITY / AFFIRMATIVE ACTION'EMPLOYER E096 RECYCLED/10% POSTPAPER
MEMORANDUM
TO: John Dorney Regional Contact: Steve Mitchell
Non-Discharge Branch WQ Supervisor: Ken-Schuster
Date:
SUBJECT: WETLAND STAFF REPORT AND RECOMMENDATIONS
Facility Name Donald and Kay Knowles
Project Number 00 0889
Recvd From APP
Received Date 7/7/00 Recvd By Region
Project Type driveway
County Wake
County2
Region Raleigh
Certificates Stream Stream Impacts (ft.)
Class
Permit Wetland Wetland Wetland Stream Acres Feet ?s ?s iP
Type Type Impact Score Index Prim. Supp. Basin Req. Req. .',
I NBR F__ O Y O N ? 27-33-(10) ?- NSW 30,402. ? F__ ??
Mitigation Wetland
MitigationType Type Acres Feet
Is Wetland Rating Sheet Attached? 0 Y 0 N Did you request more info? 0 Y 0 N
Have Project Changes/Conditions Been Discussed With Applicant? 0 Y 0 N
Is Mitigation required? 0 Y O N Recommendation: 0 issue 0 Issue/Cond 0 Deny
Provided by Region: Latitude (ddmmss) 355025 Longitude (ddmmss) 784137
Comments:
Should be able to issue. all me
cc: Regional Office
Central Office Page Number 1
Facility Name Donald and Kay Knowles County Wake
Project Number 00 0889 Regional Contact: Steve Mitchell
Date:
Comments (continued from page 1):
cc: Regional Office
Central Office Page Number 2
July 7, 2000
3212 Quiet Mill Road
Raleigh, NC 27612
(919-389-5501)
Fax [phone]
NC Dept Of Environmental & Natural Resources
is
J J1 L??x 7 20(1
L
Division Of Water Quality
4401 Reedy Creek Road
Raleigh, NC 27607
1304889
TO: John Dorney
FROM: Don & Kay Knowles
Attached are Seven (7) copies of the Pre-Construction Notification, Minor
Variance Request, and required maps.
This request is for buffer approval only to allow for a driveway crossing to
access property adjacent to Glen Laurel Drive street termination located in
Glen Laurel subdivision, Raleigh, N.C.
The crossing will impact approximately 1,100 sf of the Neuse River riparian
buffer (zone 2 onlv). Stormwater runoff is also within zone 2 only.
Bob Zarzecki and Steve Mitchell with DWQ are familiar with the project. See
attached letter. This project was reviewed at a meeting with Division of Water
Quality and the City of Raleigh on May 10, 2000.
Please let me know if additional information is needed.
Sincerely,
JVCY) 1< YD"
4ul?-.

OFFICE USE ONLY: Date Received ..... ...................... _........................................_......_..._............ Request # ........................... _.... _................
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
Variance Request Form - for Minor Variances
Protection and Maintenance of Riparian Areas Rules
NOTE: This form may be photocopied for use as an original.
Please identify which Riparian Area Protection Rule applies.
V Neuse River Basin: Nutrient Sensitive Waters Management Strategy
Protection and Maintenance of Riparian Areas Rule (15A NCAC.0233)
? Tar-Pamlico River Basin: Nutrient Sensitive Waters Management
Strategy Protection and Maintenance of Riparian Areas Rule (15A
NCAC.0259)
Part 1: General Information
(Please include attachments if the room provided is insufficient.)
1. Applicant's name (the corporation, individual, etc. who owes the property):
2. Print Owner/Signing Official (PE
Name: L7....U_n
Title: _ 0 o P)?
Street address: ,'.....Z......1...._
City, State, Zip:
Telephone: tt q i 9i 9 )...__3.
Fax:
3.
Contact person who can answer
Name: L? t71?0?
Telephone: ( D )?,?'
Fax:
Email:
posed project:
4. Project Name (Subdivision, facility, or establishment name - consistent with project name on
plans, specifications, letters, operation and maintenance agreements, etc.):
C- let3 Laurel -StAdit/Lsi)A)
5. Project Location:
Street address:
City, State, Zip:
County:
Latitude/longitude:
Version 1: February 2oo0
ible for t?e property and its compliance)
_.-.0. ............. G. _Q. ._...._._.__.......--
- _51TO I
.......................................... _ _..._..-- - ................... _.............. ........................ ...._. _ .................
11_a_).-----'-r'L_-.._t._ofa?l._._ _..__......_._..._............_ ................ _............... _ __._..._.......... -.........
_...--
k
6. Directions to site from nearest major intersection (Also, attach an 8'/z x 11 copy of the USGS
topographic map indicating the locajion of the site):
7. Stream to be impacted by the proposed activity:
Stream name (for unnamed streams label as "UT' to the nearest named stream):
Stream classification [as identified within the Schedule of Classifications 15A NCAC 26
.0315 (Neuse) or.0316 (Tar-Pamlico)]:......,,,-.,..03J,5'
........ .... ................. ...... ........................... ........... .-._----...... _....... ......................... _......... ............ __................. ............ ................. ...
8. Which of the following permits/approvals will be required or have been received already for
this project?
Required: Received: Date received:
A/0
/VO
A0
Permit Type:
CAMA Major
CAMA Minor
401 Certification/404 Permit
On-site Wastewater Permit
NPDES Permit (including stormwater)
Non-discharge Permit
Water Supply Watershed Variance
Others (specify) -
Part 2: Proposed Activity
(Please include attachments if the room provided is insufficient.)
Description of proposed activity [Also, please attach a map of sufficient detail (such as a plat
map or site plan) to accurately delineate the boundaries of the land to be utilized in carrying
out the activity, the location and dimension of any disturbance in the riparian buffers
associated with the activity, and the extent of riparian buffers on the land- Im-Itirip the aron
2.
3. Description of any best management practices to be used to control impacts associated with
the proposed activity (i.e., control of runoff from impervious surfaces to provide diffuse flow,
re- lanting vegetation or enhancement of existing vegetation, etc.):
- -ern 4!`a? ?J?- Q` t''?a?1?,??'--s--o?rt?,t2c, -?
Sx- 91J,
-'-- ?{ If ......__........._...._._
?,_(`
Variance Request Form, page 2
Version 1: February 2000
State reasons why this plan for the proposed activity cannot be practically accomplished,
re`di ced or reconfigured to better minimize or eliminate disturbance to the riparian buffers:
i
4. Please provide an explanation of the following:
(1) The practical difficulties or hardships that would result from the strict application of this
Rule.
?: e V G OS c ?:?? '? t?r DPP*
J
.........c?.... c_?r c?'9 pL?GS_._ rc.
4n f
(2) How these difficulties o. hardships result from conditions that are unique to the property
involved.
fctNJa.n1V+.?r
(3) If economic hardship is the major consideration, then include a specific explanation of the
economic hardships and the proportion of the hardship to the entire value of the Iroject.
e. _
Part 3: Deed Restrictions
By your signature in Part 5 of this application, you certify that all structural stormwater best
management practices required by this variance shall be located in recorded stormwater
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.
Part 4: Agent Authorization
Part 5: Applicant's Certification
_-K?? _O a/e r _ (print or type name of person
listed in Part I, 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 J",
deed restrictions in accordance with Part 5 of this form will be recorded with all required permit
conditions.
Signature:
Date: o_o ------...----
Variance Request Form, page 3
Version 1: February 2000