20081829 Ver 1_Minor Variance_20081215

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Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
Variance Request Form
(For Minor and Major Variances)
Protection and Maintenance of Riparian Areas Rules
NOTE: This form may be photocopied for use as an original.
Check the appropriate box below:
? Major Variance
X Minor Variance
0 §@S D
DEC 1 5 2008
DENR - vgXTER WUA t R BRIWCM
WETLANDS AND STORE
Please identify which Riparian Area Protection Rule applies (Note-this must be one of
North Carolina's four buffered river basins. The River Bain map is available at
http://h2o.enr.state.nc.us/admin/maps/.)
?Neuse River Basin: Nutrient Sensitive Waters Management Strategy
Protection and Maintenance of Riparian Areas Rule (15A NCAC 02B.0233)
o Tar-Pamlico River Basin: Nutrient Sensitive Waters Management Strategy
Protection and Maintenance of Riparian Areas Rule (15A NCAC 02B.0259)
Part 1: General Information
(Please include attachments if the room provided is insufficient.)
1. Applicant's name (the corporation, individual, etc. who owns the property):
'Q?, s 0 T4 ? ?\ .
2. Print Owner/Signing Official (person legally responsible for the property and its compliance)
Name: ?.. ? ?? us i?obr?llr? 1i ?q grS °
Title: !v\ -+
Street address: ?®i
City, State, Zip: LaLt-,42A_ ? 't' ??}zq
Telephone: Net ? -77-1 WV71-
Fax: !)IIR ' %t?%)
Contact person who can answer questions about the proposed project:
.
Name: '
Telephone: "Apt I 3?A 13T&
Fax: (% 1 'p V) O ,
Email:
!1014' is - o\4NtA-?
Version 3: January 2008
i
4. Project Name (Subdivision, facility, or establishment name -consistent with project name on
plans, specifications, letters, operation and maintenance agreements, etc.):
5, Project Location:
Street address:
City, State, Zip:
County:
Latitude/longitude: ? r3-7 l?? iG '78 30 31. a f&2_ 1,3T lW
tk7r 35°43 &7,37"" GD`T ?
6. Directions to site from nearest major intersection (Attach an 8 % x 1 l copy of the USGS
topographic map indicating the location of the site).
7. Stream to be impacted by the proposed activity:
Stream name (for unnamed streams label as "UT" to die nearest named stream):
?i8 ? 3m.64-W
'4v a6,fi5"N
8. Which of the following permits/approvals will be required or have been received already for this
project?
Required. Received: Date received: 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
Erosion/Sedimentation Control
Others (specify)
Part 2: Proposed Activity
(Please include attachments ifthe room provided is insufficient.)
I . Description of proposed activity [Also, please attach a map of sufficient detail (such as a plat map
or site plan in Adobe_(pdf) format) 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. Include the area of
buffer impact in fe.:
Ca,- 0 s It IQ;
Variance Request Form, page 2
Version 3 January 2008

2. Fill in the table below to identify the square footage of impact to Zones I & 2 in the protected
riparian buffers and the required mitigation (Fill in the impacts portion of the table, even if
mitigation is not required);
Buffer Impact
Zone of Impact in Number Purpose for
Multiplier Required
Impact Square Feet (Indicate on the Impact Mitigation
Plan Sheet
Zone 1 3
Zone2 71 ' `.
*- ?p,,esv( 1:5
Total o ' T
*Zone t extends out 30 feet perpendicular from the most landward limit of the top of bank or the rooted herbaceous
vegetation; Zone 2 extends an additional 20 feet from the edge of Zone t.
3. State reasons why this plan for the proposed activity cannot be practically accomplished, reduced
or reconfigured to better minimize or eliminate disturbance to the riparian buffers:
4. 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-
planting vegetation or enhancement of existing vegetation, etc.):
5. Please provide an explanation of the following:
(1) The practical difficulties or hardships that would result from the strict application of this Rule.
` C IACJ b--4.CL6 f 6LM 3u]T:tE, t?Iw4l H /l tr-7r L1 /S BL:- c .
(2) How these difficulties or hardships result from conditions that. are unique to the property
involved.
(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 project.
Variance Request Form, page 3
Version 3 January 2008
Part 3: Stormwater
1. Provide a description of all best management practices (BMPs) that will be used to control
nutrients and sedimentation impacts associated with the proposed activity. Please ensure to
include all applicable operation & maintenance agreements and worksheets for the proposed
BMPs. Also, include the BMPs on your plan sheets.
2. Attach a description of how diffuse flow will be maintained through the protected riparian
buffets. Please ensure to include all applicable operation & maintenance agreements and
worksheets for the proposed diffuse flow measure(s). Also, include the diffuse flow measure(s)
on your plan sheets.
3. What will be the annual nitrogen load contributed by this site after development in pounds per
acre per year without structural BMPs (stormwater pond, wetland, infiltration basin, etc)? Attach
a detailed plan for all proposed structural stormwater BMPs.
Drainage Site of Post-develophient BMP nitrogen Final Filial
basin drainage nitrogen loading removal nitrogen' nitrogen
basin rate without BMPs4 efficiencys loading rate loading
(ac) (lbslaclyr) (%) (lbs/aelyr) from
drainage
basin lbs
1
2
3
4
S
?'olals ------
l16 tOW9 ? WL UZWIOUrla UHU rUjOrertcea'.
s ,41tach calculations and references.
6 Include Phosphorus in the Tar-Pamlico Basin
Part 4: Water Quality Protection, continued
4. Attach all applicable supplement form(s) and Inspection and Maintenance (I&M) Form(s) to this
completed application. The applicable supplemental form(s) and I&M form(s) for the proposed
BMPs noted in your application can be downloaded from the following website:
hftpJ/h2o.enr.state.nc.us/su/bmp forms htm
Variance Request Form, page 4
Version 3 January 2008
Part 5; Proposed: Impacts and Mitigation
Provide a description of how mitigation will be achieved at your site pursuant to I SA NCAC
21.0242 for the Neuse Basin and ISA NCAC 28.060 for the Tar-Pamlico Basin.
If buffer restoration is the method you are requesting, be sure to include 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. A guide to
buffer restoration can be downloaded at the following, website
http://www,nceeu net/news/reggirts/bufforsiDdf
If payment into a buffer restoration fund is how you plan to achieve your mitigation requirement,
then include an acceptance letter from the mitigation bank you propose to use stating they have
the mitigation credits available for the mitigation requested.
Part 6: Deed Restrictions
By your signature in Part 5 of this application, you certify that all structural stormwater BMPs
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 frorti the
State, and that the easements will be recorded prior to the sale of any lot.
Part 7• Applicant's Certification
1 v`pU
.? ? (print or type name of person listed in
Part I, Item 2), certify thalthe information inc uded 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 Part 5 of this f m will be recorded with all required permit conditions.
Signature:
Date: t ,2 - h 45 `n 'l
Title: M ?-/tAki-%? , eM!l? 4h'
Part S: Plan Sheets
Be sure to include a copy of all of your completed application form, plan sheets and maps in Adobe
(pdf) format on a CD or floppy disk.
Part 9: Checklist
A complete application submittal consists of the following components. Incomplete submittals will
be returned to the applicant. The complete variance request submittal must be received 90 days prior
to the EMC meeting at which you wish the request to be heard. Initial below to indicate that the
necessary information has been provided.
Applicant's Item
Init az
_ (o,
Variance Request Form, page 5
Version 3 January 2008

Original and two copies of the Variance. Request.. Form and the attachments
listed below.
A vicinity map of the. project (see. Part 1, Item S) ? Q? ??,t-•? ?,
?? • Narrative demonstration of the need for a variance (see Part 2)
• A detailed narrative 'descri'ptionof stormwater treatment/management (see Part
4)
__ • Calculations supporting nitrogen (phosphorus in the Tar-Pamlico Basin)
loading estimates (see Part 4)
• Calculations and references supporting nitrogen (phosphorus in the Tar-
Pamlico Basin) removal from proposed BMPs (see Part 4)
• Location and details for all proposed structural stormwater BMPs (see Part 4)
- - --- - • Three copies of the applicable Supplement Form(s) and I&M Form(s) for each
BMP'and/or narrative for each innovative BMP (see Part 4)
• Three copies of plans and specifications, including:
0 Development/Project name
0 Engineer and firm
0 Legend and north arrow
0 Scale O"= 50' is preferred)
0 Revision number & date
0 Mean high water line (if applicable)
0 Dimensioned property/project boundary
0 Location map with named streets or NC State Road numbers
0 Original contours, proposed contours, spot elevations, finished floor
. elevations
0 - Details of roads, parking, cul-de-sacs, sidewalks, and curb and gutter
0 Footprint of any proposed buildings or other structures
Y...... ._ _._ 0 Wetlands delineated, or a note on plans that none exist
0 Existing drainage (including off-site), drainage easements, pipe sizes,
runoff calculations
_..__-_.-.-._____..._._.. 0 Drainage basins delineated
--- 0 Perennial and intermittent streams, ponds, lakes, rivers and estuaries
0 Location of forest vegetation along the streams, ponds, lakes, rivers and
estuaries
Variance Request Form, page 6
Version 3 January 2008
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AREA BY COORDINATE METHOD \. LOT SERVED BY TOWN
50 25 0 \ REFERENCE: WATER AND SEWER
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GRAPHIC SCALE LOT 137 SURVEY FOR:
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certify that this plot was drown under my supervision
from on actual survey mode under my supervision or
deed description recorded in Book page
that the boundories not surveyed ore
shown as broken lines plotted from information found
in Book page th (the error
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IT INTENDED TO. F
BROWNING REALTY &
WILLIE STANLEY MOORE
ST. MARY'S
SOU TH WI N D TOWNSHIP
IL Q _ SURVEYING AND ENGINEERING, INC. WAKE
OOOF 201 GLEN ROAD COUNTY
GARNER, INC 27529
919-773-0183
S 919-773-0148 (FAX) STATE NC
SCALE DATE DRAWING NO. 1"=50' 12/2/08 06-2225

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SETBACK INFO: G
FRONT = 35' s,
coo SIDE. = 10'
REAR = 25' ° ?J dRJSr
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NOTE: JL' `j
THIS PLAT DOES NOT NECESSARILY SITE A?
MEET GS 47-30 AS AMENDED, NOR
WAS IT INTENDED TO. F
CURVE 4
RADIUS = 403.93 wCINITY MAP
LENGTH = 51.01 SCALE
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BEARING = 330°16'24"E
CHORD = 50.97
J
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LEGEND:
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SC = SEWER CLEAN-OUT
MH = MANHOLE
50' RIPARIAN NOTES:
/ BUFFER THIS PLAT IS NOT FOR
(FROM FIELD
"0' LOT 149 ?. LOCATED BANK) RECORDATION
AREA BY COORDINATE METHOD LOT SERVED BY TOWN
50 25 0 REFERENCE: WATER AND SEWER
50 100 GREENBRIER ESTATES
B?M 2007, PG. 1735
GRAPHIC SCALE LOT 137 SURVEY FOR:
l,?+o?' M• t-tbt. BROWNING REALTY &
certify.thot this plot was drown under my supervision
from on actual survey mode under my supervision or
dead description recorded in Book page
WILLIE STANLEY MOOR E
that the boundaries not surveyed ore
shown as broken lines plotted from information found
in Book page th t the error N
.of closure as col, by lot. and dep, is 1;_ ST. MARY'S
SOU TH WI N p TowNSHiP
Witness my originol signature, regis u? CA
and Seel this- ?_doy of
i+ v S WAKE
QQ?FE$SURVEYING AND ENGINEERING, INC.
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201 GLEN ROAD COUNTY
GARNER, NC 27529
919-773-0183
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LAND
L , G OQ S 919-773-0148 (FAX) STATE NC
tie0 SCALE V=5011 DATE 12/2/08 DRAtxINC N0.
06-2225
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