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Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P,E. Director
Division of Water Quality
August 3, 2005
DWQ Project # 05-0796
#70033113000205752486
Beaufort County
Subject Property: 409 Lewis Road
Aurora, NC 27806
Jarvis Landing
Beaufort County
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Ms. Iris M Ginn
213 Eastover Drive
Snow Hill, NC 28580
Approval of Tar-Pamlico River Riparian Buffer Protection Rules Minor Variance (15A NCAC 2B .0259 (9)(b)]
Dear Ms. Ginn:
You have our approval, in accordance with the conditions listed below, to impact approximately 300 square fect
(fr) of Zone 2 of the protected buffers to construct a deck at the subject property as described within your variance
request dated May 2, 2005 and received by the Division of Water Quality (DWQ) on May 5, 2005. TIlese impacts
must be in accordance \vith the plot plan submitted with your application. TIris letter shall act as your Minor
Variance approval as described \vithin 15A NCAC 2B .0259(9)(b). In addition to this approval, you should obtain
or otherwise comply with any other required federal, state or local pennits before you go allead \vith your project
including (but not limited to) Erosion and Sediment Control and Division of Coastal Management regulations.
TIus approval is for the purpose and design that you described in your application. If you change your project, you
must notify us and you may be required to send us a new application. If the property is sold, the new owner(s)
must be given a copy of this variance approval and plot plan and is thereby responsible for complying with all
conditions. TIus approval requires you to follow any conditions listed below.
The Additional Conditions of the Certification are:
1. No Zone 1 Impacts
No impacts (except for proposed and "exempt" uses as identified \vithin 15A NCAC 2B .0259) shall occur
to Zone 1 of the protected riparian buffers unless othenvise approved by the DWQ. No impervious
surfaces shall be added to Zone I, unless othenvise approved by the DWQ.
2. Buffer Mitigation (EEP)
Option 1:
You are required to mitigate for impacts to the protected riparian buffers, The required area of
mitigation to compensate for impacts to the protected riparian buffers is 450 square fect as required under
tlus variance approval and 15A NCAC 2B .0259. You have tlle option to make a payment into tlle Riparian
Buffer Restoration Fund administered by the NC Ecological Enhancement Program (EEP) to meet tlus
mitigation requirement TIris has been detennined by the DWQ to be a suitable method to meet tlle
mitigation requirement In accordance with 15A NCAC 2B .0259, this contribution \vill satisfy our
compensatory mitigation requirements under 15A NCAC 2B .0259(9)(C). Until the EEP receives and
clears your check (made payable to: DENR -Ecological Enhancement Program Office), no impacts
specified in this variance approval shall occur. TIle EEP should be contacted at (919) 715-0476 if you have
any questions concerning payment into tlle EEP.
Oneh )'
N,i){l Cam lOa
;vo/urnl/!!
401 Wetlands Certification Unit
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: 919-733-17861 Ftv.. 919.733-6893/lnlemet: http://h2o,enr,statenc,us/ncwetlands
Applicant
Page 2 of3
Date
A
For accounting purposes, this variance approval authorizes payment into the Riparian Buffer
Restoration Fund to compensate for 450 ff of required riparian buffer mitigation for impacts to 300
ff of protected riparian buffers; 30-04-10,27-129-(1) river and subbasin."
Option 2:
The DWQ will accept an alternative method of mitigation (including but not limited to Buffer Restoration
or Enhancement) pursuant to the Buffer Mitigation Rule (15A NCAC 02B .0259) to satisfy tillS mitigation
requirement. If you choose to pursue this option, tIlen you are required to submit in writing a mitigation
plan to the DWQ WetIands/40 1 Unit! Washington Regional Office for review and approval. 'This plan
should include a proposal to plant at least three (3) native species of trees with in the riparian buffer area.
For more infonnation, please contact this office. No impacts shall occur to the protected buffers until
the mitigation plan is approved by the DWQ.
3. Diffuse Flow
An additional condition is that all stormwater shall be directed as diffuse flow at non-erosive velocities
through tile protected stream bUtTers and will not re-concentrate before discharging into the stream as
identified within 15A NCAC 2B .0259(5).
4. Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer
Rules, and any subsequent modifications, the applicant is required to return the attached certificate of
completion to the 401/WetIands Unit, North Carolina Division of Water Quality, 1650 Mail Service Center,
Raleigh, NC, 27699-1650.
Requests for appeals of this decision shall be made to the Office of Administrative Hearings. If you do
not accept any of the conditions of this approval, you may ask for and adjudicatory hearing. You must act
within 60 days ofthc date that you rcccive this'lettcr. To ask for a hcaring, send a written petition which
conforms to Chapter 150B of the North"Carolina General Statutes to the Office of Administrative
Hearings, 6714 Mail Service Center, Raleigh, NC 27699-6714. This approval and its conditions are final
and binding unless you ask for a hearing. This Minor Variance Approval shall expire five (5) years
from the date of this letter.
This lctter completes the rcview of the Division ofWatcr Quality undcr the Neuse River Riparian Buffer
Protection Rules [15A NCAC 2B .0259(9)(b)). Plcase call Kyle Barnes at 252-948-3917 if you bave any questions
or require copies of our rules or procedural materials. '
Sincercly,
Enclosurcs:
Minor Variance Approval
Certificate of Completion
cc: DWQ WaRO Regional Office
vrSWQ Central Officc, Cyndi Karoly
Central Files
Craven Co; Dcpt. of Building Inspections
AI Hodge
Division of Water Quality
Surfacc Watcr Protection
Washington Regional Office
'"
Certification of Completion
DWQ Project No.:
Applicant:
County:
Project Name:
Date ofIssuance ofIsolated Wetland Permit:
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification and Buffer Rules, and any
subsequent modifications, the applicant is required to return this certificate to the 401/Wetlands Unit, North Carolina
Division of Water Quality, 1650 Mail Service Center, Raleigh, NC, 27699-1650. This form may be returned to DWQ by
the applicant, the applicant's authorized agent, or the project engineer. It is not necessary to send certificates from all of
these.
Applicallt's Certificatioll
I, , hereby state that, to the best of my abilities, due care and diligence was
used in the observation of the construction such that the construction was observed to be built within substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and specifications,
and other supporting materials.
Signature:
Date:
Agellt's Certificatioll
I, , hereby state that, to the best of my abilities, due care and diligence was
used in the observation of the construction such that the construction was observed to be built within substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and specifications,
and other supporting materials.
Signature:
Date:
If this project was desiglled by a Certified Professiollal
I, , as a duly registered Professional (i.e., Engineer,
Landscape Architect, Surveyor, etc.) in the State of North Carolina, having been authorized to observe (periodically,
weekly, full time) the construction of the project, for the Permittee hereby state that, to the best of my abilities, due care
and diligence was used in the observation of the construction such that the construction was observed to be built within
substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature:
Registration No.
Date
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GRAPHIC SCALE
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>-;/ '.. Rip;;ri::Jt7 Buffet Design
9
Species Diversity and Composition
The most effective riparian buffers
have trees and shrubs to provide
perennial root systems and long-term
nutrient storage. The design of a
riparian buffer can be modified to fit the
landscape and the landowner's needs, for
example, by replacing shrubs with more
trees, substituting some of the trees with
shrubs, or incorporating a grass zone. In
any scenario, the ",idth of the woody
vegetation should be at least 30 feet
directly adjacent to the
streambanklshoreline.
Choose 10-12 species of native trees
and/or shrubs appropriate for site based
on site assessment and reference
conditions. In addition, please note that
this list is alphabetical and does not take
into account the assemblages of plants
found in nature. The inventory of plants
found on the reference site can help
determine an appropriate assemblage for
the restoration site. In addition, the
North Carolina Natural Heritage
Program's Classification ,afthe Natural
Communities of North Carolina: Third
Approximation is a valuable reference on
na~ural assemblages of plants (Shafele,
MIchael P. and Alan S. Weakley, 1990).
Typically, there should be at least
three or four understory trees for every
canopy tree to provide structural
diversity similar to mature forests.
Where shrub species are incorporated
into the planting plan, they should be
distributed more densely at outer edge of
riparian buffer to reduce light
penetration and recolonization by
invasive exotic species. Refer to Table 1
for a list of native tree and shrub species
appropriate for use in riparian buffers.
Table 1. Master List of Native Plants
Native Regions
M:: Mountains
p:: Piedmont
C:: Coastal Plain
Light Requirements
S:: Shade
p:: Partial Sun
F:: Full Sun
Moisture Requirements
L:: Low Moisture
M:: Moderate Moisture
H:: High Moisture
A:: Aquatic
Scientific N;jme Common N;jme Region Light Moisture
M p C S P F L M HA
Mec\ium to Llrge Trees
Acer barbatum Southern sugar maple X X X X
Acer saccharinum X
silver maple X X X X X
Acer saccharum sugar maple X X X
X
Betula alleghaniensis yellow birch X X X X
Betula lenta cherry birch, sweet birch X X
X X
Betula nigra river birch X X X X X X X
Carya aquatica water hickory X X X X
Carya cordiformis bitternut hickory X X X X X X X X
Carya glabra pignut hickory X X X X X X X X
5
Scientific N<lme Common N<lme Region Light Moisture
M P C S P F L M HA
Carya ovata shagbark hickory X X X X X X X
Carya tomentosa mockernut hickory X X X X X X X X
Celtis laevigata sugarbeny,hackbeny X X X X X
Chamaecyparis thyoides Atlantic white cedar X X X X X
Cladrastis kentuckea yellowwood X X X X
Diospyros virginiana persimmon X X X X X X X X
Fagus grandifolia American beech X X X X X X
Fraxinus americana white ash X X X X X X
Fraxinus pennsylvanica green ash X X X X X X X
Fraxinus profunda pumpkin ash, red ash X X X X
Juglans nigra black walnut X X X X X X
Liriodendron tulipifera tulip poplar, yellow poplar X X X X X X X
Magnolia acuminata cucumber magnolia X X X X X
Magnolia fraseri Fraser magnolia X X X
Nyssa aquatica water tupelo X X X X X X
Nyssa sylvatica black gum X X X X X X X X
Nyssa sylvatica var. biflora swamp black gum X X X X X
Oxydendrum arboreum sourwood X XX X X X X
Picea rubens red spruce X X X X X
Pinus echinata shortleaf pine X X X X X X
Pinus palustris longleaf pine XX X X X
Pinus rigida pitch pine X X X
Pinus serotina pond pine X X X X
Pinus strobus white pine X X X X X
Platanus occidentalis sycamore X XX X X X X
Populus deltoides eastern cottonwood XX X X
Populus heterophyl/a swamp cottonwood X X X X
Prunus serofina black cheny X X X X X X X X
Quercus alba white oak X X X X X X X
Quercus bicolor swamp white oak X X X X
Quercus coccinea scarlet oak X X X X X
Quercus falcata Southern red oak X X X X X X X
Quercus pagoda cherrybark oak X X X X X X
Quercus laurifolia laurel oak X X X X X X
Quercus Iyrafa overcup oak X X X X X
Quercus margaretta sand post oak X X X X
Quercus marilandica black jack oak X XX X X X
Quercus michauxii swamp chestnut oak X X X X X X X
Quercus nigra water oak X X X X X X X
Quercus phellos willow oak X X X X X X X
Quercus prinus chestnut oak X X X X X
Quercus rubra Northern red oak X X X X X X
Quercus shumardii shumard oak X X X X X X
Quercus stel/ata post oak X X X X X X
Quercus velutina black oak X X X X X X
Quercus virginiana live oak X X X X
Robinia pseudoacacia black locust X X X X X X
Taxodium ascendens pond-<:ypress X X X X
Taxodium distichum bald-cypress X X X X
6
I
Scientific Name Common N'lme Region Ught Moisture
M p C S P F L M H A
Tilia americana var. heterophy/fa basswood X X X X X
Tsuga canadensis Eastern hemlock X X X X X X
Tsuga caroliniana Carolina hemlock X X X X X
Ulmus alata winged elm X X X X X X X
Ulmus americana American elm X X X X X X
Sm'lll Trees
Amelanchier arborea downysenncebeny, shadbush X X X X X X
Amelanchier canadensis Canada senncebeny X X X X
Amelanchier laevis smooth servicebeny X X X X X
Asimina tri/oba pawpaw X X X X X X
Carpinus caroliniana ironwood, American hornbeam X X X X X X X
Cercis canadensis eastern redbud X X X X X X
Chionanthus virginicus white fringetree, old man's beard X X X X X X
Comus altemifo/ia alternate-leaf dogwood X X X X
Comus florida flowering dogwood X X X X X X X
Crateagus crus-galli cockspurha~horn X X X X X X X
Crateagus flabe/fata fanleaf hawthorn X X X X
Crateagus flava October haw X X X X X X
Cyri/fa racemiflora titi X X X X X
Fraxinus caroliniana water ash X X X X
Gordonia /asianthus loblolly bay X X X X X X
Halesia tetraptera (H. carolina) common silverbell X X X X X
/fex opaca American holly X X X X X X X X
Juniperus virginiana Eastern red cedar X X X X X X X
Magnolia tripetala umbrella tree X X X X
Magnolia virginian a sweelbay magnolia X X X X X X X
Morus rubra red mulbeny X X X X X X
Osmanthus american a wild olive, devilwood X X X X
Ostrya virginian a Eastern hop-hornbeam X X X X X
Persea borbonia red bay X X X X X X
Persea palustris swamp bay X X X X X X
Pinus pungens table mountain pine X X X
Prunus americana American wild plum X X X X
Prunus caroliniana Carolina laurel-cheny X X X X X
Quercus incana bluejack oak X X X X
Quercus /aevis turkey oak X X X X
Rhus g/abra smooth sumac X X X X X
Rhus hirta (Rhus typhina) staghorn sumac X X X
Sa/ix carolinian a swamp willow X X X X X X X
Salix nigra black willow X X X X X XIX
Sassafras albidum sassafras X X X X X X X
Staphylea trifolia bladdernut X X X X ,
Symp/ocos tinctoria horse-sugar, sweetleaf X X X X X X X
Ulmus rubra slippery elm X X X X X
Shrubs
." keve X X X X X
Il P
rru/ata" -- "~on alder ---- X X X X X X X X
I....
7
00 c79v
213 Eastover Drive
Snow Hill NC 28580
June 21, 2005
Ms. Debbie Edwards
401/Buffers Unit of the DWQ
2321 Crabtree Blvd
Raleigh NC 27604
REQUEST FOR ADDITIONAL INFORMATION
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Subject Property: 409 Lewis Road
Aurora, NC 27806
Jarvis Landing
Beaufort County
Dear Ms. Edwards:
Additional Information Requested: Please send detailed information addressing the height
of the deck off of the ground. This information is necessary to establish whether your
activity may be exempt or subject the riparian buffer rules.
Reply:
I was planning, if approved, to build the deck approximately 1 step off the ground. I was
planning to set out "monkey grass" around the deck to assist with vegetation growth.
Thank you. Please call me if you have any questions at 252-747-3859.
Sincerely,
...A--yYl(fj~
Iris M. Ginn
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, r.E. Director
Division of Water Quality
June 15,2005
DWQ Project # 05-0796
Beaufort County
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
70033110000206056613
Ms. Iris M. Ginn
213 Eastover Drive
Snow Hill, NC 28580
Subject Property: 409 Lewis Road
Aurora, NC 27806
Jarvis Landing
Beaufort County
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REQUEST FOR ADDITIONAL INFORMATION
Dear Ms. Ginn:
On 05 May 2005, the Division of Water Quality (DWQ) Wetlands/401 Unit received your
variance request dated 02 May 2005. The DWQ has determined that your project is eligible for
the use of the Minor Variance From the Neuse and Tar-Pamlico Riparian Buffer Rulesfor
residential structures on existing lots within the coastal counties as defined by the Coastal Area
Management Act, Approved 5/9/2001. However, the DWQ needs additional information in order
to complete the approval process of your variance. Therefore, unless additional information is
provided as described below, we will have to move toward denial of your request per 15A
NCAC 2B .0233 (9) and will place this project on hold as incomplete until we receive this
additional information. Specifically:
,1
Additional Information Requested:
1. Please send detailed information addressing the height of the deck off of the ground. This
information is necessary to establish whether your activity may be exempt or subject the
riparian buffer rules.
Please respond in writing within three weeks of the date of this letter by sending a copy of this
information to Mr. Tom Steffens of the DWQ Washington Regional Office at 943 Washington
Square Mall, Washington, NC 27889 and to Ms. Debbie Edwards of the 40 liB uffers Unit of
N7;thCarolina
401 Wetlands Certification Unit ..i\'nlllm/ly
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, SUite 250, Raleigh, North Carolina 27604
Phone 919-733-1786/ FAX 919-733-6893/lnternel: http://h2o.enr.statencus/ncwetlands
DATE:~. ~\:)/Gl\
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Variance Triage Sheet
" Josc.rh. -\- Sfl2.. f-1eWV'l ~)
PROJECT NAME:.Tv--l.r f)\^^ +0d\~ (J\.(IV\o~OD_
oS - G,q I I C>S - C1C[ lp (" t c
DWQ #: +- (\:')- C>74c't:)
R:-~l\LQ. ~vt-
COUNTY: t Jp'l \-\-
TO: Tom Steffens, Washington Regional Office
FROM: Debbie Edwards
TELEPHONE: (919) 733-9502
I,
The file attached is being forwarded to you for your evaluation.
Please call if you need a~sistance.
D "General" Major Variance
@) ~ Minor Variance
COMMENTS: As per the discussion regarding revision of the triage
and delegation processes, please review the attached file. Note that
you are the first reviewer, so this file will need to be reviewed for
administrative as well as technical details. If you elect to place this
project on hole, please ask the applicant to provide your requested
information to both the Central Office in Raleigh as well as the
Washington Regional Office. As discussed, this is an experimental,
interim procedure. Please let the Central Office know of any
complications you encounter, whether related to workload, processing
times, or lack of a "second reviewer" as the triage process in Central
Office had previously provided.
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Department of Environment and Natural Resources
Division of Water Quality
I:~.~R. WtlTER
' lo'.'DSTOR/*9U,rJ!!i.;'
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Variance Request Form - for Minor Varl~hces
Protection and Maintenance of Riparian Areas Rules
NOTE: This form may be photocopied for use as an original.
Please identify which Riparian Area (Buffer) Protection Rule applies.
o Neuse River Basin: Nutrient Sensitive Waters Management Strategy
Protection and Maintenance of Riparian Areas Rule (15A NCAC 02B
.0233)
)4 Tar-Pamlico River Basin: Nutrient Sensitive Waters Management
Strategy Protection and Maintenance of Riparian Areas Rule (15A
NCAC 028 .0259)
o Catawba River Basin: Protection and Maintenance of Existing Riparian
Buffers (15A NCAC 02B .0243)
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):
.:r~{.5_f{1 (L~tLN
2. Print Owner/Signing Official (person legally responsible for the property and its compliance)
Name: .:J:"/ ~ rn (} i.tliJ.
Title: --h.JJ.
Street address: P~~_o_L~w.J..s........Rd
City, State, Zip: EL~(;u~"A,JL~_'lg.PJ,-
Telephone: L)
Fax:
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3. Contact person who can answer questions about the proposed project:
Name: _J: '(",. ~tJ_/JUI
Telephone: u) "-I!.:zs ~J~ 7 - 110 '1--c+t-'-3.'l
Fax:. w~(~,:L5~!1-=.!tHS>..s.
Emall: W~L~~~~-'~
4. Project Name (Subdivision, facility, or establishment name - consistent with project name on
plans, specifications, letters, operation and maintenance agreements, etc.):
I)~
Version 2: November 2002
5. Project Location:
Street address: _4 o_'1~Q w ; .s_L~Q_o._q
City, State, Zip: _~_~~:z.._1_8"_Go
County: _~
Latitude/longitude: _~_
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6. Directions to site from nearest major intersection (Also, attach an 8 Y:z x 11 copy of the USGS
topographic map indicating the location of the site):
J.LJ..33-p~-~-1J-~G1_. ~_.~_~~
~-~~_a.;"_~_l>'rJ..i..o_~_~~~.____.__
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7. Stream to be impacted by the proposed activity:
Stream name (for unnamed streams label as "UT' to the nearest named stream):
E~c&..-~
Stream classification [as identified within the Schedule of Classifications 15A NCAC 2B
.0315 (Neuse) or .0316 (Tar-Pamlico)]: , 'L3.J"-Lr~,,&~)_______
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
Others (specify) _____________._______.__
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Part 2: Proposed Activity
(Please include attachments if the room provided is insufficient.)
1. 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. Include the area
of buffer impact in fe.]:
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2. 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:
~tf2_~~_~z.._~~__~.__~
~~a-.>~~_~_~_____
-~ ... -----.---------.----------.-
Variance Request Form, page 2
Version 2: November 2000
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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,
r9.:;~~han~~~.~....~_
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4. Please provide an explanation of the following:
(1) The practical difficulties or hardships that would result from the strict application of this
Rule.
_~~~"b_~~_~._~
-~~-~~. -
(2) How these difficulties or hardships result from conditions that are unique to the property
involved.
-~~'~_cJ~~__
~~~"'-vr~~
(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.
-...j~~p>_~4_.~_~.......,L_
~~......:ti:-~~-~-~~-~..uJ.H.dd(.
~~.
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
If you wish to designate submittal authority to another individual or firm so that they may provide
information on your behalf, please complete this section:
Designated agent (individual or firm):
Mailing address:
City, State, Zip:
Telephone:
Fax:
Email:
Part 5: Applicant's Certification
Variance Request Form, page 3
Version 2: November 2000
I, ~5 1Y'l. C,'If{/ (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 the
deed restrictions in accordance with Part 5 of this form will be recorded with all required permit
conditions.
Signature:
Date:
Title:
-~7P--Q~~
_'1n ~,-?"_~lt~
6J~J
Variance Request Form, page 4
Version 2: November 2000
OFFICE USE ONLY: Date Received
Request # ____ _.______m
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.
T..-......__..___ ____~_.....__"_r.__~~_~__~_.~._~_..__., ._0._"'+-- ._._ ___..___. .._____.~....,_~_..________._p..~_____._~-____.. --- . -- -- -<--'0 _.~--~,-~ .
Please identify which Riparian Area (Buffer) Protection Rule applies.
o Neuse River Basin: Nutrient Sensitive Waters Management Strategy
Protection and Maintenance of Riparian Areas Rule (15A NCAC 02B
.0233)
~ Tar-Pamlico River Basin: Nutrient Sensitive Waters Management
Strategy Protection and Maintenance of Riparian Areas Rule (15A
NCAC 02B .0259)
o Catawba River Basin: Protection and Maintenance of Existing Riparian
Buffers (15A NCAC 02B .0243)
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):
Xr.: S f(\ () aLN
2. Print Owner/Signing Official (person legally responsible for the property and its compliance)
Name: .J:t'/ ~ M I} //UJ.
Title: rt A
Street address: p~~~w is-Rq
City, State, Zip: A tL r"ol"~ Nt!. ~(,
Telephone: L_______J '
Fax: iJ
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3. Contact person who can answer questions about the proposed project:
Name: _.,J:1L~~
Telephone: u' ~;zs~J ,5:1. '7 - II Ltt--~-;.a..1
Fax: W ~ .;1.5" _\_.5~_-:1-=-'t82..s----------
Email: W~ . .
4. Project Name (Subdivision, facility, or establishment name - consistent with project name on
plans, specifications, letters, operation and maintenance agreements, etc.):
.9~
Version 2: November 2002
5. Project Location:
Street address:
City, State, Zip:
County:
Latitude/longitude:
J.I. 0 q .l. ~ w ; oS RJLo_4
~~~:z-l8.~4>.
(J.aA. .~
~_S~_L'i,+
~~~.a.ir
6. Directions to site from nearest major intersection (Also, attach an 8 % x 11 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 the nearest named stream):
e.~ J .;. - a<......~.....':l
Stream classification [as identified within the Schedule of Classifications 15A NCAC 2B
.0315 (Neuse) or .0316 (Tar-Pamlico)]: . " ~-L~-LL-~&~)
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
Others (specify)
-~
-~
.sfl!19 f
Part 2: Proposed Activity
(Please include attachments if the room provided is insufficient.)
1. 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. Include the area
of buffer impact in fe.]:
~r-'5-~
J, I "J.. '1. Co. I
(c..&~
-' )
2. 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:
~~_ . .' _ _ ~.~_m~j~~
_~a->~~-~-~~..'.. ..
_~~:;J..('''''''~'''> -----
Variance Request Form, page 2
Version 2: November 2000
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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-planting vegetation or enhancement of existing ve eta!ion., etc.):
~~~ .. _. .~_h
~-~-'j-~'
(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.
~ . ;) ..... .In '" oJ'"
_~::<""_C#.A~._3.1~_~~_~_-I-
~A:--~~~ ~~-
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
If you wish to designate submittal authority to another individual or firm so that they may provide
information on your behalf, please complete this section:
Designated agent (individual or firm):
Mailing address:
City, State, Zip:
Telephone:
Fax:
Email:
Part 5: Applicant's Certification
Variance Request Form, page 3
Version 2: November 2000
I, --Ir-.i..5 1Yl. r;'-H{/ (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 the
deed restrictions in accordance with Part 5 of this form will be recorded with all required permit
conditions.
Signature:
Date:
Title:
-~~Q~
7Yl~. ~"",s
6)~.J
Variance Request Form, page 4
Version 2: November 2000