20011626 Ver 1_Complete File_20010103

F `NATF
?O?O RpG Michael F. Easley
Governor
r William G. Ross, Jr., Secretary
Department of Environment and Natural Resources
O Gregory J. Thorpe, Ph.D., Acting Director
Division of Water Quality
November 13, 2001
DWQ Project # 01-1626
Pamlico County
Page 1 of 2
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
Richard J. and Gail C. Bachorik
184 Peninsula Drive
Oriental, NC 28571
Subject Property: Bachorik Property, Lot 27, Orchard Creek Estates, 184 Peninsula Dr., Oriental, NC
Orchard Creek [03-04-10; 27-134; SA HQW NSW (Nutrient Sensitive Water)]
Dear Mr. and Ms. Bachorik,
The Division of Water Quality (DWQ) has received your "General" Major Variance Application Form for Coastal
Counties dated October 1, 2001 for the subject property. The "General" Major Variance for Coastal Counties was approved
by the Water Quality Committee (WQC) of the North Carolina Environmental Management Commission (EMC) on May
9`s, 2001. The general variance is for new residential buildings and related structures proposed to be constructed within the
protected Neuse River riparian buffers and requires written approval from the DWQ for its use. The protected buffers
consist of fifty (50) foot riparian areas along surface waters (including, but not limited to, creeks and coastal wetlands)
within the Neuse River basin. The Neuse Buffer Rules (15A NCAC 2B .0233) that protect these areas have been in place as
temporary rules since July 22, 1997.
The 50-foot buffer is divided into two Zones. The first zone, Zone 1, consists of the first 30 feet from the edge of the
surface water or coastal wetland. This zone is intended to be an undisturbed vegetated area. The second zone, Zone 2,
consists of the outer 20 feet of the 50-foot buffer. This zone is intended to be a managed vegetated area. Clearing and
grading is allowed within Zone 2 as long as the area is left vegetated. No new impervious surface is allowed within the 50-
foot buffer. New residential buildings and related structures require a variance from the Neuse Buffer Rules (15A NCAC
2B .0233) to be constructed within the protected buffers. The approval of variances for residential buildings and related
structures within coastal counties for eligible residential properties has been delegated from the WQC to the DWQ via the
general variance. Existing uses within the buffers are exempt from the buffer rules.
You state within your application that the septic system was permitted, installed and received an Operation Permit on
July 11, 1996 and has been in use since December 1996. Please be aware (if this information is accurate) that the septic
system is considered an existing use under the buffer rules and does not require approval for the use of the general variance.
Also, any residential building or related structures built prior to July 22, 1997 are considered existing uses under the buffer
rules and do not require approval for the use of the general variance. The placement of any new impervious surface within
the buffers or clearing of vegetation or ground disturbance within Zone 1 of the buffers requires approval from the DWQ
and may require approval for the use of the general variance depending on the type of impact.
Since you have not requested any new impacts to the protected buffers, the use of the general variance will not be
required. Therefore, the DWQ will consider your variance request as withdrawn. If you wish to request additional impacts
to the protected buffers, please submit three copies of your revised general variance application in writing within three
weeks of the receipt of this letter. If we do not hear from you in writing within three weeks we will consider your
application as withdrawn. This letter only addresses the application review and does not authorize any impacts to wetlands,
waters or protected buffers. A copy of the buffer rules can be found at our web site (http://h2o.enr.state.nc.us/ncwetlands/)
North Carolina Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
919-733-1786 (phone), 919-733-6893 (fax), httpJ/h2o.enr.state.nc.us/ncwetlands/
Page 2 of 2
or by calling 919-733-1786. You may also contact your DWQ regional office located in Washington, NC at 252-946-6481.
Please contact Mr. Bob Zarzecki of this office at 919-733-9726 if you have any additional questions.
Sincerely,
jhn Domey,
Wetlands,DWQ, DENR
Cc: Deborah Sawyer, DWQ Washington Regional Office
File copy
Central Files
DWQ 011626

OF W ATF9 Michael F. Easley
?0 ?G Governor
Uj William G. Ross, Jr., Secretary
j \I Department of Environment and Natural Resources
`? u f Gregory J. Thorpe, Ph.D., Acting Director
Division of Water Quality
November 13, 2001
DWQ Project # 01-1626
GIN ?/V1?y ?? Pamlico County
55? Page 1 of 2
CERTIFIED MAIL - RETURN RECEIPT REQUESTED 1 n S
Richard J. and Gail C. Bachorik l/' \
184 Peninsula Drive
Oriental, NC 28571
Subject Property: Bachorik Property, Lot 27, Orchard Creek Estates, 184 Peninsula Dr., Oriental, NC
Orchard Creek [03-04-10; 27-134; SA HQW NSW (Nutrient Sensitive Water)]
Dear Mr. and Ms. Bachorik,
The Division of Water Quality (DWQ) has received your "General" Major Variance Application Form for Coastal
Counties dated October 1, 2001 for the subject property. The "General" Major Variance for Coastal Counties was approved
by the Water Quality Committee (WQC) of the North Carolina Environmental Management Commission (EMC) on May
9`t', 2001. The general variance is for new residential buildings and related structures proposed to be constructed within the
protected Neuse River riparian buffers and requires written approval from the DWQ for its use. The protected buffers
consist of fifty (50) foot riparian areas along surface waters (including, but not limited to, creeks and coastal wetlands)
within the Neuse River basin. The Neuse Buffer Rules (15A NCAC 213 .0233) that protect these areas have been in place as
temporary rules since July 22, 1997.
The 50-foot buffer is divided into two Zones. The first zone, Zone 1, consists of the first 30 feet from the edge of the
surface water or coastal wetland. This zone is intended to be an undisturbed vegetated area. The second zone, Zone 2,
consists of the outer 20 feet of the 50-foot buffer. This zone is intended to be a managed vegetated area. Clearing and
grading is allowed within Zone 2 as long as the area is left vegetated. No new impervious surface is allowed within the 50-
foot buffer. New residential buildings and related structures require a variance from the Neuse Buffer Rules (15A NCAC
2B .0233) to be constructed within the protected buffers. The approval of variances for residential buildings and related
structures within coastal counties for eligible residential properties has been delegated from the WQC to the DWQ via the
general variance. Existing uses within the buffers are exempt from the buffer rules.
You state within your application that the septic system was permitted, installed and received an Operation Permit on
July 11, 1996 and has been in use since December 1996. Please be aware-, ket(if this information is accurate that the septic
system is considered an existing use under the buffer rules and does not require approval for the use of the general variance.
Also, any residential building or related structures built prior to July 22, 1997 are considered existing uses under the buffer
rules and do not require approval for the use of the general variance. The placement of any new impervious surface within
the buffers or clearing of vegetation or ground disturbance within Zone 1 of the buffers requires approval from the DWQ
and may require approval for the use of the general variance depending on the type of impact.
Since you have not requested any new impacts to the protected buffers, the use of the general variance will not be
required. Therefore, the DWQ will consider your variance request as witt?drawn. If you wish to request additional impacts
to the protected buffers please submit three copies of your revised general variance application in writing within three weeks
of the receipt of this letter. If we do not hear from you in writing within three weeks we will consider your application as
withdrawn. This letter only addresses the application review and does not authorize any impacts to wetlands, waters or
protected buffers. A copy of the buffer rules can be found at our web site (http://h2o.enr.state.nc.us/ncwetlands/) or by
North Carolina Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
919-733-1786 (phone), 919-733-6893 (fax), http://h2o.enr.state.nc.us/ncwetlands/
Page 2 of 2
calling 919-733-1786. You may also contact your DWQ regional office located in Washington, NC at 252-946-6481.
Please contact Mr. Bob Zarzecki of this office at 919-733-9726 if you have any additional questions.
Sincerely,
John Dorney,
401 Wetlands Unit, DWQ, DENR
Cc: Deborah Sawyer, DWQ Washington Regional Office
File copy
Central Files
DWQ 011626
011626
Richard J. & Gail C. Bachorik
184 peninsula drive
oriental, NC 28571
[phone]
October 1, 2001
DWQ 401/Wetlands Certification Unit
1650 Mail Service Center
Raleigh, NC 2769-1650

Enclosed find a copy of a letter dated August 31, 2001 from the Pamlico County
Health Department. Upon meeting with them (Kristie Mitchell and Jenny Lasiter)
today they advised that even though they did in fact have the septic permit on file
we still were required to submit the "General" Major Variance Application Form.
This form appears to address new construction.
We wish to go on record at this time to clarify that the septic system at the above
address was permitted, installed and received a Operation Permit on July 11,
1996. It has been in use and maintained since December 1996.
Enclosed find the following:
• Three (3) copies "General" Variance Application Form, pages 1,2,3 & 4
dated 10/01/01.
• Three (3) copies Pamlico County Health Department Operation Permit
No. 3133 (Type 11-1 V) dated 7/11/96.
Three (3) copies Pamlico County Health Department Improvement
Permit (valid for 5 years) dated 7/23191. Note this permit was issued to
H. L. Stephenson the former owner.
• Three (3) copies Plat showing location of Lot 27 Orchard Creek
Estates (184 Peninsula Drive).
We trust the above will meet your requirements in this matter.
With regards,
Richard J. Bachorik

OX 3 6STREET
PAMLICO COUNTY O 203 NORTH
BAYBORO, NC 28515
252-745-5111
HEALTH FILE
DEPARTMENT 252-745-7684 FAX
August 31, 2001
Dear Pamlico County Landowner,
In 1997, the North Carolina Legislature appointed a Commission to protect the water quality
and the environment in Eastern North Carolina. Legislation was passed which may affect the intended
use of your property. In a consolidated effort of the Pamlico County Commissioners and the Pamlico
County Board of Health, a special provision has been established for you. As a Pamlico County
landowner, there is a new window of opportunity to obtain a "General Variance", as approved by the
Water Quality Committee of the Environmental Management Commission on 5/09/2001. This variance
expires on April 11, 2006.
This is your window of opportunity to apply for a variance to plan for future land use. Basically,
you must provide written proof to the State that the land was platted and recorded prior to August 1,
2001. Secondly, the State will recognize a lifetime septic permit issued by the Pamlico County Health
Department as a substantial outlay dated prior to August 1, 2001. Thirdly, the variance remains with
the property just like the septic permit for the life of the land.
Currently we have no record of a septic permit on file for you. Your property may have an old
existing system but the new laws may affect your ability to use the property if it has been un-
maintained, abandoned, or left to be fallow, if you have an old existing system, complete the enclosed
On-Site Waste Water System application and return with a fee of $50.00 to the Pamlico County Health
Department PO Box 306 Bayboro, NC 28515. This information is critical for your application to the
Division of Water Quality.
In order for you to ensure the intended use of your property you need to fill out the enclosed
"General Variance" with the correct attachments and mail it to DWQ 4011Wetlands Certification Unit,
1650 Mail Service Center, Raleigh NC 27699-1650.
The Pamlico County Health Departments goal is to assist you as much as possible with our
limited resources. 9 you have any questions or would like more information regarding this matter,
please send a written request to: Kristie Mitchell
Po Box 306
Bayboro NC, 28515
Enclosures: On-Site Waste Water System Application
General Variance Application
DWQ Special Rules
Tlank You,
Jenny siter
Pamlico County Health Director
jVkm
OFFICE USE ONLY: Date Received Request #
State of North Carolina 011626
Department of Environment and Natural Resources Division of Water Quality
"General" Major Variance Application Form -
From the Neuse and Tar-Pamlico Riparian Buffer Protection Rules for residential structures
on existing lots within the coastal counties as defined by the Coastal Area Management Act
(As approved by the Water Quality Committee of the Environmental Management Commission on 5/9/2001)
Please identify which Riparian Area Protection Rule applies.
ja( Neuse River Basin: Nutrient Sensitive Waters Management Strategy
Protection and Maintenance of Riparian Areas Rule (15A NCAC.0x33)
cl Tar-Pamlico River Basin: Nutrient Sensitive Waters Management
Strategy Protection and Maintenance of Riparian Areas Rule (15A
NCAC .0259)

NOTE:
To constitute a complete application, all of the Information requested in this form
must be provided. Incomplete applications will be returned to the applicant. The
original and two copies of the completed "General" Variance Application Form and
any attachments must be sent to the DWQ 401Megands Certification Unit, 1650 Mail
Service Center, Raleigh, NC 27099.1850, 819-733-1780 to constitute a complete
submltta l This form may be photocopled for use as an original.
Part 7: General Information
(Please include attachments If the room provided is insufficient)
1. Applicant's name (the corporation, individual, etc. who owns the property):
RlGF AP,D J, 4, GAIL c. 13AC-14"!K
2.
3.
Print Owner/Signing Official (person
Name: (j c. H6 R'D J,
Title:
Street address:
City, State, Zip:
Telephone:
Fax:
responsible for the property and Its compliance)
Aft. '• 13ACHOR 0
Contact person who can answer questions about the proposed project:
Marne: P ic.Nra0,n J, 8!JC-,Kd_K14
Telephone: (z?; .) :Z -4 Q -Z 7 78
Fax: C? J 2 4t 9 2 ,7 7.0
"General" Variance Application Form
Version 1: May 2001
tv 9-3J FE 7' 2 6 10)-=P H t 7'r6; & 4
N 0xc

Email: Q4cH&?' IK -?cuASrALNtrr, G8?`t
4. Project Name (Subdivision, facility, or establishment name - consistent with project name ors
plans, specifications, letters, operation and maintenance agreements, etc.):
4.br ?7 O?cHq?.D G?e"'G1? k.?T?7t=.,r
5. Project Location:
Street address: 1B11
W F a?? ay s v r1 !:7 2 r v ?,
City, State, Zip: o le t c- N rAnL , N C; a 8 3- -7 1
County: _PA r4 L + C o
Latitude/longitude: _N 2j- o-3 7,iL w 6-7 4 9 8 6 8 z.
6. Directions to site from nearest major intersection (Also, attach an 8'/ x 11 copy of the portion
of the USGS topographic map indicating the location of the site):
r-motj h®OkES GOR?•, ek rR.rSV' r4Kg^' J- 1 BHT
K CGU12MTy t3i1)
No+l.TN <r?sT. .____
lAK? i4 YLlfslt'r 9a4 T'e a&C-HAgp r+2icKK Ry
7. Stream to be Impacted by the proposed activity:
Stream name (for unnamed streams label as "UT' to the nearest named stream):
ORcNA2a GR?,? ?? __
Stream classification [as identified within the Schedule of Classifications 15A NCAC 2B .0315
(Neuse) or .0318 (Tar-Pamlico)]: _ eat J'
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
Active Connection to Sanitary Sewer System
NPDES Permit (including stormwater)
Non-discharge Permit
Water Supply Watershed Variance
Others (specify) s E C 47 rA--t4 rj r_ t.,&,
Part 2: Proposed Activity
(Please Include sttechments 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. Include the area
of butter impact in ftz.:
pF gm i 'rrl-z0 a N2 i usrAt,4 siN?,?_ 7?tt1 . L. t ?4 L),S t~ -5-/- k, r- Cz
"General" Variance Application Form, page 2
2. State reasons why this plan for the proposed activity cannot be practically accomplished,
reduced or recoryfigured to better minimize or eliminate disturbance to the riparian buffers:
S'4-1: L R eS Pe 4--l SE TD 1 777 N- I Pr BeV E ,
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 vegetation, etc.):
S456 k45J PsN40- Ty 7'C-4 t 46cV M
4. Please provide an explanation of the following:
(1) The practical difficulties or hardships that would result from the strict application of this
Rule.
SEC R.ES Pa "X6 -T rc, M J A are y?g
(2) How these difficulties or hardships result from conditions that are unique to the property
involved.
X egx* l*Z'eJ d 1D A 'C 7-o /7-15m t 4 6 o s/ 6
(3) If economic hardship is the major consideration, than include a specific explanation of the
economic hardships and the proportion of the hardship to the entire value of the project.
Sk'E 2?sp .u.rr = J-rcM 1 6-00 tic ki?
Part 3: Deed Restrictions
By your signature in Part 6 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:
"General" Variance Application Form, page 3
City, State, Zip:
Telephone:
Fact:
Email:
Part 5: Applicant's Certification
1, RICOARD J, 4, GA II- C, SAGHOIRI/Z (print or type name of person
listed in Part t, 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. THfiPKodEar Nos BAFON ci?xl.i7n??r5a tw c&tv, &&Ckh*4 cAr co«N
RfprtioV45e P4A"4 AAJ p,6f0 7-rLAL' 7-10"J rZ ca?r2Ar, o WIT-.4 PEITA41V.
Signature;
Date: s a r 0 i
Title: o J& -N E IRs .
NC Division of Wager Quality (DWO)
401 Wetlands Certification Unit
2321 Crabtree Blvd, (LOCATION)
1650 Mail Service Center (MAILING ADDRESS)
Raleigh, NC 27699.1850
[phone] (phone)
http://h2a.enr.state.ne. usimcwetlands/
RALEIGH REGULATORY FIELD OFFICE
US Army Corps of Engineers
6508 Falls of the Neuse Road, Suite 120
Raleigh, North Carolina 27615
General Number: [phone]
http://www.saw.usiioo,army,mil/watiands/,,egtour.htrn
WASHINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
Post Office Box 1000
Washington, North Carolina 27889.1000
General Number. [phone]
http://www.saw.usw*.army.miliwatlands/regtour.htm
Washington District Office
Division of Coastal Management
943 Washington Square Mali
Washington, NO 27889
phone: [phone]
Morehead City District Office
Division of Coastal Management
151.8 Highway 24
Morehead City, NO 28557
phone: [phone]
"General" Variance Application Form, page 4
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PAMLICO COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH SECTION
BAYBORO, NORTH CAROLINA 26515 1
J\
Psrallt valid for S years 17
ISSUED TO: PBRrIT # 3133 1 yr ?? `?y
ADDRESS-
-ORIENTAL Mr
PHONE a
MAP u
REGISTERED PLAT: MAP 80011_ PACE_ nATE
RL'GISTE,LtEA DERDs AEED SOOE PAGE_----BAT!_
NURDtVIaION: asma
e
TOWNs
LOCATION DIRsCTIONS SR •
7
WA!$R StIPPLY: (X) PUBLIC '
.,.QB,._W PRIVATE-),ioe?*at frOR asY part of septic system
HOUSE ( X )_U"ODiLE BONE ( 1 OTHER
•BXDROOMS:__3 _ SBATHROOMS:. ?PAClORS
CLASSIFICATION: ( ) SUITABLE ( X ) PROVISIONALLY SUITABLE
LAND DRAINAGE: t ) SUQGESTED ( X ) NECESSARY
t ) DITCH NECESSARY ( X ) SUB-SURFACE TILE NECESSARY set 16" deep
and 4 X) lRKNCH ROCKED TO wroru N i'OF GROUND SURFACE
and ( ) WITH POLTURITHANE CURTAIN: FRENCH DRAIN
slid l ) P+INISHED AT OOTFALL W/ SOLID PIPE A SCREEN
and ( x) FINISHED AT OUTFALL M/ CHECK VALVE
••• If lead drainage is necessary. You say need to comtact CANA for
appropriate permits: Refs Building Inspections Depsrt#!at
DESIGN:( * ) LOCATION OPTIONAL ( ) LOCATION AS •PECIFIMD ON PLOT PLAN
CONVENTIONAL SYSTEM;(ref.195S) 18"X 3'treacb, rock 12"seep
nitrification lises on S. centers
( X ) SHALLOW SYSTEM: tref.l9SS) trench _jj„' vide, rock 12"deep,
6" soil cover, rock to natural ground surface
( I Houma SYSTEM. (rsf-1950h)trench
" wide is ¦mitable fill
extending 25' boyasd day part of the systas
'"a = depth of PILL; pump necessary it usable to gravity teed
??• If fill material is prescribed, yo¦ mar need to contact The Army
Corps of Engidsere for appropriate paraltas Refs Build. lamp.
( ) LPP 9YSTEM:(re1.19S71 see comments far design criteria
( ) RED SYSTEM-(ref-1955d) sea comments for Aeslya criteria
( ) OFF-SITE DISPOSAL s(ref.19S7) see consents for dealg¦ notes
1000 gal SEPTIC VANE gal PUMP TANX ( ) GREASE TRAP
900 SQUARE FEET NITRIFICATION FIELD or NITRIFICATION BED
+300 -LINEAR FERT NITRIFICATION LINE; 3 (_100'1 or t 'I
ADDITIONAL FOR ALL SYST "S:
LANDSCAPE SYSTEM &OZA FOR SURFACE WATER RUNOFF AND CRASS
00 NOT PLACE DRITE OR ANY BUILDING OVER SYSTEM AREA
OBSRAWt ALL PROPER SETBACES: rof .1950
TANYS MUST BE PUMPED CLEAN AS A PART OF ANY SISTER RICPAIR.
D
ALAIN A ON- 0* ISC NATURAL GROUND REPOSE INSTALLATION OF ANY FILL
' IF BUILDINg RICA EYTINDSFINTOASYSTEMPAREA THIS PIN ON
RIMITBWILLA09 INVALIDS
' IF ANY OTHER REGULATORY AGENCY DENIES PERrTS FOR LAND ALUMATIONS AS
DESCRIBED HERRIN, THIS PERMIT WILL BE INVALID
PLOT PLAN MUST NOT BE AL1811E0 UNLESS BY SANITARIAN APPROVAL
ttttt.tRt.tRMtttttttt¦..sr?.?tt PLOT PLAN .t?st.???tttt.t?s*t??t.tttt¦¦
i
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SANITARIAN ATt
NOTE: ALL SEPTI oND RYZgT APPROVAL BY A
SANITARIAN OF TUN LOCAL HEALTH ICPARTMENT ...ORE BEING Covollso
01 PLACED INTO USE AND 1#0 ELECTRICAL CONNECTION SHALL BE ALLOWED
UNTIL APPROVAL HAS EICEN RECEIVED. (G, S. 130A-337d,332)
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OFFICE USE ONLY: Date Received Request #
State of North Carolina ,?
Department of Environment and Natural Resources 6 > .
Division of Water Quality
"General" Major Variance Application Fortin -
From the Neuse and Tar Pamlico Riparian Buffer Protection Rules for residential structures
on existing lots within the coastal counties as defrned by the Coastal Area Management Act
(As approved by the Water Quality Committee of the Environmental Management. Commission on 5/512001)
Please identify which Riparian Area Protection Rule applies.
Neuse River Basin: Nutrient Sensitive Waters Management Strategy
Protection and Maintenance of Riparian Areas Rule (I SA NCAC .0233)
o 'far-Pamlico River Basin: Nutrient Sensitive Waters Management
Strategy Protection and Maintenance of Riparian Areas Rule (I SA
NCAC.0259)
NOTE:
To constitute a complete application, all of the In brmation requested in this ?form
must be provided Incomplete applications will be returned to the applicant. The
original and two copies of the completed "General" Variance Application Form and
any attachments must be sent to the DWO 4011Wetlands Cerd0cation Unit, 1650 Mail
Service Center, Raleigh, NC 27099-1060,919-733-1780 to conss6tute a complete
submittal. This form may be photocopied for use as an original.
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):
RICHAap J, J GAIL G. C3AGA+172lFC
2. Print OwnerlSlgning Officlal (person legally responsible for the property and its compliance)
Name: J&ICI-IA b j, r GA?r` C- 1,acHor itJ
Title: o w fv E 2 S
Street address: 1 $ t+ P e? r vv Su L_ A V R+ V r
City, State, Zip: D n I !_ v, r!5 L- N c ;? & d" `7 I
Telephone: (..x. z) 2-,q 4- ,Z 7 7 8
Fax: .2, v 4- x 7 7 ,8
3
Contact person who can answer questions about the proposed project
Name: 1?lC_Ar4" J,
Telephone:
;Z It 9 - :R 7 7.0
Fax!
i?RJJ?Gr1S t?F_teHITr' b+?
0.1c-
"General" Variance Application Form
Version 1; May 2001
Email: 64r-14 &KI/' 9 C0AS77AL N1_: )r, r?a?J
4, Project Name (Subdivision, facility, or establishment name - consistent with project name on
plans, specifications, letters, operation and maintenance agreements, etc.):
?.bT 27 0 r_J4 ,rU C ?E 6K kS TAT
5. Project Location:
Street address: l S r???r s v w v rz ! v ??
City, state, zip. _ 0 F_ L Air- r'? t N. C: 2 8 X'71
County: PAM LlC c
Latitude/Iongitude: _ tit 3 S o.3 '1 !,1 w o 174 3 8 &. a Z
1z -
6. Directions to site from nearest major intersection (Also, attach an 8'1 x 11 copy of the portion
of the USGS topographic map indicating the location of the site):
t<?2 bry Mao??s Gore,NsrZ 1?T"?.f TAK! S7/?rar1214
T ?Q?cyHt? l3z.!)
W*AL7-0 F_ I-. TAKE I!* M1&I:tT 9K TD ar_C_"_A! 0 CItCsK ?V
A 0 b A- RIa1+T 0- ro P??+N,,ULA Dnrvyr
7. Stream to be Impacted by the proposed activity:
Stream name (for unnamed streams label as our to the nearest named stream):
0_RCM4R_a GJZ!„fs'ht
Stream classification (as identified within the Schedule of Classifications 15A NCAC 2B ,0315
(Neuse) or .0318 (Tar-Pamlico)):. e31 r
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 Ceditation1404 Permit
On-site Wastewater Permit
Active Connection to Sanitary Sewer System
NPDES Permit (including storrnwater)
Non-discharge Permit
Water Supply Watershed Variance
Others (specify) S6E fi?7 rAat4N,r- nt T?
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 butter impact In fe.:
F)E_r !3 m l r fIT v A ne,0 i ill S -rA t, a r=' y s i,u4;L !Z J P J? L, 1o u5 l?
6
4 9 "General" Variance Application Form, page 2

2. State reasons why this plan for the proposed activity cannot be practica0y accomplished,
reduced or reconfigured to better minimize or eliminate disturbance to the riparian buffers:
SLcA RESF&-4St To ) 7'h?r2 t 01r 86vE
3. Descdptlon 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.).
SE ki,5 Fbu.6 er Tv t7- -4 AOF oV
4. Please provide an explanation of the following:
(1) The practical difficulties or hardships that would result from the strict application of this
Rule.
SEA RCSP6NS6 T & 1 1-6*m I A 00V4
(2) How these difficultles or hardships result from conditions that are unique to the property
involved,
.ri'C,F-v R C ,S rJ %-A4.5C 7-0 ! 7"f5m 1 A 6?0 4/,G
(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.
a Ti'ry f a c:
Part 3: Deed Restrictions
By your signature in Part 6 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:
"General" Variance Application Form, page 3
City, State, Zip:
Telephone:
Fax:
Email:
Part 5: Applicant's Certification
% at cu A_te o ), 4 _ G A I I- C, a A c M s furs (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. 7-kEFK0J6oT 114S QLCN CO?tl7l2?c. r'ED IW CANivAYte?i #4C-a Wk IiM
?4?pn opt k' ??n???s A+up ? ?u 26.5 r+f, Trm?+? n t Yt?,wo wir/i PE'Tml'"'
d
Signature:
Date: n o o
Title: 0
NC Division of Water Quality (DWQ)
401 Wet*-As Certification Unit
2321 Crabtree Blvd. (LOCATION)
1650 Mail Service Center (MAILING ADDRESS)
Raleigh, NO 27899-1850
[phone] (phone)
http.,/lh2o.ww.#Mto.ne-us/ncwotlands/
RALEIGH REGULATORY FIELD OFFICE
US Army Corps of Engineers
6508 Fails of the Neuse Road, Suite 120
Raleigh, North Carolina 27615
General Number: [phone]
t ttp://www.saw. usim. arrny. mil/wetlands/reglour. htm
WASHINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
Post Office Box 1000
Washington, North Carolina 27869-1000
General Nurnber. [phone]
http:/twww.saw.usece.amry.mil/wetlands/regtour.htm
Washington District Office
Division of Coastal Management
943 Washington Square Mail
Washington, NO 27889
phone: [phone]
Morehead City District Office
Division of Coastal Management
151-8 Highway 24
Morehead City, NC 28557
phone: [phone]
"General" Variance Application Form, page 4

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P.2
PAMLICO COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH SECTION
BAY2020, NORTH CAROLINA 28515
IBPRDYMENrs PEVKIl
Peralt valid for S rears ?1 L?c1
ISSUED TO: PB?rIT S 3133 I l j-o 4
ADbRES3•
RECORQ 0 3462 ._/
Ojzzff'&L? NC
PHONE s
MAP t E0a_?,Li
REGISTERED PLAT: MAP BOOS PACBa,?pATE
RZGISTYR60 DEXD: DAM ld0
3USDivtaION• 0K W- PAGB=_____j)A!1: TOW t , 27
lr ¦ _ r ern -
LOCATION DIRECTIONS___ SOOTN OiF}X1- 7 s?osit a 1317 -_?
WATER SUPPLY: (X) PUBLIC
.-,QB-(X) PRIVATE->i 9--joet from $NY part of septic oyster,
HOUSE t x ) JULNOBILE HOME ( D OTHER ( )
#REDROOMS: _..a....._ sMATMROOMS: eFAClORS
CLASSIFICATION: ( ) SUITABLE ( X ) PROVISIONALLY SUITABLE
LAND DRAINAGE: ( ) SUGGESTED ( X ) NECESSARY
( ) DITCH NECESSARY ( X ) SLID-SURFACE TILE NECESSARY net 36" deep
abd ( X ) TRENCH ROCKED TO WITHIN 100F GROUND SURFACE
and t ) WITH POLTURlTHAUE CURTAIN: FRENCH DRAIN
and l ) rINISMED AT OUTFALL W/ SOLID PIPE A SCREEN
Ind 1 X ) FINISHED AT OUTFALL K/ CHECK VALVE .
000 If land dralaage is necessary, You any need to contact CANA for
eppropriete permits: Ref: 1I1111ding Inspections Department
DiSIGNI( X) LOCATION OPTIONAL ( ) LOCATION AS MPSCItIBO ON PLOY IpLAN
( ) CONVENTIONAL SYSTEM:(re[.11SS) WE 36trench, rock 1200eep
nitrification lines on if Centers
( X ) MALLOW SYSTEM: (rat.19Si) trench -11: wide, rock 12"deep,
6" soil cover, rock to natural ground surface
t ) ROUND SYSTKE:(ref_13S0b)trsnN Of wide in suitable fill
estending 25' beyond any port of the system
depth of FILL; pump necessary if enable to gravity feed
??• It fill material is prescribed, you ¦ay need to contact The Army
Corps of Eagiasers for appropriate permitsi Ref: Build. last.
( ) LPP SYSTEH;(ref.l?S?) now comments for design criteria
( ) BED SYSTEM:(rsf.1155d) see comments for design criteria
( ) OFF-SITE DISPOSAL,(ref.1g57) see congests for design notes
1000 eel SEPTIC TANK gal PUMP TANI ( ) GREASE TRAP
902 QUARR FRET NITRIFICATION FIBLD or NITRIFICATION BBD
300 LINEAR FEET NITRIFICATION LItfE; 3 (loo') er ( ')
ADDITIONAL FOR ALL SYSTEMS:
LANDSCAPE SYSTEM AREA FOR SURFACE WATER RUNOFF AND CRASS
DO NOT PLACE DRIVE OR ANY BUILDING OVER SYSTEE AREA
OBSERVE ALL PROPER SETBACKS: rA[ .1950
TANKB MUST BE PUMPED CLEAN AS A PART OF ANY BYSTER REPAIR.
DISC NATURAL GROUND BEFORE INSTALLATION OF ANY FILL
ALARM A ON-OFF FLOATS OM PUMPS MUST RE ON SEPARATE CIRCUITS
• IF BUILDING AREA EKTLNDS INTO SYSTEM AREA THIS PERMIT WILL RE INVALID
• IF ANY OTHER REGULATORY AGENCY DENIES PERMITS FOR LAND ALTERATIONS AS
DESCRIBED HEREIN, TH15 PERMIT WILL BE INVALID
PLOT PLAN MUST NOT BE ALTERED UNLESS BY SANITARIAN APPROVAL
rr•r¦¦ttt•trrrrrrrrrtr.rrr.rttt PLOT PLAN ??ttrrrrrrrrrrrttr??rrrrrrr.r
4y
i _t.
97, L f
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SANITARIAN ATE
NOTE: ALL SEPTIC MUST Bfff E ND XKCKI APPROVAL Y A
SANITARIAN OF THE LOCAL HEALTH EPARTMENT BEFORE BEING COVKRED
OR PLACED INTO USE AND NO ELECTRICAL CONNECTION SHALL BE ALLOWED
UNTIL APPROVAL HAS BEEN RECEIVED. (G. S. I3OA-3374,339)
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OFFICE USE ONLY: Date Received Request #
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality 0 1 1 6 2 6
"General" Major Variance Application Form --
From the Neuse and Tar-Pamlico Riparian Buffer Protection Rules for residential structures
on existing lots within the coastal counties as defined by the Coastal Area Management Act
(As approved by the Water Quality Committee of the Environmental Management Commission on 5/9/2001)
Please identify which Riparian Area Protection Rule applies.
g, 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)
NOTE:
To constitute a complete application, all of the information requested in this form
must be provided. Incomplete applications will be returned to the applicant. The
original and two copies of the completed "General" Variance Application Form and
any attachments must be sent to the DWQ 4011Wetlands Certification Unit, 1660 Mail
Service Center, Raleigh, NC 27699.9850, 919-733-1786 to constitute a complete
submittal. This form may be photocopied for use as an original.
Part 1: General Information
(Please include attachments if the room provided is insufficient,)
3.
1. Applicant's name (the corporation, Individual, etc. who owns the property):
R 1 r- A R,D J, t GA tL c B AC,4v 21L
2. Print Owner/Signing Official (person legally responsible for the property and its compliance)
Name: RICH ,rzb J, I. GAIL. C.13ACHoR-0k
Title: o ,a N t !,s
Street address: 18 u- F e-J r N su L, A V K , y f?
City, State, Zip: o i? i •.? r ?, i- N c ;;?8 ?r7 I
Telephone: (2„s z) z,q 9- .2 ,7 78
Fax: (zs: x} 2,,Y 9- Z 7 7 g
Contact person who can answer questions about the proposed project
Name: I IC-144 -0 J, 84C-14641k
Telephone: 2 g 9 - -? 7 78
Fax: X'(9- 2'l 7 6_
IpRoJ??rtS 10FkHi7-r6; 6
IN 0Sr--
"General" Variance Application Form
Version 1: May 2001
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:
SGT R1.SPo?4St To )Tr_'rL I #*SovE.
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 vegetation, etc.):
S-f ktQ P a -IS E T V L TC- 1-4 1 4 6 0V
4. Please provide an explanation of the following:
(1) The practical difficulties or hardships that would result from the strict application of this
Rule.
f?'rt i too y?
J-6-4F A,6,s pe,vs'6 7-,T1
(2) Now these difficulties or hardships result from conditions that are unique to the property
involved.
.d'EF RCSrN??.s? i o ! T?r? t ??05??
(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'kE 26-SpoA4.rF 7-0 I r?M I 4-r3oy4
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:
"General" Variance Application Form, page 3
City, State, Zip:
Telephone:
Fax:
Email:
Part 5: Applicant's Certification
1, RIcµARO ), 4- GA II, C, 6Ac-HaRJ/'C (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. THFf'roJi=Gr N45 QECN coA,r71t0C.rEd IW c&Njtvo?2?"lh#4 4C' 0/7'H
Af10t&Vae I??nius /a?Jp Q FV R?JY'??, TlONJ it C.&IQAGC) wiTN PFVZM!'rl,
Signature: ?-
Date:
Title: N s . NO Division of Water Quality (DWQ)
401 Wetlands Certification Unit
2321 Crabtree Blvd. (LOCATION)
1650 Mail Service Center (MAILING ADDRESS)
Raleigh, NC 276991650
[phone] (phone)
http://h2o.enr.state.ne. usincwetlands/
RALEIGH REGULATORY FIELD OFFICE
US Army Corps of Engineers
6508 Falls of the Neuse Road, Suite 120
Raleigh, North Carolina 27615
General Number. [phone]
http://www.saw.usice.arrry.mil/watiands/regtour.htm
WASHINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
Post Office Box 1000
Washington, North Carolina 27889-1000
General Number. [phone]
http://www.saw.usece.army.mil/watiands/regtour.htm
Washington District Office
Division of Coastal Management
943 Washington Square Mail
Washington, NO 27889
phone: [phone]
Morehead City District Office
Division of Coastal Management
151-8 Highway 24
Morehead City, NO 28557
phone: [phone]
"General" Variance Application Form, page 4
Email: 6/4r_J4D' /KLaC0A37'ALIJISr ce*) _
4. Project Name (Subdivision, facility, or establishment name - consistent with project name on
plans, specifications, letters, operation and maintenance agreements, etc.):
t,eT 2") O/i;c(agrU G t GK k5 Tom? C.C
5. Project Location:
Street address: I8 LJ P,5M1N S vl.A- u?21 v 1;
City, State, Zip: o k 1. k?_ M r- -z , N C p2 8 .r -7 1
County: PAr-4 L +c 6
Latitude/longitude: tN s o.3 7,71 w 6?7 6 j8 6 R z
6. Directions to site from nearest major intersection (Also, attach an 8'/ x 11 copy of the portion
of the USGS topographic map indicating the location of the site):
FI&OM MeoW-ei CQKW6k (;gJ_J_S' TWKL?r Sr/?r4?GNTf{P.Cc???w7y 1341)
N91$T0EAST. 7I4K,r !N- kIGl-Y' ot4 TD arLHARu GKet:K RD
/A r1 0 14 R l G l+-r P- t4 -r o I° E g i N $?0 J_A 12g i v er ,
7. Stream to be Impacted by the proposed activity:
Stream name (for unnamed streams label as "UT" to the nearest named stream):
OiZcMARt? GR?; r"K
Stream classification [as identified within the Schedule of Classifications 15A NCAC 2B .0315
(Neuse) or.0316 (Tar-Pamlico)]: . 8.71 ;'
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
Active Connection to Sanitary Sewer System
NPDES Permit (including stormwater)
Non-discharge Permit
Water Supply Watershed Variance
6 Others (specify) S 6 } 4 rAcr.-f ritE N T?
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.:
F mi 'rrl D A" u.STAi- i,tEtD Aac, f- if 4?. W u-SE stAtC.
"General" Variance Application Form, page 2
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'95-12-11 13:14
P.2
PAMLICO COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH SECTION
BAYBORO, NORTH CAROLINA 28515
IMPROJEMENTS PERMIT /
Permit valid for 5 years
ISSUED TO: pnol? D 3133 (G3
ADDRESS:_ po Box 46 _ RECORD s 3462
PHONE • MAP e
REGISTERED PLAT: MAP BOOR PACE_ DATE
REGISTERED DEEDS DEED BOOK PAGE__ HATE
NUBDIVISION: _p D CREEL ?mT
TOWN:
FARLI CO SR 4
LOCATION DIRECTIONS SOUTH OFF 1917 • ?_.
MATER SUPPLY: (X) PUBLIC
"OR (X) PRIVATE_>IO---Jeet from any part of septic system
HOUSE ( X ) -Q"OBILE HOME ( ) OTHER (
ODRDROOMS.- - 3 RZATHR00MS: *FACTORS
CLASSIFICATION: ( ) SUITABLE ( X ) PROVISIOVALLY SUITABLE
LAND DRAINAGE: ( ) SUGGESTED ( X ) NECESSARY
( ) DITCH NECESSARY ( X ) SUB-SURFACE TILE NECESSARY set 36^ deep
and ( X ) TRENCH ROCIED TO wrTNIN 19OF GROUND SURFACE
and ( ) WITH POLTURITHANE CURTAIN: FRENCH DRAIN
and ( ) tINISHED AT OUTFALL W/ SOLID PIPE A SCREEN
mod ( X ) FINISHED AT OUTFALL w/ CHECK VALVE
••• If land dralunge is necessary, you may need to contact CANA for
appropriate permits: Ref: Building Inspections Department
OMBIGN:( X ) LOCATION OPTIONAL ( ) LOCATION AS SPECXrlgo ON PLOT rLAN
( ) CONVENTIONAL SYSTEM;(ref.19SS) 1811 3'treach, rock 121deep
nitrification 11099 os Of Centers
( X ) SHALLOW SYSTEN:(ref.1956) trench 36° wide, rock 121deep,
61 soil cover, rock to natural ground surface
( ) MOUND SYSTEM: (ref .1950b)%reacb " wide to suitable fill
extending 25' beyond any part of the system
depth of FILL; pump necessary if unable to gravity teed
It fill material is prescribed, you may seed to contact The Army
Corps of Engineers for appropriate permits: Ref: Build. Insp.
t ) LPP SYSTEM:(ref.1957) see consents for design criteria
( ) BED SYSTEM:(rsf.1955d) see comments for design criteria
t ) Orr-SITE DISPOSAL:(ref.19S7) see comments for design notes
1000 ,gal SEPTIC YANK gal PUMP TANK ( ) GREASE TRAP
Soo SQUARE FEET NITRIFICATION FIELD or NITRIFICATION BED
300 _ LINEAR FEET NITRIFICATION LINE;
ADDITIONAL FOR ALL SYSTEMS:
LANDSCAPE SYSTEM AREA FOR SURFACE WATER RUNOFF AND CRASS
DO NOT PLACE DRIVE OR ANY BUILDING OVER SYSTEM AREA
OBSERVE ALL PROPER SETBACKS: rof .1950
TANS$ RUST BE PUMPED CLEAN AS A PART OF ANY SYSTEM REPAIR.
DISC NATURAL GROUND BEFORE INSTALLATION OF ANY FILL
ALARM A ON-OFF FLOATS ON PUMPS MUST 98 ON SEPARATE CIRCUITS
• If BUILDING AREA INTENDS INTO SYSTER AREA THIS PERMIT WILL BE INVALID
• IF ANY OTHER REGULATORY AGENCY DEMIES PERMITS FOR LAND ALTERATIONS AS
DESCRIBED HEREIN, THIS PERMIT WILL BE INVALID
PLOT PLAN MUST NOT BE ALTERED UNLESS BY SANITARIAN APPROVAL
•••...???•?••••••••••....••.?.? PLOT PLAN .•••s•••••••a••.?••••••••••..

,v
'p I

.?..r5 __T .ter
- .. ?. L7
r'
SANITARIAN ATE gmj?ql
NOTE: ALL S MUST B INSP E MD RECEIVE APPROVAL BY A - EMS SANITARIAN OF THE LOCAL HEALTH EPARTMENT BEFORE BEING COVERED
OR PLACED INTO USE AND NO ELECTRICAL CONNECTION SHALL BE ALLOWED
UNTIL APPROVAL HAS BEEN RECEIVED. (G. S. 13OA-337d,331)
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