WV0800238_Permit (Issuance)_20200408

DocuSign Envelope ID: FCB6E006-0191-4FC3-8CAF-62E20E1 101 7D
Permit # WV0800238
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION OF A WELL OR WELL SYSTEM
In accordance with the provisions of Article 7, Chapter 87, North Carolina General Statutes,
and other applicable Laws, Rules and Regulations
PERMISSION IS HEREBY GRANTED TO
Rodney Ross
FOR THE CONSTRUCTION OF a water supply well. The well will be located at 5205 White Ibis Ct.,
Southport, Brunswick County in accordance with the application received April 6, 2020 and in conformity
with specifications and supporting data, all of which are filed with the Department of Environmental Quality
and are considered part of the Permit.
This Permit constitutes a variance which acknowledges that the referenced well does not meet 15A NCAC 2C
.0107 (a)(2)(M) for separation distance to building perimeters (25 feet required vs 15 feet available). This
variance allows the well system to be used for its intended purpose (irrigation only).
This Permit is for well construction only and does not waive any provisions or requirements of the Water Use
Act of 1967, or any other applicable laws and regulations. Well construction shall be in compliance with the
North Carolina Well Construction Regulations and Standards. However, this Permit pertains to the
jurisdictional authority of the Division of Water Resource and does not waive the requirements of other
jurisdictions.
This Permit will be effective from the date of its issuance until April 8, 2021, and shall be subject to other
specified conditions, limitations, or exceptions as follows:
1. The well shall be constructed in accordance with 15A NCAC O2C .0107 except that for which this
variance is granted.
2. The well shall be located and constructed as shown on the attachments submitted as part of the permit
application.
3. Well construction record (GW-1) for the well must be supplied to the Division of Water Resources'
Information Processing Unit within 30 days of well completion. Provide the well construction permit
number on the GW-1 form.
4. Issuance of this Permit does not supersede any other agreement, permit, or requirement issued by another
agency.
5. When a well is discontinued or abandoned, it shall be abandoned in accordance with 15A NCAC
O2C.O24O and a well abandonment record (GW-30) shall be submitted to the Division of Water
Resource's Information Processing Unit within 30 days of well abandonment.
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DocuSign Envelope ID: FCB6E006-0191-4FC3-8CAF-62E20E1 101 7D
Permit # WV0800238
If any requirements or limitations of this Permit are unacceptable, you have the right to an
adjudicatory hearing upon written request within 30 days. The request must be in the form of a
written petition conforming to Chapter 150B of the North Carolina General Statutes and filed
with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, North Carolina
27699-6714. Unless such demand is made, this Permit is final and binding.
Permit issued this 8th day of April 2020
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
DocuSigned by:
E3ABA14AC7DC434...
Morella Sanchez King, PhD, PE, Regional Supervisor
Division of Water Resources
By Authority of the Environmental Management Commission
cc: Douglas Hewett — well contractor (via email)
DWR (Laserfiche)
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