20030773 Ver 1_COMPLETE FILE_20030624

QF Wrj?,q
Michael F. Easley
Governor
Ct) 7 William G. Ross, Jr., Secretary
,y Department of Environment and Natural Resources
G1 C Alan W. Klimek, PE, Director
Division of Water Quality
Coleen Sullins, Deputy Director
Division of Water Quality
October 13, 2003
DWQ Project # 03-0773
Pamlico County
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
Graham E. Lee
4822 Greenbrier Road
Raleigh, NC 27603-3818
Subject Property: Lot # 17, Tarklin Acres S/D, Pamlico County, NC
Tarklin Creek [03-04-10, 27-125-7, Sc NSW (nutrient sensitive)]
REQUEST FOR ADDITIONAL INFORMATION
Dear Mr. Lee:
On August 18, 2003, the Division of Water Quality (DWQ) Wetlands/401, Unit received additional information in regards to
your variance request dated June 15, 2003. The DWQ has determined that your property is eligible for the use of the
"General" Major Variance From the Neuse and Tar-Pamlico Riparian Buffer Rules for residential structures on existing lots
within the coastal counties as defined by the Coastal Area Management Act, Approved 51912001. However based on the
additional information that you provided dated August 12, 2003, it appears that you are not proposing to impact the riparian
buffers protected by the Neuse Buffer Rule (15A NCAC 02B.0233). Specifically, you stated"/ have had a home on this lot
for 16 years, even if I upgraded or built, nothing would be disturbed and there is 600' to 900' from site to woods, marsh or
creek." If you do not intend to disturb the protected buffer, then the general variance is not needed.
If we do not hear from you in three weeks, we will assume that you no longer want to pursue this project and we will
consider the project as withdrawn. Please me at [phone] if you have any questions.
Sincerely,
Bob Zarzecki,
Wetlands / 401 Unit, DWQ
cc: Tom Steffens, DWQ Washington Regional Office
Ted Tyndall, Morehead City District Office, 151-B Hwy. 24, Hestron Plaza II, Morehead City, NC 28557
File copy
Central Files
bz
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), hftp://h2o.enr.state.nc.us/ncwetlands/

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July 14, 2003 AUb 1 8 2003
DWQ Project # 03-0773
Pamlico County
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
Graham E. Lee
4822 Greenbrier Road
Raleigh, NC 27603-3818
Subject Property: Lot # 17, Tarklin Acres S/D, Pamlico County, NC
Tarklin Creek [03-04-10, 27-125-7, Sc NSW (nutrient sensitive)]
REQUEST FOR ADDITIONAL INFORMATION
Dear Mr. Lee:
On June 24, 2003, the Division of Water Quality (DWQ) Wetlands/401 Unit received your variance request dated June 15,
2003. The DWQ has determined that your project is eligible for the use of the "General" Major Variance From the Neuse
and Tar-Pamlico Riparian Buffer Rules for residential structures on existing lots within the coastal counties as defined by the
Coastal Area Management Act, Approved 51912001. 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:
Additional Information:
1. Plot Plan - Please provide a plot plan depicting the location of all surface waters, coastal wetlands, buffers and the
footprint of your proposed home, driveway, decks and any other impervious surfaces or clearing proposed within the
buffers. Please provide the area (in square feet) of all impacts to Zone 1 and 2 of the buffers.
2. Complete Sections - Please complete Sections 1, 2, 3 and 4 of Part 2 of the variance request.
Please respond in writing within three weeks of the date of this letter by sending a copy of this information to me and Mr.
Tom Steffens of the DWQ Washington Regional Office at [phone]. If we do not hear from you in three weeks, we
will assume that you no longer want to pursue this project and we will consider the project as withdrawn. Please call Mr.
Bob Zarzecki of this office at [phone] if you have any questions.
Sincerely,
cc: Tom Steffens, DWQ Washington Regional Ofi
Ted Tyndall, Morehead City District Office, 15
File copy
Central Files
Dome ,
etlands / 401 Unit, W
Hwy. 24, Hestron Plaza II, Morehead City, NC 28557
bz
Michael F. Easley
Governor
William G. Ross, Jr., Secretary
Department of Environment and Natural Resources
Alan W. Klimek, PE, Director
Division of Water Quality
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.ne.us/ncwetlands/
. ?0
C
ATFQ
Michael F. Easley
Governor
William G. Ross, Jr., Secretary
Department of Environment and Natural Resources
Alan W. Klimek, PE, Director
Division of Water Quality
July 14, 2003
DWQ Project # 03-0773
Pamlico County
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
Graham E. Lee
4822 Greenbrier Road
Raleigh, NC 27603-3818
Subject Property: Lot # 17, Tarklin Acres S/D, Pamlico County, NC
Tarklin Creek [03-04-10, 27-125-7, Sc NSW (nutrient sensitive)]
REQUEST FOR ADDITIONAL INFORMATION
Dear Mr. Lee:
On June 24, 2003, the Division of Water Quality (DWQ) Wetlands/401 Unit received your variance request dated June 15,
2003. The DWQ has determined that your project is eligible for the use of the "General" Major Variance From the Neuse
and Tar-Pamlico Riparian Buffer Rules for residential structures on existing lots within the coastal counties as defined by the
Coastal Area Management Act, Approved 51912001. 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:
Additional Information:
1. Plot Plan - Please provide a plot plan depicting the location of all surface waters, coastal wetlands, buffers and the
footprint of your proposed home, driveway, decks and any other impervious surfaces or clearing proposed within the
buffers. Please provide the area (in square feet) of all impacts to Zone 1 and 2 of the buffers.
2. Complete Sections - Please complete Sections 1, 2, 3 and 4 of Part 2 of the variance request.
Please respond in writing within three weeks of the date of this letter by sending a copy of this information to me and Mr.
Tom Steffens of the DWQ Washington Regional Office at [phone]. If we do not hear from you in three weeks, we
will assume that you no longer want to pursue this project and we will consider the project as withdrawn. Please call Mr.
Bob Zarzecki of this office at [phone] if you have any questions.
Sincerely,
cc: Tom Steffens, DWQ Washington Regional Of
Ted Tyndall, Morehead City District Office, 15
File copy
Central Files
bz
Dome ,
etlands / 401 Unit, DW
Hwy. 24, Hestron Plaza II, Morehead City, NC 28557
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.ne.us/ncwetlands/
?T Detail Incomplete
? Please provide a location map for the project.
?. Please show all stream impacts including all fill slopes, dissipators, and bank stabilization on the site plan.
p Please show all wetland impacts including fill slopes on the site plan. / I Z -` f U3
? Please indicate all buffer impacts on the site plan, l0
? Please Indicate proposed lot layout as overlays on the site plan.
? Please indicate the location of the protected buffers as overlays on the site plan.
? Please locate all Isolated or non-isolated wetlands, streams and other waters of the State as overlays on the site plan.
?: Please provide cross section details showing the provisions for aquatic life passage..
?t Please locate any planned sewer lines on the site plan.
? Please provide the location of any proposed stonmwater management practices as required by GC
? Please provide detail for the stormwater management practices as required by GC
c Please specify'the percent of project imperviousness area based on the estimated built-out conditions.
•Q Please indicate ail stormwater outfalls on the site plan.
? Please indicate the diffuse flow provision measures on the site plan. .
? Please indicate whether or not the proposed Impacts already been conducted.
Avoidance and/or Minimization Not Provided
a The. a on the plans does not appear to be necessary. Please eliminate the or provide additional information as to why .
It Is necessary.for this project
? This Office believes that the . labeled on the plans as can be moved or reconfigured to avoid the impacts to the Please
revise the plans to avoid the Impacts.
This Office believes that the Ya bWad on the plans av . can be moved or reconfigured to minimize the impacts to the Please.
revise the plans to minimize the impacts. =
The stormwater discharges at the location on the puns labeled will not provide diffuse flow through the buffer because Please
revise the plans and provide calculations to show that diffuse flow will be achleved through tha entire buffer. If it is not possible to achieve diffuse
flow through the entire buffer then. it may be necessary to provide stormwater management pfactices that remove nutrients before the stomwater
can be discharged through the buffer. .
,ther
I .. The application fee was insufficient because over 150 feet of stream and/or over 1 acre of wetland impact was requested. Please provide $
This additional fee must be received before your application can be reviewed:
Please complete Section(s) on the application.
Please provide a slgned copy of the application.
Please provide 'copies of the application, copies of the site plans and other supporting information.
tigation
of compensatory inillgation is required for this project. Please provide a compensatory mitigation plan. The plan must conform .
to the requirements in 15 A NCAC 2H .0500 and must be appropriate to the type of impacts proposed
Please indicate which 404 Permit the iJSACE would use to authorize this project. n
PAMLICO COUNTY
HEALTH
DEPARTMENT
August 31, 2001
Dear Pamlico County Landowner,
203 NORTH STREET
PO BOX 306
BAYBORO, NC 28515
252-745-5111
252-745-7684 FAX 030773
*TLAWS1401 GROW
JUN 2 4 2pr)dj
r?T?RQUq,
In 1997, the North Carolina Legislature appointed a commission to protect the water quality
and the environment in Eastern North Carolina. Legislation has been passed that may affect the
intended use of your property. In a consolidated effort of the Pamlico County Commissioners and the
Pamlico County Board of Health, the Commission has established a special provision 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
510912001. 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 if dated prior to August 1,2001. Thirdly, the variance remains with
the property just like the septic permit for the life of the land.
Our records indicate that you have a valid lifetime permit for your property in our records. In
order for you to ensure the intended use of the land, you need to complete the enclosed variance
request. This process should be initiated as soon as you possibly can. Applications should be mailed
to DWQ 401 etla s Certification Unit, 1650 Mail Service, Center, Raleigh,, NG 275
The Pamlico County ea epartments goal is to assist you as much as possible with our
limited resources. Copies of your permit, plat, and other surveys (if in our records) are available at a
cost of $5.00 and will be mailed directly to you to be included with your application.
Send a written request to: Kristie Mitchell
PO Box 306
Bayboro, NC 28515
Enclosures: General Variance Application
DWQ Special Rules
Thank You,
/Jentnassiter
Pamlico County Health Director
jVkm
OFFICE USE ONLY: Date Received Request #
state of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
"General" Major Variance Application Form -
From the Neuse and Tar Pamlico Riparian Buffer Protection Rules for residential structures
on existing lots within the coastal counties as defined by the Coastal Area Management Act
(As approved by the Water Quality Committee of the Environmental Management Commission on 5/9/2001)
..............
' - ?ee.
Please identify which Riparian Area Protection Rule applies.
o Neuse River Basin: Nutrient Sensitive Waters Management Strategy
Protection and Maintenance of Riparian Areas Rule (15A NCAC.0233)
o Tar-Pamlico River Basin: Nutrient Sensitive Waters Management
Strategy Protection and Maintenance of Riparian Areas Rule (15A
NCAC.0259)
L7`?::ib\?Fhb ?YN9fA?N`?i?^th?kU.cyNaYhY+W:tLfi?Y?hi?M`Y'r?'?lnfbfi:?£LNkot'::?iiK?:N5:4i*?$.DY.?i:$Fe'Y.3itiv.LYA:.:fi?.L:.U4.\`J>4'&Y?£.+t.'QiCA3??_U: »`?'?:d3.^S:»X??YLi.).W' ? .?'.1D.'..iri¢iki9.»SIX; JYv.
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 401M/edands Certification Unit, 1650 Mail
Service Center, Raleigh, NC 27699-1650,919-733-1786 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.)
1. AppH :nt's name (the corporation, individual, etc. who owns the property):
2.
Print Owner/Signing
Name:
Title:
Street address:
City, State, Zip:
Telephone:
Fax:
legally responsible for the pro'perty and its compliance)
3. Contact person who can answer questions about the proposed project:
Name: /may l
Telephone: 7 7 7- I S 7/
Fax:
"General" Variance Application Form
Version 1: May 2001
( .................)
Email:
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, ZipS?
County: ed_ J71
Latitude/longitude:
6. Directions to site from nearest major intersection (Also, attach an 8x 11 copy of the portion
of the USGS topographic map indicating the location of the site):
s-,Q?Z /;=- s 4go
/ v o ,Tomb/ lC ?A
G
7. Stream to be impacted by the proposed activity: 7-147 e,"Gi -c/ C/ riC
Stream name (for unnamed streams label as "UT" to the nearest named stream):
Stream classification [as identified within the Schedule of Classifications 15A NCAC 2B .0315
(Neuse) or.0316 (Tar-Pamlico)]:
8. Which of the following permits/approvals will be required or have been received already for
this project?y
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)
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.:
"Genera!" Variance Application Form, page 2
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:
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.):
1'Y7- 7-11-45 7-1 6
4. Please provide an explanation of the following:
(1) The practical difficulties or hardships that would result from the strict application of this
Rule.
(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 speck explanation of the
economic hardships and the proportion of the hardship to the entire value of the project.
T-- X,LT Z-&1-J Ti/V,!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
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, l t?7CF (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:
E-

NC Division of Water Quality (DWQ)
401 Wetlands Certification Unit
2321 Crabtree Blvd. (LOCATION)
1650 Mail Service Center (MAILING ADDRESS)
Raleigh, NC 27699-1650
[phone] (phone)
http:l/h2o.enr.state.nc. us/ncwetlands/
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:/twww.saw-us6ce.arrny.mil/Wetiands/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.usace.army.mil/wetiands/regtour.htm
Washington District Office
Division of Coastal Management
943 Washington Square Mall
Washington, NC 27889
phone: [phone]
Morehead City District Office
Division of Coastal Management
151-B Highway 24
Morehead City, NC 28557
phone: [phone]
"General" Variance Application Form, page 4
May WQC Agenda Item # 2 5/08101e103/01
Please note that this draft version contains edits to the version sent
in the May 3rd mailing. The changes are indicated by
stilt h and underline.
" General" MAJOR VARIANCE
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 that meet the conditions stated below.
This "general" major variance from the Riparian Buffer Protection Rules in the Neuse
(15A NCAC 2B .0233) and Tar-Pamlico (15A NCAC 2B .0259) River Basins is hereby issued by
the NC Environmental Management Commission (EMC) for impacts to the protected buffers as
long as the conditions prescribed below are met.
The applicant must submit to Division of Water Quality (DWQ) three co ies of the DWQ _
"General" Major Variance Application Form that describes how the following conditions of this
variance will be met. If these conditions can not be met, an individual Major or Minor Variance
from the Buffer Rules may be sought from the EMC. This "General" Major Variance shall expire
on April 11, 2006 unless it is renewed before that time by the EMC.
Conditions:
1. The residential lot must be located within one of the coastal counties as
defined by the Coastal Area Management Act (CAMA).
2. Applicants must show that they have met the requirements for a variance
as specified in the buffer rules in "VARIANCES" [ 15A NCAC 2B
.0233(9)(a)(i)-(iii) and 15A NCAC 2B .0259(9)(a)(i)-(iii)] for the
specific river basin where the impacts will occur.
3 Applicants must show that the residential lot has been platted and
recorded prior to August 1, 2000.
PdveF Basin; Arly 22, 199-7 ,
4. Construction is for residential buildings and related structures such as
garages, decks, porches, attached commercial buildings, driveways and
sheds.
5. Substantial expenditures and contractual obligations must have occurred
in good faith prior to the Auuust 1.2000
Substantial expenditures
and obligations must have been made in reasonable reliance upon
governmental permits and/or approvals (such as 401 Water Quality
Certifications, CAMA permits, active connection to an existing sanitary
sewer system or local septic system approvals). Supportive written
documentation must be submitted to the DWQ for review.
6. The lot must be buildable, without wetland impacts except for driveways
and/or utility crossings and any impact to the buffer shall be minimised
to the maximum extent practical.
7. Where impacts to the buffer will occur, the impact should be minimized
to the greatest extent practicable as determined by DWQ staff.
May WQC Agenda Item # 2 5/omis/oyo nvwnt
S. Any on-site wastewater treatment must not be located within 50 feet of a
surface water as specified in "ZONES OF THE RIPARIAN BUFFER"
[15A NCAC 2B .0233(4) and 15A NCAC 2B .0259(4)] of the buffer
rules. The only exceptions include any pretreatment systems meeting the
Treatment Standard 1 as found in 15A NCAC 18A. 1969 Innovative
System Approval regulated by the NC Division of Environmental Health,
On-site Wastewater Section.
9. On-site stormwater management controls must be shown on the
application and stormwater runoff must be directed away from the
adjacent surface water and/or coast wetland as determined sufficient by
DWQ staff, measures such as rain gardens, bio-retention areas,
vegetative filter strips and planting of trees or shrubs along bulkheads
and/or property lines to maximize pollutant removal may be required as
determined by DWQ staff. If the applicant is required to obtain a
Sedimentation and Erosion Control Permit or a CAMA Major Permit,
then a Stormwater Permit may be required from the DWQ.
10. Mitigation will be required at a 1:1 ratio for impacts to Zone 1. This
mitigation can be accomplished by either (1) payment into the Riparian
Buffer Restoration Fund (administered by the DWQ Wetlands
Restoration Program), (2) planting or protection of a riparian area not
subject to the buffer rules, or (3) additional planting of a partially
buffered location on-site or in close proximity to the impacted area.
Mitigation plans must be approved in writing by the DWQ prior to
construction.
11. The applicant must receive written approval from the DWQ based on the
submittal of the "General" Major Variance Application Form
acknowledging that these conditions have been met before any impacts
occur to the riparian buffer.
12. The applicant must contact the appropriate District office of the N.C.
Division of Coastal Management or Local Permitting Officer for any
current requirements for CAMA Major, Minor or General Permits.
Signed:
Dr. Charles H. Peterson, Chair
Water Quality Committee
NC Environmental Management Commission
Effective Date:
:a
PAMLICO OUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH SECTION
P.O. BOX 306
BAYBORO, NORTH CAROLINA 28515
TELEPHONE: [phone]
AUTHORIZATION TO USE AN EXISTING SYSTEM
RECORD --S
APPLICANT NAME:
ADDRESS: qZM
LOCATION/SATE:
MAP * - #i O'1 t
ERMIT # :;161
FILE LAPY
TYPE OF DWELLING: ( ) HOUSE (X) MOBILE HOME ( ) OTHER
NUMBER OF BEDROOMS: a2 BATHS Z, FACTORS
WATER SUPPLY: too*) PUBLIC ( ) PRIVATE
SYSTEM ORIGINALLY ,.INSTALLED:
OWNER AT DATE:
PERIMETER OF EXISTING SYSTEM:
To the fullest extent that we are able to determine from site
RVaiuation and/or without previous documentation, the perimeters of the
septic system in existence on this site are-as follows:
!k#tt!!#ttttttktkkt4ttlt#tikttRt!lkttkttit Plot Plan ttlt#!!ttltl:lkk!
DATA: Tank size: 1000
L3,xe, Gallons No. Lines•
No. Linear ft.?
No. Sq. ft. 3DO !#!#!!!!!t!ltltk!!tk!!!!lk;tktttltttttlttt#ttltttltltltlt;t!!t4!!ttl.
The system located at tbis"site, at this time, shows no signs of
failure to function properly and may be "-PLACED INTO USE". Should the
system show signs, in the future, of malfunction it shall be the
responsibility of the property owner to apply for an Improvements
Permit for the repair of the system.
*Failure to maintain a properly functioning septic system is considered
a public health hazard and a Violation of the North Carolina State Laws
and Rules Governing Sanitary Sewage Collection, Treatment & Disposal.
Violation of this regulation is punishable as a misdemeanor.
Sanitarian: ?xl. Date 06/27/91
PAMLICO COUNTY HEALTH DEPT.
BAYBORO. N.C.
CERTIFICATE OF COMPLETION
(GROUND ABSORPTION SEWAGE
DISPOSAL SYSTEM-G.S. CHAP-
TER 130AARTI LE 11(
OWNER ...'elf .. ......
Location ................................................................_
.............. ........................................................ S.R. #t ............
Approved As Shown on Plot Plan ( )
Approved As Shown on Final Plot
0
(
.. 13 ......Sec ........
Distance of Well: From Tank ..........................................
From Drainfield ...............................
Have Tank and Drain Lines Inspected by a represen-
tative of the Pamlico County- Health Department
before covering.
Installed By: ............. ...... ---------_----------AaDk^ Certificate of CoTTfpletion By:..........
... .. ...........
Date: .......... .........`sZ.: ,I...
'THIS DOES NOT CONSTITUTE A WARRANTY OR GUARANTEE
PAMLICO COU^ITY HEALTH DEPARTMENT
'BORO. N. C. ?
IMPROVEMENiS PERMIT
#
(GROUND ABSORPTION SEWAGE DISPOSAL SYSTEM-G.S. CHAPTER 130A ARTICLE I T I
OWNER ......RR!R).......... ?!J•?: ...............
Address.-...... i.?.v ...?.....--- -----.1 e! kW.V.ie.? S.R. No. ... ..
Location . ? ,.......... .......... 5? _.........1 ?T'_:_. ??....
cam.... ------------------------------------------------ --
.......................................................................................................... S.R. # ............
Water Supply: Private ( ) Public (y) Mobile Home Park ( )
HOUSE ( ) MOBILE HOME (y) BUSINESS ( )
NO. BEDROOMS ........ ................ NO. BATHROOMS ..................
Suitable ( ) Prov. Suitable
Locate Tank and Lines feet from well: ............... .M. ..................
Size of Septic Tank: ................ gallons
Nitrific tibn Lines: 7.2-0 square feet
o. of mines, ?..... fin. feet
Comments: ............. ................ . .... .. y...-
............
).. Lt ? .........................................................
.LN G. DUNN CO. / 43632
...........................•--...----------..................--------.._........._.----• - ............ ...................
`
IMPROVEMENTS PERMIT B,`: ..`.-? .... .
Date:
.......................................................................................
PERMIT VALID FOR THRFF VFARS
OFFICIAL RECEIPT
OF
PAMLICO COUNTY
NORTH CAROLINA
(8a 1
$_ Si WHITE - ORIGINAL
GF 50767
Bayb ro, N.C..........C'?.!.!?Lr?...?...J. ............................................
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Rec4-d of ..... ..4-5J.! (! .....-Y.4 ................................................................................................
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.... ` -A....?.?o? ............... :::...:.:
PAML OUNTY
.............................. ..
YELLOW - AUDITOR Auditor

PAMLICO COUNTY
HEALTH
DEPARTMENT
August 31, 2001
Dear Pamlico County Landowner,
203 NORTH STREET
PO BOX 306
BAYBORO, NC 28515
252-745-5111
252-745-7684 FAX
LAM 1401 GROUP
July 2 4 2003
1'ER QUAII]YSEM .
In 1997, the North Carolina Legislature appointed a commission to protect the water quality
and the environment in Eastern North Carolina. Legislation has been passed that may affect the
intended use of your property. In a consolidated effort of the Pamlico County Commissioners and the
Pamlico County Board of Health, the Commission has established a special provision 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 if dated prior to August 1,2001. Thirdly, the variance remains with
the property just like the septic permit for the life of the land.
Our records indicate that you have a valid lifetime permit for your property in our records. In
order for you to ensure the intended use of the land, you need to complete the enclosed variance
request. This process should be initiated as soon as you possibly can. Applications should be mailed
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. Copies of your permit, plat, and other surveys (if in our records) are available at a
cost of $5.00 and will be mailed directly to you to be included with your application.
Send a written request to: Kristie Mitchell
PO Box 306
Bayboro, NC 28515
Enclosures: General Variance Application
DWQ Special Rules
Thank You,
i ..: t/X
L" Jenn , assiter
Pamlico County Health Director
jVkm
OFFICE USE ONLY: Date Received Request #
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
"Genera!" 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.
? 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)
:... :...
fi w?)YSF1+tAr.$e'a'?07AlARa2e.et2?M'.ih`7.fDF3)XD?.i?"H`TG?S1 *K. -AM $ ¢""'' ,?Si£h.V4`3'dktiE>T:nN?e`o:QhY?*kJL'd?F22S. '3' .: ' ?'.xT:§tb w' }i:..
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 401M/edands Certification Unit, 1650 Mail
Service Center, Raleigh, NC 27699-1650,919-733-1786 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.)
1. Appi!9pnt's name (the corporation, individual, etc. who owns the property):
---
2.
Print Owner/Signing
Name:
Title: .
Street address:
City, State, Zip:
Telephone: ' !
Fax:
leoal{v responsible for the property and its compliance)
3. Contact person who can answer questions about the proposed project:
Name: /mar Lam- LG?
Telephone: (...1/lq) 7 7 Z- S 7/
Fax: (._.,.v.....:.)
"Genera' Variance Application Form
Version 1: May 2001
( .................)
Email:
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, ZipI54
County:
Latitude/longitude:
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):
'4'22r S ?
'Lp
7. Stream to be impacted by the proposed activity: C/??le
Stream name (for unnamed streams label as "UT" to the nearest named stream):
Stream classification [as identified within the Schedule of Classifications 15A NCAC 2B .0315
(Neuse) or.0316 (Tar-Pamlico)]:
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)
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.:
C Z4 Z ?ya e J=' a T o ? Go % G?1/GGot ? ??
"General" Variance Application Form, page 2
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:
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.):
/V,9 02 ?ti dYT 7`"lGJ..s 7-1,-1-1-
4. Please provide an explanation of the following:
(1) The practical difficulties or hardships that would result from the strict application of this
Rule. ??????_•?-? L, ? ,i ???=
(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.
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, l (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:
?F_

NC Division of Water Quality (DWQ)
401 Wetlands Certification Unit
2321 Crabtree Blvd. (LOCATION)
1650 Mail Service Center (MAILING ADDRESS)
Raleigh, NC 27699-1650
[phone] (phone)
http://h2o.enr.state. nc. us/ncwetiands/
RALEIGH REGULATORY FIELD OFFICE
US Army Corps of Engineers
6508 Falls of the Neuse Road, Suite 120
Raleigh, North Carolina 27615
General Number. (919) 87648441
http://wWw.saw-usace.army.miltwetiands/regtour.htm
WASHINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
Post Office Box 1000
Washington, North Carolina 27889-1000
General Number. [phone]
hftp://Www.saw.usace.army.miUwettands/regtour.htm
Washington District Office
Division of Coastal Management
943 Washington Square Mall
Washington, NC 27889
phone: [phone]
Morehead City District Office
Division of Coastal Management
151-B Highway 24
Morehead City, NC 28557
phone: [phone]
"General" Variance Application Form, page 4
May WQC Agenda Item # 2 5/08/015103/0104/41/%
Please note that this draft version contains edits to the version sent
in the May 3rd mailing. The changes are indicated by
st-riltlreuo and underline.
" General" MAJOR VARIANCE
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 that meet the conditions stated below.
This "general" major variance from the Riparian Buffer Protection Rules in the Neuse
(15A NCAC 2B.0233) and Tar-Pamlico (15A NCAC 2B.0259) River Basins is hereby issued by
the NC Environmental Management Commission (EMC) for impacts to the protected buffers as
long as the conditions prescribed below are met.
The applicant must submit to Division of Water Quality (DWQ) three copies of the DWQ
"General" Major Variance Application Form that describes how the following conditions of this
variance will be met. If these conditions can not be met, an individual Major or Minor Variance
from the Buffer Rules may be sought from the EMC. This "General" Major Variance shall expire
on April 11, 2006 unless it is renewed before that time by the EMC.
Conditions:
1. The residential lot must be located within one of the coastal counties as
defined by the Coastal Area Management Act (CAMA).
2. Applicants must show that they have met the requirements for a variance
as specified in the buffer rules in "VARIANCES" [15A NCAC 2B
.0233(9)(a)(i)-(iii) and 15A NCAC 2B .0259(9)(a)(i)-(iii)] for the
specific river basin where the impacts will occur.
Applicants must show that the residential lot has been platted and
recorded prior to August 1, 2000.
T
,.„, fy 1
1997 an T"". D. mlise River- Basin
22
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l
B
P
i
1,
,
;
ahr,
y
c
ve
u
4. Construction is for residential buildings and related structures such as
garages, decks, porches, attached commercial buildings, driveways and
sheds.
5. Substantial expenditures and contractual obligations must have occurred
in good faith prior to the August 1. 2000
Substantial expenditures
and obligations must have been made in reasonable reliance upon
governmental permits and/or approvals (such as 401 Water Quality
Certifications, CAMA permits, active connection to an existing sanitary
sewer system or local septic system approvals). Supportive written
documentation must be submitted to the DWQ for review.
6. The lot must be buildable, without wetland impacts except for driveways
and/or utility crossings and any impact to the buffer shall be minimised
to the maximum extent practical.
7. Where impacts to the buffer will occur, the impact should be minimized
to the greatest extent practicable as determined by DWQ staff.
May WQC Agenda Item # 2 5/08/0151",?t 04/11'°=
S: Any on-site wastewater treatment must not be located within 50 feet of a
surface water as specified in "ZONES OF THE RIPARIAN BUFFER"
[15A NCAC 2B .0233(4) and 15A NCAC 2B .0259(4)] of the buffer
rules. The only exceptions include any pretreatment systems meeting the
Treatment Standard 1 as found in 15A NCAC 18A .1969 Innovative
System Approval regulated by the NC Division of Environmental Health,
On-site Wastewater Section.
9. On-site stormwater management controls must be shown on the
application and stormwater runoff must be directed away from the
adjacent surface water and/or coast wetland as determined sufficient by
DWQ staff, measures such as rain gardens, bio-retention areas,
vegetative filter strips and planting of trees or shrubs along bulkheads
and/or property lines to maximize pollutant removal may be required as
determined by DWQ staff. If the applicant is required to obtain a
Sedimentation and Erosion Control Permit or a CAMA Major Permit,
then a Stormwater Permit may be required from the DWQ.
10. Mitigation will be required at a 1:1 ratio for impacts to Zone 1. This
mitigation can be accomplished by either (1) payment into the Riparian
Buffer Restoration Fund (administered by the DWQ Wetlands
Restoration Program), (2) planting or protection of a riparian area not
subject to the buffer rules, or (3) additional planting of a partially
buffered location on-site or in close proximity to the impacted area.
Mitigation plans must be approved in writing by the DWQ prior to
construction.
11. The applicant must receive written approval from the DWQ based on the
submittal of the "General" Major Variance Application Form
acknowledging that these conditions have been met before any impacts
occur to the riparian buffer.
12. The applicant must contact the appropriate District office of the N.C.
Division of Coastal Management or Local Permitting Officer for any
current requirements for CAMA Major, Minor or General Permits.
Signed:
Dr. Charles H. Peterson, Chair
Water Quality Committee
NC Environmental Management Commission
Effective Date:
i
i
~ -` FAMLICO OUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH SECTION
P.O. BOX 306
BAYBORO, NORTH CAROLINA 28515
TELEPHONE: [phone]
AUTHORIZATION TO USE AN EXISTING SYSTEM
RECORD #
APPLICANT NAME:
ADDRESS: 48Af
LOCATION/SATE:
MAP 4:
IT e P761
FILE CAPY
TYPE OF DWELLING: ( ) HOUSE (X) MOBILE HOME ( ) OTHER
NUMBER OF BEDROOMS: . BATHS Z, FACTORS
WATER SUPPLY: (.--) PUBLIC ( ) PRIVATE
SYSTEM ORIGINALLY.INSTALLED:
OWNER AT DATE:
PERIMETER OF EXISTING SYSTEM:
To the fullest extent that we are able to determine from site
evaluation and/or without previous documentation, the perimeters of the
septic system in existence an this site are-as follows:

DATA:
Tank size: 1000
Gallons
No. Lines:
No. Linear ft.-500
No. Sq. ft. _3W-
tlt4tt.tr# Plot Plan #t!t####!#tt:#!#!
3 Xioo'
############tt***!tt#!*****.*****t#**t*!*#t**!#*t**##*!!*t!!t!!!!###!
The system located at this"site, at this time, shows no signs of
failure to function properly and may be "PLACED INTO USE". Should the
system show signs, in the future, of malfunction it shall be the
responsibility of the property owner to apply for an Improvements
Permit for the repair of the system.
*Failure to maintain a properly functioning septic system is considered
a public health hazard and a Violation of the North Carolina State Laws
and Rules Governing Sanitary Sewage Collection, Treatment A Disposal.
Violation of this regulation is punishable as a misdemeanor.
Sanitarian:
,?f f Date 06/27/91
PAMLICO COUNTY HEALTH DEPT.
BAYBORO, N.C.
CERTIFICATE OF COMPLETION
(GROUND ABSORPTION SEWAGE
DISPOSAL SYSTEM-G.S. CHAP.
TER 130A ARiI LE 11)
OWNER ...'?nr-...... _.,,..
"-I--
Location .................................................................
................ ..................................................... S.R. # ............
Approved As Shown on Plot Plan ( )
Approved As Shown on Final Plot ( )
(..--J?? Slk ........ Sec ........
Distance of Well: From Tank
From Drainfield ................................
Have Tank and Drain Lines inspected by a represen-
tative of the Pamlico County- Health Department
before covering.
Installed By: ............. ..................
Certificate of Co'Kpletion By:
Date: ......v ...............
*THIS DOES NOT CONSTITUTE A WARRANTY OR GUARANTEE
PAMLICO COUAITY HEALTH DEPARTMENT
"SORO. N. C. ?V
IMPROVEMEII?iS P PERMIT #
(GROUND ABSORPTION SEWAGE DISPOSAL SYSTEM-G.S. CHAPTER 130A ARTICLE 111
OWNER ...... WE.M;) ......... is e`1..... . ...... .... .......................
Address ........ 10...?......... Vil...1.?.'.l? ._....}?!}?.V?t?? S.R. No. ... ....
Location . ? ...... .. 5.............ICI??- k-1.............................
c ?...........
.......................................................................................................... S.R. # ............
Water Supply: Private ( ) Public (V) Mobile Home Park {
HOUSE( ) MOBILE HOME (y) BUSINESS
NO. BEDROOMS .-......3 ................ NO. BATHROOMS....z--.................
Suitable ( )
ii Prov. Suitable ("-
Locate Tank and Lines feet from well: ...............1........................
Size of Septic Tank: .!300. gallons
Nitrific tibn Lines: 7z:0 square feet . 11 --
.. b-. o. Iof trines, ....... fin. fin. feet
Comments : ........... . .. ... ...t- .... M_
?sa4.... v.. ...
...' ... ..........................................•-...... ------.------.
,T-.N G. DUNN CO. / 43632
................................................ .......... ............................. . `......._.
IMPROVEMENTS PERMIT B,1(: ..?.... .........
Date: ................... ?V\.-................................................................................
...
PERMIT VALID FDA THRFF WARR
OFFICIAL RECEIPT
OF
PAMLICO COUNTY
NORTH CAROLINA
atp/
(b
WHITE - ORIGINAL
?rn??,?I GF 50767
Bayb ro,N.C. . 0?"?'?rt?Kh ?...
Receilrgd of ..... ..4? f11 ..........................................................................................................
.... A1 .1...A ............................................................................................................. Dollars
................
?. U ......? . .....................................
Y", .......................................................
PAML....C...... OUN..........T
.............................. ..
YELLOW - AUDITOR Auditor

PAMLICO COUNTY
HEALTH
DEPARTMENT
203 NORTH STREET
PO BOX 306
BAYBORO, NC 28515
252-745-5111
252-745-7684 FAX
WM&1 Rag
JUN '? 4 201)3
August 31, 2001
W? QUALiTygo
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 has been passed that may affect the
intended use of your property. In a consolidated effort of the Pamlico County Commissioners and the
Pamlico County Board of Health, the Commission has established a special provision 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 if dated prior to August 1,2001. Thirdly, the variance remains with
the property just like the septic permit for the life of the land.
Our records indicate that you have a valid lifetime permit for your property in our records. In
order for you to ensure the intended use of the land, you need to complete the enclosed variance
request. This process should be initiated as soon as you possibly can. Applications should be mailed
to DWQ 401ANetlands Certification Unit, 1650 Mail Service, Center, Raleigh, NC 27699-1650.
The Pamlico County Health Department's goal is to assist you as much as possible with our
limited resources. Copies of your permit, plat, and other surveys (if in our records) are available at a
cost of $5.00 and will be mailed directly to you to be included with your application.
Send a written request to: Kristie Mitchell
PO Box 306
Bayboro, NC 28515
Enclosures: General Variance Application
DWQ Special Rules
Thank You,
Jenn ? assiter
Pamlico County Health Director
jVkm
OFFICE USE ONLY: Date Received Request #
State of North Carolina
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 5/912001)
Wx?naawy,<,afix?tizr@kieiia:-.i. .:.'..-».:ir'.a?,:...:.,. ..gym,.
Please identify which Riparian Area Protection Rule applies.
? 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)
:.?
.vm?'Sw ?. a?iea??sk?k?.?r5a:a'zs*aa:?",i?ait??i&?v:O,•?av^aLY?••k?s?a+?it?>:?Y,a:?.¢?iua??::;e%?+k}S?s?wz?:zi?::Y:exa??'rv?as?Se`a ' :
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 401Metlands Certification Unit, 1650 Mail
Service Center, Raleigh, NC 27699-1650, 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.)
1. Appl!pnfs name (the corporation, individual, etc. who owns the property):
2.
Print Owner/Signing
Name: _
Title: _
Street address: _
City, State, Zip: _
Telephone: - I.
Fax:
legally responsible for the property and its compliance)
3. Contact person who can answer questions about the proposed project:
Name: L-- z -, 6-,< § ?,
Telephone: 7 7 7- 5- 7/
Fax:
"General" Variance Application Form
Version 1: May 2001
( .................)
Email:
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, Zip54
County:
Latitude/longitude:.
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):
7. Stream to be impacted by the proposed activity: '`J
Stream name (for unnamed streams label as "UT" to the nearest named stream):
Stream classification [as identified within the Schedule of Classifications 15A NCAC 2B .0315
(Neuse) or.0316 (Tar-Pamlico)]:
8. Which of the following permits/approvals will be required or have been received already for
this project?Z
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)
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 W.:
"General" Variance Application Form, page 2
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:
A_ A , w -- 1/ _ -7- ? _ _ -
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.):
/V'O d Gait/ 1)--7- 7-11-is 7-1 c
4. Please provide an explanation of the following:
(1) The practical difficulties or hardships that would result from the strict application of this
Rule. _
(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 speck explanation of the
economic hardships and the proportion of the hardship to the entire value of the project.
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
(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:
-
.S' ?-z?rt/G- Z.r?d 3
NC Division of Water Quality (DWQ)
401 Wetlands Certification Unit
2321 Crabtree Blvd. (LOCATION)
1650 Mail Service Center (MAILING ADDRESS)
Raleigh, NC 27699-1650
[phone] (phone)
http://h2o.enr.state.nc.us/ncwetiands/
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.usace.arrny.mil/wetiands/regtour.htm
WASHINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
post office Box 1000
Washington, North Carolina 27889-1000
General Number. [phone]
hftp://www.saw.usace.army.mil/wetiands/regtour.htm
Washington District Office
Division of Coastal Management
943 Washington Square Mall
Washington, NC 27889
phone: [phone]
Morehead City District Office
Division of Coastal Management
151-B Highway 24
Morehead City, NC 28557
phone: [phone]
"General" Variance Application Form, page 4
/At
May WQC Agenda Item # 2 5/08/015/03/0104/41
Please note that this draft version contains edits to the version sent
in the May 3rd mailing. The changes are indicated by
stri and underline.
" General" MAJOR VARIANCE
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 that meet the conditions stated below.
This "general" major variance from the Riparian Buffer Protection Rules in the Neuse
(15A NCAC 213.0233) and Tar-Pamlico (15A NCAC 2B.0259) River Basins is hereby issued by
the NC Environmental Management Commission (EMC) for impacts to the protected buffers as
long as the conditions prescribed below are met.
The applicant must submit to Division of Water Quality (DWQ) three copies of the DWQ
"General" Major Variance Application Form that describes how the following conditions
variance will be met. If these conditions can not be met, an individual Major or Minor Variance
from the Buffer Rules may be sought from the EMC. This "General" Major Variance shall expire
on April 11, 2006 unless it is renewed before that time by the EMC.
Conditions:
1. The residential lot must be located within one of the coastal counties as
defined by the Coastal Area Management Act (CAMA).
2. Applicants must show that they have met the requirements for a variance
as specified in the buffer rules in "VARIANCES" [15A NCAC 213
.0233(9)(a)(i)-(iii) and 15A NCAC 2B .0259(9)(a)(i)-(iii)] for the
specific river basin where the impacts will occur.

.57 Applicants must show that the residential lot has been platted and
recorded prior to August 1, 2000.
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4. Construction is for residential buildings and relaxed structures such as
garages, decks, porches, attached commercial buildings, driveways and
sheds.
5. Substantial expenditures and contractual obligations must have occurred
in good faith prior to the August 1. 2000
Substantial expenditures
and obligations must have been made in reasonable reliance upon
governmental permits and/or approvals (such as 401 Water Quality
Certifications, CAMA permits, active connection to an existing sanitary
sewer system or local septic system approvals). Supportive written
documentation must be submitted to the DWQ for review.
6. The lot must be buildable, without wetland impacts except for driveways
and/or utility crossings and any impact to the buffer shall be minimised
to the maximum extent practical.
7. Where impacts to the buffer will occur, the impact should be mini,ni?ed
to the greatest extent practicable as determined by DWQ staff.
ins
May WQC Agenda Item # 2 5/08/015103/0104/11
9 Any on-site wastewater treatment must not be located within 50 feet of a
surface water as specified in "ZONES OF THE RIPARIAN BUFFER"
[15A NCAC 2B .0233(4) and 15A NCAC 2B .0259(4)] of the buffer
rules. The only exceptions include any pretreatment systems meeting the
Treatment Standard 1 as found in 15A NCAC 18A. 1969 Innovative
System Approval regulated by the NC Division of Environmental Health,
On-site Wastewater Section.
9. On-site stormwater management controls must be shown on the
application and stormwater runoff must be directed away from the
adjacent surface water and/or coast wetland as determined sufficient by
DWQ staff; measures such as rain gardens, bio-retention areas,
vegetative filter strips and planting of trees or shrubs along bulkheads
and/or property lines to maximize pollutant removal may be required as
determined by DWQ staff. If the applicant is required to obtain a
Sedimentation and Erosion Control Permit or a CAMA Major Permit,
then a Stormwater Permit may be required from the DWQ.
10. Mitigation will be required at a 1:1 ratio for impacts to Zone 1. This
mitigation can be accomplished by either (1) payment into the Riparian
Buffer Restoration Fund (administered by the DWQ Wetlands
Restoration Program), (2) planting or protection of a riparian area not
subject to the buffer rules, or (3) additional planting of a partially
buffered location on-site or in close proximity to the impacted area
Mitigation plans must be approved in writing by the DWQ prior to
construction.
11. The applicant must receive written approval from the DWQ based on the
submittal of the "General" Major Variance Application Form
acknowledging that these conditions have been met before any impacts
occur to the riparian buffer.
12. The applicant must contact the appropriate District office of the N.C.
Division of Coastal Management or Local Permitting Officer for any
current requirements for CAMA Major, Minor or General Permits.
Signed:
Dr. Charles H. Peterson, Chair
Water Quality Committee
NC Environmental Management Commission
Effective Date:
yYy?- PAMLICO OUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH SECTION
P.O. BOX 306
BAYBORO, NORTH CAROLINA 28515
TELEPHONE: [phone]
AUTHORIZATION TO USE AN EXISTING SYSTEM
RECORD 4
APPLICANT NAME:
ADDRESS:-q1A
LOCATION/SATE:
MAP * : H041- I
T # P761
FILE OPY
TYPE OF DWELLING: ( ) HOUSE (X) MOBILE HOME ( ) OTHER
NUMBER OF BEDROOMS: BATHS Aa. FACTORS
WATER SUPPLY: Lam') PUBLIC i ) PRIVATE
SYSTEM ORIGINALLY..INSTALLED:
OWNER AT DATE:
PERIMETER OF EXISTING SYSTEM:
To the fullest extent that we are able to determine from site
&ValAatiom and/or without previous documentation, the perimeters of the
septic system in existence an this site are-as follows;
tlttttttt#ttt:!##t:tt#tttttt4tt#tttttt.:tt Plot plan !t##xtttt:tltttlt
DATA:
Tank size: 1000
Gallons
No. Lines:
No. Linear ft. _500
No. Sq. ft. 9no_
E:D
3 Xia.'
i
##tt#tttttltttt##tltt#t!t#?.#t4ttttt!#tttlt#tt#tttt!#tttttttt#tttttt!
The system located at this site, at this time, shows no signs of
failure to function properly and may be "-PLACED INTO USE". Should the
system show signs, in the future, of malfunction it shall be the
responsibility of the property owner to apply for an Improvements
Permit for the repair of the system.
!Failure to maintain a properly functioning septic system is considered
a public health hazard and a Violation of the North Carolina state Laws
and Rules Governing Sanitary Sewage Collection, Treatment A Dl?sposal.
Violation of this regulation is punishable as a misdemeanor. -'
Sanitarian: ?xf. Date 06/27/91

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. PAMLICO COUNTY HEALTH DEPT.
BAYBORO, N.C.
CERTIFICATE OF COMPLETION
(GROUND ABSORPTION SEWAGE
DISPOSAL SYSTEM-G.S. CHAP..
TER 130A ARTI LE 111 ,
OWNER ...°? ...f-Z-9,
Location ................................................................
................................................................. S.R. # ............
Approved As Shown on Plot Plan ( )
Approved As Shown on Final Plot ( )
ly .-r-'-- IT Blk ........ Sec ........
Distance of Well: From Tank ..........................................
From Drainfield ...............................
Have Tank and Drain Lines Inspected by a represen-
tative of the Pamlico County Health Department
before covering.
Installed By: ............. ....................
PAMLICO COUNITY HEALTH DEPARTMENT
'SORO. N.C. /?
IMPROVEMEN I S PERMIT #(/
(GROUND ABSORPTION SEWAGE ccDIS.POSAL SYSTEM-G. S. CHAPTER 130A ARTICLE 111
OWNER...... A ........... ?J i.'VOeI ...............
Address ....... ._.?...... _R%...`.(2 .- N S. R. No.
Location ................................................. ............ ...?1
c .. ..1.................................................................................
.................................................................................................•---.--.. S. R. tt ............
Water Supply: Private ( ) Public (y) Mobile Home Park
HOUSE( ) MOBILE HOME (y) BUSINESS
NO. BEDROOMS ..._.__. ................ NO. BATHROOMS.-...> . .............. ....
Suitable( ) ` ProvSuitable
.
Locate Tank and Lines feet from well: .......... .....1 ??. ..
.....................

Size of Septic Tank:
_ .
gallons
Nitrific ti' Lines:
f mi
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? 7?b.
. square feet
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Comments: ............. .
..........
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...' ............. ........................................... ..•----......._•---•-•--•-..
Certificate of CWpletion By:
v
Date: ..................... .`QZ 5.-
'THIS DOES NOT CONSTITUTE A WARRANTY OR GUARANTEE
,EN G. DUNN CO. / 43632
..............................................................................•-••---... _.. --•------
`
IMPROVEMENTS PERMIT B ...._
Date: .................•-i - \3 t.....-•---••---•-------........................................
._...._.........._ .
PERMIT VALID FOR THREE VICARS