20110253 Ver 1_General Major Variance_20110316

11-0)-53
OFFICE USE ONLY: Date Received __..... Request #
MAR 16 2011
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 Bt ffer- Protection Rules fbr resicler?liul structur°c:'s
oti existing lots within the coastal cortnties as defined b-v the Coastal Area Managerr enl Act
(ns approwd 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)
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, 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. Applicant'is na
2. Print Owner/Si(
Name:
Title:
Street address:
City, State, Zip:
Telephone:
Fax:
on, individtaal, etc.,who owns the
Ining Official (person legally responsibl for
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and its comp
3. Contact person who can answer g4?stions ab ut the proposed project:
Name: rr,Lt?.r`?0_ ?_ C_
Telephone: 7._ .
Fax: k `! C 1
Email:
"General" Variance Application Form
Version 1: May 2001
4. Project Name (Subdivision, facility, or establishment name - consistent with project name on
p a specifications I tter , o er ion and maintenance agreements, etc.),.
5. Project Location:
Street address:
City, State, Zip: d
Count
Latitude/longitude: w _,1??__?I(,L__.
6. Directions to site from nearest major intersection (Also, attach an 8'/2 x 11 copy of the portion
okthe USGS topographic map indicating the lgcation of t?l e Site): / I
7. Stream to be impacted by the proposed activity: v
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 Certific2tion/404 Permit
On-site Wastewater Permit
Active Connection to Sanitary Sewer Systern
NPDES Permit (including stormwater)
Non-discharge Permit
Water Supply Watershed Variance
........_...._......__.._...._..
Others (specify) ,._.....w_ ................_............
Part 2: Proposed Activity
(Please include attachments 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
2
"General" Variance Application Form, page 2
Version 1: May 2001
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,
C V?
4
(3) If economic hardship is the major consideration, then include a specific explanation of th6
e no is hardships and the proportion of the hardship to the entire value f the project
,?M ?J.

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 (ind
Mailing address:
City, State, Zip:
Telephone:
"General" Variance Application Form, page 3
Version 1: May 2001
Please provide an explanation of the following:
(1) The practical difficulties or hardships that would result from the strict application of this
R le. zz
`?`?1.1.7 ?> n f ? -5 ;? ?-? i3 :. i.. ;'"1 ? C )r' - ?,= r : ('? ! Z'l Gt... [? 1 T. _" V 'C?91 ? _Lr I -? ._ .? _..?.. _..
(2) How these difficulties or hardships result from conditions that are unique to the property
Fax:
Email:
Part 5: Applicant's Certification
(print or type name of person
listed in art 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:
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"General" Variance Application Form, page 4
Version 1: May 2001
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239 r?cE294
'I
NORTH CAROLINA
PAMLICO COUNTY OTTER CREEK RESTRICTIVE COVENANTS
KNOW ALL MEN BY THESE PRESENTS, that James K.
r
-.4
- L

Davis and wife, Dorothy B. Davis, of Oriental, Pamlico
County, North Carolina, hereinafter called 'Declarants," do,
hereby covenant and agree to and with all other persons,
firms or corporations now owning or hereafter acquiring as
owners any lot or parcel of land in the area designated or
located in or near the Town of Oriental, Pamlico County,
North Carolina, known as Lots 1 through 8 and 10 through 15,
as shown on map entitled PLAN OP OTTER CREEK SUBDIVISION,
dated June 6, 1986, and recorded in Plat Cabinet A, Slide
21-7 , of the Pamlico County Registry: said lots are hereby
subjected to the following covenants and restrictions and to
the use thereof, running with the land by whomsoever owned:
1. These covenants are to run with the land and
shall be binding on all parties and persons claiming under
them until January 1, 2006, at which time said covenants
shall be automatically extended for successive periods of
ten years unless by vote of a majority of the then owners of
the lots, it is agreed to change said covenants in whole or
in part. `
2. If the parties hereto or any of them or their
heirs, successors, or assigns, shall violate or attempt to
violate any of the covenants herein, it shall be lawful for
any other person or persons owning any real property situated
in said development or subdivision to prosecute any proceeding
at law or in equity against the person or persons violating
or attempting to violate any such covenants and either to
prevent him or them from so doing or to recover damages or
other dues for such, violation except the party of the first
part is specifically excluded from any liability for damages.
3. Invalidation of any one of these covenants by
judgment or court order shall in no wise affect any other of
the provisions which shall remain in full force and effect.
P.O. B.rSC 306
BAYBORO, N.C. 28515
A-?
IMPROVEMENT PERMIT
Owner.CHARELS H HOLTON III
Owner Address:187 LAUREN DRIVE
Owner Address(2):MERRITT NC 28556
Owner Phone #:[phone] In
Property Address:6108 HORTON RD
Property Address(2):ORIENTAL NC 28571
PIN:1092-11-5
Record #50882
Establishment Type:Home
Type of Well:Public Well
Design Flow (GPD):360
Initial Site
WASTEWATER SYSTEM: 25% REDUCTION'
Long Term Acceptance Rate(GPD/S(
Trench Width:3 FT
Trench Spacing (OC):9 FT
Trench Bottom From NGL:-12 IN 9
Septic Tank Volume: 1000 GAL
Repair Site
WASTEWATER SYSTEM: 25% REDUCTION
Long Term Acceptance Rate(GPD/S
Trench Width:3 FT
Trench Spacing (OC):9 FT
Trench Bottom From NGL'-12 IN
Septic Tank Volume: 1000 GAL
40.00 feet
1:480

AN AUTHORIZATION TO CONSTRUCT MUST BE OBTAINED AND
ALL FEES PAID PRIOR TO WASTEWATER SYSTEM INSTALLATION.
THE PAMLICO CO. HEALTH DEPARTMENT RESERVES THE RIGHT
TO REVOKE THIS PERMIT IF THE SITE IS ALTERED, INTENDED
USE CHANGED, OR ANY INFORMATION IS FALSIFIED.
ANY CHANGES TO THIS PERMIT WILL REQUIRE A REDESIGN
PERMIT AND SUBSEQUENT FEE.
Authorized Agent: q ""u""b 1%97 Date 613/2003
CHAMBERED SYSTEM WITH SHALLOW PLACEMENT
(Not to Scale)
PIN:1092-11-5
Record #:50882
Line Length:56'
Number of Lines:4
Sectional View
12 - except in send where IfIr are required from seasonal high wetness condition
Native Soil
Soil with unsuitable properties
SuZ'i?fl? 5 C PA.Z12
PiN:1092-11-5 GRAVITY FED SYSTEM
Record #:50882 (Not to Scale)
Line Length-5&
Number of Lines:4
Side vew
Supply Line Lateral (Ma)imum flail of 1- on 40 ft)
(Minimum fall of 1- in 8 feet) i
r? Oftowa FEW 0
Septic Tank Dislnbution Box Nitrification Field
Oriental Topographic Map I Lat 35.104°N Long -76.6362°W Elevation 23 Feet I Zoom 15... Page 1 of 2
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0 Ioouod Auo 13 2003
r #60.00 FILED in PAMLICO County. NC
?t.t• •t PAMLICO on Au# 13 2003 at 0308:03 PM
North C8rolina County by. SIDE H. WHITFORD
Real Est at o Excise Tax REGISTER OF DEEDS
BOOK 406 PAGE 16
NORTH CAROLINA
PAMLICO COUNTY WARRANTY DEED
THIS WARRANTY DEED, made and entered into this 11th day
of August, 2003, by and between JAMES K. DAVIS and wife, DOROTHY
B. DAVIS, hereinafter called "grantors", and CHARLES H. HOLTON,
III and wife, DINA A. HOLTON, Post Office Box 811, Oriental,
North Carolina 28571, hereinafter called "grantees";
W I T N E S S E T H:
That grantors, for and in consideration of the sum of
ten dollars and other good and valuable considerations to them in
hand paid, the receipt of which is hereby acknowledged, have
bargained and sold, and by these presents do bargain, sell and
convey to the said Charles H. Holton, III and wife, Dina A.
Holton and their heirs and assigns, a certain lot or parcel of
land in Number Five (5) Township, Pamlico County, North Carolina,
particularly described as follows:
Lot Number Five (5) as shown on the map prepared by A.
Hugh Harris, Jr., PE-RLS, dated June 6, 1986, recorded
in Plat Cabinet A, Slide 21-7, Pamlico County Registry,
entitled "PLAN OF OTTER CREEK SUBDIVISION".
Said lot also being shown on a survey and map prepared
by Herbert J. Nobles, Jr., Registered Land Surveyor,
dated April 28, 2003, entitled "SURVEYED FOR CHARLES
HOLTON", copy of which is attached hereto and
incorporated herein by reference.
Said lot is conveyed subject to Restrictive Covenants
dated July 8, 1986, recorded in Book 239 at page 294,
Pamlico County Registry, as amended by instrument dated
December 9, 1986, recorded in Book 242 at page 227,
said registry, and to the Subdivision Street Disclosure
Statement dated July 8, 1986, recorded in Book 239 at
page 291, said registry.
AETURNED TO ? Prepared by HOLLOWELL & HOLLOWELL, LLP
Attorneys at Law
1?
3 Bayboro, North Carolina 28515
BOOK 406 PAGE 17
TO HAVE AND TO HOLD the aforesaid lot or parcel of
land, together with all privileges and appurtenances thereunto
belonging, to the said Charles H. Holton, III and wife, Dina A.
Holton and their heirs and assigns, in fee simple forever.
And grantors, for themselves, their executors and
administrators, covenant with grantees and their heirs and
assigns, that they are seized of said premises in fee; that they
have a perfect right to convey the same in fee simple; that the
same are free and clear of all encumbrances whatsoever; and that
they will warrant and defend the title to the same against the
lawful claims of all persons whomsoever.
IN TESTIMONY WHEREOF, grantors have hereunto set their
hands and adopted as their seals the typewritten word "SEAL"
appearing beside each name, the day and year first above written.
(SEAL)
(SEAL)
NORTH CAROLINA
PAMLICO COUNTY
J r
, a Notary Public in
and for said county and state, do hereby certify that JAMES K.
DAVIS and wife, DOROTHY B. DAVIS, each personally appeared before
me this day and acknowledged the due execution of the foregoing
instrument.
Witness my hand and notarial seal/stamp,
day of,,,% 2003.
a® ? + c y ma`?'
W
ary PL
06» C
MY??$?? moires 1/1
O""'o? cou"','O"
this the 1 r")
Prepared by HOLLOWELL & HOLLOWELL, LLP
Attorneys at Law
Bayboro, North Carolina 28515
BOOK 906 PAGE 1B
NORTH CAROLINA
PAMLICO COUNTY
The foregoing certificate of BERNARD B. HOLLOWELL, jRa
Notary Public in and for said count
be correct. Y and state, is certified to
SUE H. WHITFORD
Register of Deeds
By: '
Asst./ Register of Deeds

Prepared by HOLLOWELL & HOLLOWELI Up
Attorneys at Law
Bayboro, North Carolina 28515
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BOOK 906 PAGE 19
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