20130256 Ver 1_401 Application_20130313

Quible
Quible & Associates, P.C.
ENGINEERING • ENVIRONMENTAL SCIENCES • PLANNING • SURVEYING
SINCE 1959
Roberto Scheller
NC Division of Water Quality
943 Washington Square Mall
Washington, NC 27889
March 8, 2013
RE: Lot 29 Pamlico Point
Ocracoke, Hyde County, North Carolina
Nationwide 18 and 401 Certification
Mr. Scheller,
2 0 1 3 0 2 5 6
P.O. Drawer 870
X ft Hawk, NC 27949
Phone: [phone]
Fax- 252 -261 -1260
Web qulble com
Enclosed is a Nationwide 18 and 401 Water Quality Certification submission for 0.90 acres of
Section 404 wetland impacts associated with a single family residential homesite. A septic
system to serve the lot will be installed on Lot 29 as shown on the site plan and as permitted by
Hyde County Health Department (See attached permit).
Enclosed is the following (5 copies):
• Agent Authorization Statement
• Site Plan
• PCN Application
• Confirmed Section 404 Wetland Delineation
• USGS Vicinity Map
• Check and Copy of the $240 Processing Fee Check to NCDENR
• NCEEP Acceptance Letter
• Copy of the Hyde County on -site wastewater system Improvement Permit
Please review and process this permit request. If you have any questions or require additional
information, please contact me at (252) 261 -3300.
Sincerely,
Quible & Associates, P.C.
qyWW4
Brian Rubino
CC: William Wescott, USACE
ftmj
waR' 4 zo�3

March 5, 2013
RE: Lot 59 Pamlico Point
A Portion of Beachside Extension
Ocracoke, Hyde County, North Carolina
As owner of the above referenced property, I authorize Quible & Associates, P.C. ( Quible) to act
as authorized agent for the purpose of environmental permitting, including USACE and DWQ
permits if necessary.
� 6 1/ t
Authorized Signature
Name: jkr—c / /'U
` � Date y
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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.0 November 2008
Pre - Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the
Corps:
®Section 404 Permit El Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 18 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps?
FEI Yes
® No
1d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
le. Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
❑ Yes ® No
For the record only for Corps Permit:
❑ Yes ® No
1f. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in -lieu
fee program.
® Yes
❑ No
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
® Yes
❑ No
1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
[]Yes
® No
2. Project Information
2a. Name of project:
Lot 59 Pamlico Point
2b. County:
Hyde
2c. Nearest municipality / town:
Ocracoke
2d. Subdivision name:
Pamlico Point, a portion of Beachside Extension
2e. NCDOT only, T.I.P. or state
project no:
3. Owner Information
3a. Name on Recorded Deed:
Plymouth Ventures, LLC
3b. Deed Book and Page No.
DB 2.54/ PG 858
3c. Responsible Party (for LLC if
applicable):
WA
3d. Street address:
P.O. Box 369 - W s
Z Branch
3e. City, state, zip:
Corolla, NC 27927
3f. Telephone no.:
252.261.3300
3g. Fax no.:
3h. Email address:
Page 1 of 11
PCN Form — Version 1.0 November 2008 Version

Section A. Applicant Information, continued
4. Applicant Information (if different from owner)
4a. Applicant is:
® Agent ❑ Other, specify:
4b. Name:
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no::
4g. Fax no.:
4h. Email address:
5. Agent(Consultant Information, (if applicable)
5a. Name:
Brian Rubino
5b. Business name
(if applicable):
Quible & Associates, P.C.
5c. Street address:
P.O. Drawer 870
5d. City, state, zip:
Kitty Hawk, NC 27949
5e. Telephone no.:
(252) 261 -3300
5f. Fax no.:
(252) 261 -1260 °
5g. Email address:
[e-mail]
Page 2 of 11
PCN Form — November 2008 Version

B. Project Information and Prior Project History
1. Property Identification
1a.. Property identification no. (tax PIN or parcel ID):
PRN 13233
1 b. Site coordinates (in decimal degrees):
35.1069'N - 75.9700W
1c. Property size:
0.15 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
Pamlico Sound
proposed project:
2b. Water Quality Classification of nearest receiving water:
SA
2c. River basin:
Tar - Pamlico
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
Single Family Residential. Nearby properties include single family residential homesites and undeveloped wetlands and
uplands.
3b. List the total estimated acreage of all existing wetlands on the property:
0.15 ac.
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
0
3d. Explain the purpose of the proposed project:
The purpose of this wetland impact permit request is for minor wetland fill impacts associated with the fill of 0.09 acres of
non - riparian Section 404 wetlands for a residential homesite. The on -site septic treatment system will be located on Lot
29 as permitted by Hyde county Health Dept. (see emclosed Improvement Permit).
3e. Describe the overall project in detail, including the type of equipment to be used:
Proposed building construction and associated grading will require minor wetland impacts. Equipment will include
backhoe, dump trucks and compactors.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
® Yes ❑ No ❑ Unknown
project (including all prior phases) in the past?
4b. If the Corps made the jurisdictional determination, what type
E] preliminary Final
ry
of determination was made?
4c. If yes, who delineated the jurisdictional areas?
Agency /Consultant Company: Josh Pelletier, US Army
Name (if known): Quible & Associates, P.C.
Corps of Engineers
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
See attached information
5. Project History
5a. Have permits or certifications been requested or obtained for
[:1 Yes ® No ❑ Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project?
❑ Yes ® No
6b. If yes, explain.
Page 3 of 11
PCN Form — Version 1.0 November 2008 Version

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
® Wetlands ❑ Streams - tributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
2b.
2c.
2d.
2e.
2f.
Wetland impact
Type of jurisdiction
number —
Type of
Type of wetland
Forested
(Corps - 404, 10
Area of impact (acres)
Permanent (P) or
impact
(if known)
DWQ — non -404, other)
Temporary
W1 ®P [IT
fill
shrub- forested
404/
❑ Yes ® No
® Corps
®DWQ
-
0.09
non - riparian
W2 ❑ P ❑ T
❑ Yes ❑ No
❑ Corps
❑ DWQ
W3 ❑ P [IT
❑ Yes ❑ No
❑ Corps
❑ DWQ
W4 ❑ P [IT
❑ Yes ❑ No
❑ Corps
❑ DWQ
W5 ❑ P ❑ T
❑ Yes ❑ No
❑ Corps
❑ DWQ
W6 ❑ P ❑ T
❑ Yes ❑ No
❑ Corps
❑ DWQ
2g. Total wetland impacts
0.09
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
3b.
3c. )
3d.
3e.
3f.
Stream impact
Type of
Stream name
Perennial (PER) or
Average stream width (feet)
Impact
number -
impact
intermittent (INT)?
length
Permanent (P) or
(linear feet)
Temporary (T)
S1 ❑ P ❑ T
❑ PER ❑ INT
S2 ❑ P ❑ T
❑ PER ❑ INT
S3 ❑ P ❑ T
❑ PER ❑ INT
S4 ❑P
[I PER [I INT
S5 ❑P
❑PER ❑INT
S6 ❑P
PER ❑INT
3g. Total stream and tributary impacts
3h. Comments:
Page 4 of 11
PCN Form — Version 1.0 November 2008 Version

C. Proposed Impacts Inventory, continued
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all o en water impacts below.
4a.
4b.
4c.
4d.
4e.
Open water
Name of
impact number
waterbody
Type of impact
Waterbody type
Area of impact (acres)
— Permanent
(if
(P) or
applicable)
Temporary
01 ❑P ❑T
02 ❑P ❑T
03 ❑P ❑T
04 ❑P ❑T
M. Total open water impacts
4g. Comments:
Page 5 of 11
PCN Form — November 2008 Version

C. Proposed Impacts Inventory, continued
5. Pond or Lake Construction
If Pond or lake construction pro osed, then complete the chart below.
5a.
5b.
5c.
5d.
5e.
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or
(acres)
number
purpose of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
,
5f. Total
5g. Comments:
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWO)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then ou MUST fill out Section D of this form.
6a.
❑ Neuse ❑ Tar - Pamlico ❑ Other:
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b.
6c.
6d.
6e.
6f.
6g.
Buffer impact
number —
Reason
Buffer
Zone 1 impact (square
Zone 2 impact
Permanent (P)
for impact
Stream name
mitigation
feet)
(square feet)
or Temporary
required?
131 ❑P ❑T
❑Yes 0 N
B2 ❑ P ❑ T
❑ Yes ❑ No
B3 ❑P ❑T
El Yes No
6h. Total buffer impacts
6i. Comments:
Page 6 of 11
PCN Form — November 2008 Version

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Fill will be sloped and stabilized; septic system is located in natural uplands.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Silt fencing to be maintained until disturbed area is stabilized with grass.
J
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State?
® Yes ❑ No
2b. If yes, mitigation is required by (check all that apply):
❑ DWQ ® Corps
2c. If yes, which mitigation option will be used for this
project?
❑ Mitigation bank
®Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter)
FType
Quantity
3c. Comments:
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
® Yes
4b. Stream mitigation requested:
linear feet
4c. If using stream mitigation, stream temperature:
warm, cool, cold
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested:
acres
4f. Non - riparian wetland mitigation requested:
0.09
acres
4g. Coastal (tidal) wetland mitigation requested:
acres
4h.. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 7 of 11
PCN Form — Version 1.0 November 2008 Version

D. Impact Justification and Mitigation, continued
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWO
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation?
❑ Yes ® No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
Zone
Reason for impact
Total impact
(square feet)
Multiplier
Required mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1.5
Total buffer mitigation required:
6c. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund).
6d. Comments:
Page 8 of 11
PCN Form — November 2008 Version

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included?
❑ Yes ❑ No
2. Determination if the Project Requires a Stormwater Management Plan
2a. Does the project require a Non -404 Jurisdictional General Permit?
❑ Yes ® No
2b. Is the project subject to General Certification 3704 or 3705?
❑ Yes ® No
3. Determination of Stormwater Review Jurisdiction
3a. Is this project subject to any of the following state - implemented stormwater
® Coastal counties
management programs (check all that apply)?
❑ HOW
❑ ORW
If so, attach one copy of the approval letter from the DWO and one copy of the
❑ Session Law 2006 -246
approved stormwater management plan.
❑ Other:
3b. In which local governments jurisdiction is this project?
Hyde County
3c. Is this local government certified to implement a state stormwater program?
❑ Yes ® No
If so, attach one copy of the approval letter from the local government and one copy
of the approved stormwater management plan (or one copy of the approved
Stormwater management plan stamped as approved).
4. Information Required for DWQ 401 Unit Stormwater Review
4a. What is the overall percent imperviousness according to the most current site Ian?
< 25 % at max. build out
4b. Does this project contain any areas that meet the criteria for "high density" per
❑ Yes ® No
General Certifications 3704 and 3705?
4c. If the site is over 24% impervious and/or contains high density areas, then provide a brief narrative description of the
stormwater management plan.
4d. Has a completed BMP Supplement Form with all required items been submitted
❑ Yes ® No
for each stormwater BMP?
Page 9 of 11
PCN Form — Version 1.0 November 2008 Version

F. Supplementary Information
1. Environmental Documentation (DWO Requirement)
1 a. Does the project involve an expenditure of public (federal/state/local) funds or the
❑ Yes ® No
use of public (federal/state) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes ❑ No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c. If you answered `yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
❑ Yes ❑ No
letter.)
Comments:
2. Violations (DWO Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
❑ Yes ® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after- the -fact permit application?
❑ Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWO Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes ® No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
4. Sewage Disposal (DWO Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non- discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
An on -site septic treatment system will be installed to serve the homesite (see Hyde County Improvement Permit).
Page 10 of 11
PCN Form — Version 1.0 November 2008 Version

F. Supplementary Information, continued
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
❑ Yes ® No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ® No
impacts?
❑ Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted.
❑ Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NC Natural Heritage Program
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
Mapping data and field investigation; proposed impact area is not within an area of surface waters.
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
❑ Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
National Register of Historic Places
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA- designated 100 -year floodplain?
® Yes ❑ No
8b. If yes, explain how project meets FEMA requirements: This type of fill is allowable with permit in AE zones.
8c. What source(s) did you use to make the floodplain determination? NFIP Flood Zone Maps (www.ncfloodmaps.com)
Applicant/Agent's Printed Name
Applicant/Agent's Signature
(Agents signature is valid only if an authorization letter from the applicant
Date
Is provided.)
Page 11 of 11
PCN Form — November 2008 Version

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Copyright (C) 1998, Maptech, Inc.

1864
QUIBLE -& ASSOCIATES P.C.
P.O BOX 870 ;
KITTY HAWK, NC 27949 66. 456.531
(252) 261 -3300 _
(� � DATE
PAY
TO THE E 1 �/ 6?M
ORDER OF -
W 6 y G DOLLARS u
FIRST BANK_.
FOR
- 11'0000 186411' - 15M53 i04568111:. 11310004 1111'

Y
.Ecosystem
3:,� .~r 1, as
PROGRAM
March 5, 2013
Plymouth Ventures, LLC
PO Box 369
Corolla, NC 27927
Project: Pamlico Point Lot 59
Expiration of Acceptance: September 5, 2013
County: Hyde
The purpose of this letter is to notify you that the North Carolina Ecosystem Enhancement Program (NCEEP) is willing to accept
payment for compensatory mitigation for impacts associated with the above referenced project as indicated in the table below. This is
a conditional acceptance. Please note that this decision does not assure that participation in the NCEEP will be approved by the
permit issuing agencies as mitigation for project impacts. It is the responsibility of the applicant to contact these agencies to determine
if payment to the NCEEP will be approved. You must also comply with all other state, federal or local government permits,
regulations or authorizations associated with the proposed activity including SL 2009 -337: An Act to Promote the Use of
Compensatory Mitigation Banks as amended by
S.L. 2011 -343.
This acceptance is valid for six months from the date of this letter and is not transferable. if we have not received a copy of the
issued 404 Permit/401 Certification /CAMA permit within this time frame, this acceptance will expire. It is the applicant's
responsibility to send copies of the permits to NCEEP. Once NCEEP receives a copy of the permit(s) an invoice will be issued based
on the required mitigation in that permit and payment must be made prior to conducting the authorized work. The amount of the In-
Lieu Fee to be paid to NCEEP by an applicant is calculated based upon the Fee Schedule and policies listed at www.nceep.net.
Based on the information supplied by you in your request to use the NCEEP, the impacts that may require compensatory mitigation are
summarized in the following table. The amount of mitigation required for this impact is determined by permitting agencies.
in Tar - Pamlico 03020105 or 03020104. Upon receipt of payment, EEP will take responsibility for providing the compensatory
mitigation. The mitigation will be performed in accordance with the N.C. Department of Environment and Natural Resources'
Ecosystem Enhancement Program In -Lieu Fee Instrument dated July 28, 2010.
Thank you for your interest in the NCEEP. If you have any questions or need additional information, please contact Kelly Williams at
(919) 707 -8915.
Sincerely,
onne Klimek
cting Director
cc: Karen Higgins, NCDWQ Wetlands/401 Unit
William Wescott, USACE - Washington
Roberto Scheller, NCDWQ-
Doug Huggett, NCDCM - Morehead City
Brian Rubino, agent
File
Restor U11t9... E .. Pro" OW St &
North Carolina Ecosystem Enhancement Program, 1652 Mail Service Center, Raleigh, NC 27699 -1652 / 919 - 919 - 707 -8976 / www.nceep.net
River
CU
Stream (feet)
Wetlands (acres)
Buffer I
Buffer 11
Basin
Location
(Sq. Ft.)
(Sq. Ft.)
Cold
Cool
Warm
Riparian
Non-Riparian
Coastal Marsh
Impact
Tar-
03020104
0
0
0
0
0.09
0
0
0
Pamlico
or
03020105••
* *EEP
can accept
payment if permitting agencies approve the use of the Small Impacts Policy for the mitigation
to be provided
in Tar - Pamlico 03020105 or 03020104. Upon receipt of payment, EEP will take responsibility for providing the compensatory
mitigation. The mitigation will be performed in accordance with the N.C. Department of Environment and Natural Resources'
Ecosystem Enhancement Program In -Lieu Fee Instrument dated July 28, 2010.
Thank you for your interest in the NCEEP. If you have any questions or need additional information, please contact Kelly Williams at
(919) 707 -8915.
Sincerely,
onne Klimek
cting Director
cc: Karen Higgins, NCDWQ Wetlands/401 Unit
William Wescott, USACE - Washington
Roberto Scheller, NCDWQ-
Doug Huggett, NCDCM - Morehead City
Brian Rubino, agent
File
Restor U11t9... E .. Pro" OW St &
North Carolina Ecosystem Enhancement Program, 1652 Mail Service Center, Raleigh, NC 27699 -1652 / 919 - 919 - 707 -8976 / www.nceep.net

HYDE COUNTY HEALTH DEPARTMENT
P.O. BOX 100 SWAN QUARTER, NC 27M
1100 MAIN ST.
IMPROVEMENT PERMIT
Permit No: 22713 -1 Dabs: February 27, 2013
Pw=ktee: 3WS Development, LLC
Address: 111 St. Clair Road, Nil Devil Hilis, NC 27948
Phone No.: ,(252) 202 -3800
Properly Location: Lot #29 & 59 Beachside Extension, Oamx*e
Facilities To Be Served: 2 bedroom house (Lot 29), Swimming Pool Bath House
(Lot 29)
Water Supply: community
"Wastewater Flow GPD: 480 gpd
Wastewater System Type: Va,1WWS- 98 -1 -R3, Puraflo Peat BioNlber, Type A
Wastewater SWUrn Repair Type: Some
Lang Term Acceptance Rate: 1.0 gpd /sq.ft.
Absorptlon Area: 360 sq.ft. (25% reduction)
Raw Sewage Lit Station: Cam as per rule .1952(e)
Septic Tank Capacity: 1500 gallons with Zabel A -300 filter
Pump Tank Capacity: 1000 gallons minimum
Bioflber gravel disposal pad bottom depth: 0" below the naturally occurring soil
Surface: The area where the disposal pad are located shall be excavated
down to a depth to remove all existing non -soil materials and compacted
sand. Clean sand fill shall be-brought In to restore to the original elevation
prior to installing the wastewater systsm.

IMPROVEMENT PERMIT
JWS DEVELOPMENT,LLC
PAGE 2
1. Plans and specifications for the wastewater system shall be submitted to the
Hyde County Health Department for a TS -I pretreatment system. The Plans
and specifications shall be prepared by a registered professional engineer
and his /her seal affixed to the submittal.
2. The plans and specifications shall contain Information necessary for
conduction of the system in accordance with the applicable rules and laws,
the system approval, and section .1938(1)(1.7) of the Laws and Rules For
Sewage Treatment and Disposal Systens.
3. Prior to the installation of the wastewater system, an on -site pre-
oonsbuction conference shall be held and attended by the Installer, Hyde
County Health Department and the owner or owner's a epresentadve.
During this conferwroe the wastewater system shall be staked out on the lot.
4. All setbacks shall be measured from a point W from the nearest edge of the
gravel support pad.
5. The manufacturer's field representative shall provide written confirmation of
their acceptance of the system installation prior to Operation Permit
Issuance.
6. The installer shall co- ordinate with the Hyde County Health Department and
design engineer In pertbrrning the 24 hour water tightness test on the pump
tank and septic tank.
7. "The estimated life of the peat media is currently 15 years. The media may
need to be replaced, in part or in full, in order to maintain specified
treatment standards."
8. Use water conserving fixtures Le. 1.6 gallon flush toilets, 2 gpm shower
heads,1 gpm all lavatories. Try to spread laundry loads out during the week.
Do not pour grease or harsh chemicals hrto the house drains.
9. This permit does not circumvent any other permits required by other
age for filling a0vities.

IMPROVEMENT PERMIT
3WS DEVELOPMENT, LLC
PAGE 3
CONDITIONS (CONTD.)
10. Prior to the Issuance of the Operation Permit, the owner shall submit to the
Hyde County Health Department a statement signed by the design engineer
stating that cow is complete and in accordance with the approved
plans and specifications and approved modifications. Periodic observations
of construction and a final Inspection for design compliance by the design
engineer or his /her representative shall be required for this statement. The
statement shall be affixed with the design engineer's seal.
11. Note the PME requirements. Prior to the Issuance of the Operation Permit, a
contract with a North Carolina certified subsurface operator who is also
certified by ANUA shall be executed and a copy submitted to the Hyde
County Health Department as per the PME requirements.
12. An Autlrorization to Consbvct will be Issued upon final approval of the
submitted plans and spedficaions and the initial site modifications.
************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
This Improvement Permit shall be valid:
WITHOUT EXPIRATION
upon a showing satisfactory to the Department or the local health department that
the site and soil conditions are unaltered, that the facility, design wastewater flow,
and wastewater characteristics are not increased, and that a wastewater system
can be Installed that meets the permitting requirements In effect on the date this
permit was Issued. This permit is subject to revocation if site plans or the
Intended use changes.
Authorized
Emrirof inntal Health Soeciallst
Hyde County Health Department

Q:\ 2006 \PO6107 \Drawings \PO6107 -NAT18 -LOT 59.dwg 3/5/2013 11:28 AM Tommy Stokely
NOTES.
1. OWNER: PLYMOUTH VENTURES, L.L.C.
P.0 BOX 369
COROLLA, NC 27927
2. BOUNDARY & LOT INFORMATION SHOWN ON THESE PLANS TAKEN FROM
SURVEY BY MESA PROFESSIONAL CORPORATION: SIGNED AND DATED BY W.L.
NORRIS, JR. ON 10/08/06 FOR GEORGE BLACKBURN WARNER & ELIZABETH
ANN WARNER. FILE NO.:0600132
3. TOPOGRAPHIC AND EXISTING PHYSICAL FEATURE INFORMATION PROVIDED BY
BARNETTE INTEGRATED LAND DEVELOPMENT; SIGNED AND DATED 6/7/11 BY
MARTIN BARNETTE FOR PAMLICO POINT. ELECTRONIC FILE #:
3261 AOA- FROMBILD- 2011- 06- 17,DWG
4 THE SECTION 404 WETLANDS LINES SHOWN ON THESE PLANS HAVE BEEN
CONFIRMED BY US ARMY CORPS OF ENGINEERS
LEGEND
Y Y Y I DOS7ING 404 WETLANDS
PROPOSED 404 WETLANDS FILL (3,935 SQ.FT 0.090 AC.)
P .01-0 SokNo
I VIMWY MAP KM1
N.T.S.
64 \ Y y �5 Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y' ` Y Y - Y I - Y
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Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
Y Y Y Y Y Y Y Y Y y Y Y
Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y y y
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y Y y y 3,935 SQ.FT. (0.090 AC.) Y Y
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AW
4 *r :..•.: itt; y ::::� w ::k: [; Y OF WETLANDS PROPOSED Y Y Y
•,'ir•w • • .: + : •w; Y TO BE FILLED Y Y Y Y Y Y
MEB*MS EXISTING 404 I •.�•'��''. ;�:•. ;u::.' �at'• ••w;•:•" Y Y Y Y Y y Y Y Y Y
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- - - -- - - - -- 0i 0.00,
-------------------- 1t
127
26
2q
IVE. 4 PURAFLO
T UNITS (TYPE A)
360 SQ.FT, 480 GPD
EA RMUC71ON U71UZE
CENTRAL DRIVE
30,"( INFROVED)
/
/
/
/
3/
IPARKING I /
THIS MAP IS NOT A CERTIFIED SURVEY
I �—
/
1 /
I'
AND HAS NOT BEEN REVIEWED BY A
LOCAL GOVERNMENT AGENCY FOR
--' -- __--- ///
NC HlNY 12
COMPLIANCE WITH ANY APPLICABLE
LAND DEVELOPMENT REGULATIONS.
PROJECT
QUIBLE &RASSOCIATES, P.C.
PLYMoUN VEffM= I+IX - NA770"WE IS
8107
THIS DOCUMENT IS THE PROPERTY OF QUIBLE
& ASSOCIATES, P.C. ALL RIGHTS ARE
RESERVED. ANY REPRODUCTION OF THIS OR
Quible SINCE 1959
LOT 59
DRAWN BY
�, D
ssociates, P.C.
TA$
POSSESSION WITHOUT PRIOR PERMISSION OF
QUIBLE &ASSOCIATES, P.0 WILL CONSTITUTE
p/Af * �y,KGo po�'l'
VIOLATION OF COPYRIGHT LAWS. VIOLATION
WILL BE SUBJECT TO LEGAL ACTION
ENGINEERING • CONSULTING • PLANNING
CHECKED BY
OCRACOKE HYDE COUNTY
ENVIRONMENTAL SCIENCES ' SURVEYING
J SL
IF THIS PLAN OR PLAT IS NOT SIGNED AND
SEALED BY A LICENSED PROFESSIONAL THEN
THIS PLAN OR PLAT SHALL BE CONSIDERED
PRELIMINARY
NORTH CAROLINA
NC License#: C -0208
PO Drawer 870, Kitty Hawk, INC 27949
DATE
0 30 60
AND NOT A CERTIFIED DOCUMENT
Phone: [phone]
llw� 3 -4 -13
AND SHALL NOT BE USED FOR CONSTRUCTION,
RECORDATION, SALES OR LAND CONVEYANCES.
GRAPHIC SCALE IN FEET 1 ra30
Fax: [phone]
E -Mail: administrator®quible.com