20131273 Ver 2_401 Application_20140314

Quible
Quible & Associates, PC
ENGINEERING • ENVIRONMENTAL SCIENCES • PLANNING • SURVEYING
SINCE 1959
March 4, 2014
Anthony Scarbrough
NC DENR DWR WQP
946 Washington Square Mall
Washington, NC 27889
Re Nationwide 18 Permit Request
{ gp
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Elwood Bower, Jr rTN
Lot 9 Broad Creek Estates
Scranton, Hyde County, North Carolina
Mr Scarbrough
P O Drawer 870
Kitty Hawk NC 27949
Phone 252 - 261 -3300
Fax 252 - 261 -1260
Web quble corn
Please find enclosed a Pre - Construction Notification form and associated documentation for a property currently
owned by Elwood and Jean Bower This property is located off of Sawyer Lane and Montgomery Road near
Scranton, Hyde County North Carolina
Please note, a Hyde County Health Department Permit and Authorization to Construct Permit have been issued
for this site for the purpose of constructing on single family dwelling (a copy of the permit #21814 -1 dated
February 18, 2014 is attached along with the approved engineered site plan showing the proposed system) The
requested fill is necessary for the installation of the wastewater system and proposed construction or installation
(owners may elect to use a travel trailer or modular home) of a hunting camp as shown on the attached
Nationwide 18 Fill Plan
The proposed mitigation plan is to preserve 1 0 acres of land currently in silviculture (see attached Mitigation
Proposal Site Plan) This will provide a preservation to impacts ratio of 10 1
Enclosed find the following
• USGS Vicinity Map
• Nationwide 18 Site Plan (with reduced size copy)
• PCN Application
• Agent Authorization Letter
• Area of Deed Restriction Exhibit
• Copy of Wastewater Permit #21814 -1 and Plat (with reduced size copy)
• Copy of the $240 Processing Fee Check to NCDENR
Please do not hesitate to contact the undersigned at 252 261 3300 if you have any questions or requests for
additional information
Sincerely,
M Associates, P C
*DE adus
cc Elwood Bower
Jennifer Burdette, NC DWR WQP (four copies)
William Wescott, USACE
file

Quible
Quible & Associates, PC
ENGINEERING • ENVIRONMENTAL SCIENCES • PLANNING • SURVEYING
SINCE 1959
March 4, 2014
William Wescott
US Army Corps of Engineers
2407 W 5th Street
Washington, NC 27889
Re Nationwide 18 Permit Request
Elwood Bower, Jr
Lot 9 Broad Creek Estates
Scranton, Hyde County, North Carolina
Mr Wescott
PO Drawer 870
Kitty Hawk NC 27949
Phone 252 - 261 -3300
Fax 252 - 261 -1260
Web qulble com
Please find enclosed a Pre - Construction Notification form and associated documentation for a property currently
owned by Elwood and Jean Bower This property is located off of Sawyer Lane and Montgomery Road near
Scranton, Hyde County North Carolina
Please note, a Hyde County Health Department Permit and Authorization to Construct Permit have been issued
for this site for the purpose of constructing on single family dwelling (a copy of the permit #21814 -1 dated
February 18, 2014 is attached along with the approved engineered site plan showing the proposed system) The
requested fill is necessary for the installation of the wastewater system and proposed construction or installation
(owners may elect to use a travel trader or modular home) of a hunting camp as shown on the attached
Nationwide 18 Fill Plan
The proposed mitigation plan is to preserve 1 0 acres of land currently in silviculture (see attached Mitigation
Proposal Site Plan) This will provide a preservation to impacts ratio of 10 1
Enclosed find the following
• USGS Vicinity Map
• Nationwide 18 Site Plan (with reduced size copy)
• PCN Application
• Agent Authorization Letter
• Area of Deed Restriction Exhibit
• Copy of Wastewater Permit #21814 -1 and Plat (with reduced size copy)
• Copy of the $240 Processing Fee Check to NCDENR
Please do not hesitate to contact the undersigned at 252 261 3300 if you have any questions or requests for
additional information
Sincerely,
Qulble A ociates, PC
Warren D Eadus
cc Elwood Bower
Jennifer Burdette, NC DWR WQP (four copies)
Anthony Scarbrough, NC DWR WQP
file

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NOTES
— DV00D5 GREEK \ - PROPERTY OWNER. ELWDDD BOWER. JR
\ \
1162 N BILACKWOOR DRI%`E
MURRELLS INLET SC
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\ - CONSULTANT OUIBLE • ASSOCIATES. PC.
I \ P 0 DRAWER 670
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- THIS PLAT IS NOT A CERTIFIED SURVEY AND SHOULD BE
n \ ` ` .W,� /y CONSIDERED PRELIMINARY BOUNDARY INFORMATION SHOWN ON THIS
!p PUT BY HOOD RICHARDSON P A AS RECORDED IN PC C. S.
'0� L (V If�f. • - PROPERTY IS LOCATED IN NFIP FLOOD ZONES AE (EL Y) AND
SUBJECT TO CHANGES BASED ON COMMUNITY CID NO 370133
PANEL 7622 ! 7624, SUFFIX d (NAP NUMBER 3720762400J k
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REVEALED BY A FULL AND ACOURATE TILE SEARCH
+,`. NOTE THIS PLAN IS PRELIMINARY AND FOR
NZ3'3L2TAYF DISCUSSION PURPOSES ONLY THIS PLAT
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RECORDATION, CONVEYANCES OR SALES
THIS MAP IS NOT A CERTIFIED SURVEY
AND HAS NOT BEEN REVIEWED BY A LOCAL
GOVERNMENT AGENCY FOR COMPLIANCE
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Corps action ID no
DWQ project no
Form Version 1 0 November 2008
Page 1 of 11
PCN Form — Version 1 0 November 2008 Version
Pre - Construction Notification (PCN) Form
A.
Applicant Information
1
Processing
1a
Type(s) of approval sought from the
Corps
® Section 404 Permit ❑ 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?
❑ Yes
® No
1 d
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
1e
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
1g
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 9 Broad Creek Estates
2b
County
Hyde
2c
Nearest municipality / town
Belhaven
2d
Subdivision name
Broad Creek Estates
2e
NCDOT only, T I P or state
project no
Q
6 1,14
3
Owner Information
iPa�
3a
Name on Recorded Deed
Elwood Bower, Jr
3b
Deed Book and Page No
3c
Responsible Party (for LLC if
applicable)
Elwood Bower, Jr
3d
Street address
1169 Blackmoor Drive
3e
City, state, zip
Murrells Inlet, SC 27576
3f
Telephone no
(843) 650 -8547 — Home
(843) 424 -2633 — Cell
3g
Fax no
3h
Email address
woodybower @live com
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
4o
City, state, zip
4f
Telephone no
4g
Fax no
4h
Email address
5.
Agent /Consultant Information (if applicable)
5a
Name
Warren D Eadus
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 j
(252) 261 -1260
5g
Email address
weadus @quible com
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)
7633 -19 -9861
1b Site coordinates (in decimal degrees)
36 0681566'N - 75 7389457'W
1c Property size
50 24 acres
2 Surface Waters
2a Name of nearest body of water (stream, river, etc ) to
proposed project
Pungo River AIWW
2b Water Quality Classification of nearest receiving water
SA
2c River basin
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
Undeveloped timber land and single family estates
3b List the total estimated acreage of all existing wetlands on the property
49 71 ac
3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property
Approx 2100 linear feet of shoreline along Woods Creek (tributary to Pungo)
3d Explain the purpose of the proposed project
The impacts are requested to allow for the construction of one single family residence /hunting camp and in accordance
with the issued Hyde County Health Department Wastewater Permit
3e Describe the overall project in detail, including the type of equipment to be used
Proposed residential building construction and associated grading will require 0 10 acres of wetland impacts Equipment
includes bulldozers, backhoes and dump trucks (and other conventional equipment as necessary)
4 Jurisdictional Determinations
4a Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
® Yes ❑ No ❑ Unknown
4b If the Corps made the jurisdictional determination, what type
of determination was made?
❑ Preliminary ® Final
ry
4c If yes, who delineated the jurisdictional areas?
Name (if known) Warren Eadus
Agency /Consultant Company Quible & Associates, P C
Other
4d If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
SAW 2013 -01867 Jurisdictional Dertimination by William Wescott, USACE
5. Project History
5a Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
❑Yes ® No ❑ Unknown
5b If yes, explain in detail according to "help file" instructions
NA
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
1a 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 T
W1 ® P ❑ T
fill
Scrub
Shrub /Managed
® Yes ❑ No
® Corps
® DWQ
010
Pine
W2 ❑ P ❑ T
❑ Yes ❑ No
❑ Corps
❑ DWQ
W3 ❑ P ❑ T
❑ Yes ❑ No
❑ Corps
❑ DWQ
W4 ❑ P ❑ T
❑ Yes ❑ No
❑ Corps
❑ DWQ
W5 ❑ P ❑ T
❑ Yes ❑ No
❑ Corps
❑ DWQ
W6 ❑ P ❑ T
❑ Yes ❑ No
❑ Corps
❑ DWQ
2g Total wetland impacts
010
2h Comments None
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 ❑ T
❑ PER ❑ INT
S5 ❑ P ❑ T
❑ PER ❑ INT
S6 ❑ P ❑ T
❑ 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 (T)
01 ❑P ❑T
02 ❑P ❑T
03 ❑P [IT
04 ❑P ❑T
4f 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 proposed, then complete the chart below
5a
5b
5c
5d
5e
Pond ID
Proposed use or
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
number
purpose of pond
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
Sf. Total
5g Comments
5h Is a dam high hazard permit required
❑ Yes ❑ No If yes, permit ID no
51 Expected pond surface area (acres)
5j Size of pond watershed (acres)
5k Method of construction
6 Buffer Impacts (for DWQ)
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 you 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?
T
B1 ❑P ❑T
El Yes [:1 No
B2 ❑ P ❑ T
❑ Yes ❑ No
B3 ❑P ❑T
El Yes [:1 No
6h Total buffer impacts
61 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 in accord with common best management practices
1b 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 grasses
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
El 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)
Type
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
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
A deed restriction will be placed on an acre of forested wetlands (non - coastal at a 10 1 ration preservation to impacts) in
the general location as shown on the attached exhibit
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 DWQ
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
la
Does the project include or is it adjacent to protected riparian buffers identified
Yes No
within
within one of the NC Riparian Buffer Protection Rules
lb
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)?
❑ HQW
If so, attach one copy of the approval letter from the DWQ and one copy of the
❑ ORW
❑ Session Law 2006 -246
approved stormwater management plan
❑ Other
3b
In which local government's 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 plan?
< 1 % 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
Site will be well less than 24% impervious at build -out as proposed
4d
Has a completed BMP Supplement Form with all required items been submitted
r-1 Yes No
for each stormwater BMP?
Page 9 of 11
PCN Form — Version 1 0 November 2008 Version

F.
Supplementary Information
1
Environmental Documentation (DWQ Requirement)
1a
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
letter )
❑ Yes
❑ No
Comments
2
Violations (DWQ 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 (DWQ 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 (DWQ 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
Conventional on -site septic system as permitted by Hyde County
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 protect occur in or near an area with federally protected species or
El ®No
habitat
5b Have you checked with the USFWS concerning Endangered Species Act
El Yes ® No
Impacts
5c If yes, indicate the USFWS Field Office you have contacted
El Raleigh
❑ 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 protect 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 WIII this protect occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
El 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 protect occur In a FEMA - designated 100 -year floodplain?
® Yes ❑ No
8b If yes, explain how protect meets FEMA requirements This type of fill is allowable with permit in AE and X zones
8c What source(s) did you use to make the floodplain determination? NFIP Flood Zone Maps (www ncfloodmaps com)
t� E(ApU.S
W-ada
3f4�1+
pllcant/Agent's Signature
Appllcan gent' Printed Name
(Agent's signature is valid only if an authorization letter from the applicant
Date
is provided
Page 11 of 11
PCN Form — November 2008 Version

Agent Authorization Form
Date: 2 ! 3
Name of Property Owner(s) Applying for Permit.
Types of Permits Sought-
tJSI OW {� ry ATIOMWID6 10
By signature below I do hereby certify that I have the authority and duly authorize Quible &
Associates, P C. to act on my behalf for purposes of applying for and obtaining any and all
necessary permits for my property located at:
This certification is valid until: �l1t�t l ads
Sincerely,
i
l 2 - y -Zd1.3

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PROJECT COPYRIGHT CI TES, 2012 WBT7iANDSA PML9MVATION MUMT
P13009 QUIBLE &ASSOCIATES, P C
THIS DOCUMENT IS THE PROPERTY OF QUIBLE Quible. SINCE 7959
& ASSOCIATES P C ALL RIGHTS ARE TRACT :9 _ BROA.D CREEK EST'AM
DRAWN BY RESERVED ANY REPRODUCTION OF THIS OR ..��}} P.C. POSSESSION WITHOUT PRIOR PERMISSION OF Associates, J1 C
OTHERS/TAS QUIBLE & ASSOCIATES P C WILL CONSTITUTE WBR / S OU
VIOLATION OF COPYRIGHT LAWS VIOLATION ENGINEERING * CONSULTING * PLANNING
CHECKED BY WILL BE SUBJECT TO LEGAL ACTION TOWNSHIP HYDE COUNTY ENVIRONMENTAL SCIENCES * SURVEYING
WDE IF THIS PLAN OR PLAT IS NOT SIGNED AND NORTH CAROLINA NC License# C -0208
SEALED BY A LICENSED PROFESSIONAL THEN PO Drawer 870, Kitty Hawk, NC 27949
THIS PLAN OR PLAT SHALL BE CONSIDERED 0 200 400
DATE PRELIMINARY AND NOT A CCRTIFIED DOCUMENT Phone [phone]
AND SHALL NOT BE USED FOR CONSTRUCTION, Fax [phone]
112 -4 -13 RECORDATION, SALES OR LAND CONVCYANCES GRAPHIC SCALE IN FEET V-200 E —Mall adminlstrator®qulble com

HYDE COUNTY HEALTH DEPARTMENT
P.O. Box 100 Swan Quarter, NC 27885
Phone # [phone]
IMPROVEMENT PERMIT
INITIAL INSTALLATION: XXX EXPANSION: REPAIR:
Permit No: 21814 -1 Date: February 18, 2014
Permittee: Elwood Bower
Address: 1169 N. Blackmoor Drive, Murrells Inlet, S.C. 29576
Phone No.: (843) 650 -8547
Property Location: Lot #9 Broad Creek Estates S/D
Facilities to be served: 3 bedroom house
Water Supply: private well
Wastewater Flow GPD: 360
Wastewater System Type: II -c, shallow placement
Wastewater System Repair: same
Long Term Acceptance Rate: .3 gpd /sq.ft.
Absorption Area: 1200 sq.ft.
Septic Tank Capacity: 1000 gallons with filter
Pump Tank Capacity: NA
Total Bed /Trench Length: 400 lin.ft. consisting of 4 lines @100' ea.
Bed /Trench Spacing: 9' on center
Maximum Bed /Trench Bottom Depth: Excavate trenches down to a 5' depth to
encounter a sand soil. Backfill with clean sand fill to within
12" of the naturally occurring soil surface, then install the
trench components

IMPROVEMENT PERMIT
ELWOOD BOWER
PAGE 2
CONDITIONS:
1. Installation of the wastewater system shall be in strict accordance with the
approved site plan and all specifications which are a part of this permit.
2. There shall be a preconstruction conference attended by the owner, installer, and
the Hyde County Health Department. The system will be staked out during this
conference.
3. All parts of the wastewater system shall be a minimum of 50' from the canal that
parallels Sawyer's Avenue.
4. Place geotextile fabric over the trenches prior t backfilling.
S. Place a 6" cap of topsoil over the drainfield to extend 5' past the trenches prior to
tapering. Shape to shed surface water and establish a grass cover. Maintain grass
height not to exceed 3" -4 ".
6. Use water conserving fixtures i.e. 1.6 gallon flush toilets, 2 gpm shower heads, 1
gpm all lavatories. Try to spread out laundry throughout the week. Do not pour
grease or harsh cleaning chemicals into the house drains.
7. The property owner shall make an application to the Hyde County Health
Department for a private drinking water well. Applications may be obtained on the
Health Department's website www.hydehealth.com or by calling (252) 926 -4380.
* * * * * * * * * * * * * * * * * * * * * * * * * * * **
This Improvement Permit shall be valid:
Without expiration
upon a showing satisfactory to the Hyde County 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 Agent:
egi tered Environ ental Health Specialist

L
HYDE COUNTY HEALTH DEPARTMENT
P.O. Box 100 Swan Quarter, NC 27885
Telephone No. (252) 926 -4380
DIVISION OF ENVIRONMENTAL HEALTH
AUTHORIZATION FOR WASTEWATER
SYSTEM CONSTRUCTION
Installation: XXX Expansion: Repair:
Permit #: 21814 -1
Owner: Elwood Bower
Date: February 18, 2014
Address: 1169 N. Blackmoor Drive, Murrells inlet, S.C. 29576
Phone No.: (843) 650 -8547
Property Location: Lot #9 Broad Creek Estates S/D
No. of Bedrooms: 3
Business (No. of people, seats, etc.): 6 max.
System Classification: II -c, shallow placement
Wastewater Flow: 360 gpd
Water Source: private well

AUTHORIZATION FOR WASTEWATER
SYSTEM CONSTRUCTION
ELWOOD BOWER
PAGE 2
CONDITIONS:
1. Installation of the wastewater system shall be in strict accordance with the
Improvement Permit #21814 -1 and all specifications thereof.
******************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
This Authorization For Wastewater System Construction shall be valid for 5
years from the date of issuance.
PC-9-
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Regis ered Environmetitall Health Specialist Date

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m RULES POR SFWAGE TREATME +T AND DISPn3,M SYSTEMS OF NORTH CAROLINA
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AS PER HYDE COUNTY LI��
WASTEWATER PERMIT) 360
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(3 BEDROOM) GAL SEPTIC TANK
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COMMISSION NO
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rbUE DATE
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_ ” \ TRENCH lYSFM "� Ul
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CONSIDERED PRELIMINARY BOUNDARY INFORMATION SHOWN ON THIS
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(4)
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SUBJECT 10 CHANCtiS BASED ON CCNAMUNITY CID 140 374113 TRFnTAENT AND DISPOSAL SYSTFJA IS 0,0 CONFCR`A 11TH SEC70N 19UO "I AW> AND
m RULES POR SFWAGE TREATME +T AND DISPn3,M SYSTEMS OF NORTH CAROLINA
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/ C� • 37207620 DIVIS'Otl OF ENL1.tACTUP4TAL NSTALL OV"ITE WACCORDAN SE CTI(NJ (1S YDIF -° o »Q� +P ou Girm�
V t ISA 1900) "(IN iRACTG" TO INSTALL SYSTEM IN ACCORDNICE YDE THE 'Y H ALTH �?x
EFFECTIVE DATE 09 -20 -2006 U/PRUVEM'NT FERWF;9 2412 -2 LOCATIOV AS APPROVED 01 HYDE CWN'Y HEALTH °� n ai ;$S" ��
�0 V u • _ THIS PLAT SUBJECT TO ANY FACTS INCLUDIIII, BUILDING SETBAIK ^EPAR WENT �� W IN��i �
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7 tool_�13 6REEK
PLANS TO BE USED FOR THE
r, 7.' i t
ei
EXISTING NON -COASTAL 404 WETLANDS
PROPOSED 404 WETLANDS IMPACTS
(4,356 SQ.FT. - 0.10 AC.)
PERMITTING OF THE 5 66° 10`24"W A — EXISTING TREATED POST
WASTEWATER SYSTEM ONLY/61.12, '— ''`IF')`
�;�330'16
NLY'16 0 — EXISTING CONCRETE MONUMENT
/9. @ — EXISTING IRON ROD, EIR
/xI 0 — CALCULATED POINT
SR �50
SITE gg
CREEK
O
6�
PUNGO RIVER
Cn
UL
scRA"V To",,
SCRANTON
SR "52
Y_ SIR 1143 W
SR
13 SLADESVILILE
VICIN17Y MAP
anw
NOTEa: vJ„31EWATER SYS1FMlI_0TES:
.
T CONTRACTOR IS RESPONSIBLE FOR LOCATING EXISTING UNDERGROUND UTILITIES IN
PROPERTY OWNER; ELWOOD BOWER, JR. AREAS OF WORK PRIOR TO ANY WORK. PROVIDE ADEQUATE MEANS OF SUPPORT AND
1169 N. BLACKMOOR DRIVE PROTECTION IF UTILITIES ARE TO REMAIN IN P' ICE.
J MURRELLS INLET, SO 27576 TION, IMPROVEMENTS OR
QUI13LE & ASSOCIATES, P.C.
Co 2, REMOVE TREES, GRASSES, SHRUBS AND OTHER VEGETA
CONSULTANT:
P.O. DRAWER 870 OBSTRUCTIONS INTERFERING WITH INSTALLATION OF NEW CONSTRUCTION UNLESS NOTED
KITTY HAWK, NO 27949 OTHERWISE.
4,
3. NEW WASTEWATER SYSTEM DESIGN PARAMETERS:
AREAS = 23,126.55 SQ.FT. - 0.53 AC. (UPLtAPS)
2,165,342.79 SQ.FT. - 49.71 A0. (WETLANDS) DESIGN FLOW: 6 PEOPLE @ 60 GALLONS PER DAY (GPD) PER PERSON = 360 GPD
N
2,188,469.35 SO -FT. - 50.24 AC. (TOTAL) ACTIVE: LONG TERM APPLICATION RATE (LTAR): 0.3 GPD/SQ.FT. FOR A CONVENTIONAL
jjjTRENCH SYSTEM.
THIS PLAT IS NOT A CERTIFIED SURVEY AND SHOULD BE (4) 100' LINES @ 9' O.C. (400 LN. FT. TOTAL)
N �25 -30' a-) E CONSIDERED PREUMINARY. BOUNDARY INFORMATION. SHOWN ON THIS APPLICATION RATE (LTAR): 0.3 GPD/SQ.FT. FOR A
XAP11 RECORDED IN P.C. C, SL. REPAIR: LONG TERM APPLIC
PLAT BY HOOD RICHARDSON, P.A. AS RECO CONVENTIONAL TRENCH SYSTEM.
225 66'
104L (4) 100' LINES 0 9' D.C. (400 LN, FT. TOTAL)
PROPERTY IS LOCATED IN NRP FLOOD ZONES AE (EL. 7') AND 4 UNLESS OTHERWISE INDICATED ON THE PLAN, CONSTRUCTION OF SEWAGE COLLECTION,
SUBJECT TO CHANGES. BASED ON COMMUNITY CID NO. 370133; TREATMENT AND DISPOSAL SYSTEM IS TO CONFORM WITH SECTION .1900 "LAWS AND
RULES FOR SEWAGE TREATMENT AND DISPOSAL SYSTEMS” OF NORTH CAROLINA
m PANEL 7622 & 7624: SUFFIX J. (MAP NUMBER 3720762400J & ADMINISTRATIVE CODE, DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES,
DIVISION OF ENVIRONMENTAL HEALTH, ON-SITE WASTEWATER SECTION (15 NCAC
37207624) 18A.1900). CONTRACTOR TO INSTALL SYSTEM IN ACCORDANCE WITH THE HYDE COUNTY
Iry EFFECTIVE DATE., 09-20-2006. IMPROVEMENT PERMIT#42412-2. LOCATION AS APPROVED BY HYDE COUNTY HEALTH
I) - THIS PLAT SUBJECT TO ANY FACTS, INCLUDING BUILDING SETBACK
U6 v DEPARTMENT.
E
RESTRICTIONS, EASEMENTS, COVENANTS, ETC., THAT MAY BE CONSTRUCTION OF SEWAGE COLLECTION SYSTEM, TREATMENT AND DISPOSAL SYSTEM IS
DEPARTMENT.
LOT e REVEALED BY A FULLAND ACCURATE TITLE SEARCH. TO CONFORM WITH ANY CONDITIONS IMPOSED BY THE LOCAL HEALTH DEPAR
P.C. C, 5L, 104L MATERIAL USED FOR COHECTION AND DISPOSAL SYSTEM SHALL CONFORM WITH SAME
ry 'LOT q REQUIREMENTS AS #4 ABOVE.
FILL MATERIAL SHALL HAVE SUCH SOIL TEXTURE TO BE CLASSIFIED AS SAND OR
LOAMY SAND (SOIL GROUP 1) UP TO THE TOP OF THE NITRIFICATION TRENCHES. THE
FINAL SIX INCHES OF HLL USED TO COVER THE SYSTEM SHALL HAVE A FINER TEXTURE
(SUCH AS GROUP 11, 111) FOR THE ESTABLISHMENT OF A VEGETATIVE COVER, THE FILL
Wr MATERIAL AND THE EXISTING SOIL SHALL BE MIXED TO A DEPTH OF SIX INCHES BELOW
CHAUNC7XN10R SAWYER THE INTERFACE. HEAVY VEGETATIVE COVER OR ORGANIC LITTER SHALL BE REMOVED
2,165,542.7cl Ft * BEFORE THE FILL MATERIAL IS INCORPORATED.
4q.,71 Aera5 =R
NEU 1,E NAE 5ANrL
DB. q5, Ft% 666
ALL SURFACE RUNOFF SHALL BE DIVERTED AROUND AND AWAY FROM THE DRAINFIELD
459 AREA. FINISH GRADE SHALL BE LANDSCAPED TO PREVENT PONDING
WILL BOOK 14, F(_ OF SURFACE
LAN (BY OTHERS).
WATER. VEGETATE DRAINFIELD AREA AS SPECIFIED 114 LANDSCAPE P
5 (22'54'00'H
166741
PROPOSED 4,356 SQ.FT::,
(0.1 AC) WETLAND FILL
SEE .,DETAIL,VIEW
.A" BELOW7,
3326 ` UPLAND AREAi
2,071.05 _15,qft
b.41 A,;re6,,
rl
5 46' 47, 110,E "
N 510 0, py 1012.54'
ROCK SHALL BE CLEAN, WASHED GRAVEL r- A PI'KER /A VENUE 62.5' PRIVATE R 16H T OF PVA L -- — — —
546047'4q"E
OR CRUSHED STONE AND GRADED OR
SIZED IN ACCORDANCE WITH SIZE NO.S*
3, 4, 5, 57, OR 6 OF ASTM D -44B. (EXISTING GRADE)
RLTER FABRIC BETWEEN
,-STONE & BACKFILL MATERIAL
3' WIDE TRENCH
REFERENCE GRADE - ±100.5'
L _-UNDISTURBED
SUBGRADE (TYP)
8AO
1/2--3/4" CIA. HOLES
k
ASlA F-405
-� I�j (LENGTH AS REO.0)
04
0 �j 4" DIAMETER CORRUGATED POLYETHYLENE (ASTM F-405) LATERAL NITRIFICATION
0 LINE, NITRIFICATION LINE TO HAVE THREE ROWS OF HOLES, EACH HOLE BETWEEN
3i ONE --HALF INCH AND THREE-FOURTHS INCH IN DIAMETER, AND LOCATED IN THE
3: LOVER PORTION OF _P.iE TUBING, THE OUTSIDE: ROWS BEING APPROXIMATELY ON
rn 120'CENTERS. SFE I411RIFICATION LINE DETAIL ABOVE.
0
PLUG EACH END OF 4" NITRIFICATION LINE. SEAL PLUG WITH WATER -PROOF
SEALANT OR CAULKING.
(L
cf)
C,
z
C 0 NVE& NITI ONAL.- Ell,
Cr MENC [ DET&
N.T.S.
0
0
Il)
ALL DRAINFIELD AND REPAIR AREAS SHALL BE SEEDED AND MULCHED
ACCORDING TO THE GENERAL SEEDING SPECIFICATIONS
0
— ------- PROPOSED ACTIVE:
(4) 100' LINES @ 9- O.C.
c6
CONVENTIONAL (FILL REQUIRED 04 Co C4
AS PER HYDE COUNTY
0111'r 36.0'
WASTEWATER— — — — -----
-- — — ----- — — — — — — — — — — — — — — — — —
PROPOSED 1,000 SQ.FT. /
RESIDENTIAL BUILDING-/ PROPOSED 1000
(3 BEDROOM) GAL. SEPTIC TANK
CONTRACTOR TO INSTALL
SYSTEM IN SUCH A MANNER AS
TO GUARANTEE POSITIVE FLOW
THROUGHOUT THE SYSTEM.
CONTRACTOR TO INSTALL SYSTEM
IN ACCORDANCE WITH THE HYDE
COUNTY IMPROVEMENT
PERMIT#42412-2. LOCATION AS
APPROVED BY HYDE COUNTY
HEALTH DEPARTMENT.
N 51, 50, 00" N
5 480 47'4qE
N26° 12'22"E
,30_5q,
N26° 12'2-2 E
24.136'
°o
73
K)
/13
L5
GRAPHIC SCALE
200' 0 100 200' 400'
IN FEET
1 inch = 200' ft.
DETAIL V151 "A"
e
4ALS Iwo
0
.Q i PROPOSED REPAIR AREA:\!/'
\J/
(4) 100' LINES 0 9' O.C.
CONVENTIONAL (SHALLOW
PLACEMENT)
PROPOSED 4,356 SQ.FT.
(0.1 AC) WETLAND FILL
Lo
N
UPLAND AREA:
20,255.52 -rq.a
ZD
En
0.47 Acres
L,
03
z C4
CD
— ------- PROPOSED ACTIVE:
(4) 100' LINES @ 9- O.C.
c6
CONVENTIONAL (FILL REQUIRED 04 Co C4
AS PER HYDE COUNTY
0111'r 36.0'
WASTEWATER— — — — -----
-- — — ----- — — — — — — — — — — — — — — — — —
PROPOSED 1,000 SQ.FT. /
RESIDENTIAL BUILDING-/ PROPOSED 1000
(3 BEDROOM) GAL. SEPTIC TANK
CONTRACTOR TO INSTALL
SYSTEM IN SUCH A MANNER AS
TO GUARANTEE POSITIVE FLOW
THROUGHOUT THE SYSTEM.
CONTRACTOR TO INSTALL SYSTEM
IN ACCORDANCE WITH THE HYDE
COUNTY IMPROVEMENT
PERMIT#42412-2. LOCATION AS
APPROVED BY HYDE COUNTY
HEALTH DEPARTMENT.
N 51, 50, 00" N
5 480 47'4qE
N26° 12'22"E
,30_5q,
N26° 12'2-2 E
24.136'
°o
73
K)
/13
L5
GRAPHIC SCALE
200' 0 100 200' 400'
IN FEET
1 inch = 200' ft.
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7s_sUE DATE
2-12-14
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DRAWN BY
TAS
CHECKED BY
WDE
7s_sUE DATE
2-12-14

-•-.q.. NOTES:_
�- `/1JOOD-5 GREEN - PROPERTY OWNER: ELWOOD BOWER, JR.
1169 N.
MURRELLSLINLIET,GOR SC DRIVE2 576
CONSULTANT: QUIBLE & ASSOCIATES, P.C.
\ P.O. DRAWER 870
e� KITTY HAWK, NC 27949
0 1 ,
5 66 .O 24 Y
161.12 AREAS = 23,126.55 SQ.FT. - 0.53 AC. (UPLANDS)
�Rr
''\ 2,165,342.79 SQ.FT. - 49.71 AC. (WETLANDS)
�- 3� - 2,188,469.35 SQ.FT. - 50.24 AC. (TOTAL)
THIS PLAT IS NOT A CERTIFIED SURVEY AND SHOULD BE
C ' \r'O.� /,' ry �3Q6 ' • CONSIDERED PRELIMINARY. BOUNDARY INFORMATION SHOWN ON THIS
q \ PLAT BY HOOD RICHARDSON, P.A. AS RECORDED IN P.C. C, SL.
�- - PROPERTY IS LOCATED IN NAP FLOOD ZONES AE (EL 7') AND
PUNGO RIVER 7J
SQrza;v rGN �Re fr\
SCRANTON
I
`. -SR 1150
SITE
SR 1143 Q
x
ED z
g� SLADESVILLE
SUBJECT TO CHANGES, BASED ON CO;-AMUNITY CID N0. 370133;
f PANEL 7622 & 7624; SUFFIX J. (MAP NUMBER 3720762400) &
\ 'f' 37207624)
EFFECTIVE DATE: 09-20-2006.
THIS PLAT SUBJECT TO ANY FACTS, INCLUDING BUILDING SETBACK
/\ RESTRICTIONS, EASEMENTS, COVENANTS, ETC., THAT MAY BE
REVEALED BY A FULL AND ACCURATE TITLE SEARCH.
9a'S 'rY,
NOTE: �p
� PLAN -SIS �L�I� �IzELI,tal�ahi�Y AND �O�
N 23 30 00 ` E
DISCUSSION PURPOSES ONLY. THIS PLAT 'I.AT
Nbe 00'15"yY' 10.00`` SWILL NOT BE- USED FOR CONSTRUCTION,
22563' . `° RECORDATION, CONVEYANCE'S OR SALES
a
THIS \,IAF' IS f!O+ A CERTIf=IEL} SURVEY
oy oC E4{�E U aPll HAS NOT (' BEENBEENPVI Br`'I' A L nC ,!_
y GOVERX",j E 1hIT AGE NC'Y FF C1n C t,IMP!_.IAiNCE
f-11�t�t 1F'�'L.!C,�NLc �;ii'.ID OEVi=Lui"1�1E�11
Y'J(il�l � � '
R (d G U (..A r l O N r..
N/I' o U A
/ LOT 8
9�
P.G. 6, 5L. 1041- (f)��✓,
Y
50,2411, -`acres
KE TI ANL" -AREA: NAF
2,165341 "a Sq.Ft. z 6HAUNGY JUNIOR 5AGYYER
4q.71 e NELL.IE MAE 5AHN 'ER
e
D.B. 95, PG. 66b
HILL BOOK 14, P6. 458
n
5 62'54'00" H
156. 74,
�O
PROPOSED 4,356 SQ.FT,,
� (0.1 AC) WETLAND FILL
SE
.D
35 26' LAND AREA; "A"BELOW
°
" 371.03 Sq. Ft.
\ / C 07 Ades UPLAND PES
20,2555 t
Cres
74
5 43° 47'11"E 1594.10', -5 4e° 47'11'E'
L3 N 51 ° 30' 00" IN --p- 1012.54'
60 .00' '�� � U �NU�'='r2/V.A TE Rl6HT OF W/-� Y �– -- — — — — �2'u�-'' 1 ,
V161MI iY MAP
off -W
LED
EXISTING NON -COASTAL 404 WETLANDS
OPROPOSED 404 WETLANDS IMPACTS
' (4,356 SQ.FT. - 0.10 AC.)
A - EXISTING TREATED POST
El - EXISTING CONCRETE MONUMENT
® - EXISTING IRON ROD, EIR
0 - CALCULATED POINT
0
�O
o�
`7_
N 51 ° 30'00" IN
N26° 12'22"E
30.34'
N26° 12'22"E
- 24.66'
— — — — `- - — — 1073.48' 5 460 47'4q" E
5 45* 47' 49" E ` rr
DETAIL VIEW 'A"
r=�'
r �
PROPOSED REPAIR AREA:' /
(4) 100' LINES @ 9' O.C.
-c
CONVENTIONAL (SHALLOW ® 4 �
PLACEMENT)
PROPOSED 4,356 SQ.FT.
(0.1 AC) WETLAND FILL
UPLAND ARf_
20,255.52 5q..
Q)
0.47 Acr ;
<\, C �,%`,%`�/ ; x ;X,
/`< \,ice
2� 0
- - - - - - - ----------------- -
PROPOSED ACTIVE:
(4) 100' LINES ® 9' O.C. LIM
CONVENTIONAL (SHALLOW q
PLACEMENT) II
L3
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PROPOSED 1000 SQ.FT. % GRAPHIC SCALE
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DESIGNED BY
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