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HomeMy WebLinkAboutNCC222198_ESC Approval Submitted_20220614IFYOF Planning, Development, & WILMINGTON Transportation Department Planning Division NORTH CAROLINA 305 Chestnut Street rrss PO Box 1810 Wilmington, NC 28402-1810 March 23, 2022 910 254-0900 910 341-3264 fax wilmingtonnc.gov CONSTRUCTION RELEASE Dial711 TTY/Voice TOMMY'S CAR WASH - OLEANDER 3915 Oleander Drive Project # 2021050 Consultant/ Mr. Will Swaringen Property 3915 OLEANDER DRIVE RE LLC Agent: Bohler Engineering Owner: 1170 PITTSFORD VICTOR RD 4130 Parklake Ave SUITE 260 Wilmington NC 28401 PITTSFORD NY 14534 The City thanks you for your investment in our community and we look forward to working with you towards the construction of a quality development project. Your project is hereby conditionally released for construction. Please make note of the conditions for this release as they appear below. These conditions must be followed and met for the construction to be approved. Conditions of Release 1. A pre -construction meeting must be held between the site contractor/superintendent and city staff prior to any site work, tree removal, clearing or grading commences on site. Failure to comply will result in civil penalties. Please contact our zoning office at 910.254.0900 to schedule the preconstruction meeting. 2. Any trees, including the critical root zone area and/or the area designated to be saved, must be properly barricaded or marked with fencing and protected throughout construction to ensure that no clearing or grading will occur in those areas. 3. No equipment is allowed on the site and no construction of any building, structure, wall, utilities, infrastructure, etc. of any kind, including footings and building slabs, will be permitted until: a. All tree protection fencing and silt fencing has been installed b. New Hanover County has issued the grading permit and authorized the activity c. Cape Fear Public Utility Authority has authorized the water and sewer activities d. The assigned city zoning compliance officer has authorized the activity 4. This development shall comply with all local, regional, state, and federal development regulations. All applicable City of Wilmington Technical Review Committee requirements must be completed prior to the issuance of final zoning approval. 5. All truck traffic to and from the site shall adhere to NCDOT and City of Wilmington truck routes and restrictions (e.g. S. 3rd Street, Market Street). See city GIS gallery for routes, weight restrictions, etc. 6. Failure to comply with the above conditions may result in the issuance of a Stop Work Order (SWO). 3p�� RTH CAROL[NA Conditions of Final Zoning Approval 1. An Administrative Adjustment was approved on October 6, 2021 for the following standards: A. Minimum Offset from an Intersection 2. A plat showing all required easements and right(s)-of-way must be reviewed by city staff and recorded at the Register of Deeds prior to issuance of final zoning approval. 3. This project will require the dedication of public drainage easement(s). 4. This project will require the dedication of public access easement(s). 5. Proper dedication of pubic easements requires an easement plat (or legal description) and a deed of easement. The easement plat or legal description is prepared by a licensed surveyor. The deed of easement is prepared by the City Attorney's Office (CAO). A title policy for the property is necessary to prepare the document. These documents can be submitted to the project planner for distribution to the pertinent city departments. Recordation of both the easement plat and the deed of easement will be required prior to the issuance of a Certificate of Occupancy. Please allow for no less than two weeks for deed preparation. 6. This project will require the submittal of a request for recycling and trash services form. Submittal of this form will ensure all residents receive city recycling and trash services as required by Section 10-4 of the city code. It is required for public street dedications serving single-family or duplex lots and is optional for private streets. This is not applicable for streets (public/private) serving commercial or multi -family development. This form can be submitted to the City Engineering Department. 7. Per the requirements of the stormwater permit, the following shall occur prior to issuance of a certificate of occupancy or operation of the permitted facility: As -built drawings for all stormwater management facilities shall be submitted to the City of Wilmington Engineering Division. An Engineer's certification shall also be submitted, along with all supporting documentation that specifies, under seal that the as -built stormwater measures, controls and devices are in compliance with the approved stormwater management plans. A final inspection is required by City of Wilmington Engineering personnel (910) 341-5856. 8. Prior to a final inspection, a walkthrough with City Construction Management staff shall take place to verify completeness of site work in right(s)-of-way. Any material test reports and stormwater videos as required shall be submitted prior to and approved by city Engineering. Please contact the City Engineering Department at 910.341.0094. 9. No construction activity shall occur within the North Carolina Department of Transportation (NCDOT) right-of-way until all NCDOT permits have been issued and received by the City. All improvements required shall be installed and approved by NCDOT prior to issuance of a certificate of occupancy. 10. Contractor shall submit a Radio Signal Strength Study for all commercial buildings that demonstrates that existing emergency responder radio signal levels meet the requirements of Section 510 of the 2018 NC Fire Code. 3p�� RTH CAROL[NA 11. This project is proposing less than 500 linear feet of right-of-way or public improvements. Per Chapter V of the City Fee schedule, the project will require Engineering inspection fees in the amount of $250.00. This fee must be paid prior to issuance of plat recordation of certificate of occupancy. Please contact City Engineering at 910.341.0094 for payment options. 12. Approval of a major or minor site plan shall expire after 18 months from the date of such approval if the applicant has failed to make substantial progress on the site. The technical review committee may grant a single, six-month extension of this time limit for major and minor site plans, for good cause shown, upon receiving a request from the applicant before the expiration of the approved plan. In the event approval of a site plan has expired, for whatever reasons, the owner and/or applicant will be required to resubmit for approval of a site plan that meets current development standards unless otherwise noted in this chapter. 13. To obtain a final zoning inspection for this construction project, the appropriate departments within the City of Wilmington must perform and approve final inspections. To arrange for inspections please contact the assigned Zoning Enforcement Officer, at 254-0900. Staff will coordinate the inspections and provide a punch -list to the Developer within 5 working days. Upon correction of the punch -list items, a final inspection will be performed. Note: Zoning will not issue final approval until all requirements of the City of Wilmington are fulfilled. 14. Please also be advised that any party aggrieved by the issuance of this approval may file a notice of appeal to the City Clerk within 30 days of receipt of active or constructive notice of this decision. It shall be presumed that all persons with standing to appeal have constructive notice of the decision from the date a sign containing the words "Zoning Decision" or "Subdivision Decision" in letters at least six inches high and identifying the means to contact an official for information about the decision is prominently posted on the property that is the subject of the decision, provided the sign remains on the property for at least 10 days. Posting of signs is not the only form of constructive notice. Any such posting shall be the responsibility of the landowner or applicant. Verification of the posting shall be provided to the official who made the decision. Absent an ordinance provision to the contrary, posting of signs shall not be required. Reference NC GS 160d-403. 15. Please notify New Hanover County Building Inspections of this release. Project Planner: 3/23/22 Jeff Walton, Associate Planner Date ITYOF pj�r�� WC NORTH CAROL[NA I hereby acknowledge receipt of this construction release and understand and agree to adhere to all conditions as contained herein. The owner/developer assumes al risks and penalties with any delay or stop work order associated with a violation of this release. The City of Wilmington assumes no liability for any costs associated with this construction release. Zoning Compliance Officer: Authorized Representative Date John Barham, Compliance Officer Date The following items are included in this release package: Item Permit Number Date Tomm s Car Wash Oleander Approved Plans Old Code 2021050 3/23/22 City of Wilmington Tree Permit TPP-21-212 3/14/22 New Hanover County Grading Permit GP 89-22 3/22/22 City Comprehensive Stormwater Management Permit 2022014 TBD Copy: John Barham Zoning Compliance Bret Russell Construction Manager Rob Gordon Engineering (email only) Jim Quinn Stormwater Specialist (email only) Aaron Reese Urban Forestry (email only) Rich Christensen Engineering (email only) Eric Seidel Engineering (email only) Trent Butler Engineering (email only) Chris Elrod Wilmington Fire Department (e-mail only) Chris Walker Wilmington Fire Department (e-mail only) Brian Blackmon Surveyor (e-mail only) Jim Sahlie GIS Addressing (e-mail only) Bill McDow Traffic Engineering (e-mail only) Mitesh Baxi Traffic Engineering (e-mail only) Denys Vielkanowitz Traffic Engineering (e-mail only) Bernice Johnson CFPUA (e-mail letter only) Beth Easley Wetherill NHC Erosion Control (e-mail only) Michelle Hutchinson GIS Engineer (e-mail only) Amy Beatty Community Services (e-mail only) Ron McMillan Community Services (e-mail only) Joan Mancuso City Zoning (email only) Catherine Meyer City Zoning (email only) Shawn Evans City Attorney's Office (email only) Courtney Salgado City Attorney's Office (email only) Joseph Wurzel NC DOT (email only) Nick Drees NC DOT (email only) Jon Roan NC DOT (email only) Ben Hughes NC DOT (email only) RECEIVED By waltonj at 11:02 am, Sep 22, 2021 C:fTYOF WLMI<GT'O'N N01UH C:AROLINA APPROVED: DENIED: Department of Planning, Development and Transportation Planning Division 305 Chestnut Street PO Box 1810 1739 Wilmington, NC 28402-1810 910 254-0900 910 341-3264 fax www.wilmingtonnc.gov Dial 711 TTY/Voice PERMIT #: TPP-21-212 Application for Tree Removal Permit Name of Applicant: Paul Sevene Phone: 919-819-1922 Date: 9/10/21 Name of Property Owner: Paul Sevene Phone: 919-819-1922 Property Owner Address: 1170 Pittsford -Victor Road, Pittsford, NY 14534 Address of Proposed Tree Removal: 3915 Oleander Drive, Wilmington, NC 28403 Description of tree(s) to be removed/reason for removal: (provide attachment if necessary) 1. (1) Crepe myrtle (in location of entrance) 6. 2. 7. 3. 8. 4. 9. 5. 10. Description of Replacement Tree(s): Proposed replacement trees at time of permit submittal include (7) Maidenhair Ginkgo, (2) American Sycamore, (9) Willow Oak, (7) Bald Cypress and (6) Trident Maple 1, Paul Sevene , certify that the property owner has given me permission to apply for this permit on his/her behalf. Applicant Signature: i"aza �6t�'Date: 9/20/2021 **********************************FOR OFFICIAL USE ONLY********************************** Remarks: APPROVED By Jeff Walton at 12:21 pm, Mar 14, 2022 ALL WORK MUST BE IN COMPLIANCE WITH THE CITY LAND DEVELOPMENT CODE, ARTICLE 8, LANDSCAPING AND TREE PRESERVATION. NEW CONSTRUCTION: EXPANSION: OTHER: PAID: Tree Preservation Permit Fees Less than 1 acre $25.00 1-5 acres $50.00 5-10 acres $100.00 Greater than 10 acres $150.00 R:PlanDev Tran/Project Management/Application Fornvs/Tree Removal Permit Application March 22, 2022 Capital Corporate Services, Inc. 120 Penmarc Drive, Raleigh , North Carolina 27603 NEW HANOVER COUNTY ENGINEERING 230 Government Center Drive, Suite 160, Wilmington, NC 28403 P: (910) 798-7139 1 F: (910) 798-7051 1 NHCgov.com Jim lannucci, PE, CiFM, County Engineer and 3915 Oleander Drive Re LLC 1170 Pittsford -Victor Road, Suite 260, Pittsford, New York 14534 RE: Grading Permit #9-22, Tommy's Car Wash Oleander Dear Mr. Paul Sevene: This office has reviewed the revised erosion and sedimentation control plan. We find the plan to be acceptable and hereby issue this land -disturbing permit. Please read the permit conditions care 11V return the sijnned blue original to our office and kee f the copy or your records. A copy of the enclosed land -disturbing permit must be posted at the job site. This letter gives the notice required by GS 113A- 61.1(a) and the New Hanover County Erosion and Sedimentation Control Ordinance Article VIII Section 8.21 of our right of periodic inspection to ensure compliance with the approved plan. As of April 1, 2019, all new construction activities are required to complete and submit an electronic Notice of Intent (eNOI) form requesting a Certificate of Coverage (COC) under the NCGO10000 Construction General Permit. The COC must be obtained prior to the commencement of any land - disturbing activity on the above -named project, according to State Stormwater requirements. The NOI form may be accessed at deq.nc.gov/NCG01. Please direct questions about the NOI form to Paul Clark at Paul.clarkL@ncdenr.toy. After you submit a complete and correct NOI Form, you will receive a link with payment instructions for the $100 annual permit fee. After the fee is received, you will receive the COC via email. The $100 fee will be charged annually until the project receives a final land -disturbance inspection. Once the project is stabilized and receives the final land -disturbance inspection, you should file a Notice of Termination (NOT) with the State to final out the project. A copy of the enclosed land -disturbing permit, a copy of the approved erosion and sedimentation control plan as well as any approved deviations, records of inspections made during the previous 12 months with the States Certificate of Compliance (COC) number on the reports, and a rain gauge must be posted at the job site as required by 15A NCAC 4B .0118(a), the NCGO1 permit, and the New Hanover County Erosion and Sedimentation Control Ordinance Article Vlll Section 8.19(o). Page 2 of 2 Four hundred and fifty dollars of the $453land disturbing fee has been paid. Three dollars is due to be paid to Beth Wetherill's attention in Engineering, prior to issuance of any Certificate of Occupancy or Certificate of Completion. A preconstruction meeting is optional prior to land -disturbing activity on this project. Please contact me at (910) 798-7139 if you would like to schedule this meeting in our office. If you choose not to have a preconstruction meeting, you must contact us with the date the land -disturbing activity will take place onsite and again once the initial erosion control measures are installed. New Hanover County's Erosion and Sedimentation Control Program is performance -oriented, requiring protection of existing natural resources and adjoining properties. If, following the commencement of this project, it is determined that the erosion and sedimentation control plan is inadequate to meet the requirements of the Sedimentation Pollution Control Act of 1973 (North Carolina General Statutes 113A-51 through 66), and the New Hanover County Erosion and Sedimentation Control Ordinance Article VIII Section 8.19 (f), this office may require revisions to the plan and its implementation of the revisions to ensure compliance with the Act and Ordinance. This land -disturbing permit will expire within 1 year following the date of approval, if no land - disturbing activity has been undertaken, as required by the New Hanover County Erosion and Sedimentation Control Ordinance Article VIII Section 8.18 (d). If no activity takes place within one year after work has begun onsite, the permit will expire. Please contact this office to reactivate a permit that has expired. Acceptance and approval of this erosion control plan is conditioned upon your compliance with Federal and State water quality laws, regulations and rules and local city or county ordinances or rules. This land -disturbing permit approval does not supersede any other permits or approvals. It is the owner's responsibility to have all the permits and approvals that are required, prior to beginning construction. Please note this approval is based in part on the accuracy of the information provided in the Financially Responsibility Form, which you provided. You are required to file an amended form if there is any change in the information included on the form. Your cooperation is appreciated, Beth E. Wetherill C.P.E.S.C. Erosion Control Specialist Enclosures: Land -Disturbing Permit NPDES NCG01 Fact Sheet and Monitoring Form cc: Jeff Walton Associate Planner, City of Wilmington Willis Swaringen, PE Bohler Engineering NC, PLLC Permit GP #9-22 Permit for a Land -Disturbing Activity New Hanover County Department of Engineering 230 Government Center Drive - Suite 160 Wilmington, North Carolina 28403 (910) 798-7139 As authorized by the New Hanover County Erosion and Sedimentation Control Ordinance This permit issued to 3915 Oleander Drive Re LLC authorizes the development of 1.51 acres of land at 3915 Oleander Drive for Tomm s Car Wash Oleander in New Hanover County with modifications. This permit issued on March 22 2022 is subject to compliance with the application and site drawings, all applicable regulations and special conditions and notes set forth below. Any. plan modifications must be approved by this office prior to field changes. It is understood by the applicant that a representative of New Hanover County's Engineering Department may inspect the site at any time following the issuance of this Permit. A copy of the approved Soil Erosion Control Plan as well as any approved deviations, this permit, a rain gauge, the Certificate of Coverage (COC) number from the State and copies of the Combined Self -Monitoring and Self -Inspection Reports must be available at all times at the site. Failure to execute the provisions of this permit and the approved Soil Erosion Plan, or any other provisions of the New Hanover County Soil Erosion and Sedimentation Control Ordinance, may result in immediate legal action by the County to the limits prescribed by the Ordinance. If the measures outlined on the approved Soil Erosion Control Plan and this Permit prove insufficient, additional Erosion Control measures can and will be required which in turn will be considered provisions of this Permit. This Permit does not preclude any other permits or approvals necessary for beginning or completing this development. Approval of an erosion control plan is conditioned on the applicant's compliance with Federal and State laws, regulations, and rules. It is the Permittee's responsibility to obtain all necessary permits and approvals and to ensure the information given for this permit is accurate and updated if ownership or the financially responsible party changes. SPECIAL CONDITIONS (THESE CONDITIONS MUST BE FOLLOWED IN ADDITION TO THE PLANS AND SPECIFICATIONS) *Ali the soil erosion control measures will be installed as the site is cleared and maintained throughout construction. These include a construction entrance, silt fences or minimum 8-inch silt socks, silt fence outlets and silt sock inlet protection or hardware cloth and rock inlet protection. Note: Another construction entrance will be required adjacent to Audubon Boulevard, or the silt fence will have to be extended to close the gap in the fence. Hardware and rock inlet protection may be used instead of silt sock inlet protection unless the engineer objects. **Note the required separate NCG01 permit that requires concrete washouts and other NCG01 regulations. *In issuing this permit New Hanover County has relied on the representations of the permit applicant. The county has no jurisdiction to determine any contested property rights or ownership. *Tree Removal Permits and/or Approvals are required from New Hanover County PRIOR to clearing of the site or removal of any required landscaping. *Silt fence stakes must be steel and will be placed six feet apart without wire reinforcement or eight feet apart with wire reinforcement. Silt fence is not allowed as inlet protection. (Continued) - Page Two Permit GP #9-22 *This permit does not preclude any permits or approvals which may be necessary including but not limited to the City of Wilmington, New Hanover County, NC DEMLR, C.A.M.A., the US Army Corps. of Engineers, DEM Solid Waste, any other agency or any approvals that may be necessary. *No sediment shall leave the site in suspension of water. *If plan revisions are necessary, you must submit a copy to this office for approval r�or to any field changes. *If soil is brought onto this site or removed from this site, it must come from or be taken to an approved or permitted site, to be identified to this office prior to being brought onsite or removal from the site. *All City and/or County and State drainage and stormwater requirements will be adhered to. *If these measures fail to adequately control erosion, more restrictive measures will be required. *If any phase of grading ceases for more than 90 calendar days following completion of construction or development the site will be stabilized. *All slopes must be stabilized within 21 calendar days of completion of any phase of activity. The approval of an erosion control plan is conditioned on the applicant's compliance with Federal and State Water Quality laws, regulations, and rules. *Note the required rates for seed, lime, fertilizer, and mulch in your seeding specifications. *Enclosed is a Combined Self -Monitoring and Self -Inspection Form that meets the requirements of both the NPDES Stormwater Permit for Construction Activities, NCG 010000 reporting and the Land Resources Self - Inspection Program that satisfies the requirements of the Sedimentation Pollution Control Act. These are mentioned below with specific requirements for each program. These reports are the responsibility of the property owner. They require a rain gauge onsite, inspections and reporting every 7 calendar days and within 24 hours of every 1.0-inch rain per 24-hour period and at specific phases of construction. Additional copies of this Combined Construction Inspection Report can be found at 1n.:J portal.ncd �r web Ir era Re j2orts must be available onsite at all times. If you have questions, please contact New Hanover County Engineering (910) 798-7139 or the Land Quality Section at the NC DEMLR Regional office at (910) 796-7215. *Note the NPDES information from the State for sites disturbing 1 acre or more and the reporting requirements. All NEW projects permitted after August 3, 2011, must include the following surface water withdrawal locations and stabilization requirement designations on the plan in order to qualify for coverage under the most recent NPDES Construction General Permit. All settling basins must have outlet structures that withdraw water from the surface, with the exception of basins or traps that have a drainage area of less than 1 acre. The NPDES permit also requires ground cover within 15 calendar days on disturbed flat areas and ground cover within 7 calendar days on all areas within HQW Zones, perimeter dikes, swales, ditches, perimeter slopes and all slopes steeper than 3:1. Exceptions include slopes that are 10 feet or less in length and not steeper than 2:1 which must be stabilized within 14 calendar days and slopes greater than 50 feet which must be stabilized within 7 calendar days. It requires inspections of all erosion control measures and reporting every 7 days and within 24 hours of every 1.0-inch rain event in a 24-hour period. This permit also includes other new requirements which are listed in the text of the NPDES Stormwater Discharge Permit for Construction Activities, which is included with the original copy of each land -disturbing permit. Continued) - Page Three Permit GP #9-22 *All construction activities are required to complete and submit an electronic Notice of Intent (eN01) form requesting a Certificate of Coverage (COC) under the NCG010000 Construction General Permit. The COC must be obtained prior to the commencement of any land- disturbing activity on the above -named project, according to State Stormwater requirements. The NOI form may be accessed at deq.nc.gov/NCG01. Please direct questions about the N01 form to Paul Clark at Paul.clarkXncddenr.Rov. After you submit a complete and correct NOI Form, you will receive a link with payment instructions for the $100 annual permit fee. After the fee is received, you will receive the COC via email. The $100 fee will be charged annually until the project receives a final land -disturbance inspection. Once the project is stabilized and receives the final land -disturbance inspection, you should file a Notice of Termination (NOT) with the State to final out the project. *Note the Land Resources Self Inspection Program Requirements. This program is separate from the NPDES reporting and requires inspection and documentation after each phase of construction. These phases include: Installation of perimeter erosion control measures, Clearing and Grubbing of existing ground cover, Completion of any phase of grading of slopes or fills, Installation of storm drainage facilities, Completion of construction or development, Establishment of permanent ground cover sufficient to restrain erosion and any Deviation from the approved plan. *Pre -construction meetings are optional. Contact Beth E. Wetherill at (910) 798-7139 to set up a meeting prior to land -disturbing activity onsite. if you do not choose to have a preconstruction Meeting prior to starting work on site, you should contact us when activity be ins and again when the initial measures have been installed. This Permit will expire one year from date of issue if no construction activity begins on site. This permit may not be amended or transferred to another party without approval of this office. Beth E. Wetherill, C.P.E.S.C. Soil Erosion Specialist/New Hanover County Acknowledgment of receipt of Permit Owner By (please print) Signature Public Services Engineering P.O. Box 1810 173s Wilmington, NC 28402-1810 910 341-7807 910 341-5881 fax wilmingtonnc.gov c.�rYOF Dial TTY/Voice INGTON NORTH CAROLINA Via e-mail: wswarinpen(@bohlerenp.com October 6, 2021 Mr. Will Swaringen, PE Bohler Engineering NC, PLLC 4130 Parkdale Avenue, Suite 130 Raleigh, NC 27612 Re: Administrative Variance Requests — Tommy's Car Wash - Oleander Dear Mr. Swaringen: On behalf of the City Engineer, I have reviewed your request for a waiver and rendered the following decision: Minimum Side Property Line Offset ® Granted ❑ Denied Minimum Offset from an Intersection Technical Standard: Chapter VII (Traffic Engineering ), Section C 2.c. (2): All driveways along the major thoroughfares shall have a property line offset of 75' measured at the curb line, however, driveways shall comply with (1) above and be at least 230 feet from the intersecting street when the lot has sufficient frontage to meet the requirement. Description: The applicant seeks relief from the 75-foot property line offset and the 230-foot offset from the intersecting street for the Oleander Drive driveway that will serve the proposed project. Justification: The parcel of land does not have enough frontage along Oleander Drive to meet the intent of the technical standards. The driveway has been sited to align with internal drive aisle and maintain the maximum distance possible from the Audubon Boulevard intersection. For these reasons, it is appropriate to grant the variance. Please contact me at richard.christensen@wilmingtonnc.gov if you have any questions. Sincerely, Pk4"d Richard Christensen, PE Project Engineer cc: David Cowell PE, City Engineer, City of Wilmington Bill McDow, Transportation Planning, City of Wilmington Mitesh Baxi, Senior Traffic Engineering Technician, City of Wilmington Jeff Walton, Associate Planner, City of Wilmington APPLICATION IDENTIFICATION N.C..DEPARTMENT OF TRANSPORTATION STREET. AND DRIVEWAY ACCESS PERMIT APPLICATION: Driveway Permit No.�ppllcatlon ate of County: New Hanover Development Name: Tommy's Car Wash 3915 Oleander LOCATION OF PROPERTY. Route/Road: Exact Distance ❑ Miles N S E W 3,500 © Feet ❑ ❑ ❑ From the Intersection of Route No. US-761US-17 and Route No, NC-132 Toward NC-1209 Property Will Be Used For: ❑ Residential /Subdivision ® Commercial ❑ Educational Facilit€es ❑ TND ❑ Emergency Services ❑ Other Proe : ® is ❑ is not within Wilmington CU Zoning Area: AGREEIVIENT • I, the undersigned property owner, request access and permission to construct driveway(s) or street(s) on public right- of-way at the above location. • I agree to construct and maintain driveway(s) or street entrance(s) in absolute conformance with the current "Policy on Street and Driveway Access to North Carolina Highways" as adopted by the North Carolina Department of Transportation. • I agree that no signs or objects will be placed on or over the public right-of-way other than those approved by NCDOT. . I agree that the driveway(s) or street(s) will be constructed as shown on the attached plans. • I agree that that driveway(s) or street(s) as used in this agreement include any approach tapers, storage lanes or speed change lanes as deemed necessary. • I agree that if any future improvements to the roadway become necessary, the portion of driveway(s) or street(s) located on public right-of-way will be considered the property of the North Carolina Department of Transportation, and I will not be entitled to reimbursement or have any claim for present expenditures for driveway or street construction. • I agree that this permit becomes void if construction of driveway(s) or street(s) is not completed within the time specified by the "Policy on Street and Driveway Access to North Carolina Highways". • I agree to pay a $50 construction inspection fee. Make checks payable to NCDOT. This fee will be reimbursed if application is denied. • I agree to construct and maintain the driveway(s) or street(s) in a safe manner so as not to interfere with or endanger the public travel. • I agree to provide during and following construction proper signs, signal lights, flaggers and other warning devices for the protection of traffic in conformance with the current "Manual on Uniform Traffic Control Devices for Streets and Highways" and Amendments or Supplements thereto. Information as to the above rules and regulations maybe obtained from the District Engineer. • I agree to indemnify and save harmless the North Carolina Department of Transportation from all damages and claims for damage that may arise by reason of this construction. • I agree that the North Carolina Department of Transportation will assume no responsibility for any damages that may be caused to such facilities, within the highway right-of-way limits, in carrying out its construction. • I agree to provide a Performance and Indemnity Bond in the amount specified by the Division of Highways for any construction proposed on the State Highway system. • The granting of this permit is subject to the regulatory powers of the NC Department of Transportation as provided by law and as set forth in the N.C. Policy on Driveways and shall not be construed as a contract access point. • I agree that the entire cost of constructing and maintaining an approved private street or driveway access connection and conditions of this permit will be bome by the property owner, the applicant, and their grantees, successors, and assignees. • I AGREE TO NOTIFY THE DISTRICT ENGINEER WHEN THE PROPOSED WORK BEGINS AND WHEN IT IS COMPLETED. 2004-07 NOTE: Submit Four Copies of Application to Local District Engineer, N.C. Department of Transportation TEB 65-04fev. 61-03419 SIGNATURES OF APPLICANT PROP ER (APPLICANT) WITNESS COMPANY Ro s Holdin 5 LLC CIO Paul Sevene NAMEJennifer Blou h SIGNATURE SIGNATURE ADDRESS 1170 Pi sf rd-Victor Road Pittsford NY 14534 ADDRESS 170Pitt rd-Victor Road Phone No. Pittsford, NY 14534 AUTHORIZED AGENT WITNESS COMPANY Bohler Engineering NC, PLLC NAME T ler H am SIGNATURE SIGNATURE ADDRESS 4130 Parklake_A_ve, Ste 130 Raleigh, NC 27612 _ ADDRESS 4130 Parklake Ave, Ste 130 Raleigh, NC 27612 Phone No. 919-578-9000 APPROVALS. APPLICATION RECEIVED BY DISTRICT ENGINEER SIGNATURE DATE APPLICATION APPROVED BY LOCAL GOVERNMENTAL AUTHORITY (when required) SIGNATURE TITLE DAT APPLICATION APPROVED BY NCDOT SIGNATURE TITLE DATE INSPECTION BY NCDOT SIGNATURE TITLE DATE COMMENTS: