20230231 Ver 1_Modifications_20230303

Staff Review Form
Environmental Quality
Updated September 4, 2020
Staff Review
Does this application have all the attachments needed to accept it into the review process? *
Yes No
ID#*
20230231
Version* 1
Is this project a public transportation project? *
Yes
No
Reviewer List: * Paul Nyarko:[e-mail]
Select Reviewing Office: *
Washington Regional Office - [phone]
Does this project require a request for payment to be sent? *
Yes
No

Project Submittal Form
Please note: fields marked with a red asterisk * below are required. You will not be able to submit the form until all
mandatory questions are answered.
Project Type: *
For the Record Only (Courtesy Copy)
New Project
Modification/New Project with Existing ID
More Information Response
Other Agency Comments
Pre -Application Submittal
Re-Issuance\Renewal Request
Stream or Buffer Appeal
Pre -Filing Meeting Date Request was submitted on:
2/7/2023
Project Contact Information
Name: Jerry Dowless
Who is submitting the information?
Email Address: [e-mail]
Project Information
Existing ID #: Existing Version:
20230231 1
20170001 (no dashes) 1
Project Name: Dowless Home Placement Buffer Variance
Is this a public transportation project?
Yes
No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
Yes No Unknown
Is this project connected with ARPA funding?
Yes No
County (ies)
Pamlico
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach document
BAF B1j - Orchard Creek Estates Plat.pdf
BAF B3b - NC_Oriental_20190720_TM_geo.pdf
BAF B3c - Soil Survey Map of Orchard Creek
Estates.pdf
BAF B4 - House Placement Mod JD.pdf
Only pdf or kmz files are accepted.
1.47MB
1.62MB
253.63KB
311.06KB

Describe the attachments or
comments:
The attachments are listed by paragraph. Also
The following are corrections or additions...
Section B1m. yes (Neuse)
Section C1c. Neuse (15A NCAC 02B.0233)
Buffer impact number — Permanent (P) or Temporary (T) Reason for impact Type of impact (exempt, allowable,
allowable w/ mitigation) Stream name Buffer mitigation required? Zone 1 impact (sq ft) Zone 2 impact
(sq ft)
B1 P T Residential Properties Allowable upon Authorization Brite Creek Yes No 320
Zone 1 Impact: 0
Zone 2 Impact: approximately 320 Sq Ft
Comments: enables the inclusion of a porch 8'x32' across the back of the building and addition of a workshop
and provides room for preinstallation of house modules storage off public lands
Sign and Submit
By checking the box and signing box below, I certify that:
• I, the project proponent, hereby certifies that all information contained herein is true, accurate, and complete to the
best of my knowledge and belief.
• I, the project proponent, hereby requests that the certifying authority review and take action on this CWA 401
certification request within the applicable reasonable period of time.
• I agree that submission of this online form is a "transaction" subject to Chapter 66, Article 40 of the NC General
Statutes (the "Uniform Electronic Transactions Act");
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General
Statutes (the "Uniform Electronic Transactions Act");
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a
written signature; AND
• I intend to electronically sign and submit the online form.
Signature:
Cif-t9 0.e.rei1J
Submittal Date: 2/24/2023
Is filled in automatically.

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REF
SIT
VICINITY rY MAP - NTS
ORCHARD CREEK ESTATES RECORDED
AB. A SLIDE 36-8
THIS PROPERTY LIES WITHIN FLOOD ZONE
▪ E ( EL 8 ) ACCORDING TO FEMA FIRM DATA
THE PRESENT OWNER OF THIS PROPERTY.
ACCORDING TO PAMLICO COUNTY GIS, IS DOUGLAS
KUETT
PIM Plan Fnr
Jerry Do wless
329 Penninsula Dr, Oriental, NC 28571
Lot 3, Orchard Creek Estates
Twsp_ 12, Pamlico County
} September 29, 2022
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