20161236 Ver 1_CAMA Application_20161214

"v
Coastal Management
ENVIRONMENTAL QUALITY
December 8, 2016
MEMORANDUM
TO:
FROM:
SUBJECT:
Applicant:
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
ter'rc?;,rry
2 3 1 6 1 2 3 6
Karen Higgins, Compliance and Permitting Unit
DWR - Water Quality Program
Doug Huggett, Major Permits Coordinator
Division of Coastal Management
BRAXTON DAVIS
CAMA/DREDGE & FILL Permit Application Review
Thomas & Julie Gardner
Project Location: Osprey Drive, Albemarle Shores Subdivision, Chowan County
Proposed Project: Retaining wall, bulkhead, pier, platform, dwelling, pool, deck, fill
Please indicate below your agency's position or viewpoint on the proposed project and return this
form by 12/29/16 to 400 Commerce Avenue, Morehead City, NC 28557 (fax: [phone]).
If you have any questions regarding the proposed project, please contact Lynn Mathis at (252)
264-3902. When appropriate, in-depth comments with supporting data are requested.
REPLY:
SIGNED
This agency has no objection to the project as proposed.
This agency has no comment on the proposed project.
This agency approves of the project only if the recommended changes are
incorporated. See attached.
This agency objects to the project for reasons described in the attached
comments.
DATE
Nothing Compares_-,,
State of North Carolina I Environmental Quality I Coastal Management
401 S. Griffin St., Ste 300 1 Elizabeth City, NC 27909
252-264-39011252-331-2951[fax]

1.
R1
3.
4.
DIVISION OF COASTAL MANAGEMENT
FIELD INVESTIGATION REPORT
APPLICANT'S NAME: Thomas and Julie Gardner
LOCATION OF PROJECT SITE: Lots #30 and #31 on Osprey Drive (Private Road),
Albemarle off of Drummond's Point Road (SRI 100), in Chowan
County, le Shores Subdivision,
on the Albemarle Sound.
C
Photo Index: 20.06:154-6765 F15, F16, G15, H14, H15
Plane Coordinates: X: 32002764633.824ftUSE 0853 76024,45.24' W
State Lat.: 37004'03.27" N Long.:
INVESTIGATION TYPE: CAMA /D&F
NVESTIGATIVE PROCEDURE: Dates of Site Visit: s o N er 30, 2016
I Was Applicant
ING PROCEDURE: Application Received complete: December 2, 2016
5. PROCESS Office: Elizabeth City
6. SITE DESCRIPTION:
(A) Local Land Use Plan: Chowan County
LUP Land Classification: W, TA & ES Conservation
(B) AEC(s) Involved:
(C) Water Dependent: Yes
(D) Intended Use: Private Residential None
(E) Wastewater Treatment: Planned: Septic System
(F) Type of Structures: Existing: Nothing,
pier & platform, bulkhead, retaining
Planned: Dwelling, p
wall and associated infrastructure.
(G) Estimated Annual Rate of Erosion: 2'
GRADED FILLED SHADING
7. HABITAT DESC11 RIPTION: 91 0s
(A) Shallow Water Bottom: EW & PTA
510sf
(B) High Ground: ES
49,407sf
22,093sf
(C) Wetlands: 404
(D) Total Area Disturbed: 72,920sf 1.67 Acres
(E) Primary Nursery Area: No
(F) Water Classification: SB Open: No 1 986' of
the installation of (4) 24" culverts
PROJECT SUMMARY: Proposed development will, 3) include the following:
8• 22,093sf of 404 we
retaining wall, 2) the filling
under a fill
driveway, 4) the construction of -255' of bulkheads sw9ithe
ng pool, and, 8) a
pier with a 20'x 20' platform, 6) a single family residence, 7
brick patio/pool deck.

Thomas & Julie Gardner
Field Investigation Report
Page 2
Proiect Setting
The applicant's project site consists of two vacant waterfront lots located at Albemarle Shores
Subdivision, in Chowan County; more specifically described as being lots #30 and #31 on
Osprey Drive. The property addresses are 226 and 228 Osprey Drive, Edenton, North Carolina.
Both lots have unprotected shorelines totaling 255.33' abutting the Albemarle Sound. A 5'
concrete barrier has been placed along the northeast corner of the applicant's shoreline by the
adjacent property owner, to protect the corner of their bulkhead. There is a 5' to 6' high
escarpment along the applicant's shoreline with clear evidence of erosion. It is estimated that
the fetch at this site is over 9 miles, making the shoreline extremely susceptible to erosion.
Both lots are deep (between 665' and 803') with two areas of high ground bisected by 1.968
acres of 404 wetlands. Uplands on the road side of the two properties is 1.262 acres
(54,972sf), and the upland area on sound side is —.735 acres (23,016sf).
Albemarle Shores is a two phase 95 lot residential subdivision Zoned Al (Agricultural) by the
Chowan County Planning Department. Located to the north of Albemarle Shores, at the end of
Osprey Drive, is the entrance to The Refuge at Drummonds Point, a vacant waterfront
residential subdivision. Located to the immediate north of the applicant's property is a
developed residential lot, to the south is a vacant residential lot with an elevated walkway over
the 404 wetlands to access the waterfront section of the property. The two lots abut Osprey
Drive to the west and the Albemarle sound to the east.
Vegetation includes, but is not limited to, Black Tupelo (Nyssa sylvatica), Narrow -leaved Cattail
(Typha angustifolia), Bald Cypress (Taxodium distichum), Arrow Arum (Peltandra virginica),
Virginia Chain Fern (Woodwardia virginica), Caric Sedge (Carex spp.), Swamp Loosestrife
(Decodon verticillatus), groundsel tree (Baccharis halimifolia), carolina- jasmine (Gelsemium
sempervirens), Sweet Bay (Mannoila virginiana), Catbrier (smilax bona nox), Loblolly Pine
(Pinus teada), American Holly (Ilex opaca), Live Oak (Quercus Virginian), Poison Ivy,
(Toxicodendron radican), Spanish Moss (Tillandsia usneoides), Red Maple (Acerrubrum), Wax
Myrtle (Myrica cerifera), Virginia Creeper (Parthenocissus quinquefolia), and Pokeweed
(Phytolacca americana).
Water depths graduate from 0' at the shoreline to -3.5' at a distance 105' offshore. The waters
adjacent to the project site are a known submerged aquatic habitat, but no vegetation was
found within any proposed work area.
One known historic site (CO 0247) is documented as being 3,500' south of the applicant's
property. There are no known geologic formations or archaeological sites associated with the
applicant's property.
Development Proposal
The applicant's, Thomas and Julie Gardner, propose the following development: 1) the filling of
22,093sf of 404 wetlands (for the construction of an access road and a waterfront building site),
2) the installation of a septic pumping station from the sound side of the property to a septic

Thomas & Julie Gardner
Field Investigation Report
Page 3
drain field on the road side of the property, 3) the construction of 986' of retaining wall to
contain the proposed wetland fill, 4) the installation of (4) 24" culverts to maintain a hydrological
the
connection between the wetland areas to the north and south of the proposed fill area,
construction of a single family residence, 5) construction of a swimming pool, 6) installation of a
brick patio/pool deck, 7) the construction of a -255' long vinyl bulkhead an average of 2'
waterward of normal water level (NWL), and, 8) the construction of a 85' x 6' pier with a 20' x
20' platform.
The applicant's consultant, George Wood, has submitted application to The Great Dismal
Swamp Restoration Bank, LLC, to obtain 1:01 wetland mitigation credits in trade for the
proposed wetland fill. Confirmation of the mitigation credit has not been received.
The total area of proposed land disturbance will be-71,500sf (1.64 acres), and the total are of
water impact will be 1,420sf
Proposed development will involve the following:
1) Wetland Fill
404 Fill: a093sf
Fill within the 75' Area of Environmental Concern (AEC) = 185sf
2) Shallow Water Bottom Fill
Bulkhead: -255' long x 2'average (5' max.) waterward of NWL 51.t3sf
3) Impervious Surface
ming pool, p
Impervious
Residence, swimatio/pool deck and gravel driveway = 9,436sf
Within the 75' AEC = 1,416sf (40' from NWL at bulkhead alignment)
4) Open Water Shading - Location to be 25' south of the nearest riparian line.
Pier: 85' x 6' = 510sf
Platform: 20' x 20' = 400sf
WR
5) Associated Land Disturbance
Disturbance associated with the installation of the septic drain field, pumping
station and bulkhead = 40AO7st
Total area of impact: Land = 71,500sf
Water= 1 420s
72 �21�s
Anticipated Impacts
1) Approximately 22,093sf of 404 wetlands will be filled.
2) Project will result in the shading
obottom wilopen
be filledwater
by thethe
constructionplatform.
a new
3) Approximately 510sf of shallow
bulkhead.

Thomas & Julie Gardner
Field Investigation Report
Page 4
4) The proposed development may temporarily disrupt animal populations within adjacent
waters and the project area.
5) Installation of pilings for the proposed piers may result in temporally suspending
sediments in the water.
6) During the project construction it is anticipated that noise levels may periodically
increase above surrounding background (ambient) levels from heavy equipment.
7) Treated wood leaches over time in surrounding waters and sediment. The amount of
leaching is dependent on the type of organic material present in the water bottom
substrate, oxygen levels and water movement; however, it is estimated that 90% of the
leaching will occur within the first 90 days.
Submitted by: Lynn Mathis
Date: December 2, 2016

RCM MP41
APPLICATION for Received.
Nefor Development Permit �� 3
(last revised 12/27/06) M�Gc
North Carolina DIVISI N OF COASTAL MANAGEMENT
1. Primary Applicant/ Landowner Information
Business Name
Project Name (if applicable)
Applicant 1: First Name
Thomas
MI
D.
Last Name
Gardner
Applicant 2: First Name
Julie
MI
M.
Last Name
Gardner
If additional applicants, please attach an additional page(s) with names listed.
Mailing Address
44 Ford Avenue
PO Box
City
Wharton
State
NJ
ZIP
07885
Country
USA
Phone No.
201 - 874 - 5801 ext.
FAX No.
- -
Street Address (if different from above)
City
State
ZIP
Email
[e-mail]
2. Agent/Contractor Information
Business Name
Environmental Professionals, Inc.
Agent/ Contractor 1: First Name
George
MI
H.
Last Name
Wood
Agent/ Contractor 2: First Name
MI
Last Name
Mailing Address
PO Box
3368
City
Kill Devil Hills
State
NC
ZIP
27948
Phone No. 1 T2512
252 - 441 - 0239 ext. 105
hone No. 2
- 423 - 1234 ext.
FAX No.
252 441 0721
Contractor #
Street Address (if different from above)
1404 S. Virginia Dare Trail
City
Kill Devil Hills
State
NC
ZIP
27948 -
Email
[e-mail]
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PROJECT NARRATIVE
THOMAS D. & JULIE M. GARDNER: , 2.1 11ti�
LOTS 30 & 31— OSPREY DRIVE`S �
ALBEMARLE SHORES II
CHOWAN COUNTY, NORTH CAROLINA n0 m -F
The applicant owns Lots 30 and 31 of Albemarle Shores I1 in Chowan County. The site is situated between
the improved Osprey Drive and Albemarle Sound. Highground along Osprey Drive is available for
wastewater disposal, and a highground area on the Albemarle Sound is desirable for residential
construction.
The project anticipates the need to fill wetlands which are subject to Section 404 of the Clean Water Act for
access and to support the residential construction. Also proposed is the construction of a bulkhead along
the eroding shoreline an average of 2 feet waterward of Normal Water yet not exceeding 5 feet. An 85 -foot
long pier with a 20 x 20 foot tee is proposed to provide access to water for a shallow draft boat. Water
depths at the end of the pier are approximately 3.5 feet.
Of the 1.968 acres of wetlands at the site, 0.14 acres are proposed to be filled for access and 0.37 acres for
house construction. All fill will be retained by a retaining wall with 15 -foot tiebacks. Mitigation is
proposed for unavailable wetland impacts from The Great Dismal Swamp Restoration Bank.

Form DCM MP -1 (Page 2 of 4)
APPLICATION for
Major Development Permit
3. Project Location -
County (can be multiple)
Street Address
State Rd. #
Chowan
228 Osprey Drive
d. Approximate elevation of tract above NHW (normal high water) or
Subdivision Name
City
State
Zip
Albemarle Shores II
Pinus taeda, Nyssa sylvatica, Smilax bona-nox, Taxodium distichum, Mannolia virginiana, Typha latifolia
NC
-
Phone No.
Lot No. (s) (if many, attach additional page with list)
- - ext.
30, 31, 1 ,
a. In which NC river basin is the project located?
b. Name of body of water nearest to proposed project
Pasquotank
Albemarle Sound
c. Is the water body identified in (b) above, natural or manmade?
d. Name the closest major water body to the proposed project site.
®Natural []Manmade ❑Unknown
Albemarle Sound
e. Is proposed work within city limits or planning jurisdiction?
f. If applicable, list the planning jurisdiction or city limit the proposed
®Yes []No
work falls within.
Chowan
4. Site Description
a. Total length of shoreline on the tract (ft.)
b. Size of entire tract (sq.ft.)
250 �zp� ��Z�
172,715.4 (2 tracts)
c. Size of individual lot(s)
d. Approximate elevation of tract above NHW (normal high water) or
88,121.9, 84,593.5,
NWL (normal water level)
(If many lot sizes, please attach additional page with a list)
+/- 6' ❑NHW or ®NWL
e. Vegetation on tract
Pinus taeda, Nyssa sylvatica, Smilax bona-nox, Taxodium distichum, Mannolia virginiana, Typha latifolia
f. Man-made features and uses now on tract
None
g. Identify and describe the existing land uses adjacent to the proposed project site.
Residential
h. How does local government zone the tract?
i. Is the proposed project consistent with the applicable zoning?
A-1 Agricultural District
(Attach zoning compliance certificate, if applicable)
®Yes []No [INA
j. Is the proposed activity part of an urban waterfront redevelopment proposal? ❑Yes ®No
k. Hasa professional archaeological assessment been done for the tract? If yes, attach a copy. []Yes ®No ❑NA
If yes, by whom?
I. Is the proposed project located in a National Registered Historic District or does it involve a []Yes ®No ❑NA
National Register listed or eligible property?
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Form DCM MP -1 (Page 3 of 4)
APPLICATION for
Major Development Permit
m. (i) Are there wetlands on the site? - .®Yes ❑No
(ii) Are there coastal wetlands on the site? ❑Yes ®No
(iii) If yes to either (i) or (ii) above, has a delineation been conducted? ®Yes []No
(Attach documentation, if available)
n. Describe existing wastewater treatment facilities.
None
o. Describe existing drinking water supply source.
None
p. Describe existing storm water management or treatment systems.
None
5. Activities and Impacts
a. Will the project be for commercial, public, or private use?
❑Commercial ❑Public/Government
®Private/Community
b. Give a brief description of purpose, use, and daily operations of the project when complete.
Single -Family Residential
c. Describe the proposed construction methodology, types of construction equipment to be used during construction, the number of each type
of equipment and where it is to be stored.
Bulldozer for fill, water jets and vibrating hammer for bulkhead, saws and hammers for construction
d. List all development activities you propose.
Pool, single-family residence, access road, bulkhead, and pier
e. Are the proposed activities maintenance of an existing project, new work, or both?
New
f. What is the approximate total disturbed land area resulting from the proposed project?
1.64 ❑Sq.Ft or ®Acres
g. Will the proposed project encroach on any public easement, public accessway or other area
❑Yes ®No [INA
that the public has established use of?
h. Describe location and type of existing and proposed discharges to waters of the state.
None Existing
None Proposed
L Will wastewater or stormwater be discharged into a wetland?
[]Yes ®No ❑NA
If yes, will this discharged water be of the same salinity as the receiving water?
❑Yes ❑No ®NA
j. Is there any mitigation proposed?
®Yes []No ❑NA
If yes, attach a mitigation proposal.
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Form DCM MP -1 (Page 4 of 4)
APPLICATION for
Major Development Permit
6. Additional Information -
In addition to this completed application form, (MP -1) the following items below, if applicable, must be submitted in order for the application
package to be complete. Items (a) — (t) are always applicable to any major development application. Please consult the application
instruction booklet on how to properly prepare the required items below.
a. A project narrative.
b. An accurate, dated work plat (including plan view and cross-sectional drawings) drawn to scale. Please give the present status of the
proposed project. Is any portion already complete? If previously authorized work, clearly indicate on maps, plats, drawings to distinguish
between work completed and proposed.
c. A site or location map that is sufficiently detailed to guide agency personnel unfamiliar with the area to the site.
d. A copy of the deed (with state application only) or other instrument under which the applicant claims title to the affected properties.
e�Theappropriate application fee. Check or money order made payable to DEN R.
f. A I' ist of the names and complete addresses of the adjacent waterfront (riparian) landowners and signed return receipts as proof that such
owners have received a copy of the application and plats by certified mail. Such landowners must be advised that they have 30 days in
which to submit comments on the proposed project to the Division of Coastal Management.
Name Michael Brown Phone No.
Address 10105 Orlando Stone Drive - Bristow, VA 20136
Name Louis Posedel Phone No.
Address 205 Cameron Glen Drive - Apex, NC 27502
Name Phone No.
Address
g. A list of previous state or federal permits issued for work on the project tract. Include permit numbers, permittee, and issuing dates.
None
I�
h. Signed consultant or agent authorization form, if applicable.
i. Wetland delineation, if necessary.
j. A signed AEC hazard notice for projects in oceanfront and inlet areas. (Must be signed by property owner)
k. A statement of compliance with the N.C. Environmental Policy Act (N.C.G.S. 113A 1-10), if necessary. If the project involves expenditure
of public funds or use of public lands, attach a statement documenting compliance with the North Carolina Environmental Policy Act.
7. Certification and Permission to Enter on Land
I understand that any permit issued in response to this application will allow only the development described in the application.
The project will be subject to the conditions and restrictions contained in the permit.
I certify that I am authorized to grant, and do in fact grant permission to representatives of state and federal review agencies to
enter on the aforementioned lands in connection with evaluating information related to this permit application and follow-up
monitoring of the project.
I further certify that the information provided in this application is truthful to the best of my knowledge.
Date September 21, 2016 Print Name George H. Wo d
Signature
Please indicate application attachments pertaining to your proposed project.
®DCM MP -2 Excavation and Fill Information ❑DCM MP -5 Bridges and Culverts
®DCM MP -3 Upland Development
®DCM MP -4 Structures Information
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Form DCM MP -2
EXCAVATION and FILL DMEC
(Except for bridges and culverts)
Attach this form to Joint Application for CAMA Major Permit, Form DCM MP -1. Be sure to complete all other sections of the Joint
Application that relate to this proposed project. Please include all supplemental information.
Describe below the purpose of proposed excavation and/or fill activities. All values should be given in feet.
1.
Access
®This section not applicable
a.
Amount of material to be excavated from below NHW or NWL in
b.
Other
Channel
Canal
Boat Basin
Boat Ramp
Rock Groin
Rock
(excluding
(NLW or
or other wetlands (WL)? If any boxes are checked, provide the
Breakwater
shoreline
NWL)
❑CW []SAV ❑SB
stabilization
Length
OWL []None
(ii) Describe the purpose of the excavation in these areas:
Width
DISPOSAL OF EXCAVATED MATERIAL
®This section not applicable
a.
Location of disposal area.
b.
Dimensions of disposal area.
Avg. Existing
(i) Do you claim title to disposal area?
d.
(i) Will a disposal area be available for future maintenance?
NA
NA
[]Yes []No ❑NA
Depth
(ii) If no, attach a letter granting permission from the owner.
(ii) If yes, where?
e.
(i) Does the disposal area include any coastal wetlands/marsh
f.
(i) Does the -disposal include any area in the water?
Final Project
(CW), submerged aquatic vegetation (SAV), shell bottom (SB),
[]Yes ❑No [INA
NA
NA
(ii) If yes, how much water area is affected?
Depth
number of square feet affected.
❑CW []SAV [:]SB
1.
EXCAVATION
®This section not applicable
a.
Amount of material to be excavated from below NHW or NWL in
b.
Type of material to be excavated.
cubic yards.
c.
(i) Does the area to be excavated include coastal wetlands/marsh
d.
High -ground excavation in cubic yards.
(CW), submerged aquatic vegetation (SAV), shell bottom (SB),
or other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
❑CW []SAV ❑SB
OWL []None
(ii) Describe the purpose of the excavation in these areas:
2,
DISPOSAL OF EXCAVATED MATERIAL
®This section not applicable
a.
Location of disposal area.
b.
Dimensions of disposal area.
c.
(i) Do you claim title to disposal area?
d.
(i) Will a disposal area be available for future maintenance?
❑Yes ❑No [INA
[]Yes []No ❑NA
(ii) If no, attach a letter granting permission from the owner.
(ii) If yes, where?
e.
(i) Does the disposal area include any coastal wetlands/marsh
f.
(i) Does the -disposal include any area in the water?
(CW), submerged aquatic vegetation (SAV), shell bottom (SB),
[]Yes ❑No [INA
or other wetlands (WL)? If any boxes are checked, provide the
(ii) If yes, how much water area is affected?
number of square feet affected.
❑CW []SAV [:]SB
❑WL ❑None
(ii) Describe the purpose of disposal in these areas:
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r
Form DCIII) NIP -2 (Excavation and Fill, Page 2 of 2)
3. SHORELINE STABILIZATION ®This section not applicable
(If development is a wood groin, use MP -4 — Structures)
a. Type of shoreline stabilization:
®Bulkhead ❑Riprap ❑Breakwater/Sill ❑Other:
c. Average distance waterward of NHW or NWL: +/- 2
e. Type of stabilization material:
Wooden Bulkhead
g. Number of square feet of fill to be placed below water level.
Bulkhead backfill +/- 20 c. vds. Riprap
Breakwater/Sill Other
i. Source of fill material.
Commercial Supplier
b. Length: 252 feet Z '
Width: 1'
d. Maximum distance waterward of NHW or NWL: +/- 5'
f. (i) Has there been shoreline erosion during preceding 12
months?
®Yes ❑No ❑NA
(ii) If yes, state amount of erosion and source of erosion amount
information.
Unknown
h. Type of fill material.
Sand
4. OTHER FILL ACTIVITIES ❑This section not applicable
(Excluding Shoreline Stabilization)
a. (i) Will fill material be brought to the site? ®Yes ❑No ❑NA b. (i) Will fill material be placed in coastal wetlands/marsh (CW),
If yes,
(ii) Amount of material to be placed in the water 20 c. yds.
(iii) Dimensions of fill area 252 x 2
(iv) Purpose of fill
Backfill Bulkhead
submerged aquatic vegetation (SAV), shell bottom (SB), or
other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
❑CW ❑SAV ❑SB
®WL 22.093 sa. ft. ❑None
(ii) Describe the purpose of the fill in these areas:
driveway & single-family residence
5. GENERAL
a. How will excavated or fill material be kept on site and erosion b. What type of construction equipment will be used (e.g., dragline,
controlled? backhoe, or hydraulic dredge)?
Fill material placed behind bulkhead or retaining wall(s). Backhoe
c. (i) Will navigational aids be required as a result of the project?
❑Yes ®No [INA
(ii) If yes, explain what type and how they will be implemented.
N/A
d. (i) Will wetlands be crossed in transporting equipment to project
site? ❑Yes ®No [:]NA
(ii) If yes, explain steps that will be taken to avoid or minimize
environmental impacts.
N/A
September 21, 2016 Thomas D. & Julie M. Gardner
Date Applicant e
Gardner
Appli Signature
Project Name
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Form DCM MP -3 n ;
UPLAND DEVELOPMENT DCM-EC
(Construction and/or land disturbing activities)
Attach this form to Joint Application for CAMA Major Permit, Form DCM MP -1. Be sure to complete all other sections of the Joint
Application that relate to this proposed project. Please include all supplemental information.
GENERAL UPLAND DEVELOPMENT
a. Type and number of buildings, facilities, units or structures
proposed.
One
c. Density (give the number of residential units and the units per
acre).
one unit per 3.965 acres
e. If the proposed project will disturb more than one acre of land, the
Division of Land Resources must receive an erosion and
sedimentation control plan at least 30 days before land -disturbing
activity begins.
(i) If applicable, has a sedimentation and erosion control plan been
submitted to the Division of Land Resources?
[]Yes ®No ❑NA
(ii) If yes, list the date submitted:
g. Give the percentage of the tract within the coastal shoreline AEC to
be covered by impervious and/or built -upon surfaces, such as
pavement, building, rooftops, or to be used for vehicular driveways
or parking.
+/-6.6%
i. Give the percentage of the entire tract to be covered by impervious
and/or built -upon surfaces, such as pavement, building, rooftops,
or to be used for vehicular driveways or parking.
5.5%
Describe proposed method of sewage disposal
On -Site Wastewater'- Ground Absorption
I. Describe location and type of proposed discharges to waters of the
state (e.g., surface runoff, sanitary wastewater, industrial/
commercial effluent, "wash down" and residential discharges).
None
b. Number of lots or parcels.
2 lots (combined)
d. Size of area to be graded, filled, or disturbed including roads,
ditches, etc.
1.64 acres
f. List the materials (such as marl, paver stone, asphalt, or concrete)
to be used for impervious surfaces.
Concrete, Gravel
h. Projects that require a CAMA Major Development Permit may also
require a Stormwater Certification.
(i) Has a site development plan been submitted to the Division of
Water Quality for review?
❑Yes ®No ❑NA
(ii) If yes, list the date submitted: N/A
k. Have the facilities described in Item (i) received state or local
approval?
❑Yes []No ®NA
If yes, attach appropriate documentation.
m. Does the proposed project include an innovative stormwater
design?
[]Yes ®No [INA
If yes, attach appropriate documentation.
252-808-28082 :: 1-888-4RCOAST wwvv nccoastetmanegem$ryne# revised: 12126/08

Form DCC P-3 (Upland Development, Page 2 of 2)
m. Describe proposed drinking water supply source (e.g., well, n. (i) Will water be impounded? ❑Yes ®No [INA
community, public system, etc.)
(ii) If yes, how many acres?
Well
o. When was the lot(s) platted and recorded?
July 16, 1998
September 21, 2016
Date
Gardner
Project Name
Thomas D. & Julie M. Gardner
Applicant ame
AppLVant Signature
p. If proposed development is a subdivision, will additional utilities be
installed for this upland development?
❑Yes ❑No ®NA
252-808-2808 :: 1-888-4RCOAST :: wwwmccmastalmanagement.net revised: 12/26/06

i � A
Form DCM MP -4_h
STRUCTURES DMEC
(Construction within Public Trust Areas)
Attach this form to Joint Application for CAMA Major Permit, Form DCM MP -1. Be sure to complete all other sections of the Joint
Application that relate to this proposed project. Please include all supplemental information.
1. DOCKING FACILITY/MARINA CHARACTERISTICS
a. (i) Is the docking facility/marina:
[--]Commercial ❑Public/Government ®Private/Community
c. (i) Dock(s) and/or pier(s)
(ii) Number 1
(iii) Length 85
(iv) Width 6
(v) Floating ❑Yes ®No
e. (i) Are Platforms included? ®Yes []No
If yes:
(ii) Number 1
(iii) Length 20
(iv) Width 20
(v) Floating []Yes ®No
Note: Roofed areas are calculated from dripline dimensions.
g. (i) Number of slips proposed
1
(ii) Number of slips existing
0
i. Check the proposed type of siting:
❑ Land cut and access channel
[]open water; dredging for basin and/or channel
®Open water; no dredging required
❑Other; please describe:
k• Typical boat length: 20'
m. (i) Will the facility have tie pilings?
[]Yes ®No
(ii) If yes number of tie pilings?
0
❑This section not applicable
b. (i) Will the facility be open to the general public?
[]Yes ®No
d. (i) Are Finger Piers included? ❑Yes ®No
If yes:
(ii) Number N/A
(iii) Length N/A
(iv) Width N/A
(v) Floating []Yes ®No
f. (i) Are Boatlifts included? ❑Yes ®No
If yes:
(ii) Number 0
(iii) Length N/A
(iv) Width N/A
h. Check all the types of services to be provided.
❑ Full service, including travel lift and/or rail, repair or
maintenance service
❑ Dockage, fuel, and marine supplies
❑ Dockage ("wet slips") only, number of slips:
❑ Dry storage; number of boats:
❑ Boat ramp(s); number of boat ramps:
® Other, please describe:
cleats
j. Describe the typical boats to be served (e.g., open runabout,
charter boats, sail boats, mixed types).
Open runabout
I. (i) Will the facility be open to the general public?
❑Yes ®No
252-808-2808 :: 1-888-4RCOAST w+Nw rsccoestainrmanw�emQnt.ggt revised: 12/27/06

Form DCM MP -4 (structures, Page 2 of 4)
2. DOCKING FACILITY/MARINA OPERATIONS ®This section not applicable
a. Check each of the following sanitary facilities that will be included in the proposed project.
❑ Office Toilets
❑ Toilets for patrons; Number: ; Location:
❑ Showers
❑ Boatholding tank pumpout; Give type and location:
b. Describe treatment type and disposal location for all sanitary wastewater.
c. Describe the disposal of solid waste, fish offal and trash.
d. How will overboard discharge of sewage from boats be controlled?
e. (i) Give the location and number of "No Sewage Discharge" signs proposed.
(ii) Give the location and number of "Pumpout Available" signs proposed.
f. Describe the special design, if applicable, for containing industrial type pollutants, such as paint, sandblasting waste and petroleum products.
g. Where will residue from vessel maintenance be disposed of?
h• Give the number of channel markers and "No Wake" signs proposed.
i. Give the location of fuel -handling facilities, and describe the safety measures planned to protect area water quality.
j. What will be the marina policy on overnight and live -aboard dockage?
k. Describe design measures that promote boat basin flushing?
I. If this project is an expansion of an existing marina, what types of services are currently provided?
m. Is the marina/docking facility proposed within a primary or secondary nursery area?
❑Yes ❑No
252-808-2808 :: 1-888-4RCOAST :: www_nccoastaimanaaeement.net
revised: 12/27/06

Forli'01 ®CM MP -4 (Structures, Page 3 of 4)
n. Is the marina/docking facility proposed within or adjacent to any shellfish harvesting area?
❑Yes [:]No
o. Is the marina/docking facility proposed within or adjacent to coastal wetlands/marsh (CW), submerged aquatic vegetation (SAV), shell bottom
(SB), or other wetlands (WL)? If any boxes are checked, provide the number of square feet affected.
❑CW ❑SAV ❑SB
OWL ❑None
p. Is the proposed marina/docking facility located within or within close proximity to any shellfish leases? ❑Yes ❑No
If yes, give the name and address of the leaseholder(s), and give the proximity to the lease.
3. BOATHOUSE (including covered lifts) ®This section not applicable
a. (i) Is the boathouse structure(s):
❑Commercial ❑Public/Government ❑Private/Community
(ii) Number
(iii) Length
(iv) Width
Note: Roofed areas are calculated from dripline dimensions.
4. GROIN (e.g., wood, sheetpile, etc. If a rock groin, use MP -2, Excavation and Fill.) ®This section not applicable
a. (i) Number
(ii) Length
(iii) Width
5. BREAKWATER (e.g., wood, sheetpile, etc.) ®This section not applicable
a• Length b. Average distance from NHW, NWL, or wetlands
c. Maximum distance beyond NHW, NWL or wetlands
6. MOORING PILINGS and BUOYS ®This section not applicable
a. Is the structure(s):
❑Commercial ❑Public/Government ❑Private/Community
c• Distance to be placed beyond shoreline
Note: This should be measured from marsh edge, if present.
e. Arc of the swing
7. GENERAL
b. Number
d. Description of buoy (color, inscription, size, anchor, etc.)
252-808-2808 :: 1-888-4RCOAST :: vvvvvv.ncc®astatmanage►e�ent.net revised: 12/27!06

Form DCM MP -4 (Structures, Page 4 of 4)
a. Proximity of structure(s) to adjacent riparian property lines
25'
Note: For buoy or mooring piling, use arc of swing including length
of vessel.
c. Width of water body
5.7 miles
e. (i) Will navigational aids be required as a result of the project?
❑Yes ❑No ®NA
(ii) If yes, explain what type and how they will be implemented.
b. Proximity of structure(s) to adjacent docking facilities.
> 30'
d. Water depth at waterward end of structure at NLW or NWL
-3.5
8. OTHER ❑This section not applicable
a. Give complete description:
September 21, 2016
Date
Gardner
Project Name
Thomas D. & Julie M. Gardner
Applicant me
Appi t Signature
252-808-2808 :: 1-888-4RCOAST :: www_niccoastaimanaaement.net revised: 12/27/06

MAJOR PERMIT FEE MATRIX
Applicant: `//i/aU05 #*dZ-6'C ��•z.c��rc�e
Selection
Development Type
Fee
DCM %
DWQ %
(14300 16014351000931625 6253)
(24300 1602 435100095 2341)
I. Private, non-commercial
E]
development that does not
$250
100%($250)
0%($0)
involve the filling or
excavation of any wetlands
oro en water areas:
II. Public or commercial
development that does not
$400
100%($400)
0%($0)
involve the filling or
excavation of any wetlands
oro en water areas:
E]
Major Modification to a
$250
100%($250)
0%($0)
CAMA Major permit
III. For development that
involves the filling and/or
excavation of up to 1 acre
of wetlands and/or open
water areas, determine if A,
B, C, or D below applies:
III(A). Private, non-
commercial development, if
$250
100%($250)
0%($0)
General Water Quality
Certification No. 3900 (See
attached) can be applied:
Ill(B). Public or commercial
development, if General
$400
100%($400)
0%($0)
Water Quality Certification
No. 3900 (See attached)
can be applied.
III(C). If General Water
Quality Certification No.
$400
60%($240)
40%($160)
3900 (see attached) could
be applied, but DCM staff
determined that additional
review and written DWQ
concurrence is needed
because of concerns
related to water quality or
aquatic life:
III(D). If General Water
Quality Certification No.
$400
60%($240)
40%($160)
3900 (see attached) cannot
be applied:
IV. For development that
El
involves the filling and/or
$475
60%($285)
40%($190)
excavation of more than
one acre of wetlands and/or
open water areas:

(PRIOR TO CONSTRUCTION)
L Pi a
-AND -LREA--&-!LILA--N-D-AR-LA-LALQ-U-LA--),AL
UPLANDS ON ROADSIDE OF WETLANDS 1 __52 ACRES
UPLANDS ON SOUNDSIDE OF WETLANDS 735 ACRES
WETLANDS = 1,968 ACRES
RD, I \ �l OSPREY �,15
ezALBEMARLE SOUND
VICINITY MAP
NTS
41
(o
PROPOD
N)j
GRAVE
ti DRIVEW-,
Ib
A)
cei
Q5,
PROPOSE
SEPTIC DRAINJ YIELD
11 AREA
(PROPOSED CONSTRUCTION CALCULATIONS)
AREA OF WETLAND FILL FOR DRIVEWAY = 5,891 SF
AREA OF WETLAND FILL FOR HOUSE = 116,202 SF
AREA OF WETLAND FILL WITHIN 75' AEC = 185 SF
IMPERVIOUS SURFACE AREA WITHIN 75 1 ACE - 1,416 SIF
TOTAL IMPERVIOUS SURFACE AREA = 9,436 SF
TOTAL AREA OF DISTURBANCE = 71,500 Sk-
CROSS SECTION A
_0 BE DESIGNED BY OTHERS)
TOP OF PROPOSED RETAN NG WALL DRIVEWAY
EXISTING GRA
CD
FILL AREA
+
hI
BOTTOM OF PROPOSED RETAIL41HG WALL
0
NOW OR FORMERLY
BROWN
D B. 470, PG, 205
P,C 11, SLID. 165A -D
CONTROLN_
REPAIR AP -14k CULVERTS
CORNER
(2)-24"RCP
All,
L 7
Ar
2.023 ACRES
A,
PROPOSED
CULVERTS
(2)-24"RCI
0) 0b,
1.942 ACRES
COP
10, L
19,
NOW OR FORMERLY A/1
POSEDEL
D.B.349, PG, 351
P -C. 1, SLD 165A -D
NOTES:
1.) ALL DIS TAHC'E'S Stiu-NN ARE HORIZONTAL GROUND DISTANCES,
2.) AREA COMPUTED= BY USING COORDINATE METHOD.
3.) THE PROPER I,' IS LOCATED IN FLOOD ZONE "AE (6)" AND "SHADED X",
AS SHOWI! HEREON, AND AS SHOWN ON FLOOD MAP PANEL
3720786z,00,i, DATED OCTOBER 16, 2008. (FEMA FLOOD ZONES ARE
SUBJECT TO CHANGE).
4.) PROPOSED R- . 1,111,1ING, WALL TIE BACKS & SHORELINE BULKHEAD TIE
BACKS ARE TO EXTEND ALONG THE ENTIRE LENGTH. THEY ARE NOT
SHOW THE �!ITIRE LENGTH HEREON FOR THE PURPOSE OF CLARITY.
CURVE TABLE
CURVERJVE
__T_
A�_ �_Erl,'TH
I RADIUS TANGENT
DELTA
CHORD BEARING
CHORD LENGTH
,
_
861,
35,00' t5.t6
46*50'06"
N53' 05' 43"E
27.82'
GRAPHIC SCALE
60 0 30 60 120
( IN FEET )
I inch = 60 ft.
2,40
1, NICHOLAS M. RACKLEY CERTIFY THAT THIS MAP WAS DRAWN UNDER MY SUPERVISION FROM AN ACTUAL
SURVEY MADE UNDER MY SUPERVISION FROM THE DEED DESCRIPTION RECORDED IN D.B. 475, PG. 738 & D.B.
475, PG, 741; THAT THE BOUNDARIES NOT SURVEYED ARE INDICATED AS DRAWN; THAT THE RATIO OF PRECISION
AS CALCULATED IS 1:10,000+; THIS MAP WAS PREPARED IN ACCORDANCE WITH G.S. 47-30 AS AMENDED.
WITNESS MY ORIGINAL SIGNATURE, [REGISTRATION NUMBER, AND SEAL -11-11S 12TH DAY OF OCTOBER, 2016,
eceived
1, NICHOLAS M. RACKLEY PLS -5062, CERTIFY,
F(II) C. THAT THE SURVEY IS OF AN EXISTING PARCEL OR PARCELS OF LAND
AND DOES NOT CREATE A NEW STREET OR CHANCE AN EXISTING STREET,
CROSS SECTION B PROPOSED
(TO BE DESIGNED BY OTHERS) DWELLING
TOP OF PROPOSED RETAINING WALL
iTK +
WETLANDS 0
TO
REMAIN
PROPOSED BULKHEAD
WITH TIE BACKS
BACKFILL AREA
FOR BULKHEADING
ISTIEIG GRADE
0
BOTTOM OF PROPOSED RETAINING WALL
PROPOSED BULKHEAD
TIE BACKS (SEE NOTE 4)
SHORELINE
SURVEY TRAVERSE LINE -
(6 --19- 2015)
CROSS SECTION C
(TO BE DESIGNED BY OTHERS)
TOP OF PROPOSED BULKHEAD & PIER ll�
0
0
BOTTOM OF PROPOSED BULKHEAD & PIER
NORMAL WATER LEVEL
ALBEMARLE SOUND
PROPOSED RETAINING WALL.
TIE BACKS (SEE NOTE 4)
Lll,,,E TAB
L I N E
T­BEA­Rl _J (3
v'I WATER DEPTH (9-8--,016
L I
si, 42 39"L
L__
T[S332-
4' 35"v,, fi
L2
S30' 29' 43"V, J11
Sf- A
-B-B-B-B-B-B-8-& e -a e-a-B-EHa-B- PROPOSED BULKHEAD NALL
5C
S2' 48 5'\""4, I_
5
0,
L6
e X
P/
L7
S59' '02' _23" - V, E 4_5____�
L8
'9
S71' 20' 16"V11
rL
S36' 20 36,7"V1,
LID
NICHOLAS LA. +,,Y
RIGHT OF WAY LINE
PLS,
1-11
Lll,,,E TAB
L I N E
T­BEA­Rl _J (3
v'I WATER DEPTH (9-8--,016
L I
si, 42 39"L
L__
T[S332-
4' 35"v,, fi
L2
S30' 29' 43"V, J11
EXISTING IRON DEBAR
-B-B-B-B-B-B-8-& e -a e-a-B-EHa-B- PROPOSED BULKHEAD NALL
E4
S2' 48 5'\""4, I_
5
S46' 08 21",
L6
SB* 07' 16"Y'y 06
L7
S59' '02' _23" - V, E 4_5____�
L8
'9
S71' 20' 16"V11
rL
S36' 20 36,7"V1,
LID
4
S41' 15 3
RIGHT OF WAY LINE
PROPOSED CONCRETE
1-11
S22' 53' 27 'J,,
- - - - - - - - - -
L.12
S17' 13' 33" lir
L13
S17` 13' 3? `R -11
L14
S30- 53 45"), 8
L15
N75- 16 3-11"'Al 2
L16
N 4 3' 17' 15 " AS
_17
N12' 34' 13"0v
_18
Nl0* 42 36"V
L19
N51' 34' 29"V,
L20
S26* 07' 57"V, 1 8
I L21
S31' 127'53
L22
S83' 53' 12"4A S _3
L23
�
S28' 40 23" Y 5
L24
S17' 11' 52E
Lzs
F
s25° 12 2, y8
L26
1
S30° 0 3 5-, 4;_
L-27
S15' 15' 02"E
L2;
56' 415 3i IV Su
WELL COVER L29 S27- 45' 47"4,
ENCROACHMENT - - - ------ __j
5,12 BULKHEAD
j ENCROACHMENT
CONCRETE BARRIERS
/'TO BE REMOVED
c '%7-__S66' 02 15 W
5,94'
E
-�_S58' 54' 43"W Eo 1 8-23"
C S76' 22' 44"N
6.90'
11�051
F3 fl PROPOSED
S54* 08"W
PIER
0
:1 55.87'
2.0'X\ _S54' 15' 08"W '5 Vin
18,35
0 12' 50,,W
)14' S54' 36' 40"W
38,24' S72' 05' 00"W
bio 40.16'
SPARSE SUBMERGED
AQUATIC VEGETATION
28,6105'
S' 18' 30"W
LEGEND
ALBEMARLE SOUND
Q{
PROPOSED WELL
v'I WATER DEPTH (9-8--,016
WETLAND SYMBOL
FEMA FLOOD 70k,FLitt L
SET IRON REBAR
30' CAMA BUFFER
EXISTING IRON DEBAR
-B-B-B-B-B-B-8-& e -a e-a-B-EHa-B- PROPOSED BULKHEAD NALL
CALCULATED POINT
.... ........................ ........ .................... ADJOINERS EXISTIN'
PROPERTY LINE
PROPERTY EXTENSION
PROPOSED WEFLAFID FjI_,
PROPERTY LINE FADED FOR CLARITY
RIGHT OF WAY LINE
PROPOSED CONCRETE
- - - -
- - - PROPERTY TIE LINE
- - - - - - - - - -
- - - - 404 WETLAND LINE
PROPOSED PATIO
"P2
U
43U
Ln
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r -
C -4
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00
rn
cn
kn
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