20051571 Ver 1_Complete File_20051031

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A961,~ ANENMM~
NCDENIR >
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
October 31, 2005
DWQ Project # 05-1571
Beaufort County

Mr. Mickey Purcell
235 Hatteras Ln.
Aurora, NC 27806
CERTIFIED MAIL: #7005 1820 0002 4630 4600

Subject Property: Bond Creek Estates Lot # 12
Tar-Pamlico Basin

Approval of Tar-Pamlico River Riparian Buffer Protection Rules Minor Variance 115A
NCAC 2B.0259 (9)(b)]

Dear Mr. Purcell:

You have our approval, in accordance with the conditions listed below, to impact 165 square
feet (ft) of Zone 2 of the protected buffers to construct a residence on the subject property as
described within your variance request dated August 13, 2005 and received by the Division of
Water Quality (DWQ) on August 16, 2005. These impacts must be in accordance with the plot
plan submitted with your application. This letter shall act as your Minor Variance approval as
described within 15A NCAC 2B .0259(9)(b). In addition to this approval, you should obtain or
otherwise comply with any other required federal, state or local permits before you go ahead
with your project including (but not limited to) Erosion and Sediment Control and Division of
Coastal Management regulations.

This approval is for the purpose and design that you described in your application. If you change
your project, you must notify us and you may be required to send us a new application. If the
property is sold, the new owner(s) must be given a copy of this variance approval and plot
plan and is thereby responsible for complying with all conditions. This approval requires
you to follow any conditions listed below.

M
A _
`dCpENR
N. C. Division of Water Quality 943 Washington Square Mall Washington, N.C. 27889 Telephone [phone] FAX [phone]

d

The Additional Conditions of the Certification are:

1. No Zone 1 Impacts

No impacts (except for proposed and "exempt" uses as identified within 15A NCAC 2B
.0259) shall occur to Zone 1 of the protected riparian buffers unless otherwise approved
by the DWQ. No impervious surfaces shall be added to Zone 1, unless otherwise
approved by the DWQ.

2. Buffer Mitigation (EEP)
Option 1:
You are required to mitigate for impacts to the protected riparian buffers. The
required area of mitigation to compensate for impacts to the protected riparian buffers is
248 square feet as required under this variance approval and 15ANCAC 2B .0259. You
have the option to make a payment into the Riparian Buffer Restoration Fund
administered by the NC Ecological Enhancement Program (EEP) to meet this mitigation
requirement. This has been determined by the DWQ to be a suitable method to meet the
mitigation requirement. In accordance with 15A NCAC 2B .0259, this contribution will
satisfy our compensatory mitigation requirements under 15A NCAC 2B .0259(9)(C).
Until the EEP receives and clears your check (made payable to: DENR -Ecological
Enhancement Program Office), no impacts specified in this variance approval shall occur.
The EEP should be contacted at [phone] if you have any questions concerning
payment into the EEP.

For accounting purposes, this variance approval authorizes payment into the
Riparian Buller Restoration Fund to compensate for 248 ft2 of required riparian
buffer mitigation for impacts to 165 ft2 of protected riparian buffers; 30-04-10, 27-
129-(1) river and subbasin."
Option 2:
The DWQ will accept an alternative method of mitigation (including but not limited to
Buffer Restoration or Enhancement) pursuant to the Buffer Mitigation Rule (15A NCAC
02B .0259) to satisfy this mitigation requirement. If you choose to pursue this option,
then you are required to submit in writing a mitigation plan to the DWQ Wetlands/401
Unit/ Washington Regional Office for review and approval. This plan should include a
proposal to plant at least two (2) native species of trees with in the riparian buffer area.
For more information, please contact this office. No impacts shall occur to the
protected buffers until the mitigation plan is approved by the DWQ.

3. Diffuse Flow

An additional condition is that all stormwater shall be directed as diffuse flow at non-
erosive velocities through the protected stream buffers and will not re-concentrate before
discharging into the stream as identified within 15A NCAC o ~5at Q ~'J D
l1

NOV 1 0 2005
LDENR - WATER QUALITY
l"rETLANDS AND STORIMATER BRANCH

4. Certificate of Completion

Upon completion of all work approved within the 401 Water Quality Certification or
applicable Buffer Rules, and any subsequent modifications, the applicant is required to
return the attached certificate of completion to the 401/Wetlands Unit, North Carolina
Division of Water Quality, 1650 Mail Service Center, Raleigh, NC, 27699-1650.

Requests for appeals of this decision shall be made to the Office of Administrative Hearings. If
you do not accept any of the conditions of this approval, you may ask for and adjudicatory
hearing. You must act within 60 days of the date that you receive this letter. To ask for a
hearing, send a written petition which conforms to Chapter 150B of the North Carolina General
Statutes to the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, NC .
27699-6714. This approval and its conditions are final and binding unless you ask for a hearing.
This Minor Variance Approval shall expire five (5) years from the date of this letter.

This letter completes the review of the Division of Water Quality under the Tar-Pamlico River
Riparian Buffer Protection Rules [15A NCAC 2B .0259(9)(b)]. Please call Kyle Barnes at 252-
948-3917 if you have any questions or require copies of our rules or procedural materials.
Sincerely,

Al Hodge/Supervisor
Division of Water Quality
Surface Water Protection
Washington Regional Office

Enclosures: Certificate of Completion
Project Plan

cc- DDWQ WaRO Regional Office
Q Central Office, Cyndi Karoly
Central Files
Beaufort Co; Dept. of Building Inspections

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Certification of Completion

DWQ Project No.: County:

Applicant:
Project Name:
4
Date of Issuance of Isolated Wetland Permit:

Certificate of Completion

Upon completion of all work approved within the 401 Water Quality Certification and Buffer Rules, and any
subsequent modifications, the applicant is required to return this certificate to the 401/Wetlands Unit, North Carolina
Division of Water Quality, 1650 Mail Service Center, Raleigh, NC, 27699-1650. This form may be returned to DWQ by
the applicant, the applicant's authorized agent, or the project engineer. It is not necessary to send certificates from all of
these.

Applicant's Certification

I, , hereby state that, to the best of my abilities, due care and diligence was
used in the observation of the construction such that the construction was observed to be built within substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and specifications.
and other supporting materials.
Signature: Date:

Agent's Certification

I, hereby state that, to the best of my abilities, due care and diligence was
used in the observation of the construction such that the construction was observed to be built within substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and specifications.
and other supporting materials.
Sk-mature: Date:

If this project was designed by a Certified Professional

1. as a duly registered Professional (i.e., Engineer,
Landscape Architect, Surveyor, etc.) in the State of North Carolina, having been authorized to observe (periodically.
weekly, full time) the construction of the project, for the Permittee hereby state that, to the best of my abilities, due care
and diligence was used in the observation of the construction such that the construction was observed to be built within
substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.

Signature: Registration No. Date

l

° L~C~CGdC~
,ECos stem_
3
_ NO V 2 ,9 2005
PROGRAM
L cTV„' DS AND STTORt1'r';ATM ERA01
RECEIPT
November 22, 2005
DWQ 05-1571
COE N/A
Mickey Purcell
235 Hatteras Lane _
Aurora, NC 27805 ( t}7
Project: Bond Creek Estates, Lot 12 County: Beaufort
The North Carolina Ecosystem Enhancement Program (NC EEP) has received a check in the amount of $238.08, check
number 78244725, as payment for the compensatory mitigation requirements of the 401 Water Quality Certification/Section
404 Permit issued for the above referenced project. This receipt serves as notification that the compensatory mitigation
requirements for this project have been satisfied. You must also comply with all other conditions of this certification and any
other state, federal or local government permits or authorization associated with this activity.
The NC EEP, by acceptance of this payment, acknowledges that the NC EEP is responsible for the compensatory mitigation
requirements associated with the project permit and agrees to provide the compensatory mitigation as specified in the permit.
The mitigation will be performed in accordance with the Memorandum of Understanding between the NC Department of
Environment and Natural Resources and the US Army Corps of Engineers dated November 4, 1998, as indicated in the table
below.
River Basin Wetlands Stream Buffer Buffer
Cataloging (Acres) (Linear Feet) Zone I Zone 2
Unit (Sq. Ft.) (Sq. Ft.)
Riparian Non-Riparian Coastal Marsh Cold Cool Warm
Tar-Pamlico 0 0 0 0 0 0 0 248
03020104
Please note that a payment made to the Ecosystem Enhancement Program is not reimbursable unless a request for
reimbursement is received within 12 months of the date of the receipt. Any such request must also be accompanied by letters
from the permitting agencies stating that the permit and/or authorization have been rescinded.
If you have any questions or need additional information, please contact Carol Shaw at [phone].
Sincerely, William D. Gilmore, PE

Director
cc: Cyndi Karoly, Wetlands/401 Unit
Doug Huggett, Division of Coastal Management
Scott Jones, USACE - Washington
Kyle Barnes, DWQ Regional Office - Washington
File

R_UtoY ' E Protect' Oar Stu t& ~~n
NCDENR
North Carolina Ecosystem Enhancement Program, 1652 Mail Service Center, Raleigh, NC 27699-1652 / 919-715-0476 / www.nceep.net

y

RCDENR'

North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
September 21, 2005

DWQ Project # 2005-1571
Beaufort County
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
#7003 3110 0002 0608 6979

Mr. Mickey Purcell
1000 Yacht Ct.
New Bern, NC 28563
D ~ U
Subject Property: Lot # 12 Bond Creek Estates 2005
~ SEP 2 3
REQUEST FOR ADDITIONAL INFORMATION o NR osSWxn s ~N
V'sm

Dear Mr. Purcell:

On August 15, 2005, the Division of Water Quality (DWQ) Wetlands/401 Unit received your
variance request. The DWQ has determined that your project is eligible for the use of the Minor
Variance From the Neuse and Tar-Pamlico Riparian Buffer Rules for residential structures.
However, the DWQ needs additional information in order to complete the approval process of
your variance. Therefore, unless additional information is provided as described below, we will
have to move toward denial of your request per 15A NCAC 213 .0259 (9) and will place this project on hold as incomplete until we receive this additional information. Specifically.

Additional Information Requested:

In Part 2: Section (1) the square footage of buffer impacts is requested. Your response was,
"build single family home on pilings". The square footage of impacts is needed to complete
your application. Please submit information indicating the number of square feet of impacts in
Zone 2 of the Riparian Buffer.

r~cuEr;~t
N. C. Division of Water Quality 943 Washington Square Mall Washington, N.C. 27889 Telephone [phone] FAX [phone]

variance letters

Subject: variance letters
From: Kyle Barnes <Kyle.13 [e-mail]>
Date: Mon, 31 Oct 2005 15:31:47 -0500
To: Ian McMillan <[e-mail]>

These were written today:

05-1571 Bond Creek Estates Lot #12
Beaufort 08/16/05 09/21/05 tp/gmv Hold: letter sent 9/21/05,
request for sq.footage on application

Issued normal conditions

05-1751 Oriental Plantation lot #56 pamlico 09/14/05 10/31/05 NBR/GMV Hold for more
information
KB

1 of 1 10/31/2005 3:42 PM

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director

September 21, 2005
DWQ Project # 2005-1571
Beaufort County

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
#7003 3110 0002 0608 6979
Mr. Mickey Purcell
1000 Yacht Ct.
New Bern, NC 28563

Subject Property: Lot # 12 Bond Creek Estates

REQUEST FOR ADDITIONAL INFORMATION

Dear Mr. Purcell:

On August 15, 2005, the Division of Water Quality (DWQ) Wetlands/401 Unit received your
variance request. The DWQ has determined that your project is eligible for the use of the Minor
Variance From the Neuse and Tar Pamlico Riparian Buffer Rules for residential structures.
However, the DWQ needs additional information in order to complete the approval process of
your variance. Therefore, unless additional information is provided as described below, we will
have to move toward denial of your request per 15A NCAC 2B .0259 (9) and will place this
project on hold as incomplete until we receive this additional information. Specifically:

Additional Information Requested:

In Part 2: Section (1) the square footage of buffer impacts is requested. Your response was,
"build single family home on pilings". The square footage of impacts is needed to complete
your application. Please submit information indicating the number of square feet of impacts in
Zone 2 of the Riparian Buffer.

Q12 10-1r-, 11,~oa~o
D
OCT 1 3 2005
DENR - WATER QUALITY
WETLANDS AND STOM MATER BRANCH
XiA
NCE)Mi
N. C. Division of Water Quality 943 Washington Square Mall Washington, N.C. 27889 Telephone [phone] FAX [phone]

Please respond in writing within three weeks of the date of this letter by sending a copy of
this information to Kyle Barnes of the DWQ Washington Regional Office at 943 Washington
Square Mall, Washington, NC 27889. If we do not hear from you in three weeks, we will
assume that you no longer want to pursue this project and we will consider the project as
withdrawn. Please call Kyle Barnes of this office at [phone] if you have any questions.

incerel ,

Al Ho ge Supervisor
Division of Water Quality
Washington Regional Office

cc: /01 Central Office

Variance Triage Sheet

DATE: 8/22/05 PROJECT NAME: Bond Creek Estates, lot 12

DWQ 20051571

COUNTY: Beaufort

TO: Kyle Barnes, Washington Regional Office

FROM: Debbie Edwards TELEPHONE: (919) 733-9502

The file attached is being forwarded to you for your evaluation.
Please call if you need assistance.

"General" Major Variance

Minor Variance

COMMENTS: As per the discussion regarding revision of the triage
and delegation processes, please review the attached file. Note that

you are the first reviewer, so this file will need to be reviewed for
administrative as well as technical details. If you elect to place this
project on hole, please ask the applicant to provide your requested

information to both the Central Office in Raleigh as well as the
Washington Regional Office. As discussed, this is an experimental,
interim procedure. Please let the Central Office know of any

complications you encounter, whether related to workload, processing
times, or lack of a "second reviewer" as the triage process in Central
Office had previously provided.

OFFICE USE ONLY: Date Received Request #

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality

Variance Request Form - for Minor Variances
Protection and Maintenance of Riparian Areas Rules

NOTE. This form maybe photocopied for use as an original.

Please identify which Riparian Area (Buffer) Protection Rule applies.

? Neuse River Basin: Nutrient Sensitive Waters Management Strategy
Protection and Maintenance of Riparian Areas Rule (15A NCAC 02B
.0233)

Tar-Pamlico River Basin: Nutrient Sensitive Waters Management
Strategy Protection and Maintenance of Riparian Areas Rule (15A
NCAC 02B.0259)

? Catawba River Basin: Protection and Maintenance of Existing Riparian
Buffers (15A NCAC 0213.0243)
D Q~

Part 1: General Information AU D
(Please include attachments if the room provided is insufficient.) G 2005
ti ps~D SA R Q ALI
1. ,~A,ppPlicant's name (the corporation, individual, etc. who owns the property).
<,glpA M,'Ckye / v- Cr' tea/ WA//amt P14f r- ! ~cH
2. Print Owner/Signing Official (person legally responsible for the property and its compliance)
Name: ~q /n/emu rc e /l
Title: ow n c r
Street address: aSi- E4q7[i e-,ys lom e-
City, State, zip: /got rd rI9, 41.c- CR 9P01o
Telephone: 0?15Z lv 7 0- 8 9 9 5'
Fax: aS2 3-? 9 (o S
3. Contact person who can answer questions about the proposed project:
Name: gyp,( lJ7. '1~~t r•c e
Telephone: aS'2 6 70 -?995
Fax: o? S2 6 3 3 o'Z 9G S
Email: /V P vr-(0 &2T~ l: n k , Ale- _
4. Project Name (Subdivision, facility, or establishment name - consistent with project name on
plans, Sp cifications, letters, operation and maintenance agreements, etc.):
Ban of ej-ge /C f S 7'~) Te.S
Version 2: November 2002

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5. Project Location: 'gd-,7 d Cree, K ~',sT 7eJ Ld7' rx"
Street address: a3 S" f/ATr r~ s Lr9w e-
City, State, Zip: )qu ro rA ~ C'i o2 7Y6 &
County: l~e,y cc, -6 r~
Latitude/longitude: &ea V ° ' o S6 - Nz9 ° Y/ ~.Z S uJ
6. Directions to site from nearest major intersection (Also, attach an 8 Yx 11 copy of the USGS ST/9/2
topographic map indicating the location of the site): 44 ror,q Hwy 13 TO Sjor:nS Wreck
9671 S r%hy Cl-ee,l? S~•n; /e, r 7-6 ;?,4, d G^e e-4 rf 7,r? Tes or, 0C r.0 'q t G.7h e,
A~proz.leoT Harrra.rLine, -,V ere la m% t. 47,od dea'/ e•n s
17 7-o pra(0erl y -
7. Stream to be impacted by the proposed activity: i~an' ° e'k
Stream name (for unnamed streams label as "UT" to the nearest named stream):
Stream classification [as identified within the Schedule of Classifications 15A NCAC 2B
.0315 (Neuse) or.0316 (Tar-Pamlico)]:, O 314

8. Which of the following permits/approvals will be required or have been received already for
this project?
Required: Received: Date received: Permit Type:
CAMA Major
CAMA Minor
401 Certification/404 Permit
On-site Wastewater Permit
NPDES Permit (including stormwater)
Non-discharge Permit
Water Supply Watershed Variance
Others (specify)
Part 2: Proposed Activity
(Please include attachments if the room provided is insufficient.)
1. Description of proposed activity [Also, please attach a map of sufficient detail (such as a plat
map or site plan) to accurately delineate the boundaries of the land to be utilized in carrying
out the activity, the location and dimension of any disturbance in the riparian buffers
associated with the activity, and the extent of riparian buffers on the land. Include the area
of buffer impact in ft2.]:
~eSc,r-p %0)1 di opo, r e.ol, c- /me-
ort P %~1 n9 s

2. State reasons why this plan for the proposed activity cannot be practically accomplished,
reduced or reconfigured to better minimize or eliminate disturbance to the riparian buffers:

1~ac e % SePT'e 49dlnI,"c,s - 1707"
1119 d1J,, 310 _V 0~ 16 CL

Variance Request Form, page 2
Version 2: November 2000

3. Description of any best management practices to be used to control impacts associated with
the proposed activity (i.e., control of runoff from impervious surfaces to provide diffuse flow,
re-planting vegetation or enhancement of existing vegetation, etc.): /
rv cc47Vro / /Q17[ ,eun -OF{ I S: /7" 7r;.17 C, -C, Gt/lL GL.ftd t~~/ illy
(,h.S /kt,~'- - a7N

4. Please provide an explanation of the following:
(1) The practical difficulties or hardships that would result from the strict application of this
Rule.
Gcl,! 7-4ye?r e- v~12/Ah CC., w /IcT ,6i q ~/z T
T-

(2) How these difficulties or hardships result from conditions that are unique to the property
involved.
.llucTa it Te-7' f~ /2t~AS ;J /IorGr~o
~2auYr, % ~/N G G~~o7s1 L U

(3) If economic hardship is the major consideration, then include a specific explanation of the
e-co,n~o/mic hardships and the proportion of the hardship to the entire value of the project.
/
GV ~ 014 vA7 jzianc- G 1,.Yn f/ 4-04//d L e4/I4CS/D/Az .1~ 2 WL
(~/Ow~~ EJL GC 17 o//L T Zvi Id azt,r 47nr- - 7Z" lOsin5 oa.,~
Aove s7;~76,Tr ;/1 Proptr?~ zvt. a,'s4- To lh,ok,- 4~m-e

Part 3: Deed Restrictions
By your signature in Part 5 of this application, you certify that all structural stormwater best
management practices required by this variance shall be located in recorded stormwater
easements, that the easements will run with the land, that the easements cannot be changed or
deleted without concurrence from the State, and that the easements will be recorded prior to the
sale of any lot.

Part 4: Agent Authorization
If you wish to designate submittal authority to another individual or firm so that they may provide
information on your behalf, please complete this section:

Designated agent (individual or firm):
Mailing address:
City, State, Zip:
Telephone:
Fax:
Email:
Part 5: Applicant's Certification

Variance Request Form, page 3
Version 2: November 2000

I , ia~P /~J; U7q t ?a rc e 11 (print or type name of person
listed in Part I, Item 2), certify that the information included on this permit application form is
correct, that the project will be constructed in conformance with the approved plans and that the
deed restrictions in accordance with Part 5 of this form will be recorded with all required permit
conditions. n ~J
Signature:
~J/ t
Date: - (3-D-:5
Title: C)GJrJG (L

Variance Request Form, page 4
Version 2: November 2000

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Environmental Health Section New Construction
Beaufort County Health Department ? Repair
220 N. Market St.
Washington, North Carolina 27889
[phone] / Fax [phone]
IMPROVEMENTS PERMIT
Improvements permits are subject to revocation if the site plans or intended use changes or site alterations occur.

ate: 7- /Z -ZGo
wner. L Phone. (336) 5cq-7ZOr3
ddress: Gary.,.- . l/. AI C .
Subdivision: ^ v /1C Lot Number-
State Road Number: Directions ZS 1,,.1 r•-1 S;. l • _V/4
244.F 10-DIGIT PIN ---'-J--------
Property Size: / a.1r 4- . ~4a c Type Structure:
No. People:
No. Bedrooms: 1:11
Water Supply: (-/1/ 14 / (Maintain minimum feet !
separation from any part of septic system and repair area.)
Classification: ? Suitable visionally Suitable ? PS with fill
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Additional Drainage: yC C L
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Seasonal Wetness Condition: 2 Soil Type 2r r r; r G = o~~~~f~~ : /~3 C )
Septic Tank: /n^ r al. Pump Tank. gal.
Nitrification Feld: _/r'" CA square feet trench bottom
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Trench Depth: 1:-2 Frl Depth: r r ~Cnv.~ r-
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Comments- e -7 ~4
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Additional for all systems: Landscape system area for surface water runoff and grass.
Do not place drive or any building over the system area or repair area. Observe all
proper setbacks (10 NCAC IOA .1950). Do not work soil or install system in wet
conditions. This permit must be on site during installation and inspection. Site Plan
Environmental Health Specialist Date:
White Owner/Contractor Yellow - Health Department Pink Building Inspections

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~~er Address:
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1 owner Address (2): G re en ville, N.C.Si" r _
i Owner Phone #:(336) S04-7200
Property Address:Bond Creek Subdivision Lot # 12 & Van
PIN:1921 r '4
combination
Record IV-
'Establishment Type:Home
Type of WeII:Public Well W _
Design Flow GPD
( ).360
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Initial Site _010 FQW, Irk
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Wastewater System: Chamber t. .50.00 feet
Chambered
System
Long Term • Y
Acceptance Rate(GPD/SQFT):0.3 ~
Trench Width:3
FT 1:600
Trench Spacing (OC):9 FTW-
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Trench Bottom From NGL:-12 IN
Septic Tank Volume: 1000 GAL
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OFFICE USE ONLY: Date Received Request #

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality

Variance Request Form - for Minor Variances
Protection and Maintenance of Riparian Areas Rules

NOTE. This form may be photocopied for use as an original.

Please identify which Riparian Area (Buffer) Protection Rule applies.
? Neuse River Basin: Nutrient Sensitive Waters Management Strategy

Protection and Maintenance of Riparian Areas Rule (15A NCAC 02B
.0233)

Tar-Pamlico River Basin: Nutrient Sensitive Waters Management
Strategy Protection and Maintenance of Riparian Areas Rule (15A
NCAC 02B.0259)

? Catawba River Basin: Protection and Maintenance of Existing Riparian
Buffers (15A NCAC 0213.0243)

Part 1: General Information
(Please include attachments if the room provided is insufficient.)

1. ~A,p plicant's name (the corporation, individual, etc. who owns the property): AUG 1 6 2005
Xq/P/ M"CAge/ v- C'gle / 4(m11,4 -c Pur•C-/
e all responsible for the roe and it512qE iq WAjEK QUALITY
2. Print Owner/Si nin Official (person l 9
9 ~A lp X /n. %~u e P P rtY ~ ~~1~4'ATER BRAIJCH
Name:
Title: Ou.n Lr'
Street address: aJ ~,t~jl~r~ys ~~L
City, State, Zip: 44 r-a r19, 4/.C, . a 7P0 G
Telephone: aSZ G 7O - 8 9911'
Fax: OFS'a G 33 --1 9 G 5-
3. Contact person who can answer questions about the proposed project:
Name: /fl , P'4 rc e
Telephone: aS2 6 70 -,'999
Fax: o2 S2 G 3 3 oZ 176 S'
Email: /rIic-f r10 carz.T//:nk. A16 %
4. Project Name (Subdivision, facility, or establishment name - consistent with project name on
plans, sp cifcations, letters, operation and maintenance agreements, etc.):
Ban cV~ Cree k 4t' 5
Version 2: November 2002

5. Project Location: o'b d Cre.e 4 6r /HTe-S L aT- ze /y
Street address: ,73.5'_ ~Ajleras 1_11we-
City, State, Zip: Acc ra r A R 7Y6 &
County: 'l;r- ,
- Nz 9 ° y/ ,Z s u~
Latitude/longitude: A/!0 V ° V/ ' 0S'(f
6. Directions to site from nearest major intersection (Also, attach an 8 Yx 11 copy of the USGS Sr/gyp
topographic map indicating the location of the site): At rot--q #-z,,9 ,;'3 ~ Slor;ny C4-,_e_lC
0071 .Srlh,! Cree4 -/,;V t/eS /a ;?4,dCr'ee,4 r4;2'Tcs(D o-n Cie -a AKe, L.gae-
Afpraz . /D'a -r T f1a77-2_ ras 44 /7 e• -Aaz l o m 47,c a( dle tJeno~ s
InT /0 raOer-J~-
7. Stream to be impacted by the proposed activity: J3an ° ei~
Stream name (for unnamed streams label as `UT" to the nearest named stream):
Stream classification [as identified within the Schedule of Classifications 15A NCAC 2B
.0315 (Neuse) or.0316 (Tar-Pamlico)]:, 0 314,

8. Which of the following permits/approvals will be required or have been received already for
this project?
Required: Received: Date received: Permit Type:
CAMA Major
CAMA Minor
401 Certification/404 Permit
On-site Wastewater Permit
NPDES Permit (including stormwater)
Non-discharge Permit
Water Supply Watershed Variance
Others (specify)
Part 2: Proposed Activity
(Please include attachments if the room provided is insufficient.)
1. Description of proposed activity [Also, please attach a map of sufficient detail (such as a plat
map or site plan) to accurately delineate the boundaries of the land to be utilized in carrying
out the activity, the location and dimension of any disturbance in the riparian buffers
associated with the activity, and the extent of riparian buffers on the land. Include the area
of buffer impact in ft2.]: /
DeScr -'p %o-h eaCP2oPof~.olrgc ;r»~ lo2we,
ors P:l1n9s

2. State reasons why this plan for the proposed activity cannot be practically accomplished,
reduced or reconfigured to better minimize or eliminate disturbance to the riparian buffers:

~cce i SLp T'c- ~.c..c,a/a7,'0,s ..AaT e~nauy~ ,ea 0-n jo
i-:ncJ~`~7cJ as. S'G' s~'r6ac~C /u~/t.

Variance Request Form, page 2
Version 2: November 2000

3. Description of any best management practices to be used to control impacts associated with
the proposed activity (i.e., control of runoff from impervious surfaces to provide diffuse flow,
re-planting vegetation or enhancement of existing vegetation, etc.):
i v C<477-re / An RZAn -OFD A X"&' let i7ct, k//// 6G Gt.rtd/ crI4,rilnj
d -Oh s /Ii!!iG 7-'-7-,

4. Please provide an explanation of the following:
(1) The practical difficulties or hardships that would result from the strict application of this
Rule.
Cc%f 7-~acJ~ vi~lL/A4 cc, w ; /IoT ,6t v A- r
dh T

(2) How these difficulties or hardships result from conditions that are unique to the property
involved.
SeT 6.,1,6 Rte/ex ,'s Ao T e io a,61.

(3) If economic hardship is the major consideration, then include a specific explanation of the
economic hardships and the proportion of the hlardsh/ip to the entire value of the project.
Cv % to'/ o µT vA/Zi IQ n e- 6 11)n / l &104/ /V/ / p G k,7 as/D b ,6 dl C-
(,~/O[~-~~ t &i7A/fit /-a Z,,; Id Ok r C. - cJ l dS,%nq aGvf
.i~ve,sT.hc~1" .n Proper`%~ we .v•'s.C. io /hook, ~J

Part 3: Deed Restrictions

By your signature in Part 5 of this application, you certify that all structural stormwater best
management practices required by this variance shall be located in recorded stormwater
easements, that the easements will run with the land, that the easements cannot be changed or
deleted without concurrence from the State, and that the easements will be recorded prior to the
sale of any lot.
Part 4: Agent Authorization

If you wish to designate submittal authority to another individual or firm so that they may provide
information on your behalf, please complete this section:
Designated agent (individual or firm):
Mailing address:
City, State, Zip:
Telephone:
Fax:
Email:
Part 5: Applicant's Certification

Variance Request Form, page 3
Version 2: November 2000

I, d2a r, / ?a rc e// (print or type name of person
listed in Part I, Item 2), certify that the information included on this permit application form is
correct, that the project will be constructed in conformance with the approved plans and that the
deed restrictions in accordance with Part 5 of this form will be recorded with all required permit
conditions.
Signature:
Date: 13 -O~
Title: C~lt~06-(1-

Variance Request Form, page 4
Version 2: November 2000

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- Environmental Health Section New Construction

Beaufort County Health Department 0 Repair
220 N. Market St.
Washington, North Carolina 27889
[phone] / Fax [phone]
IMPROVEMENTS PERMIT
Improvements permits are subject to revocation if the site plans or intended use changes or site alterations occur.
ate: -ZGrF
L Phone. (336) 5c4 -7209
caner.
ddress: N. C . /L4 58e „ba. `SQL T/'~C C-v
SubdivisLot Number
State Road Number. 1q12 Directions f4, ,
-t 41-? /~,,.~.',?r~.'r/? 10-DIGTTPIN---,-J"--"----
PropertySize: / al" '7~ ~4c c Type Structure: L /
No. Bedrooms: No. People: ~ /C 6, •S1H4r/u: 1
Water SuPP1Y' . n / (Maintain minimum / feet
separation from any part of septic system and repair area Classification: O Suitable visionally Suitable O PS with fill T -1 r /
Additional Drainage'., t-/s r ~o S/~ r ~ce t o T C! s=',,.c„ u^ t~ . !c
Seasonal Wetness Conditi on' / f Soil Type 7_~
Septic Tank: //7- 1- al . L Pump Tank: gal.
Nitrification Feld: 9G0 A'r. , c1 square feet trench bottom
Trench Depth: / F Depth: Jcoi/.? r
Comn~m-++ents: r r, I"e 1%~ , `l 'c /s
Igor T~/~~.., ~n„i': r /'re- ~i, T
i.~.ell~~.~~i`ey~.'rc-~°G ~1':~~ je.rCv°ef~ f'ro.., ~(r;~p~ ~.~r
411
Additional for all systems: Landscape system area for surface water runoff and grass.
Do not place drive or any building over the system area or repair area. Observe all
proper setbacks (10 NCAC IOA .1950). Do not work soil or install system in wet
conditions. This permit must be on site during installation and inspection. Site Play
Environmental Health Specialists Date:
White Own//Contractor Yellow - Health Department Pink Building Inspections

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I pvvnerAddress(2):Greenville, N.C.Ii*
I Owner Phone #:(336) 504_7208
Property Address:Bond Creek subdivision Lot # 12 & 5B combination _
PIN: 1921~ %PF` _
Record # vaX7 =
Ualr "'Establishment Type: Home
Type of Well:Public Well %s_ ~a a
Design Flow (GPD):360
T.1
Initial Site M" r,
Wastewater System: Chambere ~ 50.00 feet
Long Term Acceptance Rate(GPD/SQFT):0.3 F 1:600
Trench Width:3 FT R $'i' - LR
Trench Spacing (OC):9 FTj
Trench Bottom From NGL:-12 INS
Septic Tank Volume: 1000 GAL r
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p°rpatuaal °~oment to May have changed since ma ~ n
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epair uroa is logtodrt° repair area must be Provided p was surveyed and must be definiated.rior to site an a ;
~!odzuhon to construct on lot 5B which is bforauthorization to C stru-ct is issued. pproval.
ad aAArovod wr11 be iss when of this property, .
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ith QutkAtata -
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