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HomeMy WebLinkAbout20090061 Ver 1_More Info Received_20090128pF W ATFR Michael F. Easley, Governor O O O 1.0 O? ?G U William G. Ross Jr., Secretary > i ti North Carolina Departmelrt of Environment and Natural Resources Coleen H. Sullins, Director Division of Water Quality Variance Request Form (For Minor and Major Variances) Protection and Maintenance of Riparian Areas Rules NOTE: This form may be photocopied for use as an original. Check the appropriate box below: ? Major Variance /_ Minor Variance JA N 2 8 2009 1WETLAND AND STORM WATE BRANCH Please identify which Riparian Area Protection Rule applies (Note-this must be one of North Carolina's four buffered river basins. The River Bain map is available at httpL,',/h2o.enr.state. ne.Lis admin/maw.) XNeuse 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) Part 1: General Information (Please include attachments if the room provided is insufficient.) Applicant's name (t individu ens the property): ?5F8?31?A i . \? , . Print Owner/Signing Official (person legally responsible for the property and `its?compliance) 1 Name: ?h- a7M-?, Lu L40clletYJ?N?' __1t J Title: ??,Mb .w iMA fK Street address: 2-0 City, State, Zip: ?SCX l3 • C.c Z??zq __ Telephone: ,"1 ! 11g Uqu Fax: -71c g'V10 Contact person who can sw r 44uestion1s a_b- 'u_t the proposeAproject: Name: Telephone: ?q Fax: 14-10 Email: ? ( \;- Yov34t,A_C\V&.0+rlkLy C.•pM Version 3: January 2008 4. Project Name (Subdivision, facility, or establishment name - consistent with project name on plans, s ecifcations, letters, Aeration an maintenance agreements, etc.): cot _ \1,X j R .,•1 fir, p 6-- 31 Z7 `fir' u-?" 5. Project Location: Street address: 3'7 Z Q.S'c 47f\?? City, State, Zip: 1VCi Count Latitude/longitude: ?Vp 1J ??``ii ??'o'3?' , t 45"! T 6. Directions to site from nearestajor interseection (Attaacch an 8 '/z x 11 1 copy 0 the USGS topographic map indicating the location of the site). 7. Stream to be impacted by the proposed activity: Stream name (for ugnamed streams ell as "UT" to the nearest named stream): ziX-AA am 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 Erosion/Sedimentation Control 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 in Adobe (pdf) format) 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 MP GD %r6A CX' \ \,?l ()Q 7b pc? . Variance Request Form, page 2 Version 3 January 2008 2. Fill in the table below to identify the square footage of impact to Zones 1 & 2 in the protected riparian buffers and the required mitigation (Fill in the impacts portion of the table, even if mitigation is not required): Buffer Impact Zone of Impact in Number Purpose for Multiplier Required Impact Square Feet (Indicate on the Impact Mitigation Plan Sheet Zone 1 3 Zone 2 V-6 ZE UWG) TOO 1.5 Total } \DQOb 901 *Zone I extends out 30 feet perpendicular from the most landward limit of the top ofbank or the rooted herbaceous vegetation; Zone 2 extends an additional 20 feet from the edge of Zone 1. 3. State reasons why this plan for the proposed activity cannot be practically accomplished, reduced or reconfigured to better inimize or e)1i ate,is1t?ulkntce tO the riparian buffers: 4. 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.): 5. Please provide an explanation of the following: (1) The practical difficulties or hardships that would result from the stric applica ion of this Rule. Al ofi I SSu? C o r IO t'r t'?e1-o' s mz' q? 1 (2) How these difficulties or hardships result from conditions that are unique to the property involved. (3) If economic hardship is the major consideration, then include a specific explanation of the economic hardships and the proportion of the hardship to the entire value of the project. Variance Request Form, page 3 Version 3 January 2008 Part 3: Stormwater Provide a description of all best management practices (BMPs) that will be used to control nutrients and sedimentation impacts associated with the proposed activity. Please ensure to include all applicable operation & maintenance agreements and worksheets for the proposed BMPs. Also, include the MP on your pl 4n, ets. 2. Attach a description of how diffuse flow will be maintained through the protected riparian buffers. Please ensure to include all applicable operation & maintenance agreements and worksheets for the proposed diffuse flow measure(s). Also, include the diffuse flow measure(s) on your plan sheets. 3. What will be the annual nitrogen load contributed by this site after development in pounds per acre per year without structural BMPs (stormwater pond, wetland, infiltration basin, etc)? Attach a detailed plan for all proposed structural stormwater BMPs. Drainage Size of Post-development BMP nitrogen' Final Final basin drainage nitrogen' loading removal nitrogen' nitrogen' basin rate without BMPs° efficiencys loading rate loading (ac) (lbs/ac/yr) (%) (lbs/aclyr) from drainage basin lbs 1 2 3 4 5 Totals ----- ------ -- Attach calculations and references. 5 Attach calculations and references. e Include Phosphorus in the Tar-Pamlico Basin 4. Attach all applicable supplement form(s) and Inspection and Maintenance (I&M) Form(s) to this completed application. The applicable supplemental form(s) and I&M form(s) for the proposed BMPs noted in your application can be downloaded from the following website: http f12oxnr.state. tic, us au_'hmp f rm...htm Deleted: ¶ Deleted: Part 4: Water Quality Protection, continuedl ¶ I Variance Request Form, page 4 Version 3 January 2008 ,Part N: Checklist Deleted: I A complete appplication submittal consists of the following components. Incomplete submittals will 11 be returned to the applicant. The complete variance request submittal must be received 90 days prior -- - - - to the EMC meeting at which you wish the request to be heard. Initial below to indicate that the Deleted: 9 necessary information has been provided. Applicant's Item Initial • Original and two copies of the Variance Request Form and the attachments listed below. • A vicinity map of the project (see Part 1, Item 5) • Narrative demonstration of the need for a variance (see Part 2) __. • A detailed narrative description of stormwater treatment/management (see Part 4) -- • Calculations supporting nitrogen (phosphorus in the Tar-Pamlico Basin) - loading estimates (see Part 4) • Calculations and references supporting nitrogen (phosphorus in the Tar- Pamlico Basin) removal from proposed BMPs (see Part 4) • Location and details for all proposed structural stormwater BMPs (see Part 4) - • Three copies of the applicable Supplement Form(s) and I&M Form(s) for each BMP and/or narrative for each innovative BMP (see Part 4) • Three copies of plans and specifications, including: 0 Development/Project name 0 Engineer and firm 0 Legend and north arrow 0 Scale (1"= 50' is preferred) 0 Revision number & date 0 Mean high water line (if applicable) 0 Dimensioned property/project boundary 0 Location map with named streets or NC State Road numbers 0 Original contours, proposed contours, spot elevations, finished floor elevations _ 0 Details of roads, parking, cul-de-sacs, sidewalks, and curb and gutter _ 0 Footprint of any proposed buildings or other structures 0 Wetlands delineated, or a note on plans that none exist 0 Existing drainage (including off-site), drainage easements, pipe sizes, - runoff calculations -- ---- -- --- 0 Drainage basins delineated - - 0 Perennial and intermittent streams, ponds, lakes, rivers and estuaries 0 Location of forest vegetation along the streams, ponds, lakes, rivers and estuaries Variance Request Form, page 6 Version 3 January 2008 Deleted: 11 ,Part 4: Proposed Impacts and Mitigation Provide a description of how mitigation will be achieved at your site pursuant to 15A NCAC 213.0242 for the Neuse Basin and 15A NCAC 213.060 for the Tar-Pamlico Basin. If buffer restoration is the method you are requesting, be sure to include a detailed planting plan to include plant type, date of plantings, the date of the one-time fertilization in the protected riparian buffers and a plan sheet showing the proposed location of the plantings. A guide to buffer restoration can be downloaded at the following website: http://www.neeep.net/news/reports/l)uffers.pdf If payment into a buffer restoration fund is how you plan to achieve your mitigation requirement, then include an acceptance letter from the mitigation bank you propose to use stating they have the mitigation credits available for the mitigation requested. Part6: Deed Restrictions By your signature in Part 5 of this application, you certify that all structural stormwater BMPs 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 6: Applicant's Certification L?J' Y 1 r- (print or type name of person listed in Part I, Item 2), certify tAat the information in>rluded 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: 1Z Title: M eAbv` Part 7: Plan Sheets Be sure to include a copy of all of your completed application form, plan sheets and maps in Adobe (pdf) format on a CD or floppy disk. 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