20060393 Ver 1_COMPLETE FILE_20060309

OFFICE USE ONLY: Date Received Request
1,,tiu9 L, It U
State of North Carolina UU Zoos
Department of Environment and Natural Resources 0 G v 3 MFR 9
Division of Water Quality
L:Er.j-? _vrr,TER auAurr
. i?' . , S wr:D STC?i'Jfr'?AT[R EfuddC? ?
"General" Mayor Variance Application dorm -
From the Neuse and Tar-Pamlico Riparian Buffer Protection Rules for residential structures
on existing lots within the coastal counties as defined by the Coastal Area Management Act
(As approved by the Water Quality Committee of the Environmental Management Commission on 5/9/2001)

Please identify which Riparian Area Protection Rule applies.
? Neuse River Basin: Nutrient Sensitive Waters Management Strategy
Protection and Maintenance of Riparian Areas Rule (I SA NCAC.0233)
? Tar-Pamlico River Basin: Nutrient Sensitive Waters Management
Strategy Protection and Maintenance of Riparian Areas Rule (15A
NCAC.0259)

NOTE:
To constitute a complete application, all of the information requested in this form.
must be provided. Incomplete applications will be returned to the applicant. The
original and two copies of the completed "General" Varianca-Application Form and
any attachments must be sent to the DWQ 401NYetlands Certification Unit, 1650 Mail
Service Center, Raleigh, NC 27699-1650, 919-733-1786 to constitute a complete
submittal. This form may be photocopied for use as an orfgina ,_
Part 1: General Information
(Please include attachments if the room provided is insufficient.)
1. Applicants name (the corporation, individual, etc. who owns the property):
2. Print Owner/Signing Official (person legally responsible for the property and its compliance)
Name:
Title: Pro N r
Street address: ? >?2yl
City, State, Zip: r,.c i -,6 v r .7 AJ c- , -7 '/,7 6
Telephone: (33 6? i, S-3.? _33r, a 7,A -7 ? ?7_,
Fax: (33..x....) g 4 q 7 r
3. Contact person who can answer questions about the proposed project:
-Name: cT
Telephone: (33 C.) ?`1 r3.2 v dc.y ¢.,,? 33o - _?.7?2 - a 3? ay`r
Fax: (3s a ? -y '?1/7s-
"General" Variance Application Form
Version 1: May 2001
(,7:
Email: ad ?2m/zffQ;,cam Se_?t?ncf¢ry . 01C,1,1 n11 4o„J1
4. Project Name (Subdivision, facility, or establishment name - consistent with project name on
plans, specifications, letters, I7operation and maintenance agreements, etc.):
tJano,l¢,i1 T-ts"dcnGe, P5,f, or,Vc
5. Project Location:
Street address: to a., r I ? r,v e.
City, State, Zip: 0) r , ,._ ( ,V 7 71
County: P- m tr, o
Latitude/longitude:
6. Directions to site from nearest major intersection (Also, attach an 8'/ x 11 copy of the portion
of the USGS topographic map indicating the location of the site):
S2. f _? 3( IA T R. ?nko Pirt' 1)r; yo 9.a rIbu r/ e-.,i? rJ?d
7. Stream to be impacted by the proposed activity:
S,t. earn name (for unnamed streams label as "UT" to the nearest named stream):
yawn G rzc k
Stream classification [as identified within the Schedule of Classifications 15A NCAC 2B .0315
(Neuse) or.0316 (Tar-Pamlico)]:
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 w
CAMA Minor
401 Certification/404 Permit
On-site Wastewater Permit
Active Connectio6,to Sanitary Sewer System
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.)
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 fe.:
C=0n5Ara e_E,on 1P ?Gr?3na.i r (I's l?n6(
"General" Variance Application Form, page 2
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')'1f t'airk w-`t{, M/l r 1n('erne r pcf, f.er 4, rtes, -/I ?n l h<r:/d res ?r„cc rn
S c.A >rnnnrr 4t ?J in d c i ?)/10f ri k- ;,j /7rc>1?'cQl />trP_ /
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.):
2.?G d.d Gi?/ 1 /Ln ?. 'J"J r,-,t^" aC ,.n,OaP ?/JaS ??'!'Tti ?t1 Rn? fJ n„lI.SGP
G9 ?!)(c, r ? is r^-c/c?r.a. nen? ¢?? iTrm?at,/'- ;n??rl fr: l.,r?.? rcln 4'F /,?
4. Please provide an explanation of the following:
(1) The practical difficulties or hardships that would result from the strict application of this
Rule.
} fr,?Jad
m ?? res./f ,n lh,,d h'-,.n,
? ail?St _ -
(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.
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:
"General" Variance Application Form, page 3
City, State, Zip:
Telephone:
Fax:
Email:
Part 5: Applicant's Certification
I, o n v r- n (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:
Title:
M?"/, r r -A-7o 6
1?.. •r>t? Tri?11zP
NC Division of Water Quality (DWQ)
401 Wetlands Certification Unit
2321 Crabtree Blvd. (LOCATION)
1650 Mail Service Center (MAILING ADDRESS)
Raleigh, NC 27699-1650
[phone] (phone)
http://h2o. enr.state.nc. usincwetlands/
RALEIGH REGULATORY FIELD OFFICE
US Army Corps of Engineers
6508 Falls of the Neuse Road, Suite 120
Raleigh, North Carolina 27615
General Number. [phone]
http://www.saw.usace. army.miUwetiands/regtour. htm
WASHINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
post office Box 1000
Washington, North Carolina 27889-1000
General Number. [phone]
http:/Iwvvw.saw.usace.arrny.miVwetlands/regtour.htm
Washington District Office
Division of Coastal Management
943 Washington Square Mall
Washington, NC 27889
phone: [phone]
Morehead City District Office
Division of Coastal Management
151-B Highway 24
Morehead City, NC 28557
phone: [phone]
"General" Variance Application Form, page 4

IMPROVEMENT PERMIT
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT, HEALTH & NATURAL RESOURCES
t DIVISION OF ENVIRONMENTAL HEALTH, ON-SITE WASTEWATER SECTION
COUNTY: PAMLICO PIN: K07-18-10
RECORD NUMBER: A-00546
OWNER: Daniel Donovan PHONE NUMBER: [phone]
OWNER'S ADDRESS: 2905 Stratford nr,
Greensboro. NC 27408
ADDRESS/LOCATION OF PROPERTY: SR1321 then TR onto Port Drive, go
towards end of the road and the lot
is on left, approx. 250' from end.
SUBDIVISION:Brown Creek PHASE: N/A LOT: 10
TYPE OF ESTABLISHMENT
RESIDENCE: (x)YES ( )NO NUMBER OF BEDROOMS 3
NUMBER OF OCCUPANTS: 6 Max. DESIGN FLOW (GPD) 360 Max.
OTHER (DESCRIBE)
BASEMENT PLUMBING: YES( ) NO(x)
TYPE OF WELL: (x)PUBLIC ( )WELL ( )OTHER
TYPE OF WASTEWATER SYSTEM: (SEE TABLE V) III(g) III(a)
INSTALLATION DESCRIPTION INITIAL REPAIR
DESIGN FLOW (GPD) 360 360
LONG-TERM ACCEPTANCE RATE (GPD/SFT) 0.4 0.4
ABSORPTION AREA (SFT) 900 900
TRENCH WIDTH (FT) 3' 3'
-TRENCH SPACING (MIN,) (FT) 0C 9'OC
NUMBER OF TRENCHES 3 3
TOTAL TRENCH LENGTH (FT) 3(751)=225' 3(75')=225'
SEPTIC TANK VOLUME (GAT..) 1000 1000
TRENCH BOTTOM FROM NATURAL GROUND LEVEL
CONDITIONS: This system is designed to utilize an approved chamber
system for the nitrification trenches, which allows
for a 25% reduction in the amount of N Line naPdPd.'
THIS PERMIT SHALL BE ACCOMPANIED BY A LAYOUT SHOWN ON A PLAT,
INCLUDING A SYSTEMS SPECIFICATION SHEET WHICH SHALL BE AN INTEGRAL-
PART OF THIS IMPROVEMENT PERMIT.
THIS IMPROVEMENT PERMIT MUST BE ATTACHED TO A CONSTRUCTION
AUTHORIZATION BEFORE OBTAINING A BUILDING PERMIT OR OTHER
CONSTRUCTION PERMITS AND BEFORE A WASTEWATER SYSTEM IS INSTALLED.
THIS IMPROVEMENT
THE INTENDED USE
CHANGES FROM THE
DEHNR AUTHORIZED
NO. OF ATTACHMEN'
PERMIT
CHANCE
ABOVE
AGENT:
rs•
IS SUBJECT TO REVOCATION IF THE SITE PLANS OR
FROM THOSE SHOWN ON THE IMPROVEMENT PERMIT
SHALL REQUIRE HEALTH DEPARTMENT APPROVAL.
DATE:
e-,x1L74 a R-1-
EXHIBIT A
PAMLICO COUNTY HEALTH DEPARTMENT U [a?1?:_.????-? ?u)
SYSTEM LOCATION & DESIGN
DATE 3-24-98 e 2006
PIN # X07- 18- 10 MAR
RECORD # A-00546
SCALE 1'r = 60 r DErdR_ ?.;,i'rR(lUAL1Tr
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REFERENCE: A MAP RECORDED IN PLAT CABINET A; SLIDE 75-4
INPAMLICO COUNTYREGISTRY.
REFERENCE: A DEED RECORDED IN DEED BOGY 264 PAGE I83
/N TH,EPAMUCO COGWTYREG/STRY,,
THIS PROPERTY IS LOCATED If9ThYN A FLOOD HAZARD IONS. A7, ELEV ©,
ACCORDING TO FIRM PANEL NO. 370181- 0295-9 DATED SEPT. 4, 1985.
SCALE : I" r 60'
0' 30' 60' 120' 180' 240'
PREPARED QY
DENN/S FOR/VES
B Assoclales
REGISTERED LAND SURVEYOR
ORIENTAL, N. C, P657I
DATE: APRIL 23, /997 ?OB N0. 2510
J
A RESURVEY FOR
Daniel J. Dono van
Lynn H. Dono v rn ' ' ,.
Lot /O 'Brown's Crook" Subdivision
Pamllco County, North C17ralin0
SCALE: I"? 60' olm BY,6w I NO. 2 TOWNSHIP PAMLICO. COUNTY; N.C. ??? ? a