20050490 Ver 1_Complete File_20050321

Question re: NBR General Var

Subject: Question re: NBR General Var
From: Laurie Dennison <laurie.j.dennison@ncmaiLnet>
Date: Wed, 15 lun 2005 15:28:57 -0400
To: Tom Steffens <Tom.Steffens@ncmaiLnet>
CC: Kyle Barnes <kyle.barnes@ncmaiLnet>

Re: Question re: NBR General Var

Subject: Re: Question re: NBR General Var
From: Kyle Barnes <Kyle,Barnes@ncmaiLnet>
Date: Wed, 15 lun 2005 16:02:13 -0400
To: Laurie Dennison <laurie.j.dennison@ncmaiLnet>
CC: Tom Steffens <Tom.Steffens@ncmaiLnet>, Cyndi Karoly <Cyndi.Karoly@NCMaiLNet>

Laurie Dennison wrote:

Had a call today from Fred Johnston regarding this NBR General Variance project
from March 2005 (DWQ 05-0490). Tom. ..I have an email that you sent to Cyndi that
indicates Mr. Johnston withdrew the project (3/29/05). Well, now he wants to
reactivate it again. Kyle he may have spoken with you also, What's your take on
this? Should I ask him to just resubmit a new application? I could make another
line entry on this existing (but withdrawn) file to reactivate. Please let me
know what you think.

Copied particulars from File Maker:

Fred & Robin Johnston
Neuse/Smith Gut
3/29/2005 Withdrawn

Minnesott Beach

<c.l
;:::-- S 0/

~~ '"G //

~ ~9.s
~ try

Thanks,
Laurie

Laurie,
Mr. Johnston is no longer and was not eligible for the NBR General Variance when he
submitted his application. The property that he is applying for a variance he sold
back in the 90's and is being sued to buy back. His new purchase date is after August
of 2000. He can not apply for a General. I have been on this project for a year
almost and I am writing the current owner an NOV for buffer impacts.

Kyle

1 of 1

6/16/2005 10:28 AM

Question re: NBR General Var

Subject: Question re: NBR General Var
From: Laurie Dennison <[e-mail]>
Date: Wed, 15 Jun 2005 15:28:57 -0400
To: Tom Steffens <[e-mail]>
CC: Kyle Barnes <[e-mail]>

Had a call today from Fred Johnston regarding this NBR General Variance project from
March 2005 (DWQ 05-0490). Tom...r have an email that you sent to Cyndi that
indicates Mr. Johnston withdrew the project (3/29/05). Well, now he wants to
reactivate it again. Kyle he may have spoken with you also. What's your take on
this? Should r ask him to just resubmit a new application? r could make another
line entry on this existing (but withdrawn) file to reactivate. Please let me know
what you think.

Copied particulars from File Maker:

Fred & Robin Johnston
Neuse/Smith Gut
3/29/2005 Withdrawn

Minnesott Beach

Thanks,
Laurie

I of I

6/ 5/2005 3:29 PM

[Fwd: variance withdrawal]

Subject: [Fwd: variance withdrawal]
From: Cyndi Karoly <cyndi.karoly@ncmaiLnet>
Date: Wed, 30 Mar 2005 09:44:28 -0500
To: Laurie J Dennison <LaurieJ.Dennison@ncmaiLnet>

please handle - thanks again

Subject: variance withdrawal
From: Tom Steffens <Tom.Steffens@ncmaiLnet>
Date: Tue, 29 Mar 2005 16:28:14 -0500
To: Cyndi Karoly <cyndi.karoly@ncmaiLnet>
CC: Debbie Edwards <debbie.edwards@ncmaiLnet>

proj 05-0490, gen maj app has been withdrawn by applicant, please note
toms

Content-Type: message/rfc822
variance withdrawal
Content-Encoding: 7bit

1 of 1

3/30/2005 10: 13 AM

Variance Triage Sheet
DATE: -:"/Z-2/6..') PROJECT NAME: Frer::{1r.8l>IVI ~()~ VI
DWQ #: 05 - G<-I-q 0

,

COUNTY: YQfYY)ll CCJ

TO: Tom Steffens, Washington Regional Office

FROM: Debbie Edwards

TELEPHONE: [phone]

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

~ "General" Major Variance
D 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 t.o be reviewed for
administrative as well as technical details. If you elect t.o 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 t.o workload, processing
times, or lack of a "second reviewer" as the triage process in Central
Office had previously pr.ovided.

_ ~ \ OFFICE USE ONLY: ~ate Received

Request #

Stl1to of North Carolina
Departmont of Environment end Natural Raseurcas
Division of Water Quelity

D [g@~OW~@

MAt< 2 1 7005 0'"
00
· V - I- · D~'l.WATERQUALlrV 49
"General" Major arlance App IcatIGftV'P'Grrm~UIWjl~I;O
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)

~.;.30:".J..;..\.,.~;....Aol.,.~,,.,-,.......-......,,,:.,,~;,...~~.......,.,...,,.,..;..:.,t~ *,,'~,':,:,~ ....:..~-"~'t...~,,..,.,:.:-\'< ',~,....-*-.;",) :..,.....'~;,Xl~..\lJI,~..S...:,4.Jo:~.:.:"-'.~~+~..;.\\<<.~,:..."c,*....''''l-\:.;...':..,;.~:O':;~.~.'f'~",;,:....';..;..<.'~~""""",,:,;,.',1',..;.;~' ",-.(~>~..o(.

Please identify which Riparian Area Protection Rule applies.

/' Neuss River Basin: Nutrient Sensitive Waters Management Strategy
Protoction and Maintenance of Riparian Areas Rulo (15A NCAC .0233)

a Tar.Pamllco River Basin: Nutrient Sensitive Waters Management
Strategy Protection and Maintenance of Riparian Areas Rule (15A
NCAC .0259)

;.,.,~.....\",.)'lf' ~,.~.",x;,.N ....~\f .."'. - ~~,{!.;..;rii;.-""';.;.!',,; ~"\:';'.,,<,..o,~,,_'-,,,-~',:;,-,,~;';':""~;';",)' ',,;:# '; ic 'l;'';':''~-~-~' ,~~:':<,~-~~:-,Ii.-.~,.-,\(. ~'W~,'..":;";";;~~'ft;';';~ :>>.,_ o.:":I:~'~;.-.;::~;;:.c.,...:lO..~ ';,:":':'.:.:l,,";:, ;;';;;;'-,,\i 'f;;',';.,~""" J. ';'~,",\'-o-~;.i, ':{,;.,r: ~:;';.i;i~,~~:-:i'::,,)

NOTE:
To const/tuta a complete applfcatlon, all of tho Information requastad In this form
must bo provldad. Incompleto applications will be rotumod to tho appllcant. Tl,o
origInal and t\,{O coplos of tho comp/etod "Ganoral" Variance Application Form and
anyattachmonUJ must bo sont to tho DWQ 401/Wotlands Certification Unit, 1850 Mall
Sorvlco Contor, Raleigh, He 27699-1650,919-733.1786 to constltuta a comp/ota
submittal. This form may ba photocoplad for uso as an origInal.

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

1, Applicant's name (tho corporation, Indivi~ual, etc. who owns the property):
~lZED ~N'D ~~\'" ~b\~,,",i,7-n:-"l

2. Print Owner/Signing OfficIal (person legally responsible for the property and its compliance)
Name: \="e'ED ....jD\-l.uS To~
Title:
Street address:
City, State, Zlp:
Telephone:
Fax:

404- f?t2cAD 4r.
Otz \ t=l-.:lz' A L \ ~ L ""'Z--t'... 5" \
tZS.k) '2.4"1 - ~D-'- s-
t.............,)

3. Contact person who can answer questions about the proposed project:
Nama: F\Ztr:> ,\O\4-lJL;;"Cc)....)
Telephone: C?.&) (~, , - "'13 A A-
Fax: L__~J
"Gcnoral" Varia.nce Application Fonn
V13ision 1: May 2001

Emall:

4. Project Name (Subdivision, faclllty, or establishment name - consistent with project name on
plans, speclfications, letters, operation and maintenance agreements, etc.):
LOT 'L _II t=\Z.\?D I~O ~~ ~D\410,,-:>-n.1-J .:siD "

5. Project Location:
Street address:
City, State, Zip:
County:
Latitude/longitude:

!S5 'I~D\.~ B\....\.>~r-- -C~\L
M , \J t-.:) ~t.>IT n-:l'<L\-\- t ~") L.
P^-:-M'-''-O
'~4u 5~' 5"?:>" t-..J , -Zb"SO'OS"W
.

6. Directions to site from nearest major inter<Joctlon (Also, attach an 8 Y2. x 11 copy of the portion
of the USGS topographic map Indicating the location of the site):
'F\ZC'f.\ \:)t. \-\\D\{, ?O(~ \rJ Tt::\Z-'\Z.'1 !.-J-t.-Jt:J\l->l. - """\\.;>v~ 'e..,. C>\0'-C-t> ~\2.. \\2.\-
\~~P \2Z. CJ.5CD ':?e I' 'Z."Z.. \'b ~,. (")t'-) -:s: l'->Dl4...J c,\..\.JFF '[:e.
Lo-c I>r""""t' ~ a~ O'e,,,,'c.

7, Stream to be Impacted by the proposed activity:
Stream name (for unnamed streams label as "UT" to the nearest named stream):
~Cb?C:- e.''-Ice.. ~D SM\'Tl~ (..,0-'
Stream dsssificatlon [as identified withjn the Schedule of Classifications 15A NCAC 28 .0315
(Neuse) or .0316 (Tar-Pamlico)]: t-.}E\.>SE - '713 j S~, \0S\.U
~Ml-nl Gtu\:' - SCj ~w, }0s,vJ
8. Which of the following permits/approvals will be required or have been received already for
this project?

Required: Received:

Date received:

Penn it Type:
CNItA Major
CAMA Minor
401 Certiflcation/404 Permit
On-site Wastewater Permit
Active Connection to Sanitary Sewer System
NPDES Permit (including stormwater)
Non-dIscharge Permit
Water Supply Watershed Variance
Others (specify)

-lL..

1/\l~"~~~'\O~
~'1>\.\tf7\1
- '1

Part 2: Proposed Activity
(Please include attachments if the room provided is insufficient.)

1. Descriptlon 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 actMty, and the extent of riparian buffers on the land. Include the aroa
of buffer Impact In ftZ,:
GO;..J?'T1Z'-U-i:.T A \-\-oWo&::>E ~ C: lZ-^'V~L \:lrz.I\JG
=c-r'1 un" "2.. I ~ _ L>-f"') ~.
Ap--I?A (')F- E?0FPtfl.. ~)IJE" "'Z... - 'IOSO~' \---r-.
-+- - -
-Z(J~ ~ \ - \\ 0<07: Sq, \=-T,

"Ganeml" Varianca Application Form, page 2

2, State reasons why this plan for the proposed activity cannot be practically acco.mplished,
reduced or reconfigured to better minimize or eliminate disturbance to the ripanan buffers:
~\:.lr'JP\'V~'7\n0 VJ~ CJe'l.\J~,;>A-\...'-"1 DE0\b\.)~\.??1\.Jlo IS'
\ , .. C-.1I... . '?~ \ q' , l-, D~_ _ \('" l..0 \-\ ~"" c.'-' I L:ll., T \4 E.
~~'w;;:;C\-\?,; 0" 0>' ~W ~FF'i"-, -n\~ \~~"',t ",,'CL '-"'T )
B"'I \ ~ ~\.J ""1. D'I:."\\ ce \...OL A-r. 0 t-J (~tt" ?Y7t:" ~M.>"!) LCl.)~ X i:"{Z l1 \<:'

3.

4. Please provide an explanation of the following:
(1) The practical difficult!es or hardshIps that would result from the strict application of this
Rule,
'Q\"Z.A.\^-J\=\t.Lh C.AMI-)t;\" ~~ \J\tf'-.} bO 'I)...:,il"D P::>GPF-FC p~
\..h::: f\'--'m- \'A;:.-pr. ~ I P.FT~ \:'Iz\ \.) \:; \ ~ B.::> \ L <:" ~v ACL'i::;r-..b
3\\~..c \?:J "-"D ~(>II\ \ \=PT "\'n ~\.?\\..r::> 'I-\n~S 't)<C\::v<::'" I
_ \ tv ~, >;::l='t=;"1Z .

(2) How thesa difficulties or hardships result from conditions that are unique to the property
involved,
~~-r-'E"iZ- S~r=FB'e- LE(,I,?\J..-'\IOIJ - i?\Z.^"uF\\:..~1'::>o? "-AD To
~ \IIe'0'~ ~~_'\L.. u:-~f\.-"\ tv G \:) D ~:Z:o'M ':f?'t=1:"\.0 ~ Lr5r ~t?
: f\J.,.)0 _L -l~ I t=()\?'- \-\DJ SF. Lc5-C- A..T:.~ \L, ~f?i"l\.:5""(
~ -i,/-:z.., cc:.r.:.8(:.'eO ~\'\\-\ C-C.JA.C-:i?:" AL '\.,\=:'(-:;>\7 ~ ...t'''c''~ A....v? \l0tr\...ANP'/

(3) If economic hardship is the major consideraUon, then include a specific explanation of the
economic hardships and the proport n of the hardship to the entire value of the project.
t:t'.. _ Ut 1\. 65" ) - 1\> \ 10 cO() V-:). - t)..)(
c...

Part 3: Dead 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 Vt;sh to designate submittal authority to another Individual or firm so that they may provide
lnfonnatlon on your behalf, please complete this section:

Designated agent (individual or firm):
Malllng address:
"Gonoral" Vllrianca Application Form, pogo 3

City. State, Zip:
Telephone:
Fax:
Email:

~~
~

Part 5: Applicant's Certification

I. ~ ~~L~ (print or type name of person
listed in Part I, Item 2), certify that the information Included on this permit application ferm Is
correct, that the project will be constructed In conformance with the approved plans and that the
deed ~eSb1cUon,~~ame vit art 5 of this form will be recorded with all required permit
conditIons, _

SIgnature: '-
~~ z/~loS ~
Title: ~

NC Division of Water Quam', (DWQ)
401 Wotlands COrtiflcatlon Unit
2321 Crabtreo Blvd. (LOCATION)
1650 Mail Service Centor (MAILING ADDRESS)
Rnl13lgh, NC 27699-1650
[phone] (phono)
http://h20,enr,state.nc.us!ncwatlands./

RALEIGH REGULATORY FIELD OFFiCe
US Nm'l Corps of EngiMors
6508 Falls of tho Nousa Road, Suito 120
RatolQh, North Carcllna 27615
Gonoro.l Numbsr. [phone]
http:1N('f-IW.saw.usacs,llIlTly.mil/wfltland'J/regtour.htm

WASHINGTON REGULATORY FIELD OFFICE
US Army COrps of Engineers
Post Offlco Box 1000
Wa$l'Jngton, North Carolina 27689-1000
Genoral Numbor: [phone]
http://WWW.SrrN.usaco.army.mllJwotlandsfrogtour.htm

Washington District OffiCii)
Division of COl1st::.\ Manl1Qemant
S43 Wa5hlngton SqUQI'f) Maa
WlIshlngton, NC 27689
phono:2521946-6481

Morehao.d City District OffIce
Division of Coastal Managoment
151.6 Highway 24
Morehead Clly, NC 28557
phono: 2521605-2808

"Genoral" Valianco Applicaton Form, page 4

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IMPROVEMENT PERMIT

Owner: FRED JOHNSTON
Owner Add~c:$a: PO BOX 68i', ORIENTAL, NC 26571
Ownor Phono II: (019) 24"-3045
Proporty Addroaa: I~DIAN BLUFFS-MINNESOTI NEUSE RIVER
PIN.F094-76
Rocord #AOO334
Esbblianment Type:Home
Typo ofWoll'Public Well
Design Flow (GPD):360

SA WATER

27.16
t""~ . 1 J' Eeet
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"tot . . ~"i'~ - . . -- . - --
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60.......~: . . (., ,. 3 BEOROO""
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110'............... 1200 SO. FT.
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Initial Site
Type t:A Wutawater SyztemConv8f1lional Pe~ed Pipe
Long TOITT'l ~ance R.e(GPO!GCFT):O.Cl7
Trench Width:3 FT .
Trench Spacing (OC):9 FT
Soptlc rank Vol...me:1CXlO GAL

,.
,

i

Repair Site
T~ ol WlUtawlll,'r Sya;tem:Convantlon&l Perforll!J)(1 Plpa
Long TfltTT1 ~"'C4l Rr.e(QPOIOOFT):O.G7
Trench Widlh:3 FT
Trancl1 Spa:ln~ (OC):O FT
S~1c Tank VOlum.;1000 GAl..

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50.00 feot
~uY1-...v,^^""~'V",,, j

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~/~c./~~ d~~'f?).

WILLARD WALTER COL.E iii, RS

1:600.

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/ Date 7/17/98
\,. .

.............._----------~

..&'.. . ~- IMPROVEMENT PEi!fMIT
~ . . y.o' " ~ ra$ :t~
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l.owner:Fred Johnson R ! (J'
lOwner Address:P.O. Box 887 L 2:...
Owner Address(2):Oriental, N.C. 28571rt" ~
Owner Phone #:[phone]
~Property Address:lndian Bluffs-Minnesott
~PIN:F094-75-3-2~' ,
"Record #LOT # 2~ . L ~,-..s.;, _ _ ~
~Establishment Type:Home CAMA LiNe- ""G- t.::r-El <. f
"'Type of Well:Public Well ~ \~ a
De~ign F:low l.GPD~O h L fi)
--.. '" ~ --- -.... ($ '" J.
--": . ." -- '" ~L7
9~ ~~~'''''''''''-=' ~~ -- ~ r~
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Q ~ 40,00 feet <:>. ~ Ct ... 0. . c"a N
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~ 1:480 V ~.
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Initial Site. .. //.:11 A ,4
Wastewater System:Conventional Pipe " ~,
Long Terr~ Acceptanc,e f3,ate(. GP,12.'.SQFT):O.8 8~. . '~.... ....'
Trench Wldth:3 FT~.J'I~'I. / ... Ef. as
Trench Spacing (OC):9 FT ~ .. .~f~:
Trench Bottom From NGL:-24 IN.. ~~~.

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Repair will require use of innovative system with either setback or system size reduction

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Site plan must be submitted prior to Authorization to Construct being issued

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Authorized Agent: _~/.?AJ ~ #tV?/7-f~..1 / S.

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( Date 2'14'200~
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, I OFFICE USE ONLY: Date Received

Stat. of NoMh Carolin. ~[g @ 00fi@
Department of Environ~ent and Natural Resources MAK 2 1 ZOOS
Division of Water QUCllty

Request #

0501
.{,. 9 0
. . DENR. W~Ji...R aUA~~ .
uGeneral" Major VarlaJfae>~pplrleatlon Form -
From the Neuse and Tar-Pamlico Riparian Buffer Protection Rules for residential structures
on existing lots within the coastal cormties as defined by the Coastal Area Management Act
(As appro..ed by the Water Quality Committee of the Envirorunental Management Commission on 5/9/200])

. ~,<""""...>;J,t.,v,..,:......"''''''y;.,.....,,,.4y:~:-~~.~~ -~'~ ,~- .......~~~~...'Jl>-...~__...~.""'...\l>....."'+-"~'oII:-'_~..'..~~~.::.:,.~.:.v..;-;;'-~~~".t........:.y~>"\:...~-,;."t_""""l..:"",-.v.'...~~".,'li-~~-:';":":':''''~~

Please Identify which Riparian Area Protection Rule applies.

/ Nause River Basin: Nutrient Sensitive Waters Management Strategy
Protection and Maintenance of Riparian Areas Rule (15A NCAC .0233)

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

v'!.~>-<~~ ~.~~. ~'W:',.." ',::';f...,.-.r~),:";,.:{"<Jc:>l"'\:~~~:',i.<I':;':';...~~ y,j' :.H...~'::~.fliJ.:,..$'.ix.;.'NIS:::....y~'~~'-'....-.;~._~.,:~\..:.~;.;,,:>0:.t4' :h...f(......1if,.;:.;,;;4,:;!.'<-.~:. .~l):>,lw:.;;..~\.~:~(i_"f-~'~'W4, ~J,..w.~~;~' :s.o.:,;;.::<\::;;~v..~~ ':i'.~

NOTE:
To constltuto a comploto application, all of tho Information requested In this fonn
must bo provldod. Incomploto applications \VJII bo rotumad to tho applicant. The
original and t\Vo coplos of the complotod "Ganeral" Varianco Application Form and
anyattachmont:! must bo sont to tho DWQ 401/WotJands Ccrt/flcat/on Unit, 1850 Mail
SON/CO Contor, Raleigh, HC 27899-1650,919-733.1786 to constltuta a comp/ata
submittal. This form may be photocopied for uso as an origlna/.

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

1, Applicant's name (the corporatlon, Indlvl(1ual, etc. who owns the property):
\='lZED A.tvp ~\t-..l ~b\~i;,.-n;..t-....)

2. Print Owner/Signing Officlal (person legally responsible for the property and Its compliance)
Name: \-=lZED \JDl+u~ Tot-...,)
Title:
Street address:
City, State. Zip:
Telephone:
Fax:

4- 0 A- Bt2lAD ,:-:;r.
orz\tPTAL l W L -z:.5S, I
(zskJ -z.4Q - ~D.\- s
t........,......)

3\ Contact parson who can answer questions about the proposed project:
Name: F~\;p ,JO\-\-\..:i':;'Cl:;)..,)
I Telephone: C'?.5ZJ &'1' - 4 :, A A-
Fax: L___)
"Gonoral" Variance Application Form
Varsion 1: May 2001

Email:

4. Project Name (Subdivision, facility, or establishment name - consistent with project name on
plans, speclficatlons, letters, operation and maintenance agreements, etc,):
LOT 1.. - II F\Z.\?D ~~o ~~ ~C\4~S-n..t...J ~JD II
.

5, Project Location:
Street address:
City, State, Zip:
County:
Latltudellongitude:

4.55 'I~D\'~ B\..\.>~t=: \~\L
M I tJ ~ ~ \i n:.-r'\.l..\+ t "- ') C-
P~L-\c:...o
'~4" 5~1 S~" t-..J. I {,;,.. 50' OS" W
,

6. Directions to site from nearest major intersectlon (Also, attach an 8 % x 11 copy of the portion
of the USGS topographic map Indicating the location of the site):
~ \.:lL. \-\\O\.{. ?;JO(." v.> Tt:::\Z.\!.'1 ~p\~l. - \l;>'Z-lV 'e..,. C')~'1::"t'> ~ \2- \ \2.\ -
\~\ZP 12Z. l"p"1:O Se., l'Z. z.. \D '\Z-,. ON ~ NO\il,.U E'\..UFF t:;e.
Lo-c f'r'T' 'e1-1D o~ oe.\"-J't.

7, Stream to be Impacted by the proposed activity:
Stream name (for unnamed streams label as .UT- to the nearest named stream):
\--.JC;\.:;.?C g\'i ~ ~D Sl-\ \'TH- ~ \:) "
Stream classification [as Identified with)n the Schedule of Classifications 15A NCAC 28 .0315
(Nausa) or .0316 (Tar-Pamlico)]: t-.}El>Sc - -:;'13 j Sv.:., }-..)s>w
'7 M \T\-I Gt. \.) -c - Sc) ? l.N I }-J S \tJ
8, Which of tha following permits/approvals will be required or have been received already for
this project?

Required: Received:

Date received:

Permit Type:
CMAA Major
CAMA Minor
401 Certification/404 Permit
On-site Wastewater Permit
Active Connection to Sanitary Sewer System
NPDES Permit (including stormwater)
Non-dlscharge Pennit
Water Supply Watershed Variance
Others (specify)

~

- ./Vev. ,_~
fIili ~~'~~i~~{J
- '1

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
assoclated with the activity, and the extent of riparian buffers on the land. Include tho aroa
of buffor Impact In tt2.:
Go~,:>'T!Z:-\.>-f:..'- A \+O""'-;:.E ~
:;e..7'1 LoT ~ S <::'\4. au 0
A\Z.l?A (')~ BGFPccz.. Co..I~eo-

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-z:..o~e.- -z. - l,OsO~'~,
+- - .
'7.CI~ ~ \ - It OCo~ '?q. ~T,

'Goneral~ Varianca Application Form, page 2

2.

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 flOVl,
re-planting vegetation or enhancement of existing vegetation, etc.):
?LA-UI ~ ~O~96 A!2Q.:)~'O \-\c\:),-"t A~~ CDJ.\p\..~-nO'1...)

~" <c>-o'-;,"~"(Z'oJ--' T(~ ;~.. p,~ l-\ "~,;;,~~-:~ ;:::.,D IF="
=_e.v\-'>o~F __loT' \~ _ru-"_ -r\..:_ Q ______ \ CI_ ,TZ:Ee';>}
"';/f- ~ ~o ~~ C.L~,uG \~ 'et"QuHZ-tO '\D Bu'L~ A~ C'?\..k~,L:>~,

4. Please provide an explanation of the following:
(1) The practical difficult!es or hardships that would result from the strict application of this
Rule.
'D\ZA-\kJ\=I~"" (' ~~l>\ \3~ V\tf'0 ~ \i)..;)'""t'D Bc..rrE=C- p~
\-lef\t:.~ \7c-pr. ~i I\FTte- t:::'Iz.l~,= ,~ eo\L<:" ~v ~'E%-}::,
~c \0 ~D ~...rjV\ \ ~ "TD 'P:>\.?\LD -Hn\.:>4S t)<c.~L"' \
It--:> 'B.J~b1Z'

(2) How these difficulties or hardships result from conditions that are unique to the property
Involved.
~~-C-'E'tZ- 6uFFE'e- LEbi~u.-""TIOU - 'D!z-^\t0F''t:.''\.-l.><:~ \\AD To
~ ~O'V'eO BkX- Lt1\-'-'1t00 \)D ~j1\1 'f?'~~ ~ L\\.::l~
~n Bl~l~ I RJe- \~D-....}~E. ldT" ~~~ \L, ~(?Ou-c
~/ ~ c-o-.J~'eO \...:)\\"\-\ COA,~C:: AL 'l~t'7 10.. -r'D~ Avo V0tr\..A.ND'/
I

(3) If economic hardship is the major consideration, then Include a specific explanation of the
economic hardships and the proport n of the hardship to the entire value of the project.
. e. _ u't" ~ 85" ).- 4\- \ 0 coo v.::> tc)..)(
~ \\n 'M ~-r\~ \"0 'v f:>., \jE.AA c..,w.-u..... c...U=Mz,'e/) ~r'"')
C t\f CjrD)

Part 3: Dead 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
Infonnatlon on your behalf, please complete this section:

Designated agent (individual or firm):
MalUng address:
"GoneralW Vllrianco Application Form, page 3

City, State, Zip:
Telephone:
Fax:
Email:

Part 5: Applicant's Certification

I, ~ ~~-a::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 reStrlctlon,CCOrd~~ 5 of this form will be recorded with all required permit
conditions.

Signature: "-
Date: "2./'2-0 l or::;
Title:

NC DiVision of Wator Quality (DWQ)
401 Wetlands Cortif1catlon Unit
2321 Crabtree Blvd. (LOCATION)
1650 Mail Serv\C:o Center (MAILING ADDRESS)
Ralolgh, NC 27699-1650
[phone] (phono)
ht+.p:J/h20. enr.state.nc. us! ncwotlands/

RALEIGH REGULATORY FIELD OFFICE
US Nm'l Corps of EnglMors
6508 Falls of tho Neuso Road, Suito 120
Rato~h, North Carolina 27615
Goneral Number: [phone]
http:/twwW.SfroN.u.aea.army.mll/weUands/rcgtour.htm

WASHINGTON REGULATORY FIELD OFFiCe
U6 NmY Corps of Englnoors
Poet Office Box 1000
WastJngton, North Carolina 27689-1000
Genoral Number. [phone]
http://w-NN.saw.usaco.army.mlllwotlandslroglour.htm

Washington District Oftico
DIvision of CoastD.\ Managemont
943 Wa5hlngton Square Mail
Washington, NC 27689
phonlt: 2521946-6481

Morehead City District Office
DIvision of Coastal Management
151.6 Highway 24
Morchoad City, NC 26557
phon!!: :2521608-2808

"General" Varianca Application Form, page 4

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http://mapserver .maptcch.com/homepage/index.cfm ?lat=34 .980683 &lon=-7 6.8343 04&sca... 3/18/2005
I

IMPROVEMENT PERMIT

Owner: FRED JOHNSTON
OwncrAddrOlSs::PO BOX 88;', ORIENTAL, NC 28571
Ownor Phono #: (9~ 9) 2411-3045
Property Addroao: INOlAN BLUFFS-MINNESOTT NEUSE RIVER
PIN:F094-76 .
Rocord NAOO334
Establiahment Typa:Homo
Typo of WelJPubiic WeU
De$lgn Flow (GPD):360

27 15
t""~ . 13: Eeet
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Initial Site.
Type cA Wutewllter S)"IItenl:ConverIionel F>.rforstedPIpe
Long Term A<:oeptllOce ~e(aPQIGQFT):O.07 .
Trench Wldth:3 FT . . .
. Trench 8~clng {OC):9 FT
Septic Tank Volume:' 000 GAL

Repair Site
T~ cA Wawewlller Syslem:Conventlaoal F>.rfgnlled pj~
Long Term ~1II'lc. Rat,,(GPOiSQFT}:O.67
Trench WIdlh:3 FT .. ,
Tr.nch SP-dng (OC):g FT
SepClc Tank VoIum,,:1000 GAL

SA WATER

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IMI.LARD WALTER COI.E IIi, RS

1:600.

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....

( Date 7/17/98
\

''''~-.---------_..

,~- ~
~ . L IMPROVEMENT PERMIT
...er . . ....".. " -.: ~} :I -.:
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r,owner:Fred Johnson R ! U"
iOwner Address:P.O. Box 887 L. 2:...
Owner Address(2):Oriental, N.C. 28571C"t' ~
Owner Phone #:[phone]
~Property Address:lndian Bluffs-Minnesott
~PIN:F094-75-3-2________" "
"'Record #LOT # 2rq . 1- ~~ _ _ ~
~Establishment Type: Home C.4MA LiF{f- --0- 6. =r..q. <. f
~Type of Well:Public Well ~ \~ a
De~ign J:low ~GPD~O h L..~)
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~ ~ .u.~ .---=,' . ZC::z- " ~ r' /
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~ :.... 40.00 foot ~ ~ ... 0. . v f\o)

~~ ~ 14// ~x ' f/ a,~? ~ ~~.l

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Initial Site. . . jJJ A .
Wastewater System:Conventional Pipe. '. ~tI
Long Term Acceptance 13ate(G. PD._/SQFT):0.8 _~,..?
Trench Width:3 FT~J' .1'1-,. / ."
Trench Spacing (OC):9 FT ~ '.. . ,~:
Trench Bottom From NGL:-24 IN. ~t'J
,\-~~p;;.:.!:nk ~<flu.m,e:1 000 GA~" / ~li' , .~
Place soil cloth ove~ '-.J ,.01:;.......
Repair will require use of innovative system with either setback or system size reduction

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Site plan must be submitted prior to Authorization to Construct being issued

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(~;e 2/14/20~~

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