20190750 Ver 1_Minor Variance_20190606

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Division of Water Resources
15A NCAC 02B .0233 (8)(b), .0243 (8)(b), .0250 (11)(b), .0259 (8)(b), .0267 (11)(c), .0607 (e)(2)
Protection and Maintenance of Riparian Areas Rules - Variance Application
FORM: VAR 10-2013
PLEASE IDENTIFY WHICH RIPARIAN AREA PROTECTION RULE APPLIES:
O Neuse River Basin (15A NCAC 02B.0233)
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Major Variance e' Minor Variance
❑ Catawba River Basin (15A NCAC 02B.0243)
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❑ Randleman Lake Water Supply Watershed (15A NCAC 028.0250)
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Major Variance Minor Variance
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13Tar-Pamlico River Basin (15A NCAC 02B.0259)
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Major Variance Minor Variance
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❑ Jordan Lake Water Supply Nutrient Strategy (15A NCAC 028.0267)
Major Variance Minor Variance
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❑ Goose Creek Watershed (15A NCAC 02B.0606 & 15A NCAC 026.0607)
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A. General Information
1. Applicant's Information (if other than the current property owner):
Name: ff1K„vS C'vnJs�aav�O.t/ 'S�t2d)t�f INC.
Title: �"Sr� 1 J W • j[� j�RS/I16itij
Street Address: t�2S MA/r1JIfJ �L
City, State & Zip: A/L. a7,6,Qq
Telephone:
Email:11/42
2. Property Owner/Signing Official (person legally responsible for the property and its compliance):
Name:
Title:
Street Address:
City, State & Zip:
Telephone:
Email:
FORM: VAR 10 2013
221,74M.
961 -s22 -1#7%/l

3. Agent Information:
3a. Name:
Company Affiliation:
Street Address:
City, State & Zip:
Telephone:
E-mail:
3b. Attach a signed and dated copy of the Agent Authorization letter if the Agent has signatory authority for the owner.
4. Project Name (Subdivision, facility, or establishment name):
S. Project Location:
5a. Street Address: 1103 FAK,%0e1_tJVOn 'EL.
City, State &Zip: Ri ,l'/6i%JV C � 2
5b. County: J14 ge-
5c. Site Coordinates (in decimal degrees): Latitude Longitude
5d. Attach an 8 % x 11 excerpt from the most recent version of the USGS topographic map indicating the location of the site.
Se. Attach an 8 Y x 11 excerpt from the most recent version of the published County NRCS Soil Survey Map depicting the
project site.
6. Property Information:
6a. Property identification number (parcel ID): a 19q !O(e4*p' ya?.,%
6b. Date property was purchased:
6c. Deed book ? Y11 I it - and page number .iSloi
6d. Map book 1949 and page number &0
6e. Attach a copy of the recorded map that indicates when the lot was last platted.
7. Is your project in one of the 20 Coastal Counties covered under the Coastal Area Management Act (LAMA)?
L: YES �00
7a. If you answered yes above, in which AEC do you fall (30 ft or 75 ft)?
7b. if you answered yes above, what is the total percent of impervious cover that you have proposed within the AEC? _
FORM: VAR 10-2013 Page 2 of 6

8. Directions to site from nearest major intersection:
9. Stream associated with riparian buffer to be impacted by the proposed activity:
Name Water Quality Classification
9a. For Goose Creek only: Is the buffer in the 100 -year floodplain? r3 YES ❑ NO
10. List any permits/approvals that have been requested or obtained for this project In the past (including all prior phases).
Date Applied: Date Received: Permit Type:
B. Proposed Activity
1. Project Description
Ia. Provide a detailed description of the proposed activity including its purpose:
1b. Attach a site plan showing the following items as applicable to the project:
0 Development/Project name
0 Revision number & date
0 North arrow
0 Scale (1" = W is preferred)
0 Property/project boundary with dimensions
0 Adjacent streets and roads labeled with names and/or NC State Road numbers
0 Original contours and proposed contours
0 Perennial and intermittent streams, ponds, lakes, rivers and estuaries
0 Mean high water line (if applicable)
0 Wetlands delineated, or a note on plans that none exist
0 Location of forest vegetation along the streams, ponds, lakes, rivers and estuaries
0 Extent of riparian buffers on the land including Zone 1 and Zone where applicable
0 Location and dimension of the proposed buffer impact (label the area of buffer impact in ft2 on the plan)
FORM: VAR 10.2013 Page 3 of 6

0 Details of roads, parking areas, cul-de-sacs, sidewalks, and curb and gutter systems
0 Footprint of any proposed buildings or other structures
0 Discharge points of gutters on existing structures and proposed buildings
0 Existing drainage (including off-site), drainage easements, and pipe dimensions
0 Drainage areas delineated
C. Proposed Impacts and Mitigation
1. Individually list the square footage of each proposed impact to the protected riparian buffers:
Buffer Impact
Number' — Reason for Impact
Permanent (P) or
Tempora (T)
Buffer Zone 1 Impact Zone 2 Impact
Mitigation (square feet) (square feet)
Required
Bi - T
o Yes o-fQo �/ L•a
B2 - LJ P LJ T
o Yes o No
83 P T
o Yes o No
Total Buffer Impacts
'Label on site plan
2. Identify the square feet of impact to each zone of the riparian buffer that requires mitigation from the table above. Calculate
the amount of mitigation required.
'For projects in the Goose Creek Watershed, list all riparian buffer impacts as Zone 1
and use Zone 1 multiplier.
3. Provide a description of how mitigation will be achieved at your site pursuant to the mitigation requirements of the applicable
river basin/watershed.
3a. Is buffer restoration or enhancement proposed? Yes )9—No
If yes, attach 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.
3b. Is payment into a buffer restoration fund proposed? r, Yes yb.No
If yes, attach an acceptance letter from the mitigation bank you propose to use or the NC Ecosystem Enhancement
Program stating they have the mitigation credits available for the mitigation requested.
FORM: VAR 10-2013 Page 4 of 6
Required
Zone
Total Impact
Multiplier
Mitigation
(square feet)
s uare feet)
Zone 1'
3
(2 for Catawba only)
Zone 2
1.5
Total Buffer Mitigation Required:
_
'For projects in the Goose Creek Watershed, list all riparian buffer impacts as Zone 1
and use Zone 1 multiplier.
3. Provide a description of how mitigation will be achieved at your site pursuant to the mitigation requirements of the applicable
river basin/watershed.
3a. Is buffer restoration or enhancement proposed? Yes )9—No
If yes, attach 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.
3b. Is payment into a buffer restoration fund proposed? r, Yes yb.No
If yes, attach an acceptance letter from the mitigation bank you propose to use or the NC Ecosystem Enhancement
Program stating they have the mitigation credits available for the mitigation requested.
FORM: VAR 10-2013 Page 4 of 6

D. Stormwater
Provide a description of how diffuse flow will be maintained through the protected riparian buffers (e.g., re -planting vegetation
or enhancement of existing vegetation, gutter splash pads, level spreader to control of runoff from impervious surfaces, etc.).
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la. Show the location of diffuse flow measure(s) on your site plan.
1b. Attach a completed Level Spreader Supplement Form or BMP Supplement Form with all required items for each proposed
measure.
1c. Attach an Operation and Maintenance (O&M) Form for each proposed level spreader or BMP.
For Major, Catawba, and Goose Creek variance requests, provide a description of all best management practices (BMPs) that
will be used to minimize disturbance and control the discharge of nutrients and sediments from stormwater.
2a. Show the location of BMPs on your site plan.
2b. Attach a Supplement Form for each structural BMP proposed.
2c. Attach an Operation and Maintenance (O&M) Form for each structural BMP proposed.
F. Demonstration of Need for a Variance
The variance provision of the riparian buffer rules allows the Division or the Environmental Management Commission to grant a
variance when there are practical difficulties or unnecessary hardships that prevent compliance with the strict letter of riparian
buffer protection.
1. Explain how complying with the provisions of the applicable rule would prevent you from securing a reasonable return from or
make reasonable use of your property. Merely proving that the variance would permit a greater profit from the property shall
not be considered adequate justification for a variance. The Division will consider whether the variance is the minimum possible
deviation from the terms of the applicable Buffer Rule that shall make reasonable use of the property possible.
FORM: VAR 10.2013 Page 5 of 6

2. Explain how the hardship results from application of the Buffer Rule to the property rather from other factors such as deed
restrictions or other hardships (e.g. zoning setbacks, floodplains, etc).
3. Explain how the hardship results from physical nature of the property, such as its size, shape, or topography, which is different
from that of neighboring property.
4. Explain whether the hardship was caused by the applicant knowingly or unknowingly violating the applicable Buffer Rule.
S. For Meuse, Tar -Pamlico, Jordan lake and Goose Creek only: Did the applicant purchase the property after the effective date of
the applicable Buffer Rule and then request a variance?
6. Explain how the hardship is rare or unique to the applicant's property, rather than the result of conditions that are widespread.
F. Deed Restrictions
By your signature in Section G of this application, you certify that all structural stormwater BMPs required by this variance shall
be located in recorded drainage 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.
G. Applicant's Certification
I, a&$4 f (print or type name of person listed in Section A, Item 2), certify that
the informati�ded 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 Section F of this form will be recorded with all required permit
conditions.
Signature:
Date: 62 -14- xi
FORM: VAR 10-2013 Page 6 of 6

SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. PLAN NO. PARCEL ID:
Please print:
Property Owner
Property Owner: .
The undersigned, registered property owners of the above noted property, do hereby authorize
JrrAri�r/ &w&Ad _, of 1-1�kdA If 6AIM& mpt"
(Contractor J Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
Telephone: ��� 2 — / 726
We hereby certify the above information submitted In this application is true and accurate to the
best of our knowledge.
AuthorizedkSliniture Authorized Signature
Date: —oi�l9 Date:

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CADY CONSTRUCTION COMPAPIY, 11+IC.
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123 SOUTH WHITE.STRrl:[
SUBDIVISION
SURVEY OF
.f,:
-#A 10REST, NORTH -CAROLINA- 7.7587
'BANBURY
JACK R. THOMASON. Id'.
I'I IONER: 919-562-0000
WOODS PLACE
6531-202 WAKE FOREST 1111'.01i 1 1
11111 f ; OCTOBER 19'I 199H
RALEIGH, WAKE
COUNTY,
WAKE FOREST, NC 27587
MC
PHP 919-556-3307
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