CBPE 2S04D2LoD DECEIVEN - APR 23 2025 BY: Rewes CHESAPEAKE BAY PRESERVATION ORDINANCE Exception Process Guidance & Application For CBPEC Activities in the Resource Protection Area (RPA) Property owners interested in working in the Resource Protection Area (RPA) may be required to request a buffer reduction through the Exception process. The following are general guidelines and are not intended to represent every possible activity within the RPA. Please contact the Department of Environmental Programs for specific inquiries at 804-693-1217, or stop by the office, 6489 Main Street, Gloucester, or visit our website https: Libousceserago-/cminommemulpogams Exception Process (Preservation & Erosion Commission), defined in Sec. 5.5-14; for variance to requirements for Sec. 5.5-7B and 5.5-9C, requiring Public Hearing: $275.00 application fee. Meetings held the 2nd Wednesday of each month, application deadline the last working day of the month. Applications available online or in the Department of Environmental Programs. 1. New construction on an undeveloped, non-conforming lot (existing before October 15, 1991) with buildable area outside of the Resource Protection Area. 2. Construction of, additions to, accessory structures (garages, pools, sheds, pads, impervious area, grade alteration, etc.). 3. Construction of, additions to, principal structures within the seaward 50' of RPA (between 0' -50). 4. Reviews, waiver appeals, and violation. A Water Quality Impact Assessmenti is required for review of ALL activity in the RPA (Sec. 5.5-11). Revised 2/2025 * Aferthe -fact EXCEPTION APPLICATION CBPEC 25-(3 An application for Excéption is required for new, non-water-dependent development, redevelopment, and construction within 50 ofthe Resource!l Protection Area (RPA). A Water Quality Impact Assessment is required for review of ALL activity in the RPA. APPLICANT/AGENT INFORMATION: Name: MARCNS K Joncs Phone: 8-833-54P2 Mailing Address: 20600 Ekinghariey RcR City/State/Zip: Mescley MA 7312 Email: 5n A ppymTe EmAL.com PROPERTY OWNER INFORMATION: Name: MAPCks K daafmane B04-233-54B2 Mailing Address: 2D600 Skinepacter Rel Mesekeyy #23120 City/State/ Zip: Meselry VA 23/20 Email: 5nAPPY TEmAl . Com PROPERTY INFORMATION: Tax Map or RPC: Lot 19 Holly Street BehteA AdrsM: DLAG-19 RPC:29lll Date Lot Recorded: B52zt 1988 Nearest Water Body: Parkahnk RJe Distance to Feature: 50' Sq Ft. ofEncroachment: 540' DETAILS OF REQUEST: 18'30' CnePort DIRECTIONS TO THE PROPERTY: Lot Just ho right oF 6279 HallyTed Gloudesesya 2-3061 CTAO Din t) PRIVACY ACTSTATEMIENT: Information provided in the Chesapcake Bay application will be used in the permit review process and is a matter of public record once the application is filed. Disclosure oft the requested. information is voluntary. but it may not be possible to evaluate the permit application or to issue a permit if the information requested is not provided. CERTIFICATION:T am hereby applying for all permits typically issucd by Department of Environmental Quality, Virginia Marine Resource Commission, U.S. Army Corps ofl Engincers, Chesapcake Bay process, and/or Local Boards for the activities I have described herein. I agree to allow the duly authorized representatives of any regulatory or advisory agency to enter upon the premises of the project site at reasonable times to inspect and photographs site conditions, both in revicwinga proposal to issue a permit and after permit issuance to determine compliance with the permit. In addition, I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Bascd on my inquiry oft thex or persons who manage they system or those persons directly responsible for gatheringthe information, the information submitted is, to the best of my knowledge and belief, true, accurate. and complete. am: aware that there gresignificant penaltics for submitting fajci information, including the possibility of fine and imprisonment: for knowing violations. 7 MARCIS kSbnes laicus la 4-13-2025 Printed Name Signature Date Revised 2/2025 Project #: WATER QUALITY IMPACT ASSESSMENT Required for all dcdhpmem/declepmen in the Resource Protection Area; CBPO 5.5-11 A site drawing, which shows the following, must be attached to this water quality impact assessment: Location of the components of the RPA, including the 100' buffer area; Location and nature of any proposed encroachment into the buffer area, including type of paving material, areas of clearing or grading, location of any structures, drives, or other impervious cover, sewage disposal systems or reserve drain field sites, and wells; Type and location of proposed best management practices to mitigate the proposed encroachment; Location of existing vegetation onsite, including the number, type of trees, caliper, and other vegetation to be removed in the buffer to accommodate the encroachment or modifications; and Type, size, and location of replacement vegetation. Setbacks in accordance with Zoning regulations. APPLICANT/AGENT INFORMATION: Name: MAACus * ones Phone: B04-833-54BZ Mailing Address: AD6DO Skingaderp. City/State/Zip: Mpselry LA 23120 Email: Snaphmte_Gmalase PROPERTY OWNER INFORMATION: Name: MARCNE Kcors Phone: 804-833-54B2 Mailing Address: 2Db0D Sknglacter Rel City/State/Zip: moseley VA 23120 Email: SmensGnal.tem PROPERTY INFORMATION, Lot 19 Aolly Beach Scc A P/o Tax or Street Address: 23ou Map RPC29661 OLAQ-19 E911 6279 Holls Tl,GlexesayA Date Lot Recorded: A5,pra4 Nearest Water Body: PianketAnk Rilal Revised 2/2025 7-30-2024 FOR GRANTING EXCEPTION (Sec. 5.5-14) Required by Code - please provide any input as to how your project complies. 1. Requirements shall be minimum necessary to afford relief. Ne-sca CARpoCt do pake a hovl Talor 2. Reasonable and appropriate conditions arc imposed, as warranted, that will prevent the allowed activity from causing a degradation ofwater t 1oa5 a VACnt 12 Mpt to My housEo hees Woee ag dobn locatiou loas pckes to Gde baRmng a lerg frest Pine 3. Granting waiver will not confer applicant any special privileges that are denied to other property owners subject to its provisions and arc similarly situated. 4. Waiver is in harmony with purpose and intent of Ordinance and not of substantial detriment to water quality. 5. Waiver not based on selfimposed/created conditions or circumstances. 6. Other findings, as appropriate and required by Gloucester County. Please use additional sheets if necessary for completing the questions above. Revised 2/2025 Site Conditions (ofsite and adjacent lands): Existing topography: Hydrology: Soils: Geology: Fill Materials (source and composition): Cohht Ri Bese wder 57Cavel Total Amount of Disturbed area (sq ft): 54o' Total Amount of Cleared Area (sq ft): Existing Vegetation: Total Amount of Underbrush Removed (sq ft): - Types: Number of Healthy Trees Removed: A > Types: Number of Trees Limbed or Pruned: I (zlimbs) Types: OAk Number of Dead/Dying/Dseased Trees Removed: 0 Types: Proposed Vegetation Mitigation Measures: Number of New Canopy Trees Proposed: Types: Number of New Understory Trees Proposed: Types: Number of New Shrubs Proposed: Types: Proposed Erosion & Sedimentation Control Practices: Silt Fencing Temporary Construction Entrance Straw Bale Barrier(s) Inlet Protection Temporiy/Pemanent Seeding Mulching Tree Protection Sediment Trap Other: Proposed Best Management Practices: D Dry Well(s) - Infiltration Trench(es) Vegetated Filter Strip(s) Grass Swale(s) Other: Revised 2/2025 Wastewater (Septic) Element: Attach legible, clean copy of Health Department approval information to include calculations and dimensions. Description of potential impacts of the proposed wastewater systems including and proposed mitigated measures for these impacts: PRIVACY ACT STATEMENT: Information provided in the Chesapeake Bay application will be used in the permit review process and is a matter of! public record once the application is filed. Disclosure of the requested information is voluntary, but it may not be possible to evaluate the permit application or to issue a permit if the information requested is not provided. CERTIFICATION: I am hereby applying for all permits typically issued by the DEA, VMRC, U.S. Army Corps of Engineers, Chesapeake Bay process, and/or local Wetlands Boards for the activities I have described herein. I agree to allow the duly authorized representatives of any regulatory or advisory agency to enter upon the premised of the project site at reasonable times to inspect and photograph site conditions, both in reviewing proposal to issue a permit and after permit issuance to determine compliance with the permit. In addition, I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system or those persons directly responsible for gathering the information, the information submitted is, to the best ofmy knowledge and belief, true, accurate, and complete. Iam aware that there are significant penalt.ics for submitting false information, including the possibility of fine and imprisonment for knowing violations. - MAos k Jonel H-23-205 Printed Name Signature Date Revised 2/2025 OFFICE USE ONLY Project #: 2504D2lD Received byBinelFeel Paid: 550.DORecipt #: Date Received: 4-23-25 Reviewing Authority: Staff Lot recordation date verified with Clerk's Office YES - Date: 4-25-25 Project Meets Zoning Setbacks: Yes No Date Verified: STAFF DECISION: APPROVED: (Approval is valid for 36 months from the date of approval) CODE REFERENCE/COMMENTS: DENIED: **Please be advised, you may appeal the Staff decision, in writing, and apply for Exception to be heard in front of the Chesapeake Bay Preservation & Erosion Commission (new application and fees apply) CODE REFERENCE/COMMENTS: Environmental Staff Signature Date Mitigation plan required: YES INO square foot minimum Mitigation plan approved: Entitled: Dated: Date mitigation completed: Inspected by: Amount of surety required: Date surety released: Date posted: Receipt #: Payor Name: Phone #: Payor Address: Revised 2/2025 STAFF ANALYSIS (OFFICE USE ONLY) Staff responses to applicant information provided on reverse page 1. 2. 3. 4. 5. 6. 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