43175_FELTON, JAMES L JR_20051010

i;AMA / CI DREDGE & FILL
GENERAL PERMIT — Previous permit#
1-1New Modification —]Complete Reissue ElPartial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources _ ff� d /�
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC / • ��L { ,71�, ! b e
'Rules attached.
JApplicant Name 4_,wz � tyt--r f't%, 4e Project Location: County 2Ae-r&_
Address �p y���C (jam �F'R ( /yG.?C!t /_ Street Address/ State Road/ Lot #(s)
City iC? tzee �A Staten ZIP 7 ! ~�-�%- ,'rj.
Phone # (Cjl� ) 77k71 7 Fax # ( ) Subdivision �&I.t,•T
Authorized Agent City :0�,1/40.24 el) �S�e ZIP . /�
Cw
Affected iw f✓T`PTAS ❑ PTS Phone # (Z` Z) 75 y' 3 SL I River Basin (C%/1(
�
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s): Adj. Wtr. Body/man /unkn)
I PWs: ❑FC:
ORW: yes / no PNA yes / no,• Crit. Hab. yes / no Closest Maj. Wtr. Bodyr a' x' il.-_✓:
Type of Project/ Activity I,tJ L'Lx, if 1,: '�.�/i1/a,�,� r f 1w� �QC�GG
i rr� � ,✓:��, (Scale:
Pier (dock) length tL-+ -, - - --- -
s� ���5 Ck �?� ✓
Platform(s) >'T A / _ •�..-s...,./" 3•VC, C%v o 'S i '"""`--30,
Finger pier(s)
Groin length
J ----
number - -
Bulkhead/ Riprap length
I�
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift r17
Beach BulldozingSO
Other`lrfs!�.tC� El7A� ✓ jQlfl 'itt,b? �r / l+JC1�-ry 4-,e}Cro
Ll
Shoreline Length
A t
SAM not sure yes
Sandbags: not sure yes
�� p
Moratorium: n/a yes n ty�' +a, t79_.0 S ~
Photos: yel ( t
Waiver Attached: yes (-
A building permit may be required by: �„
❑See note on back regarding River Basin rules.
Notes/ Special Conditions i /i1(1 /2/<-7;.g r?q/U!!1-1Z111,:
C.//i�., �1 l ) <i'C!� .tff T� t?O .rr�u>� !.�i1'�� _�Y tA!' P/L Z �?/k / �i/�, cf�;-7- T..
i�0 9Jn n�n f..( t�!1 `lY'iC r�lww .n CY i"r\. �Y f�'1'rJ' .1r ,../T' Ali? Y4 D_l �ifi� ✓ M �1l/;i7in.;C FJ,/ ii.: l,7er! /�� 's,� A,
V) ire
Agent or;Applicant Printed NaryeZZ
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature
/jh lt,rkv� e riin /(Ca�hr�
Issuing Date // ExpiratioA Date
EM-O--arlco lea ji C7
Local Planning Jurisdiction Rover File Name

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certifythatthis project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar - Pamlico River Basin Buffer Rules ❑ Other:
� Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington
Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Central Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
400 Commerce Ave
Morehead City, NC 28557
202-808-2808/ 1-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

Detailed view for record 19 (Print)
Field Value
RREA 21850.93062
PERIMETER 730.69427
PARCEL83_ 50111
PARCEL83_I 50142
WHAT 0
PIN 539418132
MAPNUM 5394
BLOCK 31
PDOT 1485
CONDO_
MOTHER 0
MAPNAM 539418
PRID 15034H0903
PIN15 539418311485000
OWNER FELTON,JAMES L JR ETUX MARY
AN
DBOOK 110507
DPAGE 00141
DDATE 0
SALE_PRICE 0
TAX_VALUE 378217
LAND_VALUE i93200
STRUC_VAL 175714
OTHER_VAL 9303
BLT_CONDO 0
HOUSE_NUM 0007410
Field Value
DIRECTION
ST NAME SOUND
ST_TYPE DR
CITY EMERALD ISLE
ZIP 1128594
MAIL HOUSE 5330
MAtL DIR
MAIL-ST SENDERO DR
MAIL_STTYP
MAIL CITY RALEIGH
MAIL_STATE-]INC
MAIL ZIP 27612
MAIL_POBOX
TOWNSHIP WHITE OAK
CITY -LIMIT EMERALD ISLE
NBHD 1560035
FIRE DIST
RESCUE DST
LEGAL DSC L3 BA ARCHERS POINT
TOTAL ACR 0.495
Y BLT H 11984
TOT SO FT 71981
BATHROOMS 113
BEDROOMS 5

r
loc.

3
1'
U
c
L—+
E
a

I4:):i111 CIA ... ... A u—,ill.l
(�NViliC l:li I N-u-, :41
,V_1i"011et 1. ZN.C.Jcf_:.{.n1Cr1jz�c<ouices
I:`cJ.ease: Irr�x1-ledi��.te -
Dalte;: Sept, 15, 2005
_... _.... _ .._-........... ... -- --...... _...... ...._-_ __._
Corli<<I::t: Doll. IZ.cutca, Public: Affairs Dircctor
Ph.orl.(,: 91.9/715A J.1.2.
COASTAL MANAGI=,MI_ItT 01 ):1;R,S_1?.I� LIRGI J�JCX Cn,l A 1?ls).Z11�1;1, k�OR_1R)R.RI:CI�Nl3 R.l3CQVJ::;1=��1
- — T11'S 1'OR I ELPING SPE'EM UP PEIZMI l' PROC)__,1_SS —
RALEIGH — Coastal property owners who need to replace docks, piers, bulkheads or similar structures
damaged by Hurricane Ophelia along sounds, rivers and creeks may be able to do so quickly by using an
emergency general permit offered by the state Division of Coastal Management.
The permit regulations speed up the authorization process for rebuilding structures that meet state
standards. The rules also waive permit fees for those projects, as well as beach bulldozing and maintenance
dredging of existing channels related to hurricane recovery.
Bill Ross, secretary of the Department of Environment and Natural Resources, activated the general
permit today. It may be used in the following counties: Currituck, Dare, Beaufort, Hyde, Pamlico, Carteret,
Craven, Onslow, Pender, New Hanover and Brunswick. The permit does not eliminate the need to obtain any
other required state, local or federal authorization.
Property owners have until March 15, 2006 to obtain the emergency general permit. Work authorized
under the permit must be completed by Sept. 15, 2006.
The general permit cannot be used for rebuilding houses and does not apply to the replacement of
oceanfront structures. Non -oceanfront property owners who lost their houses will need either a CAMA minor
permit or a permit exemption to replace it, depending on where their house was located. Replacement of
oceanfront houses requires a CAMA minor permit.
Contact Coastal Management staff before beginning repairs or replacement work, said Charles Jones,
director of the Division of Coastal Management.
If you want to apply for the emergency general permit, here's how you can help Coastal Management
review your request as quickly as possible:
1 Please make your request in person at the Coastal Management office that Covers your county:
1367 U.S. 17 South, Elizabeth City (Camden, Chowan, Currituck, Dare, Gates, Pasquotank and
Perquimans counties); 400 Commerce Ave., Morehead City (Carteret, Craven and Pamlico
counties, and the White Oak River bank in Onslow County); 943 Washington Square Mall,
Washington (Beaufort, Bertie, Hertford, Hyde, Tyrrell and Washington counties); 127 Cardinal
Drive Ext., Wilmington (Brunswick, New Hanover and Pender counties, Onslow County south of
the New River, and Topsail Island)
-More-
Division of Coastal Management Charles S. Jones, Director
Phone: [phone] FAX [phone]
1638 Mail Service Center, Raleigh, NC 27699=1638 www.nccoastalmanagement.net
An Equal Opportunity / Affirmative Action Employer

drC'dPjrq?' You )lec"d to do"411cludilig (lin-le.tisior)s ar).10,horcb.nc lcrjgq-i- Aol)all.d
stori-a pictu.rcs of I -lie. proJect are. cxtrerncly helpful,
3. Give, your riarric, address, phoiic nurobej.- and the project: IOCatiOrl. Include any dct.afl.cd. information
that will bc).).elpful, such as the state road number, tbc riame, of the, water bo( ly and thc nan'je, of the
clevel.opme,nt.
d . For projects involving the dred.giri.g or filling of estuarine waters, please, provide, confirmation that
the adjacent riparian property owners have been notified by certified mail of Gic proposed work.
The notice should instruct neighbors to provide any cornments about ffic proposed work to Coastal
Management within 10 days of receiving the notice,, and that a lack of response by them will be
interpreted as no objection.
5. If you have, had any other CAMA permit on your property, please tell the division. Those permits
may contain information that will help Coastal Management review your repair or replacement
request.
Property owners with questions should call their local Coastal Management office;: Elizabeth City, 252-
264-3901; Morehead City, 25.2-808-2808 or 1-888-4RCOAST (1-888-472-6278); Washington, 252-946-
6481; Wilmington., 910-796-72I.5.
Division of Coastal Management Chiff—esS. Jones, Director
Phone: [phone] FAX [phone]
1638 Mail Service Center, Raleigh, NC 27699-1638 www.nccoastalmanagement.net
An Equal Opportunity /Affirmative Action Employer

Sl CTION .2500 - I?1\ 1:;R.GENCY G1:7.NERAI., 13.1 INITIATI D DISCRETION
OF 1.'1-I:L SE,,CRE`I,ARY OF'I lI DE,1'ARTMENT OF ENVIRON1rr1 N`I' AND NATURAL
RESOURCES S FOR REPLACEME?N`1' OF S 1'I:�UCTlIRES, `1'1-Il RE CONSTRUCTION OF PRIMARY
OR FRONTA.L DUNI3 SYS7:'EMS, AND TI-1.1=, MAINTLNANC131 XCAVA`l'ION 01 � EXISTING
CANALS, BASINS, CIIANNT,LS, OR DITCHES, DAMAGED,I)I�S'I'R.OYED, OR FILLI30 IN BY
14URRICANES OR TROPICAL STORMS, PROVI7X:?D .ALL REPLAC1--;,T\ :r,',NT,
RECONSTRUCTION AND MAINTENANCE E3XC:AVATION ACTIVITIES CONFORM TO ALL
CURRENT STANDARDS
15A ncac 07h .2501 PURPOSE
Following damage to coastal North Carolina due to hurricanes or tropical storms, the Secretary may,
based upon an examination of the extent and severity of the damage, implement any or all provisions of
this Section. Factors the Secretary may consider in making this decision include, but are not limited to,
severity and scale of property damage, designation of counties as disaster areas, reconnaissance of the
impacted areas, or discussions with staff, state or federal emergency response agencies. This permit
shall allow for:
(1) the replacement of structures that were located within the estuarine system or public trust
Areas of Environmental Concern and that were destroyed or damaged beyond 50 percent of the
structures value as a result of any hurricane or tropical storm,
(2) a one time per property fee waiver for the reconstruction or repair by beach bulldozing of
hurricane or tropical storm damaged frontal or primary dune systems, and
(3) a one time per property fee waiver for maintenance dredging activities within existing basins,
canals, channels, and ditches. Structure replacement, dune reconstruction, and maintenance excavation
activities authorized by this permit shall conform with all current use standards and regulations. The
structural replacement component of this general permit shall only be applicable where the structure
was in place and serving its intended function at the time of the impacting hurricane or storm, and shall
not apply within the Ocean Hazard System of Areas of Environmental Concern (AEC) or waters
adjacent to these AECs with the exception of those portions of shoreline that feature characteristics of
Estuarine Shorelines. Such features include the presence of wetland vegetation, lower wave energy, and
lower erosion rates than in the adjoining Ocean Erodible Area.
History Note: Authority G.S. 113A-107; 113A-118.1;
Temporary Adoption Eff. October 2, 1999;
Temporary Adoption Expired on July 28, 2000;
Eff. April 1, 2001.
15A NCAC 07h .2502 APPROVAL PROCEDURES
1 of 6 9/16/2005 5:11 1

(a) The applicant. rn.iist contact. tb_c Division of Coastal Mai .agf:rncnt: an.d rcgt.iest approval for structural
repl.aceiTlent, dune reconstnictiorl, or r.Tiaintenance. excavation. he. applicant. shall. provide informati033. �
on. site location, dir ensi.ons of the project area, anal his or her name and address.
(b) The applicant imust provide:
(1) Description of t:he extent. of repair, replacement, reconstruction, or maintenance excavation
needed., including dimensions and shoreline length; and
(2) In the case of structural replacements, any additional documentation confirming the existence of
the structure prior to the hurricane or tropical storm, such as surveys, previous permits, photographs or
videos.
(c) For projects involving the excavation or filling of any area of estuarine water, the applicant must
provide confirmation that the adjacent riparian property owners have been notified by certified mail of
the proposed work. Such notice shall instruct adjacent property owners to provide any comments on the
proposed development in writing for consideration by permitting officials to the Division of Coastal
Management within 10 days of receipt of the notice, and, indicate that no response shall be interpreted
as no objection. DCM staff shall review all comments and determine, based on their relevance to the
potential impacts of the proposed project, if the proposed project can be approved by this General
Permit. If DCM staff finds that the comments are worthy of more in-depth review, the applicant shall
be notified that he or she must submit an application for a major development permit.
(d) No work shall begin until a meeting is held with the applicant and appropriate Division of Coastal
Management representative. Written authorization to proceed with the proposed development may be
issued during this meeting.
(e) Replacement, reconstruction or maintenance excavation activities must be completed within one
year of each activation by the Secretary of this general permit.
(f) Authorizations under this General Permit shall not be issued more than one year following each
activation by the Secretary of this general permit.
History Note: Authority G.S. 113A-107; 113A-118.1;
Temporary Adoption Eff. October 2, 1999;
Temporary Adoption Expired on July 28, 2000;
Eff. April 1, 2001.
15A NCAC 07H .2503 PERMIT FEE
The standard permit fee of one hundred dollars ($100.00) has been waived for this General Permit.
2 of 6 9/ 16/2005 5:11 Pl

Ifistory Note: y`,wbority G.S. 1.13A-107; 113A-418.1.;
Temporary Adoption Eff. October- 2., 1999;
Temporary Adoption Expirccf on July 28, 2.000;
Eff. April 1, 2001.
15a ncac 0711..2504- GENERAL CONDITIONS
(a) This permit shall only become available following a written statement: by the Secretary that, based
upon hurricane or tropical storm related damage, implementation of the provisions of this Section are
warranted.
(b) Based upon an examination of the specific circumstances following a specific hurricane or tropical
storm, the Secretary may choose to activate any or all of the components of this Section. The Secretary
may also limit the geographic service area of this permit.
(c) This permit authorizes only the replacement of damaged or destroyed structures, the reconstruction
of frontal or primary dunes, and maintenance excavation activities conforming to the standards
described in this Section.
(d) This permit does not authorize the replacement of any structure within any Ocean Hazard Area of
Environmental Concern, with the exception of those portions of shoreline within the Ocean Hazard
AEC that feature characteristics of Estuarine Shorelines. Such features include the presence of wetland
vegetation, lower wave energy, and lower erosion rates than in the adjoining Ocean Erodible Area.
(e) Individuals shall allow authorized representatives of the Department of Environment and Natural
Resources to make periodic inspections at any time deemed necessary in order to be sure that the
activity being performed under authority of this general permit is in accordance with the terms and
conditions prescribed in this Section.
(f) This general permit shall not be applicable to proposed construction when the Department
determines after any necessary investigations, that the proposed activity would adversely affect areas
which possess historic, cultural, scenic, conservation, or recreational values.
(g) This general permit shall not be applicable to proposed construction where the Department
determines that authorization may be warranted, but that the proposed activity might significantly affect
the quality of the human environment, or unnecessarily endanger adjoining properties. In those cases, it
shall be necessary to review the proposed project under the established CAMA Major or Minor
Development Permit review procedures.
(h) This permit does not eliminate the need to obtain any other required state, local, or federal
authorization.
(i) This permit does not preclude an individual from applying for other authorizations for structure
replacement that may be available under the Coastal Area Management Act and the Rules of the
Coastal Resources Commission. However, application fees for any such authorization shall not be
3 of 6 9/16/2005 5:11 P1

waived or deferred.
History Notc: Authority G.S. 113A-107; 113A-l.18.1;
Temporary Adoption Eff. October 2, 1999;
Temporary Adoption Expired on July 28, 2000;
Eff. April 1, 2001.
15A ncac 07h .2505 SPECIFIC CONDITIONS
(a) The replacement of a damaged or destroyed structure shall take place within the footprint and
dimensions that existed immediately prior to the damaging hurricane or tropical storm. No structural
enlargement or additions shall be allowed.
(b) Structure replacement, dune reconstruction, and maintenance excavation authorized by this permit
shall conform to the existing use standards and regulations for exemptions, minor development permits
and major development permits, including general permits. These use standards include, but are not
limited to:
(1) 15A NCAC 07H .0208(b)(6) for the replacement of docks and piers;
(2) 15A NCAC 07H .0208(b)(7) for the replacement of bulkheads and shoreline stabilization
measures;
(3) 15A NCAC 07H .0208(b)(9) for the replacement of wooden and riprap groins;
(4) 15A NCAC 07H .1500 for maintenance excavation activities; and
(5) 15A NCAC 07H .1800 for beach bulldozing landward of the mean high water mark.
(c) The replacement of an existing dock or pier facility, including associated structures, marsh
enhancement breakwaters or groins shall be set back 15 feet from the adjoining property lines and the
riparian access dividing line. The line of division of riparian access shall be established by drawing a
line along the channel or deep water in front of the property, then drawing a line perpendicular to the
line of the channel so that it intersects with the shore at the point the upland property line meets the
water's edge. Application of this Rule may be aided by reference to the approved diagram in 15A
NCAC 07H .1205(q), illustrating the rule as applied to various shoreline configurations. Copies of the
diagram may be obtained from the Division of Coastal Management. When shoreline configuration is
such that a perpendicular alignment can not be achieved, the pier shall be aligned to meet the intent of
this Rule to the maximum extent practicable. The setback may be waived by written agreement of the
adjacent riparian owner(s) or when the two adjoining riparian owners are co -applicants. Should the
adjacent property be sold before replacement of the structure begins, the applicant shall obtain a written
agreement with the new owner waiving the minimum setback and submit it to the Division of Coastal
Management prior to initiating any construction of the structure.
4 of 6 9/16/2005 5:11 PP

History Note: Autbority O.S. 11.3A-1.0%; 1.13A.-11S.1;
Temporary Adoption ) ff. October 2, 1.999,
T ernporary Adoption ]3xpired on July 28, 2000;
Eff, April 1, 2001.
5 of 6 9/16/2005 5;11 P2

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property adjacent to _J. L. Felton
property located at 7410 Sound Drive
I
(Name of Property Owner)
(Street Address, Lot, Block, Road, etc.)
on Bogue Sound , in _Emerald Isle , N.C.
(Waterbody) (Town and/or County)
He/she has described to me, as shown below, the development he/she is proposing at that
location and I have no objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
9 7 V L Js l y / K� 4To be filled in by individual proposing development)
.8J'L, 4 f
S4r_'J , ss� 5
pyfopl�
1jeV
? 3/ —
%�iri SL�kK r�
�' U a , "n �. lm�wr��
Signature I&IIA b, sfeNeY\50n
Print or Type Name
zk 39 3-
Telephone Number
Date: �C' ���i' U J200

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to J. L. Felton
property located at 7410 Sound Drive
I
(Name of Property Owner)
(Street Address, Lot, Block, Road, etc.)
on _Bogue Sound , in _Emerald Isle N.C.
(Waterbody) (Town and/or County)
He/she has described to me, as shown below, the development he/she is proposing at that
location and I have no objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
,5 7�`, �� �To be filled in by individual proposing development)
/t�3Gtw,-t Pyt(v14jeY,
Q 1,
tic,
------------------------------------------------------------------------------------------------------------------
Signatur&'
14V
Print or Type Name
S 3S$4-- 3
Telephone Number
Date.-

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOA TLIFTIBOA THOUSE)
I hereby certify that I own property adjacent to J. L. Felton's
(Name of Property Owner)
property located at 7410 Sound Drive Emerald Isle, NC 28594,
(Street Address, Lot, Block, Road, etc.)
on Bogue _Sound in Emerald Isle, Carteret CO.
N.0
(Waterbody) (Town and/or County)
He/she has described to me, as shown below, the development he/she is proposing at that
location and I have no objections to this proposal. I understand that a pier/mooring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area of
riparian access unless waived by me. I have indicated my intentions by initialing below-
I do not agree to waive the 15' setback requirement.
(initials)
I do agree to waive the 15' setback requirement.
I.... 1.._._1
--------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
PICV� s
Signature
Print or Type Name
3 3-:;Z I/
Telephone Number
Date: / C'— �`

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFTIBOATHOUSE)
I hereby certify that I own property adjacent to J. L. Felton's
(Name of Property Owner)
property located at 7410 Sound Drive Emerald Isle, NC 28594,
(Street Address, Lot, Block, Road, etc.)
on _Bogue _Sound in _Emerald Isle, Carteret CO.
N.C.
(Waterbody) (Town and/or County)
He/she has described to me, as shown below, the development he/she is proposing at that
location and I have no objections to this proposal. I understand that a pier/mooring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15) from my area of
riparian access unless waived by me. I have indicated my intentions by initialing below:
I do not agree to waive the 15' setback requirement.
(initials)
I do agree to waive the 15' setback requirement.
(initials)
-------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
V_
A 1?cPiafr "
P�GV
J I
Print or Type Name
Telephone Number
Date: :���) �;; ice.`

6vLKI,�u�1
13o°Jve 50u"1 a(
q_z-K-v 5
a pT,L'
,u
PYoP,r�,�J pv. p a5c
f�vl K�cao�
c�.TFYfm5oN s
Prd f 41
p o �� - b�
r� P l acr
�Wy
� � W
II
Fe I �oV► PY6oPc4 I/
74/0 SoTvN� pr
hHw
L,'A'c
ljv�1S �rrrracl 7v 4
Ih w �7�i f}c►�'�Cta�
v e h t-l5
fto PMJ 4v

-%3u)ll �eaJ 0c4krl
10
7L 19S�7GYL &v4,4Gr yI ``nv1 57,Icc�
P-e- 5pcc- �i Lr{TIGMS
r� G��ntr�j�u�r�rd
CAP
_ iX,�"x6"

J. L. FELTON
M. A. FELTON
NCDL 2524857 462840
6400 EBENEZERR CHURCH D- PH 919 781-4217
PAY TO THE
ORDER OF _
Coastal.Federal Cre(
P.O. BOX 58429, RALEIGH, NC
www.coastaftb-Org 1
MEMO
1:2 5 31' 5049�,
66-7549/2531 3702
,
DATE i l (-7/
_DOLLARS J ....