59761_AUERBACH, STEVEN_20120227

❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
❑New ❑Modification El Complete Reissue []Partial Reissue
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
Previous permit #
Date previous permit issued
Rules
Applicant Name ,� ;± j Project Location: County
Address Street Address/ State Road/ Lot #(s)
City Sate j` ZIP
Phone # (< , r` ' �:' .:a PaX# O Subdivision
Authorized Agent ; City ZIP
AffectedEl
CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # ( ) River Basin
OEA HHF IH ❑ UBA N/A
AEC(s): ElEl❑ ❑ Adj. Wtr. Body (nat [man /unkn)
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body
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Agent or Applicant Printed Name Permit Officer's Signature
Signature ** Please read compliance statement on back of permit Issuing Date
Expiration Date
Application Fee(s)
Check # 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 [)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, certify that this project is consistent with 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
Raleigh Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ I-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
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)
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 08/09/06

P 9A 7(o JC
Date: C9
Describe below the HABITAT disturbances for the application. All values should thatch the name, and units of meal re ,e t
found in your Habitat code sheet.
DISTURB TYPE
Habitat �iarrte Choose One
TOTAL Sq. Ft,
(Applied for.
Disturbance total
f d Y
anticipated
restoration or
ternimpacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)_tern
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
impacts
FINAL Feet
final
ance.
Excludes any
restoration and/or
temp impact
amount
Dredge ❑ Fill Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ . Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
52-•13013•2'??� .. -vy ..,,,COAST..+anv:r.nCr_:'•_ac;:':?I.Sa„t::... ..........y:..rsf ;s:.,,..t. n�'e; �; i,y

usfsLocality PernutNumber
�hz�z��l
Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
(For official use only)
GENERAL INFORMATION
LAND OWNER
Name S T'
Address of j`7 C)4--0 �� C/ �LA
City ArkAo /C &ACA State
Zip ± Phone � J i 'O 6 1- b0 � t
OTHER PERMITS MAY BE REQUIRED: The activity you are planningmay qyi� pElrrtits other than the CAMA
minor development permit, including, but not limited to: Drinking Water Welk S; -L- (or other 'tgtt waste
treatment system), Building, Electrical, Plumbing, Heating and Air Conditioning, Insulation and �Lonservation, FIA
Certification, Sand Dune, Sediment Control, Subdivision Approval, Mobile Home ParkAppp�h rghway Connection, and
others. Check with your Local Permit Officer for more information.
STATEMENT OF OWNERSHIP:
I, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in an AEC or a
person authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person
listed as landowner on this application has a significant interest in the real property described therein. This interest can be
described as: (check one)
Dan owner or record title, Title is vested in e VC- N iA e1 tlJlt See Deed Book 1 3 9 S�
page �i�in the C A R«(ZGT County Registry of Deeds.
Email 70 JV e- 0-0 1. C 0 n
MA', AOOkeSi Q 6 60 r-A4S D NSW g R [Dan owner by virtue of inheritance. Applicant is an heir to the estate of
AUTHORIZED AGENT Sv , r G LY t�i4 < P l6 N NL Z r�rS probate was in County.
Name C R l G eLL / S ! p ,
Address o,0 NC) T 1 ( fj&-o1 i LA,t/� �
city t 1 age Of 4 c 11 HState N C— zip ,2'? hoe Sa 3 ti/ Z (ell
LOCATION OF PROJECT: (Address. street name and/or directions to site. If not oceanfront, what is the name of the
adjacentwaterbody.) a39 0 13) Ct4U.5 AY A/) f- T i_AV, tc 13eA" /VC —
DESCRIPTION OF PROJFCT: (list all proposed construction and land disturbance.)
SIZE OF LOTIPARCEL: `1 7 3 7 square feet acres
PROPOSED USE: Residential © (Single-family [[Multi -family Q ) Commercial/Industrial Other
COMPLETE EITHER (1) OR (2) BELOW (Contaet your Local Permit Officer if you are not sure which AEC applies
to your property):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet (includes
air conditioned living space, parking elevated above ground level, non -conditioned space elevated above ground level but
excluding non -load bearing attic space)
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: _ square feet (includes the area of the roof/drip line of all buildings, driveways. covered decks,
concrete or masonry patios, etc. that are within the applicable AEC. Attach your calculations with the project drawing.)
STATE STORMWATER MANAGEMENT PERMIT: is the project located in an area subject to a State Stormwater
Management Permit issued by the NC Division of Water Quality?
YES= Na�
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: square feet.
[Df other interest, such as written contract or lease, explain below or use a separate sheet & attach to this application.
NOTIFICATION OFADJACENT PROPERTY OWNERS:
I furthermore certify that the following persons are owners of properties adjoining this property. I affirm that I have given
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) (Address) At. 8LJ &UeJ'W
(I) GLD L. 13170 Cett-.AAL ABC S tc 831� Q Iv h1, �71Z3
(2) Degxr6 AC OAOK I L/76 s J%TeJ1CJ 3Lb FOR s ,klc t rC- a?C/17
(3)
(4)
ACKNOWLEDGEMENT&
I, the undersigned, acknowledge that the land owner is aware that the proposed development is planned for an area which
may be susceptible to erosion and/or flooding. I acknowledge that the Local Permit Officer has explained to me the particu-
lar hazard problems associated with this lot. This explanation was accompanied by recommendations concerning stabiliza-
lion and floodproofing techniques.
I furthermore certify that 1 am authorized to grant, and do in tact grant, permission to Division of Coastal Management staff
the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information
related to this permit application.
day of20
Landowner or person authorifed to act as his/her agent for purpose of filing a CAMA permit application
This application includes: general information (this farm), a site drawing as -described on the back of this application, the
ownership statement, the Ocean Hazard AEC Notice where necessary, a check far $100.00 made payable to the locality, and
artr information as amv be provided orally by the applicant. The details of the application as described by these sources are
incorporated without reference in any permit which may be issued. Deviationfrom these details will constitute a violation of
mry permit Arty person developing in an AEC without permit is subject to civil, criminal avid atkninistrative action.

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GO eI
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STEVEN D AUERBACH
Pay to the IAJ C_
Order of —
1212
51-7218/22
d-1311, 51,10
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$
Dollars
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For c,4(1/4 i. VmLll
1: 2 2 1 17 2 18 Gi: 90000 7 2 it 2 211n i212

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
I
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3 y 7 b ST.AVNi �
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A. Signature
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Is deliverydifferent M
if, a to delivery address
❑ Agent
❑ Addressee
C. Date of Delivery j
I
FEB 0 6 2012 z
3. Service Typ@
I Certified 08—lss Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(transfer from service label) 7 011 0470 0003 5251 8673
PS Form 3811, February 2004 Domestic Retum Receipt 102595-02-M-1540''

UNITED STATES POSTAL SERVICE First -Class Mail
Postage & Fees Paid
LISPS
Permit No. G-10
0 Sender: Please print your name, address, and ZIP+4 in this box 0
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■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
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B. Received by ( I 'utdd Name) C. Date f Delivery
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D. Is delivery address different from Rem 1? tEl Ves
If YES, enter delivery addres9'POWED ❑ No
FEB 2 4 201Z
3. Service Type ������� ����yy
C[3 F�h9Ssertified Mail -QD CITY
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7 011 0470 0001 j C 51 8666
(Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540

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UNITED STATES RQ%V4.;S
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0 Sender: Please print your name, address, and ZIP+4 in this box *
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I,TMOmAS EDWARD STRICKLAND 111,_ P.LS. L— 3776 CERTIFY THAT THIS SURVEY IS
OF AN E)a STING PARCEL OF LAND./ I (
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REGISTRATION NUMBER
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CERTIFICATE OF SURVEY & ACCURACY:
EDWARD STRICKLAND 10
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I,THDMAS CERTIFY THAT THIS YAP WAS
DRAWN UNOFR YY SUFERViS10N FROM AN ACTUAL SURVEY 800K MADE
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THAT THE BOUNDARIES NOT SURVEYED ARE INDICATED AS DRAWN
FROM INFORNIATION IN BOOK PAGE
OR OTHER REFERENCE THE RATIO OF PRECt"
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SOURCE.THAT
OR POSITIONAL ACCURACY IS 1:10.00D+ AND THAT THIS YAP MEETS
THE RFAUWiENEHTS OF THE STANDARDS OF PRACTICE FOR LAND
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DAY OF 12�2011
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L-3776
REGISTRATION NUIIBERR