83-052_Gwaltney, IV, P. D._19831017 (3)

STAJEMENT OF OWNERSHIP
I, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in
an area of environmental concern 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 bedescribedas follows: (check one)
an owner of record title, Title is vested in r ' y • l:
see Book '� , page �1� in the
�G
� County Registry of Deeds.
an owner by virtue of inheritance. Applicant is an heir to the estate of
; probate was in
County.
if other interest, such as written contract or lease, explain below or use a separate sheet
attached to this application.
I furthermore certify that the following persons are avers of properties adioirting this property. l afr T
ncemingv Ty mt�nt to develop this property an.i :G
apply for a CAMA permit
(AaOress,
GNr-Y Ott Lrej /yArre-0
kh.l $idee-:r: o 00 G(). Aeecvxy $L.:a..�cwlerr jL1Xe:'V' a z3 C6
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FOR DEVELOPERS IN OCEAN HAZARD AND ESTUARINE SHORELINE EROSION AREAS:
I 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
particular hazard problems associated with this lot. This explanation was accompanied by recommendations
concerning stabilization and flood -proofing techniques.
PERMISSION TO ENTER ON LAND
furthermore certify that I am authorized to grant and do in fact grant permission to the local permit officer
and his agents to enter on the aforementioned lands in connection with evaluating information related to this
permit application.
This the day of
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Land_9 ner or person authorized to act as his agent
for purposes of filing a CAMA application.
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SI' GENERAL INFORMATION
I
mid 1. LAND OWNER
Per% G u1 A c-'r E✓
Name
PH
Address
o Zp ?s Phone
City A A r-,T
2. AUTHORIZED AGENT
PH! J o Name I K) D I X
Address J. 71 8
City A4 A o —,eo.,
State N- G Zip Phone
3. LOCATION/DESCRIPTION OF PROJECT
L r ,— Aft G—S 9
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4. AREAS OF ENVIRONMENTAL CONCERN (AEC) CLASSIFICATION
(To be filled in by Local Permit Officer prior to completing application.)
DE' Ocean Hazard Estuarine Shoreline Other
5. PROPOSED USE _
y Residential Commerical/Industrial Other
1 J4 CC S.
G. SIZE OF BUILDING IN SQUARE FEET:
�.
' 7. SIZE OF SITE IN SQUARE FEET: I� �'�
NO+ This application includes: general information (this This the « day of S ,
H form), a site drawing as described on the back of this 19
application, the ownership statement, the AEC hazard
notice where necessary, a check for $25.00 made payable
to the locality, and any information as may be pro-
vided orally by the applicant. The details of the applica- App 'signature (or aut orized age t)
0. tion as described by these sources are incorporated Indicate below address and phone if not shown above.
i without reference in any permit which may be issued.
Deviation from these details will constitute a violation
of any permit. Any person developing in an AEC without
a CAMA permit is subject to civil, criminal and admini-
strative action.
SITE
SITE
i
DATE'
IS<_
OTHER PERMITS MAY BE REQUIRED...
The activity which you are planning may require permits other than the CAMA minor permit you are applying
for here. As a service we have compiled a listing of the kinds of permits which might be required. We suggest that
you check over this list with your Local Permit Officer to determine which, if any, of these may apply to your
project. This is not a requirement of CAMA, only a suggestion to help you complete your project as quickly as
possible.
zoning ... drinking water well ... septic tank (or other sanitary waste treatment system).. .
burning. electrical... plumbing ... heating and air conditioning ... insulation and energy.
conservation ... FIA certification ... sand dune ... sediment control ... subdivision approval
...mobile home park approval ... highway connection. ..others: .

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TOWN OF NAGS HEAD
NAGS HEAD, NORTH CAROLINA 27959
CARA PERMIT NOTICE
Pursuant to NCGS 113A-119(b), the Town of Nags Head, a locality
authorized to issue CAMA permits in areas of environmental concern,
hereby gives NOTICE that on September 12, 1983, P. D. Gwaltney IV,
the applicant, proposed to erect a single-family dwelling at Lot 5,
Nags -Head South subdivision, in an ocean hazard AEC.
Persons desiring to inspect the application, to comment thereon
or to appeal the local decision are directed to contact the local
permit officer at the address below.
M. Edward Harrell
Receiving Minor Development
Permits under CAMA
Address: P. 0. Box 99
Nags Head, N. C. 27959
Telephone: [phone]
For publication in The Coastland Times, September 15, 1983
Please use legal print and Nags Head logo.

Nags Head 83-052
Loral Government
Permit Number-
CAMA
MINOR DEVELOPMENT
PERMIT
.as authorized by the State o_f North Carolina, Department of Natural Resources '
and Community Development and the Coastal Resources Commission for develop-
ment in an area of environmental concern pursuant to Section 113A-118 of the
-
General Statutes, "Coastal Area Management.". ,
Issued to P. D.-Gwaltnep IV
authorizing development in an ocean hazard AEC =`at Lot 5, Nags Head South subdivision
as requested in the .. ermtttee's applicationdated September 12, ' 1983 .
This permit, issued on October 17, 1983 _
p , is subject to compliance with the `application and site drawing
(where consistent with the permit), all applicable regulations and special conditions and notes set forth below. Any violation of these
terms may subject permittee to a fine, imprisonment or civil action; or cause the permit to be null and void. `
Tbis permit action may be appealedbd the f the itsu or W-
date.other qualified persons within twenty (20) days of the issuing
From the date of an appeal, any work conducted under this
permit must cease until the appeal is resolved. Local Permit Officer (signature)
This permit must be on the project site and accessible to the M. Edward Harrell
permit officer when the project is inspected for compliance. _
Any maintenance work or project modifications not covered name
under this permit require further written permit approval. P. 0. Box 99
All work must cease when this permit expires on
f}P%/L 17, 1983 Nags Head, N. C. 27959 address .
In issuing this permit it is agreed that this project is consis-
tent with the local Land Use Plan and all applicable ordinances.
This permit may not be transferred to another party without'
the written approval of the Office of Coastal Management. Permitee (signature required if special conditions above apply to permit)