83-0037_O'Neal, Earl W._19831128 (3)

GENERAL INFORMATION
1. LAND OWNER ,
Name �t+r L.� r ✓✓�
Address d • �- �.-
City State G, Zip �-� Phone 4R r- a-IS
2. AUTHORIZED AGENT
Name
Address
City State Zip Phone
3. LOCATION/DESCRIPTION OF PROJECT I o,J
4. AREAS OF ENVIRONMENTAL CONCERN (AEC) CLASSIFICATION -
(To be filled in by Local Permit Officer prior to completing application.)
Ocean Hazard X Estuarine Shoreline Other
5. PROPOSED USE
Residential Commerical/Industrial Other
G. SIZE OF BUILDING IN SQUARE FEET: ��Ob , �7 I'�-� • 1
7. SIZE OF SITE IN SQUARE FEET: `4 n�, 7 `7 � y
This application includes: general information (this
form), a site drawing as described on the back of this
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-
tion as described by these sources are incorporated
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.
OTHER PERMITS MAY BE REQUIRED...
This the Cr day of JQa�^-���-*— ,
19
Applicant's signature (or authorized agent)
Indicate below address and phone if not shown above.
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:

Local Government Permit Number
;t
CAMA
MINOR DEVELOPMENT
PERMIT
as authorized by the State of 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 6,AIR L. LJ . • r►1E
autho izing developme t in , at -- PROP. Sib. 'T, . nt J a �9
E'.F_ o� as requested in the permittee's application dated ejaJ , aI . l cT 8
This permit, issued on of • w% . ! Q'g� , 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 may cause the permit to be null and void. "
A A.A.
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This permit action may be appealed by the itor
other qualified persons within twenty (20) days off the the issuing
ing
A
date. 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
PA
officer when the project is inspected for compliance.
I1i6'LSo
V� r.
is L.permit
Any maintenance work or project modifications not covered
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under this permit require further written permit approval.
I p,�
e..t_rnR
All � j�ork must cease when this permit expires on
JQ 2,16 1C"'>fIVX
address
In issuing this permit it is agreed that this project is consis-�-+
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tent with the local Land Use Plan and all applicable ordinances.
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SL124"
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)

OFFICE OF
North Carolina Department of Natural COASTAL MANAGEMENT
Kenneth D. Stewart .
Resources &Community Development Director
James B. Hunt, Jr., Governor Joseph W. Grimsley, Secretary Telephone [phone]
Field Services
108 S. Water Street
Elizabeth City, NC 27909
[phone]
plod �N.6G- io_ re7sa
ODASTLAtM TIMES
P.O. Box 428
Manteo, North Carolina 27954
Gentlemen:
Please elude the enclosed Notices of Filing in the Public Notice section
of the Ji. i5-, ISM edition of your newspaper. If it will not be
possible to include these notices in that edition, or if you should have
any questions about these notices, please call me as soon.as possible at
338-0206.
The State Office of Budget and Manage -Tent requires an Affidavit of
Publication prior to payment for newspaper advertising. Please send these
affidavits, copies of the published notices and the bill to Marcy Bunting,
Office of Coastal Management, Depart-nent of Natural Resources and
Conr pity Development, P.O. Box 27687, Raleigh, N.C. 27611-7687.
Thank you.
NGP/aht
Cordially yours,
WVL-
Nelson G. Paul
Coastal Management Consultant
0
P 0 Bar 27687 Ral=iah, (:. C- 27611-7687

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SITE DRAWING /APPLICATION CHECKLIST
Please make sure your site drawing includes the following information required for a CAMA
minor development permit. The drawing may be simple and not necessarily to scale. The Local
Permit Officer will help you, if requested.
PHYSICAL DIMENSIONS
label roads
label highway right of ways
label local setback lines
label any and all structures and driveways currently existing on property
PHYSICAL CHARACTERISTICS
draw and label mean high water mark (MHW) --
draw location of septic tank or filter field
If you will be working in an ocean hazard area:
draw and label dune ridges (note height)
draw and label toe of dune
identify and locate first line of stable vegetation
draw and label setback line under CAMA
draw and label topographical features (optional)
If you will be working in an estuarine shoreline area:
draw and label landward limit of AEC
describe terrain (slope)
DEVELOPMENT PLANS
draw and label areas that will be disturbed
if house to be placed on lot, describe location of house
note size of piling and depth to be placed in ground
draw and label all areas to be paved or graveled
describe composition of surface
note and list fully all trees and vegetation to be removed or relocated
show landscaping
NOTE TO APPLICANT
Have you:
• completed all blanks and/or indicated if not applicable?
• notified and listed adjacent property owners?
• included your site drawing?
• signed both application and statement of ownership?
• enclosed the $25.00 fee?
* completed an AEC Hazard Notice,if necessary?
SITE NOTICE POSTED
SITE INSPECTIONS
DATE OF ACTION:
ISSUED
EXEMPTED
FOR STAFF USE
FINAL INSPECTION
FEE RECEIVED
DENIED APPEAL DEADLINE (20 days)

STATEMENT 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 be described as follows: (check one)
an owner of record title, Title is vested in ��'t'� r^1d"-v
J , see Deed ook , page in the
r- e. County Registry of Deeds. — 6-0"_ .d L.-1 I -P" Sa /`)
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.
Ifurthermore certify thatthefollowing persons are owners o properties ajoining
that I have piv?n ACTUAL NOTICE to each of them concerning my intent to develop#his property and to
CAMA permit
ilaaf4 (Address)
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(3) 4
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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
I 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 '2 day of rjoJ", L.� ' ,19 f3.1
Land owner or person authorized to act as his agent
for purposes of filing a CAMA application.
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