83-067_Roberts, Dr. Lucien_19831202 (3)

STATEMENT OF OWNERSHIP '
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A
I, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in Z
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) p
an owner of record title, Title is vested in Igr • L Ge-IVIJ F o,ae/� TS RECEl QED
f
see Deed Book ,page in the JAN23
D q R- County Registry of Deeds. 0C C iZ
Z
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.
NOTIFICATION OF ADJACENT 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)
O ).
(2) UJ Erg,.! SNo,cT
(3)
(4)
FOR DEVELOPERS IN OCEAN HAZARD AND ESTUARINE SHORELINE EROSION AREAS:
1 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.
T�
This the 7 day of
c� W • .
nd owner or person authorized to act as his agent
for purposes of filing a CAMA application.
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GENERAL INFORMATION
1. LANDOWNER
Name
DR .
..
Addresss-1SZS imp L rF/i f-aR a -
CityyL'�,-g /Jc 157c J State 1,4 Zip
2. AUTHORIZED AGENT
Phone _
Name crt� �r}Cp7.1
Address n . ,6 7�8
City
Th u"i� State i"` G. Zip 7�`S Phone
3. LOCATION/DESCRIPTION OF PROJECT S 1 N i-G �AA tiL
�- � ; 3 � - G O cSf: Ul,`i•%C S v6 �i uiSi o r✓
4. AREAS OF ENVIRONMENTAL CONCERN (AEC) CLASSIFICATION
(To be filled in by Local'Permit Officer prior to completing application.)
Ocean Hazard Estuarine Shoreline Other
5. PROPOSED USE
Residential Commerical/Industrial Other
6. SIZE OF BUILDING IN SQUARE FEET- + /S oo S' i
7. SIZE OF SITE IN SQUARE FEET: J, 22 4
- 7 TM
This application includes: general information (this This the day of
form), a site drawing as described on the back of this 19 5� .
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 Indicate below address and phone if not shown above.
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...
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.. Arinking 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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1998
C. 27954
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•
'OWN OF NAGS FNE D
NAGS HEAD, NORTH CAROLINA 27959
CAMA 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 November 7, 1983, Dr. Lucien Roberts,
the applicant, proposed to erect a single-family dwelling at lot 38,
Goosewing subdivision, south Nags Head, in a high hazard.flood area.
Persons desiring to inspect the zpplication, 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. O. Box 99
Nags Head, N. C. 27959
Telephone: [phone]
------------------------ ------------------- ---------------------------
For publication in The Coastland Times, November 10, 1983
Please use Nags Head logo'and legal print.

Na�s'Head 83-067.
Local Government Permit Number
LAMA
MINOR DEVELOPMENT
PERMIT
as authorized by the State of North Carolina, Department of Natural Resources
and Community Development and the Coastal Resources Comrflission for develop-
- ment in an area of environmental concern pursuant to Section 113A-118 of the,
General Statutes, "Coastal Area Management.
Issued to Dr. Lucien Roberts
a ig
authorizing development ihazardfloodarea lot 38, Goosewing subdivision
n , at
as requested in the permittee's application dated oven er , This permit, issued on December 2. 1983 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.
This permit action may be appealed by the permittee or
other qualified persons within twenty (20) days of the issuing
date. From the date of an appeal, any work conducted under this Loc Permit Officer (signature)
permit must cease until the appeal is resolved.
This permit must be"on the project site and accessible to the M. Edward Harrell
permit officer when the project is inspected for compliance.
name
Any maintenance .work or project modifications not covered
P. O. Box 99
under this permit require further written permit approval. Nags Head, N. C. 27959
All work must cease when this permit expires on
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)