84-0012_Beacham, Mike A. & Wanda P._19840222 (3)

APPLICATION
FOR
CAMA
PMENT
PFRM IT
�JIJ �' ��, - ; In 7974, tt1 N�rtt� Garolma cxe��et�rAs�serr� -.�
t bly passed t Coastal Area MragQmentct��
' and set�the's r ge forguidfng'dw� to�?mentn `
1 the fragite'ap o uctivere� Cv`i�fi bor,4+�e�
f _ the statMs anssoun}dsn`� oceanfront.
Alongwitf}equ ring sggc�are by those #
ho build and, eve op, th #G neral Assembl
irected°;thsCoasfal'.Resougces mmissi�n`~tc
m le Gc e r� rJgu11at'-.`ion hich minimize
e`burden i t1e applicant.
hi applicatib for a minoruexe�lop nt per -
a ,
y rritunderC Aisart_oft liCrmissiop's '
ffort�to a the;spirit and`intent of the ,
f sepe VAsIwari It has been designed to be
,n e eral4As b
require no;more time or
L ;effort is nkt sary from the applicant.
is
Plea go er itrfolder,with the Local'
Permit VFicer ipt t e locality,in which you
a <<
' plancs,build fo a ysuYunder-
�' b stand w�at 6c ation_he_-ar_shenewis.
i Under G�AMA reu a ions the minor permit
issued withii days once a complete ;
a pic lonus in han _ en less time is needed
the project is si p e The process generally n�
r �� takes arp6t 18 da s ou can help speed the
t pprovaf process b aking certain that your
a �IiCati n is comp and signed, that your
�q `'` ,.nt.rawingAU
meets;the s e ifications given inside
k�
.� u cation fee is attached.
-your I
:t F1
' Other permits a s metimes required for
evel4ment in th astal area. While these
... . ' i 6
a
ire a otLAMAhrela'ted,:we urge,.you to check
.,
w ^mow th-the�EI�Permit`Officerto aetermi e..;
s.� hie of these �outnayneed A fisting
..
include n-page2 o ihe-folder
'We appreciate your cooperation with the
- ,... North.Carolina coastal management program
DO
and your willingness to build in a way which
protects the resources of our beautiful and
productive coast.
�-'Coastal Resources Commission ;
M� +' Office of Coastal Management
- a
a
q/
� 9>Riiqs'F
Xt
i
r � w

GENERAL INFORMATION
1. LANDOWNER
Name Mike A. or Wanda P. Beacham
Address S.R. Box.34C
City Kitty Hawk, NC State Zip �7949`r Phone 919-261-=2237:
2. AUTHORIZED AGENT
Name
Address
City
State Zip
Phone
3. LOCATION/DESCRIPTION OF PROJECT hot #19 Phase I Tuckahoe, Atlantin
Township, Dare County, North Carolina
4. AREAS OF ENVIRONMENTAL CONCERN (AEC) CLASSIFICATION
(To be filled in by Local Permit Officer prior to completing application.)
X Ocean Hazard Estuarine Shoreline Other
S. PROPOSED USE
X Residential - Commerical/Industrial Other
6. SIZE OF BUILDING IN SQUARE FEET:
7. SIZE OF SITE IN SQUARE FEET: 1
2, 000
625
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...
Thib4he 7 day of February
Applicant's signature (or authorized agent)
Indicate below address and phone if not shown above.
P - 0 - 'Roy 1081 NagsHPHate. Nn
[phone]
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 LAMA, 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:

Dare County/(NRCD)
Local Government
84-0012
Permit Number
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 Mike A. or Wanda P. Beacham
authorizing development in Dlirk , at Lot 19,_ Phase I of the
Tuekahoe Subdivision as requested in the permittee's application dated _ February 7, 1984
This permit, issued on February 22, 1984 , 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.
All development will be done in accordance with attached application and plat.
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
permit must cease until the appeal is resolved.
This permit must be on the project site and accessible to the
permit officer when the project is inspected for compliance.
Any maintenance work or project modifications not covered
under this permit require further written permit approval.
All work must cease when this permit expires on
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.
Local Permit Officer (signature)
Nelson G. Paul
108 S. Water.Street name
Elizabeth City, N. C. 27909
[phone]
address
Permitee (signature required if special conditions above apply to permit)

SIT
PI
min(
Pern
PHY
GENERAL INFORMATION
\ 1 _
1.' ANWWNER
Name Mike A. or Wanda P. Beacham
Address S.R. Boa. 34C
City Kitty Hawk, NC
2. AUTHORIZED AGENT
Name
Address
State Zip 27949 Phone 915-2'61=2237
City State Zip Phone
3. LOCATION/DESCRIPTION OF PROJECT Lot #19 Phase I Tuckahoe, Atlantic
4. AREAS OF ENVIRONMENTAL CONCERN (AEC) CLASSIFICATION
(To be filled in by Local Permit Officer prior to completing application.).
DES
x Ocean Hazard Estuarine Shoreline Other
5. PROPOSED USE
_ x_- Residential Commerical/Industrial Other
6. SIZE OF BUILDING IN SQUARE FEET: 29000
7. SIZE OF SITE IN SQUARE FEET: 0, 625
SITE
SITE
DATI
Is
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...
19 i he 7 day of February
b.
Applicant's signature (or authorized agent)
Indicate below address and phone if not shown above.
P,0. Rnx 1081 Naas jipar] Xr!
_(919) 441-4730
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:

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)
y an owner of record title, Title is vested in Svhdic*i Si on Map of T»o ahne phase I
Atlantic Township see Deed Book 349 , pag-193 & 19§n the
Dare 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.
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)
(1)Lot {#18 Cgr-olit a...-Go�rpsany, Inc; P.O. LOX 362 Jiizabetth City, NC 27907
(2)Lot #20 First Washington Co-operation 1320 W. 2nd St Washingt n .VC 27889
(3)
(4)
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 1 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 , 19
Land owner or person authorized 'to act as his agent
for purposes of filing a CAMA application.

l�T!/l�h�/Sf NOlFO.
7I N
�t
k
1114Z2
I
I, C` P CERTIFY TH UNDER
w )IlUT'll;I(Jill AND SJP`BP11SION III IS MAP
WAS h +..Ii r:.G t ' _ : i;.tl".L FIT.' U 7;t 11D-
CAT. ; l ? " U�1 i 1':") T)
...) . J !�i:._u7 �.). /��/J/���j/f /� ,�j�/�/ /��fjJ' :
WITIMS's Ilia II:,:;J ".'") ;.E"..L T: T_S `�Y.f7/Y�G//7 /". //GAM If
-- DAY OF-- ��=---------- -- 107.
-------------------------- --- T1.C�•4S-:rrr>'�a�ri
. P. 111.JR. , R. L. S. , L-2441 !i/iMlif GF Amcil /.
r,,f10~ !� / 9 8d f-R'�
o • euo� j'7T / /G ' ,eW
09' 70' 0 2
EYOR �---_

BOOK 357 `FncE 699
The property hereinabove described was acquired by Grantor by instrument recorded in Book 349, at page 190; .
..........Book 349.,.•,at. page•.193,;.. and Book_ 349, at•.page. 196A..Dare• County Public Registry.,,.
A ma showing the above described property Cabinet B Slides 215 &. 216.
A g P P Y is recorded in PlatX;t k..........._............I........ fi ... ............
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to
the Grantee in fee simple.
And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple, has the right to convey
the same in fee simple, that title is marketable and free and clear of all encumbrances, and that Granter will warrant.and i
defend the title against the lawful claims of all persons whomsoever except for the exceptions hereinafter stated, 1
Title to the property hereinabove described is subject to the following exceptions: j
i
Subject to that certain Declaration of Covenants, Conditions and t'l ~t.rict:icv_q
recorded in Book 357 at page 678 Dare County Public Regi.st.)-y.
IN-11ItYIISS Wi1rRF.OF, the Grantor has hereunto set his hand and seal, or If corporate. has caused this Instrument to he timed in
c0rpbra1f/Irtie� by'lts duly authorized officers and Its seal to be hereunto affixed by authority of Its Board of Directors, the day and )ear IIIbove wr(tten,
,
FTj 3ST WMIJINGI_'ON CORPORATION ...-._ .... (seAI
------- -- h- ---- - -------orate - 1ne> �------(--•------- M ---
.(SP.AL) �.
-- f�--y------���'�- -.l � ----------------------------------------
President
------------ _ - •
ATTEST_- •n -.(SEAL)
y---------------
.._---- _....... --- secretary (Corporate seal)
SEAL -STAMP NORTH CAROLINA--------------- _------------------- County.
n I, a Notary Public of the County and State aforesaid, certify that ---------------------------------------
y---------------------------------------------------------------------------------------------------- Granttrtt
u
personally appeared before me this day and acknowledged the execution of the foregoing Instrument. witness
Y '
7 hand and official stamp or seal, this day of
19......
Alycommission expires:----------------------------------------------------------------------- Notary Publle*-�`
,.:a,lt•nur, �
_. SEA -S7lA rf{�� f NORTH CAROLINA- ______ Y) t=C! 4i '_iry____________county.
Plop,
�� �, n
w •••••
�s~,•••.•••(�^�'' I, a Notary Public of the County and State a[oresafd, certify that ___ vn<i_rc 3==-__-- r
-� •�,• J �1, /1 r / Secretar of
�••,'t, O-/t personally came before me this day and acknowledged that -:C he is __ _.:_.__�� ___:I.__- Y
-, ^ ri+ri :First Washin tOn Cbrporati _-
Q A North Carolina corporation, and that by authority duly
cam=.2 given and as the act of the corporation, the foregoing Instrument was signed In Its name by Its
N 1t1, ` fG,� // ��;;
r+ �.� • ' 8 L ! �• ^ ' President, sealed with its corporate seal and attested by ___✓J__�1._ wits _____.1.�lZ �. ��j_! Secretary
/ !l L.(/l< .lit i - _
•. •�
.G�p •'"•••'� ��s�` Witness my hand and official stamp or seal, this __1!I _day of -----_______________1_.___. 19_.__-___.
Rr oovti .
e.
h.,,,...,rrn,,,,t•tr, i'%'rj�f- �L__ - Lt 4LrA ��.( - -- --__-(_�-- --( -- --- I(�N�tary Public
.•. my commission expires:--- ---- --------------- - ---------- -- - --- ,.
The foregoing Certificate(s) of----------�«
---------1------------_--
------------------------------------ � � ',� ti-- -----c �` - �k�-�c---'= ---------
1 i
------------------------------ ------- -------------------------------------------------------------------------------------------------
Is/are certified to be correct. This Instrument and this certificate are duly registered at the date and time and In the Book and Page shown on tl%C!;
first page hereof.
----------------------^- Q-�-`- _ ��= ��«iCL----
` -----------REGISTER OF DEEDS FOR----- n"'' - COUNTY
[v1n c1 i�
By -----------------�1 th'=l`-•-iA1,L---- Deputy -Register of Deeds
N.C. Bar Assoc. Form No. 3 4) 1976. Revised 1977. - POOLE PRINTING CO. INC av BOX hoe nALEIGN. NC ?lE x,
Primed by Agreement •ith the N C. Bar Ao •I911.

BOOK 357 TALE 698
qjar or
ty.
41
7
FILED
*B3 DEC 20 Ph 4 5Z
Tax Lot No, ..........
Verified by ....
by... ... ... ..... ......
Excise Tax
ALVA G. WISE
REGISTER OF DEEDS
PAPF ! NJNTYAO.
Recording Time, Book and Page
.. ..................... I .... I ... ............. . ... ... I ... ........ . Parcel Identifier No . ....... .
......................... I ._ . ... � ... .... County on the . .............. day of .........
Mail after recording to ...Starkey .... .....Sharp , ... TITTE StI.A...RP and MICHAET,RAttorneys 'at
Law, Post Office 221, Kitt Hawk, North Carolina 27949
.. ................................................... .1 ....... ...... ........ . ................ ......
This instrument was prepared by Starkey Sharp.
. ... ......... . . ....
Brief description for the Index Lot No. 19, Phase I, Tuckahoe7
NORTH CAROLINA GENERAL AVARIZANTY
THIS DEED made this . 2nd.... day of Decenber, 19. 83 by and between
GRANTOR GRANTEE 1.
,FTIIST WASIJINGrON CORPORATION, MIKE A. BEACH7V4 and wife, WANDA. P.
a North Carolina corporation BEACIMI, as tenants by the ent-1--ety, of,
Star Poute Box A-1
Kitty Hawk, North Carolina 27949
I'viter In appropriate block for each party: name, addrcss, and, If appropriate, character of entity, e.q. corporation or partnership.
The, designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns,
shall include singular, plural, masculine, feminine or neuter as required by context.
WITNESSETH, that -the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is h r
acknowledged, has and by these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all
certain lot or parcel of land situated in the CORW Village of Atlantic Duc
k . ........ ... .............. I ........ .... Township;,'
Darla ... ...... ......... ... . County, North Carolina and more particularly described as follows: coo
BEING loot No. 19,, Phase I, TUckahoe, as shom on a plat entitled "Subdiviijion Map
of 'Tuckahoel, Phase I", Atlantic Township Dare County, North Carolina, consisting
of two sheets, surveyed May, 1983 by C. P. Lewis Surveyor, and recorrj--d in
Plat Cabinet B, at slides 215 and 216 of the Dare County Public Regittry.
N.C. Bar Assoc. Form No. 3 X) 1976. Revised 1977.
I'mied by Agreement •ilh the NC. UrAr.C.4101111, "A

rj
Mr. Mike A. Beacham
S.R. Box 34C
Kitty Hawk, NC 27949
Carolina Company, Inc.
P.O. Box 562
Elizabeth City, NC 27909
Dear air/Ms.,
This is to inform you I have purchased lot #19 which
adjoins your property in Tuckahoe for the purpose of
developing the property. I also -plan to apply for a
CAMA permit.
Please find the enclosed platt for lot #19, an- AEC
Hazard Notice, and a copy of the NC General Warranty
Deed.
If you have any questions, please contact me at the
above address or my telephone number is 261-2237 or
441-4730.
Sincerely,
Mike Beacham
MAK:mh
Enclosures

Mike A. Beacham
S.R. 34C
Kitty Hawk, NC 27949
First Washington Corperation
1320 W. 2nd Street
Washington, NC 27889
Dear Sir/Ms,
This is to inform you I have purchased lot ;Y19 which
adjoins your property in Tuckahoe for the purpose of
developing the property. I also plan to apply for a
CAMA permit.
Please find the enclosed platt for lot #19, an AEC
Hazard Notice, and a copy, of the NC General Warranty
Deed.
If you have any questions, please contact me at the
above addressor my telephone number is 261-2237 or
441-4730.
Sincerely,
Mike Beacham
MAK:mh
Enclosure

AEC HAZARD NOTICE
YOUR PROJECT IS IN AN:
YOCEAN ERODIBLE AREA
HIGH HAZARD FLOOD AREA INLET HAZARD AREA
This notice is intended to make you, the appli-
cant, aware of the special risks and conditions
associated with development in this area, which is
subject to natural hazards such as storms, erosion
or currents. The rules of the Coastal Resources
Commission require that you receive an AEC
hazard notice and acknowledge that notice in
writing before any permit for development in this
area can be issued.
The Commission's rules on building standards,
oceanfront setbacks and dune alteration are
designed to minimize, but not totally eliminate,
property losses from the hazards. By granting
permits, the Coastal Resources Commission does
not guarantee the safety of the development and
assumes no liability for future damage to the
development.
The best available information, as accepted by
the Coastal Resources Commission, indicates that
EEI e .1 !2 Date
the annual ocean erosion ratefthe area where
your property is located is feet per year.
This figure was established by careful analysis of
aerial photographs of the coastline taken over the
past 30 to 40 years.
Studies also indic that the shoreline could
move as much as feet landward in a major
storm.
The flood waters in a major storm are predicted
to be about feet deep in this area.
Shoreline erosion control structures (excluding
beach nourishment and berm projects) are not
allowed to be built to protect development built
after June 1, 1979. Limited pushing up of beach
sand is allowed to protect new structures when
they are threatened, but bulkheads, groins, or
jetties may not be used to protect buildings put in
after June 1, 1979
W
Applicant's Signature
The applicant must acknowledge receipt of this information by signing this notice in the space above. Without
the proper signature, the application will not be complete.
SPECIAL NOTE: This hazard notice is required for development in areas subject to sudden and massive -storms and
erosion. Permits issued in this area expire in six (6) months. To continue your works past that date, you must contact
the local permit officer before the expiration date for a six month permit extension. This is granted if there is no
change in the project site or if you have made "substantial progress" on your project. Normally a permit can be
extended five (5) times for a total project life of three (3) years. If the site has changed and you have not made progress,
the LPO will determine the new vegetation line and apply the earlier setback distance to show you the new setback for
your project. IT IS IMPORTANT TO UNDERSTAND THAT YOU MUST RECEIVE OFFICIAL APPROVAL TO
CONTINUE YOUR WORK AFTER THE EXPIRATION -DATE ON YOUR PERMIT. IT IS UNLAWFUL TO
CONTINUE WITHOUT THIS APPROVAL.
FOR MORE INFORMATION, CONTACT:
LOCAL PERMIT OFFICER: JAMSOJ C. PAkto
ADDRESS:
LOCALITY:
PHONE:
5C/Rev. 6/83

r
BEFORE YOU BUILD ... f j
Setting Back for Safety: A Guide to Wise Development Along the Oceanfront ;
When you build along the oceanfront you take a calcu-
lated risk. Natural forces of water and wind collide with tons
of force, even on calm days.
There are no man-made structures guaranteed to survive
the force of a hurricane. Long-term erosion (or barrier
island migration) takes from two to ten feet of the beach
each year and, sooner or later, will threaten oceanfront
structures.
These are the facts of life for oceanfront property owners.
THE RULES
When you build along the oceanfront, coastal manage-
ment rules require that the structure be sited to fit safely
into the beach environment. Specifically, a structure along
the oceanfront must be: (1) behind the frontal dune; and,
(2) landward of the crest of the primary dune; and (3) set
back from the first line of stable vegetation a distance equal
to 30 times the annual erosion rate or 60 feet, whichever is
greater.
The Coastal Resources Commission has adopted rules
for building along the oceanfront. The rules are intended to
avoid an unreasonable risk to life and property and to limit
public and private losses from both storms and long-term
erosion. These rules do not eliminate —but only lessen —the
element of risk in oceanfront development.
As you consider building along the oceanfront, the CRC
wants you to understand the rules and the risks. With this
knowledge you can make a more informed decision about
where and how to build in the coastal area.
THE REASONS
The beachfront is an ever -changing landform. The beach
and the dunes are nature's "shock absorbers", taking the
beatings of the wind and waves and protecting the inland
areas. By setting back 30 times the annual long-term erosion
rate, you have a good chance of enjoying the full life of the
PERMITTED
STRUCTURE;
ADEQUATE
SETBACK
I SETBACK FIRST LINE OF
it—
� I� STABLE NATURAL
30xANNUAL VEGETATION
I AVERAGE
I EROSION
RATE `.
structure. At first glance, it seems very inviting to build
your dream house as close to the beach as possible but in
five years you could find the dream has become a night-
mare as high tides and storms threaten your investment.
PRE -PERMIT STRUCTURE; INADEQUATE SETBACK
PRE -STORM BEACH PROFILE
POST -STORM BEACH PROFILE
ONE YEAR AFTER STORM/BEACH REBUILDING
After the storm, the house on the dune will be gone. The other has a much greater chance of survival.
THE EXCEPTION
The Coastal Resources Commission recognized that these
rules, passed in June of 1979, might prove a hardship for a
small group of property owners. So there was an exemption
established for lots which cannot meet the setback require-
ments of 30 times the annual erosion rate. The exemption
allows building in front of the setback line under certain
conditions. These are:
(1) the lot must have been platted as of June 1, 1979,
and not capable of being enlarged by combining
with adjoining land under the same ownership; and
(2) development be as far back on the property as possible
and in no case less than 60 feet landward of the
vegetation line; and,
(3) no development can take place on the frontal dune;
and,
(4) special construction standards on piling depth and
square footage must be followed; and,
(5) all other CAMA, State and local regulations must also
be met.
The exemption is not available in the Inlet Hazard Area's
which are especially dynamic.
In seeking this exemption the Local Permit Officer will make these measurements and observations:
required setback from vegetation line max. allowable square footage on lowest floor
exception setback (maximum feasible) lot area as calculated from vegetation line
rear property line setback piling length necessary to extend 4 feet below MSL

STATEMENT -OF OWNERSHIP
I, the undersigned, an applicant fora 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)
y— an owner ofrecord title, Titleisvested in q»hriJyJ c;J on Map of Tii kahnp 'Ph ase I
Atlantic Township see Deed Book 349 page193 & 19§n the
Dare 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. .
f
r
O
n
NOTIFICATION OF ADJACENT PROPERTY OWNERS
M
1 furthermore certify that the following persons are owners of properties adjoining this property. I affirm that
1 have given ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for
a CAMA permit.
(Name) (Address)
(1)Lot 7#18 s drolita:,: Coap��Lny, Inc.:.--PX. iB0x:562. ; lizabeti Qity, NC 27907
(2)Lot ;#20 First Washington Co-operation 1320 W. 2nd St Washington ;NC 27889
3
(4)
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 m'
particular hazard problems associated with this lot. This explanation was accompanied by recommendations a
3
concerning stabilization and flood -proofing techniques.
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PERMISSION TO ENTER ON LAND 3
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I furthermore certify that I am authorized to grant and do in fact grant permission to the local permit officer a
and his agents to enter on the aforementioned lands in connection with evaluating information related to this
permit application.
This the day of 1 '19
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V
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Land owner or person authorized to act as his agent
for purposes of filing a CAMA application.

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
t _ label roads
label highway right of ways
label local setback lines
label any and all structures and driveways currently existing on property
PHYSICAL CHARACTERISTICS
_c_
draw and label mean high water mark (MHW)
` _�L_
draw location of septic tank or filter field
If you
will be working in an ocean hazard area:
L;r
draw and label dune ridges (note height)
--,LL
draw and label toe of dune
X
identify'and locate first line of stable vegetation
_-Y -
draw and1abel setback line under CAMA
—Y
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
_X_ draw and label areas that will be disturbed
_* if house to be placed on lot, describe location of house
_X— note size of piling and depth to be placed in ground
_X_ draw and label all areas to be paved or graveled
_Y_ describe composition of surface
__D__ note and list fully all trees and vegetation to be removed or relocated
n 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?
FOR STAFF USE
SITE NOTICE POSTED FINAL INSPECTION FEE RECEIVED
SITE INSPECTIONS
DATE OF ACTION:
ISSUED EXEMPTED DENIED APPEAL DEADLINE (20 days)