84-0038_Katz, Brian & Sydelle_19840417 (3)

APPLICATION
MAR 2 6184 FOR
.r CAMA
-_MINOR
DE__ELC�PMENT
PERMIT
i In'1974, tqe North Carolina Genera Assem rf
bly passed the Coastal Area Mariagerient A�
and set the�stage for guidingydevelopmen in
the fragile and productive areaswilic�i border f
the state�'sstuanes, sounds and*oceanfront.
Along with'requiring'spe j&care by those' ' t
° ; tivho build and develop; the General Assembly
directed the Coastal" Resourcesommission°to s.
d.a. a
IV_ fimplentcleat rgulationswhich minimize
the burden on the applicant.
i�
This applicatiorifor a minordeyelopmentyer
�, ¢ ii,it under CAMA is part of the,Commission°s
1
effort to meet the spirit arid' intent of the .�
General Assembly. It has been designed"to be
straightfonvardand'regwre no more time or;�
'� p
t
r ~• effort,than'jnece sary from the applicant.
Please go oer is folder with the Local
i µ Permit affieerFfor tF a locality in which you
plan fo build to bi certain thatyouu•under-
i stand wh t information he or--she-needs. t<.
`moo
f. Under CAMA regulations the minor permit
o ke, issue
pd within 3 , days once a complete
l° ��.
i. aplication is in hand. 6fien less time is needed
g t a,.rar
w u.
the prpject is situp a The process generally
Makes about 18 day,sou can help speed the N
�, h our
.� approval process b� eking certain that y
fit application is compietec and signed, that your
drawing -meets the sReifications given inside
and that-yo r ap'l cation fee is attached.
Other permits arsometimes required for
,
t development in the coastal area. While these ,
a_
'a4-. _ tGAU A3 elated ou to check
, re no r , we urge y
- wlth-the 11c ca Permit Office r:to-determine
�h
'whict�of these you may_need A listing is
^,
„ n
included o o
f �. n�page2' f�the older.
"We
appreciate your cooperation with the
,R•
North_. Carolina coastal management program -.
and your willingness to build in a way which "
�, •sue* .:_
_
protects the resources of our beautiful and
productive" coast._
..�.�
_
-Coastal Resources Commission
fce of Coastal Management _
_
,"'•:
_
-
y
w'iPwa+"i

GENERAL INFORMATION
1. LANDOWNER
Name My. a,,,J Mrs- By- 1,,t� k4-4 'Z
Address ,1� a-n IYf�, /LLr �n�.
-
City Wje-s y a-G-k. State Zip Phone(Q )0 SS?_ 1SS4
2. AUTHORIZED AGENT
Name 'Recd C5 cA=,Qes , L,4=1 .
Address
CityWQ wL State _C1i C- zip Q-794-9 Phone ;t (0 i=
3. LOCATION/DESCRIPTION OF PROJECT 1-O-i' IS. �{1�Se %, 5ta;�d Q�
Vi*tep waa
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: 18 q O
7. SIZE OF SITE IN SQUARE FEET: ,1930 3
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 ) (044 day of +'1'� 4,yl- - ,
19
Applicant's signatur 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.. XIA certification ... sand dune ... sediment control ... subdivision approval
...mobile home park approval ... highway connection. ..others:

D County/(NRCD)
84-0038
Local Government
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."
Brian and Sydelle Katz
Issued to
authorizing development in Sander I i ng at Lot Zlb, Phase 6, Vireo
Way as requested in the permittee's application dated --_March 16, 1984
This permit, issued on April 17, 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 must be in accordance with the attached conditions.
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 - o
permit must cease until the appeal is resolved. Georg H.Wood Local Permit Officer (signature)
This permit must be on the project site and accessible to the Office of Coastal Management
permit officer when the project is inspected for compliance.
Any maintenance work or project modifications not covered 108 South Water Street name
under this permit require further written permit approval. Elizabeth City, N. C. 27909
All work must cease when this permit expires on [phone]
October 17, 1984 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)
i

1. In order to avoid unreasonable danger to life and property, all development
shall be designed and placed so as to minimize damage due to fluctuations
in ground elevation and wave action in a 100-year storm. Any building con-
structed within the ocean hazard area shall comply with Appendix D, "Wind-
storm Resistive Construction," of the North Carolina Residential Building
Code, except that when any provisions of that appendix are inconsistent with
any of the following AEC standards, the more restrictive provisions shall
control.
2. All structures in the ocean hazard area will be on pilings not less than
eight inches in diameter if round, or eight inches to a side if square.
3. All pilings will have a tip penetration greater than eight feet below the
lowest ground elevation under the structure.
4. All foundations will be adequately designed to be stable during applicable
fluctuations in ground elevation and wave forces during a 100-year storm.
Cantilevered decks and walkways shall meet this standard or shall be designed
to break away without structural damage to the main structure.
5. All pilings will be appropriately treated to resist decay, insects, and
corrosion.
6. The lowest portion of the structural member of the lowest floor (excluding
the pilings or columns) will be elevated to or above the 100-year storm
elevation.
7. All exposed structural connections will be adequately rustproofed or
enclosed.
8. All utility systems will be located and constructed so as to minimize or
eliminate storm damage.
9. All walls below 100-year-base flood level will be designed and installed to:
(A) allow storm waters to rise and flow freely under the structure, (B) not
permit the breakaway themselves to become water -borne debris, and (C) not
cause the accumulation of water -borne debris. Breakaway walls will be intended
to collapse under stress without jeopardizing the structural support of the
structure.
10. No impermeable (such as asphalt or cement) surfaces will be allowed over any
functional part of a complete septic tank system.
11. The permittee will sign and return the copy of the AEC Hazard Notice which
is attached.

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c{1 D gUi[3l E: , R.I.-S., certify that this plot was dre%in from on actual field land survey;
me error of closure as calculated -ry latitudes and deportures Is 1:10,000; that It was prepored
,cc:.r,lance with G.S. 47 - 30 as amended.
Tess my hand and seal this 19 i h day of MARCH , A. p, 1964
i O
E. KATZ
LO-T 215 SQNDE
ATI_As!T� ^ RLI NG

Drafted by: Frank M. Bell, Jr.
Address of Grantees: Kenbar Road, W6st Nyack, New York 10994
NORTH CAROLINA
D E E D
DARE COUNTY
THIS CORPORATION DEED, made this the 14th day of October, 1983, by
RDC, INC., a North Carolina corporation (hereinafter called "Seller") to BRIAN E.
KATZ and wife, SYDELLE C. KATZ, of West Nyack, New York, (hereinafter called
"Purchaser"), whether one or more persons, firms or corporations;
W I T N E S S E T H:
That the Seller, in consideration of One Hundred Dollars ($100.00)
and other valuable considerations to it paid by the Purchaser, receipt of which
is hereby acknowleAged, has bargained and sold, and by these presents does
bargain, sell and convey unto the Purchaser and their heirs and assigns, a
certain lot or parcel of land in Dare County, North Carolina, and being described
as follows:
Being known and designated as Lot 215 as shown on a plat
of Sanderling Phase b, recorded in Plat Cabinet B at Slides 124 and
125 in the Office of the Register of Deeds of Dare County, North
Carolina, to which plat reference is hereby made for a more
particular description.
The above described property is conveyed subject to utility easements
and restrictive covenants of record, specifically including that certain
Declaration of Covenants, Conditions and Restrictions recorded in Book 310 at
page 557, et seq., as it may be amended from time to time, filed in the Office of
the Register of Deeds of Dare County, North Carolina, and the Purchaser, by
acceptance of this deed, do/doss agree to comply witch each term and condition
thereof; and the above described property is further subject to ad valorem taxes
for the current year which have been prorated to date of closing.
TO HAVE ARID TO HOLD the aforesaid lot or parcel of land, together
with all privileges and appurtenances thereto belonging to the Purchaser, and
their heirs and assigns, to their only use and behoof forever, and the Seller
covenants to and with the Purchaser and their heirs and assigns, that the Seller
is seized of said premises in fee, and has the right to convey the same in fee
simple and that the sane are free from all encumbrances, and that the Seller will
warrant and defend the said title to the same against the claims of all persons
whatsoever; subject, however, to the conditions and exceptions set forth
hereinabove, and incorporated herein by reference.
IN TESTD110NY WHEREOF, RDC, INC. has caused these presents to be
executed by its Vice President, attested by its Secretary and
affixed its corporate seal, all pursuant to authority duly granted.
ATTEST:
Secretary
SELLER.:
RDC, INC.
By:
Vice President

STATE OF NORTH CAROLINA )
('OUDPTY OF FORSY M )
This day of , 19 , personally came
before me, , a notary public,
who, being by me duly sworn, says that he/she knows the
corporate seal of RDC, INC., and is acquainted with _
who is the President of said Corporation, --and at he/sFie, ie sai
is the Secretary of the said
Corporation, and saw the saidPresident sign the foregoing or annexed
instrwnent, and saw the said corporate seal of said.Corporation affixed to said
instrument by said President, and that he/she, the said
signed his/her name in attestation of the execution of
said instrument in the presence of said President of said
Corporation.
Witness my hand and notarial seal or stamp, this day of
, 19
Notary Public
My CaTmission Expires:
STATE OF NORTH CAROLINA - Dare County
The foregoing' (or annexed) certificate of
is(are) certified to be correct. This the
day of , 19
STAMPS $
Probate and filing fee $ paid
Alva Wise, Register of Deeds
by
Deputy Assistant

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1, F RICVAARD OUIBLE , R.L.S., certify that this plot was drown from an actual field land survey;
that the error of closure as calculated by latitudes and departures 1s I: 10, 000; that it was prepared
in accordance with G. S. 47 - 30 as amended.
Witness my hand and seal this 19 *V% day of _ MARCH A. D. 19 84
.
LOT 215
ATLANTIC
DUCK,
R
L-
SURVEYED FOR
t. -. B R i A FJ
PHASE G
TOWNSHIP
Q
;7
E. KATZ
45ANDF-RL1 NIS
DARE COUNTY
NORTH CAROL.INA
DATE: MARCH 14, 1984
SCALE. 1" _ 40'
FILE; 0.13 84 -39 F. B1-. 1020, P. S5
R ES
uible and Associates, Inc.
Consulting Engineers and Land Surveyors
P.O. BOX 847 NAGS MEAD, NORTH CAROLINA 27959
(9191 441 - 4321

R EC
MAR Z 6 '84
OCN1 • EC
SR Box 320, Kitty Hawk, North Carolina 27949, I
March 22, 1984
Mr. Nelson G. Paul
Office of Coastal Management
108 S. Water Street
Elizabeth City, N.C. 27909
Dear Nelson,
I am enclosing 4 CAMA permits with appropriate documents and
checks for the following properties;
Lot 194------- Sanderling, R.D.C.
Lot 218 ------- Sanderlin R.D.C.
-Lot 215------- Mr. &Mrs. Brian Katz
Lot 220-------,Mr. & Mrs. David Gillis
Please let me know as the permits proceed.
Kindly send us more application forms.
Thank you,
Sincerely,yours,
Lilias J. Mo ison
LJM/sdd

North Carolina Depa rtment of Natural COASTAL MANOAFGFEM NT
Direectorctor
Resources & Community Development David
James B. Hunt, Jr., Governor James A. Summers, Secretary TeWme919733-2M
Field Services
108 South Water Street
Elizabeth City, N. C..27909
[phone]
April 2, 1984
The Coastland Times
P 0. Box 428
_Manteo, North Carolina 27954
Gentlemen:
Please include the enclosed Notice(s) of Filing in the Public
Notice section of the Thurs., April 5, 1984 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 338-1558.
The State Office of Budget and Management requires an Affidavit
of Publication prior to payment for newspaper advertising. Please
send these affidavits, copies of the published notices, and the bill
to Cathey Cottle, Office of Coastal Management, Department of Natural
Resources and Community Development, P. O. Box 27687, Raleigh, N. C.
27611-7687.
Thank you.
Cordially yours,
poll.
Consultant
GHW/fob
Attachments: Gillis Application Notice
RDC, Inc. (Lot 218)
RDC, Inc. (Lot 194)
Brian Katz Application Notice
P. O. Box 27687 Raleigh. N. C. 27611.7687

NOTICE OF FILING
OF APPLICATION FOR
CAMA MINOR
DEVELOPMENT PERMIT
Pursuant to NCGS 113A-119(b), the North Carolina Department of
Natural Resources and Community Development Office of. Coastal Management,
the State agency authorized to issue CAMA minor development permits in
Areas of Environmental Concern of unincorporated portions.of n,
County, hereby gives Notice that on �h �� , _, the
applicant, —Mr. ae ir-sz—�an--Kat*, Proposed to
--tiie-�ray, eeeaRfrent ver-Ad—struct-4rn
at hot 216, Pkase 6 Vi`^ee Wray-ganderlirig
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 below
address.
MnMMAX&A
Mr. George Wood
Office of Coastal Management
108 South Water Street
Elizabeth City, N. C. 27909
[phone]

March 10, 1984
To Whom This May Concern:
I authorize Ms Lilias Morrison to
be my agent in the obtaining of a CAMA permit for lot 215
in the Sanderling development.
Respectfully submitted,
Sydelle Katz

RICNARD OUIBLE , R.L.S., certify that this plot was drown from on actual field
t the error of closure as calculoted by latitudes and departures Is 1:10, 000; that It
accordonce with G. S. 47 - 30 as amended.
6 �
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land survey;
was prepared
oess my hand and seal this 19 -th day of MARCH , A. D. 1984
�.
J112VI
LOT 2!5 PKASL- G. SANDERLI NG �
ATLANTIC— TO:IHStIlr' li.1-tL LJUNIly

,k,-E� AEC HAZARD NOTICE
YOUR PROJECT IS IN AN:
OCEAN 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,
the annual ocean erosion rate for the 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 indicate 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.
property losses from the hazards. By granting Shoreline erosion control structures (excluding
permits, the Coastal Resources Commission does beach nourishment and berm projects) are not
not guarantee the safety of the development and allowed to be built to protect development built
assumes no liability for future damage to the after June 1, 1979. Limited pushing up of beach
development. sand is allowed to protect new structures when
they are threatened, but bulkheads, groins, or
The best available information, as accepted by jetties may not be used to protect buildings put in
the Coastal Resources Commission, indicates that after June 1, 1979.
3
Date 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 work 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_I
change in the project site or ifyou have made "substantial progress" on your project. Normally a permit' can be
extended five (5) (times fora 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 UNL"AWFUL. TO'
CONTINUE WITHOUT THIS APPROVAL.
FOR MORE INFORMATION, CONTACT:
LOCAL PERMIT OFFICER:
Office of Coastal Management
108 South Water Street
ADDRESS: Fl i 7ahpth City, NC 77gnq
[phone]
LOCALITY:
PHONE:
SC/Rev. 6/83

BEFORE YOU BUILD ...
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 I FIRST LINE OF
i� STABLE NATURAL
30x ANNUAL VEGETATLON
AVERAGE
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
i 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 Are45
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 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 e) Y 10— 10 �' S 5.4 d � )� Q-
0—+ -Z-- , see Deed Book 345 , page 3 /S' in the
en a�r-e__ 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.
(2)
(3)
(Name) (Address)
1p N ff8
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_Ra M day of MA-'Gh , 192-4L
im
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
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?
FOR STAFF USE
SITE NOTICE POSTED FINAL INSPECTION
SITE INSPECTIONS
DATE OF ACTION:
ISSUED EXEMPTED
FEE RECEIVED
DENIED APPEAL DEADLINE (20 days)