96-0004_Sadler, Ann Elizabeth_19960313

Local Government Permit Number
v M1 5 ��� AR CAMA
MINOR DEVELOPMENT
PERMITW11
-Y-
it rk
as authorized by the State of North Carolina, Department of Natural Resources
and Community Development and fKa 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 YZ/ '
authorizing developm( JQ 217 f, , at
��✓ �� cc % gs requested in the permit ee's application dated
This permit, issued on el` , is subject to compliance with the application and site drawing
(where consistent with the permit), all applicable regulations and special conditions and noies 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.
1. Permittee must take all necessary precautions to prevent any
sedimentation or foreign debris from entering any ditches, guts,
creeks, streams or bays
2. Permittee must provide adequate.ground cover within 30 days of com—
pletion of the project to prevent any erosion.
3. Permittee must -obtain all necessary building permits prior to
beginning construction.
4. This permit authorizes only the -activity specifically mentioned on
the application and site drawing originally'submitted.for this
' project.
5. Any further land disturbing activity may require additional permits
prior to beginning the activity.
6. Permittee must notify the L.P.O. upon completion of the project to
allow for inspection for compliance of the applicable Code regul—
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 fobcompliance.,
Any maintenance work or project modifications not covered
under this permit require further written permit approval.
All work musk a When this permit expires on.,.
In issuing this per it it is agreed that this project is consis-
/ ' Q Local Permit Officer (signature)
%.,
name
Y�
j address

Locality //�il���l 12Permit Number �� (6o /
GENERAL INFORMATION
LAND
Name
Address
•
AUTHORIZED AGENT
Name
Address
City
State Zip
Phone
TION OF PROJECT SR L 5b
���13�
(If not oceanfront, is waterbody natural or manmade?) Y`< i
DESCRIPTION OF PROJECT �--
AREAS OF ENVIRONMENTAL CONCERN (AEC) CLASSIFICATION
(To be filled in by the Local Permit Officer prior to completing application.)
Ocean Hazard _X__ Estuarine Shoreline ORW Shoreline Other
PROPOSED USE
Residential Commercial/Industrial Other
PJAR 0 4 1M
�a:sraaaraaaawsaae4aar..-�r.
SIZE OF BUILDING IN SQUARE FEET 1,`W D h9&�7L
Size of other impervious orbuilt on surfaces (such as driveways, etc.) within 75 feet of the shoreline (575 feet
of an ORW shoreline)
SIZE OF SITE IN SQUARE FEET
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 com-
plied 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 sugges-
tion to help you complete your project as quickly as
possible.
Zoning, Drinking Water Well, Septic Tank (or other .
sanitary waste treatment system), Burning, Electri-
cal, Plumbing, Heating and Air Conditioning, In-
sulation and Energy Conservation, FIA Certifica-
tion, Sand Dune, Sediment Control, Subdivision
Approval, Mobile Home Park Approval, Highway
Connection, Others:

STA i EMENT OF OWNERSHIP
I, the undersigned, an applicant for a CAMA minor development permit, begin 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 sig-
nificant interest in the real property described therein. This interest can be described as follows: (check one)
Zan owner of record title, Title is v sted in see Deed Book i� b o I . a•
page�_in the 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 contact or lease, explain below or use a separate sheet and attach 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) [AAA-1
(1)
(2)
(3)
(4)
FOR DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD 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 floodproofing 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 application includes: general information (this form), a site drawing as described on the back of this ap-
plication, the ownership statement, the AEC hazard notice where necessary, a check for $50.00 made payable to
the locality, and any information as may be provided orally by the applicant. The details of the application 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 per-
mit is subject to civil, criminal and administrative action.
This the=� ay of 191L
CQ
Land owner or-person4auorized to act as his agent
for purposes of filing a CAMA permit application.

019) "')VL„11Uly„ 1.4% JUI c:. 2ti�1S
(After this form is completed by the landowner proposing
a copy is given to his/her adjacent landowners for their ohnsent and
signatures. Project,
The forms are then returned, along with a building
and other applicable required information to
Office for building'e t3uilding Inspection
t ons
Permit application/processing.)
ADJACENT RIPARIAN PROPERTY OWNER STA
TEMENT EPNff
-� 1 hereby certify that I own property adjacent to
Ann Eliz=t�!Sa!der-�.�N . �,Name of lr 'N 's on Tarklin Creek
proposing development Dawson Creek
bdY of water
#�x/near_Arapahoe
conmunity Lot#__ of Camp Jo Jane
Subdivision, if applicable
Tax Parcel �� H091-171 off SR. 1350
---.-_..._• Complete description of how t6
locate this property:
3 t e end turn ri ht
o to water
The proposed project, a
described to me as shown inn t� drawing below and
and the location has been
to the Proposal. 1 have no objections
FOR A PIER Jections
I wish to FOR
the 15' minimum setback NE OF �o�OmLOWING:
I DO NOT wish to waive the 15 Y riparian access.
***************,r***,►****a*************r**:*****e*******
' minimum setback requirement.
Draw the proposed structure -in the space
Of the structure and measured distances from the d adjacent
lines, other structures on the List the size
property, and the t Property
h road, water, etc.
e�,b1 �16 PP _..
DIRT DRIVE
S 74040'W so:00' 119.00
*Et - 55.00' S.LP. E.I.P.
• I
0 7'
W G' ASK, S.
Sea
vs )EEC)
o• ( Y
SI.P.
.9
S ?Y SIP7'05'. _
wood Deer � 20 •_
rind raeunc
djacent ProPerty Owner— -- l -= Date_ GI �jJ Sic atuZ�

PUMU1. T'16 • I'AHLICO COUNTY BUILDING xf4SpkC4LU,y,i ilAVbUsu,
[phone]
(Aftpi: this. .form is completed by the l.sndowiner pto�aasiaE fine p��j "t cax'i is given to higJhor 4cij9r
,sign tuner,. 'ihe tongs are t:ien+ructtsnredent � Io wners for theft. c.or►.s�ent aM
r]Xtd otlte:, a,)Pl.icaible required informstion, to`� :�iCh a i�ti.l.ctirlg +yet;
::ffiae for building permit applicgClun/pracebs nR.-HUil.ding tnspectxon,'
ADJACENT RIPARZAN VIOPERTY OWNER STATEMENT'
EPM-zanicyned
1 hereby certify that :L ow-n Property A04cea to
.z'.1 2 Sadlas^• n A stria•, � .
Hatve of landowner r - s on Tarklin C:r _ wsc�ra t;:
A sine development ee
bndY o.� water
Wnea K-1p 01 oe
}meuni ty I.at o ' Chi J0 J&
Tax Parcel I Q9L-173 if aPCs1 _ca 1�:
off Ste .,._.• (Complete desczipt•.ioit Of how Lc:
locate this Property.- nff.SRj-.,.r ,
.l a Pa'aF+4s��ti pro3aat � a .Mlle Eirrna
deseribed to me go shown in the dx8w=---•..,.��.► and the iecaLio� has bef��
co the Proposal. below soot I tts�;e no hb3eet.ioccs
PClM A PIER, CJiEc�t oME OP TLM r,•oi., .0Wj8C.
w^sh to waive the 15, min
iUUum setback fra" ply
DU NO�, wash to waive the .�5• .
111R5r�il4!!*�f�.�{7*+***iRRRR1tA#llifl�M4Mi� *1 kR* AIF1lt41fRRRtttitllfAR#IFl:i:i
b:gW �i:lr .7 2l�8x3s':.
Proposed structure in the space of the structure end in
distances bras thedadj eat slat ��
:�..nes, other ,structures on the 4 xiX�>
"- -�-•--., ..� Pt'operGY� and the PraPerry
/ read, Matey, e�-C.
lint MM�ar
+ VIRr ORIVC
I S6.Co' S.I.P.
t' f
r
'`�`'•. �+� sR � J7'u1W�a area
big
1
S �1RT.O3'
'$CPT) " '" --ik, ��e'V_'.;.:_. r K 1/rf )�a
-- •_. 25V d. _ ....... -,� ..... W008 9WIlUd3dO OW80 WU2V :80 SG. bi ME
S

PAMLICO COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH SECTION
P.O. BOX 306
BAYBORO, NORTH CAROLINA 28515
.TELEPHONE: [phone]
AUTHORIZATION TO USE AN EXISTING SYSTEM
RECORD i PERMIT 5073
APPLICANT NAME: Ann Elisabeth Sadler
ADDRESS: 322 Meadowinds Drive
New Bern, NC 28560
LOCATION/SITE: _Camp Jo Jane. end of 1350 at Water, take right then
left, around bend on left.
HAP-*- H091-171
TYPE OF DWELLING% ( ) HOUSE W MOBILE HOME ( ) OTHER
NUMBER OF BEDROOMS: 2 BATHS FACTORS
WATER SUPPLY: (xx) PUBLIC ( ) PRIVATE
SYSTEM ORIGINALLY INSTALLED: Caton
OWNER AT DATE: same
PERIMETER OF EXISTING SYSTEM:
To the fullest extent that we are able to determine from site.
evaluation and/or without previous documentation, the perimeters of the
septic system in existence on this site are as follows:
:#+et:::ixt:sxe:ttt:t::::sttttt:itettst::: P of Plan
DATA: ' CC+�rtrvt WAtr V5A,.;z 9b' C,n•1�•'tl,�.� S'
Tank size: existing 4
�.,�
Gallons
/71
No. Lines: 1 pm �:,� l y
No. Linear ft. 28 need..) -T%IGL T"""
No. Sq. ft. 84 C,-C
" t.
Building A Deck foundations to be greater than 5' from system h tank
The system located at this site, at this time, shows no signs of
failure to function properly and may be "PLACED INTO USE". Should the
system show signs, in the future, of malfunction it shall be the
responsibility of the property owner to apply for an Improvements
Permit for the repair of the system.
*Failure to maintain a properly functioning septic system is considered
a public health hazard and a Violation of the North Carolina State Laws
and Rules Governing Sanitary Sewage Collection, Treatment b Disposal.
Violation of this regulation is puniA liable as a misdemeanor.
Sanitarian: 2!! � V�L.c�tcUcl� (,C/ 1?YDete 06/26/95
MICHAEL JOHN SOUTHWICK
N�� r`.�e art_TA-v%.k or �ra�.n X��q .

(; r
a
FAX TO PAMLICO NEWS
(919), 249-0857
COUNTY OF'PAMLICO
C.A.M.A. PERMIT NOTICE
Pursuant to NCGS 113A-119(b), Pamlico County a locality authorized
to issue C.A.M.A. Permits in areas of environmental concern, hereby
gives NOTICE that on February 28,.1996
Ann Elizabeth Sadler and Linda F. Gaskins, the applicants
Proposed to:_Place a mobile home to be used for residential
purpose
Location: Camp Jo Jane - off SR1350 at the end on Tarklin and
Dawson Creeks
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 within seven (7) days of this notice.
Ron Lehman, Building Inspector
Local Permit Officer for Receiving
Minor Development Permits under
The Coastal Area Management Act
�( P.O.Box 776 - Bayboro, N.C. 28515
Tele: [phone]
W ! J