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07-00_Jepson, James Keith_20000214
APPLI&TION FOR LAMA q _ MINOR { D E j } k VELOPMENT PERI In 1974, the North Carolina General Assembly passed the Coastal Area Management Act an&set the stage for A g guiding development in the fragile and productive areas t which border the state sounds and oceanfront. Along with requiring special care by those,who build and develop, the General Assembly directed the Coastal Resources Commission (CRC) to implement clear regula r #,� tions which minimize the burden 'on the applicant.,:,_ This application for a minor development permit under, r = CAMA is part of the Commission's effort to meet the spirit and intent of the General Assembly. It has been designed to be straightforward and require no more time or effort' necessary from the applicant. Please go over this folder with the Local Permit Officer (LPO) for f the locality in which you plan to build to be certain that you understand whatinformation he orsfieneeds. i Under CAMA regulations, the minor permit is to be issued within 25 days once a complete application is in hand. Often less time is"needed if the project is simple " The process generally takesabout 18 days. You can ` speed the approval process by making certain that youra application is complete and signed, that your drawing` meets the specifications given inside and that youra T -application fee is attached.$ >: Other permits are sometimes required for development ` = - in the coastal area. While these are not CAMA-related, we urge youWto check'witl the Local Permit -Officer to' - °""- determine ,which`of_these you may need. -A listing is __.- ,included,on page2 of this folder. We appreciate your cooperation with the North Carolina Coastal Management Program and your willingness to build in a way which protects the resources of our beautiful and productive coast. x" Coastal Resources Commission t: Division of Coastal Management Locality GENERAL INFORMATION LAND OWNER Name Permit Number Address - 46 & o is PAX tj 0 to T' City R L aI (2 f+ State l�C= Zip Z& 15- Phond (4 f q ) 8+7 a7,3 AUTHORIZED AGENT OFFICR — Name Address City LOCATION OF PROJECT State ti. Zip If Phone J (If not oceanfront, is waterbody natural or manmade?) NA'j p-Pt DESCRIPTION OF PROJECT FEL . t_J a �Auvt ►4���(J g,�}t � Zt-te-t-t&_a-o AREAS OF ENVIRONMENTAL CONCERN (AEC) CLASSIFICATION (To be filled in by the Local Permit Officer prior to completing application.) Ocean Hazard ✓ Estuarine Shoreline PROPOSED USE ✓� Residential Commercial/Industrial ORW Shoreline Other Other SQUARE FOOTAGE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT -UPON SURFACES (such as driveways, etc.) within 75 feet of the shoreline (575 feet of an ORW shoreline) NP-% SQUARE FOOTAGE OF TOTAL FLOOR AREA OF BUILDING SQUARE FOOTAGE OF SITE OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA minor development permit. As a service we have compiled a listing of the kinds of permits that might be required. We suggest you check over the list with your LPO to determine if any of these apply to your project. 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, and others. DCM/MHD Local Government #07-00 Permit Number CAMA MINOR DEVELOPMENT 3 PERMIT FEB 2 3 2000 I—__ as authorized by,the State of North Carolina, Department of Environment C and Natural Resources and the Coastal Resources Commission for development in an area of environmental concern pursuant to Section 113A-118 of the General Statutes, "Coastal Area I'ana ent." . Issued to James Keith Jepson authorizing development in Estuarine or eli at 591 Raymond Drive, Arapahoe, Pamlico County as requested in the permittee's application, dated Jan. 24, 2000 This permit, issued on Feb. 14, 2000 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. 1. All proposed development and associated construction must be done in accordance with the permitted workplat drawing(s) as originally submitted, or as revised on November 16, 1999, and January 13, 2000. 2. All construction must conform to the North Carolina Building Code requirements and all other Local, State and Federal regulations. 3. Any change or changes in the plans for development, construction, or land use activities will require a re-evaluation and modification of this permit. 4. All work must be above the mean high water mark. 5. No work is allowed outside the lateral bounds of the applicant's property without written approval of the adjacent property owners. 6. Prior to initiating any land -disturbing activities, a barrier line of filter cloth, staked hay bales, or burlap must be installed between the land -disturbing activity and the adjacent marsh or water areas, until such time as the area has been properly stabilized with a vegetated cover. See page #2 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 per- mit m,.st 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 requires further written permit approval. All work must cease when this permit expires on December 31, 2no3 In issuing this permit it is agreed that this project is consistent 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 Division of Coastal Management. ocal Permit Officer (signature) Scott Jones, Coastal Management Rep. r.u. vivision of uoasLai manageppenc name Hestron Plaza II, 151-B Hwy 24 Morehead City, N.C. 28557 Tele: required if special address above apply to permit) Minor Permit #07-00 James Keith Jepson Page 2 of 2 7. Pursuant to 15 NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise disposed or to a third -party. 8. NOTE: All development must comply with the Neuse River Buffer Rules as stated inn 15A NCAC 2B.0233. Any questions regarding these rules should be directed to Deborah Sawyer or Brad Shaver, N.C. Division of Water Quality, Washington Regional Office, 252-946-6481. NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF COASTAL MANAGEMENT NCDENR February 14, 2000 JAMES B. HUNTJR i GOVERNOR James Keith Jepson 6608 Graymont Place Raleigh, N.C. 27615 WAYNE MCDEVITT. -`SECRETARY Dear James: Attached is CAMA Minor Development Permit #07-00 for replacement of damaged bulkhead -?DONNA D. MOFFITT at 591 Raymond Drive, in the Community of Arapahoe, County of Pamlico. .." DIRECTOR In order to validate this permit, please sign both copies as indicated. Retain the original (yellow copy) for your files and return the signed copy to us in the enclosed, self-addressed r: envelope. rt -; Your early attention to this matter would be appreciated. Sincerely, Scott Jones Coastal Management Representative SJ/rcb Enclosures M ` ,a cc: Ted Tyndall, District Manager MOREHEAD CITY OFFICE HESTRON PLAZA 11 151-B HIGHWAY 24 MOREHEAD CITY NC 28557 - PHONE 252-808-2808 FAX252-247-3330 AN EQUAL OPPORTUNITY / AFFIRMATIVE ACTION EMPLOYER - 50% RECYCLED/10% POST -CONSUMER PAPER 6608 Graymont Pl. Raleigh, NC 27615 (919)847-8073 January 21, 2000 CAMA ATT. Scott Jones 151-B Hestron Plaza II Morehead City, NC 28557 Dear Mr. Jones: Attached is the application for the Minor Development Permit to replace/repair the existing seawall on our property and a check for the $50.00 fee. I apologize for the delay. The certified letter return card sent to Dr. Bensch was returned prls gned. I had to resubmit the letter. I finally received a response from him this week (see attached. I received no response from Mr. English but do have the signed feturned certificate (see attached). We hope to start on the project as soon as all the permits are approved. If you have any questions please call. pson, AI ....................... NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF COASTAL MANAGEMENT January 26, 2000 Mr. James K. Jepson 6608 Graymont Place Raleigh, NC 27615 Dear Mr. Jepson: The NC Division of Coastal Management hereby acknowledges receipt of your application for State approval for minor development of your property located off NCSR 1121 adjacent to the Neuse River at Lot D in The Bluffs subdivision within the Arapahoe community of Pamlico County. It was received on January 24, 2000, and appears to be adequate for processing at this time. The projected deadline for making a decision is February 11, 2000. NCGS 113A-119(b) requires that Notice of an application be posted at the location of the proposed development. Enclosed you will find a "Notice of Permit Filing" postcard which must be posted at the property of your proposed development. You should post this notice at a conspicuous point along your property where it can be observed from a public road. Some examples would be: Nailing the notice card to a telephone pole or tree along the road right-of-way fronting your property; or at a point along the road right-of-way where a private road would lead one into your property. Failure to post this notice could result in an incomplete application. An onsite inspection will be made, and if additional information is required, you will be notified. Please contact me if you have any questions. Sincerely, M . s,44 M. Scott Jones Coastal Management Representative msj Enclosure cc: Ted Tyndall, District Manager MOREHEAD CITY OFFICE HESTRON PLAZA II 151-B HIGHWAY 24 MOREHEAD CITY NC 28557 PHONE 252-808-2808 FAX 252-247-3330 AN EQUAL OPPORTUNITY/ AFFIRMATIVE ACTION EMPLOYER -50% RECYCLED/10% POST -CONSUMER PAPER -�"z"!a^.^}I`�.,�, � •-sg..r,• 4:'J� .eau"^.iv NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF COASTAL MANAGEMENT January 26, 2000 Pamlico News -Times Legal Advertisement Section Post Office Box 510 Oriental, NC 28571 Re: Public Notice - James K. Jepson Dear Sir: Please publish the attached Notice in the February 2,2000, issue of the Pamlico News -Times. The State Office of Budget and Management requires an original Affidavit of Publication prior to payment for newspaper advertising. Please send the affidavit, an original copy of the published notice, and an original invoice to Jaye Poole, NC Division of Coastal Management, P.O. Box 27687, Raleigh, North Carolina 27611, Telephone (919) 733- 2293. Thank you for your assistance in this matter. If you should have any questions, please contact me at our Morehead City office (252) 808-2808. Sincerely, M. Scott Jones Coastal Management Representative msj Enclosure cc: Ted Tyndall, District Manager MOREHEAD CITY OFFICE HESTRON PLAZA II 151-B HIGHWAY 24 MOREHEAD CITY NC 28557 PHONE 252-808-2808 FAX 252-247-3330 AN EQUAL OPPORTUNITY / AFFIRMATIVE ACTION EMPLOYER - 50% RECYCLED/10% POST -CONSUMER PAPER NOTICE OF FILING OF APPLICATION FOR CAMA MINOR DEVELOPMENT PERMIT Notice is hereby given that James K. Jepson has applied to the Department of Environment and Natural Resources for a Minor Development permit. The applicant is requesting to install a gabion retaining wall in order to stabilize an eroding bluff which is adjacent to the Neuse River off NCSR 1121 at Lot D The Bluffs subdivision in the Arapahoe community of Pamlico County. Persons desiring to inspect the application, or to comment thereon, are directed to contact Mr. M. Scott Jones, Coastal Management Representative, NC Division of Coastal Management, 151-B Hwy. 24, Hestron Plaza II, Morehead City, NC, Telephone (252) 808- 2808, no later than February 10, 2000. Comments received prior to that date will be considered in making the permit decision. Later comments will be accepted and considered up to the time of permit decision. Project modifications may occur based on further review and comments. Notice of the permit decision in this matter will be provided upon written request. PLEASE PUBLISH ON: February 2, 2000 N -Ex tine Jetty Existing Sea 11 11" lean High Water Line CD 0 0 CV 0 CU m rn L F— Existing Sul Proposed Gravity Wall J^- Existi Stairs � o Deck f sting Jetty Partial Site Plan Scale: 1/16"=1'-0" Existing �Sea�wall �-Existing Jetty 31X3GABEir'- - - -- TIE TO TERR 3' HIGH SOL 2 LAYERS Exfoting Seai 'TERRA MW GASOM i COJ' = EARTH AT EAO N W LIFTS TYP. NCNIOVEN GEOTECH FAN BEWM GA88ONS TYP. 3' NIGH SOLID GABI 2 LAYERS NCNW#U OWMCH FAMC CCNTHJM MID GABB" TTR CR'PACT EARTH BEWI D GAM" IN V LETS TTP. Section 1 scale: 1/16"=1'-0" TEMPORARILY REMOVE EXISTM DECK Section 2 scale: 1 /16"=1'-0" James K. Jepson, AIA Architect 6608 Graymont PI. Raleigh, NC 27615 (919) 847-8073 (252) 249-2934 Modifications to Existing Marine Construction Residence located at: Lot D "The Bluffs" Arapahoe, Township #5 Pamlico Co. NC Drawn By Checked By JKJ Scale: As Noted Sheet No. C 1.0 of 1 44A VIF—;Vj � 1/ NnRc-sD E�OLKHEAZ> (NOTF-D ON PLP,NS )/I a Li C "��vvjkra'4D OC�L\�— S 32 2s 24 20 C o1-1 18 w cry 12 0 0 F(65.10,25.00) f S=1.383 C412.23982.88} R57.20 6 12 16 20 24 26 :32 36 4D 4+ 48 52 56 W 8�F 68 l 'C7 Q �N AMA: Proms gcbfo B do Tomm 3h v +roll Aa1K 11/16/99 kin •.POLOW ny AV Iinnad Beach, POmIco Co.. NC x z 0 ca a) w ro 0 0 WE 0417.103,70.64) RtSZ.9 8 6 4 f S=1.645 0 . }.r..._._t.....,I._. a 4 e 12 16 24 24 24 : i2 as 4. 44 0 m 56 w 6+ sa ^d q CST : Pro)vd: aabbn ease a Terramesh r vall tbtec 11 f 16f 99 W. MO. 0 42 i Minnemt Beach, Pamr= Co ., NC I C.P.P. Inc. SITEWORK SUPPLIERS P.O. Box 567 Pineville, NC 28134 1-800-533-0046 (803) 548-0037 Fax Memorandum Date: 11/22/99 To: Jim Jepson From: John Parrish Subject: Terra Gabion Retaining Wall Jim, 1100-G Corporation Pkwy. Raleigh, NC 27610 Phone (919) 250-1980 Fax (919) 250-7518 This memo is to reference our proposed project on your property in Pamlico County, NC. I have configured the design for this wall several ways and in my professional opinion, the solution we have detailed is the most structurally stable and economic solution. I have enclosed a computer generated load analysis of the site with a safety factor of between 1.4 and 1.6. This means that the wall should have an expected life of 50 to 75 years without failure unless there are catastrophic weather events. I would suggest the use of PVC coated wire mesh baskets for this application because of the brackish water in the Neuse River. The PVC coating will increase the strength longevity of the mesh that makes up the baskets. I look forward to working with you and the contractor on this project. Call me if you have any questions. NOV-03-1999 09:33 AK C. F. P. INC. 1 803 548 0037 P. 02 6;bion halls calculation - SAME $902 1U MFERRI - SEORSIA Filet RAL-13 Project 1 EJAMPLE !#ftf##iff##ff#ff#ff##f#ffff!#fftff#fff##!ff!llffiflilftfti####ffir!!#i DATA INPUT PAGE 2 ff#tiiif#fifffifth#f##i#fffliii#tfflfi#f�Ftilff#f4#ff�i*iilifftf#fffff� DATA AMT THE UPHILL PATER SURFACE Initial blight tit] ...... ............... ••••••s Inclination of the first stretch Idegl........s Length of the stretch (it) ....................:' inclination of the second stretch [degl.......s Length of the stretch lit).................0..: GEOMETRICAL DATA AllO<JT FOUREAT1ON SOIL Elev. of placing fro* the base [it] ........... 1 0.00 Soil inclination ref.to bast [deg] ............: 0.00 DATA[ AM FOUNDATION SOIL Unit weight of soil tibift3l..................1120.00 Friction angle [deg] ....... ............. ......: 20.00 Cohesion([b/ft2]..... 0... 6.0.0... ..... 0.6....: 0.00 Allowable stress on foundation [Ib/ft21.......s (later level tftl ..............................s 0.00 DATA AM ADDITIONAL FOURBA71ON SOILS Layer Depth Unit weight Cohesion Frict.angle tit] [l NMI [1 NMI [degl ---------------------------------------------------------------------- DATA ABOUT DISTRIBUTED LOADS Distributed loads on batkfill First stretch (lb/ft2l.... Second stretch [ib/ft21..s Distr. loads on the wall Sarcbarge load I1b/ft2]..1 Point loads on the backfiil l.Load [lb/ft]..... ......: Dist. fro* wall top Eft].: 2-Load [1b/ft]........... I Dist. frop wall top [ftl.: Moad tab/ft]........... I Dist. fro& wall top lit)-: point loads on the wall Surcharge load [1b/ft2]..1 Dist. frog Vail top [tt1.1 DATA ABOUT SEISHIC ACTIONS Horizontal coefficient...: Vertical coefficient.....: 11/03/99 09:35 TX/RX NO.3548 P.002 NOV-03-I999 09:33 AM C. F. P. INC. 1 803 548 0037 P, 03 SLbion galls calculation - GAMC 8202 MACCAFERRI - GEORGIA File: RAL-13 Project 1 EXAMPLE :fff#fitffffff#fttif#ffftf##fffftfftfiffH#ifftfffffftfi#ftfFflffiffff RESULTS PAGE 3 tffffffF#ff#f###ff#ffffifffififf#ffffiff#fi#ffff#iffffEfffffffff#ifffi EXTERML STABILITY Active thrust Elb/ftl.........................: 6174.49 Point of application ref. to I axis tftI.......0 10.83 Point of application refs to y axis Eft]......: 5.33 Direction of tbrast ref. to I axis [deg)......: 40.34 Passive tbrast tlb/ft]........................1 0.00 Point of application ref. to X axis Eft] ..... #1 0.00 Point of application ref. to Y axis lft]...... : 0.00 Direction of tbrast ref. to I axis ldegl...... : 0.00 811010 Boreal force on the base Elb/ft]..............:15131.27 Point of application ref. to I axis lftl...... : 6.44 Point of application ref. to V axis Eft]......: 0.00 Shear force on the base Eidlftl...............: 4106@36 Resisting force on the base Elb/ftl....... ....: 2045.44 Safety coefficient.... I..............9....0...1 1.709 OVERTURNING Overturning soeest tlbft/ft]..................:25100.58 Restoring ewnt tlbft/ftl......................122393.9 Safety coefficient.......... 0.................: 4.884 STRESSES ACTING ON FM M0AT1oN Stress on oaten foundation border libIMI.... : 981.53 Stress on Inner foundation border lib/ft2l.... : 1540.24 Max. allov. stress on tAe forndation llblit2l.1 2247.45 11/03/99 09:35 TX/RX N0.3548 P.003 DIVISION OF COASTAL MANAGEMENT - -- ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Individual applying for Permit:- Address of Property:A� N �� -D t= t PA M !— I G© OQONT (Lot or Street #, Street or Road, City & County) I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described to me as shown on the attached drawing the development they are proposing. A description or drawing, with dimensions, should be provided with this letter. I have no objections to this proposal. If you have objections to what is being proposed, please write the Division of Coastal Management, Hestron Plaza II, 151-B, Hwy. 24, Morehead City, NC, 28557 or call (252) 808- 2808 within 10 days of receipt of this notice. No response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION I understand -that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be set back a minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.) V I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. 3 bo Si nat re :Date COF or.�.l,; Print Name D..04 - V3 Telephone Number With Area Code t i Z 345 007 270 US Postal Service Receipt for Certified Mail No Insurance Coverage Provided. uo not use for International Mail See reverse S; nt to D- C` Street & Number 6aG �o�co Post Office, State, & ZIP C ee Postage HC C-4 Certified Fee e' l Special Delivery ee Restricted DeGve Fee 990 Return Receipt Sho' . �+' Whom & Date eGve 21p"e a Return Receipt ShowkV to Wlra Q Date, & Addressee's Address 0 TOTAL Postage & Fees $ 7.D Postmark or Date 0 tL u) a "iits I!&IItoIIf IIII IIII�lIItin!'t�tftlt�litJtt'It'���"tf.t�l. �1°IL� �N ►c�g'a1�� Jvo �d �� • �; sa uab...� j in rn rn 0 I Q C O Co ch LL n �I Z 345 007 269 US Postal Service Receipt for Certified Mail No Insurance Coverage Provided. Do not use for International Mail See reverse Sent to vlee- / Street & Numb r 1 !� P0§1 Office, State, & ZIP Code Postage C ry ►R N ^ Certified Fee A, Special Deli+ Fe I 2 9 199Q Restricted Deli ery Fee Retum Receipt wind Whom & Date Derive f Sp Return Receipt Showing to Who , Date, & Addressee's Address TOTAL Postage & Fees $ 3 [ Postmark or Date T Z4 L L UNITED STATES POSTAL SERVICE �:"a^ _ First -Class pQail_ cn -` Postage' Fees Paid vi G r USPS Permit • Sender: Please print your name, address, and ZIP+4 in this box • HI Mef t_v i �•;i iili'l 1lls1f 11 ifJ/i01 J►J ifdo Jl Jit1Jl1 �llfi ■ Complete items 1, 2, and 3. Also complete ' item 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece,' or on the front if space permits. 1. Article Addressed to: F7VI,eY1g,�j I A16 2873 0 A -.-Received by (Please Print le r/y) I B. aTe of .- . C. ,g ature o� A a f D. Is delivery address different from a 1? ❑ Yes If YES, enter delivery address b I . ❑ No 3. Type MCertified Mail ❑Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number (Copy from service label) PS Form 3811, July 1999 Domestic Return Receipt 102595-99-M-1789 a STATEMENT OF OWNERSHIP r I, the undersigned, an applicant for a CAA minor development permit, being either the owner of property in a M an AEC 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: (check one) Zan owner or record t J �*w►8� Ic. PCi e, Title is vested in 1ARAI NM 14. JEi4�0V1 , see Deed Book M 3 , page21A in the County Registry of Deeds. an owner by virtue of inheritance. Applicant is an heir to the estate of , .,nnn ; probate was in County. j1 e a y if other interest, such as written contact or lease, explain below or use a separate sheet and attach to this application.-- r O n a 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) _!,� r �� � Av►n Imo. �N � L ► s I-1 �14- � �t_e>E � A21�rf GA rE'y��iJ, /�/L z873 (2) D 6-4E W- ?0AuSGtf & 248 GtMEASN'29A.1G'i,._ .cm C'A �5Zl�j (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 1—day of// ,arr!&-z ' 19" KI owner or perso utl f6rized to act as his agent purposes of film CAMA permit application. SITE DRAWING/APPLICATION CHECKLIST Please make sure your site drawing includes the following information required for a CAMA minor develop- ment permit. The drawing may be simple and not necessarily to scaler The Local Permit Officer will help you, if requested. s PHYSICAL DIMENSIONS label roads label highways 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 draw location of on -site wastewater system If you will be working in the 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 a house is 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 $50.00 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)