95-0040_Phillips, Alton_19951109

office.
md a i nw r n i I KITV
Dear Mr.*.Phillips:
Pleiase find enclosed CApplication #95-0040. It will be
published in the Daily Newr;.,onr e nesday.'October 25, 1995.
ueg
If you have any. -efuicthei�,,qii6igtion, F"Please contact
Sin rely, 4�N
Sin
aid I e y', fzinget
Zoning7dAMA Office
Enc I
Char
DiVi 91 6h -of Coastal_. M�.Lnagefiilbht

SIZE OF BUILDING IN SQUARE FEET 'N/A
Size of other impervious or built upon surfaces (such as driveways, etc.) within 75 feet of the shoreline (575 feet
of an ORW shoreline) i
SIZE OF SITE IN SQUARE FEET
BOTHER PERMITS; MAY BE REQUIRED .. a µ s
Zoning, Drinking Water Vhell, Septic tank (or other
sanitary waste treatment system), Burning, Electri-
The activity which you are planning may require
cal, Plumbing, Heating and Air Conditioning, In -
permits other than the CAMA minor permit you
here. As we have
sulation and Energy Conservation, FIA Certifica-
are applying for a service com-
which
tion, Sand Dune, Sediment Control, Subdivision
pplied a listing of the kinds of permits might
be regµired. We suggest that you check over this
Approval, Mobile Home Park Approval, Highway
Connection, Others:
list with your Local Permit Officer to determine
which, if any, of these may appplyy to your project.
I AMA, only a sugggges-
This is not a requirement of
as as
tion to help you complete your project quickly
possible.

STATEMENT 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)
�_ an owner of record title, Title is vested in see Deed Book
page !19 3 in the - n,n quo 1 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) 1 (Address)
L ICIors-35
(2) �`'1 �� L J fn 62— R 1u l� S l FS «PP.c.r P de, a S S
i 44)
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.
1
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. R
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 atiy 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-
.«:S..� ....1,1--s. 4........:I ..«.....« .1 --A,..ti..«

Coll
-R
f �� / ' '� r
jj t
4
i! \