2012-1015_Miller, Wade and Kelly_20121105

Pine KnollShores
Local Government
Jw�
2012.1015
Permit Number
as authorized by the State of North Carolina, Department of Environment,
and Natural Resources and the Coastal Resources Commission for development
In an area of environment concern pursuant to Section 113A-118 of the
General Statutes, "Coastal Area Management"
issued to Wade and Kelly Miller, authorizing development in the Estuarine Shoreline (AEC) at 240 Oakleaf Dr., in Pine
Knoll Shores, as requested in the permittee's application, dated Oct.15, 2012. This permit, issued on Nov.5.2012, 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.
This permit authorizes: The construction of a four bedroom septic system and associated landscaping within 75' of NHWL AS
SHOWN ON SEPTIC PERMIT #5046. Home and swimming pool permitted as shown on site plan dated Oct.13,2012 which requires
a 100' setback from NHWL per Pine Knoll Shores zoning ordinance.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on Oct.15,2012.
(2) All construction must conform to the N.C. Building Code requirements and all other local, State and Federal regulations,
applicable local ordinances and FEMA Flood 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) A copy of this permit shall be posted or available on site. Contact this office at 252-247.4353 for a final inspection at
completion of work.
(Additional Permit Conditions on 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 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
modification not covered under this permit, require further written permit
approval. All work must cease when this permit expires on:
DECEMBER 31, 2015
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.
.l
Chris Jon s
CAMA LOCAL PER FFICIAL
100 Municipal Circle
Pine Kn Tres C-4
PE ITTEE
(Signature required if conditions above apply to permit)

. . I
Name: Wade and Kelly Miller
Minor Permit # 2012.1015
Date: Nov.5,2015
Page 2
(5) The amount of impervious surface shall not exceed 30% of the lot area within 75 feet of NHWL (Estuarine Shoreline
Area of Environmental Concern), in this case, 0 square feet Is authorized.
(6) Unless specifically allowed in 15A NCAC 07H. 0209(d)(10), and shown on the permitted plan drawing, all
development/construction shall be located a distance of 30 feet landward of NHWL. No portion of the roof overhang
shall encroach into the 30 ft. buffer. No portion of the home or pool shall encroach into the town 100' setback
from NHWL.100 square feet of grade level pool apron may encroach with the 100' setback.
(7) All unconsolidated material resulting from associated grading and landscaping shall be retained on site by effective
sedimentation and erosion control measures. Prior to any land -disturbing activities, a barrier line of filter cloth 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 vegetative cover.
(8) Any proposed for grading within the 30' buffer from the NHWL must be contoured to prevent additional stormwater
runoff to the adjacent marsh. This area shall be immediately vegetatively stabilized, and must remain in a vegetated
state.
(9) All other disturbed areas shall be vegetatively stabilized (planted and mulched) within 14 days of construction
completion.
(10)
SIGNATURE: Re�lJ4DATE: �� A
P TEE

Y
OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA
minor development permit, including, but not limited to: Drinking Water Well, Septic Tank (or other sanitary waste
treatment system), Building, 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. Check with your Local Permit Officer for more information.
STATEMENT OF OWNERSHIP:
I, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in 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)
_an owner or record title T.tle is vested in _ ,see Deed Book % fJ
page _ in the CH')� County Registry of Reeds.
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 & 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) (Address)
(1)
(2)
(3)
(4)
ACKNOWLEDGEMENTS:
I, the undersigned, 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 particu-
lar hazard problems associated with this lot. This explanation was accompanied by recommendations concerning stabiliza-
tion and floodproofing techniques.
I furthermore certify that I am authorized to grant, and do in fact grant, permission to Division of Coastal Management staff,
the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information
related to this permit application.
i
This the S day of , 20
Landowner or per/On authoVzed to act as his/he(agent t' r purpose of filing a CAMA permit application
This application includes: general information (this form), a site drawing as described on the back of this application, the
ownership statement, the Ocean Hazard AEC Notice where necessary, a checkfor $100.00 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 permit is subject to civil, criminal and administrative action.

GENERAL INFORMATION
LAND OWNER
Name
Address /01 G, l,3
tcLECiaVED
City Nya K-VLo t l Z ►'l0.2 C State AJ (2- Zip $S Z Phone 9 / c3
Email
AUTHORIZED AGENT
Name
Address
City Pik, State NC Zip 5(1-Phone _ZriL—�Spt(-/3/Z
Email av� +� V�ct �e � 2. Q— . CC) r--,
LOCATION OF PROJECT. (Address, street name and/or directions to site. If not oceanfront, what is the name of the
adjacentwaterbody.) %3ogoe �2000c( aye) oc(k1,J 15�- PiLk-6-It s60L'3 Al,e
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) 1hs to f l a is �its rl_
4- W-e" A on.e
SIZE OF LOT/PARCEL: 9a. GSg square feet r75 acres
PROPOSED USE: Residential (Single-family [Z. Multi -family Commercial/Industrial ❑ Other
COMPLETE EITHER (1) OR (2) BELOW (Contact your Local Permit Officer if you are not sure which AEC applies
to yourproperty):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet (includes
air conditioned living space, parking elevated above ground level, non -conditioned space elevated above ground level but
excluding non -load -bearing attic space)
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: 10 square feet (includes the area of the roof/drip line of all buildings, driveways, covered decks,
concrete or masonry patios, etc. that are within the applicable AEC. Attach your calculations with the project drawing.)
STATE STORMWATER MANAGEMENT PERMIT. Is the project located in an area subject to a State Stormwater
Management Permit issued by the NC Division of Water Quality?
YES NO X
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: square feet.

FAX
TOWN OF PINE KNOLL SHORES
100 MUNICIPAL CIRCLE
PINE KNOLL SHORES, N. C. 28512
Phone # [phone] Fax [phone]
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FAX: 2� - 26 5�
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NUMBER OF PAGES (including this sheet):
—
ORIGINAL TO FOLLOW BY MAIL: TES NO
The information contained in this facsimile is privileged and confidential information
Intended only for the use of the individual or entity named above. If the reader of this
message is not the intended recipient, you are hereby notified that any discussion,
distribution or copy of this communication is strictly prohibited. If you have received this
communication in error, please notify us immediately.
ltb 8/25/09

0 yine
o The Town of Pine Knoll Shores
A
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October 16, 2012
Carteret County News -Times
Legal Advertising
P.O. Box 1679
Morehead City, NC 28557
NOTICE OF FILING OF APPLICATION FOR CAMA MINOR DEVELOPMENT PERMIT
Pursuant to NCGS 113A-119(b), Pine Knoll Shores, a locality authorized to issue CAMA permits
in Areas of Environmental Concern, hereby gives notice that on October 16, 2012 Wade and
Kelly Miller applied for a Minor CAMA permit to construct a single family home adjacent to
Bogue Sound at 240 Oakleaf Drive Pine Knoll Shores. The application may be inspected at the
address below. Public comments received by October 29, 2012 will.be considered. 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.
Chris Jones
CAMA Local Permit Officer
Town of Pine Knoll Shores
100 Municipal Circle RFC:;1V; D
Town of Pine Knoll Shores, NC 28512
E-mail: [e-mail] OCT 16 2012
PLEASE PUBLISH ON: OCTOBER 19,2012 ru.T-x,lC«y
100 Municipal Circle . ♦ Pine Knoll Shores, North Carolina 28512 ♦ tele: 252-247-4353
fax: [phone] ♦ e-mail: [e-mail] ♦ website: www.townofpks.com

P. 1
Communication Result Report ( Oct.16. 2012 9:42AM)
1) TOWN OF PINEKNOLL SHORES
2
Date/Time: Oct.16. 2012 9:41AM
File Page
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CARTERET COUNTY HEALTH DEPARTMENT
Environmental Health Division
3820 Bridges Street, Suite A, Morehead City NC 28557
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
CA M 5046
'No certificate of occupancy shall be issued until operation has been issued.
*No operation permit shall be issued system until installation is completed and approved and all pertinent
legal documents have been approved and recorded with the Carteret County Register of Deeds.
G.S. 130A 336: This permit expires 5 years (60) months from date of improvement Permit issuance. If expiration occurs the client
shall comply with all changes in applicable regulation, laws, technical aspects, etc, that may be effective at that time. This may require
additional preparation, more complex wastewater systems, operation and maintenance requirements, pre-treatment, etc. This could
result in less area for the home, parking, lower water usage and further development limitations.
OWNER: Frederik Wade Miller
ADDRESS: 126 White Ash Drive
Pine Knoll Shores NC, 28512
PHONE #: [phone]
APPLICANT. Robert Harrington
ADDRESS: 236 Salter Path Road
Pine Knoll Shores NC, 28570
PHONE #: [phone]
PARCEL ID: 635516933850000
PROPERTY LOCATION: 240 Oakleaf Drive NC, 28512 Subdivision PINE KNOLL SHORES, Lot 42
A/C ISSUANCE DATE: 10/15/2012
TYPE: New System
DESIGN FLOW. 480 (gpd)
SYSTEM TYPE: Conventional/Modifted
SYSTEM APPROVAL: NA
OTHER SYSTEM APPROVAL: NA
SYSTEM CLASSIFICATION: Type Ila
WATER SUPPLY. Municipal
SEPTIC TANK: 1000 (gal)
DOSING TANK: (gal)
GREASE TRAP: (gal)
A/C EXPIRATION DATE: 10/15/2017
BUILDING TYPE: House
# BEDROOMS: 4
# OCCUPANTS: <$
RECIRCULATION TANK: (gal)
FILTER DOSING TANK: (gal)
TRENCH BOTTOM DEPTH 18'rBelow Naturally Occuring Surface @ 10 W'S4- e-44-&
TRENCH WIDTH: (in) BED LENGTH: Ift)
TOTAL LINE LENGTH: (ft) BED WIDTH:1-�
LINE/LATERAL LENGTH: (ft) # OF LINES4)MA LATERALS:
ABSORPTION AREA: 720 (sq. ft) # Runs:
DEPTH OF MEDIA: 12 (in)
MINIMUM INSTALLER CERTIFICATION LEVEL REQUIRED: I
GARBAGE GRINDER: NO
DRAINAGE REQUIREMENTS:
DISTANCE TO ANY WELL: 50 (ft)
6INCH TOPSOIL COVER REQ: N/A
Page 1 of
r'E'z VtD
QCi 16 M2

TRI-PARTY AGREEMENT REQUIRED - No EASEMENT RECORDED:
PRE -CONSTRUCTION CONFERENCE REQUIRED TO BE ATTENDED BY: Installer, CCHD
COMMENTS:
1. The wastewater contractor (installer) shall be currently certified by the NC On -Site Wastewater Contractor and Inspectors
Certification Board at the level specified for the permitted system. The installer shall be currently registered with the Carteret County
Health Department.
2. The installer shall be responsible for notification of the engineer and the CCHD for system inspection in stages as required and
prior to backfilling any portion of the system. No portion of the system shall be backfilled or placed into use without prior approval of
the CCHD.
3. The system shall be installed in accordance with the APPROVED set of plans and specifications (if applicable). Any deviation in
site modifications, plans, specification, layout, materials or other system components shall be approved by the designer and the CCHD
prior to installation of the system. Failure to do so may result in delay or refusal of final approval of the system, and may render the
Permit null and void
4. Wastewater system shall not be installed in wet conditions.
5. Wastewater systems shall be installed in accordance with the laws (Article I I of Chapter 130A for the General Statutes of North
Carolina) and rules (North Carolina Administrative Code T15A. I SA .1900) for sewage treatment and disposal systems, and the
conditions specified in the improvement permit and construction authorization.
6. Structure shall be placed so that gravity flow is achieved or pump system shall be required.
7. Do not park, pave, drive, or build over any part of septic system or repair area
8. Maintain a minimum of five (5) feet between any foundation and any part of septic system or reserve area
9. Do not install well until well site has been permitted by CCHD.
10. The system shall be installed in a timely manner and staged so as to avoid unnecessary exposure to weather.
NOTICE: Construction must comply with all state and local regulations.
NOTICE: Beware much property in Carteret County is subject to Wetland Regulations and properties containing wetlands should
receive approval from U.S. Army Corp. of Engineers prior to development.
Environment 1 ealth Specialist
10/15/2012
Date
Accepted systems* may be substituted for conventional systems with gravel media if the accepted system can be placed in the
permittedlauthorized trench footprint and the installation is in accordance with the accepted system approval, without unauthorized
product alteration. Permit modification, prior approval of the health department or separated owner sign -off is not required as long as
no changes are necessary in the location of each nitrification line (except reduction in line length), trench depth, or effluent
distribution method. There shall be no reductions in trench length for trenches installed in new or existing fill, or for bed systems.
* Accepted systems include:
EZflow Drainage systems:
EZ1203H
Infiltrator chambered sewage effluent subsurface disposal systems:
Standard and Standard Side Winder (polyethylene) with 12 inch cover
High Capacity (polyethylene) with 12 inch cover
Quick 4 Standard-W, Standard SC, and Standard Sidewinder (polypropylene) models with 6 inch cover
Contour Wedge
Standard Contour Swivel
Page 2 of 2

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CARTERET COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH DIVISION
3820 Bridges Street, Suite A, Morehead City NC 28557
J.T. Garrett, Ed. D., M.P.H.
Improvement Permit 5046
Expiration Date: 10/15/2017
OWNER: Frederik Wade Miller
Construction Authorization 5046
APPLICANT: Robert Harrington
PROPERTY LOCATION:
240 Oakleaf Drive NC, 28512, Pine Knoll Shores, NC 28512, Subdivision PINE KNOLL SHORES, Lot 42
PARCEL ID: 635516833850000
-(rT)� �nnS U SITE PLAN
EnvironrA al Health pecialist
Page 1 of 1
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OCT 16 2012

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CARTERET COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH DIVISION
3820 Bridges Street, Suite A, Morehead City NC 28557
IMPROVEMENT PERMIT IP #: 5046
Exp. Date: 10/15/2017
*No building permit shall be issued until authorization to construct is issued,
*Before Authorization to Construct is issued, all site modifications, plans, specifications, and/or draft legal
paperwork must be completed and approved.
G.S. 130A-336 Improvement permit subject to revocation if the site has been altered, site plan or plat, whichever is
applicable, changes or the intended use changes.
OWNER: Frederik Wade Miller
ADDRESS: 126 White Ash Drive
Pine Knoll Shores, NC 28512
PHONE #: [phone]
APPLICANT: Robert Harrington
ADDRESS: 236 Salter Path Road
Pine Knoll Shores, NC 28570
PHONE #: [phone]
PARCEL ID: 635516833850000
PROPERTY LOCATION: 240 Oakleaf Drive Pine Knoll Shores, 28512 Subdivision PINE KNOLL
SHORES, Lot 42
IP ISSUANCE DATE: 10/15/2012
FACILITY TYPE: Single Family
Type of Application: New System
PERMIT WILLEXPIRE: 10/15/2017
SINGLE FAMILY TYPE: House
DESIGN FLOW. 480 ,S pri # BEDROOMS: 4
SYSTEM TYPE: Conventional/Modifled # OCCUPANTS: Lg
SYSTEM CLASSIFICATION: Type IIa: Conventional
System
WATER SUPPLY. Municipal
SITE MODIFICATION REQUIRED: No EASEMENT REQUIRED: No
ENGINEERED SYSTEM SPECS REQUIRED -No DRAFT TRI-PARTY AGREEMENT REQ.: No
1. All documents, including but not limited to design review plans and specification, Tri-party agreements,
Easements, and other legal agreements will become a part of the Permit. This includes operation and maintenance
procedures and other pertinent documents relating to system operation and maintenance. All legal documents must
be recorded with the Carteret County Register of Deeds.
2. This permit is effective only with respect to the specific design flow facilities, and the nature and volume of
waste described in the Permit Application, and other supporting data. Changes in the proposed use, waste flow,
nature or volume of waste render this permit void.
Page 1 of 2
r�E'CwiVED
OCT d r 2012

IP#: 5046
3. Prior to any changes in system layout, approval must be obtained from Health Department.
4. The designated repair area is to have no parking, driveways or other impervious materials located on it.
5. The issuance of this permit does not preclude the permittee from complying with any and all statutes, regulations,
or ordinances which may be imposed by other government agencies which have jurisdiction, or any other permits
issued by this department.
6. This permit shall become invalid if the information submitted in the application was falsified or changed, if the
permit was based on inaccurate or incomplete information, or if the designated site is altered.
7. This improvement permit shall not be affected by a change in ownership of the site provided both the site for the
wastewater system and the facility the system serves are unchanged and remain under the ownership or control of
the person owning the facility.
NOTICE OF EXPIRATION: This permit expires 5 years (60) months from date issued. If expiration occurs the
client shall comply with all changes in applicable regulation, laws, technical aspects, etc, that may be effective at
that time. This may require additional preparation, more complex wastewater systems, operation and maintenance
requirements, pre-treatment, etc. This could result in less area for the home, parking, lower water usage and further
development limitations.
NOTICE: Beware much property in Carteret County is subject to Wetland Regulations and properties containing
wetlands should receive approval from U.S. Army Corp. of Engineers prior to development.
Enviro mental Health Specialist
Page 2 of 2
10/15/2012
Date
R1:C- V-D
0 C T 11 2012

that you send a copy to the Office of General Counsel, N. C. Department of Health and Human
Services.
If you have any further questions please feel free to contact this office at 728-8499.
Sincerely,
Amy H. Guthrie, R.E.H.S.
Environmental Health Specialist
On -Site Wastewater Program
OCA 1 G zolz

ET CO�j'Y
A
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October 15, 2012
CARTERET COUNTY HEALTH DEPARTMENT
3820 Bridges Street, Suite A, Morehead City NC 28557
Frederik Wade Miller
c/o Robert Harrington
236 Salter Path Rd.
Pine Knoll Shores, NC 28512
J.T. Garrett, Ed. D., M.P.H.
?, llt p,,,6Q,
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W-W P-Qf ft'a. 161��
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Subject: Revocation of Improvement P rmit # A-9639 dat 12/14/04 for 240 Oakleaf Dr., Pine
Knoll Shores (PIDN: 6355.16.83.3850
Dear Mr. Miller: .
This is to notify you of our intent to revoke your Improvement Permit # A-9639 from the date of
this notice for the following reasons:
Issuance of Improvement Permit #5046 dated 10/15/12
You have a right to a formal appeal of this decision. To pursue a formal appeal, you must file a
petition for a contested case hearing with the Office of Administrative Hearings, 6714 Mail
Service Center, Raleigh, NC 27699-6714. To get a copy of a petition form, you may write the
Office of Administrative Hearings or call the office at [phone] or from the OAH web site
at http://www.ncoah.com/forms.html . The petition for a contested case hearing must be filed in
accordance with the provision of North Carolina General Statutes 130A-24 and 150B-23 and all
other applicable provisions of Chapter 150B. N.C. General Statute 130A-335 (g) provides thaf
your hearing would be held in the county where your property is located.
Please note: If you wish to pursue a formal appeal, you must file the petition form with the 4
Office of Administrative Hearings WITHIN 30 DAYS OF THE DATE OF THIS LETTER
The date of this letter is October 15, 2012. Meeting the 30 day deadline is critical to your formal
appeal.
If you file a petition for a contested case hearing with the Office of Administrative Hearings, you
are required by law (N.C. General Statute 150B-23) to serve a copy of your petition on the
Office of General Counsel, N.C. Department of Health and Human Services, 2001 Mail Service
Center, Raleigh, N.C. 27699-2001.
Do not serve the petition on your local health department. Sending a copy of your petition to the
local health department will not satisfy the legal requirement in N.C. General Statute 15OB-23
Health Department [phone] Environmental Health [phone]
Fax [phone] Fax [phone]

him
....... -- — -- ----- ................ .... ... . ........ ........ . ........ ............. . ............ ......
HOMEBUILDERS 243092
- PH [phone]
236 SALTER PATH RD
PINE KNOLL SHORES, NC 28512 L 66-30/531
DATE 133
PAY
TO THE �w-o
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OCT 16 2012
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