WO-04-15_Forsyth Holdings LLC_20150226

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Ocean Hazard Estuarine Shoreline t1/ ORW Shoreline Public Trust Shoreline Other
(For official use only)
GENERAL INFOR ATION
LAND OWNER
Name'0 iZS'Y'rH H'o� t �(�J , t_t_ `N rj G`( ��t-1'•1 �N -- M 6R�
Address IH S0 &AL --TES- TMS- i R-Dgrp pp 'p(1G next l0�
City State N C- Zip L2CIrPhone 241-- C4 2B
Email P—CrOcd ide _6i'L2.C.GaM
AUTHORIZED AGENT
Name C-,Oq:-p rV'C' l -R-iS' ( A 4y-'C t,SD
Address rS2 (a 4W y 1 O W (efT
City f' OVADtEAi7 G'TY State N C - Zip 2aW11Phone
Email (rF��'tk. tlor'C:J oaku,���l,dnes c.�,n,
LOCATION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront, what is the name of the
adjacent waterbody.) ( , . 019 1 JAL^►EfL rPM-4i, N e. vo S'-)S
DESCRIPTION OF P JECT. (List all proposed construction and land disturbance.)
SIZE OF LOT/PARCEL:
LJ 0010 square feet
acres
TZEPL4LE riUJil� (�
J►��uEjrtAE, t'l�ME ��
NEW pNE
PROPOSED USE: Residential [„ (Single-family [.Multi -family[] ) CommerciaUIndustrial n Other
COMPLETE EITHER (1) OR (2) BELOW (Contact your Local Permit Officer if you are [lot sure which AEC applies
to your property):
(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 FOOTPRINTAND OTHER IMPERVIOUS OR BUILT
UPON SURFACES:-Wsquare feet (includes the area of the roof/drip line of all buildings, driveways, covered decks,
concrete o masonry patios, etc. that are within the applica le AEC. Attach your calculations with the project drawing.)
WA imA pofED, g3a EX % PrL aG
STATE STORMNVATER MANAGEMENT PERMIT: Is the project located in an area subject to a State Stormwater
Management Permit issued by the NC Division of Water Quality?
yF-s= NC
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: square feet.

APPLICATION FOR
CAMA MINOR
DEVELOPMENT
PERMIT
In 1974, the North Carolina General Assembly passed the Coastal Area Management Act
(CAMA) and set the stage for guiding development in fragile and productive areas that
border the state's 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 regulations that minimize the burden on the applicant.
This application for a minor development permit under 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 than necessary from
the applicant. Please go over this folder with the Local Permit Officer (LPO) for the
locality in which you plan to build to be certain that you understand what information he
or she needs before you apply.
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 takes about 18 days. You can speed the approval process by making
certain that your application is complete and signed, that your drawing meets the
specifications given inside and that your application fee is attached.
Other permits are sometimes required for development in the coastal area. While these
are not CAMA-related, we urge you to check with the Local Permit Officer to determine
which of these you may need. A list is included on page two of this folder.
We appreciate your cooperation with the North Carolina Coastal Management Program
and your willingness to build in a way that protects the resources of our beautiful and
productive coast.
Coastal Resources Commission
Division of Coastal Management
DCM Form EB1952-2010/Revised April 2010

f
OTHEI, 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. Cluck with your Local Permit Officer for more information.
STATEIITNT OF OWNERSHIP:
I, the and esigned, an applicant for a CAMA minor development permit, being either the owner of property in an AEC or a
person autorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person
listed as laidowner on this application has a significant interest in the real property described therein. This interest can be
described rs: (check one)
owner or record title, Title is vested in EGQt—N IA "L A S Ls a Deed Book 11710
page -=tM in the i County Registry of Deeds.
=an owner by virtue of inheritance. Applicant is an heir to the estate of
probate wa3 in County.
F--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 vOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Dame) P'(WpEnr& (Address) MAILt^
(1) JDAV t_ Wel) RA E l S02 SA4-IZL PATH TLDl l6s &aL� pen-0 I'm Itmigo 'xActi
(2) T4 NY FfLCk5 r 2 S"a S HattE ATLaye PO t{OX Lea 1ArL't Z9 PA \4
(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 f irthennore 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 pennit application.
This the �(,� day of�_, 20 IS'"
Landowner or person authorized to act as his/her agent for purpose of filin a CAMA permit application
C vOILIQVT-q- h-4wLt-r PW� 00b HONE•fr
This application includes: general information (this form), a site drawing as described on the back of this application, the
ownership statement, the Ocean RazardAECNotice where necessmy, 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 adminishative action.

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5526 Hwy 70 West
OAKWOOD Morehead City, NC 28557
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www.oakwoodcoastalnc.com
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www.oalcwoodcoastalne.com
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTiFICATIONMAIVER FORM
Name of Property Owner: _ F-o'fLJ`i'
Address of Property: _ 1444 &A +ts"EfL rW ti-i xoprz) Aije) J'a1,1 j 3.�A-n j N G
(Lot or Street #, Street or Road, City & County) r
�RR.
C,0agrJ- tt.r` 2$;T 7 S
Agent's Name #: __Dtk1-y-GOD h:g(%ME.r Mailing Address: 47-2(o }}wY 10 6
Agent's phone #: `7�s2C 241-2122 /hoYL�,ti�pp eA.TY WC, 20Qs5'1
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 ordrawina with dimensions must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
if you ha ve objections to whatis being proposed, you must notify the Division of Coastal Management
(DCM) In writing within,10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastaimanapement neUcontact dcm hi— or by calling 1-886-4RCOAST. No
response is considered the same as no objection if you have been no by Certified Mail.
WAIVER SECTION
I understand that a pier, dock; mooring pilings, breakwater, boathouse, lift, or groin 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.)
do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owli Information)
-
Signature
Pnnt or Type Name
Mailing Address
0 O f LcHrS Ra CiTV 0 C. 2.9 fS'7
City/State/Zip
2d-?, 297 - 21 TL
Telep one Number
Date
(Adjacent Property Owner Information)
Signature
rTONY F-(LOJT
Print or Type Name
PO fSox 6
Mailing Address
City/Statelzip
Telephone Number
Date
Revised 611812012

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: F-01Z-TT -/ 63LZ1„46 f (-
Address of Property: &yy '!N L9ER P}T74 /Zo,}D ly l9 s P�'i}f/ r is
(Lot or Street #, Street or Road, City & County)
z�s7S'
Agent's Name #; _(O9Q1 n ,o flo I,r Mailing Address: _-"2_6, yw
7o wEJT
Agent's phone #: _ � '212`� � - 2i 22 MAR -SAD r., 'Y NG. 2355-�
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 descri tion or drawin with dimensions must be rovidetl with this letter.
I have no objections to this proposal. I have objections to this proposal.
lfyou have objections to what is being proposed, you must notify the Division of CoastalManagement
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastalmanatrement ne0confact dcm hfm or by calling 1-888-4RCOAST. No
,re s onse Is considered the same as no objection if ou have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin 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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Ab9JT
(Property ovvnm Information) (Adjacent Property Owner Information)
Signature Signature
6o f2ZI-rr t--z� tZ'�t� — PA U L G UTP�xt e-
t or Type Name Print or Type Name
T"�'2& gwY 10 WE,r_T
Mailing Address
/ JRCNE�}D r/Yl Y NG 2&- /
CitylStatelzip
2 CL 2,q
Telephone umber
/16'r Jgc,r2 TLo41D
Mailing Address
/Nd99-j" 9LpGf}; /`rG Zi3Y'7S'
CitylStatelZio
Telephone Number
2 "Ito -��'-
Date
Date
Revised 611812012