Not Given_Campbell, Geroge M & Carolyn F_19971205

Locality Permit
GENERAL INFORMATION
LAND OWNER
Name 6V eo& 99 e IV, -,>b
Address % 1 / ,Loc k%
City SW'q&_//0 A0Q
AUTHORIZED AGENT
Name
Address
City
DEC 171997
1: 4��M'0�c
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State AIC Zip Phone
State Zip
Phone
LOCATION OF PROJECT I10 PO q c vQdg1 � V, 6,r-7r 1-1�J (/ S29
(If not oceanfront, is waterbody natural or manmade?) N. T_61�
DESCRIPTION OF PROJECT �w PO w A-`C K e
AREAS OF ENVIRONMENTAL CONCERN (AEC) CLASSIFICATION
(To be filled in by the LocalPermit Officer prior to completing application.)
Ocean Hazard V/Estuarine Shoreline ORW Shoreline Other
PROPOSED USE
t/ Residential Commercial/Industrial Other
SIZE OF BUILDING IN SQUARE FEET
Size of other impervious or built upon 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:

STATEMENT OF OWNERSHIP a
r
I, the undersigned, an applicant for a CAMA minor development permit, begin either the owner of property in y
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 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.
-- r
O
n
a
NOTIFICATION OF ADJACENT PROPERTY OWNERS r
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) re/A Al � ��l1Jya� ,aY ���cn�j�/Y� , c/1.G ��'.
(2) SAMUEL T. KING - 156 DOGWOOD DRIVE - SWANSBORO, N.0 28584
(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 per 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 day of
-'a
Land owner, r person authorized to act as his agent
for purpose of filing a CAMA permit application.

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CARTERET COUNTY COURTHOUSE
CENTRAL PERMIT OFFICE OF
Gn$==G%6WW
COURTHOUSE SQUARE
BEAUFORT. N. C. 2851 6-1 898
728-8545
BUILDINGS. MOBILE HOMES. ELECTRICAL. PLUMBING. MECHANICAL
Pursuant to NCGS 113A-119(b), Carteret County, a locality
authorized to issue CAMA permits in areas of environmental concern,
hereby gives notice that on - �� - Cj
applied for a CAMA permit to
at
The application may inspected at three address below. Public
comments received by 1J��- , O ; 1 will be 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.
CAMA Local Permit Offi
Carteret County
Central Permit Office
Courthouse Square
Beaufort, N. C. 28516
//11 (►� [phone]
Please publish on �V , , � -1�
and return Affidavit of Publication as
soon as possible.
Thank you.