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HomeMy WebLinkAbout050112J_Smith, Michael & Lisa_20050126.1/26/2005 10:55 2526365190 PAGE 02 4. Cravtn Local Government SOl12Ly Permit Numbor LAMA MINOR DEVELOPMENT PERMIT as authorized by the State of North Carolina, Department of Environment and Natural Resources and the Coastal Resources Commission for development ,4f,pf..2� 1 Za in an area of environmental concern pursuant to Section 113A-1 i 8 of the ./ / General Statutes, "Coastal Area Management" lssupd to /N►CA4.11 4 L.ts sm �f authorizing development ►_ t leif% 7 S' Ar-n r; at��� 's �rQ•, �' R ,!yt r D r K e r n as requested in the permittee's application, dated This permit, issued on 1 a 6/0 is subject to compliance with the application and site drawing (where consistent with the permit), all applicable regulations and special conditions and notes setforth below. Any violation of these terns may subject permittoo to a fine, imprisonment or civil action, or may cause the permit to be null and void. ***This permit authorizes construction of a single family dwelling, the removal of trees And brush, and any land disturbing activity associated with proposed project Any other development will require additional permits or a modification of this permit. The following conditions shall apply: 1. All proposed development and associated construction must be done in accordance with the application dated 01/12/05 and work drawings submitted on 01/12/05. 2. All construction trust conform to the NC Building Code requirements and all 1.oca4 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. Pursuant to 15A NCAC 0710406% this permit may not be assigned, transferred, sold, or otherwise disposed of to a third party by the appHeaut, agent, or any entity other than the NC Division of Coastal Management. S. No excavation or fYllling of any wetlands or waters is authorized under this permit. 6. This project is located in the Neese River Basin and le subject to the iEMC's Neese River Riiarfan Buffer Regulations. Contact Kyle Barns with NC Division of Water Quality at (252) 946-6481 for approval prior to project initiation. This permit action may bo appealed by the pem,htee 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 Mat cease until the appeal is resolved. This permit must be on the project site and accassible to the Kermit 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 expiras on December 31, aOD %7 In issuing this permit it is agrood that this projoct 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. a.. ,/ Local Permit Officer (signature) Saw, <.s l /%W I:g,.sa�1 name address PermittQe (signature required if special conditions above apply to permit) -DAQ- f 01/26/2005 10:55 2526365190 PAGE 03 ;ENERAL INFORMATION Jame M i e L so 5 i k ►ddress 0D 'iry a >7 State JAG Zip 36 7— Phone ►UTHORU ED AGENT ►ddrew )rdl 1192 T1- �,-`1 =ity N a - Bern _ State N Zip Phone ACATION OF PROJECT: r(Aidress, strext wi-P and/or directions to site. If not oceanfront, what is the name of he adjacent waterbody?) V ` '`�r'�.11� Y�i" �' 1 �j �' i�� W 4J e°.l-rl )ESCRIPTION OF PROJECT: (List ail proposed construction and land disturbance.) il'1A4�(Arni -Wip i nCi UE OF LOTMARCEJU 533501 square feet .17 acres 'ROPOSED USE: Residential ✓ (Single-family ✓ Multi -family } Commerical/Industrial )ther 'OTAL ENCLOSED FLOOR AREA OF A. BUILDING IN THE OCEAN HAZARD AREA OF ENVI- tONN ENTAL CONCERN (AEC): square feet (includes all floors and roof -covered deeps) UE OF BUILDING FOOTPRINT ANVOTHER IIVII'ERVIOUS OR B•UMT UPON $ ACES IN 10 COASTAL SHORELINE AREA OF ENVIRONMENTAL CONCERN (AEC),.— sq. ft. Calculations include the area of the roof/drip line of all buildings, driveways, covered decks, concrete or .masonry patios, rc, that are within the applicable AEC. Attach your calculations with the project drawing.) Moose the AEC area that applies to your property: Pwithin within 75 feet of Normal High Water for the Estuarine Shoreline AEC 575 feet of Normal High Water for the Estuarine Shoreline AEC, adjacent to Outstanding resource Waters 3) within 30 feet of the Public Trust Shoreline AEC contact your Local Permit Officer if you are not sure which AEC applies to your property,) 11 TAT'E STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a rate Stormwater M"ement Permit issued by the N.C. Division of Water Quality? ES NO !ycs, list the total built-uport area/impctvious surface allowed for your lot or parcel. square feet. cod S .01/26/2005 10:55 2526365190 PAGE 04 OT14iR PERAUTS MAYBE REQUIREDe The activity you are planning may require permits other than the CAMA minor development permit As a service we have compiled a list 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 Wdl, SeptieTank (or other sanitary waste aeatment *=rn), Building, Electrical, Plumbing, Heating and Air Conditioning, Insulation and Energy Conservation, FIA Certification, Sand Dune, Sediment Control, Subdivision Approval. Mobile Home ParkApptoval, Highway, Connection, and others. STATE V= OF OWE RSHIP: I, the undersigned, an applicant for a CAMA, minor development permit, being either the owner of property in as 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 onc) / 6n owner or record tide. Title is vested in , sce Deed Book page %A-1 in the «vim Co s. 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 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 X0110E to each of them concerning my intent to develop this property and to apply for a CA.MA permit. (Name) (Address) )n ►e _Ri 1ssel l 31on /V • i"J rn 84. I%reoisbcro /VC Z ?440 (2) (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 char the local permir officer has explained to me the particular hazard problems associ- ated with this lot. This explanation was accompanied by recommendations concerning stabilization and floodproofing-tech- niques. PERMISSION TO ENTER ON LAND: I furthermore certify that I am authorized to grant and do, iri 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 application, the ownership statement, the AEC hazard notice where necessary, a check for $100.00 made payable to the locality, and any infor- mation 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. 'phis the �z day of 4Q rif 20 .01.5 Landowner or person authorized to act as his agent for purpose of filing 2 LAMA permit application. S1/26/2005 10:55 2526365190 PAGE 05 ZA1?OUN & RAINES FIRST-cmzENs S NIC &-MUST co 2529.5 CONSTRUCTION CO., INC. — NEW BEAN. NO 29M 312 SOUTH FRONT STREET 86-30/5331 NEW 6ERN, NC 28M (252) W3.0106 1/11/2005 n PAY TO THE Craven County ORDER OF $ **100.00 One Hundred and 00/100 K IA DOUAAS w Craven'County � MEMO MSMITH/Lot 4 Trent River Ih 112025295►m I:0531003001:001112433336►►' M CRA�'6� COUk"Y C-Zi YE IPTE CUSTVIER RECEIPT 441 Ca:E: ;113/zcw ma Ric�ipt no! `Am Dei1.'tiKI-Of, Qd antioy �DOtIIIY CIS, 46 FP' EU%DEN6 IgYTOLN /,CMT71, 00 e�ua� �9Y31� C' ,.4ECc Tatai r.A�cerea Eik0.Q4► T :;.: lit : 111c"/oz; is e: ice:?3;9T TNANI� YC.J FOR "CUB pW.YhEN- .01/26/2005 10:55 2526365190 Office of Planning and Community Development County of Craven Donald IL Baumgardner, Director Stephanie S. Currier, Assistant Director Shelton P. Toler, Chief Badmg Codes Inspector January 12, 2005 Michael and Lisa Smith 100 Amanda Ct. New Bern, NC 28562 Dear Mr. and Mrs. Smith: PAGE 06 Human Services Annex 2828 Neese Boulevard New Bem, North Carolina 28562 planning & CD (252) 636.6618 Fax (252) 636-5190 Inspections (252) 636-4987 Fax (252) 636-492 4 The North Carolina Division of Coastal Management hereby acknowledges receipt of your application for state approval for minor development of the property located at 4605 Trent River Dr. as received on January 12, 2005 to be adequate for processing at this time. The projected deadline for making a decision is February 6, 2005. NCGS 113A-119(b) requires that Notice of an application be posted at the location of the proposed development. Enclosed you will fiend a "Notice of Permit Filing" postcard which must be posted at the property of your proposed dcvelopmcnt. 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 the 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 leave any further questions or concerns. Sincerely, -.: � a.. C� 17. e,;;, � James A. Mathieson Local Permit Officer Enclosure cc: Stephen Lane, Division of Coastal Management 01/26/2005 10:55 2526365190 PAGE 07 NOTICE OF FILING OF APPLICATION FOR CAMA MINOR DEVELOPMENT PERMIT Pursuant to NCGS 113-119(b), Craven County, a locality authorized to issue CAMA permits in Areas of Environmental Concern, hereby gives NOTICE that on January 11, 2005 Michael and Lisa Smith applied for a CAMA permit for a single family dwelling, the removal oftrees and brush, and any land disturbing activity associated located at 4605 Trent River Dr. The application may be inspected at the address below. Public comments received by January 24, 2005 will be considered. Later comments will be accepted and connsidered 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. James A. Mathieson CAMA Local Permitting Officer Craven County Address: 2928 Ncuse Boulevard New Bern, NC 28562 Phone: (252) 636-6618 PLEASE PUBLISH ON: January 15, 2005 .01/26/2005 10:55 2526365190 PAGE 08 OF FOJNO OF Pursuant t NCGS 113- 119rb1. C ven County, a Sue CAM perror Areas o! irdnn Concern, hereby : NOTICE tt ' t on Ja LIIMM SmRP) apph el mover Rua, The application maybe In- spected • at the address below. Public comments received byy Januarryy 24, 2005 will be consldered. Later comments will be UP ii-of Permit decision. Pro14et mo cations may occur based on further review and comments Nodce of the Pe It.. decision in. this metter will be provided upon written request James A. Mathleson Pemcal OO GAMA tioc8r Craven County Address: 2828 Neuse Bivd. . Now Bern NC 28562 Phone:(252)636.6618 January 15, 2005 .01/26/2005 10:55 2526365190 PAGE 09 ._.._._' 300134 Affidavit of Publication JAN 19 Znt'ti 15052460 New Bern Sun Journal 1 of 2 Ne orn, NC Personally appeared before me, a Notary Public of the County of Craven, State of North Carolina, on this the 15th day of January, 2005 of The Sun Journal, who being duly sworn, states that the advertisement untitled Cama for Hchaet and Lisa Smith a true copy of which Is printed herewith, appeared in The Sun Journad, a newspaper published In the City of Newbern, NC, County of Craven, State of North Carolina, 1 day a week for Q.0 weeks on the following dates: January 15, 2005 NORTH CAROLINA CRAVEN COUNTY W-4v- NOTICE OF FILING OF APPLICATION FOR CAMA MINOR DEVELOPMENT PERMIT Pursuantto NCGS 113- 119(b), Craven County, a locality authorized to issue CAMA permits in Areas of Environmental Concern, hereby gives NOTICE that on January 11, 2005 Michael and Llsa5mith applied for a CAMA permit for a single family dwelling, the removal of trees and brush, and any land dsturbhg activity associated located at 4605 Trent River Road. The application may be inspected at the address below. Public comments received by January 24, 2005 will be considered. Later comments will be accepted and considered up to the tine of permit decision. Project modifications may occur based on further review and comments. Notice of the permit decision in this matt ll be provided upon written request. James A. Mathieson CAMA local Permitting Officer Craven County Address: 2828 Neuse Blvd. New Bern NC 28562 Phone; (252)636-6618 01/26/2005 10:55 2526365190 PAGE 10 300134 15052460 2of2 January 15, 2005 Affidavit of Publication New Bern Sun Journal Newbern, NC Subscribed and sworn to this 15th day of January, 2005yeo ������i A m�..•'apIAlgy%.9 X =U' Notary Public r P 1. AU 0 4a M Commission Expires 3-15-2008 Y p .,,���iFN1tC10'V�`\\`��� cn In (n N U) N r 1 -1 4 No 11(00# ]A AMA PERMIT APPLIED FOR COMMENTS ACCEPTED THROUGH �Aruar,/ q. 200_� APPLICANT: lL 1y1: r_Aaod .1 j . S4 SM:T-1 & C, Z $S6 Z i n Qq�%,e�ije0� Q7t,n - �'iD4n lYtAr►e.S ��s�.•c��e1 FOR MORE DETAILS CONTACT THE LOCAL PERMIT OFFICER BELOW: raw- j2, -AfA-Ale4an z$Z P A u4,c 6104 AI-&.W 13grA , A•C a 6� ZS2- 63 9-9611 01/26/2005 10:55 2526365190 PAGE 12 ADJACENT RIPARIAN PROPERTY OWNER ST&TEMENT I hereby certify that X own properly adjacWt to m;+h property located at Wi ver W �- _ (Lot, Block, R d, etc.) on 1 i-gr+ Rid 2 r ,. � e r , NC (Waterbody) (Town and/or County) He/She has described to me as shown below, the development he/she is proposing at that location, and I have no objections to his/her proposal. DE cmipnw AND/OR DRAWING OF PRO -POSED DEVELOPMENT po be filled in by indMaual proposing development) din le v 1�y welJ,hy . ,�� cached p�o� Signature Print or Type Name Telephone Number Date j Ftoje- "�t 1` ,r�tt%�p pLJy%%�r lad/�pW/f7 U.Os WLJ`1,�uurgt%�rt�N7LLW�LJ1 1�VAJ. �Y. ryti{VAfV11r Vvn+^"S RIW— Tr �� — - - — - - JW PAVEEFKE Sc N ri u ice' 70' aururr f t1R7tT' riles !!i � �� 0.77 7.1' ' I R4R 13 V Ai ANAL 1 WOOD NZIT - 1 1 .or rLM I z r TRlIGnm- N.G. r tMr�F-R EIGHT T01�1/N5ff_ GRAV�III GOf.1P11rYw ^�..,..,..r.+ .r or r,T r.owrrr � �r Ins ��i o rfl�vrar rnr �nr �S � Y 7-%6 0r, 5! �S jN t-(cuw< < S 1 rj•Z • S �G d (cT S GWSc- 45 MM ZW uDMXY l ow COOK Jd3L^►AGZ ' ]CD N ` V , N^ �A CS) Co m N I9 WEn wI­ ;W Ln t0 F-� tD I N 0't � N N (A Q1 I,I,w Ul CA A �. LD D G N H a� I m m u) to m to N IP) N 7p5 hT SE 15 RXi 71Gd-r,i, Sl&-FS IgFtztwT to�w OIc'aieh tn,sryt:-%%tir. n �-� WN Llgg AV .7- 71flN+� Wry- klp E �P CD �cpSc- CD A-s I (OW-0, CD w w .W W. / 111" W i I fp�/�V�Ji�MyL..AA IV F IINpLLW %.,J I riVMW. LWS to 38' PAVEMW W 1 i-- • - — - —.. � . - �. _.pep!► so• aw+xrr f urn- u� N ts''t��E.�� `- � --- -- RJ a to 0.77 ass _ u, c Lo ti ) sss� nwr qvmw Zft fALoho s WQOD G1 list Xn 1 �3 CC'+rl5f�,ltJr''t�G�IV -•-- - •....,r +cam o �ottn�r r�rontTv vciwfov Jan. 12. 2005,l 2; 39PM - ZAYTOUN & RAINRS CONSTRUCTION CO No. H45 P, 1 Ni 1—l'�11Tt �r i ` �JC.;trYl�':'� �1a4, .. ��' (�' r ►r, 7004 1160 t1002 2769 6636 40 ,T SF. PF —r QM 9T 39Vd 06T99E9Z5Z 58:0T 900Z/9z/T0 • 01/26/2005 10:55 2526365190 PAGE 16 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own ro adjacent to 1 �f f i (:.►1D1 � I m P Ply _(pame Tf prono,.a• --er) . property located at` k 1 Yer r (Lot, Block, R 4d, etc.) on -:Ef .r& 1�z i df r" , in 1'Lty e n , NC (Waterbody) (Town and/or County) He/She has described to me as shown below, the development he/she is proposing at that location, and I have no objections to his/her proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (To be filled in by ind vidual proposing development) 1n le ani, /, L)we)ll�J O-Aached Signature Wlar) 6). Print or Type Name 0�- 0- 31 Telephone N ber fig Date jo1/26/2005 10:55 2526365190 s • ,o To; PAGE 01 �IeidGll %JWLAR14y i tGtttetttt!j Ld%W QU1.111.:.M 2828 Neese Blvd. ir�S d Bem, NC 28562 Phone: (252) 636-6618 Fa (252) 636-5190 From: Fax. 25 Z- 2q7 - 333 Pages with cover. [ % Phone: bate: % /z b /D S Re: CC: Q Urgent 5Tfor Review 0 Please Comment O Please Reply. a1 ® Comments: Gr• roc. , },oy ., 4^,YA",5 - Aw -Gratt'LA Local Government ¢u4l�� 1 Z4 yTa,�1 issued to _ A4•c. % 4 CAMA MINOR DEVELOPMENT PERMIT as authorized by the State of North Carolina, Department of Environment and Natural Resources and the Coastal Resources Commission for development RqJ^ts in an area of environmental concern pursuant to Section 113A-118 of the General Statutes, "Coastal Area Management" authorizing development In --�=�- ••. as requested In the permittee's application, dated—) This permit, issued on o� ��,� is subject to compliance with the application and site drawing with the permit) aD a lieabl l ii d erm (where consistent , pp a regu a ons an special conditions and notes selforth below. Any violation of theso terms may subject permitteo to a fine, imprisonment or civil action, or may cause the permit to be null and void. ***This permit authorizes construction of a single family dwelling, the removal of trees and brush, and any land disturbing activity associated with proposed project. Any other development will require additional permits or a modification of this permit The following conditions shall apply; 1. All proposed development and associated construction must be done in accordance with the application dated 01/12/05 and work drawings submitted on 01/12/05. 2. All construction most conform to the NC Building Code requirements and all Local, State, and Federal regulations. 3. Any change or changes in the plans for development, construction, or lead use activities will require a re-evaluation and modification of this perm 4. pursuant to 15A NCAC 07J.0406(b), this permit may not be assigned, transferred, said, or otherwise disposed of to a third party by the applicant, agent, or any entity other than the NC Division of Coastal Management 5. No excavation or filling of any wetlands or waters is authorized under tbb permit 6. This project Is located in the Neon River Basin sad is subject to the EMC's Neon River Riparian Buffer Regulations. Contact Kyle Barns with NC Division of Water Quality at (252) 946-6481 for approval prior to project initiation. I nis permm 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 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 modifications not covered under this permit requires further written permit approval. All work must cease when this permit expires on December al G 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 Gcastal Management. a,.. Loa Permit officer (signature) Z994 dame address ermittes (signature required if special conditions above apply to permit) Z0 39dd 06199E9z9z 00:9i 900Z/9Z/b0 04/27/2005 08:37 2526365190 PAGE 02 GENERAL INFORMATION LAND OWNER Name M i e Address o0 City G W 6prn 4UTHORIZED AGENT Name — kddreu 2iryIO 13e— r ;4h State NC zip236lo 7, Phone tO_J'4 "3L.LJO State N Zip ,Z&5 6 Phone - L:�& ` 0/06 LOCATION OF PROJE`CZ (Address, -tact namp and/or directions to site. If not oceanfront, what is the name of he adjacenr waterbody?) V" iC l-�. iY�jr �' j v iye W r8ej-n USCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) 1 nG PIZE OF LOT/PARCEL-33, �� I square feet _ . 7 acres PROPOSED USE: Residential (Single-family ✓ Multi. -family ) Commerical/Industrial ether_ COTAL ENCLOSED FLOOR AREA, OF A BUILDING IN THE OCEAN HAZARD AREA OF ENVI- LONMENTAL CONCERN (AEC): square feet (includes all floors and roof -covered decks) :IZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUiiL'I-UPON 4URFACES IN :ZEE COASTAL SHORELINE AREA OF ENVIRONMENTAL CONCERN (AEC .- ��_� sq. f . alculacions include the area of the roof/drip line of all buildings, driveways, covered decks, concrete or masonry patios, cc. that arc within the applicable AEC. Attach your calculations with the project drawing.) :noose the AEC area that applies to your property: PU within 75 feet of Norma] High Water for the Estuarine Shoreline AEC within 575 feet of Normal High Water for the Estuarine Shoreline AEC, adjacent to Outstanding esource Waters 3) within 30 feet of the Public Trust Shoreline AEC :antact your Local Pertnit Officer if you arc not sure which AEC applies to your property.) TATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a ate Stormwater Management Permit issued by the N.C. Division of Water Quality? ES NO � yes, It the total built -upon area/impervious surface allowed for your lot or parcel. square feet. Wc6d 5 04/27/2005 08:37 2526365190 PAGE 03 OTHER PERMITS AMBE REQUIRED; The acdvityyou are planning may require permits other than the CAMA minor development permit. As a service we have compiled a list 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, SepticTank (or other sand uty waste treatment system), Building, Electrical, Plumbing, Heating andA!r Conditioning, Insulation and Energy Conservation, FIA Certification, Sand Dunc, Sediment Control, Subdivision Approval, Moblic Home PukApproval, Highway, Connection, and others. I • •M•i 1' I, the undersigned, an applicant for a CAMA minor development permit, being either the owner of properly 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. Tbis interest can be described as: (check one) Zan owner or record tide. Tidc is vested in see Deed Book Z� P in the CWP_Ci .,� Co , art 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 and attach to this application. NOWICAnON OF ADJACENT PROPERTY OWNERS; I furthermore certify that the following persons are owners of ptop=%ies adjoining this property. I affirm that I have given ACTUAL NOTICE to each of theta concerning my intent to develop this property and to apply fora CAMA permit. (Name) femur .% (1) (2) (3) (4) FOR DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS: I acknowledge that the laid 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 associ- ated with this lot. This explanation was accompanied by recommendations concerning stabilization and floodproofing tech- niques. 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 application, the awnership statement, the AEC hazard, notice where necessary, a check for $100.00 made payable to the locality, and any infor- mation as may be provided orally by the applicant. The details of the application as described by these sources are Incorporated 4thout reference in any permit which may be issued. Deviation from these details will constitute a violation of any permit. Any Jerson developing in an AEC without permit is subject to civil, criminal and administrative action. kw,§ 1 fry Landowner or person authorized to as as his agent for purpose of filing a CAMA, permit application. 4 x ►'7 bar. Srivl�S 1Nf-tcv�r ��,f'�N /fs CD CD CD try !V `71 f' �pSG—s T (�01.c�� w Iva IYL.LNilLJi I�Vi'L. � w. 1 Itv1 ul!/�.w�i av� S FfR zOW0Lo ` Lo �-- — rj�- _._ — _— _ . - — iQ. r a-_ _- — ��E N EdUI ?/ _ w cn i _ �• _-- w 7s' FAVEKENT CD J — — _ ,,yylt� a► ro- nca+Arr+ tmnr fAsorNt •�" '�. —t �` 1 pil LAVr 4 f �• � "-� � ` 0.77 RSo. + t13 ., �Ir cx rc�r 4 i1 QOOILJC 1d�Q uG IC D® f.�rL �ie I 1 rn AL all WOOD f CAN rn CRAVEN I /,+ /� /•OA l/rAf /`r111►1'YY Dt/•Ir TQV {/i/ff7l iw�/ COUNTY- �T� . 1to- ai N 1T !' ADM7FT /' f.1 UlC 491 a