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HomeMy WebLinkAbout04-09_Gaulden, Gary & Laura_20090224coasr, ( AP LICATIO FOR NOV 3 2008 CAMAMINOR 2 Morehead City ®GM DEVELOPMENT PERMIT In 1974, the North Carolina General Assembly passed the Coastal Area Management Act 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 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. 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 I 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. r _ - 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 listing is included on page 2 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 F W Locality Ocean Hazard - Estuarine Shoreline ORW Shoreline ✓ (For official use only) GENERAL INFORMATION Permit Number Public Trust o14 l}�, VN NOV 3 Z008 LAND OWNER Name C"r� LGLIL4 ra G,CL ldDn Morehead Ci�y C� DCM Address City Ac'ry_i_r5 State i C_ Zip 2ais 3) Phone 2'51- -732 -16-7317 AUTHORIZED AGENT /� _ Name �� 5�1 C cas--� Address —I Co►�� City M 0 rf_�,J QC A l_ l State i�C Zip dPhone LOCATION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront, what is the name of the adjacent waterbody.) `fit : JDc V-e_ Hcc_ e r s —I- S lc-r­, � , nC_ ►n d DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) r l�C'��er f e -fie n `�- ► o �Ve .n- S SIZE OF LOT/PARCEL: square feet'` ' 1 , I q acres PROPOSED USE: Residential ✓ (Single-family ✓ Multi -family ) Commercial/Industrial Other TOTAL ENCLOSED FLOOR ARE OF A BUILDING IN THE OCEAN HAZARD AREA OF ENVIRON- MENTAL CONCERN (AEC): /V square feet (includes all floors and roof covered decks) SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT -UPON SURFACES IN THE COASTAL SHORELINE AREA OF ENVIRONMENTAL CONCERN (AEC): square feet (Calculations 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 .) Choose the AEC area that applies to your property: 1 within 75 feet of Normal High Water/Normal Water Level for the Estuarine Shoreline AEC (2) ithin 575 feet of Normal High Water/ Normal Water Level for the Estuarine Shoreline AEC, adjacent to Outstanding Resource Waters (3) within 30 feet of Normal High Water/ Normal Water Level for the Public Trust Shoreline AEC (Contact your Local Permit Officer if you are not sure which AEC applies to your property.) 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_V-"' If yes, list the total built upon area/impervious surface allowed for your lot or parcel: square feet. r Y aq r'f'f� C 5e� am z U WF O ai O N ea U a m m r ' 47 41P r(YOD 00 1 t M K j -Sp, bb /\JLdi C} f fotP+t�ll.s 1.� fA+`'f''F land w� A�a4�-��5 &x, A.. t Q>k -c-. 651) I/J oSty L$1 u 4W r i i �IL¢ 1%•n dot ��/ NCr;u—. 01e49- CT Ccl 1 RYSTAL OAST LANDSCAPES /'ltth�Erl ��C' � l�aP11G1,+'•5 C v� � r c CZ) cli LLJ va a �rt,ew'c,- lvef'% f-, oftdt Lllr^ 4A el f C Lf CD- 0000� 01 `4- Ict u NCr u ea,-. e OL U Out rCgX� RYSTAL OAST LANDS Garycxr\c�. L e C/a) 01 `4- Ict u NCr u ea,-. e OL U Out rCgX� RYSTAL OAST LANDS Garycxr\c�. L e C/a) Carteret County 04-09 Local Government Permit Number 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 In an area of environment concern pursuant to Section 113A-118 of the General Statutes, "Coastal Area Management" Issued to Gary and Laura Gaulden, authorizing development in the Estuarine Shoreline - ORW (AEC) at 1048 Island Rd., in Harkers Island in Carteret County, as requested in the permittee's application, dated October 31, 2008 and certified complete on February 13, 2009. This permit, issued on February 24, 2009, 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: Rain garden construction including storm water treatment apparatus, along with minor landscape grading (1) All proposed development and associated construction must be done in accordance with the permitted work plat drawings(s) dated received on 2/13/09. (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) Anychange 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 252-808-2808 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. Al work must cease when this permit expires on: DECEMBER 31, 2012 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. arkGuthrdie CAMA LOCAL PERMIT OFFICIAL 400 Commerce Dr. Morehead City, NC 28557 PERMITTEE (Signature required if conditions above apply to permit) Name: Gaulden Minor Permit # 04-09 Date: February 24, 2009 Page 2 (5) 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 Normal High Water. (6) All unconsolidated material resulting from associated grading and landscaping shall be retained on site sedimentation and erosion control measures. - Prior to any land-disturbingactivities, by effective be installed between the land disturbing activity and the adjacent marsh or water areas, untilsuchtimle as the areat has been properly stabilized with a vegetative cover. (7) Any proposed for grading within the 30' buffer from the Normal High Water must be contoured stormwater runoff to the adjacent marsh. This area shall be immediately vegetatively stabilized, and must remal nn in a vegetated state. (8) All other disturbed areas shall be vegetatively stabilized (planted and mulched within completion. ) 14 days of construction (9) This permit does not authorize development within any wetlands or open water areas. SIGNATURE: DATE: PERMITTEE NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves Perdue James H. Gregson Governor Director February 24, 2009 Gary & Laura Gaulden 1048 Island Drive Harkers Island, N.C. 28531 Dear Mr. & Ms. Gaulden: Dee Freeman Secretary Attached is Minor Permit #04-09C authorizing you to construct a rain garden including storm water treatment apparatus, along with performing minor landscape grading at your property located at 1048 Island Road, Harkers Island, in Carteret County. In order to validate this permit, please sign the penrtit as indicated. Retain the buff colored copy for your files and return the signed white copy to us in the enclosed, self-addressed envelope. If the signed permit copy is not returned to this office before the initiation of development, you will be working without authorization and will be subject to a Notice of Violation and subsequent civil penalties. We appreciate your early attention to this matter. Sincerely, Barry Guthrie Coastal Management Representative BG/rcb Enclosures 400 Commerce Ave., Morehead City, NC 28557 One Phone: 252-808-28081 FAX: 252-247-3330 Internet: muvi.nccoastatmanagement.net North Carolina An Equal Opportunity 1 Affirmative Action Employer Naturally ly RT 080003.167.000 GAULDEN,GARY L ETUX LAURA 2009 1,785,732 MKT CARD 001 PID R 7335.18.42.1378000 1,785,732 PY Val USE 1,111,255 LAND 002 1048 ISLAND RD DEF 639,548 BLDG 002 LISTER 11/27/2006 AGTS HARKERS ISLAND NC 28531 1.180 ACRES 34,929 XFOB 003 TWP HARKERS ISLAND CITY FIRE HARKERS ISLAND FIRE RESCUE OTHER LOT BLK PL BK/PG PLAT ADDRESS 0001048 ISLAND RD HARKERS ISLAND 28531 NBHD 08001900 USE 000100 RESIDENTIAL DEED 1163 266 AICUZ PRINTED 11/03/2008 BY KIMF LEGAL: ACRES SR 1335 HARKERS ISLAND BUILDING CHARACTERISTICS for B1dgSeq# 001 (Item# 002 ) Code Description Code Description Code Description Code Description Code Description Code Description MODL 01 SNG FAMILY BVAL 00001A SNG FAMILY ARCH 09 BEACHHOUSE QUAL OA A GRADE STYS 2.0 SIZE N/A FNDN 02 CONC BLOCK FRME N/A WNDO N/A EXW1 29 HARDIPLANK EXW2 EXW2$ HEAT 10 HEATPUMP A/C N/A RSTR 03 GABLE RCV1 03 COMP SHNGL RCV2 RCV2$ INT1 05 DRYWALL INT2 N/A INT2% FLR1 12 HARDWOOD FLR2 11 CERAMIC FLR2$ 30 KTCH N/A DPRT 01 BATH 3.50 BDRM 3 ROOM SPCD N/A +/- 05 PLUS 5 FRPL N/A UD-3 N/A UD-4 N/A HTFL 04 ELECTRIC HTF2 N/A COND OE EXCELLENT INSP 01 OWNER UD-9 N/A UD-9 N/A UD-9% AYB 2005 EYB 2005 AREA CALCULATION TRAVERSE Subarea Actual Ad! Heated Prime Rate Value %Good RCNLD TW02005=1982$ PCH2O05=1146$ PCH2O06=160$ DKP2005=160$ TWO STO 1982 3865 3964 1982 219.71 435456 99.00 431,100 DCK2005=274$ DCK2006=274$ DCK2007=40$. PORCH 1146 401 39.42 45181 99.00 44,729 PORCH 160 56 39.42 6307 99.00 6,244 DECK/PA 160 48 33.79 5406 99.00 5,352 DECK 274 69 28.37 7773 99.00 7,695 DECK 274 69 28.37 7773 99.00 7,695 DCK2007 DECK 40 10 28.13 1125 99.00 1,114 - 19.0' c--- 40.0". - 19.0' LUMP 7700 99.00 7,628 TOTAL 4036 3964 130.35 99.00 TOTAL 4518 1982 516721 511,557 NOVLG 11z 3 2008 rehead City D 10.04 DCK2005 i 274.0' a 16.0' c = DKP2005 10' 16.0' r 160.0' 26.0' 0 16.0' o 3' e o "F i 17.0' D � m � a N 9� z PCH2O05 1146.0' a by An rr APX: 733518421378000B002 TW02005 1982.0' DCK2006 274.0' 16.0' 10' 26.0' PCH2O06 r 160.0' 10.0' 50.0' a J iy 3' 68.0' _ ._ _...... ..... . ............................... RT 080003.167.000 GAULDEN,GARY L ETUX LAURA 2009 1,785,732 MKT CARD 002 PID R 7335.18.42.1378000 1,785,732 PY Val USE 1,111,255 LAND 002 1048 ISLAND RD DEF 639,548 BLDG 002 LISTER 11/27/2006 AGTS HARKERS ISLAND NC 28531 1.180 ACRES 34,929 XFOB 003 TWP HARKERS ISLAND CITY FIRE HARKERS ISLAND FIRE RESCUE OTHER LOT BLK PL BK/PG PLAT ADDRESS 0001048 ISLAND RD HARKERS ISLAND 28531 NBHD 08001900 USE 000100 RESIDENTIAL DEED 1163 266 AICUZ PRINTED 11/03/2008 BY KIMF LEGAL: ACRES SR 1335 HARKERS ISLAND BUILDING CHARACTERISTICS for B1dgSeq# 002 (Item# 003 ) Code Description Code Description Code Description Code Description Code Description Code Description MODL O1 SNG FAMILY BVAL 00001A SNG FAMILY ARCH 10 CONVENTL QUAL OA A GRADE STYS 1.7 SIZE N/A FNDN O1 BRICK FRME N/A WNDO N/A EXW1 29 HARDIPLANK EXW2 EXW2% HEAT 10 HEATPUMP A/C N/A RSTR 03 GABLE RCV1 03 COMP SHNGL RCV2 RCV2% INT1 05 DRYWALL INT2 N/A INT2% FLR1 12 HARDWOOD FLR2 11 CERAMIC FLR2% 10 KTCH N/A DPRT O1 BATH BDRM ROOM SPCD N/A +/- N/A FRPL N/A UD-3 N/A UD-4 N/A HTFL 04 ELECTRIC HTF2 N/A COND OE EXCELLENT INSP O1 OWNER UD-9 N/A UD-9 N/A UD-9% AYB 2005 EYB 2005 AREA CALCULATION TRAVERSE Subarea Actual Add Heated Prime Rate Value %Good RCNLD SFG2005=850$. .75/FIN 850 978 638 152.10 129284 99.00 127,991 TOTAL 850 638 202.63 99.00 TOTAL 978 129284 127,991 APX: 7 Morehead City U.0' SFG2005 cV 850.0 cv 34.0' RT 080003.167.000 GAULDEN,GARY L ETUX LAURA 2009 1,785,732 MKT CARD 003 PID R 7335.18.42.1378000 1,785,732 PY Val USE 1,111,255 LAND 002 1048 ISLAND RD DEF 639,548 BLDG 002 LISTER 11/27/2006 AGTS HARKERS ISLAND NC 28531 1.180 ACRES 34,929 XFOB 003 TWP HARKERS ISLAND CITY FIRE HARKERS ISLAND FIRE RESCUE OTHER LOT BLK PL BK/PG PLAT ADDRESS 0001048 ISLAND RD HARKERS ISLAND 28531 NBHD 08001900 USE 000100 RESIDENTIAL DEED 1163 266 AICUZ PRINTED 11/03/2008 BY KIMF LEGAL: ACRES SR 1335 HARKERS ISLAND SALES BUILDING PERMITS IN Q RC M V Sale Date Sale Price Number Type Description Issued Schd Complt Revisit Act Complt Amount OT V OD V 6/03/2005 438,000 C8208E6 FRHS FRAMEHOUSE 6/09/2005 2/02/2006 400,000 OT V 24 I 11/16/2004 RVDT RVDT REVISTDATE 6/09/2005 6/01/2006 8/01/2006 WD U I 10/22/2004 438,000 C OF 0 FRHS FRAMEHOUSE 6/09/2005 3/08/2006 400,000 EXTRA FEATURES Seq Bldg Code Description Length Width Height #Units UT Qty Qual UTPrice Year Adjl Adj2 Adj3 Adj4 %Good 001 00049C PIER-C 1251.000 SF 1 OC 16.920 2006 .95 1.00 1.00 1.00 100.00 002 00010C BOATLIFT-C 1.000 UT 1 OC 7,800.000 2006 .95 1.00 1.00 1.00 100.00 003 00040C CONCRETE PAVING 1950.000 SF 1 OC 4.000 2006 .95 1.00 1.00 1.00 100.00 LAND Seq Zone Code Use Description Front Depth Back FT #Units UT UTPrice Adjl Adj2 Adj3 Adj4 Fadj Dadj Nbad Adj Eff Rate 1 081913 SOUNDFRONT 190 185 200 60 193.500 EF 6,050.000 1.00 1.00 1.00 1.00 .76 1.09 1.000 5,009.395 2 081901 RESIDENTIAL LOT 92 170 60 92.000 FF 2,800.000 .50 1.00 1.00 1.00 1.04 1.06 1.000 1,542.793 NOV 3 2008 Morehead City DCM Value 20,109 7,410 7,410 Value 969,318 141,937 THE FACE OF THIS DOCUMENT HAS A COLORED BACKGROUND ON WHITE PAPER AND ORIGINAL DOCUMENT SECURITY SCREEN ON BACK WITH PADLOCK SECURITY ICON. CRYSTAL, COAST LANDSCAPES COOPERATIVE BANK FOR SAVINGS 3148 P.O. BOX 515 404 EVANS STREET MOREHEAD CITY. NC 28557 (252) 247-6333 66-717M531 11/6/2008 PAY TO ORDER OFE NC Division of Coastal Mgmt $ **100.00 . One Hundred and 00/100*.,**************'*'*****'*"****`**'* NC Division of Coastal Mgmt Commerce Drive M h d C' NC 28557 - DOLLARS Se—ty hcatmaa f 1 chided. De,ads on Cask. ore ea ILys VOID AFTER 90 DAYS 02 MEMO ---�i11/l�� L/Z hP AUTHORIZED SIGNATURE 111003 l 4811' I: 2 5 3 1? 1,7 281: 04900 2 20 C3 r- rn r%- CIAL U E I ccl ILi Postage $ 03 rn Certified Fee • postmark M M $2.20 Here C3 Return Redept Fee (Endorsement Required) M Restricted Delivery Fee $0.00 M (Endorsement Required) M .32 11/04/2= ru Total postage & Fees $ ------ nj M Sent To ....... C � or po Box No. . ...... -aj,-§twti, WXW ... k, 1J c- -Z-1 Fr;w� S T ------------- Postal ic �4-ps, c� RTIFIED MAILT�I "(60 es A n1ye. elins ce, e Pio' c bsife at wwvi USI)s For clallwaT InfOrm"thn visit Our-w Postmark Here Total Postage& Fees —i ru Sent To O P . .� ................................... ............................. . ...... or PO Box No. /,53 If . . . ............ ............................. ... .. c- U.S. Postal ServiceTM I 1E CE 0AILTWBEC 11 Mmes Wait n F" -InsuranceCoverageProvided) _ A FordeliveryInformation visit our website at WwW-USPg'.corft-79;M 4 ------------ ...... -------- orpo No ..................... PS Form Reverse f 2 62 Yu—n; 0M��� MEE Mai1,On1y;.No Insurance Coverage Provided) s(Domestic 'T., Ourviebsite at I.It our ebsite at wlwu F delivery visit oruc .10,14 M-11 PS Form 3800, June 2002 See Reverse for Instructions< Y NOV b 2008 Morehead City DCIVI A�,� NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Michael F. Easley, Governor James H. Gregson, Director William G. Ross Jr., Secretary November 3, 2008 Gary and Laura Gauldon 1048 Island Rd. Harkers Island, NC 28531 RE: INCOMPLETE APPLICATION ADDITIONAL INFORMATION REQUIRED PROJECT ADDRESS-1048 Island Rd., Harkers Island, NC 28531 Mr. And Mrs. Gauldon: We originally accepted your application under the impression that it was complete. On subsequent review, I have discovered that additional information is needed to complete the review. process. Accordingly, I am requesting that you submit the following additional information to this office: 1. Check -for $100.00 payable to NCDENR *2. _Proof of notification of adjacent property owners (return receipt requested -green card) In accordance with the Department of Environment and Natural Resources regulations, we note that a certain time has passed while the application has remained in our office. Upon resubmission of a complete application, a local decision will be made in 25 days, provided this period is not extended as provided by law. Please contact me at 252-808-2808 if you have any questions. Respectfully, James Guthrie Division of Coastal Management 400 Commerce Ave. Morehead City, NC 28557 400 Commerce Avenue, Morehead City, North Carolina 28557 Phone: 252-808-2808 \ FAX: 252-247-3330 \ Internet: www.nccoastalmanagement.net An Equal Opportunity \ Affirmative Action Employer — 50% Recycled \ 10% Post Consumer Paper NOTICE OF FILING OF APPLICATION FOR CAMA MINOR DEVELOPMENT PERMIT Pursuant to NCGS 113A-119(b), the NC Division of Coastal Management, authorized to issue CAMA permits in Areas of Environmental Concern, hereby gives NOTICE that on February 12, 2009 Crystal Coast Landscapes, authorized agent for Gary and Laura Gaulden, applied for a CAMA permit to install a rain garden and associated rainwater treatment apparatus at 1048 Island Rd. Harkers Island, NC 28531. The application may be inspected at the address below. Public comments received by February 25, 2009 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. Barry Guthrie NC Division of Coastal Management Field Representative Address: 400 Commerce Ave. Morehead City. NC 28557 Phone:(252)808-2808 PLEASE PUBLISH ON: February 15, 2009 Michael F. Easley, Governor William G. Ross Jr., Secretary North Carolina Department of Environment and Natural Resources Coleen H. Sullins Director Division of Water Quality September 22, 2008 Gary and Laura Gaulden, Owners 1048, Island Road Harkers Island,,NC 28531 Subject: Cistern System Gary and Laura Gaulden Residence Carteret County Dear Mr. and Mrs. Gaulden: SEP 2 5 2008 Morehead City DCM On August 27, 2008, this office received a narrative and a- plan proposing a cistern system at 1048 Island Road in Harkers Island. Since this system is proposed at an existing single-family residence and not subject to a State Stormwater Permit, this office does not.have issue with the installation of this system. If you have any questions, please do not hesitate to call me at (910) 796-7215. Sin�ey, ' Edward Beck Regional Supervisor Surface Water Protection ENB\dwc: S:\WQS\STORMWAT\LETTERS\2007\CrystalCoastLandscapes(Cistern) cc: Pete Hargett Tere Barrett David Cox 'ne Carolina Naturally North Carolina Division of Water Quality 121 Cardinal Drive Extension Wilmington, NC 28405 Phone (910) 796-7215 Customer Service Wilmington Regional Office Internet: www.ncwaterguality.org Fax (910) 350-2004 1-877-623-6748 An Equal Opportunity/Affirmative Action Employer— 50% Recycled110% Post Consumer Paper OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA minor develop- ment permit. As a service we have compiled a listing 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, 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. 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, Title is vested in 41w / - a , see k ' _ t T � page -� �- in the �'c., 4-c-,,t4- County Registry d l�. an owner by virtue of inheritance. Applicant is an heir to the estate of "N 3 2008 probate was in County. �iQrehead City E)(3� 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) /I'lli.W-ke-j (2) I0J72— / rkt/f -LJ/"l�il✓kers ZS /tom-csl (3) ,�., Tom, !a•- /D 4 Son- Eaia- (��.` FlEerc Zcr� (4) Ay,,� 9917 Al 0,P V6 CW✓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 application, the ownership statement, the AEC hazard notice where necessary, a check for $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. This the If day of Or--fv 5.e� ,200 K i i� Landowner or person authorized to act as his agent for purpose of filing a CAMA permit application. SITE DRAWING/APPLICATION CHECKLIST Please make sure your site drawing includes the following information required for a CAMA minor development permit. The Local Permit Officer will help you, if requested. PHYSICAL DIMENSIONS b'm . Label roads Label highways right-of-ways. '"�" ' Label local setback lines Label any and all structures and driveways currently existing on property NOV 3 2008 Label adjacent waterbody PHYSICAL CHARACTERISTICS Wreheed City [)C[W Draw and label normal high water line (contact LPO for assistance) Draw location of on -site wastewater system If you will be working in the ocean hazard area: Draw and label dune ridges (include spot elevations) Draw and label toe of dunes Identify and locate first line of stable vegetation (contact LPO for assistance) Draw and label erosion setback line (contact LPO for assistance) Draw and label topographical features (optional) If you will be working in a coastal shoreline area: Show the roof overhang as a dotted line around the structure Draw and label landward limit of AEC Draw and label all wetland lines (contact LPO for assistance) Draw and label the 30-foot buffer line DEVELOPMENT PLANS Draw and label all proposed structures Draw and label areas that will be disturbed and/or landscaped Note size of piling and depth to be placed in ground Draw and label all areas to be paved or graveled Show all areas to be disturbed Show landscaping NOTE TO APPLICANT Have you: • completed all blanks and/or indicated if not applicable? • notified and listed adjacent property owners? • included your site drawing? • signed and dated the application? • enclosed the $100.00 fee? • completed an AEC Hazard Notice, if necessary? (Must be signed by the property owner) Site Notice Posted _ Site Inspections Date of Action: Issued FOR STAFF USE Final Inspection Fee Received 1 - I Exempted Denied Appeal Deadline (20 days) Revised Jan. 2008