WO-24-15_Isley, Chris_20151023

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Locality Permit Number
Ocean Hazard Estuarine Sbomline ORW Shoreline AZPubticTrust Shoreline Other
(For official use only)
GF,NERAi. INFORMATION
AGENT
Name
Address ?J Swr 4561
City
q'�t Z11 (a84R
LOCATION OF PROJECT: (Address. streel name and/or directions to site. if not oceanfront, w t i the name of the
adjacentwaicibody.) es 'cl Cq e- Car4,-0 f'�NC �.�,�
I�+ �7 CQp� 49 - DZ,,- ercc¢c
DESCRIPTION OF PROJECT: (last all proposed construction and land disturbance.)
SIZE. OFIDT/PARCF.L: �rrXl/� square feel acres �XOG
PROPOSED USE: Residential X (Single-fmoilyp Multi -family Q ) Commercial Industrial Other
COMPLETE EITHER (1) OR (2) BELOW (Contact your Loral Permit Oflicer if you ere nor sure which AECopplies
to your propene):
(1) OCEAN HAZARD AF,Cs: 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: square feet (includes the area of the rooVdrip line of all buildings, driveways, covered decks
concrete or masonry patios, etc. that are within the applicable AFC. Attach your calculations with the project drawing.)
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a State Stornrwater
Management Permit issued by the NC Division of Water Quality?
YES= NC=
If yes, list the total built upon arealimpervious surface allowed for your lot or parcel: square feet.
" 11
IUFL no It MM
0111ER PERMITS MAYBE REQUIRED: The activity you arc planning may require permits other than the CAMA
minor development permit, including, but not limited to: Drinking Water Well, SepticTank (or other sanitarywaste
treatment system), Building, Electrical, Plumbing, Heating and Air Conditioning, insulation and Friogy Conservation, FIA
Certification, .Sand Dune, Sediment Control, Subdivision Appmval, Mobile Home Park Approval, Highway Connection, and
others. [week with your [.Deal Permit Officer for more information.
STATEMENT OF OWNERSHIP:
1, the rmdersi6mcd, an applicant for a CAMA minor development perinit, being tither 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
Zdescri as: (check one)
caner or record title, Title is vested in h!. % At M LS �I, ee Deed Book
page —44
in the C a;T,cr �— _ County Registry of Deeds.
aan menu by virtue of inheritance.. Applicant is an heir to the estate of
probate was in County.
Qf other interest, such as written contract or lease, explain below or use a separate sheet & attach to this application.
NOTIFICATION OFADJACEN'r PROPERTY OWNERS.
I furthermore certify that the following persons are owners of properties adjoining this property. 1 affirm that I have given
ACTUALNOTICE to each of Them concerning my intent to develop this property and to apply for a CAMA permit.
(1) St" (IC N
(2) 2 o
(3)
(a)
ACKNOWi.EDGEMENTS:
(Address)
1, 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 pmlicu-
lar hazard problems associated with this lot. This explanation was accompanied by recommendations concerning stabiliza-
tion and floodpronfing techniques
1 furthermore certify that I am authorized to gran, and do in fact grant, permission to Division of Coastal Management staff,
the Local Permit Officer ao their agents to entgf on the arorementioned lands in connection with evaluating information
related to this perptit app cation. ' „
.r % ,�
This the day of , 201 S
Landowner [mason authorized to 90 as hjRlkr agent for pwlx)se of filing a CAMA permit application
This application incbides: general r raration (this form), a site drawing as described on the hack nj this opplicalion, the
ownership stoirment. the (henn AEC Notice whoa necessary, a chrckfor 5100.W made paytrble to the luatho: and
1my hilbrinarlon as may be prViAed orally by the applicant. The details of the application av described by dreare sources air.
incorporated without rrf rence in any pernrif which mqv he issued. Deviation frrna there deluilm will ctmainrte a vialarinn nj"
any permit. Anv pers'nn developing in on AM: wiihatu pernot is subject to civil, criminal and achninistrarive action.

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N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date
Name of Property Owner Applying for Permit:
CG,t S -7:1je-,l
Mailing Address:
Uo l o 0-cc Tr(•
I certify that I have authorized (agent) Atl)�Ct--i 6,k/6 L r to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) S4A- 44 eA Rc-44 t' ,, jr - l./a 1(
at (mv property located at) _?. RY�i' c brt,t/e--
This certification i� valid thru (date) Lo �--5
PropertyDwner Signature

to
' CAPE CARTERET DEPARTMENT OF INSPECTIONS
-
hV. A GENERAL CONSTRUCTION PERMIT APPLICATION
,
Date: G s Applicant: ❑ Property Owner ❑ Contractor
Project Address: I 1 �y S �t c Ip �.�U� C ! <ec� cal
Parcel Identification Number:
Property Owner: Ck r I.J '.1:1�
Address: 90301 otd pQ<r T,1. 9
City: a /r • �,
Phone #: 91 9 2 .FD
General Contractor: Y (' UU I
Phone #• 145z 02"_1
Current City Privilege License: ❑
Contractor License Number and Classification:
Type of Work:
❑ New Building
❑ Existing Alteration
❑ Addition
❑ Demolition
Other
1'4 �, Al C_
Stater Zip:
E-mail: et 3
Yes
❑ No ❑N/A
Total Sqft:
Heated Sqft:
Unheated Sqft:
Other Sqft:
Building Height:
Description of proposed work: T-n J4 It e 1-t- n ,'n i✓ dv, 0rw a,el
t—i`( c rc -/- - ,, , a,. -a f��v/'
Type of Construction: Occupancy Type: Cost:
Design Professional:
Phone #: E-mail:
❑ Architect ❑ Engineer
❑ Owner ❑ Other
Electrical Contractor:
Phone #• E-mail:
Current City Privilege License: ❑ Yes p No ❑N/A
Electrical License Number and Classification:
Cost: $ Signature:
Mechanical Contractor:
Phone #: E-mail:
Current City Privilege License: ❑ Yes ❑ No ❑N/A
Mechanical License Number and Classification:
Cost: $ Signature:

ADJACENT RIPARIAN PROPERTY Urle-T
OWNER STATEMENT
hereby certify that 1 own property adjacent to K,m . /'t z s
^ r t n _ a (Name of Pronertv Owner/
property located at
on 4.<f' C.
(Wa'
and/or County)
The applicant described to me, as shown below, the development proposed at the above
location
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fillin description below or attach a site drawing)
Set A4-,ck c a
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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.)
p/ 1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Prop"y wner Infor34 n)
Print or 7
Q"_10
t a (e -'� 16/ C -L _ (_G_LS
City/Stete/Zip
q l9 220 — 07,11
Telephope ember/email address
Q/1-P/ / f
Date
(Adja t Property Owner Information)
Signature*
X6A*A; P_
Prinj or pe N3mQ�4 n fy
_ ((mac,, 'J
M ng Address
City/Statelz
xs�- 9
Telephone Nu bet /email address
/�/!a/�aI 5'
Dote*
(Revised Aug. 2014)
'Valid for one calendar year after signature"

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to C kr,,1 1- K,m -D r 't % -s
Name of Property Owner)
property located at l t a` :Ve C � CT�� , e-
(Ad ress, Lot, B ock, Road, etc )
on /)•tcr C%.,L9 , in CLqc
(Waterbody) ( ity/Town and/or County)
The applicant described to me, as shown below, the development proposed at the above
location
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
I Q r- 04,c�d
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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.)
L— I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Propyty/)0wner I
(_-kr `J /
Print or Type Name
r) 0 1 0 Id >'%t co- a
Mailin Ad ress
�a�e-,�ALC
City/State`Lip
q q
Telepho a tuber/email address
Dnte
"Valid for one calendar year after signature'
rty Owner—l�format!qqn)
n
Si n,riw
gSf��rr� 11 i�n j
Print or Typ Name
11
Mai1i g Addre s
taf GA rt i lit, ?359 i_
City/State2ip
Telepho e Number / email address
19 1 f
Daic"
(Revised Aug. 2094)

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10/19/2015
ConnectGIS Feature Report
CONNECTGIS Printed October 19, 2015
WEB HOSTINC
See Below for Disclaimer
Address Points
•
Parcels - Updated 10-1-201.5
Centerlires
NC Railroad Riaht of Way,
13
County Boundary
Other County
aall othervalues>
Cart
PIN
Acreage
Parcel Dimensions
Lot Number
1 � 63 Feet
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ication of the information contained on this site. Carteret County assumes no legal responsibility for the information contained on this site. Carteret County does nc
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