WO 14-16 Forsyth Holding LLC

Carteret County' WO.14.16
Local GovernmentPermit Number
MINORCAMA
PERNT
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 Forsyth Holdings LLC, authorizing development in the Estuarine Shoreline (AEC) at Lot 0-13 Paradise Bay
MHP 1444 Salter Path Road, in Indian Beach, NC, as requested in the:permittee's application, dated 04/07/16, This.
permit, issued on 04/15116, 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; Replacement of existing single -wide mobile home with 1466 single -wide mobile home
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on 04/08/16.
(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) 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) A copy of this permit shall be posted or available on site. Contact this office at 252-222-5833 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. This permit must be on the project
site aid 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. All work must cease when this
permit expires on:
DECEMBER 31, 2019
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.
Chris Jone
CAMA LOCAL PERMIT OFFICIAL
7 1 C ar,Point Ivd.
dar o' t, NC 8584
PER ITTEE
(Signature required if conditions above apply to permit)

Name: Forsyth Holdings LLC
Minor Permit # WO.14.16
Date: 04115116
Page 2
(5) The amount of impervious surface shall not exceed 30% of the lot area within 75 feet of Normal High Water
(Estuarine Shoreline Area of Environmental Concern), in this case,1,407 square feet is authorized.
(6) 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. No portion of the
roof overhang shall encroach into the 30 ft. buffer.
(7) All unconsolidated material resulting from associated grading and landscaping shall be retained on site by effective
sedimentation and erosion control measures. Prior to any land -disturbing activities, a barrier line of filter cloth must
be installed between the land disturbing activity and the adjacent marsh or water areas, until such time as the area
has been property stabilized with a vegetative cover.
(8) All other disturbed areas shall be vegetatively stabilized (planted and mulched) within 14 days of construction
completion.
SIGNATURE:. DATE:
PERMITTE

Locality � ��� &u4u�—A-1.Permit Number
Ocean I larard - Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
(Fur- (�%Iic•ial use emir)
GENERAL INFORMATION
LAND OWNER
Name fL,.rY NFLDtt-JV I_.t—C Nr� (-'t g I—�JON._...�'
Address It-is-0 S'AUVE(L `P
City t ND t Ctrs i�GH _State N c- lip 2PJS'l'hane �252 2`I "1- $''{'�_
Email Gr ad +Jt- 6*, 2e-c c-r*.cx,^
AUTHORIZED AGENT
Name COfzz rrt - L—J0T-L'rL%'r' (QAy-v'�
Address S-S2ta t rwy '� WEfT
City Mot 3Et j CA- Y State N C- Zip 2USS"IPhone (2-5 _2�
Email_. gr'C.J 0 00.kw00 h+e.J, t.or%N
LOCATION OF PROJECT: (Address, street name and%or directions to site. if not oceanfront, chat is the name of the
adjacentwaterbody.)__ 14HL4S }t.'TECL QA'SH...._. 0-13t JAt.^+ESL'I�FYi�1 NC. 2.�Si�
i Ar'►'AL OFF T3oG�E J�I��D�
DESCRIPTION OF PIMJECT: (List all proposed construction and land disturbance.) 'RE_K4LE �t�►1a G_.__
Jt���wtAE t�1hE ��
SIZE OF LariPARC EL: _ �p © square feet _ '- _ acres NEwt or'C
PROPOSED USE: Residential (Single-family ["IMulti-family [] ) Conunercial. Industrial Other
COMPLETE EITHER (I) OR (2) BELOW (Corrtact}-vtrr Local Permit Officer f t oa are irol strre which AEC alihlies
to jwter pruper�y):
(1) OCEAN HAZARD AECs: 'TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet (includes
air conditioned living space, parking elevated aboveground level, non -conditioned space elevated above ground level but
excluding non -load -bearing attic space-)
(2) COASTAL5HORELINE AECs: SIZE OF BUILDING FOOTPRINTAND OTHER IMPERVIOUS OR BUILT
[lI'ON SURFACES: LDJ square feet (includes the area of the roof,`drip line of all buildings, driveways, covered dicks.
concrete of masonry patios, etc. that are %4ithin the applica le AI: C. Attach your calculations with the project drawing.)
Uq 0-) WL10 POSED, 1gT7 EX t dTt P(3
STATE STORMWATER INIANAGENIENT PERMIT: Is the project located in an area subject to a State Storni»ater
Management Permit issued by the NC' Division of \Vater Quality?
YES NC=
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: square feet.

DEVELOPMENT
PERMIT
In 1974, the North Carolina General Assembly passed the Coastal Area Management Act
(C:AIA) and set the stake 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 CANIA 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 CAi1IA-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 hio 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
Diiision of Coastal Management .
DCU Fonn 1:1;1952-2010'Ro i.wd :lpril 2010

OTHEIt PER-sIITS MAY BE ItEQUIREI): The activity you are plannino may require pe.rntits other than the CAN IA
miner development permit, including, but not limited to: Drinkin,L, Water Well, Septic Tank (or other sanitary N%aste
treatment system), Building, E.1wrical. Plumbing-,. I {eating and Air Conditiinin,,-r. insulation and F;neru% Conservation, F IA
Certification. Sand Done, Sediment Control, Subdivision Approval, Mobile Home Park Approval. Iligh�Nay Connection, and
others. Check with your Focal Permit Officer for more information.
STATEMENT OF OWNERSHIP:
1, the undersigned, an applicant for a CANIA minor Melopinent permit, being either the owner of property in an AFC or it
person authorized to act as an agent for purposes of applying, for a CAMA minor development permit. certify that the person
listed as landov%ncr on this application has a significant interest in the real property described therein. "l his interest call he
described as: (check one)
L�
an owner or record iitle,'ritle is vested in—FY-JY'-VA i't`-0L-b , 6S f_, see Deed Book
in the }�L�iE(LE[" County Registry of Deeds.
Elan owner by virtue of inheritance. Applicant is an heir to the estate of'____......_ ;
probate was in County.
=f other interest, such as written contract or lease, explain below or use a separate sheet K attach to this application
NOTIFICATION OF ADJACENT PROPEKI'Y OW ERS:
I furthermore certify that the follotying persons are owners of properties adjoining this property. I affirm that I have given
ACTUAL NOTICE to each of them concerting my intent to develop this property and to apply for a CAMA permit.
(;Name) MOMI::& (Address) MAAu�G
(i) 'PAQL- (av'i} f?rC 1 2- SpouwR PA'TN ". --- ILia.S�sl_ � n-�.t_tNAt�►� i3 cH
(2) -M0r ► FfZ<)X ' ?-Sla JWfLE MVE
(3)
ACK:tiONVLEDGEMENT:S:
1, the undersigned, acknowledge that the land otirner is aware that the proposed de,,cIopment is planned for an area which
may be susceptible to erosion and`or flooding. I acknowledge that tfie Local Permit Officer has explained to tile the particu-
lar hazard problem, associated with this lot. This explanation was accompanied by recommendations concerning stabiliza-
tion and flood proo 11 ng techniques.
I further pore 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 oil the aforementioned lands in connection with evaluating information
related to this permit application.
This the _ day of Ar4TLtt—, 20
Landotyner or person authorized to act as hinter attent for purpose of filing a CANIA permit application
Cti'1fU1YVV t�-nfLS I-r (-OPW-Wo�D H 6CJ6
This applictitioit inclutles: general Uiji.winutioii (ibis fain{}, a site (h-rowing as clesci'ibed on the back of this the
owiivi-ship statement, the Ocean llu.:aiaAEC'' Aotice it here neeessctrr; a check foi- S 100. 00 nia:le txryuble to the locality; aml
any informutiuit cis may be proviclecl vrul/v by the aplVicant. Vic rletuils oj'Ilre uj)l?licatiart as tlescribcciby these soirees OW
ineorl)oiratecl without reference in uny perniii which may be issue) Deviatioti ftvnt these cletuils ivill constitute a violation of
art)'Pelmit.:tnY person C1evC1gj)hkg hi urt AEC withuiahermit is subject to civil, crinihiul and aclntinistrative action

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285707929
3655440570
04/08/2016 [phone] 1:13 FM
Product Sale Final
Description Oty Price
First -Class 1
Mail
Letter
(Domestic)
(SALTER PATH, NC 28575)
(Waight:0 Lb 1.70 Oz)
(Expected Delivery Day)
-(Monday 04/11/2016) --�
Certified 1 $3.45
(USPS Certified Mail #) /
640000752897975) #
Return �.._1____�. $2.80
Receipt
(USPS Return Receipt #)
(9590940101905234282612)
First -Class 1 $0.71
Mail
Letter
(Domestic)
(ATLANTIC BEACH. NC 28512)
(Weight:0 Lb 1.80 Oz)
(Expected Delivery Day)
(Monday 04/11/2016).____
Certified 1 $3.45
(USPS Certified Mail #)
(70150640000752897982)
Retir —t --`' $2.80
Receipt
(USPS Return Receipt #)
(9590940101905234232629)
Total _ _.._... ....... . _ _._ $1-- _.-
3.92
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Credit Card Remitd$13.92 .
(Card Name:VISA)
(Account #:XXXXXXXXXXXX3538)
(Approval #:008481)
(Transaction #:118)
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4 "-7
Date
-TO t,1i P11,0S j
Adjacent Property Ovrner
—f'O tTox 6 Y) ---
Mailing Address
J AEI R pP►'11- , tic- 20US7 4
City, State, Zip Code
ul
Q. j -'Al TER E'ATH p4 285 5
tLl ( r�l?ikd P,t--
Ln
02
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Dear Adjacent Property: co"nT r oXULI f
This letter is to inform you that I, have applied for a CAMA Minor
Property Owne AGE#JT
Permit on my property at I qY_ IMUT (L_ ") //L_D LLY -/, _ , in Carteret
Property Address
04aA D►JE WAY /11 H 1440E -Aw9Y)
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at _ i2S2 i '2-`i 1 211:1- ,or by mail at the address listed below. If you wish to
-Applicant's Telephone
file v ritten comments or objections with the Carteret County CAMA Minor Permit Program, you may submit
them to:
Local Permit Officer for:
Tracy Barnes
Carteret County
701 Cedar Point Blvd.
Cedar Point, NC 28584
Sincerei ,
Goi2errir t-mai f
Property Gwm AbStrr 649WOOD &AGr
•C C2_(v tAwN 7o wcs-r
Mailing Address
MofLeVUEAD GrtY 0 C_ ZUs115,7
City, State, Zip Code

CERTIFIED MAIL RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: F:�O(LJY2N- a(Z� L-1—G
Address of Property: 14 N 4 JA t,-,rSfL RA x"1-� goP b � � J�y,��
(Lot or Street #, Street or Road, City &County} Z$S 7 S
Gt?-oTrrc- r-+c�tt iZ� r
Agent's Name #: Mailing Address: Sa 2(0 }}wY 'Jo wEs!
Agent's phone #: ZS2� 24'1- 211:L G��cY j V c- 2o3SS7
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 or drawing with dimensions must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is 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.nccoastalmanaaement net/contact dcm htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you 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.
jr
(Property A60
Own Information)
Signature 64x4--10 b MA LT'r
(✓3fLCZ1-sic- r-J0Q _j r
Print or Type Name
PAailing Address
1n O RE4-i�F}S� CA-fvt N C. M V-4-1
City/statefzip
? 247-21-L2
Telep one Number
(Adjacent Property Owner information)
Signature
-Nrj y r-r?,OJT
Print or Type Name n
flailing Address
JA(;J-E2 P22� tJG
Utylstatelz�o
Telephone Number
Date
Revised 611812012

7
Date
Adjacent Property Owner
(l Ia5 JAL,1S(- PAIIA %AD
Mailing Address
__ 114ZIA►J TEAC44 , tic-
City,State, Zip Code
Dear Adjacent Property:
This letter is to inform you that 1,
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C4Kv j add !'-y. mej
Property Gwf& AGej'r
ATLANTIC'BEACH 0r '28512:'
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fees _...... };}. 1(}.1; 21016
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•ter/c: GCICN, „r i ?..% 12
have applied for a CAMA Minor
Permit on my property at I qYV AqL1M P#TM RZ �� in Carteret
Property Address
?ARAA►fE jIAY MH HIDE-09v,,9'�
County. As required by CAfr1A regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at (ZSS2. 2-Lt7 2-122 or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the Carteret County CAMA Minor Permit Program, you may submit
them to:
Local Permit Officer for:
Sincerely,
Property saner Atict'c' OlAvwoo fm4 Es
S—�2lo wY 7 o wEJT
Mailing Address
wa- AEPID CXTY 11 r' C._ 210,XS7
City, State, Zip Code
Tracy Barnes
Carteret County
701 Cedar Point Blvd.
Cedar Point, NC 28584

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner.
Address of Property: Mltl DIAL -TIER )Dina J?ogb 0/3 fit,701 ja r rfC
(Lot or Street #, Street or Road, City & County) 2,S V7S-
Agent's Name#:� >2>31TT_�ARt2_I-r
Mailing Address: J-Z-2-(o
Hv'`?
7o kejJ -
Agent's phone
CITY TY
N C,
2-35-S'i
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 or drawing, with dimensionsmustbe provided with this letter.
I have no objections to this proposal. - I have objections to this proposal,
If you have objections to what is 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.nccoastafmanagement net/contact dcm htm or by calling 1-868-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
1 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.
AbeJ'r
(Property 9wne, Information)
Stgrtriture OAX04Uoa 01AL;1r
Print or Type Name
-r'Ztn Awl '? o wE.r- ;
Mailing Address
7t 317- ►rCrib C-1 1 1 Nti 21rr?
CdylStateiZip
Telephcne Number
Date
(Adjacent Property Owner Information)
Signature
PA v L G u7)-Rt L
Print or Type Name
//&s" .fqul-Fa /-off
Mailing Address
lMdjA-r 96,14C4, r c. ur- s-
CitylSta telZip
Telephone Number
Date
Revised 6/1812012

SITE URANVINC/APPLIC.ATION CHECKLIST
Please make sure your site dra%v inr, includes the follov%ing information reLluired for a CAkMA minor development pcnuit.
The Local Permit Officer will help you, if requested.
PHYSICAL DIMENSIONS
t"1 A Label roads
"� IIqA— Label highway s right-of-tiv ays
/
WA— Label local setback lines
✓ Label am and all structure, artd driveways currently existing on property
✓ Label adjacent watcrbody
PHYSICALCHiARACTERISTICS
✓ Draw and Zabel normal high +eater line (.contact L)O for assistance)
✓ Draw location of on -site wastewater system
ifvou will be working, in the ocean hazard area
_-- Draw and label dune ridges (include spat 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 bfjw-vJDeo t, f'U of
✓ Draw and label landward limit of AEC d+.�t,tEwtor~�
Dra++ and label all wetland lines (contact LI10 for assistance)
rj/ Draw and label the 30400t buffer line
DEVELOPMENT PLANS
Z Draw and label all proposed structures
rr,1A Draw and label areas that will be disturbed and/or landscaped
-4A. 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 IandsCapilla
,NOTE TOAPPLICANT
I lave 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 S 100.00 fee?
• completed an AFC Ilazard Notice. if necessary? (Must be signed by the property owner)
FOR STAFF USE
Site Notice Posted Final Inspection - Pee Received
Site Inspections
Date of Action: Issued Exempted Denied Appeal Deadline (20 days from permit action)