WO 06-16 Guthrie, Wanda

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—Permit Numbere 0—N-0 —W
Ocean Hazard Estuarine Shoreline
ORW Shoreline ✓
Public Trust Shoreline Other
(For official use onl))
GENERAL NFO MATION
LAND OWNER
Name
1" PS A tit
City State _ C Zip? / ahone�,
Email �a nnlrz.� (J rl 2 G �t \� \1&kC--0. C-OAA
AUTHORIZED AGENT v `�
Name N 1�t�
Address
City
Email
State Zip Phone
LOCATION OF PROJECT: (Address, street name and'or directions to site. If not oceanfront, what is the name of the
adjacentwaterbudy.) ;ra P inbt < f Afl0 r Ot,c{ Cre—c4< Pj0 tit_ SG und-
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) 61-f,
SIZE OF LOTIPARCEL: �'t J el) square feet Z. acres w baC TL
PROPOSED USE: Residential CE( (Single-family ($Multi -family (]) Commemiul/industrial Other 0
COMPLETE EITHER (1) OR (2) BELOW (Contact yourLocal Permit Officer ifyba are not sure whichAECapplies
to your property):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: (ksquare 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 AEC%: SIZE OP BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: _ square feet (includes the area of the rnof1drip 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.)
OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA
minor development permit, including, but not limited to: 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. Check with your Local Permit Officer for more information.
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)
din owner or record title, Title is vested in , see Deed Book (� 3
page (_ in the (�- C !Lrt'Ere-f —County Registry of Deeds.
Elan owner by virtue of inheritance. Applicant is an heir to the estate of
probate was in County.
Of other interest, such as written contract or lease, explain below or use a separate sheet & attach to this application.
NOTIFICATION OFADJACENT PROPERTY OWNERS:
1 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)
(1) Do.--� n t gc :) OrV95 50
(2) of Le,.leer r-
(3)
(4)
ACKNOWLEDGEMENTS:
L. 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 particu-
lar hazard problems associated with this lot. This explanation was accompanied by recommendations concerning stabiliza-
tion and floodproofing techniques.
I furthcmvore certify that I am authorized to grant, and do in fact grant, permission to Division of Coastal Management staff,
the Local Pcrmil Officer and their agents to enter on the aforementioned lands in connection with evaluating information
related to this permit application.
This the D % day of r; t `20
Landowner or person authorized to act as his/her agent for purpose of filing a CAMA permit application
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? This application includes. general information (this form), a site drawing as described on the back ofthir application, the
YES= NC[2H] ownership statement, the Ocean Hazard AEC Notice where necessary; a checkfor $100.00 made payable to the locality_ and
lfycs, list the total built upon arcalim�crvious surface allowed for your lot orpaTcel: square feet. any information as may be provided orally by the applicunt. The details ofthe 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.

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Dear Adjacent Property:
This letter Is to inform you that I, �lcc� l�U� have applied for a CAMA Minor
Property Owner
� f Permit on my property at �J 3 t � J ��pt—fJC , in COUNTY
Property Address
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 ate` " �� 2- � ,or by mail at the address listed below. If you wish to
Applicants Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program, you may submit
them to:
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY, STATE, ZIP CODE
Sincerely,
\)kr�
wn Property Oer
(. av
Mailing Address
NQ.t,�p tr tr Nc- Z e S'70
City, State, Zip Code

126 1 (e-
ate
MalirV2V,P�fi �Jc Ze 5-?-b
City, State, Zip Code
This letter is to inform you that I,
Property Owner
Permit on my property at in COUNTY
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my pe mit 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 aboi it my proposed project, please
contact me at a5-9, - 3y2-- ` Q S% ,or by mail at the address listed below. If you wish to
Applicant's Telephone
rile written comments or objections with the LOCAL GOVERNMENT CAMA M1 tinor Permit Program, you may submit
them to:
LPO NAME
Local Permit Officer for LOCAL GOVERP MENT
LOCAL GOVERNME JT ADDRESS
CITY, STATE, ZIP CODE
Sincerely,
Property Owner
LCcl1.e...-
Maling Address
1Uu Pa,r tic -
City, State, Zip Code