WO 12-16 Workman, Kenneth

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Carteret County WO.12.16',
Local Government Permit Number
CAMA
MINOR DEVELOPMENT
PEKMIT
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 pursuantto Section 113A-118 of the
General Statutes; "Coastal Area Management"
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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 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. All work must cease_when this ChA Jones
permit expires on: CAMA LOCAL PERMIT OFFICIAL M'
DECEMBER 31, 2019 701 Cedar point Blvd.
Cedar P jnt, NC 28584
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 r
another party without the written approval of the Division' of Coastal r I
Management. PERMITTEE
(Signature required if conditions above apply to permit) F
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(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 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 properly, stabilized with a vegetative cover.
(7) All other disturbed areas shall be vegetatively stabilized (planted and mulched) within 14 days of construction
completion.
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Locality Permit Numberr } (F p ['
. .. . ,.
Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
= (Foy- official use only)
GENERAL INFORMATION
LANDOWNER
Name
Address 1493 So U✓r .b V J LAC,
city Air%State ,.) C, Zips iUPhone 2Y/
Email�r�+l�r��ys-,at
AUTHORIZED AGENT
Name mnij
„ Address
city.State Zip Phone
Email ,
LOCATION OF'PROJECT: (Address, street name and/or directions to site. If not oceanfront, what is the name'of the
adjacent waterbody.) �S c��C�"T rlct t ' s✓lsCl/J� �'l s-, {v �i� a, �cazaii�' ls�'"r19
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) 'feil,-- (;'/ n I.pr,izf
`SIZE OF LOT/PARCEL; : r`Y0-19 ' square feet acres
PROPOSED USE: Residential 9/ (Single-family [� Multi -family n } Commercial/Industrial ❑ Other []
COMPLETE EITHER (1) OR (2) BELOW (Contact your Local Permit Officer ifyou are not sure which AEC applies
to your property):
(1) OCEAN HAZARD AECs: 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 FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: intJ square feet (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.) r
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
If yes, list the total built upon areeimpervious surface allowed for your lot or parcel: square feet.
_ s

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
y Home Park Approval, Highway Connection, and
others. Check with our Local Permit Officer for information.
Certification, Sand Dune, Sediment Control Subdivision Approval, Mobile
STATEMENT.OF OWNERSHIP:
person authorized to act as an agent for purposes of applying for a CA �t' being either the owner. of property in an AEC or a
1, the undersigned, an applicant for a CAMA minor development permit,
$ purp MA 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 �,' cf1anh 'e�eeed Book
page7 in the tit4{'t'Q t County Itegistry,of Deeds.
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 & 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
ACTUALWOTICE to each of them concerning my intent to develop this property and to apply fora, CAMA permit. ,
(Name) (Address)
(l). %fie; ✓,r1 n cr 11
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(3)
r
(4) .
ACKNOWLEDGENIENTS:
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 particu- .
far hazard problems associated with this lot. This explanation was accompanied by recommendations concerning stabiliza-
tion and floodproofing techniques.
I furthermore 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 on the aforementioned lands in connection with evaluating information
related to this permit application.
This the day of 20
Landowner or person authorized to act as his/her agentfor purpose of filing a CAMA permit application
This application includes: general information (this form), a site draining as described on the back of this application, the
ownership statement, the Ocean Hazard AEC Notice where necessary, a checkfor $100.00 made payable to the locality, and
any it formation 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
anypermit. Anyperson developing.in an AEC withoutpermit.is subject to civil, criminal and administrative action.

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PROPERTY LOCATION l ,
SUBDIVI,�ION:
LOT (,)___ BLOCK SEC:
TYPE STRUCTURE:
NO. BEDROOMS; I_� NO. BATHS:
NO. PEOPLE: �G _S( DESIGN FLOW; (d
GARBAGE GRINDER; YES ( ) NO( L)•+'r
SEPTIC TANK: GAL. PUMP TANK: GAL.
LN$S NO L' c; I— WLDTH i e. t
PAGE OF
17I
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"SYSTE.'K SHALL NOT BE INSTALLED
UNDER WET CONDITIONS
•Trench bottom deptfi to be. no deeper than � g,
naturally §Pcarrirla surface.
Pssement Required Yes kf-No
Drainage Maintenance Req. 5luface (X:I Subsurfapa ( )
tp i14 ntain Minimum !0' From Water Lino
Comments: I l �nr.Pt�G: J.ln.,� a. _ L. • .
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TOTAL. LENGTH: �� FT. TOTAL, 4- S }
�rom Death D ��n�cem layow, appmva! must be obtained
WATER SOURCE: tA.l f -a
HORIZONTAL DISTANCE FROM WELL: ��(�`� t� FT
' NOTICE: Constrvcpion must comply with all Mato And local.'
SITE MODIFIED: YES( ) No( iy �'O
rejulations. Do not install wPU until tveil•olte has been >tpproved ;
DRAINAGE REQUIREMENTS:
on inspection.
• NCYTL4E BeWaramuch property ip Carteret County is subject
lo.Wctland Repui;tions agcj prvPgtiei.containing wetlaridr,,'„
STRUCTURE SHALL BE PLACED SO THAT ORAVITY
should receive approval iroQ! U;Sr Army �erp "ef Eapinears
FLOWIS ACHIEVED OR PILMP SYSTEM SHALL PE'
prof to dcveiopmeltt. ' ' • ..
• DO NOVT PARK. PAVE, DM OR BUILD AVER ANY PAP
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:q OFSEPnC SYSTEM OR RE1%-1 AR>rA,` T ; .i " `i} :' �'� : y FOi� 9Y�S I$ I Q NF S• FlI+I4111'a'$ `' RE ICif•:.. i %: Mi:
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'REyAIRAREA:
F7LL•OiyATLEASTQROU-P1 SANOY"'• .
40AM lVer.UM
(OMCE USE FOR FIELD NOTES ONLY
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OpIiTCATION iNSPEC CiON BY:
'
' • ENVIRONMENTAL HEALTH SPECIALIST

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•.a NEWPORT K,.28570
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Cerlir lail Re.trk;ted Delivtvy $ •
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Lcl-�.di'�(/C• C3 ❑ Adull Signatwo Required S
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03/02/2016
City, State, Zip 'Code t-3 Total Postage and Fees
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�, Siroei iriilApt. No., or %'C� flox No.
Dear Adjacent Property: .,-------....................................................................
J p Crty, State, Z1Y+4
This letter is to inform d'r� � a
ou that I,
y L�l�
Property Owner
Permit on my property at A93 c �� IV6 20 in COUNTY Cgiellyvf
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 622) 7*1- 953-11 ,or by mail at the address listed below. If you wish to
Applicant's 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,
Property Owner
Mailing Address
City, ate, Zip Code

UWS.Posta �eic�wP;
CETIFIED,�MA Ir®4RE��Ei
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Date,
a
Adjacent Property Owner ti
YA A r <04 Ln
Maili g Address a
-1non- a ram/ Ci 6Z A%G Ln
City, State, Zip Code o
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....._.............
arid�pt. No., or PD Box rib.
Dear Adjacent Property:
This letter is to inform you that I, 11,10!9MaV have applied for a CAMA Minor
Property Owner
•- ....................
Permit on my property at lV 3 Sy;l��/_ l&e,i ,br-, /{devffll in COUNTY &d,,at_
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 of (2 C-) ZV / 9 �_lS ,or by mail at the address listed below. If you wish to
Applicant's 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,
Property Owner
/,ra 3
Mailing Address
City, Sfate, Zip Code