White Oak Crossing HOA

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❑ CAMA / '❑ DREDGE & FILL
GENERAL PERMIT Previous permit# �'^.•"'
❑New :❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
a '' a Rules attached.
Project Location: County
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Applicant Name 1 tY-
Address t. Q'x L Street Address/ State Road/ Lot #(s)
City < , ..,f .. State - ZIP
Phone # (lat_JR;� E-Mail Subdivision
Authorized Agent t ' t r City f'+ �1'-`� ' ZIP 1 _
Affected ❑ CW l;jtM A ❑ ES ❑ PTS Phone # ( ) River Basin e
AEC(s): ElOEA ❑ HHF ElIH ElUBA El N/A Adj. Wtr. Body (�jjt nat an unka
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Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit'*
Application Fee(s) Check #
PermitOfficer's Printed Name
Signature
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Issuing Date E . iration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules Other:
Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the
Wilmington Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
http://www.nccoastalmanagement.net/
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
Revised 08/27/ 14

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
Labelroads
Label highways right-of-ways
abel local setback lines
Label any and all structures and driveways currently existing on property
bel adjacent waterbody
PHYSICAL CJ1IARACTERISTICS
Draw and label normal high water line (contact LPO f'or 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 4 rst 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
DEYELOPMENTPLANS
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?
• noti4ed and listed adjacent property owners?
• included your site drawing'?
• signed and dated the application?
• enclosed the $100.00 fee?
• completed an AI3C Hazard Notice, if necessary? (Must be signed by the property owner)
FOR STAFF USE
Site Notice Posted _ Final Inspection Fee Received -
Site Inspections
Date of Action: Issued Exempted Denied Appeal Deadline (20 days from permit action)
Coastal Management
ENVIRONMENTAL QUALITY
APPLICATION FOR
CAMA MINOR
DEVELOPMENT
PERMIT
In 1974, the North Carolina General Assembly passed the Coastal Area Management Act
(CAMA) 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 ofthe
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 eflort 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 fec is attached.
Other permits are sometimes required for development in the coastal area. While these
are not CAMA-related, we urge you to check with the Local Permit Of4cer to determine
which of these you may need. A list is included on page two 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
j it �a� fi
-74
a�
DCM Form EB1952-2015/aevishd
n.'.,.: 2018
DCM- MHD CITY

Locality Permit Number OTHER PERMITS MAY RE REQUIRED: The activity you are planning may require permits other than the C
minor development permit, including, but not limited to: Drinking Water Well, Septic Tank (or other sanitary avast
Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other treatment system), Building, Electrical, Plumbing, Heating and Air Conditioning, Insulation and Energy Conservr
(Fox official use only) Certification, Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway Conn
Others. Check with your Local Permit Otl,cer for more information.
GENERAL INFORMAI'IOV
LAND OWNER - MAI I.I NG
Address
City
Email
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State %_ 'Lips—whotte
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AUTHORIZEDAGENT �i a Q
Name ©L7 I pyv ojv r� t4O/ /
Address _J�Pf `1 (Aj t1 0 1
City saute _ Zip�hone -1 1 D 340 le 6l�
Email t A7 r3,,-L ,* n)/l/ %� \i/? _ hf 111 I.r'
LOCATION OF PROJ ECT: (Address, street name and/or directions to site; name ofthe adjacent waterbody,)
r
DESCRIPTION OF PROJ ECT: (List all proposed construction and land disturbance.)
Dlvzpap to -1
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SIZE OF LOT/PARCEL: v square feet IL. S _ _ acres
PROPOSED USE: Residential 9, (Single-family ❑ Multi -family �) 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 HAZARDAECs: 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: square feet (includes the area of the foundation of all buildings, driveways, covered decks,
concrete or masonry patios, etc. that are within the applicable AEC. Attach your calculations with the project drawing.)
STATE STORM WATER MANAGEMENT PERMIT: Is the project located in an area subject to a State
Stormwater Management Permit issued by the NC Division of Energy, Mineral and Land Resources (DEMLR)?
YES NO
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: square feet.
STATEMENT OF OWNERSHIP:
1, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in an,
Person authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that
listed as landowner on this application has a signiL cant interest in the real property described therein. This interes
`) described as: (check one)
—an owner or record title, Title is vested in name of
see Deed Book page __ in the _ County Registry c
_`an owner by virtue of inheritance. Applicant is an heir to the estate of _
probate was in
..cif other interest, such as written contract or lease, explain below or use a separate sheet & attach to this appl i,
NOTIFICATION OF ADJACENT RIPARIAN PROPERTY OWNERS:
I furthermore certify that the following persons are owners of properties adjoining this property. I af& rm that I hav
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA pen
(3)
(4)
ACKNOWLEDGEMENTS;
I, the undersigned, acknowledge that the land owner is aware that the proposed development is planned for an are;
may be susceptible to erosion and/or flooding. I acknowledge that the Local Permit Officer has explained to me th
lar hazard problems associated with this lot. This explanation was accompanied by recommendations concerning:
tion and Aoodproo4ng techniques.
I furthermore certify that I ant authorized to grant, and do in fact grant, permission to Division of Coastal Manage
the Local Permit Ofi, cer and their agents to enter on the aforementioned lands in connection with evaluating infor
Mated to this permit ation /
'h he _ day of f 20/f
I andowp6r or n o act as ts/ nt for pur f i, ling q C/�MA permit application
0V L s 11Tf
This application includes: general information (this form), a site drawing as described on the back of this applici
ownership statement, the Ocean Hazard AEC Notice where necessary, a check for $100.00 made payable to the Ic
any information as may be provided orally by the applicant. The details of the application as described by these s.
incorporated without reference in any permit which may be issued. Deviation kom iese details will constitute a
any permit. Any person developing in an AEC without ' r:rm tal and administrative actio:
MAR 12 2018
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I hereby certify that I own property adjacent to
s s
prozl�
�, / (Name of o Owner)
on
(Address, Lot, BCPck, Roa , etc
in
(Waterbody) ve, le (City/Townn and/or County) N C.
>DO The applicant has described to me, as shown below, the development proposed at the above �]
do .
N
I have no objection to this proposal
Cl
I have objections to this proposal. V-4
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT_
(individual proposing development must rill in description below or attach a site drawing)
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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.)
1 do wish to waive the 15' setback requirement.
not wish to waive the 15' setback requirement.
Sr�Ta)ure
1/ 1
Property Owner Information)
N
rn g address 0 5 naaig�drJ4
Ci tgl,,�i i Ci4uState/Lip
elephone Number/email addres Tele ne Number/email address
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0,d I/ / r>,u<•
(Revised Aug. 2014)
'Valid for one calendar year after signature'

I hereby certify that I own property adjacent to t ncA iwv u 's
/ (Name of o Owner)
propert1located at L—
(Address, Lot,ck, Roa , etc�1
on42k tt I` B p, in � CJ C 110 ✓'(% N.C.
(Waterbody) (City/To n andlor County)
The applicant has described to me, as shown below, the development proposed at the above
1 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) J�
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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.)
(-+mil 9 1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Information)
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1"M I w Name
ding Address
wA-t& s
Cigtate/Zip
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Tele hone Number/email address
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(Revised Aug. 2014)
*Valid for one calendar year after signature`
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