38964D - Hinnant

I
CAMA / ] DREDGE & FILL
IIENERAL PERMIT Previous permit#
New �]Mol&fication Complete Reissue ❑Partial Reissue Date previous permit issued ti
ized by the State of North Carolina, Department of Environment and Natural Resources _
oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 7 Ryles
attached.
:Name LEI w f� I N I� Project Location: County ,S I b w
Street Address/ State Road/ Lot #(s)
4e"(A d 4 l Z--7tr1(
r State NC. ZIPFax # ( ) Subdivision GP<'NP,,V f
ed Agent N / IN -City #4'5h3EPdD`�l'1 ZIP Z kArC
❑ Cw )9EW PTA ❑ ES ❑ PTS Phone # ( ) —1 River Basin
El El ❑ OEA HHF IH UBA N/A Adj. Wtr. Body C lQi�3 C�
❑ PWS: ❑FC: ST art^ f� �Uh1p
�,Closest Maj. Wtr. Body
yes ' 9 PNA es / no Crit. Hab. yes /s
Project/ Activity
ck) length a x 15z
:ngth
ember
Ld/ Riprap length
g distance offshore
ax distance offshore
hannel
ibic yards
mp
use-T6atli ' Z �tC 1 Z
. ........ . . ..........
..... . ...........
ne Lengthy
(Scale: i ► ►
❑ See note on back regarding River Basin

5 HWY 17'
' T TO JYILLE
HWY 172
FOLKSTONE \ '�
11-Y MAP - NOT TO SCALE
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V tiCP
1 18
t
METAL
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3.
1- '' 4 - LEGEND
EIP = EXISTING IRON PIPE
`fit n� EIS = EXISTING IRON STAKE
CHARLES CREEK SIS =SET IRON STAKE
EPK = EXISTING PK NAIL
E o MBL = MINIMUM BUILDING LINE
R/W = RIGHT OF WAY rJ
r- CONC.- CONCRETE
PP POWER POLE
LP LIGHT POLE
—E— OVERHEAD ELECTRICAL LINE:
CENTERLINE
(, MHWL = MEAN HIGH WATER LINE
s AEC = AREA OF ENVIRONMENTAL CC
1'41'3T E CP 700 E
�Q QpAPPPARI
S 47/aj 23' E Q0.00'
CP
CP t
EIS IE
LOT 2
M.40.37 SOFT.
0.84 ACRES
CONC.
5.83 4.71
�" &
75' AEC
4.36
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v +3, TWO-STORY 21.3 n
NOW OR FORW
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OAVIC CRA
Q8:1289, PG:
R
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b
LOT 1
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5.61
LOUIS W. THOMAS III=
TRACT W _ 20.1
: 53, PG: 35, SL: L-1850 '- — — -" 64.0' _ VIRIKE
:.1
WALK
SI9 +6.24
PR
44.8r to
91
ZONE AE
R/W f CIJ P
+a 13 SIS
+7.15 +7.40
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Locality
Ocean Hazard Estuarine Shoreline ORW Shoreline _
(For offrc)al ase onli)
GENERAL INFORMATION
OTHER PERMITS MAY BE REQUIRED: The activity you are planning
Permit Number minor development permit, including, but not limited to: Drinking Water We
treatment system), Building, Electrical, Plumbing, Heating and Air Conditio
Public Trust Shoreline Other Certification, Sand Dune, Sediment Control, Subdivision .Approval, Mobile
others. Check with your Local Permit Officer for more information.
STATEMENT OF OWNERSHIP:
LAND OWNER
Name L �q iyN J� t,c`)o, Nt
Address
h�
City S RAI A State 1 "L j Zip .jyq�Q Phone
Email il,,,, N&'r 1(�' fV Z 1
AUTHORIZED AGENT
Name
Address
City State Zip Phone
Email
LOCATION OF PROJE�T: �Add�css, street name and/or directions to site. If not oceanfront, what is the name of the
adjacentwaterbody) Jto� L`kL&cc�w LfiJ
r '
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) �,� n !- ( (+ t
SIZE OF LOTIPARCEL: square feet _ acres S1
PROPOSED USE: Residential (Single-family Multi -family ❑ ) CommerciaVlndustnal ❑ Other ❑
COMPLETE EITHER (1) OR (2) BELOW (C onit"I your Local Pernrl Ojk-er iifyou are not sure %*kh AEC applies
to your property):
(1) OCEAN HAZARD ABCs: 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 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 )
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= NOrYI
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: square feel.
1, the undersigned, an applicant for a CAMA minor development permit, bei
person authorized to act as an agent for purposes of applying for a LAMA n
listed as landowner on this application has a significant interest in the real pi
described (check one)
owner or record title, Title is vested in J
page in the �f..J,S'G ..J Coulity Registry of Deeds.
Dan owner by virtue of inheritance. Applicant is an heir to the estate of _
probate was in County
Df other interest, such as written contract or lease, explain below or use
NOTIFICATION OF ADJACENT PROPERTY OWNERS:
I furthermore certify that the following persons are owners of properties adj
ACTUAL NOTICE to each of them concerning my intent to develop this I
( Name) (Address
(1)
ta) �v;.1 ciwCt 3�3 iE
(3)
(4)
ACKNOWLEDGEMENTS:
1, the undersigned, acknowledge that the land owner is aware that the propo
may be susceptible to erosion and/or flooding I acknowledge that the Local
lar hazard problems associated with this lot. This explanation was accompa
bon and floodproofing techniques
1 furthermore certify that I am authorized to grant, and do in fact grant, per
the Local Permit Officer and their agents to enter on the aforementioned tar
related to this permit application.
This the _
Landowner r rson authorized to act as his/her agent for purpose of filing
This application includes: general injbrmution (this.lorin), a site drawing r
ownership statement, the Ocean Ha-anl AF.0 Notice where necessary, a c•h,
any information as may be provided orally b ' the applicant. The details oji
incorporated without rejirence in any permit which mqv he issued. Deviate
am permit. Any person developing in an AFC without permit is subject to c

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM
Name of Property Owner:
Address of Property: 3l!� ZQ-o.C61.) l,j �f�cap S �VYZ.I ot'�S K�V
(Lot or Street #, Street or Road, City & County)
Applicant phone #: Mailing Address: 36�- be0k(k1 W
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.
_Z1 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.nccoastaimangement.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, or lift 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.
(Property Owner Information)
Si re
LA NN
Print dr Type Name
S(oS &Acb,j Lo
Mailing Address
SN P S�n , NC 4g4o
(Riparian Property Owner Information)
(1k.-Z
Signature
o� \P-(,
Print or Type'Name
C)D5 NII L"
Mailing Address
S,Ne��s FsfrkA , N C -A 0

1plicant: n lU1
ite:
Permit #: 37?6 -/
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet FINAL Feet
(Applied for.
(Anticipated final
(Applied for. (Anticipated final
bitat Name
DISTURB TYPE
Disturbance total
disturbance.
Disturbance disturbance.
Choose One
includes any
Excludes any
total includes Excludes any
anticipated
restoration
any anticipated restoration and/o
restoration or
and/or temp
restoration or temp impact
temp impacts)
impact amount)
temp impacts) amount)
v1�1
Dredge ❑ Fill ❑ Both ❑ OtherA
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted. Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
3-2
�s �e-4fy ►
❑ Agent
❑ Addressee
ite of Delivery
If YES, enter delivery address below:
3. Service Type
❑ Certified Mail 9,Press Mail
❑ Registered ai'Retum Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7011 3500 0001 3954 7378
(►!>;utster iron servke fal3elJ
Ps Form 3811, February 20D4 Domestic Return Receipt
marine I71 Fill 11 Rath 171 nthar n 1 _ 1
■ Complete items 1, ,2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
102595-02-WI540 ;
A. Signatu
❑ Addressee
B. R iv y ( Printed Name) C. Date of Delivery
?IAL�7tr lie I Z9 - /Z
1. Article Addressed to: ^r t
(— kN ^ n 10 C IY 1-.
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No