48309D - Peterman

7CAMA/ ❑DREDGE & FILL 4
3ENERAL PERMIT Previous permit#
Thew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
rized by the State of North Carolina,Department of Environment and Natural Resources / �2
:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC Al pp
Name ��rQ/e (/L Tyr ❑Rules aj�ched.
it �>< ) Project Location: County )(lbw /�77-�Ayr,-
3oG B L.•L C4+ err Ad. Street Address/State Road/Lot#(s)
4Jd/h,r„y f State NC ZIP Z 11y.�'i S!-v .r
(9/0) 312. 432(i Fax#( ) Subdivision /:"")rl+4>S ed✓e
:ed Agent City o ZIP -N
❑CW f SW Bi A- ❑ES ❑PTS Phone# ( ) 54*4v' River Basin cl-A
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body New/e e"??,Z g/i
❑ PWS: ❑FC: ^'_
yes / no PNA y s/ no Crit.Hab. yes / no Closest Maj.Wtr. Body / '�. i�e,'-Y
f Project/Activity ,S ii-A•e/4-.7 4 t .i',l^/✓el le., - f "4tSi<› •
(Scale: tr/
ck)length //F'k`/'
1(s) /U X G / - . I
ier(s) ' SLY
ngth A ' Crt..'P 'L t/
mber
d/Riprap length 1 li �s'
;distance offshore _
uc distance offshore T I f •'" y
cannel I
oic yards ' l//
Ise/Boatlift — i' VAIWIIEllii -''
IIII
ulldozing i -- 1]T '/et-- /4
1'
ti
v }/
e Length -.`/Z 2 r + /�GT/ �/`��/"�.
not sure yes --_-��
(off
s: not sure yes ,S,./:
cum: n/a yes ea pX C e.e`�(t
yes � E �s� P1',,`
�iq � �E� ! � - _— nL
\ttached: yes � t ' 1 - -_ /
ng permit may be required by: /V / cp• See note on back regarding River Basin ri
n , / i. 1 I 1

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COMMAND ASSET PROGRAM 6918
5 I _ _ 66-21/530
�,�' 1 ` BRANCH 50002
Date
-
L C' 1 1
tars
-iLTRITgi,g CODE
tiY3C5114.
0088 309 5ii' 69 L8

cality Permit Number
can Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
(For official use only)
;NERAL INFORMATION
LND OWNER
me CO-ro t 5+2Ve. '-.4}<.r l&r
dress L uC-GO•VLt Qt toa.c)
y M1I1 rn 1 n3A-L en State NC-- Zip 2$84 OS Phone q t o- 39 2- t 3 2(0
opt, -1. 19— g3210 (4
JTHORIZED AGENT
me SA Me
dress
y State Zip Phone
)CATION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront, what is the name of ti
acent waterbody.) 3ttc 1?)vCca.r14-�rt. R ) . Lo4 L
ptid a.cenk WaNevbud.) : 0,(eec_ wa,.\-e_,rttiAZ
:SCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) tObi c d - ple.r
{, L shc�(x. Tv�c - Ytc s Y lo'w ��e e�►n� w. 1_
LE OF LOT/PARCEL: 02 I) I $Y square feet acres
tOPOSED USE: Residential (Single-family ✓ Multi-family ) Commercial/Industrial
her
)TAL ENCLOSED FLOOR AREA OF A BUILDING IN THE OCEAN HAZARD AREA OF ENVIRON-
ENTAL CONCERN (AEC): 1-1(v0S4 square feet (includes all floors and roof covered decks)
'Dock.(p%e.) C .(includes
LE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT-UPON SURFACES IN THE
)ASTAL SHORELINE AREA OF ENVIRONMENTAL CONCERN (AEC)• square fee
alculations includes the area of the roof/drip line of all buildings,driveways,covered decks,concrete or masonry patio
that are within the applicable AEC.Attach your calculations with the project drawing.)
loose the AEC area that applies to your property:
(1)within 75 feet of Normal High Water for the Estuarine Shoreline AEC

•
:R PERMITS MAY BE REQUIRED:The activity you are planning may require permits other than the CAMA minor development
.As a service we have compiled a listing of the kinds of permits that might be required.We suggest you check over the list with
,PO to determine if any of these apply to your project.Zoning,Drinking Water Well,Septic Tank(or other sanitary waste treat-
ystem),Building,Electrical,Plumbing,Heating and Air Conditioning,Insulation and Energy Conservation,FIA Certification,Sa
Sediment Control,Subdivision Approval,Mobile Home Park Approval,Highway Connection,and others.
'EMENT OF OWNERSHIP:
undersigned,an applicant for a CAMA minor development permit,being either the owner of property in an AEC or s
a authorized to act as an agent for purposes of applying for a CAMA minor development permit,certify that the
a listed as landowner on this application has a significant interest in the real property described therein.This interest
described as: (check one)
0_rv11. + Sphcr. 1764 r V V-
In owner or record title, Title is vested in , see Deed Book O
L in the No to frtnnvve./ County Registry of Deeds.
in owner by virtue of inheritance.Applicant is an heir to the estate of
to was in County.
f other interest, such as written contract or lease, explain below or use a separate sheet& attach to this application.
IFICATION OF ADJACENT PROPERTY OWNERS:
iermore certify that the following persons are owners of properties adjoining this property. I affirm that I have given
UAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) (Address)
!aherk a 17. o rVno.-fle (y 3 to BvCca..,c tic_ W 0 v... ANC. Z.gyo
jcSS�co� "\3c.ge.( i TlMY et1C4-\k bZ (tvcca..vc.c QJ IM.►...,.. 1o,,. NC
DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS:
iowledge that the land owner is aware that the proposed development is planned for an area which may be susceptil:
sion and/or flooding.I acknowledge that the local permit officer has explained to me the particular hazard problems
iated with this lot.This explanation was accompanied by recommendations concerning stabilization and floodproofing
iques.
MISSION TO ENTER ON LAND:
iermore certify that I am authorized to grant and do in fact grant permission to the local permit officer and his agent:
er on the aforementioned lands in connection with evaluating information related to this permit application.
application includes:general information(this form),a site drawing as described on the back of this application,the
rship statement,the AEC hazard notice where necessary,a check for$100.00 made payable to the locality,and any

SITE DRAWING/APPLICATION CHECKLIST
'lease make sure your site drawing includes the following information required for a CAMA minor development permi
'he drawing may be simple and not necessarily to scale. The Local Permit Officer will help you,if requested.
'HYSICAL DIMENSIONS
Label roads
Label highways right-of-ways
Label local setback lines
Label any and all structures and driveways currently existing on property
'HYSICAL CHARACTERISTICS
Draw and label mean high water mark
Draw location of on-site wastewater system
'you wijJ working in the ocean hazard area:
�Wft Draw and label dune ridges(note height)
Draw and label toe of dune
Identify and locate first line of stable vegetation
Draw and label setback line under CAMA
Draw and label topographical features(optional)
'you will be working in an estuarine shoreline area:
Draw and label landward limit of AEC
Describe terrain(slope)
EVELOPMENT PLANS
Draw and label areas that will be disturbed
Nit If a house is to be placed on lot, describe location of house
A Pr Note size of piling and depth to be placed in ground
VC Draw and label all areas to be paved or graveled
Describe composition of surface
,IA Note and list fully all trees and vegetation to be removed or relocated
Show landscaping
OTE TO APPLICANT
ave you:
• completed all blanks and/or indicated if not applicable?
• notified and listed adjacent property owners?
• included your site drawing?
• signed both application and statement of ownership? V
• enclosed the$100.00 fee?
• completed an AEC Hazard Notice, if necessary?
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STORAGE
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
ame of Individual Applying For Permit: 0,af O\e_ -k-- 5- -,,pbpn �.e..}-eirry\ „,r
Address of Property: 2j(:)1p ' ,,,,y .rt.e.eit_ (3
(Lot or Street #, Street or Road)
W 11'e,\,n3 el rJc Ne t)-) )4OLr1over Coy,
. (City and County) .
I hereby certify that I own property adjacent to the above-referenced property. The indi
applying for this permit has described tome as shown on the attached drawing the developme
are proposing. A description or drawing, with dimensions, should be provided with this le
I have no objections to this proposal.
Z
If you have objections to what is being proposed, please write the Division of (
Management, 127 Cardinal Drive Extension, Wilmington. NC 28405 or call 910-79
within 10 days of receipt of this notice. No response is considered the same as no obje
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier. dock, mooring pilings, breakwater, boat house or boat lift mu:
bck a minimum distance of 15' from my area of riparian access - unless waived by me.
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the if se'_r:ac-, teauireme: =.
I do not wish to waive the 15' setback requirement.
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S ism Name "" Date
D0i4/4- 173 erf
Print Nameitiii..iis

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LOT 69 DCM WILMINGTON`
21,1885F i
STORAGE
MAY 1 8 2001
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F L OEIVEU U.S. Postal Service-.
DCM WILMINGTON, NC CERTIFIED MAIL... RECEIPT
.n„ (Domestic Mail Only;No Insurance Coverage Provided)
MAY 1 8 2007 For delivery information visit our website at www.usps.com.,
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Certified Fee
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Restricted Delivery Fee
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PS Form 3800,August 2006 Sec Reverse for Instructions
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2, and 3.Also complete A. a ure
item 4 if Restricted Delivery is desired. ❑Agent
• Print your name and address on the reverse 0 Addressee
so that we can return the card to you. �Br� eived by(Prirdced Name) I C. Date of Delivery
• Attach this card to the back of the mailpiece, �L;H lz ;J L_
or on the front if space permits.
D. Is delivery address different from item 1? 0 Yes
1. Article Addressed to: If YES,enter delivery address below: 0 No
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❑ Registered 0 Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number
(Transfer from service label) 7007 0220 0003 7190 3546
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PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
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