77919A_Southwood Management, Inc_20201112

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W ')04ew Modification Complete Reissw Partial Reissue Date previom Past issued
As atuhormed by the gate of North Cuolim. Delwnnem of &vvirmnental Quality r
and the t octal ResourcesConer+iuioan in as area of environmental concern put -�uara to i SA NCAC
Applicant Nam�e� `}01..N/t iA/r Re4w Location_ County_ ---
Address _ �. —=i� L.• ra— _ "Sif tAddress(StateRr�adlLot#�� L� i7►Y
City mIca s•.1 -,,; _ -
Phone
Subdivisim
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ti Audwbe6Ag � �
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Affected z aQ h C 111E L!1" QINA _ "
AEC(s):. ;..� Add, W'fr'.►
l�PI"_
::�-.�� :'•,;, - - Closm Mal. Win Body _
ORW: yes PI
Type of Pt o� W Act vky OV f V tA_ Gi �—�� t_� �f � X rd —{2; n �Taffm aIp 4 9VA0
Pier (dock) lef%th rr� --- -- - , _ -- - -t- . ' Y--' - - . r i •s :•r••- _r..l. • - i �i - !
i '4s�f
Fixed
xed Pwiorrn(s)
Noafirigf'laairxrn(s)- .. :(:-:= :Y•:-'?�•c+•�4"-•.'6:->`e;.-;�r•S:-::;--=S-v-,=:+•-�..�''=..-E:-�`-_..,r.�.:j..�..?�-•'r�.-T .t.�s.��s.;:.��;��rr•j
Rrigert`ier(s)-_._ .-.3. _ .. JFr,:- _ t. �•�: .J+:�-s :i- _ - ..: •ari-�+-y. :� --Y.--;-'�:%.• :� ; .
Groinierigth
MwAber
'F _ - - BulkiteatY apbe�th _.--- -,i � ..1_.--....—r-'- . -- � - -
an distance offshore __- �_t.- .•...i._.3_....:_.i-- _..:.._. .--.:..;—: �-- !--'.-..Y""'.-""' - -..s__.' !
malt dismre of(shcxe
s rl
Bmisarxxd
--._"---------- i ! i •. _i �� .�►.��[
cuhicyarrfs Y--;--•'-`T. _ ".�'( - -- r.-'-,;�!�+T";":. t --y-•tam'. 's t z. - i r t _
Boater �Y"�' - '•-•-t
Reach �
af.`4
Other___ `- tom_ •^ : �' 1- F -t�"ti9 . C rµ.
3�
Shoreline lengthSAV
not sure 6 r _ _
yes
Photon: ® ro r--+--+-••... - - -i--- - - -- , : _� -7 ^� :._��� : -
Waiver Aaaehed: yes
A building permit may be re�quwed by _ ` C See r..)w on bad. regardaC Rivet Ba>an
( Note Local Pia7mft jurisdiction) 1!
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Notes/ Specw Condkiom
Fdr,q�pi6cer't Printed Name
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s}gnan,re'Pleasereadcorroancene7tanbackaEpertric'"' ---- Srg''ela�U�0/f�]/-

� Y OFd
�. COUNTY OF DARE
Manning Department
kry cAK c P.O. Box 859, Buxton, North Carolina 27925
Manteo: [phone]
KDH Satellite: (252) 47 5-5871
Buxton: [phone]
OWNER AUTHORIZATION
For projects witfi a t.7tal construction cost of $10,000 or less does not require a licensed
gffier al o°1�WCo P �}!/A)CG
I, Tf-f A p6S- iogowner, authorize i! "L41V4
to act as my agent over the extent of the total construction and completion of this project.
I understatd and accept responsfail to comply with all regulations and required
inspections.
1 understand that a Certificate of Occupancy/Compliance issued at the time of completion
is mandatory phor to utzii=ion of any portion of this project.
r• -
irl
AJ � PC.;?- 7g iee
Address
a�;�02- 6 6
Telephone # (s)
.**THIS FORM IS REQUIRED FOR THE REVR'% PROCESS
PRIOR TO THE ISSUANCE OF A BUILDS% PERNII'I''

GENERAL INFORMATION
i
LAND OWNER
Name _ S O U'rt-- No 0 D m AV A6 g- N ly -r'� plc, � A�,
Address 5-03 / l �j7'C.
City q V 0'[� State A. ^ Zip a yob 7Phone , j ; D — 36-3 6
Email
AUTHORIZED AGENT
Name �/✓ (� A i" T �L'� V K .
Address 1 ! ! &IA)CCE55 C--
City (/ &., Dail- LA, 5 State • C- ZipA2"hone c95a 3 6 "5 —1 -?e �0
Email jaz_ r.. D>7 a-- O D X a ( l . Ca /lei
NJ
LOCATION OF PROJECT: (Address, n s, street name and/or directions to site. If not oceanfront, what is the name of the
adjacent waterbody.) 13 9 Sim (C Opt R D DR.
CO/-. / 067V 1J sego vQ L.o T &3 MCndDES ON OF PRO C (List all proposed constructidn sturbance.)
t..?� DOC I A�aD >�Gy°CAt� � x la o N EX r5`�-/�V6
SIZE OF LOT/PARCEL: square feet acres Joa, Jr 64=:74-D
PROPOSED USE: Residential C, (Single-family Q Multi -family ❑ ) Commercial/Industrial Q Other []
COMPLETE EITHER (1) OR (2) BELOW (Contact your Local Permit Officer if you 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 BUELDING 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
1
Management Permit issued by the NC Division of Water Quality?
YES NO
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: square feet.

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
li5an
as I downer on this application has a significant interest in the real property described therein. This interest can be
das: (check one)
' �jo U `I1-t+Nv�o D
owner or record title, Kitig is v d in rn AN fic 6G' m �4-L�• , see Deed Book
Page Q�ji p n the R County Registry 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
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply 1'6r a CAMA permit.
/ ► / ! / i ,)
0
OF.
ACKNOWLEDGEMENTS:
I, 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 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.
Landowner or person autlf6,d to act as
This the day of b Cr , 20 aO
A-.)T-& A c
for purpose of filing a CAMA permit application
This application includes: general information (this form), a site drawing as described on the back of this application, the
ownership statement, the Ocean Hazard AEC Notice where necessary, a check for $100.00 made payable to the locality, and
any information 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
any permit. Anyperson developing in an AEC withoutpermit is subject to civil, criminal and administrative action.

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
�5U v', H it oo 0 rYI AA/A
I hereby certify that I own property adjacent to__ p "S t ,AC RA. Hb b c' S `s
,LOT( 5e� CU k1A1t r0W 14 ARga eft (Name of Property Owner)
property located at/ 3 f 51 R ,?/ C
on /— OAC CIS 5 rLC %Ise [r in
(Waterbody)
C .all?lv
(Address, Lot, Stock, Load, etc.)
CvtiA16-reN �C
(Town and/or Commty)
'.fie has described to me as shown in the attached application and project drawing(s), the development be
is proposing -at that location, and, I have no objecdons to his proposal
�r'N�✓ �x��" C,�P ��J �X 1SriN� BU�1�1-��¢-�,
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
Signature
-7"A MARp�
Print or Type Name
Telephone Number
Date

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR OAMA ANOR PERMITS
50 v-N vJ cx,10 i1 A/VA &r1n&LTi_ t_
I hmoby certify that I own property adjacent to i' S # 46'PJr 14 A /qb p C1E 5's
Co k,W c,•-row /+4R$v0lt (Name of Properly Owner)
property located at 13 "i S/ P I C
on t= or F C-A5.7te /tiV 4,r i im
(waterbody)
C
(Address, Lot, Block, Road, etc.)
C_UC 1N6-r A,)uc
(Town anNor County)
He has described to me as siawn in the attached application and project drawing(s), the developmmi he
is proposing -at that location, and, I have no objections to his proposal
61)iL6 X)OW 4/"k15'DOC(�,
�v i ?ue vJ 1, CA C v 9v �5-X- I ST t IJG 9()C K YEM
WPLICA171ON AND DRAWIIVG OF PROPOSED MWELOPMENT ATTACHF-ID)
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Si e
A8 N VV. CAso1-Aa a
Print or Type Name
Telephone Number
Date ~

NOTES
1. AREA BY COORDINATE COMPUTATION-7,70bq.It (TbbQ
PER RECORDED PLAT=l50psg/t
PORTION TO BE QUIT Cl A(192Zfl V
I F.I.R_M ZONE SUBJECT TO CHANCE BV FEMA.
3. IT IS THE SOLE RESPONSIBILITY OF THE PE=RWMNG
MUNICIPALITY TO VERIFY SITE COIL UANCE WTH ALL
ORDINANCES, ZONING 3. SETBACKS REQUIREMENTS PRIOR
TO THE ISSUANCE OF PERMITS_ SURVEYOR MAKES NO
CERTIFICATION AS TO COMPLIANCES EITHER SHOWN OR
IMPLIED.
4-1741S SURVEY IS SUBJECT TO ANY FACTS THAT MAYBE vi
DISCLOSED BY A FULL AND ACCURA TE TITLE SEARCH
5. TOTAL PROPOSED COVER4GEAREA=1,637sgA (2t2%)
AEC COVERAGE AREA (85iq_ .) IAEC LAND AREA (3,7-9bq&) f
=(z.3x) � rForacasUe M1�et��
Man not Apvl&R ended
To Ba Owl Clei -d (22Cfm,8)
0
Fww& At
Agxrtr Line
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(30°GP.DJ7.0LTAR).
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over FY�goerty [ran
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ean.y sera, ���
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30 0 75 30
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This map is prepared
from data used for the 139 Sir Richard West DR Tax District: Colington
inventory of the real Colington NC, 27948 Subdivision: Colington Harbour Sec R
property for tax Lot BLK-Sec: Lot: 63 Blk: Sec: R
purposes. Primary
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