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Coastal Management
ENVIRONMENTAL QUALITY
APPLICATION FOR
CAMA MINOR
DEVELOPMENT
PERMIT
In 1974, the North Carolina General Assembly passed the Coastal Area Management Act
(LAMA) 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 of the
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 effort 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 fee 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 Officer 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.
01 � loo,
CA-11 /9/7
Coastal Resources Commission
Division of Coastal Management
RECEIVED
JAN 28 2021
DCM-MHD CITY
Q
DCM Form EB1952-2015/Revised

Locality
Permit Number
Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
(For official use only)
GENERAL INFORMATION
LAND OWNER - MAILING ADDRESS
Nam
Addr
City On=rr-60d Cd;[ Statey� Zip29Z5'57hone ( 25--2 7
H V 1 RVILLLGL HIiL' 1V 1
Name
Address
City State Zip Phone
Email
LOCATION OOF7 PROJECT: (Address, street name and/or directions to site; name of the adjacent waterbody.)
1 2 l (i'sr-w \ 1 1\rP 1/ rPrv� (-71J . Al I r
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.)
SIZE OF LOUPARCEL: .__ � square feet acres
PROPOSED USE: Residential (Single-family ❑ Multi -family ❑ ) Commercial/Industrial ❑ 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.+ /�"f�- 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 SHO E 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 STORMWATER 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.

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
listed as landowner on this application has a significant interest in the real property described therein. This interest can be
7an
as:(check one)
wner or record title,
see Deed Book
Title is vested in name of
page in the
_an owner by virtue of inheritance. Applicant is an heir to the estate of
; probate was in
Registry of Deeds.
County.
if other interest, such as written contract or lease, explain below or use a separate sheet & attach to this application.
NOTIFICATION OF ADJACENT RIPARIAN 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 for a CAMA permit.
(1)
(2)
(3)
(4)
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.
ris t13 day of C14tJ , 20
e
ate+. fl
Landowner or person authorized to act era or 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. Any person developing in an AEC without permit is subject to civil, criminal and administrative action.

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
Label local setback lines
Label any and all structures and driveways currently existing on property
Label adjacent waterbody
PHYSICAL CHARACTERISTICS
Draw and label normal high water line (contact LPO for 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 first 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
DEVELOPMENT PLANS
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?
• notified and listed adjacent property owners?
• included your site drawing?
• signed and dated the application?
• enclosed the $100.00 fee?
• completed an AEC 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)

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: 4/Yd filcmt
Mailing Address: %/ CT -L p
Phone Number:
Email Address:
I certify that I have authorized
am
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: � [
at my property located at -__[
in County.
1 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.
�-- narure
Print or Type Nam
Title
Date
This certification is valid through I 1,

CERTIFIED MAIL • RETURN RECEIPTREQUESTED
Name of Property
Address of Property:
Agent's Name*
Agent's phone #:
DIVISION OF COASTAL MANAGEMENT
ROPERTY O"WNEIZ NOTIFICATIONfWAIVER FORNFI
(Lot or Street #, Street or Road, City &
Mailing Address:
L
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 theattached drawn the development
they are proposing.'A.iIthpown ��-`ra' ins �t i mar 'n°useb ed"•wathryk^f Je't�te .
I have no objections to this proposal. I b
If you haveobjections to what is being proposed, you mustnotifj
(DCM) in writing within 10 days of receipt of this notice. Corre
Commerce Ave., Morehead City, NC, 28557. D'CMrepresentattve
2808, No response is considered the same as no objection if you
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, be
back a minimum distance of 15' from my area of riparian acre
wish to waive the setback, you must initial the appropriate b'
I do wish to waive the IS setback requiremer
I do not wish to waive the 16 setback requii
(Property
L-M
or Type Name
) 2 ( G-e
Umsi-
Mailing Address / ( % �
�iC'fy1JGf�/i 1` 1`J /� ,C
City/state/Zip 216j� -7
Z!5'2- 7257� 2 ?2�
Telephone Number
IIla Aa
Data
Owner Information)
Print or Type Name
I2� Chu -
Mailing Address
Crfy/statelzip
252, 2511-- .6!� 24-1
Telephone Number
DIfe
Revised 6/18/20i2

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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
TMN-RRQPERTY OVWNE-R-NOTIFICATIONIWAIVER-FORM
Name of Property Owner:
Address of Property:
(Lot or
Street or
Agent's Name* Mailing Address:
Agent's phone #:
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 drawn the develo merit
tfiey are proposing. rM
de" ¢xl t*G t- oii rgn . e s�/a '�t Sf b> t1 f -
I have no objections to this proposal. I I lave objections to this proposal.
If you ha ve objections to what is being proposed, you must notifythe Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 400
Commerce Ave., Morehead City, NC, 28557, D'CM representatives can also be contacted at (252) 808-
2808 No response is considered the same as no objection f youhave been notified by Cent fled Nlail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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.)
/I do wish to waive the 15' setback requirement.
1/ I do not wish to waive the 15' setback requirement.
(Property ¢ r information)
St nature
Print or Type Name
121 Uln/ -
Mailing Acrdress - n r
CC
City/statelLip ////� 21
?�5
l `-'�-
Telephone Number
/AVo :�2®
Data
(Adjacent Property Owner information)
Signature
Print or Type Name
Mailing^Address
1 t
Ci/ty�'/,St%ate2ip �j-� � �+
& 9I — L5a — 3 �tlJ�'
Telephone Number
ao_1
D a
Revised 6/18/2012

Deborah Sieker Boddiford
735 Hampton Place S W
Marietta, GA 30064
January 19, 2021
Division of Coastal Management
400 Commerce Ave.
Morehead City, NC 28557
To Whom it may concern:
As the adjacent property owner at 119 Core Drive West, Morehead City 28557, 1
have received a "request for waiver" form. Enclosed, please find the signed notification
waiver with my objection to the proposal and indication that I do not wish to waive the
15' setback requirement.
I received this waiver form on January 14, 2021. It was sent via UPS on January
12, 2021. Please note, this reply is being sent within 10 days of my receipt of the notice.
I am also including the two proposals presented to me by the property
owner, Patrick McLaughlin. I do not agree with proposal 1 as it encroaches the 15'
setback. I agree to proposal 2, BUT only as it pertains to the 15' setback being
respected.
Sincerely,
Debbie Sieker Boddiford

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RECEIVED
FEB 01 2021
DCM-MHD CITY
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NC Division of Coastal Management
Cashier's Official Receipt
Received From: �N (�CtG CGl(0� Y"�G�aL1Q� 1�1
Permit No.:
Applicant's Name:
Project Address: 1 � 1 Cone DC' 16 MAL
14516 A B OD
Date: I he; 20 RL
$ 160
Check No.: l ry l
Please retain receipt for your records as proof of payment for permit issued.
Signature of Agent or Applicant:
Signature of Field Representative: A14A
Date:
Date: S%L

NC Division of Coastal Management
-"A"- Cashier's Official Receipt
Received From: Pr,4- M(JaIARklin
Permit No.:
Applicant's Name: gadme,
Project Address: I;1I (Or-6 0r'
14664 A B cOD
Date: a h ;z 20
Check No.: Iq495
Please retain receipt for your records as proof of payment for permit issued.
Signature of Agent or Applicant:
Signature of Field Representative: N9
Date:
Date: 1312A )

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S�'P Do0 N
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RECEIVED
FEB 0 8 2021
DCM-MHD CITY

Eric Ellis
Marine Construction
DOCKS • SEAWALLS -BOAT LIFTS
DECKS & REPAIRS
Phone & Fax: [phone]
Cell: 252.342.6775
205 Nottingham Lane
Morehead City, NO 28557

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