30376D - Gray

0 CAMA / DREDGE & FILL N° 30376 '.
GENERAL PERMIT • Previous ermit#
)C p
New Modification Complete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources U
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC i. - ' O •.
,_,,Rules attached.
Applicant Name 6--NZ i IA' A" 61-A\f Project Location: County 0 N �v gin/
Address 1 1 of C Jcl V., 1\AcA 'E f Street Address/State Road/ Lot#(s) ! i U/. (J,/41-Gf
City A./ '".)OS A , t 1uf 4(State f\,e ZIP a'd1/o U L A A.e
Phone # ( ) Fax#( ) Subdivision VI i i'i -" 0 C /tit/3 S c.)v+1 i)
Authorized Agent City/v4''7I f —7/( ' '/ 1,_C fl ZIP )d /h
Affected CW LWcOTA ❑ES ❑PTS Phone# (`)/U 1) 3) �?i�, River Basin C ///
0 OEA ]HHF ❑IH 0 UBA ❑N/A
AEC(s): El PWS: FC. Adj.Wtr. Body <_; 7.11t.I () C 004- 1) fiat /man /unkn)
ORW: ^ / no PNA yes / no Crit. Flab. yes no Closest Maj. Wtr. Body s `i�l -SOvt'�'��
'
Type of Project/Activity Pa,v Ate F . Q/ ,
(Scale: / ' 0 c-` )
Pier(dock)length I/js) 1
I
Platform(s) \If
Finger pier(s)
Groin length
:,,,
number qq i
—
Bulkhead/Riprap length / ,! .„4 f /Y L ".-
avg distance offshore
max distance offshore
Basin,channel _y, --- -
cubic yards
Boat ramp
n
Boathouse/Boatlift - '�
P L
Beach Bulldozing i
Other
Shoreline Length
SAV: not sure yes no -
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no .
Waiver Attached: yes no ----
A building permit may be required by: /.JQ Ptli-\ --77) A ,t . See note on back regarding River Basin rules.
Notes/Special Conditions
—., . (l_)4:___1_,.e ..
Agent or Applicant Printed Name I Permit Officer's Signature
-( b 4L1/ U U 27 - /L/— °3 O(0—/ Ck o
Signature **Please read compliance statement on back of permit** Issuing Date Expiration Date
Application Fee(s) IQ( I Check# /Oa- Local Planning Jurisdiction Rover File Name

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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 I)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 Quality. Contact the Division of Water Quality at the Washington Regional Office(252-946-6481)or the Wilmington
Regional Office(910-395-3900)for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office Elizabeth City District Washington District
Mailing Address: 1367 U.S. 17 South 943 Washington Square Mall
1638 Mail Service Center Elizabeth City, NC 27909 Washington, NC 27889
Raleigh, NC 27699-1638 252-264-3901 252-946-6481
Location: Fax: [phone] Fax: [phone]
(Serves:Camden,Chowan,Currituck, (Serves: Beaufort, Berne, Hertford, Hyde,
Parker Lincoln Building
2728 Capital Blvd. Dare,Gates, Pasquotank and Perquimans Tyrrell and Washington Counties)
Counties)
Raleigh, NC 27604
919-733 2293 / 1 888 4RCOAST Morehead City District Wilmington District
Fax: [phone] 15 I-B Hwy. 24 127 Cardinal Drive Ext.
Hestron Plaza II Wilmington, NC 28405-3845
Morehead City, NC 28557 910-395-3900
202-808-2808 Fax: 9 I 0-350-2004
Fax: [phone] (Serves: Brunswick, New Hanover,
(Serves:Carteret,Craven,Onslow-above Onslow-below New River Inlet-and
New River Inlet-and Pamlico Counties) Pender Counties)
Revised 10/05/01

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• ACTION 'ATION •
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LEGEND
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CER11F1CATE OF SURVEYOR
' 2 1, Danny_Marco Padgett da certify
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that under my direction and supervision, the
N6' �1 attached physical survey was drawn from'on
1/40 0 �� S actual survey made under my supervision. That
.." the ratio of departures le 1:10,000+. Wetness my
O hand and Beal thle l4th,day of Sept.- , 2001.
2.
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DANNY MAR PADGETT R.LS. ;$.9
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• - DIVISION. OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
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Name, Of Individual Applying For Permit: gorirte_AA, elU �j0/
rn� Lo
Address Of Property: t(l 1��� V l l t cm.e
�v l ac�-�.� , i l — , a (J 4.YJ o
(Lot or Street #, Street or Road, City & County)
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,
should be provided with this letter.
I have no objections to this proposal .
•
Tf you have objections to what is being proposed, please write the
T)i vi si on of Coastal Management-, 127 Cardinal nal Drive Extension,
Wilmington, North Carolina, 2R40 or call . 910 ';95-1900 within 10
says of receipt of this notice_ No response is considered the same
as no objection if you have been notified by Certified Mai ]
WAIVER SECTION -
I understand that -a pier, dock, mooring pilings, breakwater, .boat
house or boat .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. )
®S- I do wish to waive the 15 '.setback requirement .
do not wish to waive the 15 ' setback requirement.
/ 0141.313 LOT' A?h,6 Aar 9 02_
S ' Name Date ;fit
P int Name � : ®3
Telephone Number With Area Code •
CNoRTH CAROLINA.DERARTloaNT o=
ENVIRONMENT AND NATURAL RESOURCES
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D IVI S I O11 OF OOAS L EANAG«, .,•, T -`
74TV.BCMC RIPARIAN PROPER"T*y OWNER NOTIFICATION/WAIVER FORM
Name Of Individual Applying For Permit : . G yi ct O,
, cut
Address Of Property: 119. CA CI U l 1 L.C6e rQ.VL.Q_-•
KJ\ L.---rOVSad 6a,CCjit, 1_G, 2 4-(OO
(Lot or Street #, Street or Road, City & County)
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,
should be provided with this letter.
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Y I have no objections to this proposal .
Tf you have nh-iections to what is being proposed, please write the
nivision of Coastal Management, 127 Cardinal Drive Extension,
Wilmington, North Carolina, 2R40, or pall 910 "i9''_�9o() within 10
days of receipt of this not-ire Wo response is considered the same
as no objection if you have been notified by Certified Mail
WAIVER SECTI.ON • s
:2 "understand that .a .pier, dock, mooring pilings, .breakwater, .boat
house or .boat lift -must be set back -a minimum distance of '±5 ' from
-my _area of riparian :access - unless waived by me. Cif you wish to
• waive the setback, you innst -in.iitial the appropriate blank :below. ).
do wish to waive the 15 ' setback requirement .
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I do not wish to waive the 15 ' setback requirement.
- ,L//171/
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Date
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Pr t .Name
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Telephone Number With Area Code
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NORTH CAF.OLINA.D_:HrTSMEN OF
ENVIRONMENT AND NATURAL P SDJR:F

XANADU ASSOCIATES
1900 Eastwood Rd. Ste. 11
Wilmington,NC 3
NTB Building Inspections Office -
• North Topsail Beach,NC
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To Whom It May Concern: In regard to the issue of the setbacks for Ms.Patty Gray's boardwalk,We,Xanadu Assoc.do hereby
Waive the setback requirement as the adjacent property. Any questions that may arise please call
Our development manager,Mark Yow.
Sincerely,
Managing Partner Xanadu Associ.�s

Locality Permit Number
GENERAL INFORMATION
LAND OW R,
Name VCv'IC[ C
irra Address �� ( A k V )C Cu L1,1/
City 3 t r i e_JA:1� J State IJ . Zip ,Z 046d Phone 01(93 - cc
AUTHORIZED AGENT
Name
Address
City State V Zip Phone
LOCATION OF PROJECT It IQ (o1 L
V\I TT-G T 40:a N G ZS4(o D
(If not oceanfront,is waterbody natural or manmade?) novi viAadz etaca
DESC IPTION OF PROJECT -J w 6 ae, f t!°r a VLd uL1LJ
J-'% I S ' -fro vri hDv�l ih�_
AREAS OF ENVIRONMENTAL CONCERN (AEC) CLASSIFICATION
(To be filled in by the Local Permit Officer prior to completing application.)
Ocean Hazard Estuarine Shoreline ORW Shoreline Other
PROPOSED USE
X' Residential Commercial/Industrial Other
SQUARE FOOTAGE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR
BUILT-UPON SURFACES (such as driveways, etc.) within 75 feet of the shoreline (575 feet
of an ORW shoreline)
3`
r (
SQUARE FOOTAGE OF TOTAL FLOOR AREA OF BUILDING �4t�1' _ '% LOa.I ku
5 wide= 40j.
SQUARE FOOTAGE OF SITE (Aw fQ 4-0 5625 5
OTHER PERMITS MAY BE REQUIRED: Zoning, Drinking Water Well, Septic Tank
(or other sanitary waste treatment system),
The activity you are planning may require Burning, Electrical, Plumbing, Heating and
permits other than the CAMA minor Air Conditioning, Insulation and Energy
development permit. As a service we have Conservation, FIA Certification, Sand Dune,
compiled a listing of the kinds of permits that Sediment Control, Subdivision Approval,
might be required. We suggest you check Mobile Home Park Approval, Highway
over the list with your LPO to determine if Connection, and others.
any of these apply to your project.

1 ,',--i .)-01-
APPLICATION FOR
i0
)10 :„....
MINOR
, i ,
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I - DEVELOPMENT
PERMIT
a r
In 1974,the North Carolina General Assembly passed
the Coastal Area Management Act and set the stage for
guiding development in the fragile and productive areas
which border the state's sounds and oceanfront. Along
with requiring special care by those who build and
i develop,the General Assembly directed the Coastal
Resources Commission (CRC)to implement clear regula-
�. tions which minimize the burden on the applicant.
�.� ."w �'; .� � vim=a
- ; This application for a minor development permit under
Tr Wig CAMA is part of the Commission's effort to meet the
9,,,, spirit and intent of the General Assembly. It has been
designed to be straightforward and require no more
time or effort 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
,fit(6.0 you understand what information he or she needs.
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
t t speed the approval process by making certain that your
A •", . 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,
! "'"" V �- we urge you to check with the Local Permit Officer to
determine which of these you may need. A listing is
included on page 2 of this folder.
:.,40 We appreciate your cooperation with the North
s Carolina Coastal Management Program and your
40" willingness to build in a way which protects the
,,,,� „. -�. resources of our beautiful and productive coast.
Ir
iyir
Coastal Resources Commission
Division of Coastal Management

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 1 described as: (check one)
an owner or record title Title is vested in COL414 0-4- 1-- , see Deed Book (
page �,OZ in the OycIou) 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 contact or lease, explain below or use a separate sheet and 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 for
a CAMA permit.
(Name) (Address)
(1) X a vl cA-th.t, ASSOCAb-4e-S
190v 'et.s(-woad L., S c,uie 1( W i(un.i , , A
c2) Ceal' .a Pcicu wi ��at ac zo.5 1akuakti C . Ni 1-0rad &'id . n1C
(3)
(4)
FOR DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS:
I 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
particular hazard problems associated with this lot. This explanation was accompanied by recommendations
concerning stabilization and floodproofing techniques.
PERMISSION TO ENTER ON LAND
I furthermore certify that I am authorized to grant and do in fact grant permission to the local permit officer
and his agents to enter on the aforementioned lands in connection with evaluating information related to this
permit application.
This application includes: general information (this form),a site drawing as described on the back of this ap-
plication,the ownership statement,the AEC hazard notice where necessary,a check for$50.00 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 a per-
mit is subject to civil,criminal and administrative action.
This the day of ,20
Land owner or person authorized to act as his agent
for purposes of filing a CAMA permit application.

>ITE DRAWING/APPLICATION CHECKLIST
lease make sure your site drawing includes the following information required for a CAMA minor develop-
lent permit. The drawing may be simple and not necessarily to scale. The Local Permit Officer will help you,
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
f you will be working in the ocean hazard area:
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)
f 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
if a house is to be placed on lot,describe location of house
note size of piling and depth to be placed in ground
draw and label all areas to be paved or graveled
describe composition of surface
note and list fully all trees and vegetation to be removed or relocated
show landscaping
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JOTE TO APPLICANT
Have 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?
*enclosed the$50.00 fee?
*completed an AEC Hazard Notice,if necessary?
FOR STAFF USE
Site Notice Posted Final Inspection Fee Received
Site Inspections
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Date of Action: Issued Exempted Denied Appeal Deadline(20 days)

Bank of America Advantage'
PATRICIA T. GRAY 01-02 102
910-328-6063
20N. TAMARIXPS CT. /J �/ �v O�Z.g/�p NC
702
N.TOPSAIL BEACH, NC 28460 251 Date '7 V C____
PayNC.
� � ► $ 00.00
to the orr f / 1
ji/coLctleet
�t Y / ( Dollars 8
Bankof America 1
ACH Rif 053000196 P
Memo ` D `N)37‘0' caLtot_i_
1:0 5 3000 19 61: 000 6888 6 7 2 1 2II• 0 LO 2