PN_19-02_ Holland

-
Issued by WiRO PN19-02
Pender County Permit Number
CAMA
MINOR DEVELOPMENT
PERMIT
NORTH CAROLINA
Environmental Quality
as authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission for development in an area of environment
concern pursuant to Section 113A-118 of the General Statutes, "Coastal Area
Management"
Issued to Jonathan Holland authorizing development in the Estuarine Shoreline (AEC) at 480 Roberts Road, in
Hampstead, Pender County as requested in the permittee's application, dated February 11, 2019, and received by DCM
on February 20, 2019. This permit, issued on March 11, 2019, is subject to compliance with the application and drawing
dated and received by DCM on February 20, 2019 (where consistent with the permit), all applicable regulations and
special conditions and notes set forth below. Any violation of these terms may subject the permittee to a fine,
imprisonment or civil action, or may cause the permit to be null and void.
This permit authorizes: Single-family residence with driveway.
(1) All proposed development and associated construction must be done in accordance with the permitted site drawing dated
received by DCM on February 20, 2019.
(2) Any change or changes in the plans for development, construction, and/or land use activities will require re-evaluation and
modification of this permit.
(3) A copy of this permit shall be posted or available on site throughout the construction process. Contact this office at (910)
766-7221 for a final inspection at completion of work.
RECEIVED
(Additional Permit Conditions on Page 2) MAR 2 0 2019
DCM WILMINGTON, NC
This permit action may be appealed by the permittee or other qualified persons
within twenty (20) days of the issuing date. This permit must be on the project
site and accessible to the permit officer when the project is inspected for Jason Dail
compliance. Any maintenance work or project modification not covered under CA A LOCAL PERMIT OFFICIAL
this permit,require further written permit approval.All work must cease when this
permit expires on: 127 Cardinal Drive Extension
December31,2022 Wilmington, NC 28405-3845
In issuing this permit it is agreed that this project is consistent with the local Land
Use Plan and all applicable ordinances. This permit may not be transferred to
another party without the written approval of the Division of Coastal PERMITTEE
Management.
(Signature required if conditions above apply to permit)

Name: Jonathan Holland
Minor Permit#PN19-02
Date: March 11, 2019
Page 2 of 2
(4) All unconsolidated material resulting from associated grading and landscaping shall be retained on site by effective
sedimentation and erosion control measures. Disturbed areas shall be vegetated and stabilized (planted and
mulched)within 14 days of construction completion.
(5) Any proposed for grading within the 30' Coastal Shoreline buffer (as measured from the Normal High Water level)
must be contoured to prevent additional stormwater runoff to the adjacent marsh and/or canal. This area shall be
immediately vegetated and stabilized, and must remain in a vegetated state.
(6) This permit does not authorize the excavation or filling of any wetlands, even temporarily.
(7) No impervious coverage/built upon area, including but not limited to the house (including eaves), foundation pad,
covered decking,etc.shall extend into the 30-foot coastal shoreline buffer.
(8) Shall the plan of development exceed 30% impervious coverage within 75' of the normal high water line, the
applicant shall effectively demonstrate, through innovative construction and design that the amount of impervious
surfaces exceeding 30% impervious coverage within the 75' Coastal Shoreline AEC shall be managed and the AEC
protected. All proposed development and associated construction must be done in accordance with a credible
innovative design plan, sealed and sealed by a professional engineer.
(9) Upon completion of construction and prior to the issuance of a Certificate of Occupancy(CO), a letter of certification
must be received from the designer of the innovative system installed, certifying that the permitted system has been
installed in accordance with this permit, the approved plans and his design specifications. Any deviations from the
approved plans and specifications must be noted on the Certification and a permit modification may be required
prior to receiving a CO.
(10)All structures shall comply with the NC Building Code, including the Coastal and Flood Plain Construction Standards
of the N. C. Building Code, and the Local Flood Damage Prevention Ordinance as required by the National Flood
Insurance Program. If any provisions of the building code or a flood damage prevention ordinance are inconsistent
with any of the following AEC standards, the more restrictive provision shall control.
(11)Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third-party.
----79
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SIGNATU DATE: y /5- A
PERMITT
RECEIVED
MAR 2 0 2019
DCM WILMINGTON, NC

ROY COOPER
f inrrrm,,.
MICHAEL S. REGAN
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NORTH CAROLINA BRAXTON DAVIS
Environmental flualit} I),rcrau
March 11, 2019
Jonathan Holland
1751 Avent Ferry Road
Holly Springs, NC 27540
Dear Mr. Holland:
Attached is CAMA Minor Development Permit PN 19-02 for work to be done at 480 Roberts Road,
Hampstead, Pender County. An electronic copy has been sent to the Pender County Inspections
Department.
To validate this permit, please sign both copies as indicated for our records. Retain the orange copy for
your files and of receipt in the enclosed, self-addressed
envelope.
This is not a valid permit until it is signed and returned to our office.
Thank you for your prompt attention to this matter.
Sincerely,
Tanya K. Pietila
Permit Support Technician
N.C. Division of Coastal Management
Enclosures
Cc: WiRO files
PN Co. Inspection Dept.
Old Towne Dev-Agent
State of North Carolina Environmental Quality Coastal Management
127 Cardinal Drive Ext.,Wilmington,NC 28405
919 796 7215

Locality fro/144/i) Permit Number .__...__..
Ocean Hazard Estuarine Shoreline V ORW Shoreline Public Trust Shoreline Other�_.._.._.
(For official use only)
GENERAL INFORMATION
LAND OWNER-MAILING ADDRESS1
Name_--- Jtnq}A�^ (�4liu^[
Address fl 1110_....__ !!ry
City fl�l S rip . —_State N(, Zip 1/1191� Phone (s tl) —Ib3
Email lam .%4-Yi.skr -A g1,n% • to•�
AUTHORIZED AGENT
Name _0jd r`+/ OfV ly -----.-__—._-___.-.
Address 1.41 Oral 1'+^ IA/ wA1 _.----_-
City_._ _—State rV • Zip1i1S19 Phone 91 65I q#7i]l----_
Email p ie fown,_d iv4 lopLr , `Dr%
LOCATION OF PROJECT:(Address,street name and/or directions� to site;name of the adjacent waterbody.)
�.tbtr-h IQ• }�t1m00rn d '" C,
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.)
SIZE OF LOT/PARCEL: _ .1.19up.�._.� square feet _,,,_ acres
PROPOSED USE: Residential' (Single-fatuity' Multi-family❑ ) Commercial/industrial ❑ Other i_.
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: 1-157' square feet(inchades
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:tj'1'jp 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.) a-)
STATE STORM WATER MANAGEMENT PERMIT: Is the project located in an area subject to a State W O
Stormwatcr Manag meat Permit issued by the NC Division of Energy, Mineral and Land Resources(DEMLR)? > o C7
YES NOV
_.____
If yes,list the total built upon area/impervious surface allowed for your lot or parcel: square feet. W _'
C.)

OTIIKR PERMITS MAY 1W REQUIRED:The activity you are planning may require permits other than the CA'
minor development permit,including,but not limited to: Drinking Water Well,Septic Tank(or other sanitary waste
treatment system),Building,Electrical,Plumbing,Pleating and Air Conditioning, Insulation and Energy Conserva!
Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile Flomc Patio Approval,I lighway Conine •
others.Check with your Local Permit Officer for more information.
STATEMENT OF OWNERSHIP:
t,the undersigned,an applicant for a CAMA minor development permit,being either the owner of property in an A'
person authorized to act as an agent for purposes of applying for a CAMA minor development permit,certify that !;
listed as landowner on this application has a significant interest in the real property described therein.This interes!
described as:(check one)
•
✓ an owner or record title,Title is vested in name ofjory4ton 6 H41/gn) God idico ttrtti 1"10hoiftc'_
sec Deed Rook 111igl page 641 in the Prnd4C, CoMty Registry e!
an owner by virtue of inheritance.Applicant is an heir to the estate of
:probate was in
if other interest,such as written contract or tease,explain below or use a separate sheet&attach to this applic.,
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,
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a LAMA pern�,
(Name) (Address)
('> � T4,41,5 00 l tx Sell 1447tlt ,J . Zr �� t12.)
(2)
(3) _c Cis. 0___ ._n. i --- 5'1 N. k4Jr N& -144%- `l3l -Ada i J
(4)
ACKNOWLEDGEMENTS:
I,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area
may be susceptible to erosion and/or flooding. I acknowledge that the Local Permit Officer has explained to me the;,•,
lay hazard problems associated with this lot.This explanation was accompanied by recommendations concerning st:it
Lion and floodproofing techniques.
Iitrthertnore certify that I am authorized to grant,and do in fact grant,permission to Division of Coastal Managcm
the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating inf ornr,
related to this permit application.
This the 11 T - day of._p__eb .20 1 C'
Landow or person authorized to act as h r agent for purpose of filing a CAMA permit application
This application includes:general information(this form),a site drawing as described on the hack of this applicati,
ownership statement,the Ocean Ilazar iAEC Notice where necessary,n cheek for$100.00 made payable to the loco
any information as may be prvided orally by the applicant. The details of the application as described by these son-,'
incorporated without refere»cc in any permit which may be issued.Deviation from these details will constitute o vio.
any permit,Any person developing in an AEC without permit is subject to civil,crintinplrptal�rd re erctiau
DCM WILMINGTON, NC
FEB 2 0 2019

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Uo^a i',0-\ I11"2-
Mailing Address: 115 t i V t 1 Ftri ,
i-iini. St() s fir:. 21$'70
Phone Number: 1 i 9 ‘cq ill 0
Email Address: 'il 14 ✓✓A r*t rirt e vivo •Germs
I certify that I have authorized 1L\ A ( r•4 1
A ent I Contractor
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 y ) 01614 1241, no 071 Irk 2 •
in PMPta- County.
I furthermore certify that I am authorized to grant, and do in fact grant permission tc:
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 tim
permit application.
Property Owner Information:
7-I------- ------------
Signatur
�� t�j��1 6141- t}0 j f Gi nc
Print or Type Name
Title
?- I II 1 ) Q 1'7
Date
RECEIVED
This certification is valid through 1 I I 1 j jA/ DCM WILMINGTON, NC
FEB 2 0 2019

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ENVIRONMENTAL REALM SECTION
P.O. BOX 1209
BURGAW,NC 28425 proki.
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PIN: 4213-68-5627-0000 Sale Price: $220,000 Acres:1 Pender County
Owner: JACOBS HENRY H III et al Sale Date: 2018-08-16 Land Value:$0
PO BOX 584 Plat: 00620099 Building Value: $0
Account No: 981389 Total value:$0 1:13,042
HAMPSTEAD,NC 28443 0 0.075 0.15 0.3 mi
Township: TOPSAIL Deferred Value:$0 i , ' , ' ,1 , - , ' , i
Deed Ref: 4670/1660
Subdivision: Exempt Amount: 0 0.15 0.3 0.6 km
Tax Codes: G01 F22 R40 PCL Class:R N
1 inch = 1,087 feet
Property Heated SqFeet: Xi
Address: ROBERTS RD 4" _ i
February Description: LT 2 PB 62/99 ALFRED SIDBURY SURVEY 11. 2019 '
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PIN: 4213-68-5793-0000 Sale Price: $220,000 Acres:1 Pe n d e r County
Owner: HOLLAND JONATHAN B et al Sale Date: 2018-07-23 Land Value:$0
1751 AVENT FERRY RD Plat: 00620099 Building Value: $0
Account No: 980663 Total value:$0 1:1,956
HOLLY SPRINGS,NC 27540 0 0A125 0,025 0.05 mi
Township: TOPSAIL Deferred Value:$0 I ti , I 1 , ' ri 1
Deed Ref: 4669/668
Subdivision: Exempt Amount: 0 0.0225 0.045 0.09km
Tax Codes: G01 F22 R40 PCL Class:R 1 inch = 163 feet N
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Address. ROBERTS RD Heated Sq Feet: R� 1/ �.\!r:
Description: LT 1 PB 62/99 ALFRED SIDBURY SURVEY February 11, 2019

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PIN: 4213-69-4041-0000 Sale Price: $209,000 Acres:2.99 Pender County
Owner: YOUNDT D CRAIG et al Sale Date: 2014-11-07 Land Value:$373,615
54 N RIDGE Plat: 00290151 Building Value: $330,104
Account No: 964851 Total value: $703,719 1:1,956
SURF CITY,NC 28445 0 0.0125 0.025 0.05 mi
Township: TOPSAIL Deferred Value:$0 }—', , , ' , • , ' il i
Deed Ref: 4491/317 0 0.0225 0.045 0.09 km
Subdivision: SLOOP POINT SOUTH Exempt Amount:
Tax Codes: G01 F22 R40 S63 PCL Class:R 1 inch = 163 feet \
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Address: 431 ROBERTS RD Heated Sq Feet::::2268: -: i
February 11. 2019
Description: 2.99AC SEC B SLOOP POINT SUB ROBERT W ROBERTS JR 11SP311 ��f �

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This letter is to inform you that I, Zang .n� ki0l1 y_ ? . have applied for a CAMA Minor
Property Owner
Permit on my property at ",%% Q-adv‘ 90_ in s ..2_„___
Property Address ity I Town
in Pender County. As required by CAMA regulations, I have enclosed a copy of my permit application and
project drawing(s)as notification of my proposed project.No action is required from you or you may sign and return
the enclosed no objection form.If you have any questions or comments about my proposed project,please
contact me at `tl9 long Ib3a ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the CAMA Minor Permit Program,you may submit them to:
Jason Dail,DCM Field Representative
LPO,County of Pender
NC DEC)1 DCM
127 Cardinal Drive Ext.
Wilmington, NC 28405
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Property Owner
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City,State,Zip Code RECEIVED
DCM WILMINGTON, NC
FEB 2 0 2019

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of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply
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electronic version.For a hardcopy return receipt,
complete PS Form 3811,Domestic Retum
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City,State,Zip Code
Dear Adjacent Property: �
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Property Owner
Permit on my property at 118 0 dv Ic In Ow?"T PR4___.
Property Address City/Town
In Pender County. As required by CAMA regulations,I have enclosed a copy of my permit application and
project drawing(s)as notification of my proposed project.No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project,please
contact me at 919 ‘6q /d 3 D ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the CAMA Minor Permit Program,you may submit them to:
Jason Dail,DCM Field Representative
IPO,County of Pender
NCDEQIDCM
127 Cardinal Drive Ext.
Wilmington, NC 28405
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Property Owner
17 51 gyU'i ram% ''•
Mailing Address
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City,State,Zip Code RECEIVED
DCM WILMINGTON, NC
FEB 2 0 2019

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or Priority Mail®service. -Adult signature restricted delivery service,which
Certified Mail service is not available for requires the signee to be at least 21 years of agr
international mail. and provides delivery to the addressee specified
Insurance coverage Is not available for purchase by name,or to the addressee's authorized agent
with Certified Mail service.However,the purchase (not available at retail).
of Certified Mail service does not change the •To ensure that your Certified Mail receipt is
insurance coverage automatically included with accepted as legal proof of mailing,it should bear a
certain Priority Mail items. USPS postmark.If you would like a postmark on
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endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for
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electronic version.For a hardcopy return receipt,
complete PS Form 3811,Domestic Return
Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records.
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ileakb PENDER COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH DIVISION
c 803 Walker Street,P.O.Box 1209
Burgaw,NC 28425
Phone [phone] FAX [phone]
rfo
.8. . 8 �8 R j www.pendercouutync.gov
Note Quoin Pubic Noah
r+ w P ewsw4,
IMPROVEMENT PERMIT
Parcel PIN:4213-68-5793-0000 Permit#:IP 18.231H
Application Date:10/17/18
Applicant Al Sldbury Owner: Jonathan&Jiltlan Holland
Address: 130 Broadview La. Address: 1641 Avent Ferry Rd.
Haaaprtead,NC 28443 Holly Spas,NC 27540
Phone: [phone] Phone: [phone]
Property Deac.: Roberts Rd.Lot 1 Lot Size(Acres):
Property Address: Roberts Rd. Facility Type: Single Family Dwelling
Permit Type: Residential New Water Supply: Well
INTIAL SYSTEM JJEPAIR SYSTEM
Design Flow: 480 GPD System TYPe: Pump to 25%reduction System TYPe: Pimp to 25%reduction
No.of Bedrooms: 4 System Class:mkt System Class:mg
Site Classification:pg Useable Soil Depth:40" Useable Soil Depth:30"
LTAR:0,g LTAR 0.8
Conditions:
***DO NOT DISTURB DRAINFIELD AREA***
***lutall drainl nee on contour
Refer to the attached site plan for specific information regarding location of the designated area. Soil and site descriptions are
located on file at Fender County Environmental Health. There may be other types of systems which are applicable to this site.
The permit and evaluation are valid only for the site as designated on the attached site plan. A Construction Authorization must
be issued prior to the issuance of the Building Permit and before any construction or system installation can commend
This permit is subject to revocation if the site plan,plat,or intended use changes or if the site is altered.Do not drive on or
otherwise disturb the designated soil area or this permit may be revoked
ISSUED:Nov.08,2018 EXPIRES:Nov.08,2023
Registered Environmental Health Specialist RECEIVED
DCM WILMINGTON, NC
FEB 2 0 2019

moo FENDER COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH DIVISION
10:0 803 Walker Street,P.O.Box 1209
4114
Burgaw,NC 28425
Phone [phone] FAX [phone]
o Jll31111 .111 f► www.pendercountync.gov
sent GrdirnAub�Crt»Ipo
E.rd....evarbiLearltedit
WASTEWATER SYSTEM CONSTRUCTION AUTHORIZATION
Parcel PIN:4I13-68.5793-0000 Permit#: CA 18-231H
Application Date:10/17/18 Associated IP#: IP 18-231H
Applicant Al Sidbury Owner:Jonathan&Alias Holland
Address: 130 Broadview La. Address:1641 Arent Ferry Rd.
Hampstead,NC 28443 Holly Syrians,NC 27540
Phone: [phone] Phone:[phone]
Property Address: Roberts Rd. Lot Size(Acres):
Property Description: Roberts Rd.Lot 1 Facility Type:singleFamily Dimino*
Permit Type: Residential New Water Supply: well
I1nTIAL SYSTEM REPS SYgTEDI
Design Flow 480 GPD System Type:Pomp to 25%redaction System Type:Primp to 23%reduction
No.of Bedrooms: 4 System Class:IQbg System Class:m bo
Septic Tank:1800 GAL Nitrification:(4140'Lino Nitrification:(4)40'Lines
Pump Tank: 1o00 GAL Max Trench Depth: 18" Max Trench Depth:12"
Horiz Trench Separation: 9' Horiz Trench Separation: of
Condidons/Comments:
1-NOT DESIGNED FOR GARBAGE DISPOSAL
***DO NOT DISTURB DRAINFIELD AREA***
***Inrtall drainlinee on contour
RECEIVED
DCM WILMINGTON, NC
FEB 2 0 2019
REFER TO THE ATTACHED SITE PLAN SHOWING THE SYSTEM AND FACILITY LOCATIONS AND OTHER SYSTEM SPECIFICATIONS.
THIS AUTHORIZATION SHALL BECOME INVALID AND MAY BE REVOKED IF THE INFORMATION SUBMTITID ON THE APPLICATION
OR SITE PLAN IS INCORRECT,FALDAFIED,OR CHANGES OR IF THE SITE IS ALTERED OR IF THE SYSTEM INSTALLATION IS NOT
COMPLETED BEFORE THE EXPIRATION DATE. THE SYSTEM SHALL BE INSTALLED IN ACCORDANCE WITH:
-PORTAL CAROLINA ADIKIIISIRATIVE CODE TITLE ISA 195Q,
-APPLiC♦ LE SYSTEM APPRQV LA_
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ISSUED:Nov.08,2018 EXPIRES:Nov.08,2023
Registered Environmental Health Specialist

DEAR R..1-t OP MALTS AND NUMAN NR 1 3S
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OWi _ APPLICAT1Cti DATE /
ADD S:- - �� DATE EVALUATE)/ei-
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PRC PACRITY: / np.;?4-59:__-� = PROPERT NZEr ' •LlX".,AT'1�9I? $1�i]3: 1 f+ .4.. PKMITY 1 pKDED: , --
WATER iSUPPLY. • ' Ogel SPin °cliff
EVALUATION METHOD: '.i''-" Pit Cut TYPE OF WASTEWATER: '`^ Industrial Process Mixed
s •
o SOIL MORPHOLOGY o OTIERR
7 (.I941) PROFILE FACTORS
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Date Date Check From Name of Vendor Check Check Permit Rct. #
Received Deposited Permit Holder Number amount Number/Comments
2/25/2019 Old Towne Jonathan Holland Providence 7793 $100.00 minor fee,480 Roberts Road, JD rct.7771
Developers Inc. Bank Hampstead PnCo