PN_19-10_ Medlin

Issued by WiRO PN 19-10
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 Dorothy Lea Medlin authorizing development in the Estuarine Shoreline (ORW) Areas of Environmental
Concern (AECs) at 209 Leas Lane, Hampstead, Pender County as requested in the permittee's application package,
dated July 11, 2019, and received by DCM on July 25, 2019. This permit, issued on August 12, 2019, is subject to
compliance with the application and site drawing (where consistent with the permit), all applicable regulations and special
conditions and notes set forth below. Any violation of these terms may subject permittee to a fine, imprisonment or civil
action, or may cause the permit to be null and void.
This permit authorizes:Addition to an existing single-family residence with driveway/parking area(s).
(1) All proposed development and associated construction must be done in accordance with the permitted work plat drawings(s)
dated received by the Division of Coastal Management on July 25, 2019.
(2) All construction must conform to the N.C. Building Code requirements and all other local, State and Federal regulations,
applicable local ordinances and FEMA Flood Regulations.
(3) Any change or changes in the plans for development, construction, or land use activities will require a re-evaluation and
modification of this permit.
(4) A copy of this permit shall be posted or available on site. Contact this office at [phone] for a final inspection at
completion of work.
RECEIVED
(Additional Permit Conditions on Page 2) AUG 1 9 2019
DCM ILMINGTON, 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 Jason Dail
site and accessible to the permit officer when the project is inspected for riAIGIA LOCAL PERMIT OFFICIAL
compliance. Any maintenance work or project modification not covered under t
this permit,require further written permit approval.All work must cease when this 127 Cardinal Drive Extension
permit expires on: Wilmington, NC 28405-3845
December31,2022 4ilt.L,
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 PERM E
another party without the written approval of the Division of Coastal
Management. (Signature required if conditions above apply to permit)

Name: Dorothy Lea Medlin
Minor Permit#PN 19-10
Date: August 12, 2019
Page 2
(5) 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.
(6) The amount of impervious surface/coverage on this property shall not exceed 25% within 575 feet of the Normal
High Water line.
(7) This permit does not authorize the excavation or filling of any wetlands or open water areas.
(8) Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third-party.
RECEIVED
AUG 1 9 ?019
DCM WILMINGTON, NC
SIGNATURE: 4t ATE: 1 r
PER TT E

t
issued by MO PN 19-10
Pander County Permit Number
LAMA
MINOR DEVELOPMENT
PERMITNORM CAROUNA
Envir mmental Qruxttty
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 Dorothy Lea Medlin authorizing development in the Estuarine Shoreline (ORW) Areas of Environmental
Concern (AECs) at 209 Leas Lane, Hampstead, Pander County as requested in the permittee's application package,
dated July 11, 2019, and received by DCM on July 25, 2019. This permit, issued on August 12, 2019, is subject to
compliance with the application and site drawing (where consistent with the permit), all applicable regulations and special
conditions and notes set forth below. Any violation of these terms may subject permittee to a fine, imprisonment or civil
action,or may cause the permit to be null and void.
This permit authorizes:Addition to an existing single•family residence with driveway/parking area(s).
(1) All proposed development and associated construction must be done in accordance with the permitted work plat drawings(s)
dated received by the Division of Coastal Management on July 25, 2019.
(2) All construction must conform to the N.C. Building Code requirements and all other local, State and F=.eral regulations,
applicable local ordinances and FEMA Fkxxl Regulations.
(3) Any change or changes in the plans for development, construction, or land use activities will require a re-evaluation and
modification of this permit.
(4) A copy of this permit shall be posted or available on site. Contact this office at(910) 766-7221 for a final inspection at
completion of work.
(Additional Permit Conditions on Page 2)
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 Jason Dail
site and accessible to the peal officer when the project is inspected for
compliance. Any maintenance work or project modification not covered under A A LOCAL PERMIT OFFICIAL
this permit,require further written permit approval.All work must cease when this 127 Cardinal Drive Extension
permit expires on: Wilmington, NC 28405-3845
December 31,2022
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 PE ITTEE
Management. (Signature required if conditions above apply to permit)
•
S . + Sa

Name:Dorothy Lea Medlin
Minor Permit#PN 19-10
Date:August 12,2019
Page 2
'r
(5) 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.
{8} The amount of impervious surface/coverage on this property shag not exceed 25% within 575 feet of the Normal
High Water line.
(7) This permit does not authorize the excavation or filling of any wetlands or open water areas.
(8) Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed
of to aThird-party.
I
�t� fi w�q .�
,-. . ' ^ w:x ��a 4a"fi ,• tom° ,kaa' ` ' � �.- f n • $ '
SIGNATURE: � /a oloi?
DATE. � j
PE TEE

17
ROY COOPER
Governor
[Fs
MICHAEL S. REGAN
Secretory
NORTH CAROLINA BRAXTON DAVIS
Envlronmenta€Cusfitt Director
August 12, 2019
Dorothy Lea Medlin
209 Leas Lane
Hampstead, NC 28443
Dear Dorothy,
Attached is CAMA Minor Development Permit PN 19-10 for work to be done at 209 Leas Lane,
Hampstead in Pender County. An electronic copy has been sent to the Pender County Inspections
Department and to your Agent.
To validate this permit, please sign both copies as indicated for our records. Retain the orange copy for
your files, and 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.
cS'ncerely,
anya etila
Permit Support Technician
N.C. Division of Coastal Management
Enclosures
Cc:WiRO files
PN Inspection Dept.
Paul Clark—Agent
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext.,Wilmington,NC 28405
919 796 7215

\31\) °
q(AVITA(14,4 Permit Number
Locality
Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
(For official use only)
GENERAL INFORMATION
LAND OWNER-MAILING ADDRESS
Name: DOROTHY LEA MEDIAN
Address 209 Leas Ln.
City: Hampstead State: NC Zip: 28443 Phone: [phone]
Email: [e-mail]
AUTHORIZED AGENT
Name: Paul Clark
Address: 6525 Pacific Rd.Wilmington,NC 28409
City: Wilmington State: NC Zip: 28409 Phone: [phone]
Email: [e-mail]
LOCATION OF PROJECT: (Address,street name and/or directions to site;name of the adjacent waterbody.)
209 Leas Ln. Hampstead, NC 28443
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.)
Single family residential addition,additional driveway and walkways
SIZE OF LOT/PARCEL: 47.439 square feet _ acres
PROPOSED USE:Residential 00 (Single-family 0 Multi-family ) Commercial/Industrial Other 0
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 BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: 222¢ 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.)
RE�E�IVED
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a e
Stormwater Management Permit issued by the NC Division of Energy,Mineral and Land Resourcet i,DFiIie
YES NO 0 J U L G g�Qt
If yes,list the total built upon area/impervious surface allowed for your lot or parcel: DC-Pat_ tt1VINgi'o N: NC

ETHER PERMITS MAY BE REQUIRED:The activity you are planning may require permits other than the CAMA
ninor development permit,including,but not limited to: Drinking Water Well,Septic Tank(or other sanitary waste
reatment system),Building,Electrical,Plumbing,Heating and Air Conditioning,Insulation and Energy Conservation,FIA
:ertification,Sand Dune,Sediment Control,Subdivision Approval,Mobile Home Park Approval,Highway Connection,and
)thers.Check with your Local Permit Officer for more information.
;TATEMENT OF OWNERSHIP:
:,the undersigned,an applicant for a CAMA minor development permit,being either the owner of property in an AEC or a
Jerson authorized to act as an agent for purposes of applying for a CAMA minor development permit,certify that the person
isted as landowner on this application has a significant interest in the real property described therein.This interest can be
iescribed as: (check one)
}fig an owner or record title,Title is vested in name of DOROTHY LEA MEDLIN
;ee Deed Book 825 page 329 in the Pender 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 RIPARIAN PROPERTY OWNERS:
[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) WLI Investments;60 Gregory Road,Suite 1 Belville,NC 28451
;2) Bert Lea; 301 Leas Ln Hampstead,NC 28443
:3) Dwight A Medlin
:4)
ACKNOWLEDGEMENTS:
[,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
nay 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.
[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 a.plication.
41
21110. This the 11th day of July,2019
(Paul Clark)
Landowner or person authorized to act as his/her agent 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 11.ttldp
any permit.Any person developing in an AEC without permit is subject to civil,criminal and administrative action.
JUL
QCM WILMINGTON, NC

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Do r'o+k N Lea, %Pled I i n
Mailing Address: 209 Leas Ln
Hampstead, NC 28443
Phone Number: 910-620-9677 JUL 2 5 2019
Email Address: medlindt@
I certify that I have authorized Paul Clark (Clark Architecture),
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Residential addtion
at my property located at 209 Leas Ln Hampstead, NC 28443
in Pender County.
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.
Property Owner Information:
4-14tA")-V-S74_._62--(-441L;4---
gnature
,Dora4y L . filed/;r�
Print or Type Name
611.0-1t2A)
Title
7 / / / / a0/ 7
Date
RECEIVED
This certification is valid through / / JUL 2 5 2019
DCM WILMINGTON, NC

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to an ro��u Lea.. Medlin 's
(Name of Property Owner)
property located at c.O 9 LeQ5 lane_
S Add-c2M Address, Lot, Block, Road,etc.)
on II rgeGOt7a// ilQIera)a. in /I p 4c_o/ , N.C.
(Waterbody) ( (Tow and/or County)
{,e"),1 /� C'oan�y
He has described to me as shown in the attached application and project drawing(s), the development
he is proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
Sig „/'
na e
Print or Type Name
J/I77/2 s:S`/
Telephone Number
Date
RECEIVED
JUL 2 5 2019
DCM WILMINGTON, NC

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to ici_'')/4_ 's
(Nam of Property Owner)
property located at AO 9 % E A/C �.F V 513
��/ Address, Lot, Block, Road, etc.)
onlfi/ aeoa5/2/ WQ, ida9 , in em u- �� , N.C.
(Waterbody) / (Town and/or County)
He has described to me as shown in the attached application and project drawing(s), the development
he is proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
Si natu e '
Print or Type Name
.1'/0 _&2_o -' iL
Telephone Number
l//21/1
Date
RECEIVED
JUL 2 5 2019
DCM WILMINGTON, NC

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to ,1.Jorofh 5 Lea. flied/if)
(Name of Property Owner)
property located at .AO L e a,i L a.n e ; nips ps a.ca/ A( .2.gyV
Address, Lot, Block, Road, etc.)
on a 4erenas�ci, ) Via)er n Pe lid er C ttja , N.C.
(Waterbody) (Town and/or County)
He has described to me as shown in the attached application and project drawing(s), the development
he is proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
Signature )
Print or Type Name
Teleph ne Number
Date
RECEIVED
JUL 2 5 201E
DCM WILMINGTON, NC

Receipts for
Certified Mail
JAL/y 4 a20i9 (Staple Here)
Date
��LcJi t Anf/tony 41Nc/tf?
Adju Property Owner /
/c'2s Lar2c_
Mgg Address if' '
City,State,Zip Code
Dear Adjacent Property: //
This letter is to inform you that I, 7�)or)9 T//k L 46,6////) have applied for a CAMA Minor
Ninny Owner
Permit on my property at cR0 9 Leas 1-Q4 e NCLM�OSkacc/ N� ,in COUNTY
Property Address I
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 9/0 90 e32/06 ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program,you may submit
them to:
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY,STATE,ZIP CODE
Sincerely,
PO 7Z 1 deel/ice
Property Owner/
c;?O 7 Zec c Zane
Maili g Address
Qin s/c—aa/ 'k 9 5`_3
City,Statts,Zip Code
RECEIVED
JUL 2 5 2019
DCM WILMINGTON, NC

Receipts for
Certified Mail
(Staple Here)
0-7 j(c7
Date
� L L
Adjacent Property Owner
esP:=1P
Mailinrs� %C-• 1
City,State,Zip Code
Dear Adjacent Property: I/
This letter is to inform you that I, JOro4A L. /Yle 011 n have applied for a CAMA Minor
Prdp rty Owner
Permit on my property at o0 9 Leas L ne; gam tad IYC.. ,in COUNTY
Property Address
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 /0- D- 77 ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program,you may submit
them to:
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY,STATE,ZIP CODE
Sincerely,
XA (e_
Property Owner
020 9 Las LQy
Mailing, il Address
/-/a mp ?lead n/C c S/ci3
City,State,Zip Code
RECEIVED
JUL 2 5 2019
DCM WILMINGTON, NC

910-620-9677
Dorothy Medlin
Receipts for
Certified Mail
(Staple Here)
7//2.7
Date
. L 4 ,TS
Adjacent Property Owner
1...4-N=✓ _.
M li g Address
City,State,Zip Code
Dear Adjacent Property:
/Ay 1/�u��41ave ap
plied letter is to inform you that I, C i D ` for a CAMA Minor
Property/Owner
Permit on my property at 9 2eQ s L��� ,in Ram ar i y iced A/C
Property Address /
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
209 Leas Ln
contact me at ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program,you may submit
them to: Hampstead,NC 28443
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY, STATE,ZIP CODE
Sincerely,
5/1,A,-/
Property Owner
It; 9 L? s ,Lent
Mailing Address
atd Ale (.. FI” 3
City,State,Zip Code
RECEIVED
JUL 2 5 2019
DCM WILMINGTON, NC

Dail, Jason
From: Dail,Jason
Sent: Friday, July 26, 2019 7:51 AM
To: CA
Subject: CAMA Minor permit application package - Additional Information requested
Good morning Paul, please see the information below pertaining to the subject project.
RE: INCOMPLETE APPLICATION-Dorothy Lee Medlin-ADDITIONAL INFORMATION REQUIRED
APPLICATION NUMBER-N/A
PROJECT ADDRESS- 209 Leas Lane, Hampstead, NC
Mr. Clark,
The Division of Coastal Management's Wilmington Regional office received a CAMA Minor Permit application from you
on July 25, 2019, requesting approval for development activities at 209 Leas Lane, Hampstead, NC. In reviewing your
application,we have discovered that additional information is needed to complete the review process.Accordingly, I am
requesting that you submit the following additional information to this office:
1) On Sheet C1, please show the location of the 30-foot Coastal Shoreline Buffer, 75'AEC and 575-foot Area of
Environmental Concern (AEC), as measured from the normal/mean high water line.You can make a note on the
drawing which indicates "subject property located within 575' AEC" and cover it that way rather than picking up
the normal high water line elevation at the mouth of the entrance channel, but the 75'AEC line and 30- buffer
lines should be shown on the plans. Overall, it appears by rough estimates that+/-95%of the property lies
within that 575' AEC.
2) Please provide an elevation certificate for the property.
In accordance with the Department of Environment and Natural Resources regulations,we note that the application, as
received in our office on July 25 2019, is incomplete for processing. Upon resubmission of a complete application, a
local decision will be made in 25 days, provided this period is not extended as provided by law. Please contact me at
910-796-7221 if you have any questions.
Jason Dail
Field Representative
NC Department of Environmental Quality
NC Division of Coastal Management
127 Cardinal Drive Ext.
Wilmington, NC 28405
Phone:[phone], Fax:[phone]
Jason.Dail Pncdenr.gov
"4-Nothing Compares
*E-mail correspondence to and from this address
1

; ,
ce.F
a_1 ki
NOTE:SUBJECT PROPERTY LOCATED WITHIN 575'AEC
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BOOK 9/1,PAGE 310 "7 „J BOOK 1650,PAGE 29/ ~W 11101a
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NC Division of Coastal Management Cashier's Official Receipt 879 2 A B D
7 -2j..._2‘.
Date: 20
Received From: F
iAk (/'
$ /Ms
Permit No.: ---2/N2 ? ( Check No.:
ZApplicant's Name: i /_ ` County.
Project Address: � ®� AI/ ,,/,,,,r#-_,,e( „7,___
Please retain receipt for your records as proof of payment for permit issued.
Signature of Agent or Applic t: Date:
Signature of Field Represe Date:

Date Date Check From Name of Vendor Check Check Permit Rct. #
Received Deposited Permit Holder Number amount Number/Comments
7/26/2019 Dorothy Medline& Dorothy Lea PNC Bank 7982 $100.00 minor fee, 209 Leas Lane, JD rct.
Dwight Anthony Medlin Hampstead PNCo 8792
Medlin