PN_20-03_ Forehand

Issued by WiRO PN20.03
Pender County Permit Number
CAMA
MINOR DEVELOPMENT
PERMIT
NORTH CAROLINA
as authorized by the State of North Carolina, Department of Environmental Quality 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 Brian Forehand authorizing development in the Estuarine Shoreline (AECs) at 2103 Washington Acres
Road, Pender County as requested in the permittee's application, dated February 12, 2020, and received complete by
DCM on February 13, 2020. This permit, issued on February 28, 2020, is subject to compliance with the application and
drawing dated and received by DCM on February 13, 2020 (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: Construction of a garage and pervious driveway.
(1) All proposed development and associated construction must be done in accordance with the permitted site drawing,
received by DCM on February 13, 2020.
(2) All construction shall 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, and/or land use activities will require re-evaluation and
modification of this permit.
(4) 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.
(Additional Permit Conditions on Page 2)
This permit action may be appealed by the permittee or other qualified persons y
within twenty (20) days of the issuing date. This permit must be on the project Y � ) f
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 CAMA LOCAL PERMIT OFFICIAL
this permit,require further written permit approval.All work must cease when this
permit expires on: 127 Cardinal Drive Extension
Wilmington, NC 28405-3845
December31,2023
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: Brian Forehand
Minor Permit# PN20.03
Date: February 28, 2020
Page 2 of 2
(5) This permit does not authorize the excavation or filling of any wetlands or open water area(s).
(6) 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.
(7) This permit does not authorize any development activities within 30 feet of the normal/mean high water line.
(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.
(9) Development on the subject property shall be limited to no more than 25% built-upon area.
(10) All construction shall conform to the N.C. Building Code requirements and all other local, State and Federal
Regulations, applicable local ordinances and FEMA Flood Regulations.
SIGNATURE: DATE:
PERMITTEE

� ,:-fl,^ ROY COOPER
f
Z. '''F4.1 lei
r -- `fix' MICHAEL S. REGAN
Secretary
,, I.
BRAXTON DAVIS
Director
March 2, 2020
Brian Forehand
PO Box 10793
Wilmington, NC 28404
Dear Mr. Forehand,
Attached is CAMA Minor Development Permit PN 20-03 for work to be done at 2103 Washington Acres
Road, Hampstead in 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 return the white copy to us within 20 days 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,
(v)-, ,( '', .ii / ___.-
, / AlfkkA _./' '' / -. ---
janya,K. Pietifa
F ermit.Support-Technician
N.bivision of Coastal Management
Enclosures
Cc: WiRO files
PN Inspection Dept.
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext.,Wilmington,NC 28405
919 796 7215

� �
Locality
byvkvc(\-(6La y�CV 0
Permit Number ��
. Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
(For official use only)
GENERAL INFORMATION
LAND OWNER-MAILING ADDRESS
!r-ete- ee
Name l
jlJ`4.�Address - --------
. 0,
� �/ t�
City In/, (!•-t.�j ki / t k State 6 Zip-2 FYD(Yhone 02 5 2 -���' ?6'2-!�
Email /3n`<I,, 7 'tQ, 4 (/ 31
AUTHORIZED AGENT
Name 13f'
Address e O g 6 - J 0- Ina
City L✓'s lti'.tisJvh State 14 6. • Zip 21/�cShone
Email / r' -� C/ `''`.,/ e, � �� �`=/J1^e C c��
LOCATION OF PROJECT:(Address,street name and/or directions to site;name of the adjacent waterboddy.)
`2--7 3 t 4'1G--`-1y r„ h Cry r(J cr`7f T e' ,"-te /6 (
DESCRIPTION •
OF PROJECT:(List all proposed construction and land disturbance.)
/4-6e6° 4t c. C- < f-e y ejr-GC
SIZE OF LOT/PARCEL: 2(5 square feet acres
PROPOSED USE: Residential E-- (Single-family ale lti-family ❑ ) Commercial/Industrial [] Other 0
COMPLETE EITHER(I)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: '°' --square feet(includes the area of the foundation of all buildings,driveways,covered decks,
concrete or masonry patios,etc.that arc within the applicable AEC.Attach your calculations with the project drawing.)
STATE STORM WATER 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.
RECEIVED
DCM WILMINGTON, NC
FEB 1 3 2020

LOT 12 20,007 SF
TOTAL 4358 SF IMPERVIOUS AREA
104.52'
BULKHEADS
Mc•)
22
38'9 `r)
E 10.1'
b pLL
M aU)
w v.
f`• O�
m
M d f~
M 6' R)
co
O EXISTING HOUSE O
2443 SF FOOT PRINT
16'
12' 14'9 12' •
O CO U
•
> o
wc •-
'r za..
1096 SF AVED .
10'R.O.W. TO R.O.W.
104.43' RECEIVED
SITE PLAN: 2103 WASHINGTON ACRES RD
FOREHAND RESIDENCE DEB 1 5 t02i
SCALE: 1"=30' 2-14-2020
PERPARED BY: FERRO HOME DESIGNS pCM WILMI GTON,NCi

OTiiER PERMITS MAY BE REQUIRED:The activity you arc 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,Plmbing,Ideating and Air Conditioning, Insulation and Energy Conservation, FiA
Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile Ilome Park Approval,i lighway 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
described as:(check one)an owner or record title,Title is vested in name of /3/1 r.1 T Ure 6,i i ,
see Deed Book } j S page - t/3 in the "6-- County Registry of Deeds.
an owner by virtue of inheritance.Applicant is an heir to the estate of
I ;probate was in- County.
i
• 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 arc 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) qq J (Address) Q //
(I) i'.1) 4.. / />4,'/e 6 or�O& 21/y` l✓�'s t, `., Jr,. / r /( `74./f h() ?W3
(2)^ / IN/' /( i L,f / �-✓cr.•,1/„� nref te,, ,ic.,,0/kJ i ( ,2 7 yY 3
(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 I,ocal 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.
This the /ZA day of t'4 ,202_U
Landowne .r p rson au iorized t 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 hack 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 pmvided 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 penal!is subject to civil,criminal and administrative action.
RECEIVED
DCM WILMINCTON, NC
FEB 1 3 2020

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address: 1" £ £ 0)z �� 3
Phone Number: ..2 -
Email Address: gi%4�6 4,
I certify that I have authorized , rw� ri,e4 4.-117
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: r
y4ve‘ Q
at my property located at �/C` 'f s 761 .L, rc-t 44f
in rei-lk County.
I furthermore certify that 1 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:
ure
Print or Type Name
Title
2 t 12 t 2
Date
This certification is valid through 1 I
RECEIVED
DCM WILMINGTON, NC
FEB 1 3 2020

Receipts for
Certified Mail
_/2 �) (Staple Here)
Date U
/10 /j,`/61.
Adjacent Property Ow
f7 Lerd� l�r
Maury ,t, 5 fr:, /rc .2'y//
City,State,Zip Code
Dear Adjacent Property: ��^^
This letter is to Inform you that I, flrr -t JJ eA4C,- have applied for a CAMA Minor
Property Owner
Permit on my property at /is 3, 4'', zi ,in 641.1//`a(r
Property Address City l 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 '? ,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 Pander
NCDEQ/DCM
127 Cardinal Drive Ext.
ff // Wilmington,NC 28405
Property Owner
/ YoX / / 93
MailingAddress// �) / (/
City,State,Zip Code
RREGLIVED
DCM WILMINGTON, NC
FEB 1 3 2020

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
hereby certify that I own property adjacent to e. 17`.."'f-t<<'•
(Name of Property Owner)
property located at )- I' rJ 3 G, /4 • AA-piled
// (Address,Lot,Block,Road,etc.)
O° ��/Ard g'c`" fr01441 ,in Pender County,N.C.
(Waterbody)
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
Teiephone Number
Date
RECEIVED
DCM WILMINGTON, NC
FEB 1 3 2020

A
Receipts for
Certified Mali
`2 _.2 v (Staple"ere)
go `r'5 6aP26/„.
Adjacent Propefly Owner y
h/4'_34. tcio , fri c €j /C je
Ming ddiFilL,/ I7� yvV 3
City,State,Zip Code
Dear Adjacent Property:
This letter Is to Inform you that I, fit—f' i-C i'l Lek z4'f. have applied for a CAMA Minor
Property Owner
Permit on my property at ai t.' /j `►��� lKt,��i-� / ', • t`;"{ 6
Property Address City/Town
in Pander County. As required by CAMA regulations,I have enclosed a copy of my permit application and
project drawing(s)as notification of my proposed protect.No anion 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 .`) S 1 -1V1 21'.S ,or by mall 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)/DCM
127 Cardinal Drive Ext.
Wilmington,NC 28405
Property ovine;
CaX /L' )
M*gAddress ) fir(,
br lf.� `r,j f.t 1/ ( 2 G 7 y
City,State,Zip code •
RECEO''ED
ACM WILMINGTON, NC
FEB 13 2020

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to 1//- fi-dt�t_ i 's
(Name of Property Owner)
property located at Z /V 3 1/ f/6.j J /4 res to ./A"Prf Cd
/� p ress,Lot,Block,Road,etc.)
on Pender County,N.C.
(Waterbody)
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
Telephone Number
Date
RECEIVED
DCM WILMINGTON, NC
FEB 1 3 2020

U.S. Postal Service'
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RECEIVED
DCM WILMINGTON, NC
FEB 1 3 2020

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U.S. Postal Service
CERTIFIED MAIL® RECEIPT
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RECEIVED
nr.pCM Vik_MINGTON, NC
vEB 1 3 2020

NC Division of Coastal Management 10 9 6 6 A B '�
Cashier's Official Receipt
Date: / 20
Received From: F I, � $
( VD
Permit No.: MEW
I Check No.: u Applicant's Name: 6 if MI County:
Proect Address: 2'4°3
v i"- -61.(4RCliVj
(4
Please retain receipt for your records as proof of payment for permit issued.
Signature of Agent or Applica t: Date: 2 I ,_
Signature of Field Representative:
Date:

Date Date Check From Name of Vendor Check Check Permit Rct. #
Received Deposited Permit Holder Number amount Number/Comments
2/17/2020 Brian D Forehand same South State 2057 $100.00 minor fee, 2103 Washington Acres JD rct.
Bank Rd, Hampstead PnCo 10966