PN_20-08_ Morton/Schneider

Issued by WiRO PN20-08
Pender County Permit Number
CAMA
MINOR DEVELOPMENT
PERMIT
r
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 Tammy Morton and Jeff Schneider authorizing development in the Estuarine Shoreline (AEC) at Lot 13
Crane Point, in Hampstead, Pender County as requested in the permittee's application, dated April 23, 2020, and
received by DCM on April 29, 2020. This permit, issued on May 11, 2020, is subject to compliance with the application
and drawing dated and received by DCM on April 29, 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: Single-family residence with amenities.
(1) All proposed development and associated construction must be done in accordance with the permitted site drawing dated
received by DCM on April 29,2020.
(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.
(Additional Permit Conditions on Page 2)
U
Z
This permit action may be appealed by the permittee or other qualified persons Z o
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 0 `"
Jason Dail
compliance. Any maintenance work or project modification not covered under CAMA LOCAL PERMIT OFFI
this permit,require further written permit approval.All work must cease when this
permit expires on: 127 Cardinal Drive Extensi -' >-
Wilmington, NC 28405-384
December 31,2023
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: Tammy Morton and Jeff Schneider
Minor Permit#PN20-08
Date: May 11, 2020
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) 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.
(9) Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third-party.
SIGNATURE: 11 A
PERMITTEE
RECEIVED
DCM WILMINGTON, NC
MAY 2 6 2020

*w aft, ROY COOPER
. ' 1 _
MICHAEL S. REGAN
BRAXTON DAVIS
May 13, 2020
Tammy Morton &Jeff Schneider
3014 Buckingham Road
Durham, NC 27707
Dear Ms. Morton & Mr.Schneider,
Attached is CAMA Minor Development Permit PN 20-08 for work to be done at Lot 13 Crane Point,
Hampstead in Pender County. An electronic copy has been sent to the Pender County Inspections
Department and your Agent.
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,
Tanya K. Pietila
Permit Support Technician
N.C. Division of Coastal Management
Enclosures
Cc:WiRO files
PN Inspection Dept.
Gene Young—Agent
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext.,Wilmington,NC 28405
919796 7215

csko yfi--cet-(t1 rJ 2b - z
Locality '\*\ Permit Number OTHER PERMITS MAY BE REQUIRED:The activity you are planning may require permits other than Ci�ee
minor development permit,including,but not limited to:Drinking Water Well,Septic Tank(or other sanitartiro O
Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other treatment system),Building,Electrical,Plumbing,Heating and Air Conditioning,Insulation and Energy Conekrv4uen,Fre
N
(For official use only) Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile Home Park Approval,Highway elmelion,111
CI
others.Check with your Local Permit Officer for more information. it, Z
GENERAL INFORMATION UJ.. t�
STATEMENT OF OWNERSHIP:
LAND OWNER-MAILING ADDRESS I.the undersigned,an applicant for a CAMA minor development permit,being either the owner of property nC ora_
Name Tammy Morton and Jeff Schneider-proposed buyers person authorized to act as an agent for purposes of applying for a CAMA minor development permit,certifyyttatirepers91(
Lstetras ianaowner on this application has a significant interest in the real property described therein.This irleefesan be
Address 3014 Bud/Ingham RD described as:(check one) U
Cl
City Durham State NC Zip 27707 Phone an owner or record title,Title is vested in name of
see Deed Book page in the County Registry of Deeds.
Email
AUTHORIZED AGENT an owner by virtue of inheritance.Applicant is an heir to the estate of
;probate was in County.
Name Gene Young,REHS-Applied Resource Mngmnt
X if other interest,such as written contract or lease,explain below or use a separate sheet&attach to this application.
Address 257 Transfer Station RD Agent for the prospective buyer of property with Offer to Purchase Contract and agent authorization form
City Hampstead State nc Zip 28433 phone [phone] 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
Email ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) (Address)
LOCATION OF PROJECT:(Address,street name and/or directions to site;name of the adjacent waterbody.) (I) Stephen Scaldafeni 281 Crane Point Drive,Hampstead,NC
Lot 13 Crane Point.Hampstead,NC-Take US 17N to Hampstead.Turn right on Country Club (2)Andrea L.Maggard 247 Crane Point Drive,Hampstead,NC
(3)
Drive,turn right on Mallard Drive.Turn left on Crane Point,lot is on left at end. (4)
DESCRIPTION OF PROJECT:(List all proposed construction and land disturbance.) Project is to construct ACKNOWLEDGEMENTS:
I,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
a single family residence. 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-
SIZE OF LOT/PARCEL: square feet 1.96 acres tion and floodproofing techniques.
PROPOSED USE:Residential® (Single-family 0 Multi-family❑) Commercial/Industrial 0 Other 0 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
COMPLETE EITHER(I)OR(2)BELOW(Contact your Local Permit Officer("you are not sure which AEC applies related to this permit application.
to your property): 414
(1) OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet(includes This the �r� day of ,20air conditioned living space,parking elevated above ground level,non-conditioned space elevated above ground level but ✓�/�-�
excluding non-load-bearing attic space)
Landowner or persona 'zed to act his/her a purpose of filing a CAMA permit application
(2) COASTAL SHORELINE AECs:SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: 80004square feet(includes the area of the foundation of all buildings,driveways,covered decks, This application includes:general information(this form),a site drawing as described on the back of this application,the
and a check ownership statement,the Ocean Nazar
concrete or masonry patios,etc.that are within the applicable AEC.Attach your calculations with the project drawing.) d AEC Notice where necessary, for 3100.00 made payable to the locality,
any information as may he provided orally by the applicant.The details of the application as described by these sources are
STATE STORMWATER MANAGEMENT PERMIT:Is the project located in an area subject to a State incorporated without reference in any permit which may be issued Deviation from these details will constitute a violation of
Stormwater Management Permit issued by the NC Division of Energy,Mineral and Land Resources(DEMLR)7 any permit.Any person developing in an AEC without permit is subject to civil,criminal and administrative action.
YES NO
If yes,list the total built upon area/impervious surface allowed for your lot or parcel: square feet.

ARIAI It
Geothermal, Environmental,
23 April 2020 &well Drilling
Mr. Jason Dail
127 Cardinal Drive Ext.
Wilmington, NC 28405
Re: Lot 13 Crane Point
Hampstead, NC
Mr. Dail,
On behalf of Tammy Morton and Jeff Schneider, prospective buyers of Lot 13
Crane Point in Hampstead, NC, I have included an application for a CAMA Minor
permit. Please find included, the following:
CAMA Minor Development Permit Application (with associated fee)
Agent Authorization form
Figure 1: Crane Point Lot 13 site plan
Adjacent property owner notification letters (Certified Mail receipts
attached)
Should you have any questions or concerns please do not hesitate to contact me at
(910) 270 -2919.
Sincerely,
�i _ "
61 —4S
Gene ,ung, R 2
Environme . cientist
RECEIVED
DCM WILMINGTON, NC
APR 2 9 2020
Applied Resource Management, PC
F. 0. Box 882,257 Transfer Station Road, Hampstead, NC 28443, 910.270.2919, Fax [phone]

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Fra ose,c), SLoicJ
Name of-P-r4ei.wfier Requesting Permit:anAr M 01-417 - / d 41 SC-t n e;ri1 r
Mailing Address: 301 4, t 9 � c INn
Phone Number:
Email Address: c erZe_@ arm nL. (o-m
I certify that I hive authorized -re_ Ycsk4:1',kar Or t?rv\Ate t
(Rlo)(a l-7-4 It f
to act on mybehalf, for the purpose of applying for and obtaining all CAMA permits
P P PPY 9
necessary for the following proposed development: S, + '�wi
at my property located at 1. 43 e �Qt n-r-
in 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:
Signature
J, SCLivrP/I,y
Print or Type Name
Title
1 1
Date
RECEIVED
This certification is valid through
t /7 DCM WILMINGTON, NC
APR 2 9 2020

AR-1 /1" kk
April 21, 2020
Geothermal, Environmental,
Andrea L. Maggard &Well Drilling
247 Crane Point Dr
Hampstead, NC 28443
Re: Proposed CAMA Minor Permit, Lot 13 Crane Point
Ms. Maggard,
I have been asked to assist your neighbors, Ms. Tammy Morton and Mr. Jeff Schneider in
obtaining permission from the NC Division of Coastal Management (CAMA) for the
placement of their home. As part of the CAMA Minor permitting process, you are being
notified of their intentions.
Please find enclosed a copy of the application submittal that details the proposed site plan.
Specifically, the construction will consist of locating their proposed home on the upland
area at the rear of the property. Due to placement of the wastewater system and other site
planning considerations, a portion of the home will encroach within the 75' AEC setback
from Mean High Water. These proposed improvements appear to meet required setbacks
and permitting requirements and do not appear to impact your property or riparian water
rights.
Please return the enclosed form stating no objection to Ms. Morton's and Mr. Schneider's
project so they may move forward in a timely fashion. Should you have any questions
and/or concerns please do not hesitate to contact me at [phone].
Sincerely,
Gene RE
Project Manager
RECEIVED
DCM WILMINGTON, NC
APR 2 9 2020
Applied Resource Management, PC
F. 0. Box 882, 257 Transfer Station Road, Hampstead, NC 28443,910.270.2919, Fax [phone]

Receipts for
Certified Mail
(Staple Here)
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Date
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Ad' cent Property Own
d i1? C_r�ctvl( ote r?Jf
Mai,Ijng Addres A)G 28
City,Staf Zip
Dear Adjacent Property: .r�
This letter is to inform you that I, G- a✓ / — .J have, applied for a CAMA Minor
per wner
y
Permit on my property at L T/3 CPS/LC- f o/r1T ,in___kh____ t p..JC
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 9tO (�/7--16// ,or by mail at the address listed below. If you wish to
Applicants 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 DEQ/DCM
127 Cardinal Drive Ext.
� \ / � Wilmington,NC 28405
` •`e %ow ,` 5,/S - e.7r—
Property Owner
A57 -17-Ccns r s7&-7ilm
Mailing Address
/—kreryoSieot , NC 2513
City, State/Zip Code
DCM WILMINGTON, NC
APR 2 9 2020

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delivery. USPS®-postmarked Certified Mail receipt to the
A record of delivery(Including the recipient's retail associate.
signature)that is retained by the Postal Service" -Restricted delivery service,which provides
for a specified period, delivery to the addressee specified by name,or
to the addressee's authorized agent
mportant Reminders: -Adult signature service,which requires the
You may purchase Certified Mail service with signee to be at least 21 years of age(not
Fost-Class Mail®,First-Class Package Service®, available at retail).
or Priority Mail®service. -Adult signature restricted delivery service,whtct
Certified Mall service Is not available for requires the signee to be at least 21 years of ag
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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 s
certain Priority Mail items. USPS postmark.If you would like a postmark on
For an additional fee,and with a proper this Certified Mail receipt,please present your
endorsement on the mailpiece,you may request Certified Mail Item at a Post Office'for
the following services: postmarking.If you don't need a postmark on thie
-Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion
of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply
You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.
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.
S Foon 3800.Aron 2015(Reverse)PSN 7530-02-000.9047

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to 's
(Name of Property Owner)
property located at
(Address, Lot, Block, Road,etc.)
on , 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
Telephone Number
Date
RE EIS 7
DCM WILMINGTON, NG
APR 2 9 2020

AR
April 21, 2020
Geothermal, Environmental,
Stephen Scaldaferri &Well Drilling
281 Crane Point Dr
Hampstead, NC 28443
Re: Proposed CAMA Minor Permit, Lot 13 Crane Point
Mr. Scaldaferri,
I have been asked to assist your neighbors, Ms. Tammy Morton and Mr. Jeff Schneider in
obtaining permission from the NC Division of Coastal Management (CAMA) for the
placement of their home. As part of the CAMA Minor permitting process, you are being
notified of their intentions.
Please find enclosed a copy of the application submittal that details the proposed site plan.
Specifically, the construction will consist of locating their proposed home on the upland
area at the rear of the property. Due to placement of the wastewater system and other site
planning considerations, a portion of the home will encroach within the 75' AEC setback
from Mean High Water. These proposed improvements appear to meet required setbacks
and permitting requirements and do not appear to impact your property or riparian water
rights.
Please return the enclosed form stating no objection to Ms. Morton's and Mr. Schneider's
project so they may move forward in a timely fashion. Should you have any questions
and/or concerns please do not hesitate to contact me at [phone].
Sincerely,
•
Genet oun. 'EHS
Project Manager DCiVi VVILMINGTON, NC
APR 2 9 2020
Applied resource Management, PC
P.0. Box 882,257 Transfer Station Road, Hampstead, NC 2844-3,910.270.2919, Fax [phone]

Receipts for
Certified Mail
(Staple Here)
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$I C rc n.c ?c'ei i— l—
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Dear Adjacent Property:
�
This letter is to inform you that I, (� have applied for a CAMA Minor
P operty Mier Q
Permit on my property at 0101/tr— ,in /- /A/C__
Address Cit /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 69/0)6/7—W/(71 ,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 DEQ/DCM
127 Cardinal Drive Ext.
Wilmington, NC 28405
.....Are. yo L1, 'Q, /s- �T
Property Ow
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Maili g Address
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City,Stater,Zip Code
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DCM WILMINGTON, NC
APR 2 9 2020

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43 For delivery information,visit our website at www.usps.com°i.
Certified Mail Fee $3.55
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Extra Services&Fees(check box,add fee§� Sire) 02
ID Return Receipt(hardcopy) $ 7 .41'
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A receipt(this portion of the Certified Mail label). for an g)pdtronic return receipt,see a retail
A unique identifier for your mailpiece. associate for assistance.To receive a duplicate
Electronic verification of delivery or attempted return receipt for no additional fee,present this
delivery. USPS®-postmarked Certified Mail receipt to the
A record of delivery(including the recipient's retail associate.
signature)that is retained by the Postal Service- -Restricted delivery service,which provides
for a specified period. delivery to the addressee specified by name,or
to the addressee's authorized agent
nportant Reminders: -Adult signature service,which requires the
You may purchase Certified Mall service with signee to be at least 21 years of age(not
First-Class Mail®,First-Class Package Service®, available at retail).
or Priority Mail®service. -Adult signature restricted delivery service,whlct
Certified Mail service is not available for requires the signee to be at least 21 years of ag
International mail. and provides delivery to the addressee specifiec
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 beam
certain Priority Mail items, LISPS postmark.If you would like a postmark on
For an additional fee,and with a proper this Certified Mail receipt,please present your
endorsement on the mailpiece,you may request Certified Mall item at a Post Office'"for
the following services: postmarking.if you don't need a postmark on this
-Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion
of delivery(including the recipient's signature). of this label,affix it to the mallplece,apply
You can request a hardcopy return receipt or an appropriate postage,and deposit the mailplece.
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.
R Fnrm n8011 And!9010 Mamma)PRN 75nn.ns-01140067

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to 's
(Name of Property Owner)
property located at
(Address, Lot, Block, Road,etc.)
on , in Pender County, N.C.
(Waterbody)
He/She 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
RECERrT j
DCM WILMINGTON, NC
APR 2 9 2020

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SITE DRAWING/APPLICATION CHECKLIST
_�
Please make sure your site drawing includes the following information required for a CAMA minor development permit. l
The Local Permit Officer will help you,if requested. �", �•v
•,::r
PHYSICAL DIMENSIONS Y APPLICATION FORT a
e,a U
Label roads 0
L1
Label highways right-of-ways CAMA MINOR z
Label local setbackd lines DEVELOPMENT
Label any and all structures and driveways currently existing on property
Label adjacent waterbody Coastal Management
ENVIRONMENTAL QUALITY
PHYSICAL CHARACTERISTICS PERMIT
Draw and label normal high water line(contact LPO for assistance) In 1974,the North Carolina General Assembly passed the Coastal Area Management Act
Draw location of on-site wastewater system
(CAMA)and set the stage for guiding development in fragile and productive areas that
If you will be working in the ocean hazard area: border the state's sounds and oceanfront.Along with requiring special care by those who
Draw and label dune ridges(include spot elevations) build and develop,the General Assembly directed the Coastal Resources Commission
Draw and label toe of dunes (CRC)to implement clear regulations that minimize the burden on the applicant.
Identify and locate first line of stable vegetation(contact LPO for assistance)
Draw and label erosion setback line(contact LPO for assistance) This application for a minor development permit under CAMA is part of the
Draw and label topographical features(optional) 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
If you will be working in a coastal shoreline area: the applicant.Please go over this folder with the Local Permit Officer(LPO)for the
Show the roof overhang as a dotted line around the structure locality in which you plan to build to be certain that you understand what information he r0
Draw and label landward limit of AEC or she needs before you apply. Y
Draw and label all wetland lines(contact LPO for assistance) r-
Draw and label the 30-foot buffer line Under CAMA regulations,the minor permit is to be issued within 25 days once a -1
DEVELOPMENT PLANS
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
Draw and label all proposed structures certain that your application is complete and signed,that your drawing meets the
Draw and label areas that will be disturbed and/or landscaped specifications given inside and that your application fee is attached.
Note size of piling and depth to be placed in ground
Draw and label all areas to be paved or graveled Other permits are sometimes required for development in the coastal area.While these
Show all areas to be disturbed are not CAMA-related,we urge you to check with the Local Permit Officer to determine
Show landscaping which of these you may need.A list is included on page two of this folder.
NOTE TO APPLICANT
We appreciate your cooperation with the North Carolina Coastal Management Program
Have you: and your willingness to build in a way that protects the resources of our beautiful and
• completed all blanks and/or indicated if not applicable?
productive coast.
• notified and listed adjacent property owners?
• included your site drawing? Coastal Resources Commission
• signed and dated the application? Division of Coastal Management
• enclosed the$100.00 fee? cn
• completed an AEC Hazard Notice,if necessary?(Must be signed by the property owner)
FOR STAFF USE n
rn r .j
Site Notice Posted Final Inspection Fee Received Ely
t:i
Site inspections y
zMd
o y
0 Oz 0
Date of Action:Issued Exempted Denied Appeal Deadline(20 days from permit action) J DCM Form E61952-2015/Revised

NC Division of Coastal Management 1034 2 A D
Cashier's Official Receipt
' z,.=1( 2 .
Date: 20
Received From. '0'1 $ LOC2
Permit No.: Check No.: 1 1
littleApplicant's Name: County:
Project Address:
Please retain receipt for your records as proof of payment for permit issued.
Signature of Agent or Applicant: Date:
Signature of Field Representative: ,� Date:

Date Date Check From Name of Vendor Check Check Permit Rct. #
Received Deposited Permit Holder Number amount Number/Comments
4/30/2020 Jeff Schneider same Ally Bank 1031 $100.00 minor fee, Lot 13 Crane Point, JD rct.
Hampstead PnCo 10342