PN_21-14_ Hill

RECEIVED
Issued by WiRO OCT 20 2021 PN21-14
Pender County Permit Number
CAMA DCM WILMINGTON, NC
MINOR DEVELOPMENT : "
1 ..,
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 Andrew Hill authorizing development in the Estuarine Shoreline (AEC) at Lot 44 Waterfront Circle, in
Hampstead, Pender County as requested in the permittee's application, dated September 20, 2021, and received by
DCM on September 24, 2021. This permit, issued on October 14, 2021, is subject to compliance with the application
and drawing dated and received by DCM on September 24, 2021 (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.
(1) All proposed development and associated construction must be done in accordance with the permitted site drawing dated
received by DCM on September 24, 2021.
(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)
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
compliance. Any maintenance work or project modification not covered under Jason Dail
this permit,require further written permit approval.All work must cease when this CAMA LOCAL PERMIT OFFICIAL
permit expires on:
127 Cardinal Drive Extension
December 31,2024 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
Management. PERMITTEE
(Signature required if conditions above apply to permit)

.♦ .
Name: Andrew Hill
Minor Permit#PN21-14
Date: October 14, 2021
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) The amount of impervious surface/coverage on this property shall not exceed 25% within 575 feet of the Normal
High Water line. In this case, and according to the application package, 3,040 sq. ft. of built upon area is
authorized on the subject property.
(9) 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.
(10)Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third-party.
SIGNATUREK A IN DATE: /U 064
PERMITTEE

. 4rft..
ROY COOPER �.§�":
Governor
ELIZABETH S.BISER :
Secretory
BRAXTON DAVIS NORTH CAROLINA
Director Environmental Quality
October 14, 2021
Andrew Hill
6908 Palaver Lane
Cary, NC 27519
Dear Mr. Hill,
Attached is CAMA Minor Development Permit PN 21-14 for work to be done at Lot 44 Waterfront Circle,
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 gold 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.
Sin erely,
��i/ECG
Anita M. Webb
Permit Support Technician
N.C. Division of Coastal Management
Enclosures
Cc: WiRO files
PN Inspection Dept.
PBC Design & Build -Agent
NorthDepartment Environmental Qity I Division l
D_E Q WilmingtonCarolina OfficeDep 1art127 Cardinalof Drive Extension Quality I Wilmington.of NorthCoasta CaroliManagementna 28405
NLWTNGUX)UNA
�"el�""�°""4 910.7 96.727.5

141m eG�_ PN
Locality � � _ � Permit Number
Ocean I lazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
(l"br offickil use only)
GENERAL,INFORMATION
LAND OWNER-MAILING ADDRESS
Name Andrew Hill
Address 6908 Palaver Ln.
Chit Cary State NC /it) 27519 ph1111e 919.377.0642
Email
AUTHORIZED AGENT
PBC Design + Build
Name
3902 Market St. #100
Address
City Wilmington State NC Zip 28403 Phone [phone]
Email [e-mail]
LOCATION OF PROJECT:(Address,street name and/or directions to site;name of the adjacent waterbody.)
Lot 44, Waterfront Circle Hampstead, NC 28443, Salters Haven neighborhood
Build a single family
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.)
home, including landscaping, drives & walks, pool & fence. --RECEIVED
SIZE OF[.OT/PARCEL: 12,196.8 square feet '28�_. acres SEP 2 4 2021
PROPOSED USE: Residential ® (Single-family® Multi-family ❑ ) Commercial/Industtriiaaal El dice D ONE NC
D
M
COMPLETE EITHER(I)OR(2) BELOW(Contact your Local Permit Officer ifyou are not Nitre which AEC applies
to yoar properly):
(I) 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-hearing attic space)
(2) COASTAL SHORELINE AECs: SIZE Of BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR ILA/
UPON SURFAClS3,040 square feet(includes the arca 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 STORMWATER 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 X
If yes,list the total built upon area/impervious surface allowed for your lot or parcel: N/A _square feet.

Locality _ Permit Number
Ocean I lazard Estuarine Shoreline OW Shoreline Public Trust Shoreline Other_
(For official rise only)
GENERAL INFORMATION ,
LAND OWNER-MAILINC ADDRESS
NameAndrew Hill
Address 6908 Palaver Ln,
City Cary slate NC 7il, 27519 Phone [phone]
Email __- -
AUTIIORIZEI)AGENT
PBC Design + Build
Name _
3902 Market St. #100
Address
Wilmington NC 28403 910Zi .763.8760
City State p -- Phone
Email [e-mail]
LOCATION OF PROJECT:(Address,street name and/or directions to site;name of the adjacent waterbody.)
Lot 44, Waterfront Circle Hampstead, NC 28443, Salters Haven neighborhood
Build a single family
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.)lill
NC Division of Coastal Management 15 5 81 A B C�
Cashier's Official Receipt
Date: L ' z L( 20V'
r t3C P-“' , 4�u, -_
Received From: $
r Z
Permit No.: Check No.: .�� f /
Applicant's Name: a\ ,J.hJ County: r4C/.
( ., .! v
Project Address: V ((JJ���V � _ kt, , r — '.`„ '
1
e
Please retain receipt for your records as proof of payment for permit issued.
Signature of Agent or Applicant: - ~ Date: r}
Signature of Field Representative: _ y \ Date:

OTHER 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,Plumbing, Heating and Air Conditioning,Insulation and Energy Conservation, HA
Certification, Sand Dune,Sediment Control,Subdivision Approval,Mobile[Ionic 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 AFC 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)
X an owner or record title,Title is vested in name of Andrew Hill
sec Deed Book 471 S page 1529 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:
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) (Address)
(I) Jay Milatxi-7__6025 Stag Park.Rd. Burgaw, NC_.28425
(2) Silver Lake Properties, LLC - 1713 Cedar Grove Circle Cedar Hill__TX 75104
(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 anuVor 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.
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.
rr This the 20 _ clay of Sept. ,20 21
Landowner or p • horized 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
oirne►ship statement, the Ocean Ilazw d AEC Notice where necessa►y, a cheek for$100.00 made payable to the localityy,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.[ron►these details mill constitute a violation of
any permit.Any pem con developing in an AEC without permit Ls subject to civil, criminal and administrative action.

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Andrew Hill
Name of Property Owner Requesting Permit:
6908 Palaver Ln.
Mailing Address:
Cary, NC 27519
919.377.0642
Phone Number:
[e-mail]
Email Address:
PBC Design+ Build
I certify that I have authorized
Agent/Contractor
to act on my behalf,for the purpose of applying for and obtaining all CAMA permits
Build a single family home,
necessary for the following proposed development:
including landscaping, drives&walks, pool &fence
Lot 44, Waterfront Circle, Hampstead, NC 28443
at my property located at
Pender
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:
iI&
Signature
Andrew Hill
Print or Type Name
Owner
Title
9 20 21
I I
Date
12 31 22
This certification is valid through I I

U.S. Postal Service"
CERTIFIED MAIL" RECEIPT
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9/20/21 a Okla signature dried
❑Pautarattn Restricted $ I 0 ?
Date O Poems
Jay Milani
Adjacent Property Owner rra,
6075 Stag Park Rd.
ailin Add a 28425 rY1 ‘ "�(1 a00 E`{°'
urd�aw. o root na, _Q H�
City,State,Zip Code • e;is .._ .�.. .. '
PS Form 38r J,April 20'5 See Reverse for instructions.
Dear Adjacent Property:
This letter is to inform you that I, Andrew Hill have applied for a CAMA Minor
Property Owner
Permit on my property at Lot 44, Waterfront Circle. Salters Haven in Hampstead
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 919.377.0642 _ _,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
Property Owner
6908 Palaver Ln.
Mailing Address
Cary, NC 27519
City,State,Zip Code

U.S. Postal Service"
CERTIFIED MAIL'' RECEIPT
rU Domestic Mad Only
For delivery intormation visit our website at www.usps_com'.
F•
m 'Certified man roe
Q- ,s m
Extra iSerViC*R Fe.e fcher.S bar.odd kis e4+i9+W+tew!
❑Return Receipt(rdwvf1 $ - fOstmedr
❑RstAn Reaps( , $ _. Here
O ❑Ceralled Mali Restricted DNHers S
9/20/21 0 ❑AduR Signature Required
❑Adult Signature Restricted beams$-
Date o Postage
Silver Lake Properties, LLC $
Adjacent Property Owner ra Total Poataget end P�
1713 Cedar Cove Circle
AH_ X 75104 •
r v�`eCA
, pG ru..0rU�. txiJo
City,State,Zip Code
i
PS Form 3800,April 2015 F,rd r-,� - '
See Reverse for Itotuch,
Dear Adjacent Property:
This letter is to inform you that!, Andrew Hill have applied for a CAMA Minor
Property Owner
Permit on my property at Lot 44, Waterfront Circle, Salters Haven in Hamctstead
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 919.377.0642 ,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
Property Owner
6908 Palaver Ln.
Mailing Address
Cary, NC 27519
City, Slate,Zip Code

.cm.u.r:. w.�...ser+a�+ws:•.•.�
First National Bank 223251
4140 East State Street
PBC Design + Build Hermitage.PA 16148-3487 66-1227/531
3902 Market Steet, Suite 100 DATE 09/22/2021
Wilmington NC 28403
910.763.8760
$ ****100.00
Pay: One hundred dollars and no cents
TO NC DEQ
THE
ORDER .-- S-C1
OF
N
0000 2 2 3 2 5LIP' 1:0433180921:012143I286
PBC Design +Build NCDEQ NC DEQ
DATE INVOICE NO DESCRIPTION INVOICE AMOUNT DEDUCTION BALANCE
9-22-21 HILL Lot 44, Salters Haven 100.00 100.00
DATE
CHECK CHECK
9-22-21 NUMBER 223251 TOTAL> 100.00 100.00
PLEASE DETACH AND RETAIN FOR YOUR RECORDS

Dail, Jason
From: Dail,Jason
Sent: Thursday, September 23, 2021 12:15 PM
To: Angela Roseman
Cc: John Jarvis
Subject: RE: [External] CAMA Permit - Lot 44 - Waterfront Circle - Salters Haven
Good morning. I just received the application package for Hill.
If the calculations on the application package are correct, the size of parcel is shown at 11,761 sq. ft., which would limit
the amt. of impervious coverage to 2,940 sq. ft. (25%of the lot within the 575' AEC). Despite the state stormwater
permit authorizing more than the allowable limit referenced above, DCM's Rules still limit impervious coverage to no
more than 25%of the lot. Can you figure out a way to either 1) shave off 100 sq.ft. of bua or 2) provide an engineered
collection system treating the excess above the 25%threshold?
I'll need this issue resolved before I can accept and process the application.
Thank you,
Jason
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]
[e-mail]
0 "'Not hong Compari-t
'E-mail correspondence to and from this address
may be subject to the North Carolina Public
Records Law and may be disclosed to third parties.
From: Angela Roseman [mailto:[e-mail]]
Sent:Thursday, September 23, 2021 9:19 AM
To: Dail,Jason <[e-mail]>
Cc: Angela Roseman <[e-mail]>;John Jarvis<[e-mail]>
Subject: Re: [External] CAMA Permit - Lot 44-Waterfront Circle - Salters Haven
CAUTION: External email. Do not click links or open attachments unless you verify.Send all suspicious email as an attachment to y
Report Spam.
Hi Jason,
Jarvis is dropping the paperwork off today.
Attached are the electronic copies.

Dail, Jason
From: Angela Roseman <[e-mail]>
Sent: Thursday, September 23, 2021 1:00 PM
To: Dail,Jason
Cc: Angela Roseman; John Jarvis
Subject: Re: [External] CAMA Permit - Lot 44 - Waterfront Circle - Salters Haven
Attachments: CAMA Permit App Hill.pdf
CAUTION: External email. Do not click links or open attachments unless you verify.Send all suspicious email as an attachment to
Report Spam.
Hi Jason,
I'm sorry....
That was my fault with the application. Total acreage is .28 not .27. I have updated and attached.
Angela Roseman
Office: 910.763.8760 • Cell: 910.262.0143
www.pbcdesignbuild.com
0 o 0 PBC DEBsulIGLDNI
On Sep 23, 2021, at 12:14 PM, Dail, Jason <jason.dail a ncdenr.gov> wrote:
Good morning. I just received the application package for Hill.
If the calculations on the application package are correct,the size of parcel is shown at 11,761 sq. ft.,
which would limit the amt. of impervious coverage to 2,940 sq. ft. (25%of the lot within the 575'AEC).
Despite the state stormwater permit authorizing more than the allowable limit referenced above, DCM's
Rules still limit impervious coverage to no more than 25%of the lot. Can you figure out a way to either
1) shave off 100 sq. ft. of bua or 2) provide an engineered collection system treating the excess above
the 25%threshold?
I'll need this issue resolved before I can accept and process the application.
Thank you,
Jason
Jason Dail
Field Representative
NC Department of Environmental Quality
NC Division of Coastal Management
1

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Andrew Hill
Name of Property Owner Requesting Permit:
6908 Palaver Ln.
Mailing Address:
Cary, NC 27519
919.377.0642
Phone Number:
[e-mail]
EmaII Address:
PBC Design + Build
I certify that I have authorized
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
Build a single family home,
necessary for the following proposed development:
including landscaping, drives &walks, pool &fence
Lot 44, Waterfront Circle, Hampstead, NC 28443
at my property located at
Pender
in County.
I furthermore certify that l 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.
RECEIVED
Property Owner Information:
SEP 2 3 2021
. ./C
Signature
DCM WILMINGTON, NC
Andrew Hill
Print or Type Name
Owner
Title
9 20 21
I /
Date
12 31 22
This certification is valid through I I

Receipts for
Certified Mail
(Staple Here)
9/20/21
bate
Jay Milam
Adjacent Propert Owner
6075 Stag Park Rd.
ailringaw; 1IVVs8 g A li 28425
u
City,State,Zip Code
Dear Adjacent Property:
This letter is to inform you that I, Andrew Hill have applied for a CAMA Minor
Property Owner
Permit on my property at Lot 44,,_WaterfrontCircle ,Salters Haven ,in Hampstead
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 919.377.0642 ,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 RECEIVED
NC DEQ/DCM
127 Cardinal Drive Ext. S E P 2 3 2021
Wilmington,NC 28405
DCM WILMINGTON, NC
Property Owner
6908 Palaver Ln.
Mailing Address
Cary, NC 27519
City,State,Zip Code

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Receipts for
Certified Mail
(Staple Here)
9/20/21
Date
Silver Lake Properties, LLC
Adjacent Property Owner
1713 Cedar Cove Circle
Mailing Addres
Cedar Hill,�TX 75104
City,State,Zip Code
Dear Adjacent Property:
This letter is to inform you that I, Andrew Hill have applied for a CAMA Minor
Property Owner
Permit on my property at Lot 44, Waterfront Circle Salters Haven ,in Hampstead
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 919.377.0642 ,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
NCDEQIDCM
127 Cardinal Drive Ext.
Wilmington,NC 28405 RECEIVED
11. SEP 2 3 2021
Property Owner
6908 Palaver Ln.
Mailing Address DCM WILMINGTON, NC
Cary, NC 27519
City,State,Zip Code

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delivery. LISPS®-1 ostmarked 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
First-Class Mail',First-Class Package Services, available at retail).
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 ag
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 beara
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 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 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.

Locality - Permit Number
Ocean Hazard Estuarine Shoreline ORW Shoreline Public"trust Shoreline Other
(liar official use only)
(;ENE?RAL INFORMATION
LAND OWNER-MAILING ADDRESS
Name
Andrew Hill
Address 6908 Palaver Ln.
City Cary State NC zip 27519 Phone [phone]
l:n ail
AUTHORIZED AGENT
PBC Design + Build
Name
3902 Market St. #100
Address — —_
City Wilmington Slate NC Zip 28403 Phone [phone]
Email [e-mail]
LOCATION OF PROJECT:(Address,street name and/or directions to site;name of the adjacent waterbody.)
Lot 44, Waterfront Circle Hampstead, NC 28443, Salters Haven neighborhood
DESCRIPTION OE PROJECT: (List all proposed construction and land disturbance.)
Build a single family
home, including landscaping, drives & walks, pool & fence. RECEIVED
12 196.8
.28
SIZE.OF LOT/PARCEL: square feet acres L? 4 4
PROPOSED USE: Residential E (Single-family IN Multi-family ❑ ) Commercial/Industrial 0 Other
th r ri ON,
e
OVAGT
COMPLETE EITHER(I)OR(2) BELOW(Contact your Local Permit Officer if you are►►ol sure which M Capplies
to your property):
(I) OCEAN IIAZARD 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-hearing attic space)
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING 1:OOFPRINTANi)OTIIER IMPERVIOUS OR BUILT
UPON SURFACES:37040 square feet(includes the area of the hmndation of all buildings,driveways,covered decks,
concrete or masonry patios,etc. that arc within the applicable ALL.Attach your calculations with the project drawing.)
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a State
Stormwater Mana ement Permit issued by the NC Division of Energy, Mineral and Land Resources(DEMLR)?
YES NO
I f yes, list the total built upon area/impervious surface allowed for your lot or parcel: N/A _square feet.

Date Date Check From Name of Vendor Check Check Permit Rct. #
Received Deposited Permit Holder Number amount Number/Comments
9/28/2021 PBC Design & Build Andrew Hill First 223251 $100.00 minor fee, Lot 44 Waterfront Cir, JD rct.
National Hampstead PnCo 15581
Bank