SC_13-12_ Tiffany's

Issued by WiRO SC13-12
Surf City Permit Number
CAMA
MINOR DEVELOPMENT
PERMIT
as authorized by the State of North Carolina,Department of Environment,
and Natural Resources 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 Tiffany's Motel — Baymore Properties, LLC authorizing development in Ocean Hazard Area of
Environmental Concern (AEC) at 1502 N. New River Drive, in Surf City, Pender County as requested in the permittee's
application, dated April 26, 2013 This permit, issued on May 29, 2013, 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: Reconstruction of"Tiffany's Motel", including amenities.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s)dated received on May 3, 2013.
(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.
(5) Any/all structure(s) must set back a minimum of 60 feet from the first line of stable natfi a tiVi eDNV), as
determined by the DCM, the LPO,or other assigned agent of the DCM. DCM WILMINGTON, NC
(Additional Permit Conditions on Page 2) JUN 1 0 2013
This permit action may be appealed by the permittee or other qualified persons
within twenty (20) days of the issuing date. From the date of an appeal, any
work conducted under this permit must cease until the appeal is resolved. 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 Jason Dail
modification not covered under this permit, require further written permit CAMA LOCAL PERMIT OFFICIAL
approval.All work must cease when this permit expires on:
127 Cardinal Drive Extension
December31,2016 Wilmington, NC 28405-3845
In issuing this permit it is agreed that this project is consistent with the local Land /�� � � /J
Use Plan and all applicable ordinances. This permit may not be transferred to /(\/./,N

Name: Tiffany's Motel - Baymore
Properties, LLC
Minor Permit#SC13-12
Date: May 29, 2013
Page 2
(6) All buildings constructed within the ocean hazard area 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.
(7) Any structure authorized by this permit shall be relocated or dismantled when it becomes imminently threatened by
changes in shoreline configuration. The structure(s) shall be relocated or dismantled within two years of the time
when it becomes.imminently threatened, and in any case upon its collapse or subsidence. However, if natural
shoreline recovery or beach renourishment takes place within two years of the time the structure becomes
imminently threatened, so that the structure is no longer imminently threatened, then it need not be relocated or
dismantled at that time. This condition shall not affect the permit holder's right to seek authorization of temporary
protective measures allowed under CRC rules.
(8) All buildings must be elevated on pilings with a diameter of at least 8 inches in diameter if round, or 8 inches to a
side if square; and the first floor level of the sills and joists must meet the 100-year flood level elevation.
(9) All pilings shall have a tip penetration greater than eight feet below the lowest ground elevation under the structure.
Dune disturbances will be allowed only to the extent necessary for development and if the dune's protective value is
not weakened or reduced. Disturbed dune areas will be immediately stabilized.
(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.
RECEIVED
DCM WILMINGTON, NC
J U N 1 0 2013
SIGNATURE: P. ' DATE: w ` 5
2 - 6
PERM ITTEE

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pat McCrory Braxton C. Davis John E. Skvarla, Ill
Governor Director
Secretary
May 29, 2013
Tiffany's Motel / Baymore Properties, LLC
1502 N. New River Drive
Surf City, NC 28445
Dear Ms. Taylor:
Attached is CAMA Minor Development Permit# SC 13-12 for work to be done for at Pender Ave & Hwy
210 in Surf City, Pender County.
In order to validate this permit, please sign both copies of the permit as indicated for our records.
Please retain the gold copy for your files and sign front and back of the white copy then return 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,
, )
Shaun K. Simpso
Permit Support T chnician
Enclosures
cc: WiRO files
127 Cardinal Drive Ext.,Wilmington,NC 28405
Phone:[phone] FAX:[phone] Internet:www.nccoastalmanagement.net

Arid&
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pat McCrory, Braxton C. Davis John E. Skvarla, Ill
Governor Director Secretary
May 6, 2013
Advertising@ starnewsonline.com
2 Pages
Star News
Legal Advertisement Section
Post Office Box 840
Wilmington, North Carolina 28402
Re: Baymore Properties, LLC (Tiffany's Motel) Minor Public Notice
Kyle/Heather: Please publish the attached Notice in the Thursday, May 9, 2013 issue.
The State Office of Budget and Management requires an original Affidavit of Publication prior to
payment for newspaper advertising.
Please send the original invoice and a copy of the affidavit for payment to Shaun Simpson at Division of
Coastal Management, 127 Cardinal Drive Extension, Wilmington, NC 28405, 910-796-7226.
Paying by Credit Card (number on file with Elsa Lawrence, Ref acct # 796-7215). Please send a fax of the
credit card receipt to me.
Thank you for your assistance in this matter. If you should have any questions, please contact me at our
Wilmington office.
Sincerely,
//1)11/-26--
Shaun Simpson
Permit Support Tech 'ci
Enclosure
cc: File Copy
Michele Walker- DCM
127 Cardinal Drive Ext.,Wilmington, NC 28405

CAMA MINOR PERMIT NOTICE
Pursuant to NCGS 113A-119(b), the North Carolina Division of Coastal Management, an
agency authorized to issue CAMA permits in areas of environmental concern, hereby gives NOTICE
that on May 3, 2013, Baymore Properties, LLC proposed to rebuild Tiffany's Motel, located between the
AIWW and Atlantic Ocean, at the crossroad6of Pender Ave. and Hwy 210, in Surf City, Pender County. The
application may be inspected at the address below. Public comments received by May 24, 2013 will
be considered. Later comments will be accepted and considered up to the time of permit decision.
Project modifications may occur based on further review and comments. Notice of the permit
decision in this matter will be provided upon written request.
Jason Dail
Field Representative
Division of Coastal Management
127 Cardinal Drive Extension
Wilmington, NC 28405-3845
Phone: [phone]

jc /5-'/ ,
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Locality ;.a �ts. . �:� . � r„�, igs
. .
Ocean Hazard Estuarine ShorehneT _ t qi Oliioti� a i �V, �„
• '`.-;?%‘\;7-1-17,;:i' .,tv,J.,,a441";:". . -vicl :.,-;f44,,,.,i-48.,74,,,--AtrIiii,Ait.:1:.,. 1-;:fitiil
GENERAL INFORMATION
LAND OWNER
Name -774AKY s Mm4-c..1 — Bay mowe lop 4 , U.0
Address 15b2 A) /Vc.....) /R:ve.r I)c S ,,C C:47
City 5✓c-c G;4.y State Ave,_ Zip L8YfslPhone 9/a 59.L —ki 0at<
Email /-,'Saa is y har Q ilc../i. coo-1
AUTHORIZED AGENT
Name /14,'G-ha c I A.. . l�,
Address 13 y&) AIJC. hkv y SD
City 5,4 C;4 y State ,v c Zip Z "jets-Phone ctib-32 1- 9 g)4
Email FA giS. Q Mai: t, '
LOCATION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront,what is the name of the
adjacent waterbody.) 1114-crs.,4.ror1 v4- Pe lc4cr Ave. 4- 144A/7 2 to, lhff+•.cos4,.+a. 1 1 O«...%
A/I414.1)}4 5a6 .<< d:S 4tAnCe- Au+ay
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance..)t T2-e.�?,,�, 14 A ber lcv-t
brafrttd C, c...)"'1 5'lY`t.cis rt,
SIZE OF LOT/PARCEL: /35( square feet . 2.1 c acres
PROPOSED USE: Residential 0 (Single-family❑ Multi-family ❑ ) Commercial/Industrial Er Other ❑
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: 3 77 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 roof/drip line of all buildings,driveways,covered decks,
concrete or masonry patios,etc. that are 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 Stonnwater
Management Permit issued by the NC Division of Water Quality?
YES NO
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: square feet.
RECEIVED
DCM WILMINGT.ON, NC
., r.n4el

OTHER PERMITS MAY BE REQUIRED:The activity you are 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 Home Park Approval,Highway 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 $may Mo.a_ Pr•ear 4; LL,c,,see Deed Book _ 33 Z-
page p ls4in the 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 PROPERTY OWNERS:
I 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) 67ary /-1nl jlea- ,r�3 r /51)3 t4sy !UC- Z�1 S-
(2)
(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 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.
This the _ day of Apr. ,20_13
Landowner or person authorized 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 a violation of
any permit. Any person developing in an AEC without permit is subject to civil, criminal and administrative action
HEC LAVED
DCM WILMINGTON, NC

•
OCEAN HA RD AEC NOTICE
Project is in an: Ocean Erodible Area High Hazard Flood Area Inlet Hazard Area
Property Owner: ..E,0.J b QQ'c iPrcie r`}c cA LL C
S/
Property Address: 107 lJ A1c R:4e.f" fir. 4- C;47 ili C
Date Lot Was Platted: /4 b 6 f i& 7
This notice is intended to make you,the applicant, aware of the SPECIAL NOTE: This hazard notice is required for
special risks and conditions associated with development in this development in areas subject to sudden and massive storms and
area, which is subject to natural hazards such as storms,erosion erosion. Permits issued for development in this area expire on
and currents. The rules of the Coastal Resources Commission December 31 of the third year following the year in which the
require that you receive an AEC Hazard Notice and permit was issued. Shortly before work begins on the project
acknowledge that notice in writing before a permit for site,the Local Permit Officer must be contacted to determine the
development can be issued. vegetation line and setback distance at your site. If the property
has seen little change since the time of permit issuance,and the
The Commission's rules on building standards, oceanfront proposed development can still meet the setback requirement,
setbacks and dune alterations are designed to minimize, but not the LPO will inform you that you may begin work. Substantial
eliminate, property loss from hazards. By granting pennits, the progress on the project must be made within 60 days of this
Coastal Resources Commission does not guarantee the safety of setback determination,or the setback must be re-measured.Also,
the development and assumes no liability for future damage to the occurrence of a major shoreline change as the result of a
the development. Permits issued in the Ocean Hazard Area of storm within the 60-day period will necessitate re-measurement
Environmental Concern include th'e condition that structures be of the setback. It is important that you check with the LPO
relocated or dismantled if they become imminently threatened before the permit expires for official approval to continue the
by changes in shoreline configuration. The structure(s) must be work after the permit has expired. Generally, if foundation
relocated or dismantled within two (2) years of becoming pilings have been placed and substantial progress is continuing,
imminently threatened, and in any case upon its collapse or permit renewal can be authorized. It is unlawful to continue
subsidence. work after permit expiration.
The best available information,as accepted by the Coastal For more information,contact:
Resources Commission, indicates that the annual long-term
average o • e osion rate for the area where your property is J/olJ 7)f}-i L
located is feet per year.
Local Permit Officer
The rate was established by careful analysis of aerial
photographs of the coastline taken over the past 50 years.
NC DENR
vp also indicate that the shoreline could move as much as Div. of Coastal Management
feet landward in a major storm.
127 Cardinal Drive Ext.
The t1 p�waters in a major storm are predicted to be about Wilmington, NC 28405-3845
�L�� feet deep in this area.
Preferred oceanfront protection measures are beach nourishment 91a� ?-96 —�'�--.1--1
and relocation of threatened structures. Hard erosion control
structures such as bulkheads,seawalls,revetments,groins,jetties Phon Number
and breakwaters are prohibited. Temporary sand bags may be
authorized under certain conditions.
The applicant must acknowledge this information and
requirements by signing this notice in the space below. Without
the proper signature,the application will not be complete.
AA:X ) 9j0-1 4 a6-6
Property Owner Signature Date
RECEIVED
DCM WILMING,C ,I4V010

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SITE PLAN AND SURVEY DATA SUPPLIED BY OTHERS pp ,/ (�
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A��A�A A�4r :'J DRIVE AND WALKWAY AREA=3,727 Z U
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.AAAAAAAAA' �A4 ::'' PRE FIRE ESTIMATED IMPERVIOUSARU•95% N
. ♦♦♦♦.♦ ♦, :;.AAAAAAAAAA Ali ;N I EXISTING IMPERVIOUS AREAS ARE TO BE UNDISTURBED AND
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LOWS
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IT• ♦,••�AAAAAAAAAA• �AA „� ' ,•j:l� THESE AREAS ME NOT INCLUDED IN THE STORAGE CALCULATIONS
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♦♦♦� �,••,AAAAAAAAA' A/ j UI THIS PUN DOES NOT INCLUDE AM AREAS IN THE RIGHT OF WAY
AND ACCOUNTS ONLY FOR IMPERVIOUS SURFACES WITHIN THE 1
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•EAAAAIAA�A�AA�� AjAA PROPOSED IMPERVIOUS AREAS IS c[
♦ •'EAAA .4 L .So AA ROOFED AREA•2800 SF 1
♦♦� ♦,:::AA AAAAA•AAA 4� I DRIVEWAY AREA:1,2S6 SF r r
AAA •AAAA••�A_. 1 I TOTAL IMPERVIOUS SURFACES TO cc N
♦♦♦♦♦.�♦ A.44 4,ANum BE INCLUDED IN STORAGE CALCULATIONS
c+1 p�AI :s ..R.IRROO.ro.dl1� I -4,056 TF Q Z
. O111111 ': ROAE�auD REQUIRED STORAGE OFI.S'OFRUNOFF(FlRSTFLUSH)FROM ,
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♦ -►AA♦ IIIIIIII� GaLrToR RE NK IM'ro� I IMPERVIOUS SURFACES
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rV r.�r •��r •�� �^/AAA�� •:'i •$TLSRAGEFWILL BE IN BED LOACIED UNDER THE
• • • :.:':•`:'•:':`•:��Ai�►AAAA�A� ••''I PROPOSED GRAVEL PARKING AREA
:.'I BED DIMENSIONS•WI.X ISW X TEI L j 0
+�. x: ::; BED VOULME•13TO CU BED STORGAE CMACTIY•1,350 C l%.40
�' ♦♦♦ { %VOID SPACE=540 CUFT l.L
STORAGE CAPACITY DOES NOT INCLUDE 8•DIAMETER
w010����,I S i DISTRIBUTION PIPE AND EXCEEDS REQUIRED STORAGE OF 507 CU O
I
♦♦� / 1 I ALL ROOFED AREAS ARE TO BE SEINED BYA600D WANT'/ Z
IN•. D 504104WNSPOUTS Of ALL GUTTERS ME TO BE PLUMBED TO Q m
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........... .............
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(3,827 OFF SITE)
�`��`�. -�— EASY STREET 50' R/W ((PUBLIC) •.4 IXISTNGONSTE POOL DECK NOT TOBE DISTURBED=1,9215F
1 8,3' PAVED _� (INCLUDES POOL HOUSE ROOF AREA)
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OR MLR,TO MEET ur RL'pnaxNTS Of ANY OTIATI REGULATORS AVTNGRRY ` f/d PROPOSED BUILDING AREA=2,800 SF
R'aLOING"�^'Ow0 3 (INCLUDES OVERHANG)
INFILTRATION GALLERY DETAIL
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8 7 6 5 T 'N 4 1 3 1
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A..A
NCDE1 R
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue Braxton C. Davis Dee Freeman
Governor Director Secretary
AGENT AUTHORIZATION FORM
Date: /-Zb-1^3
Name of Property Owner Applying for Permit: Name of Authorized Agent for this project:
Sa.y rjcor RIO/4;is 1-+-(__ iI;c. d..c l m-
sy
A n A &;1br-c /mac,
Owner's Mailing Address: Agent's Mailing Address:
X )Gila toot' t(alik 0- 134/10 N(. 14ry s�
,t& Corest- Nc a- Soo c,ty AJ c zWis—
Phone Number Aft l) Say OS C Phone Number(9/9 ) 210 - ` '17f.
I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
for and obtaining all CAMA Permits necessary to install or construct the following (activity):
ornN7(r cc
For my property located at /507... il/ /Ue k+vcr- Dr Sv Pc C;47, AS C
This certification is valid thru (date) /Z- 31 - Zb 13 RECEIVED
DCM WILMINGTON, NC
Z1 -a MAY �c0 - 13 3 2013
Property Own Signature Date
127 Cardinal Drive Ext.,Wilmington,NC 28405 One
Phone:[phone] FAX:[phone] Internet:www.nccoastalmanagement.net No,tr1Carolina

U.S. Postal Servic
CERTIFIED M141L
�' RECEIPT
t` (Domestic Mail Onl ;
rri Y No lensurance Coverage
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? Postage
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Date
0 (Endorsement Required)
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RestrictedDeliveryeeAdjacent Property Owner p (Endorsement Required) NC
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City, State,Zip Code o �treer Af'15-,- -- -9 --- ',„
N or PO Box No.
676 State,ZlP+4------"Y
PS Form 3800.August 2006 �✓C NC ^� (,,-___---
Dear Adjacent Property: See Reverse Instructions
This letter is to inform you that I, Bey n,brc P opt_Acc have applied for a CAMA Minor
Property Owner
Permit on my property at )SO Z A) Ne...► R;,,€.- De- So ef C:,l y , in -end- Onslow
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 q lei 5 a4 4 otC ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the Surf City CAMA Minor Permit Program,you may submit
them to:
Jason Dail,Field Representative
NC Division of Coastal Management
Town of Surf City Local Permit Program
127 Cardinal Drive Extension
Wilmington, NC 28405
Sincer
c
X
\IA) .411
Pro rty Owner
X IOW 14O4 t C*-
Mailing Address
X Wolt Fofires , 1\X., c2--M-1
City,State,Zip Code
RECEIVED
DCM WILMINGTON, NC
MAY 032013

AFFIDAVIT OF PUBLICATION
STATE OF NORTH CAROLINA
COUNTY OF NEW HANOVER r �'� yh`"Q� /
CAMA MINOR PERMIT NOTICE Before the undersigned,a Notary Public of Said County and State,
- Pursuant to NCGS 113A-119(b),the
North Carolina Division of Coastal
Management,an agency authorized Anita Thomas
to issue CAMA permits in areas of
environmental concern, hereby
gives N OTICEPro that
ieon May
3,20 3, Who,being duly sworn or affirmed,according to the law,says that he/she is
Bd
to rebuild Tiffany s Motel, located
between the AIWW and Atlantic
Ocean, at the crossroads of Pender Publisher's Assistant
Ave. and Hwy 210, in Surf City,
Pender County.The application may
beinspected at the address below.
Public commentss receivededby May corporation of THE STAR-NEWS, a organized and doing business under the Laws of the State of
2
comments4, 2013will bebec acdered. Land North Carolina,and publishing a newspaper known as STAR-NEWS in the City of Wilmington
considered up to the time of permit
decision. Project modifications may CAMA MINOR PERMIT NOTICE Pursuant to NCGS 113A-119b,the North Carolina Division
cuhtrppeirew
and comments.Notice of the permit of Coastal Management,an agency authorized to issue CAMA permits in areas of
cision in pro-
vided upon hwritten is trequest.r will be pro- environmental concern,hereby gives NOTICE that on May 3,2013,Baymore Properties,LLC
Jason Dail,Field Representative proposed
Division of Coastal Management
127 Cardinal Drive Extension
Wilmington,NC 28405-3845
Phone:[phone]
was inserted in the aforesaid newspaper in space,and on dates as follows:
5/9 lx
And at the time of such publication Star-News was a newspaper meeting all the requirements and
qualifications prescribed by Sec.No. 1-597 G.S.of N.C.
á4'utL" jLl444 Title:Publisher's Assistant
Sw rn or affirmed to,and subscribed before me this / day of
,A.D., OW13 "1..Aw
In Tes ony Whereof,I have hereunto set my hand and affixed m f�ci • , jd
year aforesaid. 4%4 .101.A R Ct
e .�.
At►B vcify ub>¢
My commission expires day of ,20_
�hwt4fassi�Mo'Y
Upon reading the aforegoing affidavit with the advertisement thereto annexed it is adjudged by the Court that the said
publication was duly and properly made and that the summons has been duly and legally served on the defendant(s).
This day of
Clerk of Superior Court
MAIL TO: RECEIVED
DCM WILM!NCTc N, NC
MAY 15 2[1i3

6467a
A'N'A Builders, Inc. TD BANK
13480 Hwy 50
Surf City,NC 28445 67-219-539
•
4/26/2013
PAY TO THE
ORDER OF NC DENR o
$ **100.00 92
One Hundred and 00/100***.***************.*****.**********.******.************.**************.******.*********.*..*.******
DOLLARS
NC DENR j U)
( Void after 90 Days n
' l NEFI}tjC- ien. L}J
Cardinal 2e i;Z� �
Wilmington, NCC 28405 05
MEMO
AUTHOR! D RE
Tiffany's Minor LAMA Permit L5C /3 67/J0 ) d7.

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