SC_13-25_ CJL Partners

•
Issued by WiRO SC13.25
Surf City Permit Number
CAMA
MINOR DEVELOPMENT4111111
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 CJL Partners, Inc. authorizing development in the Ocean Hazard (AEC) at 1304 South Shore Drive, in Surf
City, Pender County as requested in the permittee's application, dated December 18, 2013, and received by DCM on
December 18, 2013. This permit, issued on January 14, 2014, is subject to compliance with the application and survey
drawing dated (mapped) December 17, 2013, and received by DCM on December 18, 2013 (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 single family residence with associated parking, driveway, amenities and
utilities.
(1) Ail proposed development and associated construction must be done in accordance with the permitted survey drawing
dated prepared on December 17, 2013, and received by DCM on December 18, 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, 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)
RECEIVED
v ►I v \ • i,
This permit action may be appealed by the permittee or other qualified persons AP
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 C A LOCAL PERMIT OFFICIA
approval.All work must cease when this permit expires on:
127 Cardinal Drive Extension
December31,2016 Wilmin on, NC 28405-384
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

Name: CJL Partners, Inc.
Minor Permit#SC13-25
Date: January 14, 2014
Page 2 of 3
(5) With exception of the proposed structural access walkway and decking, ALL other structure(s) must be set back a
minimum of 60 feet from the First Line of Stable Natural Vegetation (FLSNV), as determined by the DCM. With
exception of the access walkway and structurally detached ocean side decking, no eaves, cantilevers, pilings, etc.
may encroach within 60'from the FLSNV.
(6) The permittee is required to contact the Local Permit Officer [phone], shortly before he plans to begin
construction to arrange a setback measurement that will be effective for sixty (60) days barring a major shoreline
change. Construction must begin within sixty (60) days of the determination or the measurement is void and must
be redone.
(7) Any structure(s) 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.
(8) Any decking located within 60 feet from the FLSNV shall not exceed a combined footprint of 500 sq. ft. and shall be
structurally independent (detached) of the residential or primary structure. The deck(s) may be cosmetically
attached, but shall remain free standing as a single unit.
(9) 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.
(10) All pilings shall have a tip penetration greater than eight feet below the lowest ground elevation under the structure.
(11) The total floor area of the permitted dwelling shall not exceed 2,654 square feet, as indicated in the permit
application.
(12) 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.
(13) 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 vegetatively stabilized (planted and mulched)
within 14 days of construction completion.
(14) 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.
RECEIVED
DCM WILMINGTON,NC
APR 072014

,
Name: CJL Partners, Inc.
Minor Permit#SC13-25
Date: January 14, 2014
Page 3 of 3
(15) 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: DATE:
PERM ITTEE
RECEIVED
DCM WILMINGTON,NC
ADD n 7 ')n4A

Issued by WiRO SC13-25- MODIFIED
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 CJL Partners, Inc. authorizing development in the Ocean Hazard (AEC) at 1304 South Shore Drive, in Surf
City, Pender County as requested in the permittee's application, dated December 18, 2013, and received by DCM on
December 18, 2013. This permit, modified on March 24, 2014, is subject to compliance with the site plan drawing dated
received by DCM on March 13, 2014 (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 single family residence with associated parking, driveway, amenities and
utilities.
(1) Ail proposed development and associated construction must be done in accordance with the permitted survey drawing
dated revised 3/7/14 and received by DCM on March 24, 2014.
(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, 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)
. R
r, M WILMINGTON,
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 APR 0 7 2014
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 C A LOCAL PERMIT OFFICIAL
approval.All work must cease when this permit expires on:
127 Cardinal Drive Extensi
December 31,2016 Wilmington, NC 28405- 5
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

Name: CJL Partners, Inc.
Minor Permit#SC13-25
Date Modified: March 24, 2014
Page 2 of 3
(5) With exception of the proposed structural access walkway and decking, ALL other structure(s) must be set back a
minimum of 60 feet from the First Line of Stable Natural Vegetation (FLSNV), as determined by the DCM. With
exception of the access walkway and structurally detached ocean side decking, no eaves, cantilevers, pilings, etc.
may encroach within 60'from the FLSNV.
(6) The permittee is required to contact the Local Permit Officer [phone], shortly before he plans to begin
construction to arrange a setback measurement that will be effective for sixty (60) days barring a major shoreline
change. Construction must begin within sixty (60) days of the determination or the measurement is void and must
be redone.
(7) Any structure(s) 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.
(8) Any decking located within 60 feet from the FLSNV shall not exceed a combined footprint of 500 sq. ft. and shall be
structurally independent (detached) of the residential or primary structure. The deck(s) may be cosmetically
attached, but shall remain free standing as a single unit.
(9) 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.
(10) All pilings shall have a tip penetration greater than eight feet below the lowest ground elevation under the structure.
(11) 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.
(12) 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 vegetatively stabilized (planted and mulched)
within 14 days of construction completion.
(13) 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.
RECEIVED
DCM WILMINGTON, NC
ADD n rf 1A 41

Name: CJL Partners, Inc.
Minor Permit#SC13-25
Date Modified: March 24, 2014
Page 3 of 3
(14) Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third-party.
L ,..
SIGNATURE: DATE:
PERMITTEE
DCM RECEIVED
NC
APR 0 7 2014

I.i VEcl ,FDOH E BYrc P11FY THAT HAYS y ` `
SURVEYED THE PROPERTY AS SHOWN HEREON IN Y
ACCORDANCE WON THE STANDARDS OF PRACTICE ill C
FOR LAND SIIRYfnNG IN ANION CARWNA THAT Nr e
THE RASA D PRECISION S CALCULATED in CO D BY XII ro[POATa,T a� 3 1IS IpIP �
LATITUDESRAT(AND PRECISION S IS LCULAT r $
A� i, MAR 1 2014 �
49/ARLES FRANKS RIGGS P.LS L-4981 y I� .�
IJ-III THIS IS TO CERTIFY THAT THE SUBJECT PROPERTY IS LOCATED p•g I 1
IN FL000 ZONE VARIES WHICH 15 A PNmALL !ll
PEDAL F 000 HAZARD AAREA
DETERMINED
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\ SIDE PROPERTY LINES FROM EDGE OF ASPHALT
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\ V• j SETBACK WITH EXCEPTION OF CONSTRUCTION OF REAR -20'
O �E'VC STEPS k WALK MTH DECK&GAZEBO ROE -7.5•
R"� ` \\/ m< {1 renew. FL. Dy,.12.0+1) PLEBS
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a 11 I\ ,L!6 'I I+�I .6.oc+s o.e,se LOT 5 *I I1 {23{-35-6002-0000
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\ z1M. _--_- ---1 I� 1 e1 j 52B'29'00'E 272.89' NYP
\ ;P / J9.3Y I ;, 81.06';r:y;^ 50.811 1 wS�t pR I 1 112.06 '!"el
LE{FBG
1. Iq• W_,.I _ d t0/]o/16 i CC -CONTROL CORNER
\ Y\ ,' ,� ..'. I t �mIM i..ta f 1, b rtGc 7 1 SI B ECM-EERSTF CONCRETE MONUMENT(FWMOxCdY1NOL C
k w I ri LOT 6 �- OP -COSTING IRON PIPE(fOUNO)
I I i I 15101 Sq.ft.
O� ER -E165TNC IRON ROD(FOUND)
\ mai1 PoeAaus I�• pn � l i I+ wK B IWIIWI lulllllllil 0.347 ACRES s DM-EXISTING MAGNETIC NAIL(FOUNDXCONTROL G(
\ 'C I YY atsti 1 T 11 Gao 1 FA( ENSTNG PARLOR-KALE!NAL(FOUNOXC0111ROL CC
1„ Y, 1 ERRS-EDS LNG RAILROAD SPIKE(FOUND)
11' ?[ �_ ' I.-• I 1 �- m YBL-MINIMUM BUILDING UNE
- N 1 1 I 11 I I I 11O NAP NON 40NUYENTED PANT
I R/W RIGHT OF WAY
34.60• •..:T I B506•` 15.65'�R 29.08•OR 15.8I IR/WMD 1 117.0Y NYP SO/ SET CONCRETE MONUMENT(CONTROL CORNER)
\ \ ' I ` •mq6 r u y,�t.ypy ♦ B I N2B79'00"W 277.95' 9P SET IRON PIPE
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3 PROPOSED PWEUJNC a 12"EAVES -1425 Sq.FL I 1ww v I 1 9PK SET PARKER-KALON NAIL(CONTROL CORNER)
i PROPOSED GAZEBO -144M Sq.Ft P \ I s.rz I I t �v rm I -CENTERLINE
PPRROOPOSED POSED TOTAL BUILT UPON SURFACE-2527 SR.Ft \ Y T� I °`bJ ORN�"WL LOT 7 1 MI-WATERH METER
IDTAI LOT AREA -15101 G Ft $ LOT 7
,F PROPOSED BULL UPON AREA -16.76 \ N \ I I LANDSCAPING AS PER TOWN OF SURF Ott ORDNANCE -WATER VALVE
1 KBE Y E R I Ala ®-SANITARY 97/ER MANHOLE
PROPOSED DWELLING&12'EAVES -1425 SR.FL \ G1j \ N(GC) 1p I ®-CLEAN OUT
PROPOSED GAZEBO -144 Sq.Ft d1 TELEPHONE PEDESTAL
PROPOSED PFRY011[JVBYE A S-Ft \ G`" \ \ ®-TELEVISION PEDESTAL
PROPOSED TOTAL II/PERVIOUS SURFACE-1588 Sq.Ft. ®-FIBER OPTIC CABLE MARKER
D'ITAL I AT AREA -15101 So Ft— \ J l'K'ELIMINA/2Y f'LAr
PROPOSED WPEAYOUS AREA -10.42 \ -PORT PPOL
-POWER POLE
1 Nor POP EECCIft7ATION, ��-POWER UNE
BEIBSIOtlS \ \ \ ,CONVEYANCES Ol'SALES XE -DOSCT1TNc TRANSFORMER
ELEVATION
i 03/07/14: REMOVED DRIVEWAY FLAIR
AT EDGE OF ASPHALT RnY q Env GRAPHIC SCALE
CHARLES F. RIGGS & ASSOCIATES, INC.(c-730) BOUNDARY SURVEY& PRELIMINARY PLOT PLAN
LAND SURVEYING — CONVENTIONAL & GLOBAL POSITIONING SYSTEMS, FOR (IN TT)
LAND PLANNING & COMPUTER MAPPING CJL PARTNERS, INC. 'Inch-S°"
502 NEW BRIDGE STREET LOT 6, BLOCK 3, PAULINE SULLIVAN, M.B. 11, P. 26 ACTUAL FIELD SURVEY DATE NOVEMBER 6,2
MAPPING DATE: DECEMBER 17,2013
X P.O.BOX 1570 101 SCOTTS HILL LOOP ROAD TOPSAIL TOWNSHIP, PENDER COUNTY, NORTH CAROLINA DRAWN BY: _1.HELMS
JAELEPHOILLE,N.C.28541-1570 VILMINGTON,N.C. 28411 RICHARD RAY SULUVAN, OWNER, D.B. 512, P. 37 CHECKED BY:c.F.,ni�.rs
TELEPHONE: [phone] TELEPHONE: [phone] FLD BOOK: 818 _ PAGE: ____2Q,_
FACSIMILE: [phone] E-MAIL riggslandmizec.rr.com 1304 SOUTH SHORE DRIVE
E-MAIL riggdandObizec.rr.corn (PROJECT NUMBER: 13-09-24 I

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pat McCrory Braxton C. Davis John E. Skvarla, III
Governor Director Secretary
March 25, 2014
CJL Partners Inc.
do Chris Majewski
2828 Brenfield Drive
Raleigh, NC 27606
Dear Mr. Majewski:
• Attached is Modified CAMA Minor Development Permit# SC13-25 for work to be done at
1304 South Shore Dr., 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 both pages of the white copy then return to us
within 20 days of receipt, in the enclosed, self-addressed envelope.
I have also enclosed the original SC 13-25 for your signature, as we have not yet received a signed
copy. It was sent to your agent, Charles Riggs, on January 15, 2014. Thanks you for your assistance.
These are not valid permits until they are signed and returned to our office.
Again, thank you for your prompt attention to this matter.
Sincerely,
-6
Shaun K. Simpson' f
Permit Support Techniciar
Enclosures
cc: WiRO files
127 Cardinal Drive Ext.,Wilmington,NC 28405
Phnno•Q1(1_7(1R_7)1c 1 FAY•alfLIQA_'2QRA Intornct•IMAM,nrrnaetalmanancmont nct

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.7•'''''''''PROJECT: Applicant proposes to construct a single-
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1 u u Januai3
, 2014
APPLICANT
FOR MORE DETAILS CONTACT
Charles F. Riggs
PO Box 1570 -- itie27bcar
c4111-jeinalt?1.iE!t.6"4446f.lii
Wilmington, NC 28405
Jacksonville, NC 28541
Jasen-Daili-Distriet-Mantager
910 79-6 7215
For: CJL Partners. Inc.

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATiON/WAIVER FORM
Name of Property Owner: } ?A i2-1-ti; ?`-)
Address of Property: �'`� 5. �O( Ia. (5v,f-- c,4-, yc
(Lot or Street#, Street or Road, City&County)
Agent's Name#: c i t,5 r/vt,k.Te t1_ Mailing Address:ZVirg/ L )c,-)z-
Agent's phone#: 1/9- 1/2/"-2 ' _ ' / . /4/L , .2,7‘D.4.
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing_the development
they,,r •roposing. A description or drawing,with dimensions, must be provided with this letter.
r
-)(- i' "I have no objections to this proposal. i have objections to this proposal,
c.`
tk If you have objections to what is being proposed,you must notify the Division of Coastal Management(DCM)in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at(910) 798-7215. No response is
considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15'from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
' i do wish to waive the 15' setback requirement.
it' i tAir . I do not wish to waive the 15' setback requirement.
(Property Owner Infor on) v7�, Ad'ace; +Property Owner Information)
fit.
Signature Signature --s7
C` igie'5 /71 J-6 4.6,e. T R.. t",5c,.1 ! ,IX, .F J i c:
Print or Type Name Print or Type Name ��
� P
Mailin Addr'e `13C
Mailing Address
city/statky
e 1 i T y r�7C. ,2 y5'S
City/State/Zip 1
f°/i
- /I7-:737 fO --;32 )�'S5Tphone Number Telephone Number
f 7 r'
Hate / (� .?t 4 A /9 2 /ill
Date
/'/ 1
Revised 6/18/2012

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:
r i
Address of Property: 1-)\--1,,,,I 50 . 'oCc {`
(Lot or Street#, Street or Road, City&County) /
Agent's Name#: ( f1 LS PI 11 JE1i.) k,, , Mailing Address: 2OX Er 06`4 /4/ of
Agent's phone#: 9/y' /2,2 ,Z3 7 G Afra %/CT° .2/7(; 6
C/
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing,with dimensions must be provided with this letter.
�;r (c�A I have no objections to this proposal. I have objections to this proposal.
� p Po
If you have objections to what Is being proposed,you must notify the Division of Coastal Management(DCM)in
writing within 10 days of receipt of this notice, Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at(910) 796-7215. No response is
considered the same as no objection if you have been notified by Certified Mail,
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15'from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
i0. 'k ' 'R .
, N. I do not wish to waive the 15' setback requirement
t .
r'N
(Property Owner Inform • n) (Adjjaarcent Prope Owner Information)
L:',,,,z/_____ / , 6tf\
SignatureI
Signature
Print or Type Name �' f Print or T) C,)7' //,' ,ype Name( Jy{
;2V51- (?6,(e.
d5 ie---;
M g Address Mailing Address ,
,/ 6k IG r , h;`C' ,�lx-)6 ` / �� — l /"
City/State/Z. City/State/Zip `
Y/ - 727 --2,3 7 k")7' 3"--r ' 575-Y
Telephone Number Telephone Number /
(3 -70 - // 00.
Date Date , .`
` Revised 6/18/2012

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
January 15, 2014
Charles F. Riggs &Associates
Attn: Charles F. Riggs
PO Box 1570
Jacksonville, NC 28541
Dear Mr :
Attached is CAMA Minor Development Permit# SC13-25 for work to be done for CJL Partners, Inc.
at 1304 South Shore Dr., 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 both pages 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.
Sin erely,
aun K. Simpso
Permit Support Technician
Enclosures
cc: WiRO files
127 Cardinal Drive Ext.,Wilmington, NC 28405
Phone:[phone]\FAX:[phone] Internet:www.nccoastalmanaoement.net

, SO; C.4--t- / � / OTHER PERMITS MAY BE REQUIRED:The activity you are planning may require permits other than the CAMA
`' y Permit Number I J �`�l 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,FIA
rand Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile Home Park Approval,Highway Connection,and
(For official use onlm) others.Check with your Local Permit Officer for more information.
J,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
WNER person authorized to act as an agent for purposes of applying for a CAMA minor development permit,certify that the person
Partners,Inc. listed as landowner on this application has a significant interest in the real property described therein.This interest can be
described as:(check one)
!828 Brenfield Drive
Flan owner or record title,Title/�v ed in see Deed Book
Ih State NC Zip 27606 Phone [phone]
page in the County Registry of Deeds.
[e-mail]
Flan owner by virtue of inheritance.Applicant is an heir to the estate of
tIZED AGENT probate was in County.
lades F.Riggs&Associates,Inc. Elf other interest,such as written contract or lease,explain below or use a separate sheet&attach to this application.
�.O.Box 1570 Contract to Purchase
NOTIFICATION OF ADJACENT PROPERTY OWNERS:
csonville State NC Zip 28541 Phone [phone] 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.
Igsland©bizec.rr.com
(Name) (Address)
(1) Mr.Russell H.Eichman,Jr.et al.,P.O.Box 2516,Surf City,NC 28445
ON OF PROJECT:(Address,street name and/or directions to site.If not oceanfront,what is the name of the
eaterbody.) 1304 South Shore Drive(Lot 6,Block 3,Pauline Sullivan,M.B.11,P.36) /L f/�h'` �7(e
r7 (2) Smith Family Real Estate Holdings Co.,LLC,19 Brittany Woods,Charleston,WV 25314
( V _ (3)
PTION OF PROJECT:(List all proposed construction and land disturbance.) Proposed Two-Story Dwelling (4)
veered Decks and Porch,Uncovered Decks,Walk,Gazebo,and Pervious Drive
LOT/PARCEL: 15,101 square feet 0.347 acres ACKNOWLEDGEMENTS:
I,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
IED USE:Residential❑✓ (Single-family 0 Multi-family❑) Commercial/Industrial 0 Other 0 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-
ETE EITHER(l)OR(2)BELOW(Contact your Local Permit Officer if you are not sure which AEC applies tion and floodproofing techniques.
'opertv):
I furthermore certify that i am authorized to grant,and do in fact grant,permission to Division of Coastal Management staff,
AN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE:2,654 square feet(includes the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information
Toned living space,parking elevated above ground level,non-conditioned space elevated above ground level but related to this permit application.
non-load-bearing attic space) ' ,/�
STAL SHORELINE AECs:SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT This the day of 4413
/
/ /
JRFACES: square feet(includes the area of the rooUdrip line of all buildings,driveways,covered decks, A �-�� _�
mr masonry patios,etc.that are within the applicable AEC.Attach your calculations with the project drawing.) ���
Landowner or person authorized t. . . t s/her agen or p .. filing :0,?..' • ..permit application
ITORMWATER MANAGEMENT PERMIT:Is the project located in an area subject to a State Stormwater
tent Permit issued by the NC Division of Water Quality? This application includes:ge era!i ormation(this'ern),a si drawing as described on the back of this application,the
D NCI i I ownership statement,the Ocea .aza t . -,t : . . ecessary,a check for S100.00 made payable to the locality and
any information as may be provided ora v by the applicant.The details of the application as described by these sources are
I the total built upon area/impervious surface allowed for your lot or parcel: square feet. 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 antiidn rf xen lictton.
DCM WILMINGTON, NC
DEC 182013

OCEAN HAZARD AEC NOTICE
Project is in an: X Ocean Erodible Area X High Hazard Flood Area Inlet Hazard Area
Property Owner: Mr,Chris Majewski,CJL Partners,Inc.
Property Address: 1304 South Shore Drive(Lot 6, Block 3, Pauline Sullivan,M.B. 11, P.26)
Date Lot Was Platted: July 1970
I his notice is intended to make you, the applicant.aware of the SPECIAL NOTE: This hazard notice is required tier
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 lleeember 11 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 LP()will inform you that you may begin work. Substantial
eliminate. property loss from hazards. By granting permits. the progress on the project must he 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 the 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 structurets)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 mare information.contact
Resources Commission, indicates that the annual long-term
average ocean erosion rate for the area where your property is
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 M)years,
Studies also indicate that the shoreline could move as much as Address
feet landward in a major storm.
The flood waters in a major storm are predicted to he about
feet deep in this area. Locality
Preferred oceanfront protection measures are beach nourishment
and relocation of threatened structures. Hard erosion control
structures such as bulkheads.seawalls.revetments,groins,jetties Phone Number
and breakwaters are prohibited. Temporary sand bags may be
authorized under certain conditions. RECEIVED
DCM WILMINGTON, NC
Time applicant must acknowledge this information and
requirements by signing this notice in the space below. Without DEC OQ 20��
the per signature.the applicati will not he complete.
November 25,2013
Property Owner Sign tune Date
Revised May 2010

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
November 25, 2013
Date
Name of Property Owner Applying for Permit:
Mr. Chris Majewski, CJL Partners, Inc.
Mailing Address:
2828 Brenfield Drive
Raleigh, NC 27606
Charles F. Riggs & Assoc. to act on m
I certify that I have authorized (agent) y
behalf,for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct(activity) proposed dwelling, as shown on plot plan
at(my property located at) 1304 South Shore Drive (Lot 6, Block 3,
Pauline Sullivan, M.B. 11, P. 26)
This certification is valid thru(date) November 25, 2014
November 25, 2013
Property Owner Signa 'e Date
RECEIVED
DCM WILMINGTON, NC
DEC 18 2013

CHARLES F. RIGGS &ASSOCIATES, INC.
Land Surveyors
Charles F.Riggs,P.L.S.L-2981 502 NEW BRIDGE STREET Wilmington Office:
James A.Lewis,P.L.S.L-4562 P.O.Box 1570 10t Scotts Hill Loop Road
Kenneth E.Johnson, P.L.S.L-4925 JACKSONVILLE,NORTH CAROLINA 28541 Wilmington,N.C. 28411
Corporate License(C-730) TELEPHONE: (910) 455-0877 [phone]
FACSIMILE: (910) 455-9033
E-MAIL:riggslandabizec.rr.com
December 17,2013
Smith Family Real Estate Holdings Co.,LLC
19 Brittany Woods
Charleston,WV 25314
Re: CJL Partners, Inc.Minor CAMA Application
Dear Sir or Madam:
On behalf of CJL Partners,Inc.,Charles F. Riggs&Associates, Inc. is submitting to the Division of
Coastal Management,North Carolina Department of Environment and Natural Resources the enclosed
Minor CAMA application for the property located at 1304 South Shore Drive. We are required to notify
the adjoiners of this CAMA application.Please review the package, sign the form provided, stating
whether you have objections or no objections to this,and return the form to us in the SASE provided.
qspectfully
r
James L. Riggs
RECEIVED
DCM WILMINGTON, NC
DEC 18 2013

CHARLES F. RIGGS & ASSOCIATES, INC.
Land Surveyors
Charles F.Riggs,P.L.S.L-2981 502 NEW BRIDGE STREET Wilmington Office:
James A.Lewis,P.L.S.L-4562 P.O. Box 1570 101 Scotts Hill Loop Road
Kenneth E.Johnson, P.L.S.L-4925 JACKSONVILLE,NORTH CAROLINA 28541 Wilmington,N.C. 28411
Corporate License(C-730) TELEPHONE: (910) 455-0877 [phone]
FACSIMILE: (910) 455-9033
E-MAIL:[e-mail]
December 17, 2013
Mr. Russell H. Eichman,Jr.
P.O. Box 2516
Surf City,NC 28445
Re: CJL Partners, Inc. Minor CAMA Application
Dear Mr. Eichman:
On behalf of CJL Partners, Inc.,Charles F. Riggs&Associates, Inc. is submitting to the Division of
Coastal Management,North Carolina Department of Environment and Natural Resources the enclosed
Minor CAMA application for the property located at 1304 South Shore Drive. We are required to notify
the adjoiners of this CAMA application. Please review the package, sign the form provided, stating
whether you have objections or no objections to this, and return the form to us in the SASE provided.
s ctfully,
ames L. Riggs
RECEIVED
DCM WILMINGTON, NC
DEC 1 82013

CHARLES F. RIGGS & ASSOCIATES, INC.
Land Surveyors
Charles F.Riggs,P.L.S.L-2981 502 NEW BRIDGE STREET Wilmington Office:
James A.Lewis,P.L.S.L-4562 P.O. Box 1570 101 Scotts Hill Loop Road
Kenneth E.Johnson, P.L.S.L-4925 JACKSONVILLE,NORTH CAROLINA 28541 Wilmington,N.C. 28411
Corporate License(C-730) TELEPHONE: (910) 455-0877 [phone]
FACSIMILE: (910) 455-9033
E-MAIL: [e-mail]
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 1304 South Shore Drive,Topsail Township, Pender County,North
Carolina,of which CJL Partners, Inc. has a contract to purchase. CJL Partners, Inc. is proposing to construct a
two-story dwelling with covered decks and porch, uncovered decks,walk, gazebo,and pervious drive,as
illustrated on the enclosed plans.This residence will be provided water and sewer service from the Town of Surf
City. All areas of environmental concern have been evaluated by the North Carolina Division of Coastal
Management and these areas have been identified on the enclosed plans.
The State of North Carolina Division of Coastal Management does not require a response, however the
State does consider no response to be no objection. If you do wish to respond or if you have objections,
please state them in the space below and return this form in the addressed, stamped envelope provided to
Charles F. Riggs&Associates, P.O. Box 1570,Jacksonville,NC 28541.
Please check the appropriate space for your response.
( ) I have objections to the proposal.
( ) I have no objections to the proposal.
Signature Date
Print or Type Name
•
Telephone Number
RECEIVED
DCM WILMINGTON, NC
DEC 1 82013

I. . -os a erviceTM
„ CERTIFIED MAILTM RECEIPT ,t,
u (Domestic Mail Only;No Insurance Coverage Provided) CERTIF tv .
For delivery information visit our website at www.usps.corn �. (Domestic Mai/On/y No Insurance
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Postage $ DC WILMINGTON, NC -aa RECEIVED
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OFFER TO PURCHASE AND CONTRACT-VACANT LOT/LAND
[Consult"Guidelines"(form 120)for guidance in completing this form)
NOTE: This contract is intended for unimproved real property that Buyer will purchase only for personal use and does not have
immediate plans to subdivide- It should not be used to sell property that is being subdivided unless the property has been platted,
properly approved and recorded with the register of deeds as of the date of the contract.If Seller is Buyer's builder and the sale involves
the construction of a new single family dwelling prior to closing,use the standard Offer to Purchase and Contract—New Construction
(Faint 800-T)or, if the construction is completed. use the Offer to Purchase and Contract (Form 2-1) with the New Construction
Addendum(Form 2A3 T).
For valuable consideration,the receipt and legal sufficiency of which are hereby acknowledged,Buyer offers to purchase and Seller upon
acceptance agrees to sell and convey the Property on the toms and conditions of this Offer To Purchase and Contract and any addendum
or modification made in accordance with its terms(together the"Contract").
1. TERMS AND DEFINITIONS: The terms listed below shall have the respective meaning given them as set forth adjacent to each
term. ll
(a) "Seller": >V'G*�As?;Z- Y r 1✓AN
(b) "Buyer": C..-3-L 1 i. rjue:,.?...5 -I--t' L.
(c) -Property':The Property shall include all that real estate described below together with all appurtenances thereto including the
improvements located thereon. NOTE: If the Property will include a manufactured (mobile) home(s), Buyer and Seller should
consider including the Manufitcutred (Mobile) Home provision in the Additional Provisions Addendum (Standard Form 2A11-T)
with this affix: fL. 5 kirk- c)r, e~
Street Address: t
City: .fir ca-411 NL. tip:
County: i),,F_ tr 7g-.r, North Carolina
(NOTE:Governmental authority over taxes,zoning,school districts.utilities and mail delivery may differ from address shown.)
Legal Description:(Complete jLL applicable)
Peat Reference:Lot/Unit to ,Block/Section ,3 yet ,SuubbdivisiiordCondrmijpium
'� 41'219'1ig Boo35 .aQ - OOP
1
The IrIN/PID or other identification number of the Property is: -
Other description
Some or all of the Property may be described in Deed Book at Page
(d) "Purchase Price':
S siimmiiim paid in U.S.Dollars upon the following terms:
S lop ' oc, BY DUE DILIGENCE FEE made_payable to Seller by the Effective Date.
S Aij BY INITIAL EARNEST MONEY DEPOSIT made payable to Escrow Agent named
in Paragraph 1(f)0 with this offer OR C]delivered within five (3) days of the
Effective Date of this Contract by 0 cash ❑personal check Q official bank check
900: O(. U wire transfer.
S BY (ADDITIONAL) EARNEST MONEY DEPOSIT made payable to Escrow Agent
named in Paragraph 1(f)by cash or immediately available funds such as official bank
aukor" wireto be delivered to Escrow Agent no later than
SdAp7z eacir✓•n 46,04 ,TIME BEING OF THE ESSENCE' with
iratd to said date.
S �� BY ASSUMPTION of the unpaid principal balance and all obligations of Seller on the
existing loans)secured by a deed of trust on the Property in accordance with the attached
$ Al/,t` Loan Avuamptian Addendum(Standard Form 2A6-7).
!T BY SELLER FINANCMO in accordance with the attached Seller Financing Addendum
(Standard Form 2A3-T).
S - BALANCE of the Purchase Price in cash at Settlement(some or all of which may be paid
' with the proceeds of a new loan).
Should Buyer fail to deliver either the Due Diligence Fee or any Initial Earnest Money Deposit by their due dates, or should any
check or other funds paid by Buyer be dishonored,for any reason,by the institution upon which the payment is drawn.Buyer shall
have one(1)banking day after written notice to deliver good funds to the payee. In the event Buyer does not timely deliver good
funds,Seller shall have the right to terminate this Contract upon written notice to Buyer.
This form jointly approved by:
To STANDARD FORM 12-T
Taw, North Carolina Bar Association Page 1 of 9 Revised 7r2012
North Carolina elation of REALTORS®,Inc. m,' „ ®7/2012
Buyer initi Seller initials Oga. _._..
_ RECEIVED
DCM WILMINGTON, NC
DEC 18 2013

I
16. ASSIGNMENTS: This Contract may not be assigned without the written consent of all parties except in cone with a tax-
deferred exchange,but if assigned by agreement,then this Contract shall be binding on the assignee and assignee's heirs successors.
17. TAX-DEFERRED EXCHANGE: In the event Buyer or Seller desires to effect a tax-deferred exchange in conrction with the
conveyance of the Property, Buyer and Seller agree to cooperate In effecting such exchange;provided,•however, the exchanging
party shall be responsible for all additional costs associated with such exchange.and provided ftnther.that a non-exr�g party shall
not assume any additional liability with respect to such tax-deferred exchange.Buyer and Seller shall execute such additlaval documents,
including assignment of this Contract in connection therewith,at no cost to the non-exchanging pasty, as shall be required to give effect
to this provision.
18. PARTIES: This Contract shall be binding upon and shall inure to the benefit of Buyer and Seller and their ve heirs,
successors and assigns. As used herein, words in the singular include the plural and the masculine includes the femie and neuter
genders,as appropriate.
19. SURVIVAL: If any provision herein contained which by its nature and effect is required to be observed,kept or!erformed after
the Closing,it shall survive the Closing and remain binding upon and for the benefit of the parties hereto until fully oerved,kept or
performed. {
1
20. ENTIRE AGREEMENT: This Contract contains the entire agreement of the parties:and there are no representations,
inducements or other provisions other than those expressed herein. All changes, additions or deletions hereto must bell in writing and
signed by all parties. Nothing contained herein shall alter any agreement between a REALTORS or broker and Sell a or Buyer as
contained in any listing agreement.buyer agency agreement or any other agency agreement between them. 1
21. NOTICE: Any notice or communication to be given to a party herein may be given to the;party or to such patty's agent Any
written notice or communication in connection with the transaction contemplated by this Contract may be given to a or a patty's
agent by sending or transmitting it to any mailing address,e-mail address or fax member set forth in the"Notice Inf on"section
below. Seller and Buyer agree that the "Notice Information' and "Escrow Acknowledgment" sections below shall i constitute a
material part of this Contract,and that the addition or modification of any information therein shall not cotlstitute a reje bn of an offer
or the creation of a counteroffer.
22. EXECUTION: This Contract may be signed in multiple originals or counterparts,all of which together constitute one and the
same instrument,and the parties adopt as their seals the word"SEAL"beside their signatures below.
23. COMPUTATION OF DAYS: Unless otherwise provided, for purposes of this Contract.the term "days"shall m consecutive
calendar days,including Saturdays,Sundays,end holidays,whether federal,state,local or religious.For the purposes of culating days,
the count of"days"shall begin on the day following the day upon which any act or notice as provided in this Contract w required to be
performed or made.
THE NORTH CAROLINA ASSOCIATION OF REALTORSS, MC.AND THE NORTH CAROLINA BAR ASSOCIATION MAKE
NO REPRESENTATION AS TO THE LEGAL VALIDITY OR ADEQUACY OF ANY PROVISION OF THIS RPM IN ANY
SPECIFIC TRANSACTION.iF YOU DO NOT UNDERSTAND THIS FORM OR FEEL THAT IT DOES NOT PROVIDE FOR.YOUR
LEGAL NEEDS,YOU SHOULD CONSULT A NORTH CAROLINA REAL ESTATE ATTORNEY BEFORE YOU SIGNS'M.
This offer shall become a binding contract on the Effective Date.Date: f t
//'" /? - / 3 Date: - 2.0 2..o I
Buyer (._--• f / " (SEAL) Seller .. . (SEAL)
• 4
Date: Date:
Buyer (SEAL) Seller = ' (SEAL)
Date: Dare:
Buyer (SEAL) Seiler 1 (SEAL)
i
1
Page 9 of 10 I STAND _ FORM 2-T
Bussed 10/2012
�
i I ; C 10/2012
m Preed wripym an F epby bylaw ts eoon eta Road'mat,tCWarlpS � tarry
DCM WILMINGTON, NC
DEC 18 2013

•
.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE
EDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008
'ational Flood Insurance Program Important: Read the instructions on pages 1-9. Expiration Date:July 31, 2015
SECTION A-PROPERTY INFORMATION •FOIk,INSURA( 4C ?M1 1N1,' ,1
Al. Building Owner's Name CJL PARTNERS, LLC Policy Number4 n' ,ff; , '< k`
n£tip.y,k.:4`Y ,MSS-"K,n t
A2. Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O.Route and Box No. Campany IVAIO"t Urt'tb1F";, 41.7 ,'t
1304 SOUTH SHORE DRIVE
City SURF CITY State NC ZIP Code 28445
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOT6,BLOCK 3,PAULINE SULLIVAN
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)RESIDENTIAL
A5. Latitude/Longitude: Lat.34d24'53"N Long.77d33'44"W Horizontal Datum: ❑ NAD 1927 ® NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 6
A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
a) Square footage of crawlspace or enclosure(s) 1871 sq ft a) Square footage of attached garage N/A sq ft
b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage
or enclosure(s)within 1.0 foot above adjacent grade 0 within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A8.b 0 sq in c) Total net area of flood openings in A9.b 0 sq in
d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? 0 Yes ® No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1. NFIP Community Name&Community Number B2.County Name. B3.State
TOWN OF SURF CITY 370186 PENDER NORTH CAROLINA
B4.Map/Panel Number B5.Suffix B6.FIRM Index Date B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone
3720423400 J 02/16/07 Effective/Revised Date Zone(s) AO,use base flood depth)
11/03/05 VE 13.0'
10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source:
11. Indicate elevation datum used for BFE in Item B9: 0 NGVD 1929 ® NAVD 1988 ❑ Other/Source:
12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes ® No
Designation Date: El CBRS 0 OPA
SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
1. Building elevations are based on: ® Construction Drawings* 0 Building Under Construction* El Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO.Complete Items C2.a-h
below according to the building diagram specified in Item A7. In Puerto Rico only,enter meters.
Benchmark Utilized:NC CORS Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a)through h)below. ❑NGVD 1929 ®NAVD 1988 0 Other/Source:
Datum used for building elevations must be the same as that used for the BFE. C)
Check the measurement used.Z
a)Top of bottom floor(including basement,crawlspace,or enclosure floor) 9.5 ®feet 0 meters Z _
b)Top of the next higher floor 19.5 ®feet Elmetersw I- o
c) Bottom of the lowest horizontal structural member(V Zones only) 17.5 El feet 0 meters
Z
d)Attached garage(top of slab) N.A El feet 0 meters()2 .-.t
e) Lowest elevation of machinery or equipment servicing the building 14.1 ®feet ❑meter0'4
(Describe type of equipment and location in Comments) -- W
f) Lowest adjacent(finished)grade next to building(LAG) 8.9 ®feet 0 meters U 0 g) Highest adjacent(finished)grade next to building(HAG) 10.4 ®feet El meters a
h) Lowest adjacent grade at lowest elevation of deck or stairs,including structural support N.A ❑feet 0 meters
SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
Phis certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation
nformation. I certify that the information on this Certificate represents my best efforts to interpret the data available. to i s i r i s i
'understand that any false statement may,t ,s. tM 1p,��fine or imprisonment under 18 U.S. Code, Section 1001. *„0..1� CA4 rr""i
E Check here if comments are provi A� Fk �y, Were latitude and longitude in Section A provided by a .� Q�,;1• •Q// ".
] Check here if attachments. N sa / �w licensed land surveyor'? 0 Yes ❑ No E Oj..
.ertifier's Name JAMES A. LEWISSPL3• Q '. ! License Number L-4562 0 d t AL
rifle PROJECT MANAGER Z' I . Ali Name: CI-\RLES F. RIGGS&ASSOCIATES,INC. 644,646
- • _ e Q• :
\ddress 502 NEW BRIDGE STREET :( City JACKS NVILLL State NC ZIP Code 28540 �s✓•.'4 A°•�,�:
Signature . 1,✓�^.�$U��Yk-ijii Telephone [phone] �+�q�g •...• 2

LVV 111 UVi• •./V1S I II IVI1 I , fl C' fo•
MPORTANT: In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
3uilding Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Policy Number:
304 SOUTH SHORE DRIVE
;ity SURF CITY State NC ZIP Code 28445 Company NAIC Number.
SECTION D—SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED)
;opy both sides of this Elevation Certificate for(1)community official, (2)insurance agent/company,and(3)building owner.
;omments DWELLING IS PROPOSED TWO STORY ON PILINGS, ENCLOSED BELOW. SURVEYOR HAS NOT REVIEWED FINAL CONSTRUCTION
'LANS. THE TOWN OF SURF CITY ADDS A 1.0'FREEBOARD TO THE BASE FLOOD ELEVATION,THEREFORE THE ELEVATION OF THE BOTTOM
)F THE LOWEST HORIZONTAL STRUCTURAL MEMBER MUST HAVE AN ELEVATION OF ATLEAST 13.0'+1.0'=14.0'(PROPOSED BOTTOM OF
3AND=17.5')
1/1111 N 114
3i nature
g .��.• OfESS/d..Isete
SECTION E—BUILDING ELEVATION INF Mit AT rigaLIRVE NO{t2EQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE)
o O AL .
For Zones AO and A(without BFE),complete Items 1—Et. tiku4562te is iptencied to support a LOMA or LOMR-F request,complete Sections A,B,
and C. For Items El—E4,use natural grade, if availa .C the measur�eflt used.In Puerto Rico only,enter meters.
Alt
El. Provide elevation information for the following artb 634 to show whether the elevation is above or below the highest adjacent
grade(HAG)and the lowest adjacent grade(LAGN •-•----- i•`
a)Top of bottom floor(including basement,crawlspa nos -.-is`% . ❑feet 0 meters ❑above or❑below the HAG.
b)Top of bottom floor(including basement,crawlspace,of tfitil6te )is ❑feet ❑meters ❑above or❑ below the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions),the next higher floor
(elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑below the HAG.
E3. Attached garage(top of slab)is . ❑feet ❑meters 0 above or ❑below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is . ❑feet ❑meters ❑above or['below the HAG.
E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management
ordinance? ❑Yes ❑ No ❑ Unknown.The local official must certify this information in Section G.
SECTION F—PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
-he property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE)
it Zone AO must sign here.The statements in Sections A,B,and E are correct to the best of my knowledge.
'roperty Owner's or Owner's Authorized Representative's Name
\ddress City State ZIP Code
signature Date Telephone
;omments
❑Check here if attachments.
SECTION G—COMMUNITY INFORMATION(OPTIONAL)
e local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G
this Elevation Certificate.Complete the applicable item(s)and sign below.Check the measurement used in Items G8—G10.In Puerto Rico only,enter meters.
I. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who
is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
t. ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO.
I.❑ The following information(Items G4—G10)is provided for community floodplain management purposes.
;4.Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued
'. This permit has been issued for: ❑New Construction ❑Substantial Improvement
I. Elevation of as-built lowest floor(including basement)of the building: 0 feet ❑meters Datum
I. BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters Datum
10.Community's design flood elevation: . ❑feet ❑meters Datum
.ocal Official's Name Title RECEIVED
DCM WILMINGTON, NC
:ommunity Name Telephone
signature Date DEC 18 2013
;omments
❑Check here if attachments.

SITE DRAWING/APPLICATION CHECKLIST
Please make sure your site drawing includes the following information required for a CAMA minor development permit.
The Local Permit Officer will help you,if requested.
PHYSICAL DIMENSIONS of(Opy14/ APPLICATION FOR
'Label roads
o0 CAMA MINOR
Label highways right-of-ways
_Zabel local setback lines . . DEVELOPMENT
_ZLabel any and all structures and driveways currently existing on property
"tabel adjacent waterbody
PHYSICAL CHARACTERISTICS >C 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
/)raw 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 wilj,lre 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
yraw and label landward limit of AEC or she needs before you apply.
4)raw and label all wetland lines(contact LPO for assistance)
Draw and label the 30-foot buffer line Under CAMA regulations,the minor permit is to be issued within 25 days once a
DEVELOP7NT 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
•/ w 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? v
• completed an AEC Hazard Notice,if necessary?(Must be signed by the property owner) Y
FOR STAFF USE ..F
trir
Site Notice Posted_Final Inspection Fee Received 2 ts
❑
Site Inspections C
RECEIVED o R
DCM WILMINGTON, NC ❑
Date of Action:Issued Exempted Denied Appeal Deadline(20 days from permit action) DCM Form EBi952-2010 Revised April 2010
DEC 18 2013

•
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CHARLES F RIGGS & ASSOCIATES INC 13269
PO BOX 1570
+
JACKSONVILLE,NC 28541-1570 15-3/540
/J /�D 896
DATE / `//V/�3
x PAY /��/j�-
e ORDER OF / ► 6- I $ / ) 60
��jt:Z Arida ,Ii ��U O DOLLARS r Fe
B PNCBANK
PNC Bank.N.A. 040
i
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FOR 6C 13'�� ii/Yt.o f a. _ - - ""
11'0 i 3 269n' 1:0 540000 301: 5 3 2 1 794 5 290