SC_14-02_ Sanders (2)

Issued by WiRO SC14-02
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 Jon E. Sanders authorizing development in the Ocean Hazard (AEC) at 618 N. Shore Drive, in Surf City,
Pender County as requested in the permittee's application, dated February 14, 2014 and received by DCM on February
25, 2014. This permit, issued on March 19, 2014, is subject to compliance with the application and site drawing dated
received February 27, 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: The addition of a roof structure over the existing street side deck and ocean side deck expansion.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s)dated received on February 27, 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, 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.
(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. 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
December31,2017 Wilmington, NC 28405-3845
In issuing this permit it is agreed that this project is consistent with the local Land RECEIVED
Use Plan and all applicable ordinances. This permit may not be transferred to DCM WILMINGTON,N
another party without the written approval of the Division of Coastal
Ann A I nn.1.

Name: Jon E. Sanders
Minor Permit#SC14-02
Date: March 19, 2014
Page 2
(5) 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 re-established.
(6) Any structure 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) 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 vegetatatively stabilized (planted and
mulched)within 14 days of construction completion.
(8) 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.
(9) This permit authorizes a maximum of 500 sq. ft. of slatted, uncovered and un-enclosed decking within the 60'ocean
hazard setback.
(10) In accordance with Rules established by the Coastal Resources Commission, structural additions or increases in the
footprint or total floor area of a building or structure represent expansions to the total floor area and shall meet the
setback requirements established in this Rule and15A NCAC 07H .0309(a). New development landward of the
applicable setback may be cosmetically, but shall not be structurally, attached to an existing structure that
does not conform to current setback requirements.
(11) 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:
ERMITTEE RECEIVED
DCM WILMINGTON, Nt

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ATM
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 19, 2014
Jon E. Sanders
618 North Shore Drive
Surf City, NC 28445
Dear Mr. Sanders:
Attached is CAMA Minor Development Permit# SC 14-02 for work to be done at 618 North Shore
Drive, 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.
Sincerely,
Shaun K. Simpson
Permit Support Technician
Enclosures
cc: WiRO files
John P. Davies, Agent
127 Cardinal Drive Ext.,Wilmington,NC 28405
Phone:[phone]\FAX:[phone] Internet:www.nccoastalmanagement.net

rilimrorrafag,1 , wit
CAMA PERMIT
APPLIED FOR
PROJECT: Applicant_proposes_to_4replace--
• .
e sii . - . . • . e • I i O - 111 4b . • ent
to the Atlantic Ocean, in Surf City, Pender Co.
COMMENTS ACCEPTED THROUGH March 14, 2014
APPLICANT: FOR MORE DETAILS CONTACT
N el At9 a idrggim wracigw&Riv:
John P. Davis
127 Cardinal Dr. Ext.
PO Box 868
Wilmingtun, NC 28405
Morehead City, NC 28557
> ...% Jasan-ilatiTffistrict-Meftagell
91-8-7-9G-7221
For: Jon E. Sanders
a

Dail, Jason
From: Dail, Jason
Sent: Thursday, February 27, 2014 9:03 AM
To: '[e-mail]'
Subject: CAMA Minor Permit application -618 N. Shore Drive, Surf City
Mr. Davies,
I received the subject CAMA minor permit application on February 25, 2014, however, your application lacks information
necessary for review. Specifically, the site plan you submitted should show the location of the First Line of Stable Natural
Vegetation (FLSNV) and the proximity of the proposed development in relation to the FLSNV.As I have observed, it
appears the FLSNV is approximately 33' from the existing home support pilings.This distance should be shown on the
work plan drawings, as well as the alignment of the FLSNV. Without this information, the application is considered
incomplete for processing. Please revise the drawing to include these changes and either fax or scan back to me.
In accordance with the Department of Environment and Natural Resources regulations, we note that the application, as
submitted on February 25, 2014, is incomplete for processing. Upon resubmission of a complete application, a local
decision will be made in 25 days, provided this period is not extended as provided by law. Please contact me at 910-796-
7221 if you have any questions.
Thank you,
Jason Dail
Field Relit r ogtt<ititie
N.C.F}ia ision of C.oAzt.dl t aita eiiieitt
ILA! Drive Extension
twitt trtn 4C284O;
i.tv:(010)395-3%4
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*Please note that e-mail correspondence to and from this address may be subject to the North Carolina Public records Law and maybe
disclosed to third parties.*
Please visit www.nccoastalmanaqement.net to subscribe to Coastal Management's quarterly newsletter,the CAMAgram.

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GENERAL INFORMATION
LAND OWNER
Name 3©N c A Betz—S
Address (gI S CIA ) 21r b 2
City S )...t . C 11 Y State• 13C Zip AtitiS Phone `17o 6,3 O I
Email e Y'/C ('1 &) v 5j-42.. . Co4
AUTHORIZED AGENT
Name 3bh,t P D}v/r9,
Address 10 kleA 0 8
City /1o(eIW J State //,/C Zip350,c1 Phone 5,1. d73 .2/? :
Email . 3p £&iJl es coil/T1Fc/i"i /JC, COI'''l . . ,
LOCATION OF PROJECT:(Address,street name and/or directions to site.If not oceanfront,what is the name of the
adjacent waterbody.) 6/S A', _S.co« Dr r
DESCRIPTION OF PROJECT:(List all proposed construction and land disturbance.) /?9,/4ll7ee/61 LC/u
SIZE,OF LOT/PARCEL: square feet . 19 acres
PROPOSED USE: Residential f . (Single-family Multi-family❑) Commercial/Industrial[] Other 0
COMPLETE ETM'HER(1)OR(2)BELOW(Contact your Local Permit Officer if you are not sure which AEC applies
to your property):
OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE:/,,square feet(includes
fir conditioned living space,parking elevated above ground level,non-conditioned space elevated above ground level but
excluding non-load-bearing attic space)
%C OASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
ON SURFACES: , It ,uare feet(includes the area of the roof/drip line of all buildings,driveways,covered decks,
concrete or masonry pa i os,etc.that are within the applicable AEC.Attach your calculations with the project drawing.)
p, .TE STORMWATER MANAGEMENT PERMIT:Is the project located in an area subject to a State Stormwater
. E:.ement Permit issued by the NC Division of Water Quality? .
YES NO NO
If yes,list the total built upon area/impervious surface allowed for your lot or parcel: squalialireEIVED
UCM WILMINGTON, NC
FEB 2 5 2014

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,FIA
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)
/ano er or record title,Title is vested in ,see Deed Book 113 if1
page 31i in the Pe46i2er 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) ,9n/Aotti 6a,o ,1/ S/*,re ,D4r se,oec.23, ,yc
(2) Ton/- 15,1fite, 616 !Y SAe r, Dr 5vri,' /1/C
(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 r L/ day of U oZ ,20/G
Landowner or n authorized to acts 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 constituteb� fif0'GE; TON,NC
D
any permit.Any person developing in an AEC without permit is subject to civil, criminal and administrative action. fil(0'G
FEB 2 5 2014

OCEAN HAZARD AEC NOTICE
Project is in an: Ocean Erodible Area _ High Hazard Flood Area Inlet Hazard Area
Property Owner:
Property Address:—673 /1/ -5-4vr{' �� { -sr✓�� Cir��r �,r�f�
Date Lot Was Platted:
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 3I 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 permits,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 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 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 ocean erosion rate for the area where your property is dirrSON) q 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.
Studies also indicate that the shoreline could move as much as NC DENR
feet landward in a major storm. Div. of Coastal Management
127 Cardinal Drive Ext.
The flood waters in a major storm are predicted to be about Wilmington, NC 28405-3845
feet deep in this area.
Preferred oceanfront protection measures are beach nourishment �n7/a9 9-9/(u -
and relocation of threatened structures. Hard erosion control
structures such as bulkheads,seawalls,revetments,groins,jetties Phan_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.
1 4
Owner Sionntnre Date
D M' NON, NC
rrn n

1
BEFORE YOU BUILD
Setting Back for Safety: A Guide to Wise Development Along the Oceanfront
When you build along the oceanfront,you take a calculated risk. The Reasons
Natural forces of water and wind collide with tons of force,even The beachfront is an ever-changing landform. The beach and
on calm days. the dunes are natural"shock absorbers,"taking the beating of the
wind and waves and protecting the inland areas. By
Man-made structures cannot be guaranteed to survive the force incorporating building setbacks into the regulations,you have a
of a hurricane. Long-term erosion (or barrier island migration) good chance of enjoying the full life of the structure. At first,it
may take from two to ten feet of the beach each year, and, seems very inviting to build your dream house as close to the
sooner or later,will threaten oceanfront structures. These are the beach as possible,but in five years you could find the dream has
facts of life for oceanfront property owners. become a nightmare as high tides and storm tides threaten your
investment.
The Coastal Resources Commission(CRC)has adopted rules for
building along the oceanfront.The rules are intended to avoid an The Exception
unreasonable risk to life and property, and to limit public and The Coastal Resources Commission recognized that these rules,
private losses from storm and long-term erosion. These rules initially passed in June 1979, might prove a hardship for some
lessen but do not eliminate the element of risk in oceanfront property owners. Therefore, they established an exception for
development. lots that cannot meet the setback requirement. The exception
allows buildings in front of the current setback, if the following
As you consider building along the oceanfront, the CRC wants conditions apply:
you to understand the rules and the risks. With this knowledge,
you can make a more informed decision about where and how to I) the lot must have been platted as of June 1, 1979,and
build in the coastal area. is not capable of being enlarged by combining with
adjoining land under the same ownership;
The Rules 2) development must be constructed as far back on the
When you build along the oceanfront,coastal management rules property as possible and in no case less than 60 feet
require that the structure be sited to fit safely into the beach landward of the vegetation line;
environment. 3) no development can take place on the frontal dune;
4) special construction standards on piling depth and
Structures along the oceanfront, less than 5,000 square feet in square footage must be met;and
size, must be behind the frontal dune, landward of the crest of 5) all other CAMA, state and local regulations must be
the primary dune, and set back from the first line of stable met.
natural vegetation a distance equal to 30 times the annual
erosion rate (a minimum of 60 feet). The setback calculation The exception is not available in the Inlet Hazard Area.
increases as the size of the structure increases [15A NCAC
7H.0306(a)(2)]. For example: A structure between 5,000 and To determine eligibility for the exception the Local Permit
10,000 square feet would require a setback from the first line of Officer will make these measurements and observations:
stable, natural vegetation to a distance equal to 60 times the
annual erosion rate (a minimum of 120 feet). The graduated required setback from vegetation line
setback continues to increase through structure sizes greater than
100,000 square feet. exception setback(maximum feasible)
rear property line setback
max.allowable square footage on lowest floor
PRE.PERMJT STRUCTURE:INADEQUATE SETBACK
...............„...... i
PEltd�IiTTED
STRUCTURE; PRE-STORM BEACH PROFILE
ADEQUATE POST-STORM BEACH PROFILE
SETBACK
*" �. • ONE YEAR AFTER STORMJBEACK REBUILDING
After the storm, the house on the dune will be gone. The other house has a much better chance of IVED
DCM Ut LL NGTON,NC
FFR 2 5 21114

4174
NCDENR
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: 2—Il` f,
Name of Property Owner Applying for Permit: Name of Authorized Agent for this project:
crr i L- N1� RS Zi NfJ ? ��l1�i 1✓S
Owner's Mailing Address: Agent's Mailing Address:
,-1 t05 5 S, A 2 1.) 'If-- P (os'
► b ; 7- C_1TY tip.
5 3 ri �35 ^I
Phone Number(480) 621-0492 Phone Number 05 a) 5 i 5 a I c)-.3
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):
R 40n,04/ o f4'1 Ce Nis oi( P?Cert 9 '-" v- 4,1%-2/ Pare"e
ei? t sf«e/ S•i P 2vc�-t
For my property located at l/g /y,5,efe.re f)r,✓e 1 Sv(/
This certification is valid thru(date) 4-3c
February 11, 2014
roperty Owner Signature Date
127 Cardinal Drive Ext.,Wilmington,NC 28405 One RECEIVED
N
Phone:[phone] FAX:[phone] Internet:vaimnccoaMtalmanagement.net NorthCaroliTIP CM WILMINGTON,
An ue1 Opportunity Arnms►re Acton empbyer ,Naturally F F R 9 5 9111,1

Receipts for
Certified Mail
i 7-- 1)J (Staple Here)
12Ak31-1 C l•-%.{ AN 0 iZ E=LID.
Adjacent Property Owner
L'dU N N o k=E.
Mailing Address
S c t'T`Y N)C, a-74`15
City,State,Zip Code
Dear Adjacent Property:
This letter is to inform you that l,�u�+ S ArvE.Ir—ems have applied for a CAMA Minor
Property Owner
Permit on my property at to 1.-S ti S U 012-a, bR_. ,in Pender/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 C (n d I 0 4�l c�- ,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
Sincerely,
:5o,t S,v4,Ars
Property Owner
7o65 s 5Mr elec. -
Mailing Address
Gil/ eric Rd. 8329.o
City,State,Zip Code
RECEIVED
DCM WILMINGTON, NC
FEB 2 5 2014

I. . •os a arvice.M •
CERTIFIED MAIL„., RECEIPT
✓ (Domestic Mail Only;No Insurance Coverage Provided)
rFor delivery inMrmetion visit our website at www.usps.com
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3
Postage
MIN Certified Fee 06
Postmark
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(Endorsement Required)
• Restricted Delivery Fee
(Endorsement Required)
n $8.90 02/19/2014
• Total Postage&Fees
Sent To
A. e�
1 Street,Apt.No.; /![
O or PO Box No. b.Z� /� Motto
©r
City, IP f
State 7 +4 .
$yr e; C 9,eiti.t6

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'S Form 3800,August 2006(Reverse)PO17530-02-000-9047

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
I hereby certify that f own property adjacent to 3p/t_c-T(1 45/b4_3 s
(Name of Property Owner)
property located at Z20 S t-LGF?..t. bi - ,
Address, Lot, Block,Road,etc.)
on•ALA..;1 c: 0 C l At`1 ,in Si.t.2 I T , N.C.
(Waterbody) (Town and/or County)
He has described to me as shown in the attached application and project drawing(s),the development he is
proposing at that location,and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
Signature
Print or Type Name
Telephone Number
Date
RECEIVED
DCM WILMINGTON, NC
FEB 252014

Receipts for
Certified Mail
(Staple Here)
•
Date
icM Su,A ?:,AR.40es
Adjacent Property Owner
c 1 v 40.> U u ICI 5 Ac t2.E e Q.�J
Mailing Address
3yciL5c Lie_ 5L
City, State,Zip Code
Dear Adjacent Property:
This letterr is to inform you that.l` °' - � -� _..have applied for a CAMA Minor
Property Owner
Permit on my property at ( I I-L 012.,e, t2__ ,in Pender/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 41 O (s, )I 0-19 ;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
Sincerely,
Property Owner
706.5 .S• Srt. Ic
Mailing Address
c;/ef/ AZ S5298-
City,State,Zip Code
RECEIVED
DCM WILMINGTON,NC
FEB 2 5 2014

g. . -os a ervicerM
CERTIFIED MAILTM RECEIPT
u (Domestic Mail Only;No Insurance Coverage Provided)
For delivery intormallen vielt our website at www.usps.com©
7', .7 °°•F g
o
Postage
r
Certified Fee MIN I"
Return Receipt Fee Postmark
n (Endorsement Required)
• Restricted Delivery Fee JJAJIJ
(Endorsement Required)
✓ $8.90 02/19/2014
n Total Postage&Fees $
Sent To_
7e:Pe1 v" 4(-46,5
Street,Apt.No.;
or PO Box No. 4141 01 I 26. tottl-ple
#C g/7
City,State
ZIP+4
4 V is gi /6

,'ertified Mail Provides:
I A mailing receipt
A unique identifier for your mailpiece
I A record of delivery kept by the Postal Service for two years
mportant Reminders:
▪ Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail(
I Certified Mail is not available for any class of international mail.
• NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. Fo
valuables,please consider Insured or Registered Mail.
For an additional fee,a Return Receipt may be requested to provide proof o1
delivery.To obtain Return Receipt service,please complete and attach a Returr
Receipt(PS Form 3811)to the article and add applicable postage to cover the
fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver foi
a duplicate return receipt,a USPS®postmark on your Certified Mail receipt it
required.
•For an additional fee, delivery may be restricted to the addressee o
addressee's authorized agent.Advise the clerk or mark the mailpiece with th(
endorsement"RestrictedDelivery".
▪ If a postmark on the Certified Mail receipt is desired,please present the arti
cle at the post office for postmarking. If a postmark on the Certified Mai
receipt is not needed,detach and affix label with,postage and mail.
MPORTAJY:Save'tfttlsfrecJipt and prbSlelif�t`tdilten making an inquiry.
'S Form 3800,August4)G6(reverse)PSN 7530-02-%d029047

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to 501'[ �/ � ./44 i3 s
(Name of Property Owner)
property located at (ol(e N SV e 2-&
Address, Lot, Block,Road,etc.)
on �'i Ar.�^ i CDCZ ,in < .c C. -r\,' , N.C.
(Waterbody) (Town and/or County)
He has described to me as shown in the attached application and project drawing(s),the development he is
proposing at that location,and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
Signature
_ J
Print or Type Name
Telephone Number
Date
RECEIVED
DCM WILMINGTON, NC
FEB 2 5 2014

souNDBAN►c 5455
Davies Contracting Cape Carteret,NC 28584
66-1246/531
103 Pine Circle
Morehead City, NC 28557 2/19/2014
m
O
PAY TO THE NC DENR
$ 100.00
ORDER OF �0,
One Hundred and 00/100**********+********************************** ****** **********.**,te****.**.********k*e*******o DOLLARS u
NC DENR
.5
ts
MEMO /' �ry A/'
,„....„.„. , /, , , _
AUTHORIZED SIGNATURE N
HMO 05455a' 1:053 L L 2466': OD L3 L ? 411'