SC_17-02_ Allen (2)

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Issued by WiRO SC17-02
Surf City Permit Number
CAMA
MINOR DEVELOPMENT
PERMIT Coastal ti,unagemenr
ENV,4ONME N T C_;]U=_'.'V
as authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission for development in an area of environment
concern pursuant to Section 113A-118 of the General Statutes, "Coastal Area
Management"
Issued to Mavis J. Allen authorizing development in the Estuarine Shoreline (AEC) at 7027 Seventh Street, in Surf
City, Pender County as requested in the permittee's application, dated February 24, 2017, and received by DCM on
March 9, 2017. This permit, issued on March 23, 2017, is subject to compliance with the application and drawing dated
and received by DCM on March 9, 2017 (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: Installation of a boat ramp approach(landward boat ramp expansion).
(1) All proposed development and associated construction must be done in accordance with the permitted site drawing dated
received by DCM on March 9, 2017.
(2) Any change or changes in the plans for development, construction, and/or land use activities will require re-evaluation and
modification of this permit.
(3) A copy of this permit shall be posted or available on site throughout the construction process. Contact this office at(910)
766-7221 for a final inspection at completion of work.
(Additional Permit Conditions on Page 2)
This permit action may be appealed by the permittee or other qualified persons
within twenty (20)days of the issuing date. This permit must be on the project
site and accessible to the permit officer when the project is inspected for Jason Dail
compliance. Any maintenance work or project modification not covered under CAMA LOCAL PERMIT OFFICIAL
this permit,require further written permit approval.All work must cease when this
permit expires on: 127 Cardinal Drive Extension
December31,2020 Wilmington, NC 28405-3845
In issuing this permit it is agreed that this project is consistent with the local Land v
Use Plan and all applicable ordinances. This permit may not be transferred to X G ei"
another party without the written approval of the Division of Coastal PERM TTEE
Management.
(Signature required if conditions above appliM n

Name: Mavis J. Allen
Minor Permit#SC17-02
Date: March 23, 2017
Page 2 of 3
(4) All unconsolidated material resulting from associated grading and landscaping shall be retained on site by effective
sedimentation and erosion control measures. Disturbed areas shall be vegetated and stabilized (planted and
mulched)within 14 days of construction completion.
(5) Any proposed for grading within the 30' buffer from the Normal High Water level must be contoured to prevent
additional stormwater runoff to the adjacent marsh and/or canal. This area shall be immediately vegetatively
stabilized, and must remain in a vegetated state.
(6) With exception of the boat ramp, this permit does not authorize any development within 30 feet of the normal high
water line.
(7) All structures shall comply with the NC Building Code, including the Coastal and Flood Plain Construction Standards
of the N. C. Building Code, and the Local Flood Damage Prevention Ordinance as required by the National Flood
Insurance Program. If any provisions of the building code or a flood damage prevention ordinance are inconsistent
with any of the following AEC standards, the more restrictive provision shall control.
(8) Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third-party.
NOTE: 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.
SIGNATURE n6'0w(-4 DATE: 7
PERMITTEE
RECEIVED
DCM WILMINGTON,NC

6 Locality u/ y Permit Number ,5C4 .0 e�
. Ocean Hazard Estuarine Shoreline /ORW Shoreline Public Trust Shoreline Other,
(For official use only)
GENERAL INFORMATION
LAND OWNER-MAILING ADDRESS
Name IAA ?vIS PI-LLO'N _
Address Po 80 . 370
City Fo K a. O A•M State hl L 'Lip 0- )S 2 YPhone l 14 — �l a. Z . O L{S O
Email A IEN A 40 so NS Q.. AM o AR O M 1►i 1. G o M
AUTHORIZED AGENT
Name
Address
City State Zip Phone
Email
LOCATION OF PROJECT: (Address, street name and/or directions to site;name of the adjacent waterbody.)
l r H 5 t 2 i£ cr S p F e,;ry CAN 41S or.1 eoek" C/7
DESCRIPTION OF PROJECT; (List all proposed construction and land disturbance.)
Z N S't'aC& t4o6 S rA t p aN e 13eni Aft 2f/� /o X 476
SIZE OF LOT/PARCEL: — square feet -S. acres
PROPOSED USE: Residential ® (Single-family 0 Multi-family ❑ ) Commercial/Industrial ❑ Other 0
COMPLETE EITHER(I)OR(2) BELOW(Contact your Local Permit Officer limn are not sure which AEC applies ,
to your property):
(1) OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet(includes
air conditioned living space,parking elevated above ground level,non-conditioned space elevated above ground level but
excluding non-load-bearing attic space)
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES:Vet square feet(includes the area of the foundation 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 STORM WATER MANAGEMENT PERMIT: Is the project located in an area subject to a Stale
Stormwater Manager�/ nt Permit issued by the NC Division of Energy,Mineral and Land Resources(DEMLR)?RECENED
YES NO DCM WILMINGTON,NC

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,bleating 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)
an owner or record title,Title is vested in name of A- t-4-4E/H t ate'S 3
see Deed Book 12. 3 3 page 10.1 in the 0 N t La
County Registry of Deeds.
___an owner by virtue of inheritance.Applicant is an heir to the estate of
;probate was in County.
if other interest,such as written contract or lease,explain below or use a separate sheet&attach to this application.
NOTIFICATION OF ADJACENT RIPARIAN PROPERTY OWNERS:
I furthermore certify that the following persons 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)
(I) C Li FF St4NLay Po d0 2 6a I S,02•Pat}-Y Nc. lity4
(2)_..__ t'N Note- 42 I1 vi c.Toa LAKk on.;vc. 4.wy.14wwiYc avi-13
(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 t N- day of rr 3. ,20 17
DO.J ,.
Landowner or person authorized to act as his/her agent for purpose of filing a CAMA permit application
This application includes:general information(this form), a site drawing as described on the back of this application, the
ownership statement, ilre Ocean flazarrl 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, crinrinal and administrative aciigtEivED
DCM WILMINGTON,NC

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: M I vir S 3 1- C cF N
Mailing Address: P O a DIN 3 7 0
Phone Number: a 1 q q 6 3 — 1 3 q
Email Address: a LctN allo SoNs p-nite-aa MGM C • COM
I certify that I have authorized 0 oty N i t A- L(.' Aj ,
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: o r 1- 1 t 0 - r
t. Pi N.6s (-4-r P S
at my property located at .7 0 21 i t-H s r s ti R F c.r ty N
in 0N5 o°,- County.
1 furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Signature
•
0-VI s nl( e /�
Print or Type Name
owNrrt
Title
3 I -7 11,017
Date
This certification is valid through I I
RECEIVED
DCM WILMINGTON,NC

ROY COOPER
•Y (701'l'IMY
MICHAEL S. REGAN
;;oastal Management
ENVIRONMENTAL QUALITY BRAXTON DAVIS
Dirrnor
March 23, 2016
Mavis J.Allen
PO Box 370
Four Oaks, NC 27524
Dear Mrs.Allen:
Attached is CAMA Minor Development Permit No. SC 17-02 for work to be done at7027 7th St., in Surf
City.An electronic copy has been sent to the Town of Surf City Inspection Department.
In order to validate this permit, please sign both copies of the permit as indicated for our records.
Retain the orange copy for your files and sign both pages of the white copy and 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
SC Inspection Dept.
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext.,Wilmington,NC 28405

N() T CI 17
Ili I, 111
CANIA PERMIT
APPLIED FOR
PROJECT' onstruction of an upland boat ramp
a . . : - - ,
canals of Surf City, Onslow Caunty
COMMENTS ACCEPTED THROUGH NIA
APPLICANT FOR MORE DETAILS CONTACT
THE LOCAL PERMIT OFFICER BELOW:
Mavis J. Allen NC Div. of Coastal Management
PO Box 370 127 Cardinal Dr. Ext.
Four Oaks, NC 27524 Wilmington, NC 28405
Jason Dail, Field Representative
SC 17-02 910-796-7221

OCEAN HAZARD AEC NOTICE
Project is in an: Ocean Erodible Area High Hazard Flood Area Inlet Hazard Area
Property Owner: M i.“44 5 A L.t_ rE p,)
Property Address: 0a` isli- S 7�R f��n S L+IL F 7*
Date Lot Was Platted: 0 7 API i S
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 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 / a l•-.1 '/ -i (._.-
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.
N.C. Dept. of Environmental Quality
Studies also indicate that the shoreline could move as much as Division of Coastal Management
feet landward in a major storm. 127 Cardinal Drive Extension
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 —7
and relocation of threatened structures. Hard erosion control "7 �' �a�
structures such as bulkheads,seawalls,revetments,groins,jetties Phone 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.
Yga t)01 iii,e/17(--' - a-
Property Owner nature Date
RECEIVED
DCM irahayTotti,NC

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DCM WILMINGTON,NC

.ENDER: COMPLETE THIS SECTION CCIIKETEIHIS SECTION ON DELIVERY
■ Complete items 1,2,and 3. A. Si. ature /
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USPS
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USPS
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9590 9402 2674 6336 7229 14
United States •Sender:Please print your name,address,and ZIP+4')in this box*
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Adjacent Property Owner
42.11 v;t-roAis r.t}KZ ORrvh
Mailing Address
1vP.v. FtPty HL ' c si 3
City, State,Zip Code
Dear Adjacent Property:
This letter is to inform you that I, M wv 1 S 3 0.L'f N have applied for a CAMA Minor
Property Owner
Permit on my property at 1 0 3.1 11'e4 S rR-r xT 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 t{' - 4 3.1 — 0 4 S O ,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,
MhviS 7 Ikt,LkN
Property Owner
po (3oX 37 A
Mailing Address
Fo4L o {Ls Kc 15 �-N
City, State,Zip Code
RECEIVED
DCM WILMINGTON,NC

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to M P1 V l S 7 t L L G N 's
p (Name of Property Owner)
property located at 70. I 7�,�,- 5114 r- it
Address, Lot, Block, Road,etc.)
on , in , 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)
//iiiOe-e/c/g61—
Signature
(-l0(/-
Print or Type Name
7a —qq — 6c(G5
Telephone Number
I7
Dat
State of North Carolina
County of sec A-44-7
Sworn to and Subscribed before m ,
on 62 -22 -2o/ 7
by �►? e 'e Ma Lt
Notary Public - Comm. Exp.
Ply Commission Expires
September 29,2021
r<ECEIVED
DCM WILMINGTON,NO

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%ENDER: COMPLETE THIS SECTION CON ETE THIS SECTION ON DELIVERY
■ Completerint your
items 1 2,and 3. A. Signature
■ Print your name and address on the reverse mil/ 1 ❑Agent
so that we can return the card to you. ❑Address
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or on the front if space permits. 04 ' 6(0 €'--
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LISPS
Permit No.G-10
9590 9402 2026 6123 8056 45
United States •Sender:Please print your name,address,and ZIP+4®in this box•
Postal Service
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(Staple Here)
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Date
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Adjacent Property Owner
po Got 7. 4 4 ►
Mailing Address
$40F c-1rY NL 153445
City, State,Zip Code
Dear Adjacent Property:
This letter is to inform you that I, M N vi s A.1,t,E.N have applied for a CAMA Minor
Property Owner
Permit on my property at 1 0 2.1 T ti S TIL F T , 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 t I a " 4 1 ^ 0 4 S O ,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,
MA,viS S pro-E.M
Property Owner
Po goX 3 -Pa
Mailing Address
I= wn o NKS NC, 2-i S
City, State,Zip Code

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to N% V S A-LC-16:PI 's
(Name of Property Owner)
property located at 700 2.5- 7AA 577,e c]`
Address, Lot,o Block, Road,` etc.)
J
on , in G,(P C,.o/ / iou' CO. , 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 c//
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Fnrrn nano e..ril .C.o_.__,DOM ACM An.,Alt,,...,

.44
FOUR OAKS
107 N RAILROAD ST
FOUR OAKS
NC
27524-9998
3627920124
02/15/2017 [phone] 12:35 PM
Product Sale Final
Description Qty Price
Utl Mlr 10.5" 1 $1.19
x16"
(Unit Price:$1.19)
First-Class 1 $1.40
Mail
Large Envelope
(Domestic)
(HOLLY RIDGE, NC 28445)
(Weight:0 Lb 2.10 Oz)
(Expected Delivery Day)
(Friday 02/17/2017)
Certified 1 $3.35
(NUSPS Certified Mail #)
(70151520000166649850)
Return 1 $2.75
Receipt
(NUSPS Return Receipt #)
(9590940220266123805645)
Total $8.69
Credit Card Remitd $8.69
(Card Name:MasterCard)
(Account #:XXXXXXXXXXXX6987)
(Approval #:04364Z)
(Transaction #:290)

f Receipts for
Certified Mail
(Staple Here) '
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date
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Adjacent Property Owner
Po 6o4 a. C 3 t
Mailing Address
$4&F Lily 14 14 4 5
City,State,Zip Code
Dear Adjacent Property.
This letter is to inform you that I, _. M 1'1;s _ t� L fc ' have applied for a CAMA Minor
Property Owner
Permit on my property at 1 0 a- 1
7 T H S r g,-F T , 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 (WA A ".W_31 ~ 04 S O .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,
M Ns/ iS � p. e
Property Owner
pa go X 3 7a
Mailing Address
r-ehR o p.Ks a-1 S 1Ay
City, State,Zip Code

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to NiNkv i S JJ R-l,tr E P/
(Name of Property Owner)
property located at
Address, Lot, Block, Road, etc.)
on — . in —.._ , NC
(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
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CERTIFIED MAIL® RECEIPT
Domestic Mail Only
9, For delivery information,visit our website at www.usps.come.
WAX+14410-11C 2E1.7r
ji Certified Mail Fee $II 7, S 0124
03
Extra Services&Fees(check box,add fee e Ifior
0 Return Receipt pardcopy) $
Li Return Receipt(electronic) $ U-UU Postmark
jD Certified Mail Restricted Delivery $ $0 011 Here
O 0 Adult Signature Required $ $0 00
0 Adult Signature Restricted Delivery$
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$1.19
Si 02/15/2017
Total Postage and Fees
$ $7.29
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City,State,ZIP-F46

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A receipt(this portion of the Certified Mail label). for an electronic retumdec''Qt,see a retail
A unique identifier for your mailpiece. associate for assistance.To recgjve a duplicate
Electronic verification of delivery or attempted return receipt for no additional fee,present this
delivery. USPS®-postmarked Certified Mail receipt to the
A record of delivery(Including the recipient's retail associate.
signature)that is retained by the Postal Service- -Restricted delivery service,which provides
for a specified period. delivery to the addressee specified by name,or
to the addressee's authorized agent.
mportant Reminders: -Adult signature service,which requires the
You may purchase Certified Mail service with signee to be at least 21 years of age(not
First-Class Mail',First-Class Package Service*, available at retail).
or Priority Mail'service. -Adult signature restricted delivery service,which
Certified Mall service is not available for requires the signee to be at least 21 years of ag,
international mail. and provides delivery to the addressee specified
Insurance coverage is not available for purchase by name,or to the addressee's authorized agent
with Certified Mail service.However,the purchase (not available at retail).
of Certified Mail service does not change the •To ensure that your Certified Mail receipt is
insurance coverage automatically included with accepted as legal proof of mailing,it should bear a
certain Priority Mail items. LISPS postmark.If you would like a postmark on
For an additional fee,and with a proper this Certified Mail receipt,please present your
endorsement on the mailpiece,you may request Certified Mail item at a Post Office'"for
the following services: postmarking.If you don't need a postmark on this
-Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion
of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply
You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.
electronic version.Fora hardcopy return receipt,
complete PS Form 3811,Domestic Return
Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records.

r'
r
FOUR OAKS
107 N RAILROAD ST
FOUR OAKS
NC
27524-9998
3627920124
)2/15/2017 [phone] 12:36 PM
3roduct Sale Final
Description Qty Price
Utl Mir 10.5" 1 $1.19
x16"
(Unit Price•$1.19)
First-Class 1 $1.19
Mail
Large Envelope
(Domestic)
(WAXHAW, NC 28173)
(Weight:0 Lb 2.00 Oz)
(Expected Delivery Day)
(Friday 02/17/2017)
Certified 1 $3.35
(IUSPS Certified Mail #)
(70151520000166649867)
Return 1 $2.75
Receipt
(®CUSPS Return Receipt #)
(9590940226746336722914)
Total $8.48
Credit Card Remitd $8.48
(Card Name:MasterCard)
(Account #:XXXXXXXXXXXX6987)
(Approval #:09416Z)
(Transaction #:291)

Receipts for
Certified Mail
(Staple Here)
— t — 1.01
Dae
_ K Qt.?"
Adjacent Property Owner
12. t1 v,c_Toltiw (.h.Kg OR.Ivh
Mailing P ili rAddressl4 i 3
City, State,Zip Code
Dear Adjacent Property:
This letter is to inform you that I, M 3 a l.un-N have applied for a CAMA Minor
Property Owner
Permit on my property at 1 O.5-1_ 1 T i Sr!L rz r 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 �19 - 43.1 — o 4__s o ,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 Sur` City Local Permit Program
127 Cardinal Drive Extension
Wilmington, NC 28405
Sincerely,
M R v i S 7 C.k N
Property Owner
Qo 4oX 370
Mailing Address
Foto,t1- o 04.1L4 K C 1 5 4
City, State,Zip Code
OCM WILM NGTON,NC

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to iNe1/4 V S 7 A I-L E N 's
(Name of Property Owner)
property located at
Address, Lot, Block, Road, etc.)
on , in , 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

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NC Division of Coastal Management
Cashier's Official Receipt 3549 A B C
Date: 3- I 0 20 6
Received From: //,f✓/c A vigN $ ( O D �-
Permit No.: PgP Check No.: F73
Applicant's Name: l S. /4 /J T`" County: CIA-5 v''
Project Address: 76-2--- ( C/ifl.44Y-ICY ' 5--17777Li
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Please retain receipt for your records as proof of payment for permit issued.
Signature of Agent or Applicant: Date:_ 7.g,_/ /
Signature of Field Representative: Date:

Date Date ; Name of Permit Check I Check
Check From (Name) Vendor
Received Deposited L Holder Number 1 amount
Four
Oaks
3/10/2017 Mavis J Allen Mavis Allen Bank 8366 3/10/2017
Permit
Number/Comments i
Major/Minor Receipt# NOTES
minor fee, 7027
Seventh St. SC,
Minor $100.00 OnsCo