HomeMy WebLinkAboutSC_17-05_ MacLeod (2) Issued by WiRO SC17-05
Surf City Permit Number
CAMA
MINOR DEVELOPMENT
PERMIT Coastal Management
ENVIRONMENTAL QUALITY
as authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission for development in an area of environment
concern pursuant to Section 113A-118 of the General Statutes, "Coastal Area
Management"
Issued to Mary MacLeod authorizing development in the Estuarine Shoreline (AEC) at 386 Atkinson Point Road, in
Surf City, Pender County as requested in the permittee's application, dated June 1, 2017, and received by DCM on June
2, 2017. This permit, issued on June 14, 2017, is subject to compliance with the application and drawing dated and
received by DCM on June 2, 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: Construction of a single-family residence.
(1) All proposed development and associated construction must be done in accordance with the permitted site drawing dated
received by DCM on June 2, 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 D 've Extension
December 31,2020 ' ilmington, N 28405-3845
In issuing this permit it is agreed that this project is consistent with the local Land l+r
Use Plan and all applicable ordinances. This permit may not be transferred to
another party without the written approval of the Division of Coastal
Management. MITTEE
(Signature required if conditions abovgipgmejmit)
Name: Mary MacLeod
Minor Permit#SC17-05
Date: June 14, 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 vegetated and
stabilized, and must remain in a vegetated state.
(6) 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: DATE: �
PERM ITTEE
RECEIVED
DCM WILMINGTON.NC
6 (.Locality Permit Number /
Ocean Hazard Estuarine Shoreline Y. ORW Shoreline Public Trust Shoreline Other
(For official use only)
GENERAL INFORMATION
LAND OWNER -MAILING ADDRESS
Name MA .H44. L VID
Address Les' G L2\JI V A//
City DS.A).1)., State Pick . Zip ,5:701 Phone 7 2/ - f O - 4 ct 22
Email h'1Yvva G e o d e LA-I)•
AUTHORIZED AGENT
Name L A i2424(
Address{ .O v 1' 4 k 2. G'4 CP ,/
City dS(4 G rt State 1.� e Zip2 44SPhone 911 • 232 . 333 2
Email IY 1 C. 0) O-1- 01-1 ,0„.1 • cowl
LOCATION OF PROJECT: (Address,street name and/or directions to site;name of the a -acent waterbody.)
3 S cv I LI So T® 1 1.J T -127D . AUJI W,4fs TAf
*St-tep G ITYI rJ.c . 2e 44 '
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) (20 k1 S-riel e cr
F `D JL.l-LIJ 1
SIZE OF LOT/PARCEL: (,p 5-2- square feet • i4 acres
PROPOSED USE: Residential u (Single-family Er-Multi-family ) Commercial/Industrial Ej Other El
COMPLETE EITHER (1)OR (2)BELOW (Contact your Local Permit Officer if you are not sure which AEC applies
to your property):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: 11144 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: 1006 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 State RECEIVED
INGTON, NC
Stnrmwater Management Permit issued by the NC Division of Energy_ Mineral and Land Resources(ILVIW
•
['HER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA
nor development permit, including, but not limited to: Drinking Water Well, Septic Tank(or other sanitary waste
atment system), Building, Electrical, Plumbing, Heating and Air Conditioning, Insulation and Energy Conservation, FIA
rtii,cation, Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway Connection, and
iers. Check with your Local Permit Off,cer for more information.
'ATEMENT OF OWNERSHIP:
he undersigned, an applicant for a CAMA minor development permit, being either the owner of property in an AEC or a
son authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person
:ed as landowner on this application has a signie,cant interest in the real property described therein. This interest can be
;cribed as: (check one)
i an owner or record title,Title is vested in name of M A M Ac-LE O l)
Deed Book De, 4624 page (578 in the rPtxjb e 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.
1TIFICATION OF ADJACENT RIPARIAN PROPERTY OWNERS:
rthermore certify that the following persons are owners of properties adjoining this property. I aft,rm that I have given
TUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) (Address)
9-I6.4ARi> LE 1-4 2E2 ' 3I7 Eh(1EwATMt2- CitAg RI). I411,/ ilifgl d 44 2g171
f2o38 k O(p -}QYv )00 b \,,t)l Liu��r';orb n�G . 2$4O 5
KNOWLEDGEMENTS:
e undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
be susceptible to erosion and/or Aooding. I acknowledge that the Local Permit Off,cer has explained to me the particu-
iazard problems associated with this lot.This explanation was accompanied by recommendations concerning stabiliza-
and AoodprooL ng techniques.
thermore certify that I am authorized to grant,and do in fact grant, permission to Division of Coastal Management staff,
Local Permit Off,cer and their agents to enter on the aforementioned lands in connection with evaluating information
ed to this permit application.
This the I 651.- day of Sit t3e ,20 I,
'owner or person authorized tglitct as his/her agent for purpose of i,ling a CAMA permit application
application includes: general information(this form),a site drawing as described on the back of this application,the
!rship statement,the Ocean Hazard AEC Notice where necessary,a check for $100.00 made payable to the locality,and
information as may be provided orally by the applicant. The details of the application as described by these sources are
rporated without reference in any permit which may be issued. Deviation from these details will constitute v� �YED
)ermit.Anv person develoning in an AFC withn�rt Hermit is cnhiect to�;.,it criminal and a�tm;n;o*. CGTON,NC
1. . •os a ervice
CERTIFIED MAIL° RECEIPT
� Domestic Mail Only
✓• For rtelivAry information-visit our website at wtvlv.usps.com .
• AL USE
3 Certified Mail Fee 33.35
n $ $2.75 C14$f2
Extra Services&Fees(check bar,add fee qgerpritaii•to)
❑Return Receipt(hardcopy) $ 7VV ��l�1y��IUU/f�
3 ['Return Receipt(electronic) $ $1)a Lr4f Postmark
3 ❑Certified Mail Restricted Delivery $ $U.CIO Here
3 ❑Adult Signature Required $ tl0—
❑Adult Signature Restricted Delivery$
Postage to.70
ro $
Total Postage and Sr go il6�f12�2�117
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1 Sent To f"�.�g e 123- TA eke.tia
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to 1 L. .I Nero N NC/ '2 3 4o 5
A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail
A unique identifier for your mailpiece. associate for assistance.To receive a duplicate
Electronic verification of delivery or attdlrrpted 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.
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for a specified period. delivery to the addressee spedfied by name,or
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nportant Reminders: -Adult signature service,which requires the
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or Priority Mail°service. -Adult signature restricted delivery service,which
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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).
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insurance coverage automatically included with accepted as legal proof of mailing,it should bear a
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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
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of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply
You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.
electronic version.For a hardcopy return receipt,
complete PS Form 3811,Domestic Return
Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records.
3 Form 3800.Aoril 2015(Reverse)PSN 7530-02-000-9047
Receipts for
Certified Mail
(Staple Here)
CQ 2811-
ae23- 1� )2K-SR'
A aD P Dt)P -0'2
c8 )•3 C 284-R's
City,State,Zip Code
Dear Adjacent Property:
This letter is to inform you that I, ► ekbe,`r N Lr o have applied for a CAMA Minor
Property Owner
Permit on property at 3 a, A��1 L�01 70 l> ' ' C, �a COUNTY
Perm my p PertY '" Property Address
County. As required by CAMA regulations,I have endosed 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 fomt If you have any questions or comments about my proposed project,please
act me at 7Z) - e40 - 4 9 2-2 ,or by mail at the address fisted below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program,you may submit
them to:
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY,STATE,ZIP CODE
Sincerely,
Awke A 4L
r d�
Property
39 C Ave
Mailing Address
f)1413 1 FA. 1570
City,State,Zip Code
RECEIVED
DCM WILMINGTON. Ne
I. . 'os a ervice
CERTIFIED MAIL° RECEIPT
u Domestic Mail Only
r
3 For delivery information,visit our website at tVLVW.LIST S.com .
WI tsic" C` ' AL USE
D Certified Mail Fee f3 35 0482
2c 02
co Extra Services&Fees(check x,add fee inpe)
• El Return Receipt(hardcopy) $ V1•����VV
3 ❑Return Receipt(electronic) $ $0.00 Postmark
• ❑Certified Mall Restricted Delivery $ $Q_00 Here
• 0 Adult Signature Required $ $0.00
0 Adult Signature Restricted Delivery$
rPostage $0.70
o $ 06/02/2017
3 Total Postage and Fpgs 80
I
9 IGC Sent To vI cg A faj/ L.6H`zt gJ
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I V—i FII VWIViiO III YG'I ICi11tO.
A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail
A unique identifier for your mailpiece. associate for assistance.To receive a duplicate
Electronic verification of delivery`or attempteu return receipt for no additional fee,present this
delivery. LISPS®-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
important Reminders: -Adult signature service,which requires the
You may purchase Certified Mail service with signee to be at least 21 years of age(not
First-Class Mail®,First-Class Package Services, available at retail).
or Priority Mail0 service. -Adult signature restricted delivery service,which
Certified Mail service is not available for requires the signee to be at least 21 years of agE
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 tee,and with a proper this Certified Mail receipt,please present your
endorsement on the mailpiece,you may request Certified Mail item at a Post Office'"for
the following services: postmarking.If you don't need a postmark on this
-Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion
of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply
You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.
electronic version.For a hardcopy return receipt,
complete PS Form 3811,Domestic Return
Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records.
S Form 3800.Ands 2m s raav„r<or PAID 7tan_nnaln tonAO
r �
Receipts for
Certified Mail
(Staple Here)
CO 72 /.?0
ate,
lG4/19,2.6 e/I1ef
Adj cent Property Owner /9reie RI)
"�ili g Addr
f11��u itess nl, Al‘ 2g4/1
City,State,Zip Code
Dear Adjacent Property: r
This letter is to inform you that I, RA AY1"t AG ZFOD have applied for a CAMA Minor
Property
Owner Q � ?&/, COUN1YPermit on my property at 3G /-1 fIN /V / i ,
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 72:41. " g�d • 4 q 2 2 ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program,you may submit
them to:
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY,STATE,ZIP CODE
Sincerely,
h /}, ,y it/t4z-A-c>h
Property OvMer
C.3g 62-44X- AVE
Mailing Address
C AA-Ak �A
City,State,Zip Code
RECEIVED
DCM WII MItir,Trvo ��
From: Simpson, Shaun
Sent: Wednesday,July 26, 2017 10:20 AM
To: 'Mary MacLeod' <mmacleod@iup.edu>
Subject: RE: CAMA Minor Permit SC17-05
I'm sorry to say that it was not delivered, or, once in the building was miss-routed with slim hopes for
recovery! I am relieved that you have the original, and thank you in advance for(re)signing.
Shaun Simpson
Permit Support&Customer Service
NC Department of Environmental Quality
NC Division of Coastal Management
127 Cardinal Drive Ext.
Wilmington,NC 28405
Phone:(910)796-7226
Shaun.Simpson@ncdenr.gov
E-mail correspondence to and from this address
may be subject to the North Carolina Public
Records Law and may be disclosed to third parties.
From: Mary MacLeod [mailto:mmacleod@iup.edu]
Sent: Wednesday,July 26, 2017 10:08 AM
To: Simpson, Shaun <shaun.simpson@ncdenr.gov>
Subject: Re: CAMA Minor Permit SC17-05
Good morning, Ms. Simpson,
I signed and returned the CAMA permit form, mailing it to the Cardinal Drive Ext. address, on June 17.
Are you certain you haven't received it?
Mary
Mary MacLeod
Associate Professor
IUP Philosophy, Chair(HSS 505H)
Women's and Gender Studies,Affiliated Faculty
•
mmacleodCa)iup.edu
(724) 357-2310
On Jul 26, 2017, at 9:36 AM, "Simpson, Shaun" <shaun.simpson@ncdenr.gov>wrote:
Hello Ms. MacLeod,
Minor Permit SC17-05 was sent via USPS to your attention on June 14, 2017. We have not yet received
your signed copy. If you did not receive, or no longer have the original, please sign/scan this attachment
and I'll have Jason Dail sign and scan a copy back to you.
Thank you for your prompt reply,
Shaun
Ms.Shaun Simpson
Permit Support&Customer Service
NC Department of Environmental Quality
NC Division of Coastal Management
127 Cardinal Drive Ext.
Wilmington,NC 28405
Phone:(910)796-7226
ROY COOPER
IC
MICHAEL S. REGAN
-
Coastal Management
ENVIRONMENTAL QUALITY BRAXTON DAVIS
June 14, 2017
Mary MacLeod
639 Clark Avenue
Indiana, PA 15701
Dear Ms. McLeod:
Attached is CAMA Minor Development Permit No. SC 17-05 for work to be done at 5386 Atkinson Pt.
Road, in Surf City, Pender County. An electronic copy has been sent to the Town of Surf City Inspection
Department and to your agent
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.
Larry Price-Agent
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext.,Wilmington,NC 28405
919 796 7215
Ar() T 17
,„
CAMA PERMIT
APPLIED FOR
PROJECP construct a famil-
sin le dwelling�► y
at 5386 Atkinson Pt. Rd., adjacent to
Waters Bay, in Surf City, Pender County.
COMMENTS ACCEPTED THROUGH N/A
APPLICANT: FOR MORE DETAILS CONTACT
THE LOCAL PERMIT OFFICER BELOW:
Mary MacLeod NC Div. of Coastal Management
639 Clark Avenue 127 Cardinal Dr. Extension
Indiana, PA 15701 Wilmington, NC 28405
Jason Dail, Field Representative
910-796-7221
Agent: Larry Price (910) 232-3332
- NOTES - -LEGEND-
1. This plot plan is of an
45 existing parcel of land. SIR.E 2'Bet bon Rod
EIR•Existing bon Rod •
$ 2. Subject to restrictive E1P-Existing tjat Iron gips e
i covenants,easements of �-C +sed Point
it
record,zoning ordinance,& DB"Map
underground utilities,if eny. Deed Book
MB•Map Book $
PG•Page
3 No title search by surveyor. R.W-Right-of-Way
4. References,MB 57,PG 83 MBL Minimum Building Line
DB 4624,PG 1578 MMNL-Mean High Water Line
5. Flood Zone-AE 9/VE 10(Effective) I'1CiIAIITY MAP" ATS
Flood Zone-VE 14(Preliminary)
Community Panel*370186 4235 J
6. Zone-MHS-SURF CITY
Setbacks.
Front-15'
Side-7.5
Rear-20
RA/
R/V
ATKINSON POINT ROAD
50' PUBIC RIGHT-DF-WAY
EWE N53'48'521 Y 19.35 N55.4'00'E 50A2
Inc3 ' IP 1 ' •EIP S55'33'59'V 50.11' Ei{1
R/Va
r--'i+-A11= -
n
( PROPOSED 24' 1MOE
GRAVEL DRIVE
ATKINSON POINT f 1
LOTS 35 and 36 8.0'I 34.0'
8.1'
MB 4, PG 132 a,' 1 PROPOSED — RICH CORKER RECOMBINATION
LOT 38R
DB 1559, PC 5 1 RE N MB 57, PG 83
`4Y3' 34'0"z44'0' + DB 4541, PG 92
. I ii FLOOD UNE IS
APPROXIMATE AND
I., ? 4 SCALED FROM FENDER
AlCOUNTY GIS_B L- _ /FLOOD MAPS
A FEMA
E-T� I,o UNCTERED` —
SCREENEp
11Pcf101CUO CALCIL4I1pNS, 45"v ,o DECK 1 PORCH
tor M1Kuo to B4#.al)-6,3Y1 W(0.14 SC) '^ 21.0' �$ t3'O'x9'2'
PRC►OM=fILMI[ACE-1.656 If
(Walfosw Motel.ofa+c-0 If
Ar 0
TOTAL MPfRNOUf COKRACE-1,666 ff(I6,1717 REAR UNCOVERED DECK SHALL BE
-1�., 1 g STRUCTURALLY PROPOSED TTHE°F
PC6t1farl a MIO►ORTY BMW 75'KC-3,624 If .--*4.-... RESIDENCE IS LOCATED *1.5'
rpT,LiIIPONOUS - -.-...4 •\ FROM THE AE/VE FLOOD LINE.
N
(tetllw 7s'ACC s11s.«X e>r(17'7f0 LOT 37R �.
—EIP 0,14 ACRES S.
S6014 'M CP S72•
1423 I 44,B'I✓ IP
,23'
CP
NORTH CAROLINA TOPSAIL SOUND
PENDER COUNTY
1,WESTON LYALL,CERTIFY THAT THIS PLAT WAS
DRAWN UNDER MY SUPERVISION FROM AN ACTUAL 30 15 0 30 60
SURVEY BUT PER DEED BOOK 4824,PAGE 1578;
THAT THIS PLAT WAS NOT PREPARED IN
ACCORDANCE WITH as.47.30 AS AMENDED. GRAPHIC SCALE
WITNESS MY ORIGINAL SIGNATURE,REGISTRATION I _
NUMBER AND SEAL THIS 2ND DAY OF APRIL,A.D.
2017. PRELIMINARY PLOT PLAN FOR
"+ +I11116j" MARY MacLEOD
�, �CARD•'i,
`‘,c LOT 37R, ATKINSON POINT ROAD
�� OfES.�/�'}}.. j�
xf � �
2 2Q S = RICH CORKER RECOMBINATION(ATKINSON POINT)
/ / SEAL y SURF CITY,NC
sl_rlr SCALE:I•=3G TOPSAIL TOWNSHIP, PENDER COUNTY NI:um 41.17 1i
L-4438
ei % ati 1t_ �yZ.
0w e MAY it SMT
•�n7oIE�r/Iu vS qV-'� ," WESTON LYALL, PE, PLS, PLLC
,, TON,'r+•Z 214 HIGHWAY 17N SUITE 1
REGISTRATION NUMBER L•4438 '+++++�++" HOLLY RIDGE,NC 28445 RECEIVED
PHONE:S1042E-9961 FIRM LICENSE 01.6011137 DCM WILMINGTON, N
__- STRUCTURAL.&CIVIL ENGINEERING&LAND SURVEYING
ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to 10 AP{ M la t LC-0 I) 's
2 , (Na f,Prcrtopperty Owner)
3 36
property located at /11-1�-l ,t oi1 t oA/V! AP
/ Address, Lot, Block, Road,etc.)
/
on , in c3t( eF G /� , 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
Date Date Check From(Name) Name of Permit Holder Vendor Check Check Permit Number NOTES
Received Deposited Number amount
6/5/2017 Larry Rice Mary LacLeod BB&T 2756 $100.00 minor,386 Atkinson Pt. JD rct.4206D
Construction Rd. SC PnCo