SC_18-01_ Fisher (2)

Issued by WiRO SC18-01
Surf City Permit Number
CAMA
MINOR DEVELOPMENT
PERMIT Coastal Management
ENVIRONMENTAL DUALITY
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 Winfield and Donna Fisher authorizing development in the Estuarine Shoreline (AEC) at 6019 6th Street, in
Surf City, Onslow County as requested in the permittee's application, dated December 27, 2017, and received by DCM
on December 28, 2017. This permit, issued on January 8, 2018, is subject to compliance with the application and
drawing dated and received by DCM on December 28, 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: Elevate existing home(on pilings)and install new decking.
(1) All proposed development and associated construction must be done in accordance with the permitted site drawing dated
received by DCM on December 28, 2017. If not existing, the "wood deck"depicted on the November 21, 2017, site plan is
omitted from this permit.
(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 Ja on Dail
compliance. Any maintenance work or project modification not covered under AMA LOCAL PERMIT OFFICIAL
this permit,require further written permit approval.All work must cease when this
permit expires on: 127 Cardinal Drive Extension
December31,2021 Wilmington, NC 28405-3845
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 S4
another party without the written approval of the Division of Coastal
Management. PERMITTEE
(Signature required if conditions above apply to permit)

Name: Winfield and Donna Fisher
Minor Permit#SC18-01
Date: January 8, 2018
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' Coastal Shoreline buffer (as measured 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) All development, unless specifically exempted in this permit, shall be located at least 30' landward of the normal
high water line.
(7) This permit does not authorize the excavation or filling of any wetlands, even temporarily.
(8) No impervious coverage/built upon area, including but not limited to the house (including eaves), foundation pad,
covered decking,etc. shall extend into the 30-foot coastal shoreline buffer.
(9) Shall the plan of development exceed 30% impervious coverage within 75' of the normal high water line, the
applicant shall effectively demonstrate, through innovative construction and design that the amount of impervious
surfaces exceeding 30% impervious coverage within the 75' Coastal Shoreline AEC shall be managed and the AEC
protected. All proposed development and associated construction must be done in accordance with a credible
innovative design plan, sealed and sealed by a professional engineer.
(10)Upon completion of construction and prior to the issuance of a Certificate of Occupancy(CO), a letter of certification
must be received from the designer of the innovative system installed, certifying that the permitted system has been
installed in accordance with this permit, the approved plans and his design specifications. Any deviations from the
approved plans and specifications must be noted on the Certification and a permit modification may be required
prior to receiving a CO.
(11)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.
(12)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: h
PERM ITTEE

Issued by WiRO SC18-01
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 Winfield and Donna Fisher authorizing development in the Estuarine Shoreline (AEC) at 6019 6th Street, in
Surf City, Onslow County as requested in the permittee's application, dated December 27, 2017, and received by DCM
on December 28, 2017. This permit, issued on January 8, 2018, is subject to compliance with the application and
drawing dated and received by DCM on December 28, 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: Elevate existing home(on pilings)and install new decking.
(1) All proposed development and associated construction must be done in accordance with the permitted site drawing dated
received by DCM on December 28, 2017. If not existing, the"wood deck"depicted on the November 21, 2017, site plan is
omitted from this permit.
(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 Ja on Dail
compliance. Any maintenance work or project modification not covered under AMA LOCAL PERMIT OFFICIAL
this permit,require further written permit approval.All work must cease when this
permit expires on: 127 Cardinal Drive Extension
December 31,2021 Wilmington, NC 28405-3845
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 PERM ITTEE
Management.
(Signature required if conditions above apply to permit)

Name: Winfield and Donna Fisher
Minor Permit#SC18.01
Date: January 8, 2018
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' Coastal Shoreline buffer (as measured 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) All development, unless specifically exempted in this permit, shall be located at least 30' landward of the normal
high water line.
(7) This permit does not authorize the excavation or filling of any wetlands, even temporarily.
(8) No impervious coverage/built upon area, including but not limited to the house (including eaves), foundation pad,
covered decking, etc. shall extend into the 30-foot coastal shoreline buffer.
(9) Shall the plan of development exceed 30% impervious coverage within 75' of the normal high water line, the
applicant shall effectively demonstrate, through innovative construction and design that the amount of impervious
surfaces exceeding 30% impervious coverage within the 75'Coastal Shoreline AEC shall be managed and the AEC
protected. All proposed development and associated construction must be done in accordance with a credible
innovative design plan,sealed and sealed by a professional engineer.
(10)Upon completion of construction and prior to the issuance of a Certificate of Occupancy(CO), a letter of certification
must be received from the designer of the innovative system installed, certifying that the permitted system has been
installed in accordance with this permit, the approved plans and his design specifications. Any deviations from the
approved plans and specifications must be noted on the Certification and a permit modification may be required
prior to receiving a CO.
(11)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.
(12)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:
PERMITTEE

lK0Localit 5c.... Q� � � Permit Number ` v /YJ
. Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
(For official use only)
GENERAL INFORMATION .
LAND OWNER- MAILING ADDRESS //
Name__�!1/iA/Fie.l t �rS!-erf DttwN1¢- S� fi L,4ev ---
Address 6Q19 4-7-wen--
City_c u �—State IN C Zip 2211Y5Phone 9/2 - 5 c--'6 0 _
Email ►,t;4- i-s1,,k- 6 4 isl e r-e4 . IvG
AUTHORIZED AGENT
Name 104w C- !C
Address A / f/ii./
City •I/✓17--xpi f ty State '7/C Zips9 'WL-' Phone ...37( - `-may% ,,-
Email , f ,- ii' y C)yicA?0 • _C itr''
LOCATION OF PROJECT: (Address,street name and/or directions to site;name of the adjacent waterbody.)
6-&I G ' 5'ram" Swr1= c.J Nc: )- ' S
DESCRIPTION OF PROJECT: (List all proposed cot struction and land disturbance.), Ira Vic' Lt•s e wi ,irrf
P k T O►- Pit s /'V.P u! C G✓.iy, -ec kS 0 r✓ L e.1-I- 5 id e c►^tia' wv --1 er S;
e
a-r
G .c•v-e F IAv e r►.4 f( e, ,✓1-w/ rr a+M r-c-r e"YI ^- i e_ cA ^d P r . 2 seA Soll
7
SIZE OF LOT/PARCEL: ii .. . square feet _ acres
PROPOSED USE: Residential E✓I (Single-family[2/Multi-family ❑ ) Commercial/Industrial ❑ Other 0
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: 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 ANI)OTHER IMPERVIOUS OR BUILT
UPON SURFACES: )/25c)square feet(includes the area of the foundation of all buildings,driveways,covered decks,
concrete or masonry patios,etc. that arc within the applicable AIiC.Attach your calculations with the project drawing.)
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to;Fi to E I V E D
Stormwater Management Permit issued by the NC Division of Energy, Mineral and Land RcsoX W4WTON, NC
YES NO
— nrr n ., line,

OTHER PERMITS MAY 13E REQUIRED:The activity you arc 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,PIA
Certification,Sand Dune, Sediment Control, Subdivision Approval, Mobile I tome Park Approval, I lighway 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 dcvelopmcnt 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 v.)v('e1 .ri►af 1C,SLv, Oc�IvIF S'1sl wi1+v f t�S, i-
see Deed Book 4 YO page 514 of in the O IVSL O w 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 arc 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) P,Others K, SiioAfa -7651 Ot.O MOCKsUilte 9 - Sah$Intry, NG
(2) Q EWwiy_frNtzt. (hit I e,r P d hoc 3 i) t2 i C LermiSi,uL a- S74-
(3) ---
(4)
ACKNOWLEDGEMENTS:
i,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
may be susceptible to erosion and/or flooding. i acknowledge that the Local Permit Officer has explained to me the particu-
lar hazard problems associated with this lot.This explanation was accompanied by recommendations concerning stabiliza-
tion and floodproofing techniques.
I furthermore certify that i am authorized to grant,and do in fact grant,permission to Division of Coastal Management staff,
the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information
related to this permit application.
This the _ day of Of c ,20 7
� y. l
6
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, the Ocean llazard AEC Notice where necessary, a check for$100.00 muck payable to the locality, and
any information as may be provided orally by the applicant. The details(Ow application as described by these somres are
inco po•ated►without reference in any permit which may be issued. Deviation from these details will constitute a violation of
any permit. Any person developing in an AEC without permit is subject to civil, criminal and administrative action.
RECEIVED

National Flood Insurance Program
V-Zone Certification
Property Information For Insurance Company Use
Name of Structure Owner Policy Number
Winfield Thomas Fisher Ill
Structure Address or Other Description
6019 6th Street
Surf City State NC Zip 28445
SECTION I: FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Note: To be obtained from appropriate FIRMs
1. Community Number 2. Panel Number 3. Suffix 4. Date of FIRM Index 5. FIRM Zone
370186 3720424500 K 02/16/07 VE
SECTION II: ELEVATION INFORMATION
Note: This form is not a substitute for an Elevation Certificate. Elevations should be rounded to nearest tenth of a foot.
1. Elevation of the Bottom of Lowest Horizontal Structure Member 12.1 feet
2. Base Flood Elevation 11.0 feet
3. Elevation of Lowest Adjacent Grade 2.3 feet
4. Approximate Depth of Anticipated Scour/Erosion used for Foundation Design 1.0 feet
5. Embedment Depth of Pilin s or Foundation Below Lowest Adjacent Grade 8.0 feet
6. Datum Used NGVD '29 X NAVD '88 Other
SECTION III: FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Note: This section must be certified by a registered professional engineer or architect.
I certify that I have developed or reviewed the structural design, plans and specifications for construction and that the methods
of construction to be used are in accordance with accepted standards of practice for meeting the following provisions:
a.)The bottom of the lowest horizontal structure member of the lowest floor(excluding the pilings or columns) is elevated to
or above the BFE; and
b.)The pile or column foundation and structure attached thereto is anchored to resist flotation, collapse and lateral
movement due to the effects of the wind and water loads acting simultaneously on all building components. Water
loading values used are those associated with the base flood including wave action. Wind loading values used are
those required by the applicable State or local building code. The potential for scour and erosion at the foundation has
been anticipated for conditions associated with the flood, including wave action.
SECTION IV: FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Note: This section must be certified by a registered professional engineer or architect.
I certify that I have developed or reviewed the structural design, plans and specifications for construction and that the methods
of construction to be used for the breakaway walls are in accordance with accepted standards of practice for meeting the
following provisions:
a.) Breakaway collapse shall result from water load less than that which would occur during the base flood; and,
b.) The elevated portion of the building and supporting foundation system shall not be subject to collapse, displacement, or
other structural damage due to the effects of wind and water loads acting simultaneously on all building components
(wind and water loading values defined in Section III).
SECTION V: CERTIFICATION
(Check: Section III X and/or Section IV X)
Name of Certifier Title
M. Floyd Adams Engineer
Firm Name License Number
The Adams Company, Inc. 12273
Street Address Phone Number
708 Abner Phillips Rd. ( 910 ) 293-2770
City State Zip Code
Warsaw NC 28398
Signature = � :rt,'�L ` Z Date
1 :73 = 12(g1ICEIVE igg
N.C. Division of Emergency agement .'
DOM WILMINGTON, NC

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: 1U;IAj-;eI tombs F.SLer ' ,Dc t'r' l Inver fi3'�Y
Address of Property: 6 0 i/c) t:% 5 Ti2 T Su e.F c;f t7, ri✓ • , d-g ct i
(Lot or Street#, Street or Road, City&County)
Agent's Name#: 1 Cacs'iGi7 Mailing Address:// j19 L. ke /,L t
w rr' d!1
Agent's phone#: °Ii 0 3•74 S972— s �' 4'f / fery rvL 1Y46 U
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.
1 have no objections to this proposal. I have objections to this proposal.
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.
I do not wish to waive the 15' setback requirement.
(Property Owne,r Information) (Adjacent Property Owner Information)
.pti
IUW2 tip_ i404nAl j1
Signature ,Signature
t., iv ,•�(j 7 , i.a
tom v s N Lem C:1 tic-'
Print or Type Name Print or Type Name
6'GYt 6 % 5 g _- 77(051 CIt\ t)t,\
Mailing Address Mailing Address
SUvF CH-1 /v C -`X,1r-s11.0-A,\ C Nig \
City/State/Zip City/State/Zip
919 9ic1 114C
Telephone Number Telephone Number
[)ure c��,r — ECEIVED
RevisedC$k/8112WLMINGTON, NC

Emailed again on 7/30/18
From: Simpson, Shaun
Sent: Friday,July 20, 2018 10:35 AM
To: '[e-mail]' <[e-mail]>
Cc: '[e-mail]' <[e-mail]>
Subject: FW: SC18-01 address confirmation
Hello Sirs:
I have attempted to reach you and your agent in order for you to sign the attached permit. Can either
you, or your agent please sign the attached permit and return to me? This permit is not valid until we
have your signature on file in the Wilmington office.
Thank you for a prompt reply to this very important matter,
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:[phone]
Shaun.Simpson @ncdenr.qov
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: Simpson, Shaun
Sent:Tuesday,January 16, 2018 8:17 AM
To: [e-mail]
Subject: FW: SC18-01 address confirmation
Good Morning Mr. Cassidy,
Can you please check this mailing address for me? I have not gotten a reply from Mr. Fisher to my
email.
Thank you,
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:[phone]
Shaun.Simpson(cJncdenr.qov

From:Simpson, Shaun
Sent: Monday,January 08, 2018 3:29 PM
To: '[e-mail]' <[e-mail]>
Subject: SC18-01 address confirmation
Mr. Fisher,
I am preparing your permit for USPS mail. Can you please confirm you mailing address? Our files show
it as 6019 6th St., Surf City. If you prefer I send it to another address, please let me know asap.
Thank you,
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:[phone]
[e-mail]
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: Dail,Jason
Sent: Monday,January 08, 2018 2:57 PM
To: [e-mail]; [e-mail]
Cc: Patti Arnold ([e-mail]) <[e-mail]>; Steve Padgett
([e-mail]) <[e-mail]>; Simpson, Shaun
<[e-mail]>
Subject: CAMA minor permit-9019 6th Street, Fisher residence
Good afternoon. Please find attached a copy of the subject CAMA minor permit.A signed hard copy will
follow via USPS. Please let me know if you have any questions.
Take care,
Jason
Jason Dail
Field Representative
NC Department of Environmental Quality
NC Division of Coastal Management
127 Cardinal Drive Ext.
Wilmington,NC 28405
Phone:[phone],Fax:[phone]
[e-mail]

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
Coastal Management
ENVIRONMENTAL QUALITY BR A XTON DAVIS
Director
January 8, 2018
Winfield Thomas Fisher I I/
Donna Stamper Fisher ) / v
6019 6th Street
Surf City, NC 28445 f , I411
Dear Mr. & Mrs. Fisher:
Attached is CAMA Minor Development Permit SC 18-01 for work to be done at 6019 6th St., in Surf City,
Onslow County. An electronic copy has been sent to the SC Inspection Department and to your agent.
To validate this permit, please sign both copies as indicated for our records. Retain the orange copy for
your files, and return the white copy 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.
John Cassidy-Agent
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext.,Wilmington,NC 28405

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MAP BOOK TI,PAGE 30
,W\
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\\ BOUNDARY SePHYSICAL SURVEY FOR:
\ IFINFIhLD THOMAS FISHER III
AND WIFE, DONNA STAMPL'R PISIXL'R
LEGEND: NOTES: GRID TIES AND COORDINATES: REFERENCES- CURRENT OWNER: AINF1EWD THOMAS FISHER, III AND WIFE,
DONNA STAMPER FISHER
EPP-DOSING PINCHED PPE I)THE PROPERTY 9101W1 HEREON IS LOCATED ENTRELY VATHN O5 NO.102 - NORTH.256,734.262 DEED BOO(4620,PAGE I349 136 S. PLEASANT COATS ROAD, BENSON, NC 27504
OS-EXISTING IRON STAKE A SPEOAL 100 YEAR FLOOD HAZARD AREA.ZONE VE.ACCORDING
EMT.E105TNC PX.NM_ TO ROW INSURANCE RATE MAP NO.3720424500K DATED (CONTROL CORNER) EAST.4 2,447,431.042 LOT 3 BLOCK 40.SECTION 4
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AG.TOP ABOVE GROUND SURFACE 2)ALL N.C.ODD DATA SHORN HEREON IS BASED ON NM 1963 EPA NO.105 NORTH=256,6439.189
BG TOP L_WGROUND SURFACE 2011 ADJJSINENT USING THE NCGS RIX R PKO<SYSTEM. (CONTROL CORNER) EAST-2,447,462393
STUMP SOUND TOWNSHIP, ONSLOW COUNTY, N.C.
4 -CENIERLIE 3)AU.DISTANCES 9DMN HEREON ARE N.C.GRID DISTANCES
I• - NORTH u1E UNLESS OTHERWISE NOTED. GATE: NOVEMBER 21, 2017 r_v
NCGS-NORTH CAROWA GEODETIC COMBINED 4)CD GRID FACTOR= 0.999970585 SCALE: 1*• 20'
-F-E- -OVERHEAD UTUTY LINE
▪ MISTY POLE 5)ALL U➢UTY LINES SHOOT HEREON MAY HAVE IASEENTS ✓O//A'IVY✓. II/LLlAI6'LAND SURVBYIAC, PC=I.4 WATER METER AND RIGHTS ENTRANCE AND MAINTENANCE ASSOCIATED
MTH THEM' P.O.BOX 778,BEULAVILLE,N.C. 28518
4 6) ZONED PROPERTY IS zOO w5 R Ha:@ Aanll,ttWl�ln W n E 4 PHONE: [phone] FAX: [phone] EN
ELE MSC85 Re mom, EMAIL: JWILLIAMSOJWSURVEY.CO1 ARM NO. C-2532

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: V;tA F;eLk ` I,er„�s F:S�rr iJ &Aiwa S iTmAcc �i3/-
Address of Property: EGI C) L% 5re et—r SNei- c;-} , .C, d-k4tt
5 _
(Lot or Street#, Street or Road, City&County)
Agent's Name#: � thy C c,c S;ci7 Mailing Address. jig_.ke i s Z r r• �lj
Agent's phone#: °l t r" 3.7 I c-.9 .L c1v E2Ae1d/1' �-�•'. ry� 3?4 U
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.
3C� 1 have no objections to this proposal. 1 havr objections to this proposal.
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 unmess waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Pro rty wnq'Information) (Adj cent Property Owner Infor tion)
signature :rr� 1! miltttlir,.
o l►�A' 5. F S 1, v 1e,vh,$ E /0 , t l teP‘,
Print or Type Name Print or Type Name
la ti = 5-Tie6br PD, t3'X 3t`3
Mailing Address Mailing Address (L
7 iA v r= i`:i-1 /I, a-lr 4 4 j ► �7�1 C, a g-CV
City/State2ip City/ tate/Zip
"jig 9i;1 Hite _ �IO sc32 .3 RECEIVED
Telephone Number 'elephone Number DCM WILMINGTON, NC
IS14-0./1 __—.- -__ . ._./ _/ 7 - _DEC 2 8 2017
Date 1'ui
Revised 6/18/2012

1,JOYNNY J.NWAMS,PROFESUCNAL LAND SURVEYOR.CERTIFY THAT
THIS YAP WAS PREPARED UNDER MY SUPERN90H FROM AN ACTUAL \�. .
SURVEY MADE UNDER MY SUPERVISION COMPLETED ON 11/21/2017
FROM REFERENCES AS 910YN HEREON THAT BOUNDARIES NOT \ \ ?
SURVEYID ARE NOTED AS SUCH AND PLOTTED FROM REFERENCES
AS SHOWN HEREON THAT TINS OPS SURVEY WAS PERFORATED TO \ s
SECOND ORDER CLASS I FGCC SPECIFICATIONS; THAT CPS HELD
PROCEDURES AHD COORDINATES MERE MANED BY NCGS INK SI
NETWORK ADJUSTMENTS: THAT MIS CPS SURVEY WAS PERFORMED \ 61` 11
USING MOLE SURVEY MACE(PS UNITS: THAT All COOIDNAIES , 0
N N.C. 0 ARE BASED OC. NORTH(NAD 1983 2007 ADJUST TENT): \ .A
THAT ALL DATA MIMED NTH RPS METHODS AS WELL AS
CCNVENTMNAL METHODS ARE N ACCORDANCE WITH A CLASS A \ \'Z. 9
SURVEY AS DEFINES BY 1111E 21.CHAPTER 65.SECTION.1600 O n 3
THE N.C.ADADISTRARVE CODE;AND THAT MIS MAP WAS 4\ \ \tf '5 + ,
PREPARED IN ACCORDANCE MTH TITLE 21,CHAPTER56.OF III'N.C.
ADMINISTRATIVE COOS. \ \ ETA VICINITY SKETCH
\
,N CAA DI7p \� (NOT TO SCALED
III 29 ill \O0.lE5Vp .,'; \\ \ `-'
.l Y9WILLJAMS•P.LS..L-3170 _ ' - a�s.
-=:y SEAT fir: _ `� \'� _
:� L.31T0�O:, \\ .,., \N� z G Z
' N `` ROANS K SNOW,■ AEDI IN MITIALVE �c `„ \ TN H C.
DEED BOOK 4591.PAGE 774 J.
W
LOT 4,BLOCK 40,SECTION AELEGIAC \b. T'..'}A\\5. \ a- 2 i.
OLD SETTLERS BEACH T�
YAP BOOK 11.PACE 30 \A00-' • if. f \-A S [4 2 GV
1 CI
alike
\ y.
l/A N4
40
`�`
0.177 ACRES s's
Aoao oaE- \ ` DEAR FAN MILLER
\
DEED BOOK 3436.PACE 660
J
CANAL ° LOT 2,BLOCK ION 40,SECT 4
\V`' OLD SETTLERS BEACH
_—
n IMP BOOK II,PAGE 30
\
BOUNDARY Sc PHYSICAL SURVEY FOR:
\ 1lINPIA'lD THOMAS FISHArle IIIW
WIF AND E. DONNA STAMPA'R I'ISHA'R
LEGEND: NOTES. GRID TIES AND COORDINATES. REFERENCES; CURRENT OWNER: WINFIELD THOMAS FISHER, III AND WIFE.
DONNA STAMPER FISHER
EPP-COSINE PINCHED PPEDEED BOOK 4620.PAGE 649
85-ENSIMG NON STAKE 1)DIE PROPERTY YEAR HEREON R LOCATEDA d1RRY WPM NEIST NO. C - NORTHT -256.751.042 136 S. PLEASANT COATS ROAD, BENSON, NC 27504
A SPEQAL 100 YEAR ROOD HAZARD AREA.ZONE D ACCORONC (CONTROL COINER) EAST-2.447.431.042
EPK-EXISTOTLINO P.K.NAIL TO ROOD INSURANCE RAZE YAP N0.3720424500c DATED LOT3,BLOCK SUET 4
0 _ �+GN Po++T FEBRVAtRY le,2007. OLD SETTERSBEACHP SIWAASDN INDIVIDUAL TRACT ON N.C.S.R. 1611 (6th STREET)
-OP 48O HAG GR NAILGROUND
MAP BOOK 11,PAGE 30 TOWN OF SURF CITY
AG A.LOP ABOVE GROIlN11 SURFACE 2)ALL N.C.GRID DATA SHOWN HEREON S BASED ON NAD 1963 EPP NO.105 NORTH=256,689.189
RM WOIPLELOW GROUND SURFACE 2011 ADJUSTMENT USING TIHE NCGS RIX IE1W(M SYSTEM. (CONTROL CORNER) EAST=2.447,462393 STUMP SOUND TOWNSHIP, ONSLOW COUNTY, N.C.
I -P ER ])ALL DISTANCES HE fXID DISTANCES
NOVEMBER 21 2017
OWN ARE NC. STANs , °
I -PROPERTY
ENE UNLESS OTHERWISE NOTED. I
NCGS-NORTH CAROUNA GEODETIC
SURVEY 4)COMBINEDMEO FACTOR- 0.999970585 SCALE: 1- = 20'
-f-f- E.OVERHEAD UTILITY UNE
♦-UTILITY POLE 5)ALL UTUTY LINES SHOWY HEREON MAY HAW 1 ASEYENTS
=1-WATER METER AND Rg11S CF ENTRANCE AND MANTENANCE AmOOATED ✓ORNNY J. FULL✓AYS LAND SURVEY/AC P.C.
BOTH THEM. P.O. BOX 778, BEULAVILLE,N.C. 28518
•
C-IW MVP.VP.TOILED, 4N ST PHONE: [phone] FAX: [phone]
8)MS PROPERtt IS ZONED YHS DU WWe Rs10R111
IDS HL M1nWDH7 EMAIL: JFAWAAISH(♦,AYSURVEY.CW FlRAI NO. C-2532

Date Date Check From Name of Vendor Check Check Permit Number NOTES
Received Deposit (Name) Permit Holder Number amount
ed 1
12/28/2017 NCSECU Thomas Fisher NC SECU 89637 $100.00 minor fee, 6019 6th JD rct
Cashiers St., SC OnsCo 5420E
Check, Thomas
Fisher