SC_18-03_ ANA Builder's Inc

Issued by WiRO SC18-03
Surf City Permit Number
CAMA
MINOR DEVELOPMENT
PERMIT Coastal Management
ENVIRONMENTAL QUALITY
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 ANA Builder's Inc. authorizing development in the Ocean Hazard Area (AEC) at 104 S. Shore Drive, in Surf
City, Pender County as requested in the permittee's application package, dated December 11, 2017. This permit, issued
on January 10, 2018, is subject to compliance with the application and site drawing (where consistent with the permit)
dated and received by DCM on January 2, 2018, and all applicable regulations and special conditions and notes set forth
below. Any violation of these terms may subject permittee to a fine, imprisonment or civil action, or may cause the permit
to be null and void.
This permit authorizes: Residential Addition.
(1) All proposed development and associated construction must be done in accordance with the permitted drawing dated and
received by DCM on January 2, 2018.
(2) All construction must conform to the N.C. Building Code requirements and all other local, State and Federal regulations,
applicable local ordinances and FEMA Flood Regulations.
(3) Any change or changes in the plans for development, construction, and/or land use activities will require re-evaluation and
modification of this permit.
(4) A copy of this permit shall be posted or available on site throughout the construction process. Contact this office at(910)
796-7221 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
compliance. Any maintenance work or project modification not covered under
this permit,require further written permit approval.All work must cease when this Jason Dail
permit expires on: A LOCAL PERMIT OFFICIAL
December31,2021 127 Cardinal Drive Extension
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 RECEIVED
. 11/another party without the written approval of the Division of Coastal DCM WILMINGTON, P
Management.

A a y
Name: ANA Builder's Inc.
Minor Permit#SC18-03
Date: January 10, 2018
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 redone.
(6) Any structure(s) constructed within the Ocean Hazard area shall comply with the NC Building Code, including the
Coastal and Flood Plain Construction Standards of the N. C. Building Code, and the Local Flood Damage
Prevention Ordinance as required by the National Flood Insurance Program. If any provisions of the building code
or a flood damage prevention ordinance are inconsistent with any of the following AEC standards, the more
restrictive provision shall control.
(7) All structure(s) authorized under this permit must be set back a minimum of 60 feet from the First Line of Stable
Natural Vegetation (FLSNV), as determined by the DCM, the LPO, or another assigned agent of the DCM.
(8) The combined total floor area of the existing residential structure and authorized addition shall not exceed 5,000 sq.
ft.
(9) 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.
(10) 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.
(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:(y ;i� �; DATE: ) /17`Tid/ '
PERMITTE
RECEIVED
DCM WILMING T ON. NC

3c,„
OTHER PERMITS MAY BE REQUIRED:The activity you are planning may require permits other than the CAMA
Locality Permit Number 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
Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile Home Park Approval,Highway Connection,and
(For official use only) others.Check with your Local Permit Officer for more information.
GENERAL 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
LAND OWNER person authorized to act as an agent for purposes of applying for a CAMA minor development permit,certify that the person
Name A N A Builders Inc listed as landowner on this application has a significant interest in the real property described therein.This interest can be
described as:(check one)
Address 104 South Shore Dr
Flan owner or record title,Title is vested in ,see Deed Book 4093
City Surf City State rvc Zip 28445 Phone [phone]
page 501 in the Onslow County Registry of Deeds.
Email [e-mail]
pan owner by virtue of inheritance.Applicant is an heir to the estate of ,
AUTHORIZED AGENT probate was in County.
Name MO Afify-A'n'A Builder's Inc. I,/If other interest,such as written contract or lease,explain below or use a separate sheet&attach to this application.
Address 13480 NC Hwy 50
NOTIFICATION OF ADJACENT PROPERTY OWNERS:
City Surf City State NC Zip 28445 Phone [phone] I furthermore certify that the following persons are owners of properties adjoining this property.I affirm that I have given
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
Entail [e-mail]
(Name) (Address)
(i) Batts Properties Inc et al 110 W Lake Ridge Road Raeford NC 28376
LOCATION OF PROJECT:(Address,street name and/or directions to site.If not oceanfront,what is the name of the
adjacent waterbody.)Atlantic Ocean t lot 4.5 ho(t nt: 501'( y (2) Callaway Richard E Trustees 411 Queen Annes Rd,Greenville NC 27858
(3) Mark Harvill et al 106E S Shore Dr Surf City NC 28445
DESCRIPTION OF PROJECT:(List all proposed construction and land disturbance.) Residential Addition (4)
SIZE OF LOT/PARCEL: 5663 square feet 0.13 acres ACKNOWLEDGEMENTS:
I,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
PROPOSED USE:Residential Q (Single-family 0 Multi-family El) Commercial/Industrial D Other D 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-
COMPLETE EITHER(1)OR(2)BELOW(Contact your Local Permit Officer if you are not sure which AEC applies tion and floodproofing techniques.
to your property):
(1) OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE:320 square feet(includes 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 infonmation
air conditioned living space,parking elevated above ground level,non-conditioned space elevated above ground level but related to this permit application.
excluding non-load-bearing attic space)
ber
(2) COASTAL SHORELINE AECs:SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT This the day ofBR ,20 17
UPON SURFACES:736 square feet(includes the area of the roof/drip line of all buildings,driveways,covered decks, //
concrete or masonry patios,etc.that are within the applicable AEC.Attach your calculations with the project drawing.)
La one person authorize. o.' asri iigc agent for purpose of filing a CAMA permit application
STATE STORMWATER MANAGEMENT PERMIT:Is the project located in an area subject to a State Stormwater
Management Permit issued by the NC Division of Water Quality? This application includes:general information(this form),a site drawing as described on the hack of this application,the
YES I I N ownership statement,the Ocean Hawn,AEC Notice where necessary,a check for S 100.00 made prim to the locality:and
If yes,list the total built upon area impervious surface allowed for your lot or parcel: any information as may be provided orally by the applicant.71u details of the application as described by these sources are
square feet. incorporated without reference in any permit which may be issued Deviation firm these details will consvitsat a violation of
any permit.Any person developing in an AEC without permit is subject to civil,criminal and administranwe action.
'JVILivi►NGTON, NCC 'I11r:
DC
WILMINGTO1NI M _
n.f�l JAN
_

ROY COOPER
t.x.
Governor
MICHAEL S. REGAN
Secretary
Coastal Management
ENVIRONMENTAL OUAUTY BRAXTON DAVIS
Director
January 10, 2018
A'n'A Builders
c/o Mo Afify
13480 NC Hwy 50
Surf City, NC 28445
Dear Mr. Afify:
Attached is CAMA Minor Development Permit SC 18-03 for work to be done 104 S.Shore Dr., in Surf City,
Pender County. An electronic copy has been sent to the Surf City Inspections 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,
<1;3 ,
Shaun K.Simpson
Permit Support Technician
Enclosures
Cc: WiRO files
SC Inspections Dept.
M.Afify-Agent
•
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext.,Wilmington,NC 28405

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0 PROPERTYI CONTROL MONUMENT 1 1
'2AA EXISTING SPOT ELEVATION I NOTE: I
FLSNV FIRST LINE OF VERTICAL DATUM BASED ON NAVD 1988 1 •11.`5
STABLE NATURAL VEGETATION 1
SURVEY REFERENCE
MAP BOOK 3 PAGE 45
PENOER COUNTY REGISTR'
PROPOSED BUILDING ADDITIONFOR
p
P ��q NOTE: I CERTIFY THAT THIS MAP WAS DRAWN UNDER A N A U I I N G °
�.�� -q FIRST LINE OF STABLE NATURAL VEGETA 1BN MY SUPERVISION FROM AN ACTUAL SURVEY
�J DF SHOWN ON THIS PLAN AS DETERMINED BY NC MADE UNDER MY SUPERVISION FROM INFORMA-
0� OS DIVISION OF COASTAL MANGEMENT 0)Y i��+`lcfmn"LON SHOWN ON PLAT' AT THE POSITIONAL -LOT 3 -
y \� MARCH 17, 2017. � 00
Gys QSP �Q .`� UpACY IS , f_1- -: AND THAT THIS MAP BLOCK 19
rp4, �oQF . iaOQ ��ESSIO4,', Rl1THE REQUIREMENTS
LAND SUOF THE
GSTANDAN RDSTH TOPSAIL TOWNSHIP
y'fF S - �S c Z Z'2Q SEPL �CAf DL INA (21 NCAC 56. 16001.. PENDER COUNTY NORTH CAROL INA
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\/'I C 1 N I TY MAP ��2,flim u" W910181 ON. NC 28403
(910 tB15-O775
PW656 ..,„,

OCEAN HAZARD AEC NOTICE
Project is in an: Ocean Erodible Area High Hazard Flood Area Inlet Hazard Area
' /A
Property Owner: n L�vis ��
Property Address: ia`/ 5 C: e Suf1 C 1..�, AJC z /fc�
u Date Lot Was Platted: &/1, /Ts:xD co /
This notice is intended to make you, the applicant, aware of the SPECIAL NOTE: This hazzrd 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 he 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
located is feet per year.
Local Pen-nit 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 Address
feet landward in a major storm.
The flood waters in a major storm are predicted to be about
feet deep in this area. Locality
•
Preferred oceanfront protection measures are beach nourishment
and relocation of threatened structures. Hard erosion control
structures such as bulkheads,seawalls, revetments,groins,jetties Phone Number
and breakwaters are prohibited. Temporary sand bags may be
authorized under certain conditions.
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. � ►
��'JVIt.Ui1NUTON,1
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Property Owner oil re Date

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CERTIFIED MAIL! RECEIPT
Domestic Mail Only
For delivery information,visit our website at www.usps.com
H0L4 D 4 C 44 b fm
Certified Mail Fee
3 $3.35 ��yy 0445
Extra Services&Fees(check Gar,add lee kg*.•ate) 07
❑Return Receipt(hardcopy) $ I I 1
❑Return Receipt(electronic) $ $0.00 Postmark
0 Certified Mall Restricted Delivery $ !0 a 00 Here
, ❑Adult Signature Required $ a0 00
❑Adult Signature Restricted Delivery$
3 Postage
$ $0.49
Total Postage and Fees 12/19/2017
$ $3.84
- Sent To
3 Street andrApt.No.,or 15 116i No.
City,State,ZIP+44

OCIAIIIOU MI 111`.itlrVKGtl prvinula! UCrICIILS:
A receipt(this portion of the Certified Mall label). for an electronic return receipt,see a retail
I A unique identifier for your mailpiece. y associatg for assistance.To receive a duplicate
Electronic verification of delivery or attempted return receipt for no additional fee,present this
delivery. USPS®-postmarked Certified Mail receipt to the
I 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
r You may purchase Certified Mall service with signee to be at least 21 years of age(not
First-Class Mails,First-Class Package Services, available at retail).
or Priority Mails service. -Adult signature restricted delivery service,which
I Certified Mail 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
I 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
certain Priority Mail Items. USPS postmark.If you would like a postmark on
I 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.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.
aar10 e..ai nn.c io......_...,ncu-ffcnn_M nn,.,n..

Receipts for
Certified Mail
(Staple Here)
114/4/2or 7
Date
lt- &hevi It CI ..1
Adjacent Property Owner
Io& 5." Sl.". i7.;v.t.
Mailing Address
SioS Cal At. LfcY*c
City,State,Zi6 Code
Dear Adjacent Property:
This letter is to inform you that I, ' nA 8.41Lo L. have applied for a CAMA Minor
Property Owner
Permit on my property at kw/ ..5.14 S 2• .J c /z , in PenderlOnslow
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 retum
the enclosed no objection form.If you have any questions or comments about my proposed project,please
contact me at 1/0' 3Z T— 7ff 1 ,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,
ProtOwner
rtY
/3q6D r)
Mailing Address
• er zfYys
City,State,Zip Cide
• RECEIVED
DCM WILMINGTON,NC

I. . -os a ervice
CERTIFIED MAIL® RECEIPT
7
Domestic Mail Only
3
For delivery information,visit our website at www.usps.com`''.
RAEFQRD, NC"28376
3 Certified Mail Fee
3.35 0445
1 Extra Services&Fees(check box,add fee aT �§te) 07
' ❑Return Receipt(hardcopy) $ s)t 'IJJ[[JJ
❑Return Receipt(electronic) $ $`}.00 Postmark
3 ❑Certified Mail Restricted Delivery $ $0.00 Here
3 ❑Adult Signature Required $ $0-0y
El Adult Signature Restricted Delivery$ i_ V V
3 Postage $0.44
$ 12/19/2017
Total Postage and Fees
$ $3.84
Sent To
9 �
3 Street and Apt.No.,or Pb ffoX ffo.
City,State,ZIP+411

.eranea man service proviaes me renewing neneTlts:
r A receipt(this portion of the Certified Mail itbel). , for an electronic return receipt,see a retail
A unique identifier for your mailpiece. assoclate for assistance.To receive a duplicate
I Electronic verification of delivery or attempted return receipt for no additional fee,present this
delivery. USPS®-postmarked Certified Mail receipt to the
I 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 specdled period. delivery to the addressee specified by name,or
to the addressee's authorized agent.
mportant Reminders: -Adult signature service,which requires the
I 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,whist
I Certified Mail 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
I 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 s
certain Priority Mail Items. LISPS postmark.If you would like a postmark on
I 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.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.

r
Receipts for
•
Certified Mail
(Staple Here)
l7 r 1/?oe 1'
bae
&ft, Anc,_ .4 a
Adjacent Properly Owner
/ro w LaKa ;R:154 R.41
Mailing Address
Rv fed NL Z p'37-c
City,State,Zip Code
Dear Adjacent Property:
This letter is to inform you that I, A'!, '/+ & Idei, /.K. have applied for a CAMA Minor
Property Owner
Permit on my property at WI 5 Sib.", De rf 417 /VL , 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 *o-32 T— 18/1 ,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,
PrO caner
/31fto /VC /"w y S!)
Mailing Address
5w-4 c; /tic z''VVc
City,State,Zip Code
• RECEIVED
DCM WILMINGTON,

U. . •os a ervice
CERTIFIED 4 AIL`a' RECEIPT
Domestic Mail Only
For delivery information,visit our website at www.usps.com`w.
] f"'" '',r' NCena58,6
3 Certified Mail Fee $3.35 0445
s �[� �� 07
Extra Services&Fees(check box,add fee a;;appTo i�;te)
] 0 Return Receipt(hardcopy) $ 1I,,II v lJ�i_�i
] ❑Return Receipt(electronic) $ $0.00 Postmark
] ❑Certified Mall Restricted Delivery $ SO.00 Here
] 0 Adult Signature Required $ $0.00
❑Adult Signature Restricted Delivery$ V V
] Postage $0.49
Total Postage and Few.84 1 2/1 9/2017
- Sent To
] Street and Apt.No.,or Pb Box P19.
City,State,ZIP+4®

L. rU11CQ IYRUi sefvu.e pwVIUeb l:I7E.'Iu.Iow.tIJ DCIICIII,:
I A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail
I A unique identifier for your mailpiece. associe+for assistance.To receive a duplicate
I Electronic verification of delivery or attempted return receipt for no additional fee,present this
delivery. USPS®-postmarked Certified Mail receipt to tht
I 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
I You may purchase Certified Mall service with signee to beat least 21 years of age(not
First-Class Mail®,First-Class Package Servicee, available at retail).
or Priority Mail®service. -Adult signature restricted delivery service,whicl
I Certified Mail service is not available for requires the signee to be at least 21 years of ag
International mall. and provides delivery to the addressee specifier
I Insurance coverage Is notavailable for purchase by name,or to the addressee's authorized agen
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
certain Priority Mail items. USPS postmark.If you would like a postmark on
I 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.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.

Receipts for
Certified Mail
(Staple Here)
iZ ?/20/1
Dat
Adjacent Property Owner
yfr QQccvi A net r Rd
Mailing Address
A,- . l!t NC. z I $S9
City,State,Zip Code
Dear Adjacent Property:
This letter is to inform you that I, 44A have applied for a CAMA Minor
Property Owner
Permit on my property at� 5 S4.mt Z r:vc £ c (.3y A"C_ , in PenderlOnslow
Property Address /
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s)as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project,please
contact me at `?ta-$Z7- 1II 9 ,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
1390> Nc ll Sv
Mailing Address
A•r f /i(d' Z0/91—
City,State,Zip Code
• RECEIVED
DCM Wlt_MINGTON, NC

ippoper- Iiii:
NC Division of Coastal Management 5 4 2 3 A B C2
Cashier's Official Receipt
/ —
Date: � I
20
( 4-14,frH Received From: (\A, Iau $ moe---
Permit No.• Check No.: iro‘k
A—,--10—
Applicant's Name: 4-- i PTAS
County:
Project Address: I N q- 5
(-4) ----
7
Please retain receipt for your records as proof of payment for permit issued.
or
Signature of Agent or Applican • ��il Date:
iffp'
Signature of Field Representa '-: ill.. r` Date:

Date Dat Check From Name of Permit Vendor Check Check Permit Rct. i
Received e Holder Number amount Number/Comments
Dep
osit
ed
1/3/2018 ANA same First 18066 $100.00 minor fee, 104 S. Shore JD rc
Builders/Michael South Dr., SC PnCo 5423
Afify Bank