SC_19-13_ Dixon

11
Issued by WiRO SC19-13
Surf City Permit Number
CAMA
MINOR DEVELOPMENT
tic
PERMIT
NORTH CAROLINA
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 Jason and Melissa Dixon authorizing development in the Estuarine Shoreline (AEC) at 142 Atkinson Road,
in Surf City, Pender County as requested in the permittee's application, dated March 7, 2019, and received by DCM on
March 8, 2019. This permit, issued on March 29, 2019, is subject to compliance with the application and drawing dated
and received by DCM on March 8, 2019 (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: Proposed residential dwelling with driveway, retaining wall and parking areas.
(1) All proposed development and associated construction must be done in accordance with the permitted site drawing dated
received by DCM on March 8, 2019.
(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)
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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 -J
site and accessible to the permit officer when the project is inspected for Jason Dail CC ..
compliance. Any maintenance work or project modification not covered under C A LOCAL PERMIT OFFICIAL
this permit,require further written permit approval.All work must cease when this U
permit expires on: 127 Cardinal Drive Extension a
NC 28405-3845 01..l
December 31,2022
In issuing this permit it is agreed that this project is consistent with the local Land z�
Use Plan and all applicable ordinances. This permit may not be transferred to
another party without the written approval of the Division of Coastal PFRMITTFF

. �
Name: Jason and Melissa Dixon
Minor Permit#SC19-13
Date: March 29, 2019
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) With exception of 182 sq. ft. of elevated, slatted uncovered wood decking and retaining wall, all other development
shall be located at least 30' landward of the normal high water line.
(7) 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.
(8) The proposed retaining wall construction shall be located above(landward)of all wetlands.
(9) This permit does not authorize the excavation or filling of wetlands or open water areas, even temporarily.
(10)Because the plan of development exceeds 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.
(11)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.
(12)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.
(13)Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third-party.
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SIGNATUR : DATE: u1
PERMITTEE U r
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]/t&/ Y‘Ii5j t 61---1 1, OTHER PERMITS MAY BE REQUIRED:The activity you are planning may require permits other than the CAMA
Locality Permit Number �t//C 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 Dime,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 Jason Michael Dixon and wife,Melissa Dawn Dixon 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 45-725A Lanipola Place
Om owner or record title,Title is vested in Fee Simple see Deed Book 4440
City Kaneohe State HI Zip 96744 phone [phone] page 29 in the Pender County Registry of Deeds.
Email [e-mail]
man owner by virtue of inheritance.Applicant is an heir to the estate of ,
AUTHORIZED AGENT probate was in County.
Name Charles F. Riggs&Associates, Inc. Elf other interest,such as written contract or lease,explain below or use a separate sheet&attach to this application.
Address P.O. Box 1570 NOTIFICATION OF ADJACENT PROPERTY OWNERS:
City Jacksonville State NC Zip 28541 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.
Email [e-mail] (Name) (Address)
(1) Mr.and Mrs.John Lee Brogan,Jr., 1920 Blue Slate Court, Raleigh, NC 27603
LOCATION OF PROJECT:(Address,street name and/or directions to site.If not oceanfront,what is the name of the
adjacent waterbody.)142 Atkinson Road,Surf City,Pender County (2) Qi Chen and Aron W.Kimmerly,9 Hopewell Drive,Durham,NC 27705
(3)
DESCRIPTION OF PROJECT:(List all proposed construction and land disturbance.) Proposed Two Story (4)
Dwelling on Pilings with Decks Over Concrete Slab Enclosed below for Entry,Storage and
SIZE OF LOT/PARCEL: 6,806 square feet 0.156 acres Garage with Pervious Drives ACKNOWLEDGEMENTS:
I,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
PROPOSED USE:Residential❑✓ (Single-family 0 Multi-family❑) Commercial/Industrial❑ Other ❑ 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):
I furthermore certify that I am authorized to grant,and do in fact grant,permission to Division of Coastal Management staff,
(1) OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE:N/A square feet(includes the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information
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) 'l �/ /
(2) COASTAL SHORELINE AECs:SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT / This the f/ day of/sAK°+w,20
UPON SURFACES:1,258 square feet(includes the area of the roof/drip line of all buildings,driveways,covered decks, ad
concrete or masonry patios,etc.that are within the applicable AEC.Attach your calculations with the project drawing.)
Landowner or person authorized to act as,, er.,le. dt pu se 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 info r tio, thi form),a site drawing as described on the back of this application,the
YES I1 NOI I ownership statement,the Ocean Hazard A:C No e where necessary,a check for S100.00 made payable to the locality and
1,330 any information as may be provided orally by e applicant.The details of the application as described by these sources are
If yes,list the total built upon area/impervious surface allowed for your lot or parcel: square feet. 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,criminal and administrative action.
RECEIVED
MAR &.8 2019
nr_nt WI MINGTON. NC

ROY COOPER
41106::- Governor
rMICHAEL S. REGAN
Secretary
NORTH CAROLINA BRAXTON DAVIS
Environmental'ihrcriir, Director
March 29, 2019
Jason and Melissa Dixon
45-725A Lanipola Place
Kaneohe, HI 96744
Dear Mr. & Mrs. Dixon,
Attached is CAMA Minor Development Permit SC 19-13 for work to be done at 142 Atkinson Rd., in Surf
City, Pender County. An electronic copy has been sent to the Topsail Beach Inspections Department and
your Agent.
To validate this permit, please sign both copies as indicated for our records. Retain the orange copy for
your files, and 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,
ya . Pi tila
ermit upport Technician
N.C. Division of Coastal Management
Enclosures
Cc:WiRO files
TB Inspection Dept.
Charles Riggs—Agent
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext.,Wilmington,NC 28405
010706771c

SITE DRAWING/APPLICATION CHECKLIST
Please make sure your site drawing includes the following information required for a CAMA minor development permit.
The Local Permit Officer will help you,if requested.
PHYSICAL DIMENSIONS 0 COMM/ APPLICATION FOR
/Label roads *ON CAMA MINOR
Label highways right-of-ways
Label local setback lines DEVELOPMENT
Label any anddall structures and driveways currently existing on property
Label adjacent waterbody
PHYSICAL CHARACTERISTICS )C PERMIT
_."-JD.and label normal high water line(contact LPO for assistance) In 1974,the North Carolina General Assembly passed the Coastal Area Management Act
/Draw location of on-site wastewater system
(CAMA)and set the stage for guiding development in fragile and productive areas that
If you will be working in the ocean hazard area: border the state's sounds and oceanfront.Along with requiring special care by those who
1Draw and label dune ridges(include spot elevations) build and develop,the General Assembly directed the Coastal Resources Commission
Draw and label toe of dunes (CRC)to implement clear regulations that minimize the burden on the applicant.
Identify and locate first line of stable vegetation(contact LPO for assistance)
_Zpraw and label erosion setback line(contact LPO for assistance) This application for a minor development permit under CAMA is part of the
"Draw and label topographical features(optional) Commission's effort to meet the spirit and intent of the General Assembly.It has been
designed to be straightforward and require no more time or effort than necessary from
If you will be working in a coastal shoreline area: the applicant.Please go over this folder with the Local Permit Officer(LPO)for the
,how the roof overhang as a dotted line around the structure locality in which you plan to build to be certain that you understand what information he
.apraw and label landward limit of AEC or she needs before you Orpraw and label all wetland lines(contact LPO for assistance)
Draw and label the 30-foot buffer line Under CAMA regulations,the minor permit is to be issued within 25 days once a
DEVELOPMENT PLANS complete application is in hand.Often less time is needed if the project is simple.The
process generally takes about 18 days.You can speed the approval process by making
w and label all proposed structures certain that your application is complete and signed,that your drawing meets the
J)raw and label areas that will be disturbed and/or landscaped specifications given inside and that your application fee is attached.
/Note size of piling and depth to be placed in ground
/Draw and label all areas to be paved or graveled Other permits are sometimes required for development in the coastal area.While these
how all areas to be disturbed are not CAMA-related,we urge you to check with the Local Permit Officer to determine
Show landscaping which of these you may need.A list is included on page two of this folder.
NOTE TO APPLICANT
We appreciate your cooperation with the North Carolina Coastal Management Program
Have you: and your willingness to build in a way that protects the resources of our beautiful and
• completed all blanks and/or indicated if not applicable? productive coast.
• notified and listed adjacent property owners?
• included your site drawing? Coastal Resources Commission
• signed and dated the application?
Division of Coastal Management
• enclosed the$100.00 fee?
• completed an AEC Hazard Notice,if necessary?(Must be signed by the property owner)
FOR STAFF USE C
y
Site Notice Posted Final Inspection Fee Received ❑
Site Inspections
Zr
❑C
Date ofActiy,isat rrtempted Denied Appeal Deadline(20 days from permit action) DCM Form EB1952-2010/Resised April 2010
MAR G.8 ",_9;9
kin

CHARLES F. RIGGS &ASSOCIATES, INC.
Land Surveyors
Charles F.Riggs,P.L.S.L-2981 Corporate License(C-730) James A.Lewis,P.L.S.L-4562
502 New Bridge Street 502 New Bridge Street Landfall Executive Suites
Jacksonville,North Carolina 28540 P.O.Box 1570 1213 Culbreth Drive
[phone] Jacksonville,North Carolina 28541 Wilmington,North Carolina 28405
[e-mail] [phone] [phone]
[e-mail]
March 7, 2019
To: Mr. Jason Dail
Division of Coastal Management
North Carolina Department of Environmental Quality
127 Cardinal Drive
Wilmington,North Carolina 28405
Re: Jason Michael Dixon and wife, Melissa Dawn Dixon
Submittal for Minor CAMA Permit
Dear Mr. Dail:
On behalf of Jason Michael Dixon and wife, Melissa Dawn Dixon, Charles F. Riggs &Associates,
Inc. submits for your review the enclosed application for a Minor CAMA permit for the property at 142
Atkinson Road, Surf City, Pender County,North Carolina.
Re ectfully,
il
James L. Riggs
RECEIVED
MAR C.8 2019

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
July 10, 2018
Date
Name of Property Owner Applying for Permit:
Jason Michael Dixon and wife, Melissa Dawn Dixon
Mailing Address:
45-725A Lanipola Place
Kaneohe, HI 96744
I certify that I have authorized (agent) Charles F. Riggs & Assoc. to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) proposed dwelling, as shown on map
at (my property located at) 142 Atkinson Road, Surf City, Pender County
and I grant permission to the Division of Coastal Management to access
the property to mark/flag the First Line of Stable Natural Vegetation, etc.
This certification is valid thru (date) July 10, 2019
July 10, 2018
Property Owner Signature Date
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: Jason Michael Dixon and wife, Melissa Dawn Dixon
Address of Property: 142 Atkinson Road, Surf City, Pender County
(Lot or Street#, Street or Road, City&County)
Agent's Name#: Charles F. Riggs & Assoc. Mailing Address: P. O. Box 1570
Agent's phone#: [phone] Jacksonville, NC 28541
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.
I 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. Contact information for DCM offices is
available at www.nccoastalmanaaementnet/contact dcm.htm or by calling 1-888-4RCOAST. No
res onse is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pi , ck, mooring pilings, breakwater, boathou , , or groin must be set
back a minimum distance of my area of riparian ac nless waived by me. (If you
wish to waive the setback, you must i ' ' the ap ' e blank below.)
I do wish to waive setback requi t.
I of wish to waive the 15' setback requirement.
(Propert er Info ation (Adjacent Property Owner Information)
Signature Signature
Charles F. Riggs, ag application
Print or Type Name Print or Type Name Z
P. O. Box 1570
Mailing Address Mailing Address
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Jacksonville, NC 28541 > z
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13/4,71/
Date Date

CHARLES F. RIGGS & ASSOCIATES, INC.
Land Surveyors
Charles F.Riggs,P.L.S. L-2981 Corporate License(C-730) James A.Lewis,P.L.S. L-4562
502 New Bridge Street 502 New Bridge Street Landfall Executive Suites
Jacksonville,North Carolina 28540 P.O.Box 1570 1213 Culbreth Drive
[phone] Jacksonville,North Carolina 28541 Wilmington,North Carolina 28405
[e-mail] [phone] [phone]
[e-mail]
March 7, 2019
Mr. and Mrs. John Lee Brogan, Jr.
1920 Blue Slate Court
Raleigh, NC 27603
Re: Jason Michael Dixon and wife, Melissa Dawn Dixon
Submittal for Minor CAMA Permit
Dear Mr. and Mrs. Brogan:
On behalf of Jason Michael Dixon and wife, Melissa Dawn Dixon, Charles F. Riggs & Associates,
Inc. is submitting to the Division of Coastal Management, North Carolina Department of Environmental
Quality the enclosed application for a CAMA permit for the property located at 142 Atkinson Road,
Surf City, Pender County, North Carolina. Jason Michael Dixon and wife, Melissa Dawn Dixon are
planning to construct a two-story dwelling on pilings with decks over concrete slab enclosed below for
entry, storage, and garage with pervious drives. We are required to notify the adjoiners of this submittal.
Please review the package and sign, address and date the form provided and place a check and
your initials beside whether you have objections or no objections to this. If you have no objections,
please return the form to us in the self-addressed stamped envelope provided. If you have objections,
please send the form along with your comments to Mr. Jason Dail, Division of Coastal Management,
N.C. Department of Environmental Quality, 127 Cardinal Drive, Wilmington, NC 28405 within 10 days
of receipt of this notice.
Respectfully,
es L. Riggs
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endorsement on the mailpiece,you may request Certified Mail item at a Post Office'"for
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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.

CHARLES F. RIGGS & ASSOCIATES, INC.
Land Surveyors
Charles F.Riggs,P.L.S. L-2981 Corporate License(C-730) James A.Lewis,P.L.S.L-4562
502 New Bridge Street 502 New Bridge Street Landfall Executive Suites
Jacksonville,North Carolina 28540 P.O.Box 1570 1213 Culbreth Drive
[phone] Jacksonville,North Carolina 28541 Wilmington,North Carolina 28405
[e-mail] [phone] [phone]
[e-mail]
March 7, 2019
Qi Chen and
Aron W. Kimmerly
9 Hopewell Drive
Durham,NC 27705
Re: Jason Michael Dixon and wife, Melissa Dawn Dixon
Submittal for Minor CAMA Permit
Dear Qi Chen and Aron Kimmerly:
On behalf of Jason Michael Dixon and wife, Melissa Dawn Dixon, Charles F. Riggs & Associates,
Inc. is submitting to the Division of Coastal Management, North Carolina Department of Environmental
Quality the enclosed application for a CAMA permit for the property located at 142 Atkinson Road,
Surf City, Pender County, North Carolina. Jason Michael Dixon and wife, Melissa Dawn Dixon are
planning to construct a two-story dwelling on pilings with decks over concrete slab enclosed below for
entry, storage, and garage with pervious drives. We are required to notify the adjoiners of this submittal.
Please review the package and sign, address and date the form provided and place a check and
your initials beside whether you have objections or no objections to this. If you have no objections,
please return the form to us in the self-addressed stamped envelope provided. If you have objections,
please send the form along with your comments to Mr. Jason Dail, Division of Coastal Management,
N.C. Department of Environmental Quality, 127 Cardinal Drive, Wilmington, NC 28405 within 10 days
of receipt of this notice.
Res ctfully f /
James L. Riggs
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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.
nportani 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,whict
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
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. USPS 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.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.

OCEAN HAZARD AEC NOTICE
Project is in an: Ocean Erodible Area High Hazard Flood Area Inlet Hazard Area
Property Owner: Jason Michael Dixon and wife, Melissa Dawn Dixon
Property Address: 142 Atkinson Road,Surf City,Pender County
Date Lot Was Platted: April 2014
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 dabs 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
located is feet per year.
Local Permit Officer
The rate was established by careful analysis of aerial
photographs of the coastline taken over the past 50 years.
Studies also indicate that the shoreline could move as much as 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.
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The applicant must acknowledge this information and Z
requirements by signing this notice in the space below. Without 0-, Z
the proper signature.the application will not be complete. oC. / O
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Property Owner Signature Date CC
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Revised May 2010

U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008
Federal Emergency Management Agency Expiration Date: November 30, 2018
National Flood Insurance Program
ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
Copy all pages of this Elevation Certificate and all attachments for(1) community official, (2) insurance agent/company, and (3)building owner.
SECTION A-PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owner's Name Policy Number:
JASON MICHAEL DIXON&WIFE, MELISSA DAWN DIXON
A2. Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Company NAIC Number
Box No.
142 WALTER R. ATKINSON ROAD
City State ZIP Code
SURF CITY North Carolina 28445
A3. Property Description (Lot and Block Numbers,Tax Parcel Number, Legal Description, etc.)
LOT 6,THE PENINSULA AT TOPSAIL
A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory, etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat.34d24'51"N Long.77d34'09"W Horizontal Datum: ❑ NAD 1927 ❑x NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 6
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 1320.00 sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s)within 1.0 foot above adjacent grade 7
c) Total net area of flood openings in A8.b 1400.00 sq in
d) Engineered flood openings? ❑Yes ❑x No
2
A9. For a building with an attached garage: 0 C
a) Square footage of attached garage 0.00 sq ft j L
Z
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0 U
L.11c) Total net area of flood openings in A9.b 0.00 sq in CC 3
d) Engineered flood openings? ❑Yes ❑x No
C
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1. NFIP Community Name&Community Number B2. County Name B3. State
TOWN OF SURF CITY 370186 PENDER North Carolina
B4.Map/Panel 85.Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s)
Number Date Effective/ Zone(s) (Zone AO, use Base Flood Depth)
Revised Date
3720423400 J 02-16-2007 02-16-2007 AE 8.0'
B10. Indicate the source of the Base Flood Elevation (BFE)data or base flood depth entered in Item B9:
❑ FIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source:
B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes ❑x No
Designation Date: ❑ CBRS ❑ OPA
1 I I

OMB No. 1660-0008
ELEVATION CERTIFICATE Expiration Date: November 30, 2018
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Policy Number:
142 WALTER R.ATKINSON ROAD
City State ZIP Code Company NAIC Number
SURF CITY North Carolina 28445
SECTION C—BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: 0 Construction Drawings* ❑Building Under Construction* [] Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations—Zones A1—A30,AE,AH,A(with BFE),VE,V1—V30,V(with BFE), AR, AR/A,AR/AE,AR/A1—A30,AR/AH, AR/AO.
Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters.
Benchmark Utilized: NC CORS Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a)through h) below.
❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source:
Datum used for building elevations must be the same as that used for the BFE.
Check the measurement used.
a) Top of bottom floor(including basement, crawlspace, or enclosure floor) 4.50 x❑ feet ❑ meters
b) Top of the next higher floor 14.50 ❑x feet ❑ meters
c) Bottom of the lowest horizontal structural member(V Zones only) N/A ❑ feet ❑meters
d) Attached garage(top of slab) N/A ❑ teet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building 10.10 ❑x feet El meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished) grade next to building (LAG) 4.10 ❑x feet ❑ meters
g) Highest adjacent(finished)grade next to building(HAG) 4.20 0 feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A ❑ feet [1] meters
structural support
SECTION D—SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor,engineer, or architect authorized by law to certify elevation information.
I certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false
statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
Were latitude and longitude in Section A provided by a licensed land surveyor? ❑Yes ❑No ❑Check here if attachments.
Certifier's Name License Number
JAMES A. LEWIS L-4562 ,.``�N ICAiii,/ /
Title .` •. �i
PROJECT MANAGER OQ'•OFf�SS/0�.�9'�
Company Name = . 4 SELL r —
CHARLES F. RIGGS &ASSOCIATES, INC. _ • —
Address �9 L-4�2 O�•
e ...-:
502 NEW BRIDGE STREET o �''• ,�f
City State ZIP Code /�''i FS A. `* ' \`‘
JACKSONVILLE North Carolina 28540 ��rri i I ���
Signature Date Telephone Ext.
b —7 9 /Pi [phone] 41
Copy all ges of this Elevation Certificate and all attachments for(1 co munity official, (2)insurance agent/company, and(3)building owneb
Comments(including type of equipment and location,per C2(e), if applicable)
PROPOSED DWELLING IS TWO STORY ON PILINGS, ENCLOSED BELOW. CIZO
W (—
PRELIMINARY FLOOD MAPS SHOW A CHANGE IN BASE FLOOD ELEVATION TO 10.0',THEREFORE SURVEYOR> Z
RECOMMENDS PLACING MACHINERY OR EQUIPMENT SERVICING THE BUILDING AT AN ELEVATION OF 10.1'QU HIGHER.
0
CC §

Date Date Check From Name of Vendor Check Check Permit Rct,
Received Deposited Permit Holder Number amount Number/Comments
3/11/2019 Charles F. Riggs and Jason and Melissa First 16015 $100.00 minor fee, 142 Atkinson Road, JD rct.7
Associates Inc. Dixon Citizens Surf City PnCo
Bank