SC_19-34_ Debnam

Issued by WiRO SC19.34
Surf City Permit Number
CAMA
MINOR DEVELOPMENT
PERMIT
NORTH CAROLINA
as authorized by the State of North Carolina, Department of Environmental Quality 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 Ann Debnam authorizing development in the Ocean Hazard (AECs) at 1421 N. Shore Drive, in Surf City, Pender
County as requested in the permittee's application, dated September 26, 2019, and received by DCM on October 7, 2019.
This permit, issued on October 23, 2019, is subject to compliance with the application and drawing dated received by DCM
on October 7, 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: Addition and/or medication to existing residence(roof replacement).
(1) All proposed development and associated construction must be done in accordance with the permitted drawing, dated received
by DCM on October 7, 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) 796-
7221 for a final inspection at completion of work.
RECEIVED
(Additional Permit Conditions on Page 2) OCT 3 0 2019
DCM WILMINGTON, NC
This permit action may be appealed by the permittee or other qualified persons
within twenty (20) days of the issuing date. This permit must be on the project
site and accessible to the permit officer when the project is inspected for Jason Dail
compliance. Any maintenance work or project modification not covered under CAMA LOCAL PERMIT OFFICIAL
this permit, require further written permit approval.All work must cease when this 127 Cardinal Drive Extension
permit expires on:
Wilmington, NC 28405-3845
December 31,2022
In issuing this permit it is agreed that this project is consistent with the local Land �r V/' riLi y \a`k
Use Plan and all applicable ordinances. This permit may not be transferred to
another party without the written approval of the Division of Coastal PERMITTEE
Management. (Signature required if conditions above apply to permit)

Name: Ann Debnam
Minor Permit#SC19-34
Date: October 23, 2019
Page 2 of 2
(4) The pemiittee is required to contact the Local Permit Officer(910) 796-7221, shortly before he/she 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.
(5) 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.
(6) All development shall be located a minimum distance of 60' landward of the First Line of Stable Natural Vegetation
(FLSNV).
(7) 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.
(8) 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.
(9) Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third-party.
NOTE: All construction must conform to the N.C. Building Code requirements and all other local, State and Federal
regulations, applicable local ordinances and FEMA Flood Regulations.
//141 v
SIGNATURE: DATE:
PERMITTEE
RECEIVED
OCT 30

CNLocality v v' Permit Number O 1 ��
Ocean Hazard , Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
(For official use only)
GENERAL INFORMATION
LAND OWNER-MAILING ADDRESS
Name A n 11 032.1)1 a►1'? -_-- ----_-_-- -- -Address
City l State Zip-LO`l Z 1 Phone gi_D . -L J J 1 a____-
E:mail_TA n h ry_a C n ICI ern mn , 1-
AUTHORIZED AGENT
Name 1 � AB*I
Address
City • V- State • f Ve_. _ Zip Phone ( J
Email LI LLIt/ ) ,_fief
LOCATION OF PROJECT:(Address,street name and/or directions to site;name of the adjacent waterbody.)
I 2I N . 5horc. . , 5Rr-C 0.1; : i IBC a2S415
Qeex) n
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.)
recnnS ruoi 1o�
SIZE OF LOT/PARCEL: 'q i©58 square feet D D B acres
PROPOSED USE: Residential [r (Single-family 12/ Multi-family ❑ ) Commercial/Industrial❑ Other ❑
COMPLETE EITHER(I)OR(2)BELOW(Contact your Local Permit Officer lima are not sure which AEC applies
to your property): a�
—(1) OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE:as pp
o square feet(includes
air conditioned living space,parking elevated above ground level,non-conditioned space elevated above ground level but
excluding non-load-bearing attic space)
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: square feet(includes the area of the foundation of all buildings,driveways,covered decks,
concrete or masonry patios,etc.that arc within the applicable AEC.Attach your calculations with the project drawing.)
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a StateRECEIVED
Stormwater Management Permit issued by the NC Division of Energy,Mineral and Land Resources(DEMLR)?
YES NO v IlCT 0 7 2019

OTHER PERMITS MAY BE 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, HA
Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile Home Park Approval, I lighway Connection,and
Whets.Check with your Local Permit Officer for more information.
STATEMENT OF OWNERSHIP:
1,the undersigned,an applicant for a CAMA minor development permit,being either the owner of property in an AFC or a
person authorized to act as an agent for purposes of applying for a CAMA minor development permit,certify that the person •
listed as landowner on this application has a significant interest in the real property described therein.This interest can be
described as:(check one)
V an owner or record title,Title is vested in name of NatjtAJ1 L ) ruskt.'..5
see Deed Book 46 20 page IZ91 t the r 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) 12 z (',u2J C ureaenl Sa,n NC,
(2)1 r __ _ le_ 238 God-s� Lane. Q enui�' .1 �G ��5� o r73
3 .
(3)
(4)
— -- — -
ACKNOWLEDGEMENTS:
1,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 2 0 day of46112 "'20 ict
L owne71/2r or rson authorized to t as his/her agent for purpose of filing a CAMA permit application
This application includes:general information mation(this form), a site drawing as described on the back of this application, the
ownership statement, the Ocean llaza&AEC Notice whew necessary;a check for$100.00 made payable to the locality, and
any information as nut),be provided orally by the applicant. The details of the application as described by these sources are
incorporated without reference in any permit which may be issued. Deviation Jivm these details will constitute a violation of
any permit.Any person developing in an ABC without permit is subject to civil, criminal and administrative action.

Locoiiiy
Permit Number
11.4 .�+wlaum wir aw
. Ocean Hazard Estuarine Shoreline ORIN Shoreline Public Trust Shoreline Other
(For official use only) _ .n.. .�o .,- •� ._=,..
voiSQ>Meeml iam,l way Mive ibroe str itat,
QoENIE.iI A L IIi4 ORMATIION -
W ell411111111101WONO TRH 1'A1T
LAND OWNER-MA➢➢ANC ADDRESS yoga.imwiall YemorPi in yam/N IK)s id ammiiwa as . s Dell.1
(� 1 " . u AM PO wql i i44ati ar+aaq+tw ad MOM at as tas.a b�e►.wet soa"%nig
Name `l}��� De��
Address—.r._D_.-_i,e2 U JC ___ -'- __ — , x bednar+t+
City. ... 1
Qn _.. .._ Slate l e-> Zip-.23 Phone
2) g1E - A 71- 56 q �-----
EEmail n.0_ lC -_4(..l. G liar) , C(Jrn
AUTIIIORdZIED AGENT
,�w�alb w sari me a aw�wtt*M !NW-
Name cT.ru m - l 1 .
i
t Address tjl,.� ,, �
-
CiflY ' LL
l C_- Zipiii-k f o a6q (o 4
state �Phone � -a � I
Email.. ' Q, • n E
•
LOCAII"IION OF FROJll CC'➢•:(Address,street name and/or directions to site;name of the adjacent waterbody.)
hone, DciO, c.SIAr-f 0.l I\CC� 02g 5 '
/
A+10 r o , °ouch ct.
DESCRIIP'➢TON OF PROJECT: (List all proposed construction and land disturbance.) '*'14+e•4•%:,7. look
Y OCS re(1( nsl ror tor-) +r .l
.,,_., tin ..a.a s.v ts+wi *.0 rt asd mei
SIZE OD LOT/PARCEL: I,D 58 - square feet f ja---- acres smosoloalow rm 1s la sail
PROPOSED U'S&E: Residential Er (Single-family( " Multi-family❑ ) Commercial/Industrial 0 Other 0 ill ;
COi Fll RTIH FATHER(➢)OR(2)BEE OW(CanYeen8Jy'®eaa-Local Pennal?Officer if am are aol sure which AEC applies
do yyeuirpaopeer?,yy)o
•-(II) OCZAN HAZARD AECE Tom 11 FLOOR AREA Ol'iP➢BOI1DOSIIM S 'RUC ITUIIIBEN;:a320 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 S98O'ELMNE AE(Cs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT U
UPON SURFACES: square feet(includes the area of the foundation of all buildings,driveways,covered decks, Z
concrete or masonry patios,etc. that are within the applicable AEC.Attach your calculations with the project drawing.) 67 0
t-
STA➢�E S'II'ORWII`WAVER MANACII.MlENT F[ERNii6'6': Is the project located in an area subject to a State r'
Stemmata-Management Permit issued by the NC Division of Energy,Mineral and Land Resources(DEMLR)? U — -
YES NO 111 �, �
fr u
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: Vlum."rpm 2

1 ..
1 OTElgE g PERM RTS MAY EE RD:QU.1DREED:The activity you are planning may require permits other than the CAMA
minor development permit,including,but not limited to: Drinking Water Well,Septic Tank(or other sanitary waste
treatment system),Building,Electrical,Plumbing,Heating and Air Conditioning,Insulation and Energy Conservation,PIA
Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile Home Park Approval,i lighway Connection,and
others.Check with your Local Permit 0 nicer for more information.
STATEMENT'OF OWilig" Dill?:
I,the undersigned,an applicant for a CAMA minor development permit,being either the owner ofproperty in an AEC or a
person authorized to act as an agent for purposes of applying for a CAMA minor development permit,certify that the person
listed as landowner on this application has a significant interest in the real property described therein.This interest can be
described as:(check one)
V an owner or record title,Title is vested in name of J D ) rL! s- S
see Deed Book 4 I C) page r,z9`"( n the ,S IkEV g r 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.
NOTD1):DCATIIO i OFAII➢.DACENT I IIIPAI18iIAN PROPERTY OWHfEDBS:
I furthermore certify that the following persons are owners of properties adjoining this property. I affirm that I have given
ACTUAiI,NOT11C11s to each of them concerning my intent to develop this property and to apply for a CAMA permit.
•
(I)1Y' (Name) +(Address.).
.6
(2)119.1or ._ me. 2 38 @ u se I ile 8 eui ilM I NC, 251 6 (21753,a-
(3)— — -
(4)
ACKNO`.' ILtDGEM1ENTS: _ , firatf i,.-- s.41..,,.n,y.- f;.,� s!_ . n -r-rtnt..w0 feet s-V a --.:
f,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 stall,
the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information
misted to this permit application. lar+ t+tttllfw"i Wow
V/y� rs 4,,a
't�f -fir
This the 2, 113 day of ;i i;' i Rt ,20 a
e.4 io
. _,._14U lihr�__ _
L owner or on authorized to t as his/her agent for purpose of filing a CAMA permit application
9
This applicali000 indeadeso general information(this form),a she drawing as described on the back of this application, the
ownership statement, the Ocean llaza&AEC Notice where necessaiT; a check for$100.00 made payable to the locality,and
any information as may be provided orally by the applicant. The details of the application as described by these sauwrer are
incorporated without reference in any permit which may be issued.Deviation jinn 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.

ROY COOPER
Governor
r
MICHAEL S. REGAN
Secretary
NORTH CAROLINA BRAXTON DAVIS
Environmental Oualtly
Director
October 24,2019
Ann Debnam
PO Box 55
Atkinson, NC 28421
To Ms. Debnam,
Attached is CAMA Minor Development Permit SC 19-34 for work to be done at 1421 N Shore Drive, 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 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.
Sinc ely,
Ta a K. la
it Support Technician
N.C. Division of Coastal Management
Enclosures
Cc:WiRO files
SC Inspection Dept.
Jennifer D.Augi—Agent
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext.,Wilmington,NC 28405

OCEAN HAZARD AEC NOTICE
Project is in an: Ocean Erodible Area High Hazard Flood Area Inlet Hazard Area
Property Owner: I fl Df210
r nan x
Property Address: 1 2-1i( * 3 r l[5Y Dr, (\5 4 l_.L I CJ ' k A r,
Date Lot Was Platted: .....!!!!! I
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 3I of the third year following the year in which the
require that you receive an AEC Hazard Notice and permit was issued. Shortly before work begins on the project
acknowledge that notice in writing before a permit for site,the Local Permit Officer must be contacted to determine the
development can be issued. vegetation line and setback distance at your site. If the property
has seen little change since the time of permit issuance,and the
The Commission's rules on building standards, oceanfront proposed development can still meet the setback requirement,
setbacks and dune alterations are designed to minimize, but not the LPO will inform you that you may begin work. Substantial
eliminate, property loss from hazards. By granting permits, the progress on the project must be made within 60 days of this
Coastal Resources Commission does not guarantee the safety of setback determination,or the setback must be re-measured.Also,
the development and assumes no liability for future damage to the occurrence of a major shoreline change as the result of a
the development. Permits issued in the Ocean Hazard Area of storm within the 60-day period will necessitate re-measurement
Environmental Concern include the condition that structures be of the setback. It is important that you check with the LPO
relocated or dismantled if they become imminently threatened before the permit expires for official approval to continue the
by changes in shoreline configuration. The structure(s) must be work after the permit has expired. Generally, if foundation
relocated or dismantled within two (2) years of becoming pilings have been placed and substantial progress is continuing,
imminently threatened, and in any case upon its collapse or permit renewal can be authorized. It is unlawful to continue
subsidence. work after permit expiration.
The best available information,as accepted by the Coastal For more information,contact:
Resources Commission, indicates that the annual long-term
average oce r ion rate for the area where your property is \j/M2 JJ ig-/ L—
located is /// feet per year.
Local Permit Officer
The rate was established by careful analysis of aerial
photographs of the coastline taken over the past 50 years.
N.C. Dept. of Environmental Quality
also indicate that the shoreline could move as much asrpo
Division of Coastal Management
feet landward in a major storm. 127 Cardinal Drive Extension
Wilmington, NC 28405-3845
I* waters in a major storm are predicted to be about
Z.- feet deep in this area.
Preferred oceanfront protection measures are beach nourishment 9/0 - W63 —
�- 2'
and relocation of threatened structures. Hard erosion control 7
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.
V
t,4197i1 RECEIVED
q ���1/q� OCTG72019
Property Owner Signature Date
DCM WILMINGTON, NC
Revised May 2010

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September 8, 2019
HOWARD, JACK P
2122 BARBECUE CHURCH RD
SANFORD NC
Dear Mr. Howard,
This letter is to inform you that I, Ann Debnam, have applied for a CAMA Minor
Permit on my property at 1421 N Shore Drive, Surf City, NC 28445, in
Pender/Onslow 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 question or comments about my proposed project,
please contact me at 910-471-5597, or by mail at the address listed below. If you
wish to file written comments or objections with 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,
dzn VZ4a,
Ann Debnam
PO Box 55
Atkinson, NC 28421
RECEIVED
OCT 07 2019
DCM WILMINGTON, NC

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to 1 �fnfOd p be5f(17 fl I/' ;�
z-C..c��� 's
(Name of Property Owner)
property located at J4Z I / t c2r/ (SHO eE .D12► V C
Address, Lot,Block,Road,etc.)
on ATIJ Ync- A c71 iV �uQF. inC-I Ty .N.C.
(Waterbody) (Town and/or Co6nty)
He has described to me as shown in the attached application and project drawing(s),the development he is
proposing at that location,and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
Signature
Print or Type Name
Telephone Number
•
Date
RECEIVED
OCT 072019
DCM WILMINGTON, NC

LAMM
�.ti.�..
=rtr.r.w
.y.ar.ry
41.111
. r�acm°
wr+rr.
ir
JC81 Enterpflses
919 868.6365
Plan #1920
N.Shore/
Debnam
Sht 8
Roof Layout
& Structural
RECEIVED
OCT 07 2019
DCM WILMINGTON, NC

jill,
I\ 1
I - 0
0*
Nu 919.868-6365
Plan i
N.Shore/
Debnam
Sht 1
Isometric
Sketch
RECEIVED
OCT 07 2019
DCM WILMINGTON, NC

., •
•
September 8, 2019
Mr and Mrs Taylor Perdue
238 Gatsey Lane
Beaufort NC 28516
Dear Mr and Mrs Perdue,
This letter is to inform you that I, Ann Debnam, have applied for a CAMA Minor
Permit on my property at 1421 N Shore Drive, Surf City, NC 28445, in
Pender/Onslow 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 question or comments about my proposed project,
please contact me at 910-471-5597, or by mail at the address listed below. If you
wish to file written comments or objections with 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
Si erely,
Ann Debnam
PO Box 55
Atkinson, NC 28421
RECEIVED
OCT 0 7 2019
DCM WILMINGTON, NC

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to ilatitiJoi4 Di2bnam f t 1<s4ee-S 's
I (Name of Property Owner)
property located at lk� \ I` I t t2T H 51-k-t,R
1 Address, Lot, Block,Road,etc.)
on kVi-t'<1\ri l C, DL (\( , in c51,.4 t- ( UT , N.C.
(Waterbody) (Town and/or County)
He has described to me as shown in the attached application and project drawing(s),the development he is
proposing at that location,and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
Signature
Print or Type Name
Telephone Number
•
Date
RECEIVED
OCT 07 2019

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JCBJ Enterprises
9i9.868-6365
Plan #1920
N.Shore/
Debnam
Sht 8
Roof Layout
& Structural
RECEIVED
OCT 4 7 2 Oi0
r1f'RA 1A1II RAIKInTflK) [5.I(`

_„,
iri- 1
1—›— 1->— :1
0 XEU Enterprises
9194486365
Plan #
N.Shore/
Debnam
Sht l
Isometric
Sketch
RECEIVED
OCT C72019
DCM WILMINGTON, NC

Locality Permit Number It Wit'` 'q rsrf
i •
- Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
(For official use only) ..,v ; ,an> + . 41 r drtr*
GENERAL INFORMATION .
rIVIVOISOPPIWO 110 TINIMPIrrilktP
LAND OWNER-MAILING ADDRESS -pie Amoy mairmintwralb is io AMA')* *.borterembau and
A �� mile A')a'MII tt �, . w lave
Name 1 2.2�1-rt m
Address � ; X 5 5 t4turroi .sit txsommesb
City--Pc_ �1_ — State __Sc., Zip_284zi Phone'
Email_ gain l iY91)(m !7 bLn 1�
AUTHORIZED AGENT *" sir or yet"a*�a
Name
. � - a a�=: .' 4, :, . alit*i -tom •
Address t. 1 L 4 t,t
City - . t State I..} - ZipA`) 5 Phone _gip. -- a 54 -a(o 2 i n~
Email Qrl 13b1A`v 1 ' - e+ 1► F l ,441, a*--,a-0..1p
LOCATION OF PROJECT:(Address,street name and/or directions to site;name of the adjacent waterbody.)
bore 0,1l40 02gz-1-1 5
OOP
(4.!
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) #
_---- -mar —,d
o( _f fl n oo J I r k
11
VW; .craw...
SIZE OF LOT/PARCEL: 1 i()5 t7 square feet D,_O acres Aroudeowileeitivill
PROPOSED USE: Residential [r (Single-family Er Multi-family 0 ) Commercial/Industrial® Other 0
COMPLETE EITHER(I)OR(2)BELOW(Coeliac!your Local Permit Officer if j'orr are no!sure which AEC applies
to your property):
(1) OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE:Z320 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) rotrhitriverffm,, if< •
(2) COASTAL SHORELINE AM: SIZE OF BUILDING FOOTPRINT ANI)OTHER IMPERVIOUS OR BUILT
UPON SURFACES: square feet(includes the area of the foundation of all buildings,driveways,covered decks,
concrete or masonry patios,etc.that arc within the applicable AEC.Attach your calculations with the project drawing.)
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a State t•t CEIVED
Stormwater Management Permit issued by the NC Division of Energy,Mineral and Land Resources(DEMLR)?
YES NO v ' JLi 0i ,_uu
If yes,list the total built upon area/impervious surface allowed for your lot or narcel: smiarn font

OTHER PERMITS MAY BE REQUIRED:The activity you are planning may require permits other than the CAMA
minor development permit,including,but not limited to:Drinking Water Well,Septic Tank(or other sanitary waste
treatment system),Building,Electrical,Plumbing,Heating and Air Conditioning,Insulation and Energy Conservation,HA
Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile i-lome Park Approval, i lighway Connection,and
others. Check with your Local Permit Officer for more information.
STATEMENT OF OWNERSHIP:
1,the undersigned,an applicant for a CAMA minor development permit,being either the owner of property in an AF.0 or a
person authorized to act as an agent for purposes of applying for a CAMA minor development permit,certify that the person
listed as landowner on this application has a significant interest in the real property described therein.This interest can be
described as:(check one)
an owner or record title,Title is vested in name of 14,1Wki J) )3'a J ri.45"kin
see Deed Book AO 20 page I 2.2:111 the ' �" ° 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:
1 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 • (Addres
(I) 21 2Z &Arb2P (1J1LU'(.h �,n NCB
(2) .10r ._ 'CLAP. zss @ t t Lane, 6 ecu r , NCB R261 to a r/53
(3)—— —
(4)
ACKNOWLEDGEMENTS: tart - f,:tvio.tertimettr2 ,o mirt, „
1,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 ftoodproofing techniques.
wow
1 furthermore certify that I am authorized to grant,and do in.fact grant,permission to Division of Coastal Management stall,
the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information
related to this permit application.=a`goroppoiwo w,^3/4w..t,vimik n.w.: i w ►.l ll t '
� ��� This the ZLc' day of i 41f" H ,20
'TO _ .. _.
L owner or rson authorized to 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 tliis application, the
ownen-hip statement, the Ocean llaza►r/AEC Notice where necessar7; a check for$100.00 made payable to the locality,and
any information as may be provided orally by the applicant. The details of die application as described by these sornres are
incorporated wit/rout reference in any permit which may be issued.Deviation fivin these details will constitute a violation of
any permit.Any person developing in an ABC without permit is subject to civil,criminal and administrative action.
wls.was mioy mitt

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: A n n L) bncirri
Mailing Address: PD E. 55
PAnsun r 2s)-1 1
Phone Number: 6110 - 2 g3 54 II me. coo- 171 - aill 5591
Email Address: C k i n n ielCC3 C) en @ �� DO . CO(')
I certify that I have authorized TeA n;•cYAtIc ci QI itQ l/lioy
Agent/ContractorJ
to act on my behalf, for the purpose of applying for and obtaining all
CAMA permits
necessary for the following proposed development: Z) r\terriii aio v' N.,
wr-f City i 1 (rcb odf I n e,
at my property located at 1 21 S)'1p'(e .Dr j Sur-f Cstj NC
in Pander County.
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.
Property Owner Information:
.6k rzo
Signature
AN'N JEr3N/A rV\
Print or Type Name
Title
RECEIVED
Date OCT 07 20;,)
DCM WILMINGTON, NC
This certification is valid through 16

- NOTES-
1.THIS SURVEY IS OF AN EXISTING PARCEL OF LAND.2.SUBJECT TO RESTRICTIVE COVENANTS,EASEMENTS OF
RECORD,ZONING ORDINANCE,&UNDERGROUND UTILITIES,IF ANY.
3.NO TITLE SEARCH BY SURVEYOR. •
z.�` 010:ITE
4.REFERENCES;DB 4620 PG 1287;MB 3,PG 86
.03
5.FLOOD ZONE:VE(EL 14&15) `
NCFIRM MAP#3720-424500-K,EFFECTIVE DATE 02/16/2007 �a� +�� N
6.ZONE:R-5-SURF CITY y
SETBACKS:FRONT-15', SIDE-7.5',REAR-20'
7.FLOOD ZONES SCALED FROM GIS "< ATLANTIC OCEAN
___------ EIP VICINITY MAP (NTS)
m l�
410
m; EXISTING 20' ACCESS
Irn
N53°53'1TE 50.00'
SIR
SIR -
i�PO
N
�o� 20'MBL IMPERVIOUS CALCULATIONS:
C, Z 8.9.r DEEDED LOT AREA-4,050 SF(0.09 AC)
EXISTING BUILDING-988 SF
EXISTING DRIVEWAY-483 SF
EXISTING j c4 TOTAL IMPERVIOUS COVERAGE:1,471 Sr(36.3%)
�o TOTAL.ALLOWABLE BUA:1,620 SF(40%)
: 41'X24.5' a
TAYLOR PERDUE r° • , 1 RESIDENCE : Fric`„ "IDB 11155,PG 337 te -
n m
0° � r- T. JACK HOWARD
r � 02
DB442,PG14
8.9' : 16 8'
••�� � RECEIVED
10'DEIKv • •
.• ala0, 15'MBL O C T Q 7 2 019
of co
EIPD EIPD . . < .. �• DCM WILMINGTON, NC
• •
Y N52°41'5TE 48.61' 7 . .. S53°03'17"Vlr•'e,00' SIR LEGEND
'/ EXISTING . SIR 1/2"Set Iron Rod
/ EIP-Existing Iron Pipe
/ PP • 24'C• ONC.- EIR Existing Iron Rod
/� R1V�WAY. ECM Existing Concrete Monument
�%/ S CP-Calculated Point
e..,.. R/W-Right-of-Way
o/ _-_ • . DB-Deed Book
,/ MB Map Book
WI
y/ N. SHORE DRIVE PG Page -PropertyLineSurveyed
IV/ (50'PUBLIC RAN) ------- Property Line Not Surveyed
cat
PROPERTY INFORMATION:
EIR /� OWNER:HAYWOOD DEBNAM,TRUSTEES
d- -- --_--• ADDRE_pS:3900 Q.QUpa IR&IL--
ATKINSON,NC 28421
�o �_

1. . Postal ServiceTM
CERTIFIED MAIL® RECEIPT
Domestic Mail Only
mFor delivery information,visit our website at www.usps.com
f Certified Mall Fee
tti $ $3,50 0425 •
Dateru t /n / Extra Services&Fees(checkbox edd reef*. a 08
r iv f j 1 Y i/�wb ❑Retun Receipt(hardcopY) $ t RECEIVED
�,•�, ru Return Receipt(electronic) $ 40.Ot1.. Postmark
NacinteoPrty Ow ter D ❑CertHled Mall Restricted Delivery $ $p fyly e
uric
/�' Y �� p ❑Adult Signature Required $.—� �y.pp� (� /�toliri �� ^ ❑Adult Signature Restricted Delivery: fly e OCT T 0 7 2019
rr
Postage
$0.55
City,State,Zip Code m To05
$ Po
stage DCIVP I.W8TON, NC
m Sent To a Li' per w, .
Street d t o r1 _•
,__ --_... ._....
' 1_4G n0--
Dear Adjacent Property: '6 e zzt
1 PS Form 3800,April 2015 PSN 7530•02-000.9047 See Reverse for Instructions
This letter is to inform you that I. Ai'i r DP brn n have applied for a CAMA Minor
Property Owner
Permit on my property at lq Z1 i$rl.h cSh1re b Ve,
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 9 any questions or comments about my proposed project,please
contact me at , -r J" 1 1 1 ,or by mail at the address listed below. If you wish to
Applicants Telephone
file written comments or objections with the Surf City CAMA Minor Permit Program,you may submit
them to:
Jason Dal,Field Representative
NC Division of Coastal Management
Town of Surf City Local Permit Program
127 Cardinal Drive Extension
Wilmington,NC 28405
Sincerely,
An t Jbncrn
Property Owner
Po ,t3ai
Mailing Address
} rksori it 274 I
City,State,Zip Code I
RECEIVED
OCT 072019
DCM WILMINGTON, NC

1. . •ostal ervice '
CERTIFIED M^rr " RECEIPT
N- Domestic Mail Only
143
m For delivery information.visit our website at www.usps.com
" tFF23IAL, USE
a -A - ; ru s P- Certified Mail Fee #,..a 5il 0425
D ///��� rr/' ���]J /"J� ra Extra Services&Fees(check box.add rea I 08
-1` IAat L.1 ❑Return Receipt(herdcoP» $ -.1 I� , C E i V E D
rU ❑Return Receipt(electronic) $ $( 00 Postmark
Me4Aopeti2lOwnnectilL //�� f /' 0 Certified Mall Restricted Delivery $ $0I.00 Here
C ilvcI^ O ❑Adult Signature Required $ $(�t.0 � 0CT f? 7 2019
r) ❑Aduk Signature Restricted Delhrery$
o Postage $0.55
1 33 O Total Postage and Fees IX;WI yy L14 i 7A' 9NC
City,State,Zip Code m $ $4.05
co Sent To
r•a Q C� eZJa.
o street or : ,,
/ 'yi v rcw
C;a Mate / .,
Dear Adjacent Property: �C ,; • c C 32733 a__
PSForm 3800,April 2015:'SN 7530-02-000-9047 See Reverse for Instructions
This letter is to inform you that I, Ann Deb nCin have applied for a CAMA Minor
Property Owner
Permit on my property at 1121 174 SfItYQ Dv Sue((f f,f/ ,in Pender/Onslow
s J Property Addre
County. As required by CAMA regulations,I have enclosed a copy of my permit application and project
drawings)as notification of my proposed project.No action is required from you or you may sign and return
the enclosed no ectio have any questions pr comments about my proposed project,please
at ( 7.1f
` J ,or mail at the address listed below. If you wish to
contact meY
Applicant's Telephone
file written comments or objections with the Surf City CAMA Minor Permit Program,you may submit
them to:
Jason Dal,Field Representative
NC Division of Coastal Management
Town of Surf City Local Permit Program
-
127 Cardinal Drive Extension
Wilmington,NC 28405
Sincerely,
Pon th cwi
Property Owner
P1) &L55
Mailing Address
ht 6 i\) 1 � lC 955E-0e
City,State,Zip Code
RECEIVED
• OC.c Q 7 201c,
..... Immo MN, NC

ilil NC Division of Coastal Management
Cashier's Official Receipt 8 5 7 3 A B ��
Date: 20 L7
Received From: i fillAM,l ftA, N ( $ tt t
7 q '7--
Permit No.: Check No.: V
Applicant's Name: Nal% ^I ift-WV" - County: `
Project till
Address: 44111 Ns , / Ci
.
Please retain receipt for your records as proof of payment for permit issued.
Signature of Agent or Applicant: Date:
Signature of Field Representative: Date:11) 7_7(

late Date Check From Name of Vendor Check Check Permit Rct. #
.eived Deposited Permit Holder Number amount Number/Comments
/2019 Jennifer and Ann Debnam First 3697 $100.00 minor fee, 1421 N Shore Drive, JD rct.
Richard Augi Citizens Surf City PnCo 8573
Bank

cite Date Check From Name of Vendor Check Check Permit Rct. #
eived Deposited Permit Holder Number amount Number/Comments
/2019 Jennifer and Ann Debnam First 3697 $100.00 minor fee, 1421 N Shore Drive, JD rct.
Richard Augi Citizens Surf City PnCo 8573
Bank