SC_19-37_ Tyndall

Issued by WiRO SC19.37
Surf City Permit Number
CAMA
MINOR DEVELOPMENT
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 Mark and Deborah Tyndall authorizing development in the Estuarine Shoreline (AEC) at 1037 First Street, in
Surf City, Onslow County as requested in the permittee's application, dated October 15, 2019, and received by DCM on
October 15, 2019. This permit, issued on October 31, 2019, is subject to compliance with the application and drawing
dated and received by DCM on October 15, 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: Construction of a single family residence.
(1) All proposed development and associated construction must be done in accordance with the permitted site drawing dated
received by DCM on October 15, 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)
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 J son Dail
compliance. Any maintenance work or project modification not covered under CA LOCAL PERMIT OFFICIAL
this permit,require further written permit approval.All work must cease when this
permit expires on: 127 Cardinal Drive Extension
Wilmington, NC 28405-3845
December 31,2022
In issuing this permit it is agreed that this project is consistent with the local Land
Use Plan and all applicable ordinances. This permit may not be transferred to
another party without the written approval of the Division of Coastal PERMITTEE

Name: Mark and Deborah Tyndall
Minor Permit#SC19-37
Date: October 31, 2019
Page 2 of 2
(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) 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.
(7) This permit does not authorize the excavation or filling of wetlands or open water areas, even temporarily.
(8) 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.
(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.
SIGNATURE: IC �' "" DATE: k //-/7-/9
PERM ITTEE

Name: Mark and Deborah Tyndall
Minor Permit#SC19.37
Date: October 31, 2019
Page 2 of 2
(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) 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.
(7) This permit does not authorize the excavation or filling of wetlands or open water areas, even temporarily.
(8) 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.
(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.
SIGNATURE: DATE:
PERMITTEE

1 )
Locality U' `F — ` t ( 0 Permit Numbers ��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
Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other treatment system),Building,Electrical,Plumbing,Heating and Air Conditioning,Insulation and Energy Conservation,FIA
(For official use only) Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile Home Park Approval,Highway Connection,and
others.Check with your Local Permit Officer for more information.
GENERAL INFORMATION
STATEMENT OF OWNERSHIP:
LAND OWNER-MAILING ADDRESS 1 1 t Y I,the undersigned,an applicant for a CAMA minor development permit,being either the owner of property in an AEC or a
Name /,►QC k. .gf:sue - d J'J + Ile 00 f EAS•'W Gt f l t elevi 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
Address `2 O(. U..1\.rc,rsil,,:..ci`�be. NWy�p ) C u described as:(check one)
City w,\SOr. State NC. Zip /p 1I0 Phone cri5,7'J420'S 18.1 ' 9 ,
.y ,_(, an owner or record title++,�Title is vested in name of M(.i!� 1S�:kd•`�c,'r�r}p,��
Email iv tk •T �6,� Q MO+tpt1� Itw� •GOM see Deed Book Sci23 page M_ in the 0:NS101v County Registry of Deeds.
y 529
AUTHORIZED AGENT an owner by virtue of inheritance.Applicant is an heir to the estate of
r-. ;probate was in County.
Name )/,kOr% MG1/:"'OSI. .— Leila Lai k9rv►tS
�' , JJ J if other interest,such as written contract or lease,explain below or use a separate sheet&attach to this application.
Address mmaus Cto.rci, Z�
City b 14 A le.) State N C. ziagui Phone 9 l q-2 2 3-11(.4 NOTIFICATION OF ADJACENT RIPARIAN PROPERTY OWNERS:
I furthermore certify that the following persons are owners of properties adjoining this property.I affirm that I have given
Email I e q0.L l� k PtgS Q 1►H I a cO/� ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) (Address)
LOCATION OFJ PROJECT:T:(Address,street name and/or directions to site;name of the adjacent waterbody.) (1) Clare n[� Q \It n 2S Pa l�tr 124 I ?)�'
,28
103-) I Sr (2) IZobie4- E IA Ilan k I i4-1 Cou,t4 ry C i....I. Wl. Z, ,t.,�rw.Yt1tV,NG 21t
(3) J J
StArQ C;}0 tNC .�z '+1 (4)
DESCRIPTION OF PROJECT:(List all proposed construction and land disturbance.) L vr\S l't-ut4,.,;-... ACKNOWLEDGEMENTS:
I,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
0 At to erne on P,1►w)( 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-
SIZE OF LOT/PARCEL: square feet 0 a'39 acres tion and floodproofing techniques.
PROPOSED USE:Residential (Single-family Multi-family❑) Commercial/Industrial 0 Other ❑ I furthermore certifythat 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
COMPLETE EITHER(1)OR(2)BELOW(Contact your Local Permit Officer if you are not sure which AEC applies related to this permit application.
to your property): r 74
(te
I isFlr day of a/ ,20A
(1) OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: N/14 square feet(includes
•
air conditioned living space,parking elevated above ground level,non-conditioned space elevated above ground level but 4.
excluding non-load-bearing attic space)
Landowner or person authorize o act as his/her agent for purpose of filing a LAMA permit application
(2) COASTAL SHO �AECs:SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: ►t/square feet(includes the area of the foundation of all buildings,driveways,covered decks, This application includes:general information(this form),a site drawing as described on the back of this application,the
concrete or masonry pAios,etc.that are within the applicable AEC.Attach your calculations with the project drawing.) ownership statement,the Ocean Hazard AEC Notice where necessary,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 sources are
STATE STORMWATER MANAGEMENT PERMIT:Is the project located in an area subject to a State incorporated without reference in any permit which may be issued.Deviation from these details will constitute a violation of
Stonnwater Management Permit issued by the NC Division of Energy,Mineral and Land Resources(DEMLR)? any permit.Any person developing in an AEC without permit is subject to civil,criminal and administrative action.
YES NO
If yes,list the total built upon area/impervious surface allowed for your lot or parcel: square feet. 6 LOZ 9 T 13 O
oN ` NO±ONIWlIM woa
a3A!3O3 J

AGENT AUTHORIZATION FOR C6MA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Mark& Deborah Tyndall
Mailing Address: 2406 Williamsburg Dr NW
WNson, NC 27896
Phone Number: 252-560-8482
Email Address: marklyndallOmotion-Ind.com
I certify that I have authorized Legacy Homes—ShIon McIntosh
Apent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Home on pilings
at rmi property located at 1037 Street Surf City, NC 28445
in Onslow 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:
• .ti'44,-(_r
Signet
Mark Tyndall I Deborah Tyndall
Print or Type Name
Owners
Title
10 15 / 2019
_
Date
This certification is valid through _06 i_15
_ _ _

ROY COOPER
Governor
r • .
MICHAEL S. REGAN
• » Secretary
NORTH CAROLINA BRAXTON DAVIS
Environmental "aua(r Director
November 4,2019
Mark& Deborah Tyndall
2406 Williamsburg Dr. NW
Wilson, NC 27896
To Mr. and Mrs.Tyndall,
Attached is CAMA Minor Development Permit SC 19-37 for work to be done at 1037 1st Street, in Surf
City,Onslow 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.
Si cerely,
i. �
anya ietila
Permit Support Technician
N.C. Division of Coastal Management
Enclosures
Cc:WiRO files
SC Inspection Dept.
Shion McIntosh—Agent
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext.,Wilmington,NC 28405
910 796 7715

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to Mar k. 13 , 1y,‘16,.\k 's
(Name of Property Owner)
property located at i CO 1 % S4 Su:X C.4-3 N C. _844S ,
Address, Lot, Block, Road, etc.)
on Ca,AA , in Ski,..-C Ci OnS\a") , 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)
Sign ture
KcjocrTh-
it
Print or Type Name
dlIG rsY .. -2C6� �
Tdlepho e Numb
Date
O0•4\
?7
LLCC\
o 0
20

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to Mark 13 , 's
(Name of Property Owner)
property located at i DV/ S% 54 S4Ar C 4-3 N C. �8 5
Address, Lot, Block, Road, etc.)
on C(}..61,1 , in SL.t: Lid' ©nS cw , 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
re/7C / /1le-,
Print or Type Name
Telephone Number
2 ?- 1
Date
81C/14R
Wit 40E-1)
0071 N IC
5 2
19

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:
Mark B. Tyndall and Deborah E. Tyndall
A2. Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Company NAIC Number
Box No.
1037 First Street
City State ZIP Code
Surf City North Carolina 28445
A3. Property Description(Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot 12, Block 48, Section 3, Map Book 11, page 31
A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory,etc.) Residential
A5. Latitude/Longitude: Lat.34-26-42.9 Long.77-31-13.5 Horizontal Datum: ❑ NAD 1927 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) 280 sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s)within 1.0 foot above adjacent grade 2
c) Total net area of flood openings in A8.b 280 sq in
d) Engineered flood openings? ❑Yes 1 No RECEIVED
DCM WILMINGTON, NC
A9. For a building with an attached garage:
a) Square footage of attached garage 0 sq ft O C T 1 5 2019
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A9.b 0 sq in
d) Engineered flood openings? ❑Yes ❑ No
SECTION B—FLOOD INSURANCE RATE MAP(FIRM) INFORMATION
B1. NFIP Community Name&Community Number B2. County Name B3. State
Town of Surf City 370186 Onslow North Carolina
B4. Map/Panel B5. Suffix ! B6. FIRM Index B7. FIRM Panel B8. Flood Zone(s) B9. Base Flood Elevation(s)
Number Date Effective/
(Zone AO, use Base
Revised Date Flood Depth)
3720424500 K 02/16/2007 02/16/2007 VE 11.0
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 Li Other/Source: ‘% l ji
ti B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Are�� 'a` s O' 'it t�gr
Designation Date: ❑ CBRS ❑x OPA = a Ov �y
��1��17U
FEMA Form 086-0-33(7/15) Replaces all previous editions. fet/R4e.�`t67f

ELEVATION CERTIFICATE Exp No. 16a
Expiration Date: Nos
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:
1037 First Street
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: x❑ 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: NCGS RTK network 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) 3. 5 0 feet ❑ meters
b) Top of the next higher floor 13. 8 ❑x feet ❑ meters
c) Bottom of the lowest horizontal structural member(V Zones only) 12. 0 ❑x feet ❑meters
d) Attached garage(top of slab) n/a, x❑ feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building 11. 0 ❑x feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building (LAG) 2. 7 ❑x feet ❑ meters
g) Highest adjacent(finished)grade next to building(HAG) 3. 1 ❑x feet 0 meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including 2. 8 ❑x feet ❑ 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 7 Check here if attachments.
Certifier's Name License Number
Johnny J.Williams L-3170 , -,�����r�
Title �� . ,
Professional Land Surveyor : Q •e*t,ss<O'
Company Name ' 'Q. F S L �9r"
Johnny J. Williams Land Surveying, P.C. _ •r tee/70 i•
Address = ,.7 Here•
+ 4•g
P.O. Box 778 i y0• 8•
�
City State ZIP Code Yca. ovoss
\
Beulaville North Carolina 28518
ture Date Telephone
07/02/2019 [phone]
C y p s of this Elevation Certificate and all attachments for(1)community official,(2)insurance agent/company, and(3)building owner.
Comments(including type of equipment and location, per C2(e), if applicable)
C2e-Proposed elevation based on S WoWh'6 r requirement. To be verified prior to construction
DCM WILMINGTON, NL
OCT 1 5 2019
FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 2 of 6

ELEVATION CERTIFICATE OMB No. 16a
Expiration Date: Nob
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:
1037 First Street
City State ZIP Code Company NAIC Number
Surf City North Carolina 28445
SECTION E—BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)
FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zones AO and A(without BFE),complete Items El—E5. If the Certificate is intended to support a LOMA or LOMR-F request,
complete Sections A, Band C. For Items El—E4, use natural grade,if available. Check the measurement used. In Puerto Rico only,
enter meters.
El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below
the highest adjacent grade(HAG)and the lowest adjacent grade(LAG).
a) Top of bottom floor(including basement,
crawlspace,or enclosure)is ❑feet ❑meters ❑above or ❑below the HAG.
b) Top of bottom floor(including basement,
crawlspace,or enclosure)is
❑feet ❑meters ❑above or ❑below the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 1-2 of Instructions),
the next higher floor(elevation C2.b in
the diagrams)of the building is ❑feet ❑meters ❑above or ❑below the HAG.
E3. Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑below the HAG.
E4. Top of platform of machinery and/or equipment
servicing the building is ❑feet ❑meters ❑above or ❑below the HAG.
E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's
floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G.
SECTION F—PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A(without a FEMA-issued or
community-issued BFE)or Zone AO must sign here.The statements in Sections A, B,and E are correct to the best of my knowledge.
Property Owner or Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
a/r .:
DCM V11Llvl;. ... tiiv, NC
OCT 152019
❑Check here if attachments.
FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 3 of 6

ELEVATION CERTIFICATE OMB No. 1660-0008
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:
1037 First Street
City State ZIP Code Company NAIC Number
Surf City North Carolina 28445
SECTION G—COMMUNITY INFORMATION(OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete
Sections A,B,C(or E), and G of this Elevation Certificate. Complete the applicable item(s)and sign below.Check the measurement
used in Items G8—G10. In Puerto Rico only,enter meters.
G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,
engineer, or architect who is authorized by law to certify elevation information.(Indicate the source and date of the elevation
data in the Comments area below.)
G2. ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)
or Zone AO.
G3. ❑ The following information(Items G4—G10)is provided for community floodplain management purposes.
G4. Permit Number G5. Date Permit Issued G6. Date Certificate of
Compliance/Occupancy Issued
G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as-built lowest floor(including basement)
of the building: ❑feet ❑ meters Datum
G9. BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑ meters Datum
G10. Community's design flood elevation: ❑feet ❑ meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments(including type of equipment and location,per C2(e),if applicable)
DCM WILMINGTON; NC
OCT 152019
Check here if attachments.
FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 4 of 6

BUILDING PHOTOGRAPHS OMB No. 1660-0008
ELEVATION CERTIFICATE See Instructions for Item A6. 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:
1037 First Street
City State ZIP Code Company NAIC Number
Surf City North Carolina 28445
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the
instructions for Item A6. Identify all photographs with date taken; "Front View"and"Rear View'; and, if required, "Right Side View"and
"Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or
vents,as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page.
Photo One
Photo One
Photo One Caption
aCM WILMINGTON, NC
ocr 1 5 2019 Photo Two
Photo Two
Photo Two Caption
FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 5 of 6

•
BUILDING PHOTOGRAPHS OMB No. 1660-0008
ELEVATION CERTIFICATE Continuation Page 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.
1037 First Street
City State ZIP Code Company NAIC Number
Surf City North Carolina 28445
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs
with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable,
photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8.
Photo One
Photo One
Photo One Caption
r%EIVED
'_.MINGTON, NC Photo Two
OCT 1 5 2019
Photo Two
Photo Two Caption
FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 6 of 6

Check
Date Received Date Deposited Check From/Name) IName of Permit Holder _ Vendor Check Number amount Permit Number/Comments Receipt or Refund/Reallocate
_ Columnl Column2 Column3 Column4 Column5 Column Column? Column8 Column9
10/16/2019 10/16/2019 Legacy Homes Inc Mark Tyndall BB&T 6339 $ 100.00 minor fee,1037 1st St.SC Ons JD rct.8538D
10/16/2019 10/16/2019 AMW Docks and Marine Construction LLC Tim Hams BB&T 5608 $ 200.00 GP 74507D JD rct.9117D