SC_19-47_ Jones

Issued by WiRO SC19-47
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 Phyllis Jones authorizing development in the Estuarine Shoreline (AEC) at 400 Little Kinston Road, in Surf
City, Pender County as requested in the permittee's application, dated October 18, 2019, and received by DCM on
November 25, 2019. This permit, issued on December 9, 2019, is subject to compliance with the application and
drawing dated and received by DCM on November 25, 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 November 25, 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 2
within twenty (20) days of the issuing date. This permit must be on the project
cn
site and accessible to the permit officer when the project is inspected for Jason Dail 0 o C
compliance. Any maintenance work or project modification not covered under W N IF
this permit, require further written permit approval.All work must cease when this CAN LOCAL PERMIT OFFICIAI> a� s'
permit expires on: 7 Cardinal Drive Extension W 1-1
Wilmington, NC 28405-3845 La ,`
December 31,2022 o
In issuing this permit it is agreed that this project is consistent with the local Land Prru,,) •
PcUse Plan and all applicable ordinances. This permit may not be transferred to l
another party without the written approval of the Division of Coastal PPPMITTPP

Name: Phyllis Jones
Minor Permit#SC19-47
Date: December 9, 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: PA DATE:
PERMITTEE
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Locality Permit Number 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 ConsOO tion,FIA?
(For official use only) Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile Home Park Approval,Highway Cjection,add
others.Check with your Local Permit Officer for more information.
GENERAL INFORMATION
STATEMENT OF OWNERSHIP: W Lti•
LAND OW1 R-MAILING ADDRESS I.the undersigned,an applicant for a CAMA minor development permit,being either the owner of property i AEC ora-
Nante
%.0‘14.'S 3o ac.,5 person authorized to act as an agent for purposes of applying for a CAMA minor development permit,certify the p
listed as landowner on this application has a significant interest in the real property described therein.This in t can b
Address 1140 K t.3 St 4 r"it. , a.
''pp�� elk
) ,_C described as:(check one)
Cityc� Q.,VS, State �C/ Zip, g��cPhone(l i9)')39r-.t 5+t(( V./an owner or record titleTitle is vested in name of I.V I.3 So,.I�
e ��l`e see Deed Book 10 page Ljg"1 in the Ps.")rye.�L County Registry of Deeds
Email B V"1 ,.•l0 V S I+ph1 its, C.421v�
AUTHORIZED AGENT
� _an owner by virtue of inheritance.Applicant is an heir to the estate of
Name CN�a*-` V QL1,.(s'Pri-lA probate was in County.
���3 Ht.J N if other interest,such as written contract or lease,explain below or use a separate sheet&attach to this application.
Address Q
City 14 k 04 S-rtif{� State OC_ ZiP-17y 13 Phone l f1 t 40 0 0519-- 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 v..£ISN Cti Q j'lV ek.. t tom/ `l btu •-ic-. Cilyy— ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) (Address)
LOCATION OF PROJECT:(Address,street name and/or directions to site;name of the adjacent waterbody.) (1) R.Gw.%.4 QQ A0%A 35Sg L i T L.ry e 1 wi.^fp N k p.
40rp LA-Tr(.c_ K i*r5N1-4 (Zo. S.>eF C.--'0" `'l )"IC. 3$�'•I�5. (2) Lupo rtou,r the (.irr t k...J5' J .
e o
(3) Of•Tri Ceti)tri't.S u,L 1 t_.rrl.eL rFb-'sue' L P. Goss Tu*e
(4) s-r-r..EFTJ
DESCRIPTION OF PROJECT:(List all proposed construction and land disturbance.) ACKNOWLEDGEMENTS:
J�
I,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
91-RG�' 0 L.C. kA.�.�e� ‘4(T4 RA-s 1 Dt' fl-At I. Kb►VI 6>N gI(..tsJiS 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: 51(l p, �p` square feet •V ` acres tion and floodproofing techniques.
PROPOSED USE:Residential 8 (Single-family% Multi-family❑) Commercial/Industrial❑ Other ❑ I furthermore certify that lam authorized to grant,and do in fact gant,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):
110(
This the 1 V day of 0eA ,20 1 et
(1) OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet(includes
air conditioned living space,parking elevated above ground level,non-conditioned space elevated above ground level but A.>e•Al `/Q L l.C.-4-1-AI 'hCO r c•
excluding non-load-bearing attic space) Lan..wner or pert, authorize,to act as his/her agent for purpose of filing a CAMA permit application
(2) COASTAL SHORELINE AECs:SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT This application Inc u es:general information(this form),a site drawing as described on the back ojthis application,the
UPON SURFACES: square feet(includes the area of the foundation of all buildings,driveways,covered decks,
concrete or masonry patios,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*$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
Stormwater Manage 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 V
if yes,list the total built upon area/impervious surface allowed for your lot or parcel: square feet.

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: et-I L1 L L I S 5-0 YJE S
Mailing Address: '140 Ki 1,.5 S `-''1 T I LL K .
ri -r„ O t-t ✓�. I I, L ?g 3
Phone Number: ()t_ t01) tQ5'8 `-1 `-1 (o
Email Address:
I certify that I have authorized lSc+0r'1/4-1 VOLueftr—i 'iz& 110rt3,
Agent/Cont(FU
ctor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: QS,LA cKT> (4,o 4,.4- '•,rti
r-4t"' i ) Pi►-4-(A-1— W' VY Z A- (, L try roL)N -n "w
at my property located at 400 L 1 TILL go-lc-rah,' R i
in (34 8L- 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:
f ied&e; %---
Sign t ure
PIyi.}„-s- T Ads
Print or Type Name
O.A) tZ
Title
t 0 1 l L{ I l q RECEIVED
Date
NOV 2 5 2019
ACM WILMINGTON, NC
This certification is valid through i 0 / i g /

«••� ROY COOPER
.t t Governor
MICHAEL S. REGAN
BRAXTON DAVIS
December 10, 2019
Phyllis Jones
740 Kinsey Mill Road
Mount Olive, NC 28365
Dear Phyllis
Attached is CAMA Minor Development Permit SC 19-47 for work to be done at 400 Little Kinston Rd., in
Surf City, Pender County. An electronic copy has been sent to the Surf City Inspections Department and
to you 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,
anya etila
Permit Support Technician
N.C. Division of Coastal Management
Enclosures
Cc: WiRO files
SC Inspection Dept.
Kenny Vollrath—Agent
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext.,Wilmington,NC 28405

I.JOHNNY J.WIWAMS,PROFESSIONAL LAND SURVEYOR,CERTIFY THAT
THIS MAP WAS PREPARED UNDER MY SUPERN90N FROM AN ACTUAL
SURVEY MADE UNDER MY SUPERN90N COMPLETED ON 07/16/2019
FROM REFERENCES AS SHOWN HEREON THAT BOUNDARIES NOT Nx N;
SURVEYED ARE NOTED AS SUCH AND PLOTTED FROM REFERENCES
AS SHOWN HEREON; THAT THE GPS PORTION OF THIS SURVEY WAS
PERFORMED TO A CLASS A SURVEY AS OPINED BY TITLE 21.CHAPTER
56.SECTION.1603 OF THE N.C.ADMINISTRATIVE CODE USING A RR( r�y�
NETWORK VAN A POSITIONAL ACCURACY OF 0.09 U.S.FEET;THAT THIS U
CPS SURVEY WAS PERFORMED USING A CARLSON BRXB ROVER AND/OR
A TRIMBLE 5800 ROVER;THAT ALL COORDINATES ARE BASED ON N.C. _ -- /SITE
GRID NORTH(HAD 1983 2011 ADJUSTMENT 0E0012 MODEL);THAT THE
CONVENTIONAL PORTION OF THIS SURVEY HAS A RATIO OF PRECISION --
IN —
EXCESS OF 1:10,000 AND IS ALSO PERFORMED TO A CLASS A O ,l0A
SURVEY AS DEFINED BY TILE 21,CHAPTER 56,SECTION.1603 OF _ BOP R
AND THAT THIS MAP WAS API ---
PREPARED INO ADMINISTRATIVE CODE;
TITLE 21,CHAPTER 561600 OF THE LITTLE KINSTON ROAD —— ——
S.C.ADMINISTRATIVE CODE.
— _ N(NITY SKETCH
10/25/19 (NOT TO SCALE)
JOHNNvC:6 F.L.S.,L-3170 ,„Il,,,,r — —
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▪ ZR ~�. 1A611a1T.. Ne GP 1 PROPOSED %��i a/EI
SEAL 1 MM TOMe,m L .- PRE-:- TR UNE � Sie•Ag� — ex Gs
▪ L-3170 04.. _' ,1110 Wa Ie6)'-,+e sic EP E� Q_ s er«•1a•E us 15
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LEGEND: _ a- T_- / �e �t I Z
OP-EXISTING IRON PIPE _ / N T- S." -
OS-EXISTING IRON STAKE pry I I e> ear ."�2 1 Z
EMN-EXISTING HAG NAIL t _
I55 IRON STAKE SET / 1 1 e\e 1 C O
MNS-MAG NAIL SET 1 / •
rP
AG-TOP ABOVE GROUND SURFACE ii
BOOK•
SURVEY euXnWe IMP BOOK 3,
-e--FF -OVERHEAD UTILITY UNE I rµp- P PAGE ST r,
O-UTILITY POLE DEED BOOK 1AOt, O 177 4 0' V -
9-WATER MEIER AGE 2fi2 ♦� Wa'EgAWy I O
El CLEAN OUT I ENCI.N.NING BY
LOT 2J RWNR LOT
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MAP BOOK], oE« W� ICC I PACE 57 Y e; C 3
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GRID TES AND COORDINATES: STEPS•E o III VA
I _ 1
1 5 ecn'ss"W O
ERRN0.lot - NORTH-251.868.089 I.a Si°k I
EAST-2,434,571.107
oo
DIN NO.102 - NORTH-251,888.413
I f y-'S�% -' — ^�` —— —
EAST-2,434,521.087 j j N 36'0.7'15'w — S MST w
Spr DP Ai SUM FY
..911.OW 8Y
BOUNDARY SURVEY &
NOTES. TOPSAIL INLET SOUND .•.•.r
1)THE PROPERTY SHOWN HEREON IS LOCATED ENTIRELY WITHIN PRELIMINARY PLOT PLAN FOR:
A SPECIAL 100 YEAR FLOOD HAZARD AREA ACCORDING
TO FLOOD INSURANCE RATE MAP NO.3720423500J —
DATED FEBRUARY 16,2007. PHYLLIS T
2)ALL N.C.GRID DATA SHOWN HEREON IS BASED ON NAD 1963 880 f e JONES
2011 ADJUSTMENT USING THE NEED RD(NETWORK SYSTEM.
3)ALL DISTANCES SHOWN HEREON ARE N.C.GRID DISTANCES
UNLESS OTHERWISE NOTED. `�
t)COMBINED GRID FACTOR- 0.99997349 CURRENT N HYWS T.JONES
740 KINSEY MILL ROAD,MOUNT OLIVE. NC 28365
5)ALL UTILITY LINES SHOWN HEREON MAY HAVE EASEMENTS
AND FIGHTS OF ENTRANCE AND MAINTENANCE ASSOCIATED
8810 THEM. INDIVIDUAL TRACT ON LITTLE KINSTON ROAD
6)IRIS PROPERTY IS ZONED MHS. ' TOWN OF SURF CITY
7)DEVELOPMENT CAUTION: PROSPECTIVE BUYERS ARE CAUTIONED THAT REFERENCES. TOPSAIL TOWNSHIP, PENDER COUNTY, N.C.
PORTIONS OF THE LOTS SHOWN ON THIS PLAT MAY BE RESTRICTIVE IN OEEO BOOK 764,PAGE 587
USE BY WETLANDS MD IN ERSER JURISDICTION PURSUANT TO THE 1i
ARMY CORPS ENGINEERS SECTION 404TIREGULATIONS. INDIVIDUAL U.S.U.SL TOP SAIL SUBOMSION DATE: OCTOBER 23, 2019 iq
LOTS REVIEWS TO ENSURE COMPLIANCE WITH THEIR FEDERAL LAWS AND LOT 22 SCALE: 1" = 20' a illi
REGULATIONS ARE ENCOURAGED. VERIFICATION OF LOCATION AND MAP BOOK 3,PAGE 57
RESTRICTIONS SHOULD BE MADE PRIOR TO INDIVIDUAL LOT DEVELOPMENT.
IN ADDITION LOTS SHOWN ON THIS PLAT MAY BE SUBJECT TO CAMS RULES,
REGULATIONS,AND SETBACKS.VERIFICATION WITH LOCAL CALLA OFFICER JOHNNY J. IFIIU4liS."LAND SUR{/TYJIKr. P.C.
CONCERNING CAMA LINES,SETBACKS,AEC'S.ETC.SHOULD BE MADE P.O.BOX 778, BEULAVILLE, N.C. 28518
PRIOR TO INOmOLIFL LOr DEVELOPMENT. - _aWS-u0I1F KNSm, PHONE: [phone] FAX: [phone]
TOS ALL.,v vx mle EMAIL: JWIW AMSOJWSURVEY.COM FIRM NO. C-2532

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to 6K-1 1.L S �� n e_S
� // (Name of Property Owner)
property located at ` 0 b
Address, Lot, Block, Road, etc.)
on , in S 'SLc , 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)
n uFas
-V _L'c' //Oki—
Print or Type Name
C/ f -yS/ - 7 �' ji;
Telephone Number
`'//
Date
RECEIVED
NOV 2 5 2019
DCM WILMINGTON, NC

Receipts for
Certified Mail
tO\. Qj�A (Staple Here)
Date
C.AK-''t (3 A
Ad scent roperty Owner ' j
�j C.O0►sv-47L-1 C-c-o t -b.
Magng_Aldress rC a�STh6
City,State,Zip Code
Dear Adjacent Property:
This letter is to inform you that I, `M`'t Lt-($ JO+p-*_S have applied for a CAMA Minor
Property Owner
Permit on my property at I-1O0 ( <T1 k a 5-1-7),-.1 , in, Pe.��r';�
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s)as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me akct(k9 ' , '-0 CID-- ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program,you may submit
them to:
Local Permit Office ; r- C-b c LA) r 1(27-0 t eg(o o OCC-10E
13 1 cz. p 4r
W�Liv‘ w(1 i"VN r.)C-- 05
Sincerely,
Arra' : j Sor-> s7*l
(2{-o-tt. t.
Property Owner
`1q0 /..>sk_ A L fZ-a.
Mailing Address
City,State,Zip Code RECEIVED
NOV 2 5 2019
DCM WILMINGTON, NC

1. . •os a ervice
CERTIFIED MAIL° RECEIPT
Ill Domestic Mail Only
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* For delivery information,visit our website at www.usps.com'".
r1 � ri
-R Certified Mail Fee ` 3
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rl $ L, (10 ..
Extra Services to Fees(check box,add tee pe,50p{ggqare)
❑Return Receipt(hsdcopy) $ ! SM
❑Return Receipt(electronic) $ $C i,I__t `Q
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A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail
A unique Identifier for your mailpiece. associate for assistance.To receive a duplicate
Electronic verification of delivery or attempted return receipt for no additional fee,present this
delivery. USPS®-postmarked Certified Mail receipt to the
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.
rnportant Reminders: -Adult signature service,which requires the
You may purchase Certified Mall service with signee to beat least 21 years of age(not
First-Class Mails,First-Class Package Services, available at retail).
or Priority Maas service. -Adult signature restricted delivery service,which
Certified Mail service Is itotavallable fob requires the signee to be at least 21 years of age
international mail. and provides delivery to the addressee specified
Insurance coverage Is notavallable for purchase by name,or to the addressee's authorized agent
with Certified,Mall service.However,the purchase (not available at retail).
of Certified Mall service does not change the •To ensure that your Certified Mall receipt Is
insurance coverage automatically included with accepted as legal proof of mailing,ft should bear a
certain Priority Mall 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 Mall item at a Post Office'"for
the following services: postmarking.If you don't need a postmark on this
-Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion
of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply
You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.
electronic version.For a hardcopy return receipt,
complete PS Form 3811,Domestic Return
Receipt'attach PS Form 3811 to your mailpiece; IMPORTANT.Save this receipt for your records.
r'n,,.,3A011 nn,e 9m c ia„t.,R„l PAN 7sa0 000-c1na7

Receipts for
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161
Date
1-k0
Adjacent Property Owner
341t3 sP�c�cco�:,
Mailing Address
ittA tCo-1, �1lcb(e
City,State,Zip Code
Dear Adjacent Property:
This letter is to inform you that I, P(?-1L 1.& S have applied for a CAMA Minor
Property Owner
Permit on my property at g00 O. ,in eF,r4beZ-
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s)as notification of my proposed project.No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at (F.S.t0)5 r a-- O5C0— ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program,you may submit
them to:
Local Permit Office•; CDtib� "'' ``.-4"1-4'v;u`' (c- o
T 0
Sincerely,
A�rJ
K�Lt_ t S
Property Owner
N0 tct>Jcc.1 MLLL .
Mailing Address
(91—L vt c?-g3( RECEIVED
City,State,Zip Code
NOV 2 5 2019
DCM WILMINGTON, NC

I. . e os a ervice
CERTIFIED MAIL° RECEIPT
✓ Domestic Mail Only
r
7- For delivery information,visit our website at www.usps.com'.
Certified Mall Fee $7.r 0 0443
.r) $ In.rill (i
Extra Services&Fees(check box,add fee eiterl ryte) -
m ❑Return Receipt(hardcopy) $
1 0 Return Receipt(electronic) $ $I-1• l l A MA ostmark
1 0 Certified Met Restricted Delivery $ r ±i k ere
M ['Adult Signature Required $ $i r i"
❑Adult Signature Restricted Delivery$
Postage . CI
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A receipt(this portion of the Certified Mall label). for an electronic return receipt,see a retail
I A unique Identifier for your mailpiece. associate for assistance.To receive a duplicate
I Electronic verification of delivery or attempted return receipt fot no additional fee,present this
delivery. USPS®-postmarked Certified Mail receipt to the
I A record of delivery(including the recipient's retail associate.
signature)that Is retained by the Postal Service- -Restricted delivery service,which provides
for a specified period. delivery to the addressee specified by name,or
to the addressee's authorized agent
mportant Reminders: -Adult signature service,which requires the
I You may purchase Certified Mall service with signee to beat least 21 years of age(not
First-Class Mail®,First-Class Package Service®, available at retaiq.
or Priority Mail®service. -Aduh signature restricted delivery service,whist
I Certified Mail service Is notavailable for requires the signee to be at least 21 years of ag
International mail. l and provides delivery to the addressee specified
I Insurance coverage Is not available for purchase by name,or to the addressee's authorized agent
with Certified Mail service.However,the purchase (not available at retail).
of Certified Mail service does not change the •To ensure that your Certified Mail receipt Is
Insurance coverage automatically included with accepted as legal proof of mailing,it should bear a
certain Priority Mail items. USPS postmark.If you would like a postmark on
I For an additional fee,and with a proper this Certified Mail receipt,please present your
endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for
the following services: postmarking.If you don't need a postmark on this
-Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion
of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply
You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.
electronic version.For a hardcopy return receipt,
complete PS Form 3811,Domestic Return
Receipt attach PS Form 3811 to your mailpiece; IMPORTANT.Save this receipt for your records.

Receipts for
Certified Mail
to( v,(Let (Staple Here)
Date
BAITS eot) , ( s_s LLB
Ad(oen�t Prc 'ccerl
lin M Address
'� eF ►mac_ a_e)4�-cs
City, State.Zip Code
Dear Adjacent Property: /�
This letter is to inform you that I, P�L1 Li_ t S have applied for a CAMA Minor
Property Owner
Permit on my property at `1 DO ? D , , in PE ej,D
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s)as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project. please
contact me at (C._k.c c) st o1 — /c)-- .or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program,you may submit
them to.
Local Permit Office; r\)C-1)e_ Q. ;E
a-`1 C P-fZo `.i sF t )R
Sincerely, rt. c ' JCP-7"Ocv
5
Property Owner
ILO K t s ,y,, L-L
Mailing Address
t✓¢1 r3 L a Qc3 (off
City. State.Zip Code
RECEIVED
NOV 2 5 u,y
DCM WILMINGTON, NC

g. . -os a ervice
CERTIFIED MAIL° RECEIPT
3 Domestic Mail Only
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- For delivery information,visit our website at www.usps.comr.
HOL R r "°'
Certified Mail Fee c 4,.:
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Return Receipt(hardcopy) $ _A P• C.Q•
❑Return Receipt(electronic) $ $!_1• 1r Postma
7 0 Certified Mali Restricted Delivery $ sn.nrt Here
1 Adult Signature Required $ $ih.OV l SAS
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❑Adult Signature Restricted Delivery$ I r 1
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Jerlllleu m2111 servwe pruvrues cues Iu1IUWYHH19 ueflellls:
A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail
r A unique identifier for your mailpiece. associate for assistance.To receive a duplicate
I Electronic verification of delivery or attempted return receipt for no additional fee,present this
delivery. USPS®-postmarked Certified Mail receipt to the
A record of delivery(Including the recipient's retail associate.
signature)that Is retained by the Postal Service" -Restricted delivery service,which provides
for a specified period. delivery to the addressee specified by name,or
to the addressee's authorized agent.
'mportant Reminders: -Adult signature service,which requires the
I You may purchase Certified Mall service with signee to beat least 21 years of age(not
First-Class Mail°,First-Class Package Service°, available at retail).
or Priority Mail®service. -Adrift signature restricted delivery service,which
Certified Mall service Is notavailok(e for ' requires the signee to be at least 21 years of ago
International mail. and provides delivery to the addressee specified
I Insurance coverage Is notavallable for purchase by name,or to the addressee's authorized agent
with Certified Mail service.However,the purchase (not available at retail).
of Certified Mari servicedoes not change the •To ensure that your Certified Mall 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
1 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.
'S Form 3800.Aorrl 2015/Rwversxl PSN 7530-02-000.0547

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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:
Phyllis T.Jones
A2. Building Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and'Box No. Company NAIC Number
400 Little Kinston Road
City State ZIP Code
Surf City North Carolina 28445
A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.)
Pender County tax parcel number: 4235-41-6708-0000
A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory,etc.) Residential
A5. Latitude/Longitude: Lat.34-25-59.8 Long.77-33-31.3 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 5
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 0 sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s)within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A8.b 0 sq in
d) Engineered flood openings? ❑Yes ❑x No
A9. For a building with an attached garage:
a) Square footage of attached garage 0 sq ft
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 ❑x 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 Pender North Carolina c
7
B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8 Flood Zone(s) B9. Base Flood Elevation(s)
c
Number Date Effective/ (Zone AO, use Base
Revised Date Flood Depth) Q oN F
3720423500 J 02/16/2007 02/16/2007 AE 9.0 > Lez 5
cv
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9:
W o
❑ FIS Profile x❑ FIRM ❑ Community Determined ❑ Other/Source: z
B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source���� 1I I1ith gee
•
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Alas•ky? ❑ Yes •L'4
�•44 7'SEAL r• =
Designation Date: ❑ CBRS ❑ OPA \ —
C) v �--31T0 0�•
FEMA Form 086-0-33(7/15) Replaces all previous editions. /,/1, F Q e‘I of 6

ELEVATION CERTIFICATE OMB No. 1te: N Da
Expiration Date: b
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:
400 Little Kinston 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: 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) 16. 8 ❑x feet ❑ meters
b) Top of the next higher floor n/a. ❑x feet ❑ meters
•
c) Bottom of the lowest horizontal structural member(V Zones only) 15. 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 9. 0 ❑x feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building(LAG) 6. 5 ❑x feet ❑ meters
g) Highest adjacent(finished)grade next to building(HAG) 7. 1 ❑x feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including 6. 6 ❑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 maybe 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? x❑Yes ❑No ❑Check here if attachments.
Certifier's Name License Number
Johnny J.Williams L-3170
��� � �A�4/ �
11 1 t'J�i
Titlefik„ >'/
Professional Land Surveyor ��c: •• 'EsS,•.
Company Name •••pace ''"1",-",
Johnny J.Williams Land Surveying, P.C. • 4 SditEAL. T—•
Address 're31 7002e• —
P.O. Box 778 : •?O• g��
City State ZIP Code �'• J. \\P\\��
Beulaville North Carolina 28518 /�� f1111111 '
Si nature Date Telephone •
2 9 II, 07/29/2019 [phone]
Co y page 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-This elevation is based on Surf City having no free board requirement to be verified prior to construction ECEIVED
NOV 2 5 2019
FEMA Form 086-0-33(7/15) Replaces all previous editions. DCM WILMINGDTrONg®ICof 6

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:
400 Little Kinston Road
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 E1—E5. If the Certificate is intended to support a LOMA or LOMR-F request,
complete Sections A, B,and 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
RECEIVED
NOV 2 5 2019
DCM WILMINGTON, NC
❑Check here if attachments.
rr. nnn n oo Pardarac all nrovinns editions. Form Page 3 of 6

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:
400 Little Kinston Road
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. •
Gi. ❑ 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) ❑ feet meters❑ Datum
of the building:
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)
RECEIVED
NOV 252019
DCM WILMINGTON, NC
❑ Check here if attachments
FFMA Fnrm nRR-0-33(7/151 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:
400 Little Kinston Road
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
Photo Two
RECEIVED
NOV 252019
DCM WILMINGTON, NC
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:
400 Little Kinston Road
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
Photo Two
RECEIVED
NOV 2 5 2019
DCM WILMINGTON, NC
Photo Two
Photo Two Caption
FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 6 of 6

Date Date Check From Name of Vendor Check Check Permit Rct
Received Deposited Permit Holder Number amount Number/Comments
11/25/2019 Kenneth Vollrath Phyllis Jones State 1801 $100.00 minor fee,400 Little Kinston, Surf JD rct
Employees City PnCo 9436
Credit
Union