SC_20-08_ Pritt

RECEIVED
Issued by WiRO MAR 2 0 2020 SC20-08
Surf City Permit Number
DCM WILMINGTON, NC
CAMA
MINOR DEVELOPMENT
v
PERMIT 1'
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 Donnie Pritt authorizing development in the Estuarine Shoreline (AEC) at 6033 6th Street, in Surf City,
Onslow County as requested in the permittee's application, dated February 19, 2020, and received by DCM on February
21, 2020. This permit, issued on March 4, 2020, is subject to compliance with the application and drawing dated and
received by DCM on February 21, 2020 (where consistent with the permit), all applicable regulations and special
conditions and notes set forth below. Any violation of these terms may subject the permittee to a fine, imprisonment or
civil action, or may cause the permit to be null and void.
This permit authorizes: Proposed residential dwelling with driveway and parking areas.
(1) All proposed development and associated construction must be done in accordance with the permitted site drawing dated
received by DCM on February 21, 2020
(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 Jason Dail
compliance. Any maintenance work or project modification not covered under CA A 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 31,2023
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 DAAITTCC

Name: Donnie Pritt
Minor Permit#SC20-08
Date: March 4, 2020
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) Shall the plan of development exceed 30% impervious coverage within 75' of the normal highwater line, the
applicant shall effectively demonstrate, through innovative construction and design that the amount of impervious
surfaces exceeding 30% impervious coverage within the 75' Coastal Shoreline AEC shall be managed and the AEC
protected. All proposed development and associated construction must be done in accordance with a credible
innovative design plan, sealed and sealed by a professional engineer.
(9) Upon completion of construction and prior to the issuance of a Certificate of Occupancy (CO), a letter of certification
must be received from the designer of the innovative system installed, certifying that the permitted system has been
installed in accordance with this permit, the approved plans and his design specifications. Any deviations from the
approved plans and specifications must be noted on the Certification and a permit modification may be required
prior to receiving a CO.
(10)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.
(11)Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third-party.
SIGNATURE: DATE: -- � —D
PERMITTEE

Issued by WiRO SC20-08
Surf City Permit Number
CAMA
MINOR DEVELOPMENT
u
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 Donnie Pritt authorizing development in the Estuarine Shoreline (AEC) at 6033 6th Street, in Surf City,
Onslow County as requested in the permittee's application, dated February 19, 2020, and received by DCM on February
21, 2020. This permit, issued on March 4, 2020, is subject to compliance with the application and drawing dated and
received by DCM on February 21, 2020 (where consistent with the permit), all applicable regulations and special
conditions and notes set forth below. Any violation of these terms may subject the permittee to a fine, imprisonment or
civil action, or may cause the permit to be null and void.
This permit authorizes: Proposed residential dwelling with driveway and parking areas.
(1) All proposed development and associated construction must be done in accordance with the permitted site drawing dated
received by DCM on February 21, 2020
(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 Jason Dail
compliance. Any maintenance work or project modification not covered under CA A 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 31,2023
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 PFRMITTFF

Name: Donnie Pritt
Minor Permit# SC20-08
Date: March 4, 2020
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) Shall the plan of development exceed 30% impervious coverage within 75' of the normal highwater line, the
applicant shall effectively demonstrate, through innovative construction and design that the amount of impervious
surfaces exceeding 30% impervious coverage within the 75' Coastal Shoreline AEC shall be managed and the AEC
protected. All proposed development and associated construction must be done in accordance with a credible
innovative design plan,sealed and sealed by a professional engineer.
(9) Upon completion of construction and prior to the issuance of a Certificate of Occupancy (CO), a letter of certification
must be received from the designer of the innovative system installed, certifying that the permitted system has been
installed in accordance with this permit, the approved plans and his design specifications. Any deviations from the
approved plans and specifications must be noted on the Certification and a permit modification may be required
prior to receiving a CO.
(10)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.
(11)Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third-party.
SIGNATURE: DATE:
PERMITTEE

DN\
Locality 6 0 3 3 -/r�P-f r G i 7� Arc Permit Number
y
. Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
(For use only)
GENERAL INFORMATION
LAND OWNER-MAILING ADDRESS
Name Db
Address� � gL �1 / ) 7iY
City _ 5 cr3CY State ! G Zii/pp //3.Phone 9��-
Email ria rt ni i e y ri717 tD in d /�fS�G /6 56, C6'r91_ ---
AUTHORIZED AGENT
Name__, a '�LG�,L ,i Address c2c26 9 1 - hy/ 1 /1/ ._.
City A/a.ry 5 an) State /✓C Zip o P11-'3 Phone 9I0- d d 3-O 13l
Email ne)'Pnaa Lf5L,/1COMOcicc 12.i'6-}af/ram s5. Gtly.-�
LOCATION OF PROJECT: (Address,street name and/or directions to site;name of the adjacent waterbody.)
O 33 / 4 (,.J / oVe , e574/
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) gzi;101 d — � rrt e-
rns cia 1�/' 1)6011e,
SIZE OF LOT/PARCEL: square feet U. /7g acres
PROPOSED USE: Residential ❑ (Single-family© Multi-family ❑ ) Commercial/Industrial ❑ Other 0
COMPLETE EITHER(1)OR(2) BELOW(Contact your Local Permit Officer ifyou are not sure which AEC applies
to your property):
(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
excluding non-load-bearing attic space)
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES:624/ b 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..),
l) b
STATE STORM WATER MANAGEMENT PERMIT: Is the project located in an area subject to a State
0 CV
Stormwater Management Permit issued by the NC Division of Energy, Mineral and Land Resources(DEMLR)? Z *-+
YES NO U "
_ III _ m

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,FIA
Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile Home Park Approval,Highway Connection,and
others. Check with your Local Permit Officer for more information.
STATEMENT OF OWNERSHIP:
I,the undersigned,an applicant for.a CAMA minor development permit,being either the owner of property in an AEC or a
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) �J `
✓an owner or record title,Title is vested in name of _...5 m i/,j-ir,Lies ,
see Deed Book 4.3/a page q/3 in the 45/d i J 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 are owners of properties adjoining this property. I affirm that I have given
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) (Address) //��
(I) 4ir viod He,1i Parker �iQ 3/ Z ee Sui�' eiy /I�e
(2) er ��Ida1d��C 6.4 3 �i'�'S rem .surf g'�y,
(3)
(4)
ACKNOWLEDGEMENTS:
I,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 /9 day of 4ruary,20 o'�d
/(0fffr-d....da4. 4(:)
Landowner or person authorized to act 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 this application, the
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
incorporated without reference in any permit which may be issued.Deviation from these details will constitute a viol't_ ip&3
any permit.Any person developing in an AEC without permitis subject to civil, criminal and administratki a V
DCM WILMINGTON, NC
rrn f 1 %Oil

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: -D6 n nix a ;
Mailing Address: ,a6161 1i i J Qy /'7i7
ilia )o s ea d
Phone Number: 9'/p - 3 - O 7.
o�ennaaus in tnodu/cars /e��. Cep-)
Email Address: �nr�I� n, , f�a? nila/a.�s rye 55, do r,-)
I certify that I have authorized �d n u54`."
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: fetii7ci DI-I 7�am�
�ar i")0rne
at my property located at /,0 3 3 1,0 ' reel C.."r-/ de, 8 /
in Ohs 5 kit) 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.
Prope Owner Information:
71t-
4,ii
Signatu
Print or Type Name
DIOn
Title
QaI / 9 I20
Date
This certification is valid through /c. / I &/ 2/ RECEIVED
DCM WILMING T ON, NC
crn 0 , ')non

ROY COOPER
covet nor
MICHAEL S. REGAN
BRAXTON DAVIS
March 4, 2020
Donnie Pritt
22019 US HWY 17N
Hampstead, NC 28443
Dear Mr. Pritt,
Attached is CAMA Minor Development Permit SC 20-08 for work to be done at 6033 6th Street in Surf
City, Onslow County. An electronic copy has been sent to the Surf City Inspections Department and your
Agent.
To validate this permit, please sign both copies as indicated for our records. Retain the orange copy for
your files, and return the white copy to us within 20 days of receipt in the enclosed, self-addressed
envelope.
This is not a valid permit until it is signed and returned to our office.
Thank you for your prompt attention to this matter.
Sincerely,
Tanya K. P etila
PermitSu portTechnician
N.C. Division of Coastal Management
Enclosures
Cc:WiRO files
SC Inspection Dept.
Donna Austin—Agent
State of North Carolina Environmental Quality[Coastal Management
127 Cardinal Drive Ext.,Wilmington,NC 28405

I,JOHNNY J.WILLIAMS,PROFESSIONAL LAND SURVEYOR,CERTIFY THAT ya
THIS MAP WAS PREPARED UNDER MY SUPERVISION FROM AN ACTUAL t
SURVEY MADE UNDER MY SUPERVISION COMPLETED ON 08/08/2019
FROM REFERENCES AS SHOWN HEREON;THAT BOUNDARIES NOTVE .� SI'
SURVEYED ARE NOTED AS SUCH AND PLOTTED FROM REFERENCES
AS SHOWN HEREON; THAT THE GPO PORTON OF THIS SURVEY WAS , `\-4
PERFORMED TO A CLASS A SURVEY AS DEFINED BY TI T1E 21,CHAPTER
58,SECTION.1603 OF THE N.C.ADMINISTRATIVE CODE USING A RTC 59'�
NETWORK WITH A POSITONAL ACCURACY OF 0.09 U.S.FEET;THAT THIS `\\a4.� \ µLL
GPS SURVEY WAS PERFORMED USING A CARLSON BRX6 ROVER AND/OR \
ai
A CARLSON BRX6+ROVER;THAT ALL COORDINATES ARE BASED ON N.C. ,Q \ \
GRID NORTH(NAD 1983 2011 ADJUSTMENT GEED12 MODEL);THAT THE
CONVENTIONAL PORTON OF THIS SURVEY HAS A RATIO OF PRECISION \
IN EXCESS OF 1:10,000 AND IS ALSO PERFORMED TO A CLASS A / \,
SURVEY AS DEFINED BY TITLE 21,CHAPTER 58,SECTOR.1803 OF / \\`L. �Q \ \ pM>`
TH N.C.ADMINISTRATIVE CODE ,1�11111 : r
ESN CAA.O.'' /
pfi.:Egli•..4.T, \t3, :„
`��� UT/30/2om=2:`DF °M1'`7 / 4 e \ •
VICINITY SKETCH
JOH Y WI S.PLS..L-3170 _ 'R SEAL Ti.... - / \.. i' (NOT TO SCA1F
VOIy \p.° /
i:n IILBBD (V I _
/ \ p o
\ / RA CADWICK,JR
v / a f
/ DEED BOOK 513,PAGE 801 \ \ CV
\ / LOT 11.BLOCK 40,SECTION 4 \ S / > CD
\ MAP BOOK 11,PAGE 30 ili
/ e� osc�#.\,:\
\F V \�/ Na \ S /3
\\/V
/ \. ,�4/ eP9m aaD \ / \ �a \\ fN —.-J
Gil
i50. y,. \ \s22. ��.-Fr \ o CO
\ ePoox \ W
\ +'�\,� `:°moo° \�/9�� o \ tCC
LL
\ Tio,cx , 014?EMS
\\�/ \ \
SURFACE CALCULATIONS: \\sr•� \ \\\ 0.178 ACRES `,.. "y \ \
- ® 5,+ -'-'- ,p0* :RF"�0 °°"" \�� \
TOTAL AREA OF lDT 7,735 CO.FEET 'fr Y \ \
^' \
'<'c \
HOUSE/PORCH FOOTPRINT AREA UNDER �„ y1111S1111. / 'N
COVERED ROOF-2,124 S0.FEET(27.4%) �• \ / 6 _ \ \la
CONC.PAD AREA-732 SO.FEET(9.4X) v" 5�\ �Ta WAIVED // \ \\
TOTAL IMPERVIOUS SURFACE- RIUDIRPO
4' / LYNWOOD K.PARKER
/ \ \
2.856 S0.FEET(36.9%) \8_
DEED BOOK 928,PAGE 153 /
. I LOT 9,BLOCK 40,SECTION 4 / \
TOTAL AREA OF DECKS.STEPS,ETC.-730 SO.FEET CANALMAP BOOK 11,PACE 30 / \
TOTAL AREA OF DRIVEWAY-455 S0.FEET _
\ /
\ V
\ // BOUNDARY SURVEY &
PRELIMINARY PLOT PLAN FOR:
NOTES CUSTOAf BUILT .f!OAM'S OF
1)THE PROPERTY10 SHOWN HEREON IS LOCATEDA ACCORDING
WITHIN
A SPECIALFLOODNSU YEAR FLOOD HAZARDNO.AREA ACCORDING
TO FLOOD INSURANCE RATE MAP NB.3720424500K THE' CA. ?OLI. AS, LLC
DATED FEBRUARY TESL 2007.
2)AU.N.C.GRID DATA SHOWN HEREON IS BASED ON NAD 1983 REFERENCES'2011 ADJUSTMENT USING THE NCGS RTK NETWORK SYSTEM. LEGEND: GRID TIES AND COORDINATES: R CURRENT OWNER: CUSTOM BUILT HOMES OF THE CAROLINAS, LLC
3)ALL DISTANCES SHOWN HEREON ARE N.C.GRID DISTANCES pp EXISTING IRON PIPE DP NO.119 - NORTH-257,005.759 DEED BOOK 5061,PAGE 602 22019 US 17, HAMPSTEAD, NC 28443
UNLESS OTHERWISE NOTED. pp-
=EXISTING P.K.NAIL EAST=2,447,243.881
ISS-IRON STAKE SET OLD SETTLERS BEACH
4)COMBINED GRID FACTOR- 0.99997030 AG-TOP ABOVE GROUND SURFACE LDT 10,BLOCK 40,SECTION 4 INDIVIDUAL TRACT ON N.C.S.R. 1611 (6TH STREET)
BG-TOP BELOW GROUND SURFACE MAP BOOK II.PAGE 30 TOWN OF SURF CITY
5)ALL UTILITY UNES SHOWN HEREON MAY HAVE EASEMENTS RAY=RIGHT-OF-WAY ISS NO.120 - NORTH-257.051.169
AND RIGHTS OF ENTRANCE AND MAINTENANCE ASSOnATED I -CENIERUNE EAST-2,447,212.403 STUMP SOUND TOWNSHIP, ONSLOW COUNTY, N.C.
WITH THEN. E -PROPERTY UNE 7y �p Hy
6)THIS PROPERTY IS ZONED NHS AND WILL BE SUBJECT TO NCGS-NORTH CAROUNA GEODETIC DATE: AUGUST 8,2019
AU.RESTRICTIONS IN THE TOWN OF SURF CITY LAND USE SURVEY SCALE: 1`= 20'
ORDINANCES.THE TOWN OF SURF CITY SHOULD BE CONTACTED t-[-H--OVERHEAD UTILITY LINE ,
FOR DETAILS ON RESTRICTIONS PRIOR TO LOT IMPROVIEMENTS. •-UTILITY POLE
THESE RESTRICTIONS MAY INCLUDE,BUT NOT BE LIMITED TO. S-WATER METER JOXNNY✓. JPII.LIAdIS LAND SURP�77NG, P.C.
SETBACKS.HEIGHT RESTRICTIONS,IMPERVIOUS SURFACE OO-TELEPHONE BOX I�
TrNi
_ REQUIREMENTS.ETC.ADDITIONAL RESTRICTIONS MAY APPLY IF ----=UNE NOT SURVEYED �`, II P.O.BOX 778, BEUTAVILLE, N.C.28518
THERE ARE RESTRICTIVE COVENANTS ASSOCIATED M7H THIS o-v99.ccr.9mw 1ou_oe,s-a,N LLLLJII✓%%/���JJJ PHONE: [phone] FAX: [phone]
PROPERTY.SURVEYOR HAS NOT PERFORMED RESEARCH TO RL NUIE 1100000tm
DETERMINE IF RESTRICTIVE COVENANTS APPLY. 100 NAI PRI/0.012 EMAIL: JWIWAMSID,IWSURVEY.COM FIRM NO.C-2532

Ramp
6 10 Jet Ski
14 x Area
12 14
12a12 Make boat lift
10 Boat start 2 foot over
Lift from Ramp
18. L//
a
C)
7 jj
11- m
r
z sv TT1
III
^' O m
z0
z
0

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: n n e, , /171
Address of Property: �i4 3j /o ai/ec't ft (. I "L� P �Q,{
(Lot or Street#, Street or Road, City&County)
y 44
Agent's Name#: D,,,�,-ta XLtr�4rt Mailing Address: aaQ�-i as >Lu/ /7
Agent's phone#: `7/D- '73/ /A/y d 7-
I hereby certify that I own property adjacent to the above referenced property, The individual
applying for this permit has described to me as shown on the attached drawing the development
they are p oposing.A description or drawing,with dimensions, must be provided with this letter.
I have no objections to this proposal, I have objections to this proposal.
If you have objections to what/s being proposed,you must notify the Division of Coastal Management(DCM)in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405.3845. DCM representatives can also be contacted at(910) 796-7215. No response is
considered the same as no objection if you have been notified by Certified Mall.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15'from my area of riparian access unless waived by me. (If you
wish to waive thesetback, you must initial the appropriate blank below.)
-i '`'' I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Prope 0 er Information) (Adjacent Property Owner Information)
,/' � - A
Signature / Signature
gn
[ Y7 nie f ( i T7 D(JE�Y`'4 ' . CAA dwkk. S
Print or Type Name Print or Type Name
�a v 9 Li 5 >dt.oy /7/K 5 vS h e P\SL.
-
Mailing Address Mailing Address n `
?m 5')e ad A/C-- 02244.3 ►'12 t n fo n Nra7
City/Stat62ip City/State/Zip
q/6 Y0 3 o,73/ q 1 a o /
Telephone Number Telephone Number
G
Dale Dale
Revised 6/18/2012

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
'I I hereby certify that I own property adjacent to ,— �i��ii�. n
,721/- 's
'l, (Name of Property 8wner)
1 property located at to 6 ,,33 �p -/ee,/
(Address, Lot, Block,Bo ad, etc.)
�I on Clana i , in 4. ,,>`v , N.C.
II (Waterbody) (City/T6wn and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
I have no objection to this proposal.
i.
I have objections to this proposal.
i
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
,
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to waive
the setback, you must initial the appropriate blank below.)
r7/3 I do wish to waive the 15'setback requirement:
I do not wish to waive the 15' setback requirement.
(Pro e y Owner Information) (Adjacent Property Owner Information)
/ ,
�//
Signature Pr cS aj1C t1 Crl tJ tNC ''
PrMt or Type Name. r Tg J e
,c2da/4 I1S noa uy 1` /Y ale_ Ufa be. /�.
a7ing Address lMa�{ie Address V C� e
- /vc. a g 4- 3 w� � = t� l
Cit to e2i x t/�U zit ' oc ,D 7 7 /
a3- Gi3/ 1y
Telephone Number onezt,,, 7-
U
Dale Dale
(Revised 6/18/2012)

•
.C47 11
Atom umg
.326.0 100MXI4S ira'a
/fg Xx.xl x1.11 ta'a
x
9
Icisozu
``'Ice

CERTIFIED MAiL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: D-n P;N
Address of Property: _40 33 to - red . a -f O/y /7G ri.g,(
(Lot or Street#, Street or Road, City&County)
Agent's Name#: T) n na ) 4 Mailing Address: ao7Dl qi as >dek/ /7/►i
Agent's phone#: q/D f3- Z/13/ 4-rr ni 47C o2g—5/3
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are p posing.A description or drawing, with dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed,you must notify the Division of Coastal Management(DCM)in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at(910) 796-7215.No response is
considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15'from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15'setback requirement.
(Prope 0 er Information) (Adjacent Property Owner information)
/4?4,,,t;?iee-At4t-cck,t
Signature n ,/ Signature
7) nor>. �'(i �7 RDbeAh.�A . CA4 dw, S
Print or Type Name Print or Type Name
ac IQ 215 >dedy /7/)/ 5 05 RcL
Mailing Address Maili g Address
4� ad // . ag-d-43 w�.` r� `{-�, Nea?"6
f� J° n
City/Stat 2ip City/State/ZipU
9/e 5703 6'73/ 9'0 'A 3 #1..• 67 `7 /
Telephone Number Telephone Number w a N
02t6 W glA 6 — 7
Date Date t _a
Revised 6/18/2012 _ ;

' A
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ,�,�
j ,(Name of Property Owner)
property located at 6 0 3,3 to (31/re
(Address, Lot, Block, oad, etc.)
on ("cilia I , in is ' (/ , N.C.
(Waterbody) (City/T6wn and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
0-"e e a7qaG t ec1
•
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to waive
the setback, you must initial the appropriate blank below.)
I do wish to waive the 15'setback requirement.
I do not wish to waive the 15'setback requirement.
(Pro rty Owner Information) (Adjacent Property Owner Information)
0441—$4444/4.1 ,1'
nature n ure /
nnie. ; cber -,�T dt Jir h-
Print or Type Name o i rr T
�a6/q Nab U y ll/V o e ��� Ufa h E. �
a7ing Addre s t j Address 0
cia
Cit,% , r S7 /Zi. .D 7 0
3613/ 3.2 7 / z
Telephone Number one u .
Date Date > ( v
p r.i z *M
(Revised 6/18/2012) cu

f
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: '`A yam;n Ali-/
Address of Property: 4D 33 /a '4 , 1-/ r� , -fv 4V'
(Lot or Street#, Street or Road, City&County)
Agent's Name#: (De nrla 4-6.h/i Mailing Address: c2?6/ 9 t X[cv/ /747
Agent's phone#: V/e - S' 3- 731 141nia4.ad /1VC .9 7 3
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing_the development
they are proposing.A description or drawing,with dimensions, must be provided with this letter.
f' 11 f r I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed,you must notify the Division of Coastal Management(DCM)in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at(910) 796-7215. No response is
considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15'from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15'setback requirement.
(Pr Owner Information) (Adjacent Property Owner Information)
( 7
0-4-- izill7,
Signature Signatu
Donnie �r/ G •
yii/ii jgD p/1-6,' 7 ,AAc'Ui
Print or Type Name Print or Type Name
�?.R6r71a. y /7n/ i13Ct/5 76'/5,
Mailing Address Mailing Address
in d she.ac/ /1/- .2.9 �3 re2" g "VC5 /1' i 2 7h 24
City/Stat /Zip City/State"AS.
0
91G- gid3- d73/ q1 f �16 - 727r z
Telephone Number Telephone Number �0 N
7C5 N
Date Date 0 z� coRevised 6/18/2012 HIS ui

Date Date Check From Name of Vendor Check Check i Permit Rct
Received Deposited Permit Holder Number amount Number/Comments
2/24/2020 Custom Built Donnie Pritt First 1097 $100.00 minor fee, 6033 6th Street, Surf JD rct
Homes of the Citizens City OnCo 10975
Carolinas, LLC Bank