SC_20-14_ Jackson

Issued by WiRO SC20-14
Surf City Permit Number
CAMA
MINOR DEVELOPMENT
v
PERMIT r
NORTH CAROLINA
as authorized by the State of North Carolina, Department of Environmental Quality Environmental Quality
and the Coastal Resources Commission for development in an area of environment
concern pursuant to Section 113A-118 of the General Statutes, "Coastal Area
Management"
Issued to Willard and Paulette Jackson authorizing development in the Ocean Hazard AEC at 2713 S. Shore Drive, in
Surf City, Pender County as requested in the permittee's application, dated March 26, 2020, and received by DCM on
March 30, 2020. This permit, issued on April 22, 2020, is subject to compliance with the application and drawing dated
and received by DCM on March 30, 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: Construction of a swimming pool (with associated decking/apron)and putting green.
(1) All proposed development and associated construction must be done in accordance with the permitted site drawing,
received by DCM on March 30, 2020.
(2) All construction shall conform to the N.C. Building Code requirements and all other local, State and Federal regulations,
applicable local ordinances and FEMA Flood Regulations.
(3) Any change or changes in the plans for development, construction, and/or land use activities will require re-evaluation and
modification of this permit.
(4) 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.
0
(Additional Permit Conditions on Pages 2 and 3) Z
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This permit action may be appealed by the permittee or other qualified persons U J 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 CC 2
compliance. Any maintenance work or project modification not covered under FIELD REPRESENTATIVE U
this permit,require further written permit approval.All work must cease when this C]
permit expires on: 127 Cardinal Drive Extension
Wilmington, NC 28405-3845
December31,2023
In issuing this permit it is agreed that this project is consistent with the local Land c. b/14---
Use Plan and all applicable ordinances. This permit may not be transferred to
another party without the written approval of the Division of Coastal PERMITT E
Management.
ICinnatnrp rani iirpri if rnnriitinnc ahnvp annly to nprmitl

Name:Willard and Paulette Jackson
Minor Permit#SC20-14
Date: April 22, 2020
Page 2 of 2
(5) The permittee is required to contact the Local Permit Officer [phone], shortly before he plans to begin
construction to arrange a setback measurement that will be effective for sixty (60) days barring a major shoreline
change. Construction must begin within sixty (60) days of the determination or the measurement is void
and must be re-verified.
(6) Any structure(s) constructed within the Ocean Hazard area shall comply with the NC Building Code, including the
Coastal and Flood Plain Construction Standards of the N. C. Building Code, and the Local Flood Damage
Prevention Ordinance as required by the National Flood Insurance Program. If any provisions of the building code
or a flood damage prevention ordinance are inconsistent with any of the following AEC standards, the more
restrictive provision shall control.
(7) All unconsolidated material resulting from associated grading and landscaping shall he retained on site by effective
sedimentation and erosion control measures. Disturbed areas shall be vegetated and stabilized (planted and
mulched)within 14 days of construction completion.
(8) Any structure authorized by this permit shall be relocated or dismantled when it becomes imminently threatened by
changes in shoreline configuration. The structure(s) shall be relocated or dismantled within two years of the time
when it becomes imminently threatened, and in any case upon its collapse or subsidence. However, if natural
shoreline recovery or beach renourishment takes place within two years of the time the structure becomes
imminently threatened, so that the structure is no longer imminently threatened, then it need not be relocated or
dismantled at that time. This condition shall not affect the permit holder's right to seek authorization of temporary
protective measures allowed under CRC rules.
(9) All development shall be located a minimum distance of 60' landward of the First Line of Stable Natural Vegetation
(FLSNV).
(10) Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third-party.
(11) If a court of competent jurisdiction determines that a party other than the permittee has legal rights to any part of the
area approved under this permit, this permit shall be null and void as to the area the court determines is not owned
by the permittee. This condition shall take effect on the date such court judgment becomes final. In such event, the
permittee shall consult DCM prior to initiating or continuing any further development under this permit.
SIGNATURE: bL DATE: 5-
(2- ' 2n2
PERMITTEE
RECEIVED
DCM WILMINGTON, NC

bi C 0---)
( .i OTHER PERMITS MAY BE REQUIRED:The activity you are planning may require permits other than the CAMA
'hjj
Permit Number minor developmentpermit,including,but not limited to:Drinking Water Well,Septic Tank(or other sanitary waste
Locality oP g
treatment system),Building,Electrical,Plumbing,Heating and Air Conditioning,Insulation and Energy Conservation,FIA
Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile Home Park Approval,Highway Connection,and
(For official use only) others.Check with your Local Permit Officer for more information.
GENERAL INFORMATION STATEMENT OF OWNERSHIP:
I,the undersigned,an applicant for a CAMA minor development permit,being either the owner of property in an AEC or a
LAND OWNER person authorized to act as an agent for purposes of applying for a CAMA minor development permit,certify that the person
Name Willard Jackson and wife.Paulette B.Jackson listed as landowner on this application has a significant interest in the real property described therein.This interest can be
described as:(check one)
Address 2508 Sharon View Lane
nan owner or record title,Title is vested in Fee Simple ,see Deed Book 4425
City Raleigh State NC Zip 27614 Phone [phone] page 174 in the Pender County Registry of Deeds.
Email [e-mail]
nan owner by virtue of inheritance.Applicant is an heir to the estate of •
AUTHORIZED AGENT probate was in County.
Name Charles F.Riggs&Associates,Inc. of other interest,such as written contract or lease,explain below or use a separate sheet&attach to this application.
Address P.O.Box 1570 NOTIFICATION OF ADJACENT PROPERTY OWNERS:
City Jacksonville State NC Zip 28541 Phone [phone] I furthermore certify that the following persons are owners of properties adjoining this property.I affirm that I have given
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
Email [e-mail]
(Name) (Address)
(1) Mr.John L.Batchelor,8 Milan Manor Drive,Milan,OH 44846
LOCATION OF PROJECT:(Address,street name and/or directions to site.If not oceanfront,what is the name of the CEB SR Properties,LLC;1009 Manor Glen Way,Raleigh,NC 27615
adjacent waterbody.)2713 South Shore Drive,Surf City,Pender County (2) Pr�n g
Proposed Pool with (3)
DESCRIPTION OF PROJECT:(List all proposed construction and land disturbance.) p (4)
Pool Decking,and All Proposed Physical Improvements,as Shown on Map
SiZE OF LOT/PARCEL: 7,141 square feet 0.164 acres ACKNOWLEDGEMENTS:
I,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
PROPOSED USE:Residential Q (Single-family 0 Multi-family❑) Commercial/Industrial 0 Other 0 may be susceptible to erosion and/or flooding.I acknowledge that the Local Permit Officer has explained to me the particu-
lar hazard problems associated with this lot.This explanation was accompanied by recommendations concerning stabiliza-
COMPLETE EITHER(I)OR(2)BELOW(Contact your Local Permit Officer if you are not sure which AEC applies non and floodproofing techniques.
to your property):
504 Sq. Ft.of Coping and Deck I furthermore certify that I am authorized to grant,and do in fact grant,permission to Division of Coastal Management staff,
(1) OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet(includes the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information
air conditioned living space,parking elevated above ground level,non-conditioned space elevated above ground level but related to this permit application.
excluding non-load-bearing attic space) I
(2) COASTAL SHORELINE AECs:SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT / Aril
This the i( day of 20
UPON SURFACES: square feet(includes the area of the roof/drip line of all buildings,driveways,covered decks, /,�A
concrete or masonry patios,etc.that are within the applicable AEC.Attach your calculations with the project drawing.) m Landowner or person • o act as *s/her agent • '.urpose of filing a CAMA permit application
STATE STORMWATER MANAGEMENT PERMIT:Is the project located in an area subject to a State Stormwater
Management Permit issued by the NC Division of Water Quality? This applic,',n in hides:general info ation(this form) a site drawing as described on the hack of this application,the
YES r1 NCd ✓ I owners gatemen the Ocean H,., ,AEC Notice wh' •necessary,a check for$100.00 made payable to the locality and
any i ormation as m, ,• ,rovi,'•orally by the a, ican.The details of the application as described by these sources are
If yes,list the total built upon area/impervious surface allowed for your lot or parcel: square feet. Inc.rporated without reference in any permit ch may be issued.Deviation from these details will constitute a violation of
an permit.Any person developin: ', . C without permit is subject to civil,criminal and administrativ ion.
RECEIVEf3
DCM WILMINGTON, NC
MAR 3 0 2020

SITE DRAWING/APPLICATION CHECKLIST
Please make sure your site drawing includes the following information required for a CAMA minor development permit.
The Local Permit Officer will help you,if requested.
PHYSICAL DIMENSIONS (cl 5141 APPLICATION FOR
____,Label roads e CAMA MINOR
7 Label highways right-of-ways o
/Label local setback lines DEVELOPMENT
Label any and all structures and driveways currently existing on property
Label adjacent waterbody PERMIT
PHYSICAL/HARACTERISTICS
/Draw and label normal high water line(contact LPO for assistance) In 1974,the North Carolina General Assembly passed the Coastal Area Management Act
Draw location of on-site wastewater system
(CAMA)and set the stage for guiding development in fragile and productive areas that
If you wipe working in the ocean hazard area: border the state's sounds and oceanfront.Along with requiring special care by those who
Draw and label dune ridges(include spot elevations) build and develop,the General Assembly directed the Coastal Resources Commission
/Draw and label toe of dunes (CRC)to implement clear regulations that minimize the burden on the applicant.
_Identify and locate first line of stable vegetation(contact LPO for assistance)
/Draw and label erosion setback line(contact LPO for assistance) This application for a minor development permit under CAMA is part of the
Draw and label topographical features(optional) Commission's effort to meet the spirit and intent of the General Assembly.It has been
designed to be straightforward and require no more time or effort than necessary from
If you will be working in a coastal shoreline area: the applicant.Please go over this folder with the Local Permit Officer(LPO)for the
Show the roof overhang as a dotted line around the structure locality in which you plan to build to be certain that you understand what information he
/Draw and label landward limit of AEC or she needs before you apply.
Draw and label all wetland lines(contact LPO for assistance)
/Draw and label the 30-foot buffer line Under CAMA regulations,the minor permit is to be issued within 25 days once a
DEVELOPMENT PLANS complete application is in hand.Often less time is needed if the project is simple.The
process generally takes about 18 days.You can speed the approval process by making
<praw and label all proposed structures certain that your application is complete and signed,that your drawing meets the
aw and label areas that will be disturbed and/or landscaped specifications given inside and that your application fee is attached.
Note size of piling and depth to be placed in ground
Draw and label all areas to be paved or graveled Other permits are sometimes required for development in the coastal area.While these
/_Show all areas to be disturbed are not CAMA-related,we urge you to check with the Local Permit Officer to determine
Show landscaping
which of these you may need.A list is included on page two of this folder.
NOTE TO APPLICANT
We appreciate your cooperation with the North Carolina Coastal Management Program
Have you: and your willingness to build in a way that protects the resources of our beautiful and
• completed all blanks and/or indicated if not applicable?
productive coast.
• notified and listed adjacent property owners?
• included your site drawing? Coastal Resources Commission
• signed and dated the application? Division of Coastal Management
• enclosed the$100.00 fee?
• completed an AEC Hazard Notice,if necessary?(Must be signed by the property owner)
FOR STAFF USE
tri
Site Notice Posted Final Inspection Fee Received
Site Inspections
RECEIVED °
DCM WILMINGTON, NC
Date of Action:Issued Exempted Denied Appeal Deadline(20 days from permit action) DCM Form EB1952-2010 Revised April 2010
MAR 3 0 2020

/--.40, .. .. ROY COOPER
f�
'v' - MICHAEL S. REGAN
BRAXTON DAVIS
April 24, 2020
Willard and Paulette Jackson
2508 Sharon View Lane
Raleigh, NC 27614
Dear Mr. & Mrs.Jackson,
Attached is CAMA Minor Development Permit SC 20-14 for work to be done at 2713 South Shore Drive
in Surf City, Pender County. An electronic copy has been sent to the Surf City Inspections Department
and to your Agent.
To validate this permit, please sign both copies as indicated for our records. Retain the orange copy for
your files, and 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.
Sincer-ly,
•
•anya K.'tila
Permit Support Technician
N.C. Division of Coastal Management
Enclosures
Cc: WiRO files
SC Inspection Dept.
Charles F. Riggs—Agent
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext.,Wilmington,NC 28405
919796 7215

CHARLES F. RIGGS &ASSOCIATES, INC.
Land Surveyors
Charles F.Riggs,P.L.S.L-2981 Corporate License(C-730) James A.Lewis,P.L.S.L-4562
502 New Bridge Street 502 New Bridge Street Landfall Executive Suites
Jacksonville,North Carolina 28540 P.O.Box 1570 1213 Culbreth Drive
[phone] Jacksonville,North Carolina 28541 Wilmington,North Carolina 28405
[e-mail] [phone] [phone]
[e-mail]
March 26,2020
To: Mr.Jason Dail
Division of Coastal Management
North Carolina Department of Environmental Quality
127 Cardinal Drive
Wilmington,North Carolina 28405
Re: Willard Jackson and wife,Paulette B. Jackson Submittal for Minor CAMA Permit
Dear Mr. Dail:
On behalf of Willard Jackson and wife,Paulette B.Jackson,Charles F. Riggs&Associates,Inc.
submits for your review the enclosed application for a Minor CAMA permit for the property at 2713
South Shore Drive, Surf City,Pender County,North Carolina.
Respectfully,
atii,:::;--) 1
ames L. Riggs
RECEIVED
DCM WILMINGTON, NC
MAR 3 0 2020

CHARLES F. RIGGS &ASSOCIATES, INC.
Land Surveyors
Charles F.Riggs,P.L.S.L-2981 Corporate License(C-730) James A.Lewis,P.L.S.L-4562
502 New Bridge Street 502 New Bridge Street Landfall Executive Suites
Jacksonville,North Carolina 28540 P.O.Box 1570 1213 Culbreth Drive
[phone] Jacksonville,North Carolina 28541 Wilmington,North Carolina 28405
[e-mail] [phone] [phone]
[e-mail]
March 26,2020
Mr.John L. Batchelor
8 Milan Manor Drive
Milan, PH 44846
Re: Willard Jackson and wife, Paulette B.Jackson Submittal for Minor CAMA Permit
Dear Mr. Batchelor:
On behalf of Willard Jackson and wife, Paulette B.Jackson, Charles F. Riggs&Associates, Inc. is
submitting to the Division of Coastal Management,North Carolina Department of Environmental Quality
the enclosed application for a CAMA permit for the property located at 2713 South Shore Drive, Surf
City, Pender County,North Carolina. Willard Jackson and wife, Paulette B.Jackson are planning to
construct a pool with pool decking,and all proposed physical improvements,as shown on map. We are
required to notify the adjoiners of this submittal. If you have objections, please contact Mr.Jason Dail in
a timely manner at(910) 796-7221,[e-mail],or by mail at the Division of Coastal
Management,N.C. Department of Environmental Quality, 127 Cardinal Drive, Wilmington,NC 28405.
pectfully,
/1149i7n
j ,lames L. Riggs
RECEIVED
nCM WILMINGTON, NC
MAR 3 0 2020

U.S. Postal ervice
v CERTIFIED MAIL® RECEIPT
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You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.
electronic version.For a hardcopy return receipt,
complete PS Form 3811,Domestic Return
Receipt,'attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records.

CHARLES F. RIGGS &ASSOCIATES, INC.
Land Surveyors
Charles F.Riggs,P.L.S.L-2981 Corporate License(C-730) James A.Lewis,P.L.S.L-4562
502 New Bridge Street 502 New Bridge Street Landfall Executive Suites
Jacksonville,North Carolina 28540 P.O.Box 1570 1213 Culbreth Drive
[phone] Jacksonville,North Carolina 28541 Wilmington,North Carolina 28405
[e-mail] [phone] [phone]
[e-mail]
March 26,2020
CEB SR Properties, LLC
1009 Manor Glen Way
Raleigh,NC 27615
Re: Willard Jackson and wife, Paulette B. Jackson Submittal for Minor CAMA Permit
To whom it may cocern:
On behalf of Willard Jackson and wife, Paulette B.Jackson,Charles F. Riggs&Associates, Inc. is
submitting to the Division of Coastal Management,North Carolina Department of Environmental Quality
the enclosed application for a CAMA permit for the property located at 2713 South Shore Drive, Surf
City, Pender County,North Carolina. Willard Jackson and wife, Paulette B.Jackson are planning to
construct a pool with pool decking, and all proposed physical improvements,as shown on map. We are
required to notify the adjoiners of this submittal. If you have objections, please contact Mr.Jason Dail in
a timely manner at(910)796-7221,[e-mail],or by mail at the Division of Coastal
Management,N.C. Department of Environmental Quality, 127 Cardinal Drive, Wilmington,NC 28405.
Respectfully,
hii,071775)
James L. Riggs i
RECEIVED
DCM WILMINGTON, NC
MAR 3 0 2020

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delivery. LISPS®-postmarked Certified Mail receipt to the
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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 Mail service with signee to be at least 21 years of age(not
First-Class Mail°,First-Class Package Servicee, available at retail).
or Priority Mail°service. -Adult signature restricted delivery service,which
Certified Mail service is not available for requires the signee to be at least 21 years of agi
international mail. 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
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endorsement on the mailpiece,you may request Certified Mail item at a Post Office'"for
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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
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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:
WILLARD JACKSON&WIFE, PAULETTE B.JACKSON
A2. Building Street Address(including Apt., Unit, Suite,and/or Bldg.No.)or P.O.Route and Company NAIC Number:
Box No.
2713 SOUTH SHORE DRIVE
City State ZIP Code
SURF CITY North Carolina 28445
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOT 6,SUNWARD COVE
A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory,etc.) ACCESSORY
A5. Latitude/Longitude: Lat.34d23'50"N Long.77d35'20"W Horizontal Datum: ❑ NAD 1927 0 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
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 0.00 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 0.00 sq in
d) Engineered flood openings? ❑Yes 12 No
A9.For a building with an attached garage:
a) Square footage of attached garage 0.00 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 0.00 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
B4.Map/Panel B5. Suffix B6. FIRM Index 67. FIRM Panel B8. Flood B9. Base Flood Elevation(s)
Number Date Effective/ Zone(s) (Zone AO, use Base Flood Depth)
Revised Date
3720422300 J 02-16-2007 02-16-2007 VE 14.0'
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 89: ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes ❑x No
Designation Date: ❑ CBRS ❑ OPA RECEIVED
DCM WILMINGTON, NG f
CCU A noc /7N c% IAA n n n anon r,......n...... sc

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:
2713 SOUTH SHORE DRIVE
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: NC CORS Vertical Datum:NAVD 1988
Indicate elevation datum used for the elevations in items a)through h)below.
❑ NGVD 1929 ❑x NAVD 1988 ❑Other/Source:
Datum used for building elevations must be the same as that used for the BFE.
Check the measurement used.
a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 13.00 x❑ feet ❑ meters
b) Top of the next higher floor N/A ❑ feet ❑ meters
c) Bottom of the lowest horizontal structural member(V Zones only) N/A ❑ feet ❑meters
d) Attached garage(top of slab) N/A ❑ feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building feet
(Describe type of equipment and location in Comments) 18.10 ❑ ❑ meters
f) Lowest adjacent(finished)grade next to building(LAG) 12.30 ❑x feet ❑ meters
g) Highest adjacent(finished)grade next to building(HAG) 12.90 ❑x feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs,including
structural support N/A ❑ feet ❑ meters
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? ❑x Yes ❑No ❑Check here if attachments.
Certifiers Name License Number
JAMES A.LEWIS L-4562 \\\ON-t I
o CAR f//,
TItle ROJECT MANAGER pQESS/04��,L P
Company Name — ' 4�:.SEAL 9r -
CHARLES F. RIGGS&ASSOCIATES,INC. — 2 4 —
Address ; .:
502 NEW BRIDGE STREET �'S'�S' ` �0 `
City State ZIP CodeG A•.
JACKSONVILLE North Carolina 28540 /t r/r r t l l t��— �7
Signature Date Telephone Ext. ,/
ii /9�l g [phone] 41
Copy all p es of this Elevation Certificate and all attachments for(1)co unity official,(2)insurance agent/company,and(3)building owner.
Comments(including type of equipment and location,per C2(e), if applicable)
EXISTING DWELLING IS TWO STORY ON PILINGS,ENCLOSED BELOW.
THIS ELEVATION CERTIFICATE IS FOR AN ACCESSORY, PROPOSED POOL EQUIPMENT,FOR PROPOSED POOL.
PROPOSED EQUIPMENT TO BE PLACED ON EXISTING HVAC STAND.TOP OF HVAC STRIE.CEEIVED
BOTTOM OF METER BOX= 18.8' DCM WILMINGTON, NC
MAR 3 0 2090
CCRAA C.....-.!IOC CI 77 /7/A C\ rf__,___- _„--_...•_.._ _n...•

CHARLES F. RIGGS &ASSOCIATES, INC.
Land Surveyors
Charles F.Riggs,P.L.S.L-2981 Corporate License(C-730) James A.Lewis,P.L.S.L-4562
502 New Bridge Street 502 New Bridge Street Landfall Executive Suites
Jacksonville,North Carolina 28540 P.O.Box 1570 1213 Culbreth Drive
(910)4 7 Jacksonville,North Carolina 28541 Wilmington,North Carolina 28405
[e-mail]
[phone] [phone]
[e-mail]
AGENT AUTHORIZATION FORM
Date: December 20. 2019
Name of Property Owner Applying for Permit:
Willard Jackson and wife._Paulette B.Jackson
Mailing Address:
2508 Sharon View Lane
leiuh_NC' 27614
I certify that I have authorized Charles F. Riggs&Associates,Inc. to act on my behalf, for the purpose
of applying for and obtaining all CAMA Permits necessary to install or construct the proposed pool, as shown
on map and located at 2713 South Shore Drive, Surf City,Pender County,North Carolina,and I grant
permission to the Division of Coastal Management to access the property to mark/flag:
x The First Line of Stable Natural Vegetation
The Coastal Wetlands
The Normal High Water Line
This authorization is valid thru
(e)
e
p rty Owner Signature I) c mher 0 20l 9
Pro
Date

OCEAN HAZARD AEC NOTICE
Project is in an: Ocean Erodible Area __ High Hazard Flood Area Inlet Hazard Area
Property Owner: Willard Jackson and wife,Paulette B.Jackson
Property Address: 2713 South Shore Drive,Surf City, Pender County
Date Lot Was Platted: July 1996
Ibis notice is intended to make you. the applicant,anare of the SPECIAL NOTE: ibis hazard notice is required for
special risks and conditions associated with deselopment in this deselopment in area. subject to sudden and massise storms and
area.which is subject to natural hazards such as storms.erosion erosion. Permits issued fir dexetopment in this area expire on
and currents. the odes of the Coastal Resources Commission December :I of the third year follosing the year in %high the
require that you recrise an NE( Ilazard \otice and permit star issued. Shonly before cork begins on the project
acknowledge that notice in sriting before a Ix-rmit for site,the Local Permit Officer must be contacted to determine the
development can be issued. vegetation line and setback distance at your site. If the property
has seen little change since the time of permit issuance. and the
The ('omit uss ion's rules on huihirfig standards. oceanfront proposed de%elopntent can still meet the setback requirement_
setbacks and dune alterations arc designed to minimize. but not the LP()sill inform you that sou may begin work. Substantial
eliminate. property loss trom hazards. Ely granting permits. the progress on the project must be made within 60 days of this
Coastal Resources Commission does not guarantee the safety of setback determination.or the setback must be re-measured. ,also.
the deselpinent and assumes no liability for future damage to the occurrence of a major shoreline change as the result of a
the deselopment. Permits issued in the (kean Hazard .\rea of storm nithin the 60-day period %si►l necessitate re-measurement
En%ironmental Concern include the condition that structures he of the setback. It is important that you check with the I.PO
relocated or dismantled if they become imminently threatened before the permit expires for official approxal to continue the
by changes in shoreline configuration. The structuretsl must be lark after the permit has expired. (generally. if foundation
relocated or dismantled nithin two (21 years of becoming pilings base been placed and substantial progress is continuing.
imminently threatened, and in arty case upon its collapse or permit renewal can he authorized. It is unlasfil to continue
subsidence. work after permit expiration.
The best atailahic information.as accepted by the Coastal For more information.contort:
Resources Commission, indicates that the annual long-term
asera_e ocean erosion rate for the area where your property is
located is feet per year.
Local Permit Officer
The rate was established by carefid analysis of aerial
photographs of the coastline taken oxen the past 50 years.
Studies also indicate that the shoreline could muse as much as Address
beet landnard in a major storm_
The flood satcrs in a major storm are predicted to be about
feet deep in this area. Locality
Preferred oceanfront protection measures are beach nourishment
and relocation of threatened structures. Hard erosion control
structures such as bulkheads.serially,re%etments.groins,jetties Phone Number
and hreaksaters arc prohibited. Temporary sand bags may he
authorized under certain conditions.
the applicant must acknon ledge this information and
requirements by signing this notice in the space bcloss 11 ithoui
the proper signature.the placation sill not he compfeto
Property Owner Srgnatur Date
ri tR d Rtalit-gMp6�'.-MTh^i
MAR 30 2020

Date Date I Check From Name of Vendor Check Check Permit Rd
Received Deposited Permit Holder Number amount Number/Comments
4/3/2020 4/3/2020 Charles F Riggs & Willard and First 16431 $100.00 minor fee, 2713 South Shore Dr., JD rct
Associates, Inc. Paulette Jackson Citizens Surf City PnCo 1040(
Bank