SC_20-19_ Bennett

. .
RECEIVED
Issued by WiRO SC20-19
Surf City JUL 2 4 Permit Number
CAMA r>^�k WILMINGTON, NC
MINOR DEVELOPMENT
PERMIT _`
NORTH CAROLINA
Environmental Quality
as authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission for development in an area of environment
concern pursuant to Section 113A-118 of the General Statutes, "Coastal Area
Management"
Issued to Matt and Monica Bennett authorizing development in the Estuarine Shoreline (AEC) at 141 Atkinson Road,
in Surf City, Pender County as requested in the permittee's application, dated June 12, 2020, and received by DCM on
June 16, 2020. This permit, issued on July 6, 2020, is subject to compliance with the application and drawing dated and
received by DCM on June 16, 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, parking areas and cabana(with pervious walk).
(1) All proposed development and associated construction must be done in accordance with the permitted site drawing dated
received by DCM on June 16, 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 CAM LOCAL PERMIT OFFICIAL
this permit,require further written permit approval.All work must cease when this
permit expires on: 127 Cardinal Drive Extension
December 31,2023 WI I I711
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 PF'MITTEE

Name: Matt and Monica Bennett
Minor Permit#SC20-19
Date: July 6, 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) All structures shall comply with the NC Building Code, including the Coastal and Flood Plain Construction Standards
of the N. C. Building Code, and the Local Flood Damage Prevention Ordinance as required by the National Flood
Insurance Program. If any provisions of the building code or a flood damage prevention ordinance are inconsistent
with any of the following AEC standards, the more restrictive provision shall control.
(9) Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third-party.
SIGNATURE: DATE: X Z7 ZCr2
PERMITTEE

+l Ck
9 G 2A >t \ OTHER PERMITS MAY BE REQUIRED:The activity you are planning may require permits other than the CAMA
Locality Cif*' 1 Permit Number 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
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 Matt Bennett and wife,Monica Bennett 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 207 North Sea Lily Court
Elan owner or record title,Title is vested in Fee Simple ,see Deed Book 4668
City.Hampstead State NC Zip 28445 Phone [phone] page 2158 in the Pender County Registry of Deeds.
Email [e-mail]
Elan 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. 1--If 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)
(I) Mr.Robert John Martin,36719 West Main Street,Purcellville,VA 20132
LOCATION OF PROJECT:(Address,street name and/or directions to site.If not oceanfront,what is the name of the
adjacent waterbody.) 141 Atkinson Road,Surf City,Pender County (2) Peninsula at Topsail HOA,111 Augusta Court,Advance,NC 27006
(3)
DESCRIPTION OF PROJECT:(List all proposed construction and land disturbance.) Proposed Three-Story (4)
Dwelling on Pilings with Decks Over Concrete Slab Enclosed below for Storage,Entry&Garage
SIZE OF LOT/PARCEL: 10,569 square feet 0.243 acres with Pervious Gravel Drive and All ACKNOWLEDGEMENTS:
Proposed Improvements as Shown I,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
PROPOSED USE:Residential ID (Single-family 0 Multi-family❑) Commercial/Industrial❑ Other Ei 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 stabilize-
COMPLETE EITHER(1)OR(2)BELOW(Contact your Local Permit Officer if you are not sure which AEC applies tion and floodproofing techniques.
to your property):
(1) OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: N/A square feet(includes I furthermore certify that I am authorized to grant,and do in fact grant,permission to Division of Coastal Management staff,
airthe Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information
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)(2)COASTAL SHORELINE AECs:SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUiLT . This the le/ti day of AdOt/)e ,20 20
UPON SURFACES:1,077 square feet(includes the area of the roof/drip line of all buildings,driveways,covered decks,
concrete or masonry patios,etc.that are within the applicable AEC.Attach your calculations with the project drawing.) a6/i Landowner or person authorized to act as hi er //for purpose 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 application includes:general informalio I form),a site drawing as described on the hack of this application,the
YES=✓ NC( I ownership statement,the Ocean Hazard AEC / e where necessary,a check for$100.00 made payable to the locality and
1,330 any information as may be provided orally b '/ applicant.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. incorporated without reference in any permit which may be issued Deviation from these details will constitute a violation of
any permit.Any person developing in an AEC without permit is subject to civil,criminal and administrative action.
RECEIVED FEE EI ED
DCM WILMINGTON, NC DCM WILM. GTON NC
JUN 1 6 2020 JUN 1 7 20

SM ROY COOPER
yyyy r_
`� MICHAEL S. REGAN
A
BRAXTON DAVIS
Dtredor
July 7, 2020
Matt& Monica Bennett
207 North Sea Lily Court
Hampstead, NC 28445
Dear Mr. & Mrs. Bennett,
Attached is CAMA Minor Development Permit SC 2019 for work to be done at 141 Atkinson Road, Surf
City in Pender County. An electronic copy has been sent to the Pender County 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.
)
Sincerely,
Tarya K,iPietila
Permit Support Technician
N.C. Division of Coastal Management
Enclosures
Cc: WiRO files
PN Inspection Dept.
Charles F. Riggs-Agent
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext.,Wilmington,NC 28405

Dail, Jason
From: Mark Kuhlmann <[e-mail]>
Sent: Wednesday, September 8, 2021 6:49 AM
To: Dail, Jason
Subject: [External] Bennett pool
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an
attachment to Report Spam.<mailto:report.spamnnc.gov>
Good morning Jason. Here are the changes for the Bennett pool. We are adding a 10'x 10' section to pool 100sgft. While
removing 100 sqft of pervious deck in the same foot print. Thanks for your help. Mark 843-602-0427.

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THE PENINSULA AT :- _ 41
TOPSAIL 004
M.Q. 56, P. 39
lo
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BOUNDARY & TOPOGRAPHIC SURVEY & PRELIMINARY PLO
FOR
MATT BENNETT Sc
WIFE ,
MONICA BENNETT
LOT 1, PENINSULA AT TOPSAIL, M.B. 56, P. 39
TOPSAIL TOWNSHIP, PENDER COUNTY, NORTH CAROLII
MATT BENNETT & WIFE, MONICA BENNETT, OWNER; D.B. 466E
141 ATKINSON ROAD

OCEAN HAZARD AEC NOTICE
Project is in an: Ocean Erodible Area High Hazard Flood Area Inlet Hazard Area
Property Owner: Matt Bennett and wife, Monica Bennett
Property Address: 141 Atkinson Road, Surf City, Pender County
Date Lot Was Platted: April 2014
Ibis notice is intended to make you.the applicant. aware of the SPECIAL NOTE: Ibis hazard nonce is required for
special risks and conditions associated ssith development in this development in areas subject to sudden and massive storms and
area, sshich is subject to natural hazards such as storms.erosion erosion. Permits issued fur development in this area expire on
and currents. The rules of the Coastal Resources Commission I)ecember 31 of the third sear following the sear in sshich the
require that sou receive an At(' Hazard Notice and permit was issued. Shortly before stork begins on the project
acknowledge that notice in writing before a permit for site.the I.oscal Permit Officer must be contacted to determine the
development can be issued. scgetation line and setback distance at your site. If the prupern
has seen little change since the time of permit issuance. and the
The Commission's rules on building standards. oceanfront proposed development can still meet the setback requirement.
setbacks and dune alterations arc designed to minimize. but not the LPO will inform you that you ilia% begin cork. Substantial
eliminate, property loss from hazards. say granting permits. the progress on the project must be made within 60 days of this
Coastal Resources Commission does not guarantee the octets of setback determination.or the setback must be re-measured, Also.
the deselopment and assumes no liability for future damage to the occurrence of a major shoreline change as the result of a
the des ekspment. Permits issued in the Ocean Ilarard Ina of storm within the 60-day period sill necessitate re-measurement
Insironmental ( oneem include the condition that structures he of the setback. It is important that you check with the L.PO
relocated or dismantled if they become inmminently threatened before the permit expires for official approval to continue the
by changes in shoreline configuration. the structure(.) must be stork after the permit has expired. Generally. if foundation
relocated or dismantled within two t2.1 years of becoming pilings have been placed and substantial progress is continuing.
imminently threatened. and in any case upon its collapse or permit renewal can be authorized. It is unlawful to continue
subsidence. cork after permit expiration.
The best as ailable information,as accepted by the Coastal For more information.contact:
Resources Commission, indicates that the annual long-term
ascrage ocean erosion rate for the area where sour proper is
located is feet per year.
Local Permit Officer
The rate was established by careful analysis of aerial
photographs of the coastline taken over the past 50 years.
Studies also indicate that the shoreline could move as much as Address
feet landward in a major storm.
1he Ilood waters in a major storm are predicted to be about
feet deep in this area. Locality
Preferred oceanfront protection measures arc beach nourishment
and relocation of threatened structures Hard erosion control
structures such as bulkheads,seasalts,resetrnents,groins,jetties Phone Number
and breakwaters are prohibited, Temporary sand bags may be
authorized under cenain conditions.
I he applicant must acknowledge this information and
requirements by signing this notice in the space below 11 ithout
the pro signatu the application will not he complete.
RECEIVED
S it
7.O DCM WILMING i ON, NC
roper O►w Signa ore Da J U N 1 6 2020
/t/s_
Rev,sea ma, 2:';;

VIM
Owner ignatur,e
Date
RECEIVED
DCM WILMINGTON, NC
J U N 1 6 2020

ter ——
no
3
CHARLES F. RIGGS &ASSOCIATES, INC.
Land Surveyors
Charles F Riggs,P t S 1•2981 Corporate t tc nsc(C.730) James A Lewis,PL S L 4562
502 New Bridge Street 502 New Badge Street Landfall Eaccutwve Swtea
Jackaatvtlk,North Carolina 28540 Pt) Box 1570 1213 Cuthrcth Drive
[phone] Jacksonville,North Carolina 28541 Wilmington,North Carolina 28405
char levtggcanggatarwln,corn (910)455-01177 [phone]
punctlewn4ngplanclac cool
AGENT AUTHORIZATION FORM
Date: _May 19.2020
Name of Property Owner Applying for Permit:
Matt Bennett and wig,Monica Bennett
Mailing Address:
_207_North Sea I il5'Court
llarnp teal NC 28445
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 proposed dwelling,as shown
on attached map and located at 141 Atkinson Road,Surf City,Pender County,North Carolina,and I grant
permission to the Division of Coastal Management to access the property to markillag:
The First Line of Stable Natural Vegetation
X The Coastal Wetlands
.X The Normal High Water Line
This authorization is valid thru May 19,2020 RECEIVED
DCM WILMINGTON, SIG
JUN162020

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]
www.riggslandnc.com [e-mail]
June 12, 2020
To: Mr. Jason Dail
Division of Coastal Management
North Carolina Department of Environmental Quality
127 Cardinal Drive
Wilmington,North Carolina 28405
Re: Matt Bennett and wife, Monica Bennett Submittal for Minor CAMA Permit
Dear Mr. Dail:
On behalf of Matt Bennett and wife, Monica Bennett, Charles F. Riggs&Associates, Inc.
submits for your review the enclosed application for a Minor CAMA permit for the property at
141 Atkinson Road, Surf City, Pender County,North Carolina.
Respectfully,
4-6 i
James L. Riggs
RECEIVED
DCM WILMINGTON, NC
J U N 1 6 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]
www.riggslandnc.com [e-mail]
June 12,2020
Mr. Robert John Martin
36719 West Main Street
Purcellville,VA 20132
Re: Matt Bennett and wife, Monica Bennett Submittal for Minor CAMA Permit
Dear Mr. Martin:
On behalf of Matt Bennett and wife, Monica Bennett,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 141 Atkinson Road, Surf City,
Pender County,North Carolina. Matt Bennett and wife,Monica Bennett are planning to construct a three-
story dwelling on pilings with decks over a concrete slab enclosed below for storage,entry and garage
with a pervious gravel drive and all proposed 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
[phone],[e-mail],or by mail at the Division of Coastal Management,N.C.
Department of Environmental Quality, 127 Cardinal Drive, Wilmington, NC 28405.
spectfully,
James L. Riggs
RECEIVED
DCM WILMINGTON, NC
J U N 1 6 2020

1. . •os a ervice
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insurance coverage automatically included with accepted as legal proof of mailing,it should bear a
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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.April 2015(Reverse)PSN 7530-02-000-9v47

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]
www.riggslandnc.com [e-mail]
June 12,2020
Peninsula at Topsail HOA
111 Augusta Court
Advance,NC 27006
Re: Matt Bennett and wife,Monica Bennett Submittal for Minor CAMA Permit
To whom it may concern:
On behalf of Matt Bennett and wife, Monica Bennett,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 141 Atkinson Road, Surf City,
Pender County,North Carolina. Matt Bennett and wife, Monica Bennett are planning to construct a three-
story dwelling on pilings with decks over a concrete slab enclosed below for storage,entry and garage
with a pervious gravel drive and all proposed 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
[phone],[e-mail],or by mail at the Division of Coastal Management,N.C.
Department of Environmental Quality, 127 Cardinal Drive, Wilmington, NC 28405.
A
Respectfully,
i
ames L. Riggs
fie
IP
RECEIVE
DCM WILMINGTC1iV, NC
JUN 16 2020

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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,o
to the addressee's authorized agent
Important 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 Service®, available at retail).
or Priority Mail®service. -Adult signature restricted delivery service,whir
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international mail, and provides delivery to the addressee specifif
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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
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
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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.April ems(po,ov Ar pera 7s2n.no.nrvr.onnr

U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008
Federal Emergency Management Agency Expiration Date: November 30,2022
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:
MATT BENNETT AND WFE, MONICA BENNETT
A2. Building Street Address(including Apt., Unit, Suite,and/or Bldg.No.)or P.O. Route and Box No. Company NAIC Number:
141 ATKINSON ROAD
City State ZIP Code
SURF CITY North Carolina 28445
A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.)
LOT 1,THE PENINSULA AT TOPSAIL
A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory,etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat.34d24'49"N Long.77d34'09"W 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 6
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 980.00 sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s)within 1.0 foot above adjacent grade 5
c) Total net area of flood openings in A8.b 1000.00 sq in
d) Engineered flood openings? ❑Yes 0 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 63. State
TOWN OF SURF CITY 370186 PENDER COUNTY North Carolina
B4.Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8.Flood B9. Base Flood Elevation(s)
Number Date Effective/ Zone(s) (Zone AO,use Base Flood Depth)
Revised Date
3720423400 J 02-16-2007 02-16-2007 AE 8.0'
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 89:
❑ FIS Profile 0 FIRM ❑ Community Determined ❑ Other/Source:
B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 x❑ NAVD 1988 ❑ Other/Source:
612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Opp t rnledtd.Area(OPA)? ❑Yes 0 No
Designation Date: ❑ CBRS ❑ OPA DCM WILMINGTON, NC
}UN 1 6 211211 °T;,2 S/Zo/iota
FFMA Fnrm o86-0-33(12/19) Replaces all previous editions. Form Page 1 of 6

OMB No. 1660-0008
ELEVATION CERTIFICATE Expiration Date:November 30,2022
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:
141 ATKINSON ROAD
City State ZIP Code Company NAIC Number
SURF CITY North Carolina 28445
SECTION C—BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
Cl. 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) 5.5 x❑ feet ❑ meters
b) Top of the next higher floor 15.5 x❑ 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 10.1 0 feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building(LAG) 4.0 ❑x feet ❑ meters
g) Highest adjacent(finished)grade next to building(HAG) 4.3 ❑x feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs,including ❑ feet ❑ meters
structural support N/A
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.
/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.
Certifier's Name License Number
JAMES A.LEWIS L-4562 ````\�N��CARo'o,/,
Title
i
PROJECT MANAGER O.O4,�SS •/04;•• •ale
_ � 9
Company Name = 4 SEAL r .*:
CHARLES F. RIGGS&ASSOCIATES,INC. _ • -. _ ,
Address — :„1/ Off.'
502 NEW BRIDGE STREET O Si5gj1G,.
City State ZIP Code 'ir F AL
, \'
JACKSONVILLE North Carolina 28540 �irr S
i etz,fr.�Lo
Signatureiyi,_,..piA4.
Date Telephone
10)455-0877 41rt
��7w/'lo'l�o
Copy all p es of this Elevation Ce cote and all attachments fo (1)community official,(2)insurance agent/company,and(3)building owner.
Comments(including type of equipment and location,per C2(e), if applicable)
PROPOSED DWELLING IS THREE STORY ON PILINGS,ENCLOSED BELOW.
SURVEYOR RECOMMENDS 5 ENGINEERED FLOOD EVENTS WITHIN THE ENCLOSURE.ENGINESr1 BART
VENTS(MODEL#1540-570)COVERING 200 SQ.FT.EACH.
PRELIMINARY FLOOD MAPS SHOW A CHANGE IN FLOOD ZONE TO AE(10), SURVEYOR REC I I II OGI'(RI$T
FINISH FLOOR AND ELECTRICAL EQUIPMENT AT 10.0'OR HIGHER.
J U N 1 g #1 s-07-34)
Form Page 2 of 6
FEMA Form 086-0-33(12/19) Replaces all previous editions.

Date Date Check From Name of Vendor Check Check Permit Rd
Received Deposited Permit Holder Number amount Number/Comments
6/25/2020 Charles F Riggs and Matt and Monica FCB 16528 $100.00 minor fee, 141 Atkinson Rd, Surf JD rct.
Associates, Inc. Bennett City PnCo 10238