SC_20-29_ Swan

Issued by WiRO SC20.29
Surf City Permit Number
CAMA
MINOR DEVELOPMENT
tip
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 Steve Dutton/Swan Song Properties, LLC authorizing development in the Estuarine Shoreline (AEC) at 465
Atkinson Point Road in Surf City, Pender County as requested in the permittee's application, dated April 8, 2020, and
received as complete by DCM on July 6, 2020. This permit, issued on July 27, 2020, is subject to compliance with the
application and drawing dated and received by DCM on July 6, 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 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 July 6, 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 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
December31,2023
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 PPRMITTP

Name: Steve Dutton
Minor Permit#SC20.29
Date: July 27, 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) All development shall be located at least 30' landward of the normal/mean high water line. 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 any wetlands, 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

Locality Permit Number
Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
(Fir official use only)
GENERAL INFORMATION •
LAND OWNER-MAILING ADDRESS
Name -cra/e b o -F-7- 'AV St.✓4,v -i - eft Pe r i
Address^-- 2 ? I Sr/'010/Ni5 01(
City W -M rV&Tc/1/ State NC- Zip ? 1(L Phone l(d-a 9`f- (033 _(o
Email SW*,v'S CAl G- ,o2oPe21't•PS ri Cti
AUTHORIZED AGENT
Name
Address City - -__ State • Zip Phone
Email
LOCATION OF PROJECT: (Address,street name and/or directions to site;name of the adjacent waterbody.)
9 6 ¶ /4-27—/fr NS pc(Ai (Z__O ( -
1fZF CrY✓ NC r1 •
Y3
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.)
Neti/ j( N64 ., 'lArA4 L V r2 es 6peNice. ccA/ 5•-7-7e Jc r ,c N
SIZE OF LOT/PARCEL: square feet • a5—acres
PROPOSED USE: Residential ,0 (Single-family, Multi-family ❑ ) Commercial/Industrial ❑ Other ❑
COMPLETE EITHER(1)OR(2) BELOW(Contact your Local Permit Officer if j'mi are not.sure which AEC applies
to four property):
(1) OCEAN IIAZARD 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 a
UPON SURFACES: square feet(includes the area of the foundation of all buildings,driveways,covered decks, 0
concrete or masonry patios,etc.that arc within the applicable AEC.Attach your calculations with the project drawing.) c-
r m
STATE STORM WATER MANAGEMENT PERMIT: Is the project located in an area subject to a Stale � m
Stormwater Mana ement Permit issued by the NC Division of Energy,Mineral and Land Resources(DEMLR)? Z _
YES NO N O Ill
I '...... t:..•N,..a.. ..1 1...:1 /;.,,..o..........�.,.•f nn nnn.vwl 4n.•vn, ,'Int nr wrnnl• cnnarp 1i'rl G 7 ri

OTHER PERMITS MAY 1W REQUIRED:The activity you arc 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,NIA
Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile I Ionic Park Approval, i lighway 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 pwposes 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)V ,� ,,/ /�
' an owner or record title,Title is vested in name of 14"' 5C/✓6- kC Peer' ,
see Deed Book 110* page /(p9? in the PeA/W 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) j ✓e ,p-Tfl c 4/3 c Pa i'i/; RI/ L&r
(2) -- Sr(/e D✓Troy 5.5" /FT-Km/cc ti Pe rN 7-- tag t_c,-
(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 stall;
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 D day o0-14e iL ,20 10
Landowner or rsoi author ed o act as his/her agent for purpose of filing a CAMA permit application
This application includes:general information(Ibis form), a site drarwing as described on the back of this application, the
o►vnersbip statement, the Ocean Hazard AEC Notice where necessary; a check for$100.00 made payable to the locality, and
any it Jb;inatiorr as may be provided orally by the applicant. The details of the application as described by these wares are
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 administrati>a .E IV D
DCM WILMINGTON, NC
JUL 0 6 2020

ROY COOPER
Governor
MICHAEL S. REGAN
� Secretary
NORTHCAROLINA BRAXTON DAVIS
Environmental Quality Director
July 30, 2020
Swan Song Properties, LLC
c/o Steve Dutton
221 Simmons Drive
Wilmington, NC 28411
Dear Mr. Dutton,
Attached is CAMA Minor Development Permit SC 20-30&SC 20-29 for work to be done at 475 and 465
Atkinson Point Road 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.
These are not valid permits until signed and returned to our office.
Thank you for your prompt attention to this matter.
Siinn)erely, l'
Tany K. ietila
rml upport Technician
N.C. Division of Coastal Management
Enclosures
Cc: WiRO files
SC Inspection Dept.
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext.,Wilmington,NC 28405

SITE PLAN
Note: Any and all developmental restrictions
(Federal, State, Local, P.O.A., H.O.A., Deed, Site
Etc.) must be verified with the parties 2 �a
responsible for enforcing those restrictions y Qo`O�
prior to any design or construction. y�
(I, Topsail Sound so i'24
N S�O145" E- a
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/ / 9h Water Line VICINITY MAP N.T.S.
/
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Qe) Ia. N.
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N Lot 86 °' N.
12,574 s.f. N
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-- \
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Wetlands \ C,4Mq
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d
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Lot 88 Lot 87 3 N /a.w o Lot 85 I Lot MR
0 3i 14.9' 01
O 14.9'�< ✓/ r
_a)) ^C in
:d' o o I ���� 7 ' AEC__
Atkinson Point M oN v -o b dine Atkinson Point
MB 4 Pg 102 z o ; tn� MB 36 Pg 136
to at 1' I I
L
In a
L_ JN
15'Front
Setback S 55'41'00" W 1 N 55'41'00" E
_Tie(Line S 55'41'00' W 1149.7D' 50.00' 50.00'
"—Y S 55'41'0Y W
49.9r
---I 19.0• F--
Atkinson Point Road
( 50' Public R/W )
Scale: 1 40' Legend:
_ 0 Existing Iron Pipe
mooZoning District = MHS OO Existing Iron Rod
40' 20' 0' 40' • New Iron Pipe
SITE PLAN FOR: I, Paul D. Talbot, do certify that
Swan SongProperties, LLC this actual survey and map was ;`p`` kkCA �4,�i 0
P performed and drawn under my �t�.••-•--..,l/ Z
465 Atkinson Point Road supervision in accordance with 0:' ESS/ '•,y=, Q
P `�.QepE O f'f.y Z
Lot 86 "The Standards of Practice for `
O
Atkinson Point Subdivision Land Surveying In North Carolina SEAL E._
W Q c
witness my original signature, L-4a99 ` _ N
Surf City Township, Pender County, NC license n be;and seal. - '� e; ' 0
SURy Z CO
Date: April 9, 2020 w1 - Aq •• •jP�QQo'` W 0
�6' 4144.. Di u n"s�, ()
Survey Reference: Paul D. Talbot, P.LS. L-4099 `" r. J
Deed Book 4656 Page 2532 1A :;,
Map Book 4 Page 142 Talbot Land Surveying, P.C. L;I. .7:y
This property is located 170 Lafayette Street ,
within a Special Flood Hazard Area. Wilmington, North Carolina 28411 f f",
Firm license C-2722- --- ----e

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Map Source: Pender County GIS Online
JUN I I LULU
LEGEND
DCM WILMINGTON,NC
P.0 Potential Uplands -Area of planned disturbance and impervious areas may require
�5'x' stormwater and sediment/erosion control permitting approval
J
Potential 404/Coastal Wetlands as regulated by the US Army Corps of Engineers - no
development, soil disturbance or fill activities without prior 404/401 permitting approval.
Wetlands were delineated in the field with numbered, pink ribbons and numbered, orange
pin flags. Flag numbers shown in Red.
1
This is not a survey. The information contained on this map
has been interpreted using an aerial photograph. The SCALE 1" - 100'
distances and acreages shown are approximate and not meant
to be absolute. Review and approval by the US Army Corps of
Engineers along with a survey of the delineated areas is THIS MAP FOR PRELIMINARY PLANNING ONLY
recommended prior to any detailed site planning. TRACT BOUNDARY SHOWN IN YELLOW
Needham Environmental, Inc. Preliminary404
Atkinson Point Lots 84-87 Environmental Consultants
Pender County, NC Wilmington, NC Wetland Delineation

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PIN: 4235-74-9128-0000 - Sale Price: $150,000 Acres:0 Pender County
Owner: SWAN SONG PROPERTIES LLC -7 Sale Date: LAST_SALE_DATE Land Value:$38,430
221 SIMMON DR 0 E o Plat: 00040102 Building Value: $0
Lii P =--' Account No: 1000893 Total value: $38,430 1:1,378
WILMINGTON, NC 28411 e� I----
0 0.01 0.02 0.04 mi
0 Township: TOPSAIL Deferred Value:$0
Deed Ref: 4680/1692 17 z C® I r r i
C Subdivision: ATKINSON POINT SUBDIVISION Exempt Amount:0 0 0.015 0.03 0 06 km
Tax Codes: G01 C53 R40 PCL Class:R N
Property J 1 inch = 115 feet
Address: Heated Sq Feet: " , , F
11
January 8, 2020
Description: LT 86 PB 4/102 ATKINSON POINT U Iff

Receipts for
Certified Mail
(Staple Here)
Adjacent Property Owner
c231 5-;,4AtOA/ S Di
Mailing Address 1p-
,i��t r r.V6 ten Nc d `/ L/
City, State,Zip Code
Dear Adjacent Property:
S�Ve N
This letter is to inform you that I, � have applied for a CAMA Minor
Property Owner n , p
Permit on my property at `Y1b r— �Kc�✓SC N PG 1 N i I in Pender/Onslow
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 jf(C )2`(- b ) 1 ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the Surf City CAMA Minor Permit Program,you may submit
them to:
Jason Dail, Field Representative
NC Division of Coastal Management
Town of Surf City Local Permit Program
127 Cardinal Drive Extension
Wilmington, NC 28405
Sincerely AIM*
Prope wner
221 fiA4A( ci/s tie
Mailing Address
W �il�r r —rc it/ A/GY
City,State,Zip Code
RECEIVED
DCM WILMINGTON, NC
.jug 0 s 2020

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
fit° 6- Tc /
I hereby certify that I own property adjacent to �
(Name of Property Owner)
property located at T 7� //-.rlir 61 sz "V , is I Ar /Q �
Address, Lot, Block, Road, etc.)
on T CP5S rL 5 i s/ ^/9 , in Sci F �'C / / , 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)
Sig lure
S�dP4/ J . OJ rrc N
Print or Type Name
9(0._ 0, ) Y- 6V'
Telephone Nu ber
acd
Date
RECEIVED
DCM WILMINGTON, NC
JUL 0 6 2020

Receipts for
Certified Mail
(Staple Here)
f � aca °
Dat
STC� vo rc 4/
Adjacent Property Ownernt
Mailin Addr
/,t/gr d�iss
4/ ) C n/ NC 2v C/
City, State,Zip Code
Dear Adjacent Property:
This letter is to inform you that I, $r [ e t" have applied for a CAMA Minor
Property Owner
Permit on my property at ''b 5 / 7 k'r NSC N Pc f^�� ,in Pender/Onslow
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(( a?Y b,3(oor by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the Surf City CAMA Minor Permit Program,you may submit
them to:
Jason Dail,Field Representative
NC Division of Coastal Management
Town of Surf City Local Permit Program
127 Cardinal Drive Extension
Wilmington,NC 28405
/()
Sincere)
rty Owner
?a1 (4t/t4ctir D /2
Mailing Address
f L M r n/ c/1/ 1✓C )7--4( (
City, State,Zip Code
RECEIVED
DCM WILMINGTON, NC
JUL 0 6 2020

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to ,we b J T T ' N ,s
(Name of Property Owner)
property located at r�`t N 5 t`A/ Po Al r '/ , •
/Address, Lot, Block, Road, etc.)
on TaPS�A-i-- 50VA/ , in 5Z 'I T- C r Y , N.C.
(Waterbody) (Town and/or County)
He has described to me as shown in the attached application and project drawing(s),the development he is
proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
Sign-ape,,p b /.tr .o 1 /
Print or Type Name
Telephone Num er
Date
RECEIVED
DCM WILMINGTON, NC
JUL 0 6 2020

c, '1,
Receipts for
Certified Mail
077 3oo (Staple Here)
Date N
Adjacent Propert Ow er
1 9 �P_LLaA(4- L/AL_
Mailing ress
23(a
City,State,Zip Code
Dear Adjacent Property: "/
This letter is to inform you that I, eve J.✓�C�V
have applied for a CAMA Minor
Property Owner
Permit on my property at , 7 b ,p0�N I Arr ��7 RD �_ in Pender/0nslow
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/O `c 'Y' 63.3b ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the Surf City CAMA Minor Permit Program,you may submit
them to:
Jason Dail, Field Representative
NC Division of Coastal Management
Town of Surf City Local Permit Program
127 Cardinal Drive Extension
Wilmington, NC 28405
Sincerely,
Prope y wner
da1 S/rfi''(o�s Q(.
Mailing Address /
W r li/►l (/11 6-rrti A(C-- 3-- 11 l
City,State,Zip Code RECEIVED
MAY 2 0 2020
DCM WILMINGTON, NC

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3 Form 3800.April 2015(Reverse)PSN 7530-02-000-9047

•` ' r
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to Sr�ve b7'T�'V
's
(Name of Property Owner)
property located at 4. (Q6 *rk't is'oA1 j 1 Al j- RD GC/T- rb,
Address, Lot, Block, Road, etc.)
on 'TV d54IL 57>010 in J`C,1IF CC TY
(Waterbody) , N.C.
(Town and/or County)
He has described to me as shown in the attached application and project drawing(s),the development he is
proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
Signature
k Ji/ SELL I C//4
Print or Type Name
Telephone Number
Date
RECEIVED
MAY 2 0 2020
ACM WILMINGTON, NC

-0
Receipts for
Certified Mail
(Staple Here)
Date
4N1(P ✓ 3()(# ,,1,41/t/
Adjacent Property Owner'
tv,p y cvASW i a- N R
Mailin
414,-/ Pjj RI) NG
a r1493
City, State,Zip Code
Dear Adjacent Property: /�
This letter is to inform you that I, 5 lafrrc'" have applied for a CAMA Minor
Property Owner
Permit on my property at 4'75--fr -f-l475D4 fC IAir R� ' n �S—
in Pender/Onslow
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 meat 9(0— ?,y- _6.'3 ' ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the Surf City CAMA Minor Permit Program,you may submit
them to:
Jason Dail,Field Representative
NC Division of Coastal Management
Town of Surf City Local Permit Program
127 Cardinal Drive Extension
Wilmington,NC 28405
Sincerely,
Prope Owner
Mailing Address
JAPAM/4/ r-Cfi✓ A/ a Ste/ r l
City, State,Zip Code
RECEIVED
MAY 2 0 2020
DCM WILMINGTON, NC

I. . -os a ervice
CERTIFIED MAIL® RECEIPT
11 Domestic Mail Only
For delivery information,visit our website at www.usps.com'.
T
HArlkISTEftQr 4v
r) Certified Mail Fee _...
T' $ $ii fij,
Extra Services&Fees(check box,add reeaiappropriate)
❑Return Receipt(hardcopy) $ 1.1.'-'!'
❑Return Receipt(electronic) $ 3 U-(;11 Postmark
0 Certified Mail Restricted Delivery $ �I 1 Ili 1 Here
❑Adult Signature Required $ S.j I,III I
❑Adult Signature Restricted Delivery$
Postage
]^ $%.7_
$ I15./06/2020
Total Postage and Fees
$ $11.1'u
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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. assozlsg 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.
nportant Reminders: -Adult signature service,which requires the
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,which
Certified Mail service is not available for requires the signee to beat least 21 years of age
international mail. and provides delivery to the addressee specified
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 Mall 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. UPS 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 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 mailplece; IMPORTANT:Save this receipt for your records.
3 Form 38O0.April 2015(Reverse)PSN 7530-02-000-9047

•
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to 5eUe- D)r7-c 4( s
/� (Name of Property Owner)
property located at '/ / 4K( -✓j5^ 4sCi A/% 0 1arr
j'�1 /� Address, Lot, .Bllock, Road,etc.)
�,/
on ! f'7.� (1- SeUA10 in ' C ( / t" , N.C.
(Waterhody) (Town andlor 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.
jAPPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
Signature
04,i (p4 J(W4,'i 4/
Print or Type Name
Telephone Number
Date
RECEIVED
MAY 2 0 2020
DCM WILMINGTON, NC

ate Date Check From Name of Vendor Check Check Permit Rct. #
?ived Deposited Permit Holder Number amount Number/Comments
2020 Swan Song same TD Bank 5521 $100.00 minor fee, 465 Atkinson Pt Rd, JD rct.
Properties, LLC Surf City PnCo 10247