SC_21-19_ Lombardo (2)

•
Issued by WiRO SC21-19
Surf City Permit Number
CAMA
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 Keith Lombardo authorizing development in the Ocean Hazard Area of Environmental Concern (AEC) at
1713 N. Shore Drive, Surf City, Pender County as requested in the permittee's application package, dated May 11,
2021, and received by DCM on May 17, 2021. This permit, issued on June 7, 2021, is subject to compliance with the
application and site drawing (where consistent with the permit) dated received on May 17, 2021, all applicable
regulations and special conditions and notes set forth below. Any violation of these terms may subject permittee to a
fine, imprisonment or civil action, or may cause the permit to be null and void.
This permit authorizes: Ground level enclosure(i.e. storage areas)
(1) All proposed development and associated construction must be done in accordance with the permitted work plat drawing
received by the Division of Coastal Management on May 17, 2021.
(2) All construction must 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, or land use activities will require a re-evaluation and
modification of this permit.
(4) A copy of this permit shall be posted or available on site. Contact this office at [phone] 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 Jason Dail
site and accessible to the permit officer when the project is inspected for C A LOCAL PERMIT OFFICIAL
compliance. Any maintenance work or project modification not covered under
this permit, require further written permit approval.All work must cease when this 127 Cardinal Drive Extension
permit expires on: Wilmington, NC 28405-3845
December 31,2024
In issuina this permit it is aareed that this oroiect is consistent with the local Land

•
Name: Keith Lombardo
Minor Permit#SC21.19
Date: June 7, 2021
Page 2
(5) The permittee is required to contact the LPO at [phone], shortly before he/she 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 redone.
(6) Any/all structures 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 Area of Environmental Concern
(AEC) standards,the more restrictive provision shall control.
(7) 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.
(8) This permit does not authorize the removal and/or transportation of sand from the subject property.
(9) 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 Coastal Resources Commission (CRC) Rules.
(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.
,.. .r

Locality ✓�I Permit Number .KJG 21-I% OTHER PERMITS MAY BE REQUIRED:The activity you are planning may require permits other than the CAMA
minor development permit,including,but not limited to:Drinking Water Well,Septic Tank(or other sanitary waste
Ocean Hazard I"- Estuarine Sho me ORW Shoreline Public Trust Shoreline Other treatment system),Building,Electrical,Plumbing,Heating and Air Conditioning,Insulation and Energy Conservation,FIA
(For official use only) Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile Home Park Approval,Highway Connection,and
others.Check with your Local Permit Officer for more information.
GENERAL INFORMATION
STATEMENT OF OWNERSHIP:
LAND OWNER-MAILING ADDRESS I,the undersigned,an applicant for a CAMA minor development permit,being either the owner of property in an AEC or a
Name V-e i+k La kfuk AJ ci r. Q 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
Address 1 1 1' 3 ikl 5 o ;t Dr. described as:(check one)
q CA,'
� fe� (,, (Q J n (� `1
City J u y l_y �I State C Zip SPhone LI �C y l o D (i �an owner or record MIA.Title is vested in name of 4-li)({� ko vA oa rdo ,
Email K(�l I 0 `ha,f C LJ e_ M C k.Y t . �0 V� see Deed Book S7 LzJ page DIY D in the CVf�v`3 County Registry of Deeds.
l AUTHORIZED AGENT an owner by virtue of inheritance.Applicant is an heir to the estate of
L K` ` L ;probate was in County.
n - Cc5`Name tKe 5�ai er �1..)0,\ QdNS r�tLlig°(/�
5 M4 �-` if other interest,such as written contract or lease,explain below or use a separate sheet&attach to this application.
Address 1
a p /C' ZZ �1'E 3 Ct 0 �Q.j /.,U jJ c NOTIFICATION OF ADJACENT RIPARIAN PROPERTY OWNERS:
City tNk g�e 4 State Iv r Phone I 4C 1
I furthermore certify that the following persons are owners of properties adjoining this property.I affirm that I have given
Email M 1 'e-'e C c rt.Q.7 Lt 61 '-i: C k p U.d ,C.0,v,.. ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) Addres
LOCATION OF PROJECT:(Address,street name and/or directions to site;name of the adjacent waterbody.) , �� �t �� �{ ,
(I)IDd a n-1 KOt 1 Yl11\3 !�, Amore N. 51.(( f(L kC �0�1L)5 (2) K4 W i'‘.0."al‘ntnc?it D r Acex 3e: 5et)c- - ► 1i t is IQ 5ho
lav(i-ycr C C('_q4 2 v\d �.0� ©wte C Qu �nt^I 1.ev 1 (4>
DESCRIPTION OF PROJECT:(List all proposed construction and land disturbance.) `J 1 t 2- ACKNOWLEDGEMENTS:
(� ^� I,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
f S
Co �fA c� 1 r Q u 4\d k C�j,le`1 t/43Q two i X t may be susceptible to erosion and/or flooding.I acknowledge that the Local Permit Officer has explained to me the particu-
4-0 S1,2 ki S. lar hazard problems associated with this lot.This explanation was accompanied by recommendations concerning stabiliza-
SIZE OF LOT/PARCEL: square feet 0 Z acres Lion and floodproofing techniques.
PROPOSED USE:Residential, (Single-family, Multi-family 0) Commercial/Industrial 0 Other 0 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
COMPLETE EITHER(1)OR(2)BELOW(Contact your Local Permit Officer if you are not sure which AEC applies related to this permit application.
to your property): /�
This the 11" day of f 1 .0 ,20 Z I
(1) OCEAN HAZARD AECa:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet(includes /1/(j2- Jair conditioned living space,parking elevated above ground level,non-conditioned space elevated above ground level butexcluding non-load-bearing attic space)
wner or person authorized gt66/
s his/her agent for purpose of filing a CAMA permit application
(2) COASTAL SHORELINE AECs:SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES SO( square feet(includes the area of the foundation of all buildings,driveways,covered decks, This application includes:general information(this form),a site drawing as described on the back of this application,the
a check ownership statement,the Ocean Hazard AEC Notice where necessary,
concrete or masonry patios,etc.that are within the applicable AEC.Attach your calculations with the project drawing.) 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
STATE STORMWATER MANAGEMENT PERMIT:Is the project located in an area subject to a State incorporated without reference in any permit which may be issued.Deviation from these� r��� a violation of
Stormwater Management Permit issued by the NC Division of Energy,Mineral and Land Resources(DEMLR)? any permit.Any person developing in an AEC without permit is subject to civil,criminal'aR �Trt�tion.
YES NO/If yes,list the total built upon area/impervious surface allowed for your lot or parcel: square feet. MAY 17 2 0,
0CM WILMINCTor ;

Permit Number OTHER PERMITS MAY BE REQUIRED:The activity you are planning may require permits other than the CAMA
minor development permit,including,but not limited to:Drinking Water Well,Septic Tank(or other sanitary waste
:ard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other treatment system),Building,Electrical,Plumbing,Heating and Air Conditioning,Insulation and Energy Conservation,FIA
(For official use only) Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile Home Park Approval,Highway Connection,and
others.Check with your Local Permit Officer for more information.
L INFORMATION
STATEMENT OF OWNERSHIP:
VNER-MAILING ADDRESS I,the undersigned,an applicant for a CAMA minor development permit,being either the owner of property in an AEC or a
e/ p ' L�tJ vv t k ' ^ ,i Q o person authorized to act as an agent for purposes of applying for a CAMA minor development permit,certify that the person
�'^C U listed as landowner on this application has a significant interest in the real property described therein.This interest can be
' 3 6 Iv 3 5 1\o f f Dr. described as:(check one) a
< CI u state W C. Ztp Phone 10 , Q L r 01
O _ an owner or record tills,Title is vested in name of ( � (il(/M(,,txr-do ,
KQ I©Wl `ha { d_Irn Cl V CO Y1/� see Deed Book 5/Z.j) page y/�0 in the A.,r� (0 County Registry of Deeds.
an owner by virtue of inheritance.Applicant is an heir to the estate of
IZED AGENT ;probate was in County.
1 t 5 (AA
r \ LA
2 t�1 if other interest,such as written contract or lease,explain below or use a separate sheet&attach to this application.
,tMQSte4
U State NC_ ;ip 4 4 J Phone �'(o SO Y�y). (Q U 4} 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
tM 1 Id-e C f t{9,4 4 e L r i 0 t..C .Co N. ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
)N OF PROJECT:(Address,street name and/or directions to site;name of the adjacent waterbody.) (1)
t` 11 '` v(cam, 1-7\4Addre ' Stiv© ^f.
> IV, `)�)f e O(, 5u( f Ctt ke, /,` 1 6 (2) --)Ka wr ot.43)iNorr ar Atex. 5r, s�l� i7t• s_hu_skOI
(3)
6"1L €CeoA 2 ` 6. ( .CQ.-) V\Ow car U nil 1,QVe\ (4)
TION OF PROJECT:(List all proposed construction and land disturbance.) �1 — 1.1 12 ACKNOWLEDGEMENTS:
�lA C�' b�L u C\ n 1 i L�Q ` x I,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
C L may be susceptible to erosion and/or flooding.I acknowledge that the Local Permit Officer has explained to me the particu-
STo q 5'424
lar hazard problems associated with this lot.This explanation was accompanied by recommendations concerning stabiliza-
LOT/PARCEL: square feet ' Z acres tion and floodproofing techniques.
ED USE:Residential, " (Single-family.0'Multi-family❑) Commercial/Industrial❑ Other ❑ 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
;TE EITHER(1)OR(2)BELOW(Contact your Local Permit Officer if you are not sure which AEC applies related to this permit application.
'perry):
This the J I+' day of (l"L0 20 .2
.N HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet(includes
3ned living space,parking elevated above ground level,non-conditioned space elevated above ground level but
non-load-bearing attic space) andowner or person authorized t act as his/her agent for purpose of filing a CAMA permit application
iTAL SHORELINE AECs:SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
RFACESSLt square feet(includes the area of the foundation of all buildings,driveways,covered decks, This application includes:general information(this form),a site drawing as described on the back of this application,the
r masonry patios,etc.that are within the applicable AEC.Attach your calculations with the project drawing.) ownership statement,the Ocean Hazard AEC Notice where necessary,a check 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
CORMWATER MANAGEMENT PERMIT:Is the project located in an area subject to a State incorporated without reference in any permit which may be issued.Deviation from these� Y a violation of
:r Management Permit issued by the NC Division of Energy,Mineral and Land Resources(DEMLR)? any permit.Any person developing in an AEC without permit is subject to civil,criminal'anSi� t tion.
NO
the total built upon area/impervious surface allowed for your lot or parcel: square feet. MAY 1 7 2 0c_'.1
ma
DCM WILMINGTC'•. '

STATf � ,,
ROY COOPER
Governor ,„
JOHN NICHOLSON �.=j
Interim Secretary 4s`9,+^„1°"l
BRAXTON DAVIS NORTH CAROLINA
Director Environmental Quality
June 8,2021
Keith Lombardo
1713 North Shore Drive
Surf City, NC 28445
Dear Mr. Lombardo,
Attached is CAMA Minor Development Permit SC 21-19 for work to be done at 1713 North Shore Drive
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 gold 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,
1,1,4) wthiji
Anita M.Webb
Permit Support Technician
N.C. Division of Coastal Management
Enclosures
Cc:WiRO files
SC Inspection Dept.
Mike Redifer—Coastal Swell Construction—Agent
ma. Ma ^\ Unrth carnlina Ilnnartmnnt of Fnvirnnmental Duality I Division of Coastal Manaaement

.
Text Box
Keith Lombardo-owner Ground level Proposed total square feet 564
1713 N Shore Dr consisting of 2 storage bldgs. With no roof unfinished,
Surf City NC 28445 not heated or cooled on existing concrete slab. No
5/8/2021 landscaping or areas disturbed.
Proposed bldg. 1- 20x12 consisting of 2 floods vents
Scale: I'1,• l0.-P-1' 1 double 36in exterior door
existing structure Proposed bldg.2- 27x12 consisting of 3 flood vents
,
setbacks 2-36in exterior doors
**** proposed 1-10x7 garage door
X flood vent
/ door
XXXX garage door
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Text Box
.t Keith Lombardo-owner
;" �� 1713 N Shore Dr
:tSi �,,�-��_ ;�.; Surf City NC 28445
©O 5/8/2021
... ,� ,n �/ Scale: �' �- �� �
..
:. ' , ; existing structure
' ' le X setbacks
. Ak � k **** proposed
j
ram• X flood vent
f• X X door
'� /
_o `., x �. �`� XXXX garage door
S �.•'te �'•. 1 el
S U R F p.t1T-,Y A I
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Ground level Proposed total square feet 564 1 711 Et .
sisting of 2 storage bldgs. With no roof unfinished,
heated or cooled on existing concrete slab. No ;,� 'N,J\�
iscaping or areas disturbed.
nosed bldg. 1- 20x12 consisting of 2 floods vents
)uble 36in exterior door RECEIVED
Proposed bldg.2- 27x12 consisting f flood vents 1711 ti rkA
iin exterior doors IIAY3 17 2021 A
1-10x7 garage door pCM wlL
MINGTQ, NC • „

Lithe ntisign ID:48F1 B904-1 C88-47D8-9D02-AA232CF56BA3
♦
Receipts for
Certified Mail
5// ZD Z/ (Staple Here)
Date
h‘ttAJn \-_5;n„ o or Pie& 3mcqV._ 11118 ►VSi\Dre-
Adjacent Properly Owner
,3T(0 5krOn V)tE` t2f, t4�t
Mailing Address n f�
City, State,Zip Code
Dear Adjacent Property.This letter is to inform you that I, k--(1-
1 1 cNtel,�d0 have applied for a CAMA Minor
Property Owner 0A5I01/4A)
?
Permit on my property at 1 7 S ko to [ {. u I c, {-r in COUNTY
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 704 619 0710 ,or by mail at the address listed below If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program,you may submit
them to
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY, STATE, ZIP CODE
Sincerely
[Kr-1/4.4.1.444
Property Owner 5/4/2021 4:46:12 PM GMT
5 0 11,0 vvta 5 1-fe I.. S
Mailing Address
/'5 In yr )Ie WC 2 /D 3
City,State,Zip Code
RECEIVED
MAY 17 20/1
DCM WILMINGTON, NC

I. . •os a ervice
CERTIFIED MAIL® KCEIPT
Domestic Mail Only
11 For delivery information,visit our website at www.usps.com".
Meni PArkl CA ,S0q5 '
u Certified Mail Fee $3.60 0482
$Extra Services&Fees(check box,add feetyptako0.00tate) 02
0 Return Receipt(hardcopy) •
Return Receipt(electronic) $ to.ao Postmark
j Certified Mail Restricted Delivery $ 00 Here
j Li Adult Signature Required $ Si).00
CI Adult Signature Restricted Delivery$
3 Postage
$1.40
3 Total Postage and Fees 05/13/2021
.00
Sent To
3 Street and Apt No.,or PO Box No.
—^*
City,State,ZIP+45

.eranea man service proviaes the rouowing oenents:
A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail
A unique identifier for your mailpiece. associate for assistance.To receive a duplicate
Electronic verification of delivery or attemptedt 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 notavailable for requires the signee to be at least 21 years of age
international mail. and provides delivery to the addressee specified
Insurance coverage Is notavailable 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
For an additional fee,and with a proper this Certified Mail receipt,please present your
endorsement on the mailpiece,you may request Certified Mail item at a Post Office'"for
the following services: postmarking.If you don't need a postmark on this
-Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion
of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply
You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.
electronic version.For a hardcopy return receipt,
complete PS Form 3811,Domestic Return
Receipt.attach PS Form 3811 to your mailpiece; IMPORTANT.Save this receipt for your records.
,�_—anon ._..,. ...,,....,...,�.....�

uthentisign ID:48F1B904-1C88-47D8-9D02-AA232CF56BA3
Receipts ir0�
Certified Mail
(Staple Here)
51I /z /
Date
"odd p‘tI Kav, G!•l - 17/sW shore
Adjacent Pro erty Owner
2_2 o
Mang Address
OeayeC �� 1 �
City,State,Zip Code
Dear Adjacent Property:
This letter is to inform you that I, KQ t'rV\ 1—.o►-10°'Lect o have applied for a CAMA Minor
Property Owner
Permit on my property at 17 (3 6v 5‘,10.re., Vr_v S�(ec,+ki , in COUNTY
Property Address I
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
704-619-0710
contact me at ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program,you may submit
them to:
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY, STATE,ZIP CODE
Sincerely, Authe„'
5/42021 4:46:39 PM GMT
Property Owner
I/4/50 rhAO vt4 cts /Lei-s kd
Mailing Address
1 a fs 14 V)-f ( e. We Z 3103
City, State,Zip Code
RECEIVED
MAY 17 2C??
DCM WILMINGT©N, NC

. . Postal ervice
CERTIFIED MAIL° RECEIPT
Domestic Mail Only
II For delivery information,visit Aur'websi.ie at www.usps.com".
Bear ilk1500rA
a
u Certified Mail Fee $3.60 0482
CIExtra Services&Fees(check box,add fee$0.
i„f mate) 02
El Return Receipt(hardcopy) $ 7„
j ❑Return Receipt(electronic) $ $J.Jit Postmark
❑Certified Mail Restricted Delivery $ $(1,CIO Here
❑Adult Signature Required $ $01.lj0
❑Adult Signature Restricted Delivery$
7 Postage
1.40
$Total Postage and Fes �l��l 3�7�I`i
7 $5.t►0
7 Sent To
u
7 Street and Apt.No.,or Pb ffoidffa
City,State,ZIP+45

,ercmea man service proviaes me Tonowing oenenis:
A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail
A unique identifier for your mailpiece. associate for assistance.To receive a duplicate
Electronic verification of delivery or attempted return receipt for no additional fee,present this
delivery. USPS®-postmarked Certified Mail receipt to the
A record of delivery(Including the recipient's retail associate.
signature)that is retained by the Postal Service a Restricted delivery service,which provides
for a specified period. delivery to the addressee specified by name,or
to the addressee's authorized agent.
rnportant Reminders: -AMA signature service,which requires the
1 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 be at least 21 years of agi
international mail. and provides delivery to the addressee specified
l 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
For an additional fee,and with a proper this Certified Mail receipt,please present your
endorsement on the mailpiece,you may request Certified Mail item at a Post Office'"for
the following services: postmarking.If you don't need a postmark on this
-Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion
of delivery(Including the recipient's signature). of this label,affix it to the mailpiece,apply
You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.
electronic version.For a hardcopy return receipt,
complete PS Form 3811,Domestic Return
Receipt;'attach PS Form 3811 to your mailpiece; IMPORTANT.Save this receipt for your records.

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Locality Permit Number OTHER PERMITS MAY cu
minor development permit, Q 1 h
Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other treatment system),Building I y
(For official use only) Certification,Sand Dune,S I
others.Check with your Lo
GENERAL INFORMATION Cr) 1 O O
STATEMENT OF OWNS. N N
LAND OWNER-MAILING ADDRESS I,the undersigned,an appli. wcj- .: ��
a
fI �., person authorized to act as: Z 1.
Name �) l �� Di
Q� listed as landowner on thishi
\ ��. a)
Address 1 1 4 3 iv 5 I\o r�c V i. described as:(check one) 0 L,``\ V N
City S u P T CA:�- State VV C Zip ' Phone 10 L1 , ` -1 . + D G L C .� an owner or record tits i=
Email K 1© WI�ha 1'G U C.ti V t C O W‘ see Deed Book �(L 41
AUTHORIZED AGENT an owner by virtue of a
l N
Name 1�<eO�; e� - Coco �u12�` CO+�S{�uL ►�q CD +. ,78.7 c,„
�� (Act(( \ if other interest,such cn a E
Address i�/, al •,7 al
�./� 21p 4i, �y NOTIFICATION OF All C a City 4-Q uk f 5 re 4 a State NC "Zip _4 3 Phone T i 0 SO LI,. lQ U C U «-
I furthermore certify that[, a) 4, - O
Email (V\ I le-? cc d,9,4 C� ., 6 0 u d .(a n"_ ACTUAL NOTICE to ea 0
(Name) •5 a
LOCATION OF PROJECT:(Address,street name and/or directions to site;name of the adjacent waterbody.) I U
1113 IV, .1e\o ce Or, 5u( f C: �/C, `,0�9 5 (2) ,,q w Y1 0 0co
tri
(3) U
0
�kla��IL �CeAA 2 `^ (Z0� Dwt� it vu Ark �Qve) (4) . 4
DESCRIPTION OF PROJECT:(List all proposed construction and land disturbance.) `J — �L I Z ACKNOWLEDGEMEE 0 . �j
ii (� I,the undersigned,acknm •7) 2 >+
Co S r�L+ Q v {nC` Q t,]e l (/�t:� Lo Z may be susceptible to era! U `O
s(o(4 $ lar hazard problems assoc 0 Q a4-,
SIZE OF LOT/PARCEL: square feet f - acres tion and floodproofing tee Q
U a)
0
PROPOSED USE:Residential, (Single-family.0'Multi-family❑) Commercial/Industrial❑ Other 0 I furtheimore certify that Z
the Local Permit Officer r C
COMPLETE EITHER(1)OR(2)BELOW(Contact your Local Permit Officer if you are not sure which AEC applies related to this permit appl `4 t
to your property): `
OE
N ;_;
(1) OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet(includes / a 0 e
air conditioned living space,parking elevated above ground level,non conditioned space elevated above ground level but � a U
excluding non-load-bearing attic space) andowner or person auf a
_ Q
(2) COASTAL SHORELINE AECs:SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACESSU square feet(includes the area of the foundation of all buildings,driveways,covered decks, This application include O
concrete or masonry patios,etc.that are within the applicable AEC.Attach your calculations with the project drawing.) ownership statement,the hi c''
any information as may t E iii N
without ref
O - Z 2 Q
STATE STORMWATER MANAGEMENT PERMIT:Is the project located in an area subject to a State incorporated `
Stormwater Management Permit issued by the NC Division of Energy,Mineral and Land Resources(DEMLR)? any permit.Any persona IL ••. rn O
O -
YES NO N Z c Q 2
3
If yes,list the total built upon area/impervious surface allowed for your lot or parcel: square feet. *' U
y U
a)
lit
N d a 2
¢ a < a in

SITE DRAWING/APPLICATION CHECKLIST yy
sake sure your site drawing includes the following information required for a CAMA minor development permit. by
al Permit Officer will help you,if requested. tro"
AL DIMENSIONS APPLICATION FOR >
N
/
Labelhigghhwaysright-of-ways CAMA MINOR
z
V Label locany se all k l DEVELOPMENT
nes
,/ Label any and all structures and driveways currently existing on property
1,7_Label adjacent waterbody Coastal Management
ENVIRONMENTAL QUALITY �/�
L'AL CHARACTERISTICS PERMIT
Draw and label normal high water line(contact LPO for assistance) In 1974,the North Carolina General Assembly passed the Coastal Area Management Act
b/1(t Draw location of on-site wastewater system
(CAMA)and set the stage for guiding development in fragile and productive areas that
If you will be working n 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
if\k,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 to
Draw and label landward limit of AEC C
or she needs before you apply. 9
• Draw and label all wetland lines(contact LPO for assistance) t'
• Draw and label the 30-foot buffer line Under CAMA regulations,the minor permit is to be Issued within 25 days once a
.OPMENT 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
Draw and label all proposed structures certain that your application is complete and signed,that your drawing meets the
Draw and label areas that will be disturbed and/or landscaped specifications given inside and that your application fee is attached.
K 't( Note size of piling and depth to be placed in ground
lV\t5i Draw and label all areas to be paved or graveled Other permits are sometimes required for development in the coastal area.While these
I Show all areas to be disturbed are not CAMA-related,we urge you to check with the Local Permit Officer to determine
V.(4( Show landscaping which of these you may need.A list is included on page two of this folder.
FO APPLICANT
We appreciate your cooperation with the North Carolina Coastal Management Program
1II' 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?
ion
• signed and dated the application? Coastal ResourcesCastalManagement
• enclosed the$100.00 fee? Division of Coastal Management
en
• completed an AEC Hazard Notice,if necessary?(Must be signed by the property owner)
FOR STAFF USE m tn"
ice Posted Final Inspection Fee Received cn td C�
ElCn
pections RECEIVED zz to
❑
MAY 17 z z
Action:Issued Exempted Denied Appeal Deadline(20 days from permit action) 2 L(, '
DCM Form EB1952-2015/Revised
DCM WILMINGTC `

Date Date Check From Name of Vendor Check Check Permit Rd
Received Deposited Permit Holder Number amount Number/Comments
5/18/2021 Keith Lombardo same BOFK, NA R209750008 $100.00 minor fee, 1713 N.Shore Dr, Surf JD rci
Money Order 81 City OnCo 1413: