Equity Trust Co. 84200C

o�° ° " ❑CAMA ❑DREDGE & FILL N9 84200 A B C.G' D
GENERAL PERMIT Previous permit
Date previous permit issued
❑Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
r�
15A NCAC ' ❑Rules attached. El General Permit Rules available at the following link: wwwdeq.nagov/CAMArules
Applicant Name Authorized Agent
Address - Project Location (County): -
City State / ( ZIP :.' Street Address/State Road/Lot #(s)
Phone#(_)�
Email Subdivision
City i i ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wen Body ' (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no II
Type of Project/ Activity I N F'q /'
(Scale: )
Access Length
i
�
i
I
--
-*-i_
--
Pier (dock) length
Fixed Platform h s
Floating Platform(s)
_
_
_...
!
_\ii
Finger pier(s)
r
1
.
1
.(t.LI
-
Total Platform area
'�I-
-
-
--
Groin length/#
Bulkhead/Riprap length 7--0(7
Avg distance offshore
Breakwater/Sill•-
Max distance/ length
Basin, channelCubic yards /
Boat ramp
Boathouse/ Boatlift
iI
�-
-�-
I.
-�
--
-
-
Ti-
+-
-
-}�,
-
L•
Beach Bulldozing
Other
-
-
-
=I
SAV observed: yes no N
Moratorium: n/a yes no I-
i-
F
i
�
_
__
__
_
__
_
Site Photos-. yes no
Riparian Waiver Attached: ves no
"_._
...,.
_. ..,
.,...
_...
.....
�.._
A building permit/zoning permit may be required by:
Permit Conditions
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROIECTAND REVIEWED COMPLIANCE STATEMENT. ,(Please Initial)
Agent or Applicant PRINTED Name
Signature "Please read compliance statement on back of permit'*
Application Feels) Check p/Money Order
Permit Officer's PRINTED Name /
i
Signatu e r
Issuing Date Expiration Date

�COMA, FICAMA ❑ DREDGE & FILL N9 84200 A B '"C D
GENERAL PERMIT Previous permit
* Date previous permit issued
RPNew ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
ISA NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant
City
Phone # (_ )
Email
Authorized ,agent
Project Location (County):
'r State ZIP Street Address/State Road/Lot#(s)
Subdivision
City
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body I
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale: )
<6nrolinu I unmF � �-
_._.,..�.i_..
Access Length
Pier(dock)length
Fixed Platform(s)—
/
.
-..I
I
—
—
Floating Platform(s)
r-
Fingerpier(s)
Total Platform area
Groin length/q_
Bulkhead/ Riprap length
Avg distance offshore"-"i
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
--�
I----
—
---
—
-
—
'`
_
,+
,r
'-
1
-
—
--
--
-j
(---
�._--
-
Other
—
r
—
—
-
-
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: no es
Y
Riparian Waiver Attached: yes no
1—
�-
-
-
-
A building permit/zoning permit may be required by:
❑TAR/PAM/NEUSE/BUFFER (circle one)
Permit Conditions
_ ❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. .(Please Initial)
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature *`Please read compliance statement on back of permit" Signature
Application Fee(s) Check#/Money Order Issuing Date Expiration Date

AGENT AUTHORIZATION FOR LAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Equity Trust Company Custodian C/O Phillip Lewis
Mailing Address: PO Box 662,
Greenville, NC 27835
Phone Number: 252-531-9704
Email Address:
[e-mail]
I certify that I have authorized Samuel F Ballou/ SF Ballou, Inc
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
Bulkhead
at my property located at 1824 Salter Path Rd. - Lot 1, Indian Beach, NC 28512
in Carteret
County.
I furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
Philip Lewis
Print or Type Name
Property Owner
Tr
Date
This certification is valid through

ZONING PERMIT
TOWN OF INDIAN BEACH
1400 SALTER PATH ROAD
PHONE # [phone]
FAX #[phone]
Email: adminQindianbeach.ora
DATE: 1/12/22
OWNER: Equity Trust Company Custodian C/O Phillip Lewis
INDIAN BEACH ADDRESS: 1824 Salter Path Rd. Lot 1
INDIAN BEACH ZONING CLASS: PDD
MAILING ADDRESS: PO Box 662, Greenville, NC 27835
PHONE#: [phone]
EMAIL ADDRESS: [e-mail]
TYPE OF WORK Bulkhead
NAME OF CONTRACTOR: Samuel Ballou
BUSINESS NAME AND ADDRESS: SF Ballou Inc. dba SF Ballou Construction Co., 3302-1 Bridges St. MHC
NC License # 16314
All construction must meet the Town of Indian Beach zoning set -backs. Building permits must be obtained from
the Carteret County Building Insyector's office located at 701 Cedar Point Rd. Cedar Point, NC 252-222-5833.
OWNER/AGENT
SIGNATURE: _
TOWN MANAGE
P."il Fee $25 W
AL/COMMENT:

ME
9
ti

■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
1�1DN
Pb 0ox W
00VhA"-he
III IIIIIII�II IIIII�IIII II'I III'IIIIIIIIII III
9590 9402 5603 9274 5292 11
120 1290 0000 7946 4605
Ps Form 3311, July 2015 PSN 7500-02460-3053
A. signature
0 Agent
X'S'M I -A �� ElAddre
D. Is delivery address differedt from item 12 urea
If YES, enter delivery address below: ❑ No
❑ Paodty Mall ExWNO
0 Registered Mail -
Delivery
❑ Registered Mall ResWed
Delivery
slivery
0 Hatum R=Pt for
;ed Delivery
M
0 Signature 0onff tlonnature
m
livery
Restricted Delivery
Domestic Return Receipt

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
1 /12/2022
Religious Exemption
Name of Adjacent Riparian Property Owner
PO Box 338
Address
Thomasville, NC 27360
City, State Zip
To Whom It May Concern:
Date
This correspondence is to notify you as a riparian property owner that I am applying for a CAMA Minor permit to
Build a bulkhead
on my property at 1824 Salter Path Rd. - Lot 1, Indian Beach, NC 28512
in Carteret
County, which is adjacent to your property. A copy of the application and project
drawing is attached/enclosed for your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to:
(LOCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, ZIP CODE)
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact (LOCAL PERMIT OFFICER) at (PHONE NUMBER), or by email at: (LPO EMAIL).
Sincerely,
Phillip Lewis
Property Owner's Name
y
PO Box 662, Greenville, NC 27835
Address
City
252-531-9704
Telephone Number
State
I have no objection to the project described in this correspondence.
I have objection(s) to the project described in this correspondence.
Adjacent Riparian Signature
Print or Type Name
1830 Salter Path Rd., Indian Beach, NC 28512
Zip
Date
Telephone Number COPY
Address City State Zip
Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
1 /12/2022
Equity Trust Company Custodian
Name of Adjacent Riparian Property Owner
1010 East Rock Springs Rd
Address
Greenville, NC 27835
City, State Zip
To Whom It May Concern:
Date
This correspondence is to notify you as a riparian property owner that I am applying for a CAMA Minor permit to
Build a bulkhead
on my property at 1824 Salter Path Rd. - Lot 1, Indian Beach, NC 28512
in Carteret County, which is adjacent to your property. A copy of the application and project
drawing is attached/enclosed for your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to:
(LOCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, ZIP CODE)
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact (LOCAL PERMIT OFFICER) at (PHONE NUMBER), or by entail at: (LPO EMAIL).
Sincerely,
Phillip Lewis
Property Owner's Name
PO Box 662, Greenville, NC 27835
Address
dI
r\ I
City
252-531-9704
Telephone Number
State
objection to the project described in this correspon ence.
ection(s) to the project described in this correspol ence.
Signature Da e
Equity Trust Company Custodian C/O Phillip Lewis
Print or Type Name
1822 Salter Path Rd., Lot 2 Indian Beach, NC 28512
252-531-9704
Telephone Number
01
Address City State Zip
Revised July 2021

SITE DRAWING/APPLICATION CHECKLIST
lnZ
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
Labelroads
Label highways right-of-ways
Label local setback lines
Label any and all structures and driveways currently existing on property
Label adjacent waterbody
PHYSICAL CHARACTERISTICS
Draw and label normal high water line (contact LPO for assistance)
Draw location of on -site wastewater system
If you will be working in the ocean hazard area:
Draw and label dune ridges (include spot elevations)
Draw and label toe of dunes
Identify and locate first line of stable vegetation (contact LPO for assistance)
Draw and label erosion setback line (contact LPO for assistance)
Draw and label topographical features (optional)
If you will be working in a coastal shoreline area:
Show the roof overhang as a dotted line around the structure
Draw and label landward limit of AEC
Draw and label all wetland lines (contact LPO for assistance)
Draw and label the 30-foot buffer line
DEVELOPMENTPLANS
Draw and label all proposed structures
Draw and label areas that will be disturbed and/or landscaped
Note size of piling and depth to be placed in ground
Draw and label all areas to be paved or graveled
Show all areas to be disturbed
Show landscaping
NOTE TO APPLICANT
Have you:
• completed all blanks and/or indicated if not applicable?
• notified and listed adjacent property owners?
• included your site drawing?
• signed and dated the application?
• enclosed the $100.00 fee?
• completed an AEC Hazard Notice, if necessary? (Must be signed by the property owner)
FOR STAFF USE
Site Notice Posted _ Final Inspection Fee Received
Site Inspections
Date of Action: Issued Exempted Denied Appeal Deadline (20 days from permit action)
Coastal Management
ENVIRONMENTAL QUALITY
APPLICATION FOR
CAMA MINOR
DEVELOPMENT
PERMIT
In 1974, the North Carolina General Assembly passed the Coastal Area Management Act
(CAMA) and set the stage for guiding development in fragile and productive areas that
border the state's sounds and oceanfront. Along with requiring special care by those who
build and develop, the General Assembly directed the Coastal Resources Commission
(CRC) to implement clear regulations that minimize the burden on the applicant.
This application for a minor development permit under CAMA is part of the
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
the applicant. Please go over this folder with the Local Permit Officer (LPO) for the
locality in which you plan to build to be certain that you understand what information he
or she needs before you apply.
Under CAMA regulations, the minor permit is to be issued within 25 days once a
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
certain that your application is complete and signed, that your drawing meets the
specifications given inside and that your application fee is attached.
Other permits are sometimes required for development in the coastal area. While these
are not CAMA-related, we urge you to check with the Local Permit Officer to determine
which of these you may need. A list is included on page two of this folder.
We appreciate your cooperation with the North Carolina Coastal Management Program
and your willingness to build in a way that protects the resources of our beautiful and
productive coast.
Coastal Resources Commission
Division of Coastal Management
z
c�
DCM Form EB1952.2015/Revised

Locality
Ocean Hazard Estuarine Shoreline ORW Shoreline _
(For official use only)
GENERAL INFORMATION
LAND OWNER - MAILING ADDRESS
Name Equity Trust Company Custodian C/O Phillip Lewis
Address PO Box 662
City Greenville
Email [e-mail]
AUTHORIZED AGENT
State NC
Name Samuel F Ballou - SF Ballou Inc.
Address 3302 Bridges St. Suite I
City Morehead City State NC
Email [e-mail]
Permit Number
Public Trust Shoreline Other
Zip 27835 Phone [phone]
Zip 28557 Phone [phone]
LOCATION OF PROJECT: (Address, street name and/or directions to site; name of the adjacent waterbody.)
1824 Salter Path Rd. - Lot 1, Indian Beach, NC 28512, Roosevelt Cove on sound side of Salter Path
Rd., Bogue Sound
DESCRIPTION OF PROJECT. (List all proposed construction and land disturbance.) Bulkhead
SIZE OF LOT/PARCEL: square feet 1.136 acres
PROPOSED USE: Residential ® (Single-family ® Multi -family ❑ ) Commercial/Industrial ❑ Other ❑
COMPLETE EITHER (1) OR (2) BELOW (Contact your Local Permit Officer if you are not sure which AEC applies
to your property):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet (includes
air conditioned living space, parking elevated above ground level, non -conditioned space elevated above ground level but
excluding non -load -bearing attic space)
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: square feet (includes the area of the foundation of all buildings, driveways, covered decks,
concrete or masonry patios, etc. that are within the applicable AEC. Attach your calculations with the project drawing.)
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a State
Stormwater Management Permit issued by the NC Division of Energy, Mineral and Land Resources (DEMLR)?
YES_ NO
OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA
minor development permit, including, but not limited to: Drinking Water Well, Septic Tank (or other sanitary waste
treatment system), Building, Electrical, Plumbing, Heating and Air Conditioning, Insulation and Energy Conservation, FIA
Certification, Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway Connection, and
others. Check with your Local Permit Officer for more information.
STATEMENT OF OWNERSHIP:
I, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in an AEC or a
person authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person
listed as landowner on this application has a significant interest in the real property described therein. This interest can be
described as: (check one)
an owner or record title, Title is vested in name of Equity Trust Company Custodian
.
see Deed Book 1742 page 357 in the Carteret 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)
(1) Equity Trust Company Custodian 1010 East Rock Springs Rd., Greenville, NC 27835 (1822 Salter Path Rd.)
(2) Religious Exemfon PO Box 338, Thomasville, NC 27360 (1830 Salter Path Rd.)
(3)
(4)
ACKNOWLEDGEMENTS:
I, the undersigned, acknowledge that the land owner is aware that the proposed development is planned for an area which
may be susceptible to erosion and/or flooding. I acknowledge that the Local Permit Officer has explained to me the particu-
lar hazard problems associated with this lot. This explanation was accompanied by recommendations concerning stabiliza-
tion and floodproofing techniques.
I furthermore certify that I am authorized to grant, and do in fact grant, permission to Division of Coastal Management staff,
the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information
related to this permit application.
This the 12 day of January 20 22
or person authorized to act as his/her agent for purpose of filing a CAMA permit application
This application includes: general information (this form), a site drawing as described on the back of this application, the
ownership statement, the Ocean Hazard AEC Notice where necessary, a check for $100.00 made payable to the locality, and
any information as may be provided orally by the applicant. The details of the application as described by these sources are
incorporated without reference in any permit which may be issued. Deviation from these details will constitute a violation of
anypermit. Anyperson developing in an AEC withoutpermit is subject to civil, criminal and administrative action.
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: square feet.

SITE DRAWING/APPLICATION CHECKLIST
I TIT -
10
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
Labelroads
Label highways right-of-ways
Label local setback lines
Label any and all structures and driveways currently existing on property
Label adjacent waterbody
PHYSICAL CHARACTERISTICS
Draw and label normal high water line (contact LPO for assistance)
Draw location of on -site wastewater system
If you will be working in the ocean hazard area:
Draw and label dune ridges (include spot elevations)
Draw and label toe of dunes
Identify and locate first line of stable vegetation (contact LPO for assistance)
Draw and label erosion setback line (contact LPO for assistance)
Draw and label topographical features (optional)
If you will be working in a coastal shoreline area:
Show the roof overhang as a dotted line around the structure
Draw and label landward limit of AEC
Draw and label all wetland lines (contact LPO for assistance)
Draw and label the 30-foot buffer line
DEVELOPMENTPLANS
Draw and label all proposed structures
Draw and label areas that will be disturbed and/or landscaped
Note size of piling and depth to be placed in ground
Draw and label all areas to be paved or graveled
Show all areas to be disturbed
Show landscaping
NOTE TO APPLICANT
Have you:
• completed all blanks and/or indicated if not applicable?
• notified and listed adjacent property owners?
• included your site drawing?
• signed and dated the application?
• enclosed the $100.00 fee?
• completed an AEC Hazard Notice, if necessary? (Must be signed by the property owner)
FOR STAFF USE
Site Notice Posted _ Final Inspection Fee Received
Site Inspections
Date of Action: Issued Exempted Denied Appeal Deadline (20 days from permit action)
Coastal Management
ENVIRONMENTAL OUALITY
APPLICATION FOR
CAMA MINOR
DEVELOPMENT
PERMIT
In 1974, the North Carolina General Assembly passed the Coastal Area Management Act
(CAMA) and set the stage for guiding development in fragile and productive areas that
border the state's sounds and oceanfront. Along with requiring special care by those who
build and develop, the General Assembly directed the Coastal Resources Commission
(CRC) to implement clear regulations that minimize the burden on the applicant.
This application for a minor development permit under CAMA is part of the
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
the applicant. Please go over this folder with the Local Permit Officer (LPO) for the
locality in which you plan to build to be certain that you understand what information he
or she needs before you apply.
Under CAMA regulations, the minor permit is to be issued within 25 days once a
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
certain that your application is complete and signed, that your drawing meets the
specifications given inside and that your application fee is attached.
Other permits are sometimes required for development in the coastal area. While these
are not CAMA-related, we urge you to check with the Local Permit Officer to determine
which of these you may need. A list is included on page two of this folder.
We appreciate your cooperation with the North Carolina Coastal Management Program
and your willingness to build in a way that protects the resources of our beautiful and
productive coast.
Coastal Resources Commission
Division of Coastal Management
s
0
R
DCM Form EB1952-2015/Revised

Locality
Ocean Hazard Estuarine Shoreline ORW Shoreline _
(For official use only)
GENERAL INFORMATION
LAND OWNER - MAILING ADDRESS
Name Equity Trust Company Custodian C/O Phillip Lewis
Address 1010 East Rock Springs Rd.
City Greenville
Email [e-mail]
AUTHORIZED AGENT
State NC
Name Samuel F Ballou - SF Ballou Inc.
Address 3302 Bridges St. Suite I
City Morehead City
[e-mail]
State NC
Permit Number
Public Trust Shoreline Other
Zip 27858 Phone [phone]
Zip 28557 Phone [phone]
LOCATION OF PROJECT: (Address, street name and/or directions to site; name of the adjacent waterbody.)
1822 Salter Path Rd. - Lot 2, Indian Beach, NC 28512, Roosevelt Cove on sound side of Salter Path
Rd., Bogue Sound
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) Bulkhead
SIZE OF LOT/PARCEL: square feet •668 acres
PROPOSED USE: Residential ® (Single-family ® Multi -family ❑ ) Commercial/Industrial ❑ Other ❑
COMPLETE EITHER (1) OR (2) BELOW (Contact your Local Permit Officer ifyou are not sure which AEC applies
to your property):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet (includes
air conditioned living space, parking elevated above ground level, non -conditioned space elevated above ground level but
excluding non -load -bearing attic space)
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: square feet (includes the area of the foundation of all buildings, driveways, covered decks,
concrete or masonry patios, etc. that are within the applicable AEC. Attach your calculations with the project drawing.)
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a State
Stormwater Management Permit issued by the NC Division of Energy, Mineral and Land Resources (DEMLR)?
YES NO
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: square feet.
OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA
minor development permit, including, but not limited to: Drinking Water Well, Septic Tank (or other sanitary waste
treatment system), Building, Electrical, Plumbing, Heating and Air Conditioning, Insulation and Energy Conservation, FIA
Certification, Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway Connection, and
others. Check with your Local Permit Officer for more information.
STATEMENT OF OWNERSHIP:
I, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in an AEC or a
person authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person
listed as landowner on this application has a significant interest in the real property described therein. This interest can be
described as: (check one)
an owner or record title, Title is vested in name of Equity Trust Company Custodian
see Deed Book 1742 page 358 in the Carteret 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 1 have given
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) a 00> (p&-)f,Address)
(1) Equity Trust Company Custodian Greenville, NC 27835 (1824 Salter Path Rd.)
(2) Janise Asset Management Co 605 Blenheim Dr. Raleigh, NC 27612 (1816 Salter Path Rd.)
(3)
(4)
ACKNOWLEDGEMENTS:
I, the undersigned, acknowledge that the land owner is aware that the proposed development is planned for an area which
may be susceptible to erosion and/or flooding. I acknowledge that the Local Permit Officer has explained to me the particu-
lar hazard problems associated with this lot. This explanation was accompanied by recommendations concerning stabiliza-
tion and floodproofing techniques.
I furthermore certify that I am authorized to grant, and do in fact grant, permission to Division of Coastal Management staff,
the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information
related to this permit application.
This the 12 day of January 2022
authorized to act as his/her agent for purpose of filing a CAMA permit application
This application includes: general information (this form), a site drawing as described on the back of this application, the
ownership statement, the Ocean Hazard AEC Notice where necessary, a check for $100.00 made payable to the locality, and
any information as may be provided orally by the applicant. The details of the application as described by these sources are
incorporated without reference in any permit which may be issued. Deviation from these details will constitute a violation of
any permit. Any person developing in an AEC without permit is subject to civil, criminal and administrative action.

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Equity Trust Company Custodian C/O Phillip Lewis
Mailing Address: 1010 East Rock Springs Rd
Greenville, NC 27858
Phone Number: 252-531-9704
Email Address: [e-mail]
I certify that I have authorized Samuel F Ballou/ SF Ballou, Inc
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
Bulkhead
at my property located at 1822 Salter Path Rd. - Lot 2, Indian Beach, NC 28512
in Carteret County.
I furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
evaluating information related to this
Philip Lewis
Print or Type Name
Property Owner
Title
I I
Date
This certification is valid through I I

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ZONING PERMIT
TOWN OF INDIAN BEACH
1400 SALTER PATH ROAD
PHONE # [phone]
FAX #[phone]
Email: admin(a-�ndianbeach.org
DATE: 1/12/22
OWNER: Equity Trust Company Custodian C/O Phillip Lewis
INDIAN BEACH ADDRESS: 1822 Salter Path Rd. Lot 2
INDIAN BEACH ZONING CLASS: PDD
MAILING ADDRESS: 1010 East Rock Springs Rd., Greenville, NC 27858
PHONE#: [phone]
EMAIL ADDRESS: [e-mail]
TYPE OF WORK Bulkhead
NAME OF CONTRACTOR: Samuel Ballou
BUSINESS NAME AND ADDRESS: SF Ballou Inc. dba SF Ballou Construction Co., 3302-1 Bridges St. MHC
NC License # 16314
All construction must meet the
the Carteret County Building Ii
OWNER/AGENT
SIGNATURE:
TOWN MANAGER
Pev it Fee $25.W
of Indian Beach zoning set -backs. Buildingpermits must be obtained from
)r's ce located at 701 Cedar Point Rd. Cedar Point, NC 252-222-5833.
n

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAIL, RETURN RECEIPT REQUESTED or HAND DELIVERED
1 /12/2022
Equity Trust Company Custodian
Name of Adjacent Riparian Property Owner
PO Box 662
Address
Greenville, NO 27835
City, State Zip
To Whom It May Concern:
Date
This correspondence is to notify you as a riparian property owner that I am applying for a CAMA Minor permit to
Build a bulkhead
on my property at 1822 Salter Path Rd. - Lot 2, Indian Beach, NC 28512
in Carteret County, which is adjacent to your property. A copy of the application and project
drawing is attached/enclosed for your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to:
(LOCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, ZIP CODE
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact (LOCAL PERMIT OFFICER) at (PHONE NUMBER), or by email at: (LPO EMAIL).
Sincerely,
Phillip Lewis
Property Owner's Name
1010 East Rock Springs Rd., Greenville, NC 27835
Address
City
252-531-9704
Telephone Number
State
y I have no objection to the project described in this correspondence.
I have b' tion(s) to the project described in this correspondence.
ent R rian Signature ate
Equity Trust Company Custodian C/O Phillip Lewis
Print or Type Name
1824 Salter Path Rd., Indian Beach, NC 28512
Address
City
252-531-9704
Telephone Number
State
Zip
Zip
Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAIL, RETURN RECEIPT REQUESTED or HAND DELIVERED
1/12/2022
Janise Asset Management Cc fa ` yi}�j�L2- Date
Name of Adjacent Riparian Property Owner
605 Blenheim Dr.
Address
Raleigh, NC 27612
City, State Zip
To Whom It May Concern:
This correspondence is to notify you as a riparian property owner that I am applying for a CAMA Minor permit to
Build a bulkhead
on my property at 1822 Salter Path Rd. - Lot 2, Indian Beach, NC 28512
in Carteret County, which is adjacent to your property. A copy of the application and project
drawing is attached/enclosed for your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to:
(LOCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, ZIP CODE)
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact (LOCAL PERMIT OFFICER) at (PHONE NUMBER), or by email at: (LPO EMAIL).
Sincerely,
Phillip Lewis
Property Owner's Name
1010 East Rock Springs Rd., Greenville, NC 27835
City
252-531-9704
Telephone Number
State
no objection to the project described in this correspondence.
objection(s) to the project described in this correspondence.
i� ilo Zy
j cent Ripari Signature—� Date
n� 3 0—, qlh'_c� yol (.
Print or Type Name Telephone Number
1816 Salter Path Rd., Indian Beach, NC 28512
Zip
Address City State Zip
Revised July 2021