TB_19-15_ KSMA

Issued by WiRO TB19-15
Topsail Beach Permit Number
CAMA
MINOR DEVELOPMENT
:v'
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 KSMA, LLC C/o Skalchunes authorizing development in the Estuarine Shoreline (AEC) at 1506 Carolina
Blvd., in Topsail Beach, Pender County as requested in the permittee's application, dated June 5, 2019, and received as
complete by DCM on July 3, 2019. This permit, issued on July 15, 2019, is subject to compliance with the application
and drawing dated and received by DCM on June 5, 2019 (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: Demolition of existing dwelling.
(1) All proposed development and associated construction must be done in accordance with the permitted site drawing dated
received by DCM on June 5,2019.
(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) DECEIVED
JUL 2 5 2019
DCM WILMINGTON, NC
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 C A LOCAL PERMIT OFFICIAL
this permit,require further written permit approval.All work must cease when this
permit expires on: 127 Cardinal Drive Extension
December 31,2022 )1 ionAe
NC 28405-3845
In issuing this permit it is agreed that this project is consistent with the local Land etSiff - _
Use Plan and all applicable ordinances. This permit may not be transferred toion
another party without the written approval of the Division of Coastal pPR(\AITTPP

Name: KSMA, LLC
Minor Permit#TB19-15
Date: July 15,2019
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) This permit does not authorize the excavation or filling of any wetlands,even temporarily.
(7) 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.
(8) 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 6
SIGNATURE: DATE:
PERMITTEE
.‘tfai JUL/9'
RECEIVED
JUL 2 5 2019

b,^fv `ll � 1 °1- \4
Locality t Permit Number
. Ocean I larard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other_
I (For o ficial use only)
RECEIVED
GENERAL INFORMATION
LAND OWNER-MAILING ADDRESS JUL 0 3 2019
Name LLL Con f act i5 KAy ko I d L e
Address yL.21 - Mun�ev
City._- State C_ /ip27D/Z Pirmnc (334,) 207 - OOt Z)
Email Ksk .144 u„es � ass ex 'IAG....
AUTHORIZED AGENT
Name 00al-..-. eatref (reevett "" )
_
Address P.O- ape .8 s 1 OS- SuitettiAe_-_c__
City_A uctipsJ4 State /UL • Zip 2419Yf3 Phone 910 -a?°l_-0173
Email W i 1l«tuCt...•T? 1__•.Lar_'_t..__-- —
LOCATION OF PROJECT: (Address,street name and/or directions to site;name of the adjacent waterbody.)
/1'o( (Qroli►-a, 31vd .
I a`r, k N t' 20 21y
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) \~�
r " /l
au se . J,1sw �►�rts -E �c1�C�tYI 1�
SIZE OF LOT/PARCEL: obt
Q' bU square feet acres
PROPOSED USE: Residential E r (Single-family[multi family ❑ ) Commercial/Industrial[] Other [�
COMPLETE EITHER(1)OR(2) ,OW(Contact your Local Permit Officer ifyou are not sure which AEC applies
to your 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
UPON SURFACES: square feet(includes the area of the foundation of all buildings,driveways,covered decks,
concrete or masonry patios,etc.that arc within the applicable AEC.Attach your calculations with the project drawing.)
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject toa State
Slormwater Management Permit issued by the NC Division of Energy,Mineral and Land Resources(DEMLR)?
YES NO

OTi#ER PERMIT'S MAY 1W 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"lank(or other sanitary waste
treatment system), Building, Electrical,Plumbing, Bleating and Air Conditioning.Insulation and Energy Conservation,EIA
Certification,Sand Dune, Sediment Control,Subdivision Approval,Mobile I tome Park Approval,I lighway Connection,and
others. Check with your Local Permit Officer for more information.
STATEMENT OF OWNERSIiIP:
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 A ,
see Deed Book 3572_ page zog in the 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 arc owners of properties adjoining this property. I affirm that I have given
ACTt1Al NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) (Address)
(1) ACSACAa .L — ___INZL_ f-6n'ierc Ru r Dc. — _ CIewtmonrtN(- z7b/2
(2) _H____Notkic tAkcy 0.._1101!..._3SIZ_ iopxt.! lle24, (Bet)tio4.6,,E9
(3)
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 .$ +_ day of ���� ,20 _l9
_.c •
[.. ndowncr or person author' .ed to act as his/her agent for purpose of filing a CAMA permit application
This applications includes:general information(this farm), a site dran'ing as described on the lack of this applicatio►►, the
ownership slalement, the Ocean!hazard AEC Notice where necessary, a check for$100.00 made Mythic to the locality, and
any information as may be provided orally by the applicant. The details oldie application as described by these smarm air
incorporated without reference in any permit which may be issued Deviation.fivmn these details will con.RigEgiQ1 of
any permit.Any person developing in an AEC without permit is subject to civil, criminal and administrative action.
JUL 032019

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: )$M A a1J L
Mailing Address: '/tl2! r n e rr 'Run r)r- _
el e pn s GU- • z?o/z.
Phone Number: (auj 202 - too) 0
Email Address: kS c? essekX t,e , AS
I certify that I have authorized I,,P,I ( h ee (Reduet <.1447 0.1 / ni f.LLC)
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: V '4 ii o/i/Tbn r7f
;ox is t c.5 Tl Zit j�
at my property located at /S Z)fc Caro'I 1 Ake( t p JJ'J
in ?Older _County.
I furthermore certify that f 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.
Property Owner Information:
yolitSignature
�c �4 ztc v /-py
Print or Tye4ht
Vka4c.4r&ti Ti le
l /& 12°/
Date
?i7
This certification is valid through `� I 1 RECEIVED
JUL 0 3 2019

ROY COOPER
,,overnor
MICHAEL S. REGAN
Secretary
BRAXTON DAVIS
!),rector
June 16, 2019
KSMA, LLC
c/o Kay Skalchunes
4421 Hunters Runs Drive
Clemmons, NC 27012
Dear Ms.Skalchunes,
Attached is CAMA Minor Development Permit TB 19-15 for work to be done at 1506 Carolina Boulevard,
in Topsail Beach, Pender County. An electronic copy has been sent to the Topsail Beach Inspections
Department and your Agent.
To validate this permit, please sign both copies as indicated for our records. Retain the orange copy for
your files, and ;' 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.
Spcerely,
anya • -tila
Permit upport Technician
N.C. Division of Coastal Management
Enclosures
Cc: WiRO files
TB Inspection Dept.
Will Reeves—Agent
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext.,Wilmington,NC 28405
919 796 7215

BEFORE YOU BUILD
Setting Back for Safety: A Guide to Wise Development Along the Oceanfront
When you build along the oceanfront,you take a calculated risk. The Reasons
Natural forces of water and wind collide with tons of force,even The bcachfront is an ever-changing landform. The beach and
on calm days. the dunes are natural"shock absorbers,"taking the beating of the
wind and waves and protecting the inland areas. By
Man-made structures cannot he guaranteed to survive the force incorporating building setbacks into the regulations,you have a
of a hurricane. Long-term erosion (or barrier island migration) good chance of enjoying the full life of the structure. At first,it
may take from two to ten feet of the beach each year, and, seems very inviting to build your dream house as close to the
sooner or later,will threaten oceanfront structures. These are the beach as possible,but in five years you could find the dream has
facts of life for oceanfront property owners. become a nightmare as high tides and storm tides threaten your
investment.
The Coastal Resources Commission(CRC)has adopted rules for
building along the oceanfront.The rules arc intended to avoid an The Exception
unreasonable risk to life and property, and to limit public and The Coastal Resources Commission recognized that these rules,
private losses from storm and long-term erosion. These rules initially passed in June 1979, might prove a hardship for some
lessen but do not eliminate the element of risk in oceanfront property owners. Therefore, they established an exception for
development. lots that cannot meet the setback requirement. The exception
allows buildings in front of the current setback, if the following
As you consider building along the oceanfront, the CRC wants conditions apply:
you to understand the rules and the risks. With this knowledge,
you can make a more informed decision about where and how to 1) the lot must have been platted as of June 1, 1979,and
build in the coastal area. is not capable of being enlarged by combining with
adjoining land under the same ownership;
The Rules 2) development must be constructed as far back on the
When you build along the oceanfront,coastal management rules property as possible and in no case less than 60 feet
require that the structure be sited to fit safely into the beach landward of the vegetation line;
environment. 3) no development can take place on the frontal dune;
4) special construction standards on piling depth and
Structures along the oceanfront, less than 5,000 square feet in square footage must be met;and
size, must be behind the frontal dune, landward of the crest of 5) all other LAMA, state and local regulations must be
the primary dune, and set back from the first line of stable met.
natural vegetation a distance equal to 30 times the annual
erosion rate (a minimum of 60 feet). The setback calculation The exception is not available in the Inlet Hazard Area.
increases as the size of the structure increases [15A NCAC
71-1.0306(ax2)]. For example: A structure between 5,000 and To determine eligibility for the exception the Local Permit
10,000 square feet would require a setback from the first line of Officer will make these measurements and observations:
stable, natural vegetation to a distance equal to 60 times the
annual erosion rate (a minimum of 120 feet). The graduated required setback from vegetation line
setback continues to increase through structure sizes greater than
100,000 square feet. exception setback(maximum feasible)
rear property line setback
max.allowable square footage on lowest floor
NNE PI.K64II SI kW IORE thAtilvt:Alt SI IRACK
PLRAIiI ITO--
STKUC 1 l'Kk, � Pitt s1t1KM REACH PKlrl tl.!
ADrQI+ATi POSTS OKM atM.H PROi Ito
StInAC.w - I .. OTst.Yi AR Ai 1t R C1oKM0utPAH RtuU.LutNt;
After the storm, the house on the dune will be gone. The other house has a much better chance of swvi al-I V E D
JUL 0 3 20i9

OCEAN HAZARD AEC NOTICE
Project is in an: Ocean Erodible Area High Hazard Flood Area Inlet Hazard Area
Property Owner:
Property Address:
Date Lot Was Platted:
This notice is intended to make you, the applicant,aware of the SPECIAL NOTE: This hazard notice is required for
special risks and conditions associated with development in this development in areas subject to sudden and massive storms and
area,which is subject to natural hazards such as storms,erosion erosion. Permits issued for development in this area expire on
and currents. The rules of the Coastal Resources Commission December 31 of the third year following the year in which the
require that you receive an AEC Hazard Notice and permit was issued. Shortly before work begins on the project
acknowledge that notice in writing before a permit for site,the Local Permit Officer must he contacted to determine the
development can he issued. vegetation line and setback distance at your site. if the property
has seen little change since the time of permit issuance,and the
The Commission's rules on building standards, oceanfront proposed development can still meet the setback requirement,
setbacks and dune alterations are designed to minimize, but not the LPO will inform you that you may begin work. Substantial
eliminate, property loss from hazards. By granting permits, the progress on the project must be made within 60 days of this
Coastal Resources Commission does not guarantee the safety of setback determination,or the setback must be re-measured.Also,
the development and assumes no liability for future damage to the occurrence of a major shoreline change as the result of a
the development. Permits issued in the Ocean Hazard Area of storm within the 60-day period will necessitate re-measurement
Environmental Concern include the condition that structures be of the setback. It is important that you check with the LPO
relocated or dismantled if they become imminently threatened before the permit expires for official approval to continue the
by changes in shoreline configuration. The structure(s) must be work after the permit has expired. Generally, if foundation
relocated or dismantled within two (2) 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. work after permit expiration.
The best available information,as accepted by the Coastal For more information,contact:
Resources Commission, indicates that the annual long-term t
average ocean erosion rate for the area where your property is J � 7)� /
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.
N.C. Dept. of Environmental Quality
Studies also indicate that the shoreline could move as much as Division of Coastal Management
feet Landward in a major storm. 127 Cardinal Drive Extension
Wilmington, NC 28405-3845
The flood waters in a major storm are predicted to be about
feet deep in this area.
Preferred oceanfront protection measures are beach nourishment / 10 - 6
and relocation of threatened structures. t-lard erosion control
structures such as bulkheads,seawalls,revetments,groins,jetties Phone Number
and breakwaters are prohibited. Temporary sand bags may be
authorized under certain conditions.
The applicant must acknowledge this information and
requirements by signing this notice in the space below. Without
the proper signature,the application will not be complete.
RECEIVED
Property Owner Signature Date J U L 0 3 2019
DCM WIleklitilliffratin NC

Receipts far
Certified Mail
(Staple Here)
6/szal�
Date
KSMA , LL(
Adjacent Property Owner
yyzl HlAnicrr Ru �1r--
Mailing Address
CI emrr►ons ) 2?0/z
City,State,Zip Code
Dear Adjacent Property:
This letter is to inform you that I, KSM A , Lr`L have applied for a CAMA Minor
Property Owner
Permit on my property at /cow Corro I na. RI ik.1 ,in Topsail Beach,
Property Address
Pender 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 C336) ?02- 0010 ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the CAMA Minor Permit Program,you may submit them to:
Jason Dail, DCM Field Representative
LPO, Town of Topsail Beath
NC DEQ/DCM
127 Cardinal Drive Ext.
Wilmington,NC 28405
kSNI4/ LLC_
Property Owner
yyZ/ Puolert Ruh pr•
Mailing Address
CPrnmoHt Ale_ Z 70/z
City,State,Zip Code
RECEIVED
JUL 0 3 2019

I. . osta ervice
CERTIFIED M#IL°.FIECEIPT
Domestic Mail Only
For delivery information,visit our website at www usps com
1 CLPINWP F7f.rt2!1
3 Certified Mail Fee Cl 0445
$3 Extra Services&Fees(check box,add fee vostf.te) 07
Return Receipt(hardcopy) $
3 ID Return Receipt(electronic) $ $O 00 Postmark
30 Certified Mail Restricted Delivery $ $0 00 Here
Adult Signature Required
$ $0.00
Ei Adult Signature Restricted Delivery$
3 Postage
$0.70
1 $
Total Postage and Fees 06/05/2019
4 $7.00
3 Sent To
KSAsi Pg Li-
3 Street and not
Rwn.Driwtp.i ,
+4 avt s 2.7 oi

;eranea maii service proviaes the renewing 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 attempted k' ret receipt for no additional fee,present this
delivery. USA -postmarked Certified Mail receipt to the
A record of delivery(including the recipient's reassociate.
signature)that is retained by the Postal Service"' -Restricted delivery service,which provides
for a specified period. delivery to the addressee specified by name,or
to the addressee's authorized agent.
mportant Reminders: -Adult signature service,which requires the
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,whist
Certified Mail service is not available for requires the signee to beat least 21 years of ag
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 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. LISPS 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 Mall 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.

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to Cj/ A .U ..L 's
(Name of Property Owner)
property located at )50to Caro(i r i. (31vd
Address, Lot, Block,Road,etc.)
on ,in M opsai Secteln , N.C.
{Waterbody) (Topsail Beach, Pender 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
Print or Type Name
Telephone Number
Date
RECEIVED
JUL 0 3 2019
nrRA Wu MIM( Tnnl nlr_

Receipts for
Certified Mail
(Staple Here)
Date
Adjacent Property Owner
P. ,flox ,37 2
Mailing Address
7opsa t ri3ehet„ A1C z8'!�lS
City, State,Zip Code
Dear Adjacent Property:
This letter is to inform you that 1, k-Sn94 have applied for a CAMA Minor
Property Owner
Permit on my property at /5b6 Caro/Jra.(3/01 ,in Topsail Beach,
Property Address
Pender 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 (3.363i ZD Z- OO I Z> ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the CAMA Minor Permit Program,you may submit them to:
Jason Dail, DCM Field Representative
LPO, Town of Topsail Beach
NC DEC)/DCM
127 Cardinal Drive Ext.
Wilmington, NC 28405
JoSivi A / JCL
Property Owner
th 1ryc u� hr.
Mailing Address
CIPI1�f,ti►0itr jtJ 270/z
City, State,Zip Code
RECEIVED
JUL 0 3 2019

. . •osta ervice
CERTIFIED MAIL° RECEIPT
J Domestic Mail Only
1 For delivery information,visit our website at www.usps.com'^'.
H0 e 54 4
3 Certified Mail Fee $r:r.50 Qt 0445
) Extra Services&Fees(check box,add fee a$ roodate) i i 7
❑Return Receipt(hardcopy) $ S ','I'
3 ❑Return Receipt(electronic) $ $0_00 Postmark
3 ❑Certified Mall Restricted Delivery $ $0 CIO Here
3 ❑Adult Signature Required $
$0.00
❑Aduk Signature Restricted Delivery$
3 Postage
$0.70
$ 06/05/2019
9 Total Postage and Fees
4 $ $7.00
3 Sent,To
3 .tr etet and Apt. o.,or Pb Box Iwo.
City,Sta0,ZIP+4-Pk_ __S
"MOJA A Beata.. Nri. 281/4-{f'

reranea mail service proviaes we rouowing oenems:
A receipt(this portion of the Certified Mail Zabel). 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 attemp>!d ?Rum receipt for no additional fee,present this
delivery. LISPS®-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 Servicee, 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 agi
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 Mail service does not change the •To ensure that your Certified Mall receipt is
insurance coverage automatically included with accepted as legal proof of mailing,it should bear a
certain Priority Mail items. LISPS 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
Receigattach PS Form 3811 to your mailpiece; IMPORTANT.Save this receipt for your records.

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
1 hereby certify that I own property adjacent to k5/11
(Name of Property Owner)
property located at MY,(9 Care) ;Ass PI lid
Address, Lot,Block,Road,etc.)
on , in `rpps ; I 6eack. ,N.C.
(Waterbody) (Topsail Beach,Pender 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
Print or Type Name
Telephone Number
Date
RECEIVED
JUL 0 3 2013

SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY.
■ Complete items 1,2,and 3. A. Signature r
■ Print your name and address on the reverse X �, 'e tf�r'i /!1 Q Agent
so that we can return the card to you. �Y4� Q Addressee
II Attach this card to the back of the mailpiece, 1.1 B. Received by+Pn..ed Name) C. Date of Delivery
or on the front if space permits. / lf/��-6I
1. Article Addressed to: D. s eiiv ad ress different from Item 1 'Oki Yes
Kw 04 ,A , LL.C._ If YES,enter delivery address below: 0 No
Li 4{ 2 t 1 ►" eun fr-.
C ew\wtons Ak 2.701'2-
1111111111111111111111111111111111111111 Type
3A�JgResbsLted Delivery 0 Mail Expireig
9590 9402 4356 8190 6646 53 0u- Cerc tied M aai Restricted Deliver`/ Ci Return Receiptfor
0 Collect on Delivery Merchandise
2. - livery Restricted Delivery 0 Signature Confirmation'"
7 018 1130 0000 8464 5529 o Signature Confirmation
iestncted Delivery Restricted Delivery
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'PaForrn,381 1,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3. A. Signature 1
■ Print your name and address on the reverse x ,,, ,7 :r
so that we can return the card to you. i•%: 0 •' �"-"ee
al Attach this card to the back of the mailpiece, B ': •ivedpby(Printed Name) C. Date of Delivery
or on the front if space permits. tit. /' 1 k- L.�-_f�
1. Article Addressed to: ' D. is delivery address di item 1? ❑Yes
If YES,enter delivery address below: 0 No
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111 I II,Ill l N11 I 111111 1,111111111111 3CI0 Adult Signaturice e
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9590 94.02 4356 8190 6646 46 0 Certified
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O Collect on Delivery Merchandise
-"ect on Delivery Restricted Deriver/ 0 Signature Confirmation"
7 018 113 00000 8464 5 512 red Mail 0 Signature Connrmatoor
'Ted Mail Restricted Delivery Restricted Deliver.
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PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt •
•
RECEIVED
JUL 0 3 2019

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,SIN: 4202-93-1155-0000 Sale Price:$0 Acres:0 Pender County
OWer: KSMA LLC Sale Date: LAST-SALE-
DATE Land Value:$425,726
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C m 4421 HUNTERS RUN DR Plat: 00040002 Building Value: $70,952
Account No: 917748 Total value:$496,678 1:578
CLEMMONS,NC 27012 0 0.00425 0.0085 0.017 ml
Township:TOPSAIL Deferred Value:$0 i ,' , / , ' , 5 r i
is Deec ef: 3572/205 Subdivision: NEW TOPSAIL BEACH Exempt Amount:0 0 0.005 0.01 0.02 km
Tax Codes: G01 C54 R40 PCL Class:R N
Property 1 inch =48 feetfli
Address: 1506 CAROLINA BLVD Heated Sq Feet:1464 `V - b NG
Description: L14,PB 4/2,BK 38
June 5, 2019

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PIN: 4202-93-1155-0000 Sale Price: $0 Acres:0 Pender County
O1er: KSMA LLC Sale Date: LAST_SALE_DATE Land Value:$425,726
Plat: 00040002 Building C m 4421 HUNTERS RUN DR 9 Value: $70,952
r Account No: 917748 Total value: $496,678 1:578 0 CLEMMONS,NC 27012 0 0.00425 0.0085 0.017 mi
C m Township: TOPSAIL Deferred Value:$0 i ,' , , r , ' , , i
c.,..,Dee cef: 3572/205 Subdivision: NEW TOPSAIL BEACH Exempt Amount:0CV 0 0.005 0.01 0,02 km
m Tax Codes: G01 C54 R40 PCL Class:R N
c.o ProRrty 1 inch =48 feet
Heated Sq Feet:1464 wAddress: 1506 CAROLINA BLVD
04.E
June 5, 2019 np
Description: L14,PB 4/2,BK 38 S

Date Date Check From Name of Vendor Check Check Permit Rct,
Received Deposited Permit Holder Number amount Number/Comments
7/8/2019 Reeves Custom KSMA, LLC First Bank 1611 $100.00 minor fee, 1506 Carolina Blvd, JD rct.
Homes LLC Topsail Beach PnCo 8785