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HomeMy WebLinkAboutTB_19-25_ Circle Issued by WiRO TB19-25 Topsail Beach Permit Number CAMA MINOR DEVELOPMENT Aft PERMIT •:;-'1; yr 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 Circle Q Equity, Inc. authorizing development in the Estuarine Shoreline (AEC) at 922 Observation Lane, in Topsail Beach, Pender County as requested in the permittee's application, dated September 24, 2019, and received as complete by DCM on October 9, 2019. This permit, issued on October 28, 2019, is subject to compliance with the application and drawing dated and received by DCM on October 9, 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: Construction of a sing-family residence. (1) All proposed development and associated construction must be done in accordance with the permitted site drawing dated received by DCM on October 9, 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) This permit action may be appealed by the permittee or other qualified persons *e 2 within twenty (20) days of the issuing date. This permit must be on the project co-) LU site and accessible to the permit officer when the project is inspected for Jason Dail > `N.' O compliance. Any maintenance work or project modification not covered under — cv C7 this permit,require further written permit approval.All work must cease when this AMA LOCAL PERMIT OI '.J o ,i, Z permit expires on: 127 Cardinal Drive Extension . December 31,2022 Wilmington, NC 28405-3845O z In issuing this permit it is agreed that this project is consistent with the local Land . I_t o Use Plan and all applicable ordinances. This permit may not be transferred to I another party without the written approval of the Division of Coastal PERMI TEE ►A ....,..i Name: Circle Q Equity Minor Permit#TB19-25 Date: October 28, 2019 Page 2 of 3 (4) All unconsolidated material resulting from associated grading and landscaping shall be retained on site by effective sedimentation and erosion control measures. Disturbed areas shall be vegetated and stabilized (planted and mulched)within 14 days of construction completion. (5) Any proposed for grading within the 30' Coastal Shoreline buffer (as measured from the Normal High Water level) must be contoured to prevent additional stormwater runoff to the adjacent marsh and/or canal. This area shall be immediately vegetated and stabilized and must remain in a vegetated state. (6) All development shall be located at least 30' landward of the normal/mean high water line. No impervious coverage/built upon area, including but not limited to the house (including eaves), foundation pad, covered decking, etc. shall extend into the 30-foot coastal shoreline buffer. (7) This permit does not authorize the excavation or filling of any wetlands, even temporarily. (8) All structures shall comply with the NC Building Code, including the Coastal and Flood Plain Construction Standards of the N. C. Building Code, and the Local Flood Damage Prevention Ordinance as required by the National Flood Insurance Program. If any provisions of the building code or a flood damage prevention ordinance are inconsistent with any of the following AEC standards,the more restrictive provision shall control. (9) Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise disposed of to a third-party. SIGNATURE: DATE: PERMITTEE v z O LU cv a V '" Z X 5 \ X Locality * Permit Number VG\ 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 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. GENERAL INFORMATION STATEMENT OF OWNERSHIP: LAND OWNER-MAILING ADDRESS r I,the undersigned,an applicant for a CAMA minor development permit,being either the owner of property in an AEC or a r. y j )K-C_ person authorized to act as an agent for purposes of applying for a CAMA minor development permit,certify that the person Name �`� �2, \ _ listed as landowner on this application has a significant interest in the real property described therein.This interest can be Address 1 1 6 . Lis- r V v� '�(; described as:(check one) (I. City 1(f "'�l State G ✓• one '7t 2 0 ?. 1 Sc- _tan owner or rec rd tile,Title is vested in name of i krf� "`•• � 4 l f ����� / 111 see Deed Book 3 f page in the Count egistry of Deeds. Email / V � � AUTHORIZED AGENT _an owner by virtue of inheritance.Applicant is an heir to the estate of ;probate was in County. Name if other interest,such as written contract or lease,explain below or use a separate sheet&attach to this application. Address City 5.1„„ivkd State Zip Phone _ 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 Email ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit. LOCATION OF PROJECT:(Address,street name and/or directions to site;name cf the adjacent terbody.) (Name) I Zi (Ad sj D ^to 9 22 0175e\ A-I-io 1 -Er )r► I SIG (2) tf� f V (3) (4) DESCRIPTION OF PROJECT:(Lis 11 proposed construction and land disturbance.) ACKNOWLEDGEMENTS: I �S f e./1��1 , ( �,^ I,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which lll///111 L \ 111 _.J{-Fvy Y ` may be susceptible to erosion and/or flooding.I acknowledge that the Local Permit Officer has explained to me the particu- laryy..,,�� hazard problems associated with this lot.This explanation was accompanied by recommendations concerning stabiliza- SIZE OF LOT/PARCEL:' ' '` quare feet t\.1 acres tion and floodproofing techniques. PROPOSED USE:Residenti /aI (Single-family 0 Multi-family 0) Commercial/Industrial 0 Other Ei 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): � �p This the [7 day of ,20 `q (1) OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet(includes Yr/ L air conditioned living space,parking elevated above ground level,non-conditioned space elevated above ground level but �`�/ 'i(l en. 1/_„^ i'ki;,w ar excluding non-load-bearing attic space) Landowner or.-'son authorized to act his/her a ent for ipurpose of fi ing a CAMA permit application (2) COASTAL SHORELINE AECs:SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT This application includes:general information(this form),a site drawing as described on the back of this application,the UPON SURFACES feet(includes the area of the foundation of all buildings,driveways,covered decks, concrete or maso os, tc. at 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 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 details will constitute wet) YESof Sto wat 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 and gyyyrjyYil V G LI YE NO CV G If s,list the total built upon area/impervious surface allowed for your lot or parcel:13 square feet. 0 C T 09 2019 DCM WILMINGTON, NC I, MARC F. GLENN, CERTIFY THAT THIS PROPERTY WAS SURVEYED AND MAP DRAWN UNDER MY SUPERVISION: t:' N DESCRIPTION AS SHOWN ON THE FACE OF THIS PLAT;RATIO OF PRECISION A5 CALCULATED BY COMPUTER �� /5 /:20,000+;THAT THE BOUNDARIES NOT SURVEYED ARE SHOWN BY BROKEN LINES PLOTTED FROM /VAS 'FINFORMATION REFERENCED; THAT THIS PLAT WAS PREPARED IN ACCORDANCE WITH"THE STANDARDS OF es OFF W E 0 `1'9 SITE I '1' S PRACTICE FOR LAND SURVEYING IN NORTH CAROLINA"; WITNESS MY ORIGINAL SIGNATURE,LICENSURE o r NUMBER AND SEAL THIS 22ND DAY OF JUNE A.D. 2019. c is , 'oy 9` F c92 ��� 9 MARC F. GLENN �a \G N.C. PLS No. L-4308 9F • P�� \\\\�1UIItlll//��� BOAT BASIN �,.��N CARP %,, VICINITY MAP `_:•.,e- ..... •1 04,.. -9 NOT TO SCALE SEAL = i _ 8.0' �_ 5'INGRESS, EGRESS, REGRESS, ' L-4308 DRAINAGE, 4 UTILITY EASMENT ..1110 r J •% �� I • ///�'pc//F. 1G\`\\\\\` 30.0' COMMON AREA J MB 62 PG 53 30'LAMA 30'CAMA� SETBACK LINE 7 • O.I' - 5 43°17'33"E 34.00' / / / / 2 OAT '4% 0.0' —.-.4 PROPOSED 1, Z / 3 STORY z e / DWELLING n �r',o .p° / #922 .p s PAD 12 ro 34'X 35'FOOTPRINT N PAD I 0 `1 MB 62 PG 53 v / LOT 1 I R v MB 62 PG 53 ,T / MB 62 PG 53 rn (6'3 / I,19 I sq.ft. PAD AREA (1313 a> / PAD IIR / 1,344 sq.ft. IMPR. SRF. m / (ALLOWABLE AREA) l,199 sq.ft. ®/I < /( C / / / / / I 1300 II 34.00' PROPOSED 13' I it` , 11 N 43°1 7'33"W WIDE DRIVEWAY J _-1_ MA/ 13.00' KAV PROPOSED IMPERVIOUS SURFACE — 10.6' "6 3' RECEIVED PROPOSED HOUSE FOOTPRINT I, 190 SQ. FT. OBSERVATION LANE PROPOSED CONCRETE DRIVE l 35 SQ. FT. PRIVATE RIGHT OF WAY O C T 0 9f 2019 VARIES IN WIDTH TOTAL 1,320 SQ. FT. RECORDED AVAILABLE TOTAL I,344 sq. ft. DCM WILMINGTON, NC AVAILABLE IMPV. REMANING 24 SO. FT. JUNE 25, 2019 SURVEY REFERENCE DEED BOOK 4636 PAGE 1252 SITE PLAN FOR MAP BOOK 62 PAGE 53 Circle Q EGq u i y, Inc. MAP BOOK 55 PAGE 25 BUILDING PAD #I I R QUEENS GRANT MAP BOOK 57 PAGE 4 Quinn Queens Grant Site Plans_Lot I I R 922 Observation Lane.dwg TOWN OF TOPSAIL BEACH TOPSAIL TWSP. FENDER CO. NC N-- LEGEND 20 0 10 20 NN _` NF POMNIS O=EXISTING REBAR ` mm mil to� ! SUR�/EY/A/G MO =5/8"REBARS SET L� 1 INCH = 20 FEET �y, iv E "6.4' =SPOT ELEVATION ` �� 202EASTBEDFORDROAD NOTE: THIS LOT IS LOCATED WILMINGTON,NC 28411 q =CENTERLINE IN ZONE AE 12 �� PNl9101-616.4210 R/W =RIGHT OF WAY PRELIMINARY FIRM COMMUNITY PANEL --"_._-_..--- ------•- ---- #372042 I K 1 Receipts for r� Certified Mail �. 2—I 1 q (Staple Here) Oa oole) spy, caner ent P ert L ng Addr ss 1-10 5 City,State,Zip Code Dear Adjacent Property: Vc4X ic /0- 6 This letter is to inform you that I, have aiplied for a CAMA Minor Property Owner --re7p5 ; 101.4.d. 0 2-g Permit on my property at I I'll' 3/4SC.w(4"14\ I4\ ,in COUNTY I V Property Address I0L f de f— Ca 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 qf rI '5 it7 ,or by mail at the address listed below. If you wish to Applicant's Telephone 411,Ni 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, pp-� tvcte 1-17 1,46, , frfrir Art) Property Owner i1 SSA_ 0#5` Dv Mailing Address 147 C CPI/C- City,State,Zip Code o� (IteS RECEIVED nrr A a ?n10 . . "os a ervice CERTIFIED MAIL° RECEIPT 9 Domestic Mail Only For delivery information,visit our websit- •t www.usps.com-. " :, h. l] Certified Mail Fee J. 0 y Ci48Tn D Extra Services&Fees(check box,add tee a :7�ate) 0L ❑Return Receipt(hardcopy) $ 'fiI (J D ❑Return Receipt(electronic) $ $0_00 Postmark D ❑Certified Mail Restricted Delivery $ $0•00 Here j ❑Adult Signature Required $ MOO 00 ❑Adult Signature Restricted Delivery$ D Postage $0.55 $ 0 ,.7l�f11 2 . a Total Postage and Fees �f $ $6.85 D Sent To q ; SCOTT OGLE 2 SPRINGHOUSE PLACE DURHAM, NC 27705 :ernTiea Mali service proviaes the Tonowing 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 return receipt for no additional fee,present this delivery. CC USPS®-postmarked Certified Mail receipt to thr A record of delivery(including the reipient'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. 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®,Rrst-Class Package Service®, available at retail). or Priority Mao service. -Adult signature restricted delivery service,whist Certified Mail service is notavailable for requires the signee to be at least 21 years of ag international mail. and provides delivery to the addressee specifier I 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 Mall service does not change the •To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear t 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 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. Receipts for Certified Mail (Staple Here) Date dja�e r erty 0 r ain Ald rss (it& 5. NC 2-7 City, State,Zip Code Dear Adjacent Property: This letter is to inform you that I, Cr Y"C/1 f ` v( aS�e applied for a CAMA Minor Property Owner d" G Permit on my property at ��/ V b Se waft" LO ,in COUNTY 7iQ t Property Address (C.tcr 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 110 5LF7 Z� 5~ ,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, (tic Ie • ;.- )1Ac ( &zv7 /1 .2) Property Owner - f rl a • Ma0g Address t,4 1� ( w\itf City,State,Zip Code / l RECEIVED OCT 0 a 2019 fll+AA IAt11 AAIAI/+T/111 Ali+ . . •os a ervice CERTIFIED MAIL° RECEIPT Domestic Mail Only 2 • For delirery ini rmefion visit our wrvsite tit www.usps.com". 1 s p Certified Mail Fee $.50 0482 F $ $2.80r1 i 2 Extra Services&Fees(check box,add fee as pr� ❑Return Receipt(hardcopy) $ ry' ❑Return Receipt(electronic) $ $0.(tr Postmark El Certified Mail Restricted Delivery $ $0.00 Here 3 ❑Adult Signature Required $ $0.00 ❑Adult Signature Restricted Delivery$ Postage $0.55 Total Postage and Fe .85 09/27/2019 a KEVIN PATRICK PERRY 129 LOLLIBERRY DRIVE _t HOLLY SPRINGS, NC 27540 .erarrea man service pravraes me ranawrng aenems: 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 r attemptn return receipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to the A record of delivery(Including the repipient':j retail associate. signature)that is retained by the Postal Service- -Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent. nportant Reminders: -Adult signature service,which requires the You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mail®,First-Class Package Service®, available at retail). or Priority Mail®service. -Adult signature restricted delivery service,which Certified Mail service is not available for requires the signee to be at least 21 years of agr 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. 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 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. III IIIIIIIIIIIIIINIIIIIIIIIII III Doc No• 20044304 Recorded: 01/03/2019 02:03:04 PM Fee Amt: $26.00 Page 1 of 3 Pender County North Carolina Sharon Lear Willoughby,Register of Deeds BK 4677 PG 646-648(3) 1111M11111111uIII1I 11111 GARY Doc No: 10021387 ANGE Recorded: 01/03/2019 12:09:44 PM Fee Amt: $26.00 Page 1 of 3 Duplin County North Carolina June H.Hargrove,Register of Deeds BK 1886 PG 633-636(3) PREPARED BY: THOMPSON &THOMPSON, P.C., ATTORNEYS AT LAW, POST OFFICE BOX 901, WARSAW, NORTH CAROLINA 28398 STATE OF NORTH CAROLINA DURABLE POWER OF ATTORNEY COUNTY OF DUPLIN KNOW ALL MEN BY THESE PRESENTS, THAT I,KIM S. QUINN, as President of CIRCLE Q EQUITY,INC., and R& Q,INCORPORATED, the undersigned, a resident of Duplin County,North Carolina, hereby make, constitute and appoint and by these presents do make, constitute and appoint GARY ANGE,of Duplin County, State of North Carolina, as my agent, for me and in my name, place and stead for the purposes hereinafter set out. If my agent is unable or unwilling to act for me,I name as my successor agent: If my successor agent is unable or unwilling to act for me, I name as my second successor agent: ( ) I give to my acting agent the full power to appoint another to act as my agent, and full power to revoke such appointment, if no agent named by me above is willing or able to act. I. Grant of Powers. I hereby give and grant unto my agent and any successor agent full authority to act for me with respect to the following subjects as defined in the North Carolina Uniform Power of Attorney Act, Chapter 32 C of the eneral Statutes which includes each of the following subjects: ( )Real Property RECEIVED ( ) Tangible Personal Property 1`�' • Cf3 ( ) Stocks and Bonds J OCT 0 9 2019 ( ) Commodities and Options /` '' nks and Other Financial Institutions I e one, DCM WILMINGTON, NC shown onth ( ) Operation of Entityor Business I , Is retuyaw rn g. ) Insurance and Annuities t ` ( ) Estates,Trusts, and Other Beneficial Interests Me 17c/r + ( ) Claims and Litigation • vU�ri ( )Personal and Family Maintenance ( )Benefits from Governmental Programs or Civil or Military Service Bk 4677 ( ) Retirement Plans _ __ Pg 547 ( )Taxes Book 1886 ( )All Preceding Subjects Page 534 GRANT OF SPECIFIC AUTHORITY (OPTIONAL) My agent MAY NOT do any of the following specific acts for me UNLESS I have INITIALED the specific authority listed below: I understand that by granting any of the following I do give my agent the authority to take actions that could significantly reduce my property or change how my property is distributed at my death. I have INITIALED ONLY the specific authority I WANT to give my agent. ( )Make a gift, subject to the limitations provided in G.S. 32C-2-217 ( ) Create or change rights of survivorship ( ) Create or change a beneficiary designation ( )Authorize another person to exercise the authority ( )Waive my right to be a beneficiary of a joint and survivor annuity,including a survivor benefit under a retirement plan ( )Exercise fiduciary powers that I have authority to delegate ( )Disclaim or refuse an interest in property, including a power of appointment ( )Access the content of electronic communications. EXERCISE OF SPECIFIC AUTHORITY IN FAVOR OF AGENT (OPTIONAL) ( )UNLESS INITIALED, an agent MAY NOT exercise any of the grants of specific authority initialed above in favor of the agent or an individual to whom the agent owes a legal obligation of support. ADDITIONAL PROVISIONS AND EXCLUSIONS (OPTIONAL) ( ) EFFECTIVE DATE This Power of Attorney is effective immediately and shall expire on December 31, 2019. RECEIVED NOMINATION OF GUARDIAN O C T 0 9 2019 (OPTIONAL) I will initial below ONLY if I want my acting agent to be my Guardian. DCM WILMINGTON, NC ( ) If it becomes necessary for a court to appoint a guardian of my estate or a general guardian,I nominate my agent acting under this power of attorney to be the guardian and to serve without bond or other security. Bk 4677 Pg 548 RELIANCE ON THIS POWER OF ATTORNEY ,- Book 1886 Page 535 Any person, including my agent, may rely upon the validity of this power of attorney or a copy of it unless that person knows it has terminated or is invalid. IN WITNESS WHEREOF, I have hereunto set my hand and seal on and executed the foregoing Power of Attorney this the //f11 day of December, 20+-9.05 CIRCLE Q EQUITY,INC. id, -,;•�1 (SEAL) M S. QUINN,P esident R& Q,INCORPO TED _ . (SEAL) IM S. QUINN, President NORTH CAROLINA DUPLIN COUNTY I, 41 vM R. `~Vet" , a Notary Public in and for said State and County, do hereby certify that Kim S. Guinn,personally appeared before me this day and acknowledged that he is the President of Circle Q Equity, Inc., and President of R& Q, Incorporated,the corporations named herein, and that he as President,being authorized to do so, executed the foregoing on behalf of the corporations. Witness my hand and notarial seal, this t1b'4' day of December, W. o ubiic `ounturr,,,��'//, My Commission Expires: 4fi7/ZOZ/ .0 Notary Public v2 cr Duplin N = County -- My Comm. Exp. 2 09-17-2021 4' ifs:,. �,�,i.. °i°y��y'�i C;'4,�4°,, RECEIVED OCT 0 9i 2019 li-li 7, NC Division of Coastal Management 9058 Cashier's Official Receipt A B D Date: C t / ! 20 / Received From: e*4-441-- $ 7O C ------ Permit No.. 1112fi r Check No.: Y S 6 ail11� Applicant's Name: ( 4"i/& r/L /"�� County: /��i�L�►II / 1 _ Project Address: 2 2 04Cliiji` /�/U Y'' / l I-- am_ Please retain receipt for your records as proof of payment for permit issued. Signature of Agent or Applicant: Date: i_17, 1 Signature of Field Representative: Date: Date Date Check From Name of Vendor Check Check Permit Rct Received Deposited Permit Holder Number amount Number/Comments Circle Q Equity, $ minor fee, 922 Observation Ln, TB JD rci 10/14/2019 Inc. same BB&T 25436 100.00 PNCo 90581