TB_20-24_ Arleth (2)

6 -
Issued by WiRO TB20-24
Topsail Beach RECEIVES Permit Number
CAMA OCT 1 9 2020
MINOR DEVELOPMENiIcM WILMINGTON,
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 James Arleth authorizing development in the Estuarine Shoreline (AEC) at 944 Observation Lane, in Topsail
Beach, Pender County as requested in the permittee's application, dated September 2, 2020, and received as complete
by DCM on September 8, 2020. This permit, issued on October 5, 2020, is subject to compliance with the application
and drawing dated and received by DCM on September 8, 2020 (where consistent with the permit), all applicable
regulations and special conditions and notes set forth below. Any violation of these terms may subject the permittee to a
fine, imprisonment or civil action, or may cause the permit to be null and void.
This permit authorizes: Construction of a single family residence.
(1) All proposed development and associated construction must be done in accordance with the permitted site drawing dated
received by DCM on September 8, 2020.
(2) Any change or changes in the plans for development, construction, and/or land use activities will require re-evaluation and
modification of this permit.
(3) A copy of this permit shall be posted or available on site throughout the construction process. Contact this office at(910)
766-7221 for a final inspection at completion of work.
(Additional Permit Conditions on Page 2)
This permit action may be appealed by the permittee or other qualified persons
within twenty (20)days of the issuing date. This permit must be on the project
site and accessible to the permit officer when the project is inspected for Jason Dail
compliance. Any maintenance work or project modification not covered under C MA LOCAL PERMIT OFFICIAL
this permit,require further written permit approval.All work must cease when this
permit expires on: 127 Cardinal Drive Extension
Wilmington, NC 28405-3845
December 31,2023
In issuing this permit it is agreed that this project is consistent with the local Land
Use Plan and all applicable ordinances. This permit may not be transferred to
another party without the written approval of the Division of Coastal P TEE

Name: James Arleth
Minor Permit#TB20-24
Date: October 5, 2020
Page 2 of 2
(4) All unconsolidated material resulting from associated grading and landscaping shall be retained on site by effective
sedimentation and erosion control measures. Disturbed areas shall be vegetated and stabilized (planted and
mulched)within 14 days of construction completion.
(5) Any proposed for grading within the 30' Coastal Shoreline buffer (as measured from the Normal High Water level)
must be contoured to prevent additional stommwater 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) The proposed development shall maintain compliance with NC Division of Energy, Mineral and Land Resources
Stormwater Water Permit No. SW871111 for the Queens Grant Subdivision and Marina.
(9) Upon completion of construction and prior to the issuance of a Certificate of Occupancy(CO), a letter of certification
must be received from the designer of the innovative system installed,certifying that the permitted system has been
installed in accordance with this permit, the approved plans and his design specifications. Any deviations from the
approved plans and specifications must be noted on the Certification and a permit modification may be required
prior to receiving a CO.
(10)All structures shall comply with the NC Building Code, including the Coastal and Flood Plain Construction Standards
of the N. C. Building Code, and the Local Flood Damage Prevention Ordinance as required by the National Flood
Insurance Program. If any provisions of the building code or a flood damage prevention ordinance are inconsistent
with any of the following AEC standards,the more restrictive provision shall control.
(11)Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third-party.
(12)All work authorized under this permit shall remain confined to the permittee's property. No development is
authorized beyond the permittee's property boundaries.
SIGNATURE: a---- DATE: /0! y0(
PERMITTEE

-� 90,
Locality �0' �, AvtT Pcrmit Number
. Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
(For official use only)
GENERAL INFORMATION SEP O 8 2020
LAND OWNER-MAILING ADDRESS
Name Pt l-II& DCM WILMINGTON, NC
Address .39 LASS riovQ/d ---
City CA Aloe/ (7 I l State N G Zip.7-r/y Phone .73 ---a Y ;,2vc7
Email A R L € , spo Q S V Df c-5. CDM
AUTHORIZED AGENT
Name
Address_ f JU'
City / State • Zip Phone __-
Email__
LOCATION OF PROJECT: (Address,street name and/or directions to site;name of the adjacent waterbody.)
yy 5Rs s//1iOm' L-4I'E roPs t & )1
TA, ivfRti coAs174 1 14. ewk
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.)r -
[louse,
S I�1 ft'� (-A"
A� ,�� Uu E..
SIZE OF LOT/PARCEL: / O / square feet acres
PROPOSED USE: Residential SI, (Single-family['], Multi-family ❑ ) Commercial/Industrial ❑ Other ❑
COMPLETE EITHER(1) OR(2)BELOW(Contact your Local Permit Officer if you are not sure which ABC 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: I I S/ 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 STORM WATER MANAGEMENT PERMIT: Is the project located in an area subject to a State
Stormwat r Management Permit issued by the NC Division of Energy,Mineral and Land Resources(DEMLR)?
YES_ V 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, HA
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
see Deed Book page in the County Registry of Deeds.
an owner by virtue of inheritance.Applicant is an heir to the estate of
; probate was in County.
1. if other interest,such as written contract or lease,explain below or use a separate sheet&attach to this application.
�jb 0 ' �� :�/ c� f L�r�l vl >"a• i 7 �tJQ',.�f
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) 1u5 14 `s cP/6 obse,ev her✓ �r4lve /0g Pucktuoct1' Li€ C , Nc 21S
(2).—_5eA,J S )otl errs k etHa ObSe- 04*, tAve • 5-ya5 Muss,' IPd .1;fd,40/ / ll 0 fI 115=
(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 day of t� �.. ,20%��
Landowner or erson 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 oldie 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.
SFP 0 R 2020

.:.„, ROY COOPER
4it -
,4 MICHAEL S. REGAN
\eerelorr
October 5, 2020 BRAXTON DAVIS
riot,,,,,
James Arleth
396 Less Traveled Rd.
Chapel Hill, NC 27514
Dear Mr.Arleth,
Attached is CAMA Minor Development Permit TB 20-24 for work to be done at 944 Observation Lane in
Topsail Beach, Pender County. An electronic copy has been sent to the Topsail Beach Inspections
Department.
To validate this permit, please sign both copies as indicated for our records. Retain the blue 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.
Sin erely,
dip
Tanya K - ila
Permit Support Technician
N.C. Division of Coastal Management
Enclosures
Cc: WiRO files
TB Inspection Dept.
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext.,Wilmington,NC 28405

� ,/ 0.a'
�/jjsnr
MEAN HIGH WATER UNE
� �000°* _CEP 0 8 2020
0"4K4- ULKHEAD BP EXISTING IRON PIPE
ES COSTING IRd4 AICE
N.G' SS SET IRON STAKE
� „c E MONUMENT ,,i WILMINGTON,
EPK ATLANTIC OCEAN MBL MINIMUM BUILDING UNE
RAW RIGHT CF WAY
VICINITY MAP- NOT TO SCALE Of Ed. EDGE OF PAVEMENT
CONC. CONCRETE
,7 WM WATER METER
PP POWER POLE
ST SEPTIC TANK
30'CAMA BUFFER PT PUMP TANK
-E- OVERHEAD ELECTRICAL UNES
0 -X- FENCE
t0 TW TOP OF WALL GRADE
M 8 BOTTOM OF WA GRADE
.1 -PROP.GRADE LL
7-4
I -CENTERLINE
A.
6 CANTILEVERED DECK ts,
OVERHANG(DRIP THROUGH). 9"
NO GROUND CONTACT. —
r _a—
I I
— I S .17'33'E .2.00' I - —
°D PA110 I to r1
'f .0'CANTI a',a. PLATFORM OVERHANG
18'4-
' (DRIP THROUGH).NO GROUND CONTACT
I1I-{ \JGl
LOT 22iiit
p 1,064.85S0.FT. I a
2 0.02ACRES I 41.1 2
41
N I LOT 21
cr a QUEENS GRANT
Y I I
N 14 MB:56.PG:8
V PROPOSED V
DWELLING
= F.F.ELEV.:18.0 /I ENCLOSURE ON ut
SLAB:8.1 GROUND-FLOOR
1 & ® Li
1.0' 0 5' I
\ l l 01. 1.0'
. 1xF
'STpRMVjlA1.ER FASE]IFIIT
y 4f .
AREA CALCULATIONS 592.55'TO PC OF R/W
OF BUMBLE BEE LANE.
BUILDING FOOTPRINT I.002
WALK/DRIVEWAY I49 OBSERVATION LANE
TOTAL IMPERVIOUS I,15 I -R/W VARIES(PRIVATE)-
ALLOWABLE IMPERVIOUS I,337
REFERENCES: ADDRESS:
MB:57, PG:4 PRELIMINARY PLOT PLAN 944 OBSERVATION LANE
LOT NO. 22 BLOCK
SUBDIVISION QUEENS GRANT
THIS IS TO CERTIFY THAT THIS MAP WAS DRAWN TOPSAIL TOWNSHIP PENDER COUNTY, N.C.
FROM THE REFERENCED PLAT MB:57, PG:4.
AN ACTUAL SURVEY WAS NOT PREFORMED BY ME. PIERCE DEVELOPMENT LLC.
PREPARED FOR:
JOHN L. PIERCE, P.LS., L-2596 JOHN L. PIERCE & ASSOCIATES, P.A. (C-1888)
405 JOHNSON BLVD., JACKSONVILLE, NC 28540
NOTE: THIS DOCUMENT ORIGINALLY ISSUED AND SEALED BY: PHONE: [phone] FAX: [phone]
JOHN L. PIERCE,PLS, L-2596, ON AUGUST 28, 2012,
THIS MEDIA SHALL NOT BE CONSIDERED A CERTIFIED DATE: JUNE 5, 2015 SCALE: 1"= 10'
DOCUMENT. .

RECEIVED
SEP 0 8 2020
DCM WILMINGTON, NC
3
,
O
ECH
� � w Z
PAR., � c�
i!i1Ii Q 74
o
—�. REVISIONS
NO. DATE
® FOUNDATION lPLAN'N GROUND FLOOR$GLE'PLAN
S ALE. =1' ® .1Po1' DAAWIRCiR6
0S/3120
DATE
CAI ccurroxs I WL
DRAWNBY
SHEET

RECEIVED
SEP 0 8 %020
DCM WILMINGTON, NC
3
Qz ;
O
U-,
F-
U
d ----- ME=
-- -- .. — =dm
..... t
M�BiER�?E Li.,
y 4„,h. - II •— om L P�iQlt• U
..
, L
[ .1111M
:maw a
=�i ri 1111 � ETInii=IIIIIIM
I UI
1111
eEoaooMa L ®im
....,„,,......
•
11111 I' .. <1
�H'
__ P - ,1 REVISIONS
NO. DATE
©I 1ST FLOOR PLAN O 2ND FLOOR PLAN
tLNE.tp•=1' P2 SGLE.1/<•=1' Da NO
06/31/0
DATE
,
DRAWNBY
SHEET
A2

r.'V::r•ir:IN fr'r:n
SEP 0 8 ZOZO
LM 1 N c:, •.
• i, 4 8
A
5,!i !
0)
crIE- .
'82
,..),
u
....
li -r"---r 1
\
1 1
1 1
I -
o
Z <
w 4
',. J L i .•7 ,
'LDI e[ I 1-fTlf-Th 1 0 0 r I -I-, . cii
W-
II ..,/
i'CA1
\ 1 NNA> 4 1
LWLI-1
e.&r=1 6
1t -r--ir 1
8z5,a1l.
/11 t CPC1 g'
1 1\
NO. DATE
ROOF PLAN
SCALE 110..1. 0 3RD FLOOR PLAN0
Am&viEni-tar, annuu
08/31/20
DATE
DA DRA BY
PA.%.CUt 4110,1q
inao :1°4'' SHEET
ERIEr— rl, A3

SEP 082.020
DCM WILMINGTON, NC
fN
z
�o
82
vE
F
11�—11
1�� w
U
IMIMI MI MI IIIINIIM 1 ll ll 1J U IJ U U I1 U U ll )__ z a
: . REF:=7:::::==. .7:: —1
aa
tr C''V
Z I C7
a
0
0a
a «
. I N <
Q 'El'
s
4
F
a
I w
-
:::��e__ I iijiijji; jiji 0 . • � NO. DATE
OFRONT ELEVATION ® LEFT ELEVATION1'SCALE.Sr.1' 3G1E.1/1'•
.1.115L
DRAW IN(,NO.
08/31R0
DATE
OIL
DRAWN BY
SHEET
msA. Logs cosge, A4

0
4 e
6 x
i
1 i
I 1
1 I i I
i Alm
it• N. __ lil in __
J1EI!7/
�o
'z I
1
w�mw�� .—.aw. ( II
1
I i
I 1
it I 1
i
1
11 ,
i 1
II 1
iikI__i ! B!i !!!!1 i; i ii!
�i.
11
'
f`! =K _` , —111 m„___ 11:1111 1011t1 11 PI:ii Di
.,.
iEir ii1 =i:••+Z .
Iisillis }!y _ _ //I— 1 , n
I
I
Iii I 1 1 , f
in, Ili S I , 1 ..— III sr c $ _,
gg i i i a m i M'i e rri M
l..—•v 1 .. I,� .� a ;Rill <�-c
IR C.. 111
t ' Q
Coastal Tradions •
ARLETH-ASPELL RESIDENCE DeagnBUIC
>it o_ COASTALLOT B QUEENS GRANTC I T TRADITIONSvi H � 944 OBSERVATION LANE ao�u�..ze.ze
TOPSAIL BEACH,NORTH CAROLINA ::sue•BOLD
91031�

Receipts for
Certified Mail
(Staple Here)
Seel A ,.2o)o
Date Jst►'�v
Adjacent Pro erty Owner
f ..4C, WAN' Lowe,
Maili�gAdressy
CC,,
City,State,Zip Code
Dear Adjacent Property:
This letter is to inform you that I, v 4/4.1 es I— r l e have applied for a CAMA Minor
Property Owner
Permit on my property at C. a' ✓R,Set VA /(, k. 4-' E ,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 youy have any questions or comments about my proposed project,please
contact me at C73 \ 6 / C.200 ,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 DEQ/DCM
127 Cardinal Drive Ext.
Wilmington,NC 28405
• �1
J !3M�s �i+2��
Property Owner
. L-es5 ?RA Pc)
Mailing Address
C 4.q , F1"!J tic
City,State,Zip Code
RECEIVE'
SEP082K)

1. . •os a ervice
CERTIFIED MAIL® RECEIPT
r
3 Domestic Mail Only
....
For delivery information,visit our website at www.usps.com''.
U
✓ CarP g Pt* C I -iti L U 6 L
.13 Certified Mail Fee
n $3.55 0580
us 09
Extra Services&Fees(check box,add fee al ZgortAte)
0 Return Receipt(hardcopy) $ $0.00
O PReturn Receipt(electronic) $ $0.00 Postmark
D 0 Certified Mail Restricted Delivery $ i 0.00 Here
D 0 Adult Signature Required $
['Adult Signature Restricted Delivery$ MOO
1 Postage
✓ $0.70
us
-R Total Postage and Fees 09/03/2020
$ $7.10
Sent To f
U U5r1 i'l 1444g;5
Street an tefto.,or RER box vo.
Vvc f<fra'
City,St ,ZI , ,6
—I A)C 21578'

,el uiueu mall servlGe prvvtues the Km:twiny uenents:
A receipt(this portion of the Certified Mall label). for an electronic return receipt,see a retail
A unique identifier for your mailpiece. assoc ate for assistance.To receive a duplicate
Electronic verification of delivery or attempted t 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 Mails,First-Class Package Services, available at retail).
or Priority Mail®service. -Adult signature restricted delivery service,which
Certified Mail service is not available for requires the slgnee to be at least 21 years of agi
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 Mall service does not change the • •To ensure that your Certified Mail receipt is
insurance coverage automatically included with accepted as legal proof of mailing,it should bear a
certain Priority Mail items. USPS postmark.If yop would like a postmark on
For an additional fee,and with a proper this Certified Mail receipt,please present your
endorsement oh 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.

Receipts for
Certified Mail
(Staple Here)
Soy/- , :711)020
Date
Adjacent Property Owner
si — iv '.,1111'
MailingA r s
City,State,Zip Code
Dear Adjacent Property:
"/gig
This letter is to inform you that I, y NS r` have applied for a CAMA Minor
Property Owner
Permit on my property at OESF$2(�t)�.10M �-Al���
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 r-7 32 -";2(1:,a -.)u20),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 DEQ l DCM
127 Cardinal Drive Ext.
Wilmington, NC 28405
Jars f-�IRe
Property Owner
39-!J Less �l VQirt'J Rd
Mailing Address
( i4 e. ! f,,';/ A/C, 7.9Y
City, State,Zip Code
RECEIVED
SEP 0 8 2029
DCM WILMINGTON, NC

I. . •os a ervuce
CERTIFIED MAIL® RECEIPT
-1 Domestic Mail Only
....
For delivery information,visit our website at www.usps.com .
1.1
I ' v' v- '' s"AL
1-
XI Certified Mail Fee $3.55 05.1
I] $ $2.85 09
1J
Extra
Services&Fees(check box,odd fee 4044143te)
0 Return Receipt(hardcopy) $ $0.00
0 Return Receipt(electronic) $ Postmark
$0.00
M OCertified Mail Restricted Delhiery $ Here
j 0 Adult Signature Required $ $0.00
El Adult Signature Restricted Delivery$
M Postage $0.70
r $ 09/03/2020
1J
-.1 Total Postage and ler.1 0
$
.1.1 Sent
,....3 eii;ir.plya.,-or Pter. - /2 j
04 15-2,(5

.erunea mail service proviaes the toiiowing nenents:
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 4. 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 Mails,First-Class Package Services, 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 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 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.

Queens Grant Soundside
Architectural Request Form
The Declarations of Covenants, Conditions and Restrictions for your community specifies that all exterior improvements to your
property must be approved in writing by the Architectural I Design Review Committee before improvements begin. Please complete and
return this form according to the provided instructions. One form per project.
Name: James Arleth and Jennifer Aspell Request Date: 9/2/2020
Street Address: 396 Less Traveled Road, Chapel Hill, NC 27514
Home Phone: [phone] Cell Phone: [phone] Email: [e-mail]
Estimated Start Date: 12/1/2020 Completion Date: 7/1/2020
List the Type of Modification: New construction
Location: 944 Observation Lane, Topsail Beach, NC
Size: 2612 square feet
Color Behr Half Sea Fog N470-3 with white trim; 1st floor exterior doors Behr Whitewater Bay PPU11-10
Material: Fiber Cement siding per elevations
Contractor Na : TBD
Owner Signature: v- 5. '
Date: 9/2/2020
REQUIREMENTS:
Type of Modification: Location Material Style Size Stain/ Built Upon Area/ Images/
on Plot and/ Color BUA*** Plans
Plan I Height (see BUA
Survey , I instructions)
Fence I Fence Enclosure i X X j X X X P x
Utility Building/Shed � X X X X X X X
Porch Conversion } X X X X X X X
Exterior Paint X X
Pool X ( X X X X
Patio/Deck X X X X X X
Extended Driveway/Walkway X I X r — X X X
Gazebo X X X X X X X
Landscape I X i I X
Addition ; X X X X I X i X
INSTRUCTIONS:Please read and follow carefully.
LI Please refer to the above chart for specific requirements for your particular project. Provide all"X"items along
with this completed Request Form. If your project is not specified above please provide a written description
(see next paragraph).
0 For ALL requests,attach a written description of the scope of the proposed changes including the general nature of
the work, location of the changes, colors and materials to be used plus any plans, drawings, photos or brochures
necessary to illustrate the dimension, size and appearance. Please be sure to include details of any landscaping
changes or removals which may be necessary to accomplish the changes proposed.
0 Attach a property survey/plot plan with the location of the proposed changes clearly marked on the survey I
plot plan. This item MUST be included so that there is a clear understanding of precisely where the changes will
occur in relation to the home, driveway, other structures and any easements or rights of way which may exist on the
property. Note:Your project will not be sent for Committee review without a copy of the property survey/plot plan. A
plot plan can be obtained from your closing documents or you may reach out to your builder for a copy.

t*'BUA INSTRUCTIONS(Built Upon Area)
Projects which require owner(s)to submit BUA amounts,include but are not limited to the following; hardscape around in-ground pools,
patio, patio extensions, driveway extensions, walkways and sheds. BUA is considered any impervious surface that does not allow
rainwater to infiltrate into the ground-i.e.footprint of the home,sq.ft.of driveway,concrete walks/patios,etc. Note: For pool requests
the surface area of the pool should not be included in your BUA calculations.
Complete this section for BUA/impervious surface projects:
Existing BUA-located on your plot plan: sq.ft.
Proposed BUA-total square footage of your project: 1151 sq.ft.
Maximum Allowable BUA-refer to CC&R's: 1337 sq.ft.
IMPORTANT: Please allow up to 3-4 weeks for the Committee to complete the review and response process. Requests which do not
include the items described above will delay the process. Email is the quickest and most efficient way to submit a request The review and
response is based on the community's governing documents and the information submitted with this request The property owner is
responsible for investigating and complying with any and all other local requirements,permits or jurisdictions the property is subject to as well
as HOA governing documents. Homeowners are encouraged to review HOA governing documents prior to submitting a request.
HOW TO SUBMIT YOUR REQUEST:
• Email,Mail or Fax request form AND supporting documentation to:
«Your Community's Name>>
P.O.Box 12051
Wilmington,NC 28405
Fax: [phone]
Email:ARC n PremierManagementNC.com
For email requests: Please assemble electronically into a single email with preferably a single PDF attachment. Include
your Community's Name,your Last Name and your Property Address in the subject line.
♦******►***.*****m+r»i►+rt**** *****w****rtrrw******r*rw+►*****.*******.*** ****.x+r-..*****.**.**..fl*fl**'***********a*.fl***.******sari*.*
Committee Use Only
Approved
❑ Approved with Conditions
Conditions:
❑ Denied
Comments:
Name of Committee Member: - Association Manager-Per Board
Signature of Committee Member t' d d- ILQ.d-
Date:

�� '14. 0.8'
COI `� MEAN HIGH WATER LINE
W LEGENB---
0AK 13- EIP DOMING IRON PIPE
ULKHEAD EIS EXISTING IRON STAKE
'AC' SIS SET IRON STAKE
ECM EXISTING CONCRETE MONUMENT
EPK EXISTING PK NNL
ATUNTC OCEAN MBL MINIMUM BUILDING UNE
R/W RIGHT OF WAY
VICINITY MAP- NOT TO SCALE 6, EOP EDGE OF PAVEMENT
4 CONC. CONCRETE
,..1 MA WATER METER
PP POWER POLE
ST SEPTIC TANK
30'CAMA BUFFER PT PUMP TANK
-E- OVERHEAD ELECTRICAL UNES
M -X- FENCE
Ih TW TOP OF WALL GRADE
InBW BOTTOM OF WALL GRADE
18,1 I-PROP.GRADE
Y. -CENTERLINE
S.
B CANTILEVERED DECK !,�•
OVERHANG(DRIP THROUGH). 9,Y.
NO GROUND CONTACT.
I I
I S 17'33'E 12.00' I
18'4 I s' ---
'co PATIO I io n 1
`f, .0'CANTILEVERED PLATFORM OVERHANG
I (DRIP THROUGH), NO GROUND CONTACT
18'4' `J
LOT 22 ,'
1,084.86SD.FT. b
",5, 0.02ACRES I n
L, I • 3
iD I LOT 21
IN N QUEENS GRANT
I PROPOSED I V MB:56, PG:8
N I _
DWELUNG
z F.F. ELEV.:18.0 I to
ENCLOSURE ON
SLAB:&1 I
1 GROUND-FLOOR
® .
\ I
\ 1.0'� 0.s' 81I o._, 1.0'
`.••``-^:. N 43 17'33'.W:32.D0 .
• •,'. ', ONC D V
'STpRM1yATER.E
AREA CALCULATIONS 592.55'TO PC OF R/W
OF BUMBLE BEE LANE.
BUILDING FOOTPRINT I,002
WALIVD RI VEWAY 149 OBSERVATION LANE
TOTAL IMPERVIOUS I,15 I - R/W VARIES(PRIVATE)-
ALLOWABLE IMPERVIOUS I,337
REFERENCES: ADDRESS:
MB:57, PG:4 PRELIMINARY PLOT PLAN 944 OBSERVATION LANE
LOT NO. 22 BLOCK
SUBDIVISION QUEENS GRANT
THIS IS TO CERTIFY THAT THIS MAP WAS DRAWN TOPSAIL TOWNSHIP PENDER COUNTY, N.C.
FROM THE REFERENCED PLAT MB:57, PG:4.
AN ACTUAL SURVEY WAS NOT PREFORMED BY ME. PREPARED FOR: PIERCE DEVELOPMENT LLC.
JOHN L. PIERCE, P.L.S., L-2596 JOHN L. PIERCE & ASSOCIATES, P.A. (C-1888)
405 JOHNSON BLVD., JACKSONVILLE, NC 28540
NOTE: THIS DOCUMENT ORIGINALLY ISSUED AND SEALED BY: PHONE: [phone] FAX: [phone]
JOHN L. PIERCE,PLS, L-2596, ON AUGUST 28, 2012
THIS MEDIA SHALL NOT BE CONSIDERED A CERTIFIED DATE: JUNE 5, 2015 . SCALE: 1"= 10'
DOCUMENT. „,_ „,. ..-., .,-.

I
I
6
s
6
a
0
i
D
Z
_2
I Y,
6v.
1
y'-
18
1..
ag
acr Mktg ii
14" P
o g ARLETH-ASPELL RESIDENCE COASTALcosifti.. eWat] o LOr 22 QUEENS GRANT C TTRADITIONS
�► IrI ' a >z 944 OBSERVATION LANE PM Cam..
o �'^ I OPSAIL BEACH,NORTH CAROLINA �� � 9u4.i v,e AGM.

O
1
fi
C
-
Ri
i ,', F 1
o Q,1tf�® '�'
P .......... ....... .. . .—
‘ 0 1 Jilin Il ' 1 V
i 111 11
0 II
g @ s • I 1 ,11 .
1 0
IITIg 11 €gym;F.
I is ' �' r 1 1
hill t
11011
Coastal T`aEitiooa
I $ t
ARLETH-ASPELL RESIDENCE COASTAL °"`� a°
N 4 -a i° LOT22QUEENSGRAN'I
944 OBSERVATION LANE ( � T TRADITIONS a,a�� 3e
46
TOPSAIL BEACH,NORTH CAROLINA

n
1
i
i
y�
Q
ti
a
/ '.h ai 7-
N
niory
,..
L ..___ .
ti
.,,,,,,
,.5
T , ..,
-
..
1f�!
,p„ ,
Me 2
8 dii g�il I
221 i z
Iris
222�bl9 g�{f
ti og ARLETH-ASPELL RESIDENCE COASTAL °°"°°B'°°
x � -
h'1 ��o�= � �o LO7'ZZ QUEENS GIUN'f 1 TRADITIONS
(. � R >z 944 OBSERVATION LANE i...n,rn.ax_i
" TOPSAIL BEACH,NORTH CAROLINA nua.!IN

4
L a $ a
I C x n
g
,
I:11 1 " 1111111 hill Ilkil. II'
1
11illlimit mom!
i�
IIIIII__ il�ll����� 11 mom
I�
L
.,
, ❑ H l R 1 -11: . '
/1 � 111111111 II IIII
.D
'z II
II
!I
II 1 I
1, •
I
1
!
li 1,111I 1. I l
;s:
a 1 _ ie
4.
•
——, i
In i
llll 111
,,a -
111 _
JJSS 1em 6" 44 d 6 1
I.I
Ie i: i
Gomel Tladitima
o2 ARLETH-ASPELL RESIDENCE o�.�aeWa
COASTAL
Iti7 �'= ; LOI'22 QUEEN$GRANT l TRADITIONS „,�-d.,.ra
z 944 OBSERVATION LANE
'�" TOPSAIL BEACII,NORTII CAROLINA "Gn an'� „u we a,w

r a a e
i i 1 1
iii
b 6
2@ 1 i 1
1-1
❑ J. In '1 1��111
❑f 11 in -�J----� _: jLJi €
—
:O ,
t I
I I i
'i
.I ,
,
it
,i
j
it
-I
' I i
I IiHIIIIII II I;
1.�11{a t I •'
I:, i! ■ 111
'II it
I, El I� ' ---
1
I I I J
("; LI I 1 HI �I��I��I, 0
• !i 1 i III I illlj' � i L —Tn
1
i. E16 R k
k 'i% i'I.s' ss9 i a�42
d4 d g gc
Ia h�
61ti
Coaaw tta°non.
1�y rn o m og ARLETH-ASPELL RESIDENCE COASTAL o°ass e°°°
tri �>- ; LOI'22QUEENSGRANI C�'I TRADITIONS
(� w 940 OBSERVATION LANE ro'^=•�- •
TOPSAIL 13PACII.NORTH CAROLINA ,�•y,.yiw

Date Date Check From Name of Vendor Check Check Permit Rct,
Received Deposited Permit Holder Number amount Number/Comments
9/15/2020 James J. Arleth same Coastal 700 $100.00 Minor Fee, 944 Observation Ln, JD rct.
FCU Topsail Beach OnCo 11639