TB_21-03_ Circle (2)

.. _ .
RECEIVED
Issued by WiRO TB21-03
Topsail Beach MAR4 2021 Permit Number
CAMA DCM WILMINGTON, NC
MINOR DEVELOPMENT
PERMIT
NORTH CAROLINA
Environmental Quality
as authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission for development in an area of environment
concern pursuant to Section 113A-118 of the General Statutes, "Coastal Area
Management"
Issued to Circle Q Equity, Inc. authorizing development in the Estuarine Shoreline (AEC) at 914 Bumblebee Lane, in
Topsail Beach, Pender County as requested in the permittee's application, dated February 1, 2021, and received as
complete by DCM on February 3, 2021. This permit, issued on February 22, 2021, is subject to compliance with the
application and drawing dated and received by DCM on February 3, 2021 (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 February 3, 2021.
(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)
1r�
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 CAMA LOCAL PERMIT OFFICIAL
this permit, require further written permit approval.All work must cease when this
permit expires on: 127 Cardinal Drive Extension
December31,2024 Wilmington, NC 28405-3845
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 PFRMITTFF

-
Name: Circle Q Equity, Inc.
Minor Permit#TB21-03
Date: February 22, 2021
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 proposal 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) 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 Manna.
(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.
SIGNATURE '. DATE:X
PERMITTEE

Locality —1—CD S5, permit Number I r? 7\ C� OTHER PERMITS MAY BE REQUIRED:The activity you are planning may require permits other than the LAMA
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
Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile Home Park Approval,Highway Connection,and
(For official use only)
others.Check with your Local Permit Officer for more information.
GENERAL INFORMATION STATEMENT OF OWNERSHIP:
LAND OWNER-MAILING ADDRESS I,the undersigned,an applicant for a CAMA minor development permit,being either the owner of property in an AEC or a
r person authorized to act as an agent for purposes of applying for a CAIvLA minor development permit,certify that the person
Name C�r� l e tXNI '� I I • listed as landowner on this application has a significant interest in the real property described therein.This interest can be
Address 1 t(p Se.4 061S 0 v•• described as:(check one) -
City al Cj State ,V[i Zi PhoneSif:-/ an owner or record uric,Title is vested in name of ,
1, ,/� t- see Deed Book 4n 24 paged j in the re I'Y/e r County Registry of Deeds.
Email ��/V►/llJl CO. �M IX - Imo{ . Wry,ff ��JJ an owner by virtue of inheritance.Applicant is an heir to the estate of
AUTHORIZED AGENT ;probate was in County.
Name
Address Spc,.
M • _if other interest,such as written contract or lease,explain below or use a separate sheet&attach to this application.
/ State Zi Phone NOTIFICATION OF ADJACENT RIPARIAN PROPERTY OWNERS:
City P 1 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.
(Name) (1, �(Address) /.
LOCATION OF PROJECT:(Address.street name and/or directions to site;name of the adjacent waterbody.) (1) F/ It i�Vt S-F- A:Fs/ u-C a0 t`' $ C. " /p 14 C Z,SI y
9lt-t _Du`(`^1)Ip Ve,e k To (,1 \, ` KSC --V8 " (2) L L-.r (4 r
C(l. 7 Pie L . re4,-.7 FJ '1 G --1Slq
2)
( DA1 P c,ft 1-9 o-vex2,1M (r-Yemr- ) (4)
DESCRIPTION OF PROJECT:(List all proposed construction and land disturbance.) ACKNOWLEDGEMENTS:
1/ n I,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
V Q j l \0\,�(j•, (n 5 -11(/L(4. l( 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 stabilize-
SIZE OF LOT/PARCEL: L '3 r square feet 73_acres lion and foodproofing techniques.
PROPOSED USE:Residential (Single-family gr Multi-family❑) Commercial/industrial 0 Other 0 I furthermore certify that lam authorized to grant,and do in fact grant,permission to Division of Coastal Management staff,
the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information
COMPLETE EITHER(1)OR(2)BELOW(Contact your Local Permit Officer if you are not sure which AEC applies related to this permit application.
to your property):
This the 11) day of ,20 YI
(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 aa_ A rum- (I W\
excluding non-load-bearing attic space) Landowner or on authorized toto act as is/her a ent for purpose of filing a CAMA permit application r
(2) COASTAL SHORELINE AECs:SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT POPt' t•'eN4er Gam^- y. r3 k 9-7 3 5- r9'- 4 V y
UPON SURFACE uare feet(includes the area of the foundation of all buildings,driveways,covered decks,
This application includes:general information(this farm),a site drawing as d sc ibed o the eh of this application,the
¢t ownership statement,the Ocean Hazard.4EC Notice where neces.rary a check for S100.00 made payable to the locality,am
concrete or masonry at oc etc.that are within the applicable AEC.Attach your calculations with the project drawing.) �. ppp application>in Demotion as may he royided orally by•the applicant The details of the a lication as described by these sources are
STATE STORMW ATER MANAGEMENT PERMIT:Is the project located in an area subject to a State incorporated without reference in any permit which may be issued.Deviation fivm these details will constitute a violation q
Stormwater Management Permit issued by the NC Division of Energy,Mineral and Land Resources(DEMLR)? any permit.Any person developing in an AEC without permit is subject to civil,criminal and administrative action.
YES NO If yes,list the total built upon area/impervious surface allowed for your lot or parcel: 1 a{ItO•0 square feet.

ROY COOPER
MICHAEL S. REGAN
BRAXTON DAVIS
February 22, 2021
Circle Q Equity, Inc.
116 Sea Oaks Drive
Surf City, NC 28445
Dear Circle Q Equity,
Attached is CAMA Minor Development Permit TB 21-03 for work to be done at 914 Bumblebee 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 gold copy for
your files, and return the white copy to us within 20 days of receipt in the enclosed, self-addressed
envelope
This is not a valid permit until it is signed and returned to our office.
Thank you for your prompt attention to this matter.
Sincerely,
,dne.A., A4-166h
Anita M.Webb
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

I, MARC F. GLENN, CERTIFY THAT THIS PROPERTY WAS SURVEYED AND MAP DRAWN UNDER MY SUPERVISION: G a�� ® N
DESCRIPTION AS SHOWN ON THE FACE OF THIS PLAT; RATIO OF PRECISION AS CALCULATED BY COMPUTER ,zY �
'
IS 1:20,000t; THAT THE BOUNDARIES NOT SURVEYED ARE SHOWN BY BROKEN LINES PLOTTED FROM
INFORMATION REFERENCED; THAT THIS PLAT WAS PREPARED IN ACCORDANCE WITH "THE STANDARDS OF �� Gms G� W—E
PRACTICE FOR LAND SURVEYING IN NORTH CAROLINA"; WITNESS MY ORIGINAL SIGNATURE, LICENSURE 0P r is B� S
NUMBER AND SEAL THIS 21ST DAY OF JANUARY A.D. 2021. 04
.'�F� �oy 9 B.
.7 '� ,• el,
TOPSAIL SOUND 9.
BULKHEAD MARC F. GLENN lc',N.0 �(i�gi b.IILLr4308 BULKHEAD 'II?' C �
\� EI.g1•,i.,•may NORMAL HIGH WATER IS-}
�'eS E A L •• s AT BULKHEAD VICINITY MAP
)COMMON AREA
NOT TO SCALE
MB 58 PG 8 30' CAMA
L-4308 SETBACK
.�1:4P /LINE______J11� — .
—I N 5g13'35" E 37.00' ,
i /
• DECK ' DECK
/
I, DECK
/
/ d .
O z N
w HEATED SPACEfe.I. n
HEATED PORTION Li a
OF EXISTING o PROPOSED
z
STRUCTURE N 3 STORY cA ni oo
#916 I x �` DWELLING ` Z ' HEATED PORTION
f #914 m OF ADJOINING
STRUCTURE
o• cr)► #912
W
4
N
/,
PAD #29-R
1534 SF. FT. 1
1940 SF. FT. ALLOWABLE
...._i_.--- (11 ,s
R/W y S 6036'51' W 37.03' R/W
�, BUMBLEBEE LANE
PRIVATE RIGHT OF WAY
SVARIES IN WIDTH
R W
�c° \ 7 JANUARY 21, 2021
SURVEY REFERENCE SITE PLAN FOR
DEED BOOK 4728 PAGE 2015 Circle Q Equity, Inc.
MAP BOOK 58 PAGE 25 #914 BUMBLEBEE LANE
PAD# 27R QUEENS GRANT
TOWN OF TOPSAIL BEACH TOPSAIL TWSP. RENDER CO. NC
Quinn Queens Groot Site Planslot 29 914 BumbleBee Lane.dwg
N LEGEND 20 0 10 20
N,��1���� POLARIS O= EXISTING REBAR
eisk At , SURVEY/NS,, PEWI1= 5/8" KEBABS SET 1 INCH = 20 FEET
20211; EASTREDFORDROAD = CENTERLINE
`y -!;'� NOTE: THIS LOT IS LOCATED
WILMINGTON NC 28411 R/W= RIGHT OF WAY IN ZONE AE 10
.......�...,..,. ...... FIRM COMMUNITY PANEL

Receipts for
Certified Mail
(Staple Here)
— I , a- f
Date
L')C Property-er
M� ping Address ^G
C� Zi pCode
ty, � P
Dear Adjacent Property:This letter is to inform you that I, Cr`�G(f 6 e" I/1
L ' 11`•�ave applied for a CAMA Minor
Property Owner
- �fS�c'tttti3 tk
Permit on my property at i`� B VM Pko b lu ►- N ,in COUNTY
rokrn ' Proper(Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s)as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project,please
contact me at It 5-4 1 --Z-t 55 ,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 JQso A Dq
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY, STATE,ZIP CODE
Sincerely,
C c of cgvwk�
Property Owner
1 b Se6 Oc Lis \)✓.
Mailing Address
N C
City,State,Zip Code

1. . •os a ervice
CERTIFIED MAIL° RECEIPT
• Domestic Mail Only
• For delivery information,visit our website at www.usps.comx.
u
Curer NC 27512
nCertified Mail Fee $3.60 r7-Q 0482
Extra Services&Fees(check box,add fee$s��pTjSCate) i)4
❑Return Receipt(hardcopy) $ j�I.�rlt
❑Return Receipt(electronic) $ $IJ-GV Postmark
❑Certified Mall Restricted Delivery $ 80.00 Here
j ❑Adult Signature Required $ ��•(y
❑Adult Sir,xture Restricted Delivery$
7 Postage
f' $1.55
$ 02/02/20121
Total Postage rd Fees
3S $7.00
pu Sent
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♦CI UII U IVI011 ACIVIVO 1.7IVVIUCA II UCiiCIIIS.
A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail
A unique identifier for your mailpiece. associate for assistance.To receive a duplicate
Electronic verification of delivery or attempted return receipt for no additional fee,present this
delivery. USPS®-postmarked Certified Mail receipt to the
A record of delivery(including the recipient's retail associate.
signature)that•is retained by the Postal Service-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 beat 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 age
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 Mn 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 mallpiece,you may request Certified Mail item at a PoktOffice'"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 mailplece.
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.
4 c...,.,asnn Anvil 4411A ocu 7cln110-ra11-011n7

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to
cy cLe v1-)--1 . T/Nc S
��(( ((���� II-- (Name of Prop rty Owner)
property located at 1 1` QijM �l(a �.Q Q .t� T� ()sal;I N�/ P+C
P°t 2, )
� Address, Lot, Block, Road, etc.)
on tqAttitti d\MA.. J in P-PN,, nn
C7 4 v , N.C.
(Waterbody) (Town and/or 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

r.a
•
Receipts for
Certified Mail
(Staple Here)
Date
1V c1�.cl GonRA/A—
Adicent PropertyOwner
6 -1t)l $kit [-, .
MajNng Addrev � -2-21 s 1
1
City,State,Zip Code
Dear Adjacent Property:
This letter is to inform you that I, 6" '& ` " "'have applied for a CAMA Minor
Property Owner t
acAdA
c, r_ � �"
Permit on my property at I iLI- Wyk (- ref 1 -2.1 AF'S,in COUNTY
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s)as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at t O �'� ,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 J aSo r � i
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY, STATE,ZIP CODE
Sincerely,
Property Owner
`a KS tV
Mai�ing Address
C W C. --2— `f5
City,State,Zip Code

I. . •os a ervice
CERTIFIED MAIL° RECEIPT
3 Domestic Mail Only
o For delivery information,visit our website at www.usps.com®.
u
Car9, N 271,519
U Certified Mail Fee $3.611 �1432
n $ $2 5
] Extra Services&Fees(check box,add fee proate) 04
❑Return Receipt(hardcopy) $ l•�1tff''
] ❑Return Ft celpt(electronic) $ I I_fill Postmark
] 0 Certified Mail Restricted Delivery $ $LI•`III Here
] ❑Adult Signature Required $ $II•00
0 Aduk Signature Restricted Delivery$ i V
] Postage
$ $0.75
] 12/i12/2i121
] Total Postage and Fees
$ $7.20
L]1 SentT[�41c+�oe1 - roy1elio
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City Stets,zt 1\1,G ) 2 f q,

.Clurreu mart ServlGe IJULIVIU1S6 m e 7Vriuwrriy Uerrerrls:
A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail
A unique identifier for your mailpiece. associate for assistance.To receive a duplicate
Electronic verification of delivery or attempted return receipt for no additional fee,present this
delivery. USPS®-postmarked Certified Mail receipt to the
A record of delivery(including the recipient's retail associate.
signature)that Is retained by the Postal Service' -Restricted delivery service,which provides
for a specified period. delivery to the addressee specified by name,or
to the addressee's authorized agent.
nportant Reminders: -Adult signature service,which requires the
You may purchase Certified Mail service with signee to be at least 21 years of age(not
First-Class Mail®,First-Class Package Service®, , available at retail).
or Priority Mail®service. -Adult signature restricted delivery service,which
Certified Mail service is notavailable for requires the signee to be at least 21 years of age
International mail. and provides delivery to the addressee specified
Insurance coverage Is notavailable for purchase by name,or to the addressee's authorized agent
with Certified Mail service.However,the purchase (not available at retail).
of Certified Mail service does not change the •To ensure that your Certified Mail receipt is
insurance coverage automatically included with accepted as legal proof ofanailing,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 mailplece,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 mailplece.
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.
e c..,..%f%Rflfl n..,,,*ma nnn,

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
-yam
41
I hereby certify that I own property adjacent to Ck V'� `� / �'� s
(Name of Proppe Owner)
� (
property located at ( / a P_2 [At o rPr/ �G Z + J
(n
}, I"a/ . ) Address, Lot, Block, Road,etc.)
v�on ,���' Ik$ C��0 , in P A 1 (p� , N.C.
(Waterbody) (Town and/or County
He ��►
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

C/1 CI)n -0 > -0 :iJ go
to cQ - "a
--
a CDCD
I w CD °. E m
c c _
5
m
Permit Number OTHER PERMITS MAY BE RE( m m Q .- O 0-
minor development permit.includini — O 0_ Z .. o
Estuarine Shoreline OEM Shoreline Public'trust Shoreline Other treatment system),Building,Electric -rl > 2 W 3
Certification,Sand Dune,Sediment I 3 •
(For official use On(v) Ti. (D
others.Check with your Local Perm
0
DJ
IRMAIION 0 o „�
STATEMENT OF OWNERSHIP: 0
•MAILING ADDRESS I,the undersigned,an applicant for a N - \.
person authorized to act as an agent c = _
'Arc �e (,? �Gj l/�1 �7 f hike •_ listed as landowner on this applicant pj pni m c
�' J 1 Ce4 Oak( Dr• described as:(check one) �. = \
/(o 1 Le t 1G 4/ 9.'0 S�-a — )' I S� 2.
( State'/IV /� Li y;�Phone an owner or record title,Title it w
KM 0 — 1``-C . Core see Deed Book 4� c
JZ
aGENT an owner by virtue of inheritan. N n
C 1
Ps.M� _if other interest,such as writtct �O C �.
NOTIFICATION OFADJACEN' c
_= 0
State Zip Phone 1 furthermore certify that the follow (2 (D
ACTUAL NOTICE to each of the cmi - O
O to
(Name) a Q n
AROJEC P:(Address.street name and/or directions to site:name of the adjacent waterbody.) t I) 4- 0, C
v.M AID t3 kie -))8►- '
73
P cat Z.1 G2 sJ Q.t/to (r-vA4--1-) (a) XJ
K
-, (1) ly
)F PROJECT:(List all proposed construction and land disturbance.) ACKNOWLEDGEMENTS: -p C)
n [,the undersigned,acknowledge the C (Q
✓p�1 .Vt'I.�- s\ CD O >54-� ((\ may be susceptible to erosion and/u f
`JJ !!U//r111•�� lar hazard problems associated with c cp
LRCEL:'L Jt square feet _acres lion and tloodprooting techniques. 't- ei
O =
Residential '
(Single-family Multi-family❑) Commercial/Industrial❑ Other 0 I furthermore certify that I ant auth# 0 '-r
the Local Permit Officer and their
'HER(1)OR(2)BELOW(Contact your Local Permit Officer ij;rou are not sure which AEC applies related to this permit application. , -
i. to e'' c0 (1)fA
;ARD AEC:s:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet(includes C j C
ng space,parking elevated above ground level,non-conditioned space elevated above ground level but � \ Z
I-bearing attic space) Landowner or {nn authorized to o
1'�/c : i l7 0 (A)
IORELINE AECs:SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT T� r Di Di ,," j
This application includes:general, a) [p
Fume feet(includes the area of the foundation of all buildings,driveways,covered decks, ownership statement.the Ocean N
ry at os,etc.that are within the applicable AEC:.Attach your calculations with the project drawing.) any in%nrnrntian as may he pmvidei
i1ATER MANAGEMENT PERMIT:Is the project located in an area subject to a State incorporated without reference in yI ,. o
lenient Permit issued by the NC'Division of Encrgy,Mineral and Land Resources(DEMLR)^. any permit.Any person develapinb�i I
�,\ �`. t ��y'`, ��_ --.. N W
built upon area/impctvious surface allowed tirr your lot or parcel: I { if•,•0 square feet. ��. (")
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s
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Permit Number OTHER PERMITS MAY BE RE( > = Z an)
O a . O
minor development permit.includini 9, 0, a
Z O
Estuarine Shoreline ORW Shoreline ,Public Trust Shoreline Other treatment system),Building,Electra 11 >( CD p)
Certification,Sand Dune,Sediment I ca tp t! 3
(For official use only) others.Check with your Local Perm CD
13
(D O
IAITON STATEMENT OF OWNERSHIP: -0 D
MAILING ADDRESS •
I,the undersigned,an applicant fora N
CD I]
V
r prrsun authorized to act as an agent n•
\ Jf a N -I-7�/I I )Y^`L listed as landowner on this applicant A) 1))
described as:(check one) 0« a)
i(o Secs Cak-s- Or a)
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"-( State 1 V G Li hone I,°S Ph-1-1 Ss- .4 an owner or record title,Title is -
see Deed Book 471 7
an owner by virtue of inhcritatn N V.'- 0GENT
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M� dottier interest,such as writtct{
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NOTIFICATION OEADJACEN'1 C co
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State Zip Phone I furthermore certify that the follow F13 --
ACTUAL.NOTICE to each of Cher o 4( - CD(1 0
(Name) O
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Rno.,ECT:(Address.street name and/or directions to site;name of the adjacent waterbody.) (I) FM R i✓w!S f W _ O 0
(Dv.M i)I p f),2e Tv 41 V'az�` kiC (2) /0itiNce.( () L r cn
p Get ave o 1/ -`•) (4) io
CD 1:0
IF PROJECT:(List all proposed construction and land disturbance.) ACKNOWLEDGEMENTS: i N CT.) =
I,the undersigned,acknowledge th:E a
VQ jt I) I,�� 34-�(& (( may be susceptible to erosion aniV lcp 13 D
q tar hazard problems associated with CD 3
RCEL: f.- 3 r square feet OS acres lion and Iloodpruoting techniques. P O (p
:Residential% (Single-family xi' Multi-family❑) Conunercial/lndustrial❑ Other ❑ I furthermore certify that 1 am authj 'a ri-
the Local Permit Officer and their`
HER(1)OR(2)BELOW(Contact your Local Permit Officer,J:rou are not sure which AEC applies related to this permit application. t f
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AR AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square.feet(includes C =• c) 0
rig space,parking elevated above ground level,non-conditioned space elevated above ground level but 2 .. Z N
-hewing attic space) Landowner or p o{nn authorized to . . O N -`
1'�f s p)
IORF.LINEAECs:SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT This application includes:general
mare feel(includes the area of the foundation of all buildings,driveways,covered decks, CD CD
ownership statement,the Ocean/!c ••
y at os,etc.that are within the applicable AEC.Attach your calculations with the project drawing.) any inJnrntatinn as may he provide; CD
incorporated without reyetence in ,r ' ` _
i'ATER MANAGEMENT PERMIT:Is the project located in an area subject to a State rtrq,permit.Ar{y person developingc
cment Permit issued by the NC'Division of Energy,Mineral and Land Resources(DEMLR)?
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built upon area/impervious surface allowed lice your lot or parcel: I9 •0 square feet.
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Date Date Check From Name of Vendor Check Check Permit Rct
Received Deposited Permit Holder Number amount Number/Comments
2/4/2021 Circle Q Equity, Inc. same BB&T 25699 $100.00 minor fee, 914 Bumblebee Ln, JD rct
Topsail Beach PnCo 1362C