TB_21-13_ Sarbone (2)

RECEIVED
Issued by WiRO TB21-13
Topsail Beach JUN 2 8 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 Silvia Sarbone authorizing development in the Estuarine Shoreline (AEC) at 916-A S. Anderson Blvd, in
Topsail Beach, Pender County as requested in the permittee's application, dated May 20, 2021, and received as
complete by DCM on May 24, 2021. This permit, issued on June 15, 2021, is subject to compliance with the application
and drawing dated and received by DCM on May 24, 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 May 24, 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)
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
f ilmin•ton NC --3845
December 31,2024
In issuing this permit it is agreed that this project is consistent with the local Land W�`
Use Plan and all applicable ordinances. This permit may not be transferred to
another party without the written approval of the Division of Coastal
PERMITTEE

{.
Name: Silvia Sarbone
Minor Permit#TB21-13
Date: June 15, 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
coveragelbuilt 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.
X -2-o2
SIGNATUR . DATE:
PERMITTEE

Locality —ib 51 1Jc.JC J..QLLC--Y l Pennit Number TB- 2.1- f 3 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 I,the undersigned,an applicant for a CAMA minor development permit,being either the owner of property in an AEC or a
l person authorized to act as an agent for purposes of applying for a CAMA minor development permit,certify that the person
Name ..;'via 7-�Sair a�I U r1 a listed as landowner on this application has a significant interest in the real property described therein.This interest can be
Address/ 4/5 //e.�/c h a S e. /Lane r� described as:(check one) Q /
City %akA iif 6 0 a( State /{/f Zip,0f/d I Phone 73a-9/a_Gab" V an owner or'record title,Title is vested in name of Akr/ Ltd i /I//a Sa—h Yl G ,
/ / see Deed Book /// pagea'f1 in the Penda/' County Registry of Deeds.
Email $k-/Qre$(G CO y/aA00•dQYY)
AUTHORIZED AGENT J an owner by virtue of inheritance.Applicant is an heir to the estate of
-yam / ;probate was in County.
Name Don n a /hr k i�n
�O�Of`7 U J /4lLUt/�ID N if other interest,such as written contract or lease,explain below or use a separate sheet&attach to this application.
Address / /
N 5J� State h 9/0-00 3-d'/3/ NOTIFICATION OF ADJACENT RIPARIAN PROPERTY OWNERS:
City /y t✓ Zi Phone I furthermore certifythat the followingpersons are owners of properties adjoiningthis roe I affirm that I have given
Jya-�y'� ./ I / P P property.rtY•
Email CAnru aLi$iZi O trI odU/ r/E.SS•Core) 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 of the adjacent waterbody.) (Name) (Address) - l
9i� �bu (Z)Tug/� D� T.o5a,l Lei 9/ S#f�Jel6a AlYd Tn5 it
yf1h A1derstin ,pulcvard T�sa,'/&aeA ( )�h, tip et/G.ns /es 2r,/P a.,r-yoslead /✓� C di-e/
(3)
NC 021 . -,/,,r(,oasia/ /,da)/zday (4)
DESCRIPTION OF PROJECT:(List all proposed construction and land disturbance.) 24i 41 64- ACKNOWLEDGEMENTS:
j I,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
arre noodu far 1OYYIe. Q If) ////)C�5 may be susceptible to erosion and/or flooding.I acknowledge that the Local Permit Officer has explained to me the particu-
larI Q ✓ hazard problems associated with this lot.This explanation was accompanied by recommendations concerning stabiliza-
SIZE OF LOT/PARCEL: 6,a j 4 square feet acres tion and floodproofing techniques.
PROPOSED USE:Residential" (Single-family 0 Multi-family Ei) Commercial/Industrial Ei Other El 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): nn��
(1) OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet(includes This the o� day of May ,20 p2/
air conditioned living space,parking elevated above ground level,non-conditioned space elevated ab ound level but /6r7t )CtiJ a f"�
excluding non-load-bearing attic space) Landowner or person authorized to act as his/her agent for purpose of filing a CAMA permit application
(2) COASTAL SHO L1 ECs:SIZE OF BUILDING FOOTPRINT AND OTHER I OUS OR BUILT
UPON SURFACES: Q re feet(includes the area of the foundation of all buildings, eways,covered decks, This application includes:general information(this form),au
site drawing as described on the back ofthis application,the
concrete or mason patios,etc.that 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 a violation of
Stonnwater 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�eiil}ftl7reelrH er,
YES NO ✓ 1[CLC�1/CU
If yes,list the total built upon area/impervious surface allowed for your lot or parcel: square feet.
MAY 242021
DCM WILMINGTON. NC

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: `5/Ivi d J (&)ne_
Mailing Address: 4/.5 7)_(,cC11;7 se lane"
Phone Number:
Email Address: _4J re s/ yz- /46t e
I certify that I have authorized Donna %,54h
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: / ,; Ian ag-ka.Yle
at my property located at 9/Zil Sd4,/17 Avtik\43id %�5a,/,60(M /le
in r",(fl� County.
1 furthermore certify that I am authorized to grant, nd 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.
Propert -Worm ion:
Signature
Silvia Sarbone
Print or Type Name
l
539
Date
RECEIVED
This certification is valid through I / MAY 2 4 2021
DCM WILMINGTON, NC

ROY COOPER
Governor \44V.
JOHN NICHOLSON
Interim Secretary
BRAXTON DAVIS NORTH CAROLINA
Director Environmental Quality
June 16, 2021
Silvia Sarbone
45 Deerchase Lane
Lakewood, NJ 08701
Dear Ms. Sarbone,
Attached is CAMA Minor Development Permit TB 21-13 for work to be done at 916 A South Anderson
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 gold copy for
your files, and return the white copy to us within 20 clays 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,
�i if 1 • -t•
Anita M.Webb
Permit Support Technician
N.C. Division of Coastal Management
Enclosures
Cc: WiRO files
TB Inspection Dept.
Donna Austin -Agent

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L JCHNNY J.YAWAMS PROFESSIONAL LAND SURVEYOR.CERTIFY THAT BANKS CHANNEL
``.��µC n,,, THIS MAP WAS PREPARED UNDER MY SUPERVISION FROM AN ACTUAL ....... ""'^
0. E88j,-4 SURVEY MADE UNDER MY SUPERVISION COMPLETED ON 02/04/2021
F p4 O'+.t FROM REFERENCES AS SHOWN HEREON;THAT BOUNDARIES NOT r
F1 :=Q? �.%; � SURVEYEDARE NOTEDASSUCH AND PLOTTER FROMREFERENCES._,-,___, = rS = ASSHOWNHON; THATTHEONOFTHISSUR WASfix,, �ppyy
L-3170 - PERFORMED ID A CU55 A SURVEY AS DEFINED BY 7111E 21,CHAPTER MOLEMMa pgpt,p8
:f Q i - 58.SECTION.1603 OF THE N.C.ADMINISTRATIVE CODE USING A RTX
i =1. '7,� ,4Oi T NETWORK WITH A POSITIONAL ACCURACY OF 0.09 U.S FEET,THAT THIS ,I,�,
SVRV : GPS SURVEY WAS PERFORMED USNG A CARLSON BRK6 ROVER AND/OR
y� J�bV'y```�. A CARLSON BRK6+ROVER;THAT ALL COORDINATES ARE BASED ON N.C. N A00880I Bou1v8
k
l - ���I, GRID NORTH(NAD 1983 2011 ADJUSTMENT GEOIO12 MWEL):THAT THE
BANKS CHANNEL S CONVENTIONAL ADPCHITON1083 OF THIS SURVEY HAS A RARO OF PRECISIONATTH �j
IN EXCESS OF 1:10,OW AND IS ALSO PERFORMED 70 A CLASS A ocFix OWL..
SURVEY AS DEFINED BY TIRE 21,CHAPTER 56,SECTION.1803 OF
THE N.C.ADMINISTRATIVE CODE
c O2/12/2021 VICINITY SKETCH
419 b JOH Y S P.LS,L-3170 (NOT 70 SCALE)
45"23'42"E
12.32'
5 4527.W23'42"E d LEGEND:
SURFACE CALCULATIONS:
A H.WATER Rl N. 0., p 4 X OP n•DIMING IRON PIPE
RR IMP Boa[M.PILL aP 9e TQ
^h. 5 'b� LOT 9184 ES-COSTING IRON STAKE
lee'
ECM-EXISTING CONCRETE MONUMENT
Tp�b TOTAL LOT AREA 11.085 S0.FEET EL4NUNS EXISTING HAG NAIL
4ttb
MNS-NAG NAIL SET
�y'l• I!, tk © AREA OF COVERED HOUSE FOOTPRINT- NP-NOP ABOVE
ENRE0 POINT
M Vi6/1 W.
�` S — h ,mu MEC WE/ / 2,070 SO.FEET(18.75 IMPERVIOUS) BG TOP BELOW GROUND SURFACE
N. ...f.,.,.:YJp o'^` TOWN OF TOPSAIL BFICH TOTAL IMPS IOUS AREA-2070 50.FET(18.71i) R/W-RIGHT-OF-WAY
09 V` Jj. / DEED BOON 2955,PAGE 64 E :CENTERUNE
® �_ / f/. 0 -PROPERTY LINE
_ / NCCS Ngt1H CAROLINA GEODETIC
.4,� APPROX AREA OF ROOF OVERHANGS OUTSIDE SURVEY
auxpEA. [____:_:.;. �� F`� / OF HOUSE/BUILDING FOOTPRINTS-204 SO.FEET MOW --- -UNE NOT SURVEYED
'rj_#y7 FgA /num / J(� AREA OF DECKS.STEPS.ETC.-672 SO.FEET --OVERHPOLEAD URUTY UNE
J 7.':„_-� �,..-xo,/ / �' mR L AREA OF DRIVEWAY-972 50.FEET B-WATER METER
..~ � .9 / ., 4 LOT 9164(75'AEC UNE)
5' SS AND AN UTILITY EASEMENT ENTSP. �.r_':*
INGRESS AND0 G PER ?. _.: ./ O/ 'E.Ey AREA OF LOT WITHIN 75'CAMS AEC
IMP WOK 66,PAGE 30 � /Wa
J. ''../ - . LINE-5.623 SO.FEET
4 ::.�_� �; ,� , REFERENCES;
Tpygy6Q/ / AREA OF COVERED .6X IL FOOTPRINT— LOT 916A
P.TF9r m > 1.107 50.FEET(19.6U IMPERVIOUS)
a`{� DEED BOON 4720.PAGE 2798
,Oa, ',.< / , fix 1F � \ AREA OF ROOF OVERHANG WITHIN 75'CAMS
13 / \, ? S AEC LINE-106 W.FEET LOT 915A
`' <'\� ��,p MAP BOOK 66,PAGE 30
PHLLP J.5TNEW8 P' !- `BP `. \ 4' ``�\ 'i. AREA OF DECKS.STEPS,ETC WITHIN 75'CALLA TAN PARCEL NO.4212-28-9837-OOW
DEED BOOK 589.PAGE 237 14�f1 \\ %• NEC UNE-386 SO.FEET
y SS BR/S O. f
LOT 15A 'Y S T7ro 5 \ I I I'T'A rt FOR Um Ru N pp
MAP BOOK 27.PAGE BS \/ / Bain aa,viAF.n ``Y LOT 9159
/ J� p$A/ DEED BOOK 4728,PARE ROT
Ov •\� \\ .�• / LOT DI6B
LOT 9189 / / MAP BOOK 66,PAGE 30
,N, 0.207 ACRES 1�r ns / (� TAX PARCEL N0.4212-36 0527-ooOD
GRID TIES AND COORDINATES // .* �/ I,
EIS NO. 3 - NORTH-228,508.561 s s ``' ../ / 4/14
EAST-2413.048.897 / .. ` A9
/ 4. \ ./ / A //
OP NO. 4 - NORTH-226,592948 / \\ /%`/ /
EAST-2412.961.192 \ /
/ 1 AND CESS.EEASEMEVT PER `o 019 14 �a Q
MAP BOOK 66.PAGE 30 '''B ..._:.:.,' '✓• / ` /
:.__ :;;k' �/ A) / BOUNDARY SURVEY AND
_ ".::°s_ 5 / S0' / PRELIMINARY PLOT PLAN (LOT 916A) FOR:
DEED BOOK ORB,J.STEVENS
PAGEE 237 11.Ro6®, . / Or /
LOT 15B a;�rE y .F (V ROBIiRT SARBON�i'
NOTES;)TTPROPERTY SHOWN HEREON IS LOCATED WITHIN MAP BOOK 27,PACE 85 / .py�t�' // AND WIFE, SILVIA SARBONL'
A SPECIAL 1W YEAR FLOOD HAZARD AREA ACCORDING / ,P //
70 FLOOD INSURANCE RATE MAP NO.3720421200J ,� /
DATED FEBRUARY 16.2007. // �SF / S. /
2)ALL N.C.GRID DATA SHOWN HEREON IS BASED ON NAD 1983 i. CURRENT OWNER: ROBE7TT SARBONE AND WIFE, SILVIA SARBONE
2011 ADJUSTMENT USING THE NCGS RTK NETWORK SYSTEM. / $ '�4 / GQ / AND SPIFFCO, LLC.
3)ALL DISTANCES SHOWN HEREON ARE N.C.GRID DISTANCES eY 4 +E+• `Q'9
UNLESS OTHERWISE NOTED. C / INDIVIDUAL TRACT ON N.C. HIGHWAY NO. 50
4)COMBINED GRID FACTOR-0.99999116 '�J' / P`I // (S. ANDERSON BOULEVARD)
5)ALL UTILITY LINES SHOWN HEREON MAY HAVE EASEMENTS / TOWN OF TOPSAIL BEACH
AND RIGHTS OF ENTRANCE AND MAINTENANCE ASSOCIATED ./ OCi /WITH THEM TOPSAIL TOWNSHIP, SENDER COUNTY, N.C.
RECEIVED
6)THIS PROPERTY IS ZONED B2 AND WILL BE SUBJECT TO G. // G DATE: FEBRUARY 4, 2021 T Z py
ALL RES7PoCTONS IN THE TOWN OF TOPSAIL BEACH LAND T. / SCALE: 1'- 30'
USE ORDINANCES.THE TOWN OF TOPSAIL BEACH SHOULD BE
CONTACTED FOR DETAILS ON RESTRICTIONS PRIOR TO LOT
IMPROVEMENTS THESE RESTRICTIONS MAY INCLUDE.BUT NOT /BE MAY 2 4 207-1 , ,yyY I: ,r)yL/�LAND SDRrimmiP Pe
UNITED T0,SETBACKS,HEIGHT RESTRICTIONS IMPERVIOUS
SURFACE THERE RE ETC.ADDITIONAL RES CNS MAY P.O.BOX 775. BEULAVILLE,N.C.2851E
APPLY IF THERE ARE RESTRICTIVE COVENANTS ASSOCIATED C_vROccB yepi,mom_Hm_N4Lmx PHONE: [phone] FAX: [phone]
WITH THIS PROPERTY.SURVEYOR HAS NOT PERFORMED
RESEARCH TO DETERMINE IF RESTRICTIVE COVENANTS APPLY. TT,�; 1m EMAIL: JWIUJAMSOJWSURVEY.COM FIRM NO. C-2532
DCM WILMINGTOP 41;

I, JOHNNY J. WILLIAMS, PROFESSIONAL LAND SURVEYOR, CERTIFY THATL.----
S
`\.`��NtCAl. '%,, SURVEY MADS MAP E UNDER MYARED UNDER MY SUPERVISION SUPERVISION COMPLETED ONOM AN 02/04/202L
- 0 ..FEsSIp•,''L�; FROM REFERENCES AS SHOWN HEREON; THAT BOUNDARIES NOT
�•Q-0 �'y SURVEYED ARE NOTED AS SUCH AND PLOTTED FROM REFERENCES
• Q SEAL f ' : AS SHOWN HEREON; THAT THE GPS PORTION OF THIS SURVEY WAS
• r L-3170AL = PERFORMED TO A CLASS A SURVEY AS DEFINED BY TITLE 21, CHAPTERBOULEVARD
56. SECTION .1603 OF THE N.C. ADMINISTRATIVE CODE USING A RTK
• v�y0 €•k? NETWORK WITH A POSITIONAL ACCURACY OF 0.09 U.S. Ftti; THAT THISN.C.
O •• SURD•... t1` GPS SURVEY WAS PERFORMED USING A CARLSON BRX6 ROVER AND/OROI
�'1 y'VA/-" \,\. \` A CARLSON BRX6+ ROVER; THAT ALL COORDINATES ARE BASED ON N.C.
/�'�' Y�1110" \ GRID NORTH (NAD 1983 2011 ADJUSTMENT GEOID12 MODEL); THAT THE
CONVENTIONAL PORTION OF THIS SURVEY HAS A RATIO OF PRECISION ri
IN EXCESS OF 1:10,000 AND IS ALSO PERFORMED TO A CLASS AB
SURVEY AS DEFINED BY TITLE 21, CHAPTER 56, SECT10N..1603 OF
THE N.C. ADMINISTRATIVE CODE.
` 141, 02/12/2021 F.
; ��
JOH;, Y `:: WI ►,•MS, P.LS., L-3170
,
LEGEND:
SURFACE CALCULATIONS: EIP = EXISTING IRoI•
EIS = EXISTING IRON
LOT 916A ECM - EXISTING COI
TOTAL LOT AREA = 11,085 SQ. FEET EMN = EXISTING MA
MNS = NAG NAIL Si
AREA OF COVERED HOUSE FOOTPRINT a NP - NONMONUMEN
2,070 SQ. FEET (18.7% IMPERVIOUS) AG = TOP ABOVE G
BG = TOP BELOW G
?F TOPSAIL BEACH TOTAL IMPERVIOUS AREA - 2,070 SQ. FEET (18.7%) RE= C RIGHT- F V
OK 2955, PAGE 64 t = PROPERTY U
NCGS = NORTH CAI
APPROX. AREA OF ROOF OVERHANGS OUTSIDE SURVEY
OF HOUSE/BUILDING FOOTPRINTS = 204 SQ. FEET --- = UNE NO'
C C = OYERHE�
AREA OF DECKS, STEPS, ETC. - 672 SQ. rtEi -0 = UTIUTY POLE
AREA OF DRIVEWAY - 972 SQ. FEET O = WATER MEli
_ LOT 915A (75' AEC UNE)
AREA OF LOT WITHIN 75' CAMA AEC
UNE = 5,623 SQ. FEET REFERENCES:
AREA OF COVERED HOUSE FOOTPRINT = LOT 916A
1,107 SQ. FEET (19.6% IMPERVIOUS) DEED BOOK 4720,
AREA OF ROOF OVERHANG WITHIN 75' CAMA LOT 916A
s, AEC UNE = 106 SQ. FEET MAP BOOK 66, PI
,)', AREA OF DECKS, STEPS, ETC WITHIN 75' CAMA TAX PARCEL NO.
\• • ea, AEC UNE a 588 SQ. FEET
:,F
sAao \, LOT 9158
•
`\\ 4 DEED BOOK 472E
•• ,S- / f LOT 9168
T 9/6B / MAP BOOK 66, F
7 •
t�CRJ •aSr S.
`. NO.C >>/ a
/ / ,f y / i it,

U.S. Postal Service'
CERTIFIED n'ECEIPT
ra Domestic Mail Only
• ru For delivery information,visit our website at www.usps.com'.
Ha , IC 2 '�g�" A 1,�' rr ,- �, la�.
rr :: a lry..
rl
ru Certified Mail Fee $3.60 0482
02
.0 Extra Services&Fees(check box,add fee l'7 p8Zate)
, 0 Return Receipt(hardcopy) $ ii '•
071'2 ❑Return Receipt(electronic) $ SU.UU Postmark
/ O 0 Certified Mail Restricted Delivery $ •00 Here
Date 0 El Adult Signature Required $ $( 00
!'� ) .// l 0 Adult Signature Restricted Delivery$
�Jh/ t 7 r' t/?,r)5 p Postage
Adj
a//c,entPro erty0ym�ry f0•55
/&�di/
F�f (1Jart En $otal Postage and Fees
ft��i({/2�t21
M.iang •
Addres /'/ $ // 87.U1►
An Ad ; ��� _, ,)(4.0.3.0.3 D SA�/ ,
City, State,Zip Code O StreeetandAp N rPQBoy,
.e,ZIP:i. /ead 4/67 o?8
• PS Form 38G0,April 2015 PSN 7530-02-000-9047 See Reverse for Instructions
Dear Adjacent Property:
This letter is to inform you that I, —,`/N.7i R J 6dna . have applied for a CAMA Minor
..�� Property Owner
Permit on my property at ( J/, ,in Pander/Onslow
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 9/4 ��3 t%3/ ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the Surf City CAMA Minor Permit Program,you may submit
them to:
Jason Dail,Field Representative
NC Division of Coastal Management
Town of Surf City Local Permit Program
127 Cardinal Drive Extension
Wilmington, NC 28405
Sincerely,
4 4,,„„„)a,,,,,,5
Property Owner
D- r" sue. . re.
•
Mailing Address •
City, State,Zip Code •
RECEIVED
MAY 2 4 2021
DCM WILMINGTON, NC

% }
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to PJ /l,P 3;42,via,o s 's
—71 / (Name of Property Owner)
property located at ��'�� !!a�f'1 �7-7n re
������
Address, Lot, Block, Road, etc.)
on G'aasid/d-Z Ld8y , in P6andQ,r �6 r) , 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
RECEIVED
MAY 2 4 2021
DCM WILMINGTON, NC

U.S. Postal Service"
CERTIFIED MAIL"' RECEIPT
p-- Domestic Mail Only
I-']
co For delivery information,visit our website at www.usps.comf.
1-4 Hap) licticoVC; 844
7 02/ fll Certified Mail Fee
m $ i's.f�il i1482
Date /� Extra Services&Fees(check box add fee. U2
rail e-G�.�fj , ❑Return Receipt(hardcopy) $ YY1iYr.IateJAdjacent Pro e D ❑ReturnReceipt(electronic) $ $u_00 Postmark
/� S P Y �/j/ J1� ❑Certned Mail Restricted Delivery $ $() `10Here
t /✓/�// co ❑Adult Signature Required
Mai ing Address �� h / Restricted❑Adult Signature $►J
Delivery$ .+IU
/eid 5,2;/ /De- A 476 .c2V- '/ O/J5 , Postage iJ.55
Ci y,State,Zip Code p Total Postage and,Fees
$ $7.00 4'S%10/2t�21
ru D Sen� //""yy.�}/�-
Street ancfApt No. or g jyp-""-'-` -c
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Dear Adjacent Property: c,ty,State,ZIP+`a � -� . �n �✓.
// 5 ti' e c ���/ 5
This fetter is to inform you that I, /vt "�� PS Form 3800,April 2015 PSN 7530-02-000-9047 See Reverse for Instructions
Property Owner
Permit on my property at 9/G J`Je1 L,42iald91 .ert /D/t/d ,in Pender/Onslow
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 9/U- Od 3 ,or by mail at the address listed below, If you wish to
Applicant's Telephone
file written comments or objections with the Surf City CAMA Minor Permit Program,you may submit
them to:
Jason Dail, Field Representative
NC Division of Coastal Management
Town of Surf City Local Permit Program
127 Cardinal Drive Extension
Wilmington, NC 28405
Sincerely,
Property// Owner
-//5 Deefe h /dam
Mailing Address
/4eldifn /17,T (2f 7D/
City, State,Zip Code
RECEIVED
MAY 2 4 2021
DCM WILMINGTON, NC

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS.
I hereby certify that I own property adjacent to D-f 7;2)Sit;/Ar-.7C;1? s
/ (Name of Propertyr Owner)
property located at q,id 5 4 � n SQ ) 1'v` /v1JSa%
Address, Lot, Block,Road,, etc.)
on sla/ lag Gr/zy in A,-der N.C.
(Waterbody) (Town and/or Count)
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
MAY 242021
nrio v►ni nMIN( TflN r!C.

• SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3. A. Signature
• Print your name and address on the reverse X 0 Agent
so that we can return the card to you. ❑Addressee
• Attach this card to the back of the mailpiece, B. Received by(Printed Name) C. Date of Delivery
or on the front if space permits.
1. Article Addressed to: D. Is delivery address different from item 1? 0 Yes
-dun o� 7� Sail ,teach ,
If YES,enter delivery address below: 0 No
'gad 5 k)cG✓Sa n /61(ci
-7 ai'l /3ede h /VC c 445'
/;2,I 9 . /J.0,6 V e ✓J
• 3. Service Type ❑Priority Mall Express®
11111111
IIIIIII III III I IIII III I II II II I I III I I El Adult Signature 0 Mall,.
❑Adult Signature RestrictedDelivery 0 Reggistered Mail Restricted
9590 9402 5793 0034 3168 69 o certifled Mall® Delivery
❑CertifiedMail RestrictedDelivery ❑Return Receipt for
❑Collect on Delivery Merchandise
2 Artinla N.nnhar(Transfer from service label) 0 Collect on Delivery Restricted Delivery Signature Confirmation M
7020 0090 0001 8 3 21 8 2 9 8 it ❑Signature Confirmation
it Restricted Delivery Restricted Delivery
_
1 1 I twci,yuwJ
PS Form 38 ,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
• Print your name and address on the reverse X i' (- EVAgent
so that we can return the card to you. f y �"` ❑Addressee
• Attach this card to the back of the mailpiece, B. d by(Printed Name) C. Da-of Delivery
or on the front if space permits. 1e r,( C kt1 5 /
1. Article Addressed to:// D. Is delivery address different from item 1? 0 yes
e.Ye n$ If YES,enter delivery address below: No
/461 - ' t 11- di
A"anyss1 •ad / 3 a -54<3
Ill111111 III 11111111 III I 11111 III III III 3. Service Type 0 Priority MailExpress®
El Adult Signature ❑Registered Mail.,
❑Adult Signature Restricted Delivery ❑Registered Mail Restricted
9590 9402 5793 0034 3168 76 0 Certified Mail®
0 Certified Mail Restricted Delivery Delivery
0 Return Receipt for
❑Collect on Delivery Merchandise
o Artinia NI imher(Transfer from service label) ❑Collect on Delivery Restricted Delivery 0 Signature Conflrmationn,
7020 0090 0001 8321 8281 ail 0 Signature Confirmation
ail Restricted Delivery Restricted Delivery
._ . ... �)
PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt
RECEIVED
MAY 2 4 2021
DCM WILMINGTON, NC

USPS TRACKING#
First-Class Mail
Postag
ng I i " USPS e&Fees Paid
111
I 1111111 I .t��.4r 3 ` 111111 Permit No.G-10
9590 9402 5793 0034 3168 69
United States •Sender:Please print your name,address,and ZIP+4®in this box•
U s
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Postal Service n ) 'U,77 ,ryes fo
dad/9 us y /7/✓
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"iiIII11iiililluilll'iu111Il1llll'ithhuiuuiul1iuliiiill'iili1111
USPS TRACKING# I
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I ; i 1 [ w ; 28Q Postage&Fees Paid
I
I 1I , ! !l!1:1 .L
Perrmimi
t No.G-10
9590 9402 5793 0034 3168 76
United States •Sender. Please print your name,address,and ZIP+4®in this box'
Postal Service
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Saoly 2.1s y /7i✓
any kad, " a84✓g
""IIII�IIIIIII'II'III n IIII��IIII a IIIIII�ir111I}IIIII�II�I'I L
RECEIVED
MAY 2 4 2C
DCM WILMINGTON.

U. ID 0 CD-0 X
t . FE
Q cQ �. - 3 m
a) a) •
o 5 .:
'-� ¢, z 0C al D 0 a
OTHER PERMITS MAY BE] CT) a ..
Pennit Number O O a rn
71
minor development permit,inch!
w
3
lazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other treatment system),Building,El 7! > Nm Si? 3
Certification,Sand Dune,Sedit Q C CD
(For official use only) others.Check with your Local ,.tD O
,
tAL INFORMATION STATEMENT OF OWNERS CD D •
-
OWNER-MAILING ADDRESS 1,the undersigned,an applicant to 6
f_ person authorized to act as an a C n.
�i/If/2 Sc)i'gOY1P listed as landowner on thisappli w v`\
4/5 —Deere. a 5t lane described as:(check one) ,.. CD
m -, •'C�\ C
J ,�/ m V
ea ke Ill is Q z: State /1/f Zip AM/Phone '73a-9�a -G a of ✓ an owner or record title,Ti \ pt
�1 / see Deed Book ii me . -�~ 1
....
ilf-CldYe5/4 l(6l ya1760.6QYh •• m �+
_an owner by virtue of inhet! 11%` li n C
ORIZED AGENT
C
Den n a 9SLc/SV�n NY\( (7
if other interest,such as wr �, 1 U) U
s .�?a�la 1/5U/a�oN � oi..... c
yfir414 A/c? /•1/3 9/0 go3-ei3/ NOTIFICATION OFAD.In( I \ c = _State Zi Phone I furthermore certify that the(oL \ ,�P� ACTUAL NOTICE to each of
r ;..,,, -% C
/WM-15)Lit/ 0mcaiu/ars-6r'/e55.CD»') o O.
(Name) a 0
TION OF PROJECT:(Address,street name and/or directions to site;name of the adjacent waterbody.) to
(1)72Cun Of Tq 5: , Iv C
[. /4 �uu r ndersari /"�lta/Psat-A T)Osa,`/Eat?h (3)-Ph;II;lo ire \, D .
-
2RV-' 24i,na54/ JiJahc,de,' (4) ) 8
Ai o 0 -
RIPTION OF PROJECT:(List all proposed construction and land disturbance.) /JL/id t7' ACKNOWLEDGEMENTS: i``
1 I,the undersigned,acknowledgd N
rle. rnociu tar / Me. D n I t//n". may be susceptible to erosion ati
` I ✓ lar hazard problems associated V, CD
OF LOT/PARCEL: Q„4 4 square feet acres tion and floodproofing techniqul t
i 3'
'OSED USE:Residential la (Single-family 0 Multi-family El) Commercial/Industrial 0 Other EI 1 furthermore certify that I am at
the Local Permit Officer and the! ((D
PLETE EITHER(1)OR(2)BELOW(Contact your Local Permit Officer if you are not sure which AEC applies related to this permit application, 3
r+ (fl
v property): , N O
CEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet(includes ^ �� a n P
//L(iG(
nditioned living space,parking elevated above ground level,non-conditioned space elevated ab ground level but Z m
ding non-load-bearing attic space) Landowner or person authorize O
0 0 F1
DASTAL SH L ECs:SIZE OF BUILDING FOOTPRINT AND OTHER I IOUS OR BUILT This application includes:genet h
'I SURFACES: Q Ore feet(includes the area of the foundation of all buildings,dr eways,covered decks, ownership statement,the Ocean N N 2) .."44i) , 'DI
ere or mason patios,etc.that are within the applicable AEC.Attach your calculations with the project drawing.) any information as may he pmv) )"a
PE STORMWATER MANAGEMENT PERMIT:is the project located in an area subject to a State
incorporated without referenced �.
'twiner Management Permit issued by the NC Division of Energy,Mineral and Land Resources(DEMLR)'! any permit.Any person develops # • A 1 \ (�
NOV tv G
0
t,list the total built upon area/impervious surface allowed for your lot or parcel: square feet.
—

Locality Pennit Number 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 i,the undersigned,an applicant for a CAMA minor development permit,being either the owner of property in an AEC or a
Name ) /�//3 Ste,-hU, a person authorized to act as an agent for purposes of applying for a CAMA minor development permit,certify that the person
// 1 listed as landowner on this application has a significant interest in the real property described therein.This interest can be
Address/ ��7 rJ -PL?er n a se. Lane described as:(check one)
City f akA LLJ/I Q d State /►//�.T Zip 6$7Q Phone 7,3, -9/4 -G aaf v an owner or record title,Title is vested in name of Jef kr/ arrd it ily;a 5:tebe/-I e
�4r/n,re5/Z, )ya�t70.de5Yr� see Deed Book <{`lo3U page in the
Email 1T p g aln PartIer County Registry of Deeds.
AUTHORIZED AGENT A an owner by virtue of inheritance.Applicant is an heir to the estate of
�� ;probate was in County.
Name Donna Sin
Address��a,,19 2/5 ,e,Loy a/e N if other interest,such as written contract or lease,explain below or use a separate sheet&attach to this application.
/ —
City f17/ J5,? L State We, Zt Phone q/o g03-e 13/ NOTIFICATION OF ADJACENT RIPARIAN PROPERTY OWNERS:
Qg / �//t I furthermore certify that the following persons are owners of properties adjoining this property.I affirm that I have given
Email ()YI rl�3aus iL!et 0modulay5 t<'/85 A5. CID rn 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 of the adjacent waterbody.) (Name) (Address)
9/1, 4 'llulA 4ndersorl j,u/r�,c,-3rd T;o5a,./&,3eA (2) Pt el
e.. ial /cid Z,/cJJ �d nag, 2d' ll
/VC 028 o" Z 1I12ie.na 5/a/ /(hacai5 / (4)
DESCRIPTION OF PROJECT:(List all proposed construction and land disturbance.) ,.ii;id Q ACKNOWLEDGEMENTS:
-cra ]j J i,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
an le, YY�Cdu Jar ill)MB lh InP i-//n5. may be susceptible to erosion and/or flooding.I acknowledge that the Local Pennit Officer has explained to me the particu-
lar hazard problems associated with this lot.This explanation was accompanied by recommendations concerning stabiliza-
SIZE OF LOT/PARCEL: Q,p?rj 4 square feet acres tion and floodproofing techniques.
PROPOSED USE:Residential la" (Single-family Q Multi-family El) Commercial/industrial El Other El i furthermore certifythat I am authorized togrant,awl 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(I)OR(2)BELOW(Contact your Local Permit Officer if you are not sure which AEC applies related to this permit application.
to your properly):
(I) OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet(includes This the / day of �r3J ,20 0�/
air conditioned living space,parking elevated above ground level,non-conditioned space elevated ab round level but A. . _ I I
excluding non-load-bearing attic space) ///������7tiX.Gl
Landowner or person authorized to act airs his/her agent for purpose of filing a LAMA permit application.
(2) COASTALSH��L1ECs:SIZE OF BUILDING FOOTPRINT AND OTHER i IOUS OR BUILT
UPON SURFACES: re feet(includes the area of the foundation of all buildings,dr eways,covered decks, This application includes:general infomation(lhi.s form),a,rile drawing as described on the hack of this application,the
concrete or mason patios,etc.that are within the applicable AEC.Attach your calculations with the project drawing.) ownership.r[ateutent,the Ocean Hazar AEC Notice where necessary,a check,for$II10.00 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 a violation of
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 flmcC I VE
YES NO ter
If yes,list the total built upon area/impervious surface allowed for your lot or parcel: square feet.
MAY 2 4 2021
)CM WILMINGTON NC

Date Date Check From Name of Vendor Check Check Permit Rct
Received Deposited Permit Holder Number amount Number/Comments
5/25/2021 5/27/2021 Custom Built Silvia Sarbone First 1186 $100.00 minor fee, 916 A S Anderson Blvd, JD rct
Homes Citizens Topsail Beach PnCo 14141
Bank