HomeMy WebLinkAboutTBEX_13-15_ 470A NorthAA':�,,
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NCDENR
North Carolina Department of Environment and
Division of Coastal Management
Pat McCrory
Braxton C. Davis
Governor
Director
December 19, 2013
Exemption Number — TBEX13-15
470A North Anderson,
LLC
Attn: P. Phillips
104 Coastal Bluff
Hampstead, NC 28443
Natural Resources
John E. Skvarla, III
Secretary
RE: EXEMPTED PROJECT (MINORS) SINGLE FAMILY RESIDENCES WITHIN THE HIGH HAZARD
FLOOD AREA OF ENVIRONMENTAL CONCERN — (15A NCAC 07K .0213)
PROJECT LOCATION/ADDRESS —470A North Anderson Blvd., Topsail Beach, NC
Dear Mr. Phillips:
I have reviewed the information you submitted to our office concerning the necessary filing of an application for a
CAMA Minor Development Permit under the Coastal Area Management Act. After making a site inspection on 12/18/13,
I have determined that the activity you propose is exempt from needing a CAMA Minor Development Permit as long as it
remains consistent with your project drawings and paperwork, dated received 12/17/2013, and it also meets the conditions
specified below. If you plans should change and your project will no longer meet these conditions, please contact me
before proceeding.
SINGLE FAMILY RESIDENCES WITHIN THE HIGH HAZARD FLOOD AREA OF ENVIRONMENTAL
CONCERN EXEMPTED
All single family residences, including associated infrastructure, accessory structures or structural additions to an existing
single family structure, constructed within the High Hazard Flood Area of Environmental Concern are exempt from the
CAMA Minor Permit requirements provided the development is consistent with all other applicable CAMA permit
standards and local land use plans and/or rules in effect at the time the exemption is granted including the following
conditions and limitations:
1. Development shall not be located within the Ocean Erodible or the Inlet Hazard AEC.
2. Any building shall be constructed on pilings and comply with the North Carolina Building Codes and the
local flood damage ordinances, as required by National Flood Insurance Program (NFIP).
3. The development does not require any permission, licensing, approval, certification, authorization or
approval from any state or federal agency.
4. A signed AEC hazard notice indicating that the property owner is aware of the special risks and conditions
associated with development in this area.
This exemption to CAMA permit requirements does not alleviate the necessity of your obtaining any other State,
Federal or Local authorization. This exemption expires one (1) year from the date of the letter.
i cerely, `
son Dail, LPO
Cc: DCM — WIRO
Christina Watkins, Town of Topsail Beach
i Lax 13-i.
Locdlity /y PS fI 1 �— �C/ii✓I'f Permit Number
Ocean Hazard X Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
(For official use only)
GENERAL INFORMATION
W.1IZI1I]`A'A►`I � I
Name 4-70A 1J oe-rH A nrol e iz SUri- C L(2,
Address _ _ 109 C.0 A &rA j, _tt> L,4—
City }-� �ti,,g d State l4C Zip 7'94'4'hone (Rto -(o20 - B 37 O
Email /� Oi0 i, i 11 i'p 5 466lM6' RXC A4LO II A/A . C0�
AUTHORIZED AGENT
Name �q_A-Z0 / i P JA Co it S -rCr��71 iJg; (�! P D
Address Po Sox 2 3 1 �
City ldR 4 C; State Ivy Zip 2S'Iq5 Phone 910 32'8 6` f
Email G_A-nl /.a C�G)aS f ,v, @ r' M,4i
LOCATION OF PROJECT: (Addrecc gtrPPt name and/or directions to site. If not oceanfront, what is the name of the
adjacent waterbody.) q 1 b /} r�-022_714- 4ride iZ s crn — b eGd 4o "- �, 9 W O ceA-t_J
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) J fC_
SIZE OF LOT/PARCEL:
sg6re feet acres
PROPOSED USE: Residential (Single-family Multi -family E]) Commercial/Industrial -Other
COMPLETE EITHER (1) OR (2) BELOW (Contact your Local Permit Officer if you are not sure which AEC applies
to your property):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: .209G square feet (includes
air conditioned living space, parking elevated above ground level, non -conditioned space elevated above ground level but
excluding non -load -bearing attic space)
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: square feet (includes the area of the roof/drip line 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 STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a State Stormwater
Management Permit issued by the NC Division of Water Quality?
YES K NO
If yes, list the total built upon area/impervious surface allowed for yo,40ool-?i el a118 square feet.
DC" " WILMINGTON, NC
OFF' 1 7 9nn
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, FIA
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 4'1 a Awd-G2sr/YM L,LC- , see Deed Book 430 3
page 244_ in the _Pe_,jaLe,Z County Registry of Deeds.
an owner by virtue of inheritance. Applicant is an heir to the estate of
probate was in County.
if other interest, such as written contract or lease, explain below or use a separate sheet & attach to this application.
NOTIFICATION OF ADJACENT 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) R08eRT S_ P,ekc9- 106Z 15+LA,vr- t,1IJ 41ek,omzg JC, 2s(.0 1
(2) ?e4- ' e,tu QROwhJ 115 A-naS SRO Wr..lZ)G2 3Ac 5O'n4"1Lc 1JL ZS540
(3) S� s+ Pn,r. caa E s Po 60Y. 111 3 VJAAV4cy t1 C- 2.844G to
(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 4 day of �D2G , 20 13
authorized to aceas 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 of the 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
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THIS IS TO CERTIFY THAT THE SUBJECT PROPERTY IS LOCATED
IN FLOOD ZONE VARIES NHICH IS A
SPECIAL ROOD HAZARD AREA AS DETERMINED BY THE FEDERAL
EMERGENCY MANAGEMENT AGENCY. AND THE NATIONAL FLOOD
INSURANCE PROGRAM. COMMUNITY PANEL NUMBER
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VERTICAL DATUM: NAVO 88
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BOUNDARY SURVEY & PRELIMINARY PLOT PLAN
FOR
470A NORTH ANDERSON, LLC
TRACT 1A, EXEMPT PLAT FOR KATHRYNE H. WELLS, M.B. 52, P. 20
TOPSAIL TOWNSHIP, PENDER COUNTY, NORTH CAROLINA
470A NORTH ANDERSON BOULEVARD
X - ETOSTING SPOT ELEVAT
GRAPHIC SCALE
( DR reef )
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ACTUAL FIELD SURVEY DATE: JUNE 26, 2013
MAPPING DATE: JULY 1, 2013
DRAWN BY: . 1. I lPl_Aq'•
CHECKED BY:
FIELD BOOK: 814 PAGE: 1
PROJECT NUMBER: 13-06-29
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December 4, 2013
Robert J Pierce
1062 151h Avenue NW
Hickory NC 28601
This letter is to inform you that 470A North Anderson, LLC, Nick Phillips, has applied for a CAMA
minor permit for their property located at 470A North Anderson Blvd., Topsail Beach, NC 28445 in
Pender County. As required by CAMA regulations, I have attached a copy of the project drawings, and a
copy of the permit application along with this letter for reference and to serve as notification of m
proposed project. No action is required by you, or you may sign and return the nclosed no objection
GE) If you have any questions or comments about my proposed project, please contact me at 910 /
328-6400, or by mail at the address listed below. If you wish to file written comments or objections with
the local government for CAMA Minor permits, you may submit them to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845.
Thank You, -e
7//a oast Contracting
Licensed general contractor and representative
PO Box 2391
Surf City, NC 28445
910-328-6400L '0 v"
AECEIVED
DCM WILMINGTON, NC
DEC 17 2013
Custom o� Re� Mons
PO Box 2391 Surf City, NC 28445 1 910-329-9792 Office J 910-329-9793 Fax �,,�%'jG0-4e
rarnlinarna,�tmntrartinn(anmaiI cnm I www_carnlinacoastcontractina.com
L
Carolina Coast
Contracti V
December 4, 2013
Jeffrey Brown
115 Atlas Brown Drive
Jacksonville NC 28540
ft
This letter is to inform you that 470A North Anderson, LLC, Nick Phillips, has applied for a CAMA
minor permit for their property located at 470A North Anderson Blvd., Topsail Beach, NC 28445 in
Pender County. As required by CAMA regulations, I have attached a copy of the project drawings, and a
copy of the permit application along with this letter for reference and to serve as notification of my
proposed project. No action is required by 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 910 /
328-6400, or by mail at the address listed below. If you wish to file written comments or objections with
the local government for CAMA Minor permits, you may submit them to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845.
Thank You,
Licensed general contractor and representative
PO Box 2391
Surf City, NC 28445
910-328-6400 RECEIVED
GCM WILMINGTON, NC
DEC 17 2013
Custom Homes & Renovations
PO Box 2391 Surf City, NC 28445 1 910-329-9792 Office 1 910-329-9793 Fax
carolinacoastcontracting@gmail.com I www.carolinacoastcontracting.com
E�
Postage $�
Certified Fee
Return Receipt Fees
Postmark
.;
Here
(Endorsement Required)
Restricted Delivery Fee
$Il,lll
(Endorsement Required)
el'
1.i tl�i ir'111iJ
Total Postage & Fees
bent to OCM WILMINGTON, NC
---------------.....-----------------------....__......---- - - --------------
Street, Apt. No.;
or PO Box No. nrr . n nn47
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• Sender: Please print your name, address, and ZIP+4 in this boxCA
•
/� s
u,e � C ; ('j C- Z gy ,{
Carolina Coast
Contractina
0
December 4, 2013
Sea Crest Properties, LLC
PO Box 1113
Wallace, NC 28466-1139
This letter is to inform you that 470A North Anderson, LLC, Nick Phillips, has applied for a CAMA
minor permit for their property located at 470A North Anderson Blvd., Topsail Beach, NC 28445 in
Pender County. As required by CAMA regulations, I have attached a copy of the project drawings, and a
copy of the permit application along with this letter for reference and to serve as notification of my
proposed project. No action is required by 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 910 /
328-6400, or by mail at the address listed below. If you wish to file written comments or objections with
the local government for CAMA Minor permits, you may submit them to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845.
Thank You,
aaast Contracting
Licensed general contractor and representative
PO Box 2391
Surf City, NC 28445
910-328-6400 R E C E I V E D y
DCM WILMINGTON, NC
DEC 17 2013
CLIstom Homes & Renovations
PO Box 2391 Surf City, NC 28445 1 910-329-9792 Of fice 1 910-329-9793 Fax
carolinacoastcontracting@gmaii.com I www.carolinacoastcontracting.com
Postage $
Certified Fee • 1
Postmark
Return Receipt Fee $ ,fir; Here
(Endorsement Required)
Restricted Delivery Fee
(Endorsement , Q!l
(Endorsement Required)
Total Postage & Fees I $RE C EyV F I'+I.14,/?I I j
Sent To vvrvr vvTF.
treat, Apt No.; �� { rf'-T%ii'(
or PO Box No. r.� 1 C L l) 1
City, State, ZIPF4
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a duplicate return receipt, a USPS® postmark on your Certified Mail receipt i;
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ii For an additional fee, delivery may be restricted to the addressee o
addressee's authorized agent. Advise the clerk or mark the mailpiece with tht
endorsement "Restricted Delivery".
i If a postmark on the Certified Mail receipt is desired, please present the arti
cle at the post office for postmarking. If a postmark on the Certified Mai
receipt is not needed, detach and affix label with postage and mail.
MPORTANT: Save this receipt and present it when making an inquiry.
IS Form 3800, August 2006 (Reverse) PSN 7530-02-000.9047
Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
Print your name and address on the reverse
so that we can return the card to you.
Attach this card to the back of the mailpiece,
or on the front if space permits.
Article Addressed to:
NE L I D30
ON `NOiONIV1f`IIM WOCj
® A1303H
A. ep, ure
X ❑Agent
❑ Addressee
B.A / eJd,�(Prin� C of Delivery
D. Is `livery ra dii fererit from*m �s
If YES, an elivery address below:
40
Le
3. Service a�Rtum
❑ Certifiedil
❑ Registeredeipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
!. Article Number ?010 1870 0003 6340 2545
(Transfer from service label)
'S Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1541
UNITED First -Class Mail
... ..... Mh Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
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C
N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date i 4 - 13 13
Name of Property Owner Applying for Permit:
ft
Mailing Address:
z
i certify that I have authorized (agent) 'j/aq-fi��7w-4 to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) niC�Ll) 'oi n1GL-,, TAA.AlL - Cleyl.�+-ZUL-+7 u7U ,
at (my property located at)
Lk-iOA N
This certification is valid thru (date)
Property Owner Signature
Zs44
12-- 31— 1+
' L 4�-'
IZ 13-1
Date
RECEIVED
DCM WILMINGTON, NC
DEC 1 7 2013
PIN: 4223-15-0152-0000
Scale: 1" = 20'
SIR \
,�
Ln
Peat
Peat
B ofilte 5
Initial Biofilte
System Repair
0
0' x 30' System
�0
3' x 23'
101
i
32'
4 Bedroom Home W
Includes porches, decks;A�
or any portion of the home -
in contact with ground
20'
J
� s$ o
(DRIVEWAY
Notes:
Survey Provided by: Charles Riggs & Associates
Septic system must be located at least 10' from any property line, 5' from home, and 2' from septic tanl,
Wastewater Treatment System r)esinn
— 4 Bedroom Home; 480 gal/day flow rate
--1000 gal septic tank
— >48" soil wetness condition
— Elevate home to provide gravity flow or a pump & pump tank will be required
Initial - Type "A" Fcnfln System
-- 1.2 gal/ day/ sq ft LTAR
-- 480/1.2 = 400 sq ft
- with 25% reduction = 300 sq ft
--Level system area prior to installation of bed
— Module centered on a 13' x 23.1' bed
— Install 8" bed bottom 30" below lowest elevation point in system area
Repair_TypP A "Peat Riafilter" System
-- 1.2 gal/ day/ sq ft LTAR
-- 480/1.2 = 400 sq ft
— with 25% reduction = 300 sq ft
— Module centered on 10' x 30' bed
--Level system area prior to installation of bed
— 8" thick rock bed installed 30" below the lowest
elevation in system area
U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE
FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008
National Flood Insurance Program Important: Read the instructions on pages 1-9. Expiration Date: July 31, 2015
SECTION A - PROPERTY INFORMATION s
Al. Building Owner's Name 470A NORTH ANDERSON, LLC
A2. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
470A NORTH ANDERSON BOULEVARD ` • :. x 9
City TOPSAIL BEACH State NC ZIP Code 28445
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
TRACT 1A, EXEMPT PLAT FOR KATHRYNE H. WELLS
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat. 34d23'16"N Long. 77d36'03"W Horizontal Datum: ❑ NAD 1927 ® NAD 1983
A6. Attach at least 2 photographs of the building If the Certificate is being used to obtain flood insurance.
AT Building Diagram Number j
A8. For a building with a crawlspace or encosure(s): AS. For a building with an attached garage:
a) Square footage of crawlspace or enclosure(s) 33131 sq ft a) Square footage of attached garage N/A sq ft
b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage
or enclosure(s) within 1.0 foot above adjacent grade Q within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in AB.b Q sq in c) Total net area of flood openings in A9.b 0 sq in
d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes i8 No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number B2, County Name B3. State
TOWN OF TOPSAIL BEACH 370187 �PENDER NORTH CAROLINA
B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood 89. Base Flood Elevation(s) (Zone
3720422300 J 02/16/07 Effective/Revlsed Date Zone(s) AO, use base flood depth)
02/16/07 VE 14.0'
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in hem B9.
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source:
811. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source:
812. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No
Designation Date: ❑ CBRS ❑ OPA
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl. Building elevations are based on: ® Construction Drawings` ❑ Building Under Construction' ❑ Finished Construction
`A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations -Zones Al-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, ARIA, AR/AE, AR/A1 A30, AR/AH, AR/AO. Complete Items C2.a-h
below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters.
Benchmark Utilized: NC CORS Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ® NAVD 1988 0 Other/Source:
Datum used for building elevations must be the same as that used for the BFE. Z
a) Top of bottom floor (including basement, crawlspace, or enclosure floor)
b) Top of the next higher floor
c) Bottom of the lowest horizontal structural member (V Zones only)
d) Attached garage (top of slab)
e) Lowest elevation of machinery or equipment servicing the building
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG)
g) Highest adjacent (finished) grade next to building (HAG)
h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support
Check the measurement uS�FiZ
9.9
® feet
❑ meterC O
o
21.9
® feet
❑ meters
�r
19.9
N.A
❑ feet
❑ feet
❑ meters" Z
❑ meters
ti
'-4
,Z,g.1
® feet
❑ meters)
v
iJ jLLI
9.5
® feet
❑ meters
t�
2.5
® feet
❑ meters
N.A
❑ feet
❑ meters
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation
information. I certify that the information on this Certificate represents my best etkrts to interpret the data available. A110 +�
I understand that any false statement may be punishable by fine or imprisonment tinder 18 U. S. Code, Section 1001.
® Check here if comments are pro,;�� 8k .6ffpan, Were latitude and longitude in Section A provided by a
❑ Check here if attachments. �� (�I , ..f, , I licensed land surveyor? ® Yes ❑ No Q :7
Certifier's Name JAMES A LEV1Q37itbL1Q"' License Number L-4562
Title PROJECT MANAGER any Ne HARLES F. RIGGS & ASSOCIATES, INC.
Address 502 NEW BRIDGE 1; 7RE�T(, CKSANV LE State NC ZIP Code 28540
Signatur Date Telephone (910)4 0877
L.LLYA I VI• VLI\1 wA, L, 4JQy0 L
IMPORTANT: In theses aces, co the corresponding " p copy p g information from Section A. 1=oR �nT ,. 1WY USE
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. RolicyN%j be +I ~
470A NORTH ANDERSON BOULEVARD
City TOPSAIL BEACH State NC ZIP Code 28445 "` `,pp�� y NAIC Ni;rn�"
�i71Yh'r:idl;�. •n 1
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments PROPOSED DWELLING IS TWO STORY ON PILINGS, PARTIALLY ENCLOSED BELOW (ENCLOSURE IS ENTRY AND STORAGE AREA)
THE TOWN OF TOPSAIL BEACH ADDS A 1.0' FREEBOARD TO THE BASE FLOOD ELEVATION, THEREFORE THE ELEVATION OF THE BOTTOM OF
THE LOWEST HORIZONTAL STRUCTURAL MEMBER MUST HAVE AN ELEVATION OF ATLEAST 14.0' + 1.0' = 15.0' (PROPOSED BOTTOM OF BAND =
19.9')
,14�14144191�`
CA ''% Lpz
Signature ��OX 0810
• Date
SECTION E -BUILDING ELEVATION I11FOIiMXTJ} j§UR 6 N4T REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zones AO and A (without BFE), complete Iter��`S E Ps . A_hMi �tels infinded to support a LOMA or LOMR-F request, complete Sections A, B,
and C. For Items E1-E4, use natural grade, if avalTable. k thege. r me sed. In Puerto Rico onl ,enter meters.
9YE1. Provide elevation information for the following'�dd��ecxes to show whether the elevation is above or below the highest adjacent
grade (HAG) and the lowest adjacent grade (LA�i;
a) To of bottom floor (including basement, crawls° �,r• • . , P (� g p�,� r �� lq�y�j is El feet ❑meters El above or El below the HAG.
b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 8-9 of Instructions), the next higher floor
(elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management
ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community -issued BFE)
or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
❑ Check here V attachments.
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G
of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8-G10. In Puerto Rico only, enter meters.
G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who
is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA-issued or community -issued BFE) or Zone AO.
G3. ❑ The following information (items G4-G10) is provided for community floodplain management purposes.
G4. Permit Number I G5. Date Permit Issued I G6. Date Certificate Of Compliance/Occupancy Issued
G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters Datum
G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum
G10. Community's design flood elevation: ❑ feet ❑ meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
RECEiV ED
❑ Check here if attachments.
DCM WIC '
National Flood Insurance Program
V-Zone Certification
Property Information For insurance Company Use
Name Policy Number
470A North Anderson, LLC
Structure Address or Other Description
470A North Anderson
City State Zip Code
Topsail Beach NC 28445
Section I: Flood Insurance Rate Map (FIRM) Information
Note: to be obtained from appropriate FIRMS
1: Community Number 2: Panel Number 3: Suffix 4: Date of FIRM Index 5: FIRM Zone
370187 3720422300 J 2/16/07 VE
Section II: Elevation Information
Note: This form is not a substitute for an Elevation Certificate. Elevations should be rounded to the nearest tenth of a foot.
1. Elevation of the Bottom of The Lowest Horizontal Structure Member ............... 17.1 feet (NGVD)
2. Base Flood Elevation............................................................................. 14 feet (NGVD)
3. Elevation of Lowest Adjacent Grade......................................................... 9.5 feet (NGVD)
4. Approximate Depth of Anticipated Scour/Erosion Used for Foundation Design.. 2.1 feet
5. Embedment Depth of Pilings or Foundation Below Lowest Adjacent Grade...... 8 feet
Section III: Zone Certification Information
Note: This section must be certified by a registered engineer or architect
I certify that I have developed or reviewed the structural design, plans and specifications for construction
and that the methods of construction are in accordance with the accepted standards of practice for meeting the
following provisions:
a) The bottom of the lowest horizontal structure member of the lowest floor (excluding the pilings or
columns) is elevated to or above the BFE.
b) The pile or column foundation and structure attached thereto is anchored to resist flotation collapse and
lateral movement due to the effects of the wind and water loads acting simultaneously on all building
components. Water loading values used are those associated with the base flood including wave action.
Wind loading values used are those required by the applicable State or local building code. The potential
for scour and erosion at the foundation has been anticipated for conditions associated with the base
flood.
section Iv: tsreaKaway Wall Gertitication Statement
Note: This section must be certified by a registered engineer or architect when breakaway
walls exceed a design safe loading resistance of 20 pounds per square foot.
I certify that I have developed or reviewed the structural design, plans and specifications for construction
and the design and methods of construction of the breakawaywalls are in accordance with accepted
standards of practice for meeting the following provisions:
a) Breakaway collapse shall result from a water load less than that which would occur during the base
flood.
b) The elevated portion of the building and supporting foundation system shall not be subject to collapse,
displacement, or other structural damage due to the effects of wind and water loads acting
simultaneously on all building components (wind and water loading values defined under Section III).
Section V: Certification
(Check: Section III X and / or Section IV X )
Name of Certifier
Gilbert W. Reece
Title ••,adA•,_ License Number
Structural EgdJ gelf:Alb.:J14. 022659
Street Add` } -'W, " - Phone Number
402 No i N •re 910.200.7616
City ? 444State Zip Code
Su E _ NC. 28445
11-14-13
11V' �,. v DCM WiLfviiiNU (-ON, NG
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CAROLINA COAST CONTRACTING, CORP.
P.O. BOX 2391
SURF CITY, NC 28445
(910)328-6400
PAY TO THE
ORDER OF
A TAMPER RESISTANT TONER AREA A
MEMO,
BANK OF AMERICA, NA
SURF CITY, NC 28445
66-19/530
I" DO 5098110 Boo 5 3000 b9610 2 3 200 54 IS
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