CasB_17-01_ Hudson

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Issued by WiRO AMW Cash #17.01
Caswell Beach Permit Number
CAMA
MINOR DEVELOPMENT
PERMIT
as authorized by the State of North Carolina, Department of Environment,
and Natural Resources 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 Kenneth Hudson, authorizing development in the Estuarine Shoreline AEC at 634 Caswell Beach in Caswell
Beach, Brunswick County, as requested in the permittee's application, dated November 11, 2016. This permit, issued on
January 3, 2017, is subject to compliance with the application and site drawing (where consistent with the permit), all
applicable regulations and special conditions and notes set forth below. Any violation of these terms may subject
permittee to a fine, imprisonment or civil action, or may cause the permit to be null and void.
This permit authorizes: the construction of a single family home and retaining wall
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on December 12, 2016.
(2) All construction must conform to the N.C. Building Code requirements and all other local, State and Federal
regulations, applicable local ordinances and FEMA Flood Regulations.
(3) Any change or changes in the plans for development, construction, or land use activities will require a re-
evaluation and modification of this permit.
(4) A copy of this permit shall be posted or available on site. Contact this office at [phone] for a final
inspection at completion of work.
(Additional Permit Conditions on Page 2)
This permit must be on the project site and accessible to the permit officer when
the project is inspected for compliance. Any maintenance work or project
modification not covered under this permit, require further written permit
approval. All work must cease when this permit expires on:
December 31, 2020
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
Management.
RECEIVED
OCM WILMINGTON, NC
JAN 19 2017
ara Mac -Ph rs
Field Represen ' e
127 Cardinal Drive
Wilmington, NC 28405-3845
PERMITTE

Name: Ken Hudson
Minor Permit CasB #17-01
Date: January 3, 2017
Page 2
(5) The amount of impervious surface shall not exceed 30% of the lot area within 75 feet of normal high water (NHW) in
the Estuarine Shoreline Area of Environmental Concern, in this case 301 sq. ft. is authorized.
(6) Any proposed for grading within the 30' buffer 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 stabilized, and must
remain in a vegetated state.
(7) No structures shall be located within the 30' Coastal Shoreline buffer
(8) 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 vegetatively stabilized (planted and mulched)
within 14 days of construction completion.
(9) This permit does not authorize any development within any wetlands or open water areas.
(10) 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:
PERMIfTEE
OCM WILM NI VED G ON, NO
JAN 19 2017

Locality
/ c
Permit Number a
6 ;ttQ�
Ocean Hazard Estuarine Shoreline
GENERAL INFORMATION
LAND
Name
`/ ORW Shoreline
(For official use only)
Address
` 1
City / State r
AUTHORIZED AGENT
Name
Public Trust Shoreline Other
fW as k�i n/o c-A �r
A JJ, cif..,— - .cat 2
Zip 7 - Phone 3 � � l L - Ay L(O
Address. 3 Z�-
City State ) Zip Phone0633
�Z C
LOCATION OF PROJECT: (Address, Areet name and/or y4rectiorjs to sitev"ot oceanfront, what is the name of the
DESCRIPTION OF PROJECT: (List all proposed construction and land
SIZE OF LOT/PARCEL: square feet B ZO acres
PROPOSED USE: Residential Single-family. zmulti-family ) Commercial/Industrial
Other
TOTAL ENCLOSED FLOOR AREA OF A BUILDING IN THE OCEAN HAZARD AREA OF ENVIRON-
MENTAL CONCERN (AEC):
square feet (includes all floors and roof covered decks)
SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT -UPON SURFACES IN THE
COASTAL SHORELINE AREA OF ENVIRONMENTAL CONCERN (AEC):
square feet
(Calculations 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 .)
Choose the AEC area that applies to your property:
(1) within 75 feet of Normal High Water/Normal Water Level for the Estuarine Shoreline AEC RECEIVED
(2) within 575 feet of Normal High Water/ Normal Water Level for the Estuarine Shorelin©.CMN111W bLGiTQN, NC
Outstanding Resource Waters Rj� 16 2016
(3) within 30 feet of Normal High Water/ Normal Water Level for the Public Trust Shoreline
(Contact your Local Permit Officer if you are not sure which AEC applies to your property.)
STATE STORMWATER ANAGEMENT PERMIT: Is the project located in an area subject to a State Stormwater
Management Permit iss ed by the NC Division of Water Quality?

ma
W-
QFCOM 41 APPLICATION FOR
hO
0
CAMA MINOR
Z DEVELOPMENT
PERMIT
In 1974, the North Carolina General Assembly passed the Coastal Area
Management Act and set the stage for guiding development in fragile and
productive areas that border the state's sounds and oceanfront. Along with
requiring special care by those who build and develop, the General Assembly
directed the Coastal Resources Commission (CRC) to implement clear
regulations that minimize the burden on the applicant.
This application for a minor development permit under CAMA is part of the
Commission's effort to meet the spirit and intent of the General Assembly. It
has been designed to be straightforward and require no more time or effort
necessary from the applicant. Please go over this folder with the Local Permit
Officer (LPO) for the locality in which you plan to build to be certain that
you understand what information he or she needs.
40
Under CAMA regulations, the minor permit is to be issued within 25 days once
a complete application is in hand. Often less time is needed if the project is
simple. The process generally takes about 18 days. You can speed the approval
process by making certain that your application is complete and signed, that
your drawing meets the specifications given inside and that your application
fee is attached.
Other permits are sometimes required for development in the coastal area.
While these are not CAMA-related, we urge you to check with the Local
Permit Officer to determine which of these you may need. A listing is included
on page 2 of this folder.
We appreciate your cooperation with the North Carolina Coastal Management
Program and your willingness to build in a way that protects the resources
of our beautiful and productive coast.
Coastal Resources Commission
Division of Coastal Management
DCMw LMING ON NC
!���62016
.0l

-4'
OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA minor develop-
ment permit. As a service we have -compiled a listing of the kinds of permits that might be required. We suggest you check over the list
with your LPO to determine if any of these apply to your project. Zoning, 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.
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 , see Deed Book
page in the County Registry of Deeds.
an owner by virtue of inheritance. Applicant is an heir to the estate of
probate was in County.
otheinterest, such as wri%n contract or lease,Rplain below orb
NOTIFICATION OF ADJACENT PROPERTY OWNERS:
a separate sheet & attach to this application.
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.
fflame) I (Address)
(1)
(2)
(3)
(4)
FOR DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS:
I 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 particular hazard problems
associated with this lot. This explanation was accompanied by recommendations concerning stabilization and floodproofing
techniques.
PERMISSION TO ENTER ON LAND:
I furthermore certify that I am authorized to grant and do in fact grant permission to the local permit officer and his agents to
enter on the aforementioned lands in connection with evaluating information related to this permit application.
This application includes: general information (this form), a site drawing as described on the back of this application, the
ownership statement, the AEC hazard 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. RECEIVE[
0CM WILMINGT'
This t o day of 20 NOV 1 6 20

SITE DRAWING/APPLICATION CHECKLIST
Please make sure your site drawing includes the following information required for a CAMA minor development permit.
The Local Permit Officer will help you, if requested.
PHYSICAL DIMENSIONS
Label roads
Label highways right-of-ways
Label local setback lines
Label any and all structures and driveways currently existing on property
Label adjacent waterbody
PHYSICAL CHARACTERISTICS
Draw and label normal high water line (contact LPO for assistance)
Draw location of on -site wastewater system
If you will be working in the ocean hazard area:
Draw and label dune ridges (include spot elevations)
Draw and label toe of dunes
Identify and locate first line of stable vegetation (contact LPO for assistance)
Draw and label erosion setback line (contact LPO for assistance)
Draw and label topographical features (optional)
If you will be working in a coastal shoreline area:
Show the roof overhang as a dotted line around the structure
Draw and label landward limit of AEC
Draw and label all wetland lines (contact LPO for assistance)
Draw and label the 30-foot buffer line
DEVELOPMENT PLANS
Draw and label all proposed structures
Draw and label areas that will be disturbed and/or landscaped
Note size of piling and depth to be placed in ground
Draw and label all areas to be paved or graveled
Show all areas to be disturbed
Show landscaping
NOTE TO APPLICANT
Have you:
• completed all blanks and/or indicated if not applicable?
• notified and listed adjacent property owners?
• included your site drawing?
• signed and dated the application?
• enclosed the $100.00 fee?
• completed an AEC Hazard Notice, if necessary? (Must be signed by the property owner) RECEIVED
FOR STAFF USE 1DCM W ILMINGTON' NC
Site Notice Posted Final Inspection Fee Received
1 � Zg16
Site Inspections

AGENT AUTHORIZATION FOR CAMA PER101I APPLICATION'
Name of Property Owner Requesting Permit:
Mailing Address:
Phone Number:
Email Address: N(% %_, T,�'G C;a 1) --T Q1
I certify that I have authorized as
Agent i Contractor
to act on my behalf, for the purpose of applying for and obtaining all LAMA permits
necessary for the following proposed development:
at my property located at G3 q
n t-x) -, - sCounty.
/ futthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Pen -nit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
y4m')(0t7-,C, —IN ck-s,,�--
Print or Type Name
Title
Z4*
Date
PaCENEOMc
This certification is valid through j)CM\NW1NC"
tAO 16 ZWS

Coastal Management
ENVIRONMENTAL QUALITY
Mr. Kenneth Hudson
Dear Mr. Hudson:
January 3, 2016
�Iz,�� cy5
1 6o5 loC�
U-D : 0 5 , O.7 SGk1M . l� C
ROY COOPER
Uovemor
BRAXTON DAVIS
Direclur
Attached is CAMA Minor Development Permit # CasB 17-01 for work to be done at 634 Caswell
Beach Rd., in Caswell Beach, Brunswick County. An electronic copy of the permit has been
sent to the Casewell Beach Inspections Dept., and to your agent.
In order to validate this permit, please sign both copies of the permit as indicated for our
records. Please retain the orange copy for your files, sign both pages of the white copy, and
return 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.
Enclosures
Cc: WiRO files
CB Inspection Dept.
Ken Kiser, Agent
Sincerely,
Shaun K. Simpson
Permit Support Technician
DCM W� M NG ON, NC
JAN 19 2017
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext., Wilmington, NC 28405

Coastal Management
ENVIRONMENTAL QUALITY
January 3, 2016
Mr. Kenneth Hudson
250 Cedar Point Lane
High Point, NC 27265
Dear Mr. Hudson:
ROY COOPER
Governor
BRAXTON DAVIS
Dimaor
Attached is CAMA Minor Development Permit # CasB 17-01 for work to be done at 634 Caswell
Beach Rd., in Caswell Beach, Brunswick County. An electronic copy of the permit has been
sent to the Casewell Beach Inspections Dept., and to your agent.
In order to validate this permit, please sign both copies of the permit as indicated for our
records. Please retain the orange copy for your files, sign both pages of the white copy, and
return 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.
Enclosures
Cc: WiRO files
CB Inspection Dept.
Ken Kiser, Agent
Sincerely,
SS a u n K. Simpson
Permit Support Technician
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext., Wilmington, NC 28405

\0
Coastal Management
ENVIRONMENTAL QUALITY
January 3, 2017
Mr. Gary Miller
209 Updike Place
Danville, VA 24541
Dear Mr. Miller:
PAT MCCRORY
Ciovemor
DONALD R. VAN DER VAART
Secretary
BRAXTON DAVIS
Director
This letter is in response to your correspondence, which was received by the N.C.
Division of Coastal Management on November 16, 2016, regarding your concerns about
the proposed development by Kenneth Hudson, at property located at 634 Caswell
Beach Road in Caswell Beach, NC. The project consists of the construction of a single
family home and associated retaining wall. The project has been determined to comply
with the Rules of the Coastal Resources Commission (07H .0209) — Coastal Shoreline
AEC, and as such, a permit has been issued to authorize the development. I have
enclosed a copy of the permit, as well as, the relevant statutes.
If you wish to contest our decision to issue this permit, you may file a request for a Third
Party Appeal. The Chairman of the Coastal Resources Commission will consider each
case and determine whether to grant your request to file for a Contested Case Hearing.
The hearing request must be filed with the Director, Division of Coastal Management, in
writing and must be received within twenty (20) days of the permit decision. I have
enclosed the applicable forms and instructions that must be filed prior to that deadline.
Please contact me at 910-796-7221, if you have any questions, or if I can provide any
additional information.
Respectfully yours,
Tara MacPherson
Field Specialist
N.C. Division of Coastal Management
127 Cardinal Dr. Extension, Wilmington, N.C. 28405
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext., Wilmington, NC 28405

CAMA PERMIT
APPLIED FOR
PROJECT:
634CC 51.5, W W -Vt mearh moad. acitacenr M
If
/or in Ca!zmmll Roarb
themE.I.iZz.a.. b orb RA MW 0 a N 0 I -ow 1� -� W - .W,
Brunswick Countv NIA
COMMENTS ACCEPTED THROUGH
APPLICANT:
Kenneth Hudson
250 Cedar Point Lane
High Point, NC 27265
FOR MORE DETAILS CONTACT
THE LOCAL PERMIT OFFICER BELOW:
NC Div. of Coastal Management
127 Cardinal Dr. Extension
Wilmington, NC 28405
Tara MacPherson, Field Specialist
910-796-7425

Simpson, Shaun
From: MacPherson, Tara
Sent: Tuesday, December 06, 2016 8:41 AM
To: Ken Kiser
Cc: Simpson, Shaun
Subject: Hudson Minor Permit
Good Morning.
I received the email from LIZ at the USACE for this project and the offer to purchase that you sent. I still need the AEC
information on Page 1 of the application. Please indicate the footprint and impervious or built upon surface located
within the 75 ft. ES AEC. I will post a site card this week and get the ball rolling on my end while I am waiting for the
information from you.
Thanks!
Tara MacPherson
Field Specialist
NC Division of Coastal Management
Department of Environmental Quality
910 796-7425 office
910 395-3964 fax
[e-mail]
127 Cardinal Drive Ext
Wilmington, NC 28405
N. - Z-
-_.. Nothing Compares ---
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.

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LMINGTON, NC
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RECEIVED
OCM WILMINGTON, NC
Nov 16 2016

dotloop signature verification: www.dotloop.com/my/verification/DL-200981'.
DocuSign Envelope ID: E1F7B08D-DE3A-4447-99A2-A8388C96DE39
AGREEMENT TO AMEND CONTRACT
WARNING: ALL PARTIES, INCLUDING ANY LENDER AND SETTLEMENT AGENT,
MUST BE PROVIDED A COPY OF THIS AGREEMENT
Kenneth J. Hudson , as Buyer, and
Richard J. Miller, Donna P. Miller , as Seller,
have entered into a contract on the Offer to Purchase and Contract (form 2-T) or the Offer to Purchase and Contract - Vacant Lot/Land
(form 12-T) ("Contract") regarding the purchase and sale of the following property (insert property address): 634 Caswell Beach
Raod, Caswell Beach, 28465 ("Property")
Buyer and Seller hereby agree to amend the Contract as set forth below [check applicable box(es)]:
® Purchase Price. The Purchase Price is hereby changed to: $ 214, 500.00
❑ (Additional) Earnest Money. The (Additional) Earnest Money Deposit is hereby changed to: $ N/A
❑ (Additional) Earnest Money Deposit Date: The date by which the (Additional) Earnest Money Deposit shall be paid to Escrow
Agent is hereby changed to: N/A
❑ Building Deposit. The Building Deposit is hereby changed to: $ N/A
❑ Due Diligence Fee. The Due Diligence Fee paid to Seller is hereby changed to: $N/A
Due Diligence Period. The expiration date of the Due Diligence Period is hereby changed to November 7, 2016
at 5:00 p.m., TIME BEING OF THE ESSENCE.
Settlement Date. The Settlement Date is hereby changed to: November 11, 2016
❑ (check only if the following also will apply) Notwithstanding anything to the contrary in the Delay in Settlement/Closing
paragraph in the Contract, if a Delaying Party fails to complete Settlement and Closing within four (4) days following the
Settlement Date above, the Delaying Party shall be in breach and the Non -Delaying Party may terminate the Contract in
accordance with the Delay in Settlement/Closing paragraph.
❑ Expenses. The amount Seller shall pay at Settlement toward Buyer's expenses associated with the purchase of the Property is
hereby changed to: $
All terms and conditions of the Contract not specifically amended herein shall remain in full force and effect.
THE NORTH CAROLINA ASSOCIATION OF REALTORS®, INC. MAKES NO REPRESENTATION AS TO THE LEGAL
VALIDITY OR ADEQUACY OF ANY PROVISION OF THIS FORM IN ANY SPECIFIC TRANSACTION.
DocuSlgned by: dotloopp verified
11/5/2016 11/06/1 BX-4K B-LR
Buyer: � (1-k.�,sew Date J U Seller: wd v7Hx-Psex-alcove-LauQ
r 1 ,EHudson Richard J. Miller
dotloopp ve10:1e1Pd
11/06/16M EST
���-ram' /'! HZV2-OAP8-MHJ0-U2Q2
Buyer: Date Seller:
Donna P. Miller
Entity Buyer: Entity Seller:
(Name of LLC/Corporation/Partnership/Trust/etc.)
By:
By:
Name: Name:
Title: Title:
Date: Datgg,
(Name of LLC/Corporation/Partnership/Trust/etc.)
® This form jointly approved by: DUN%
North Carolina Bar Association DEC
21
REALTOR@ North Carolina Association of REALTORS®, Inc. 0OPPORTUNITY
UAL HOUSIN0
FORM 4-T
Revised 7/2015
© 7/2016
os
��" ° Hudson
Southport Oak Island RE, 1004 Captain Adkins Dr Southport, NC 28461
Phone: [phone] Fax: Charles Young
Produced with zipForm® by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026 www.ziDLooix.com

MacPherson, Tara
From:
Hair, Sarah E CIV CESAW CESAD (US) <[e-mail]. miI>
Sent:
Thursday, December 01, 2016 2:01 PM
To:
Ken Kiser
Cc:
MacPherson, Tara
Subject:
RE: [EXTERNAL] 634 Caswell Beach Rd.
Ken,
As discussed during our site visit on November 22, as long as any land disturbance occurs landward of the wetland flags
hung by SEG, locations verified, then no Corps 404 authorization is required for the bulkhead construction at 634
Caswell Beach Road.
Please let me know if you have any questions, or if can be of further assistance.
Thank you,
Liz Hair
Project Manager
USACE-Wilmington District
Wilmington Regulatory Field Office
69 Darlington Avenue
Wilmington, NC 28403
910-251-4049
[e-mail]
-----Original Message -----
From: Ken Kiser [mailto:[e-mail]]
Sent: Monday, November 21, 2016 4:59 PM
To: Hair, Sarah E CIV CESAW CESAD (US) <[e-mail]>
Subject: [EXTERNAL] 634 Caswell Beach Rd.
Attached is the form giving you permission to enter the lot. I will be happy to meet you there. Thanks
Thank you, Ken
1FtECFIUEC'
Custom Island Homes DCM N]ILMINGTON, NC
DEC 0 5 2016
910-524-0633
[e-mail] <mailto:[e-mail]>
Blockedwww.ken kiserhomes.com

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
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Name of Property Owner: 11
Address of Property:
(Lot or Street #, Street or Road, City & County)
Agent's Name #:rL-
Agent's phone #:.Z%t%
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I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing with dimensions must be provided with this letter.
I have no objections to this proposal. y✓ I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive &t,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no objection if Lou have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be sat
back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must 't� the appropriate blank below.)
I do wish to waive the 15' setback requirement.
_ I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Inf
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mportant Reminders:
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Certified Mail is not available for any class of international mail.
NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables, please consider Insured or Registered Mail.
For an additional fee, a Return Receipt may be requested to provide proof of
delivery. To obtain Return Receipt service, please complete and attach a Return
Receipt (PS Form 3811) to the article and add applicable postage to cover the
fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for
a duplicate return receipt, a USPSm postmark on your Certified Mail receipt is
required.
For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent. Advise the clerk or mark the mailpiece with the
endorsement "Restricted Delivery".
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 Mail
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

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
Address of Property:
(Lot or Street #, Street or Road, City & County)
Agent's Name #:�
Agent's phone #: y�10 - Sj L/ e (_ _
Mailing Address:
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
if you have objections to whatis being proposed, you must notify the Division of Coastal Management (DCM) in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no objection if Lou have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
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ertified Mail Provides:
A mailing receipt
A unique identifier for your mailpiece
A record of delivery kept by the Postal Service for two years
mportant Reminders:
Certified Mail may ONLY be combined with First -Class Mail® or Priority Maile
i Certified Mail is not available for any class of international mail.
i NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables, please consider Insured or Registered Mail.
For an additional fee, a Return Receipt may be requested to provide proof of
delivery. To obtain Return Receipt service, please complete and attach a Return
Receipt (PS Form 3811) to the article and add applicable postage to cover the
fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for
a duplicate return receipt, a USPS® postmark on your Certified Mail receipt is
required.
For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent. Advise the clerk or mark the mailpiece with the
endorsement "Restricted Delivery".
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 Mail
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

Coastal Management
ENVIRONMENTAL QUALITY
November 21, 2016
Mr, Kenneth Hudson
250 Cedar point Lane
High Point, NC 27265
RE: INCOMPLETE APPLICATION ADDITIONAL INFORMATION REQUIRED
APPLICATION NUMBER —CB 16-08
PROJECT ADDRESS — 634 Caswell Beach Road
Dear Mr. Hudson:
PAT MCCRORY
Gnrernur
DONALD R.. VAN DER VAART
Secretary
BRAXTON DAVIS
pireclor
The Division of Coastal Management's Wilmington Regional office received a CAMA Minor Permit application from
your contractor Mr. Ken Kiser on November 16, 2016, requesting approval for development activities at 634 Caswell
Beach Road, Caswell Beach, Brunswick County. In reviewing your application, we have discovered that additional
information is needed to complete the review process. Accordingly, I am requesting that you submit the following
additional information to this office:
1. The Section 404 Wetland line needs to be approved by the US Army Corps of Engineers to align the
retaining wall landward of all wetlands. Please contact Liz Hair at 910 251-4049.
2. On page 1 of the application, please indicate which Area of Environmental Concern (AEC) the project
is located in and indicate the size of the buildable footprint and other impervious or built upon surfaces
located within the 75 ft. Estuarine Shoreline AEC.
3. The offer to Purchase and Contract must be included with this application.
In accordance with the Department of Environment and Natural Resources regulations, we note that the application,
as submitted on November 16, 2016, is incomplete for processing. Upon resubmission of a complete application, a
local decision will be made in 25 days, provided this period is not extended as provided by law. Please contact me at
910-796,-7425 if you have any questions.
Respectfully yours,
�t
Tara MacPherson 75
Field Specialist
Division of Coastal Management
127 Cardinal Drive Extension
Wilmington, NC 28405
cc: WiRO files
Ken Kaiser, 137 NE 37th St., Oak Island, NC 28465
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext., Wilmington, NC 28405
919 796 7215

Payment Proccessing Confirmation
Date Received 1 11/16/2016
Check From (Name) Custom Island Homes by Ken Kiser
Name of Permit Holder Kenneth Hudson
Vendor Crescom Bank
Check Number 1637
Check amount $100.00
Multiple Permits No
Major/Minor Minor
Permit Number/Comments Minor fee 634 Caswell Beach Road/Brunswick
Receipt or Refund/Reallocated TM/3455D

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