HomeMy WebLinkAboutSB_17-22_ Rucker (2)`A
LF q 1g -ZD22-
Sunset Beach SB-17-22
Local Government Permit Number
CAMA
MINOR DEVELOPMENT
PERMIT
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 David and Tonya Rucker, authorizing development in the Estuarine Shoreline (AEC) at 1509 North
Shore Drive East, in Sunset Beach, Brunswick County as requested in the permittee's application, dated
October 5, 2017, initially received by the Town on October 6, 2017. This permit, issued on October 26, 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 the
permittee to a fine, imprisonment or civil action, or may cause the permit to be null and void.
This permit authorizes: Construction of an Elevated Single -Family Residence.
(1) All proposed development and associated construction must be done in accordance with the permitted revised site
drawing dated received by the Town on October 16, 2017.
(2) All construction must conform to the N.C. Building Code requirements, the Town of Sunset Beach Unified
Development Ordinance and all other local, State and Federal regulations, applicable local building and zoning
ordinances and NFIP 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 910-579-6297 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
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.
H m J. Marzi no, II
CAMA LOCAL PERMIT OFFICIAL
700 Sunset Blvd N
Sunset Beach, NC 28468
PERMITTEE
(Signature required if condibo�s,i}bove apply to per6it)
C k. LJ
DCIU WILMINGTON, NC
0 C T 2 6 2017
k'
Name: David and Tonya Rucker
Minor Permit # SB-17-22
Date: October 26, 2017
Page 2 of 2
(5) The applicant has effectively demonstrated, through innovative construction design, that the amount of impervious
surface areas may be exceeded in a way that runoff water will be managed and the AEC protected, so as to allow
46.6 percent of impervious areas within the 75' Coastal Shoreline AEC. All proposed development and associated
construction must be done in accordance with the design specifications of the permitted innovative design on the
plan dated received October 16, 2017. [Designed is sealed under construction documents on file at the Sunset
Beach Planning and Inspections Department.]
(6) The innovative designed system may not encroach into the 30' buffer from the normal high water line.
(7) Upon completion of construction and prior to the issuance of a Certificate of Occupancy (CO), a letter of certification
must be received from the designer of the innovative system installed, certifying that the permitted system has been
installed in accordance with this permit, the approved plans and his design specifications. Any deviations from the
approved plans and specifications must be noted on the Certification and a permit modification may be required
prior to receiving a CO.
(8) The landowner or permittee shall at all times provide the operation and maintenance necessary to assure the
permitted stormwater system functions at optimum efficiency. The landowner or permittee shall maintain the
permitted stormwater system for the life of the project.
(9) 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.
(10) Any proposed 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 vegetatively
stabilized, and must remain in a vegetated state.
(11) With exception of an elevated wooden walkwayistairs and 200 sq. ft. or less of elevated slatted uncovered wood
decking, no other development is authorized within 30 feet of the normal high water line, or the line previously
established by the existing structure relative to the redevelopment of the existing structure.
(12) Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third -parry.
(13) Projects shall not increase stormwater runoff to adjacent estuarine and public trust waters.
(14) Prior to any development, silt fence shall be properly installed between all planned land disturbance and the
adjacent marsh, open water areas, and adjacent properties; the silt fence shall be properly maintained throughout
the construction period. Silt fence shall be installed such that it is properly toed -in to the soil.
SIGNATURE:
PERMITTEE
DATE: C C"71 V E D
DCNI WILMINGTON, NC
0 C T 2 6 2017
GENERAL JNFORMATION
LAND OWNER
Namerl��
Address mg
City
Email ,t// roo
AUTHO AGENT
Name I
Address_ (9
city S�
Email l�
LOCATION OF PROJEC-��T- ( c
adjacent waterbody.) _ I
Zip:�/b/s Phone Tq V6 � dd
/� (, zip Phone 'l �+J S 7 7100
directions to site. If not oceanfront, what is the name of the
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) `'1,w vsi
SIZE OF LOTIPARCEL: � square feet acres ` C / ` X k__Q
(
PROPOSED USE: Residential Itsj (Single-famil
`T'" SiY 0 Multi -family ) Commercial/Industrial [l Other [�
COMPLETE EITHER (1) OR (2) BELOW (Contact your Local permit
to your property): pr ijyou are not sure which AEC applies
(1) OCEAN HAZARD AECs: TOTAL FLOOR
air conditioned living AREA OF PROPOSED STRUCTURE:
g spy, Parking elevated above ground level, non -conditioned space elevated above feet (includes
excluding non -load -beating attic space) ground level but
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND O
UPON SURFACES:square feet (includes the area of the roof/drip line of all burldinTBER 'ERVIOUS OR BUILT
concrete or masonry patios, etc. that are within the applicable AEC. Attach your calculationss with the prroojcovereddrawing.)
STATE STORIITWATER 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 NO�
If yes, list the total built upon area/impervious surface allowed for your lot or parcel:
square feet.
GCM WILMINGTON, NC
0 C T 1 12017
O- TiER PERMITS MAY BE REQUIRED: The activity you are
minor development permit, including, but not limited to: Drinkiplanning may require permits other than the CAMA
ng treatment system), Building, Electrical, Plumbing,Heatingand Air ondi well eptic Tank (or other sanitary waste
Certification, Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park
> Insulation and Energy Conservation, FIA
others. Check with your Local Permit Officer for more information. -AppLoval HighwayCOM ection, anc
STATEMENT of owNERsBEW: ( the undersigned, 0 C T � 2017 i
)y an applicant for a CAMA minor development permit, being either t er of roe
person authorized to act as an agent for purposes of applying Sat ._ pp__' an AEC or a
listed as Landowner on this application has a significant for a CAMA minor develapma� peZ�� � ifthe person
interest in the real property described therein This interest can be
described as: (check one)
owner or recor title, Title is ve ted in . (`� r
page �� Lin the � G' ul v r � (� see Deed Book _?j -�s-
County Re�istry o '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 ofproperties adjoiningthis property. ACTUAL NOTICE to each of them concerning P Peri3' I affirm that I have given
my intent to develop this property and to apply for a CAMA permit:
'Address)
(2)nh Z 1'r 11�h ID
(3)
i R l�C
(4)
ACKNOWLEDGEMENTS:
L 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 Offices. has explained to
lar hazard problems associated with this lot. This explanation was accompanied by recommendatime the particu-
ons concerning stabiliza-
tion and floodproofing techniques.
I furthermore certify that I am authorized to grant; and do in fact
the Local Permit Officer and their agents to enter on the aforementioned lands sin onnsion to ectionowith evaluatinn of Coastal g informatioement n
related to this permit application.
Landowner
This the _
J day of 20
Person authorized to act as his/her agent for
tiling a CAMA permit application
This application includes; general inform
ownership statement, ation (this form), a site drawing as described on the back of this application, the
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
any permit. Any person developing in an .AEC without permit is subject to civirirni I and administra e action, ofi-am these details will constitute a latzon of U N C
,u TON
0CI 112017
CAROLI NA BLUEWATER CON5T7 UCTION
Custom Beach, Mainland, an4 Golf Course Homes
Complete Design / Engineering / Building
6934-9 Beach Dr. SW, ocean Isle Beach, North Carolina 28469 (910) 575-7100
JINKS CREEK Ffinert cANAL
Exlnttng wood 0ulktwad
x4.4
4J!
4.5
1
x4.7
LOT 29
5,085 SF
sa" I
aa.a•
I sa
1
170 SF of Open Dock
in 3W Setback (85 SF Per Flan)
30'CAMA
— — — —x5.t — —
— —
SETBACK
_
I s Fr«,uRear °vmhm�_ — J.
5.5
(i
A
xs.0
(�
a
Nnrse Awft
m
JN
i
-
Gndut edroeclM ed Arlan
1
} a
*•
2
L^
toRoc lnfi4atbn Basks
1.8255E
(
{
i
's
m -
:a
x
jj
io.
v
o
Z A'O 4
W
u�iu1O•W
5.7,
c^5.
•
Nave Abarl �
tl1
I
Haum ALwe
_14-4
75'CAIA - ' _ aw-11'25 SETBACK
SETBACK
iiI __ Landscape Area
MEAN HIGH WATER LINE
RUNS ALONG BOTTOM OF
FROSTING BULKHEAD
0
N U�
3: m io
n m °�
a
a ID
kzo Z o 'm
9m1tY
Area
Area within 75' Setback: 3,810 SF
(using Bulkhead)
Impervious Area within
75' Setback: 1,778 SF
% Impervious Area: 46.6%
Impervious Area Within 75'
Setback to Rock Trench: 1,778 SF
% Impervious Area after Rock Trench: 0 %
Lot Impervious Area
Roof w/ Overhang: 1,825 SF
Total Impervious Area: 1,825 SF
Lot Area: 5,085 SF
% impervious: 35.8%
Impervious Area Within
lot to Rock Trench: 1,825 SF
% Impervious after Rock Trench: 0%
RECEIVED
DCM WILMINGTON, NC
OCT 17 2017
� '—
�) i�C:EIVED
PT Wood
v
OCT 1 G 2017
6.1 .7 5.7
IB 1
'p i�'
x 5.9
S79°08'28"W 50.02' r
5.7
+ NORTH SHORE DRIVE
(30'RIGHTOFWAY) Lot 29,1509 North Shore Drive
Sunset Beach, NC
CAMA- New Construction Rouse
R-EC EIV
F:D
1, CHRISTOPHER D. STANLEY, P.L.S., CERTIFY THAT THIS PLAT OF SURVEY IS j\TRUffiA
ACCURATE REPRESENTATION OF LAND SURVEYED AND PLATTED UNDER MY�B
AND IS IN ACCORDANCE WITH THE STANDARD AND PRACTICE FOR IANU� g --
CAROLINA.WfTNESS MY ORIGI IG AT EGISTRATION NUMBER APIDip
OF APRIL, 2017. — 2- y . 904 <�
SEAL
CHRISTOPHER D. STANLEY, P. S.
AL •�� ' su.'
............ �q�. SITE —\
RIPARIAN
Nl5 5%E ,\� LINE
P\ SUNSET BEACH
VICINITY MAP
ptER `5, pF�S�' ANNEL) �, 21 NO
EDGE Of
r�
r\ N69' D5' 00"E
RIPARIAN z\l 50.82' 4.8 X4.7
LINE �\ X4.4 MEAN HIGH WATERLINE
WOOD 1 X4.7 RUNS ALONG BOTTOM
BULKHEAD 4.4 4.5 OF EXISTING BULKHEAD
30' CAMA
SETBACK
X 5.1
1
5.5 i i ' 4.9
i X 5.0
X s 5 LOT 30
LOT 29 s
LOT 2$ 5,085 SQUARE FEET X6.3
y5.75.8
/(5.7
X6A X5.9
� 1
Z
1
1 X 5.7
X 6.+ 2g"VI X 5.9 5D.02
X 5.7 9' 08 5.8
— jilW 5.7.E
6D0 p ORAV�S.e PROJECT BENCHMARK
MAG NAIL FOUND
NOTES: ELEV=6.16' 5.93
BASED ON FEMA FLOOD MAP 3720105400J, THIS 9-- _ —1,5� AVD 88) f59
PARCEL APPEARS TO BE LOCATED IN FLOOD ZONE
"VE", BASE FLOOD ELEVATION = 17.0'. yj\v �VC5 0
FOR ADDITIONAL TIE LINE, SEE MAP CABINET 77, PAGE-5.8
76, 16.a
ALL ELEVATIONS BASED ON N.A.V.D.88 DATUM AND
WERE OBTAINED BY NC REAL TIME NETWORK.
w
0
AREA BY COORDINATE METHOD.
DEED REF: BOOK 3855, PAGE 1052 � E C �'v E C �
pCti1 WILMINGTQNI p
REPUTED OWNER: DAVID & TONUA RUCKER
STREET ADDRESS: OCT 1 1 2017
Snn kinoni cunor nonir
X 6.6
� pOg OFOF
I`� '—�_SS' 44' 39"W
_A + 6.17 13.98'(TIE) SFH�T
r5`9 EDGE OF A j W
6.0 Y Y
T� Sion D
OR:tz �0' ?3GKT of
W AY
LEGEND
LABEL
SYM.
DESCRIPTION
IPF/IRF
O
IRON PIPE /ROD FOUND
IRS
O
1/2' REHAR SET
MNF
♦
WAG NAIL FOUND
CAN
0
CABLE TV PEDESTAL
TPED
ID
TELEPHONE PEDESTAL
SMH
L9
SEWER MANHOLE
SCO
0
SEWER CLEANOUT
GS
xzl.5
Saar ELEVATION
CAROLI NA BLVEWATER CONS MVCTION
Custom Beach, Mainland, and Golf Course Homes
Complete Design / Engineering / Building
6934-9 Beach Dr. 5W, Ocean Isle Beach, North Carolina 28469 (910) 575-7100
JINKS CREEK FEEDER CANAL
Existing Wood Bulkhead �^
X4A
4.5 X4,7
! LOT 29
! 5,085 SF
n
170 SF of Open Deck
in 30' Setback (85 SF Per Floor)
I! — 0 DeW Above__ — — -
30' CAMA 12. Ovemanp `�-
SETBACK — ram- — — X5.1
ss "w o��Amw<
X5.0
N
N
L
U
y
v -
�
J N
Oni
o
ff
'
2
a.
Z
a
0 0 ,
v
x
I-
z = m° E
X
IS
to w O N
Z
N.
NUo u_
I
3m
a0
I
75'CAMA
SETBAO( _ Y
Q
m! W
N! ir)
N !
6.1
5.7
t
Home Above
i
Shaded Area Is Rod Area to be '
Guttered. Colev[W. a loped
N to Rods lnOraton Its-
825 SF
57
I
two.. Atme
I
House Pbv+e —
SU�B FFE 7.0,
bw-
3rt 25' SETBACK
Landsrape Area
PT Woeo
Orlve Runners
,7
Xs.s —
S79'08'28'W 50.02'
NORTH SHORE DRIVE
(30' RIGHT OF WAY)
MEAN HIGH WATER LINE
RUNS ALONG BOTTOM OF
EXISTING BULKHEAD
u
G
�
C
O
F
t Lo
y
u
n
m w
o
It
C C N
o m o
v
oY atz
x
z Z ao 'all
O N
N ClltitY
w
m CD
r
` c
o
aD
in
IREC
`
i
OCT 6 Z017
I Bl Y__`_.
Area
Area within 75' Setback: 3,810 SF
(using Bulkhead)
Impervious Area Within
75' Setback: 1,778 SF
% Impervious Area: 46.6%
Impervious Area within 75'
Setback to Rock Trench: 1,778 SF
% Impervious Area after Rock Trench: 0 %
Lot Impervious Area
Roof w/ Overhang: 1,825 SF
Total Impervious Area: 1,825 SF
Lot Area: 5,085 SF
% Impervious: 35.8%
Impervious Area within
lot to Rock Trench: 1,825 SF
% Impervious after Rock Trench: 0%
RECtEIVED
6� DCM WILMINGTON, N
0 C T 1 1 2017
!P
W
in 4
(
! 57
!
Lot 29, 1509 North Shore Drive
Sunset Beach, NC
CAMA- New Construction House
IIIIIIIIIIIIIIIIIIIIIIIIlliillllillll 148 P1052m ons 4316
Brunswick County, NC Register of Deeds page 1 cf 2 PROP
_ Gash ;h . __ . FM mO
��9YIeylbledtlet00001mp
dsveftbyed0
b? reprcduced nrmltMF.
Brenda M. Clemmons Register of Deeds
Revenue $412.00 12-28-2016 13:44:43.000 Brunswick County, NC
NC REVENUE STAMP: $412.00 (#513265)
This instrument prepared by Cynthia D. Bridgers, a licensed North Carolina attorney,
Delinquent taxes, if any, to be paid by the closing attorney, to the Brunswick County Tax
Collector upon disbursement of closing proceeds.
The property herein conveyed is NOT the primary residence of Grantor
Brief Description for the Index: Lot 29, Block 14-R, Sunset Beach
STATE OF NORTH CAROLINA
GENERAL WARRANTY DEED
COUNTY OF BRUNSWICK
THIS DEED made this 21 day of December, 2016, by and between NORTH
SHORE SUNSET BEACH, LLC, a South Carolina limited liability company,
GRANTOR, whose permanent mailing address is 2120 Sea Mountain Highway Suite
1200, North Myrtle Beach, South Carolina 29582 and DAVID MARK RUCKER and
wife, TONYA LANE RUCKER, GRANTEE, whose permanent mailing address is
7009 North Ridge Drive, Raleigh, Raleigh, North Carolina 27615.
The designation Grantor and Grantee as used herein shall include said parties,
their heirs, successors, and assigns, and shall include singular, plural, masculine,
feminine or neuter as required by context.
WITNESSETH:
The Grantor, for a good and valuable consideration paid by the Grantee, the
receipt of which is hereby acknowledged, has and by these presents does grant, bargain,
sell and convey unto the Grantee in fee simple, all of their interest in that certain lot or
parcel of land situated in the city of SUNSET BEACH, SHALLOTTE Township,
BRUNSWICK County, North Carolina and more particularly described as follows:
BEING ALL of Lot 29 as shown on a survey map by Christopher D.
Stanley, dated 11 March 2013, entitled, "Re -Plat of Subdivision of Sunset
Beach, Lots 3-6, 8-15, AND 17-36 Block 14-R AND Lots 179-200 Block
15", and recorded in the Office of the Register of Deeds for Brunswick
County, North Carolina in Map Cabinet 77 at Pages 75-78; said survey
map incorporated herein by reference for greater certainty of description.
REC=iVED
DCM MMINGTQN, NC
0 C T 1 12017
Brenda Pl@53m o s 43rp00
Brunswick County, NC Register of Deeds page 2 of 2
For back reference see Book 3395 at Page 0612 of the Brunswick County
Registry.
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges
and appurtenances thereto belonging to the Grantee in fee simple.
And the Grantor covenants with the Grantee, that Grantor is seized of the
premises in fee simple, has the right to convey the same in fee simple, that title is
marketable and free and clear of all encumbrances, and that Grantor will warrant and
defend the title against the lawful claims of all persons whomsoever except for the
exceptions hereinafter stated.
Title to the property hereinabove described is subject to the following exceptions:
2017 Ad Valorem Property Tax;
all applicable governmental and land use regulations; and
all applicable easements and rights of way of record.
IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the
day and year first above written.
NORTH SHORE SUNSET BEACH, LLC, a South
Carolina limited liability company
(SEAL)
MACE WATTS, Managing Member
STATE: NORTH CAROLINA
COUNTY:BRUNSWICK
1, r, ex-'b. `x a Notary Public of the County and State aforesaid, do
here y rtify that MAC WAT , Manager/Member of BEACH, LLC, a
South Carolina limited liability company, either b ' pe known to ;e7 n by satisfactory
evidence (said evidence being , persona y appeared before me this day, and
as the Managing Member of NORTH SHORE SUNSET BEACH, LLC, and being authorized to do so,
acknowledged the voluntary due execution of the foregoing instrument by he/she/the for the purposes and
in the capacities stated therein. Witness my hand and Notarial stamp or seal, this Z- day of December
2016. RECEIVED
My commission expires: j`-7.o—'11�f1
n iLMINGTON, NC
Notary ? —"lip 0 C T 1 1 2017
G=BRIDGERSDGERSICBh Carolinatvly Coember 20, 2017
to
Er
.n
a
Cc
0
0
..n
m
0
0
0
0
s
0
Ln
0
N
oyN:tkN BLIj��C�VTr:
OCT 6 - 2017 ;
U
CONSTFkX-T ON
6934-9 Beach Dr. SW CUSTOM BEACH, MAINLAND, AIND GOLF COURSE HOMES 910-575-7100
Ocean Isle Beach, NC 28469 Fax 910-575-1214
Tuesday, October 03, 2017
CEJ Holdings LLC
PO Box 567
Fairmont, NC 28340
Subject: CAMA Application Notification
1509 North Shore Dr.
Sunset Beach, NC
Dear Whom It May Concern:
This letter is to inform you that I have applied for a Minor CAMA Permit on behalf
of David & Tonya Rucker for the property located at 1509 North Shore Dr. in Sunset
Beach, NC. CAMA regulations require me to notify you of my intentions. I have
enclosed a copy of my permit application and a copy of the drawing of my proposed
project.
If you have any comments on my proposed project, please contact the Town of
Sunset Beach Local CAMA officer at 910-579-6297 or you may contact me.
Sincerely,
J6
Scott W. Quaintance
RECEIVED
DCM WILMINGTON, NC
0 C T 1 12017
oy1Z•1A BL(l�ty�-C-T:�VFD
OCT 6 2017
l
C O N S -I- R iJ C T I O ---- ----1
CUSTOM BEACH, MAINLAND, AND GOLF COURSE HOMES
6934-9 Beach Dr. SW 910-575-7100
Ocean Isle Beach, NC 28469 Fax 910-575-1214
Tuesday, October 03, 2017
Barry & Karen Wishon
7608 The Pointe
Raleigh, NC 27615
Subject: CAMA Application Notification
1509 North Shore Dr.
Sunset Beach, NC
Dear Whom It May Concern:
This letter is to inform you that I have applied for a Minor CAMA Permit on behalf
of David & Tonya Rucker for the property located at 1509 North Shore Dr. in Sunset
Beach, NC. CAMA regulations require me to notify you of my intentions. I have
enclosed a copy of my permit application and a copy of the drawing of my proposed
project.
If you have any comments on my proposed project, please contact the Town of
Sunset Beach Local CAMA officer at 910-579-6297 or you may contact me.
GEHTIFIED MAIL'= RECEIPT
Domestic A?ail Only
For delivery information, visit our website at ivww usoc r.,,,,
cot W N—r—
co c F _
r Ja.
M u fi Roaeipt p m) $ P r_t , ii �2 .
p ❑ Re�ot�io) s
C7 ❑ Certified Mai! ReaiddId Delivery
[] ❑Adult Signatue Required
0 Adutt stnamre Read oam,e,y s
C] Postage _
ofeI Postage and oe6 '
� rn
4111%xw
�
-� At
h:
Postmark
Here
11�1/06/201 ;r
Sincerely,
Scott W. Quaintance
RECEIVED
DCM WILMINGTON, NC
0 C T 1 12017
F'D
AGENT AUTHORIZATION FOR CAMAJ PERMIT APPLICATION OCT 6 Z011
i
Name of Property Owner Requesting Permit: JDA U E o i ' e
Mailing Address: 7W 9 A/6t
Phone Number:
,g - &98 _ J �00
Email Address: A)Af11
I certify that I have authorized U1,
to act on my behalf, for the purpose of applying for
necessary for the following proposed development:
at my property located at c"? dof
r.
in (duns L„ck _County.
4rl
/ Contractor
J obtaining all CAMA permits
1fa _41114 -
I furthermore certify that l am authorized to grant, end do in fact grant permission to
Division of Coastal Management staff, the Local Per it Officer and their agents to enter
on the aforementioned lands in connection with e luating information related to this
permit application.
r
Pr "e �wner ion:
Sip ture
Print or Type Name
oct j rjo-
Title
/_ 3_/__ L 7 __...
Date
RECEIVED
This certification is valid through DCM WILMINGTON, INC _ _ //_
O C T 1 12017