BC_18-09_ Dillard (2)

LF S�-ZZ
Brunswick CountBQ%09
Local Government Permit Number
CAMA
MINOR DEVELOPMENT
PERITIT
as authorized by the State of North Carolina
4W*W 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 William G. Dillard, Jr, authorizing development in the Estuarine Shoreline Area of Environmental Concern
(AEC) at 1948 Fiddlers Drive SW, in Supply NC 28462, as requested in the permittee's application package, dated
20-Jun-18. This permit, issued on 24-Jul-18, is subject to compliance with the application and site drawing dated
received on 20-Jun-18, (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: Single Family Residence with attached garage and 2 covered porches.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on 20-Jun-18.
(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. RECEIVED
DCI'vi WILMINGTON, NC
(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, 2021
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.
AUG o 12018
Connie Marlowe
CAMA LOCAL PERMIT OFFICIAL
PO BOX 249
Bolivia, NC 28422
L" PERMITTEE
(Signature required if conditions above apply to permit)

Name: William G. Dillard, Jr.
Minor Permft # BC18.09
Date: 24-Jul-18
Page 2
(5) Unless specifically allowed in 15A NCAC 07H-209(d)(10), and shown on the permitted plan drawing, all
development/construction shall be located a distance of 30 feet landward of Normal High Water. No portion of the
roof overhang shall encroach into the 30 foot buffer.
(6) All unconsolidated material resulting from associated grading and landscaping shall be retained on site by effective
sedimentation and erosion control measures. Prior to any land -disturbing activities, a barrier line of filter cloth must
be installed between the land disturbing activity and the adjacent marsh or water areas, until such time as the area
has been property stabilized with a vegetative cover.
(7) Any proposed for grading within the 30' buffer from the Normal High Water must be contoured to prevent additional
stormwater runoff to the adjacent marsh. This area shall be immediately vegetatively stabilized and must remain in a
vegetated state.
(8) All other disturbed areas shall be vegetatively stabilized (planted and mulched) within 14 days of construction
completion.
(9) 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
0.32% impervious surface of the impervious areas within 75' Coastal Shoreline AEC. All proposed development
and associated construction must be done in accordance with the design specifications of the permitted innovative
design, sealed by design professional, Michael A. Copeland on 24-Jul-18.
(10) 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 the permit, the approved plans and his design specifications. Any deviations from the
approved plans and specifcaWns must be noted on the Certification and a permit modification may be required
prior to receiving a CO.
(11) 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.
SIGNATURE: - DATE
P MITTEE
i t- -' _. °v E n
E(�r`101LONGTON, NC
AUG 0 12018

Locality
Y"W it u h-T Permit Number
Bc is- 09
Ocean Hazard Estuarine Shoreline---,,ORVM. oreline Public Trust, Shoreline Other _
(For official use only) t` Y o,r`tr-I p�l,uAt�a o!
GENERAL INFORMATION
LAND OWNER
Name Willian G. Dillard Jr ETUX Ruby Charlotte Kelley
Address
114 W. Peach Rd
City Winnsboro
State SC Zip 29180 Phone [phone] _
Email [e-mail]
AUTHORIZED AGENT
Name Ginger Cain, Manis Custom Builders
Address 411 Ocean Hwy W.
City supply State NC Zip 28462 Phone [phone]
Email [e-mail]
LOCATION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront, what is the name of the
adjacent waterbody.) 1948 Fiddlers Drive, Supply, NC Shallotte Creek
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) House w/ attached Garage
and 2 Porches ove-real
SIZE OF LOT/PARCEL: 15,083 square feet 0.3463 acres
PROPOSED USE: Residential ® (Single-family [2 Multi -family El) Commercial/Industrial F] 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: 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: 3474 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 NO
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: square feet.
RECEIVED
JUN 2 2 2018 JUN 2 0 2018
DCM WiLMINGTON, NC

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)
Dillard, William G JR ETUX Ruby C.Kelleyy
XX an owner or record title, Title is vested in , see Deed Book BO 106
page 0034 in the Brunswick 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) LARRY HELMS 1944 Fiddlers Dr SW Mailing: PO Box 2333, Georgetown, SC 29442
(2) State of North Carolina 116 W Jones St., Raleigh, NC 27603
(3)
(4)
ACKNOWLEDGEMENTS:
I, the undersigned, acknowledge that the land owner is aware that the proposed development is planned for au area which
may be susceptible to erosion and/or hooding. 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.
Gin er Cain AgentA.This the 19 day of 1 20
�(D( 6et - (A441
La Towjter or ptrson authkfrized to act as hislh'K 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 madepayable 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 admini"apw- k D
JUN 2 `PEQEIVED
.JUN 2 0 201
DCM WILMINGTON, N�

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: William G. Dillard Jr.
Mailing Address: 114 W. Peach Rd.
Winnsboro, SC 29180
Phone Number: 803-718-6891
Email Address: [e-mail]
1 certify that I have authorized Ginger G. Cain ,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: build a Modular home with two porches
and an attached Garage
at my property located at 1948 Fiddlers Dr SW, Supply, NC
in Brunswick County.
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.
Property Owner Information:
Signature
William G. Dillard, Jr.
Print or Type Name
Title
Date
This certification is valid through Aug 1 31 1 2018 RECEIVED
JUN 2 2 2018
DCM WILMINGTON, NC

06-18-18
Date
Larry Helms
Adjacent Property Owner
PO Box 233S
Mailing Address Georgestown, SC 29442
City, Slate, Zip Code
Dear Adjacent Property:
CERTIFIED IVIAIL�'RECEIPT
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Extra Services & Fees (check box,
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This fetter is to inform you that I, Willaim G. Dillard, Jr. have applied for a CAMA Minor
Property Owner
Permit on my property at 1948 Fiddlers Drive SW, , Supply, NC in
COUNTY Property Address
Brunswick 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 803-718-6891 , or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the Brunswick County CAMA Minor Permit Program, you may submit
them to:
Sincerely,
William G. Dillard, Jr.
Property Owner
114 W. Peach Rd.
Mailing Address
Winnsboro, SC 29180
City, State, Zip Code
Connie Marlowe
Brunswick County Planning Department
PO Box 249
Bolivia NC 28422
i
RECEIVED f
JUN 2 2 Z018
DCM WIL.MINGTON, NC

SITE
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VICINITY MAP NTS
E.IRON
IN
WILLARD G. DILLARD
ST 3977/540
OPEN
DECK / m
HWL+— / �O STD, ,• ZONE AE 11.0
/ STK/ o�� S , u4 `75' CAMA LINE
/30 BUFFER oo O c�
/ AREA /STEP �o JUP
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E.IRON�4.24Z QQo
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STK. 1 GPR `Sp.r� 0 �� E-IRONS°E.IRON
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\/ EP TI C , ) Cog
FIDDLERS COVE IF
SUBDIVISION Crw ^ .jam TANKr�1 c�31 t}�}Y'sfGd !i%'�
MAP CAB. K. PG. 238 t \•� C?Ivlul
75' CAMA LINE IV E S5� O��R� `� g� et<'ihe - 3J)
LOT 25 PP r\� Q ,t 3�. 3 �''".'
E.IRON � � r
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NOTES: SETBACKS:
SURVEYED BY USING MAP PG. 238 � r t
AND EXISTING PHYSICAL CONDITIONS FRONT 25'
PROPERTY IS IN A FLOOD HAZARD AREA SIDE 5 JQ7
COMM NO, 370295 REAR 30' BUFFER LINE
MAP/PANEL NO. 37202GO600J (JUNE 2, 2006) (REV. 10/16/2008) Call
ZONE AE 11.0
MAY BE ERRORS / BY SCALING ADMINISTRATIVE VARIANCE TO BE APPLIED FOR
CAMA SETBACK LINES TO BE CHECKED BY COUNTY
CARo PLOT PLAN FOR SCALE 1" = 30'
WIWAM G. DILLARD ET. UX.------- p'r 1
f� ,1P0 1 9 OF TOWNSHIP LOCKWOOD FOLLY t >�� Ml1j•-,'.'�/^
f LOT 23 REVISED
!_125E) FODLF>:S COVE sUMVISI«+ COUNTY BRUNSWICK
MAP CA8. 106, PG 34 STATE N.C. �6
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MAP CAB, K• PC. 238 TOWN
TAX PARCFL 2150AO24
v� p ti
K- j,- DATE REV.6/16/2018 ..�`
JAN K_ DALE FIELD BOOK 14/0I/A3
N.C. REG. NO. L-1250 —
PL JAN K. DALE 891 COPAS RD. — SHALLOTTE, N.C. DRAWN BY JKD �if JYtL(1j/
N. REG. NO. L-1250 910-754-4477 DWG. N0. C/OAK1
RECEIVED
RECEIVED JUN 2 2 201 �
JUN 2 0 2018 DCM WILMINGTON, NG

• ,.
wall I WE ENO
GARDNER-DILLARD JR.
GRANT . RUBY CHARLOTTE KEL
IIIJNIIII1II11111MU11111111 B3977In�►�ei "
Bru snick County. Register of Deeds page 2 of 2
oot
STATE OF"Alm)
COUNTY OF
I certify that the following person(s), WILLIAM GARDNER DILLARD aka WILLIAM G.
DILLARD aka WILLIAM GARDNER-DILLARD JR. personally appeared before me this day,
acknowledging to me that he voluntarily signed the foregoing document for the purpose stated therein
and in the capacity indicated: GRANTOR,
[eck One]
(i) I have personal knowledge of the identity of the principal(s); or
_ (ii) I have seen satisfactory evidence of the principal's identity by a current state or
identification wit�,Aa,iµpkal's photograph, in the form of a
NOTARY
PUBLK+
(Official
STATE + _ 4_ t.+ !
COUNTYOF •f rr`7 -
federal
Printed Name of Notary Public
My Commission Expires:AN/2�23
# certify that the following person(s), RUBY CHARLOTTE KELLEY personally appeared before
ige this day, acknowledging to me that she voluntarily signed the foregoing document for the purpose
#ted therein and in the capacity indicated: GRANTOR,
Freck One]
(i) I have personal knowledge of the identity of the principal(s); or
(ii) I have seen satisfactory evidence of the principal's identity by a current state or federal
5entification, with,ar ,} W's photograph, in the form of a
Date: 2017
NOTARY
PUB00 E No blic Signature
'• ��`1t,�
(Official Seal6�'dtere) / 177/ij
Printed Name of Notary Public
My Commission Expires: tV 23 z�07/ZDZ3
DECEIVED
JUN 2 2 2018
DCM WILMINGTON, NC

This certifies that there are no deflm*Wnt ad
vakxem taxes, tees, assessments or other
liens which the Brunswick County Tax
Collector is charged that are a
lien on: Parcel Numbe�°� r
as notated by the &unswiok GountN
Assass&s Office. This is rot a certifiWilOn
that the parcel number mekfiaa the deed
descripption.
CCT 2 4 2017
pqe wwo Tax Cat I Det. Tax Spea
arunsuick Can v, Rsyister of Dssds pays t of 2
r • � �ol(
retwn to Type
rotel
ckS�ck0 Cash3
Refund Cash $ Finance
G porwra of docwnent are ft ble due to condfion
Of orlow.
n Dooxnent cornalm seak+vertfied by OrOnw
inattument that carurot be reproduced or copied.
STATE OF NORTH CAROLINA D4E�D OF CorYTBiNA-noKJ
REVENUE STAMPS: $
PARCEL #215OA017, 215OA018, 2150A019, 215OA020, 2150A021, 215OA022, 215OA024
DRAWN BY: KIRBY LAW FIRM, PLLC
RETURNED TO: KIRBY LAW FIRM, PLLC
Brief Leeal: Lots 17, 18,19, 20, 21, 22. 23 and 24, Fiddlers Cove
This deed, made and entered into this o t day of 2017, by and
between WILLIAM GARDNER DILLARD aka WILLIAM G. DILLARD aka WILLIAM
GARDNER-DILLARD JR. and wife RUBY CHARLOTTE KELLEY (mailing address: 114 W.
Peach Road, Winnsboro SC 29180), Grantor(s), and WILLIAM GARDNER DILLARD JR. and
wife RUBY CHARLOTTE KELLEY, Grantee(s),whose address is: 114 W. Peach Road,
Winnsboro SC 29180
WITNESSETH, that said Grantor, for and in consideration of valuable consideration paid by the
Grantee, the receipt of which is hereby acknowledged, has remised and released and by these presents
4 oes remise, release, convey and forever quitclaim unto the Grantee, his heirs and/or successors and
assigns, all right, title, claim and interest of the Grantor in and to a certain lot or parcel of land located
in the County of BRUNSWICK State of NORTH CAROLINA, more particularly described as
follows:
ikipg all of Lots 17, 18, 19, 20, 21, 22, 23 & 24 of Fiddlers Cove Subdivision, Section 1 as shown on
# revision map recorded in Map Cabinet K at Page 238 and Map Cabinet K at Page 337 of the
) runswick County Registry.
is the intent of the parties to combine the above mentioned properties into a single tract of land
winch is described by one (1) common boundary line for the purpose of complying with all applicable
ppyisions of the Brunswick County Zoning and Subdivision Ordinances; and,
T4 property herein conveyed is not the primary residence of the Grantor.
To have and to hold the aforesaid lot or parcel of land, together with all privileges and appurtenances
thereunto belonging to him, the Grantee, his heirs and/or successors and assigns, free and discharged
from all right, title, claim or interest of the Grantor or anyone claiming by, through or under him.
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.
In witness whereof the Grantor has hereunto set his hand and seal the day and year first above written.
RECEIVED
JUN 2 2 2018
_D - WILMZ*TON, NC

06-18-18
Date
State of North Carolina
Adjacent Property Owner
116 W. Jones St.
Mailing Address Raleigh, NC 27603
City, State, Zip Code
Dear Adjacent Property:
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This letter is to inform you that 1, William G. Dillard, Jr. have applied for a CAMA Minor
Property Owner
Permit on my property at 1948 Fiddlers Drive SW, Supply, NC in
COUNTY Property Address
Brunswick 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 oryou may sign and
return the enclosed no objection form. If you have any questions or comments about my proposed project,
please contact me at 803-718-6891 or by mail at the address listed below. Ifyou wish to
Applicant's Telephone
file written comments or objections with the Brunswick County CAMA Minor Permit Program, you may submit
them to:
Sincerely,
William D. Dillard, Jr.
Property Owner
114 W. Peach Rd.
Mailing Address
Winnsboro, SC 29180
City, State, Zip Code
Connie Marlowe
Brunswick County Planning Department
PO Box 249
Bolivia NC 28422
RECEIVED
JUN 2 2 2018
DCM WILMINGTON, NC

BRUNSWICK COUNTY HEALTH DEPARTMENT
DATE REC: 0912012017 FILE NO.: '1987014755A1 ZONING:
DILLARD WILLIAM G JR ETUX RUBY C $0.00 215oa024
REC. FROM AMT. PAID TAX PARCEL
114 WEST PEACH ROAD WINNSBORO SC 29180 8037186891
ADDRESS CITY STATE ZIP CODE PHONE
DILLARD WILLIAM G JR ETUX RUBY C 23 & 24
CURRENT PROPERTY OWNER LOT BLOCK SECTION
PROPERTY LOCATED TOWN/CITYlAREA: CO SUBDIVISION: FIDDLERS COVE
DIRECTIONS: i846XIDDLERS DR SW 28462
HWY 17 S TO HWY 130 S, RIGHT ON OXPEN, RIGHT ON FIDDLERS DRIVE
AUTHORIZATION FOR WASTEWATER CONSTRUCTION PT
NEW: REVISION: RELOCATION: LERII�IREPAIR: NOTES
g 360 gpd Septic Tank Size: t 'vi 5 TwC— Z� 1. Septic. Tank shall have an approved
Design Flow gal Type: effluent filler and access devices as
applicable.
No. Bedrooms: Y_ No. oc4nWemployees Max 2. Maintain all setbacks distances for
septic tank systems and wells.
�" 3. All components of the septic systems
Trench/Bed Bottom Depth: ��`Z 7 Inches: shall be located 100 feet from well.
/ t 4. An "Accepted" system may be used in
No. Lines: Length Each: tp Bed Dimensions: the place of a "conventional' system.
Fill Check:
Approved:
Date
Authorized Agent
❑ See the attached Site Plan for the wastewater
system location
PERMIT ISSUE DATE: 10 — t`Z — `l.-7
Permit Expiration Date:
/ h
(�+
— Z
Authorized Agent �c
Registration:
NOTE: PERMIT IS SUBJECT TO R15VOCATION IF
SITE PLANS OR THE INTENDED USE CHANGES.
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Waste Water System Installer. (Nit VOw"\ Dale:
Comments: (tank jnfolbarrier approved) tSCvaJ(� TAA/14
Rock: 7 Polystyrene gate Chamber- Other:
OPERATION PERMIT- t e- /! Date:
Authorized Agent Signature
Actions of local health department representitives or the State engaged in the evaluation and determination of measures required to effect compliance with the
applicable laws and rules shall in no way be taken as a warranty that sewage treatment and disposal systems approved and permitted will function in a satisfactory
manner for any given period of time. This insurance of Its permit does not preclude the Permittea from compioying with any and all statues, rules and regulations or
ordinancos which may be imposed by other government agencies (Ic _al state, and federal) which have jurisdiction.
RECEIVED
JUN 2 2 2W RECEIVED
DCM WILMINGTON, NC
JUN 10 2018