BC_18-10_ King (2)

Brunswick County
Local Government
CAMA
MINOR DEVELOPMENT
PERMIT
BC18.10
Permit Number
K`C�.
Coastal Management
ENVIRONMENTAL QUALITY
as authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission for development In an area of environmental
concern pursuant to Section 113A-118 of the General Statutes, "Coastal Area Management"
Issued to William Cale King, Jr., authorizing development in the Estuarine Shore Area of Environmental Concern (AEC) at
1310 Riverbend Drive SW in Shallotte NC 28470, as requested in the permittee's application package, dated 11-Jul-18
and received complete 12-Jul-18. This permit, issued on 23-Jul-18, 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: Sin41e Family Residence, 5' x 44' Paver Walkway, 10'x10' Open Deck and Fill Dirt.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on 11-Jul-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.
(Additional Permit Conditions on Page 2)
This perrmt 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.
RECEIVED
JUL 2 4 2018
C�NI'
Connie Marlowe
CAMA Local Permit Official
PO Box 249
Bolivia, NC 28422
C— q
PERMITTEE --
(Signature required if conditions above apply to permit)
DCM WILMINGTON, NC

Name: William Cole King, Jr.
Minor Permit # BC18-10
Date: 23-Jul-18
Page 2
(5) The amount of impervious surface shall not exceed 30% of the lot area within 75 feet of Normal High Water
(Estuarine Shoreline Area of Environmental Concern), in this case 375 square feet is authorized.
(6) Unless specifically allowed in 15A NCAC 07H-0209(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.
(7) 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.
(8) 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. This area shall be immediately vegetatively stabilized, and must
remain in a vegetated state.
(9) All other disturbed areas shall be vegetatively stabilized (planted and mulched) within 14 days of construction
completion.
SIGNATURE: U�-' Q-� C—— Q DATE: , Z3
PERMITTEE
RECEIVED
JUL 2 4 2018
DCM WILMINGTON, NC

. r r rs . ' �,:: � ,� y✓" G'ty�`� �.r n +K+S,A1cYs'wr,�,......�-p�. t � , Y'' �z i :'"� .'. � y$'.�a?''�ytil.!a � rn,, s ,
Locality Peim:tiruxuber s
Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Othera
For o cial us,e nl �
( �)� �3C�
. ,,.:a.�M'+W�:. z.r..0 �..,r.`;x�'�...c.:::�.±�....s_.ct,.�.r.�.>tk..y�.:.fri: ....�. �.. �,�1wr..'k.•.�;q�'.r+"`.'`�`''......1:. �.�ta ,.s.., a'.._, .: '. �s t? W_�."„'�Cd�±� .�v�..... r � %--:: �...� ._�Y"�! GENERAL INFORMATION
LAND OWNER
Name William Cole King Jr.
Address 4507 Pleasant Green Rd.
City
Durham
State NC Zip 27705 Phone
Email [e-mail]
AUTHORIZED AGENT
Name William Cole King III
Address 4477 Pleasnt Green Rd.
City
Durham
[phone]
State NC Zip 27705 Phone [phone]
Email [e-mail]
WCATION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront, what is the name of the
adjacent waterbody.) 1310 Riverbend Dr. SW Shallotte, NC 28470 / Shallotte River
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) Construction of new
single—family home ,57l(q y
SIZE OF LOT/PARCEL: 24,500 square feet ,56 acres
PROPOSED USE: Residential ®. (Single-family ® Multi -family C) ) Commercial/Industrial n 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: N/A 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: 375 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? RECEIVED
YES NO g
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: J U L 12 2 01 square feet.
DCM WILMINGTON, NCRECEIVED
JUL 1 1 1010

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)
I an owner or record title, Title is vested in William Cole Ring Jr. , see Deed Book 04028
page 0596 in the Brunswick County Registry of Deeds.
an owner by virtue of inheritance. Applicant is an heir to the estate of
probate was in i 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 fiirthermore 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) Rebecca S. Judge Trust of 2007 67 Frost Fish Hill North Chaths3m, mA0,.265C
(2) Riverbend Shallotte LLC 1306 Riverhend Dr SW Shallotte NC 28470
(3)
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 24th day of June , 20 18
(� w
Landowner or person authorized to act as hiAer agent for purpose of filing a CAMA permit application
This application includes: general information (this form), a site drawing ` lathe back of this application, the
ownership statement, the Ocean Hazard AEC Notice where necessary, a check or100.00 made payable to the locality, and
any information as may be provided orally by the applicant. The details of the appllclillrf described by these sources are
incorporated without reference in any permit which may be issued. Deviation from hese details will consttit�ute { j {ton of
any permit. Any person developing in an AEC without permit is subject to civil, criminal f6 arc tistratti- tiV a.
DCM WILMING Uf`� JUL 117018

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: William Cole Ring Jr.
Mailing Address:
Phone Number:
Email Address:
4507 Pleasant Green Rd.
Durham, NC 27705
[phone]
[e-mail]
I certify that I have authorized william Cole King III ,
Agent I Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
Construction of new single-family house.
at my property located at 1110 Ri.mrhenri Dr. SW Shallotte, NC 28470
in
Brunswick
County.
l 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 Cole King Jr.
Print or Type Name
Landowner
Title
06 / 24 / 2018
Date
This certification is valid through 06 / 24 / 2020
RECEIVED
iuL 12 2018
0CM WILMINGTON, NC

. 06[24118
Date
Riverbend Shallotte LLC
Adjacent Property, OWnot'
... 1306-Riverbend Dr. SW
Mailtry,AdOress
SU .11ofte. NC .28470
City] State; Zip Code
Dear Adjacent Property;
C3
M
0
co
M
Ir
E3
0
E3
C3
C3
Ln
I,--
C3
.n
r-1
0
rl-
This letter is to inform you that Ii, William Colt! Ring Jr. have appIIed'f9r,q CAMA,MInQr
Property,One,(
".-At jj10 !�Lv ll
Permit on my. omp _erbend Dr. SW Shaotte, NC 28470 in
ftwick
I Propeq..'Address
Coimty. As required by 0AW regulatibns, I have�%ClbsW:A copy of nly. -p.W , poLm0eq.-And pe6jbd
drewing(s) as notificatlo"'�Iy proposed project. No action is reqWred-ftqw" qr yop rr taytign, and r*,ro
0WeA*6ed no objectlorf, f* If yotf have any. qMlions of OMM"pttlpi3sedptgjsCe
oontact me at (919).819-8645 or by mail at the address listed. below. Ifypuvilla to,
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT
OVERNMENT CAMA Minor Pe(M#PrOgram, you may submit
btflit
them to:
.POAMF
Local Perm l(Offldoft.01 CAL G.OVERNMF-NT
LOCAL 00M, NMENT AUDRE83
CITY, STATE, ZIP CODE
Sincerely,
William Cole Ring Jr.
Property Owner
4507 Pleasant Green IK4.
Mailing Address,
Durham. NC, 2Z705.
Cit � y, State, ZIpCqde
RECEIVED
JUL 12 2018
DCM WILMINGTON, NC
U7—

°GIs
a� Brunswick County Health Services
2i Courthouse Drive N.F.: Pot Office Bo-, 9
Bolivia. ?forth Carolina 28422-0009
r?nr cAeo910-2{ 3 __2 50 1-833-4 _' 8— t 429 Public ►icaldf
DOVid 11. Shilderi71, Erecurire DAec:or
Health and Humun Services _4gencl
Site Plan For (Check One): Improvement Permit
D Well Permit
Date: 71q[(t
BCHS #: 2017073045
Tax Parcel #: 2300001101
criv Harrelson, Direc;or
D"rintent gfHealth Sen tees
0 Fill Plan Authorization to Construct Permit
0 Proposal
�l G
REHS Signatu
*SITE PLAN ONLY. THIS IS NOT A PERMIT*

Shallotte River
�0 `yd' Aj F`ti
34
1
So' w
O � � o
00'
u 'O • P� N �
C OY4 fl6 C b
+ + .
� d. _ Ce�F0.Ev 5•
0 ` ST oo� y
.p J P 10 'TA Nw
yW 2.S o v
y N+
• � r4
i1 •
Aj
N •
l
q
Y
V
o /
l V 60
Property Owner: William Cole-iCing Jr.
Property Address: 1310 Rk rbend Dr. SW
S1tgdlotte, NC 28470 4
O
Dated: 06/24/18 b EIVED
Scale: 1/16" - 1.9 ft. N N220�3 JUL 12 2018
Impervious Surface = 375 SF -
__ DCM WILMINGTON, NC

0

Shallotte River
o
E/ d hj
55 A 4,
N
4-4
In O OPEN N
+ D6clG / { 0 H
10' 0 Y 7 N bD
C Od �jED
x
�+ °i
O P4
+ + ..
r{� '1.C-t �1ov5� �
,;.a� tia^5 N
- I5•
F- d C„gGREfl
,gyp O Gr 10• gCCov AN,
+
H : 5 S?IT'S G
y dJ �'2�.�-Q •,
N • .y
} ,Ho`.X L1 1b i
d u
•� � �-- Kai.
RECEIVED
" 63 r�
Property Owner: William COLA -King Jr. N �✓"
Property Address: 1310 nVlii rbend Dr. SW JUL 12 201
3itt�lotte, NC 28470 a
Dated: 06/24/18
p RI�IINGTON, NC
Scale: 1/16" - 1.9 ft. w 22°033 RE'l.t:NE
Impervious Surface = 375 SF JUL 11 2018

IMPERVIOUS SURFACE CALCULATIONS
19 x 10 = 190 x .50 = 95 SF - Covered Porch
10 x 10 = 100 x .60 = 60 SF — Open Deck
55 x 04 = 220 SF - Paver Walkway
095.00
060.00
+ 220.00
375.00 Total Square Feet of Impervious Surface
RECEIVED
JUL 12 2018
DCM WILMINGTON, NC

24/18
Date
Rebecca S. Judge Trust of 2007
Ad.9ceht'Property Offer
67 Frost Fish Hill
Mailing Address
North Chatham, MA 02650
City, State, Zip Code
Dear Adjacent Property:
-• Domestic Mail Only
For delivery 1rNormatior
Codified Fee
O
O
Retum Receipt Fee
C3
(Endorsement Required)
O
Restricted Delivery Fee
(Endorsement Required)
oru
$Q.
r.q
Total Postage & Fees
ru
t,
U E
,_i7rl 4
i C
$il,l:i+j 1
II Postmark
Here
0_1
06/25/2018
J dJM IU
�-S'lreet&Apt No., — — ---------------------•----•----•• ..
M1 or PO 9ox No.------ (.-I
-- Fr V S..•' - T' ;. 1 --- -----------
City State, ZIP+4
This letter is to inform you that I,- William Cole Bing Jr. have applied for a 0t1N�j�uljnor
Property Owner
Brunswick
Permit on mypropeay at _;1310 Riverbend Dr. SWr>Shallotte, NC 28470 , in COUNTY
Property Address --
A regulations, I have etidlosed avpyofmy permit application and Project
County, As requlredby-C�
drawing(s) as notificationoi:"iny proposed project. No action is: required'from you or you may- sign ang return
the enclosed no objection tmjf you have any questions or comments aboilt my proposed project;, pie,
cohtact me at [phone] ,or by mail at the address listed below. Ifyouwjsh to:
ApplieanftTelephone
file written commehl bt (tons with the LOCAL 00t.PRNNff'fiItM1'prtt"Y,:Yomaystibrlt
them: to:
tPO NAME
W4' t (ft r srt t VER1 M iJ'f
LOCAL GOVERNMENT ADDRESS
E't ,S't'i6cIL-AP CODE
Sincerely,
William Cole King Jr.
Propetmer
4507 Pleasant Green
Mailing Address
Dunham _NC 27705
City; State, Zip code
RECEIVED
JUL 12 2018
DCM WILMINGTON, NC

r su4 -coo tv. � Racist*,
ci st* r0 ands Ii, C3esorro ,iPRROP Brunsr�ek County. tIC Reuistar of Deeds eaw 1 of 2
Brand- N. Clamso Register of needs
03-15-2018 10:48:18,000 arunwlck County, NC
NC REMUE STAM,: $728.08 (#573471)
Tatum to �'V Tytte
Total Rav__ Int.
Ck $ Ck M Cash $
�Refund ash Fhance
13 Portions of document are Illegible due to condition
of onginai.
The attorney preparing this instrument has made no record 13 Document contains soals vented by a 4r nai
search or title examination as to the property herein instrument that cannot be roProduced or copiec
described, unless the stone is shown by his written and
signed certificate. wingvwr tbw3, IF cty-)� f to
'of paid bu0C15lrq aV"(U.LA.
Excise Tax $720.00 Recording: Time, Book and Page
Tax Parcel Identifier No.: 2300001101
Return to:
Prepared by: Biberstein & Nunalee, Attorneys at Law, P. O. Box 428, Burgaw, NC 28425.
Brief Dese. for the Index I Lot #5 MB 9l117
THIS PROPERTY IS ❑ OR IS NOT X THE GRANTOR'S PRINCIPAL RESIDENCE.
NORTH CAROLINA GENERAL WARRANTY DEED
THIS DEED made thisrdday of March, 2018 by and between:
GRANTOR GRANTEE
Arthur INC Rogers, Jr. and wife, Gwen C. Rogers William Cole King, Jr. and wife, Paula Booth King
590 Red Fox Trail U�-:M PteasanrGf&n Qd
Hampstead, NC 28443 D W `)ck: 'fl IOC Z- )O!E
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, that the Grantor, for a 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 that certain
lot or parcel of land situated in Brunswick County, North Carolina and more particularly described as follows:
Being all of Lot #5, as shown on a map entitled "Map of Survey for McKee C. & John 1. Pigott", dated Nov.
21, 1969 and recorded in the office of the Register of Deeds for Brunswick County, North Carolina in Map
Book 9 at Page 117.
The property hereinabove described was acquired by Grantor by instrument recorded in Book 1406, Page 427 of the
Brunswick County Registry.
RECEIVED
JUL 12 2018
DCM WILMINGTON, NC

I�IIt1�6IIJI�I�IlII'�IUIr Brend M. el 0 me PROP
e'.
irrcc nnnnnn papal of 2
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 sirrrple, 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:
1. Restrictions of record.
2. Ad valorem taxes for the year 2018.
3. Routine utility easements and highway rights of way.
IN WITNESS WHEREOF, the Grantor has hereunto set his hand and seal, or if corporate, has caused this
instrument to be signed in its corporate name by its duly authorized officers, the day and year first above written.
JAg R &4
(SEAL)
Arthur M. Rogers, Jr.
Co
lip
Gwen C. Rogers
STATE OF NORTH CAROLINA
COUNTY O PENDER
I, y iVJC_, a Notary Public in and for the aforesaid County and State, do hereby certify that
Arthur M. Rogers, Jr. and Gwen C. Rogers personally appeared before me this day and acknowledged to me that he/she
voluntarily signed the foregoing document for the purpose stated therein.
Witness my hand and notarial seal this theay of March, 2018. wuma
Notary Public NOTARY
My Commission Expires: �(,iv ck/ a Olg Q PUBLIC
F:%WS COREL 8 F1LES1 JI MEEDS 2018TJNG.ROGERS.DOCX
RECEIVED
ML 12 2018
JCMi WILMINGTON, NC

File No.: 2017073045
BRUNSWICK COUNTY HEALTH SERVICES
Post Office Box 9 BOLIVIA, NC 28422 [phone]
IMPROVEMENT PERMIT
Type:
PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE
An Authorization for Wastewater Construction must be attached to the Improvement Permit before an
other permit can be issued and before a wastewater system can be installed
Supporting documents such as the completed application form, site evaluation form, fill plan, etc. are considered
a part of the Improvement Permit.
Owner's Name' ROGERS ARTHUR M JR ET GWEN C Tax Parcel 2300001101
Lot s: 5 Block:
Residential: Water Supply:
Sec SUBDIVISION
Private (well) Public X
No. of units: � No. of bedrooms L_ No. of occupants
Commercial: Type of business: No. of Employees:
Size of septic tank: /e00 LTAR: /, C) gpd/sq.ft. Drainfield sq. feet: 3e0n
I
No. of Lines: 3 Length ea.: Trench width 3 Bed : A/V� Design Flow gpd:
Trench/ Bed bottom depth no deeper than: 6' L inches Pump tank volume: AA
(if applicable)
If applicable, the following conditions must be met prior to issuance of an Authorization for Wastewater
Construction and prior to wastewater system installation.
X Keep 100 feet from all water supplies (minimum of 50 feet must be maintained).
X Keep 10 feet from all water lines .
X Keep 10 feet from any property lines (no less than 5 feet for lots recorded prior to 7/1/77)
X Do not drive over, park, pave, or build any structure over the area for the septic tank system and the repair
area if applicable.
X Do not install the septic system during wet conditions.
X Maintain Gravity Flow for septic system,
Drainage Maintenance Required.
Suitable Fill material must be installed exactly per the Health Services Department approved fill plan.
Fill check must be completed by the Health Services prior to issue of Authorization for
Wastewater Construction Permit.
Approved for use of Altemative/Innovative Wastewater System (Specify)
_ Submit Wastewater plans to the Health Services for review/approval
X If Septic System Uses Rock Aggregate/Approved Filter Fabric Covering Required
X Septic Tank System must be installed per the Construction Authorization Permit.
X An "accepted' system may be used in the place of a "conventional" System_
X Submit approved storm water plans i applicable.
X Repair Area: 2 /.)r--3 -S: I
See the attached Site Plan for the wastewater system location
IMPROVEMENT PERMIT ISSUANCE DATE: 71,10 If— — EXPIRATION
This permit expires 60 months from the date of issuance unless o h�pecified
Permit Not Valid Unless Si
cLned by Authorized Agent:
Signatur
Actions of Brunswick County Health Services representatives 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. Permit Is subject to revocation If the site
plan or plat whichever is applicable, or the intended use changes.
The issuance of this permit does not preclude the Permittee from complying with any and all statutes, rules, regulations, or ordinances which may
be imposed by other government agencies (local, state, and federal) which have jurisdiction.
SEPTIC TANKS SHALL HAVE AN APPROVED EFFLUENT FILTER & ACCESS DEVICES
Rev: 04/10/13, REV 04/2016
Updated 01/08/2008

BRUNSWICK COUNTY HEALTH DEPARTMENT
DATE REC: 12/21/2017 FILE NO.: 2017073045 ZONING:
ROGERS ARTHUR $0.00 2300001101
REC. FROM AMT, PAID TAX PARCEL
590 RED FOX TRAIL HAMPSTEAD NC 28443 9103981035
ADDRESS CITY STATE
ZIP CODE PHONE
ROGERS ARTHUR M JR ET GWEN C
CURRENT PROPERTY OWNER
5
LOT BLOCK SECTION
PROPERTY LOCATED TOWN/CITY/AREA: CO SUBDIVISION:
DIRECTIONS: 1310 RIVERBEND OR SW 28470
17S TO VILLAGE POINT RD TO HOLDEN BEACH RD TO RIVERBEND ON L
AUTHORIZATION FOR WASTEWER CONSTRUCTION PERMIT
NEW: REVISION:
,/ RELOCATION: REPAIR: NOTES
Design Flow: 41, *,O gpd Septic Tank Size: �00 V T 1 • Septic Tank shell have an approved
gal Type: 3G effluent filter and access devices as
applicable.
No. Bedrooms: No. o cy ants/employees g Max 2. Maintain all setbacks distances for
„ septic tank systems and wells.
Trench/Bed Bottom Depth: Inches: 3. All components of the septic systems
shall be located 100 feet from well.
No. Lines: 3 v 4. An "Accepted' system may be used in
Length Each: y r� Bed Dimensions: the place of a "conventional* system.
Fill Check Approved:
Date Authorized Agent
ee the attached Site Plan for the wastewater system location
PERMIT ISSUE DATE: / O (8 Permit Expiration Date:
Authorized Agent: Registration: ZCi�
NOTE: PERMIT IS SUBJECT TO REVOCAfTON IF SITE PLANS OR THE INTENDED USE CHANGES
e 05C 0t' Poc t'b iYA�=,.�� 0")L, y
• Ina�atl f-cenc� l?" 4+ tdca4,,o,. ® -to /e,tt q 0
? 50' io cor wear lo' +0 Vj"*(- Gnies
C)V +A.' otRr s�src�-
R�;�qt< 1 s ZI' -4r3S' �P-d syr4e1-k
A5°la geppvcTv„v -wcAl
Waste Water System Installer: Date:
Comments: (tank info/ barrier approved)
Rock: Polystyrene Aggregate Chamber Other:
OPERATION PERMIT- 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 tis permit does not preclude the Permittee from comploying with any and all statues, rules and regulations or
ordinances which may be imposed by other government agencies ( local state, and federal) which have jurisdiction.

U_ t� --lo
Brunswick County Planning Department
P.O. Box 249
75 Courthouse Drive N.E., Bldg I
Bolivia NC 28422
VIA EMAIL
12-Jul-18
William Cole King, Jr.
4507 Pleasant Green Road
Durham NC 27705
RE: Incomplete Application — Additional Information Requested
Project Address: 1310 Riverbend Drive SW, Shallotte NC 28470
Dear Mr. Cole:
We originally accepted your application under the impression that it was complete. On
subsequent review, I 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. Please provide a copy of the approved on -site wastewater system permit (septic permit);
and
2. Please provide a revised site plan indicating the distance the proposed structures will be
located from the front yard.
Upon submission of a complete application, a local decision will be made in 12 days after the
approved on -site wastewater system permit (septic permit) has been received, provided this
period is not extended as provided by law.
Please contact me at 910.253.2034 if you have any questions.
Respectfully submitted,
eoKK;i IffawaWe RECEIVED
Connie Marlowe, LPO JUL 12
C: Patrick Amico, Wilmington Field Representative E)CM WILMINGTON, NC
TELEPHONE [phone] • [phone] • FAX [phone]