BC_18-16_ Vignola (2)

LP- 5.s- 22
AMW
Brunswick County
Local Government
CAMA
MINOR DEVELOPMENT
PERMIT
as authorized by the State of flort>h 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"
FctnnrinP Slhnrr
BC18.16
Permit Number
NORTH CAROLINA
Errvironmeniul Quality
Issued to Philip & Bambi Vignola authorizing development in the Geeaft+4zef4Area of Environmental Concern (AEC) at
3828 Courtenay Drive SW in Supply NC 28462 as requested in the permittee's application package, dated 18-Jun-18,
and received complete 27-Auq-18. This permit, issued on 07-Sep-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: Inground Pool with paver decking, 4' fence and concrete stone steps.
(1)
(2)
(3)
(4)
All proposed development and associated construction must be done in accordance with the permitted work plat drawings(s)
dated received on 27-Aug-18.
All construction must conform to the KC. Building Code requirements and all other local, State and Federal regulations,
applicable local ordinances and FEMA Flood Regulations.
Any change or changes in the plans for development, construction, or land use activities will require a re-evaluation and
modification of this permit.
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, 2021
RECEIVE
MAR 0 4 2019
DCM WILMINGTON, NC
ON.-L" N vl�_
Connie Marlowe
CAMA LOCAL PERMIT OFFICIAL
PO Box 249
Bolivia, NC 28422
In issuing this permit r! 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 ERMITTEE
Management.
(Signature required if conditions above apply 10 permit)

Name: Philip & Bambi Vignola
Minor Permit # BC18-16
Date: 07-Sep-18
Page 2
(5) The amount of impervious service shall not exceed 30% of the lot area within 75 feet of Normal High Water
(Estuarine Shoreline Area of Environmental Concern), in this case 1 0 Pervious Pavers 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 properly 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.
RECEIVED
MAR 0 4 2019
DCM WILMINGTON, NC
SIGNATURE: DATE; �b-f
ERMITTE

Brunswick County
Local Government
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"
BC18.16
Permit Number
NORTH CAROLINA
F_nvironmental Quality
Issued to Philip & Bambi Vignola authorizing development in a Ocean Hazard Are f Environmental Concern (AEC) at
3828 Courtenay Drive SW in Supply NC 28462 as requested s application package, dated 18-Jun-18,
and received complete 27-Aug-18. This permit, issued on 07-Sep-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: Inground Pool with paver decking, 4' fence and concrete stone steps.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat drawings(s)
dated received on 27-Aug-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
(Additional Permit Conditions on Page 2) DCIV WILMINGTON, NC
SEP262018
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.
CA-Z' N adYWIL-
Connie Marlowe
CAMA LOCAL PERMIT OFFICIAL
PO Box 249
Bolivia, NC 28422
PERMITTEE
(Signature required if conditions above apply to permit)

Name: Philip & Bambi Vignola
Minor Permit # BC18-16
Date: 07-Sep-18
Page 2
(5) The amount of impervious service shall not exceed 30% of the lot area within 75 feet of Normal High Water
(Estuarine Shoreline Area of Environmental Concern), in this case 1,000 (Pervious Pavers i square feet is
authorized.
(6) Unless specifically allowed in 15A NCAC 07H-0209(d)(10), and shown on the permitted plan drawing, all
develop ment/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 properly 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:
RECEIVED
DGM WILMINGTON, NC
DATE:
SEP262018
PERMITTEE

Locality- Bro-risWc
Permit Number��
Ocean Hazard Estuarine Shoreline V OIlw Shoreline y�-P� Public Trust Shoreline Other
(For official use only) I &w PG..YCx,1 _43ZA!3&
a
LAND OWNER
Name' 1��. "�P►r-,. t� �,! G, wso
Address
City
�"z a State %. L Zip ZS 09-1 Phone 5 \(— S ` 4, t < i-
Email `��tCos-�c,�.A Toe-�oLA(-,�oU� .Corn -
AUTHORIZED AGENT
Name EF (= P� sc�skc5
Address 4k' -7 "—") L '--
City `J..>cv `f State V- X - Zip Z` 40Z Phone I=) th Z 63 -- Q t(0 6 �
Email
LOCATION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront, what is the name of the
adjacentwaterbody.) 2� cc��-'QTc^' ( '�R'
DESCRIPTION OF PROJECT: (List all Dronosed construction and land disturbance.)' �A Poo,-,
SIZE OF LOT/PARCEL: � 3 square feet acres
17 o q
PROPOSED USE: Residential 2�- (Single-family ❑ Multi -family ❑ ) Commercial/Industrial n Other ❑
COMPLETE EITHER (1) OR (2) BELOW (Contact your Local Permit Officer ifyou are not sure which AECapplies
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: 000ot-square feet (includes the area of the roof/drip line of all buildings, driveways, covered decks,
patios, etc. that are within the applicable AEC. Attach your calculations with the project drawing.)
concrete or masorl�
NAV,a,,s v tz,5 �*[lS(tv�c, L*.QrQv �a • tr� '
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 tot or parcel: 5 squam RECEIVED et.
RECEIVED
AUG 2 7 7018 AUG 2 8 M'3
DCM WILMINGTON, NC

ti
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:
1, 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���� l�►r , see Deed Book O 4-y ic'Z
page 1 in the ''k'>Qa.-Sw� caIL 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 giver,
ACTUAL. NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name)
(Address)
4'�PP cL tit t
(1) �E.-,.... t�?. Ftit�tlE3FktCA �o��ree..s 2Z3 '�siP�rceoP<c�! �'O. C + *.tL
(2) I'^��E SCo�R t�.cEF Zl lr�QtZC�A�V�s �r.�A'� �.Jo(ttzxtL ,ice a2C3Si.
ACKNOWLEDGEMENTS:
1, 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 Ianda a connection with. evaluating information
related to this permit application.
This the t day of �� �' , 20 l '
Q_'O
Landowner or person autiiod2bd to act as hV/her agent for purpose of filing a CAMA permit application
This application includes: general information (this form), a site drawing as described on the back of this application, the
ownership statement, the Ocean Hazard AEC Notice where necessary, a check for $100.00 made payable to the locality, and
any information as may be provided orally by the applicant. The details of the application as described by these sources are
incorporated without reference in any permit which may be issued. Deviation from these details will constitute a violation o
any permit. Any person developing in an AEC without permit is subject to civil, criminal and administrative actio+EI
AUG 2 7 2018

Name of ftroperty Owner Requesting Permit
Mailing Address:
O -I
Phone Number: ` 91 o - t 4--
Email Address:
1 certify that I have authorized �0�•--3 yolk
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all LAMA permits
necessary for the following proposed development: L 6,- ctr--
S w i raw. o: 4c oti !Z�L A --C^l �7- Cam,
at my property located at _'2- 8 2 8 C�a ��r�--�o'c Vtz •ice t. ]c, z9. y Z,
in `�(L�,�s��cK- County.
I furthermore certify that i am authorized to grant, and do' Pre 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 infatuation:
rt
Lff�
Data
This certification is valid through 'I I \ S i \`)
RECEIVED
AUG 2 8 2018

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RECEIVED AUG 2 8 ?018
AUG 2 7 2018
DCM WILMINGTON, NC

July 18, 2018
Marie Scola Trustee
21 Margauvs Way
Norfolk, MA 02056
This letter is to inform you that I have applied for a CAMA Permit on property at
3828 Courtenay Dr., in Brunswick County, town of Supply, N.C. and owned by Philip
& Bambi Vignola. 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 Coastal
Representative listed below. No response within ten (10) days is the same as no
objection when you have been notified by Certified Mail.
Connie Marlowe
Brunswick County Government Complex
P.O. Box 249
Bolivia, NC 28422
Sincerely,
Jeff Vanjoske
[phone]
L
rq ' Domestic Mail Only
M .
0 Certlfled Mail Fes S3 ¢r 0459
o $ ��
Extra rvfces 3 eeS (check bnr, add lac
17-1 0 Return Receipt (hwdk py) $ 1 i
E-3 ❑ Return Receipt {eleeaanlc) n $0 i11T 1 Postmark
Co C1Ceritflad Mal Restrlcted Delivery $ _t () Here
[I Adult Signature ReGUGad $
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�Total Postage and Fees 1�7��1 ��(ti
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C3 '`heat andApt: No.,- of ptl Ffoz No:
Glty, 5tate,�lP+4s---•- ---•-- - - �,���
, MN
AUG 2 $ H18
DC;M WiLIAING T ON, NC

J4y 18, 2018
Kenneth & Barbara Bollen
223 Stagecoach Rd.
Chapel Hill, NC 27514
This letter is to inform you that I have applied for a CAMA Permit on property at
3828 Courtenay Dr., in Brunswick County, town of Supply, N.C. and owned by Philip
& Bambi Vignola. 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 Coastal
Representative listed below. No response within ten (10) days is the same as no
objection when you have been notif ied by Certified Mail.
Connie Marlowe
Brunswick County Government Complex
P.O. Box 249
Bolivia, NC 28422
Sincerely,
A
Jeff Van joske
[phone]
EC33
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Domestic Mail Only
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1HrL rl0 L U S E
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',t1�-,2711A
Certified Ma' Fee 43.45 0459
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Total Postage and r6 s9 5 07/21/2018
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RECEIVED
AUG 2 8 2018
DCM WILMINGTON, NC

Ilflllillfll[Ilf fl�llllllltll!!I!I!I e � Pml 16:57 36.One
Brunswick County, NC Register of �dy' cloomem PROP
Thia owliPos t�=#,.PT3 are no d r�ncuam ad Brenda R. Clemens Register of 0 Pogo
1 of 6
vik-nomtaxed, fees, awessments or othor 06-13-2018 15:57:3e.Me Brunswick County, NC
Unswhich the Brunswick
O�County Tax NC REVENUE STA11P: $1752,09 (p5a7099)
Ion: Parcez-ator is l Nuumdberp�J t a( a
so notated by the Brunswick County *('
ype
Asmssor's Office. 'tads Is not a cerfifloc9on ietum toId
MA thee pare-$ number
/matches the dosd Totaf _ RashCk
it Refund Cash$ Flnance
Dada (Awl) -kK (M.1 Dsi. TitgleC. G Porticns of document are illegible due to condition
of original.
130ocument contains seals varifled by original
instrument that cennet be reproduced or cope'
Excise Tax: $ Parcel Identifier No.2331AO66
Prepared by: James R. Prevatte, Jr., (tm)
P.O. Box 10969
Southport, NC 28461
Return to: THE WEBSTER LAW FIRM, P.C.
Brief Description for the Index: LOT 383, SECTION A, PHASE TWO, (LOT "P2-A-383"),
MARINA VILLAGE OF SEASCAPE AT HOLDEN PLANTATION
NORTH CAROLINA GENERAL WARRANTY DEED
THIS DEED made this day of Jtme, 2018 by and between
GRANTOR GRANTEE
PAUL GREGORY MYERS, and wife, PHILIP A. VIGNOLA, and wife,
MARY S. MYERS BAMBI L. VIGNOLA
7108 Horseman Court 4735 Reynolds Parkway
Summerfield, NC 27358 Boone, NC 28607
"THIS INSTRUMENT PREPARED BY: JAMES R. PREVATTE, JR., 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 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
RECEIVED
AUG 2 8 2018
DCM WILMINGTON, NC

NIIII�[IlIN�IIIIIIIiIIlIIIflINI L7!11,2-156'7�30,'00arun"ick aunty, Riter of Dpaga 2 of 6
W ITNESSETH:
THAT said GRANTORS, for a valuable consideration paid by the GRANTEES, the receipt of
which is hereby acknowledged, have and by these presents do grant, bargain, sell and convey to
the Grantees in fee simple, that certain lot or parcel of land situated in Brunswick County, North
Carolina, and more particularly described as follows:
SEE EXHIBIT W, ATTACHED HERETO AND INCORPORATED HEREIN BY
REFERENCE.
Reference is also made to deed recorded in Book 3531, Page 0734, and Book 3657, Page 297
Brunswick County Registry.
o If this box is checked, subject property is permanent residence of one or more Gramm.
TO HAVE AND TO HOLD the above described tract or parcel of land, together with all
privileges and appurtenances thereunto belonging, unto the said Grantees, their heirs and assigns,
to the only use and behoof of Grantees and their said heirs and assigns, FOREVER.
AND said Grantors covenant to and with said Grantees that they are seized of the property
in fee simple and have the right to convey the same in fee simple; that the title is marketable and
free and clear of all encumbrances, and that they do hereby and will forever warrant and defend
title to the same against the lawful claims of all persons whomsoever.
RECEIVE,)
AUG 2 8 2018
DCM W"MINGTON, NC

IIIIIIN1111�11(lilllll(� I�IIIII� � � Pia5 �� 38 Pam
Brunswick County, N epister of Deeds paps 6 of 6
EXHIBIT_ "Cn
!?Bdlif Fr7tLD' Aa++ �er.�•.a.• • Wee A. -cement across and made the tract or parcel of land ahoun or
deaorib.d on Bxhibit no attached hereto tthe 'Drain Field parcel.) for
purPOlN of ingress wed egreN, ryatm installation, operative, maintenance,
monitoring sad repairs of nodaagtuuu.d .epti. ayStwe drain liras, sad
and other ftQuipment related tserstn, u nsoeesary to provide affette lawag Pump.
disposal to serve the Boamaite, together with a-ven-exclueiw saaeseM anzou
sad under the oul-de-lam of C== = Drina and Clntrtemay Drive of 20, 1n width axtebding in a nortberly direction along Court®ay Drive sa shorn n the map hereinafter referenced to the Point -bare said mae—art, turns in a
westerly direction and fgllowe the northern property Tine of lot 387 and the
southern Property lima of Leta 3s& and Sae, Phase 2, to the point of
oonmctive with the vested! property line of Lot D2-A-3s7 and 92-A-365 to t2i.
point of eo csrtioc With the draiDfield parcel, es abavn oa a plat recorded in
Map Cabinet 27 at PAt 377, Brunswick Canty Aegiatzy, for
and egress, iretallaticnI operacim. maintenance, a —It— purposes re of ,morass
wastewater el. +rod regain of a
har.ia omo Pips free the Bomasite to than Drain Field parcel. The aasamenta
vayad ere eubjeee to the following terms and conditlama,
1. Theca eeewents are dPP=tsoact to and shall run with the title to the
Boaesite and my not be conveyed separate from the Banmaite.
2. These easemesta are aoamoalulive and Shall not preclude any other uses. of
the burdened pttparty that do not Sntrrfere with the petpome. of said
easements.
3. A11 piPbff,,lime, Pumps and other equipment installed vithin theca
sasaments to serve the ff—site aba11 be mintaizod by. and at the
expense of, um
the owner of the Bosite ins good condition and in compliance
with all applieabls laws, rules and regulatioom of the state of Borth
Carolina, the Brunswick County Health Department, and say other '
governmental authority, The owner of the 6onaalte shall repair any
damage to the land subject to said easements, sad any lmproveamnta
located thereum, resDltiay from the use of said "we,,cts.
a. SQAS4Pa At 8oldan Plantation, run., or any Ouoceseor owmar of the Drain
Field Parcel, shall haw the right at any tiros to terminate the easement
herein granted on the Drain Field Parcel by causing a replacement ameage
disposal system for the Bon i" to be installed en another Parcel other
than the Drain Field Parcel and/or on the Brnasite itself; provided that
(A) snob owner of the Drain Field Parcel shall obtain all required
parait. and aPpzavals for the replacement system, pay all s.p—.x of
Ouch installation and pcovide easements for all portions of the
replacement Oystam not located ='the Bomesite ar within an existing
eaaemaot, all at on cost to the owner of the 8aesita and lb) the
sapluement system or any Portions thereof located on the 8osecite ahall
le installed To
A manner that does not prevent the construction of a
typical elan dwelling on the Homasite. The easement on the Drain Plaid
Parcel shall automatically terminated and be of ao further force or
effect upon the completion of imtellative at tba replecsmaat eyetem,
Dpeo or at airy time after such automatic torminatim, the owner of the
Hoassits aball execute and deliver In recordable form such tarmiaationm,
quitclaims ar release instruments as may be requested by the owner of the
Drain Field Parcel or any other land subject to the aaesments granted
herein that are not needed for the replaoameat eyet—.
S. Theme nansmente aball automatically terminate and be of no further force
or affect upon completion of eoaatzuctimu of A public, county, regionel,
cma miry or other central vastewataz eaa treatt or sewag* systm that is
available to serve the Bomesite, The owner of the Bwnssit. shall be
responsible for any tap fee or other coat to connect the BammSite to _on
System. Up— or at sty ties after such automatic tatmination, the —at
of the Bpeesite shall easccte and deliver in recordable form such
terminations, quitclaima Or release imtmnmeots as may be requested by
.
say owner of say p— ion of the lead subject to said easement._
By acceptance of these saaemants, the grantee *grew, for the grentas and
the great-1. hairs, aceoesaou0 and assigns, to abide by and comply with all
of the terms and Conditions act forth shove.
RECEIVED
AUG 2 S 2018
DCM WILMINGTON, NC

flllllal(II 111{Illllll lllq>'�il111 64 7 Pi@85 IS:57 381e,
Brunswick County, MC Reglstor of Dodds pops 6 of 6
EXHIBIT "B"
BEING all of that area designated as "Off Site Sanitary Sewer Field Distribution Area Serving Lot
P2-A-383" as more particularly described in a survey plat dated August 16, 2002, revised March 4,
2003, entitled "Plat of Revised Easement Survey for Off Site Sanitary Sewer Fields for Lot P2-A-382
and P2-A-383, ScaScape at Holden Plantation", prepared by Thomas W. Morgan, R.L.S., and
recorded in Map Cabinet27 at Page 377 in the Office of the Register of Deeds for Brunswick County,
North Carolina, to which plat reference is hereby made and which is incorporated herein for greater
certainty of description of said property.
RECEIVED
AUG 2 8 2018
DCM WILMINGTON, NC

IIIIIIII I II IIIII f Illi III IIIIIII III B4a61 PM, C4aaans 39�PROP
Brunswick County, Reglstar of Deeds page 4 of 6
EXHIBIT "A"
BEING all of Lot 383, Section A, Phase Two (Lot "P2-A-383") Marina Village of SeaScape at Holden
Plantation, as shown on a plat thereof dated January 15, 2001, and as revised February 23, 2001,
prepared by Thomas W. Morgan, R.L.S., a copy of the plat of which is duly recorded in Map Cabinet
24 at Pages 38, 38, and 39 in the Office of the Register of Deeds for Brunswick County, North
Carolina, to which plat reference is hereby made and which is incorporated herein for greater
certainty of description of said property.
TOGETHER WITH OFFSITE DRAIN FIELD AND CONNECTING LINE EASEMENTS AS
DESCRIBED ON Exhibit "B" and "C" attached hereto and incorporated herein by reference.
RECEIVED
AUG 2 8 2018
DCM WILMINGTON, NC

II1i1811IIIIIIINII II 'K6m 919tor of Deeds page 3 ofeRoPhIII�
IN TESTIMONY WHEREOF, said Grantors has hereunto set their hands and seals, the
day and year first above written.
(SEAL)
PAUL GRE O Y YERS
(SEAL)
MAR RS
STATE OF NORTH CAROLINA
COUNTY OF
I, �trv.r�a 1s, �N\W&yy$ . Notary Public for said County and State, do
hereby certify that Paul Gregory Myers and wife, Vary S. Myers either being personally known to
me or proven by satisfactory evidence, personally appeared before me this day and acknowledged the
due execution of the foregoing instrument.
Witness my hand and official seal, this the fO� _ day of June, 2019.
AMIktONYA 0 WIIWM�
Notary Pt'c, North Carolina
Rockmyham Coumv
(4p� g.on EYpnas
m"tiY, 13.2020
My commission expires: \l\\S12-02�0
NOTAkY PUBLIC
RECEIVED
AUG 2 S 2018
DCM WILMINGTON, NC

Brunswick County Health Department BCHD # -A 73
Environmental Health Section
Wastewater Collection, Treatment
and Subsurface Disposal System
OPERATION PERMIT
In accordance with the provisions of Article 1 l of Chapter 130A, General Statutes of
North Carolina 15A NCAC 18A.1900 et seq., and other applicable Laws and Rules as amended,
PERMISSION ISj HEREBY GRANTED TO:
Owner W j Lu AM Coo K
Address 151 4P5 N E STK CET
___DDVEK , NA A 0,520.30
FOR THE
operation of a 360 GPD wastewater collection, treatment and disposal system
WHICH SHALL SERVE: A Three Bedroom Single Family Residence
LOCATED: Lot # 383 Seascape at Holden Plantation
Tax Map Reference 2331AO66
GIS Location _3828 Courtney Drive SW
with no discharge of wastes to the ground surface or surface waters p to 15A NCAC 18A section.
19000 et seq. -Laws and Rules for Sanitary Sewage Collection Treatment, and Disposal
[Hereinafter "Laws and Rules"] and in conformity with the project plans, specifications, and
other supporting data subsequently filed and approved by the Department of Environment,
Health, and Natural Resources and/or the Brunswick County Health Department (BCHD) and
considered part of this permit
The wastewater collection treatment, and disposal system ["the system" or "the facility"] as
described in the Improvements Permit and accompanying data.
The system is classified as a TYPE 4A Wastewater Treatment and Disposal System in
accordance with 15 NCAC 18A.1961
The Owner shall be subject to the following conditions and limitations:
I. GENERAL CONDITIONS
1. This permit is effective only with respect to the specific design flow facilities, and
connections and the nature and volume of waste described in the Permit Application,
RECEIVED
AUG 2 8 2018
DCM WILMINGTON, NC

and other supporting data. Changes in the facilities, connections, nature or volume of
waste render this permit void.
2. Ownership or management changes shall be provided to the BCHD within 90 days of such
changes.
3. All documents, including but not limited to site evaluation, design review plans and
specifications, Triparty Agreements, Easements, and other legal agreements will become a
part of the Permit. This includes operation and maintenance procedures and other pertinent
documents relating to system operation and maintenance.
All legal documents must be recorded with the Brunswick County Register of Deeds
and proof of filing submitted before the Operation Permit is issued conditional on
recordation and enforcement of easement conditional.
4. The Owner/Operator, as applicable, is responsible for compliance with 15A NCAC 18A
Section. 1900 et seq.-Laws and Rules for Sanitary Sewage Collection, Treatment, and
Disposal.
5. No addition, expansion, alteration, or repair (other than the replacement of components with
like components) shall be made to the system without first obtaining authorization or an
Improvement Permit from the BCHD in accordance with NCGS 130A-336. Replacement of
components shall be noted on inspection reports.
6. This permit may be suspended or revoked unless all conditions of this permit are complied
with and the system. is in all respects in compliance with this permit.
T Failure to abide by the conditions and limitations contained in this permit may subject the
Owner to enforcement action in accordance with NCGS 130A-18, 130A-22C, 130A-23,
and/or 130A-25.
8. A useable repair area as designated herein, with buffers, shall be maintained and reserved for
the addition to or replacement of the initial system drainfields. The area shall be separate
from the area of the initial system.
9. No traffic, vehicles, construction of any type or excavation shall be allowed on the system or
repair area.
10. The BCHD may amend, revise, or revoke and reissue this permit including frequencies in the
schedule of operation and maintenance based on monitoring data, water usage, system
performance, or facility use.
11. It shall be the responsibility of the Owner to notify any future or subsequent owners of the
requirements contained within this permit, including the requirement to contract with a
management entity.
12. The owner is responsible for compliance with 15A NCAC 1$A section .1900 - Laws and
Rules for Sewage Collection, Treatment, and Disposal.
13. All subsequent owners of this property and sewage system, shall execute a contract between
the owner and. an approved management entity or the operations permit will become invalid
immediately. Management of the sewer system to be provided at all times.
14. All contracts between owners, management entity (Public or Private), or Health Department,
shall be reviewed and approved before being accepted.
15. The issuance of this permit does not preclude the permittee from complying with any and all
statutes, regulations, or ordinances which may be imposed by other government agencies
which have jurisdiction, or any other permits issued by this department.
16. A properly certified Operator shall be provided at all times as indicated on the
Authorization to Construct.
OPERATION PERMIT
11/12/197

II. PERFORMANCE STANDARDS
l . In the event of failure of the system to perform satisfactorily, as determined by the
BCHD, the owner shall take immediate corrective actions, including actions as may
be required by the BCHD, such as the construction of additional or replacement
wastewater treatment or disposal facilities, upon receipt of a repair Improvement
Permit.
2. The septage generated from this system shall be transported and disposed of in
accordance with Article 9 of Chapter 130A 15A NCAC 13B et seq. and in a manner
approved by the North Carolina Division of Solid Waste Management. The Owner
shall specify the approved hauler and disposal sites and submit this information in
writing to this office within 30 days. The BCHD shall be notified of any changes in
this information.
3. Adequate measures shall be taken to divert stormwater from the system and drainfield
areas.
4. Diversion or bypassing of untreated or partially treated wastewater from the facility is
prohibited.
5. The issuance of this permit shall not relieve the Owner of the responsibility for
damages to surface or groundwaters resulting from the operation of this facility.
III. OPERATION AND MAINTENANCE REQUIREMENTS
l . The system shall be properly maintained and operated at all times in accordance
with the Laws and Rules, and with the Schedule of Operation and Maintenance of
this permit
2. The application rates to the disposal field shall not exceed 360 gal/sq.R.day.
3. No. traffic, vehicles, or excavation shall be allowed on the system drainfield or
repair area except that of the system operator or authorized personnel.
4. The Owner shall have at all times, an Operator in Responsible Charge [ORC]
designated for this system who is properly certified for subsurface wastewater
treatment and disposal systems and/or wastewater treatment as deemed applicable
for this system. The ORC shall be under contract to the Owner or an employee of
the Owner for the duration of this permit. A copy of the executed contract shall
be submitted to the BCHD prior to the date of Operation Permit issuance.
Notification of any changes to this contract or a change in the system ORC shall
be submitted in writing to the BCHD at least 30 days in advance of the change.
5. This system is classified as a Type ) M System and shall be inspected by the
ORC at a minimum frequency of TWICE or 2 times per year.
6. The facilities shall be effectively maintained as a ground absorption system to
prevent the discharge of any wastewater to the ground surface, surface waters, or
groundwater.
7. The owner is responsible for keeping the plumbing system of the house in good
repair and eliminating leaks, drips, or excess flows as they are found. The owner
shall also test the alarm panel monthly to insure proper operation.
- A "startup" inspection shall be conducted with the engineer, the BCHD, the
installer, the Owner, and the Operator present
OPERATION PERMIT
11112J197

A permanent barrier shall be provided and in place around the systerr/repair areas
before the Operations Permit is issued.
TOTAL DESIGN CAPACITY 1 Connections x 3 Bedrooms/residence
120 GPD for a total flow of �360 GPD.
THE FOLLOWING DOCUMENTS ARE CONSIDERED A PART OF THIS PERMIT
AND COMPLIANCE IS REQUIRED:
- The application for Permit.
- The site evaluations.
- The Improvements Permit -The Authorization to Construct.
- Article I I of Chapter 130A o f the General Statutes of North Carolina entitled
"Wastewater Systems".
- Rules for Sewage Treatment and Disposal Systems 15A NCAC 18A.1900.
- Approved Plans and Technical Specifications.
- Letters.
- The Declaration of Easement, Tripartite Agreements, Covenants, Homeowners
Association By -Laws, Articles of Incorporation, Conditions and Restrictions
regarding this installation and system-
- As -Built plans and specifications and technical manuals.
- Other
SCHEDULE OF OPERATTON AND MAINTENANCE
Every 6 months: Septic tanks shall be inspected for influent/effluent line blockage, tank / riser / pipe
connection leakage, wastewater levels and solids accumulation. Blockages or leaks shall be repaired. Tanks shall be
pumped when the solids level exceeds one-third of the liquid capacity of the tank in the inlet chamber, and as
otherwise detennined necessary by the ORC or the BCF D. The outlet filter shall be inspected for clogging
(recommend cleaning at each inspection)
Every6 months: The actual dosing volume shall be measured at each dosing station. The flow rate to
field zone shall be measured after each field has be flushed and pressure head adjusted.
Every 6 months: All laterals of each drainfield zone shall be flushed of solids accumulation with the zone
valve opened. Design pressure had adjustment shall be made.
Every 3 months: Pump shall be inspected for leaks and solids accumulation. Leaks shall be repaired and
solids removed as necessary. Pump controls, floats, and alarm shall be checked for proper operation. All
components of the pump/control system shall be kept in compliance with design standards.
Every 3 months: Collection sewer and components shall be inspected for blockage, leakage, sludge and
accumulation. Systems shall be purged of solids accumulation. Any leaks shall be repaired immediately.
Every week: Dosing pump chamber or station shall be inspected for leaks and solids accumulation.
Leaks shall be repaired and solids removed as necessary. Pumps, controls, floats, panel components, alarm and
autodial shall be checked for proper operation. All components of the pump/control system be kept in compliance
with design standards.
OPERATION PERMIT
11/12/197

Every 6 months: Drainfields area shall be inspected for seepage or saturation, settled ground surface, broken pipes,
maintenance of vegetation, protection from traffic, and diversion of surface water. The owner/operator shall repair
of any broken pipe, lateral end caps, or cleanouts within 24 hours of becoming aware of such a problem. The peat
modules will be inspected for any structural damage, accessibility, adequate ventilation, excess odors, insect
infestations, etc...
Every 6 months: control panel, pumps, floats, valves, electrical controls, and alarms shall be evaluated and field
verified for proper functioning.
Every 6 months and at each inspection: Dosing station flow meters / elapsed run time meters and event counters shall
be read and recorded.
As required
- For grassed sites - Grass shall be cut regularly or when it exceeds 22-1/2 inches in height. Light
weight mowers shall be used for cutting grass. Heavy brush / weeds over growth of the site shall
not be allowed. - Saplings, briars, brush, and grass shall be eliminated by hand cutting and/or
herbicides as often as necessary.
IV. MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring deemed necessary by the BCHD to insure surface and
groundwater protection will be established and an acceptable sampling reporting
schedule shall be followed in accordance with Table V(b) of Rule .1961(b) of
Laws and Rules and this permit.
2. One copy of all monitoring data and maintenance records signed by the Owner
and Operator shall be submitted on or before the last day of the month following
each N/A month period after permit issuance to the following address:
Brunswick County Health Department
Environmental Health Division
Management Entity Section
P.O. Box 9
Bolivia, N.0 28422
the monitoring data shall include meter and counter readings from the recording
flow meters at each dosing station.
3. The ORC shall -be responsible for keeping a log of inspections including at least
the following: dates, durations, and times of site visits, observations made,
procedures carried out, any maintenance, repairs or corrective actions taken, meter
readings, measurements, and drawdown rates. This log shall be maintained by the
ORC during the term of this permit and shall be made available to the BCHD
upon request.
4. A record shall be maintained of all septage removed from the facility. The record
shall include the name of the hauler, permit authorizing the disposal or a letter
from the treatment facility agreeing to accept the septage, date the septage was
hauled, and volume of the septage removed.
5. The Owner/Operator shall report by telephone to the BCHD [910-253-22501,
extension 2280 as soon as possible, but in no case more than 24 hours upon
finding the system is malfunctioning by surfacing or back-up of effluent,
OPERATION PERMIT
11/12J197

discharging directly into groundwater or surface waters, or when repairs are
needed in accordance with NCGS 130A-334(9)(a) and Rule .19610 of Laws and
Rules.
V. GROUNDWATER REQUIREMENTS
All groundwater monitoring, samples, and reporting as deemed necessary by the State of
North Carolina, Department of Environment, Health and Natural Resources, the Division
of Environmental Management and the Brunswick County Health Department shall be
provided.
VI. INSPECTIONS
1. Adequate inspection, maintenance, and cleaning shall be provided by the Owner
to insure proper operation of this facility.
2. The Owner shall inspect the facility to prevent malfunction, deterioration,
operator error, and discharges which may cause or lead to the release of wastes to
the environment, a threat to human health, or a nuisance. The Owner shall keep
an inspection log including at least the following information: date and time of the
inspection, observations made, and any maintenance, repairs, or corrective actions
taken by the owner. This log shall be maintained by the Owner during the term of
this permit and shall be made available upon request to the BCHD.
3. Any duly authorized officer, employee, or representative of the BCHD or the
premises, or place on or related to the disposal site and system at any reasonable
time for the purpose of determining compliance with this permit; may inspect or
copy any records that must be kept under the terms and conditions of this permit;
or may obtain samples of soil groundwater. surface water, effluent, septage, or
leachate.
VIII. SPECIAL CONDITIONS
1. For multi-use/connection systems.
IA. Each connection to this wastewater system shall be permitted separately as an
amendment to this operations permit. Each connection step shall be applied for
separately. For additional connections to be considered, the system have had to be
designed to handle multiple facilities.
1 B. Prior to the issuance of each STEP system improve permit, the lot owner shall
submit a set of floor plans and a site plan to the BCHD for review. After
installation and inspection of and before connection of each STEP system to the
collection system, the BCHD shall issue an amendment of this Operation Permit
to include that STEP.
2. Recommend garbage grinders not be installed in homes.
3. Brunswick County Health Department shall be notified in writing of any changes
in ownership, address, phone # or designated party/agency for
operation/maintenance. Failure to notify the Department of changes shall result in
the permit becoming invalid.
OPERATION PERMIT
11/12/197

BCHD # 2002.59243
Permit issued this �G b day of usmkc . I d , 2006
Environme
Brunswick County ealth Department
l . Operator N/A
Address
Phone
Operators Contract attached (OYes) ((—No)
2. System installation By e 9, C)e✓ei-r wrvf
Tank Information
Septic Tank: S TO 4Gx1O V4
Pump Tank: __ PT lock) C!i>;
OPERATION PERMIT 7
11112/197

............. .
LI