OIB_04-112_Hickey

AUTHOR AGENT
Name ?
Address / 01147
t
city [ moo
� Zip `/ Phone
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LOCATION OF PROJECT � / of d
(If not oceanfront, is waterbody natural er rmrunade?)
DESCRIPTION OF PROJECTC TM
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AREAS OF ENVIRONMENTAL CONCERN (AEC) CLASSIFICATION SIVE
(To be filled in by the Local Permit Officerp®r to completing application.) SEP _z 9 2004
Ocean Hazard —Z Fs tuarine Shoreime _ORW Shoreline 41he
b'VISION OF
PR POSED E CQASTAL.MANAGEMENT
idential _ Commercial/Industrial _ Other
SQUARE FOOTAGE OF BUILDING MOTPRINT AND OTHER IMPERVIOUS OR
BUILT -UPON SURFACES (such as driveways, etc.) within 75 feet of the shoreline (575 feet
of an ORW shoreline)
SQUARE FOOTAGE OF TOTAL FLOmR AREA OF BUILDING
SQUARE FOOTAGE OF
OTHER PERMITS MAY BE REQUU ED-
The activity you are planning may tegaire:
permits other than the CAMA minor
development permit. As a service we have: -
compiled a listing of the kinds of permits tthat
might be required. We suggest you check_
over the list with your LP0 to determine iC`
any of these apply to your project
Zoning, Drinking Water Well, Septic Tank
(or other sanitary waste treatment system),
Burning, 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.

TM
STATEMENT OF OWNERSHIP r
I, the undersigned, an applicant for a CAMA minor development permit, begin th ipn r periy
an area of environmental concern or a person authorized to act as an agent far ses of app Yy�lr�� a f
CAMA minor development permit, certify that the person listed as landowner on this a'��a sig-
nificant inten!st in the real property described therein.. This interest can be desks"16$>fl � A�N EMEN T
Bo
an owner of record. titie,Titisee Deed oke is vested in County Registry of Deeds.
-page in the tY gt try
an owner by virtue of inheritance. Applicant is an heir to the estate of Count
probate was in Y
d other interest, such as written contact or lease, explain b or use a separate sheet and attach to this
n fs (!� 2 n nn ra r�
I [OWN OF OCEAN ISLE BEACH ` I
NOTIFICATION OF ADJACENT PROPERTY OWNERS rLANNING & iNSaECTioNS
I furthermore certify that the following persons are owners of properties adjoining this property. I affirm that l
have given ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for
a CAMA permit.
(Name) (Address)
(2) U K r,L�V Lb3q�T
(3)
(4)
FOR DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS:
I acknowledge that the land owner is aware thatthe proposed development is planned for an area which may
be susceptible to erosion and/or flooding. I acknowledge that the local permit officer has explained to me the
particular hazard problems associated with this lot. This explanation was accompanied by recommendations
concerning stabilization and floodproof ng techniques.
PERMISSION TO ENTER ON LAND
I furthermore certify that am authorized to grantand do in -fact grant permission to the local permit officer
and his agents to enteron the aforementioned lands in connection with evaluating information related to this
permit application.
This application includes: general information (this form), asite drawing as described on the back of this ap-
plication, the ownership statement, the AEC hazard notice where necessary, a check for $50.00 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 maybe issued. Deviation
from these details will constitute a violation of any permit. Any person developing in an AEC without a per-
mitis sub.ect to fivil, criminal and administrative action
This theL day of f19
oh ��
Lan r person authorized to act as his agent
forpurposes of filing aCAMA permit application.

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LOT 13
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DAV i D AND BETH HICKEY SCALE � = 30 I
� TOWNSHIP SHALLOTTE
LOT 12 COUNTY BRUNSWICK
BLOCK 13—B STATE N.C.
OCEAN ISLE BEACH TOWN OCEAN ISLE BEACH
MAP BOOK 21, PAGE 28 DATE q/24/o4
JAN K. DALE FIELD BOOK 0167
N.C. REG . NO . L—'I 250 DRAWN BY JKD
891 COPAS RD. — SHALLOTTE, N.C. DWG. N0. 99 0127
910-754-4477

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6934-9 Beach Dr. SW
0"m Isle Beach, NC 28469
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WORM W ATER PLAN
FOR
OCEAN TS" REACH, NC 29469
FOR
STEVE HARDEN
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Date: 01.2144
Scale: IW-1•
Drawn Ry: 9WQ
292004
SOON OF
MANAGEME

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STORMWATER PLAN
FOR
LOT 12, BLOCK 13.6, CRAVEN STREET
OCEAN ISLE BLAC9L NC 28469
FOR
STEEE HARDEN CONSTRUCTION
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S P 2 9 2004
TA MAN OF
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AU Lot au" t E6.. Pb^ i t
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2 Scott W. Quaintanee, P.E. Date: 09-2I44
6934-9 Beach Dr_ SW Scale:
Ocean Isle Beach, NC 28469 Drawn By: swQ
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CERTIFIED MAIL RECEIPT
(Domestic Mail Only; No Insurance Coverage Providec
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Return Receipt Fed
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(Eorsenrent Requaed)
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Here
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cO Restdcted Dailvery Fee
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$ $2.67
09/27/2004
ru Total Postage a Pen
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Certified Fee
09
0
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PMum Receipt Fee
(Endorsement Required)
Hera
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ru (ER�ul
$2.67
$
09/27/2004
fJ TotalPostage AFees
rant
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SEP 2 9 2004
DIVISION OF
COASTAL MANAGEMENT