OIB_04-73_Gold

Locality _ o.wn ,-rS(e' gnacA
GENERAL INFORMATION
LAND OWNER
Name
Address
city 62-2: S
AUTHORIZED
Name
Address
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Permit Num 04— s 3
�LLff
city i State �Zi�p �/ ne 2sa 400
LOCATION OF P OJECT �� 7
(If not oceanfront, is waterbody natural or manmade?)
DESCRIPTION OF PROJECT
AREAS OF ENVIRONMENTAL CONCERN (AEC) CLASSIFICATION
(To be filled in by the Local Permit Officer prior to completing application.
XOcean Hazard Estuarine Shoreline _ORW Shoreline _
PROPOSED USE
X Residential Commercial/Industrial Other
SIZE OF BUILDING IN SQUARE FEET
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JUN 720704
Size of other impervious or built upon surfaces (such as driveways, etc.) within 75 feet of the shoreline (575 feet
of an ORW shoreline)
SIZE OF SITE IN SQUARE FEET
OTHER PERMITS MAY BE REQUIRED ...
The activity which you are planning may require
permits other than the CAMA minor permit you
are applying for here. As a service we have com-
plfed a listing of the kinds of permits which might
be required. We suggest that you check over this
list with your Local Permit Officer to determine
which, if any, of these may apply to your project.
This is not a requirement of CAMA, only a sugges-
tion to help you complete your project as quickly as
possible.
Zoning, Drinking Water Well, Septic Tank (or other
sanitary waste treatment system), Burning, Electri-
cal, Plumbing, Heating and Air Conditioning, In-
sulation and Energy Conservation, FIA Certifica-
tion, Sand Dune, Sediment Control, Subdivision
Approval, Mobile Home Park Approval, Highway
Connection, Others:

JU ��
STATEMENT OF OWNERSHIP CO,q O/�N / 4 �Oy
I, the undersigned, an appplicant for a CAMA minor development permit, begin either thew /S/R� erty '
9
an area of environmental concern or a person authorized to act as an agent for purposes of app�/a
CAMA minor development permit, certify that the person listed as landowner on this application h
nificant interest in the real property described therein. interest can be described as follows: (check o Ni
an owner of record title, Title is vested in / l see Deed Book
page in the 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 contact or lease, explain below or use a separate sheet and attach to this
application.
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NOTIFICATION OF ADJACENT
VUU6 L
I furthermore certify that the follow' - s o properthes -,eljc+iiti�Lfli`iA�i4ci�an�ffirm that
have given ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for
a CAMA permit.
(1)
(2) `?`(tzt
(3)
(4)
FOR DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS:
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I 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
particular hazard problems associated with this lot. This explanation was accompanied by recommendations
concerning stabilization and floodproofing techniques.
PERMISSION TO ENTER ON LAND
I furthermore certify that I am authorized to grant and do in fact grant permission to the local permit officer
and his agents to enter on the aforementioned lands in connection with evaluating information related to this
permit application.
This application includes: general information (this form), a site 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 may be issued. Deviation
from these details will constitute a violation of any permit. Any person developing in an AEC without a per-
mit is subject to civil, criminal and administrative a on.
J _
This the -7— day of A'e.- .19
Land er or -person authorized to act as his agent
for yurposes of filing a CAMA permit application.
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U.S. Postal
Service
CERTIFIED
MAIL RECEIPT
(Domestic
Mail
Only; No Insurance
Coverage Provided)
rfiALEifiH HC 27613.+ 6
M Postage $ *U.J/
0 $2.30 0459
r3 Certilled Fee 07
O Postmark
Retum Reeei0t Fee Here
� (Endorsement Required) $0.00
E3 RwMatetl Delivery Fee
p (Endorsement Required)
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Total Postage 6 Feea $ $2.67 06/07/2004
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O ant To
f`- 8liaat, AP4 NaJ..�r'.��X.:-X .--_---------------- _._...-�
or PO Box Ba- yyAq �a / /�/,ryapj��^�--•
ph. Btata. DW -1 SG--F---r-rrA- Ile--
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IRE: CANLk Application Notification
Dear A/o-11
; r6
yYKJ1-
This letter is to inform you that I have applied for a Minor CAMA Permit on my property
located at Lot Block . Section : with a physical address of
in Ocean Isle Beach, NC. CAMA regulations require me to notify
you of my intentions. I have enclosed a copy of my permit application and a copy of the
drawing of my proposed project.
If you have any comments on my proposed project, please contact Justin Whiteside,
Local CAMA Permit Officer for the Town of Ocean Isle Beach at 910-579-3469.
Sincerely,
91U wz. - 4,/Or-,V
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a'4�
aw/I
WM

CAMA PERMIT NOTICE
Pursuant to NCGS 113-119(b), the
municipality of Ocean We Beach, a
locality authorized to issue CAMA
permits in the areas of environ-
mental concern hereby gives NO-
TICE that onibi H nt
Eli Gold, applied for a CAMA min-
or development permit to construct
a pool and deck in the rear of his
existing residence at 469 East Third
Street, Lot 1, Block 10, Section A.
The application may be inspected
at the below address. Public com-
ments received by June 18, 2004,
will be considered. later comments
will be accepted and considered up
to the time of permit decision. Pro-
ject modifications may occur based
on further review and comments.
Notice of the permit decision in
this matter will be provided upon
written request.
Justin Whiteside
Local CAMA Permit Officer
3 West Sid Street
Ocean Isle Beach, NC 28489
[phone]
June 10
D6
OLA-1
Inc .27V17,
STATE OF NORTH CARD J U L 19 2004
COUNTY OF BRUNSWIC
DIVISION OF
COASTAL MANAGEMENT
AFFIDAVIT OF PUBLICATION
Before the undersigned, a Notary Public of said County and State,
duly commissioned, qualified, and authorized by law to administer
oaths, personally appeared
Scott R. Harrell
who, being first duly sworn, deposes and says: that he is
Publisher
(Owner, partner, publisher, or other officer or employee
authorized to make this affidavit)
of The Brunswick Beacon, a newspaper published, issued, and en-
tered as periodical mail in the Town of Shallotte in the said County
and State; that he is authorized to make this affidavit and sworn state-
ment; that the notice or other legal advertisement, a true copy of
which is attached hereto, was published in The Brunswick Beacon on
the following date(s):
June 10, 2004
and that the said newspaper in which such notice, paper document or
legal advertisement was published, was at the time of each and every
such publication, a newspaper meeting all the requirements and qual-
ifications of Section 1-597 of the General Statutes of North Carolina
and was a qualified newspaper within the meaning of Section 1-597
of the General Statutes of North Carolina.
This the 10th day of June, 2004.
��
................ ..............................
(Signature of person making affidavit)
Sworn to and subscribed before me this 10th day of
June, 2004. \AY E
t�OTARY'ty2
03
.. !9G'L�•pUBL\G i2
(Notary Public) ''%',7CK COV�;%``��
My commission expires: December 29, 2004.