OIB_04-108_Wagner

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GENERAL INFORMATION
LAND O'
Name
l�Et�f �� e►3�ih4e•:�
� 1 , ll►t � -
LOCATION OF PROJECT
(If not oceanfront is waterbody natural or tr-zmmade?)
DESCRIPTION OF PROJECT
Zap
AREAS OF ENVIRONMENTAL CONCEFIN (AEC) CLASSIFICATION
Phone
(To be ed in by the Local PermitOffit�� pr to completing application.) -
Ocean Hard _ EstuarineSnorailine ORW Shoreline Other
PROPOSED USE
f,�Residential Commercial/lndus=ial _ Other
SQUARE FOOTAGE OF BUILDING FiOOTPRINT AND OTHER IMPERVIOUS OR
BUILT -UPON SURFACES (such as driveways, etc.) within 75 feet of the shoreline (575 feet
of an ORW shoreline) C
SQUARE FOOTAGE OF TOTAL FLOOR AREA OF BUILDING J�
SQUARE FOOTAGE OF SITE I ��
• ea• • r or
The activity you are planning may requim
permits other than the CAMA minor
development penniL As a service wehave
compiled a listing of the kinds of permits. ttimt
might be required. We suggest you check.
over the list with your LPO to dete* nim 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.

EGEHVE
r
STATEMENT OF OWNERSHIP SEP 2 9.2004
I, the undersigned, an applicant for a CAMA minor development permit, begin ei erg gwner of ro y
o act as an agent forosdf
an area of environmental concern or a person authorized t, gg}}�� r a
CAMA minor development permit, certify that the person listed as landownel�drt �li� 3E�ISI�N T
nificant interest in the real property described therein..This interest can be described as foilows: (check one)
an owner of record. title, Title is vested in 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 inCounty.
_ if other interest, suchwtten contact or lease, explain below or use a separate sheet and attach to this
TOWN OF OCEAN ISLE FEACN
NOTIFICATION OF ADJACENT PROPERTY OWNERS PLANN� NSFECrL;NS
I furthermore certify that the following persons are owners of properties adjoining this property. 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
_% (Address)
FOR DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS:
I acknowledge that the landowner is aware that the proposed development is planned for an area which may
be susceptible to erosion and/or flooding. 1 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 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 rely ted to this
permit application
This application includes: general information (this form), a site drawingas described an 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-
mit is subject civil, criminal and admfnistrativeaction-
This the. ;ay of /Jl n1e%(J
Lanerson aut onz ct as his agent
forpurposes of filing a CAMA permit application.

SCREE
� SEC�NO �DN�
EPS
BOX
11rP �G.
aPEN it
LOT 14
o\ 0
LOT 7
PROPERTY IS IN A FLOOD HAZARD AREA ZONE `S 17.0
SURVEYED BY USING MAP BOOK 3, PAGES 179-179A
AND EXISTING PHYSICAL CONDITIONS.
RECORDED LOT SIZE 50' X 100'
PROPOSED
2.S.F.H.
ON PILINGS
NO. 30
RDf PUN 1a1
A'
?� R
FRANK and CARRIE WAGNER
LOT 15
BLOCK 4
L-1250
*
SECTION C
*
G'1'D
OCEAN ISLE BEACH
SU
MAP BOOR 3. PAGES 179-170A
JAN K. DALE
N.C. REG. NO. L-1250
i P JAN K. DALE
891 COPAS RD. — SHALLOTTE, N.C.
lol.C. REG. NO. L-1250
910-754-4477
2004 L
DIVISION OF
STAL MANAGEMENT
LOT 16
BLOCK 4
LOT 15
y0•� W \ LOT 5
sl
LOT 8
SCALE
1" = 20'
TOWNSHIP
SHALL077E -
COUNTY
BRUNSWICK
STATE
N.C.
TOWN
OCEAN ISLE BEACH
DATE
9/14/04
FIELD BOOK
0168
DRAWN BY
JKD
DWG. NO.
2000/0WOS2

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Postage
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Certified Fee
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ReturnReceipt Fee
(Endorsemeet Required)
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Restricted Delivery Fee
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(Endorsement Required)
$ $2.67
09/17/2004
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PS Fonn 3800, April 2002
See Reverse for Instructions
J.S. Postal Service
CERTIFIED MAIL RECEIPT
(Domestic Mail Only., No Insurance
Coverage Provided)
FIT r t
0470
06
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M Hb Form UMUU, Apn! 20OZ See Reverse for Instructions

09/27/2014 23:51 57B4557b12
d9/YI/i MAY le:ll:11 V'Vae 'Lana
WAUNEk Lil — rn jtll� V AJ
AEC HAZARD NOTICE OCT 0 12004
aIa
Proloot is I i An: Ocean Erodible Area _ M19n Hazard flood Area ON OF
_ Irtlgc �iMANAGEMENT
'.;Us notice i i intended to make you, the applicant, aware
.; f the spe• jet risks and conditions associated with
develupmet t itl thla area, which is subject to natural
hazards suc i as stonrra, erosion And currents- Tile a rules f
ate Cbaata resources Commission reel that
receive aA bSC Hazard write and ackrowle a that
a�ee in or tting before a permit For devAopmene can be
Issued.
"'MeCoY+rn;sior.'sruler•onbWldingstandards:oceAri(rcnt
sttba•asan iduneaisersnonsiadestgned tomlrlmlae,but
rot 4i*^.S.^; te, '='•Curt.' 1^e5 (rOm haazards. ny;taming
permits, t1 a Coastyal i;esources Commission does not
iiabLL.ty !or funttte damage to the developmemrnt nt. tan as no
Vne t est a% silable information, a l acmFtedby the Coastal
n___ .._.. maca:nn. indi,ates the the annual ocean
;A t for theereA where yourpropertyfslocat iserL-, feel per year.
.he rate as established by careful analysts of aerial
)het agrsp ,s of the coastline taken over the put 90 years.
Stud.os i1 indicate that the shoreline could move as
muds ae O aDfeet landward in a major storm.
'T)}Cblood r cetera lr. a major storm are predicted to be About
vj_ feet jeep in tlils Area.
?referred oceanfront protection measures are beach
nowialtm:nt and relocation of threatened structures.
Fiar.f ero:lon control atrttcturoa sueh As bulkheads,
seavaLLs, ; ovetments, groins, istdea and breakwaters are
ptot tbltec . Temporary devices, including sand liege, may
oe allowL4 under certain condtdors
This strut ire shallbe relocated or dismantled within two
.•ears of b• coming imminently threatened.
ine applt -ant must acknowledge th0a information and
relclretni ids by signing this notice Ir the below space.
Without t to proper sWature, the afepllcation will not be
c'om oleic.
App9ca,7t' tpratuM
gIZS/Dy
aan�
11�
SPECIAL NOTE! This hazard notice is regder dulred for
ivir
storms" derosium.rerm'4616 Ausvedft to ordevelo?mentrn mthis
area expire or December w s the third year _ Stfors t g the
year in which the permit was 1ssUed. Si+nnlr baton wvrk
begins on the project site, the Local Permit Officer will
determine the va getadon line and setback distance a: your
sateif the property has seen little change and the prc posed
developmert can still meet the satbsca requiramait, the
LPO will intone youVfttp"U rosy begin work.It is i mp'tt•
rant that you check t% th the LPO before the pert it: xpirse
for official airtroval to continue the work after the .1en;tt
has ax ired. Yaenarally. L' foundation pilings have hew
paced And substanI.Al progress is c"ntatuins, permit
rertewal :nay s`.�t be necessary, if substantlel �+rog-:ss l,ss
not been mlide, the permit must be renewed and A new
setback line established. It is u'tlaWful W continua work
After permit expiration without this Approval'
For more information, contatt:
Coca FermitOHlcar
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A�ress
Locality
9[o-S9g-3q (D9
PAcna
Revfs®o a r,as