17-22_PERMIT APP

Permit Number: WB 22-0017
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APPLICATION FOR
CAMA MINOR
DEVELOPMENT PERMIT
In 1974, the North Carolina General Assembly passed the Coastal Area Management Act
(CAMA) and set the stage for guiding development in fragile and productive areas that border
the state's sounds and oceanfront. Along with requiring special care by those who build and
develop, the General Assembly directed the Coastal Resources Commission (CRC) to
implement clear regulations that minimize the burden on the applicant.
This application for a minor development permit under CAMA is part of the Commission's
effort to meet the spirit and intent of the General Assembly. It has been designed to be
straightforward and require no more time or effort than necessary from the applicant. Please go
over this folder with the Local Permit Officer (LPO) for the locality in which you plan to build
to be certain that you understand what information they he or she needs before you apply.
Under CAMA regulations, the minor permit is to be issued within 25 days once a complete
application is in hand. Often less time is needed if the project is simple. The process generally
takes about 18 days. You can speed the approval process by making certain that your
application is complete and signed, that your drawing meets the specifications given inside and
that your application fee is attached.
Other permits are sometimes required for development in the coastal area. While these are not
CAMA-related, we urge you to check with the Local Permit Officer to determine which of
these you may need.
We appreciate your cooperation with the North Carolina Management Program and your
willingness to build in a way that protects the resources of our beautiful and productive coast.
Coastal Resources Commission
Division of Coastal Management
Address: 17 East Raleigh Street
Description: Install in -ground pool
Received: 7-26-2022 Accepted Complete: 7/29/2022
Site Posted: 7/29/2022 Site Inspected: 7/27/2022
Sent to DCM: 8/3/2022 Issued:
Final Inspection Date: Inspected By:
Notes:
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Locality: 1-ou- of Wrightsvill€-Be-ach Permit Number: W R22-0017
Ocean Hazard X Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
(For official use only)
General Information
Land Owner n
Name: Lk) L L C_
Address:
City: ��c � State: VC__- Zip: �111,a L 5 Phone: 9 1 9 `21 5— 7 3 1 3
Email:
Authorized Agent
Name: 03,,
Address: 1
City:��
Email: Cat
State:_P/, ` _ Zip: QL� Z)' _Phone: -G l O-- kJ 's L1 q i 2
Location of Project: (Address, street
of the adjacent waterbody?)
C.
directions to site. If not oceanfront, what is the name
I _C:;�' 'Al
Description of Project: (List all proposed construction and land disturbance.)
\ n ,
Size of Lot/Parcel: square
acres
Proposed Use: E-(Single-Family) ❑ (Multi -Family) ❑ Commercial/Industrial ❑ Other
Complete Either (1) or (2) Below (Contact your Local Permit Officer if you are not sure which AEC ap-
plies to your property):
(1) Ocean Hazard AECs: Total Floor Area or 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: square feet (includes the area of the roof/dip 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? ❑ Yes ❑ No
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: square feet.

Other Permits May Be Required: The project you are planning may require permits in addition to the
CAMA minor development permit, including, but not limited to: Drinking Water Well, Septic Tank (or other
sanitary waster 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 under signed, 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 , see Deed Book 6,
page�in the New Hanover 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.
Notice of Adjacent Property Owners: I furthermore certify that the following per sons 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)
Iro
(2)
(3)
(4) C! (ff-y. f !-:N. tF7✓y�)1 e1 l-C '�'D
Acknowledgements: I, the under signed, 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.
I furthermore certify that I am authorized to grant, and do in fact grant, permission to 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 day of-�. k\ 20 a22 .
Landowner or person authorized to act as his/her agent for purpose of filing a CAMA permit information
This Application Includes: general information (this form), a site drawing as described on the back of this application, the ownership state-
ment, the Ocean Hazard AEC Notice wherenecessary, y 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 of any permit. Any person developing in an AEC without permit is subject to
civil, criminal, and administrative action.
3CQ

DocuSign Envelope ID: A40B9F24-DEA5-4FB9-92A2-B2992DA38D3E
Name of Property Owner Requesting Permit: Tom Conley (o'a(Zf U-C-
Mailing Address:
�,1.CJ L fV� 27L) S
Phone Number: (910) 215- 7313
Email Address:
I certify that I have authorized ,r_t --
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: (,
h 1'0.vwVV\ ov, 0tom,
at my property located at
inCounty.
1 furthermore certify that 1 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:
DocuSirgn�ed by:
lgna ure
Tom Conley
Print or Type Name
owner
Title
7/25/2022
Date
This certification is valid through I l

+7-1�15 -
Owner
City, State,lip Code
Dear Adjacent Property:
This letter is to inform you
Permit on my property at
County. As required by CAI
drawing(s) as notification of
the enclosed no objection foi
Property Owner
W
have applied for a CAMA Minor
in New Hanover
Property Address
regulations, I have enclosed a copy of my permit application and project
proposed project. No action is required from you or you may sign and return
If you have any questions or comments about my proposed project, please
contact me at l K 1 ,or by mail at the address listed below. If you wish to
Applicant' Telephone
file written comments or objec ions with the Town of Wrightsville Beach LAMA. Minor Permit Program, you may submit
them to:
Tony Wilson
Local Permit Officer for the Town of Wrightsville Beach
P.O. Box 626
Wrightsville Beach, NC 28480
twilsong(.towb.or
[phone]
Sincerely,
Property Owner
�s s �s
Mailing Address
\ �
City, State, Zip Code

7-as a�
n�+o
M.
Dear Adjacent Property:
Receipts for
Certified Mail
(Staple Here)
This letter is to inform you that I, U0 �) �Z, P ky c — have applied for a CAMA Minor
Property Owner
Permit on my property at P c-- 14 � , in New Hanover
Property AddUss
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at RJ Q Z I �, 7 3 13 ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the Town of Wrightsville Beach CAMA Minor Permit Program, you may submit
them to:
Tony Wilson
Local Permit Officer for the Town of Wrightsville Beach
P.O. Box 626
Wrightsville Beach, NC 28480
twilson(atowb.org
[phone]
Sincerely,
Property Owner
. g3 2s s ��
Mailing \Address
City, State, Zi13-Code

-- 2 S 02-2-
Date h
acent
Ma' ' g Address \
City, State, Zip Code
Dear Adjacent Property:
This letter is to inform you
Permit on my property at
County. As required by CAI
drawing(s) as notification of
the enclosed no objection foi
W
O�
to � U have applied for a CAMA Minor
Property Owner
in New Hanover
Property Address
regulations, I have enclosed a copy of my permit application and project
y proposed project. No action is required from you or you may sign and return
If you have any questions or comments about my proposed project, please
contact me at Li M � _ 7 3 �_ ,or by mail at the address listed below. If you wish to
Applicant'E Telephone
file written comments or objec ions with the Town of Wrightsville Beach CAMA Minor Permit Program, you may submit
them to:
Tony Wilson
Local Permit Officer for the Town of Wrightsville Beach
P.O. Box 626
Wrightsville Beach, NC 28480
twilson(cD,towb.org
[phone]
Sincerely, n
L13
Property Owner
3 a-5 S
Mailing Address
�phe
City, Sta,

Receipts for
Certified Mail
(Staple Here)
7-2,5 -
Adjacent Property Owner
City, State, Zip Codd
Dear Adjacent Property:
This letter is to inform you tha T w C-- have applied for a CAMA Minor
Property Owner
y property
rty �l _� , in New Hanover
Permit on m roe at
Property Address
County. As required by CAM k regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of n y proposed project. No action is required from you or you may sign and return
the enclosed no objection for . If you have any questions or comments about my proposed project, please
contact me at q ( a) �, — 73V3 or by mail at the address listed below. If you wish to
Applicant' Telephone
file written comments or objec ions with the Town of Wrightsville Beach CAMA Minor Permit Program, you may submit
them to:
Tony Wilson
Local Permit Officer for the Town of Wrightsville Beach
P.O. Box 626
Wrightsville Beach, NC 28480
twilsolip,towb.org
[phone]
Sincerely,
�3V �,
Property Owner
13
Mailing Address
City, State, Zili Code

ADJACENT RIPRIAN PROPERTY OWNER STATEMENT FOR
CAMA MINOR PERMITS
I hereby certify that I own proper adjacent to !&,i V�� ���"C s
(Name of Property Owner)
property located at, � �� ' '
Address, Lol, Block, Road, etc.)
on c��ck, , in fA I l 1 e N.C.
(Waterbody) (T6 vn and/or County)
The propertyowner has described�to me, as shown in the attached application and project drawing(s), the development they are
proposing at that location, and I h ve no objections to their proposal.
Signature
Print or Type Name
Telephone Number
I

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