BC_09-05_Fullwood

Brunswick Countv BC09.05
Local Government Permit Number
CAMA
MINOR DEVELOPMENT
PERMIT
as authorized by the State of North Carolina, Department of Environment,
and Natural Resources 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'
Issued to Emerson Fullwood, authorizing development in the Estuarine Shoreline (AEC) at 172 Genoes Point Road, in
Supply, NC, as requested in the permittee's application, dated 10-Aug-09. This permit, issued on 09-Sep-09, 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: Single Family Residence/Stump Removal/
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on 20-Aug-09.
(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 910.253.2034 for a final inspection at
completion of work.
(Additional Permit Conditions on Page 2)
This permit action may be appealed by the pernittee or other qualified persons
within twenty (20) days of the issuing date. From the date of an appeal, any
work conducted under this permit must cease until the appeal is resolved. 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, 2012
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.
� / I
Connie Marlowe
CAMA LOCAL PERIJMRV E D
PO Box 249
Bolivia NC 284p14 2009
PER ITW9Ev'1TC1N, NC
(Signature required if conditions above apply to permit)

Locality Dny1sW ; C ((- C'6LKb
Ocean Hazard Estuarine Shoreline ORW Shoreline _
(For official use only)
GENERAL INFORMATION
LAND OWNER 1
Name i mP_rSon Fwk W Ood
Permit Number ' — ` —os
Public Trust Shoreline Other
la� PaVC.l P O N nOt)a
Address\ \A ie.1 A
City ,�"tTS�u C[ State Zip 4 Phone S85- 2Lgg_Z513
AUTHORIZED AGENT
Name��c�.ard _ lov,c5
Address
City Scw.��u State'(_ Zip Z4i 1 Phone
'4'9%,Z743
LOCATION OF PROJECT: (Address. street name and/or directions to site. If not oceanfront, what is the name of the
adjacent waterbody.)
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) ransirutt;avi ':!� ko",&
SIZE OF LOT/PARCEL: U- L 1, 15�_ square feet acres
PROPOSED USE: Residential V (Single-family ✓ Multi -family ) Commercial/Industrial
Other
TOTAL ENCLOSED FLOOR AREA OF A BUILDING IN THE OCEAN HAZARD AREA OF ENVIRON-
MENTAL CONCERN (AEC):
square feet (includes all floors and roof covered decks)
SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT -UPON SURFACES IN THE
COASTAL SHORELINE AREA OF ENVIRONMENTAL CONCERN (AEC): I 'I✓ �3.b ( square feet
(Calculations includes the area of the roof/drip 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.)
Choo a the AEC area that applies to your property:
within 75 feet of Normal High Water/Normal Water Level for the Estuarine Shoreline AEC
(2) within 575 feet of Normal High Water/ Normal Water Level for the Estuarine Shoreline AEC, RE tE I V E D
Outstanding Resource Waters
(3) within 30 feet of Normal High Water/ Normal Water Level for the Public Trust Shoreline AEC AUG 2 5 2009
(Contact your Local Permit Officer if you are not sure which AEC applies to your property.)
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a State
rwater , NC
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.

[ER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA minor develop -
permit. As a service we have compiled a listing of the kinds of permits that might be required. We suggest you check over the list
a
your LPO to determine if any of these apply to your project. Zoning, Drinking Water Well, Septic Tank (or other sanitary waste
bd
ment system), Building, Electrical, Plumbing, Heating and Air Conditioning, Insulation and Energy Conservation, FIA Certification,
Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway Connection, and others.
y
�_i
TEMENT OF OWNERSHIP:
Z
e undersigned, an applicant for a CAMA minor development permit, being either the owner of property in an AEC or a
on authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person
d as landowner on this application has a significant interest in the real property described therein. This interest can be
ribed as: (check one)
C-
an owner or record title, Title is vested in EmvSo, F4wbo A see Deed Book (c)5(f,
c
g5'( in the' &-u_nSu_�) i c�_ County Registry of Deeds.
" 1
an owner by virtue of inheritance. Applicant is an heir to the estate of
)ate was in County.
_if other interest, such as written contract or lease, explain below or use a separate sheet & attach to this application.
rIFICATION OF ADJACENT PROPERTY OWNERS:
thermore certify that the following persons are owners of properties adjoining this property. I affirm that I have given
rUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) (Address)
it DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS:
mowledge that the land owner is aware that the proposed development is planned for an area which may be susceptible
,-osion and/or flooding. I acknowledge that the local permit officer has explained to me the particular hazard problems
iciated with this lot. This explanation was accompanied by recommendations concerning stabilization and floodproofing
niques.
tMISSION TO ENTER ON LAND:
thermore certify that I am authorized to grant and do in fact grant permission to the local permit officer and his agents to
r on the aforementioned lands in connection with evaluating information related to this permit application.
> application includes: general information (this form), a site drawing as described on the back of this application, the
tership statement, the AEC hazard notice where necessary, a check for $100.00 made payable to the locality, and any
rmation as may be provided orally by the applicant. The details of the application as described by these sources are
trporated without reference in any permit which may be issued. Deviation from these details will constitute a violation
ny permit. Any person developing in an AEC without permit is subject to civil, criminal and administrati'REt .E I V C
This the 19 vi, day of 20 Lq V G
n ^ �� 1 � UG 2 5 2009
RECEIVED WG�-..JL
W-� y
AUOI�rQd� v DCM WIIMINGTON, NC
er or person authorized to act as his agent for purpose of filing a CAMA permit application.

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This letter is to inform you that I, IF 1Ne4-3 br•1 }Iel\ 60D'd have applied for a CAMA Minor
Property Owner
Permit on my property at l�l L es ei►.oc- 5 {A I n'+ in COUNTY
Property Address
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 SSA) 7— fl - 3 313 or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program, you may submit
them to:
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS

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Dear Adjacent Property:
This letter is to inform you that I,
have applied for a CAMA Minor
Property Owner
Permit on my property at 0 -- P® r v- T� in COUNTY —6f'w.S tj C�
Property Address
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 (61[f o 2'4 V ^ 3 31 3 or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program, you may submit
them to:
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY, STATE, ZIP CODE
Sincerely,
1 uak Weoa
Property Owner
4 l�,v►.a� Drry c
Mailing Address
Zl, f0,Y I8s34
City, State, Zip Code
RECEIVED
AUG 2 5 2009
DCM WILMINGTON, NC

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NaaK I05G PG0857
Mcam Pa mna wAneaxrr DPRD
TRIS D;aD, Made this the llth day of 0mtdxw e:.._:Y. "Y:oio-:.:,;u
1995 , by and between '::! . )01% !-4,&S7
GRAIEMCT 11 PH 3: 03
CRUDO L BIDS CORPOPATTOS, BY 02T II. YDLLMOOK) and wife,
a corporation organized and VffiiTfA POLLWOOD ^' °•'"'•'�i�Ull
existing under the laws 4 zingsfiald Drive 6[CIS)E70FDEEDS
the State of north Care Pittsford, aT 24SAMISVCK COOT. B.C.
The designati�oyyNi�,,, tar and Grante us shall
include said par,�w, their keiza, note q(/�J�,� p��
shall include e ar, pluzahp� ecu21ne, feminine dr iioj/y(s
required by teact. �k�%t �v
xxTNasBa
0
The (;rantor, for valuable consideration, paid by the Grantee,
the receipt of which is hereby acknowledged, has and by these
presents does grant, bargain, sell and convey unto the Grantee in
fee simple, all that certain lot or parcel of land situated in
Lockwood Folly Township, .Brunswick County, North Carolina, and
more particularly dasid as follows -
BRIM all of Lo 301 of Polly, Phus 7
according to y� sp by Patrick L.B., dated July
20, 1989, a m��t of which appear e o )dpp Cabinet V.
Page 17 of,. BS�ruuxWicl�untY Registry.
This co aDas is made SOH to [he Master Declare, nd
Davel Plan for Lockwood as appears in Dead Book
695 at Page 968 and the Suppl Declaration for Single
Pandly, Detached Castom Soros Lots appears in Dead Book 771
at Page 594 of the Brunswick County Registry (sae Deed Book
716 at Page 97 for Submission of Lockwood Polly. Phase 3 to
v ze fully repeal d hereint�anppdamid covenants and
Base OBtOut if they
sil ehaiTun dammed p
with the lote(in future oonvaysacasurt*amEkt to the �) and
TO BAVa AM To S.oLn the aforesaid lot (a) or Parcel(A) of land
and all privileges theraunto belonging to the Grantea in fee
simple, subject to
and restrictions set out
above. �
he Grantor
And the Gra'''���m" covamisenant�Al en h the`Gtdh!mt het lt'�
is seized of >remiees in sSi��mp�le, has Cho D Y
the same in simple, the title�'iy�//m�ssz�kecabla and free and
clear of all encumbrances, and the Gra`IStbr will warrant and
defend the title against the lawful claims of all persona
whomsoever, reserving and preserving, however. RtL feserve XiPtniark
restrictions and exceptions eat out above, 1p[Id___JOe W- r //QLG
ex. r CEfVE
p(.— "/30.Co t Y
PRaPARRD aT AMpaPBOM MTOSMSTS AT LAM �'' .
wTTROM OVIMDN OP °AAtiG 2 5 2009
99mn m cxn
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1 17

Brunswick County Health Department
Environmental Health Section
Wastewater Collection, Treatment
and Subsurface Disposal System
Application # 1990-27477A
Tax Parcel # 217 NA 002
Type Va
IMPROVEMENT PERMIT
FOR WASTEWATER COLLECTION, TREATMENT, AND DISPOSAL SYSTEM
In accordance with the provisions of Article 11 of Chapter 130A, General Statutes of North Carolina, 15A NCAC 1 BA . 1900 et seq.,
and other applicable Laws and Rules
PERMISSION IS HEREBY GRANTED TO:
Owner Emerson Fullwood
Address 4 Kinasfield Drive
Pittsford NY 14534
Phone
For the Installation of a wastewater collection, treatment, and disposal system to serve:
Residential X Bedroom 4 Commercial N/A Employees N/A Max Occupant 8
Comments/Use Four (4) Bedroom Single Family Residence Domestic Wastewater Use Only
pursuant to 15A NCAC 18A.1900 as amended and in conformity with the application and other supporting data subsequently filed and
approved by the DEHNR/or the Brunswick County Health Department and considered a part of this permit.
Facility to be served: Name Emerson Fullwood
Address/Location 172 Genoe's Point RD SW 28462
Description LTAR = 1.0 gpd/sgft Ecoflo ® Type A configuration
Peat Bio-filter with no areal reduction in drain field
The owner shall be subject to the following conditions, limitations, and construction requirements for the installation and operation of
this system:
1. This permit is effective only with respect to the specific design flow facilities, and the nature and volume of waste described in the
Permit Application, and other supporting data. Changes in the proposed use, waste flow, nature or volume of waste render this
Permit void.
2. All documents, including but not limited to site evaluation, design review plans and specifications, Tri-party 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.
3. The designated repair area is to have no parking, driveways, or other impervious material located on it.
4. The issuance of this permit does not preclude the permittee from complying with any and all statues, regulations, or ordinances
which may be imposed by other government agencies which have jurisdiction, or any other permits issued by this department.
5. The permit shall become invalid if the information submitted in the application was falsified or changed, if the permit was based on
inaccurate or incomplete information, or if the designated site is altered.
6. Before Authorization to Construct a Wastewater Treatment and Disposal System is issued, all site modifications, plans,
specifications, draft legal paperwork must be completed and approved.
7. Sites requiring complex designs for wastewater systems may require approval of plans and specifications before the Improvements
Permit is issued.
PERMIT ISSUED THIS 291" DAY OF December , 2008 .
DATE OF PERMIT EXPIRATION December 29 2013
BRUNSWICK COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH DIVISION
Soil Scientist RECEIVED
AUG 2 5 2009
DCM WILMINGTON, NC
PERMIT.STA 11/101197

Brunswick County Health Department BCHD # 1"0.027477A
Environmental Health Section Tax Parcel # 217 NA 002
Wastewater Collection, Treatment Type: Va
and Subsurface Disposal System
AUTHORIZATION TO CONSTRUCT
FOR
WASTEWATER COLLECTION, TREATMENT, AND DISPOSAL SYSTEM
In accordance with the provisions of Article 11 of Chapter 130A, General Statutes of North Carolina as amended,
AND other applicable Laws and Rules
PERMISSION IS HEREBY GRANTED TO
Owner. Emerson Fullwood
Address: 4 Kinosfield Drive
Pittsford, NY 14534
Phone:
To construct, install a sewage treatment and disposal system as described below:
To Serve: Residence Yes # Bedrooms Four(4) Maximum # of residents (8) Eight
Business # employees
Residence/Business Description: 4 Bedroom Single Family Residential Dwelling Unit
Subdivision Lockwood Folly LOT 301 Blk. Phase III
Address/Location: 172 Genoes Point Road, Supply, NC 28462
The system components consist of: Type system: Va Design Flow 480 GPD
System Description Pressure Dosed Pretreatment Peat System (TS-1)
I. Collection System Conventional Plumbing (Must comply with all applicable state and local plumbing codes)
II. Tankage: A. Septic Tank(s) 1000 Gallons Capacity - (Sizing notes: )
B. Pump Tank(s) 1000 Gallons Capacity
C. Grease Trap . N/A Gallons Capacity
NOTE: RISERS REQUIRED OVER SEPTIC TANK AND PUMP TANK.
All tanks, force mains, pressure lines to be leak tested and certified by appropriate parties.
Access risers required on all inspection & service hatches on tanks — Risers to extend 4-T above finished grade
III. DISPOSAL FIELD:
Peat Biofilter:
#IWWS: 2000-3-R4 Brand name: EcoficO Peat Biofilter Manufacturer: Premier Tech Environment Inc.
One 1 # of modules required Manifold size: n/a " # of modules equipped with weep holes at bottom: n/a
Disposal Field - LTAR: 1.0 opd/ft' Max. bed bottom depth 12 inches lower than bench mark elevation
Backfill: To be installed over gravel beds and next to modules. Module tops to remain at 6 inches above finished
grade. Minimum soil cover over rock beds is 6 inches. Backfill to be installed with a side slope of at least 1:4.
Type A Installation: Utilizing a rock bed under each module — Sample chambers next to modules.
BED LENGTH 12 FT. WIDTH 40 FT. (480 fe) Depth of rock used for bed (81N MIN.) 8 INCHES
Allowed % reduction of drainfield aerial sq. fe.: 480 salt no aerial reduction
Setback reduction allowed: Vertical separation from SA waters taken& 100 feet requirement reduced to 70 feet
Comments: Geotextile fabric (car)able of removino silt sized narticlesl is to he use nn au evnnswi surrneoe . f fh.
permit.aut
5/97
AUG 2 5 2009
DCM WILMINGTON, NC

VII. APPURTENANCES TO SYSTEMS:
A. Subsurface drainage - Type: Depth:
Installer. Date Installed:
B. Area fill - Fill depth: Material:
Size of basal area:_X' (Wide) x A_(Long)
C. Landscape each site as needed. All sites shall be landscaped sufficient to provide surface runoff and to prevent
ponding of rain or other surface waters.
D. Comments:
The Owner shall be subject to the following conditions, limitations, and construction requirements for the
Installation of this system:
1. This authorization is effective only with respect to the specific design flow and facilities, and the nature and volume of
waste described in the Permit Application, and other supporting data.
2. This permit is not transferable and must be reapplied for at such time as ownership, or management changes.
3. The designated repair area is to have no parking, driveways, or other impervious material located on it. This
area is to be protected, reserved and maintenance in a natural state.
4. All subsequent owners of this property and sewage system, shall execute a contract between the owner and an
approved management entity before the operations permit is issued. Management of the sewer system to be provided
at all times.
5. All contracts between owners, management entity (Public or Private), or Health Dept. shall be reviewed and approved
before being accepted.
6. A properly certified Operator shall be provided as indicated: (check those that apply)
Wastewater Treatment System Operator
Certified Subsurface System Operator X
Collection System Operator
7. 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
8. This authorization shall be valid for 60 Months from the date of issue. The authorization shall become invalid if
the information submitted in the application was falsified or changed, if the permit was based on inaccurate or
incomplete information, or if the designated site is altered, or expiration of this authorization, a new application shalt be
submitted to the BCHD with updated information, as may be applicable or requested.
9. "A permanent traffic barrier shall be provided as required by the Board of Health Barrier Policy and
In place around the systemirepair area before the Operations Permit is Issued.
10. All applicable setbacks shall be maintained. No irrigation systems, storm water ponds/basins, surface/subsurface
drainage shall be located in the area of the wastewater system or its required setbacks.
INSTALLATION REQUIREMENTS
1. The system installer shall be currently licensed by the State of North Carolina and registered with this department.
2. A pre -installation conference is to be held on the site prior to beginning any site modification or construction of the
proposed structure or the sewage collection, treatment, and disposal system. Attending these conferences shall be
representatives of the State of Local Health Department; project engineer or designer, contractor, builder; proposed
system operator/installer; and the owner or his authorized agent.
3. The contractor shall be responsible for notification of the engineer and the BCHD for system inspection in stages as
required and prior to backfiiling any portion of the system. No portion of the system sha)I;be I p� ced into
use without prior approval of the BCHD. EI V C Ll
permit.aut 2 AUG 2 5 2009
5/97
DCIM WILMINGTON, NC

4. The system shall be installed in accordance with the approved set of plans and specifications. Any deviation in site
modifications, plans, specification, layout, materials or other system component shall be approved by the design
engineer and the Brunswick County Health Department prior to installation of the system. Failure to do so may result
in delay or refusal of final approval of the system, and may render the Permit null and void.
5. The system shall be installed in a timely manner and staged so as to avoid unnecessary exposure to weather.
6. The location and identification of all property lines, easements, water lines, and other appropriate utilities shall be the
responsibility of the installer.
7. Other: Trench Bottom Depth shall be no deeper than 12 inches lower than the bench mark elevation The bench
mark elevation is on the fire hydrant flange on the "Alabama" Stamp located near the front left property comer. Refer
to septic plans for location.
OPERATION PERMIT REQUIREMENTS
1. An Operation Permit shall be issued by the BCHD prior to placing the system into use, or making any connections to
the system.
2. Prior to issuance of the Operation Permit.
- the system shall be completed, installed, and tested in accordance with the approved design, including proper
abandonment of tanks existing wells, and other components,
- final landscaping, water diversion devices, and vegetative cover requirements and pressure adjustment shall be
completed,
- the engineer or applicable responsible parties shall submit as -built plans to the BCHD, the plans shall reflect any
changes or alterations from the as -approved plans.
3. For systems that have been engineered, the design engineer shall certify in writing to the Brunswick County Health
Department, that he/she has inspected the installation and that it has been installed according to the approved plans
and specifications.
- Any necessary easements, plats, or documents shall be recorded with the Register of Deeds and copies
submitted to the BCHD,
- The owner and a Public Management Entity/Subsurface System Certified Operator shall execute a contract that
addresses all of the requirements for maintenance, monitoring, and reporting in Section .1961 and the
requirements of the Schedule of Operation and Maintenance to be a part of the Operation Permit for the facility.
Provisions of said contract shall be in effect for as long as the system is in use.
R E C E I IVED
AUG 2 5 2009
t7CKr, W/ILMINGTON, NC
permit.aut 3
5/97

Nakedwwliiallan-ThisArlhod�eow Firm( Years( 60 Morift)Framdatediasue.
ff etpliahm occus, the cierd shallcomply wih ai charges it applicable regamorrs, laws. , . Al i— aspects ebc...,that maybe
dFiectim at tot Stun. Ttas may rurgtie ad3tional prellmafion rrtore =TgAM waslew IOr systems, operation and ape
regtianrerds pe teefman , eic... This could remit it leas area for the home, parldna lawer ureter usage and fiather developrrrerrt
tirr9aGors.
BRUNSWICK COUNTY HEALTH DEPARTMENT ALTERNATIVE SYSTEM IMPROVEMENTS
PERMIT/OPERATION PERMIT BCHD # 1990.027477A
Initial Site evaluation by: Danny Thornton DATE Sept. 11. 2007 and Feb. 19. 2009
Approved Plans received from: Walter Marley DATE July 20, 2009
Plans reviewed by: Danny Thornton DATE July 21, 2009
Site modifications prepared by : NA (Installer) DATE
Site modifications completed and inspected by: N/A DATE
AUTHORIZATION TO CONSTRUCT ISSUED THIS 290' DAY OF December 2008
Dallaoferpfrabbrc Decernber2%2M3
BRUNSWICK COUNTY HEALTH DEPARTMENT - ENVIRONMENTAL HEALTH DIVISION
R.S.
1. Pre -construction conference for site by:
Present for conference(list):
2. Pre -construction conference for construction of system by:
Date:
Present for conference(list):
RECEIVED
AUG 2 5 2009
permit.aut 4
5/97 DCM, WILIVIINGTON, NC

Pursuant to NCGS 11SA119(b),
Brunswick County, a locality au.
thorized to issue CAMA permits in
areas of environmental concern,
hereby gives NOTICE that on 20-Aug-
09 Emerson Fullwood applied for a
CAMA minor development permit
to construct a Single Family Resi-
dence/Stump Removal at 172 Genoes
Point Road, in Supply NC 28462. The
application may be inspected at the
address below. Public comments re-
ceived by 08-Sep-09 will be considered.
Later comments will be accepted and
considered up to the time of permit
decision. Project modifications may
occur based on further review and
comments. Notice of the permit de-
cision in this matter will be provided
upon written request
Connie Marlowe
CAMA Local Permit Officer for
Brunswick County
PO Box 249
Bolivia, NC 28422
Phone [phone]
Aug. 27
STATE OF NORTH CAROLINA Vim-' U q — U J
COUNTY OF BRUPISWICK
AFFIDAVIT OF PUBLICATION
Before the under;igned, 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 dull sworn, deposes and says: that he is
Publisher
(Owner, partnor, publisher, or other officer or employee
aut iorized to make this affidavit)
of The Brunswick Beacon, a newspaper published, issued, and en-
tered as periodical n ail in the Town of Shallotte in the said County
and State; that he is a uthorized 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 datc(s):
August 27, 2009
and that the said newspaper in which such notice, paper document
or legal advertiseme it was published, was at the time of each and
every such publication, a newspaper meeting all the requirements
and qualifications of Section 1-597 of the General Statutes of North
Carolina and was a qualified newspaper within the meaning of Sec-
tion 1-597 of the Get eral Statutes of North Carolina.
This the 27th day of August, 2009.
Sig ature of person making affidavit)
Sworn to and sub;cribed before me this 27th day of August,
2009.
�0
(Notary Public)
My commission etpires: December 29, no I
VED
SEP 10 2009
DCM WILMINGTON, NC

Pr'