PC_09-03_Sample

Ponder County 2009.03
Local Government Permit Number
CAMA
MINOR DEVELOPMENT --r
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 113P-118 of the
General Statutes, "Coastal Area Management"
Issued to Gary Sample, authorizing development In the Estuarine Shoreline - ORW (AEC) at terminus of Dogwood Lane,
In Hampstead, Fender County, NC, as requested In the permittee's application, dated July 22, 2009. This permit, issued
on August 12, 2009, 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: Construction of a 19' x 30' storage building with 1' overhang.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat'
drawings(s) dated received on July 24, 2009,
(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 reevaluation and
modification of this permit.
(4) A copy of this permit shall be posted or available on site. Contact this office at 910.259-1202 for a final Inspection at
completion of work, L G
(Additional Permit Conditions on Paget) XM WILMINGTON, NC
OCT - 0 1 2009
This permit action may be appealed by the permlitee 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 oinoer 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 ow
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.
Kenneth Vafter
CAMA LOCAL PERMIT OFFICIAL
PO Box 1519
conditions above apply to permit)

Name: Gary Sample
Minor Permit # 2009-03
Date: August 22, 2009
Page 2
(5) The amount of impervious surface shall not exceed 256/o of the lot area within 575 feet of Normal High Water
(Estuarine Shoreline - ORW Area of Environmental Concern), In this case,11,217 square feet is authorized.
(6) Unless specifically allowed In 15A NCAC 07H, 0269(d)(10), and shown on the permitted plan drawing, all
development/construction shall be located a distance of 30 feet landward of Normal High Water, No portion of the
roof overhang shall encroach into the 30 ft. buffer.
(7) All unconsolidated material resulting from associated grading and landscaping shall be retained on site by effective
sedimentation and erosion control measures. Prior to any land -disturbing activities, a barrier line of filter cloth must
be Installed between the land disturbing activity and the adjacent marsh or water areas, until such time as the area
has been properly stabilized with a vegetative cover.
(8) Any proposed for grading within the 30' buffer from the Normal High Water must be contoured to prevent additional
stormwater runoff to the adjacent marsh. This area shall be immediately vegetatively stabilized, and must remain in
a vegetated state.
(9) All other disturbed areas shall be vegetatively stabilized (planted and mulched) within 14 days of construction
completion,
DCM WILMINGTON, NC
O C T 0 1 2009
?�,2?�q p
SIGNATURE: DATE:--_
MI EE

9
Locality r44 of 'U•w."003 16,41. k" 7. Permit Number So
Ocean Hazard Estuarine Shoreline ORW Shoreline '--� Public Trust Shoreline Other
(For official use only)
GG NFRALINFORMATION
LAND OWNER
Name
AddressS
city ��i�, State +4S` Zip z�L13 Phone
AUTHORIZED AGENT
NameSO ACSL
Address 10 N 5TRGZ.C7AZQ
City State ) C" Zip a�4�13 Phone q 10-yq,;w tS
LOCATION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront, wh t is thearme-of the
adjacent waterbody.) ��d L.ZM l l LA Al tl `i-kt c �.94 �.(
DESCRIPTION OF PROAT: (List al] proposed construction and land disturbance.) l r /r To67;y
A _ r
_Carr r-A c�t 1
SIZE OF LOT/PARCEL:
square feet l • O 30 acres
PROPOSED USE: Residential (Single-family Multi -family— ) Commercial/Industrial
Other -)t— %* rm- t
TOTAL ENCLOSED FLOOR AREA OF A BUILDING IN THE OCEAN HAZARD AREA OF ENVIRON-
MENTAL CONCERN (AEC): )919 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): GL* 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.)
Choose the AEC area that applies to your property:
(1) within 75 feet of Normal High Water/Norma) Water Level for the Estuarine Shoreline AEC
within 575 feet of Normal High Water/ Normal Water Level for the Estuarine Shoreline AEC, adjacent to
Outstanding Resource Waters
%w (3) within 30 feet of Normal High Water/ Normal Water Level for the Public Trust Shoreline AEC °
(Contact your Local Permit Officer if you are not sure which AEC applies to your property.)
RECEIVED
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subjUMa fit r NC
Management Permit is5ued by the NC Division of Water Quality?
YES NOJUL 2 7 2009
t j 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 pemtits that might be required. We suggest you check over the list
your LPO to determine if any of these apply to your project. Zoning, Drinking Water Well, Septic Tank (or other sanitary waste
nent 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.
TEMENT OF OWNERSHIP:
: undersigped, an applicant for a CAMA minor development permit, being either the owner of property in an AEC or a
xi authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person
i as landowner on this application has a significant interest in the real property described therein. This interest can be
ribed as: (check one)
An owner or recor itle. Title is vested in 0=2 A" 5AMPL , see Deed Book U 8 B
c25(1,_ in the -,?I County R gistry of Deeds.
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.
HFICATION OF ADJACENT PROPERTY OW HERS:
thermore certify that the following persons are owners of properties adjoining this property. I affirm that I have given
'UAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
t DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS:
:nowledge 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
ciated with this lot. This explanation was accompanied by recommendations concerning stabilization and floodproofing
niques.
;MISSION 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
ersbip statement, the AEC hazard notice where necessary, a check for $ MOM made payable to the locality, and any
miation as may be provided orally by the applicant. The details of the application as described by these sources are
rporated without reference in any permit which may be issued Deviation from these details will constitute a violation
ty permit. Any person developing in an AEC without permit is subject to civil, criminal and administrative action.
Landowner or person authorized
of !� ,20
l hl RECEIVED '
-�UUM WILMINGTON, NC
his agent for propose of filing a CAMA permit application
JUL 2 7 2009

i
D. -
14
i fs 111T. 6 B-1-164
Dear Adjacent Property:
Receipts for
Certified Mail
(Staple Here)
ISS
This letter is to inform you that I, 1111: "i" +`ram — have applied for a CAMA Minor
�Property Owner '
Permit on my property at .� I JL7, Uto Cone— in Pander
Or6perty Address
County. As required by CAMA regulations, 1 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 q 10 a%O' LW,'� or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the Pender County CAMA Minor Permit Program, you may submit
them to:
Kenneth Vafier
Local Permit Officer for Pander County
805 S. Walker Street
Burgaw, NO 28425
Sincerely,
Property- w er
1351 :�)WU.X d
rMa�ilinggA�dd�ress
City, State, Zip Code
.�hj5 IS CO✓+fe- replaccrLUA-f- OF RECEIVED
�c�bflrl9 z-fn'agc- zhcc( c�nC.0 DCM WILMINGTON, NC
JUL 2 7 2009

0
)r
er
,a
Receipts for
Certified Mail
(Staplo Here)
0
Dear Adjacent Property:
This letter is to inform you that I, a vi : k'4 x a el have applied for a CAMA Min
�
Property Owner
Permit on my property at 35R j.(Iu=d C x a in Penc
Pr6perty 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 ret
the enclosed no objection form. If you have any questions or comments about my proposed project, plea
contact me at q lo. a7)- 4�ss or by mail at the address listed below. If you wish
Applicanfs Telephone
file written comments or objections with the Pander County CAMA Minor Permit Program, you may subm
them to:
Kenneth Vafier
Local Permit Officer for Pander County
805 S. Walker Street
Burgaw, NC 28425
�/ ; a�.�. \ I.L.• '
op
\5513xg)xs kanL
Mailing .:
City, State, Zip Code
RECEIVED
DCM WILMINGTON, NC
JUL 2 7 2009

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that 1 own property adjacent to
J
j�� (Name of Property Owner)
property located at�
J
Address, Lot, Block, Road, etc.)
on in A Q ftp��Oj , N.C.
(Waterbody) Town and/or County)
He has described to me as shown in the attached application and project drawing(s), the
development he is proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
(q1b - al )-449S
Telephone Number
Date
RECEIVED
DCM WILMINGTON, NC
JUL 2 7 2009

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
1 hereby certify that I own property adjacent to Wil'OLW F—• L.I. &ctr 's
�cn '� ,1 (Name of Property Owner)
property located at , IIa�[A (c )1e,
Address, Lot, Block, Road, etc.)
on
and/or County)
N.C.
He has described to me as shown in the attached application and project drawing(s), the
development he is proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
gio- 0-10-L4gg5
Telephone Number
!3' dt' dLJIJ 7
Date
RECEIVED
DCM WILMINGTON, NC
JUL 2 7 2009

U.S. Postal Service.!,
CERTIFIED MAIL,, RECEIPT
(Domestic Mali Only; No Insurance Coverage
Provided)
For delivery Information visit our webaite at
a
www.unpn.eom�
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:s
PS Farm 3BW.Aagus12006
See Pwerse for Instructions
U.S. Postal Service—
CERTIFIED MAIL.,
RECEIPT
(Domestic Mail only; No Insurance
Coverage Provided)
FarFor dele[lon visit our
weosita el www.usps.00mo
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C3 lFso'+reeMw Requr
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rq � TaW poategsB Fees .$
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RECEIVED
DCM WILMINGTON, NC
JUL 2 7 2009

(6
REC
JUL 2 7 2009
KO

Doi-e)3
NOTICE OF FILING
OF APPLICATION FOR
CAMA MINOR DEVELOPMENT PERMIT
Pursuant to NCGS 113A-119(b), Pender County, a locality authorized to issue CAMA permits in
Areas of Environmental Concern, hereby gives NOTICE that on July 24, 2009, Gary Sample applied for a
CAMA permit to construct a 19' x 30' storage building with a V overhang at the terminus of
Dogwood Lane, Pender County, INC.
The application may be inspected at the address below. Public comments received by August
20, 2009 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
decision in this matter will be provided upon written request.
Kenneth Vafier
CAMA Local Permit Officer for
Pender County
PO Box 1519, Burgaw, NC 28425
910-259-1734
PLEASE PUBLISH ON: August 5, 2009
RECEIVED
DCM WILMINGTON, NC
AUG 2 7 2009

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