PN_15-03_Forehand

Pender Countv 2015.03
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 Brian D. Forehand, authorizing development in the ORW Shoreline (AEC) at Lot 12 Washington Acres Road,
in Hampstead, NC, as requested in the permittee's application, dated January 22, 2015, This permit, issued on January
29, 2015, 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 2,432 square foot single-family residential structure and 1,200 square foot driveway with
associated clearing, grading, and landscaping on the subject property.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on January 22, 2015.
(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 910-259-1408 for a final inspection at
completion of work.
(Additional Permit Conditions on Page 2) H 1=G L I V E D
DCM WILMINGTON, NC
o 6 2015
This permit action may be appealed by the permihee or other qualified persons
within twenty (20) days of the issuing date. 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, 2018
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.
,r-r1" k� Ccr,37
Andy Christy
CAMA LOCAL PERMIT OFFICIAL
805 South Walker Street
PO Box 1519
Burgaw, NC 28425
PERMITTEE
(Signature required if conditions above apply to permit)

Name: Briar W.Fdr6hand
Mjnor,?,grrqLt,# gjktQ?
Date: January 29, 2015
Page 2
(5)
surface shall
(6) Unless specificallyallowed,
clevelopmentljxnstrucfioniE
" I � V. ikr
575 feet of Normal High Water (ORW
bsurface,is'authodzecl at this time,
drawing, all
(7) All unconsolidated mitedalresulUfigfrom-a's's"o"ci'a-t'ed--g'r'ading-and'iandtdWiqgrghbll'WtdWinedon-sitb by effective
sediinentation and erosion control'Mekuresk6etoany land -disturbing activities, a barrier line Of filter cloth'must
`be Installed between the land disturbingacti marsh or water areas, 666i si&fimi as the area
has:1 F,
SR6 OffioMy'kablik 6-`d-,Ah b'�Ve'og"6tA6vd
rlj Iti
ge eNoftaliKig4Wateffe6st,6W6ci'n'iour6d t6oruft add0b`okW.
(8)4 propo�ed.fdrgrWirg; itlfhth��3��Uu rfrb mth
I
stormwitelrtuhPffjolhe qtace,ht-mars4.-This-,ateAshaltb6im-tediately,,vegbtafivelk,'sbbiliidd,i:and,Must-re mM-'rfIr-F*.z- 1
a vegetated state. i::�6
(9) All other disturbed areas shall be vageWyelystabilized-(planted and,mdlched) within 14 days of construction
V
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uO,
ISIGNATURE";I DATE:
It
PERMITTEE

Pender County 2015.03
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 Brian D. Forehand, authorizing development in the ORW Shoreline (AEC) at Lot 12 Washington Acres Road,
in Hampstead, NC, as requested in the permittee's application, dated January 22, 2015. This permit, issued on January
29, 2015, 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 2,432 square foot single-family residential structure and 1,200 square foot driveway with
associated clearing, grading, and landscaping on the subject property.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on January 22, 2015.
(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 910-259-1408 for a final inspection at
completion of work.
t : -iV EU
(Additional Permit Conditions on Page2) DCM WILMINGTON, N(
FEB 0 4 2015
This penult action may be appealed by the permittee or other qualified persons
within twenty (20) days of the issuing date. 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, 17
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.
Andy Christy
CAMA LOCAL PERMIT OFFICIAL
805 South Walker Street
PO Box 1519
Burgaw, NC 28425
PERMITTEE
(Signature required if conditions above apply to permit)

Name: Brian D. Forehand
Minor Permit # 2015.03
Date: January 29, 2015
Page 2
(5) The amount of impervious surface shall not exceed 25% of the lot area within 575 feet of Normal High Water (ORW
Area of Environmental Concern). In this case, 3,635 square feet of impervious surface is authorized at this time,
whereas 5,002 total square feet may be permitted.
(6) Unless specifically allowed in 15A NCAC 07H. 0209(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.
(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.
"CCEIVED
DCM WILMINGTON, NC
TB 0 4 2015
SIGNATURE:,2L� � DATE:
PERMITTEE

Pender County 2015.03
Local Government Permit Number
CAMA
MINOR DEVELOPMENT i
•
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 Brian D. Forehand, authorizing development in the ORW Shoreline (AEC) at Lot 12 Washington Acres Road,
in Hampstead, NC, as requested in the permittee's application, dated January 22, 2015. This permit, issued on January
29, 2015, 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 2,432 square foot single-family residential structure and 1,200 square foot driveway with
associated clearing, grading, and landscaping on the subject property.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on January 22, 2015.
(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 910-259-1408 for a final inspection at
completion of work. E I V E D
(Additional Permit Conditions on Page 2) uCM WILMINGTON, NC
JAN 2 2 26j5
This permit action may be appealed by the permittee or other qualified persons
within twenty (20) days of the issuing date. 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, 2�J
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.
Andy Christy
CAMA LOCAL PERMIT OFFICIAL
805 South Walker Street
PO Box 1519
Burgaw, NC 28425
PERMITTEE
(Signature required if conditions above apply to permit)

Name: Brian D. Forehand
Minor Permit # 2015.03
Date: January 29, 2015
Page 2
(5) The amount of impervious surface shall not exceed 25% of the lot area within 575 feet of Normal High Water (ORW
Area of Environmental Concern). In this case, 3,635 square feet of impervious surface is authorized at this time,
whereas 5,002 total square feet may be permitted.
(6) Unless specifically allowed in 15A NCAC 07H. 0209(d)(10), and shown on the permitted plan drawing, all
development1construction shall be located a distance of 30 feet landward of Normal High Water.
(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.
SIGNATURE: DATE:
PERMITTEE
RECEIVED
DCM WILMINGTON, NC
JAN 2 2 2015

RECEIVED
Locality ir4drY cO✓i'lbPem:i1 YnniMr LOf s - 075
Ocean Hazard __ Esacerine Shoreltrc49- ORW Shorelme _,_ Public Trull Shmehue-_ Other —
GENERAL INFORM A'I ION
LAND OWNER r� /
Name dr`e ay. D, /�A
Add., PC), Bdg //
City /n)r/I
` ^" :roc ivn State zP -2—&4(. s25;;?
AUTHORIZED AGENT
Name
CIty l'l a-,!- ')Lµ' Snake _N C_ Zio=Y a5�L-rf/-f- 746.9S
JAN 2 21015
OTHER PERMITS MAY BE RF.QI tg�1�stiyQyy,o-u� are planning may require pemnta other dun the CAMA
minor development permit, including, but tot lime&d� Well, Septic Teak (or other sanitary waste
treatment system), Building, Electrical, Plumbing. Heating and Arc Conditioning, insulation and Energy Conservation, FIA
Certification, Sand Dote. Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway Connection, and
mli.m. Check with your I. ] Permit Officer for mom irdonnution.
SI'.ATEMENT OF OWNERSHIP:
I, the u dmigned, an applicant for a CAMA minor develupmrnt permit, being either the owner of property in an AEC or a
person authorized to act m an agent for purposes of applying for a CAMA mior development pemtit certify that the person
listed as landowner an this application has a significant interest in the real property described therein. This interest can be
described ss: (check one)
.-'. owns or record tide, Tith ia,oued to B� `f P JG-eAei' . rec Deed Book
Page jyj in the County Registry of Dasds
_an owner by virtue of iohericar". Applicant is an heir to the estate of
probNe was in County.
_if other interest, such as omen eommmr or lease, explain below m use a separate sheet & stench to this application.
NOTIFICATION OF ADJACENT PROPERTY OWNERS:
I furthermore certify that the following persons me owners ofpmperties adjoining this property. I a6um that I have given
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA parom.
LOCATION OF PROJECT: (Address, anent mime and/or di oat to tiro. If�m an oeafrom, what is the mime of the 1-1adjacentwNerWdy) 12/ 0 T w/4'-775A-t. Nero ,�,{�, (2)
(3)
DESCRIPTION OF PROJECT: (Lim all proposed cmaunstam and had dutusbanco) h��/R/s^ to"' elF (g)
SIZE OF LOT/PARCEL: d� square feet e Y acre
PROPOSED USE: Residential V (Single -fatuity ❑ Mulfi-family ❑ ) Commercial/Industrial ❑ Other ❑
COMPLETE EITHER (1) OR (2) BELOW (Caalactyaur Local Permit Officer Ifyou are am sire which AEC Witter
sa your proparyp
(1) OCEAN HAZARD AECia TOTAL FLOOR AREA OF PROPOSED STRUCTURE: _ square fact (includes
air conditioned living space, parking elevated above ground level, oo-condirioned space elevated above ground level bur
excluding ton -load -bearing aaic space)
(2) COASTAL SHORFLINE AEC,: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BURT
UPON SURFACES: uam feet (includes the area of the roof/drip line ofall buildings, driveways, covered docks,
concrete or masonry patios. one. that ante within the applicable AEC. Attach your calculations with the project drawing.)
3435
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area abject W a State Sweetwater
Mansigum5tiferand issued by the NC Division of Water Quality'
YESi/ NO_ nn
If yes, list the Wend built upon mea/imporvious surface allowed for your lot or parcel: Sri'v b sgnere (ace
Wj
ACKNOWLEDGEMENTS:
1, the undersigned, acknowledge tbal the land owner is aware that the proposal development is pl&mcd for an arm which
may be suwcpnble to erosion and/or flooding. I acknowledge then the Local Permit Officer has cxplamcd to me the parricu-
I., hazard problems associated with this lot This explanation was sccomponied by recommmdstwiti concerning smbilia-
rum and floodproanng techniques.
I Oath rmore certify thin 1 am authorized W grant. and do in fact gram, perm union to Division of Coastal Management staff,
the Local Permit Officer and their agents to enter on the aforementioned ends in connection with evaluating information
related W this permit application.
Thia the �ds of ;-N , 20 15'
of filing a CAMA petmil applicarton
This application indades: general information (this form), a site drawing as described on the back ol'this application, the
ownership stares mt, the hear, Hazard AEC Notice where nee aviary, a check for $100.00 made paysbk in the locehty, and
any infarmarion as may be provided orally by the applicant The details of the application as dwilhod by these sources are
incorporated without&fereace in any permit which may be Issued. Devint/orefrom these derails will corms ut, a 11,1011" of
any permit. Anypersoa developing in an AEC without permit is subject so chill, crtai al and administrative action.
FicCEIVED
DCM WILMINGTON, NC
,29f/r) 3
JAN 2 2 M15

SITE DRAWING/APPLICATION CHECKLIST
Pleaenmako sum year site drawing indludesthefollowing inPortnedw required fora CAM .minor davelopmen[permit
The Local Penult ONm.will help you, if requested.
PHYSICALMMNSIONS
_Labd mods
Label highways aghtof-ways .
label local setback bass
Label any and al itmmtes and driveways currently existing onproperty
label adjacent welerbody
_ draw and label annual high water line (maw ,LPO for assistance)
Draw location ofou�hc wastewater system
Ifyou wiill6c IdngMlhe seem hazard stem .
_Draw label dune ndgca (Mcludespo[elevations}
Draw an bel tea ofdones
_^Identi and 'lust line ofstable vegoacZ(eanmct LPO for'msismacc)'
_. Drawandlebel a 'on setback he (co tnctLPOformotance)
Drawandlab.l toga bleat feaanes'(oimoad)
Ifyou will be working inn coutalshomlbrc are:
_ Show,the roofoverbang=a dotted time amend the structure
_ Dmw and label landward Harit of AEC
Dmw and lahe(.allwelland Uses (contactLPO for assistance)
_ Draw and label the 30-foot buffer lme-
DEVELOPMENTPLANS
_ Draw"evd label all proposed stuctum
_Drawand label arrasibm will be disnubedandlot landscaped
—Now size ofpiling and depth to bople.ed in ground
_ Draw ad label allareastdbe paved orgraveled
_ Shawell areas"m be dlatarbed
_ghowlandscaping
NOTETOAPPLICANT
Haveyou:
• completed all blanks and/or indicated if not applicable?
• notified and ,listed adjacent pro"owneral'
'• included'your sit. drawing!
• signed and dateMe application?
• minted the$100.00 fee?
• completed an AEC Hazard Notice, ifotcesso•y!(Must be signed by the, property owns)
APPLICATION FOR
CAMA MINOR
DEVELOPMENT
PERNHT
the burden on the applicant
This. application for, a Minordevelopmont permit,undefCAMAIs part of the
Camssiwiou'a effort to mat the spirkand intent ofthe General Assembly., R boibeen
designed to be slialgle forvmrd and require uomoretime or effort than necessary from
the applicant, Floatage over, this folder with the Lawl Permit ONeeklal?9) for the
lowgtyln which you plan to build toN be certain at you and erstaad what information be
orsho needs before you apply.
UnderCAhIA regolatlona, the minor ferrets Is to be Issued within 25 days once a
complete appgcatian is In hond. Often less time Is needed Ifthe project is sbnple.The
prowls generally takes about 18 days; Vou can speed the approval f rocem by maklug
eertah, thotyour npplieadon Is complete and signed; Natyaordrow)ng Mesta the
speefihatlansgiiza Inside and that your affiliation feetsattached.
Other pervaits are sometimes requlied,for development in the waste[ oreo. While these
wenot!AMA-mIntei4-we rage you to check with the focal Permit Officer to delermine
which of these. you may need. Alist Is Included on page two of this folder.
We appreciate your cooperation with the North Carolina Centel blaoagementPmgram
and your willingness tabuild in a way thatpmlects the resources of our beautiful and
productive coast
Coastal Resources Comminsion
Division of Coastal Management
Jgfy 212 1015
t�
PMDER
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'DCM Eo®EB195YS01lVRcvncdAaal 2010

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Ad' nt Property Owner
'15
M.a7ing Address /V z�
City, State, Zip Code
Dear Adjacent Property:
. Postal
Service
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MAIL,
RECEIPT
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estic Mail
Only;
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information
visit our
website�
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This letter is to inform you that I, /?/ r oh T -elx iY have applied for a CAMA Minor
i Property Owner
Permit on my property at A) W <'(4 AL, if, in
Property Address
Pender County. As required by CAMA regulations, I have enclosed a copy of my project drawing(s)
as notification of my proposed project No action is required from you. If you have any questions or
comments about my proposed project, please contact me at e2S"2—g ys— -74Ca-c- or by
Applicants Telephone
mail at the address listed below. If you wish to file written comments or objections with the Pander County
CAMA Minor Permit Program, you may submit them to:
Local Permit Officer for Pender County
PO Box 1519
805 South Walker Street
Burgaw, NC 28425
Sincerely,
RFECEws"'
1AN 2 2 V15
111,00MECEIVED
DCM WILMINGTON, NC
JAN 222015

Adjacent Property Owner C { f> I
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0
MAddress
Mw.
City, State, Zip Code
Dear Adjacent Property:
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U.S. Postal Service
CERTIFIED MAIL. RECEIPT
(Domestic Mai, only: No Insurance .,overage Provided)
For delivery information visd nor wehsite at www.usps.com
AL I
P~; • � 't
CaNfletl Fee t�. _1�.
peeUnerk
Rerum ReceKK Fee tax, H"e
(Enao9eme^t Requl�
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This letter is to inform you that 1,r tan �arlha.,�! have applied for a CAMA Minor
Property Owner
Permit on my property at �� 13 iT� AGr(r �cY in
Property A ss
Pender County. As required by CAMA regulations, I have enclosed a copy of my project drawing(s)
as notification of my proposed project No action is required from you. If you have any questions or
comments about my proposed project, please contact me at 5.;2 - -3 6 � r or by
Applicant's Telephone
mail at the address listed below. If you wish to file written comments or objections with the Pender County
CAMA Minor Permit Program, you may submit them to:
Sincerely,
i
(0, J3nY /0793
Maaing Address
City, State, Tip Code
Local Permit Officer for Pender County
PO Box 1519
805 South Walker Street
Burgaw, NC 28425
RECEIVED
JAN 2 2 W5
FENDER PLAtM111Nr• US"'
RECEIVED
DCM WILMINGTON, NC
JAN 2 2 2015

.Z
pEGENE�
JAN 2 2 20",
PLM800 Devi•
Lot 13
Ni
Note: Any and all developmental
restrictions (Federal, State, Local,
P.O.A., H.O.A., Deed, Etc.) must
be verified with the parties
responsible for enforcing those
restrictions prior to any design
or construction.
mneled Waterway.
k2OCr
_I
3
0
0
I
I
IBenchmark
Top of EIR
— — — —
— — — — — Elev.=7.29'
V
_(NAVD 88)
Lot 12
20,007 s.f.
M
I 'LL
� I
' o
— S 3622'00" W 104.43'
Washington Acres
(40' Private R/W)
Scale: 1'= 40'
40' 26 0' 40'
PLOT PLAN FOR:
A.T.S. Construction of the Carolinas
Washington Acres Road
Lot 12, Section 5
Long Point Estates Subdivision
Topsail Township, Pender County, NC
Date: January 13, 2015
Survey Reference:
Deed Book J= Page 3a
Map Book J& Page ,S¢
This property is located
within a Special Flood Hazard Area.
Project fI: 1472 Mop Name: 1472 PP.dwe Drafter:
a Site
VICINITY MAP r1
I
I
•-Ipol: Z+32
~,
W Lot 11
0
0
M
LO
i7
---------------
10 Utility Easement
Rd.
3
This map has been drawn from
ted in the
references aormation nd as noted and ail
01\k 1CARO",,,,
......
Improvements are proposed and
pQ ..f
ay =
are for planning purposes only.
: ?, o •iy
No actual field survey has been
'Prellminer.
SCtI ��'•4
7 Ek
performed. , not for
_
1
recordatiopa conveyances. or isles: L-4094, _
Paul D. Talbot, P.L.S. L-4099 ""ir„IIi„ii�"
Talbot Land Surveying, P.C..
16747 U.S. Hwy 17, Suite 106
Hampstead, North Carolina 28443
Firm Ucense C-2722 /
Phone: [phone]a24 Fax: (910) 270—OM