BC_15-03_Mansfield

Brunswick Countv BC15.03
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-116 of the
General Statutes, "Coastal Area Management'
Issued to Perry Mansfield, authorizing development in the Estuarine Shoreline (AEC) at 6518 Walden Pond Lane SE, in
Southport NC 28461, as requested in the permittee's application, dated 23-Mar-15. This permit, issued on 13-Apr-15, 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: Attached Garage
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on 31-Mar-15.
(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 permitlee or other qualified persons
within twenty (20) days of the issuing dale. 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.
HEC EIVCD
MINGTC,,
U�rl (Xil I lj k t/vV e
Connie Marlowe
CAMA LOCAL PERMIT OFFICIAL
PO Box 249
Olivia NC 28422
2 �v
ERM TEE
(Signature required I tions above apply to permit)

Name: Perry Mansfield
Minor Permit # BC15.03
Date:13-Apr-15
Page 2
(5) The amount of impervious surface shall not exceed 30% of the lot area within 75 feet of Normal High Water
(Estuarine Shoreline Area of Environmental Concern), in this case, 774 square feet is authorized.
(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. 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 bamer 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 property stabilized with a vegetative cover.
(8) Any proposed 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.
RECEIVED
DCM WILMINGTON,
APR 1 4 7Q15.
SIGNATURE: DATE: 4--14 f�
PER ITTEE

Locality
TV LL4L-)W ► C 6-
Ocean Hazard Estuarine
GENERAL INFORMATION
LAND OWNER
Permit Number'
ORW Shoreline Public Trust Shoreliinne ,/ Other
(For official use only)��I(�r, vcr_I 26�,O� 4,3
Name MJJZ 1, y t l t- v tt
Address IWl4l._ 0l' ►y PQ I) C riJ S N
Cityri ACXL� T- State (_tjkj Zip _aRglp i Phone Cril�'1� qA 3 "Y3o9
Email IJP_QQLq C' m
AUTHORIZED AGENT
Name
/� v
Address ►Ci9Cq 1'YiaRf2 D� 1`
CityState IUL Zip: kg61 Phone
0 j
LOCATION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront, what is the name of the
adjacentwaterbody.) 4S1A LL) peU PnICI �.rJSN
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) RTrAcCndip jgA 1�C?.
SIZE OF LOT/PARCEL: 9A3 S qb squarefeet , y , �.� acres
PROPOSED USE: Residential M/� (Single-family M Multi -family ❑ ) Commercial/Industrial ❑ Other ❑
COMPLETE EITHER (1) OR (2) BELOW (Contact your Local Permit Officer ifyou are not sure which AEC applies
to your property):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF 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 SHORELIct" E I: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES ��`+31qua" Ye et (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.)
77q5`I I.
�A.
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.
RECEIVED ii-C;EIVED
'ivl WILMINGTON, NC
MAR 31 2015
APR 2 8 2015

OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA
minor development permit, including, but not limited to: Drinking Water Well, Septic Tank (or other sanitary waste
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 undersigned, 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)
Zan owner or record title, Title is vested in see Deed Book
-J
page 3_ Le inthe 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.
NOTIFICATION OF ADJACENT PROPERTY OWNERS:
I furthermore certify that the following persons 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)
(1)
(2)
(3)
(4)
ACKNOWLEDGEMENTS:
(Address)
I, the undersigned, 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 particu-
lar hazard problems associated with this lot. This explanation was accompanied by recommendations concerning stabiliza-
tion and floodproofing techniques.
I furthermore certify that I 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.
Landowner
This the A day of TAAk&1 , 2011y
to acCas his/her agent for purpose of firing a CAMAperrHt application
This application includes: general information (this form), a site drmving as described on the back of this application, the
ownership statement, the Ocean Hazard AEC Notice where necessary, 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.
RECEIVED t 1 E C E I V E D
MAR 3 1 2013 .1 WILMINGTON, NC
APR 282015

0 a�
HCDE R
North Carolina Department of Environment and Natural Resources
Pat McCrory Donald R. van der Vaan
Governor
Secretary
AGENT AUTHORIZATION FORM
Date: .3 - 3 ' 9,01-5
Name of Property Owner Applying for Permit: Name of Authorized Agent for this project:
GIZA C'ctast ra:c ruxo 4,43c.
GU R.Aror3C (}t,^_t32(Z
Owner's Mailing Address:
Cs-??) LOALAevc, PCniA kru S�
Email:
PeRI-U
L� i�Rr
6 L8 gO.crrAeRS ,Corl\
Phone
(91(s)
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Agent's Mailing Address:
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Email: a
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Phone
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I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
for, and obtaining all CAMA Permits necessary to install or construct the following (activity):
AT-rra-cL,1P c�.aLl=,c"� e-
For my property located at _e t) I9 Lf4Lde-n; Pd4l kN S
Wiz_
s
This certification is valid 1 year from (date) 3 R 1
Property Owner Signature
3-au• aalS
Date F3EC' EIVED
DCM WILMINGTON, NC
APR 2 E 2015
N.C. Division of Coastal Management
127 Cardinal Dnve Ext., Wilmington, NC 28405
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net
An EAU,v opPM.niry, Affil 6eAc rEMRMy

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, R 2 8 2015
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0313112015 14:38 Brtmsco EH Dept. 1FA)W102M52 P.0011001
BRUNSWICK COUNTY HEALTH DEPARTMENT TYPE: Ma
DATEREC.:11-14-95 P,I.N.: FILENO.:95 / 43357
PATTEN.CAROLINA LAND 50.00 206BA068 95007427
REC. FROM AMT. PD. TAX PARCEL
3973A MARKET-ST WILMINGTON NC 28403 t910763-0071
ADDRESS CITY aT ZIP PHONE
.WINDING.. CREEK::.. .: / / III
CURRENT PROPERTY OWNER SUBDIVISION LOT sLX SEC
SOUTHPORT �._ 65 .>WALDEN _P.OND.: LA,.,
PROPERTY LOCATED. TOWNI07VAREAI DIRECTIONS TO PAOPERTYr
NE -RE ..HWY 97S TO AETHMT. An
AI,ITHORIZATION FOR WASTEWATER CONSTRUCTION PERMIT
PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE.
NEW EXISTING SYSTEM REPAIR RENEWAL
NOTE: All the conditions specified on the IMPROVEMENT PERMIT must be met.
Design Flow: Y`ae gpd. Septictanksize: 1000 gal
No. Bedrooms -±L No. employees N 4 Maximum Trench/Bed Bottom Depth: / 8 rr inches
/
No. Lines: 3 Length each: 8 9 Bed dimensions: N A
Fill Check:
Approved:
wre Auewdted Agent
PERMIT ISSUE DATE: !r �' (Expires 60 Months from date of issue.)
PERMIT NOT VALID UNLESS SIGNED BY AUTHORIZED AGENT: Pile,
Wastewater System Installer:
Comments: (tank Info) —
OPERATION PERMIT:
__f y
Date:
�VED
i -TON, NC
c Date:_
Authorized Agent Signature
Actions of local health department representalives or the Slate engaged in the evaluation and determination of measures required to effect compliance with the
applicable laws and rules shall In no way be taken as a warranty that sewage treatment and disposal systems approved and permitted will function In a satisfactory
manner for any given period of time. The Issuance of this permit does not preclude the Permiltes from complying with any and all statues, rules, regulations, or
ordinances which may be imposed by other government anemias (local. stele. and federal) which have iuriartichnn

Date
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Adjacent Property Owner
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City, State, 2�e
Dear Adjacent Properly:
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This letter is to inform you that I, Per2fti.i M pw!z f 2L6 have applied for a CAMA Minor
Prop" Owner
Permilonmyproperty at Coh)R Wt i4 )&j Po1Jc) klk3 Sr= 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 meat SDI 16) 3 & 1- .3 y or by mail at the address listed below. If you wish to
Applicants Telephone
AL USE
30
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$0.00 ;
file written comments or objections with the LOCAL GOVERNMENT LAMA Minor Permit Program, you may submit
them to:
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY, STATE, ZIP CODE
Sincerely,
pe'm-t Me"'r'FlC, lr
Property OWner
6519 LJAL&-� Pcvr4 A Ly,:, s S
Mailing Address
Sou rt Ae&r. rt1C'
City, State, Zip Code
RECEIVED
DCM WILMINGTON, NC
APR 2 8 2015

Date
W1tc�1;51 Crzelc Crnwm Sao lg5czc..x=-,
PdjacentPr pe Owner
Mai'ng Ad ress
City, State, IP Code
Dear Adjacent Property:
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or PO Box No. rto.-IW-/--------------
This letter is to inform you that I, Pt'y w m qvo'l'' uhave applied for a CAMA Minor
'Ibroperty Owner
Permit on my property at (yAu) e!s i An41) 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 at (I I Q) U,7 - A'4 1 or by mail at the address fisted below. If you wish to
Appficanfs Telephone
file written comments orobjections 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,
Pey-a a 11\� as-E,eLi�
Property er
Mailing Address
yklo—
City, State, hp Code
RECEiVEO
DCM WILMINGTON, NC
APR 2 8 2015

MINUS
Date.
Q+G 4914 10 A?JIa &82 )-14"
A ,jacent P�rpQpGGr�tty}' 1 w
�iY•.7.G LL'Jlt'�CeR; Yfltia
M ding Ad�yrd,�rress n
City, State, Zip Code
Dear Adjacent Property:
tall I It-ItU WIAIL" RECEIPT
Domestic Mail Only
For delivery information, visit out website at www.usps.com'.
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This letter is to inform you that I, PCIZ Z,(.t (y) A"wz Ft Q LCA have applied for a CAMA Minor
Property Owner
Permit on my property at 1p.s` )P i Q i-it- ?f30 7"o,,O S t= 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 at 6 1 C) 3 tc'7 3 y Cs or by mail at the address listed below. If you wish to
Applicanfs 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,
Property OEmer
4PSIB WALloo 1116C kari Sf
Mailing Address
_$Vurl,t Deis Viael—
City, State, Zip Code
0
Postmark
TT ))53 Hers
0
RECEIVELD .
DCM WILMINGTON, NC
APR 2 8 2015