OI_16-07_Welch

Oak Island 0116-07
Local Government Permit Number
CAMA
MINOR DEVELOPMENT
PERMIT
as authorized by the State of North Carolina, Department of Environmental,
Quality 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 Barbara & Ed Welch, authorizing development in the Ocean Hazard & Estuarine Shoreline (AEC) at 5410 W.
Dolphin Dr., in Oak Island, NC, as requested in the permittee's application, dated 1/1512016. This permit, issued on
1/29/2016, 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: the construction of an arbor over the existing front deck, arbor along the west side of the house, and a free
standing arbor on the back east side of the house also a fence along the perimeter of the property.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on 1/15/2016.
(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 910-278-5024 for a final inspection at
completion of work.
(Additional Permit Conditions on Page 2) RECEIVED
DCM WILMINGTON, NC
This permit action may be appealed by the permiffee 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, 2019
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 wrtten approval of the Division of Coastal
Management.
Donna F. Coleman
CAMA LOCAL PERMIT OFFICIAL
4601 E. Oak Island Dr.
Oak Island, NC 28465
PERMITTEE
(Signature required if conditions above apply to permit)

Name: Welch
Minor Permit # 0116-07
Date: 01115/2016
Page 2
(5) The amount of impervious surface shall not exceed 30% of the lot area within 75 feet of the normal high water
(Estuarine Shoreline Area of Environmental Concern), in this case, No increase to the existing square footage 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 the 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.
SIGNATURE: DATE:
PERMITTEE
RECEIVED
DCM WILMINGTON, NC
JAN 2 9 2016

Locality6_1 ���F1GL Permit Number O= t 6— 6
Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline "Other
x(For official use onl))
GENERAL INFORMATION
LAND OWNER
RECEIVED
1115I)L,
Address \3�1 ' N� %k y�
City ��Gt�% J-`i t 0,CJ, State �}_ Zip�1S Phone
Email
AUTHORIZED AGENT
Address
City
Email
State
r C_
Zip Phone
LOCATION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront, what is the name of the
adjacent waterbody.) !!5 L[ 1 O W �0(D t� R � i�� , N G Z 53 q(, ' Doev i
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.)-Fe_Y'1Ce_ rcu k'—LOf— iiVt"
S7X 53
SIZE OF LOT/PARCEL: Sr)X I t to square feet acres
PROPOSED USE: Residential X (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 applies
to your property):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: tD Teo 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: ,P d square feet (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.)
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a State Stormwater
Management Permit i ed 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: gttINGTO Q
- DCM WILMINGTON, NC
!AN 2 8 2016

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)
A5—an� owner or record title, Title is vested inl2ibaM, 4 CA V�JOJ see Deed Book
page �v `� in the�ZV-U/y,51Jl (,V_, 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) (Adrtrecc) 11__ I,�
ACKNOWLEDGEMENTS:
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. ff
� 6
/nt'� // This the � _ day of*v\ 20 A�
) A I L-4 A n 1 .0 hY U_
person authorized to act as his/her agent for purpose of filing a CAMA permit application
This application includes: general information (this form), a site drawing as described on the back of this application, the
ownership statement, the Ocean Hazard AEC Notice where necessary, a checkfor $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 administrqdyeaetM.V F_ D
DCV V11MINGTON, NC
jAN282016,;

y ,yy yh R, pe� M5 - 1759. Cent* fto We pla
NORM
wm dAAn rsdY�.^.YJr.r. Fan-* wlwwwY
, VOTMCY93JlONMAPf
""k "f1 I1Y �4'^'-'^' fiY MM'II bm Cho. M
/I(J�aiW. x 4wtw Do.
Atd boob MMMKed,O AIR-i,w bovl! Mference
i mIwt b
YWT;705AZv2 omm
Tm lro'rln nvasim
PRAM m
sho d(q��p�,gingra4tedvA�S
Ov '
fitlt uA ww4bB,el
p d OHilxS.
!2n!
5fflow
QK OLAW, NC.
i
FA 1233sAL1]9
SEAL
L4759
nq
10T6
MU DMU"
PARItV 233AN(Kb
BIG DAMS CANAL
CA W. DOL?HIN DKIVE
lam'
W-FXL9liN0Iww Na
KW-ftWrd WAY
R - coomm.4r..
l9f • fRPVSIAT2IV1/NO
IFl-b�1/AGitl9ff
5K1B/C163
N¢d%f-1O'
,BAR-20
slag- a
[or♦
WdIOMAW
auaa5i2ssntaYa
/10Ca9TATAfCVI..
— - aa'iAY
I/AY
NRAl: 3rOzv2
LOl O.�DLOPC r24rxu.
vAAv.2atc
tuvn
�.�
XM'® YL IC
MT.f16- /G. I l9
AT L�GYJVI,' LW /L�621Y G
OaAPgc WC
1� �1
su*ry
5urvcyvr5. Inc. P.A.
PROFOR
DOW/ DIAIZ-WELCH
JCEY AWCHM I.1759
201i5-0004 OWNSON
427 ft�"'5t
-onow BY.. JRB
5410 W. Da4v1aN DR1V[
0*Wwd, N.C, 16*65
pwfla910-2569192
B N DRAWY, ,328
;
OAK MAW. N.G.
CrU, 910-523-6122
mn
CNP2JRB
DAM 03•I 112015
-14MOt/S rWSP. - . Ba#r,*YCK CO. N.C.
A•:»:dru6uu
SCAIC. I • 3O
OAM "11115 SCAIC r- - 50
Rmdarfvl I fanr�vl SRe Flan
lot Suwys 1 hW Oev. Cernbcafa
PRBItnKvt✓i fqT PoR RGOAIArtON tmNM'MY.Y'9 /x s.10'
erw:tl dstlNAwiw u'q�g�/��+^
VpsWmaiLgoocje.com/maiI/L Mpabel/5410+W+DolphirJl4eeb2e059ebae39?projector=l
RECEIVED
DCM WILMINGTON, NC
JAN 2 S 2016 vl

Receipts for
Certified fiiail
(Staple Here)
Date
ia r� l?waas�►n
Adjacent Property Owner
Cat } tAt -vi s h N-: ve
Mailing Ad Tess
City, State, Zip Code t J q'2 -70
Dear Adjacent Property:
This letter is to inform you that I, 1g=`�L'°' ` w 1 k In have applied for a CAMA Minor
Property Owner
Permit on my property at 56i►d w WN'Dir• 41% N6 in Brunswick
Properly 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 al �tl�" �JZ �J �� ,or by mail at the address listed below. If you wish to
Applicants Telephone
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Donna F. Coleman
Local Permit Officer for the Town of Oak Island
4601 E. Oak Island Dr.
Oak Island, NC 28465
Sincerely, U'S. Postal Service"'
CERTIFIED MAILO RECEIPT
-
Property Owner r
ba o1w11. b 1
Mailing Address `
rl,-X1L f,-LArwCA
City, State, Zip Code
rr
Co
0
Ln
t3
paamo Wptldst M E
O
❑CNIIIatl MelInnalcletl DaP s
C3
❑Aewts atva n.auaaa $
❑Muksgnriu,anwbY.te DW—V s
o Post.,
�$
m
� Total Postage end Fass
t�
a
Ln
r, Sent io .0
$IreateM a W&... ..-
EMI
REH3EIVED
0 WILMI GTON, NC
�� N 18 2016

Receipts for
Certified Mail
(Staple Here)
ate
Adjacent i r grty Owner f W .D r
' I
Mailing Addres ktbc(t) 0 2 7 205,
City, State, Zip Code
Dear Adjacent Property:
This letter is to inform you that I, ?rWJ)U Ja J.Jil2iGt>� have applied for a CAMA Minor
Property Owner
Permit on my property at 154 110 U, t 1 01 06,;o byP. � NC, . in Brunswick
Property Address r /
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 �� '` t,�i j:+�� or by mail at the address listed below. If you wish to ,
Applicants Telephone
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to
Donna F. Coleman
Local Permit Officer for the Town of Oak Island
4601 E. Oak Island Dr.
Oak Island NC 28465
Si cerely,
Postal
TIFIEn
. o
RECEIPT
nw"Ld.'
V`�41N'v
u'
m
.. nly
Property Owner
N
0FF1C
L
.,
USE
�
Cerufietl Mal Fea
Mailing Address.
o
$
i
o wm R�P O p»
r
❑ n.mc Pecelpt (eiacwnic)
$
Postmark
City, State, Zip Code
C3Ica
mae Mai a.,w iea oai a
$
Hera
p
❑ndaa sgne[ine PagNretl
i
❑nma sgnewre raeea++aeo�ans
G
Postage
ri
C
$
mCrq3
Total Postage h Fees
-
seer ro 4 W r�
?
M1
So-eermgApi No:-« --------_'__ _—- ..............
n
-"
D
DCM WILMINGTON, NC
JAN 2 8 2016

Fence Permit Application
Project Description -t f lCe LRDo C 1 gyykcnVI
Residential or Commercial &- A -,A
1 to I p 11 1
Height of fence: backyard f`i. 5 side yard w f_ front yard
Address of Project: C W pA# 0011)1uV1 -i', 1
Lot # Block
—L9-0—'—tW6SectionL6tAbJg Parcel # 133 KAt X
*Include site plan showing fence and setbacks from property lines with application.
Property Ownerjadbgi -Q� 9 68VJ tl-4 .kC*-'
Property Owner Address #`mil((} 1>,i IlylO^�,r\R1� Dii, 0-, LJL INL�
Phone Number (H)' l (B) `v �� (C)
Value of construction'$ 1 O0, 00
Q t
Contractor Szl
Contractor Address 5 y 1 o Vd , lbk V �► Y% by . 0':T , NC'. Z f3 4(0
Contractor Phone Number (B) l 1 (C) (p -�j23 -1Go lCi
License # ��Oak Island Privilege License # rd f
Signature ofApplicant WAE
ForQT= Use Only
Notes or special conditions:
Approval:
RECEIVED
DCM WILMINGTON, NC
JAN 2 8 2016

m
U.S. DEPARTMENT DF HOMELAND SECIIRBY EMATrON CERTIFICATE. QMB
0. i'660 o0W8 . .
FEDERAL EMERGENCY MANAGEMENT AGENCY Fjlpi
IMPORTANT: Fvllow the instructiona an pages_i-9.
on Oates July 31, �(
N.drod.Rod b m. PwErm
.SECTION A - PROPERTY "WORMATIQN IFQR
V
USE
At, Building Owner's Name Bobbl. Di2Z-We)Ch
P�MOVAY
A2. Bulwfln Street Adore(indudmg ApL. UniLSuite and/ay Bfdg.. ) or PD. Roule'ard Box No...
NMC Number:
5�10 W. Dop in Drive
city Oak Island State N.0 zIP toe
28465
A3. Property Descaption (Lot and Block Numbers. Tax Parcel Ni ..
LOT 5,. Block 120 & 120A, Long Beach MB 6, P . 119 .. -.
A4. Building Usefe.g.. Residential, No"esidential,Addition,Aceessag Me)RDSIdeGflaf ,
9t1272 Horizontal oatum:j
ONAD 1927 ® NAD 1983
A5. Latitude/Longitude: LUL 13 9140A __ Loyd; _78
A& Attach at least photographs of the budding ff the Certificate is being used to obtain hood insurance..
A7. Building Diagram Number R
M. For a building with an attached
rage:
A8. For a building with a f crawlspac , enclosanclosuure(s)
a) Square footage oFcrawlspace a endosure(s) 1644 sq ft. a) Square footage of allached�rage
NIA sq R
b) No. of permanent flood openings in the cra ispace a 0 b) Number of permanent flood
openings in the attached garage
m tVA—
endosure(s) within 1.0 foot abode adjacent grade within 1.0 foot above adja
0 sq in c) Total net area of flood open
grade
ngs in A9.b NIA sq in
c) Total net area of flood openings in A8.b
d) Engineeredfloodopeningst
❑Yes ONO
d) Engineered flood openings? ❑:Yes ONO
SECTION 8.- ROOD INSURANCE RATE MAP (FIRM) INFORMATION
BL Name& Community Number
Eq.1Cour.ltName
N.0 1e
370523rmmity
84. Map/Pan ai Number 65. Ballot B6. flRM index 17ate
87. ETRM Panel Effective! 88. Flood Zones)
Date
, 63se Flood ElevatloMs) Rohe
AO, use base-flooddeplh)
37202036 J
Revised
06/02/2006 VE...
16.
KoLfrn icate the source of the Base Flood Elevation ISM data or base flood depth entered in item+e9:
❑FIS profile I@RRM ❑Comnunfybetermined ❑:other/Source:
BiL Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 DO NAVD 19118 ❑ 0thW'$our00:
ONO
WAs the budding located Ina:Coastal Barger Resources System (COBS) area or otherwise protected Area (OPA)7 0+
Designation Date: --/—/— 11 CBRS ❑OPA
. SECTION C BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)'..
shoe Censtrucbon
CL Building elevations are based on: ❑ Construction Drawings• ❑ BuluYngUnder Construction i
+A new Ele tatian Certidrate win be required when construction of the building is complete.
O;. Elevations Zones A1-v130, AE. AH. A (with SM. VE, V1-V30, V IWO BFE). AR. ARIA. AR/Alt, AR/A1-A3Q,.AR/AH. A` ,
AO. Complete Items
C2.e-h below according to the building diagram specified in Item A?. In Puerto Kim only, enter meters. i
Benchmark utilized_ Middleton: Vertical Datum: 1988
Indicate of ation datum used for the elevatransin items a) through h) below. ❑ NGVD 1929 P§NAVD 1988 ❑
/Source:
Datum used for building elevations must be the same as that used for the BTE Check the :.measli
used,
a) Top of bottom floor (including basement, aawlspace, ar enclosure Hoar?. feat
meters
t5
b) Top of the next higher floor 40 ID feet
meters.
c) Bottom of the lowest horizontal structural member (V Zones fray) 14.20 19 feet
miners
d) Attached garage (top of slab) _ _ 0.0 ® feet
meters
e) Lowest ele atlon of machinery or equipment servicing the building 8 . 00. Meet
meters
(Describe type of equipment and location in Comments)
0 Lowest adjacent (finished) grade next to building (LAG) � . 20 ®feet
meters
6
g) Highest adjacent (finished) grade next to budding (RAG) 8 •0. - ®fleet
meter'+.
h) Lowest adjacent grade at lowest elevation of deck or stairs, including 09 feet
meters
structure[ support
_
SECTION D—.SURVEYOR. ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engneer, or architect auttwdzed by lax to certify elevation
the Plata
.NF.
0,.
Information. 1 certify that the information on this Gurtlfleate represents my best efforts to Interpret erd8ebte.
I understand that any false statement may be punishable by one or imprlswo mg under 18 U & Code. Section 1001
v.� GAiTo
� .(
�•�
❑ Check hem if comments am provided on back of form. Were latitude and longtude in Section A provided by a
�.
:� ti$"S`)Q �a�'9
❑Check here it attachments.. licensed fund surveyor? ®Ya5 Cl NoHL
'Z.L T . ..
h $ 1
Name
tl1w7a5e�Mpnha
Ce.uderls
Joseph R. Brochure -
L-IX
o W r
O )�O SU8'��� •J�J�
eSFa •.•••..
MF TN
Tee
Land Su '11Y r
cry dame
Island Surveyors, Ind. RAC.
Address ..
427 Womble St
Q Is)atxl
61.G1991.
slgrub,e
�
07l29/207�
reteo)horhe
910):250-9192,
FfMA Fdm (7j12) Ic
See reveme side for continuation.
httpsl/mail.goaje.c /mail/UOMabel/5410FW+DdphirJt4eeb2eO69ebae39?projector=l
ileplaces all previous editions.
R ECETVF-D
DCM WILMINGTON, NC
JAN 2 8 2016 1"

ELEVATION CERTIFICATE, page 2
Building Street Address (including Apt.,Urdl, Side; and/a Rldg. No:) or 20. Rode eriABotr No.
IMPORTAt(rthi dress spaces, colt' the correspenilling lnkrmatio„ tram So-diki:A. !!7p
5410 W. Dolphin olive
Cry state ZIP code
Oak (stand KC 28465
RANCECOWANYUSE
'
wgl tA. ZZ
SECTION D —SURVEYOR ENGINEER OR ARCHITECT CERTIFICATION (CONTI
Copp both sides of this Elevation Certificate Tor (1) COnimnnty official, (21 insurance: agewcomparry, and (3) building ovmeI
Commends ACTUAL. FIELD MEASUREM;NTS, C2e hvac
07129=15
SECTION E - B(1RMNG ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND
ORE A (WMIOUT II
complete Sections A. B and C.
_
For Zones AO and A (without BFE). complete hems Et-E5. if the Certificate is )mended to support a LOMA s LOMR;` reque
For Items Et-E4, use nmural grade, if available, Check the measurement used. In Puerto Rico onyx enter meters
El. Provide elevation information for the folowing and: check the appropriate boxes to show whether the elevation is above.
�rbalm the highest adjacent
grade (HAG) and the lowest ae)acent grade (LAG).
a) Top of bottom goon (including basement, vawlspace, a enclosure) is. _ . _ Q feet []meters [Jabove
a ❑ below the M.
b) Top or bottom floor (including basement, crawispace, or enclosure) is ❑ feet ❑ meters 9
above or ❑.below the LAG.
E2. For Buff ing Diagrams 6-9 with permanentroad openings provided in Settiori A Items VmVor9 (see pages 83 of I
ens),
the next higher flea (elevation C2:b In the diagrams) of the Wilding is --------- ❑ feet El memrs
above or [I below the HAG.
E3. Attached garage (top Of stab) is _..._ []feet ❑ meters
ahove or I] below the HAG.
E4. Top of platform of machinery andlor equipment servicing the building is Qfeet ❑meters gabove
or I]below the HAG.
ESS, Zone AO only: g no good depth number is available, is the too of the bottom floor elevated In accordance with the cDartauriity's
floodplain management
ordgradca? ❑ Yes ❑ No ❑Unknown. The local official must centy this information in Section G.
.... SECTION F- PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFIC
ON
or communkyrissued FIFE) or
The property owner or owners authorized representative who completes Sections: A, B, and E for Zone Alwigiout a FEMAtsliiad
Zone AD must sign here. The statements In Sections A. B, and E are correct to the best of my lanMMeAge-
Property Owner or OwnePs Authorized Representative's Name
Address.. tYy State
Z1P.Cade
signature Date
Comments
E]t heck here V attachments.
SECTION G - COMMUNITY INFORMATION (OPTIONAL
The kical official who is authortzed by few a OnAnarce to aemmLster the community's floodplam management adhiaiice cars
G of flits Elevator, Certi(Nate. Complete the applicable tern(s) and sign below. Chick the measurement used In items GB-fi1
peter Sections A. O. C Ia Q. and
, in Puerto Fr" ong; enter meters
G3. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a bcen
information. (Indicate the source and date of' elevdtlondata in t
surveys, engineer, or architect.
ie Comments area below.)
who its authoreed by law to certify elevation
G2. 0 A:communrry official completed Section E for a building located in Zone A.(without a FEMA Issued Or Communi111I
LIFE) or Zone AO.
G3. d The following Information (Items G4-G9) is provided for communitflootplain mamagemeM:purposes
y
i
64. Permit Number
G5. Date Permit Issued
CA. Plate f:ab'flcato OF C
anoe/Orxiipam.Y Issued
67. This perrnit has been issued tor: ❑ New Construction ❑ Substantial ImprMtlrient
(Teel ❑ meter
inn
Ga. eavation of astruitt lowest floor (including basement) a the bulid'nlg: --
G9 BFE or (in Zone AO) depth of flooding at the budding site: _... --. o feet 11meters Oatum
-
G10.Communly's design flood elevation: „—.. _ - Ofeet ❑ meters Oatum
_.
Local Ofldal§ Name Title
Community. Name Tebplrsie '
Signature Defer .
Comments
I ❑ Check here if editions.
attachments-
FEMA Farm Ofi (7712) Replaces tip previous
ittps://m ail.google.com/mai I/u/0/Mabel/5410+W+DoiphiNl4eeb2eD69ebae39?projector= l
R ECEtC%EE5
DCM WILMINGTON, NC
JAN 2 8 2016 1"

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to 1w,, W tx 's
(Name of Property Owner)
property located at
Address, Lot, Block, Road, etc.)
on-D(1-\i(> Lt�l(1t9 � in T) y-a kne t;J i CK N.C.
(Watarbody) (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)
Signature
Print or Type Name
Telephone Number
Date
RECEIVED
DCM WILMINGTON, NC
JAN 2 8 2016

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent toy [ QlfYL,�WQ.�C k' x—a
(Name of Property Owner)
l
property located at
Address, Lot, Block, Road, etc.)
on (i1 �' in jI,�YLAV).5Udi;CV 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)
Signature
Print or Type Name
Telephone Number
Date
RECEIVED
DCM WILMINGTON, NC
JAN 2 S 2016