HomeMy WebLinkAboutSB_16-04_Port City Advisors LLCTown of Sunset Beach
Local Government
SB 16.04
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 Port City Advisors, LLC, authorizing development in the Ocean Hazard (AEC) at 1840 East Main Street (Palm
Cove Lot #6), in the Town of Sunset Beach, as requested in the permittee's application, dated December 231d, 2015.
This permit, issued on January 19th. 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: Fill and grade
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on December 3151, 2015.
(2) All proposed development and 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. If any provisions of the building
code or a flood damage prevention ordinance are inconsistent with any of the following AEC standards, the more
restrictive provision shall control.
(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 910-579-0068 for a final inspection at
completion of work.
i!C
(Additional Permit Conditions on Page 2)
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, 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 written approval of the Division of Coastal
Management.
I& 1�1�
Richard Hathcock
CAMA LOCAL PERMIT OFFICIAL
700 Sunset Blvd. N.
Sunset Beach, NC 28468
PERMITTEE
(Signatur egmred if conditions above apply to permit)
Name: Port City Advisors, LLC
Minor Permit # SB 16.04
Date: January 191h, 2016
Page 2
dune disturbances will be allowed only to the extent necessary for development and if the dune's protective
value is not weakened or reduced. Disturbed dune areas will be immediately stabilized.
(6) All unconsolidated material resulting from associated grading and landscaping shall be retained on site by
effective sedimentation and erosion control measures. Disturbed areas shall be vegetatatively stabilized
(planted and mulched) within 14 days of construction completion.
(7) Any new dunes established shall be aligned to the greatest extent possible with existing dune ridges and
shall be of the same general configuration as adjacent natural dunes.
(8) Existing primary dunes shall not, except for beach nourishment and emergency situations, be broadened or
extended in an oceanward direction.
(9) Adding to dunes shall be accomplished in such a manner that the damage to existing vegetation is
minimized. The filled areas shall be immediately replanted or temporarily stabilized until planting can be
successfully completed.
(10) Sand used to establish or strengthen dunes shall be of the same general characteristics as the sand in
the area in which it is to be placed.
(11) No new dunes shall be created in inlet hazard areas.
(12) Sand held in storage in any dune, other than the frontal or primary dune, may be redistributed within the
AEC provided that it is not placed any farther oceanward than the crest of a primary dune or landward toe
of a frontal dune.
(13) No disturbance of a dune area shall be allowed when other techniques of construction can be utilized and
altemaMve site locations exist to avoid unnecessary dune impacts.
SIGNATURE: 24 o-t -- DATE: 0 1 Z& /41
(ERMITTEE
AU; HALAKD NOTICE
Projbct Is In An: Ocean Erodible Area x High Hazard Flood Area _
Property Owner: Port City Advisors, LLC
Property Address: Lot #6, Palm Cove Subdivision, 1840 East Main Street, Sunset Beach, NC 28468
Date Lot Was Platted: November 2004
This notice is intended to make you, the applicant, aware of the
Special risks and conditions associated with development in this
area, which is subject to natural hazards such as storms, erosion
and currents. The rules of the Coastal Resources Commission
require that you receive an AEC Hazard Notice and acknowledge
that notice in writing before a permit for development can be
issued.
The Commission's rules on building standards, oceanfront
setbacks and dune alterations are designed to minimize, but not
eliminate, property loss from hazards. By granting permits, the
Coastal Resources Commission does not guarantee the safety of
the development and assumes no liability for future damage to
the development. Permits issued in the Ocean Hazard Area of
Environmental Concern include the condition that structures be
relocated or dismantled if they become imminently threatened by
changes in shoreline configuration, The structure(s) must be
relocated or dismantled within two (2) years of becoming
imminently threatened, and in any case upon its collapse or
subsidence.
The best available information, as accepted by the Coastal
Resources Commission, indicates that the annual long-term
average ocean erosion rate for the area where your property is
located is 2 feet per year.
The rate was established by careful analysis of aerial photographs
of the coastline taken over the past 50 years.
Studies also indicate that the shoreline could move as much as
440 feet landward in a major storm.
The flood waters in a major storm are predicted to be about
18 feet deep in this area.
Preferred oceanfront protection measures are beach nourishment
and relocation of threatened structures. Hard erosion control
structures such as bulkheads, seawalls, revetments, groins,jetties
and breakwaters are prohibited. Temporary sand bags may be
authorized under certain conditions.
The applicant must acknowledge this information and requirements
by signing this notice in the space below. Without the proper
signature, the application will not be complete.
Applicant Signature Date
Inlet Hazard Area
SPECIAL NOTE: This hazard notice is required for development
in areas subject to sudden and massive storms and erosion. Permits
issued for development in this area expire on December 31 of the
third year following the year in which the permit was issued.
Shortly before work begins on the project site, the Local Permit
Officer must be contacted to determine the vegetation line and
setback distance at your site. If the property has seen little change
since the time of permit issuance, and the proposed development
can still meet the setback requirement, the LPO will inform you
that you may begin work. Substantial progress on the project
must be made within 60 days of this setback determination, or
the setback must be remeasured. Also, the occurrence ofa major
shoreline change as the result of a storm within the 60-day period
will necessitate remeasurement of the setback. It is important
that you check with the LPO before the permit expires for official
approval to continue the work after the permit has expired.
Generally, if foundation pilings have been placed and substantial
progress is continuing, permit renewal can be authorized. it is
unlawful to continue work after permit expiration.
For more information, contact.
Richard Hathhcock
Local Permit Officer
700 Sunset Boulevard
Address
Sunset Beach, NC 28468
Locality
(910)579-0068
Phone Number
RECEIVED
DCM WILMINGTON, NC
JAN 1 2 2016
Revised 2107
ADJACENT'RIPA'R A.`d PRCPC--iTy DtiiiiCi^ STATEMENT
I hereby certify that I own property adjacent to Pont City Advisors, LLc •s
(Rmnx a; p opd-ii; Currier)
Property located at 1840 ]Rest plain street, Lot 6, Palm Cwe
(Address, Lot, Block, Road, etc.)
On Jinks Creek in Sunset Beach N.0
(Waterb edy) (C41iown zndtor Count')
The applicant has described to me, as shown below, the deve'opment proposed at the above
location.
x I have no objection to this proposal.
I have objections to this proposal.
f; 0, ♦ •� ;'S1s�iT
(frr+tFvfr f ircYx s pig developarralf liww Nil AT dascs* won baraw ar auch a site o'rawwy)
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' from my area of riparian access unless waived by
me. (If you wish to waive the setbzck, you rtlmt ir&nl the appropriate blank below.)
I do wish to waive U'le 15' setback requirement.
1 de not wish to wanle the 15' setback requirement
(propar of C*'�r zr h acre saga n;
S !tn e
City Advisors, LLC
Pnnt or Type Name
P.0 Box 1967
Wading Address
nmi iln ton, HC 28402
4910)540-9716
Telephone Number I eemail address
12/21/15
Dole
"Valid for are calendar year after signature'
ir�C(,]/�a'�C/.;RCii: t�i0�8ri��t"�S4'Tt.r :itiJfT2f�On)
_ .fJQ'.Y.OLLJ J LtJ �32L?�B� "
Signahme*
Donna W. Corner
PAW or Type Name
13279 Catiarpin valley Drive
Afading Address
Gainesville, VA
Cdrdstate/Lp
(703)407-9988
Telephone Numbar/emad address
12�21/1.5 5..,: = JVED
Dme' DCM WILMINGTON, NC
(Revised Aug. 2014),1 R
£'d £LZZ-t49L-£0L ;euu00 euuop dLZ £09 6 £Z 000
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Port City Advisors, LLC $
(Name of Property Owner)
property located at 1840 East Main Street, Lot 6, Palm Cove
(Address, Lot, Block, Road, etc.)
on Sinks Creek ,in Sunset Beach , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
x I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' from my area of riparian access unless waived by
me. (If you wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
yYfgfulture
(Po City Advisors, LLC
t or Type Name
503 Olde Waterford way
Mailing Address
Leland, NC 28451
City/State/Zip
(910)383-1044
Telephone Number/ email address
12/21/15
Date
T"'Jjj
'Valid for one calendar year after signature'
(Adjacent Property Owner Information)
Signature*
Long Leaf Pine, LLC
Print or Type Name
P.O Box 1967
Mailing Address
Wilmington, NC 28402
City/StatelZip
(910)540-9716
Telephone Number/email address
l21/1s
Dale" --RECEIVED
D
`;M WILMINGTON, NC
(Revised Aug. 2014)
JAN 1 2 2016
IL11111 i111111 11 P&Pan a —
1rM n. cl. aaa/a!r err Mefo
12-11-2014 W,15:11.Ne ll u.Iek county. we
ere aEVERLE STAMP: s aa2." iM2a"2)
Ares'• IS
p"Wdar Rel:
4 Tool'9���"� . Rev E .'inter
Ck f�Ck4Caeh2
RB hd Casn$_Fhaga_�
ElpabratlaLlAalx"ae6�a Cue m mdla
13 Wusu lmurtatensr"ty0 ull ,fir
WARRANTY DEED
Prepared by: MURCHISON, TAYLOR, & GIRSON, PLLC
16 North Fifth Avenge, Wilmington, NC 23401
WE PREPARED THE DEED IN THIS TRANSACTION BUT WE MADE NO EXAMINATION OF
TITLE AND WE EXPRESS NO OPINION ON TITLE TO THE PROPERTY.
This instrument was prepared by Joseph O. Taylor, Jr., a thawed North Cornana attorney.
Ddlaqucat taxes, B any, ate b be paid by the closing attorney to the
anmwick County Tax Collector upon disbursement of closing proceeds.
STATE OF NORTH CAROLINA Revenue Stamps S 4.452 00
COUNTY OF BRUNSWICK Parcel Number 256MB002. 256MB003,
256NO006
THIS WARRANTY DEED, made this 3Qaay of Deeernber, 2014 by and
between BRUNSWICK LAND HOLDINGS, LLC, a North Carolina limited liability company
with a mailing address of P.O. Box 1%7, Wilmington, NC 28M (herein called "Gramtor") and
PORT CITY ADVISORS, LLC, a North Carolina limited liability company with a mailing
address of 503 Olde Waterford Way, Suite 200, Leland, NC 28451 (herein called "Grantee"):
WITNESSETH:
NOW THEREFORE the Grantee, for and in consideration of the stml of Ten
Dollars ($10.00) and other valuable considerations to it in hand paid by the Grantee, the receipt
whereof is hereby acknowledged, has bargained and sold, and by these presents does hereby grant
bargain, sell, and convey unto Grants, its successors and assigns forever, all that certain real
property located in Brunswick County, North Carolina, and more particularly described in Exhibit
A attached hereto and incorporated herein by reference.
125104.1
Return to MTG !
=LIVED
DCM WILMINGTON, N
JAN 1 2 2016
Q-.
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory Donald R. van der Vaart
Govemor Secretary
AGENT AUTHORIZATION FORM
Name of Property Owner Applying for Permit:
Port City Advisors, LLC
Owner's Mailing Address:
503 Olde Waterford Wav, Suite 200
Leland, NC 28451
Email.
Phone
Name of Authorized Agent for this project:
Elizabeth Nelson, Cape Fear Enrzineerine
Agent's Mailing Address:
Cape Fear Eneineering
151 Poole Rd, Suite 100
Belville, NC 28451
Email: elizabeth.nelson(ii),capefeareneineerine.com
Phone (910) 383-1044
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):
Single family residence fill and grade only
Project Site Address: Lot 6 Palm Cove Subdivision, 1840 E Main Street,
Sunset Beach
Property Owner Signature Date'
This certification is valid 1 year from date signed by property owner.
RECEIVED
DCM WILMINGTON, NC
N.C. Division of Coastal Management JAN 1 2 2016
127 Cardinal Drive Ext., Wilmington, NC 28405
Phone: 910-796-72151 FAX: 910-395-3964 InterneCw ,nccoastalmanagement.net
An Equal Opportunity 1 Af6mWive Action Employer
CAPE FEAR
ENGINEERING
151 Poole Road, Sufte 100
BeMlle, NC 28451
TEL (910) 383-1044
FAX (910) 383-1045
w .capefearengineering.com
To:
Sunset Beach Building Inspections
Ate:
Richard Hathcock/Rawls Howard
❑ As Requested ❑ For Your Files
❑ Sent via Mail ❑ Sent via Courier
Transmittal
Date: I December 31, 2015 1
File: 675-0306 "38"
Subject: Palm Cove Subdivision, Lot 6
CAMA Minor Permit
Sunset Beach, NC
❑ For Distribution ® For your Review / Action / Approval
Quantity
Drawing No.
Description
1
Original
Check for $100 for required Permit Fee
1
Original
CAMA Minor Development Permit Application
2
Copies
Grading Plans
1-full size 22" x 34", 1-reduced size 11" x 17"
1
Copy
Agent Authorization Form
1
Copy
AEC Hazard Notice
1
Copy
Adjacent Riparian Property Owner Statements, from Lot 4 & Lot 7 property owner
1
Copy
Property Deed
REMARKS ' Permit for Fill and Grade
CC: Cape Fear Engineering, Inc.
File 675-0306- "38"
Signed:
titzabeth elson, PE
Received B
Date:
DCM WILMINGTON, NC
P.6755]5-03 ADMI WCAMA Mh of 2@015 Fill and Gtade12016-12-23 SS TranemiMal,dw
JAN 1 2 2016
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CURVE
RADIUS
CHORD LENGTH
CHORD BEARING
C1
1314.51'
84.36'
S
79'35'52"
W
C2
1344.51'
50.47'
N
79'47'22"
E
C3
1363.21'
43.30'
S
79'37'42"
W
C4
23.00'
26.73'
N
65'45'46"
W
UNE
BEARING
DISTANCE
L1
S
89'12*05;
W
35.96'
L2
N
87'54'39"
W
48.46'
L3
S
87'30'12"
W
13.68'
L4
N
30'14'23"
W
12.09'
L5
N
30'14'230
W
64.81'
L6
S
30'14'23"
E
5.00'
L7
N
65'45'05"
E
47.91'
LB
S
32'42'18"
E
19.62'
L9.
S
32'42'18"
E
32.80'
L10
S
32'42'18"
E
20.70'
L11
N
30'14'23" W
21.63'
L12
S
59'45'37"
W
15.00'
L13
N
59'45'37"
E
20.00'
L14
S
30' 14 23"
E
25.84'
ADJLXNING PROPERTY OWNER&
L07 5 - PORT CITY ADMSCRS, LLC
503 OLDE WATERFORD WAY, SUITE 200
LELAND, NC 28451
D.B. 3489. PG. 0278
LOT 7 - DONNA CONNER
13279 CAINARRN VALLEY DRIVE
GAINESWLLE, VA 20155
D.B. W87, PG W91
REFERENCE Is MADIF TO THE FOII OYANG
1. ALL STREETS SHOWN ME PRWATE UNLESS OTHERWISE NOTED.
'2. REFERENCE SURVEY CAPE FEAR ENGINEERING. INC. DATED DEC 22.
2014.
3. AREA BY COORDINATE METHOD.
4. ALL DISTANCES ME GROUND HORIZONTAL UNLESS OTHE tWSE NOTED.
S THE U AS
SHOWN AR E FTY FEEM& FLOOD INSURANCE RYIN HEREON LIES IN EATE MAP. COMMUNITY
PMEL NUMBER 3720105(00J, DAZED JUKE 2. 2005.
6. ERE ARE NO VIABLE ENCROACHMENTS ON THIS PARCEL
7. PROPOSED USE OP THIS LAND IS flESIDENIUL
S THIS PROPERTY IS ZONED CR-1.
9. EJ.EVATOIIS BASED ON HAW 8a
10. TOTAL DISTURBED AREA IS 0.31 ACRES
It. SURVEY OF FIRST LINE OF STABLE VEGETATION SURVEYED BY CAPE
FEAR ENGINEERING AS NOTED.
12. TOTAL SITE AREA w 1.25 ACRES.
13. RUNG SIZE IS 8' X B; PILINGS DEPTH STIOLID BE A MINIMUM OF IW
OR 20 TIMES E ANNUAL LONG TERM AVERAGE OCEAN ER051DN RATE
OR PER STRUCTURAL ENGINEER SPEQR 111014S.
15. THE MAXIMUM BUA IS 6,207 PER NCDENR STORNWATER PERMIT NO.
SIYB 05/025. NO IMPERWWS AREA PROPOSED AT TOPS TIME.
16, FRONT YARD SEIBAM 50 FEET FROM TIE PROPERTY UNE; OCEAN
FRONT YARD: NOT LESS NAN 25 FEET FROM THE ESTABLJSHED LAMA
UNE.
17. REM YARD SETBACK: 25X M THE MEAN LOT DEPTH; PROVIDED THAT
THE REAR YARD NOT EXCEED 25 FEET.
18. DENSITY: A MAXIMUM OP ONE DETACHED SINGLE-FAMILY RESIDENTIAL
DWELUNG PER ACRE
19. TAX PARCEL ID IN LOT 6 IS 25WBOU6 OBTAINED FROM O.I.S.
20. MINIMUM SEPARATION BETWEEN DETACHED SINGLE FAMILY RE51DQ1TAL
OWEWNGS SHAM BE 20'.
21. WASTEWATER SYSTEM: 5' FROM STRUCTURE PER BRUNSWICK COUNTY
HEALTH DEPARTMENT.
22. E PROPOSED BUILDING PAD IS AT 12.50.
21 EXISTING TOPO WITHIN PROPOSED UNITS OF DISTURBANCE FROM RELD
SURVEY BY CAPE FEM ENGINEERING. INC. ON DECEMBER 21. 2015.
/Irk-`t//!%IIJ�llf�rrl 7 ! J / DAVID A TENDLER
mX 6115AN E
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ovmnoa _
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F8 7, PG al _
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PB M, PG at IO/0/IaI
CX'LAN 6tODBtI 475.16'
BEIBIJ.'K NlF
fin / lr T j1PORT CrrY
ADvIsotts, LLr(\�
W, FIG 51
!y LONG LEAF
! / PINE, LLC
4
MC 84, PG. 81
9 4C' �.
2r X 34' SKEET 1 NOR w4O'
4O' 4N 80'
11' X 17' SHEET 1 INCH -BO'
-jEGtWEG
.i Mi-MINGTON, NC
JAN 12 2916
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ALDNG PAD
ISSUED FOR
REGULATORY REVIEW
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DESCRIPTION
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REVISIONS
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CAPE FEAR
ENGINEERING
151 Pa Rd,S f00; BI, F ,NC, 28(5T
M (910).'1 IIW: FAX (910) 369 IW
WRrr Gsp/amg4rnkg'mn
PALM COVE
�y
11"1 CARSLINS T�BF1A�aEAA0 �
NCX OL
LOT 6
GRACNG PLAN
675-0306 I G-I
Locality
Ocean Hazard �stuarine
GENERAL INFORMATION
LAND OWNER
Name Port City Advisors, LLC
ORW Shoreline
(For official use only)
Address 503 Olde Waterford Way, Suite 200
City Leland State NC Zip 28451
Email N/A
AUTHORIZED AGENT
Name Cape Fear Engineering, Inc.
Address 151 Poole Rd, Suite 100
City Belville
Permit Number t _li 0q
Public Trust Shoreline Other
Phone N/A
State NC Zip 28451 Phone (910) 383-1044
Email elizabeth.nelson@capefearengineering.com
LOCATION OF PROJECT. (Address, street name and/or directions to site. If not oceanfront, what is the name of the
adjacent waterbody.)1840 East Main Street, Sunset Beach, NC, Lot #6 Palm Cove, Ank's Creek
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) Single Famlly Residence, Fill and grade only
SIZE OF LOT/PARCEL: 54,330 square feet 1.25 acres
PROPOSED USE: Residential Q (Single-family 0 Multi -family Q ) Commercial/Industrial ❑ Other ❑
COMPLETE EITHER (1) OR (2) BELOW (Contact your Local Permit Officer ifyou are not sure which AEC applies
to your properly):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: N/A square feet (includes
air conditioned living space, parking elevated above ground level, non -conditioned space elevated above ground level but
excluding non -toad -bearing attic space)
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: N/A 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 issued by the NC Division of Water Quality?
YES= NC=
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: 6,207 (all lots) square feet.
RECEIVED
DCM WILMINGTON, NC
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:
1, 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)
Qan owner or record title, Title is vested in Port City Advisors, LLC see Deed Book 3600
page 0358 in the Brunswick County Registry of Deeds.
nan owner by virtue of inheritance. Applicant is an heir to the estate of
probate was in County.
[71f 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) (Address)
(1) Donna W. Conner 13279 Catharpin Valley Drive, Gainesville, VA 20155
(2) Long Leaf Pine, LLC P.O. Box 1967, Wilmington, NC 28402
(3)
(4)
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.
This the 23 day of December 20 15
authorized to act as his/hei 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 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.
rit( LIVED
DCM WILMINGTON, NC
JAN 1 2 2016
JAN 1 2 2016