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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 l � `\ / % i / _! % % i ✓l/,! i= (;;e !• r _ 4E ®. B) ' \Ifhir L L/1 1"»' i ♦ = 1 •. AFPROxenA.rE LMIS Cr ANN 'I r PRST L E OF STABLE VE6ETAT)014 ' \ !r"j{ PHiP.tY SLOAT® OWON5. TO BQ FIELD VMPOD BY DCI !!!�..'Zi '\\s7l ' , ! ��,'/:�4/ / / ^% / 1 i:' - I' \q%' \V. �\ < 11 • ; / /. i . W OCEAN def IADrAiyl ! ` '! cil � / B"_TBAoc / / S ` ,�;r % / • ' a : % .�i ` `.. 6 ` I! � � rti �/-'-~ os �,+� aF 1 , $. \\I si' !•. / / ! / �. %� /�`.f T'� �-`� ,l /IL`y TT d, A .�!lhg ��\1:.� a`i. '% i �k / ' � ' � (" . \ • _/ U ! ' /! - ''' tl. T 9 R I 1 1^ \L<� era W.�I It f ��x i ' ® ..y •/ \= 'Z .:L/�/"�/ /'`J% FIB d! Nf" I: ! ii 1. 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 ! / 11 5PRATT / i DB 3L96, PG Oa30 PG at i FLOOD ZONE VVEGa.10) / :I EF FINLEY E, PG. LLC 1 E .44. 44fr � j / j .- � ! APB B4, m at LBlOOBLE a,L J+; �2d.: �'llt H L f _LOCAT® AHD AR40V'® / VEGIEFTATION ovmnoa _ i N/F I I' I I iDONNA W CONNEIR \ it DB 81 3687, PG F8 7, PG al _ NlF / / I \ tIfII r'.\ ADVISORSS, LLC 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 :BIRO ASTS OF DISTtf181ANCIM %COD ZONE ZEE �•^ ^4 QOPvRrr PICU DART •ASaBiT - -_---- .EANH WATER LIE--------- rTOETARDSETBACK ... •....... DQSiN6OCINTOLRS - ...-12- _ rROPoS® (.'IXJToLRS WSf LAE of 15WrAT10N -wv -- %MIA SETBACK m ALDNG PAD ISSUED FOR REGULATORY REVIEW A 1581JE0 FOR RC4IMTORY REVIEW EMN t20W15 DESCRIPTION her REVISIONS N�C'AR� a o1-.0 o4 a a!? • FFAL �Or�?Y 4errrikF49.'k '.1b4:11.44b 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