BC_16-05_Davis

Brunswick County BC16.05
Local Government Permit Number
CAMA
MINOR DEVELOPMENT i
�
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 George A. Davis authorizing development in the Estuarine Shoreline Area of Environmental Concern (AEC) at
2415 William Street SW, in Supply NC 28462, as requested in the permittee's application package, dated 11-Aar-16.
This permit, issued on 21-Apr-16, is subject to compliance with the application and site drawing dated received on
11-Apr-16, (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: Landscaping/Grading/Fill DirU6' Wide Walkway.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on 11-Apr-16.
(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 [phone] for a final inspection at
completion of work.
r=tECC;vED
(Additional Permit Conditions on Page 2) DCM WILMINGTON, NC
JUN "2016
n
This permit action may be appealed by the pernittee 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.
Connie Marlowe
CAMA LOCAL PERMIT OFFICIAL
PO Box 249
RP
a, NC 28422
MITTEE
(Signature required if conditions above apply to permit)

Name: George A. Davis
Minor Permit # BC16.05
Date: 21-Apr-16
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 0 square feet is authorized.
(6) Unless specifically allowed in 15A NCAC 07H-0209(d)(10), and shown on the permitted plan drawing, all
developmenticonstruction 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 activiti4es, 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 level 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:
t--Z- ECtIVED
DCM WILMINGTON, NC
JUN 2 12016

LAND
Name
Address
City :Z a \Cmo'{ State J�G Zip__cc hone
Email f�)zt �L\-Q_-6n C 4C�LKC ., .
AUTHORIZED AGENT
Address
City �C, \ V � State OU
LOCATION OF PROJECT: (Ad,t eet name and/or directions to site. If of oceanfront, what is the name of the
adjacentwaterbody.) c9445 (A c l0.pl�S b`� &-/ r G � ,)(2- ae(/o
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) t CT
SIZE OF LOTIPARCEL: square feet acres
PROPOSED USE: Residential (Single-family 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 FLOORAREA 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 SHOWINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: 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 Pe t ' sued 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.
i-; --�- �; t=1 V E D RECEIVED
DCM WILMINGTON, NC APR 11219
APR 112016

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)
y an owner or record title, Title is ves in _ A iz�{�y5 see Deed Book �—
page I Mq in the e*DWoVQ ( i` � 1 County ILegistry 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) (Adrlreac)
(1)
(2)
(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 do 1 day of�, 20 �p
authorized to act as hislher agent for purpose of filing a CAMA permit application
This application includes: general information (this farm), a size 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 mqy be provided orally by the applicant. The details of the application as described by these sources are
incorporated without reference in arty permit which may be issued Deviation from these details will constitute a violation of
any permit. tiny person developing in an AEC without permil is subject to civic, criminal and administrative aRKEIVED
APR 112016
APR 1 1 2016

GA
1"-69
SOD
UAVIS
HOUSE
SI4ACKLETON:
2415 Williams St,
Supply, NC 28462
DECK EXTENSION
SOD
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I povaci 10- 1 Psi I
ILL DI
(75FT
FILL D T
AND SOI
REC I
DCM WILMINGTCi
APR 1?2016
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LINE
FILL DIRT
AND SOD
a
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&Kt5I -n NY-1 PIER
INTER -COASTAL RECEIVED
WATER WAY APK 112016

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address:
PO Box 1576
Shallone NC 28459
Phone Number: 704-363-5179
Email Address:
Gemge a Esris
Aleadmsecuntysysteme.com
I certify that I have authorized Panwaber[)MmWoft
Agent! Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at 24'5 Miliams st sw supply NC 28452
in emaswlck County.
t furthermore certify that l 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.
Property Owner Information:
Signature
e, Iq
Prinl or Type Name
`7 , mill 6
Date
This certification is valid through } �12Lt -12 0/
iVED
t7CM WILMINGTON, NC
APR I i 2016

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04105/2016 13:10 (FAX) P.0011001
BRUNSWICK.COUNTY HEALTH DEPARTMENT
FILE NO.:2003060948A
DATE REC.: W24l2009 P.I.N. ZONING 2009067950
EVANS OTTRUE 226.00 231MBOD301
REC. FROM FAX PARCEL
663 WESLET TRL SW SUPPLY NC 28462- [phone]
ADDRESS CT' 3T ZIP PHONE
MONROE WILLIAM L ET FELECI 6 A
CURRENT PROPERTY OWNER j,O'T!. SLK SEC
PROPERTYLOCATEO.TOWWGITY/AREAF BRUNSWICKCOUNTY' "slLIservlspN HURRICANE HAVEN
DIreCHons: 2415 WQ.L.IAM ST SIN HYUY-173 TO L ON MT PISGAH RD TO-RT ON KIRBY R.D
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AUTHORIZA-1101MR WASTEWATER CONSTRUCTION PERMITge ,A -s CQ ,e�,a'7 X-
NEW_ REVISION RELOCATION UPGRADE_ REPAIR T'8awkkhallnvee��I
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Design Flow: � % gpd. Septic Tank Size: C3 gai. .Type: j� veo,,,ve.;�e ne evvll�ae_
No. Bedrooms No. occupants/employees ,Z Max. Trench/Bed Bottom Depth: AttQ inches 2. Mal.Anellwaaa owl .r«,
� aepl�lenk eyMeme and walla.
No. Lines:. Length Each: 67 Bed Dimenalona:
- mlwn. Metl ba loralad 100 fen '',..
Fi l Check: eL% d[ Approved: .. tii q - - 4. An •AocaW' eyemm may ba.
used In m placed e
PERMIT ISSUE DATE Permit expire onths from date of issue'unless otherwise s^pecifiedem
__ I 030 days from date of Issue 0 Other
Authorized Agent 44 �"'� L r �i�� P e . f , Registration: /z s�S—
NOTE: PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGES.
IMPROVEMENT PERMIT CONDITIONS MUST BE MET. Ac . r•eo 7— �' r•,> /e
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4/5/2016
Date
Roger Lee Hegler
Adjacent Property Owner
2409 Williams St. Sw
Mailing Address
Supply, INC 28462
City, State, Zip Code
Dear Adjacent Property Owner:
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$6.96
This letter is to inform you that I, George A. Davis have applied for a CAMA
Property Owner
Minor Permit on my property at 2415 Williams St. in Brunswick County.
Property Address
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 [phone] or by mail at the address
Applicants Telephone
listed below. If you wish to file written comments or objections with the LOCAL GOVERNMENT LAMA
Minor Permit Program, you may submit them to:
Connie Marlowe
Brunswick County Planning
PO Box 249
Bolivia, NC 28422
Sincerely,
George A. Davis
Property Owner
PO Box 1576
Mailing Address RECEIVED
DCM WILMINGTON, NC
Shallotte, NC 28470
City, State, Zip Code APR 0 7 2016

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4/5/2016 0
Date
Tami Dunn & Woodrow Smith ru
Adjacent Property Owner a
m
12960 Stratford Dr.
O
Mailing Address r`
Laurinburg, NC 28352
City, State, Zip Code
Dear Adjacent Property Owner:
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Total Postage and Fees
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a
This letter is to inform you that I, George A. Davis have applied for a CAMA
Property Owner
Minor Permit on my property at 2415 Williams St. in Brunswick County.
Property Address
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 [phone] or by mail at the address
Applicants Telephone
listed below. If you wish to file written comments or objections with the LOCAL GOVERNMENT CAMA
Minor Permit Program, you may submit them to:
Connie Marlowe
Brunswick County Planning
PO Box 249
Bolivia, NC 28422
Sincerely,
George A. Davis
Property Owner
PO Box 1576 RECEIVED
Mailing Address DCM WILMINGTON, NC
Shallotte, NC 28470 APR o 7 2016
City, State, Zip Code

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APR 1 1 2016

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RECEIVED
[)CM WILMINGTON, NC
APR 11 N16

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date
Name of Property Owner Applying for Permit:
Mailing Address:
I certify that I have authorized (agent)l AMC-S Ro bb: RS
to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) beck CkAA
at (my property located at) sy,
This certification is valid thru (date) y'q'17
Property Owner Signature
,V/
Date
`r-,-CEiVED
DCM WILMINGTON, NC
APR o 7 2016

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NC REVENUE STatp: $790.00
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Revenue Stamps: S 790.00
Parcel No. 231MB00301
This Instrument prepared by: The Webster Law Firm, PC. Without Opinion on Title.
Delinquent tax", if any, to he paid by the closing attorney to the county tax collector upon
disbursement of closing proceeds.
NORTH CAROLINA WARRANTY DEED
THIS DEED, made this Rs�day of April, 2015, by and between
GRANTOR
GRANTEE
WILLIAM L. MONROE and wife, GEORGE A. DAVIS
FELECIA P. MONROE F0 Bwe )571p
SAAUMTEyNC e28L 70
717 East Prospect Avenue
Raeford, NC 28376
The designation Grantor and Grantee as used herein shall include said parties, their heirs,
successors and assigns, and shall include singular, plural, masculine, feminine or neuter as
required by context.
WITNESSETH:
The Grantor, for a valuable consideration paid by the Grantee, the receipt of which is
hereby acknowledged, has and by these presents does grant, bargain, sell and convey onto the
Grantee in fee simple, subject to the reservations and restrictions hereinafter stated, all that
certain lot or parcel of land situated in Shallone Township, Brunswick County, North Carolina,
and more particularly described as follows:
BEING all of Lot 5, Block A, of Hurricane Haven Subdivision, according to a
plat of which is recorded in Map Book 14 at Page 1 of the Brunswick County
Registry said plat having been prepared by Roach & Nobles, R.L.S., 13 October
1973, said plat being incorporated herein by reference.
This conveyance is made subject to that certain Modification of Declaration of
Covenants, Restrictions and Easements which apply to Hurricane Haven
Subdivision and duly recorded in Book 341 at Page 895 of the Brunswick
County Registry, said Modification of Declaration of Covenants, Restrictions
and Easements being incorporated herein to the same extent as if set out in full.
Said Declaration and covenants to run with the lot herein conveyed upon any
subsequent transfer of the herein described lot. ''M I
For back ieference see Book 1738, Page 491, Brunswick County Registry. APR
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