OI_17-21_Pensco Trust Company LLC

Oak Island
Local Government
01 17.21
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 Pensco Trust Company LLC, authorizing development in the Ocean Hazard (AEC) at 4003 E. Beach Dr., in
Oak Island, as requested in the permittee's application, received 4/1712017. This permit, issued on 5/11/2017, 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 a single family residence, deck, landward of the Development Line, walkway and gazebo
with associated development.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on 4117/2017 & MI 4125/2017.
(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.
(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, 2020
In issuing this permfl 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 gh_C�astai JED
lm-rf l ��
Donna F. Coleman
CAMA LOCAL PERMIT OFFICIAL
4601 E. Oak Island Dr.
Oak Island, INC 28465
Management. PERMITTEE
�i,M WILMINGTON, NC
(Signature required if conditions above apply to permit)
MAY1?2017

Name: Pensco
Minor Permit # 0117-21
Date: 5/11/2017
Page 2
(5) The structure must set back a minimum of 60 feet from the first line of stable natural vegetation, as determined by
the DCM, the LPO, or other assigned agent of the DCM and house structure with deck and hot tub placed landward
of the 01 Development Line.
(6) The pernittee is required to contact the Local Permit Officer [phone], shortly before he plans to begin
constriction to arrange a setback measurement that will be effective for sixty (60) days barring a major shoreline
change. Construction must begin within sixty (60) days of the determination or the measurement is void and must
be redone.
(7) All buildings constructed within the ocean hazard area shall comply with the NC Building Code, including the
Coastal and Flood Plain Construction Standards of the N. C. Building Code, and the Local Flood Damage
Prevention Ordinance as required by the National Flood Insurance Program. 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.
(8) All buildings must be elevated on pilings with a diameter of at least 8 inches in diameter if round, or 8 inches to a
side if square; and the first floor level of the sills and joists must meet the 100-year flood level elevation.
(9) All pilings shall have a tip penetration greater than eight feet below the lowest ground elevation under the structure.
(10)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.
(11)AII 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.
(12)Any structure authorized by this permit shall be relocated or dismantled when it becomes imminently threatened by
changes in shoreline configuration. The structure(s) shall be relocated or dismantled within two years of the time
when it becomes imminently threatened and in any case upon its collapse or subsidence. However, if natural
shoreline recovery or beach renourishment takes place within two years of the time the structure becomes
imminently threatened, so that the structure is no longer imminently threatened, then it need not be relocated or
dismantled at that time. This condition shall not affect the permit holders right to seek authorization of temporary
protective measures allowed under CRC rules.
SIGNATURE:
PERMITTEE
DATE:
D
tiec ;V-TON,NG
DGIv WILMING'�p11
MAY 1

Oro 'Este Ds i LI
I.ncalitY L'_- In Pamir Nutnixr
Ocean llamtd _./— Lstmrim Shoreline_ ORW Shmeline __ Public Tmal Shoreline_ Othff
(1%a, afli'ial I'm onf)f
GENER LINFORMATION
IAND ONV ISER - MAILIN-G�'ADDD�RfEM
Name en-s, �,( if—
City TYAy__Statek�Nr /�-.U7LPb— "I !o'47J'0175"
Email�i2ad�s�ltiOnf Kfx Cold _---_--------
AUTHORIZED AGENT —7-
Nam<__
Addrm/sj� nir 109 SC Zb"4 S+Ireer_ �/
Ciry jj/IS land seem NG a Im Phuoe 910-L94
Email biMhu:Idets WC @yuhoo. C --
LOCATION OF PROJECT: (Addmax, siren norm• mayor direction to situ; nutno of the adjacent w m ablulY 1
dna� e Aar h Qrfre
OF PROJECT: (List ell proptsed convow,ion a.d la:d dismrbnnce.t Ao --
SIZE OF LOT/PARCEL: 7,4yOU Were feet --- .._ acre,
t�l 2 r—
O oe
OTHER PERMITS MAY RK RKQVIRER The senility )on arc planning may repuim remad"Ahertlian the CAMA ? Z r
minor devel imrm permit. imitating, but non limited to: Drinking Water Well, Septic Tank (or other sanitary wsNe ra
Itrotmeln eysecml. building, Gleciricnl,Plumbing, Nearing and Air(btditiatinB.lnodation eml C•naBy Catarvmiai, PfA J T
Cbnificalinn, Stand Oune. Sedimen Control, SUMlivisimt APProvaf, Mobile Uume Park Appmeul. Ilighxay C'vntkMinn, a G.
Open. Check with your Local Permit Officer for more inromration. `G
r �
S'rAl FAIFINT NFOWNFRSH IP:
I, Ow nmknigned. an applicArd fora CAMA mupx development permit being either the owner orptmpeny in ail the ly a Q
penal numorlxed to act as an agent for purPosea of applying fat a CAMA milsra devekr mum prnnih certify (hen rite penun
fired a landowner on this application bus n significant intemet in the cud property desedbal therein. This interest can be
dncribed SS'. (cbak one)
_an owner or record title, Title is vested In name of
se: new Bask Pape In rho Csmnly Rogisha.
y of Ihad
an owner by vinoe of inheritmRe. Applicant is an heir to the esmm of
; probate was in
Cerny.
✓lfother mu mad. such as wriden contract In law. explain below or use a separate sheen & aNtch m ibis application.
Contracf-
NOTIFICATION OF ADJACENT RIPARIAN PROPERTY OWNERS:
1 fhRiomem ceri%that the following pelf are owners of properties adjoining this property. 1 eflum that 1 have given
ACTUAL NOTICE to euch of them concerning my in:ear m develop (his popery and to apply fir a CAMA permit.
(Name) , _ _ _ IIAddmal . A . - n L _ .. I _ IL. I I r ID
(1).1
(2) fe
(3) _
(a)
ACKNOWLEDGEMENT'S:
I, it. tudunigned. Setru wlcdgc that the land owner is nwen that IM: proptxd development is platowd for rot once which
Amy be mtaeeptible to erosion and/or flooding, [acknowledge
that the Local limitet Officer has explained tome the panto -
Inn board pmblenis associated with this lot.'I'his explanation was Accompanied by recanmeneations ameerning
Iranian —km Still flo tipnwting Lechnitlucs.
PROPOSED USE; Residential tj (Single-fmnily 1r Muhi.t'amily ❑ ) Commeniabltdus rinl ❑ ()they ❑ I flmhentmrc certify chat I an, mdunired m grant, aml do in fact g ird. permanismn li Division of Cussed Mnwgemnnt stnR.
The Lecal Permit OlDcer and their agents to otter on time aroratrentiated ISndA in emmaatmt with evalasting Utilitarian.
EITHER it,
OII(I18EGOVP(CeneaNyiia,LeealMswb9JRrarif)crrAn ampaime wMink AKCWHn _.. mimed
NjunrproprrN): ����a� This the day olf.20
O) OCEAN HAZARD AECS: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square fect(indudus
air conditioned living spree, parking elevated allow ground Icvel, rupnt s ittood apace elevated above ground Icvel but
excluding limn -load -bearing Saw epee)
(2) COASTAL SHORFI,INK AKCs: SIZE (IF RIJII.DIN(i FOOTPRINT' ANO CYI'HPR IMPERVIOUS OR RUILT
UPON SURFACES: _ square far (itwlu&, the area arrive foundation ofall buildings, driveways, covered decks,
concrete or Am eAty pntitu, etc, that am svilhinlhc applicable AEC. Allnch yamoakahaions with it. project flowing.)
STATE STORMWATER MANAGEMENT PERMIT: Is the pmjml Itaatcd in nu Ana rtbjemt to a State
Sumnwater Management Permil issued by the NC Diviniun of Gtergy. Mineral mid Lord Resentem (DF M LR)"
YES_ NOS
Ifyae, list the total Wilt upm nna/iripervions our ,ec dlowed for your Im or Posted: . aymoc feel.
Lan ",-Tor person Sueharized to MI as i' agent for purpose of filing a CAMA permit application
1'6fa' AppfnatloA imehtdre: general irlfavvnntion (thin frnwd. Axim dnnriug as rlercrjImj on the bark carthis applicadem. the
mtm+shlp.tatement.the (hares Hrrzarl AM* A'aliae where accenivy, acheckfor Y 00001madvpa)mble to the hitvfiti. and
ally igform itan, an, mop be providad.,Uy Ly do applionm, r/n dewily ifthe applienlimr as described by toes" ae"Im are
Itamrpnratrd wahow reference it, A10' permit nddch mac be issued. Oeeiuthen from thew Maaits will coastimle a violation of
any permit. Am'per'smr develophtg in as AAY' n'irhant Kral, is sahjeer to cfvf criminal And Admini'molive action.

OFFER TO PURL ASEAND CONTRACT. VACA:iT LOTA.A.ND
ICPosult'Cio; lines" (lbou'LIQ for guidance in'.tlmpletatgthisfeasnl
NOTE: This: cancnci u. attendedfor anunp -ed real property fleas Buyer )PH, porchgra, only: for personal .ute and does M* have
immediate plans to subdivide. h should nor be used to self Property that is being subdivided unless the pmpeny has been planed,
properly approved and recorded with the register of deeds as of the date of the cohttnet It Seller is Buyers builder and me sale involves
the constmc.ion of anew single fan:iiyy'dwehLng print: ro ' . use -the standard Offer to Purchase'- *ph {,dnnani-New fonstitution
c{�8
Adde;Formndum
S m (F or, if the coaunretion is �mplefid, tnz the''tlffeY td'Pnrdtsse and fmtna fFmin £-.. with he Tew Corehtiiiction
ACfdeedum (Focr. ',ti-T), .. -
For vihuote conademP on. the receipt and legal safiie- -) ofwbkh'grc iie"k. acbiivakdged. Buyer offers to Oxrha c and Seller upon
«eptani:e skroes W sell and Convey the property on tiie umrs 3thlc06dfti "' ofthis fit%rTo Purchase anilfotitiaet 3nd'artg addendum
or mCxhfcation made in tecordance with its terms (iwlNe-ACimttaat"}
L TERMS AND DEFI+iMUNIS: The, rersas listedbelow aiatll havevhe VC01506*9C Meaning given thetas as set forth adjaeem to -each
term: _
+a) "Seger':: itoneld-H Adcock.... Carolan H_ Adcock _.
fbi 'Boyer, : Ponseo Trost 22MA GV LLC Custod3ast fbo Chad R Norris .
cr 'Property': The Propa:y shag Include aft ttu real evoite &scribed below fopdW wash all aPpartauncep:tlferetU melrnhng the
.mprstvetnents located theaon N'O3V- if the pFOPOnY will uicfode a numu%ettme (moM7el h rrWs4.. Soya and Seller should
consider including the Manufaauned Mobile) Home provision in the Additional Provisions Addendum (Standard Form 2A I i-T')
with this offer-
Stnsm- Address: A003 E Beach Dr. -
County:
(NOTE:
Legal DESCsiptiow (Comptere ALL appliciiile)
school diyttim
shown.)
Plat Reference: L WL:rnit L-2 . BtotkLSecriun 8-17 -S-2 ... .
. SuTi�visitxUL'otdomminm 16Mg Beech.
.: . xs shown mn Eiiat $onk}Sfide 1 at Pagc{s?. . 96-99 ..
The PL°l.'PF koromer idgtrificid n,mabgafthe ftpetty vs 249AGO1903
Other.desrriptioe;L-2:B-.13..5-2..IS..PSa§T.1�%-99 ..
Some of aSt o€tie-1?ropetty irsey be desciibedini3eetlBook --
(d) 'Pbrchm Price
S -
S 0
i
a=_'Page . 625
.paid m:iJ5,13ok7an;uoon #}tp fotietvipg,ttems:
BY DU'l DIUGENCE FEE madq.t>ava4le and Cteiiycred t4-Sellerby_WF.fFaafive Due.
BY IN MAL. EARNEST. MONEY DEP,OSU made. payable mod;, to. Escrow
Agent named in Paraeraph 1(f). by 0 cash UU Personal check oT"i bank check
D wire transfer. ❑ electronic tram. fer. EITHER `r) with this offer OR M within
five fa) days of the EffeetiveDme of this Contract_
BY (ADDfTfG%AL.) EAPOWST M0,NEl' DEPOSIT made payable'U& delive ed, in
Bvcroii' Agent named in Para rap. 3(f) by cash or immedtatdy av-dilabie funds xuch
as._official .. bank check. wire taasferor elecuonic vaasftt no Liter.- than
TIME BELVG OF THE ME.VCE.with regard
:asaid done.
_ BY ASSUMPTION pf the Unpaid principal baLao v and all QWIgotEonn of Selitr on.thc
cmaitig k/ait(s) secured by a deed of ouston the Property Ca. acca;thance withthe anached
I.oaaAssumptetm Addendum CSnmdad ForRxL95-T).
U SELLER FIIiANC&P in, accordance with the anxited Setter Fittanung Addettdum
(Standard Form 2A5-T).
BALANCE of the Purchase Price in cash at Settlement tsomr or all of which may be paid
rviththeproceedi ofa Crew -loan?
This form joinds approved : b Page I of 11 y Sf-4IvDA1tD FORM L-T
\nett Carolina Bar.Association Revised 7r1616
North Caroba2w-'�'
iation of RE.AL,TORS®, Inc. r 07-r-M16
Buva nit:alsSeller widais SL7Lcbva_.yitit Fa' }R )'AdRF
SGe �" �.,Ni"y'xf t3/+X�tBOPJGRMN[W F-z Hew.l.E[�+?5'S u.0 IWiFRe\
tEC =;VED
I)CM WILMINGTON, NC

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: PEM00
Mailing Address: -3`%1 NOrff1 hei1 SiYeef"
Tau �G 273-71
Phone Number: 8225
Email Address: OIL C�_Sh,IOhfZtCk �orY�
I certify that I have authorized _K it aLuJ j ei S 71:rnfC
Agent 1 Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: _ k 11SP
at my property located at kPd _j I V
in }btUri JtLL County.
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.
Property Owner Information:
N
i mc_& iraKt I e0
Signature
�et� Cv IrdSf-lpr
Print or' Type Name
i.0 n PE
Title
04 t a4 t�
Date
VIEC--'VED
[)GM WILMINGTON, NC
This certification is valid through / / MAY 1 12011

AEC HAZARD NOTICE
Project Is In An: ocean Erodible Area High Hazard Flood
Property owner: r L AS c o F-A w ( % f /-- [/f76 tl� /;.I /
Property Address:
Date Lot Was Platted: L: f /
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 :he 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. Pewits 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 availabic 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 a 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
,9 J6 feet landward in a major storm.
The flood waters in a major storm are predicted to be about
I q 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, grouus, jenies
and breakwaters are prohibited. Temporary sand bags may be
authorized under certain conditions.
The applicant mustaclmowledge this information and requirements
by signing this notice in the space below. Without the proper
signature, the application will not be complete.
pplicant Signature
Inlet Hazard Area
i
SPECIAL NOTE: This hataril noticeis 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 Ito 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 sethaerkrtquirement, the LPO will inform you
that you may begin work..I1 Substantial progress on the project
must be made within 60 days of this setback determination, or
the setback must be remed. Also, the occurrence of a major
shoreline change as the result ofa storm within the 60-day period
will necessitate remeasurdinent of the setback. It is important
that you check with the LPQ 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 afterpermit expiration.
For more information, conract.
-Dot,imA F_ Cniernan
Local Permit Officer //�� ( _�
4(opi E. CaL _%4cZr1A I
Address
Oak. Tslar,d, N C LSH(0s
Locality
t910) oral So4�7
Phone Number
clColernat�� cl. Cak-tS�.nd. 0C . us
nEC .+VED
DCM WILMINGTON, NC
Revised

VICINfTY MAP ESCARPMENT _ — — f7.7•
Nm 1D scatr: FIRST LINE OF 8.4't - t12.7'
VEGETATION (FLOV) 12.4'3 -- - - -
FLAGGED BY A RIDGE OF DUNE (FLOV)
WN
DFFIc�CAALL GRAPHIC SCALE
SITE LS 9 75 15 30
,ry i INCH = 30 FEET
EAST BEACH DRIVE
_
=
N 76"25'00" W
p
50.00'
4t
I5_8
w EAST DOLPHIN DRIVE �' - -
- - - _ _7
IRS
LANDWARD TOE/SANDTOE/SAND FENE
IRS
i
60' LANDWARDSETBACK
c'
1: SEED & STRAW ALL DISTURBED AREAS
2: ONE (1) TREE TO 8E 15' IN HEIGHT OR OVER
1/2000 USAGE MHW-C
AT MATURITY MUST BE PLANTED OR REMAM AFTER
CONSTRUCTION PER EACH 1450 SF. OF LOT AREA.
I 1 - '" 5.4't I
a
3: ONE 9' X 18' PARKING AREA MUST BE
PROVIDED ON THIS PROPERTY PER HABITABLE
ROOM MINUS ONE COMPLETELY OFF OF THE
STREET RIGHT-OF-WAY.
ro
O
O
LOT AREA = 7500.0 SF
O
(
(�
O
TOTAL IMPERVIOUS AREA.
I
62f
(1660.0/7500.0)100=24.89.
Y
AREA & RETENTION CALCULATION
DEffLOPAIENT r
*' _
W
1=(357.0 SF X 1.5)/12-44.6 CF/3.53 12.6=15 LF
LINE I
`O, e
2=(357.0 SF X 1.5)/12=44.6 CF/3.53=126=15 LF
3-(357.0 SF X 1.5)/12=44.6 CF/353=12.6=15 LF
« e I
-
O
4=(357 0 SF X 1.5)/12=44.6 CF/3 53=12.6=15 LF
I OIn
5=(216.0 SF X 1.5)/12=27.0 CF/221 1.2=1 CHAMBERS
O
DECK z.
In
6=(216.0 SF X 1.5)/12=27.0 CF/22.1=1.2=1 CHAMBERS
L0
M
ADJOINER'S
In
I
st a'
RESIDENCE
TOTAL VOLUME TO BE RETAINED=232.4 OF
M
7'S f 0 '`
z
1998 STATIC
ESTABLISH VEGETATIVE
I
('-��
I.. ¢I I I
VEGETATION LINE
COVER (TIP) ATTACH DOWNSPOUTS (n
I VE-19
72" NATIVE FILL TO 4' PERFORATED
IPE
VE-17 x
8.0' - - 8.0'
2 STORY
5.0' FROM FOUNDATION
8 HABITABLE ROOM
FROM PIU FILTER FABRIC
ra
RESIDENCE
ON PILINGS
x
1
N
15' MBL
12" Qi10WX
x X
$SYN
3.0' 3.0 2.0' BUNDLE
GEOSYNTHET (lip) (TYP)
6.7't
m °' O1 1 we
E
A���—((N�ON LOAD BEARING)
IRE
.� SO.00 t7• oRRS
?�7GROUND
GROUNDELEVATIONS
1203 H EZFLOW DETAIL
om S 7625'00" E
2HIS GAL/LF OR 3.53 CF/LWITHIN
4003 EAST BEACH
DRIVE
NOTE: THIS PROPERTY LIES WITHM THE
C.&MA OCEAN ERODIBLE AREA OF
ENVIRONMENTAL CONCERN.
60'
PUBLIC RIGHT—OF—WAY
10' #57 STONE
ENCASED WITH
LEGEND(IF USED)
GRADE
FILTER FABRIC
INFILTRATOR
IRF=IRON ROD OR REBAR FOUND
o
-
QUICK4 PLUS HIGH
PF=PIPE FOUND
ri
-=
-
".-,-�CAPACIIY
CHAMBER
MBL=MINIMUM BUILDING LINE
y1. -.
AND END CAPS
IRS=IRON REBAR SET
CMF=CONCRETE MONUMENT FOUND
UNDISTURBED S OILS
CP-CALCULATED POINT
1.0' 157 STONE
3.5•TRAN-
CBB=CA9BLE P OEDESTX-
TP=TELEPHONE PEDESTAL
OAK
(LOAD BEARING)
CHAMBER DETAtd
M
CAw--CDAsTPL AREA MANAGEMENT AGENCY
ISLAND
f
SSMH=SANITARY SEWER MANHOLE
SSCO=SANITARY SEWER CLEANOUT i^�L1V
ZONING
22A OF / PER 4�SECT
ON
F.EMA=FEDERAL EMERGENCY MANAGEMENT
R7
AGENCY
SURRP7�'R a RATE MAP
BEACH FRONT= 15'
SIDE- 8'
TAX PARCEL
# 249DG01902
MHWL= MFAN�H
REAR- 20'
N,3
FLOOD CERTIFICATION: LOT SURVEY
THIS PROPERTY LIES WIT111N F.EA MSPECIAL FLOOD HAZARD AREA VE-17
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Price
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First -Class 1
$0.49
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REC_ =,VED
DGM WILMINGTON, NC
l,io 1 1 2017

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: Pr/an M a o6' M on I a L 8 U rip K2✓
Address of Property:
(Lot or Street #, Street or Road, City
�I7.(17SR1 IG�L
Agent's Name #E Lt tuidtfs --Z . mailingAddmw:�33 4-A dsside AV2ntu
Agent's phone #: q11) -19, - 14&.3 Char /e ifQ �J �— 2-9;409
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing with dimensions must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what Is beingproposed, you must notify the Division of Coastal Management (DCM) in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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) (Adjacent Property Owner Information)
gnatwe
Chad 1 I o rrfs
Print or Type Nam
371 K! J' lAen -: }Hed-
MaNfng Address
lr6V, NC 27371
City/state/Zip
91c q�,, -a1T.q—
Telephone Number
Qh 4- 17
Date ��
Signalure
Print or Type Name
Mailing Address
City/stata2ip
Telephone Number f�EC' - V O0 NC
nGM`N�� 1p11
Date
Revised 6/182012 kj 1 -

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONtWAIVER FORM
Name of Property Owner: 11r-CLbefI1 90J G= d C_k' Lt:e i
Address of Property: 00 'ack j)rl✓Q IL� a#10 �C' ltiiCjL
(Lot or Street #, Street or Road, City & ComtY) )
Agent's Name #:�2Gtif_f LUJ jS Zn _, MANAddrese5 0-, .SL n&e
Agent's phone #: qiG -Lg4-1 h&3 te5 ee- 1 Z Z
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing with dimensions must be provided with this letter
1 have no objections to this proposal. 1 have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal0anagement {DCM) in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 147 Cardinal Drive Ent.,
rYtmington, NC, 28405-3845. DCM representatives can also be contacted at 1gf0J 796-0215. No response is
cnncidared the same as no objection if you have been notified by Certified Mail. _
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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)
mgwture
Chad } 100-6
Print or Type Nama
371 ti &I hen Sty
Maki» g Address
II �i1 ti`c 2137.1
City/StaMao
gjo-97S-oi7b�
Telephone Number
Date 044 q_______.
(Adjacent Property owner Information)
Signature
Print or Type Name
Mailing Address
City/Statelzip
Telephone Number E_ U
t� TON, NG
_ r,try"LMING
DateedsnenofAy 1 i 2011

U
Z
Donna Coleman r,�l4�ll n
To: [e-mail]; Scott Buff z
Subject: CAMA Minor Permit Application OI 17-21 IJ �_ r
Dear Sir: in
We originally accepted your CAMA Minor application under the impression that it was complete. On subsequent review,
I have discovered that additional information is needed to complete the review process. Accordingly, I am requesting that you submit the following additional information to this
office:
,\�, A'.. A copy of the side view elevation of the proposed residence.
%ti6 ✓1. A signed AEC Hazard Notice by the proposed buyer. (attached)
­"1 Your failed to enter the total floor area of the proposed structure. (includes air conditioned living space, parking elevated above ground level, non -conditioned space
elevated above ground level but excluding non -load bearing attic space).
1
In accordance with the Department of Environment and Natural Resources regulations, we note that a certain time has passed while the application has remained in our office.
Upon resubmission of a complete application, a local decision will be made in 20 days.
Please contact me at [phone] if you have any questions.
Respectfully yours,
Donna Coleman, LPO
Donna F. Coleman, CFM
LAMA-LPO / Building Inspector
Town of Oak Island
[phone]
[phone]fax

Donna Coleman
1 � To:
{� Subject:
V
Dear Sir:
[e-mail]; Scott Buff
CAMA Minor Permit Application OI 17-21
We originally accepted your CAMA Minor application under the impression that it was complete. On subsequent review,
I have discovered that additional information is needed to complete the review process. Accordingly, I am requesting that you submit the following additional information to this
office:
1. A copy of the side view elevation of the proposed residence.
2. A signed AEC Hazard Notice by the proposed buyer. (attached)
3. Your failed to enter the total floor area of the proposed structure. (includes air conditioned living space, parking elevated above ground level, non -conditioned space
elevated above ground level but excluding non -load bearing attic space).
r
In accordance with the Department of Environment and Natural Resources regulations, we note that a certain time has passed while the application has remained in our office.
Upon resubmission of a complete application, a local decision will be made in 20 days.
Please contact me at [phone] if you have any questions.
Respectfully yours,
Donna Coleman, LPO
Donna F. Coleman, CFM
CAMA-LPO / Building Inspector
Town of Oak Island
[phone]
[phone]fax

Locality
I! ,k= -1%lan ea' Permit Number 8:1 I T C.
Oceenplonld ✓ Esivarine Shoreline ORW Shoreline —Public Trost Shoreline —Other -+
(For q(jicial nee onfy)
MAILING ADDRESS
Namc_t-� ! t
City State _J_ Zipa7�uPho,e
Email_. Chi
AUTHORIZED AGENT
Name �dtti<� Riu)ders 1ne.
Address SC 310-4 :5..4IT�ee f'
city ,(Pak IS IZHId State NC Zipl Phone 9/D-L94-14(03
Email FvJ��bu Iclels fr7C P Vahoo cum
LOCATION OF PROJECT: (Address, street mole and/or directions to site; name othee adjacent waterbody.)
46n-3 k.r /pall, Lig
(List all proposed construction and land disturbance.) '7/ou1e
SIZE. OF LOT/PARCEL: 7600 square feet acres
PROPOSED USE: Rcsidcntial N (Singlo-f'annily V Multi -family ❑) CommerciaVlndus rial ❑ Other
._--f:OMPlh Ike. F.1'11{pR 1 OR 2 NFLOW(Cniand)mur Local Yermlt O�eerifyao ore nal cure whudrAh,'C ryr as. -
to your property):
(1) OCEAN HAZARD AEClo 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-loud-bcoring attic space)
(2)COASI'A HORELINh: AbICa: SI I..I HI.IILDIN(I FOO
S. '1'PRIN"-'AND OTHER IMPF.'RVIOUSOR HIJII:T
UPON SURF square fact (includes the ,on of the foundation of all buildings, driveways, covered decks
m,
con'gpar mar n tins, etc. that am within the applicable. AEC. Atmch your calculations with the pmjml drawing.)
� C
STAT$ETO G ER MANAGEMENT PERMIT: Is (he project loaned in an area subject to a State
Smn(r>mler M m ml Permit issued by the NC Division of Energy, Miami and Land Resources (DE'MLR):'
YES._ 13P-M
Ifycs, list the ligal=uilt upon 0,walipchviouxsurface allowed for your lot or parcel: aquarc feel.
{ M
OTHER PERMITS MAY HE REQU[RED:'1 he activity you are planning may require permit. other (hall the CAMA
minor development permit. including, but not limited to: Drinking Water Well, Septic Tank (or other sanitary waste
heatnont cymend, Building, Electrical, Plumbing, floating and Air Conditioning, Insulation and Energy Conservation, PIA
Certification, Sand nurse, Sediment Control, Subdivision Approval. Mobile Home Park Approval. Highway Connection, and
others. Check with your Local Permit Officer for more information.
NI'Al'EMF-NT OF OWNERSHI P:
1, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in ah 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 an this application box a significant interest in the real property described therein. This interest can be
described as: (check one)
on owner or record title, Title is vested in name of
sec Dm:d Hook page in the County Registn• of needs.
- in owner by virtue of inheritance. Applicant is an heir to the estate of
was
if other interest, such as written contract or le,se, explain below or use a separate sheet & attach to this application.
Ccn'1T acf-
NOTIFICATION OF ADJACENT RIPARIAN PROPERTY OWNERS:
I hnrthennorc certify that the following pemoas are owners of properties adjoining this property. 1 affirm that I have given
ACTUAL NOTICE to each of them concerning my intent In develop this property and to apply for a CAMA Iwmnit.
(Nanml (Address)
(1)Qltan an� MlArle (troLe✓_iy llsaAe Aye haryo NC�ZB
(3)
(d)
ACKNOWLEDGEMENTS:
I, the undersigned, acknowledge that the hod owner is aware that the pmpoxxi development is planned for an area which
may be susceptible on 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 stabilin-
tion and flooelprouling techniques.
I furthermore cenifv 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 It, enter on the aforementioned lands in connection with evaluating information
related to this permit application._._.
Tile$ the _ _ day of , 20
Landowner or person authotind to act as lnsffzl,gent for purpose of filing a CAMA permit application
This application includes: gooeml irlromafiun (tlris (oral. ¢.site drawing as descrihed on file lna'k q(dds upplicali(m, the
mvner hip.slarenrenl. the Ocean Haza d AECEntice where necevsarg a check for J1of.0O made payable to the localfl); and
aqv iu(ormatiorr av nia)• he provided orally lry the applicwra The detni2r gfthe application ne descrlbed by fhece sowres mr
inrorprvoled u'illrnul r'aferrnca in nap per'mil whicd auc he issoed Ocriation (urn these detains ail/ conahitute a violotinrr of
env prnnit. Aql' person den elaPhrg in mr AEC nllhoul pn'rnit d+Jecr to civil, c.ro ina/ and adrninishntism action.
RECEIVED
DCM WILMINGTON, NC
APR 2 12017

- OFFER TO Pt}RCHASE-AND Cn!i7RACT-.I'ACA4T LOTH AND
[Consult"Guidelines",(form12G) for gaiilamw ocomp6etingthis:f0fin, -
tiOl'E This contractisintended ffbr.:unimpraved real. pn,peny dud .B,nydx-wilF pttrenas�,oniy,f r personal„Arse and dues not have
irlolediate plans to subdivide. h should not be used to sell property drat is being subdivided unless the property hai been plaited,
properly approved and recorded with the register of deeds as of the date of the contract If Seller is Buyer's builder and the sale involves
the constrachon'Of a new sirs -iam'vig: i{welGrsg priefto ei&ing, itsr ft standard Offer to, Paw ia'se aadEanuacr-New Construction
?Form 300-Ti or: if the construetion iv"cvinpleteti, ase'the tlffsrtti' Ptrrehase- and -Contract fFdm 2-7p with the New ConstrtPction
` - Addendum tTwn 2A3-T).
" For ialuabfe considetalioa. the receipt a,j legal suificttncy of wheel are ireciiiy at'7ttitiiwlafge$ Bayerotfeis to pitrahw�r atiil Seller tgxia
a;-epiwce agrees., to self and convev rhe'Pkopetty olithe 'dvirfsdcmidlifilos uf"rtfi5'E9fk 'iy pttrreha 'aitiid-Cdid- zmdrio adiiiindum
or modificarion made in'tccordaace with its tefutst 'lluii'ihe'Cikit�2ni"j:"
- 1. TEX%IS AND DEFINITIONS: iYte:terrriti listed belbie shall baveAhc-respeeti-ve �:»eaainggew'err�hetn as: et forthseemto each
(a) "Seller":: d2oca2d B. ..
th) "Buyer': Pensca ':'rust tbtaar�sty LLC CusEeditiii !i>o"C;iiad R '1Qprris�
tell "Property": -R e Property sW indude all that real: estate describmfbelow topediBr with all ap{satimtatrc tdterata inclttihnrs the
impruvettten[s located :hereon NOIEV if the Property will iln:nade 41 manaaaiitbvi (tttofttle) 7m rwi�Y ,Huyar and Seller srr ld
consider including the Manufactured (aLiobile) Home proVision in the Additional Prttivisions Addendum (Standard Form 2A 11-1")
:+. - _ - . .
a :_, with this ohe'r. _
St_= Address: 4003 B.Beach Dr. ... - .. _
City: Oak IsSand :
s_ • �tpc:26465-55Ifi ..
Couary: Hrupsrrialt: _
T 1pr7tf C-WAw
_,. (.NOTE: Gocemntentatl atoortly over mAtcr,'a30ittg,.schoddistdas: utilities, and amg-deliverlt alav differ from addresc:shamm 5.
i.:esal Dcsciiption (Compleie df[. applica
�pla's Reference:-[nrAAliitit ...:`i.-2.. `:'.. BludkJSectioie 8=2�.:'3-'2.�Sit$d(eisirnt7Cr'�dtriGniait 'toassdr�9aa�3:
I at page(s) 96-,99:,
The.PLtitlallltuother trknrifecattrm nwn6erofttye y2�i9H:G4k903
l=""''. Otherdesr[iptioti.L2..Hrt23;&-8,-i$+F+T,.,AI'a,'2tf9.G-9S
tiSoule of all efthe Prop" Ftffity be described iwDa*- fottk .W27 - arpgV . 625
id) "PurdhasePrice':
T 5 ..._pax l vr.ti,SEJathrt pgn,kll- i#9ICTF4s......:.
�:, ..5 : . SY.DET&D1i-iGE�€f�£lT>€s r+rat$n-Pay�fe awl deliveXed ra.Settevci�'�,Sffxc£sye Dare. -
... .. 5 R; BY Ia itT7,4I.. EARlis&T4 +tfglTE3G iiBFO93T:ntade..payab inEscrow
.v Agent named in Paraetsph t(f) by C] rash W persnml check Q offte+al Crank cbeck
❑ wire transfer'.. L-1 eldrnonic transfer,. ErMER 0 v iih this offer OR i& within
.'five f3j'days`ofdie-Effeetiue'1!horofthis'Crmjmct.' ..
$ BY (.Al7C MONAC) E-A1ZL MT a UNEY bEPOSff rnade paya6 liod detivWedto
. ...F-*row .Ageiirt' named sn. Paragrph I(f) by cash or inunediatety available funds such
.. _ .:.as. .olfieial.. bank cheek, wire. uaasfsr ; or +:kcugrrw ;irpti'fa _ tw .. later,. than
_..
.. .. ., TOW, RMG Qf �i18,ES5£:SiCE,.witb regard
-..tn said date..
5 IIY ASSlj3IPTtfll�,t�f i :{mfk?td Pt?ti"-?pa pal. and'altqb1torg.pps ff S.elicc;ow.ehe
LoartAsstunphosAddepdam (SzW*I Foctet 511.
. 5 if SELLER. FWA:'V` * trtaoaxdaace wttb the,Anaebed.Stiff Ftnancrag ?Addendum
.. (standard Poem 2A3-T).
S BALANCE of the Purrhace price in cash m Sctticmem (,some or all of whichmay he paid
; with the proceeds of new loaa): - -
Thisforin jointiv a owed b - Page I of I i . .
Pun' io S'TANUAAR Revised
7 i.. "C
Arorffi Carolina BarAssociation Revised ?tA116
rarz� 'north Caroim"yv i en of REALTORSO. Inc.
Bever inisafs SJl r initials
AAe.TtF�'+Q:xii t-Caere t'✓•.a 61 .a Yc Lotus.. pn5 o; c:Ter-Fill trv' w:a;:.y: to Ku,e6e>b
r:-3:51;{e+•=dtt2H �':GrtmeaN+z%�rtn®aya�Y.�+r89Tl F:fien::34Aua:rwm.t�e�.�ass ..�.,�.-.:.em.em

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Perm
``it
ff:
Mailing Address: 3`7l riIDr+k - i j 1 hf-Q S YC'ef'
Phone Number:
Email Address:
certify that I have authorized
lY6U �� 27 37 i
q!o-571� - gzz5
Chad 0_sh,16hL4- rL eon)
to act on my behalf, for the purpose of applying forand obtaining all CAMA permits
necessary for the following proposed development: le-C K 17SP
at m}y�� property located at 4f
in J�YI (f1SGl i -L County.
V
! furthermore certify that I am authorized to grant, and .do, in fact grant permission to
Division of Coastal Management staff, the Local Permit Ofcerand their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
16
l C t�SCb 1Y21(i le-0 /I ,f'n. ". ez
'Signature
/J'r�SCa IYUSi %gin �'_l,d i< Il;ri't5
Print or Type Name
Title
ci/ te r1T
Daate I
This certification is valid through

' 'Domestic Ma111C
�Fordellvery nforn
�,firmiwitieer
mCerIfled
McOFee $3.35
to
$
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bdra SONCee&F6ea(c kbo aedfen
❑Return Rereipl jnerddcoPY) $-
0
❑ROE R=lpt(We Wc) S_
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❑Ganged Me!IROSV W DeWery a_
0
0
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Pastege $0.49
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$
$oral POSWgO and Fps
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M Certified Mall Fee $3.35
`a $-
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C3 I ❑PfM1:nn R.,.Ix Qwrd.pY) a
C3 ❑RSWm R.dpt (OleOdmnk] $�yayty—,
O ❑C Igsd MOII RocWW Dc!Ivcry 3�i1� (T
C ❑Ado al,m. Reeubed S _ 40 000—
PAOel,.t.ReWlCledMe 75
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fU Total Prshgo and �6F e^
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C
rHPORT
®® I� NASH ST
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U 6 1-3987
14 )20461
275-8777 1:38 PM
Postmark
Here
Sale Final
Oty Price
04/14/2017
/0 �''` 28209)
------------------------------
60 Oz)
--------------------- -------- ery Day)
]17)
1 $3.35
TWOSP ertlfied Mail 8)
(701621400000)8347436)
Return 1 $2.75
Receipt
(@OUSPS Return Receipt N)
(9590940305715183419328)
First -Class 1 $0.49
Mail
(Domestic)
(CHESNEE, SC 29323)
(Weight:0 Lb 0.60 Oz)
(Expected Delivery Day)
017)
fed Mail 0) $3.35
8347429)
1 $2.75
Receipt H)
183419335)
0461
14
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(XXXXXXX5827)
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04/14/2017
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