OI_17-29_B & C Seaside Development Co.

Oak Island 01 17.29
Local Government Permit Number
CAMA
MINOR DEVELOPMENT —1
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 B&C Seaside development Co, authorizing development in the Ucean Hazard (ALU) at Izd W. beach Ur., In
Oak Island, as requested in the permittee's application, received 5/22/2017. This permit, issued on 6107/2017, 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 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 512212017.
(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 permit it is agreed that this project is consistent with the local Land
Use Plan and all applicable ordinances. This pemlt may no( be transferred to
another party without the written approval of the Division of Coastal
Management.
Donna F. Coleman
CAMA LOCAL PERMIT OFFICIAL
4601 E. Oak Island Dr.
Oak Island, NC 28465
PERMITTEE
(Signature required if coed" s above b permit)
ECf= VED
DCM WILMINGTON, NC
J U N 0 6 2017

Name: B & C Development Corp.
Minor Permit # 01 17.29
Date: 6/07/2017
Page 2
(5) The permittee is required to contact the Local Permit Officer [phone], shortly before he plans to begin
construction 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.
(6) 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.
(7) 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.
(8) All pilings shall have a tip penetration greater than eight feet below the lowest ground elevation under the stricture.
(9) 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.
(10) 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.
(11) 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: DATE:
PERMITTEE
`lE, ,`ED
L i.M WILMINGTON, NC
SUN 0 6 2017

Donna Coleman 5e 4- Slat I in (a 3:58"
To: [e-mail]; Scott Buff
Subject: CAMA Minor Permit Application OI 17-29
Dear Sir:
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:
4
A copy of the side view elevation of the proposed residence.
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),
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 16 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

Perron urMrr
. � A ,,�,.__ OAR' SMrcliae _ I"ablit Tnat Slprtifrr_ Odttt
k lF.uopir(alYoe,,sAr
GENERAL INt�.T,y 2er_'A
LANDOWNER - MAILING ADDRESS
C' State rt--7i,271% Phone
AUTHORIZED AGENT
Cary (1/f2CjSi Q fYJ State eJ C'_ z.PZS4 Ltphone 9b-L94-/4103
Email /jlAffhr,alrlP�c,n YahmiCbty)
LOCATION OF PROJECT: (Address, street name and/or directions to site; name of Ne adjacent watere dyd
PROJECT: (List all proposed amsrucnon and lard dismrbartce.l
SIZFOPLOT/PARCEL: 5y4-00 squarefect � acres
PROPOSED T'SE: Residential l.Y (Single-family G( Mutd-family Q ) Conimencial/indusoial ❑ Other ❑
COMYLFT F. F.IT'HER (1) OR (2) RELOW (Cnnhm year Lerel Pamir Oj/Iswr Ijysa ens our s'vre whlrh AECepId/n
myearpaqwry):
(1) OCEAN HAZARD AEC,u TOTAL FLOOR AREA OF PROPOSED STRUCTUREPa,T1' -%cave teat(nncludes
air conditioned living space, parking elevated above ground level, non -conditioned space clrvated above ground level but
excluding non-bmd-le-aring unc specs)
(2)COASTALSH AECV SIZEOF RU)LDIVO F'OOTPRIN7' AND OTHER IMPERVIOUS OR HUHT
UPON SU"ACES feet (includes the are of the foundation of all buildinga, driveways, covered decks,
awcr t or mammy, patios, etc. that are within the applicable AEC. AaeWh Your cMoulations with the project drawing.)
STATE STORMWATER MANAGEMENT PERMIT: Is the pmjcat loaamd in in area subjm( to a State
Sturmwmr Management Permit issued by the NC Division of Energy. Mineral and Land Resomca (DEMLR)"
YES_ NO
Ifyee, list the coral built upon erea'imperviouseurface slowed for your lot or parcel: I -S"" square lat
Vzw,q 5 /221 1 `1
OTHER PEHMI15 MAY BE REQUIRED: 'I'he activity ywt arc planning may rtquirc prnnils other thus taro CAMA z
minor development pereah, including, but not limited W. Drinking Water Well, Septic Tank (or other sonnets, waste z
treatment system),Building,Electrical, Plmnbing, Heal ing and Air Conditioning, Insulation and Energy Conservation,FIA
Certification. Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway Connection, ardW 0
p�
other. Check wide your Local Permit Officer for more Information. 3
N
STATEMENT OF OWNERSHIP: z
�
ell
1, the undersigned. ut applicant for a CAMA mires development permit, being either Me owner of propasy in an AEC or a / `.
person authorized m sties an agent for purposes of applying for a CAMA minor development permit certify drat due person 11
Id
Z
listed ae landowreron this applieudon has a significant interest in the mat property draenbed thercia.'fhis interest can he -I
described as: (check ate)
�7 f yY
✓en owner or record tine, Title is vested in name of FC S�.aS-t UQr �aiQerric it.ai
see heed Bank, Mac S page A is the aga9'KtlIPJL Cnunly Registry uC Dsods, 111:::...]]]
_an owner by virtue of irdreritance. Applicant is an heir in the senior of __
probate was
Couch.
_if other interean such ae written contract or lease, explain below or use a sepia nit sheet & attach an this application.
NOTIFICATION OF ADJACENT RIPARIAN PROPER "I V OWNERS:
I fn1berrnort certify Nat one following perame, arc ownen of properties adjoining this property. I a1Hn r that I have given
ACTUAL. NOTICE to each of them concerning my intent to develop this property and m apply for a CAMA permit.
, (Name) I _ (Addryta)
(1)
(2)
(3)
(4)
I, the tandeasigned, ocknowledgc that the land owner is aware that the proposed development is planned Fur en area which
my be susceptible m erosion and/or flooding. I acknowledge that the Local Permit OtBeer has explained to nut the parimt-
lar lianad pmblens associated with this lot. Thin explanation wm eetompurded by rtcomm nahau na concerning stabilim-
line and floalpnuling techniques.
I hnthemmore certify that 1 can authorized to grant, end do in fact gram. penuit.ion b Division ofCoestal Muria n ant stag,
the Local Paint Office and then agents It, enter on the aforementioned lands in cooneeticn with evaluating information
related to this permit application.
Th `Ne _L2 __ d+y WrAAk ?n / 7
Landowner err pmamu authorized mom as his/her agent
This Applicarien Aedades: generul brio, motion (that jar m). a sit d,,Wiag as deeeriherl an the Mrk W this eppile b n, as,
mvntrship statment, the Ocemr Hawrif AEC Native where nereattaq a check jar I100.0ii wade payable to the lucafip; and
aav hparmatloa m may be providedW all), by tat applicant. Tit, deralla of the applimdan as desMbof 4v dust source, am
mcorpmaced Willi lVeedaCC in tiny peons which mnv be Issued. Devlaflmt jaom these derail, a Ifl cnmavlmte a via/mbar, aj
any pump Ann pnoon develapLg car an AEC oiouna permit is subject to civil, .intros' and mhninirionitfve arson.
RECEIVED
DCM WILMINGTON, NC
JUN 0 2 2017

D
� w"d
—I gIzZ�1`�
VICINITY MAP
Nm m wl
WEST DOLPHIN DRIVE
60' PUBLIC RIGHT-OF-WAY
wF S 8530'00" E oa
i7•w 50.00' &6•S •ssc0
_ 2s' IBL t(�
it SEED tr STAW ILL NSTURBEO-
2: ONE (t) TREE TO BE 15' IN HEIGHT OR OVER 1 3
9 MATURITY MUST BE PVNTED OR Rf:MA91 AFTeB I a I p
CONSTRUCTION P EACH 14M SF. OF LOT NiFA
3: ONE 9' X 18' PMIONG MEN MUST BE
PROVIDp d h S PROPERTY PER 14MMABLE O O
RD01! MINUS ONE COMPLETELY OFF OF THE I O 37.Y O '
STREET RIGHT-OF-WAY. IO ' N
LOT AREA - 750D.0 SF I 1 S ITRY E I ? 3
TOTAL. %PER S AREA 1 C s HABITABLE
C2736.6/7500)100=S6.Sx J w ROOM 3
n• A RETENPON M �1 Ai1pNS I p R RESIDENCE M o I
1=(4882 SF X 1S)/12-61B CF/3s3-172-20' ¢Flow o e.t. ON RUNGS d a.r p
12=(4 2 SF x 1.5i/tt=61.0 CF/3.53-17.2-20' EZRLY/ _
3-(4 Z SF x 1.5)/12-51.0 CF/3.5i 172-20' EZFLOw I VOi 1 ml d' M
4 10.2 SF X 1.5)/12-a1.0 CF/3.53-1T.2-20' EZFLOW a �331 x +.
S-(391 B SF X 1.5)/12-49.0 117/22.1-2 -2 CEMMBERS T O L4
6=(391.9 SF X 1.5)/12-494 C£/221-2.2-2 CHAMBERS •I t7S'' a i s I O , a
TOTAL VOLUME TO BE RETNNEO-342A CF ti REa✓ Z 1W, LLLJJJ i ri
N
> PORCH, `'� I L;
j ESTABLISH VEB ATNE
COVER CTYP)� ATGDN DOY44POUT5 a b
12" NCTWE FILL TO 4' PET6ORATED-
60' FROM FOUNDATION I . a 25' MBL
FgTER FABRIC i. fAK
aS �i� TP q�NI 'G WXL� TRNi
FFP) - .-_ 1 728
CF1UF
DfG
LEGEND(* USED)
B'Ygi�WRJF! R00 OR NEW FCUNO
PFw� FOUND
1RL-MIMMUM BUILDING LINE
IP6-WON REBM SET
CMF-COMCRETS MONUMENT FOUND
CP-CACULGTEO PDINT
TAN=iWNSFORMER
CB-C/81E PFDC5TK
TP-TE10HDNE PEYS
C -COA & MEA MAACEMENT AGENCY
ss I sANRMY SEWER M0.VNOLE
SSM-SMwlA SEWER CLEMOU!
FEMA-FEDQt EMERGENCY WNAGENEM
F_.RN.- FFDEPAL WSUANCE ATE MM
F. CERDFH'ATWN:
1. iM6 PRMERIY LIES WRNIN FZ. S WL FLOOD NAW MEI, W-17
W-16 AS MOAN ON FLRM. 372p205WO1. DATED 6/02/2D06.
GflIEAt NOTES
I. MEASUREMENTS ON TINS NAP ARE N FIDEULHERE T mX) DECRS TOF.
2. ALL SET CCItARE
E 1/2' IRON RMB UNLESS 07118011SE NOTED.
3. TNS PROPERTY NAY BE SUBJECT TO AWIROWL EASEMENTS. Y 175 OF
l n AND RESTRILTONS NOT DISCERNIBLE BY OBSt]FVATiON AT THE
T91E OF SU OR TAT WY SE OF RECORD. W TIRE 6 14 W
TNOm`;S 0. VON CWDN.
RETEREMCFS
1. PLAT OF NEST LONG BEACH. SFLTION 3. MORD60 IN MP f BINET i3
PAGE 264. ON 5/13/1946 N TF.E BRUNSA9C1< COUNTY, NORTH CAR0LIM
RE®S1ER w DEEDS.
2. DEED 8OOV 1003, PAGE M. RECORDED IN THE MUNSNCK COUNTY.
NORM CAROLRM REGISTER OF DEEDS.
N 85'30'00" W
WEST BEACH DRIVE
60' PUBLIC RIGHT-OF-WAY
^ti5.v s' 98TLTRATOR
CAPAC PLUS HIGH
A AND END GFIAMBER
1� AND END CAPS
1& #57
ILL M n I OF
/ PE"
4' SECTION
ZONING GRAPHIC SCALE
�
Eu S IS 3]
® SETBACKS
FRONT- 25. 1 TNGH - s0 FEer
WE
B'
REMi-= zD• TAX PARCEL #234NCO1902
PRELIMINARY SITE PLAN
FOR: BUFF BUILDERS
LOT 14
BLOCK 73, SECTION 3,
WEST LONG BEACH
OAK ISLAND, SMITHVILLE TOWNSHIP
BRUNSWICK COUNTY, NORTH CAROUNA
VCS & CO., INC. C-2160
1 YAUPON WAY
OAK ISLAND, INC
TELE. [phone]
EMAIL vcsbmnsco®ec.Trma
EC' AVED
NILMINGTON, NC
JUN 0 6 2017

Donna Coleman
To: [e-mail]; Scott Buff U
Subject: CAMA Minor Permit Application OI 17-29 Z
0 z r-
W O o
>r
0
Dear Sir: o
We originally accepted your CAMA Minor application under the impression that it was complete. On subsequent review, W
1 have discovered that additional information is needed to complete the review process. Accordingly, I am requesting that you submit the following additiggal 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).
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 16 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

U
Z
RECEIVED
DCM WILMINGTON, NC

Project Is In An:
Property Owner:
AEC HAZARD NOTICE
Ocean Erodible Area 11'� High Hazard Flood Area
Property Address. 728 LL)1,5f tUc4L)1_DrIV'¢
Date Lot Was Platted: 4113bg4l'O
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 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
AS- feet landward in a major storm.
The flood waters in a major storm are predicted to be about
-11�3_ feet deep in this area.
Preferred oceanfiantprotection 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 he complete.
Inlet Hazard Area
d iUG M
SPECIAL NOTE: This hazard notice is requited 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 ofpermit 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 checkwith the LPO before the permit expires for official
approval to continue the work after the permit has expired.
Generally, iffoundation pilings have been placed and substantial
progress is continuing, permit renewal can be authorized, it is
unlawful to continue work afterpermitexIiratiom
For more inforinadon, comae%
-nol,lM A F.-
Local Permit Officer
14 (,o l G, Oak a- 6r.d
Address
nay-- �slar,�lf �C Z$LI(05
Locality
(910) Dot- 8049
Phone Number
dcolematn@ C I.Oak-tslartd. nc.us
RECEIVED
DGM WILMINGTON, NC
JUL 14 2017
Applicant Signature Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: J i f C -laSi(1P Wor men t clwp
Mailing Address: &7 / ) / --�,I{1en
Inca AIC 2-73-7/
Phone Number: 10 - S 7 6- 8 2 zS
Email Address: Chaul6a')Shy10�'+oci ,C'0(Y-)
I certify that I have authorized �.__'�UH tuJ d P r5 :::J�iC . ,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: _ Qi.J C16(" i a6h of) -
at my property located at 7,�8 IQ_S-t- r (� r1'1'e
in _&J)Su tc1C County.
1 furthermore certify that I am author
Division of Coastal Management staff,
on the aforementioned lands in cony,
permit application.
Property Owner Information:
Signature
Print or Type Name
4,osirI Pn t-
Title
-I Date?
�t
?ed to grant, and do in fact grant permission to
the Local Permit Officer and their agents to enter
action with evaluating information related to this
This certification is valid through S / / 9
RECEIVED
DCM WILMINGTON, NC
�� JUN 0 6 2017

y Bak IStaA
Slarehnt._.,_ ORW Shatrelme __ 1q Mw i w Ylnrreline� 1late
rFm ufh<mi aaa o,,h,
NE AIfF�g INFORMATION 'ZC�Jd S�l?�17
LANDOWNE MAILINGADDRESS , !s
Ciq _(y_y�2t 737l Ph— qlD-574,T,J�•�•5
AUHRORIZED AGP.NT
City
Stara ill r- _TrpiOALPhma 91D--294-141A
LOCATION OF PROJECT: (Address, street name and/or directions to
OF PROJECT: (List all proposed consm action and land disturbance.)
BIZEOFLOT/MRCn, co mu�.lJ amaleer I
,,,..._acres
PROPOSED USE: Residential (Single-family [� Multi -family �) CommercislInduslrisl ❑
COMPLETE EITHER (1) OR f2) BELOW (Connrd lwar Laaw/ Permit Office, if swa ere nor surz x
ro youepropov):
(1) OCEAN HAZARD AEC,: TOTAL FLOOR AREA OF PROPOSED STRUCTU : _square feet (includes
air conditioned living space, parking elevated above ground level, non -conditioned elevered above ground level but
excluding marl. W-bearing .,it, apnea)
(2) COAS'17ALSHO�Ik rj6 AEC,: SITE. OF BUILDING FOO' NT AND O'I HER IMPERVIOUS OR BUILT
UP SCIRFACES fa�,j(�rare fret (includes the aran of oundatiou ofall buildings, drivewa)a, covered decks,
cancreto or mmnnry patios. car. that arc within Da: epp' cACC. Attach your calculations with the projca dmwitgl.)
STATE STOR?4WATERMANAGEME>r4tRMTD Is the projnd located in an site subject to a Sate
Stmmwattt Management Permit foes y the NC Division of Energy, Mineral cad lad Resources (DEMLR)•/
YES__ NO_
If yes, list the tarot upon srearirnpervious surface allowed for your tot or patent; squrc fed.
Z
OTHER PERMITS MAYBE REQVIRF.MOicecovityyumam plcnrnngmayrequim pcmilsoba, than the CAMAD Z
mina development permit, including, but cot limited ten Drinking Water Well, Septic Think (or othersanitary waste �,f,,� O ~
treatment system), Building Electrical, Plumbing, floating and Air Conditioning, Insuhniop and Energy Conxervation, l3Q F�r_} N
Certification, Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway Comecda V
others. Check with your Local Permit Officer for more infatuation. (. ! Z
/1 0
STAFFMFN'FOF OWNERSHIP:
1, the undersigned. at applicant for a CAMA minor development permit, being either the it of pzg/iftythai
C ow
person authorized to act ar an agent for purposes of applying for a LAMA minor develrrpmenr permit,e peyWlisted as landowner on this application has a significart interest in the rut properly dcxribad therci .This mr hen bLi-
described es: (chock one) /+ /I/ y. /,r(sU��,[�
✓an owner or record tills, Title is vested in name of �f� �(ZdCS./()Q' f.�GV��:%IQUr, dr
au Deed Book I hS S page io the Cmmry Registry of Decds.
_pn owner by smue of inheriamec. App)1cant is an heir rothe esmic of
was in
if other intemst, such as written contractor lance, "Plain bet of use a separate sheet A atach to this application
NOTIFICATIONOFAWACRNT RIPARIAN PROP '1'VOWNERS:
1 furthermore Certify that the following Panora ere o ors ofpropeties adjoining this property. I affirm that I have given
ACTUAL NOTICE tot to develop this property and to apply far a CAMA permit.
t (Nome) I I .Z� . (Addrr�a) , y, A ,
(p
(21
(3)
(4)
1, the nigved, acknowledge that the land owner is aware that the proposed do clopnsont is planned for an arcs which
t M susceptible to erosion and/or flooding. I acknowledge that the Local Permit Officer has explained in me the patio.
Inn hazard problems associated with this lot. This explanation was accompanied by recommendations concerning smbiliza-
tion and flmdpr omq, recliniques.
I ru note ceni ry that I ant authorized to Smnt and do in fact grant peroumion to Division of Casuist Management smR.
the LocbRomsit Of ear and their ngenb in coast on the aforementioned hands in connection with evaluating information
related to thilftemit application.
This the �,�_ day of[. 20 L7
or person auhoneed toRalas h)sdrer.gem for
This appGcatlon /ndadta; gtnetJ irrlwmali hi>,hnmr). a site drtruing as damrfhal nn /ht kick u(rhivupplicanon. Jry
m*nershfp.rkteman, the ekemr HaarFd AFL Nor," he
rr noerrsary,acheckfm5/drl:!)(I mrndr)Wynhlerofhe laallryt and
env infoteatron ae may beprovided orally by the npph hr lemlle o7tXe ayPfieallwr tee dmcHbed br these snarces ore
inea �,vred wirhnw ro%rexce k any permit wXkh men fx' Its Dniorum from Iherrt Aerei4r rein/ cmwirvM a vinlarinn aJ
agvpermit.Am�person developing inapt AEC whhoutpermit is subj dvi(. rrimlea/arrd adminbrnnye cordon.
dc.Z760b
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