BC_17-06_Puglisi

Brunswick County
Local Government
���i In
MINOR DEVELOPMENT
PERMIT
BC17-06
Permit Number
Coastal Wriagement
EN VIiCNYFNT�I OU.�UTY
as authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission for development in an area of environmental
concern pursuant to Section 113A-118 of the General Statutes, "Coastal Area Management"
Issued to William and Barbara Puglisi, authorizing development in the Estuarine Shore Area of Environmental Concern
(AEC) at 3428 Eagle Crest Drive SW in Supply NC 28462, as requested in the permittee's application package, dated
28-Mar-17 and received complete 28-Mar-17. This permit, issued on 10-Apr-17, 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: Single Family Residence with porch and steps Stump Removal and Landscaping.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on 28-Mar-17.
(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 must be on the project site and accessible to the permit otLcer 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 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
Bolivia, NC 28422
PERMITTEE
(Signature required if conditions above apply to permit)

Name. _William and Barbara Pugiisi
Minor Permit # BC17.06
Date: 10-Apr=17
Paget
(5) The amount of impervious: surface shall not exceed30% of the lot area within 75 feet of Normal: High Water
(Estuarine Shoreline Area of Environmental Concern),.In this case 7451square feet is authorized.
(6) Unless specifically allowed in 15A NCAC 07H-0209(d)(10), and shown an the permitted plan drawing, all
development/construction shall be located a distance of 30 feet landward of Normal li'gh Water. No: portion:o( the
roof overhang shall encroach into the 30 foot 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 activities, 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 39 buffer from the Normal High Water level must be contoured to prevent
additionatstorrnwaterrunoff to the adjacent marsh. This area shall be immediately vegetatively stablized', 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:
ERMITTEE

Locality
3 JruAs W � ck:-
Ocean Hazard Estuarine Shoreline ORW Shoreline
(For official use only)
GENERAL INFORMATION
LAND OWNER
Permit Number'' _ C
Public Trust Shoreline Other
Name C At"a.1 1- �7aah�anlu Iti PU&I-IsI
Address 2 S l- L !rr o n�9lilN 02
City A-r A;*BPiLc' State N7 Zip OS?Dl Phone '?Of 757 �S 3
Email 0Pu&LIci P , A-)i i
AUTHORIZED AGENT
Name
Address
City S as n i State iJL Zip .7 eY62 Phone tic, eZ 3 7 2 0 6 2
—�T
Email cam..,
LOCATION OF PROJECT (Address, street name and/or directions to site. If not oceanfront, what is the name of the
adjacent waterbody.) Go7 5'7 3 ti x.V e-A 7 04 f --rt 1'2 zuc., 3J v`a `t � . -cc9
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) &. ew 9
34'v tewiroo-,. •t, fh"4r 4?'-y (F 't•I f•NGrlt i7M+.-t.� 1�eJ��Jm'Cn
SIZE OF LOTtPARCEL: t/ 9 3 k J' square feet 1,13 acres i�•� j%
PROPOSED USE: Residential FJ (Single-family [4 Multi -family ❑ ) Commercial/Industrial ❑ Other ❑
COMPLETE EITHER (1) OR (2) BELOW (Cbntact your Local Permit Officer if you are not sure which AEC applies
to your property):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: Witt 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 SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: Tyr 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_ NO
If yes, list the total built upon area/impervious surface allowed for your lot or parcel:
C.SOt:
square feet.
RECEIVED
EG`-IVED
DCM WILMINGTON, I
MAR 3 0 2017

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)
%an owner or record title, Title is vested in Pti rw iJ i see Deed Book 3 3 ct
page )ts LL in the bA�.s w, c IL. County Registry 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)
(Address)
(I} &EPt St$ tnscnw,c�r,�S 1ZdcY 13 E� �e11.p ©.rxg��[�,v� )ej
(2) AL4,j t1,; w L cW,+ ?d' i ? &4AA> U,Ol /0,O t.ew,s ui (lee Nc :L 7,a2 3
(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 _ -$ day of MA,* 20 17
�J:cfs �W�,lrr7d
Landowner or person authorized to act as his/her 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 adm�i iissg afti �� I V E D -
WILMINGTON, NC
MAR 2 8 2017 MAR 3 0 2017

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Nlt_wlNGION, C
MAR 3 0 2017

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: _ CU', lhmp +6Aik beae 3. Pu
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
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ANror+prrt.e A117 0360
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to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Opts 7&K tha A�
at my property located at t.-o7 ,d- Ci 3 `t a, 8' t= 4Cam,E cn C 5 7 p z.
S�fpr7 ,�� arvc-1
in - I' aswc�L County.
1 furthermore certify that 1 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
7
�Prriint or Type Name
V �c &U111 e L
Title
Date
SEC-.-AVED
This certification is valid through 3 I a `7 / td' DCM WILMINGTON, NC
MAR 3 0 2017

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This letter is to inform you that 1, 0 % f 1 Pu e L-r 3 I have applied for a CAMA Minor
Property Owner
Permit on my property at Z-074'17 3Y,T 8 r Br&LC- Glcsi can, Su4)f71- y .ec in
6A�s—�74L COUNTY Property Address -�,xlei.
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Brunswick County. As required by CAMA regulations, 1 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. Ifyou have any questions or comments about my proposed project,
please contact meat 908 -25 -) 3 f 1> or by mail at the address listed below. Ifyou wish to
Applicant's Telephone
file written comments or objections with the Brunswick County CAMA Minor Permit Program, you may submit
them to:
Connie Marlowe
Brunswick County Planning Department
PO Box 249
Bolivia NC 28422
Sincerely,
Property Owner
Mailing Address
&erv40-0-6 rM7 V"of
City, State, Zip Code
r-iEC-iVED
DCM WILMINGTON, NC
MAR 3 ') 2017

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Dear Adjacent Property:
This letter is to inform you that I, fl ✓�C'L F s r have applied for a CAMA Minor
Property Owner
Permit on my property at L- F 7 crt �F w 5� e)v° rL'c in
s �L lja.COUNTY PropertyAddress�YIea-
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Brunswick County. As required by CAMA regulations, I have enclosed a copy of my permit application and
projectdrawing(s) as notification of my proposed project. No action is required from you oryou may sign and
return the enclosed no objection form. Ifyou have any questions or comments about my proposed project,
please contact me at t of i 9 -7 .3 s �3 or by mail at the address listed below. Ifyou wish to
Applicants Telephone
file written comments or objections with the Brunswick County CAMA Minor Permit Program, you may submit
them to:
Connie Marlowe
Brunswick County Planning Department
PO Box 249
Bolivia NC 28422
Sincerely,
Property Owner
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Mailing Address
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City, State, Zip Code
REC' :IVED
DCM WILMINGTON, NC
MAR 3 0 2017

No. 191742
I
O OAR RENT! "r{
OZASH
ACCOUNT
TO
PAYMENT
BAL DUE I �-- 1 OCREDIT
�J CARD
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REC IVED
DCM WILMINGTON, NC
MAR 3 0 2017

nllllll i.k CIIIIIIIIIIIII� I"t., at naa a
armda M. el..aau gpsat.e of a.".
e7-2a-2e13 a:as:eS. nee ararvlsk Ceaty, NC
NC eevFleli $TAMP: $ 43.e41 (Wet 23
gbnln Wee, fees aeseasmetpe ar other
Mons whlah the Brunswick County Tax
000actor is Charged with collect' that am a
Inn on: Patcol Numbs
IS mead by me 7 wcw G cou
Aeeeawb Office. This is not a certification
foal ate parcel mariner matches the dead
deeuiptlut
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NORTH CAROLINA
SPECIAL WARRANTY DEED
Exist -fax: Recording Than Book and Page:
Consideration: $21,150.00 Amount of Tax:
Tex Map No.: P.1 Idati6er No.: 230KA008.
Mailing after recording to: NauoodBuk REO, 345 Rouser Road Bldg. 5, Compolis, PA 15108
Send Tax Statements to:
This iratrntnerx was prepared by William V. Power, Esq., Deeds on Demand, PC
THIS DEED, made this i9th day of July , 2013_, by and between
GRAMOR
PNC BANK, NATIONAL ASSOCIATION as successor by merger to RBC BANK (USA),
Mailing Address:
GRANTEE
W ILLIAM M. PUGLISI and BARBARA B. PUGLISI, husband and wife,
Mailing Address:
Pmperty Address: 3428 SW Eagle Crest Dr., Supply, NC 29462
. _ . Prepared by Deeds on Demand PC
5029 Corporate Woods Drive, Suite 225-A, Virginia Beach, VA 23462. 757421fi976.
The ancer ey(ies) who prepared this iment rem havlmw net performed a title amnbation of the subject pmputy
and denefore makes no opinion in wesmnry m to the quid icy oftitie. The parties m this instrument agree they have
reviewed, understand and xcept its turns, acknowledge that they beve ree4 understand it agree with the terem of
the Dads on Demand (.voice, Client Disciosum end Agreemeat (eee www deedsondemand.comhemu-of-
senice.asai, and thin the enemey/.Gent relationship between the Oica (s) mduing and paying for the milmarent
and attomey(ies) Preparing rids instrument is suiWY limited to the immunam'f preparation. Order k 26617
REC'7IVED
DCM WILMINGTON. NC
MAR 3 1) 2017

83434 P025upxim
Br,neolck cow ty, Re Restate, of 0—ele aurae 2 of a
The designation Grantor and (manor as used herein shall include said parties, their heirs,
successors, and assigns, and shall include singular, plural, masculine, feminine or neuter as
required by come.
WITNESSETH, that 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 by
special warranty, unto the Grantee, as tenants by the entirety with rights of survivorship, all that
certain lot or parcel of land lying and being in the City of Supply, County of Brunswick, State of
North Carolina, and more particularly described as follows:
TRACT ONE
Being all of Lot 97, Phase Il of Oyster Harbour, as set fonh in that Plat Survey by Brian N.
Hobbs, P.L.S., dated August 4, 2000 and recorded in Map Cabinet 23 at Page 172 in the Office
of the Register of Deeds of Brunswick County, North Carolina
TRACT TWO (Easement Tract)
A non-exclusive easement over, under and across the below described land:
BEGINNING at the common boundary line of Lots 97 and 99 of Oyster Harbour Subdivision
and running over, under and across that 15 foot wide utility easement adjacent to Eagle Crest
Drive and across Lots 97, 96, 95, 94, 93, 92, 91, 90 and 167; thence over, under and across that
20 foot easement located on Lot 167 and Lot 90 to the "drain field," all as shown on that Plat of
Survey by Brian N. Hobbs, P.L.S., dated August 4, 2000 and recorded in Map Cabinet 23 at Page
172 in the Office of the Register of Deeds of Brunswick, North Carolina. From set point over,
under and across that 10 foot access and utility easement to the drain field area designated "97A"
and consisting of 5,625 square feet, all as shown on that Plat of Survey by Brian N. Hobbs,
P.L.S., dated August 29, 2001 and recorded in Map Cabinet 26 at Page 270 in the Office of the
Register of Deeds of Brunswick County, North Carolina. Said easement shall be for the purpose
of installing and maintaining lines and other equipment necessary to serve a septic tank drain
field for the use and benefit of the owners of Lot 97. This easement shall run with the land and
shall be for the use and benefit of the owners of Lot 97, Phase B, Oyster Harbour Subdivision,
their heirs and/or assigns.
TRACT THREE (Easement Tract)
BEING an exclusive easement over, under and across that tract of land designated as 97A as
described in that Plat of Survey by Brian N. Hobbs, P.L.S., dated the 29th day of August, 2001
and worded in Map Cabinet 26 at Page 270 in the Office of the Register of Deeds of Brunswick
County, North Carolina, said easement being for the purpose of installing and maintaining a
drain field and repair area for the use and benefit of the owners of Lot 97, Pbase B, Oyster
Prepared by Deeds on Demand,PC
5029 Corporate Woods Drive, Suite 225-A, Virginia Beach, VA 23462. 757-321.6936.
The aromey(ies) who prepared this inswmenthas&ave net performed a title examination of the subject Property
and shvefore makes w opinion or v nranty as io the quality of tide. The parties to this instnmmr agree they have
reviewed, understand and accept its tears, acknowledge drat they have read, understand and agree with the terms of
the Deeds on Demand Invoice, New Disclose and Agtammn (w www dtedsondemandcorn tens-of-
service.asnxl, and than the anomey/client relatioathip between the.1b nt(s) erdeniq; and paying for the insunaban
and sanmey(ies) preparing this instramenl is strictly drafted to the imrunia Cs preparation. Order R 26617
qE% -iVED
DCM WILMINGTON, NC
MAR 3 02017

IIIIIIIIIIIIIIIIIIIIIIII111111ll aka e�-201,
arureWek County. ore Rapister or 0. pa, a e( a
Harbour Subdivision. This easement shall be perpetual in nature and shall run with the land for
the use and benefit of the owners of Lot 97, Phase IL Oyster Harbour Subdivision, their heirs
and/or assigns. Provided however, that portion of Tract 97A designated "access and utility
easement" shall be non-exclusive to the extent necessary to provide access to other drain fields
shown on the above referenuA Plat.
The easements granted in Tracts Two and Three shall continue until 90 days after public sewer
becomes available to all lots utilizing the drain fields shown on the aforedescnbed Plat of
Survey.
TRACT FOUR
BEING a one -fifth undivided interest in that tract of land consisting of drain fields for Lots 98A,
97A, 156A, 138A and 155A, and recorded in Map Cabinet 26 at Page 270 in the Office of the
Register of Deeds ofBnmswick County, North Carolina.
By acceptance hereof, Grantees, their hews and/or assigns hereby covenant and agree that as
owners of the aforedescribed drain field, Grantees shall be responsible for the care and
maintenance of the drain field area as an "owner" under the terms, covenants and conditions as
set forth in the Declaration of Covenants, Conditions and Restrictions for Oyster Harbour
Planned Community recorded in Book 1402 at Page 1427 of the Brunswick County Registry,
together with any amendments, additions or modifications thereto.
All or a portion of the property hereinabove described as acquired by the Grantor by instrument
recorded in Book 2926, Page 137, Brunswick County Registry.
Pmsuent to NCGS 105-3171 Grantor certifies that the property - does _does not include
the Grantor's primary residence,
TOHAVE AND TO HOLD, the aforesaid lot or parcel of land and all privileges and
appurtenances thereto belonging to the Grantee, as tenants by the entirety with rights of
survivorship.
THIS CONVEYANCE is made and accepted subject to the lien for current taxes and other
assessments and all valid and subsisting restrictions, reservations, conditions, limitations,
encumbrances, covenants, exceptions and easements as may appear of record, if any, affecting
the above described property.
Prepared by Deeds on Demand. PC
5029 Corporate woods Drive, Suite 225-A, Virginia Brarb. VA 23462. 757-321 fi936.
The a,mmey(u s) who prepared this instrument hasrLave out performed a tide examination fthe sabjm property
and therefore makes no opinion or warranty as m the quality oftitle. The parties to mis instrument agree may have
reviewed, understand not accept is terms, acknowledge that they have read, understand and agree wild We terms of
the Deeds on Remand Invoice, am Disclosure and Agreement (see www dredsomdvnand.comAerms-of-
savice.4m and thin the momey/client relationship between the cliemt(s) ordering and paying for the instrument
and anomcy(us) preparing this insaamemt is strictly limited w the i+umrment's preparadoa Order a 26617
REC;_IVED
DCM VfIMINGTON, NC
MAR 3 1) 2017

%'IIIII1IIIIIHIIIIJI11111llmu ,MIIyl 0ee
THIS CONVEYANCE made subject to all casements, and building or use restrictions of record,
including but not limited to, those for public roads and highways, restrictive covenants, utilities,
railroads, and pipelines. The conveyance is also subject to all applicable zoning, ordinances,
statutes, rules, or regulations, u amended.
IN WITNESS WHEREOF, the Grantor has hereunto set their hand and seal, or if corporate, her
caused this instrument to be signed in its corporate name by its duly authorized offtcer(s), the
day and year first above written.
PNC BANK, NATIONAL ASSOCIATION
as successor by merger to BBC BANK (USA)
llylN Waddell,
Title: Melissa J•
pNC Bank, Natlonnl AeaodatkM
STATE OF Oh'o , COUNTY OF nmle, to -wit:
1, the undersigned Notary Public, in and for the County and State aforesaid, do hereby certify
that Mehssa 1. Waddell as Off. for PNC BANK,
NATIONAL ASSOCIATION as, successor by merger to BBC BANK (USA), personally
appeared before me this day and acknowledged the execution of the foregoing instrument before
me in the County and State aforesaid, on this 12d, day of Inly , 20_I _.
ria`�',
Notary'Public 'd, `- %' +S JILLAFOATNEY
My Commission"pines: 300/16 - 1 Notary Pobae, stare of Oho
j MYC entaeimu Pxplres
Mamh 30, n16
Prepared by Deeds on Ibrmvd, PC
5029 Corporate Woods Drive, Suite 225-A, Virgin u Beach, VA 23462. 757-321-6936.
The anorotAies) who prepared this iasuumera has/have not performed a ride ezamittation of the subject property,
and therefore makes no opinion or warranty, as to the quality of title. The Parries to this immanent agree they have
reviewed, understand and rapt its norms, aeknowledge that they have read, wdersiond and agree with the terms of
the Deeds on Demand Invoice. Client Discbsme and Agreement(sec uww deedsondemaod ovtemus f-
scrvke.asoz), and that the enorrcy/clinm mlationsbip bmwun the chemf(s) ordering and paying for the instrument
and attemey(ies) preparing this inmumeat is strictly limited to the instrument's preparnion. Orders 26617
REc'-IVF_,D
DCM WILMINGTON, NC
MAR 3 ,) 2017

DATE REC. 0511212018 BRUNSWICK COUNTY HEALTH SERVICES FILE NO.: 2001056497AI
PUGLISI WILLIAM M ETUX BARBARA B $0.00
Rcc FROM
25 HOOK MOUNTAIN DR
ADDRESS
PUGLISI WILLIAM M ETUX BARBARA B
CURRENT PROPERTY OWNER
AW PAD
ANNADALE NJ
Cm STATE
ZONING:
230KAOGS
TAX PARCEL
08801 9067973523
ZP CODE PHONE
97
LOT BLOCK SECTDN
PROPERTY LOCATED TOWNICITYfAREA: CO SUBDIVISION: Oyster Harbor
DIRECTIONS: 3428 EAGLE CREST OR SW 28462-
AUTHORI TION FOR WASTEWATER CONSTRUCTION PERMIT YDTPs
NEW REVISION: RELOCATION. REPAIR:
Design FWAr 3 r n 9Pd SeptiC Tanks e ' / 6! 0 gal TWa i /� ' �%Pec Tank WW have an appr¢
f eNueM Afw and areess de ces as
/ APOKaole.
No. Bedrooms. _ No. xCLIMKI Uempbyees (cs MaX 2 Mamttn all sonlacks loslances for
"PC tank SYSIO TS and wets.
TrencNBed BOIlprfi Depth Al compgMnls of the sepaC systems
_ 'h JH Pe Uxuded 100 feet epm wel
No Lines. _r 3 F ! Bad Dmensions. ,� t L- / A An -'Accepted" systa , Do used :n
Lengl! Each % 6 � •ne poet at a-vorwoneonar system
/ r / PHI Check: I �f Q ApprWea .��/ C(
Dale M 0Xfo Ae
PERMIT .SSUE DATE ,Y�/t / Y / Permrt E4lin Cn Dsm E i.y 3 2 .t /
A.&Xmiseo AIwK 1 Y / (% f (A i�C C �,'7 �. Req!sv / -i- �7 .Y
NOTE-. PERMIT is Si1BJCCT TO RE'(QCA',Y;N:V SST=PtAN56R'I'E N'ENO€J _a-aGEc
-tlr• 7f i e S C a C-�
5-Ca
Z._Kec
Waste Water System Installer: '_- per,: J-'—
Comments (tank info bamer aWowd) ,-----"��
Rock: Polystyrene Aggregate CbandbwOthw.
OPERATION PERK+•' Date
•.m�.n.e awn; S+s=s-.<
ACt�ons at!cu! naalta depa^meat r¢praaert!n!wes r. r.}!. ,'ate ¢ngagw n the tvdna:::n ar;D ae:Yr^+'R9Ton .> .-.eas.�ros �eP!:�: ed a eNect cpmpliaru w+m cnb
appAPeDta ors and'talea anat:.n no way ice aken as a wa+rinry mw sewage !rern+e,., anp p�sPasa syssems aPCavec a.^d per^a¢ea wN Nnctaal m a x:.staPiory
manna' bf AN IIYen y Dc jr Lld y Ot 9eur8nfe hi:M LenC t ¢¢ee nOl pttl[:udC M.2 P4•^'Ht23 t•D.^ ComP-31n9 xih any anp MI 9!a;UCS Nlai irq regyary'oM p!
pfd>nai!CL•$ ibh:{.n may PC �m(A` eed py Dtn¢t �'spr:-.n't:.! a�enCY9 i k1i8i Salle a.^.p :eGetai I w�Atii td Y I4Y.:5^ :Ito^
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CM WILMINGTON, NC
MAR 3 1)2017

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