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HomeMy WebLinkAboutSB_16-26_YarbroughTown of Sunset Beach SB-16.26 Local Government Permit Number CAMA MINOR DEVELOPMENT PERMIT as authorized by the State of North Carolina, Department of Environment, and Natural Resources and the Coastal Resources Commission for development in an area of environment concern pursuant to Section 113A-118 of the General Statutes, "Coastal Area Management" Issued to Ralph Yarbrough (agent), authorizing development in the Ocean Hazard (AEC) at 907 W. Main St., in the Town of Sunset Beach, as requested in the permittee's application, dated August 31d, 2016. This permit, issued on August 22md, 2016, is subject to compliance with the application and site drawing (where consistent with the permit), all applicable regulations and special conditions and notes set forth below. Any violation of these terms may subject permittee to a fine, imprisonment or civil action, or may cause the permit to be null and void. This permit authorizes: Demolish existing structure and construct a 4,414 sq. ft. two family dwelling. (1) All proposed development and associated construction must be done in accordance with the permitted work plat drawings(s) dated received on July 27, 2016. (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 910-579-0068 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, 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. Richard Hathcock CAMA LOCAL PERMIT OFFICIAL 700 Sunset Blvd. N. Su t Beach, NC 28468 P ITTEE (Signature required if conditions above apply to p6rlimp OCM WILMINGTON, NC 0 C T 2 4 2016 Name: Fred Yarbrough Minor Permit # SB-16-26 Date: August 22nd, 2016 Page 2 (5) The stricture must set back a minimum of 120 feet from the first line of stable natural vegetation, as determined by the DCM, the LPO, or other assigned agent of the DCM. (6) The permittee is required to contact the Local Permit Officer 910-579-0068, 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. (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 relorated 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 holder's right to seek authorization of temporary protective measures allowed under CRC rules. SIGNATURE: DATE: 4ERIVIIZTE�v SEC =iVED DCM WILMINGTON, NC 0 C T 242016 Locality_. / y1 �/�s� /U F L / O'l Permit Number ��/,/a - 2 Ocean Hazard L.— Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other (For g1ficial use only) GENERAL INFORMATION LAND OWNER Name GtiRISTa&-M MEE. At%/4T&K P Address 3 / %f/� T �T� /%/��l✓� City Meyd"g^.- State (/ �T Zip ®%!//rid Phone . i7f- Alf- AUTHORIZED AGENT /p yA 1 Name Qrl �T`i P/1 /� 7/7�F// ro4G ;d �/TI1 ���C1✓%� /�jilQ .<tfai�/Y / //%.F��JY�� Iyc Address / ® & '� w77 CityAr eAkl I;i� Aa4l/' State Al<� Zip Phone LOCATION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront, what is the name of the adjacentwaterbody.) `70 % Gt,,4y1-eeMM nor ! 6l:nc� 3%/� srsds�T d�iP�-li` DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.)f71/��fICl4%/�� � fi4t�fl�Y SIZE OF LOT/PARCEL: square feet acres PROPOSED USE: Residential i (Single-family Multi -family w/ ) Commercial/Industrial Other f TOTAL ENCLOSED FLOOR AREA OF A BUILDING IN THE OCEAN HAZARD AREA OF ENVIRON- MENTAL CONCERN (AEC): ` ,i square feet (includes all floors and roof covered decks) SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT -UPON SURFACES IN THE COASTAL SHORELINE AREA OF ENVIRONMENTAL CONCERN (AEC): atQ� 57, ef square feet (Calculations 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.) Choose the AEC area that applies to your property: (1) within 75 feet of Normal High Water/Normal Water Level for the Estuarine Shoreline AEC (2) within 575 feet of Normal High Water/ Normal Water Level for the Estuarine Shoreline AEC, adjacent to c Outstanding Resource Waters (3) within 30 feet of Normal High Water/ Normal Water Level for the Public Trust Shoreline AEC ` (Contact your Local Permit Officer if you are not sure which AEC applies to your property.) STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subjkaFoC 1& >,8W rater Management Permit i ued by the NC Division of Water Quality? DCM WILMINGTON, NC T YES NO_41 AUG 0 5 201f If yes, list the total built upon area/impervious surface allowed for your lot or parcel: square t. HER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA minor develop - it permit. As a service we have compiled a listing of the kinds of permits that might be required. We suggest you check over the list y IV t your LPO to determine if any of these apply to your project. Zoning, Drinking Water Well, Septic Tank (or other sanitary waste tment system), Building, Electrical, Plumbing, Heating and Air Conditioning, Insulation and Energy Conservation, FIA Certification, d Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway Connection, and others. y O ATEMENT OF OWNERSHIP: z ie undersigned, an applicant for a CAMA minor development permit, being either the owner of property in an AEC or a son authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person -d as landowner on this application has a significant interest in the real property described therein. This interest can be cribed as: (check one) _an owner or record title, Title is vested in CflR (G e Deed Book .Z`7laQ e in the AiQ(M16c &:X County Registry of Deeds. _an owner by virtue of inheritance. Applicant is an heir to the estate of bate was in County. f other interest, such as written contract or lease, explain below or use a separate sheet & attach to this application. rTIFICATION OF ADJACENT PROPERTY OWNERS: rthermore certify that the following persons are owners of properties adjoining this property. I affirm that I have given 'TUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit. (Name) (Address) 11flR�Ey % /v'/1�/i,Eifllff�! �4/.�K/S tit1�i.� A/LV sT/�dlb}*.�lc �75�16f/ r O n 9 r a R DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS: knowledge that the land owner is aware that the proposed development is planned for an area which may be susceptible :rosion and/or flooding. I acknowledge that the local permit officer has explained to me the particular hazard problems Dciated with this lot. This explanation was accompanied by recommendations concerning stabilization and floodproofing iniques. RMISSION TO ENTER ON LAND: rthermore certify that I am authorized to grant and do in fact grant permission to the local permit officer and his agents to -r on the aforementioned lands in connection with evaluating information related to this permit application. s application includes: general information (this form), a site drawing as described on the back of this application, the nership statement, the AEC hazard notice where necessary, a check for $100.00 made payable to the locality, and any )rmation as may be provided orally by the applicant. The details of the application as described by these sources are orporated without reference in any permit which may be issued. Deviation from these details will constitute a violation my permit. Any person developing in an AEC without permit is subject to civil, criminal and administrative action. This the day of S/ PAi-V E D �e' 'Se /%r r)CM WILMINGTON, NC v � rt�, �p Landowner or person authorized to act as his agent for purpose of filing a CAMA permft4fV1"-CV.16 AEC HAZARD NOTICE Project Is In An: / Ocean Erodible Area High Hazard Flood Area _ Inlet Hazard Area Date Lot Was Platted: &o -X -O 6 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 buildingstandards, oceanfront setbacks and dune alteration 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. The best available information, as accepted by the Coastal Resources Commission, indicates that the annual ocean ero ion rate for the area where your property is located is feet per year. The rate was established by careful analysis of aerial photographs of the coastline taken over the past 50 years. Studies at�n 'indicate that the shoreline could move as much __ U(7{1 feet landward in a major storm. Thp flnnd waters in a major storm are predicted to be about �, _ , :et deep in this area. Preferred oceanfront protection measures are beach nourishment and relocation of threatened structures. Hard erosion control structures such as bulkheads, seawalls, revetments, groins, jetties and breakwaters are prohibited. Temporary devices, including sand bags, may be allowed under certain conditions. This structure shall be relocated or dismantled within two years of becoming imminently threatened. The applicant must acknowledge this information and requirements by signing this notice in the below space. Without the proper signature, the application will not be Date 1 SPECIAL NOTE: This hazard notice is required for development in areas subject to sudden and massive storms and erosion. Permits issued for development inthis 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 will determine the vegetation line and setback distance at your site. If the property has seen little change and the proposed development can still meet the setback requirement, the LPO will inform you that you may begin work. It is impor- tant that you check with the LPO before the permit expires for official approval to continue the work after the permit has expired. Generally, if foundation pilings have been placed and substantial progress is continuing, permit renewal may not be necessary. If substantial progress has not been made, the permit must be renewed and a new setback line established. It is unlawful to continue work after permit expiration without this approval. For more information, contact: A�fn fU�GI Local Permit Officer Address f' IG�n bl� funlai �pfiL�l Locality '(o- S71-Oo --- Phone RECEIVED DCM WILMINGTON, NC AUG 0 5 2016 Revised 11193 i �11L' L'10E1vYElyIT/iFYLll.til'11i� Vae+t.lt�i+ii�x Please make sure ,your:site dtawiag:in6ludes the:following infotmatioarequired for:a.CAMA minordevelgpment,permit. The Local Fermit Officer will helpyou, if requested. PHYSICAL DIMNSIONS Label toad's - Label -highways: right-o_f-ways L ,local setback.lines: Label any and;all structures and driveways cuaently existing on property_ ..Label adjacentwaterbody PHYSICAL CHARACTERISTICS Draw and.label normal high.waier.line (contact LPO for assistance) _ _ _a'Draw location of on -site wastewater system If you will b_ a working in the -ocean hazard area;. Draw and4label dune ridges Qnclude:spot elevations) _DMw.and'label toe ofdhnes - Ideafify and; locate fits[ line of stable vegetation (contact L-PO:for'ass_is'tance), Draw:and'label erosion setbackline (contact LPO:for assistance) if you will be worknigAn a coastal shoreline area: —Show the roofoverhang as a dotted:line around the stracture .,Draw and; label.landward limit'o£AEC _ _ _' Draw aridlabel DE.VELQPWNTPLANS — Draw and' 1661 all proposed structures, _ Draw andlabelare as that will be disturbed and/or landscaped ^I tote size of piling and depth tube placed in ground Draw; and iabel•all' areas to'be°paved or graveled Show all areas to be:distoibed. Show landscaping NOTE TO AP:-PILICANT Have you: completed.all blanks and/or indicate'diif, •not applicable? notified and.listed adjacentproperty owners? incladed your site drawing? signed and dated the application? • 'enclosed the; $10000fee? • completed an AEC Odzard'Notice ; if necessay? (Must be signed by the property owner) y j} " EORSTAFFIISE x ;3T StteN d.tide P116— s teoi,g ' Finalanspecho 1?ee Ri ceived Sit- Inspect J Jj i ' � e.�APJ vJ � • y C Date ofAcnoi =Issued _Exempted _' Denied 3AppeaMeadhne'(20.daysfw w s x Revised -Jan. 2008. AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Applying for Permit: CAdjj7&,1jYA4 ",# Aggff& IftlSh rrS Mailing address: 3/ hlhGG,EA7Z aulk &�EsT o A y cE , a 769sa Phone Number: r-og —31t/ - `O,�j I certify that I have authorized KACOh' f 5(!?AAWOa - i , Agent / Contractor to act on my behalf, for the purpose of applying and obtaining all CAMA permits necessary for the proposed development of 4fAd& &A& Ot- �)CisT�dG SrituclL�E Z4,40Q 6�7W,47AVc7-/AIG ,9 AlAlX E)t at my property located at %9 � 66,E&KT ,UAlfl in GRU,S(s�tctf County. This certification is valid through &Za Date (Property Owner Information) Signature Print 6r Type amen Title 1 &n Date Phone Number (1o5(-'(Z%1(1) &cwL m Email Address 7-Ze-)L. RECEIVED DCM w1LMINGTON, NC AUG 0 5 2016 )N..N1...P.,P PREII..INMY - NOT FOR CONY IMCE OR REC .— _. . LAW. — NOES u..+... rP. r/.. nN.n w nx m..x } � ��.n.Wi'w l..n sl� inn pei nsu wiM m xarn. Fp M a� 1. wnwnY x u. wnearle .v.. m M pn. 1 .11 IM �JNw IMF Wlu. v.rn x upw. -nvw « IQFaEtl65 0... B.N,W-PR J1L IF7Ftl4 p x.. M s M .Y• _� ly ae rr... iF. p roe) rrh Ywxxl Mh.. 4.rf fW 0 iiyw/4N PYYY till! � Irt Yan sN.a ! ss' M - ^dMe rRW i .p] I r ® t I Ix YlPmnole Rw cRirlu)onf xlPlnnm.lf sa rt. hn.nlu9a M lal R{ R/W - flgM W Nq 9WMb.). PIN IM a4 $pel fRwrb. Su.w) UI "Christopher V. Hughes and wife, Dorothy S. Hughes" sn.mu. rw.pw aF.x.lr cwn.w x.c aw In Mp,R IJ. M6 P.v, U, 37. MIG (ft. Rm) IAI P. R. tnq Y N.neblr /jY�Jx\ PA OR .II] (fl JS.-6.100 InP n.-s.ae r.. i. Snn�p aW IM n.Y^W M Isw, w�Y�Y^wT (o ervplM .vC� w JY4� 1y. JLL. Ne) +I xr MFM T�Yn IW�W s ulm,w Y e unMpelx av«Ynn NU Ot n-]X • Wtl Tu �/ erpxY Ypn1Y4 blx wTM �e r uY nu er a Ny. Nv. ZNL w,X/ IM InY xrw/ 4 N ^r .rYlYy ,wM RRQIIMINMV - NOV VOR COTKYwNCfi yx OR RECOxOATON P tkwx Ywx.lri)IY ��c DNwrrwe y mi. }. IwN MnY Y Yppsp aM a wem,nr. rerwmle we/v rrx4wnlr MM nryrmnYl mqa n1. N. r.^ eI ,Ne aronU �n y M .wW�Jlr M rNr pelNnue MIM mi rcerNr I,wJ T,mnM m wmrN re W M.K+Im xem n ♦.Y psm. >»n lwaYnM.Nw me ,e rrYKn. S L. 1Y M1^I W. - Y1PA e. ZwM � Snx XwY. M-1 ss Yrn cM. Y.Tiwnnl. >W r s wup M.n xro 1w acaa(nccs iw. we. vw O!1 ro cmi ,I 1 raw _SL IEfFLO 4 xw . Mr rM wl Tt m ,.rnr mr m fi0. YnwY Nr 0� rI1M � -0' ern wl � er M/fM. SYe _ _ nwq,w rwr M wpn el rnr t [wYnr mu.x mm. 0 pw11e m[n. na M a S1 l 9,r..xx«' Own ,ap 0 f,IrNm, YrY^Y Qa•"- w"X e_ 4-4-______.--- --_--e 1p) I w Y<n Y 41 ® g �I P I 1 1 Y r tl>11 INVOMpR MG WLUA)ONS 1 Wti I S I 1 VRGVEMp11$ =R.. 40. I.iN.O 1 1 Nxa pk.../ le XM n).c 1 T,IN MgrvTT Nw WS).S 0.rt,n1 a N W 9S 1 I MM � IqM N WeY 1 1 I 1 ) 1� 1 1$ I I I 1 IY t4 011,r Bw^evY. PNI Nn wq RTI 6wtlq SurwY p "Christopher V. Hughes Y and wife, Dorothy S. Hughes" K AIIIIY TmMY 6wnYY fantY. M C. o• a• $W 120' 0,g LNr - FRI M«elw 13, 2010 Mr..W, V. 3016 (Pbl vlm) vaer N. sTy • •.rr.xw A Bu 111) AYblw. N.G YwN-1111 Iv1v) ns-awv (910) )IhSW fx ff�r IECEIVED WILMINGTON, NC AUG 052016 ED NC AUG 0 5 2016 i 1 � I I I I al _ I p— ❑---_ e J I # I I I 4L . t 4 /.1WR •``� .Er �� I t ,m &AE t 11 lftdL— Lid I ermur � I 6e°„Yr.f i ti I� pev[A i t I, i \ C 31 ,} r _ .......... �T. j L,f/dflL I 1IYftJf SGEpff[ ni..... O 0 I( 3 dIEE/�ck YdYdYd ll.—a n � of Jl topl___ e.✓er[a eft t h i ✓. nE/ \I ,kl ' reran zI � _ I�.i I :.} 1• � a. I x IED 3 4_ t 1 e e 9 1 h>3ISE lX)]IIK a u IB-B" RECEIVED ;M WILMINGTON, NC AUG 0 5 2016 lirFer,A e«....ti .r r. ✓rn [�-- X f✓r. .,E• I/.'.Ace,. u N.uiw L:.l[NL— F VI � If R _ o + _ 26 T� s tD4KN V ♦ ___ �. _. � � 0. n O O I •. i+ r t I b I x I WILINGTON, NC �Ay eEe / ♦ �tEaaare< t,� AA I ,4 • I ...T .rr s/ t � I Za } I t iD♦ef i 4 \ h)v°S�� ' ,..�e avau a✓ud I r—oxo7 .°�_ 4 _1.06GfL1A64fL.— t dasl (212 u Naarl • I r r -Postal CERTIFIED MAIL' RECEIPT Domestic Mail Only I a Receipts for ru CHAM f12Lf7"a �C(B44� � � � r�Certified Mail t� (Staple Here) rq R.A. 4 0470 r 10 o Certified Fee so.r10 poswwk O Return ReceiH pt Fes ere p (EndoreementRequired) $0.013 O R.Modrd Delivery Fee O (ErWursoment Required) ru y0. DTotal Postage 8 Fees 08/02/2016Er — 6-6R oenf o _ s alt,�f �'? 'PRI�y --.--/....... -_._----- r ruP-9!!No.Z.IL--1!Y_F-<--- �j^--------•-------- cey, smt , z � /`fiA� Ile % See Roverst, for Instructions Dear )acent rope This letter is to inform you that I, FAis Z109Y41 Ar2� %� have applied for a CAMA Minor Property Owner Permit on my property at Bin OUNTY Property Address County. 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 endosed no objection form. If you have any questions or comments about my proposed project, please contact me at '7',I0 - r>, -,&APX or by mail at the address listed below. If you wish to Applicanfs Telephone file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program, you may submit them to: — — - _— C/o ,2/cN,4x-D A,(rHGock. -7ao SaA/647 ,BWD Sincerely, �fli2lS fivClf�s Property Owner Mailing Address City, State, Zip Code RECEIVED DCM WILMINGTON, NC AUG 0 5 2016 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT FOR CAMA MINOR PERMITS I hereby certify that I own property adjacent to property located at (Name of Property Owner) Address, Lot, Block, Road, etc.) ,5 on in N.C. (Waterbody) (Town and/or County) He has described to me as shown in the attached application and project drawing(s), the development he is proposing at that location, and, I have no objections to his proposal. (APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED) Signature Print or Type Name Telephone Number Date RECEIVED DCM WILMINGTON, NC AUG 0 5 2016 m DomesticEr 111ru sT110Y,t NgM1J"C 1 A L U S E R 4g3 00 r to $0.00 Leff' Fen O p Rehm Receipt Fee (En&fwment Required) Po . Wk time ' $IJ,aa O Restricted Delivery Fee (Endorsement Requked)' ' E3 n $a. a- T*WPomege&F. $ 08/0212016 C o ,&lx'"S! .-_t!J,/Cry!.-'-------'-------------- t- Po^✓o/ �,txrs <UuA ,4oAD Dear Adjacent Property: Receipts for Certified Mail (Staple Here) This letter is to inform you that I, —'129%STd/1W 11"1W have applied for a CAMA Minor Property Owner Permit on my property at qD Gy�9T hl it CO NTY�I� Property Address County. 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 meat �//D —J�%�—�o .30.s' or by mail at the address listed below. If you wish to Applicanfs Telephone file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program, you may submit them to: Touu/ Gf Sa,JStT .C3fivc/1 C/o ArcNAaD M,r-rKLocL' -700 SaA-'SL7 Sincerely, Property Owner 3 / !!x GGkxTY pAilt� Mailing Address lv�sT '.4"a'4 , ./cF City, State, zip Code RECEIVED DC M VV"M'NGTON, NC AUG 0 5 2C16 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT FOR CAMA MINOR PERMITS I hereby certify that I own property adjacent to property located at (Name of Property Owner) Address, Lot, Block, Road, etc.) on in . N.C. (Waterbody) (Town and/or County) He has described to me as shown in the attached application and project drawing(s), the development he is proposing at that location, and, I have no objections to his proposal. (APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED) Signature Print or Type Name Telephone Number Date The Toww Of suwset teach 700 Sunset Boulevard North . Sunset Beach . NC . 28468 Phone: (910) 579-0075 or (910) 579-0068 • Fax: (910) 579-1840 Storm Water Worksheet Project Address: 1D9 &I"7_10NAl OVAF4E7- Total lot area (sq.ft.) P, 30% of lot area (sq. ft.) I tg 303,.01 House, garage, shed including overhangs (sq. ft-) t j.*0 Driveway, sidewalks, and patios (sq. ft.) `j P' -r Other impervious surfaces (sq. ft.) Total square footage of impervious surfaces Yes No / Does the total impervious surface (s) exceed 30% of the total lot area? 0 (More than 30% impervious area requires an engineered solution to be submitted with application) Calculate impervious surface as follows: % Built -Upon = Built Upon Area _ Total Project Area x 100 % Built -Upon Area= Stormwater Collection System Please provide a detailed description of the collection system indicated ❑ Infiltration / 0 Collection / BNegetation / 0 Innovative Certification I, R, f V4AMa416')f certify that the information included on this submittal form is correct, that the project will be constructed in conformance with this information, and that to the best of my knowledge, the proposed project complies with the requirements. I hereby affirm that 1 am the property owner, or authorized agent representing the property owner for the specific property for which this permit application is being made. Stormwater Worksheet Revised 6/8/2016 fl :1 /6 Date Page I of I RECEIVED DCM WILMINGTON, NC AUG 0 5 2016 It RECEIVED DCM WILMINGTON, NC AUG 0 5 2016