BHI_16-04_York

Village of Bald Head 2016.04
Island Permit Number
Local Government
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 John York, authorizing development in the Estuarine Shoreline (AEC) at 43 Cape Greek Road, in Bald Head
Island, as requested in the permittee's application, dated June 2, 2016. This permit, issued on July 1, 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: New Single Family Residence
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on June 6, 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 910-457-9700 for a final inspection at
completion of work.
(Additional Permit Conditions on Page 2) --
uuivi WILMINGTON, NC
OCT 1 2 2016
This permit action may be appealed by the perm=dee 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 whiten permit approval. All work must cease when this
Permit expires on:
DECEMBER 31, 2019
In issuing this perm l it is agreed that this project is consistent wdh the local Land
Use Plan and all applicable ordinances This permit may not be transferred to
another party without the whiten approval of the Division of Coastal
Management.
An4jL�=M�
BDyett
LOCALCAMA OFFICIAL
PO Box 3009
Bald Head Island, NC 28461
PERMITTEE
(Signature required if conditions above apply to permit)

Name: York
Minor Permit # 2016-04
Date: July 1, 2016
Page 2
(5) The amount of impervious surface shall not exceed 30% of the lot area within 75 feet of Normal High Water
(Estuarine Shoreline Area of Environmental Concern), in this case, 7,211 square feet is authorized.
(6) Unless specifically allowed in 15A NCAC 07H. 0209(d)(10), and shown on the permitted plan drawing, all
development/construction shall be located a distance of 30 feet landward of Normal High Water. No portion of the
roof overhang shall encroach into the 30 ft. buffer.
(7) All unconsolidated material resulting from associated grading and landscaping shall be retained on site by effective
sedimentation and erosion control measures. Prior to any land -disturbing 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 30' buffer from the Normal High Water must be contoured to prevent additional
stormwater runoff to the adjacent marsh. This area shall be immediately vegetatively stabilized, and must remain in
a vegetated state.
(9) All other disturbed areas shall be vegetatively stabilized (planted and mulched) within 14 days of construction
completion.
SIGNATURE:
PERMITTEE
.,iEGt_iVED
DCNI WILMINGTON, NC
DATE:
OCT 1 0� 2016

GENERAL INFORMATION
LAND OWNER
AsAftlwAft
Name: John and Sally York
MAN 91
Address: 5300 Cherry Blossom Trail
City: Nashville State: TN Zip: 37215 Phone: [phone]
AUTHORIZED AGENT
Name: Scott Sullivan
Address: PO Box 10091
City: Wilmington State: V]_CC, Zip:28404 Phone:[phone]
LOCATION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront, what is the name of the
adjacent waterbody.) Lot 843, Cape Creek Road. BHL adjacent to Cape Creek
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) Construct new single family
residence
SIZE OF LOTIPARCEL: 24,038 square feet .55 acres
PROPOSED USE: Residential ® (Single-family ® Multi -family ❑) Commerical/Industrial ❑ Other ❑
TOTAL ENCLOSED FLOOR AREA OF A BUILDING IN THE OCEAN HAZARD AREA OF
ENVIRONMENTAL CONCERN (AEC): _ 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): 5110 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 for the Estuarine Shoreline AEC
(2)within 575 feet of Normal High Water for the Estuarine Shoreline AEC, adjacent to Outstanding Resource Waters
(3)within 30 feet of 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 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. square feet.
` Li __ i.iV1_-:CD
DUVI WILMINGTON, NC
OCT 1 2 2016

OTHER PERM ItS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA minor development'pemlit.
As a service we have compiled a listing of the kinds of permits that might be required. We suggest you check over the list with your LPO to
determine irony of these apply to your project. Zoning, 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.
STATEMENT OF OWNERSHIP:
1, the undersigned, an applicant for a CAM 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 CAM 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 John and Sally York, see Deed Book 3326
page 009 in the Brunswick 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 and 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 CAM permit.
(Name) (Address)
(1) Charles and Patricia Rollins i 11 Oak Park Drive Chapel Hill NC 27517
(2)
(3)
(4) —
FOR DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS:
I 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 particular
hazard problems associated with this lot. This explanation was accompanied by recommendations concerning stabilization
and floociproofing techniques.
PERMISSION TO ENTER ON LAND:
I furthermore certify that I am authorized to grant and do in fact grant permission to the local permit officer and his agents
to enter on the aforementioned lands in connection with evaluating information related to this permit application.
This application includes: general information (this form), a site drawing as described on the back of this application, the
ownership statement, the AEC hazard 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 aviolation
of any permit. Any person developing in an AEC without permit is subject to civil, criminal and adritinistrative action.
UGIVI UVILIJ;lIVGit�,S�•1, I -
This the 20 day of Feb 15 O C T 1 2 2016
or person authorized to act as his agent
se of filing a CAM permit application

SUtLIVAN
D E S I G N C O M P A N Y
PO Box 10091
Wilmington, North Carolina 28-404
phone [phone]
I June, 2016
Charles and Patricia Rollins
I I I Oak Park Drive
Chapel Hill NC 27517
Dear Adjacent Property Owner.
This letter is to inform you that 1, Scott Sullivan, an authorized agent for John and Sally York,
have applied for a CAMA permit at lot 843 Cape Creek Road, Bald Head Island, NC in Brunswick
County.
As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of the proposed project. If you have any questions or comments about my
proposed project, please contact me at 910-686-1223,or by mail at the address listed above. If
you wish to file written comments or objections with the Village of BHI CAMA Minor Permit
Program, you may submit them to:
Stephen Boyette
Local Permit Officer for Village of Bald Head Island
P.O. Box 3009
Bald Head Island, NC 28461
Sincerely,
C
Cott Sullivan,
Authorized agent
;-AEL .... ! V ED
DCM WILMINGTON, NO
OCT 1 2 2016
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North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pat McCrory Braxton C. Davis John E. Skvada, III
Governor Di+actor Secretary
AGENT AUTHORIZATION FORM
Date: 1 to
Nof Property Owner Applying for Permit: Name of Authorized Agent for this project:
ar{�a
` + 0 to --,J p 1 a P -(i, Scott R. Sullivan
Owners Mailing Address: _
S3Db C.,QCC-4 1 tK)SCe, 1r�.
Agent's Mailing Address:
PO Box 1 G091
Wilmington, NC 28404
Phone Number( t 1 III —8�Aj_ Phone NumbedL 910 ) 686-1223
I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
for and obtaining all LAMA Permits necessary to install or construct the following (activity):
Cx�1.l sit cF+ s NQ V) N e
For my property located at Lil CAfM= Ce LLtL 12� rg , k v Qlt3
This certf iication is valid thru (date)
Property Own Sign a Date
127 Caodlnel Drive Ext, Wning'cn, NC 28403
Phone:010-79&7215l FAX [phone] IntemeC www.acwastalmanagemenl.nel
DEL •-i VED
GC[A WILMINGTON, NC
OCT 1 2 2016
Non` Carolina
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