BC_04-12_Kelly

Locality by
Pernin Number 04' la-
Ocean Hazard
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Estuarine Shoreline / ORW Shoreline _Public
(For official use only) T
GENERAL INFORMATION
LAND OWNER
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Adress
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LOCATION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront, what is the name of
he adjacent waterbody?) V I 4 t rrach
hatch ; I # on C- Ih ort re
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DESCRIPTION OF PROJECT (List all proposed construction) and land disturbance.)
AZE OF LOT/PARCEL: gl0Q AW square feet acres
?ROPOSED USE: Residential ✓ (Single-family ✓ Multi -family _) Commerical/Industrial
Dther
COTAL ENCLOSED FLOOR AREA OF A BUILDING IN THE OCEAN HAZARD AREA OF ENVI-
IONMENTAL CONCERN (AEC): �� square Feet (includes all floors and roof -covered decks)
iIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT -UPON SURFACES IN
17H.E COASTAL SHORELINE AREA OF ENVIRONMENTAL CONCERN (AEC): 13 k - sq. &.
Calculations include the area of the roof/drip line of all buildings, driveways, covered decks, concrete or masonry patios,
:tc. that are within the applicable AEC. Attach your calculations with the project drawing.)
;,)loose the AEC area that applies to your property.
I 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.)
iTATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a
;rate Stormwater Mana&craent Permit issued by the N.C. Division of Water Quality?
'ES N
f yes, list the total built -upon area/impervious surface allowed for your lot or parcel, square feet.

OTHER PERMITS MAYBE REQUIRED: The activityyou are m ma ry Sequire permits orb the CAMA minor
development permit. As a service we have compiled a list of the kinds of per [: fight be required. We sug�gFs on check over the list
with your LPO to determine if any of these apply to your project: Zoning, D 9'AterWell, SepticTmk(or oth sanitarywaste
vestment system), Building Electrical, Plumbing Heating and Air Conditio Insulation and Energy Conservati , FIA Certification,
Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park A r , Hibhway, Cbnneeaon, and ' rs.
DMS' _)N OF
STATEMENT OF OWNERSHIP: COASTAL MANAGEMENT
:, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in an AEC or a
3erson authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person
isted as landowner on this application has a significant interest in the real property described therein. This int es can be
iescribed as: (check one)
/an owner or record title. Title is vested in -F3r0.n see Lie, d IZ
)age 02, 7 in the 444rnw aunbu&ICK County Registry of Deeds. O
y��A
an owner by virtue of inheritance. Applicant is an heir to the estate of 7 '2-
=bate was in County. i(P
_if other interest, such as written contract or lease, explain below or use a separate sheet and attach7'ye applicati)j.�
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
kCTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) (Address)
(1)
(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 associ-
ated with this lot. This explanation was accompanied by recommendations concerning stabilization and floodproofing tech-
niques.
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.
Phis 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 infor-
mation 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 administrative action.
RECEIVED This t ?t day of Y ` �✓ 20 0
DEC 2 9 2004-
Landowner or person authorized to act as his agent for purpose filing a CAMA permit application.

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December 07, 2004 K E W\VY
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Paul Skiver
5304 Gray Cliff Drive COASTAL MANAGEMENT
Greensboro, NC 27406
Dear Mr. Skiver,
This letter is to notify you that I have applied for a CAMA permit I am required to notify
you of my intentions to build the following structure (detailed in the drawing attached) on
Lot 4 at Goose Creek subdivsion, Ocean Isle Beach, I am also enclosing a copy of my
completed CAMA application.
Sincerely,
Brian E. Kelly
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August 14, 2004
Mr. and Mrs. Donnie R Harris
3286 Donnie Harris Lane
Maiden, NC 28650
Dear Mr. and Mrs. Harris;
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JAN 0 1 <<y�
C `qc HIVI AANAGE
MENT
This letter is to notify you that I have applied for a CAMA permit. I am r to
notify you of my intentions to build the following structure (detailed in
attached) on Lot 4 at Goose Creek subdivision, Ocean Isle Beach. so g a
copy of my completed CAMA application. 0 (�
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Sincerely,
9�z DBrian E. Kelly �
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CIIY.Sfate. IlPfdPS Form 3800, June 2002 See Reverse for Instrudion.
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