SC_05-38_Pollert

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ocal Governme
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Permitmb r
CAMA
This permit, issued on — Q 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 REMOVAL OF A SINGLE FAMILY DWELLING
1-All proposed development and associated construction must be done in accordance with the
permitted workplat drawing as originally submitted and dated _12-03-04,
2-All construction must conform to the NC Building Code requirements and all other Local, State,
and Federal 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-The amount of impervious surface areas shall not exceed 30% of the lot area within the 75' Area
of Environmental Concern.
5-In order to prevent sedimentation, a vegetated buffer zone must be maintained between all
disturbed areas and the adjacent waterbody or marsh.
6-Prior to initiating any land -disturbing activities, a barrier line of filter cloth, or burlap must be
installed between the land -disturbing activities, and the adjacent marsh or water areas, until such
time as the area has been properly stabilized with a vegetated cover.
7-Pursuant to 15 NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold
or otherwise disposed of to a third party.
8-There will be no construction allowed within 30' (feet) of normal high water.
This permit action may be appealed by the permittee or other
qualified persons within twenty (20) days of the issuing date.
From the date of an appeal, any work conducted under this per-
mit m..st cease until the appeal is resolved.
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 modifications not covered
under this permit requires further written permit approval.
All work must cease when this permit expires on December
31. .2011 %
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.
Local Formit unicer (signature)
Steve Padgett
name
PO Box 2475
address
Surf City, NC 28445
Permittee
(signature required if special conditions above apply to permit)

r Locality; J(u-f �ttZ (�{�S��tN Permit Number S(; CG dg
Ocean Hazard __ Estuarine Shoreline �__ORW Shoreline _Public Trust Shoreline Other
(For official use y1
GENERAL INFORMATIONIr LAND OWNER I
DEC 0 7 2004 U
r� , DIVISION OF
Name nUfY ccr .l) . �(oI u r C rOASTAL MANAGEMENT
Address 4--'U• ID" 1A1G
City O-Ln1 a1r) State IVr✓ ZipC�Y'3aG Phone q19
AUTHORIZED AGENT
Address 10 q
y �
�f�1 L-
City WON A/ ON 0e.L_
State
Vt._ Zip ;Z70 i
Phone9(5-3(�—
LOCATION OF PROJECT -
(Address, street name and/or directions to site. If not oceanfront, what is the name of
the adjacent waterbody?) 4-UPS 4 1-) Stt e -+
DESCRIPTION OF PROJECT. (List all proposed construction and land disturbance.) Yl lO li(I 1 iJ
l�n ry fi A r,i, I (A - n � A r , v-m Z ran 14-1 n . .n L, . r ! ,nJ— �
SIZE OF LOT/PARCEL: square feet A acres
PROPOSED USE: Residential—)( (Single-family —Y Multi -family _) Commerical/Industrial
Other
TOTAL ENCLOSED FLOOR AREA OF A BUILDING IN THE OCEAN HAZARD AREA OF ENVI-
RONMENTAL CONCERN (AEC): —I\VA-- 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): 1W _3rY q, ft.
(Calculations include 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.)
se the AEC area that applies to your property:
(1) ithin 75 feet of Normal High Water for the Estuarine Shoreline AEC
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 Man ement Permit issued by the N.C. Division of Water Quality?
YES NO
If yes, list the total built -upon area/impervious surface allowed for your lot or parcel._ square feet.

OTVER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA minor
development permit. As a service we have compiled a list of the kinds ofpermits that might be required. We suggest you check over the list
with your LPO to determine if any 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, Insulatio F�on, FIA Certification,
Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, High o e �(Ey!
C
L
STATEMENT OF OWNERSHIP: DEC 0 7 2004 t
I, the undersigned, an applicant for a CAMA minor development permit, being either the @j~(ft(DtFin an AEC or a
person authorized to act as an agent for purposes of applying for a CAMA minor Q"jaZALpA4MA@Aa10Eqft 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 see Deed Book
page in the County Registry of Deeds. t
_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 CAMA permit.
(I)
(2)
(3)
(4)
e kXA Mile, rn .� (Address)
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 floodproofrng 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.
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 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.
This the 24 da o uovcm, - , 2104
�6
Landowner or person authorized to act as his agent for purpose of filing a CAMA permit application.
E
K

DEC 0 7 2004
DIVISION OF
COASTAL MANAGEMENT
Wil uulil
NOTICE OF FILING OF APPLICATION FOR CAMA MINOR DEVELOPMENT PERMIT
Pursuant to NCGS I I3-119(b), Town of Surf City, a locality authorized to issue CAMA permits
in Areas of Environmental Concern hereby gives NOTICE that on 11-24-04 Delmar D. Pollert
applied for a CAMA permit to move a single family dwelling in the Estuarine Shoreline AEC at
4068 4" Street to 4065 4s' Street. The application may be inspected at the address below. Public
comments received by 12-09-04 will be considered. Later comments will be accepted and
considered up to the time of permit decision. Project modifications may occur based on further
review and comments. Notice of the permit decision in this matter will be provided upon written
request.
Steve Padgett
Town of Surf City
PO Box 2475
214 North New River Dr.
Surf City, NC 28445
(910)-328-4131
Please publish on 12-01-04

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D (H Ci DRIVEWAY'
D� EDP " — EDGE OF PAVEMENT
r N2833'32'W N28'33'49'W eEPK -CA
N EPK 1406.41' NPK 41.96'
--1 AT INTERSECTION OF EOP EDGE OF PAVEMENT
m H AND F CANAL STREET
4th STREET (60' R/W) NCSR 1604
R/W
THIS IS TO CERTIFY THAT THIS PROPERTY 15
LOCATED IN FLOOD HAZARD ZONE 'AE10'
PER COMMUNITY 3 UH. PANEL 0002E
THIS IS TO CERTIFY THAT THIS MAP AND
SURVEY WAS DONE IN ACCORDANCE WITH
THIS SURVEY IS AN
LAND. .
R/W
BASE FLOOD = 10'
4065 4th STREET FF TO BE = 10'
PER FIRM 370186 0002E
PRELIMINARY SURVEY DATED JANUARY 22, 1998
LEGEND WFI--WATER METER NWIS--NEW WITNESS Rt STAKE
EP--EXISTING MN PPE PP --POWER POLE MSL-MINIMUM WILDING LYE
MR--OEEO BOOK PG --PAGE EPK--EMSTING PK NNL OS --EXISTING IRON STA
R/W--RIGHT OP WAY M8--MAP BOq( NPK--NEW %( NAIL NIS--NEW IRON STAKE
CA.--CENTERUNE CP--COMPUTED POINT R--RAGUS ECM --EXISTING CONCRETE MONUMENT
-E---OMDLEAD ELECTRIC LINE CONC--CONCRETE D R U. E--GHNNAGE AND UTILITY EASEMENT
SLMVEY FOR
GUY BRASHEAR
9103 RICHLANDS HIGHWAY
RICHLANDS, NC 28574
910 324-4616
910 324-8430 FAX
21
07 200y
ISION OF
MANAGEMENT
I. CANADY PLS