NTB_15-28_470 Anderson LLC

Issued by WiRO NTB15.28
North Topsail Beach Permit Number
CAMA
MINOR DEVELOPMENT
PERMIT
as authorized by the State of North Carolina, Department of Environmental Quality
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 470 Anderson LLC authorizing development in the Ocean Hazard (AEC) at 179 Topsail Road, in North
Topsail Beach, Onslow County as requested in the permittee's application, dated November 5, 2015, and received by
DCM on November 12, 2015. This permit, issued on November 30, 2015, is subject to compliance with the application
and site drawing dated received on November 12, 2015 (where consistent with the permit), all applicable regulations and
special conditions and notes set forth below. Any violation of these terms may subject the permittee to a fine,
imprisonment or civil action, or may cause the permit to be null and void.
This permit authorizes: Construction of a single family residence to include driveway, parking and deck.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received by DCM on November 12, 2015.
(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, and/or land use activities will require re-evaluation and
modification of this permit.
(4) A copy of this permit shall be posted or available on site throughout the construction process. Contact this office at (910)
766-7221 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 proiect 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, 2018
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.
Jason Dail
AMA LOCAL PERMIT OFFICIAL
127 Cardinal Drive Extension
Wilmington, NC 28405-3845
PERMITTEE
(Signature required if conditions above apply to permit)

Name: 470 Anderson LLC
Minor Permit # NTB15.28
Date: November 30, 2015
(5) The structure(s) must be set back a minimum of 60 feet from the first line of stable natural vegetation, as determined
by the DCM.
(6) All structure(s) must be set back a minimum of sixty (60) feet from the First Line of Stable Natural Vegetation
(FLSNV), as determined by the DCM, the LPO, or other assigned agent of the DCM.
(7) The permittee is required to contact the Local Permit Officer [phone], 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.
(8) 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.
(9) 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.
(10) All pilings shall have a tip penetration greater than eight (8) feet below the lowest ground elevation under the
structure. The deck shall be constructed independently from the residence and shall be structurally detached.
(11) All 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 relocated 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.
(13) Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third -party.
SIGNATURE:
DATE:
PERMITTEE

N -r
Coastal Management
ENVIRONMENTAL QUALITY
November 30, 2015
470 Anderson, LLC
104 Coastal Bluffs Ct.
Hampstead, NC 28443
To Whom It May Concern:
PAT MCCRORY
Govemor
DONALD R. VAN DER VAART
Secretary
BRAXTON DAVIS
Dimror
Attached is CAMA Minor Development Permit # NTB 15-28 for work to be done at 179 Tosail
Road, in North Topsail Beach, Onslow County.
In order to validate this permit, please sign both copies of the permit as indicated for our records.
Please retain the orange copy for your files, sign the front and back sides of the white copy, and
return to us within 20 days of receipt in the enclosed, self-addressed envelope. An electronic
copy has been sent to your agent.
This is not a valid permit until it is signed and returned to our office.
Thank you for your prompt attention to this matter.
Enclosures
Cc: WiRO files
Carolina Coast Contracting
Sincerely,
Shaou/
P
Permit Support Technici
Nothing Compares? �
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Fx ., Wilmington, NC 29405
910-796-7215

LOT 11
M.B. 25, P. 136
S WALK EASLENT FOR
FLOOD ZONE "VE"
(ELEVATION=13.0'+2')
APPRO1a"n FLOOD LRE, _ , —
FLOOD ZONE "VE"
(ELE VAT(ON=14.0'+2')
Illg
LAND DISTURBANCE FROM R/W M REM OF LOT
PUNG DEPTH AS PLR ENGINEER
LINNOSCAPING AS PER TOWN OF NORTH 10PSAA
BEACH MXNANCES
�1VN1M OCEAN
LREC,cyi
M.B. 9'#A#9© Y
ACM WlCM1NGT0
N=
GROUND: 184 S4Ft
nm BOOR: 816 SpFL
SECOND
. n(YYF SaR.00R: e18 2 SyFI
R.
MAL FLOOR AREA, 2515 S4i7t
AS PER BILNNG PLANS
BE`d9Lm5
CA INTERSECTKN Oi
03/04/18: MOYED PROPOSED DWELNG
TOPSAIL ROAD
181N AYENUE e /
RENSED PROPOED NRVEWAY
60' R W
� (ASPHALT
TOPSAIL ROAD
— _ — -
-PUBLIC)
LOT 7
—_---,r^nD.
5012 Sq.Ft.
TAX ID
0.115 ACRES
M - GENTRW CORNER
ECM . EMSING CONCREii WNRAENT (FDIDXOONTROL CORNER)
BOY-N.8
BP - COMIC IRON PIPE (FWND)
OR - EASTNG IRON RW (FWND)
EMN - EPSDNG MAGNETIC NAIL (iWNDXCONTRIX. CI 0)
BONEEmm 9BNORS TIME SOURCE
ZONED R-8
EPK - ENSUING PAIMER-NALCN NAIL (FWNDXIX IRIX C NER)
D.B. 4358, P. 7W JM GAINER D.B. 4358. P.
780 TONIN. SETBACKS
ERRS - EXISTING RAIMAD SPIKE (FWND)
Y.B. 25. P. 13a
FRONT - 20'
IIBL - MINIMUM BOILING UNE
REAR - 10'
NMP - NON MMUMENTED PINT
DNS IS M CER MAT THE S11B.€CT PROPERTY IS
SIDE a- e'
R/W - RIGHT OF WAY
LOCATED IN FLOOD ZME K MHICH
SCM - SET CONCRETE MONUMENT (CONTROL WRNER)
IS A SKIAL FLOOD HAZARD AREA AS
SIP - SET IRON PIPE
FRDEILENED BY ME FEDERAL EMERGENCY MANAGEMENT
SIR - SET IRON ROD
AGENCY. AND THE NATIONAL ROOD INSURANCE PRMAY.
SNN - SET YAGNEIIC NAIL (CONTRA CORNER)
�ii NDi a PANR NssDMD.I.
179 TOPSAIL ROAD
� - � PAWDt-KALON NAL (CONTROL GIBER)
NoetvBER a. zoos
It GENTERUNE
I. =' PXNE�01lAL LAND 16-02-33 BOUNDARY SURVEY & PRELIMINARY PLOT PLAN FOR
SURVEYOR, W HEREBY CER M ,(( 1'111N ,m �
SURVEYED THE PROPERT�Y��y;c�� M�;,�, 470 ANDERSON, LLC
ACCORDANCE NN T1E.,,L':.35. �y�. � n. �
SEA *R 4. me LOT 7
L-2981 - py� REVISION OF OCEAN BREEZE
.. 5... ` "° STUMP SOUND TOWNSHIP.
583/51
1 502 NEW BRIDGE STREET
LANDFALL EXECUTIVE SUITE 217
P.O. BOX 1570
JACKSOWALLE, NC 28540-1570
1213 CULBRETH DRIVE
WILMINGTON, INC 28405
raF
1- — 20-1
TELEPHONE: [phone]
TELEPHONE: [phone]
E—MAIL riggelondOriggelandnc.com
NC

/�� may/ OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA
Locality / V Permit Numbed 11 minor development permit, including, but not limited to: Drinking Water Well, Septic Tank (or other sanitary waste
treatment system) Building Electrical Plumbin Heatin and Air C df iI I
Ocean Hazard _ Estuarine Shoreline_ ORW Shoreline _ Public Trust Shoreline_ Other_ pp g y nnec on, an
(For official use oniv) others. Check with your Local Permit Officer for more information.
LAND
City
State
City a16 CtVi �State
\\ \ C ZinDE46hone 9)()--`-1i]4i,-3:,
Email CCXU�t(�0.(C.UcYtCA'Ct`C '�'�nB
LOCATION OF PRO ( dress, str_ce[ nnnd/or directions to site. If not oceanfront, what is the name of the
adjacent waterbody.) �-�ei r, \'�. i1D�i h-I-atnCz �Qp[�. ✓\-\-�},C
ITZ`
DESCRIPTION OF PROJECT: (List all proposed construction and lard disturbance.) 1 p' C(1
SIZE OF LOTIPARCEL: �r square feet a I 1 acres
PROPOSED USE: Residential LI (Single-family ❑ Multi -family[]) Commercial/Indusuialo Other
COMPLETE EITHER (1) OR (2) BELOW (Coulacryour Local Permit Office, ifyna are not sere which AEC applies
to your property):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: 0! 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 FOOTPRINTAND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: square fact (includes the area of the rooVdrip 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= NC=
Byes, list the total built upon area/impervious surface allowed for your lot or parcel: square feet.
g, g on r conng, nsu at and Energy Conservation, FIA
Certification, Send Dune, Sediment Control Subdivision Approval Mobile Home ParkA ravel Hi love Co t d
STATEMENT OF OWNERSHIP:
I, the undersigned, an applicant for a CAMA minor development permit, being either the owner ofproperty in an AEC or a
person authorized to act as an agent for purposes ofapplying 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) (,���Q
an � e,(or record 'Ile, Tit a is vested in 1 lD 111 IAeY�1� —� see Deed Book
page ( D.{n the O County Registry of Deeds.
Qan owner by virtue of inheritance. Applicant is an heir to the estate
probate was in Countv.
Qfother interest, such as written contract or lease, explain below or use a separate sheet & attach to this application.
NOTIFICATION OFADJACENT 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.
(1)
(2)
(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 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.
((11
r I n n This the � day of 0�,20 IS
purpose of filing a CAMA
This application includes: general inform, o (this form), a site draiving as described on the back afthis application. the
nivnership statement, the Ocean HazardA Nance where necessary, a checkfor $100,00 made payable to the locality, and
any bfarmatron as may be provided orally by the applicant The derails of the application as described by these sources are
ir¢orpomied without reference en any permit which niay be issued. DevinOonfrom these details ivill constnute a violation of
ony permit Anyperson developing in an AEC wrthotn permit is subject to civil, criminal and administrative action.
RECEIVED
DCM WILMINGTON, NC
NOV 12 2m

LEM

IMPERVIOUS CALCULATIONS
5037.3 SO. FT. IN LOT
IMPERVIOUS
3' WALK EN'
LOT 7
MB 25, PG 136
DB 1758, PG 882
0.11 ACRES
LOT 6
MB 25. PG 136
R/W
THIS IS TO CERTIFY THAT THIS PROPERTY IS
LOCATED IN FLOOD HAZARD ZONE 'VE• PER
COMMUNITY d 370 PAN 56
LOT 11
MB 25, PG 136
SETBACK INFORMATION
ZONED: R-B- NORTH TOPSNL BEACH
FRONT SETBACK: 211
SIDE SETBACK: 8'
SIDE STREET SETBACK: N/AREAR SETBACK: 10'MAXIMUM
HEIGHT-48'
MAXIMUM IMPERVIOUS-=
OSTE
FLOOD INFORMATION
FLOOD ZONE VE
BASE FLOOD ELEVATION:14'
FREEBOARD-. +2'
LOWEST HORIZONTAL MEMBER: 16.00'
VICINITY MAP NO SCALE
NAVD 88 DATUM
LOT 12
M8,25,qPG 136
FlR
.
pa
17
gry0
W
OJ
3'36•E
WAS' m
METAL
plmrasm
a sm8r
MI&a.Y v1An
7'
Mge of
pavement
TOPSAIL ROAD
ED, PUBLIC RIGHT -OF -war
LOT 2
MB 9, PG 69
TP `
1 NAIL SET IN POWER POLE
AT 16.00' MSL NAVD 88
30 15 0 30 60
GRAPHIC SCALE
A wulwlw N um tmur m wN m
BOOXNAe P SOOR
NA OR
_ ___.. .._ __.
E—OWVWGE 4 URUIY FASETI- 5�_
1AC 00
THs
SURVEY FOR: xM GUNER
OF MEETS THE
Oruro RU (21
).• TH6 6
15 '
SUBDIVISION: OCEAN BREEZE
SE
r L.2904
9
xDAIRY
LOT �� BLOCK, N/A SECTION: N/A
CANARY SURVEYING
vjO
P.O. BOX. 915
2780 INSTON HIGHWAY
KIN
ONSIOW COUNTY STUMP SOUND TOWNSHIP
R'74
O CEpl 8
I
D
m,w , ceuenv
mp e
GATE a-17-15 SCALE: =30' FB zsz ]
___._ .....,-..... _.._ .�.....,....
MBX:[phone]t_I_0J3898460
.MINGTON, NC
12 20151

AEC HAZARD NOTICE
Project Is In An: LL11 Ocean Erodible Area High Hazard Flood Area Inlet Hazard Area
PropertyOwner: LLB
Property Address: I IA R l ) 6k\ k 1 VA,
Date Lot Was Platted:.
This notice is intended to make you, the applicant, aware of the
special diks 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 anAEC Hazard Notice and acknowledge
that notice in writing before a permit for development can be
issued.
The Commission's rules on building standards, oceanfront
setbacks and dune alterations 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. Permits issued in the Ocean Hazard Area of
Environmental Concern include the condition that structures be
relocated or dismantled ifthey become imminently threatened by
changes in shoreline configuration. The structirle(s) must be
relocated or dismantled within two (2) years of becoming
imminently threatened, and in any case upon its collapse or
subsidence.
The best available information, as accepted by the Coastal
Resources Commission, indicates that the annual long-term
average ocean erosion 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 also indicate that the shoreline could move as much as
feet landward in a major storm.
The flood waters in a major storm are predicted to be about
feet deep in this area.
Preferred oceanfrontprotection 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 sand bags may be
authorized under certain conditions.
q'he applicantmust acknowledge this information and requirements
by signing this notice in the space below. Without the proper
signature, the application will not be complete.
App lcal nt Signature Date
SPECIAL NOTE: This hazardnotice is required for development
in areas subject to sudden and massive storms and erosion. Permits
issued for development in this 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 must be contacted to determine the vegetation line and
setback distance at your site. If the property has seen little change
since the time ofpermit issuance, and the proposed development
can still meet the setback requirement, the LPO will inform you
that you may begin work. Substantial progress on the project
must be made within 60 days of this setback determination, or
the setback must be remeasured.Also, the occurrence of major
shoreline change as the result ofa storm within the 60-day period
will necessitate remeasurement of the setback. It is important
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 beenplaced and substantial
progress is continuing, permiurenewal can'be authorized. It is
unlawful to continue work afterpermit expiration.
For more information, contact.
Local Permit Officer
Address
Locality
Phone !Number
RECEIVED
DCM WILMINGTON, NC
N 0 V Veag&2107

U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE
FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008
National Flood Insurance Program Important: Read the instructions on pages 1-9. Expiration Date: July 31, 2015
SECTIONA- PROPERTYINFORMATION rFbfjINSURANCE`COMPANYt1SO,
Al. Building Owner's Name Jim Gainer FPol, o `Number �
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Gampany�NAIG3dutnber"� -"
179 Toosail Drive 1�-,,'Y,
City North Topsail Beach State NO ZIP Code 28460
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot 7 Ocean Breeze mb 25 pg 136
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lat. 34°27'53.07" Long. 77°28'41.47" Horizontal Datum: ❑ NAD 1927 ® NAD 1983
AS. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 6
A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
a) Square footage of crawlspace or enclosure(s) 150 sq It a) Square footage of attached garage We sq ft
b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage
or enclosure(s) within 1.0 foot above adjacent grade 2 within 1.0 foot above adjacent grade n/a
c) Total net area of flood openings in A8.b 468 sq in c) Total net area of flood openings in A9.b n/a sq in
d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes ® No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Bt. NFIP Community Name $ Community Number B2. County Name - B3. State
370466 North Topsail Beach OnsC1, NC
B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevations) (Zone
3720425600 J 2/16/2007 Effective/Revised Date Zone(s) AO, use base flood depth)
11/3/2005 "VE" 14.0'
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source:
B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No
Designation Date: We ❑ CBRS ❑ OPA
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl. Building elevations are based on: ® Construction Drawings* ❑ Building Under Construction` ❑ Finished Construction
'A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations - Zones Ai-A30, AE, AH, A (with BFE), VE, VI-V30, V (with BFE), AR, ARIA, AR/AE, AR/A1 A30, AR/AH, AR/AO. Complete Items C2.a-h
below according to the building diagram specified in Item AT in Puerto Rico only, enter meters.
Benchmark Utilized: NCGS "PUBLIC" Vertical Datum: NAVD 88
Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source: _
Datum used for building elevations must be the same as that used for the BFE.
Check the measurement used.
a) Top of bottom floor (including basement, crawlspace, or enclosure floor)
8.00
® feet
❑ meters
b) Top of the next higher floor
18.00
® feet
❑meters
c) Bottom of the lowest horizontal structural member (V Zones only)
16.00
® feet
❑ meters
d) Attached garage (top of slab)
n/a.
❑ feet
❑meters
e) Lowest elevation of machinery or equipment servicing the building
96.00
® feet
❑ meters
(Describe type of equipment and location in Comments)
0 Lowest adjacent (finished) grade next to building (LAG)
7.2
® feet
❑ meters
g) Highest adjacent (finished) grade next to building (HAG)
7.5
® feet
❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support
7.3
® feet
❑ meters
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation �� 1111I information. I certify that the information on this Certificate represents my best efforts to interpret the data available.\\\ /
I understand that any false statement may be punishable by line or imprisonment under I8 U.S. Code, Section 1001. �� \� C A R
❑ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ��� �� I •:�y��
❑ Check here if attachments. licensed land surveyor? ® Yes ❑ No I 6ti, li
Certifier's Name Garry I. Canady License Number L-2904
Title Land Surveyor Company Name Gairy Canady Surveying RECH
Address PO BRx916 City Richlands State NO ZIP Code 28T9f- M WILMIN
Signature
Date 8/13/15
Telephone [phone]
FEMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions.

ELEVATION CERTIFICATE, page 2
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR tNSLIRANf F nnnnanr v 1 Icr
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. polfcyNumber)
179 Topsail DRIVE
City North Topsail Beach State NC ZIP Code 28460 ,Comtienv NAIL Number
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments
Date 8/13/15
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zones AO and A (without BFE), complete Items E7-E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,
and C. For Items E1-E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.
El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade (HAG) and the lowest adjacent grade (LAG).
a) Top of bottom floor (including basement, crawlspace, or enclosure) Is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG.
b) Top of bottom floor (including basement, crawlspace, or enclosure) is _ _ ❑ feet ❑ meters ❑ above or ❑ below the LAG.
E2. For Building Diagrams 6-9 With permanent flood openings provided In Section A Items 8 and/or 9 (see pages 8-9 of Instructions), the next higher floor
(elevation C2.b In the diagrams) of the building is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E3. Attached garage (top of slab) is - _ ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management
ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community -issued BFE)
or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledee.
Property Owner's or Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
Check here if attachments.
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who Is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B. C (or E), and G
of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8-G10. In Puerto Rico only, enter meters.
G1. ❑ The information In Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who
is authorized by law to certify elevation Information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA-issued or community -issued BFE) or Zone AO.
G3. ❑ The following information (Items G4-G10) is provided for community floodplain management purposes.
G4. Permit Number I G5. Date Permit Issued IG6. Date Certificate Of Compliance/Occupancy Issued
G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters Datum _
G9. BFE or (in Zone AO) depth of flooding at the building site: _ _ ❑ feet ❑ meters Datum _
G10. Community's design flood elevation: _ _ ❑ feet ❑ meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments ffeEIVED
DCM WILMINGTON, NC
❑ Check here if attpIghments.
NOV
I-tMA I-orm U86-0-33 (7112) Replaces all previous editions.

I r . .
Receipts for
Certified Mail
(Staple Here)
II
Adjacent Progeerty Owner
M 'in,C r nms� t'\ 1
City, State, Zip Code
Dear Adjacent Property:
This letter is to inform you that I, LM �l5�(1, L A L have applied for a CAMA Minor
Property Owner 3`t5`'1lo
1 Permit on my property at U`�ia� '4V6Cth -\1'771'.,\ �� in COUNTY
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 me at ` \c) -6-do -33--�o ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program, you may submit
them to:
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY, STATE, ZIP CODE
Sincerely,
Property Owner —
5115 A&jV SE-) �p- \o\
Mailing Address
City, State, Zip Code
RECEIVED
DCM WILMINGTON, NC
NOV 12 2015

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Domestic Mail Only
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1 11/05/2015

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to i—o A,4,et-:: 6` � , LLc— ,s
y� �' O \ (Name of Property Owner) �G
property located at \ C\ �l�`i�U� \ C�C7. \ 0� �� G,� GL� sx %LIi6c)
((�� Address, Lot, Block, Road, etc.)
on \ tlL CCA?' , in �1�ck�. \J� A ��\(� N.C.
(Waterbody) (Town and/orCounty)
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
NOV 12 Z015

Receipts for
Certified Mail
(Staple Here)
1. l -�- (5,
Date
A 'cent Iperry Owner
x a\oo
"MI Irt a',. C1L a`?'L ALAs-
City, State, Zip Code
Dear Adjacent Property:
Lc -
This letter is to inform you that[, ('nci N-AeI�;bC\ ,L have applied for a CAMA Minor
Property Owner
Permit on my property at t M \O�a� kujNN p \ \Seo& X( in COUNTY
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 Tatum
the enclosed no objection form. If you have any questions or comments about my proposed project, pledse
contact meat 1�kC) —6QD'��3^l� ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program, you may submit
them to:
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY, STATE, ZIP CODE
Sincerely,
Property Owner
13T,)Z3 US �wy 5b S6,
Mailing A dress
Sic 0
City, State, Zip Code
RECEIVED
0CM WILMINGTON, NC
NOV 12 2013)

■ Complete items 1, 2, and 3.
• Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to: �y
?cD -\-box allo(=,
IIIIIIIIIIIIIIII1I11IIIIIIIIIIIIIIIIIIIIIIIIII
9590 9403 0258 5155 4707 48
7015 0640 0004 1610 9291
Ps Form 3811, April 2015 PEN 7530-02-000-9053
A. Sign `
X/ -fl Agent
ddressee
B. /e�eived by no�te[r//lyame) L C. ate of Delivery
D. Is delivery address different from Rem 17 ❑ Yes
If YES, enter delivery address below: ❑ No
a. aervlce type
❑ Priority Mail Express®
❑Atlult Signature
❑ReglsteredMail—
� Adylt SignatureResMcted Delivery
edlfied Mall®
❑ Registered Mail Restricted
Delivery
❑ Certified Mail Restricted Delivery
❑ Return Receipt for
❑ Collect on Delivery
Merchandise
❑ Collect on Delivery Restricted Delivery
0 Signature Confirmation*^
❑ Insured Mail
❑ Signature Confirmation
❑ Insured Mail Restricted Delivery
Restricted Delivery
(over $500)
Domestic Return Receipt
7015 0640 0004 1610 9291

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to m CAY\�5bo , L 1 ,L -s
(Name of Property Owner)
property located at
\ - Address, \Lot, Block, Road, etc.)
on � �li ��� C_ (GXO in ���U C t (� �rJ . ` Y'tiGil N.C.
(Waterbody) (Townand/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
iECEIVED
DCM WILMINGTON, NC
NOV 12 2015)

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910.200.1615 FAX [phone]C6
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CM WILMINGTON, NC
NOV 12 2015