NTB_05-42_McInnis

im, r�"__
—NTB---
Local Government
COASTOIVISI
AL Ani
CAMA
EVELOPMENT
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 Statues, "Coastal Area Management"
ENT
-----05/42_
Permit Number
Issued to Mr. Richard McInnis, authorizing development in Estuarine Shoreline AEC at 703 Tradewinds
Drive, NC 28460 as requested in the permittee's application, dated April 19, 2005. This permit, issued on
May 3. 2005, 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.
DEVELOPMENT FOR THE ESTAURINE SHORELINE - 7H. 0209
This permit authorizes the construction of a single family dwelling with driveway.
1. All proposed development and associated construction must be done in accordance with the
application submitted on April 19, 2005. All construction must conform to the N.C. Building
code requirements and all other Local, State and Federal regulations.
2. Any change or changes in the plans for development, construction, or land use activities will
require a re-evaluation and modification of this permit.
3. The amount of impervious surface shall not exceed 30% of the lot area within the 75' of the
normal high water contour/normal water contour, which defines the Coastal Shoreline AEC at
this location. In this case 3.296 square feet of impervious surface is authorized.
4. In order to prevent sedimentation, a vegetated or planted buffer zone must be maintained
between all disturbed areas and the adjacent water body or marsh. In this case a 30-foot wide
buffer has been accepted.
Conditions continued on second page
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 permit must
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 modification not covered under
this permit, require further written permit approval.
All work must cease when this permit expires on December 31,
2008
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.
CAMA Local Permit Official
Permittee (signature required if conditions above apply to permit)

Name: MCINNIS
Minor Permit *05 /42
Date: 05 / 03 / 05
5. Prior to initiating any land -disturbing activities, adequate sedimentation/erosion control
measures must be employed to prevent the movement of unconsolidated materials into the marsh
or water. These measures must remain in place until such time as the area is properly stabilized
with vegetated cover.
6 .Pursuant to 15 N CAC, Subchapter 710406 (b), this permit may not be assigned, transferred,
sold or otherwise disposed of to a third party by the applicant, agent, or any entity other than the
NC Division of Coastal Management.
7. It is noted that coastal marsh does exist on the property, and that the proposed development
addressed on the submitted plat dated April 15, 2005 is not located within this marsh.
8. No excavation or filling of any wetlands or waters is authorized under this permit.
9. The development authorized under this permit must be accomplished a minimum of 30'
landward of the normal high water contour/normal water contour, maintaining this as a
vegetated or planted buffer area.
10. The area proposed for grading within the 30' buffer from the normal high water
contour/normal water contour must immediately be vegetatively stabilized, and must remain
in a vegetated state.
11. This permit does not authorize the construction of any piers or docks.
12. A copy of this permit must me maintained on site during development.
ho 9
Signature Date
�2

168474 Affidavit of Publication
15067063 Jacksonville Daily News
1 of 2 Jacksonville, NC
Personally red before Wary Public of the County of Onslow, State of North Carolina on this the 23rd day
of April, 05
of The Daily News, who being duly sworn, states that the advertisement entitled CAMA- MdNNIS, RICHARD a true
copy of which is printed herewith, appeared in The Daily News, a newspaper published in the City of Jacksonville, NC,
County of Onslow, State of North Carolina, 1 day on the following dates:
April23, 2005
NORTH CAROLINA
ONSLOW COUNTY
NOTICE OF FILING
OF APPLICATION
FOR CAMA MINOR
DEVELOPMENT PERMIT
Ift
603�VE
MAY 0 9 205
COAS AL IISION OF
MANAGEMENT
Pursuant to NCGS 113A-119 (b), the Town of North Topsail Beach, a locality authorized to issue CAMA permits in
Areas of Environmental Concern, hereby gives NOTICE that on April 19, 2005, Mr. Richard McInnis, applied for a
CAMA permit to construct a single family dwelling with a foot print of 1,050 at 703 trade Winds Drive, North Topsail
Beach, Onslow County, North Carolina. The application may be inspected at the address below. Public comments
received by May 2, 2005, 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 inthis
matter will be provided upon written request. CAMA PERMIT #05/42
Sue McLaughlin, CAMA
Local Permit Off ioer
Town of
North Topsail Beach
2008 Loggerhead Court
North Topsail Beach,
NC 28460
April23, 2005

APR 2 5 2005 r
olvlslTLICATION FOR
OAST i :.VAM�
A MINOR z
C-2 DEVELOPMENT
�\ PERMIT
In 1974, the North Carolina General Assembly passed the Coastal Area
Management Act and set the stage for guiding development in fragile
and productive areas that border the state's sounds and oceanfront. Along Ir✓
with requiring special care by those who build and develop, the General
Assembly directed the Coastal Resources Commission (CRC) to imple-
ment clear regulations that minimize the burden on the applicant.
This application for a minor development permit under CAMA is part
of the Commission's effort to meet the spirit and intent of the General
Assembly. It has been designed to be straightforward and require no
more time or effort necessary from the applicant. Please go over this
folder with the Local Permit Officer (LPO) for the locality in which you
plan to build to be certain that you understand whatinformation he or
she needs.
n
a
83
Under CAMA regulations, the minor permit is to be issued within 25
days once a complete application is in hand. Often less time is needed if
the project is simple. The process generally takes about 18 days. You
can speed the approval process by making certain that your application
is complete and signed, that your drawing meets the specifications given
inside and that your application fee is attached.
Other permits are sometimes required for development in the coastal
area. While these are not CAMA-related, we urge you to check with the
Local Permit Officer to determine which of these you may need. A
listing is included on page 2 of this folder.
(4
We appreciate your cooperation with the North Carolina Coastal Man-
agement Program and your willingness to build in a way that protects
the resources of our beautiful and productive coast. U
Coastal Resources Commission
Division of Coastal Management
CA

-leas
erm
�qui
,m
Locality 1 � /�CL5 1V_'P"0f_Q%'-)os Permit Number
Ocean Hazard _ Estuarine Shoreline ORW Shoreline liter Shoreline _Other
(For off[cial use only) ,21j{d�y C V j�y
GENERAL INFORMATION APR 2 I'
5 2005
LAND OWNER D I V I
Name(Pt DIUN OF
Address L(M
t9 P'rAqro
H�I Ciy 1 tom• ��i �i�.0 Sra[e Zi Phone
AUTHORIZED AGENT
't q 78-Oa�3 N�
'yoi Name
Address
City State Zip Phone
LOCATION OF PROJECT: (Address, street name and/or directions to site. 1f not oceanfront, what is the name
.yoi the adjacent waterbody?)
►EV DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.)
SIZE OF LOT/PARCEL: 61c88- rI4 square feet acres
PROPOSED USE: Residential (Single-family _ Multi -family _) Commerical/Industrial
Other
101 TOTAL ENCLOSED FLOOR AREA OF A BUILDING IN THE OCEAN HAZARD AREA OF ENVI-
lave RONMENTAL CONCERN (AEC): square feet (includes all floors and roof -covered decks)
SIZE OF BUILDING FOOTPRINTAND OTHER IMPERVIOUS OR BUILT -UPON SURFACES IN
THE COASTAL SHORELINE AREA OF ENVIRONMENTAL CONCERN (AEC): sq. fL
(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.)
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
S, (3) within 30 feet of the Public Trust Shoreline AEC
S (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 Mana ement Permit issued by the N.C. Division of Water Quality?
YES_ NOT
v
If yes, list the total built -upon area/impervious surface allowed for your lot or parcel. square feet.

AEC HAZARD NOTICE
Project Is In An: /Ocean Erodible Area vZHigh Hazard Flood Area Inlet Hazard Area
Date Lot Was Platted: / 9 7.;)—
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 building standards, 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,Sion rate for the area where your property is located is
eL 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?�U feet landward in a major storm.
The flood waters in a major storm are predicted to be about
t"eet 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
complete.
W Na,11 wldlalll;�4
Applicant's Signature
4- xu5
Date
SPECIAL NOTE: This hazard notice 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 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:
fs,/- Jv-VA 10
Local Permit Officer
Address
V-A 2s,(4 �-o c)
Locality
qlo-
Phone
DC I�rr_ L! u�
APR 151C;J
DIVISION uF
rnAcTAi_ AMN,?GEMENT
Revised 11193

NOTICE OF FILING
OF APPLICATION FOR
CAMA MINOR DEVELOPMENT
PERMIT
Pursuant to NCGS 113A-119(b), the Town of North Topsail Beach, a locality authorized
to issue CAMA permits in Areas of Environmental Concern, hereby gives NOTICE that
on April 19, 2005, Mr. Richard McInnis, applied for a CAMA permit to construct a
single family dwelling with a foot print of 1,050 at 703 Trade Winds Drive, North
Topsail Beach, Onslow County, North Carolina. The application may be inspected at the
address below. Public comments received by May 2, 2005, 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. CAMA PERMIT # 05/42
Please print on April 23, 2005
Sue McLaughlin
CAMA, Local Permit Officer
Town of North Topsail Beach
2008 Loggerhead Court
North Topsail Beach, NC 28460
Tri
APR 2 5 2005
COASTDA'� M I AGEMENT

A—DJACENT P.IP a_Rlk-N PROPERTY OWNER STAT TIY=-NT
I hereby certify that: own property adjacent to e -,AAU J.-'r p, s
(Name of Property Uwnarj
property located at k)IQ051-J12
nn (Lot, Blnclt., Road, eta)
on a7l''nn� W W in I�D�utd 16�51Ai IAni—� N: C.
(FFaterbody) (Town andidr County)
a has described to ma as shown below, the development he is proposing t that Ineation,
and, I have no objeeHons to his proposal. ;
DESCRZFTION AND/OR DRAWING OF PROPOSED. DEVELOPMENT
(TO bejiilLed in by iadividud proposing o(evelopmen2j Jul.
0:k 91C)
.k
Signature
7.
APB 2 5 2005
CO_,q� At tOfV r;�
Print or Type Name •
Telepbone Number
Data:
0

210
WAAY
APR 51 �
oele\I SITE
OA
�T�.
r)ivlsIC
ISO
90' CANAL EASEM{ey>F Mqp g
ATLAN
TIC OCEAN
NCTNITY MAP - NOT TO SCALE
_ S 71'3 _ W
90 31
N
h
d
nl
MEAN
HIGH WATER
w
SEA
WALL
EPK
S 6_ 88'15'13" W
69.68'
—
o
r
r-
a�
MEAN HIGH WATER nv
mlaj
30'
,0 CAMA BUFFER
N
1p
}5.28
5,18
L7 ---
3
LOT 12
•�
LOT 15
pnj
30' CAMA BUFFER
o
-i�,�
— 3.e
3 /
TOTAL y 35.0'
s
N
w
__ DECK o
EIS
0
w N
Z
Y
•00'
35.0'
m
r
4.38." LOT 14
N
o `° Total Area =.aB o PROPOSED 10
4.58
LOT 13 00
15.288.74 sq.ft. o MULTI-STORYo
� 0.35 acres `b DWELLING-
HOUSE
0
~ 35.0'
WOOD DECK
'b DECK o
ZCORNERS�
47•03'
PUMP
8 20' SETBACK
STATION
d
5' GRADING EASEMENT
R/W
R/W
11.21 ,
160.0' TOR W OF 4.28 N 66'47 00 E 90.00' a.18
MA INA WAY
a
3.97�J +4.24
TRgDE WINDS DRIVE - 50' R/W +.22
LINE TABLE
LINE_j
BEARING
I LENGTH
L1
S68'40' 4"W
18.40
L2
S19'13'29"E
30.17
R/W R ZONE = R-10 NOTE: THIS PROPERTY IS LOCATED IN /W
SETBACKS: A 100 YEAR FLOOD PER FEMA MAP
LEGEND: FRONT - 20' 370466-0004C, DATED MARCH 6, 1998
R/W a RIGHT OF WAY SIDE
-830 FPK =EXISTING PK NAIL ' BUFFER AND IN ZONE VE (EL.12)
.,,,.,..PRELIMINARY MAP,

Ohslow County, NC Property Record Card rq
Ln
to
.n
OWNERSHIP 02222005
2289 302
(PROPERTY DESCRIPTION LTA}
u'1
BUNTING NADISON JR 6
ELISABETH
GALLEON BAY L15
STf '
NOT -0
11616 BACK CREEK ED
m
Postage $
BISHOPVILLE MD
21813
TET
DEED:1912 792Q10162002 170000-
7 705 TRADE WINDS DR
S
ru
Certified Foe
........... 28............
9....
TOPO STREET
JUTILM IZM O
Retum Receipt Fee
O
(Endorsement Required)
•
LEVEL LT
ALL PUB
1
1
(IGHPAVED
IVD]
D B-Required)
Cr
(Endorsement Required)
WOODDECK
# LAND CLASS I
SIZE BASERA] co
a
R1
Totel Poetege 8 Fees V
1-22NWPCAN
BSF 112D
O
0
..... ._..-/.......-.-
3 3
Itieee(
PO Box Ma 10
.
2 C 2
LAND VALUE:
or
ciy, Stele, ZiPa<.....-.•L)
8,5
# OTHBR FBAT
SIZE HASERAI
'It
1 39CBULKHEAD
65• 1
85.22 0.
2 13CCONCRETE
4• 28
2.11 0.60
1.62
3 13CCOIT RSTE
10. 100
2.39
0.80
1.91
4 13CCONCRETB
14• 38
2.53
0.60
1.52
3 3
5 13CCONCRETB
10• 28
2.63
0.60
1.58
8 A- 8
BCHHOUSE
:..9...:
OTHER VALUE:
PIILINGS (ALUM VNL GABLE ICOMPSHNGI 1.50STHT
IWALLPNSH FLOORS HEAT"IR HEATFUELI I
NRY
PAANELALL VIIRPBDRM
LET IHEATPUMP ELECTAIC I.7 ROOM(
LFUF
W
.......... 28......... :
112
1000
532
280
N
181
1910
809
442
// `� �l
NNVV// 4,%� I T JT�
COgsT/S/ szoo0(s VIA
<MgN�p DWELLING COTTAGE C+05 81978 AVERAGE CONDITION
DIMENSIONS:A-CU38R28D38L28 B-U38CU10R28D10L28 C-U48R28CR9➢32L9U32H
# STRUCTURE SKTCH-SF•STHT=
AREA
RATE•GRDF+HEAT+E L•WLHT-ADJRAT•
AREA.
RPCN•
DEPF•CNDF-STR-VALUE
A 63CSCNHOUSE
1064 1.50
1596
41.01
-1
05 3.71
1.50
0.94I 45.37
1596
72411
0.78
56481
2 .00 SAME
2600.00
5200
0.78
4056
28.22
1.86
28.63
12485
B BBkWCODDECK
280 1.00
288
1.05
C 88 WOODDECK
288 1.00
288
8.22
1.D5
288
0.78
1938
2128HSF, 2696TSF RPCN- 49.62/HSF 94950 VALU- 34.80/HSF 74061
STRUCTURE VALUE: 74061
VALUATION I VALUE I PREV-VAL. I P-Nk I SAL.S I S-Nt I TOTAL VALUE 128726
LAND
48000
16639
2BBk
QDALFIED
219630LV/AC
OTHBRPEAT
6665
2966
224%
10162002
STRUCTURE
74061
61346
120%
1912-792
60TV/HSF
TOTAL
128726
80951
159t
170000
]St
79SP/HSF
APPRAISED -VALUE: 128726
http://www.roktech.net/cgi-bin/onslow/CreatePRC 2.pll?recNum=%2025199 3/18/2005

Onslow County, NC Property Record Card s g
Ln
OWNERSHIP 02322005 43841 303 IPROPERTY 08SCRIPTION TA7 u-1 _
r9
KOURY ERNIE A GALLEON BAY L13 STf ,m
PO BOA 850 NOI m 93
Postage E
BURLINGTON NC 27216 T@ ru
DEED:2312 826SO9032004 442501-21 901 TRADE WINDS DR S M Certified Fee
...9..............31........... TOPO STREET UTILITY ZOI C Retum Rece*Pt Fee
(Endorsement Required)All
LEVEL PAVED PUHWATER
8 D 8 H- 8 PUHSEWER O Realdcted Dallvery Fee U
PORCH NONE ELECTRIC O' (EnOorsamant Required) L
CO :..9..:........ 90. 31.. .. ... ...: 1#LAND CLASS I SIZE BASBRA' TolelPostage 8 Faes A
1-22NWFCAN B0F 160D� = 0.
M e69t ou•c
0
r` Sheet. APL W...: O jj ----0----
-------------
e.PoBoxNu P -
LAND VALUE: CM'. -Me- ZlP� � ! -
�q OTNBR F%AT SIZE HASERA err
3 3 1 13CCONCRSTB 29• 35 2.44 0.90 0. 98 840 823
2 HCHHOUSB 2 2I 2CNOODDBCRI 30• ] 13.32 0.60 ].99 70 559
@.............. 40..28.........:
1 1
0 C- 0
WOODDECR
OTHER VALUE: A 1382
f�?
s
R p 5�os
.......: I BOAS o(VMAti of
DWELLING COTTAGE C 81974 R1997 AVERAGE CONDITION AGFM��
DIMENSIONS:A-CU32R40D32L40 E-U32R9CUBR31D8L31 C-R12CD10R28U10L28 D-U32CUSR9DBL9H
WOODNGS IALTIHIP COMPSHNG I.00STHT
I WALLFNSH I FLOORS I HBATbAIR HEATFU%LI
PANEL IV�D �DIHEATPUMP SL%CTRIC I.5 ROOM
k STRUCTURE SRTCH-SF+STHT-
AREA
RATE•GRDF+HHAT+B%NL•NLHT--ADJRAT-
AREA-
RPCN•
DBPP•CNDF=STR-VALUE
A 63CBCHHOUSE
1280 1.00
1280
45.06
3.]1
1.50
50.2]
1280
64346
0.]4
47616
2.00 EATHS
2600.00
5200
0.74
3848
E 80 PORCH
248 1.00
348
15.10
15.10
248
3]45
0.74
2]]1
H 84 PATIO
248 1.00
248
2.16
2.16
248
536
0.74
397
C 88 WOODDECR
280 1.00
200
8.22
8.22
280
2302
0.74
1703
D 83 CANOPY
72 1.00
72
8.34
8.34
72
600
0.74
444
H ]] ATUNFGAR
1280 1.00
1280
13.07
1.50
14.57
1280
18650
0.74
13801
1280HSF, 3408TSP RPCN- 74.51/HSF 95379 VALU- 55.14/HSF ]0580
STRUCTURE VALUE:
70580
VALUATION)
VALUE PREV-VAL. P-Nk
SALSIS-N%l
TOTAL VALUE
119962
LAND
88000
18590
358k
STAMPS
163350LV/AC
OTHERFEAT
1382
657
210%
09032004
STRUCTURE
]0580
5326E
132k
2312-826
93TV/HSF
TOTAL
119962
72965
165t
442500
27k
345SP/HSF
APPRAISED -VALUE:
119962
http://www.roktech.net/cgi-bin/onslow/CreatePRC 2.pll?recNum=%202725 3/18/2005

OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA minor y
development permit. Asa service we have compiled a list of the kinds of permits that might u sY check over the list ~J
with your LI'O to determine if any of these apply to your project: Zoning, Drinking Wa[er I, e toj�te�yhnt
treatment system), Burning, Electrical, Plumbing, Heating and Air Conditioning, Insulation nergy ons on, F e i6 tion,
Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highw onnecg� a` J LUb
r 11�� [ U z
STATEMENT OF OWNERSHIP: DIVISION OF
COASTAL MANAGEMEA(T
I, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in an or a
person authorized to act as an agent for purposes of applying 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)
Van owner or record title. Title is vested i4c)roRA L >v NMekwl F_ aA(-L14)15, see Deed Book �'ID l `i
page 107.1 in the P51�1SIdt.J County Registry of Deeds.
i
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.
(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 jl
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 floodpiroofing tech-
niques.
PERMISSION TO ENTER ON LAND: raw
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.
T(yjs the day of �/ \ , 20 0
Landowner or person authorized to act as his agent for purpose of filing a CAMA permit application.

SITE DRAWING/APPLICATION CHECKLIST
lease make sure your site drawing includes the following information required for a CAMA minor development
ermit. The drawing may be simple and not necessarily to scale. The Local Permit Officer will help you, if
-quested.
HYSICAL DIMENSIONS
Label roads
Label highways right-of-ways
Label local setback lines
Label any and all structures and driveways currently existing on property
'HYSICAL CHARACTERISTICS
Draw and label mean high water mark
Draw location of on -site wastewater system
you will be working in the ocean hazard area:
Draw and label dune ridges (note height)
Draw and label toe of dune
Identify and locate first line of stable vegetation
Draw and label setback line under CAMA
Draw and label topographical features (optional)
'.you will be working in an estuarine shoreline area:
Draw and label landward limit of AEC
Describe terrain (slope)
)EVELOPMENT PLANS
1
COAS qIV ISION OF
MANAGEMENT
Draw and label areas that will be disturbed
If a house is to be placed on lot, describe location of house
Note size of piling and depth to be placed in ground
Draw and label all areas to be paved or graveled
Describe composition of surface
Note and list fully all trees and vegetation to be removed or relocated
Show landscaping
TOTE TO APPLICANT
lave you:
• completed all blanks and / or indicated if not applicable?
• notified and listed adjacent property owners?
• included your site drawing/
• signed both application and statement of ownership?
• enclosed the $100.00 fee?
• completed an AEC Hazard Notice, if necessary?
FOR STAFF USE
Site Notice Posted 21 Final Inspection Fee Received
Site Inspections
Date of Action: Issued Exempted
Revised 3/2003
Denied Appeal Deadline (20 days)