NTB_05-11_North Topsail Partners LLC

__NTB__ E C E I VE OS'/ 11
Local Government Permit Number
FEB 14 2M CAMA
COASTALIM °,AM .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 Statues, "Coastal Area Management"
Issued to North Topsail Partners LLC, authorizing development in Ocean Hazard AEC at, 4132 Island Drive,
North Topsail Beach, NC 28460, as requested in the permittee's application, dated lanuary 25, 2004. This
permit, issued on February 8. 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.
OCEAN HAZARD AEC 15 NCAC 7H.0300
RESIDENTIAL DEVELOPMENT IN AN OCEAN HAZARD AEC
This permit authorizes the construction of a single family dwelling with gravel drive and landscaping.
1. The structure shall comply with the NC Building Code, including the Coastal and Flood Plain Construction
Standards, Chapter 34, Volume 1 or Section 39, Volume 1-B, 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. All proposed development ant associated construction must be done in accordance with the drawings as
submitted on January 25, 2005.
2. The structure must set back 60 feet from the first line of stable natural vegetation.
3. The structure must be located entirely off of the frontal dune, and if a primary dune is present, behind the crest of the
primary dune.
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 dale. 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 permill, 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.
M1
Sue McLaughlin
CAMA Local Permit Official
Permittee (signature required 9 conditions above apply to permit)

Name: N. PARTNERS
Minor Permit #05/11
Date: 01 /08/05
it
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4. The structure must be elevated on pilings with a diameter of at least 8 inches and the first floor level of the sills and
joists must meet the 100-year flood level elevation.
5. All pilings shall have a tip penetration greater than eight feet below the lowest ground elevation under the structure.
For those structures so located on the primary dune or nearer to the ocean, the pilings must extend to five feet (5)
below mean sea level.
6. No impermeable surfaces shall be allowed over any functional part of the septic tank system.
7. Dune disturbances will be allowed only to the extent necessary for development and if the dune's protective value is
not weakened or reduced. Disturbed areas will be immediately stabilized.
8. This permit may be renewed for one (1) year if requested before the expiration date.
9. The amount of built -upon area shall be limited to no more than 30% of the AEC area of the land to be developed, in
this case 8.695 square feet.
10. Pursuant to 15 NCAC, Subchapter 71.0406 (b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third party.
11. This permit other than those shown on original plot design permits no additional covered structures.
12. The permittee is required to contact the Local Permit Officer shortly before he plans to begin construction to arrange
a setback measurement which 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.
13. Sand used to strengthen dunes must be brought in from an outside source and must be of the same nature as the sand
in the area which it is to be placed. No sand is to be removed from the lot.
14. Sand held in storage in any dune, other than frontal or primary dunes, may be moved laterally in order to strengthen
existing primary or frontal dunes if the work would enhance the protection to the proposed development activity and
the sand is immediately stabilized.
15. All development must be consistent with all -applicable Federal, State and Local Standards.
16. 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 Hiles.
17. Any change or changes in the plans for development, construction, or land use activities will require a re-evaluation
and modification of this permit.
18. A copy of this permit must be posted on the property during construction. Please call (910-328-1349) for final
inspection.

A
Not
168474 Affidavit of Publication r
15053955 Jacksonville Daily News N
1 of 2 Jacksonville, NC
Personally a eared before me, a ary Public of the County of Onslow, State of North Carolina, on this the 28th day
of Janu 2 05
of The Daily News, who being duly sworn, states that the advertisement entitled CAMA- NORTH TOPSAIL
PARTNERS 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:
January 28, 2005
NORTH CAROLINA
ONSLOW COUNTY
NOTICE OF FILING
OF APPLICATION
FOR CAMA MINOR
DEVELOPMENT PERMIT
FEB G 7 2005�y
CpA s ,SIAC &1On'4. OF
NT
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 January 25, 2005, North Topsail Partners, applied for a
CAMA permit to construct a single family dwelling with a foot print of 1,656 square feet at 4132 Island Drive, Onslow
County, North Carolina. The applications may be inspected at the address below. Public comments received by
February 8, 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#05/11
Sue McLaughlin, CAMA
Local Permit Officer
Town of
North Topsail Beach
2008 Loggerhead Court
North Topsail Beach,
NC 28460
January 28, 2005

JAN 3 12005 I '
IVE
1SION of LIGATION FOR
MANCAMA MINOR
DEVELOPMENT
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
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.
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.
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.
Coastal Resources Commission
Division of Coastal Management
r
Y
O
z

Locality —ql 3a gk�\ DIZ Permit Number
Ply '
Pe Ocean Hazard _K_ Estuarine Shoreline
re4
pi GENERAL INFORMATION
LAND OWNER �}
Name l+ T_ t / Go I
Address Q o. _ �f)`� I O'
PI city
ORW Shoreline _Public Trust Shoreline
(For official use only)
State l L Zip
Other_
AUTHORIZED AGENT
If Name ("U54-fm E lnr
Address oL onnade r
City State '� Zip Phone q) 6� 7 �(] "� 1! Z
LOCATION OF PROJECT: (Address, street name and/or directions to site.. I,f no oceanfron , wheat is the name of
If, the adjacentwaterbody?) �41`32 ISI��� �� LOf" 2 i )1"IIiLl)o IJ"Ci
DI DESCRIPTION OF PROJECT: (List all proposed constr ction and land disturbance.)
U n 1yll si Ie :fZ'W_Jlu�1jrfJl6ir��n(Ii q,-S
SIZE OF LOT/PARCEL: L� 19 P)G • in square feet acres
PROPOSED USE: Residential,[ (Single-family 7K_ Multi -family _) Commerical/Industrial _
Other
N( TOTAL ENCLOSED FLOOR AREA OF A BUILDING IN THE OCEAN HAZARD AREA OF ENVI-
Ha RONMENTAL CONCERN (AEC): 0 / S 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): 9;0; ' sq. &
(Calculations include the area of the roof/drip line of all buildings, driveways, covered decks, concre 4 asonry 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 Ma 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.
F

OTHER PERMITS MAY BE REQUIRED: The activity you are planting may require permits other than the CAMA minor
development permit. As a service we have compiled a list of the kinds of permits that might be requ' d. We suggest you check over the list
with your LPO to determine if any of these apply to your project: Zoning, Drinking Water Well, S t ank (or other sanitarywaste - M
treatment system), Building, Electrical, Plumbing, Heating and Air Conditioning, Insulation servation, FIA Certification,
Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highwa ne thers. H
O
STATEMENT OF OWNERSHIP: c09s ��✓Q'�'3, lY
T L�
1, the undersigned, an applicant for a CAMA minor development permit, being eithei 1 e er o perry C or a
person authorized to act as an agent for purposes of applying for a CAMA minor develop .�rmit, cerd a person
listed as landowner on this application has a significant interest in the real property describe Th' t t can be
Jesccribed as: (check one)
V an owner or record title. Title is vested in 1) ((twyj` d 1 �}�j 96 Lam, see Deed Book'
g�'age aJ__ in the OW-71OIJ 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
kCTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) (Address)
A)
'2)
'3)
14)
15
FOR DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS:
acknowledge that the land owner is aware that the proposed development is planned for an area which may be susceptible to
arosion and/or flooding. I acknowledge that the local permit officer has explained to me the particular hazard problems associ-
tted with this lot. This explanation was accompanied by recommendations concerning stabilization and floodprooftng tech-
iiques.
PERMISSION TO ENTER ON LAND:
furthermore certify that I am authorized to grant and do in fact grant permission to the local permit officer and his agents to
.nter 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
3wnership 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
3erson developing in an AEC without permit is subject to civil, criminal and administrative action.
This the _ day of
,20
Landowner or person authorized to act as his agent for purpose of filing a CAMA permit application.

FROM
FAX NO.
Jan 20.05 10:53a
Sep. 29 2003 06:42AM P3
p.3
H,.:.
ATm. noN To Quiu.m
January 20, ZOOS
TO: Stainback Family Partnership,
Res Lot 2 Whitcwood Dunes
The propose of this letter is to notify you that North Topsail Patrons, LLC has applied
for a CA -MA permit on lot 2 Whitewood Dunes, Hwy 210-Island Drive, North Topsail Beach,
NC Attached is a copy of the proposed project for your review. Please sign and return the
"Adjacent Riparian Property Owner StatemerC in the enclosed self addressed, stamped
envelope. Thank you for your time and consideration.
Sincerely,
F !r
Tim Bo"
North Topsail Partners, LLC
U.S.
Postal
Service,,
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ERTIFIED
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visit our wehsite at www.usps.com;
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Jan 20 05 10:53a
FAX NM Sep. 29 2003 06:41AM P2
p.2
CLB T(T=.:
ATTENTILN TO QUALITY
January 20, 2005
To: Stephen R. Wiley
Kevin Adkins
Re: W 2 Whitewood Dunes
The purpose of this letter is to notify you that Nodh Topsail partners, LLC has applied
fora CAMA permit on lot 2 Whitewood Dunes, Hwy 210-bil" Drive. North Topsail Beach,
NC. Attached is a copy of the proposed project for your review. Please tags and reran the
"Adjacent Riparian Property Owner Statement" in the enclosed self addressed, stamped
envelope Thank you for your time and consideration.
V
Tiif$ooraa
North Topsail partners, i,l_C
Postal
CERTIFIED MAILTm RECEIPT
o(DomesticCoverage
Provided)
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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 January 25, 2005, North Topsail Partners, applied for a CAMA permit to construct a
single family dwelling with a foot print of 1,656 square feet at 4132 Island Drive, North
Topsail Beach, Onslow County, North Carolina. The application may be inspected at the
address below. Public comments received by February 8, 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 #
05111
Sue McLaughlin
CAMA, Local Permit Officer
Town of North Topsail Beach
2008 Loggerhead Court
North Topsail Beach, NC 28460
Please print on January 28, 2005

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FROM : FAX ID. Sep. 29 2003 06:42AM P4
Jan 20'05 10:54a p,4
/ AEC HAZARD NOTICE
Projetals In An: v Ocean Erodible Area High Hazard Flood Area _ Inlet Hazard Area
Date Lot Was Platted: OZUU3
This notke to intended to make you, the applicant aware
of the special risks and conditions associated with
development L-t this area, which Is subject to natural
hazards such as storms, erosion and currents. The runes of
the Coastal Resources C,.ommiWon require that ,you
receive an AEC Harard Notice and acknowledge that
notice in writing before a permit for development can be
issued.
Thet'omtnlsFion•srt tlesonbulidingstartc n&, oceanfront
se:ha&sarddw.e ilterationaredaignedtomirirnizebut
not eliminate, property !oss From hazards. By n antfrg
permits, the Coastal Resources Commission dos nol
grocer tree the safely of the devektp:nmt and assumes nu
liability for future damage to the development.
The best available 1 nformatton, as accepted by the Coastal
Resources Commission, indicates that the annual ocean
etos-. rate fur the area where your property is located is
et feet per year.
The rate was established by careful analysis of serial
photographs of the enasdute taken over the past 50 years.
S,,uLiiett also indicate that the slicneline could move as
much as JM)ieet landward in a major storm.
Ti Ilnrm ndwatersinamajorstowepredictedtobeabout
j�(pfeat deep in this arrm.
Preferred oceanfront protection measures are beach
nourishment and relocation of threafxe ed structures.
Hard erosion control structures such as bulkheads,
seawalls, revetments, groins, jetties and breakwaters are
p ohibited. Temporary devices, Indudktgsandbags,may
be allowed under certain conditions.
This structure shall be relocated or disimmiled within two
years of becoming imminently threatened.
The applicant must acknowledge this inionnation and
reequirements by signing this notice in the below space.
Wiftut the proper signal=, the app ' ' r, will not be
complete.
app /re tsSignatulos
Dale
SPECIAL NOTE: This hazard notice Is required for
development in areas subject to sudden and massive
storms and erosion. "ermitstssuedfordevekfpmentin this
area expireon Diccember3l of the third yearfollowing the
year in which the permit was issued Shortly before work
begins on the -RojK1 site, the Iocal Permit Officer will
determine the vegetation line and setback distance at your
site. It theprope rty has sera little changeand theproposed
develutnoent cart still meet the setback requirement, the
LFOw'itltnformyouthat ouma beginuvrk.Itisimpor-
tant that you check with tine LPO before thepermitexplres
for official approval to continue the work after the permit
has expired. Ceneratly, if foundation pilings have been
placed and substantial progress is continuing, permit
renewal r..vty tint be neee Wry.If substantial progress has
not beer. made, the permit must be repo ed and a new
setback line established. It is unlawful to continue work
after partnit eayiration without this appravai..
For more infuriation, sumac!:
>(Ae 1� C_ i.&WIA1,f L
Local Perini Officer . U
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`SITE DRAWING/APPLICATION CHECKLIST
Please make sure your site drawing includes the following information required for a CAMA minor development
permit. The drawing may be simple and not necessarily to scale. The Local Permit Officer will help you, if
requested.
PHYSICAL DIMENSIONS
Label roads
Label highways right-of-ways
Label local setback lines
Label any and all structures and driveways currently existing on property
PHYSICAL CHARACTERISTICS
Draw and label mean high water mark
Draw location of on -site wastewater system
If you will be working in the ocean hazard area:
Draw and label dune ridges (note height) 4-0,
Draw and label toe of dune
,
Identify and locate first line of stable vegetat o
Draw and label setback line under CAMA
Draw and label topographical features (optional)
�o
D
If you will be working in an estuarine shoreline area:
Draw and label landward limit of AEC Fify�
Describe terrain (slope) tiT
DEVELOPMENT PLANS
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
NOTE TO APPLICANT
Have 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 �c�2inal Inspection Fee Received
Site Inspections
Date of Action: Issued Exempted Denied Appeal Deadline (20 days)
Revised 3/2003

2005/APR/1.2/TUE 11:11 AM TOWN N TOPSAIL BEACH PAX No.910 328 4508 P. 025
. A14
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•MordW4uAg e
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This application fpx,
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aid
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S, ) P, o e issued5
days once a co d. Often less time' needed
Nihe project is I P., 8 takes about on
P. 91
.can speed the alp oces making certain that your appliwuon
completean drawing meets the specifications given,
'j6side =d that your application fee is attached Other permits are sometimes required for development in the coastal
While these are not CAMA-related, we urge you to check with the
*e IMM Permit Officer to determine which of these vou may need. A

2005/APR/12/TUE J 1:13 AM TOWN N TOPSAIL BEACH FAX No.910 328 4508
P. 026
GENERAL INFORMATION
LAND OWNER
Address
City
AUTHORIZED AGENT
Address
City I
LOCATION OF PROJEf�-7-2
the adjacenrwarerbod��
y?) 4z
OF PROJECT (List
State No., , Zip X Phone
state Phone
street. name and/or directions to site. If not ocea%
all proposed eonstrlicuon and land disturbarim)
SIZE OF LOTIPARCEL% U.,q K, ` rl squaze feet
PROPOSED USE: Residential; Z (Single-family 7'K— Mulu-family
Other
what is the name of
aces
) CommericaVIndustrial
TOTAL ENCLOSED FLOOR AREA OF A BUILDING IN THE OCEAN uaZaun AREA OF ENVI-
RONNU2frAL CONCERN (AEC): / 67' _ square feet (includes all floors and roof -coveted decks)
SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT UPON SURFACES IN
THE COASTAL SHORELINE AREA OF ENVIRONMENTAL CONCERN (AEC): sq. ft,
(Calculations include the area of the roof/drip line of all buildings, driveways, covered decks, concre only patios,
em that are within the applicableAEC. 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
ResourceWaters
(3). within 30 feet of the PublicTh= Shoreline AEC
(Contact your Local Permit Officer if you are not sure which AEC applies to your property.)
STATE STORMWATER MANAGENIENT PERMIT% Is the project located in an area subject to a
State Stonnwacer mmugement Permit issued by the N.C. Division of Water Quality?
YES— N
If yes, list the total built -upon areali%npetvious surface allowed for your lot or parcel square feet.
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2005/APR/12/TUE,11:13 AM TOWN N TOPSAIL BEACH FAX No,910 328 4508 P.027
OTRUPERNIITSMAYBEREQUIRM The aaivityyouarc planningmayrequirepermitsotherthantheCAMAminor y
development permit. Asasevicewehavecompiled aEst ofthekinds ofpemvrsthat might berequire&Wesuggettyou check ova the list
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Whh yourLPO to determine if aay ofthese apply to yomproject: Zoning. Drinking WaterVa Sept!cT2nk (or othersanitatywaste
treanamt systdn). Building, Electrical, Plumbing, HearingandAit Conditioning, Insulation and Energy Conservation, pIA Certification, .
Sand Duna Sediment Control, SubdivisionApproval, Mobile home ParkApprm,21, Highway, Conncctioa, and others.
STATEMENT OF OWNERSHIP: le-
1, the undersigned, an applicant for a CAMA 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 CAMA minor development permit, certify that the person
fisted as landowner on this application has a significant interest in the real property described therein. This interest can be
itscribed as: (check one)
,i/ an owner or record title, the is vested in I 1 M It I P PY�7' l�J .� see Deed Book
?age 0A — In the U County Registry of Deeds.
_,an owner by virtue of inheritance. Applicant is an heir to the estate of
?robate was is 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 cerdf7 that the following persons are oveners of properties adjo'^� this property. I affirm that I have givcn
4CTUAL NOTICE To each of them concerning my intent to develop this property and to apply fox a CAMA permit.
FOR DEVELOPERS IN OCEAN HAZARD AND ES tARTNE HAZAR0 .AREAS:
acknowledge that the land owner is aware that the proposed development is planned for an area which may be susceptible to
':rosion and/or flooding. I acknowledge that the local permit officer has explained to me the particular hazard problems associ-
ued with this lot. This explanation was accompanied by recommendations concerning stabilization and floodproofing tech-
Aques.
PERMISSION TO ENTER ON LAND:
: furthermore certify char 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.
Ibis application includes: general information (This form), a site drawing as described on the back of this application, the
?wnership statement, the AEC hazed notice where necessary, a check for $100.00 made payable to the locality, and any infer-
nation as may be provided orally by the applicant The details of the application as described by these sources are incorporated
nthout reference in any permit which may be issued. Deviation from these details will constitute a violation of any permit Any
arson developing in an AEC without permit is subject To civil, criminal and administrative action.
This day of 20
G
Landowner or person authorized to act as his agent for purpose of filing a CAMA permit application.
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2005/APR/L2/TUE,11:14 AM TOWN N TOPSAIL BEACH FAX No.910 328 4508
P. 028
SITE DRAWMG/APPLICATION CHECKLIST
Please make sure your site drawing includes the following information required for a CAMA minor development
permit. The drawing may be simple and not necessarily to scale. The Local Permit Officer will help you, if
requested
PHYSICAL DIMENSIONS
Label roads
Label highways right-of-ways
Label local setback lines
Label any and all structures and driveways currently existing on property
PHYSICAL CHARACTERISTICS
Draw and label mean high water mark
Draw location of on -site wastewater system
If 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 featurt-s (optional)
If you will be working in an estuarine shoreline area:
Draw and label landward limit of AEC
Describe terrain (slope)
DVVELOPA SNT PLANS
Draw and label areas that will be disturbed
If a house is to be placed on lot, describe location of house
Note size of pilitrg and depth to be placed in ground
Draw and label 2l areas to be paved or graveled
Describe composition of surface
Note and list fiilly all trees and vegetation to be removed or relocated
Show -landscaping
NOTE TO APPLICANT
Have you: .
• completed all blanks and / or indicated if not applicable?
• notified and listed adjacent property owners?
• included your site drawing/
• signed both appplication and statement of ownership?
• enclosed the $100.00 fee?
• completed an AEC Hazard Notice, if necessary?
FOR STAFF USE
Site Notice Posted 40?*�mal Inspection Fee Received
Site Inspections
Date ofAc ion: Issued Exempted
Revised 3/2oo3
Denied Appeal Deadline (20 days)
1 1111119 1 1