TBEX22-06-POWELL

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
BRAXTON DAVIS
Director
Julian Powell
1208 Jeanelle Moore Blvd., Apt 2
Wilmington, NC 28411
NORTH CAROLINA
Environmental Quality
October 13, 2022
RE: EXEMPTED PROJECT (MINOR) EXEMPTION
Accessory Structure (I SA NCAC 7K .020 .E Exemption# TBEXZZ-ft hi
911 Ocean Blvd., Topsail Beach, NC
AREA OF ENVIRONMENTAL CONCERN — Ocean Hazard AEC
Dear Mr. Powell:
I have reviewed the information submitted to this office in your inquiry concerning the necessary filing of an
application for a minor development permit under the Coastal Area Management Act. Based on the information
provided, I have determined that the activity you propose is exempt from needing a minor development permit as
long as it remains consistent with your site drawing dated received by DCM on October 11, 2022, and meets the
conditions specified below. If your plans should change and your project will no longer meet these conditions,
please contact me before proceeding.
ACCESSORY STRUCTURE/USE
I . The work authorized under this exemption specifically includes construction/installation of a 10' x 15'
uncovered deck along the ocean side of the existing residence. The final project dimension(s) shall not
exceed a footprint greater than 150 square feet. The exemption also authorizes a walkway from the proposed
cargo lift to the driveway (4' x 12').
2. The development must not involve removal, damage, or destruction of threatened or endangered animal or
plant species.
3. The development must not alter naturally or artificially created surface drainage channels.
4. The development must be consistent with all applicable use standards and local land use plans in effect at
the time the exemption is granted.
5. The proposed development shall remain consistent with the attached work plan drawings.
6. This permit does not authorize the removal of vegetation or sand from the frontal dune.
7. ALL DEVELOPMENT AUTHORIZED UNDER THIS EXEMPTION SHALL BE LOCATED A
AUMMUM OF 60-FEET LANDWARD OF THE FIRST LINE OF STABLE NATURAL
VEGETATION (FLSNV).
This exemption to CAMA permit requirements does not alleviate the necessity of your obtaining any other State,
Federal or Local authorization. This exemption expires 120 days from the date of the letter.
tnc rely, `
anon Da'
Field Representative
cc: DCM — WIRO
Stephanie Moore — Topsail of Topsail Beach
.r" D-FQ
WML106 au
North Carolina Department of Environmental Quality I Division of Coastal Management
Wilmington Office 1 127 Cardinal Drive Extension I Wilmington, North Carolina 28405
910196.7215

i b
Zl2
Locality
Occau Hazard Eslttaritle Sliorelitte ORW Sliotciitte
(For 00ciabaseon/y)
GENERAL INFORMATION
LAND OWNER - MAILING ADDRESS
Na111C �'-1 "A 4, P J
Address % j2 ©r .. %
City ` l Jftc 14 t 0k State. /1!' C Zip 21I P
Entail ,/a eV n'f li VW%f %`ir � t %/> fl 6e, e- 0 44-Y
AUTHORIZED AGENT
Name
Address
City
Email
'State Zip Phone
A
Permit Nn er 22
tst Shoreline Other
DCM WILMING O , NC
LOCATION OF PROJECT: (Address, street name and/or directions to site; name of the adjacent waterbody.)
CP-X., 40J VJ 75
-'0 C:O'C', -&e ®'q �-
ezl%
��-e. z",
i DESCRIPTION OF PROJECT: (List all proposed.construction and land disturbance.) �ar.(I u •1r1/ bCtX H ��r'
i
s a Alo-O d��at n g.;�f�o j �jS '��� (,ky� 't��oz Gfe! .ex� "74
SIZE OF LOT/PARCEL: square feet 4a4_�L acres
o-r1 ��• � t� r m �� �
PROPOSED USE: Residential ®, (Single-family Multi -family[]) Commemia ndust,nal F1 Other []
"1 -
COMPLETE EITHER(l) OR (2) BELOW (Conlrrclyow-Local Permit Officer ifyolr are not sure spisicAAECapiilles
!d yourprovel-ty):
(l) OCEAN IdAZARD.AECs:-TOTAL FLOOR AREA OF PROPOSED STRUCTURE: /Yo 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 FOOTPRINT AND O'rI4ER IMPERVIOUS Olt BUILT
UPON SURFACES-1 4stuare feet (includes the: area.of the foundation 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 i14ANAGEINENT PERMIT: Is the project located in an atca subjcct.to a State
Stornnvater Mona em nt Pert -nit issued by the NC Division of Energy, Mineral and Land Resources (DEMLR)?
YES NO
If yes, list tile. total built upon area/impervious surface allowed for your lot or parcel: _� square feet.

911 Ocean Blvd
Extend uncovered deck northward (to the left) 9.4' to the edge of NE corner to the house, then another
5S to the northeA cargo elevator (54.25 "X 54.2V) will be placed next to the house newly extended
deck.
1.1 ' 1
LLJ
BUILDING
ESN E
1.5V
10 4,;
s - a6 A
• `0i
f. *fW �
p .
�j A ( r
10 �
r EA' `
24.4
Uf-4.. -,0" REt3 DFCK
W! 1-0.0 � I �bs
r-
�j
COVERED
tJiej DECK
% X I Sf IN
6 ( 1i�.�1,' Co
on r
i s!
sr
3
ON NOlJNIWIIM A)®4//d oil) LfI WL 9��j�,
Roo i 1 130
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i
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or
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(33AI3038

RECEIVED
OCT 112022
ADJACENT RIPARIAN PROPERTY OWNER STADCM
TEMENT WILMINGTON, NC
FOR CAMa4 MINOR- PERMITS
I hereby certify that 1 own properly adjacent to LL
s
(Name of Property Owner)
property located at., / J V ecL ��4 j �/�_
Address; Lot, Block; Road, etc.)
on yj In / e-
(Waterbody) (Topsail Beach, "Pander Coun(y)
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.
1APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
Signature
Print or Type Name
Telephone Number
Oate

RECEIVED
Receipts -for
Certified Mail
(Staple Here)
62. ri
a &V ICLA�
A ' nt,Property Owner
lieoe
Zj
Mailing Address
City, State, Zip Code
Dear Adjacent Property:
OCT 112022
DCM WILMINGTON, NC
This letter is to inform you that I, 7.1 4'm .4( U fl u� 4j have applied for a CAMA Minor
Property.Owner
Permit.oh my property at �P v a > �� in Topsail Beach,
71ZProperty Ad Tess
Pender County. As required by CAMA regulations, t have enclosed a copy of-mypermitapplication and
project drawing(s) as notification of my proposed projecL Nol action is required from you or you may sign and return
the enclosed no objection -foam. If you have anygaestions or comments about my proposed project, please
contact me at 71r� 414 US� j© ,or by mail at the address listed below. If you wjsh to
Applicants Telephone
Me written comments or objections with the LAMA Minor Permit Program, you may.submit them to.
Jason Dail, DCM Field Representative
LPO, Town of Topsail Beach
NC DEQ / DCM
127 Cardinal Drive ExL
Wilmington, NC 2840.6
Property Owner
Mailing Address
City, State, Zip Code

7
RECEIVED
911 Ocean Blvd 'r
O C T 112022
Extend uncovered deck northward (to the left) 9.4' to the edge of NE corner to the house, then another
5.5' to the nor7
A cargo elevator (54.25 "X 542V) will be placed next to the house neWICUTMOO N GTO N, NC
deck. �ii
ill
^� 1- 5.0
244ft
_ o, UN(..O'F...,REr DC L
WILDING A.
LINE
1.9' COVERED
it A DECK L
stye' ��r IrExIST1 NG
DWELLING ai
•.0 Ito
LANIXNG
� E
FFNCF
,� Q�� VA) L6X/-9���� v�

FLOW ZONE 'VE'
(EIEVATION.IW+3)
APg.D10NAif ME.1N
e
APPRO)ONAIE
R.COD UNE
FLOW ZONE WE'
MPROKWATE
FLOOD USE
NOW OR FORMERLY
HILLARD
D.B. 4622, P. 1367
LOT 5, BLOCK 13 .
FIRST EDITION OF
NEW TOPSAIL BEACH
M.B. 3, P. 56
HAW ZONE -VC
(UEVATION-16'+Y)
�%L ) i�• Ln
LOT 5'S
4' POST
SLAT FE
LOT 5'9 4' POST a SLAT FENCE
ENCROACES O4 UPON LOT D MPRO7RWATE
AS SMOMI, FLOOD UNE
FLOW ZONNE 'YE'
(ELEVATION-14'+3')
ATLANTIC OCEAN
NMP S52'51'38•W 5D.D6'
NMP
EN5TIN0 D%FOND WTH EAVES . 14W Sq.FL
P111SIINRfOILOI k WALK e
AP ETNS:Mo iOTAI INPERNOUS AIRFKE- 1a07 sq.i4
IMPERVIOUS457 ".-w
NR�TIM mr , ; • a ; m Aare . w s,,.m.
LINEµ ENSIMM WPERYIOUS AREA . 20.6%
&x'
r
NOTE:
9L.
y, �� TOP Gk1E
KrV BLOQ i0U 1I DAATIC ND PMNiU LAY DCOSED
g
�i
6
BELOW FOR ENTRY & STORACE
F
XOIE7
�+
>. P. aB SHOWS LOT 6 HAVOIO A
'
NC
DEPTH i0 TXE A7lAN1IO GLEAN.
W.4 CAR' I5 SNOW A OFFM OF
FOR THE NORTHERN SWEUHE
�Q.
0•
f AP S,1826'00"W 0400'
NNP
230.80'
AIM A DEPTH OF 2Z7.0V FOR TIE
,•
PLATTED LOT E
��
•
SOUINERN 9DEI.INE A9 SUITON
OAT 13, 2022
L07 6
I
Ipa
11445 Sq.FI.
W
0.202 ACRES
ZONED R-1
ZONED cElf1ACN9
..•.
z z
NOW OR FORMERLY •
FRONT - 7.5'
AR
2' EAAE9
r
CARR
SOL Y
°•
'RCN
D.B. 4605, P. 187
LEI
mw 1 Op. - m uEDNo
LOT 7, BLOCK 13
FIRST EDITION OF
am=
QUAN ANTHONY POWELL a WWFE
LNE I OPEN IT 14.D
BELOWjn
NEW TOPSAIL BEACH
ALB. 3, P. 66
LYNN LOwse POWELL
Oq
CDwrcD
IA
TITLE SOURCE
's
D.B. 4783, P. 890
IpVCK
h ENSTNO
DYM MO
DOT
tax u,lw .
4212-30-3/W-00W
l0 T `
HVAC ST D
NOTE:
LOT UP NVAC STAND QIE9
0' UPON LOT 0 AS 6HOVALHOVAL
clummm
OB. M P. fB7
D.B. 4822, IR P. T307
-
ALL 47 P 50P. BW
YA. 3, P, lIO
'E >A I
LOTTdl7,S
OECN
B
B
pNDER ,
I
VAT” RKL.
I�
FENCE
LFENCEJJ
tY
EMN EMMA _ IN" _ _--�N/aB'10'55•E_ 40..g -
3 NIBOB$1'E 17D.00 - 'I N469YOYE 40.OS'�- N45'02'62'E 51.OB EUN SNN
OCEAN BOULEVARD
c M SECRGN m ASPNAL or 60' R/W (ASPHALT-PUBUO)
a CREWS AVENUE &OCEAN Bw1WARD
NOTE:
4POST & SLAT FENCE UES VIVID!
Lot 6 AS S"I.
R/W
--Q
BOUNDARY & PHYSICAL SURVEY
FOR
JULIAN ANTHONY POWELL
ASSOCIATES, INC. (c-730) & WIFE,
& GLOBAL POSITIONING SYSTBMSP LYNN LOUISE - POWELL
:OMPUT6R MAPPING LOT 6, BLOCK 13, FIRST EDITION OF NEW TOPSAIL BEACH, M.B. 3, P. 56
LANDFALL EXECUTIVE SUITES TOPSAIL TOWNSHIP, PENDER COUNTY, NORTH CAROLINA
1213 CULBRETH DRIVE
WILMDIGTON, NC 28405 JULIAN ANTHONY POWELL & WiFE, LYNN LOUISE POWELL, OWNER: D.B. 4783. P. 896
TELEPHONE: [phone] OCEAN BOULEVARD
LECEMI
00 Como- CORNER
ECU • EXIMO Calcl= wMUNtFNT (rwND)iwm% CO N OR)
EIP r6msTNO Niel PVC (FOUND
FASTINGOFASTINGIRO O N ROD (FOUNO
EMN - FJOSTINO MAGNETIC MAIL (FOUND) CONTROL CORNER)
EPK • ETOSTNO PM U-KALOI NAO (FOND CONTROL CORNER)
MOVE . EgSTINO RAILROAD SPIKE WND
MBL . MINIMUM SUILDNO UNE
NUP . NON MONUMENTED FCINT
RM • RNOIT OF WAY
SCM - SET CONCRETE UWTWMENT (CONTROL CORNER)
SIP - SET KION PIPE
OR . SET IRON ROD
SUN - SET MAGNETIC NAIL (CONTROL CORNER)
PM . SET PARKOI-KALGI NAIL (CONTROL CORNER)
Q . CENTERLNE
FIRES M
WATER VALVE
®. SANITARY SEWER MANHOLE
®. CLEAN OUT
®- TELEPKONe PEWSTAL
®- IVLEUSON PEDESTAL
FIBER OPTIC CABLE UAFM
41, PC flt �CLE
—�►-- - POWER MNE
(M- ELECTIOC TRIWSFORIER
KO - 09 S�T�S A110N
GRAPHIC SCALE
l0 20 ' a w
( IN FEET)
E 1DNN - ED EL
ACTUAL FIELD SURVEY DATE: JULY 13, 2022
MAPPING DATE: AUGUST 08, 2022
FIELD BOOK: 1284 PACE: 15
PR J CT ER' 22-07-13 1 JTG
„4
v �-..�-. .... ___. .. -.. st• r.�.�a:;.a�e,+;+*........-... _rKaAr.- r •..w.�•.a-�.. :.ic- ,....... .. _ ........,._ ..��1 : R � .�i,,:;, ....•�.. `tiar-� O;ti:
ieiG":.i:>&"'nii�iiivr£•• �•.i: ....._.._.... ... _I • \.. .....W.,......,. .. •W � t! .. . a St!::��y'.... !f�"'"')'......._L ............. ��_ ..-E"•--°'-------._�_.._ _..

RECEIVE®
5 `
Receipts for OCT 112022
(erupted Mail (Staple Here) Crary WILMINGTON, NC
at
Adjacent Prope Owner �-�n s e s
D
Mailing Address
_ C / �
City, State, Zip Code
Dear Adjacent Property:
This letter is to inform you that I, T at f q'm r r­--� k have -applied for a CAMA Minor
Property.Owner
Permit on my properly at P v /V in Topsail Beach,
Property Ad ress
Pender County. As required by CAMA regulations, I -have enclosed a copy of my permit application and
project drawing(s) as noli )canon of my proposed project. No-ac6on Is re from -you or you may sign and re#urn
the enclosed no objection foam. if -you have any questionsor comments about my proposed project, please.
contact me at Y/O fE' 4Z 3 ,or by mail at the address listed below. . if you wish to
Applicants Telephone
file written comments or objections with the CAMA Minor Permit Program; you may.submit them to.
Jason. Dail, DCM Field Representative
LPO, Town of Topsail Beach
NC DEQ / DCM
127 Cardinal Drive Ext.
Wilmington, NC 28406
irk
t `
Property Owner �^
/ 2egfS s fell wgzep B/vg f
Mailing Address
j f`rn //
City, state,.Zip e

Locality Permit NumberUUT . 2022
Ocean Ha and Esluarine Shordliilc ORW Shoreline Public Trust Sliorelilte Other
Fern lcralrrsewd DCM WILMINGTON, NC
( f7 31
GENERAL INFORMATION
LAND OWNER - MAILING ADDRESS
t
NaL Namew t A 4
Address -Z2_ b if _ ,?? 1' �1
4 `
City W I State. Zip 2-9 J/ Phone —
t nta l '� k dy�-y /5^ tlC? /�4� V 4V
i�-•
AUTHORIZED AGENT
Name
Address
City State
Entail
Zip Phone
LOCATION OF PROJECT: (Address, street name and/or directions to site; name of the adjacent waterbody.)
40) d J , / AAI. 19 / le4lAeio ZORK 2
DESCRIPTION OF -PROJECT: (List all proposed -construction and land disturbance.) 'Petra. jbcaae m �e L '
'r10 -P-0 ors 9 1�� � ��� ~ �.S/v �GiLi ✓C'L/ e
SIZE OF LOT/PARCEL: sgaare eet T T� acres / ��o o, j 7 4 nw .t-I�
o n . �1f�wu$ tuft, f M her !2
PROPOSED USE: Residential (Single-family p Multi -family ❑) Commercial/industrial ❑ Other []
COMPLETE ElTH> R (1) OR (2). BELOW (Comae/your Local Yereti! Officer if jtou are not sure which, AEC dpplies
ta3,01rr:proper1y):
(1) OCEAN I-IAZARD,AECs: TOTAL FLOORAREA OF PROPOSED STRUCTURE:l square feet (includes
air conditioned living spacv,.parking elevated above ground level, non -conditioned space elevated above ground level but
excluding non -load -bearing attic space)
(2) COASTAL SHORE LINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACCS% � t(aare feet (includes (he: area.of the foundation of all buildings, driveways, covered decks,
concrete or masonry patios, etc. that are within the-applicablc AEC. Attach your calculations with the project_ drawing.)
STATE STORNIWATER MANAGEi1IENT PERMIT: Is the project locatedin an area subject.to a- Slate
Stormwater Mana e MAP ermit issued by the NC Division of Energy, Mineral and Land Rcsources (DEMLR)?
YES NO
if yes, list the.total built upon area/impervious surface allowed for your lot or parcel: _^ square feet.

OCT 112022
ADJACENT RIPARIAN PROP-ERTY OWNER ST A
FOR LAMA MINOR PERMIT`S. lNCTON, NC
I hereby certify that 1 own property adjacent to t7 fl L i a � we Z,
�'j s
q (Name of Property Owner)
propertyy located at
Address, Lot, Block; Road, etc.)
on G eat 04 in r19_Pas e2i/ d eae , N.C.
(1Naterbody) opsail Beach, 'Pander County)
He has descdbed-to mews shown in the•attached,-application and project drawing(s), the development he is
pfoposing at that location. and, I have iio objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
Signature
Print or Type Name
Telephone Number
Date

RECEIVED
OCEAN HAZARD AEC NOTICE OCT 112022
Project is in an: __�L Ocean Erodible Area _ High Hazard Flood Area DCplA11(di4WEeT4DPJ eWC
Property Owner: 7U t a. rt 4 4—y h n t r tv l i'
Property Address: Z�C ���I �1r���T J�/J i' Qi� �� 44 f
Date Lot Was Platted: �� Z t>-z Z'
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 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 if they become imminently threatened
by changes in shoreline configuration. The structures) 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 a sion rate for the area where your property is
located is feet per year.
Z
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
^
-1feet landward in a major storm.
e fl cad waters in a major storm are predicted to be about
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 sand bags may be
authorized under certain conditions.
The applicant must acknowledge this information and
requirements by signing this notice in the space below. Without
the proper signature, the application will not be complete.
4Prpefty Owner Signature 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 must be contacted to determine the
vegetation line and setback distance at your site. If the property
has seen little change since the time of permit 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 re -measured. Also,
the occurrence of a major shoreline change as the result of a
storm within the 60-day period will necessitate re -measurement
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 been placed and substantial progress is continuing,
permit renewal can be authorized. It is unlawful to continue
work after permit expiration.
For more injorniatitw, co,rtact.
t 0,\J s . R-I —
Local Permit Officer
N.C. Dept. of Environmental Quality
Division of Coastal Management
127 Cardinal Drive Extension
Wilmington, NC 28405-3845
Phone Number
Revised May 2010

RECEIVED
Locality Permit Ntnnber
OCT 112022
Ocean Hazard Estuarine Shoreline ORW'Shoieliuc Public Trost Shoreline ®CM WILIUMN, NC
(Fw7�•Q'icir! rise otrly),
GENERAL INFORMATION
LAND OWNER - MARLING ADDRESS
Name
Address Jr26--K ;rdCLb1 1I - W,.
City 'ti`) l KI, tii -- State 'Lip ?:? ['hone
Ismail ,ram' np of It Vm-L /g" Lxf�p �A©, c ,V 44-1 - -
AUTHORIZED AGENT
Name
Address
City _ —_ State
Email
Zip Phone
LOCATION OF PROJECT: (Address, street name and/or directions to site; nalne of the adjacent waterbody.)
�i ce- 12.1�1 �� �� ��; / ��; , �� 0��,��e� emu
4,A
DESCRIP'I'ION OF PROJECT: (List all proposed construction and land disturbance.) at. r+ bCt �' OF
ee.,l�` �S'i�r `We�u�'�
�a �aVaZ ra n �j /: fe I 'r Ay ta k de--, �exoA'14%r- �?11 i-
SIZE OF LOT/PARCEL square feet �f_ acres y �o o. j .7 tow
o �1 yl t(z t YK
PROPOSED USE: Residential (Single --family Q- Multi -fancily[]) Commercialllndustrial n Other
COMPLETE EITHER (1) OR (2) BELOW (Coutact your Local Peruril Officer if you ore m/ sure which AEC applies
to your properly):
(1) OCEAN i•iAZARD 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 sliace)
(2) COASTAL StIORELiNE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES. s`�ttare feet (includes the. area,of the founds"lion .fall builiiings, driveways, covered decks,
concrete or masonry patios, etc. that are within the applicable AEC. Attach yom• calculations with the project drawing.)
STATE. STORMWATER MANAGEMENT PERMIT. Is the project located in an area subject toll State
Stormwater Malls em nt Permit issued by the NC Division of Energy, Mineral and Land Resources.(DEMLR)?
YES NO
if yes, list the.total built upon area/impervious surface allowed for your lot or parcel: _ ____ square feet.

RECEIVED
OCT 112022
OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits 1 I -�©
minor. development permit, including, but not limited to: Drinking Water Wall, Septic'1'ank (or otf r sanitary itwaste N' NC
treatment system), Building, Electrical, Plumbing, bleating and Air Conditioning, insulation and I. nergy Conservation, PIA
Certification,.Sand Dune, Sediment Control; Subdivision Approval; Mobile. Home Park Approvali Highway Connection, and
others. Check with your Local Permit Officer for more inforination.
STATEMENT OF OWNERSHIP:
1, .the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in an AK or a
person authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that (lie person
listed as landowner on this application leas a significant interest in the real property described therein. This interest can be
described as: (check one)
e an owner or record title, Title is vested in name of J LJ " 94 '- !ion a ta/
see Deed Book YT 7 9 �5 page in"the. 1�_�n46elZ County Registry of Deeds.
an owner by virtue of inheritance. Applicant is an heir to thc. estate of
prolate was in County.
if other interest, such as written contract or lease, explain below or use a separate sheet & attach to this application.
NOTIFICATION OF ADJACENT RIPARIAN PROPERTY OWNERS:
furthermore certify that the. following persons are owners of properties adjoining this property. I affirm that I have given
ACTUAL NOTICE to each ofthem concerning my intent to develop: this ptopctty and to apply for a CAMA permit.
(Name) (Address)
(1) (R Q F� �e�� ter.mn
(2)
(3)
(4)
AC10OWLEDGEMENTS:
I, the undersigned, .acknowledge that the landowner is aware that the proposed development is planned for on 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, 'Phis explanation was accompanied by recommendations concerning stabiliza-
tion and floodproofing techniques.
1 furthermore certify that I 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.applieation.
This the 2-- day of Ve7 , 2022
Land r ner or person authorized to act as his/her agent for purpose of filing a CAMA permit application
This application includes: genes al information (this forur), a site eh•aiving cis described on the back of this cpplication, the
owneiship.statement, the Ocean Ilazaid AEC Notice where necessaip, a check fol• $100.00 made payable to the locali4; and
oil), iJ f i-inalion cis may be pirovided of all), by. the applicant. The details of the application cis described by these sources are
incoihoi-ated 11+il1101it i%fence in any permit which may be issued. Deviation join these details will constitute a violation of
any permit. Any person developing in an AEC without permit is suliject to civil, edininal aid administrative action.